Dentistry goes digital, makes a better impression

It looks like something out of the opening credits of the "Six Million Dollar Man." Three dimensional, real-time images of teeth rapidly appear one by one on a computer screen as a dentist waves a wand about the size of an electric toothbrush in a patient's mouth.

The whole process takes a minute or two, and the dentist has captured an image of the patient's teeth which can be

sent to a lab to create a crown. It's a long way from the uncomfortable process of taking an impression using liquid

and an impression tray.

The device, called the Lava Chairside Oral Scanner, is a creation of Lexington-based Brontes Technologies. The firm, part of 3M Co., of St. Paul, Minn., began marketing it to Boston-area dentists at the end of 2007.

"Being able to do this digitally has many positive effects," said Dr. Steven Spitz, who began using a prototype of the scanner about 18 months ago and now uses it for most of the impressions he takes. "I love the instant feedback," he said. "It's cut out a lot of time." Although the device currently is marketed only for making impressions for crowns, Spitz has also used it to gather data for creating bridges and entire arches, or one row of teeth.

For Spitz's patient Matthew Pukel, the system resulted in a much more comfortable crown and a virtually touch-free procedure, versus having to hold his mouth shut over a tray filled with goop. "I really hate biting into that gummy paste," he said. "It was a much better experience overall than it was with the old-fashioned technique." Digital scanning rather than actual impressions can cut down on turnaround time for crowns; create more accurate models of teeth, resulting in a better fit; improve patient education; and give patients and dentists a more comfortable, less invasive way to get the data necessary for crowns.

"It really makes a big impact in the quality of care," said Eric Paley, Brontes Technologies' general manager and cofounder. "It's a much better patient experience." The scanner consists of high-speed image-processing algorithms, real-time modeling software, and an optical system containing multiple lenses and blue LED cells. he technology is the first of its kind, according to its creators. Although there are products that create images of a patient's mouth, they use point and click methods - similar to taking pictures with a camera to create an image - while the Lava C.O.S. captures data in a video sequence in real time. It can capture 20 3D data sets per second. The device costs $24,000 and there is a $16 to $20 charge for processing each case.

Once the scan is complete and the dentist is satisfied with the images, they are sent to Brontes Technologies, which inturn sends the images to a dental lab. All that can happen within an hour, compared with a lag time of several days to ship traditional impressions to a lab. Turnaround time for crowns using digital impressions has been halved from two weeks to a week at Advance Dental Technologies in Stoneham. The LAVA device allows dentist and labs to connect the digital data directly from a patient's mouth to a digital program and CAD software, eliminating steps in the crown-creation process and potential errors.

"Every once in a while in dentistry a revolutionary product comes out, and I really think this is one of them," said Advance Dental's president, Bob Cohen. "There really is a 'wow' factor."

CONSCIOUS SEDATION

TAKING THE FEAR OUT OF DENTISTRY

I'll never forget the day my father told me he had broken a tooth. I knew he was in pain, but he kept making excuses as to why he couldn't come to the office. As I was looking forward to giving back to the man that had given so much to me, he was in sheer terror. My father finally told me that when he was a child, his dentist sat him in down, strapped his arms to the dental chair and went to work. The thought of entering a dental office, even with me, scared him to death. Another patient of mine explained how being the youngest of six kids in a poor neighborhood, the only dental care he even experienced was when he had a toothache and his dentist extracted it. He came to me at 35 years old with full upper dentures, and eight teeth on the bottom. Another patient told me that her recollection of dental care growing up was a pair of oversized hands coming at her (without gloves) and working in her mouth. It made her feel helpless and as if she couldn't breathe. To this day she becomes nervous when she sees hands moving towards her. What do these patients all have in common? They each have a tremendous fear of the dentist, dental care and the dental office. And, with help of oral sedation, they have all received the dental care they needed and wanted - comfortably. Oral sedation is also for patients that may have difficulty getting numb or have a fear of needles, as none are used. fear of the dentist, dental care and the dental office. And, with help of oral sedation, they have all received the dental care they needed and wanted - comfortably. Oral sedation is also for patients that may have difficulty getting numb or have a fear of needles, as none are used.

WHAT IS ORAL SEDATION?

Conscious sedation also referred to as oral sedation or ‘sleep dentistry’ is a great option for many individuals for most procedures, including for use with the laser. Conscious sedation is administered through a small oral pill that creates feelings of relaxation while eliminating anxiety. Some individuals may not remember their appointment and surely will not remember any discomfort or fear. The medication is administered an hour prior to the appointment and in some cases, again immediately proceeding the procedure. The patient can answer questions and follow direction, and is ‘awakened’ from the ‘sleep’ by juice or sugary food. A good night sleep should follow, with a feeling of rest and relaxation the next morning. Individuals with a history of medication or alcohol concerns should consult their physician prior to their treatment using conscious sedation.

conscious sedation, and has completed a three-part conscious sedation course through DOCS, Dental Organization for Conscious Sedation, including Advanced Cardiac Life Support (ACLS). Smileboston is one of the first offices in Massachusetts to be a part of the Sedation Dentistry Network. SDN is a group of Massachusetts’s dentists that have specific training and licensure to treat clinically and personally individuals that have moderate to severe issues with fear of dentists and dental treatment.

In addition to conscious sedation, we offer a variety of options for those who are interested in seeking dental treatment from the basics of music to treatment within a local hospital using IV sedation.

Quiet Relaxation: Whether you choose to close your eyes to your favorite music or use our special glasses to watch a great movie, you’ll enjoy quiet relaxation. Smileboston boasts one of the best DVD collections in any dental office in Boston, from Blazing Saddles to Zenthura.

In-Office Medical Options: Along with Triazolam, we offer our patients nitrous oxide (sleeping gas) that dissipates immediately and pre-medications such as Valium to relieve anxiety prior to your appointment. Discussing your concerns and options with Dr. Spitz will allow you to choose the option that is right for you.

Hospital IV Sedation: If having the majority of your dental needs taken care of while under IV sedation is your choice, Dr. Spitz can schedule your visit and complete almost your entire treatment at Franciscan Children’s Hospital in Brookline. Franciscan Children’s Hospital has a treatment area specifically dedicated to dental needs. Dr. Spitz has full privileges at the hospital and has comfortably treated many of his patients there since 1997.

Why does the Waterlase Laser work?

Heat, vibration and pressure are the primary causes of pain associated with the use of the traditional dental drill. Since cutting both hard and soft tissues (teeth and gums) with the Waterlase® does not generate heat, vibration or pressure, many dental procedures can be performed with fewer shots, less need for anesthesia, less use of the drill and fewer numb lips! Additionally, using the Waterlase® for gum procedures reduces bleeding, post-operative pain, swelling and the need for pain medication in many cases. - http://www.waterlase.com/
When using the laser, in many cases anesthetic may not be necessary as it is ‘numbing’ the area as it is being treated. Furthermore, as the surgical site is minimized without the need of the scalpel and/or drill, the discomfort is as well. Without anesthetic, returning to work the same day following the procedure is viable as there is no residual numbing effect and, as the fear of the needle is relieved, many individuals can get the treatment they need without worrying about ‘the shot’.