This week, I had two particular patients that presented clinical challenges. In both cases, treatment involved lower posterior teeth. I’ve written about the Isolite in this blog twice before:
Win the Isolation Battle with Isolite! (see video, too!)
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 #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 two 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.
Now, I’ll tell you that when I initially place it in your mouth, it will feel a big awkward. But, once it’s in place, most patients report that it’s very comfortable.
Back to our story about the gagging patient. I was SURE that he would not tolerate it. But, I did my Isolite-introduction schpiel. And, in it went! I held my breath. My patient took in a deep breath as he curled his fingers. Then he relaxed. “You OK, Joe?” He gave me the thumbs-up. And, off to the races we went. I was able to remove the old amalgam, clean up decay, etch, bond, place the V3 matrix and ring, and incrementally build up a fairly large 3-surface composite. Throughout the procedure, I confirmed that he was doing OK. I popped out the Isolite and checked his occlusion. Done!
What do you think about the Isolite, Joe?
“That thing is AWESOME! We’ll be using that anytime I’m back here for work.”
You got it, Joe. And, don’t be bashful about reminding me, OK?
Later, my front desk told me that he raved about the Isolite to her while he was checking out.
Charlie was another long-time patient for whom I’ve completed extensive dental treatment (nearly a full mouth rehab). One of the few teeth that I had not yet restored had broken. It was #18 and the plan was to prepare it for a crown.
Charlie happens to be another super nice patient whose body… shall we say… has no sharp edges. ;) Accordingly, his tongue and cheek instantly spring into action to cover his lower posterior teeth keeping the evil dentist away. Not a gagger, though. Nevertheless, the Isolite came to the rescue. Prepping the lingual axial surface would have been particularly difficult unless my assistant spontaneously grew another arm or two.
Without using the Isolite, the preparation of this tooth would have been a stop-and-go affair. With the Isolite, the work progresses in an efficient, linear fashion. And, it reduces the stress that goes with fighting the tongue, cheek, and water. I was able to remove the old amalgam, do a composite build-up, prep, and use my Picasso Lite laser with absolute ease.
Tough day transformed into a great day
The Isolite just makes my life SO much easier. If you haven’t looked into it, or have reservations, I hope my experience helps answers some questions. I have no financial interest in this product. I just can’t imagine not having it at this point. After both cases described above, my assistant and I again agreed that the Isolite is VITAL equipment.