Geographic tongue - Laser Dentistry Forum

This topic is empty.

Viewing 15 posts - 1 through 15 (of 15 total)

Author

Posts
June 19, 2003 at 1:20 am #3326 Reply

dkimmel
Spectator

Just got done using family as test subjects. 12 y/o niece with recurrent geographic tongue. Very painful. Just caught her out break at the beginning stages. Did .25 W with 11% a and no water. Just painted the tongue in a defoused mode. Did not even get the whitish painting of the tissue. The pain is gone! One happy kid.
Preop

Post op

David

(Edited by dkimmel at 9:21 pm on June 18, 2003)

(Edited by dkimmel at 9:22 pm on June 18, 2003)

(Edited by dkimmel at 9:23 pm on June 18, 2003)

June 19, 2003 at 2:49 am #10239 Reply

Swpmn
Spectator

Hmmm. Good idea, never thought of geographic tongue.

How far were you defocused? 5mm?

Al

June 19, 2003 at 3:41 am #10237 Reply

ASI
Spectator

Hi David and Al,

Good application for geographic tongue. I suppose this will apply to most cases of stomatitis.

How long did you paint the area for?

Thanks for sharing.

Andrew

June 19, 2003 at 5:28 pm #10230 Reply

dkimmel
Spectator

I stayed about 5 mm from the tissue. I just continued to paint the area until she said she felt better. Just a few sec. I had planned to coat the area like a apthus ulcer.
At 24 hrs she was better but other areas popped up. Plan on retreating several times. This last time I treated it just like an apthus ulcer on the major areas.
The photos are 24 hr post op.

David

June 20, 2003 at 2:17 am #10229 Reply

Anonymous
Guest

David,

I’ve been reading some on Biostim and it seems many wavelengths activate a cellular response at about 100 seconds Tx time (also interesting considering Mark C’s and others using 90-120 seconds to ‘anesthetize’ teeth) . Maybe next treatment, time the procedure and see if pain relief coincides w/ about 100 seconds. I’d also think about biostimming the other areas to see if it stops further erruptions.

Be interesting to see what happens.

June 20, 2003 at 3:01 am #10231 Reply

dkimmel
Spectator

Great Idea Ron. Talked with her tonight. Better by far but now her discomfort is futher back. I’ll give it a try.
What/Who are you reading on Biostim?
I hate quoting articles! I have a tough time remembering names etc. I remember the important stuff and move on. Looks like this will be something in my past. Starting to get some local flak about using the laser. Wondering if we could start a thread that just list articles that were of relevance. Seems like it could be a good idea. If there is already a spot on the board like this, forgive me a point me in the right direction!
DAvid

June 26, 2003 at 10:31 pm #10232 Reply

dkimmel
Spectator

Ron,
I gave your ideal a try. Much better.
However, this is not an ideal Tx. It can be a nightmare if you treated patients with this technique.
There is relief. The outbreak is much smaller.
It is that the lesion is so diffuse and the tongue has a lot of surface area. Relief is 100% for about 6 hours max and then slowly comes back. When it comes back so does the patient!!! The patients deal with the pain but when they find they can get relief ,they don’t want to deal with it. I’ve been down to the office afterhours a bunch of late. Makes the kid smile!!
I sort of expected this result. Since we are only treating symptoms.
David

June 26, 2003 at 11:58 pm #10226 Reply

Anonymous
Guest

QUOTE

Quote: from dkimmel on 11:01 pm on June 19, 2003

What/Who are you reading on Biostim?
I hate quoting articles! I have a tough time remembering names etc. I remember the important stuff and move on. Looks like this will be something in my past. Starting to get some local flak about using the laser. Wondering if we could start a thread that just list articles that were of relevance. Seems like it could be a good idea. If there is already a spot on the board like this, forgive me a point me in the right direction!
DAvid

There wasn’t a ‘spot’ but there is now (see main page). Great Idea! Thanks for the suggestion.

Just to keep the biostim discussion going, have you thought of using your diode w/ the whitening wand to biostim and cover a greater surface area? Anyone doing this, or have any thoughts/ parameters on this (other than hack2 :biggrin: ) ?

June 27, 2003 at 2:22 am #10233 Reply

dkimmel
Spectator

Ron, Thanks for making a spot . Should turn into a great place to quickly find relevant article. Maybe we can get hack2 to post a few of his!!
I have used the wand with the laser for some TMD patients. Thought about it with the tongue. Pretty tough getting back in the posterior regions .
David

June 27, 2003 at 3:39 pm #10234 Reply

dkimmel
Spectator

Ron, So smart you are! Used the wand with the Lasersmile. 5W 15 sec. continous. Results maybe be better then with the Waterlase. Bit tough in the posterior but much faster and no water.
We are on day 10 and it has almosted cleared up. In the past she would have been full blown and looking at a month to get to this point!
David

(Edited by dkimmel at 11:41 am on June 27, 2003)

June 27, 2003 at 4:00 pm #10227 Reply

Anonymous
Guest

Ok David, now I’m going to do what Bob Gregg 😉 used to do to me when the board first started.

Why did you use the settings and times you used , and how did you arrive at them? Why that time? Why continous as opposed to pulsed?

Don’t in any way take this as me trying to be difficult, but one of the great things Bob Gregg taught me was that, as a laser user, you better have good reasons to do what you did and be able to defend them (witness the hack2, rfw, azoperio posts on DT). The other reason for the question is I’m still learning and like to see how people arrive at the treatments they do.

Glad the suggestion appears to be useful,

June 27, 2003 at 9:15 pm #10235 Reply

dkimmel
Spectator

Ron, You got me! I just pushed the buttons and fired her up. Lased away.

As I said before I am real bad with articles. Somewhere I picked up using the Diode at half the Watts(5W) in the bleaching mode for 15 sec. It sounded pretty good but I did the math. Came up with a dose of .15 J/cm2. This is seemed a rather low value . If you use a 1 J/cm2 as max. Since less is better, I fiqured I could retreat.
The patients feedback after treatment determined if retreating was indicated. None was. She could feel the decrease in swelling rather quickly. At first I though I was numbing the area, but 6 hours later to still have no pain is not form numbing.
Continous vs pulsed? I really can not justify why I did not us pulsed. Most of what I had read was with continious! Any thoughts on using pulsed over continous.
Bob is right and so is hach2. Looks like I need to have my ducks in a row.

Speaking of ducks.
How are you writing up your charts. Are you giving specfic settings that you are using? Indicating the estimated dose given?
David

(Edited by dkimmel at 5:19 pm on June 27, 2003)

June 27, 2003 at 10:05 pm #10228 Reply

Anonymous
Guest

QUOTE

Quote: from dkimmel on 5:15 pm on June 27, 2003

The patients feedback after treatment determined if retreating was indicated. None was. She could feel the decrease in swelling rather quickly. At first I though I was numbing the area, but 6 hours later to still have no pain is not form numbing.
Continous vs pulsed? I really can not justify why I did not us pulsed. Most of what I had read was with continious! Any thoughts on using pulsed over continous.

How are you writing up your charts. Are you giving specfic settings that you are using? Indicating the estimated dose given?
David

(Edited by dkimmel at 5:19 pm on June 27, 2003)

David,

As I understand it (any experts feel free to jump in and correct me ), the dose is more important than pulsed vs. continous. Low pulse rates seem to give better results than high rates (T. Karu book).

Did your patient feel any thermal effect? I know that, one of the things Del told me about using the nd:YAg to treat a sprain, was to get a thermal effect w/o causing pain. Was your patient’s relief, before or after feeling a thermal effect (if she did)? Just curious.

As far as notes go-

I’d enter the following e.g for troughing
Diode 1.0CW PEW (CW = continous wave, PEW= protective eye wear)
If it was biostim I’d include time and whether it was the fiber or the whitening attachment .

One of the great things about the Periolase MVP 7 (nd:YAG) is that the machine records Joules and can print it out w/ the operator and patient name on it- really cuts down on chart entry. Just one of those things that Bob and Del knew to include because they actually use the laser they designed (wish the Waterlase and Lasersmile did the same).

June 27, 2003 at 11:33 pm #10236 Reply

dkimmel
Spectator

Ron,
She felt better after the thermal affect.
Bob and Del are really starting to tick me off!! Why did they not go to DentalTown in Vegas. I hope they make it next year.
I am finding that keeping great records are a must with the use of the laser. You tend to get a few more of the dental delights then usual. I had one the other day. We worked on tooth#2. Four days later she has a numbness feeling on her lower lip. She wants to see me right away as she has had a bad reaction to the laser. The bad reaction was that she has been chewing on her lower lip. She is wound rather tight! Just reinforced the need to document!
David

June 29, 2003 at 2:11 am #10238 Reply

Anonymous
Inactive

Sorry we didn’t get to you first David. Wish we could be more places at once to share. Yesterday we had three places to be at once and so Bob’s family suffered because he was doing training. Don’t get me wrong – we truly love what we’re doing – but it does come with a price. We do feel it is worth it though.
Author

Posts

Viewing 15 posts - 1 through 15 (of 15 total)