FREQUENTLY ASKED QUESTIONS
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ASSEMBLY
If you find the cheek retractor assembly starts to stick or gets tight after sterilization simply add lubricant (vaseline/lip balm/soap) to the joint to get it working smoothly.
- Check that the ‘L’ and ‘R’ labeled lip cradles are engaged to the patient's left and right sides respectively. The channels that link the suction tubing of the tongue crib should face superiorly (upwards).
- The tongue crib is oriented correctly if the ‘UP ’ arrow (located on the anterior tip of the crib) is pointed superiorly (upwards). The ‘UP ’ arrow should face you when inserted in the patient’s mouth.
If you find the cheek retractor assembly starts to stick or gets tight after sterilization simply add lubricant (vaseline/lip balm/soap) to the joint to get it working smoothly.
If you find it difficult to fit the tubing onto the y-adapter, place some lubricant (vaseline/lip balm/soap) onto the y-adapter and it will slide on easily.
There are three components to the external cheek retractor. A right and left lip cradle/cheek retraction projection and a metal arm U bar connector. Connect the right and left lip cradles to the U bar connector via the male/female interlock that can be engaged in a clock wise or counter clock wise rotation once you have slid the key past the opening on either side of the U bar. The internal tongue crib comes pre-bent to wrap around the patients dentition. Slide the free ends of the right and left suction tube through the channels of the cheek retractor that you have already assembled (see above). Once the XerosGuard is comfortably placed and the possable arms have been adjusted to the desired positions in the patients mouth, slide the free ends of the right and left suction tube into the bifurcated openings of the Y-adaptor. The low volume suction can now be hooked up to the opposing end of the Y-adaptor and turned on to the desired amount of suction. The tubing of the XerosGuard appliance can be further secured by sliding the tubing into the hook on either side of the U-bar. This will also keep the tubing secure while retracting excess tubing away from the visual field.
INSERTION
The XerosGuard appliance is very comfortable. The XerosGuard takes advantage of the new silicone materials and manufacturing techniques that are made to be softer and more pliable to not irritate or impinge on any soft tissues like preceding appliances. The cheek retractor has also been designed with rounded edges to maximize patient comfort.
It is highly recommended you perform a patient try-in (inserting only the tongue
crib with integrated suction) prior to inserting the assembled XerosGuard. Please view
the ‘Adjustment Video’ to perform the recommended pre-adjustment bends to the tongue
crib prior to insertion.
Please view the ‘Insertion’ video to learn how to perform the recommended pre-adjustment bends to the tongue crib prior to insertion.
Generally this is due to the position of arms. Pose the arms such that the suction port rests on the retromolar pad, and the arms are clear of any occlusal contact.
You also may wish to check the antero-posterior length of the arms as the suction port and must clear the terminal teeth posteriorly.
First, check the position of the arms and make sure they are on the retromolar pad behind the terminal teeth in the arch. Check if the sublingual suction is clear of any mucosa. Lastly, check if the Y-adapter connection at the low-volume suction port is tight and secure.
If the tongue crib collapses simply pre-bend the wire in the tongue crib out laterally. This adjustment can be made either outside or inside the mouth.
Firstly try the Tongue Crib only in the patients mouth until the patient feels comfortable. If this does not work, give the patient the internal member of the appliance to try it in their mouth for themselves until they feel comfortable. Try to wet the appliance prior to insertion to see if this eliminates the gagging reflex.
XerosGuard comes equipped with (patented) poseable arms that may be adapted to most mouth sizes. Simply bend the arms up, down, in or out to match your patient’s intra-oral anatomy.
The anteroposterior position of the tongue crib may also be adjusted by sliding the arms anteriorly or posteriorly. It is recommended you start with the tongue crib in the most anterior position and simply slide the arms posteriorly after insertion.
A common insertion problem is observed when the posterior suction port does not sit on the retromolar pad. In order to resolve this, pre-bend the poseable arms inferiorly (downward) such that the suction ports sit on the retromolar pad.
The XerosGuard appliance is very comfortable. The XerosGuard takes advantage of the new silicone materials and manufacturing techniques that are made to be softer and more pliable to not irritate or impinge on any soft tissues like preceding appliances. The cheek retractor has also been designed with rounded edges to maximize patient comfort.
When demonstrating the XerosGuard appliance to the patient, point out the soft nature of the silicone and the collapsibility of the retractor. Encourage the patient to breathe through their nose and if they are prone to gagging, it maybe of benefit to have patient try the internal portion of the XerosGuard appliance by themselves until they feel comfortable with the appliance in their mouth.
Prior to inserting the XerosGuard, you may wish to consider placing some petroleum jelly or lip moisturizer on your patients lips to maximize their comfort and facilitate easier insertion.
Insert the XerosGuard in one piece. Run your finger along the commissure to ensure the retractor cradles your patient’s lips. Now examine the suction arms and tongue crib. The suction arms should wrap around the distal of the terminal teeth and the suction ports should sit on the retromolar pads. The tongue crib should encase the tongue. It’s sometimes helpful to ask your patient to “stick their tongue into the crib”. Also ensure the the sub-lingual suction ports are free and clear of sub lingual mucosa by running your finger along the sublingual of the tongue.
If you have done this correctly your patient should be able to comfortably bite down into maximum intercuspation. Ask your patient if they are biting on anything, if they are not you have successfully inserted the XerosGuard. If not adjust the poseable suction tube arms until this is the case. Don’t forget to check the suction tube ports again if you have modified the suction tube arm positioning.
Finally attach the Y-adapter to your chairside suction and turn on your suction. You should hear the intra-oral fluid starting to be evacuated. Adjust the strength of suction to meet your needs
Generally this is due to the position of arms. Pose the arms such that the suction port rests on the retromolar pad, and the arms are clear of any occlusal contact.
You also may wish to check the antero-posterior length of the arms as the suction port and must clear the terminal teeth posteriorly.
First check the position of the arms and make sure they are on the retromaolar pad. Check if the sublingual suction is clear of any mucosa. Lastly check if the Y-adapter tubing is tight and secure.
If the tongue crib collapses simply pre-bend the wire in the tongue crib out laterally. This adjustment can be made either outside or inside the mouth.
Firstly try the Tongue Crib only in the patients mouth until the patient feels comfortable. If this does not work, give the patient the internal member of the appliance to try it in their mouth for themselves until they feel comfortable. Try to wet the appliance prior to insertion to see if this eliminates the gagging reflex.
XerosGuard comes equipped with (patent pending) poseable arms that may be adapted to most mouth sizes. Simply bend the arms up, down, in or out to match your patient’s intra-oral anatomy.
The antero-posterior position of the tongue crib may also be adjusted by sliding the arms anteriorly or posteriorly. It is recommended you start with the tongue crib in most anterior position and simply slide the arms posteriorly after insertion.
A common insertion problem is observed when the posterior suction port does not sit on the retromolar pad. In order to resolve this, pre-bend the poseable arms inferiorly (downward) such that the suction ports sit on the retromolar pad.
REMOVAL
Once you have finished your procedure remove the XerosGuard in one piece. Disconnect the Y-adapter from the suction.
Disassemble the tongue crib with integrated suction from the cheek retractor and dispose of it. Retain and disassemble the cheek retractor and sterilize it with your other equipment. You may wish to disassemble this piece for space considerations in your autoclave.
Once you have finished your procedure remove the XerosGuard in one piece. Disconnect the Y-adpater from the suction and detach it from the XerosGuard ( you will retain this piece and sterilize it with your other equipment). Disassemble the intra-oral component from the cheek retractor and dispose of it. Retain the cheek retractor component and sterilize it with your other equipment. You may wish to dissemble this piece for space considerations in your autoclave.
WHO SHOULD USE THE XG APPLIANCE?
The XerosGuard appliance was designed by Dentists for Dentists. With that in mind it can be used by dentists, dental specialists, dental assistants, and hygienists.
Any procedures where the operator requires retraction of the soft tissues, maximum access and an unobstructed vision to the desired working field.
All dental procedures which require retraction of the soft tissues, a dry working field with an unobstructed view including attachments, braces, lingual wires, sealants, fillings, crowns, implants, and scaling and planing.
STERILIZATION
- Here at XerosGuard, the health and safety of the patients and operators are of the highest priority.
- To eliminate any chance of cross-contamination, any portion of the XG appliance in direct contact with the patient's fluids or foreign debris which cannot be mechanically cleaned or directly steam sterilized (such as the tubing running throughout the XG appliance) are single patient use
- The cheek retractors and bite blocks can be safely sterilized via stream autoclave following mechanical debridement in a machine wash.
- The basic principle of steam sterilization/autoclave is to expose each item to direct steam contact at the required temperature and pressure for the specified time. Thus, there are four parameters of steam sterilization: steam, pressure, temperature, and time. Pressure serves to obtain the high temperatures necessary to quickly kill microorganisms.
- Specific temperatures must be obtained to ensure the microbicidal activity.
- The two common steam-sterilizing temperatures are 121°C (250°F) and 132°C (270°F) These temperatures must be maintained for a minimal time to kill microorganisms.
- Recognized minimum exposure periods for sterilization of wrapped healthcare supplies are 30 minutes at 121°C (250°F) in a gravity displacement sterilizer or 4 minutes at 132°C (270°F) in a pre-vacuum sterilizer.
- At constant temperatures, sterilization times vary depending on the type of item (e.g., metal versus rubber, plastic, items with lumens), whether the item is wrapped or unwrapped, and the sterilizer type.
Recommendation For Cheek Retractor Is Steam Autoclave (6 Critical Factors)
- Time (15 to 30 min)
- Temperature (121-132°C)
- Moisture
- Direct Steam Contact
- Air removal
- Drying
Sterilization Protocols for Tongue Crib with Integrated Suction
- Recommendation is to discard after single use
Here at XerosGuard, the health and safety of the patients and operators are of the highest priority. To eliminate any chance of cross contamination, any portion of the XerosGuard appliance in direct contact with patient’s fluids or foreign debris which cannot be mechanically cleaned or directly steam sterilized such as the tubing running throughout the XerosGuard appliance is disposed of.
The external cheek retractors, Y-adaptors and bite blocks can be safely sterilized via stream autoclave following mechanical debridement in a machine wash. The basic principle of steam sterilization/autoclave, is to expose each item to direct steam contact at the required temperature and pressure for the specified time. Thus, there are four parameters of steam sterilization: steam, pressure, temperature, and time. Pressure serves as a means to obtain the high temperatures necessary to quickly kill microorganisms. Specific temperatures must be obtained to ensure the microbicidal activity. The two common steam-sterilizing temperatures are 121°C (250°F) and 132°C (270°F). These temperatures must be maintained for a minimal time to kill microorganisms. Recognized minimum exposure periods for sterilization of wrapped healthcare supplies are 30 minutes at 121°C (250°F) in a gravity displacement sterilizer or 4 minutes at 132°C (270°F) in a prevacuum sterilizer. At constant temperatures, sterilization times vary depending on the type of item (e.g., metal versus rubber, plastic, items with lumens), whether the item is wrapped or unwrapped, and the sterilizer type.
PROTECTING THE OPERATOR AND THE PATIENT
Yes, the compact design of the XG appliance will allow the operator to use auxiliary high volume evacuation to assist the suction of the XG appliance to reduce aerosols and splatter during AGP (aerosol generating procedures).
Here at Xerosguard, the health and safety of the patients and operators are of the highest priority. To eliminate any chance of cross contamination, any portion of the XG appliance in direct contact with patient’s fluids or foreign debris which cannot be mechanically cleaned or directly steam sterilized such as the tubing running throughout the XG appliance is disposed of.
PRODUCTIVITY, EFFICIENCY AND SAVINGS
XerosGuard was designed by clinicians with the intention of creating a one step full/dual arch isolation appliance while maintaining the ability of the patient to fully function, unlike any other isolation appliance on the market today. This unique function of the XerosGuard appliance will lead to up to 50% reduction in chair time for particular procedures where full mouth isolation and maximum intercuspation are desired. Greater efficiency translates to faster appointments, more appointments, and single assistant/clinician procedures. The reduction of stress for the operator also leads to a more productive day. The XerosGuard appliance will also directly reduce the cost of auxiliaries such as dry angles, gauze, cotton rolls, and saliva ejectors.
GENERAL QUESTIONS
With the environment in mind, the XerosGuard appliance was designed in two parts, one of which is fully autoclavable. The cheek retractor portion of the XerosGuard appliance is made of a high heat autoclavable material to be reused. We also believe the XerosGuard appliance will replace the need for dry angles, gauze, cotton rolls and saliva ejectors in many procedures done today with inherently end up in landfills and do not degrade with time.
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