Forums › Erbium Lasers › General Erbium Discussion › Desensitizing Teeth
- This topic is empty.
-
AuthorPosts
-
PatricioSpectatorHow long does the desensitization of hypersensitive teeth last. (0.25w x 30-40 seconds)? Is it somewhat predictable. Can we offer the patient a service which when effective at the time will last for weeks or months?
Pat
Robert Gregg DDSSpectatorDear Pat–
It is “light dose” dependent. Depending on whether you are in “contact” or defocused. My goal would be to be defocused to get the effect, not in contact, as we learned it is both a problem of open tubules AND hyper-polarized dentinal tubules. So just glazing the surface is not enough.
It also depends on surface are of the effected area involved.
Often with dentinal hypersensitivity, you can “chart” a reduction in areas that have no response to stimuli, but the patient doesn’t perceive that there is any change in sensitivity. So, the “take-away” is that you need to chart the effected area in your notes (using an air syringe and short puffs). Rate sensitivity on a scale of 1 to 10–record it!
Done properly, it last for years–decades even. My tooth is going on 13 years (and it is still vital thank you).
It is very predictable, once you find the best settings and approach with your individual device settings.
You should charge as you would to place a restoration on a Class V.
Keep us posted,
Bob
(Edited by Robert Gregg DDS at 2:10 am on Oct. 4, 2002)
Samuel MossSpectatorHi,
I have been using the Waterlase since last July. I have many questions. I will start with the fact that everyone has had the cold pain when I use the enamel setting. Sometimes, I start with the dentin setting (3.5 W, 65% air, 55% H20). Invariably, they raise their hand that “the cold hurts.” I go to the slow speed with round burs, then go back to the laser. Just about all these sensitive problems are on the molars. I read about defocusing and anesthetizing with the Waterlase. Exactly, how is this done? Do you keep the laser settings the same, pull back, bathe the buccal and lingual for 60-90 seconds? Or do you go to the .25W setting with 0 air and water staying about 10 mm away (I assume this is “defocused”) and bathe the buccal and lingual? Or do you do one or the other but on the occlusal surface? Any word on this would be extremely helpful.Mossman
whitertthSpectatorNot to rain on mark’s parade,as i reference him in all my lectures, mark;s technique utilizes mthe laser 10 mm away from the tooth at settings of 5.5 to 6 watts 90/90 or 90/75 for 1.5 to 2 minutes…i rotate that handpiece circumferentially around the tooth, nice and slow .
Glenn van AsSpectatorHi there mossman and welcome to Rons outstanding site.
THis has been going since summer of 2002 when there were about 8 members when I joined early on…….maybe less.
Alot of these issues are still located on this board so dont be afraid to look back and see some of the groundbreaking stuff that Mark has done.
If you want to desensitize there are two ways.
1. Mark Colonnas high energy defocussed settings of
5.5-6w with 90/90 or 90/75 around 10 mm away bathing all sides of the tooth for 1.5-2 mins and then you can find in alot (NOT ALL) patients that they can tolerate the laser for 3-5 mins at high settings. Now not all will make it but the average non squeamish patient will be fine.2.Bill Chens low to high which starts of with .25w and water and air settings that are lower and builds up. I find the low to high protocol works good for me in Class V lesions but the other protocol works better for Occlusals.
I hope this helps……….I have a Continuum (Hoya Con bio laser ) so the exact settings arent the same for me, so keep this in mind.
Basically one way is high to low and the other is low to high and I have used both, and often they will help.
When I asked my patients to rate the pain between 0-100
80% rated the pain as 0-15
10% rated the pain as 15-50
10% rated the pain as 50+ and those I often had to anesthetize.Typically those getting the laser for the first time rated the pain as 15 points higher or so then the next time when they werent so worried about feeling something.
Hope that helps and welcome to the board and happy reading as there is a TON of really really great material put up by so many here including
Mark, Rod, the two Ronnies, Al , Pat, Bob Gregg and so many others here that you can literally get a laser education just from this board.
All the best.
Glenn
-
AuthorPosts