Case No 10. RA & The Wand(TM) A Win-Win

Well here we are again back on cloud nine. This case combined my newly delivered Wand Plus LA machine and RA. Yesterday's case involves a 12/13 year old. She was seen for the first time recently with a deep carious cavity in # 46. X-ray and symptoms indicated a likely pulpal exposure. #47 was in position and #48 was present on radiograph.

At her first treatment visit , she easily accepted RA and we proceeded with normal ID block. Very careful caries excavation produced an evident vital exposure. This was dressed and a discussion with mother followed re endo or ext and ortho to move #47 mesially keeping it upright. She attended about a week later requesting Ext.

We went ahead with her RA sedation and acheived adequate levels within 2-3 minutes. Using the Wand and the single tooth technique . #46 was individually anaesthetised -NO ID BLOCK was used and the tooth ext painlessly about 1-2 minutes later.

Result. Relaxed happy patient and mother ( who watched the entire procedure- her choice not mine !). Her Mother , also a new patient has recently had RA for her treatment too. Will I use this combination again- why certainly ! Would it have worked with conventional IDB - why certainly but the wand meant no numb lip for hours afterwards and a rapid and predictable anaesthesia. I have yet to review her regarding healing and her experience of the post op period. I'll let you know when I do.

REVIEW
Case History Case 10- REVIEW We reviewed our case 10 ,young lady, treated as described below. She and her mother were absolutely delighted with the result. The healing was quite uneventful, and the patient in question had some further restorative treatment under RA which was starightforward too. Result: Happy patient ~ Happy Dentist - Win- win with RA !

Case No 9RA is not for every patient

Well, in truth , probably not. However in my opinion the success rate is in the high 90% in terms of being able to successfully complete a planned procedure.

In Case 9 I have included a touch of honesty ! Today I examined an adult male in his mid 40s. He attends irregularly as he is a moderate gagger. His perio condition indicated the need for a number of periapical radiographs. He managed the first but then began to gag. In the past he had had RA for treatment. Unusually he requires a maximum dose to have a worthwhile effect. He agreed to using RA for the rads. Despite sedating him to a max 70% Nitrous : 30% oxygen, he had some difficulty in permitting the radiogrphic examination.

However we eventually succeeded with he minimum of gagging. In all probabliity, he was mouth breathing, at least for some of the time and so did to gain the full benefit.

So was he fully sedated? - No.

Did the RA negate his gag reflex? - Partially.

Did I manage to take the required x-ray images? - Yes

Was this a success?- Partially.

Will he return for further treatment? - I expect so.

There you have it. Is RA always the answer. No.

This afternoon I interviewed a prospective patient in need of some major dental treatment. It took her 20 minutes to cross the road to enter the practice. I have no doubt that the depth of her anxiety means she is more suited to IV sedation and intend to offer her this form of sedation.

Case No. 8. Composite @ #46 with No LA

This afternoon I treated a 10 year old with a carious DB fissure in tooth 46 (LR6). The cavity was into dentine though only a little wider than the fissure. She has had RA before. She was easily sedated and I completed the cavity prep without LA. acid etched. bonded and 3 layers of composite. She was ready to leave about 12 minutes after coming into the surgery and no numb lip.

Are you interested in being able to treat youngsters as easily as this? If so, read on and discover what RA could do for you and your practice.

Contact me for course details richard@the-ra-coach.com