The first patient has been in my practice for many years. Super nice guy. He is remarkable in that his gag reflex is strong and easily triggered. The plan was to restore tooth No. 30 with a 3-surface posterior composite. I?ll just say that he is a ?big boy,? and the intraoral soft tissues instantly obscure the lower posterior teeth. Retracting his tongue, cheek, and using suction is nearly impossible to perform effectively without causing him to convulse, gag, and cough. I?ve tried rubber dams on him before. NO GO! So, how do we effectively perform adhesive dentistry? Not very easily, that?s for sure!
I?m particular about using meticulous technique when doing composites, and fighting soft tissues and the saliva tsunami with an assistant that only has 2 arms is truly frustrating. I had previously tried to use rubber dam with this patient. It was a no-go. He couldn?t tolerate it. My assistant said, ?What do you think about trying the Isolite for this patient?? I had considered it and assumed that his gag reflex would surely eliminate placing an Isolite in his mouth. BUT? Why not try? And, so we did.
I always introduce the Isolite for first-timers before I go shoving it in their mouth without so much as a how-do-ya-do. This is basically what I say (with a focus on patient benefits):
OK, Joe? Today we?re going to do something new (for you). In the past, I?m sure you?ve had the uncomfortable experience of chunks and dust from the old silver being removed and water gathering at the back of your throat. Today, you won?t have to worry about that at all.
I?ve got a fantastic technology that prevents any debris at all from accumulating back there. It?s a very soft and flexible silicone screen (let the patient feel it) that immediately and continuously sucks all that stuff right out. It also protects your tongue and cheek from getting in the way of our work. You?ll also be able to rest your jaw on this. Your jaw won?t get tired from trying to stay open.
Because it allows us to meticulously control the environment, we can finish your treatment about one third faster than before.
It keeps the tooth nice and dry so I can bond your white filling with confidence that there is no contamination to interfere with the seal of your new restoration. This means your dental treatment will be more effective and last longer. Think of it as quality control.
And, check this out, Joe? the cool part is that it also lights your mouth up like a hockey arena! Between that and my headlight, I can see everything super-clearly.
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This blog was re-posted with permission from TheDentalWarrior.com.