Hollie has authored numerous manuscripts on clinical assisting and practice-management topics. She is on the editorial board of Dental Assisting Digest ™ and Contemporary Product Solutions, and is a consultant for various dental manufacturers. She is the former editor-in-chief of Contemporary Dental Assisting magazine and currently serves on the advisory board for DentalCompare. She is a member of the American Academy of Dental Office Managers, American Academy of Cosmetic Dentistry, North Carolina Dental Association, Academy of Comprehensive Esthetics, and the American Dental Assistants Association. Ross Nash and clinical instructor and treatment coordinator at the Nash Institute. Hollie Bryant is a graduate of Bowman Gray Dental Assisting Program, and is the former chairside assistant for Dr. Do you think observing the pitfalls and finding the solutions can prevent these issues? Take the extra time now so that you can save time in the long run. Patient time is lost, an unnecessary excess of material is used, wax-ups aren’t as good, temporaries take longer to make, and sometimes cases even have to be remade due to bad impressions. These pitfalls are costly in the treatment process. Looking back at the impressions you have taken over the past few months, have you recognized any solutions that could prevent you from making these mistakes again? Take the extra seconds and get it right the first time. Solution: Don’t use handle, and break suction over premolar area and pull tray down. Don’t have patient bite down on tray because this prevents even pressure on the tray. Solution: Hold over bicuspids to keep even pressure and steady (do not hold the handle of tray while it is setting up). Pitfall: Unbalanced or crooked impressions. Solution: Not enough impression material in tray, and keep tip of the material gun in the tray while loading material.
Pitfall: Air bubbles in impression after removing the tray.
Allow the material to set to completion, and do not remove the impression until the timer goes off. Look at the back of the throat to know when to stop seating (when you see material oozing to throat, stop and wipe). Solution: Not enough impression material in tray, or not seated properly (the tray should be seated parallel to the long axis of the teeth). Pitfall: Runs and pulls at the gumline of the impression. Solution: There has not been enough impression material in the tray, the tray did not get seated properly, or the PVS, alginate, or alginate substitute set up too much before the tray was seated in the mouth. Borders are not captured in the impression (missing half of the gum tissue).
Pitfall: Removing the impression and all the teeth are present, but the gum tissue and bone has not been captured. Failure to get the proper amount of impression material will prevent an accurate impression. Fill tray properly with impression material. Solution: Trying the tray in the mouth and looking to see if the tray is the correct size is the most common error. Not all the teeth have been captured in the impression. Pitfall: The impression is removed from the mouth and there are teeth missing. How does this affect our patients? How can we prevent retaking impressions? Here are a few common pitfalls that occur when taking impressions: Often a simple step such as trying in the tray, underfilling, overfilling, or even failing to allow the material to sit for the required time prevents someone from taking an accurate impression. Maybe cutting corners is a way to save time, or maybe it’s lack of training. Maybe over the course of time the “I’ve got it” attitude sets in. How many impressions are you retaking? As a dental assistant, I have found that corners are often cut when taking impressions. Editor's note: To find out if there are specific education or examination requirements for dental assistants to take impressions in your state, or if taking specific types of impressions are not allowed to be delegated to dental assistants, check with your state’s dental board or visit the State-Specific section of DANB’s website.
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