I?m not even adding the extra time it would have taken for me to try to calm her down and convince her that after she experienced every child?s worse nightmare, a shot, that nothing else would hurt. The use of a hard-tissue laser allowed this young child to have a positive pain-free dental experience.
Dentists using lasers in the treatment of young children have the opportunity to change the perception of dentistry for an entire generation of patients. I used a Waterlase MD with settings of 4.0W 70% air 30% water and 15 Hz to remove enamel and gain access to the interproximal caries. As I entered the dentin, I lowered the power setting to 3.5 W. When using any laser, hard or soft tissue, you want to use the lowest power setting that will still allow you to accomplish your treatment objectives. When removing caries from the occlusal or interproximal areas, I usually use 4.0 W of power, however, when removing caries from the cervical areas of teeth, I generally use 2.0 W to 3.0 W with 30% air 70% water 15 Hz.
From my experience, about 8 out of 10 patients do not require any injected anesthetic to accomplish caries removal or soft-tissue procedures when using lasers; however, there are some patients who will require anesthetic. If a patient has a carious lesion that is sensitive to cold, I will use injected anesthetic to keep them comfortable as the laser has a water spray. Sometimes patients are so fearful that they feel calmer if they are numb and I will give them anesthetic.
Since I began using lasers, I have not used any retraction cord. I do not miss packing retraction cord for crown and bridge impressions. I use both the LaserSmile diode laser and the Waterlase MD for gingival troughing before taking impressions. If the tooth has been endodontically treated, the patient will not require any injected anesthetic; however, just before the gingival troughing, I will paint some TAC20 Gel which is a strong topical gel that is made by Professional Arts Pharmacy. When using the Lasersmile diode laser I use .6 W to .8 W of power with the tip initiated and in contact with the tissue. When using the Waterlase MD for gingival troughing I use 1.0 W to 1.25 W 7% water 11% air at 50 hz with a T4 or Z6 tip. The impressions are nice and sharp and I have not had the lab call me to ask me to take another impression.
Using lasers effectively in dentistry requires a commitment to training and attention to detail. Every dentist has the skills necessary to use lasers in their dental practice to improve their patients? dental experience and treatment for the better!
Cynthia Jetter, DMD, owns a private laser dentistry practice with her husband, Donald W. Jetter, DMD, in Voorhees, New Jersey.