Forums › Erbium Lasers › General Erbium Discussion › Anesthesia
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PatricioSpectatorHi Gang,
Being a baby laserdentist/microdentist every thing is new and first time. Today I “anesthetized” tooth #13 which had an MOD Irm temporary in about 30 seconds and then removed the temporary with my high speed on a rather touchy patient with no problem. Finished up as needed with the laser and restored in no time flat. Great experience – no shot and no pain. I am looking forward to “anesthetizing” a touchy abutment prior to cementation or etching or what ever. Feels great. Used a hemostatic agent today after digging out a sub gingival cavity. No weeping into the prep. Thanks for the guidance. Keep the info coming. I tried to punch a hole in a procera crown I wanted to open for endo that did not work. With a little kindling we could have stated a fire.
Pat
2thlaserSpectatorGreat Pat, Now I need to ask, what settings are you using for “anesthesia”? Just wondering. We are starting to research what porcelains we can “cut” through. Some have just enough stuff in em that we do the old Bill Cosby routine…”schmmmmoke!” I have removed others, it’s been interesting. Keep up the good work. You are starting to really come up to speed now it seems, how fun!
Mark
Glenn van AsSpectatorSo it does seem that Biolase has some porcelains it wont cut. I have yet to find a porcelain that Continuum can cut but when you guys do find one, let me know and I will check out whether the Continuum can cut it.
Good research Mark……….
Glennn
PatricioSpectatorMark,
I have been routinely using 1.5W for “anesthesia” for this type of procedure and in some cases I am preping the gingiva for the ligajet as well. It has felt to me to be a little less intrusive to the patient as to sound and water and I find I do not need to wait for an assistant as the water level is the preset of 7% water and 11%air. The trained patient will probably do well at any setting. I suspect that as I get more comfortable at higher watts the patient will be as well.What is the latest on etching? Are there some laser preps which no longer need the etchant step? I etch routinely cause that is what my grampa told me to do.
Pat
2thlaserSpectatorHi Pat,
You ought to try the 5.5-6.0W anesthesia, it works, and is very profound. I can elaborate if you wish. As far as etching, Glenn has posted a few things about to etch or not to etch on DT, maybe he can post it here too. I use Prime n Bond 2, self etching primer, I don’t acid etch. I have not had a debond at all since using the laser. Your grampa shoulda had a laser! 😉
Have a great Thanksgiving!!! Looking forward to your next posts!
Mark
AnonymousGuestHey All,
Looks like everybody is making great progress. I’m jealous because I haven’t used my laser for a week and a half. Been remodeling 2 ops and adding a 5th. When done I’ll post before/after pictures- kinda like Christmas time in the office.The other thing keeping me away from laser stuff was that my wife needed emergency surgery Monday for an infected urachial cyst that ruptured. Anybody that remembers their anatomy and can explain that one gets a prize. She’s improving but a little extra prayer wouldn’t hurt. We’re hoping to get her home Saturday. Meanwhile, my daughters and I are trying to tackle the turkey for tomorrow.Maybe a little prayer there would be a good idea too 😉
As far as the anesthesia goes, I had been using 5.25 90/90 defocused for 45-60 seconds. Non tapered tip. It might also be good in future posts if we include tapered vs. nontapered tip because of the power density difference.
Lots to be thankful for this year-wife getting better, 3 teen daughters, lasers, new ops, and of course, all you guys and your posts which have helped make me a better laser dentist.
Happy Thanksgiving!
Glenn van AsSpectatorCouldnt have said it better myself Ron……….happy thanksgiving to all my friends in the USA.
THink of me when I am hacking and wheezing and coughing tomorrow at work.
Glenn
Robert Gregg DDSSpectatorRon–
Many thanks to you, best wishes for the holidays to all, and good prayers for your wive.
When she gets home, you can do her a great favor using your diode to biostim for pain relief and wound heal acceleration. May not need to remove any bandage over her naval if you defocus enough…
Let us know how she does…
Bob
PatricioSpectatorMark,
With regards to “anesthesia” I am now banging away at 5.5W with no problems beyond a slight jerk on the part of th patient when the machine gun goes off for the first time. Seems to be working fine for me. Thanks for the push.I seem to be getting a significant number of very fear full new patients through our marketing. I wonder how this will work out for comprehensive dentistry. What has been your experience? Do most find they are able to follow through or do too many disappear when their chief complaint no longer bothers? We have had exposure via TV and the local daily newspaper which is bringing them in.
Pat
2thlaserSpectatorPat, Glad to see you get to the “next” comfort zone for yourself. I usually “warn” them of what to expect just prior to setting off the laser, it helps. Also, most the patients seem to stay, even after treating their chief complaint. It really has alot to do how we treat them, and how we treat them. Treat with kindness at all times and treat with the laser, they always want that laser! We eventually get them to follow through on their big treatment planning visit and consultation, then sign them up for work as their budget allows. Keep the faith, and keep the laser running!
Mark
PatricioSpectatorHi Beamers,
Another great day. I discovered after completing endo and five restorations that I had forgotten I wanted to do an additional composite on #2mo replacing an old amalgam with recurrent decay. I prepared the tooth at 5.5/w for 45 seconds and removed the amalgam with a high speed and the decay removal and final preparation with the laser and finished the restoration. No anesthetic (or wait)for any of the work and no discomfort. On another patient I was able to easily dig out the margins on a crown prep preped well into the tissue. Cheated as directed and used a hemostatic agent to control bleeding quickly. Both efforts are nothing special accept to the neophite(me).
Bought an airline ticket for Dana Point yesterday. Mark you better be good! Just kiding, I am sure you will carry us forward in giant steps. Thanks for confirming what I would expect from patients treated with kindness, respect and appreciation.
Pat
Glenn van AsSpectatorPat: great to read your posts, the laser does allow for more treatment in one appointment due to no anesthetic.
Great stuff………
Glenn
2thlaserSpectatorSee Pat, YOU can be above the curve as well. I am still struggling just a bit with the amal removal area you and Ron are having success with. I still get a bit of “antsyness” with these patients, as I remove the amalgam. Maybe I am looking for too much results, as if I am using the laser, where they don’t flinch a bit? Either way, I am still going to proceed with that area of treatment of removing amalgams. We all help eachother learn here, that is what I love about Ron’s forum. I will do my best at Dana Point. I have alot to share. It’s going to be a blast, believe me!
See ya soon!
Mark
Glenn van AsSpectatorHi guys…….i dont have the patience to do alot of amalgam removals unless the patient is firm on no anesthesia.
I do find that alot of my patients “feel” something during the process and sometimes it is a reasonable amount of discomfort but when I ask them I found.
80% rated the discomfort as 0-15/100
10% rated the discomfort as 15-50/100
10% were higher and these I often had to numb up.I was not using the bathing technique Mark and others speak of.
Almost all patients receiving a laser restoration for the 2nd time will rate the discomfort as lower than the first time even if the restoration is larger.
Around 95% would have the laser again, and I do have patients who request anesthetic but the laser because they hate the sound and feel of the drill that much.
Just some food for thought……….for those lurking or thinking about why some patients feel it and others dont.
Glenn
2thlaserSpectatorHey guys, Just one other thing to help reduce sensitivity with the Waterlase, Glenn, I am not sure with the Continuum unit, maybe you can help here. When I was in Phoenix, we were talking anesthesia with the laser, and I remembered to let everyone know that you can warm up the water in a waterbath before attaching to the unit for use. This makes it a bit more comfortable, especially for us in these colder climates. We turn our heat down a bit at night, so the standing distilled water cools down with the room. When we warm it, the patients definitely notice it when using it warm, that it’s more comfortable for them. It would be nice to have a inline water heater, BUT there is already so much in the lasers guts, that the waterbath seems to work real well. (And it’s free!). 😉 Just a tip that I hope helps those who use the Waterlase. Glenn, what type of water connection is in the laser you use?
Mark -
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