Sick kid and the laser.

[ASI]

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

Andrew

[Andrew Satlin]

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

[dkimmel]

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

[Robert Gregg DDS]

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)

[dkimmel]

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!!
David
David

[Robert Gregg DDS]

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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