Added: 4 years ago
From: DrHaddix
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  • Why Cant my dentist have that =( !

  • Disculpen mi ignorancia en el tema de la odontologia , pero mi pregunta es esa agua que le aplican al molar es acido o algo parecido? Porque por lo visto pareciera que degrada el diente

  • Hi Dr. Haddix! Which mark of laser are you using?

  • @MrBamBamTV  The VersaWave manufactured by Hoya Con Bio.

  • can i ask, what bur were you using to trim the composite? we're learning to use a 7901 flame-shaped bur, but I find it cut EVERYTHING (tooth and resin alike!) It seems your bur was able to cross onto the tooth surface without much enamel damage at all. Nice job by the way!

  • @4001katrina1004 The finishing bur was an ultrafine diamond; while it will cut enamel, it doesn''t cut it nearly aggressively as 12 fluted finishers and allows a very fine, well blended margin. It works best if you sculpt the resin to nearly ideal shape first.

  • nice filling

  • @kkvh7823 Thank you.

  • Well, turns out they numbed me about 5 times and i felt all the drilling they were doing so they are giving me valume or something like that and i have another appointment on the 22nd....I dont think they are going to do the laser thing sorry though

  • @polorgirl33 Sorry to hear that. If you have teeth that are sensitive to cold, you will still likely need anesthetic, and if you are anxious (like nearly every patient is), then valium helps as well. It is an irony that a technique that can allow fillings to be done without anesthetisc is least effective on patients for whom it would benefit most, i.e. anxious patients.

  • Im a kid and I have to get that done today! Are you 100% sure that it wont hurt? I cryed when I got a tooth pulled so Im serious!?

  • @polorgirl33 PG, no, I'm not 100% sure. Whether you feel something depends on where the cavity is, how large, and to a degree, the skill and training of your dentist. Please post and let us know how your appointment was.

  • @scavenski The caries, or decayed tooth structure, is visible as the dark, soft material visible when the overlying enamel is removed in the video.

  • @DrHaddix Does that hurt your patient at all. That looks pretty painful. Also what causes that?

  • @coreythegangsta0901 Corey: This patient experienced no pain; that is normal for this type of procedure. The water spray keeps the tooth cool and the laser impulses are below the tooth's sensation threshold. Additionally, the laser induces a temporary analgesia in the tooth, allowing this procedure to be completed without an injection. The area being treated is a cavity that developed in a defect of the enamel in this patient's tooth.

  • You are totaly right. I dont understand this device, when you have got to finish cleaning with a bur.

  • @gilbelu You are right, you don't understand this device. I'm not certain why viewers are hung up on using the bur or not using the bur when no anesthesia is required for the treatment; so what if I'm using a bur?

  • I have had thousands & thousands of dollars worth of dental work in my lifetime. I have taken the needle hundreds of times and I never get used to it. It just freaks me out. Believe me, if given a choice, i would go to a dentist that can do the same procedure well w/out the needle......AND GLADLY PAY MORE

  • @inkey2

    You should ask your dentist about intra-venous sedation. It still involves a needle in the arm but I think for most dental-phobic people the whole experience is better compared to not having sedation.

  • wouldn't it damage the nerves? and what about deep caries? risk of traumatic exposure?

  • Good question. This wavelength laser does not damage the nerve in this type of procedure. In the event of deep caries, the usual precautions to avoid pulp exposure are taken, but in the event of an exposure, there is actually little to no trauma to the pulp tissue and much less than results from an exposure with a bur or currette. This laser can be used to create a sterile cap of tissue in small exposure; I can't say it survives better than mechanical exposures, just no worse.

  • where is the water of that handpiece?? it must heat a lot!

  • There is a very fine water mist cooling the tooth; this laser used with water actually cools the tooth.

  • Thank you, satch. You'll receive that $50 in your PayPal account very soon ; )

  • Dr. Haddix, YOU ARE REALLY REALLY GOOD! great posting and thx!

  • e a restauração infiltrada na mesio-oclusal; não vai remover não?! esse dente vai doer!!! E no final acabou usando o "motorzinho"!

  • Indeed ; )

  • I still dont understand why is it done under no anesthesia? if the enamel does not have sensitive nerves, and the afected dentin was removed by a burn, why would it be not painfull?

    In my opinion, if you are going to use a burn at the end, use it from the begining, its going to be a lot faster. I never seen nothing better than a burn yet. Laser, micro ecthing, ultra sonic gear. For dentistry and prostheses, it still got to get beter.... But congratulations anyway, very interesting though.

  • what is the white thing?

  • The 'white thing' in the lower right field of view is a suction tip to remove the saliva and debris from the patient's mouth; the 'white thing' in the upper left side is an absorbent pad used to keep the area dry and protect the cheek.

  • i guess it must be the expander or a sucker.

  • Very nice job

  • i wanna mean this, my tooth has a big hole

  • i have a question i have one hole very big y my tooth is my second or three toots is very big what you think. i quit this tooth or not please help is very hurt

  • Nice video Dr. Haddix, Just wondering if this is the general sequence for most preps. It seems that the laser replaces the high speed for gross caries removal, and residual decay is removed w/ slowspeed (with either technique). Also, does the laser allow you to put any retentive form into your preps for amalgam, or are all restorations composite w/ a laser prep? Some of my pts prefer amalgam in unaesthetic areas because of its longevity.

  • For the most part, yes, this wavelength of laser removes tooth structure without using a high speed handpiece. All the restorations I place are composite, especially the laser preps, and yes, you can place retention very nicely with the laser. The slow speed bur is used to remove any residual caries as well as a layer of ablated tooth structure which will otherwise reduce bonding strenghths. Patients usually experience no discomfort during any of these procedures.

  • but i have to include that, for caries presented in vid, indeed no needle is needed even working with turbine. real difference between laser and trubine make our choice towards to laser is as i mentioned below, amount of removal of health tooth tissue.

  • Arguable. The only way to know for certain is to perform blinded studies, handpiece vs. laser. In my nine years of experience, I can say that the laser allows me to perform a multitude of procedures without anesthesia that I could not perform in the same manner with a handpiece. Also, if you have never used a laser, commentary on their applications becomes speculative. Interested in your input and experience.

  • thanks for such a educatinal vid. shortly, as seen in present vid, espically deeper caries removal, takes too much time with laser. but, whilst laser is certain the most noninvasive caries removal instrument, we must consider combining laser with ultra conservative tehniques, so we can make laser more feasible to us instead of using turbine for caries removal.

  • "Takes too long". Depends on whether you consider onset of anesthesia as part of the procedure. The laser is slower than a handpiece, to be sure, but the viewpoint of the person on the distal end of either instrument is pretty important, if you know what I mean.

  • whts the point if you have to use a bur any ways. having an expensive laser unit does not seem justified watching this video

  • The procedure was accomplished without anesthetic - no shots, no needles, no numbness; that alone seems to be a justification in the minds of some patients.

  • Will it be that important for us dentists to spend that ammount of money on a laser handpiece just to treat 1% of those patients who have extreme needle fobia?

  • they better spend that money!! im one of those 1%!!!

  • thank you this was very helpful.sir I would like to know one thing-my backside teeth has black i think so cavities or carries I dont know. how should I cure it??wating for ur answer

  • Go to the dentist immediately. Your tooth is rotting. You have a strong chance of developing what it called sepsis where the infection transfers to the bloodstream which can spread the infection or cause death.

  • He needs a new slow speed Hand piece. The run out is unacceptable. As is the composite in the molar already. Wonder if he did that one.

    Horse and Pony show to justify an expensive gadget which has no advantage to conventional high speed equipment.

    But, it may impress a layman.

  • Thank you for your constructive critique and demonstrating your ability to find the flaws in all things human. I'm certain you are a wonderful person to be around and that your words of encouragement lift all those around you. Thank you for your comments.

  • Great vid Dr! I cannot wait to be a dentist!

  • If the procedure finally require the employment of a round bur(Which causes pain)The laser benefits are few.

  • you are right.....

    the laser machine is expensive and needs a lot of procedures to avoid laser hazards.

    i like conventional method (which is faster) than laser method in removing careis.

  • This laser is not as dangerous as you might think. A highspeed handpiece is more of a hazard than this laser. As far as speed, yes, a handpiece is faster, but smaller areas can be treated in as little time as a handpiece because no time is required to wait for anesthesia to onset, and your patient does not have persistent numbness after the appointment - they really appreciate that.  And yes, this class of lasers is expensive, too much so in my opinion, and most dentists don't have the skills.

  • Actually no. The photoacoustic effect of the pulsed laser cause a 2 to 4 minute period of analgesia to the tooth, during which the round bur is used with no discomfort to the patient. If you had a procedure performed with the laser, you would more clearly see the benefits this technology can offer.

  • how much is laser?

  • maybe a hell of money

  • This laser retails for approximately $55,000 USD.

  • thanks for showing all these good demonstrations

  • does the heat of the lazer expose the pulp to any type of danger....ie possible root canal?

  • Good question, and the definitive is no. The air/water irrigation actually cool the pulp during preparation. This was addressed very early on in development and FDA Certification for all Erbium class lasers to be used on teeth to remove decay.

  • I avoid the dentist consequently I usually have to have oral surgery years later. It is horrifying waiting for the IV to start working so I can hurry up and fall asleep for the procedure. I am trying to desensitize myself by watching these videos.

  • Your anxiety is not uncommon; I might recommend to you that you find a general dentist who is qualified to provide sedation; you can be pre-medicated so that by the time you reach the office you don't care about the IV, or much of anything else for that matter; and instead of having teeth removed, you can have them reapired. Our practice regularly sedates patients due to anxiety in order to do fillings and other reparative procedures in order to save teeth instead of removing them.

  • Cool. Wish I had more patients like you ;)

  • That looks painful.

  • I wish I could tell you that all dentistry was painless; things are getting better. I can tell you that the patient did not experience any pain during the procedure shown, but yeah, it sure doesn't look like something you'd want to do every day. And remember, this patient left without any "numb limp" for the next hour or or so.

  • I love about the numb limps, or lips, i remember i could carely talk when i got a needle in my mouth and after i finish from the Dr, i got a water which spilled all over me hahahahahaha lol

  • how much this laser???

  • The device being used is an Erbium:YAG infrared laser operating at 2940 nanometers wavelength; the water is a both a coolant and used to flush away debris removed by the laser.

  • i heard there really is such thing as a cavity disolving liquid. just have the dentist put it on and its gone. has anyone else heard of this miracle substance. please let me know

  • You heard right, it was called "Caridex", and it's been around 20 years or so. It never caught on because it is not as easy to use as it sounds and still requires drilling to expose the cavity before the solution can be used. A good idea in theory, but it turned out to be flawed and time consuming in actual parctice

  • i guess it defeats the purpose if you still have to drill anyway. thanks for the reply.

  • Yeah, that ended up killing the idea. It was very time consuming as well, we have considered using it with in conjunction with this laser, but it actually prolongs the procedure. We're still trying to improve the procedure with new lasers that have better output parameters, and the outlook for the patient is very good.

  • Is there any popping noises during its operation like waterlase? thanks

  • Yes; these are pulsed lasers, and the number of pulses per second is set by the doctor according to certain variables. The popping is called "photoacoustic" effect and is a result of the mechanism by which this laser removes tooth structure.

  • what kind of laser machine are you using?

  • How much time takes you to remove caries with this technique? Does laser, save more time than a handpiece?

  • im guessing this is a class one cavity. buccal side. intresting. im training as a dental assistant now and ive never heard of this technique.

  • Hi, Sam, thanks for the comment. Technically this is a class V cavity as it is on a facial surface, whereas a class I is on the occlusal surface. When you say you've never heard of the technique, are you referring to using lasers to remove cavities, or the "can-opener" method? I think I was just the first person to put that name on a commonly used method and then post a video for other doctors to view.

  • Oh I see! Class 5, I thought class 5 was 1/3 gingival on the lingual side. anyways yea ive never hear of using a laser to remove cavities.

  • hello drhaddix.

    my dentist told me today that i had caries but she didnt fix them( dont know why) but she told me that if i dont quit eating two much candy i will have to fix my teeth next year when i visit my dentist again. My question is can i use things to regenerate my teeth or quit the caries progress?

  • Cavities in teeth can be "healed" with special fluoride and calcium treatments, but only in the earliest stages. Once the decay has progressed beyond a certain point, it needs to be removed and the cavity filled.

    Caries are a result of acid erosion of teeth; the acid is produced by the bacterial plaque on your teeth. Constant sugar intake gives the plaque a rich diet, and hence, a lot of decay. The remedy: brush/floss off the plaque and limit food intake between meals to sugarless gum.

  • does this hurt? ive not been visiting the dentist cos it hurts too much

  • MKG: This patient had no pain during the procedure; I would say I am able to treat 80 to 90% of cavities without shots (I don't use the laser on all cavities for various reasons) That being said, even when it is necessary to give a shot, we can almost always do it with no pain due to recent advances in anesthesia techniques. Dentistry is much better in this aspect now than it was 8 years ago when I started using the lasers.

  • ok Dr haddix is the control of this device like the control of the handpiece , and why it is better than hanpiece . thanx for your reply ...

  • Thanks for the question. The control is different from a handpiece in that there is much less tactile feedback. Speed of tooth structure removal is limited by the amount of energy you can safely apply to the tooth, or in this instance, limited by the amount of energy that can be applied without causing pain. It's not "better", only different; it is more precise, and of course, many procedures, like the one pictured, can be performed without anesthesia.

  • this laser remove the caries only or cutting the tooth structure

  • This is an Er:YAG laser at 2940 nm wavelength and is highly absorbed in water. The more water the tooth structure contains, the more effective the laser is in removing the structure. Healthy tooth structure is removed, but not as aggressively as caries due to the higher water content of the caries.

  • is this a laser??why there is water?

  • Yes, this is a mid-infrared laser. Water is used as a coolant. As in all lasers, photothermal reactions can cause damage to the substrate; with water irrigation, the cutting action actually cools the tooth as the laser is used, resulting in increased precision and comfort. The water also serves to flush away debris from the preparation site so that the laser acts directly on the tooth instead of already cut debris.

  • Teeth are like the rest of the body and can heal themselves when cared for properly. Cut, burn or poison is OLD SCHOOL mentality.

  • Teeth are like the rest of the body in that when improperly cared for, or sometimes even when properly cared for owing to imperfect development, they do become diseased beyond the bodies ability to repair itself. This is neither 'old school' or 'new school' this is fact. Your words are those of someone selling something that gives false hope to many who don't understand this; your remarks are those of a predator of the hopeful.

  • It maybe tooooooo expensive.

  • i gona ask my densit do do this i hate thouse shots

  • really, thank you for this great video,, i am still a student in faculty of dentistry and u can't imagine how much we benifit from such videos,,

    thanks alot

  • good job

  • what si the benefit from using laser if we return to use a metallic round bur and we can use metallich burs from the beginning w w w sultan org

  • Erbium laser technology allows these procedures to be performed without local anesthesia; the procedure shown was performed with no local anesthesia at all. The pulsed laser induces a short term inhibition of the sensory receptors in the pulpal nerve tissue of the tooth, most likely as a result of photoacoustic effects of the laser. And, while caries excavation can be accomplished with the laser, mechanical removal is both faster and ensures complete removal of the caries.

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