have u been properly trained. Some units need maintenance and a contract is important but you must be trained properly. Try to attend either our training course in NY or Barr/ Colona or any other training courses and then see how your laser cuts. where r u located?

Several factors come to mind when discussing poor cutting ability

1. As Ron said……you must have clinical training
2. You must have higher than average magnification. A minimum of 4.5X has been suggested. 6.0X is better. A scope is best
3. You should have your machine inspected to see if it is working properly. Is the handpiece and mirrors ok. Is the fiber ok.

There are alot of factors including expectations (its not ever going to be as fast as a handpiece) that affect performance, and I would suggest that if you want to make a concerted effort to use the laser more that you include the above mentioned variables when attempting to conquer the learning curve regardless of laser brand.

Sincerely,

Glenn

Hi Glenn
Concerning your question on Joule, hope this helps:

E=P x t (where E-energy, P-power and t-time)

Where: 1Joule = 1watt/second x 1 second

PRR= 1/ôpd (where PRR-pulse repetition rate, ôpd – pulse delay)

Or PRR= 1 / ôp + ôpp (where PRR-pulse repetition rate,
ôp – pulse duration, ôpp – period between pulses)

And Pavg = Ep x PRR (where Pavg- average power, Ep – pulse energy, PRR – pulse repetition rate)

Take care
Etienne

Good topic, Ron. I’ve often wondered the same thing.

Anecdotally, I’ve tried with and without on contralateral teeth with identical lesions and found a marked difference between the two. The side without the pretreatment is ALWAYS more sensitive to the patient. I can’t explain it.

However, that said, I’ve also found that I am much more relaxed when I give a little anesthetic and not worry about the patient jumping. Most of my patients really don’t mind being “a little numb” and we both can relax.

I know that’s heresy around laser guys, but I don’t mind. I usually hear a different beat anyway …

Excellent Don,
Try 10hz and let us know…don’t use any laser anagesia, around 2 w of power….

Mark

JKline, I doubt you’ll get any hate mail. Most here are pretty nice folks who are probably confused why you’ve had such a miserable experience with the DELight.

Have you had it checked out? I was having really crappy results when I first started (ask anyone on this board — they endured my tirades!) and it turned out that the laser wasn’t working properly. Once replaced, I’ve been quite pleased.

As I’ve posted here and on DentalTown, I’ve begun to use anesthetic more and more … I’ve begun to separate reality from hype and am more confident knowing what I can and can’t do with it comfortably.

If your laser’s working OK, I would imagine that somebody will be happy to take your dust collector off your hands. Heck, I might even oblige you …

If you’ve truly given up, I’m sorry for you. I think you’re missing out on some really good stuff for your patients. However, I also know that most of what I do with the laser can also be done faster with the drill. If you decide to give it another go, I’m sure many here on LDF will be happy to help in any way they can.

Good luck.

— Don

Ron K:

When we speak of “Laser Analgesia” let me suggest that we make sure to qualify that on this thread we are referring to erbium wavelengths in the 2780-2940nm range. There could be something to laser analgesia with other wavelengths and I’m thinking of the pulsed Nd:YAG. Just my opinion, but to me it never made much physics sense that a wavelength which will be immediately absorbed on the tooth surface could provide any sort of analgesia to the pulp.

Getting that out of the way, I personally had poor clinical success with erbium laser pre-treatment analgesia. Like you say it began to appear that my success rate was similar whether or not I used the pre-operative, defocused bathing with the erbium. My clinical findings seemed to support what I had been taught from laser physics.

So, I began to experiment with different energy/Hz setttings and found that with my 2940nm erbium, 10Hz rep rate with 175-225 mJoules energy seemed to give good success. Under magnification, the setting ablated efficiently and by learning to keep the focal point moving across the treatment site, patients appeared to feel little or nothing. Combining this with careful selection of patient, tooth and lesion has allowed me to finally achieve a 90% success rate on the patients and teeth which I CHOOSE to treat in this manner. Now I’m not saying I have a 90% success rate with all patients requiring composite restorations. Many times I combine chemical anesthesia with erbium laser preparation and my patients greatly appreciate reduction in use of the high speed/slow speed handpiece.

Al