I have had my DELight laser for about a month and have experienced your level of frustration, so belive me when I say that I understand. The learning curve is a definite hurdle, many times I found myself wondering if I  had made a wise decision to buy it.  

Now, I am achieving pulpal analgesia, using it for simple operative procedures and I make myself use the laser every chance that I get. I can say the lately I have been practicing “painless” dentistry, the patients love it and I am getting better at using it and deciding when to use it.
Now if I can just master that pesky troughing around my crown preps I think my assistant would adore me more than she does now.

Pam Robinson
Las Vegas, NV

Glenn,

Thanks for sharing your insight and experience.

I am using magnification but only 2.5x loupes… for now. I am enjoying learning how to use the laser and so far the patients don’t mind the extra time or increase in fee for the procedures.

I did take the LVI course last november and I am sure another won’t hurt.

I WHOLEHEARTEDLY agree with Glenn on the magnifcation issue. 2.5x is NOT enough, seriously. You will see your success rate skyrocket with higher magnification. Pam, RUN don’t walk to Glenn’s course, it’ll be worth its rate in more gold than you can count. I am totally serious! Good luck, and keep asking questions…..

Mark

Marc,
Let me just say I performed a pulpotomy on a child today, no anesthetic, Waterlase MD…the soft tissue settings are excellent. Sorry you went to Buffalo, (Just kidding)…anyhow, as far as magnification, I use Designs for Vision 6.0x, most laser users are using 4.5x-6.0x and /0r a operating microscope. I hope to have my scope later this month. I see no reason, pedo or not, (Glenn, chime in please) to use higher magnification. It is ESSENTIAL for efficient laser useage. Understand another thing about the MD…it’s new, and yes, there are always “things” about new products, that being said, Biolase DOES STAND behind their product. I do get paid honorariums from them, so I disclose that, BUT it IS an excellent product, and David Kimmel, who is on this board, has both, you might want to ask his opinion as well…he is as honest as they come.

IF you get the MD, we have our training courses often, just email lisa@waterlasetraining.com for the schedule. IF you get the Hoya, DON’T BE TRAINED BY ANYONE OTHER THAN GLENN! Period! He is truly the best in our field with the Hoya laser.

I have trained many a pedodontist, and we cover extensively how to use the Waterlase and Waterlase MD on both hard and soft tissues….You can, again, email lisa for that information if you need to…Good luck!

Mark

Hi Marc: First off a very good friend of mine is Larry Kotlow who is a pediatric dentist using the Hoya Con Bio DeLight for a LONG time in Albany New York so look him up if you can. He also uses a scope and he told me he didnt think he would be able to use the scope with kids but was shocked at how still the kids hold with the scope. I have alot of pedo in my practice and the kids are wonderful with the scope and DeLight laser.

As for the bleeding……..let me show you a case I did yesterday removing a soft tissue frenectomy that was snipped on this adult when he was but a wee lad!!

It was still sitting in the diastema and was creating some problems……..note no bleeding and I post this because so many are talking about how one laser does so much more soft tissue without bleeding than another.

Just food for thought.

Glenn

Marc, when are you getting certified?

You don’t want to try the tricaine Blue? Ibet it is better than dark liquid.

Glenn, what laser was that with? settings? time of treatment? and fee?

(Edited by sultan of smiles at 5:34 am on Feb. 4, 2005)

Hi Alan

I have had my laser almost 2 years now and had gone through some similar frustrations as you did. It did take some time but now I am able to treat with the Er without much difficulty. I still pick up the anesthetic for some patients as I just know they are not going to tolerate any sensation. And in some cases the enamal is very tough to get through but there are techniques. As to your original post:

“”the kid is 11, huge cavity (DOL) on a 75 (retained, no premolar)…after trying to treat him with the laser at 25Hz/255mj, with laser analgesia , i had to lower it to 200mj, then to 175 and gave up …needle and drill…50 mins for this treatment…””

Those settings are pretty high to begin with. 6.37 watts is a lot to be using on a huge cavity, especially if you are just removing caries. It is best to start low and go higher rather than high and then turn it down.

I have had great success in cases like you described above by starting at 20hz/70mj (1.4W) then scaling up to 20hz/170mj (3.4W). I always place topical around the gingivae to allow for matrix placement also. I will also use a hand held rotary, and round burr and spoons to remove bulk decay.

Some things you might want to look at as far as your laser goes, if you are not already.

– check the air pressure on the back of the unit is about 25-30

– get a measuring cup and timer set for 1 min and get your water flow to about 12-14ml / min. ( on my unit it is 3/4 turn counterclockwise for air and 2 turns counterclockwise for water – but every unit is different so check yours.)

– check that the tip is clear and transmitting light well. ( i hold mine towards my view box and look under magnification – (I polish mine up with brassler porc. discs if they are dull looking.)

– make sure high speed suction is not taking all your water away during proceedure.

– don’t get to close to target tissue when treating as you will limit water flow and may build up heat and sensitivity. (a little easier to do with higher magnification)

– cut perpendicular to target tissue ( if you have the laser at any other angle to the enamal you will find it tough to get through) and if you place the tip right over a groove without angle you may not get enough water flow into the groove and create enough heat to produce sensitivity. Mark C has some pics on this forum of that technique.

– keep the tip moving over the target tissue rather than holding stationary. (a little easier to do with higher magnification)

– get patients to give you a left hand signal if sensation is more than they are comfortable with, and then lower the mj to get comfort.

– don’t give up! it will come.