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Analgesia vs. anesthesia

As dentists, we understand and are very comfortable working on patients that are anesthetized. It is how we were trained and almost all of our patients are numbed prior to treatment. When we numb our patients, we remove most of their sensation. In effect, we are blocking nerve impulses from leaving a specific area, e.g. a tooth. This includes cold sensation, light and deep pressure, vibration, and what we are most concerned with: pain. However, we know there are limits to local anesthetic. For example, a tooth may be numb, but the areas around the tooth aren't completely sensationless. The most profound anesthesia is generally centered around the area infiltrated. You may block for a mandibular tooth extraction, yet the patient can experience all kinds of pressure (and even pain) in their TMJ. This doesn't mean the anesthesia isn't working, it means we need to coach the patient as to what is normal sensation and what isn't.

Believe it or not, our patients don't enjoy this

So what is analgesia? Analgesia is relief or prevention of pain. I would argue that this is really the main goal. We want to prevent pain, not necessarily all of the other stuff (pressure, vibration, temperature) when doing simple restorative and soft tissue procedures.

We often talk about Solea as providing analgesia or having a transient analgesic effect. This means that the patient does not experience pain (with proper technique of course) but they DO experience other sensations such as cold and pressure, etc. This is VERY important to remember when communicating with our patients. We cannot be lazy with our language and say things like "you won't feel anything Ms. Jones." This simply isn't true. It wasn't true when they were numb either, was it? As I mentioned above, even when they were numb they would feel pressure and vibration while we worked on them. Or they may feel cold on adjacent teeth that aren't numb.

I say things like, "Ms. Jones, you will probably feel some cold and that's a good thing because it means your tooth is alive and healthy!" I also warn them every time I change the stimulus. For instance, if you are prepping two to three teeth for 5-10 minutes straight, they will settle in and relax because they get used to what the laser sensation feels like. If you then switch to the handpiece or place a matrix band without warning them that they will feel vibration or pressure. They will usually jump or be startled because it takes them off guard. You just spent 5-10 minutes lulling them and their tooth to sleep, you can't sucker punch them with a drill and expect it not to surprise them.

So...because Solea is providing an analgesic effect, most first time patients need to be coached and we need to set appropriate expectations. Once the majority of your patient base has heard what the Solea laser is and what it does they will come into the operatory knowing what to expect and excited.

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