The Magic of Laser Assisted Cosmetic Dentistry

The Magic of Laser Assisted
Cosmetic Dentistry
Hugh Flax, DDS FICOI
Accredited Member AACD
Atlanta ,GA
JOIN THE REVOLUTION OF
NEW TECHNOLOGY
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Smarter
Quicker
More precise
More comfortable
for the patient
Greater satisfaction
Bottom line: You are
“raising the standard
of care”
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FLAX DDS
LASER is an acronym for :
L = Light
A = Amplification by the
S = Stimulated
E = Emission of
R = Radiation
Doctor’s advantages when using a laser
1.
Less Hemorrhage to control
2. Less Pain - Reduced need for prescription
drugs for pain
3. Less need for post operative
bandages…lymphatic help seal
4. Less need for local anesthesia….saves time
for many procedures
5. Patients appreciate the technology and will
pay more
6. Fewer post-op complications …..reduced
microbial colonization.
Tissue effects caused by thermal exposure
Zone of
coagulation - most
of the tissue will
recover and return
to normal
Zone of Necrosis tissue is
irreversibly
damaged and will
die
Vaporized
Area
Spectrum of Medical Lasers
Diode 812nm
Diode (980nm)
ErCr:YSGG 2.78 µm
Excimer
KTP (532nm)
Er:YAG ( 2.94µm)
KrF (248nm) XeF(351 nm)
CO2 (9.6 or 10.6m)
HeNe (632nm)
Ultraviolet
Visible
Infrared
100 nm
400 nm
ArF (193nm) XeCl (308 nm)
Ruby (694nm) 750 nm Ho: YAG 10,000 nm
Nd: YAG (2,08 µm)
Argon (514 nm)
(1,06 µm)
Argon (488 nm)
-rays
10-12
x-rays
UV
1 0 -9
visible IR microwaves radio waves acoustic waves
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1 0 -6
10-3FLAX DDS
1
103 wavelength, meters
Expansion and Micropropulsion of a
Macrosphere of Water Molecules
During excitation
2.78-µm light
(ErCr:YSGG)
Excited region vaporizes
and expands rapidly.
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After excitation
Droplet (macrosphere)
propelled by rapidly
expanded molecules.
What does HydroKinetic® mean ?
The Energy of Water in Motion
Examples:
1. Erosion to the rocks caused by the
oceans moving
2. Hosing down the sidewalk to remove
debris
3. Damage to property caused by rivers
during flooding
4. Mining for precious metals using high
pressure hoses and water
ErbiumTechnology
Cosmetic Restorative Clinical Applications
Soft Tissue Procedures
•Gingival Recontouring
•Gingivectomy
•Frenectomy
•Troughing
•Fibroma Removal
•Hemostasis
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ErbiumTechnology
Cosmetic Restorative Clinical
Applications
Hard Tissue Procedures
(for adult & pediatric patients)
•Desensitization for bleaching
•Cavity Prep - Classes I-VI
•Caries and Restorative Material Removal
•Roughening & Etching
•Enameloplasty
•Bony recontouring
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Clinical Paradigm Shift
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Micro dentistry (conservative
care)
Minimally invasive soft/hard
tissue treatment
Little to no need for anesthesia
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BE GENEROUS TO YOUR
PATIENTS !!
(as if the clinical benefits weren’t enough)
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Give
Give
Give
Give
Give
them comfort
their teeth strength
people courage and hope
them beauty...mimic nature
people a message
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Laser “Anesthesia”
Proposed mechanism of action
Reducing the action of the sodium
potassium pump at the cellular level
thereby slowing or even stopping nerve
conduction in the pulpal tissues long
enough to “painlessly” ablate enamel
and dentin without the use of
anesthesia in most cases
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DENTAL CARE GETS
COMFORTABLE !!!
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Reduction of intra- pulpal temperature 0° to 2°
C (Rizoiu, et al 1998) compared to :
High speed (wet) 3° to 4°C increase
High speed (dry) 14° C increase
Vibration free- fewer microfractures and less
functional disturbance
Theoretical
Photo-acoustic effect (Scott,2003)
Blocking the C-fiber afferent nerves (Japan)
Chemically- Increased endorphins
Decreased serotonin
Decreased pain
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WHAT IS ESTHETICS ?
The science of beauty in nature as an art
“Beauty is the association of many complex
associations”
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Charles Darwin
ESTHETIC PROPORTION
From PPAD
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GINGIVAL
SYMMETRY/CONTOUR
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No excessive display
Centrals match each other
and canines
Laterals?
Edentulous
spaces ?
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Evaluating Gingival Contour*
FACIAL LANDMARKS
Ophraic Line (eyebrows)
Interpupillary Line (mid-eye)
Interalar Line (nose)
Commissural Line (lips)
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*From Ken Canzoneri
FLAX DDS
Most Common Undesirable Outcome
Using the incisal plane as
the sole reference
point for gingival
evaluation.
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Reality Check
“The Biologic Zone determines the cervical limitations of
tooth preparations and will ensure the preservation of a
healthy periodontal attachment.”
John Kois
Contemporary Esthetic Dentistry Vol.2 No.1 1996
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FLAX DDS
John Kois
Contemporary Esthetic Dentistry
Vol.2 No.1 1996
“Biologic width is not a contrived illusion of
mathematical precision. Because of human
variability, the precise clinical delineation of the
individual components of the DGC is illusive”
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Degree of inflammation
Amount of probing force
Location of the tooth
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Based on a study of 100 healthy
patients with unrestored teeth
“The total dentogingival complex is more
clinically significant to ensure predictable
results”
John Kois
“Altering gingival levels: the restorative
connection part I: biologic variables”
J Esthet Dent Vol 6 No1 1994
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In this study it was found that 85% 90% of the time
John Kois
Contemporary Esthetic Dentistry
Vol.2 No.1 1996
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The Gingival-Esthetic
Restorative Challenge
How to:
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Create an esthetically pleasing gingival
architecture ?
Maintain biologic width by mimicking
the osseous scallop?
THE ANSWER:
Using a
Erbium Hard/Soft
Tissue Laser
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Precautions
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Anatomical-treating the correct genotype
Esthetic-patient concerns and the demands of
the dentist---especially the metal margins
around the crowns on # 8 and 9
Air embolism
Excess heat generated –avoided by lowest
level energy, tip out of contact, H20 spray
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Postoperative Care
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Plaque removal
Massage of the labial gingiva toward
the teeth
Oxygel application
Rinses of 0.12 % Chlorhexidine
Immediate post-op rinses with salt
water for 48 hours
Ibuprofen 200
mgPROPERTY
x3 tab
q6h for 3 days
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Follow-up Care
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Vigorous homecare with Sonicare, flossing,
and CariFree CTX 4 gel as well as daily wear
of maxillary occlusal appliance
Regular maintenance visits at 3 month
intervals during the first year
Monitoring occlusal bite guard and natural
contacts for any centric and exclusive
interferences.
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WHAT’S NEXT?
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Evidence based research (co-op?)
Specialty acceptance
New standard of care
Public awareness to increase demand
Penetration into the dental market
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FLAX DDS
CONCLUSIONS
Avoid lengthy recovery times from gum
surgery (less invasive.....no stitches !)
 Give the dentist more control of their
cosmetic cases (no referrals and better
artistry !)
 The best part: Patients are happier by
completing the "smile makeover“ cases 2-3
months faster (much better customer
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service!)
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THE BU$INESS OF MAKING
LASER COSMETIC
DENTISTRY PROFITABLE
You Got
A Problem
With That
??
Hugh Flax DDS FIADFE
Accredited Member AACD
Atlanta ,GA
Before you begin marketing
Be fluent in all aspects of laser treatment
Make sure you can practice what you
preach
Training
Move on to advanced procedures
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Basic Laser Techniques
Anesthesia
Operative
Routine soft tissue
Endo
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Advanced Techniques
Crown and Bridge
Perio
Combination soft and hard tissue
(i.e. cosmetic “gum lifts”)
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REALITY
People “buy” to feel good or solve a
problem
People love solutions that easy , quick,
and painless
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FLAX DDS
The Laser Dentistry Market
Adults
Children
Apprehensive patients
People who don’t like numbness
People who have had bad dental
experiences
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Addressing Needs
No pain
No shots
No numbness
No sound of the drill
Conservative
Great for kids
“Life changing dental visit”
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LAW OF THE MIND
It is better to be first in the mind than first
in the marketplace
If you have a laser and don’t advertise it
and someone else comes along after you
and does, it is impossible to convince the
public that you were first or better
You will always be remembered as “the
first”
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GIVE PEOPLE A MESSAGE
Internal MarketingAnnouncements to patients
Brochures and articles
Managing Expectations (Assistant’s set up)
Asking
“Bun –Warmers”
External Marketing
Website
Print Media
Press Releases
Market to specialists
BRAG about the benefits
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DEAR DOCTOR
866-429-8188
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www.FlaxDental.com
Josh Talkington www.CVTentertainment.com 615-430-3445
PROFESSIONALLY DONE VIDEOS
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BRAGGING KEYWORDS
Virtually painless
No injections
Extremely precise
Microscopic fillings
Extremely conservative
Allows me to place tiny white fillings not the
darks ones
Popcorn popping sound
Only 1 of X dentists that have made the
substantial investment in technology
( WHY….? “I’ll give you 70000 reasons why)
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FLAX DDS
EDUCATING
You and your staff—make your investment payoff
In-office trainingGraeme Milicich CD’s are the
best(www.advanceddental-ltd.com)
Seminars –WCLI
User –groups
Join the World Congress of Microdentistry
Your patients
Utilize your marketing materials
Use Powerpoint
Display and/or give copies of articles
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OF HUGH
ALWAYS KEEPCOPYRIGHT
“THE
PARACHUTE”
OPEN
FLAX DDS
DO IT OFTEN!
IF YOU DON’T USE IT YOU LOSE IT!
Practice
Always try new things as you climb up
Unconscious
the “learning curve”
Competence
Conscious
Competence
Conscious
Incompetence
Unconscious
Incompetence
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FLAX DDS
THE LEARNING CURVE
INSURANCE
Use the right codes to maximize benefits
Fully document claims
Charting –Periodontal; Diagnodent
Photographs
Supplement with research articles if needed
Let your patient know you are providing a
higher level of service not only about their
dental care but the “extra mile” you may be
going to help with claims
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FLAX DDS
DO IT RIGHT!
Use the Right Tools
KaVo DIAGNOdent®
SLAM DUNK SUCCESS
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FLAX DDS
“Good-to –great organizations avoid
technology fads and bandwagons, yet
they become pioneers in the application
of carefully selected technologies…used
technology as an accelerator of
momentum not the creator of it”
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A FINAL THOUGHT…….
“We are not creatures of circumstance;
we are creators of circumstance”
Benjamin
Disraeli
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FLAX DDS
CONTACT INFORMATION
HUGH FLAX,DDS
(404) 255-9080
Email: [email protected]
For lecture info
on cosmetic dentistry, implants,
and lasers
http://www.catapultelite.com/flax.php