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whitertthSpectatorwhen a patient starts to become alittle uncomfortable what do all of u do? Do u reanaesthetize with the laser? I havent had alot of success doing that ? Do u give local ? do u just decrease power down to 1.5 watts? Do u spoons if possible? Just curious!!!!
whitertthSpectatorMark, Do u think they have good spinach there?
whitertthSpectatorweuse a prophy jet as well and treat anything 20 and over
AnonymousSpectatorRon,
I’ve been defocusing,dropping down about half a watt and bathing (sometimes buccal/lingual, but more often just into prep). I then slowly move into focus. If still sensitive, drop .25-.5 watts more and repeat til comfortable. Ask patient if they want a “shot”-response is usually no. Eventually local if no success. I bet Mark has some tips on this.
AnonymousSpectatorp.s.
As I thought some more about the question, it seemed like this might be a good thread to collect a little info regading pain or sensitivity while prepping and see if there might be a pattern.
So how about giving some input on the following?
Most difficult to anesthetize with the laser-
Patient -male/female/age
Tooth number
Where the beam is aimed, when sensitive – floor of prep/buccal/lingual etc.
focused/defocused
My personal most difficult are- female 13-25/lower second molars. Seems like most often get sensitivity directing beam at floor of prep or distocervically on max. laterals. Cervical box area class II’s also seem to be more problematic (not enough water getting to prep?). I also seem to have more sensitivity when I get inside the focal point-scatter maybe?
What have been your experiences?
GeoffSpectatorAndy, My only experience with lasers has been with Millennium’s PerioLase MVP7 and since the day it arrived after ” laser boot camp ” I shelved my radiosurg and haven’t packed any cord. The bulk of my treatment is C&B and the time saved in not worrying about hemostasis has been welcomed. I take hydrocolloid impressions so tissue retraction is a must. Patients report faster healing and less pain post op. I’ll echo their comments since I’ve also been a patient. ( no relation to hair club for men ad ). Take the plunge and get a PeriioLase Nd:YAG and their unparralled training and support. I’m only an hour away so if want to see the MVP-7 in action give a holler.
whitertthSpectatorfemales, all 2nd molars but usually only when if deeper dentin…usually i am slightly defocussed and still getting discomfort
2thlaserSpectatorNot sure, but a NY trip is in order!!!
Thanks buddy!
Mark
mickey franklSpectatorAre there any dentists who use Cerec and Erbium laser at their practice,and if so how do they complement each other?
jetsfanSpectatorfolluw up on the swelling following mandibular frenectomy:To reiterate
Frenectomy done on Wed of last week. Procedure was uneventful. A few hours after procedure patient reported swelling in the right cheek from TMJ toward neck.
Ice and NSAIDS were recommended. Next day(Thurs) patient still swollen, no worse perhaps somewhat improved. Fri, Still swollen, again, no worse. As I was out of town, I suggested she see an oral surgeon.
I spoke with patient this a.m.(Sunday). She is much improved
very little swelling. Surgeon was unsure of what was actually going on here. Here is what impressed me most….
The oral surgeon asked her about the canker sore in the mandibular anterior region. I hope everyone can appreciate the question. 1.5 days after the frenectomy the healing was so rapid that the surgeon thought she had a small aphthous ulcer.COOL! I am afraid the swelling will remain a mystery, but fortunately it was nothing serious and she healed remarkably fast.
BNelsonSpectatorHi All,
Pretty much the same with me. Get dentinal sensitivity fairly often on max 2nd molars that can be reanesthetized, but often the mand 2nd molars don’t want to calm down and some people request anesthetic.
BNelsonSpectatorI often shape the canal with the Ultradent AET system and finish sterilizing the canals with the Waterlase. Strangely, in two cases lately, after no feeling ( the tooth is anesthetized) when I use the laser 3mm from apex, the patient complains that they feel it and it is uncomfortable. Any ideas why? I assume that if many of you do the entire procedure without anesthetic, this shouldn’t be a problem?
whitertthSpectatorpossible if u have a water delay in your sysem and are firing pure laser energy down the canal they could conceivably feel it..also is your setting set at 1.25 watts with about a 14/8 air water ratio… Shouldnt be any more wattage than that…..anyone else?
AnonymousSpectatorAnyone else?
2thlaserSpectatorI think I would like to ask one more thing. We have found from a psychological standpoint, that we tell the patient they WILL feel something. Cold, air, like an ice cream cone on your tooth. Then they EXPECT a little sensitivity, and when I ask them about it, on a scale of 1-10, I consistently get a “2-3”. They NEVER want the anesthetic. I also, when I enter the dentin, power down to 2.75W, and usually ablate it at that rate. Sometimes even lower wattages if neccessary. BUT don’t forget, I then use my microspoons to finish, and they NEVER feel that. I think that is so cool that it is so comfortable on them.
Like everyone else…usually teenage girls, and sometimes, upper 2nd molars on women.
Mark -
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