Mark,
Have you noticed any difference in cutting with the warm h2o? It ‘s probably my imagination , but I warmed up the water bottle(placed bottle in bowl of tap h2o as warm as it would get) and it seemed like I was able to remove tooth faster than anytime before. I could actually imagine prepping for a crown and not being there 2 days doing it Anyone else see variation w/ h20 temp?

Still not good, the doc says with pneumonia that the coughing doesnt stop for up to 6 weeks ( I am in week 3) and that the energy levels can be low for up to 3 months.

I am working 5 hours a day this week, trying not to overdue it and have a set back.

Thanks for asking and if I can get through the next 2 weeks then I will have 2 weeks off to get better.

Cya

and thanks for asking.

Glenn

PS interesting stuff about the water bottles makes me want to get an enclosed system and see if it will work better…….with the warm water.

Glenn

Bob : that is the great thing about your posts, is that you have seen it all and done almost all and yet you still find the energy and desire to educate us.

I get tired of listening to the naysayers and when I get to that point I just think fine, I will do it and there will come a time when others will want to listen.

I also have found that pictures solve alot of the naysayers. Its easy to disagree with someone til they provide proof, then people get a little quiet. Particularly if the pics are microscope ones.

I have talked to Gary Carr who is in Sandiego and a pioneer of microscopes in endo…….he rarely talks about his travels because he got tired of all the criticism.

In Nov. he gave a little history lesson and a testimonial to all the people he taught microscopes to, the pics were from 94 , 95 etc………even before I even knew about scopes.

He told us that the first lecture he ever did , the future president of the AAE stood up half way through and yelled out………..this scope stuff is utter B.S. and walked out…………..

Can you imagine how he felt, well he realized that S.E.M.s werent gonna mean squat and he started to get GREAT photos from his microscope doing apical retrofills with ultrasonics and when he showed these pics at 10-24X power guess what happened……….

People got awful quiet………..

I find the same thing, but will admit that there is comfort in posting here , yes there are lurkers but no derision .

In closing I have seen a paradigm shift happen at the laser board at Dental Town. Now that some of the leaders have purchased a Waterlase, the rest of t he guys are asking well how much does it cost etc . etc.

The critical mass will move a product when there are enough people using it but then the novelty disappears.

The same thing will happen with scopes or some form of advanced magnification and I do hope to be still praciticing then.

This board is great Ron because it is for sharing and learning and kudos to the “old guard” like you Bob who share not only your incredible knowledge but your history.

As for making a laser……….nah…….no time.

To many other microscope projects on the go.

Take care and all the best………..

Glenn

PS thanks for the great read as usual.

You said 5.5 watts defocus. At what distance from the tooth is defocus. And what is the air and water setting.

I zapped my palm pretty good at 6 watts and no water about three inches away with my waterlase the other day. I can hear you laughing!

Please spell it out so a dummy like me can get the details.

My training on anesthesia was about .5 watts about 10mm from the tooth with no air or water to speak of.

There is a big difference between 5 watts and .5 as I was trained to do. What am I missing?

Hi Pat,
One of the things I have noted over time is that teeth with fractures, crazes, and especially worn areas due to bruxism, have much more sensitivity than most with the laser. In addition, it seems that lower molars especially are more prone to extra sensitivity. I usually make sure I anesthetize with at least 5.5W for almost 2 minutes, BUT if the patient is already “jumpy”, or as you say, a little on edge, they expect pain, so, I just numb them anyway, as I have learned the hard way. They may not be feeling anything, but their PERCEPTION is that of discomfort, and there is no winning in that situation as you found out! I wish I could tell you I have had no problems in that regard, but I can’t. I think if you would have just tapped gently with an explorer on his tooth, he would have reacted, and sometimes I do just that to “test” the patients expectations before I even start. As far as the improved potential, you are right, the composite will have good retention from the laser prep alone as well as the bonding agents too. You did good, as usual, caring for your patient. Sorry I couldn’t help you along any further. Bob, what are your thoughts as you read this thread? Glenn? Ron?
Mark

Pat, As far as the spare fiber is concerned, they are quite expensive. I had some trouble in the beginning too, but mostly operator error that blew a fiber or two, but Biolase came to the rescue overnight each time with a new fiber, and within 2 minutes I was back in the laser business. They are great with service. I recommend keeping your laser up to date with the service contract they have. ANYTHING that can happen will be covered, and believe me, as you get used to having that laser around, you won’t be able to operate without it, your patients will reshedule rather than have the drill, I know, it’s happened. We renamed our pratice The Montana Center for Laser Dentistry, and when you don’t have a laser working, hmmm…..You get it? SO, that being said, I keep up to date, and make sure also that my staff is trained to keep the laser in good working order. TLC is mandatory for these precise instruments. Anyway, keep the thread going, good anethesia cases. I also did another amal removal the other day, so cool what you guys have taught me! Thanks.
Mark