When these teeth have deep, stained fissures, a prophy brush with a bit of pumice works great to remove this stain. [5] Based on these variants, pastes are available in fine, medium, coarse and super-coarse grits. - before placement of a dental dam. You've come a long way since the day I used to spit in a bowl! Alternatives to rubber cup polishing. Additionally, we offer several Continuing Education courses throughout the year. Note: For students under age 18 there may be restrictions on participating in certain Health Sciences programs. The bioactive glass polishing agent requires less powder per treatment because it is a dense powder that when applied to the tooth surface stays in place. This brings up another point - I completely disagree with dental offices that schedule children in the dental assistants chair for coronal polishing and charge for a prophy. Dentistry and dental hygiene, on the other hand, change by the minute. Full mouth polishing is still widely practiced but selective polishing is recommended by many educational institutions. 2. I treated these lovely girls into college age. All rights reserved. For cosmetic restorations, use Proxyt by Ivoclar Vivadent. The only stains I cannot see in my mouth are on the linguals of the maxillary anterior teeth. However, it shows that those who may seek advancement within their Dental Assistant position or within the dental . It delivers an air-powder slurry of warm water and sodium bicarbonate for polishing. Advances in Dental Research 2009; 21: 35-9. I demonstrated sulcular brushing in her mouth with a mirror, then had her go to the sink and brush all her teeth. Nancy W. Burkhart, EdD, MEd, BSDH, AAFAAOM. I discovered that this is a wonderful way to evaluate home care, show them where they are missing (without a bunch of red or purple stuff!) Some might say that polishing is not therapeutic. These include: sodium restricted diet, hypertension, respiratory illnesses, infectious diseases, chronic kidney disease, Addison's or Cushing's disease, and some medications (mineralocorticoid steroids, anti-diuretics, potassium supplements). http://www.adha.org/profissues/polishingpaper.htm, http://www.osap.org/?page=Issues_DUWL_7&hhSearchTerms=polish. ), Most peri-implant lesions (peri-implant mucositis or peri-implantitis) are caused by plaque/biofilm colonization around the implant surface.19 There is a statistically significant higher incidence of peri-implantitis for dental implants placed in patients with a history of chronic periodontitis (28.6%) compared with periodontally healthy individuals (5.8%).20 The correlation between the presence of periodontitis and the development of peri-implantitis has been supported by a recent systemic review.21, Schwarz et al. The professionals that support the Dentist consist of Dental Hygienists, Expanded Function Dental Auxiliaries and Dental Assistants. Flemmig TF et al. [Epub ahead of print]. Although benign in the majority of patients, the natural course of the disease may result in significant disturbance of body morphology, reduced thoracic volume, impaired respiration, increased rates of back pain, and serious . Surfaces of restorations may be damaged by conventional tooth polishing with prophylactic paste. Quintessence Int. Excessive pressure can lead to frictional heat that may cause pulpal discomfort or necrosis of the dental pulp.[5]. The Dental Hygiene program is designed to be completed in five (5) semesters on a full-time basis when the student begins the technical portion of the program. Let's look at the science and professional guidelines surrounding this "elephant in the room," because it hasn't been talked about much. Narongdej T, Sakoolnamarka, R, Boonroung T. The effectiveness of a calcium sodium phosphosilicate desensitizer in reducing cervical dentin hypersensitivity. The effect of air-polishing abrasives on wear of direct restoration materials and sealants. Allied Health Department; Contact Information Dental Hygiene Program Phone: 513-558-7928 Email: badenhyg@ucmail.uc.edu. This patient described polishing first in a wonderful way, Its like sweeping the floor before you scrub it. Why would you want to mop around a bunch of loose dirt on the floor? 3. When adapting the rubber cup, angle to flare at the gingival margin to reach the distal, facial, lingual, and mesial surfaces, and maintain this by rotating the handpiece. 14. However, if you're looking for a much more noticeable change in tooth color, other whitening options might be more appropriate. The curriculum is approved by the Commission on Dental Accreditation of the American Dental Association and leads to an Associate of Science Degree in Dental Assisting. Placement of crowns and bridges. Gutkowski S. (Nov. 2001). Here is a thorough list of the indications and contraindications for coronal polishing. A colleague who went to work in an office with 50-minute hygiene appointment times for adult patients rather than the traditional one-hour, started polishing first to help her stay on schedule. nal plane ( kr'-nl pln) A vertical plane at right angles to a sagittal plane, dividing the body into anterior and posterior portions. Most of the in vitro research on sodium phosphosilicate, to date, has been focused on its ability to form a layer of hydroxycarbonate apatite on tooth dentin and enamel, as well as its effectiveness as a desensitizing and remineralizing agent. The Michaelis-Menten equation can be rearranged so that a plot 1/V01 / V_01/V0 versus 1/[glucose] produces a straight line. No case of emphysema has been reported after instrumentation subgingivally with the device that delivers the glycine-based powder subgingivally. She can be contacted at maahst@lanecc.edu. Pursuant to section 4715.39 of the Revised Code and this rule, certified assistants shall receive certification to perform coronal polishing and may do so under the restrictions set forth in rule 4715-11-02 of the Administrative Code. Now that she understands firsthand the benefits of polishing first, we have gotten brave enough to present the idea in the educational setting, and encourage students to think outside the box and use a critical-thinking process to decide when it is appropriate to polish first. and reduce the scaling time significantly. Participants who successfully complete the course may obtain coronal polishing certification in the State of Ohio. 13. Prophylactic paste contains abrasives that vary in size, shape, and hardness. "Coronal polishing" means the removal of plaque and extrinsic stain from exposed natural and restored tooth surfaces using an appropriate rotary instrument with rubber cup or brush and polishing agent. Familiarity with aerosol shield reduction devices or the difference between air polishing powders is paramount. Part 2 of 3. Therefore, it has the potential to facilitate regeneration. It did not take me long to observe the benefits of polishing first, so I started performing the procedure on adults as well. After successful completion of the curriculum the student is . I had already decided that this was the time to try out the polishing first thing.. The American Dental Hygienists' Association 2010 Position on Polishing Procedures lists the following as contraindications for air polishing procedures:1. In fact, polishing only the crown portion of your teeth is sometimes called cosmetic polishing, according to an article published in the Journal of Indian Society of Periodontology (JISP). http://www.adha.org/proissues/polishingpaper.htm (accessed 28 June 2006). Bristle brushes are used in the prophylaxis angle with a polishing paste. Method of Teaching: Didactic instruction/clinical participation 1. The program in Dental Hygiene at Sinclair Community College is accredited by the Commission on Dental Accreditation and has been granted the accreditation status of Approval (without reporting requirements). Your teeth have demineralized spots on the enamel or root decay. I explain to the patient that it helps me look around their entire mouth before I begin scaling one tooth at a time, assists me in evaluating home care, helps me focus on what cannot be removed with the toothbrush, floss, or other interproximal aid, reduces scaling time, and alerts me to possible sensitive areas. The authors mentioned in the discussion section of this study's report that, on average, 66% to 77% percent of subgingival root surfaces were biofilm-free in pockets with probing depths 4 mm. compared the efficacy and efficiency of a sodium bicarbonate air polishing and rubber cup (pumice) system in orthodontic patients.12 Sixty-two patients were divided into two groups: one that did not rinse with chlorhexidine and one that did and showed visible extrinsic staining. When I see some of these students, now colleagues, at continuing education events, they tell me that they polish first, and they love it. The relative abrasiveness of this bioactive glass has not been studied, but studies have been conducted to show the removal of surface stains and hypersensitivity.10,11. When we find a red flag like this, it doesn't necessarily mean the protocol is wrong. Always seek the advice of your dentist, physician or other qualified healthcare provider. Root caries. Caries Prevention and Coronal Polishing for the Dental Assistants Course Description. This proves to me again and again that patients cannot go it alone. There are two popular types of prophy cups: 4 webs and 6 webs. This is because, other than removing stains and plaque to smooth and shine the tooth, polishing offers no other therapeutic benefit. (mechanical engineering) Smoothing and brightening a surface such as a metal or a rock through the use of abrasive materials. Didactic: The trade name for this bioactive glass is NovaMin. The damaging effects of bacterial plaque take place below the gumline, so professional debridement/recare is imperative, and polishing first fosters taking the time and opportunity to focus on this aspect of dental hygiene care. Stay #DAstrong! Although some procedures can be messier than others, virtually all dental procedures produce aerosols, and the air polisher is no exception. Polishing can: Create a smooth tooth surface that is less likely to retain plaque, calculus, and stain. Pelka MA, Altmaier K, Petschelt A, Lohbauer U. Kentucky Community & Technical College System 300 North Main Street Versailles, KY 40383 Toll Free (877) 528-2748. A copy of the standards and Commissions policy on third-party comments may be obtained on the internet at www.ada.org. She said enamel does not get abraded, and she likened this to scrubbing a porcelain sink with cleanser. This course provides the dental hygienist with essential skills and knowledge necessary to safely and effectively administer local anesthesia. Coronal polishing is a procedure used to remove stain and plaque from the enamel surfaces of the teeth, after the removal of hard deposits such as calculus from the tooth surfaces. 2010 Jan; 141(1): 63-70. After your dentist or dental hygienist cleans and polishes your teeth, you may want to enjoy that clean, smooth-teeth feeling more than just twice a year. It's an exciting time for hygiene instrumentation in many respects, and future dental hygienists may choose to disrupt subgingival plaque/biofilm with a unique device that delivers amino acid glycine powder at limited pressure subgingivally. Focus on the gingival one-third and areas of visible stain. Regardless of a patients best efforts at self-care, there are areas where plaque will be missed. You want that stuff out of your way so you can concentrate on cleaning the real dirt. Evaluate home care and show the patient where they are missing. For program specific information click on the program below: Working as part of a dental team, dental hygienists treat patients needing non-surgical periodontal therapy and radiographs, apply preventive agents, provide intra- and extra-oral exams and oral hygiene instructions. Ability to perform coronal polishing; CDHC Course registration CDHC Course payment. Courtesy of KHN (Makris Music Society; Boja Kragulj), Dental device purported to fix jaws results in wrecked teeth, allege patients, Medical History Mysteries: Benzodiazepines vs. barbiturates: What to know before you prescribe, 162063215 Sergey Chuyko | Dreamstime.com, Dentists top 5 financial mistakes (and how to avoid them), 66404851 Iakov Filimonov | Dreamstime.com, In brief: Why toothpaste flavor matters; Senate concerned about HCW shortage. J Clin Periodontol 2009; 36 (Suppl. The Indiana State Board of Dentistry approved coronal polishing and fluoride administration as a permitted function for a trained Dental Assistant. The goal is to enhance knowledge and become the best dental professional you can be! Wilkins states, Certain stains can be removed by scaling, whereas others require polishing. Darby and Walsh state, Because hand instruments are small, they can remove stain in areas inaccessible to a rubber cup., Therefore, it makes sense to remove stains with polishing first, then the clinician can focus on the remaining stains with power-driven or hand scalers. You need to remove residue from temporary cements. Register Cost: $400 Designed For Dental Assistants Dental Credit Statement Why are we still using it? Subgingival plaque removal at interdental sites using a low-abrasive air polishing powder. 15. Abstract. This information packet prepares you to participate in the course. Patients with hypertension, Addisons disease, Cushings syndrome, and metabolic alkalosis, as pumice can contain sodium. The degree program consists of open enrollment courses (general education and division specific) and program specific courses with limited enrollment. Adam, you guys always have something new. 1995 Aug; 26(8): 535-43. Code 114.5 - Coronal Polishing. Keep in mind that these findings correlated with the type of powder used and air polishing time. The sodium content is less than 500 milligrams which is very little in comparison with 2,000 to 3,000 milligrams in sodium bicarbonate (which is highly soluble and will dissolve quickly). I supervised and provided feedback, then gave her privacy to complete the task. Some prophylactic pastes contain fluoride to aid in the remineralization of the enamel surface and others help reduce dentinal sensitivity. Intrinsic stain. "Coronal polishing" pertains to the removal of plaque and extrinsic stain from exposed natural and restored tooth surfaces using an appropriate rotary instrument with rubber cup or brush and polishing agent. This is why, if extra polishing is necessary, it should be done with the least abrasive paste, using the proper technique, pressure and speed. Prophy cup: I prefer a small, short [pedo size] soft rubber cup. Participants will receive instructions that will allow them access to Indiana University's Canvas system. If polishing does occur on these surfaces, fluoride therapy can minimize the risk of dental caries. A contraindication, then, is a symptom or condition that makes a treatment risky, such as taking certain other medications at the same time. She has a full dentition (30 teeth!) Avoid reintroduction of bacteria immediately after SRP and NSPT. Shirley Gutkowski, RDH, reported in an article that while most hygiene schools teach students to use fine paste, about 50 percent of hygienists actually use coarse as their primary paste. Knows indication/contraindications for sealants. All rights reserved. While coronal polishing is sometimes part of a routine dental cleaning, it is not a replacement for regular oral prophylaxis, which removes all plaque and calculus. Sodium biocarbonate-based powders did not affect irregular grooves and pits, but sharp-edged elevations were markedly flattened. What about the idea of polishing first? Petersilka G et al. instruction in coronal polishing must include didactic and clinical instruction in: YES NO . For dentin sensitivity or root or dentin exposure, NuCare or Proclude are very effective and low in abrasion. Oral examination, charting, medical and dental histories, sterilization, lab, and infection control procedures are emphasized. 2023 Endeavor Business Media, LLC. Some disadvantages are the production of contaminated aerosols, but rubber cup polishing produces fewer aerosols than air-driven or power-driven scalers. She founded StudentRDH and SmarterDA, which offer dental hygiene and dental assisting exam prep courses. I tell her that at school we still teach selective polishing, and now part of that is selecting the patients who are appropriate to polish first. Dent Hyg 1981: 53(9). Demonstrate clinical competency in performing coronal polishing in a preclinical setting. Forbes said she polishes first to remove plaque and stain, then there is less plaque to remove with scaling. The American Dental Hygienists' Association 2010 Position on Polishing Procedures lists the following as contraindications for air polishing procedures:1 Patients with restricted sodium diets Patients with respiratory, renal, or metabolic disease Patients with infectious disease Children Patients on diuretics or long-term steroid therapy All faculty members shall have the education, background, and occupational experience and/or teaching expertise necessary to teach, place, and evaluate coronal polishing. "It's not going to impact tooth decay, gum disease or oral cancer.". They are best used as an instrument to assist and direct us with patient selection and proper patient care. GPAP was safe with no adverse events reported, and was perceived to be more acceptable to patients. I may elect to selectively polish certain areas as I move through the dentition (I still scale/debride by sextant). Not all (though many) patients with renal disease would be on sodium restriction. [5] Areas with exposed root surfaces should also be avoided as well as, areas with tooth sensitivity and gingival inflammation. McGraw-Hill Dictionary of Scientific . However, when this patient returns for periodontal scaling/root planing appointments, polishing and flossing the previous quadrant while he/she is getting numb is an excellent way to assess home care, demonstrate home care, evaluate for sensitivity, and apply desensitizing medicaments. Abrasive powders included sodium bicarbonate and glycine-based powder. Description: Denise Kissell, RDH, MS, EFDA Postle Hall 305 W. 12th Avenue This lecture/hands-on course satisfies the 7 hour CE requirement for CDA's seeking Coronal Polishing Certification from the Ohio State Dental Board (OSDB). After completing the course and meeting state requirements, they can perform the polishing procedure with the supervision of a dentist. J Biomed Mater REs Part B: Appl Biomater 2009; 88B: 83-91. https://www.linkedin.com/showcase/4000114/, Mr. Borneo asks Adam, RDH: "What's that huge monstrosity in the corner of your operatory that looks like a muscular elephant trunk? Bicarbonate-based air polishing powders have been limited by substantial abrasiveness on composite materials.1 Besides the most common air polishing sodium bicarbonate-based powders, there are some newer air polishing products that are worth mentioning (see "Sources for air polishing powders"). The Ohio State Dental Board allows Certified Dental Assistants, Registered Dental Assistants,and Registered Dental Hygienists to enroll in this training. Phoenix, AZ 85007 Provide the patient with protective eyewear. When she was seated again in the chair, I told her I was going to polish her teeth first. The patient also perceives a shorter appointment time. [5] Particles within the prophylactic paste can go below the gumline and cause inflammation or delayed healing. Extracoronal preparation are created by occlusal and axial surface reduction. [1][2] Tooth polishing has little therapeutic value and is usually done as a cosmetic procedure after debridement and before fluoride application. Sodium bicarbonate powders 3M ESPE's C&P Air Polishing Powder Biotrol's Perfect Choice Air Polishing Powder Dentsply's Cavitron Prophy-Jet Powder Electro Medical Systems' (EMS) Air-Flow Powder Classic Satelec Acteon Group's Powder Max Young Dental's Air Polishing Powder, Glycine powdersElectro Medical Systems' (EMS) Air-Flow Powder PerioElectro Medical Systems' (EMS) Air-Flow Powder Soft, Other powdersDentsply's Cavitron Jet-Fresh Powder (aluminum trihydroxide)KaVo's ProphyFlex Powder (calcium carbonate)OSspray's Sylc (Novamin/calcium sodium phosphosilicate). You are encouraged to complete Cardiopulmonary Resuscitation for the Health Care Provider (or ALH 1130 Basic Life Support Training) prior to entry to the Dental Assisting program. Idiopathic scoliosis is a three-dimensional deformity of the growing spine, affecting 2%-3% of adolescents. I will say, You can be sure that all that gritty stuff will be rinsed out of your mouth by the time treatment is complete.. 17. For tougher stains (coffee, tea, tobacco, black line stain), consider NADA pumice paste. American Dental Association Medical Dictionary for the Health Professions and Nursing Farlex 2012 coronal plane A vertical anatomical plane that divides the standing body into front and rear halves. demonstrate correct coronal polishing techniques including patient/operator position and instrumentation . You are alerted to sensitive areas and can follow up with the application of a desensitizing medicament prior to scaling. Gingiva that is Inflamed, Intro to Dental Hygiene Chapter 10: vitals, DHE 110 pharmacology Ch 5 Nonopoid analgesics, DHE 110 Ch 6 Opoid analgesics and antagonists, DHE 110 pharmacology ch 7 antiinfective agents, April Lynch, Jerome Kotecki, Karen Vail-Smith, Laura Bonazzoli, Woody Plants: MidTerm Review (Shrubs pt. https://www.linkedin.com/showcase/4000114/. Use these key points as a checklist to assess whether youre making the right choices when performing coronal polishing. A. Polishing teeth may make them feel smooth and gleam, but the procedure isn't necessary. Code 114.5 - Coronal Polishing State Regulations Compare (a) "Coronal polishing" means the removal of plaque and extrinsic stain from exposed natural and restored tooth surfaces using an appropriate rotary instrument with rubber cup or brush and polishing agent. Lynne is the CEO of Perio C Dent, a dental practice management company that specializes in the incorporation of conservative periodontal therapy into the hygiene department of dental practices. IF YOU DO NOT MEET THE SPECIFIC REQUIREMENTS TO PERFORM THESE DUTIES/FUNCTIONS, CHECK THE APPROPRIATE BOX IN THAT SECTION. An initial therapy patient who requires quadrant scaling with anesthesia would not be a candidate for polishing first. 9th ed. EN English Deutsch Franais Espaol Portugus Italiano Romn Nederlands Latina Dansk Svenska Norsk Magyar Bahasa Indonesia Trke Suomi Latvian Lithuanian esk Unknown The authors reported that the sealants performed better in terms of abrasion resistance than did the flowable composites tested and recommended the use of low-abrasion powders for frequent cleanings. She did not like the hand scaling, and the tears in her eyes were pretty impressive, so I used the ultrasonic to complete treatment. Plus, polishing tooth enamel removes a bit of the tooth's fluoride-rich layer, which then takes about three months to rebuild, according to the JISP article. [5] Short intermittent strokes should be used in order to avoid damage. You would like to work with a variety of people and perform multiple tasks. [5] This can become problematic because some microorganisms remain in the air for an extended period of time and can contaminate hard surfaces. Air polishing dental surfaces removes biofilm but can also damage the tooth/restoration surface by increasing its roughness.6 Calcium carbonate is an active ingredient in one commercial air polishing powder. As with all procedures we perform, however, it is imperative that we resist a "cookie cutter" approach to guidelines. 2023 Endeavor Business Media, LLC. Trauma to soft tissues may result from improper technique or prior inflammation of tissues. Ramaglia et al. Clinical practice of the dental hygienist. The student will be introduced to the fundamentals of working in a dental office as a chair-side dental assistant. This randomized, split-mouth clinical trial compared GPAP to conventional curette/ultrasonic debridement in 50 subjects. 1 year of clinical work experience as a dental assistant is required. Admin. Untreated perio and COVID-19: What is the evidence? 2. Results indicated that all powders studied were equally effective in removing plaque/biofilms on titanium surfaces. Coronal Polishing Certificate Practice when the dentist is not physically present ALL SECTIONS OF THIS DOCUMENT MUST BE COMPLETED INDICATING THE DUTIES AND/OR FUNCTIONS YOU HAVE BEEN APPROPRIATELY TRAINED/EDUCATED TO PROVIDE. Position papers and treatment guidelines are valuable tools in clinical decision-making, and those of higher quality include unbiased scientific evidence. Coronal polish procedures may aggravate ulcerations and/or wounds of the lips and intraoral tissues and highly inflamed or traumatized gingiva thereby complicating the healing process. The phrase "an elephant never forgets" refers to the tenacity of this large mammal to follow the same path, no matter what the circumstance. J Periodontol 2003; 74: 307-311. It will include 14 hours of didactic and 4 hours of laboratory . Polishing paste, prophylactic paste, usually containing fluoride, is used with the rubber cups for polishing. Just polishing a childs teeth and applying a fluoride treatment is not complete patient care. Areas of exposed cementum (due to tissue recession) or exposed dentin should not be polished. Areas of Demineralization The field of Dental Health Sciences offers various career options at multiple educational and professional levels. Regardless of the abrasive used, there was some variation in root defects generated by different devices and the glycine-based powder produced the least amount of root damage. J Clin Periodontol 2008; 35 (Supp. This course is designed to meet the requirements of the State of Nebraska to allow dental assistants to perform coronal polishing under the direct supervision of a licensed practicing dentist. Revisiting our polishing options is beneficial to patients and clinicians. Borneo? Know appropriate patient and operator positions. [Glucose]outside(mM)RateofGlucoseEntry(M/min)0.5121.0192.0273.0324.035\begin{matrix} \ {[Glucose]_{outside}(mM)} & \ {Rate \ of \ Glucose \ Entry (\mu M / min)}\\ \text{0.5} & \text{12}\\ \text{1.0} & \text{19}\\ \text{2.0} & \text{27}\\ \text{3.0} & \text{32}\\ \text{4.0} & \text{35}\\ \end{matrix} It is important to use clinical judgment and remember the philosophy of individualized patient care when deciding to polish first. As oral health-care providers, we are constantly pushing to keep current with technology and research. Completion of this course prepares the dental hygienist to take the CDCA examination required for dental hygiene local anesthesia credentialing in Ohio. Ask the patient to remove any dental prosthetic appliances he or she may be wearing. The American Dental Hygienists Association Position Paper on Polishing Procedures states, Polishing should be performed only as needed and not be considered a routine procedure.. Dental polishing can remove surface stains on teeth and leaves them shiny and smooth, putting the finishing touches on preventive dental treatment. There is evidence of tooth polishing dating back to Roman and Greek times. Renvert S. Persson GR. When reviewing a medical history, we often refer to recommended guidelines and position papers. However, if your dentist feels that you would benefit from an extra polishing, you should feel comfortable going ahead with the procedure. Anaerobe cultivation was used to assess the mean reduction of total colony-forming units immediately after treatment. Additionally, the program strives to motivate students to become community-minded citizens and life-long learners. One laboratory project obtained the data shown here for glucose transport. 1. Polishing is not recommended for a patient with inflamed, enlarged, soft, spongy, or bleeding tissue. You have three opportunities to successfully take the TEAS. 18. 21. Many ideas and opinions exist about polishing teeth, including whether or not polishing is a necessary part of a prophylaxis appointment. Quintessence Int. 1. Microbiologic samples were taken and total bacterial counts and counts of six periodontal pathogens were determined by real-time polymerase chain reaction. "There is no health benefit to polishing," said Julie Frantsve-Hawley, the editor of The International Journal of Evidence-Based Practice for the Dental Hygienist. 4. Programs equip students with a variety of educational tools and techniques to use in their health professions by emphasizing both health behavior theories and practical application. Click here for the Dental Hygiene Program Advisory Committee, Sinclair Community College There are forms of sticky plaque that do not come off with rubber cup polishing. Terri Tillis, RDH, discussed in her course at a recent RDH Under One Roof that intact enamel is harder than the particles in toothpastes. Other external factors that can lead to extrinsic staining are smoking, some antimicrobial rinses, and environmental working conditions where there is exposure to metallic dust. 1740 W Adams Suite 2470. and less than optimal home care even though I know she tries. No one likes the cleaning lady stigma. Important Information about Health Sciences Programs:The Health Sciences (HS) Programs consist of open enrollment courses (general education and division specific) and program specific courses with limited enrollment. If you know your indications and contraindications, you will provide better care. Gloves Off: Can a nightguard kill a sleep apnea patient? This includes the use of a toothbrush. Register, Volume 40, Number 50, December 11, 2015, TexReg, Texas Around the wire is the magnetic field of (3.0i^4.0k^)103T(3.0 \hat{\mathbf{i}} \times 4.0 \hat{\mathbf{k}}) \times 10^{-3} \mathrm{~T}(3.0i^4.0k^)103T. Find the magnetic force on this segment.