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  • #3392 Reply

    dkimmel
    Spectator

    Today alone was worth every cent I paid for my laser. Not because it made me any &#36 but for the smile I got in return.
    We have this 6 Y/O that is the greatest kid. Always up and comes in with a run of jokes that would put any standup to  shame. We love him and he is just one of those special patients we all have.
    His mom calls us at the end of the day. The kid is just miserable. He can not eat ,drink or talk! Just foundout he has mono. On top of that his mouth is full of sores and his lip also has a sore.
    The kid comes in and he is life less. He has a herpatic lip that hurts to look at . His mouth has so many small apthus ulcers, I don’t see how he is dealing with it!
    We jump in and treat the apthus ulcers. The kid cannot believe it. He starts showing us all of them to make sure we don’t miss a one. Then we do the lip.
    The kids eyes are bright again and he has one of the best smiles I have ever seen on a kid. His mouth no longer hurts.
    Sometimes its great to do what we can do!
    David

    (Edited by dkimmel at 9:22 pm on May 1, 2003)

    #10822 Reply

    ASI
    Spectator

    How wonderful! He is lucky to have a dentist with a laser like you.

    Andrew

    #10825 Reply

    Andrew Satlin
    Spectator

    Hi David ,
    I know it has been discussed before but could you be more specific about how you treated the ulcers. Time, Settings etc.
    thanks,
    Andy

    #10820 Reply

    dkimmel
    Spectator

    Andy. The apthous ulcers were with .25 W with 11% air and no water. Just painting the surface coming from a defoused distance until I just get that whitish covering.
    The herpatic lesion was .25W with 11%air and just enough water to make a mist and not droplets. I cannot remember off hand the setting for the water. Usually I do not use the water on herpatic outbreaks. In this case he had older lesions that were scabed and prevesical areas. If I used the 25W with 11% air he would get a little pin prick feeling, which scared him. With the water and coming from a defocused length in to paint he felt nothing.
    I will say I was rather concerned about treating the herpatic leason because of the possible plume. Hopefully the water helped control this as well as the vaccum. Along those lines what are others doing as percations in dealing with these times of leasons?
    David

    #10823 Reply

    Robert Gregg DDS
    Spectator

    Hey Andy,

    100 usec, 3.00 watts, 20 hz, defocused, 100 joules/mm diameter lesion for your pulsed Nd:YAG.

    No concern regarding plume since no vaporization is taking place. Still, high volume evacuation helps keeps the site cool. No requirement for H2O. Air is sufficient.

    (Edited by Robert Gregg DDS at 9:36 am on May 2, 2003)

    #10821 Reply

    dkimmel
    Spectator

    Bob, Got to play with the laser this morning. The wife had a herpatic lesion pop up this morning. I played with the air and the water remembering what you said about no need for water.
    Using the water stops all discomfort. The discomfort my wife felt was along the lines of a jellyfish sting. She could deal with it but could see why a kid would not. Increasing the air from 11% helped but 20% air and no water was better.
    Now for the kicker! A key word you used in your reply! DEFOCUSED!!! Gee, Stayed with the .25 W 11%A and no water started out at 20mm painting and working my way in. No discomfort!
    Once you pickup the handpeice it is a reflex to just try and go at it. Defocusing and working your way in I believe is key to most laser work. Just got to remember to do it everytime!!!!
    Isn’t it great to have family to learn on!!smile.gif
    David
    David

    #10824 Reply

    Robert Gregg DDS
    Spectator

    Excellent David–

    Defocused is the key and working your way in–as is the air to cool.

    Glad it worked for you and your wife. Thanks for posting that.

    Bob

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