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Robert Gregg DDSSpectatorGlenn–
VERY nice case. VERY nice service. VERY nice value for service rendered.
I would have handled it the exact same way….just charged more.:biggrin:
Did I miss something? What is EMLA?
Bob
PatricioSpectatorGlen,
I have not done a fibroma but your work gives me confidence and a vision of what to expect. Thanks.
Pat
PatricioSpectatorGlenn,
In my own case I went from 2.0 to 3.5 mag. and fully understand what you are saying. Until you can watch it cut you cann’t optimize the cutting. For me there has been a learning curve to get the light, the scopes and the patient all at optimum distance while working. I am still having a hard time with upper teeth working in a mirror which frequently had water on it. Any suggetions for improving mirror vision. The assistant is spraying air but with other things to attend to we have periods of poor vision or obstructed vision with suction etc. Based upon your experience I imagine I will want something grander as I go forward.
Pat
Janet CenturySpectatorHi All (and especially Mark)
I was wondering if you could post step by step what you do to “anesthetize” the tooth. I was doing really well at first, but it seems lately that I have been having more people feel the laser – primarily with class I’s.
I have been starting with the enamel setting, defocused (about 8-10mm away) for 60 seconds. (25 Hz, 220 mj). Does it matter if you start bringing it towards the tooth too early? Any other tips would be appreciated, especially from other DELight users. Oh and I did just check the calibration.
Thanks!
Janet
2thlaserSpectatorPat, 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
Janet CenturySpectatorRon – how about an update. Have you continued advertising in the local paper, and have new patients kept up? We met last night with our local newspaper and will start placing ads after the new year starts. Any tips?
Thanks
Janet
2thlaserSpectatorJanet,
If you go to the General Erbium disscusion, there is a 3 page thread there on anesthesia, that Pat started. Let me know if it helps, Glenn can help you much better with the Continuum, the Waterlase is a bit different, but the basics SHOULD be the same.
Mark
AnonymousSpectatorJanet,
I actually only ran the ad 1x/week for 4 weeks.
We were busy before doing so, but were getting swamped afterwards. We averaged about 3 np calling to schedule each day while running the ad and now w/o the ad 1np/day.Word of mouth is powerful and all we can handle right now. So no more ads for awhile.
As far as the ad, get Howie Horricks books ,or Rod Kurthy’s new one which I think are available thru http://newpatientsinc.com/. The best thing about these is that they get you focused on patients emotions and what they’ll react to as opposed to whether or not you can do a composite. I ran my ideas past Rod who was nice enough to offer feedback on my ideas (thanks again ,Rod). I’m no expert but will do the same for others here. My ad turned out to be 1 picture, 2 bold print lines and four short text lines (besides name ,location, etc.)
I have a preliminary copy of the ad (which is copyrighted) online and regular posters here can email me if they’d like to see it. I won’t post it for lurkers as I’ve gotten too many email requests from people who don’t want to do any work, but rather just copy it.Good Luck with the marketing,
p.s. Mark,just read the post about naming your practice. Great name. One of the things I ran past Rod was a new name for the practice. Last August I decided on Midwest Center for Laser Dentistry and its taken til last Thursday to get the state to approve my PLLC restatement papers. I’ve also got a great online place for logo development , mine should be done in the next couple days. Very reasonable- 跾 for logo, and business package including letterhead. The next to final logo can be seen at the new website I’m developing. I’ll email that to regular posters if they’re interested also.
SwpmnSpectatorGlenn:
Great case and excellent service.
Bob:
EMLA is Eutectic Mixture of Local Anesthetic. Specifically it is a mixture of lidocaine and prilocaine developed to topically anesthetize the epidermis. EMLA is also the world’s greatest dental topical anesthetic.
Marketed by AstraZeneca International:
http://www.astrazeneca.com/mainnav1/s_products/s_ptherapy/s_pain/c_pain/emla.html
Al
PatricioSpectatorMark,
I had two fibers which were damaged early which Biolase returned to me repaired at no cost. No over night waiting for me now. Most dentists have redundent systems for various equipment and I wonder what the issues will be for the one laser.The technical people are very good and responsive but to fly into the bush requires a little planning and lead time. If I need a tech it will be at least two to three days from my call based upon experience. I have had to reschedule patients already and eventually most patients will come to expect laser care and want to wait if possible. In my own case I have open times during the week where I can shift people when necessary to keep production up.
I am going to think about the idea of a name change reflecting the laser. Right now I am marketing the laser through the media. The TV station is coming in tomorrow for the third time this year. They call us. We are having our annual Christmas charity day tomorrow. The have filmed the laser in action and our Rembrandt whitening program.
I expect two or three other offices in my community will have lasers in the future and we could all end up with laser center in our signage. Our wonderful service to our patients is our real advantage.
I had a gentleman today who had tooth #25 waving in the wind. It was very painful and had some swelling of the tissue on the lingual. There was no bone support.
I began with the laser at 1.50W preset and numbed the tooth as usual and then began to work the tissue around the root away from the root. I found I could only go so far down and then my vision and efficiency seem to peter out. He could feel no pain upon deflecting the tooth at that point but when I began to extract the tooth it hurt. So we got out the needle and proceeded. I wonder if I had defocused over the apex for a time it this would have made a difference? What do you guys think?
Pat
SwpmnSpectatorGlenn:
No doubt. I’m convinced that magnification is absolutely essential to ablation of tooth structure with the Erbium laser. I use Designs for Vision 2.5 loupes with headlamp and probably will eventually upgrade to higher mag loupes.
Does the Continuum laser have optic illumination? I looked at the Cavilase by ADT and thought that the general idea of the 45 degree beam(vs. 90) with light illumination and offset water spray was fantastic for improving vision. Would like to see Biolase upgrade the handpiece with the same features the now dying Cavilase presented.
What do you think or did you get a chance to see the Cavilase concept? What is the beam angle from the handpiece with the Continuum as I know nothing about your laser. I know you have mentioned there are two handpieces, one straight and one contra-angled I think?
Al
SwpmnSpectatorRon:
Great pics and wonderful use of your laser to benefit the patient!
I often find that even with implant healing abutments as soon as I remove them the tissue collapses over the implants and makes it tough to get clear impression. I’ve discussed the issue with periodontists and some suggested using a 4mm biopsy punch. I’m scared to use the radiosurge unit although I have done it on occasion with no failures.
Here is a case where I used the Biolase Waterlase to remove redundant tissue around four implants for an overdenture.
Al
P.S. What a fantastic shade blend with your implant crown!!!!!!!!![img]https://www.laserdentistryforum.com/attachments/upload/wiliamsa05.JPG[/img][img]https://www.laserdentistryforum.com/attachments/upload/williamsa06.JPG[/img]
whitertthSpectatorThanks for the nice words…. Nice case u posted. what size r u posting your pictures ? I am stll having problems with this on the site?
Glenn van AsSpectatorHi Allen……..great to see people with an open mind……..
One of the handpieces is exactly like the biolase.
The other looks like a pen and is straight and this is the one I use because it gets the head out of the way so I can see.
There is a white aiming beam on the Erbium and the tips come in Straight, 30 degrees, and 80 degree bends and the tips come in 400 and 600 microns wide and they are making all sorts of new tips all the time (like the chisel shaped tip I am using for flaps and the endo tips.)
Here is a picture of the delivery system……..does this help at all.
Glenn
PatricioSpectatorJanet,
We discussed marketing at our staff meeting yesterday and concluded from our tracking that in our case we are receiving new patients from several directions including direct advertizing as Ron is doing, the phone book, word of mouth from satisfied patients, articles about our practice in the paper etc. We concluded that we are mostly trying to keep our name in the top two or three in peoples minds so when they are ready the may well think of us. This week a lady called who found us in the phone book. She had seen a piece some time ago on TV but could not recall our name until she looked in the phone book. So far with the newspaper ads I can easily say they pay for themselves in immediate response but we have not had Rons new patient numbers. Also we are not looking for new patients as such but people with certain demographic including the ability to pay for comprehensive care. I would be hapy with two or three of those a month.
Pat
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