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Glenn van AsSpectatorThanks Mark……..worked half a day today and am exhausted so its gonna take time.
Kids are much easier to work on , and I use ONE TOUCH topical made by Hagar and distributed by Patterson as it has two active ingredients ( tetracaine hydrochoride ( longer lasting around 30 mins) and benzocaine (shorter acting).
Its cherry flavoured (pink in color) and really numbs up the gums for rubber dam , matrices etc………
That and telling kids ,
“this is the worst part, if you can stand this you wont need a SHOT……”
Both seem to help and most things on kids can get done without anesthetic.
Glenn
Glenn van AsSpectatorI just ordered mine Bob………if you recommend it , then it must be ordered.
Glenn
Glenn van AsSpectatorRon ……….I am presently mentoring 2 people so I can help out to if you want.
Glenn
Glenn van AsSpectatorHi Mark: My unit is one of the first Continuum units and has water and air into the laser, with a filter pack.
Now they have the same distilled water system available and you can put warm water in the unit.
I havent got that luxury but could order the water bottle. I might do so but let me think about it for a while.
By the time I get around to it , it will be June and the weather will be warm…….
Good point though- as usual.
Glenn
PatricioSpectatorGlenn,
Your photos are very useful to me to confirm what I have been doing as to prep shape, decay removal and banding. Your suggestion of preping with band in place moves me one more step forward. For a guy who is not feeling well you sure do good work. Thanks.Pat
SwpmnSpectatorNice cases Glenn!
Thursday I extracted tooth number “I” on a seven year old and used EMLA topical for palatal injection. Kid didn’t even flinch.
We then placed a Class II DO composite on tooth number “B” using the laser with no local anesthetic and no EMLA. Just used an old Mylar strip with a wedge and got a good contact but good ideas regarding the metal matrix.
Al
AnonymousParticipantThanks Glenn,
Exactly what does the mentor do?
AnonymousParticipantMark,
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?
Glenn van AsSpectatorThanks Allen, just something to try and keep in your mind. The laser users get some idea looking at the photos to see how one person does it and it hopefully gives them confidence that they are doing things along the same line.
This group is good because we talk less about the importance of our machines and more about the nuances of technique.
Its a good group and I for one feel privileged to present ANY ideas to you.
You all are always complimentary and yet you ask good questions which in turn make me a better dentist.
I wonder if EMLA is available in Canada.
Hey as an aside I have started trying to use my endo tips for periodontal abscesses and pericoronitis as the water flushing out and the tiny size of the fibers really has given me good results. I use 30 Hz and 30-50 mj and sometimes I wonder if it is working cuz I only see water but if I put the tip next to tissue I get that tell tale white spot.
ALmost all the patients have improved right away after doing the laser for 30-45 secs.
Any other people doing this…….
PS here is a link to some pics of a pericoronitis case.
Nothing earth shattering but just to give you some thoughts….
http://www.sendpix.com/albums/021209/191130000002e6064a411659683a88/
Glenn
Glenn van AsSpectatorPS Bob I know an Nd:Yag would be idea, without fear of wrecking tooth, cementum or bone.
I like the erbium yag because the combo of the water and the fast pulse rate (like an NdYag) allows me to put this tiny 200-300 micron fiber in the pocket and not very often do I need anesthetic. Patients like that and its not to possible with my Argon or Diode in CW.
Glenn
Glenn van AsSpectatorHe just provides you with some help in getting through it.
The thing that people screw up on most is a couple of things
1. Degree of difficulty is determined as follows
Simple- One procedure on one tooth. (ie Class V on a premolar)
Moderate – two procedures on one tooth (ie Class V with soft tissue removal on one tooth)
Difficult – multiple procedures on multiple sites.Ie- Class Vs ( 2 or three of them in the maxillary anterior with a frenectomy at the same appointment and the Class V have soft tissue and one is an old composite).
Osseous recontouring and decay removal around 2-3 teeth is also difficult.
YOu have to have 5 cases and you need to have a mixture of stuff. Ideally 2 difficult , 2 moderate and 1 simple.
The cases have to be written up in the long format used in wavelengths that follows the Clinical Case Guidelines.
The most common thing is people dont have proper follow up on their cases
ie Preop, during procedure and then Immediate postop.
3 day or 7 day postop. 2 week postop. one month postop. 3 months minimum postop and even longer is better.This is why a ton fail and then they dont organize their two best into oral format and these must be completed in 30 mins or less ( I did mine in powerpoint) and they need to have all five cases in a binder typed out neatly etc with all the photos……….
Just to give you some idea of what is involved.
Glenn
whitertthSpectatoreven though I have been using lasers for 12 years. I never took any proficiency exam or joined an organization.. Not to offend anyone I found that most of the old ALD stuff was very political and alot fo BS…. Is everyone here a member of the ALD? Do i really need a proficiency course for any reason…..Thanks for replying
Glenn van AsSpectatorHi Ron: I think it is something that you can show in case anything god forbid goes wrong is that you did get the standard level. Most of the newer laser companies now provide standard level proficiency as part of the buying price.
I would for one take a course by a company just to say you have it.
Just my two cents worth.
Glenn
2thlaserSpectatorHi Ron,
Actually now that you mention it, it does seem that way. I DO know that patient comfort is a bit more steady, in that the warmer water is more “gentle” to the dentinal tubules. Let’s face it, when we blow air on a cut tooth, it’s sensitive anyway, add water, cold at that, and more sensation, mix the laser energy in, it lessens, BUT warm water helps. Another thing would be to warm the air, but I don’t have a clue how they could do that. Interesting observations huh?
On another note, Glenn, how are you feeling?
Mark
2thlaserSpectatorI have no picture for this, BUT, when I have trouble removing temporaries, I have used the laser to remove them quite easily. I started doing this on of all people, my wife! She said it was great, no sensations whatsoever. I had a darn time removing it, this newer material and cement really attaches itself, so I just lased it in half, and using an instrument, popped it off. Anyone else ever try this? If so, how did it go for you?
Mark -
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