A novice looking for suggestions

[moguldoc]

Hi, I’ve owned a waterlase for just over a year and have been lurking on this website for quite some time. I’ve been trying to work out the techniques and indications for laser vs bur/scalpel dentistry. Other than an occasional classI or class II lesion and some gingival curretage, I haven’t been using it much. Its a pretty expensive piece of equipment to own and maintain. Is it appropriate in this forum to ask about codes and fees? When you use the waterlase for 15 seconds in a 6 mm pocket, is it really flap surgery and does it really reduce the pocket? Sometimes I think that my electrosurge would do the same thing. Any suggestions?

[Glenn van As]

David: I dont own the waterlase but the competitor DeLight laser.

I use it for quite a few things daily including restorative preps (Class 1 through 5) , Alot of soft tissue work, endo (bacterial disinfection, and bone work.

I have a couple of questions for you first.

Have you taken any trainig courses.

Have you taken a standard proficiency course or similar thing from the ALD or WCLI

What kind of practice do you have.

Have you read any books or viewed any DVDs.

I want to tell you that you will need training (ie Mark Colonna/Bob Barr, Ron Kaminer, or someone like that).

Next off I would strongly encourage you to take either a course in basic laser physics and science. It will help you alot understand what can and cant work.

I will say that it is probably not a great thing to stick an erbium laser in a pocket. You cant bill for it and more importantly there is NO evidence to show you that this will help with pocket reduction therapy like an Nd:YAG (Periolase MVP 7) will help.

I think we need to know a little bit more about you, your practice and what you have done to find out about training with the Waterlase.

SIncerely,

Glenn van As

PS try reading other threads on this website. I really think you need some training by an expert to see the possibilities of what you can do…….

Oh ya the van As question.

What power loupes do you have now.

Cya

Glenn

[Swpmn]

Dr. Fried:

Is it appropriate in this forum to ask about codes and fees?
Absolutely. I don’t use the erbium laser for treatment of periodontitis so have no knowledge of appropriate coding.

When you use the waterlase for 15 seconds in a 6 mm pocket, is it really flap surgery and does it really reduce the pocket?
No, it is NOT flap surgery. Initial trials I ran using manufacturer recommended protocols to treat periodontitis showed no improvement in periodontal indices(these were old recommendations from 2001).

Sometimes I think that my electrosurge would do the same thing.
You are probably right. In fact, with heat applied along the length of an electrosurge tip rather than just the end, could be you would see disinfection of the pocket and some initial improvement in periodontal indices.

I think the erbium laser is best used for hard and soft tissue surgery like composite preparation/removal, reduction of bone in open flap procedures, troughing around broken down teeth to facilitate extractions, frenectomies and biopsies of fibromas. Also works pretty good to obtund the discomfort of apthous ulcers.

Al

[Glenn van As]

Great minds think alike Allen, I agree with EVERYTHING you said in your post…….

Heck you must have absorbed a ton of osmosis from me in that fleeting moment where you hugged me in your avatar photo!!

GRIN……

Wait , maybe I absorbed it from you………..no it couldnt be, I still never have a date when I go to dinner. You usually bring TWO!!

Glenn

PS I changed my DT avatar…..you happy now??

Grin

[cerecdoc]

One suggestion I see I could make is in the realm of dentures. Instead of adjusting the denture, you have the opportunity to adjust the patient. Using the “alveoloplasty” codes and the “vestibuloplasty and frenectomy” codes is both ethical and appropriate in this area of practice.

[Anonymous]

QUOTE

Quote: from cerecdoc on 11:21 am on Feb. 5, 2006
One suggestion I see I could make is in the realm of dentures.  Instead of adjusting the denture, you have the opportunity to adjust the patient.  Using the “alveoloplasty” codes and the “vestibuloplasty and frenectomy” codes is both ethical and appropriate in this area of practice.

How is ‘adjusting the patient’ when you could adjust the denture ethical? :confused: :confused:

[cerecdoc]

When adjusting the patient will give you a better fitting denture, with better retention than whittling on the denture would give. Otherwise those alveoloplasty codes would not be there.

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