Forums › Laser Treatment Tips and Techniques › Hard Tissue Procedures › The ‘Numbing" Process
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PatricioSpectatorHi from the frozen north,
I have been successfully numbing anteriors and bicuspids at 1.5w(not 100% Jetsfan). What additional benefits are amassed by using 5.5W as Mark and others do? I am just thinking out loud and wanting your thoughts.
I do know I must enter another watt level to cut so maybe 1.5w is less efficient time management. I also begin without my space helmet and light. When I have fogged the tooth for 30 to forty five seconds, sometimes two or three teeth in the same 30 to 45 seconds. I stop and reset the machine at 3.5 to 5.5w and put my eyes on and away we go. Are there different predictible results for numbing which we can devine at various wattages? How much is enough?
Pat
2thlaserSpectatorPat,
These are valid questions. I usually always use the 5.5-6W defocused (at 10mm away), 90%air, 73%water. I know that this weekend in Dana Point, Stu Rosenberg will be discussing 2 other methods he uses with the Waterlase in our afternoon hands on seminar. I think he will discuss the way you do it, a la Dr. Chen, and then I know Bill Grieder has another way he will discuss. I, like you, am interested in learning other methods. I DO have GREAT success so far the way I am doing this, so who knows. Glenn, what do you do with your Er?
Mark
jetsfanSpectatorIf you can post the various ways others use to achieve anesthesia with the laser it would be appreciated. I just am unable to predictably achueve anesthesia for restorative dentistry i.e, class I or II. Today after 1.5 min at 5.5W on a 16 year old boy, I attempted to do class I. When I reached the decay, he absolutely felt pain. I tried to anesthetize again without success. He felt low speed round burs and spoon excavator. When it came to a second tooth he wanted the needle. I wish I knew how you guys do it.
A FRUSTRATED JETSFAN
jetsfanSpectatorBTW,
I have been using this for over 1 year, have done all those procedures that have been talked about. Crown lengthening biopsies ,apico, endo extractions, but I still don’t know how to predictably anesthetize for a stupid class I. Of course , as patients begin to feel it, you go more slowy , and try different techniques. This has the effect of doubling the time to do the procedure rather than shorten the time.
JETSFAN
greg holmSpectatorLet’s say you have a pretty busy practice. Your pt flow is very important to having a good day. Since the only way you’re going to know whether you could achieve anes on a pt is to actually use it w/o injecting, would you be better off trying the laser on diagnodent readings of 40 or less, or would you want to come in and use the laser for fills on a day off for awhile until you had your act down? I am talking about not bogging down by getting into the middle of something and then going ahead and injecting anyway.
Greg(Edited by greg holm at 9:48 am on Feb. 16, 2003)
Glenn van AsSpectatorHi Greg: I use the laser on areas over 40 in some and on others it isnt possible. I can show you big ones where the patient didnt flinch and others that are small where I had to anesthetize.
One interesting thing that Dr. William Thompson does with his laser is use it in a room not typically used for restorative /endo/ pro procedures.
He will take a patient from hygiene if the lesion is small (under a certain number on the diagnodent….say 40 for instance) and bring them back. He will then proceed to numb up the patient in the other op and as the anesthetic is setting he will do the small restoration in OP#2 .
He also will book doubled up on things like Class 5s and class 4 fractures so that while one patient is numbing up and the rubber dam is going on the next one he is completing the anesthetic free procedure.
Pretty good way of increasing the revenue from this Op.
Patients dont mind either going from hygiene to the Op #2 if they arent going to be numb and in addition get the restoration done without having to come back for a second appointment.
Its a win-win for all parties.
Just an idea……….
Glenn
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