 Hello, I'm Noah Levine, Editorial Director with 

®. Today I'm joined by Micah Huish. Micah is with DentiMax, and he works, setting up x-rays for dental practices all across the country. Micah. Welcome. Thanks for joining us.

Thank you for having me. I'm really excited to be here and kinda to talk about dental x-rays and what people like and dislike.

Wonderful. Well, to give our audience a bit of a background, can you tell us a little bit more about what it is you do in dental practices.

So what I do is I go in, we set up their software with our software and our sensor, or we go in with our sensor into their software, get them working with it, see how it functions, make sure they're familiar and comfortable with all of that. And then the fun part comes in where we actually do what we call our dial in process. So the dialing process is where we actually have you guys take a couple test x-rays on actual teeth, usually we recommend doing that, like on a co-worker, or employee, that way, we have time to talk and make changes. And then we actually kind of dig in and find out what you guys want, what's your guys's image, what you guys like, what's your kind of perfect looking image. And then we go in with our what are called precapture filters and adjust those filters to make it look more how you want it so that it's the best diagnostic image that we can get for you.

Can you tell me about some of the different settings and kind of controls that you have at your disposal to adjust the x-rays?

Of course. So in most cases, all softwares have the ability to adjust the image. After you take the x ray, they have some type of filter, some type of brightness, contrast tool, gamma tool, something like that. So we have the ability to adjust the capture filters with our sensor and our software so that we can have the image appear more how you want it right off the bat. So some of the things that we can adjust there. Obviously those same filters, the brightness, contrast, the gamma, how sharp the images, we can actually even adjust the types of contrast that you have. So maybe some person likes it a little bit more black and white, while somebody else maybe likes it, or maybe a more mono gray color. So all of those different things, we have normalized filters, we have unsharpened filters, there's a whole bunch of different filters that we can adjust to make the image come back into the software more how you want it.

So is there sort of a typical look for x-rays that you know most practices are looking for?

That's the thing that I think is so amazing, that's something I've found, that's pretty funny as you can go and work with six doctors all in one day. And I'll get I'll be like that's the image they're gonna love. Because that looks just like the one that I just got that the last doctor loved. And it looks nothing like and like, No, I don't want anything like that. I want it to be completely different. Most doctors do tend to like or kind of move towards the image does what they're used to, which is meaning what they've had in the past, what they've used for the last few years. So we go in there and adjust based on that. But no two doctors like the same image. There may be some similarities, but you can show the 10 doctors the same image. Five of them will say it's amazing. Five of them will say it's horrible.

If they don't all agree on what is the type of image they like to diagnose with? Is there an image that you know, is kind of universally they don't want?

Yeah, so the thing that we probably hear most often that they don't want is a grainy image when the image is too grainy. They feel like it adds in things that aren't really there. It makes it harder to see, you know, caries and decay all that stuff. The second probably most common thing that they want to be able to have is they want a good level of contrast, so that they can distinguish between the DEJ, the dentin, and the enamel, they can see the you know, the apex of the root very clearly, they can see caries very easily. So those are the two things that they want most is not to have a grainy image and to have enough contrast, because if they don't have enough, it's too hard to distinguish between the areas of the teeth.

Are there controls that they can adjust in the practice themselves, or is it really something they should be setting up initially and then just continuing to shoot with the same settings every time?

So the settings that we adjust usually, yes, once we have them set up, you just keep moving forward, you don't look back, you'll just continue getting the same good image. As long as they're being consistent. Obviously their exposure time plays a big factor, and the technique of the staff, plus how far away how close to the face if they're lining up their shots properly, all of that goes into what causes the image to look good or bad. And from our experience, what you'll notice is when they kind of slow down and take their time and take good x-rays, they should get a consistent image with the settings that we lock in, once we get them dialed in.

In terms of that dialing in process, what does that look like?

So again, that can depend on the doctor and their liking. So different specialties, like different features on an image. Say he's like an endodontist, they're gonna really like a super sharp image in most cases, because that allows them to see the apex and be able to see you know, all of the areas of the teeth that they specialize in. When you start taking x-rays, you get used to reading a specific style or look of x-rays. So when you switch to a new sensor, you either want it to be way better, or usually very similar to what you're used to, or kind of a mix between the two. And that's kind of what most doctors are looking for something they're familiar with, that's better than what they already have. And we can do that very, very often.

If someone, you know, adds a DentiMax sensor to their practice, they've been using some other brand sensor for a while, and this isn't going to be a replacement, but an extra sensor, are you able to dial in that sensor to essentially mimic whatever other sensor that the practice is using?

All sensors do take different images, they have different components, products, filters, things like that. But we have made integrations that allow it to be very, very close. Lots of doctors can't tell the difference between the two images. But just based on things that we know, we can usually tell the difference between them. Most software out there now, automatically apply a filter after you capture. So you take the x-ray, if you were to look at that x-ray, what it looked like just with the actual sensor and what it captured before their filter was added, you probably be pretty surprised at what really is returning before they added their filters. Most offices use filters, there's a lot of filters out there that make the image, to my eye, much more pleasant, much more readable. But again, that is a complete preference based on usually again what you're used to. But yes, I recommend that doctors play with filters, try filters, see what helps them diagnose better, because the more they're diagnosing, obviously, the better off they're going to do. And those filters are created to help diagnose images.

Are there specific filters that you find doctors using more than others?

Yeah, so the one that we see most often is the brightness contrast/filter. Hygenists use it to try and adjust the image to help diagnose. Doctors use it to adjust the image to diagnose. What that technically does, is it usually changes how light or how dark the image is. And an also adds in more or less contrast, which helps kind of make some of those areas of the tooth pop a little bit more. Such as you know, interproximal caries, it also helps it so that if you're not sure on something, when you adjust it, a lot of times caries will stay a darker color no matter where you adjust that brightness contrast tool. So it just kind of helps reiterate the fact that yes, that is a caries right there.

Can you see different things in a darker or lighter x-ray image?

From my experience, hygenists usually like the image a little bit lighter, doctors usually like them a little bit darker, and that there's some variation in that. But in a darker image, the problem with having an image that's too dark is it can sometimes introduce like burnout if the image is a little too overexposed, where it actually is starting to almost eat away part of the image because the burnout kind of starts to evaporate the teeth kind of look. You may not be able to see caries because the image is so dark that it's hidden behind some of that shadowing, you know, things like that. So those are kind of the downfalls of going too dark. But what it also does is when you're darker, your pulp chambers usually pop more allowing you to see the apex a little bit easier, things like that, you can see the apex of the root all of that very visibly, because the image is darker. When they're too light. It kind of is actually somewhat similar where it's so light you might not see it caries because it's so washed out that there's no distinguishing features of the tooth where you can't see the DEJ very clearly. You can't determine what the different colors of each part of the tooth are.

How does the communication with a practice go? I imagine most doctors don't know the specifics of how to ask for what they want and an image so how do you work with them to get it to that image?

Yeah, I wish you could hear some of the phone calls. It's sometimes, it's a guessing game because we'll hear the word sharpen, and my definition of what a sharper image is, would mean like more crisp, the lines are crisp, they're sharp, they're hard edge, you know, but somebody else may be using the word sharp to me, they want a more of a contrast, they want a sharper image, meaning more colors more bright, like brighter colors, more defined colors, things like that. So it is a little bit of a guessing game. But we usually ask, you know, questions. So we usually start out the call, by having them show us kind of what they like kind of talking about what they want to see. And that allows us to kind of try and understand some of their verbiage or their terminology a little bit better, so that when we are in the process of asking the questions of how they want their image, it makes it easier for us to understand them. But usually we ask questions. And then if we don't understand, we'll adjust. And we have the ability to show them what we think they mean. And then if that's not that we can undo and redo and change to whatever it is that they really do mean, we like to have them show us what they like or dislike. In some cases, it didn't have anything they may like, and tell us why they like it. Show us kind of point things out to us. And then we'll do our best to either, like I said, mimic that image as close as possible or getting something that plus much better. That's what I love doing. I love trying to have that competition to see how much better I can make their image than what they already have.

Well, Micah Huish thank you so much for joining us sharing your expertise and telling us all about what you do for DentiMax.

Awesome. It was a pleasure having this conversation with you. If you guys have any questions, feel free to reach out to DentiMax and anytime we'd love to talk with you and kind of get to know you guys a little bit better and teach you what we know.

Videos

DentiMax IT Specialist Micah Huish joins Dental Products Report® Editorial Director Noah Levine to share his experiences helping dental practices set up digital x-ray systems to capture images that look exactly the way they prefer. [12 Minutes]

Dental Product Insights: Digital X-ray Set-Up Best Practices

Once again, welcome to ProductBites from Dental Products Report, the podcast that brings you the latest releases from the dental industry. I’m your host Kristin Hohman. I hope everyone has a safe and wonderful 4th of July holiday!

We’re going to get right to several new products!

Overjet recently received 510(k) clearance from the US Food and Drug Administration for its AI-powered caries detection platform, Caries Assist.

Overjet Caries Assist is designed to allow clinicians to detect caries accurately and reduces the rate of missed lesions (false negatives).

To demonstrate the validity of the software, Overjet analyzed more than 7000 tooth surfaces. With the aid of Caries Assist, dentists were said to be able to detect 32% more tooth surfaces containing caries.

With this technology, Overjet aims to support so clinicians can be more effective and efficient by presenting them with accurate findings, identifying anatomical structures and common pathologies, and providing instant visualizations while improving patient-dentist communication.

Glidewell & Medit fastscan.io Intraoral scanner

The fastscan.io Intraoral Scanner combines the same technology behind the Medit i700 scanner, the Glidewell.io In-Office solution, as well as Glidewell’s dental lab.

These 3 aspects merge to create an intraoral scanner that is said to offer dental practices an advanced scanning solution at an affordable price point.

The fastscan.io scanner is designed to be lightweight, with reversible tips, a detachable cable, and a UV-C LED disinfecting light.

Users will also receive access to Medit applications, Ortho Simulation, Model Builder, and Crown Fit among others.

It will be available in both wired and wireless versions, with both being offered a bundled opportunity that comes with a cart and a computer/laptop optimized for the fastscan.io’s technological specifications.

Oryx Dental Receives FDA 510(k) Clearance for Its Imaging Product

Oryx Dental has secured 510(k) FDA clearance for its imaging product, Oryx Imaging, now allowing the cloud-based company to directly market and sell its imaging platform directly to dental practices.

Oryx Cloud Imaging’s dental imaging software includes the ability to acquire, view, annotate, and organize dental radiographs and color images—integrating with most dental imaging devices, such as intraoral x-ray sensors, intraoral cameras, and scanners.

This open integration is designed to allow clinicians a wider choice of imaging products. They can mix and match acquisition devices from a variety of manufacturers, or simply allow them to consolidate costs on its dental management software, pulling all needed components into 1 platform.

Oryx Cloud Imaging can be used as a standalone product that integrates into existing systems but is also designed to work with the Oryx dental practice management software.

Align Announces Invisalign Outcome Simulator Pro Visualization Tool

Align has announced the introduction of a new smile visualization tool called the Outcome Simulator Pro.

This chairside software uses patient photos captured through the Invisalign Practice mobile application combined with scans taken on the iTero Element Plus series of scanners to create and simulate end results for Invisalign patients.

Invisalign Outcome Simulator Pro works during a consultation, allowing patients to receive a full predictive image of what their potential smile will look like with continued Invisalign therapy.

This tool is designed to help dentist boost their efficiency during clear aligner treatment.

OrthoFX Using AI Technology to Enhance Its Aligner Therapies

OrthoFX has launched 2 new clear aligners,  Rescue™ and Bright Aligners™.

The 2 aligners are breakthrough polymer innovations that are designed to eliminate treatment breakdowns while providing instant gratification to orthodontic patients.

Rescue aligners work in conjunction with OrthoFX's proprietary, AI-driven remote monitoring solution—FXOnTrack™—creating a closed-loop system for the proactive detection and elimination of aligner failure.

When FXOnTrack reports that a case is off-track, doctors can trigger the production of a rescue aligner which is shipped directly to the patient's home. This unique aligner provides the required flexibility and consistent forces to correct up to one month of deviation from the plan with no office visits.

Consumers today expect instant gratification from the products they use. OrthoFX is addressing this timely need with the Bright aligner, which is designed to make teeth appear whiter and straighter from day one of wear.

Podcasts

This week, we introduce you to products from Align Technology, Overjet, Glidewell, OrthFX, and more!

ProductBites Episode 15

Each year, a select panel of dental technology experts gather to discuss the state of dental technology and debate which products deserve to be recognized as the best.

The panel consists of the editors of leading dental publications and recognized speakers and experts in the many areas of technology in dentistry.

Instead of trying to determine which products are the tops of their individual categories, this panel seeks to identify the products that are breaking new ground and expanding the possibilities within the world of dentistry. There is no minimum nor maximum number of awards to hand out, but after a lengthy dialogue, the products with the biggest potential to enhance both dental patient care and dental practice operations are named recipients of the Cellerant Best of Class Technology Award.

AIRFLOW® Prophylaxis Master

Amplify

ChairsideCAD

CS 9600

DentalMonitoring / ScanBox pro

DTX Studio™ Suite

Excelsior

EyeSpecial

FirstPlug®

i700

Infinix™

MiniBio Auto Reader

Nova

Pro S

RE-GEN™ Universal Adhesive

Remote Monitoring / The Grin Scope®

Second Opinion

TRIOS 4

YAPI

YOMI®

The Panel

2022 Cellerant Best of Class Technology Awards

Articles

Presenting the Dental Product Innovations Named Winners of the 2022 Cellerant Best of Class Technology Award.

The Standout Dental Technologies Of 2022

Dr Geissberger has practiced in Marin County (San Francisco) since 1991. He splits his time equally between his private practice and educating practicing dentists. He is an adjunct clinical professor in the Department of Preventive and Restorative Dentistry and served as the chair of the Department of Integrated Reconstructive Dental Sciences at the University of the Pacific, School of Dentistry for 15 years. He has maintained a faculty appointment continuously since 1991. Dr Geissberger has been awarded fellowship in the International College of Dentists, American College of Dentists, and the Pierre Fauchard Academy. He has won several teaching awards and completed a fellowship with the American Dental Education Association’s Leadership Institute. He has served as the president, president-elect and vice president of both the Supreme Chapter of Omicron Kappa Upsilon and University of the Pacific’s Alumni Association. Dr Geissberger is a researcher and author in the areas of dental materials, contemporary fixed prosthodontics, and esthetic dentistry. He has lectured on adhesive dentistry, cosmetic dentistry, photography, ceramic, fixed prosthodontics, and treatment planning. 

Warming composite to assist clinicians in seating restorations, placing, and manipulating composites has been in regular use since the 1980s.

 AdDent, Inc, has a long history in developing warming technology to improve clinical outcomes and provide a predictable way of effortlessly placing composite restorations.

As composite resin technology has improved with increased strength, higher filler content, lower volumetric shrinkage, and better polishability, composite handling has become more challenging. The improvements made in composite resin technology have produced products that are far stiffer than previous generations, which has created a conundrum for clinicians.

Should they continue to use inferior, older technology with easier handling or move to a new composite with dramatically improved characteristics but with significant challenges when placing the restoration because of significantly higher stiffness? Fortunately, the answer does not have to be either one or the other. Clinicians can incorporate composite warming technology and pair that with a modern, nano-filled composite of their choice, which will dramatically lower the viscosity of the composite with higher filler loading, making it easy to place and manipulate.

Composite warming was first discussed in literature in the early 1980s.

 These articles discuss the physical properties and changes that occurred with warming composites. From these articles, many clinical techniques were developed using the concept of warming composite.

 Warmed composites have an increase in kinetic energy and great movement compared with room-temperature composites. This phenomenon leads to heated composites experiencing greater monomer conversion and increased depth of cure.

Examination of margin adaptation has demonstrated that heated composites lead to better marginal adaptation than those restorations placed at room temperature.

 Muñoz et al demonstrated that both hybrid and nanohybrids had significantly increased surface hardness and depth of cure when 

 Heated composites provide several advantages to clinicians and have the potential to dramatically improve clinical outcomes.

Indication and Uses of Compex HD Composite Warming Technology

Warming conventional composites for all anterior and posterior direct restorations

Warming flowable composites for use as a liner in various situations

Warming flowable and conventional composites for injection molding techniques

Warming composite resin to be used as a resin cement when placing indirect restorations

Traditional Composite Warming Technology Compared With Compex HD


AdDent has a long history of producing composite warming technology, with many substantial improvements over the past several decades, including the Calset Composite Warmer (

). Traditionally, all composite warmers were stand-alone technologies that utilized a warming device to heat composites to 155 °F. These systems heated composite by warming a traditional composite gun preloaded with the selected composite. Although quite effective, once the gun leaves the warming device, the composite begins to lose heat immediately.

Between each incremental layer of composite, the gun should be returned to the warmer to maintain its temperature at 155 °F. This problem has been eliminated with the creation of AdDent’s Compex HD composite warming gun (

). This wireless, rechargeable composite gun warms composite in 1 to 2 minutes and can dispense approximately 100 compules before the unit needs to be recharged. The unit is extremely lightweight and possesses an ergonomic design, making composite placement easy and efficient.

In a recent evaluation of Compex HD with Catapult Education, Compex HD was evaluated by 8 clinical evaluators, 7 of which had extensive experience with composite warming technology and techniques. A total of 100 patients were treated using the Compex HD, with more than 150 restorations being placed. All evaluators (100%) said they would use the Compex HD composite warming device in all restorative and composite procedures, 87% were “very satisfied” with the performance and construction of the warmer, and the remaining 13% were “satisfied” with its performance and construction. The evaluators felt the Compex HD greatly assisted in the placement of composite, making the material far easier to manipulate. AdDent’s Compex HD was awarded the Catapult Education Vote of Confidence, which is a demarcation reserved for only those products that receive overwhelmingly positive reviews and feedback.

This 24-year-old patient presented with fractured incisal edges of #8 and #9, which occurred during a traumatic accident as an adolescent (

). His desire was to have the incisal edges of his front teeth restored as conservatively as possible without sacrificing an esthetic outcome. With this in mind, the decision was made to utilize a diagnostic wax-up and corresponding incisal edge putty matrix to aid in the placement of Class VI composite resin restorations (

Prior to anesthesia and tooth preparation, the putty matrix was tried in to confirm proper seating and fit, and composite shades were selected. Teeth #8 and #9 were prepared using a pointed diamond bur, establishing an irregular bevel along the incisal ¹/3 of each incisor (

). A Mylar strip was placed in the putty between #8 and #9 to prevent bonding the teeth together. Using the Compex HD, the lingual incisal portion of the putty was loaded with A1 composite (Mosaic; Ultradent Products, Inc) and placed under an orange protective shield. The incisal edges of both incisors were etched with 37% phosphoric acid (Ultra-Etch; Ultradent Products, Inc) (

Catapult is an organization that consists of more than 50 clinicians spread throughout Canada and the United States. As a company, manufacturers pay a fee for their product to be evaluated and what we deliver are truthful, independent answers from surveys that we develop with them. We have had many products that have either had to be altered before hitting the market or simply never arrived because of our openly honest evaluations. In this way, Catapult assists the manufacturer to avoid potentially releasing a faulty product, or simply a product that needs refinement. Lastly our clients are omnipresent in the industry, small to large, no favoritism, simply reviewing the latest products in our practices.

A bonding agent was applied to all etched surfaces and cured with a LED curing light (

). The preloaded putty matrix was carried to the mouth and placed to deliver the lingual portion of the composite to the prepared teeth. Excess material was cleared from the facial aspect of the restorations to provide room for the enamel veneering composite (

). This lingual layer of composite was cured using an LED curing light. The lingual matrix was removed, leaving the Mylar strip in place between #8 and #9.

Using the Compex HD, Enamel Neutral composite (Mosaic; Ultradent Products, Inc) was placed on the facial aspect of #8 and #9 (

). The composite was quickly manipulated into place using a composite placement instrument (

). The restorations were then finished using interproximal finishing strips (

) and polished using the A.S.A.P. polishing system (Clinician’s Choice Dental Products, Inc). The completed restorations (

) created a beautiful result and were made simple to place by using the Compex HD by AdDent.

1.Lopes LCP, Terada RSS, Tsuzuki FM, Giannini M, Hirata R. Heating and preheating of dental restorative materials-a systematic review. 

. 2020;24(12):4225-4235. doi:10.1007/s00784-020-03637-2

2.Bausch JR, de Lange C, Davidson CL. The influence of temperature on some physical properties of dental composites.

. 1981;8(4):309-317. doi:10.1111/j.1365-2842.1981.tb00505.x

3.Daronch M, Rueggeberg FA, De Goes MF, Giudici R. Polymerization kinetics of pre-heated composite. 

 2006;85(1):38-43. doi:10.1177/154405910608500106

4.Trujillo M, Newman SM, Stansbury JW. Use of near-IR to monitor the influence of external heating on dental composite photopolymerization. 

 2004;20(8):766-777. doi:10.1016/j.dental.2004.02.003

5.Wagner WC, Asku MN, Neme AM, Linger JB, Pink FE, Walker S. Effects of pre-heating resin composite on restoration microleakage. 

6.Muñoz CA, Bond PR, Sy-Muñoz J, Tan D, Peterson J. Effect of pre-heating on depth of cure and surface hardness of light-polymerized resin composites. 

7.Daronch M, Rueggeberg FA, Moss L, de Goes MF. Clinically relevant issues related to preheating composites. 

. 2006;18(6):340-351. doi:10.1111/j.1708-8240.2006.00046.x

Compex HD by AdDent, Inc, is awarded Catapult Education’s
Vote of Confidence after evaluators test it on 100 patients. 

The Next Generation in Composite Warming Technology

Stan Goff is the Managing Editor of Dental Products Report, Dental Lab Products and Modern Hygienist. He has covered the dental industry since 1999 and can be reached at sgoff@mjhlifesciences.com.  

Information provided by Cavex Holland BV.

Cavex Cream Alginate, the newest Cavex alginate after Cavex ColorChange, Cavex Orthotrace, Cavex Impressional and Cavex CA37

Any dental practice that uses impression materials

For dental impressions that require high accuracy, like crown or bridgework.

Does a procedure require more accuracy? Cavex Cream is an optimal choice. Due to the combination of excellent elastic properties and extremely accurate 5-µm detail reproduction, equal to VPS materials, this alginate impression material is said to be unrivaled when it comes to precision.

Cavex has been at the forefront of the development of high-quality dental alginates since the 1950s. When developing Cavex Cream, the most important properties of a good alginate have been combined: high tensile strength and elasticity and the perfect viscosity. The name actually says it all: Cream. When mixed, the alginate powder is quickly absorbed by the water, after which an easy-to-mix, creamlike alginate mix is created that allows a perfect application on the impression tray. Because of the pleasant bubblegum smell and the controlled viscosity that prevents the alginate from running, an impression taken with Cavex Cream is also pleasant for the patient.

This premium alginate from Cavex Holland BV combines 5-μm accuracy, high tear strength, and excellent elasticity—unique properties for an alginate, challenging those of VPS materials.

5Ws* Cavex Cream Alginate

Edward Kusek, DDS, stands out as a leading dentist in Sioux Falls, South Dakota, and uses the latest in dentistry techniques to provide patients with beautiful and healthy smiles. Additionally, he believes strongly in education to prevent oral health problems before they occur and makes sure to keep patients fully informed about their dental health. Dr Kusek is a general dentist and is truly compassionate about continuing education and offering his patients the latest advancements in general dentistry. He is a clinical instructor for Straumann (implant dentistry training) and Ultradent (laser training) and an instructor for GPT (Greater Plains Technologies) laser dentistry.

 fans will remember Bones and his tricorder, a device he could wave over a damaged site and repair it almost right before your eyes. Well, photobiomodulation (PBM) may not be as dramatic as the tricorder, but it does use light energy to repair damaged areas for a patient.

As dentists, we treat the oral cavity, and with the aid of PBM, we can make the patient heal faster and repair a damaged site like a tricorder.

PBM is used by certain professional sports teams, colleges, Olympic athletes, chiropractors, veterinarians, and dentists. PBM can be used in the dental profession to decrease pain, pretreat for orthodontics, treat erosive lichen planus, paresthesia, angular cheilitis, aphthous ulcers, temporomandibular disorders (TMDs), and prevent infections—just to name a few.

 It is also used in postsurgical applications, endodontics, and periodontics. This article will go over some of the uses of PBM.

PBM is like photosynthesis in plants but is the use of certain wavelengths of light in the red and near-infrared spectrum (ideal range is 660-980 nm). PBM causes intracellular photochemical changes that lead to a cascade of downstream intracellular, extracellular, and physiological changes.

 The mitochondria (within the cell wall) are particularly receptive to this process. At the cellular level, visible red and near-infrared light energy are absorbed by mitochondria, which perform the function of producing cellular energy called adenosine triphosphate.

The Gemini EVO laser, used by the author, has 16 preset procedures divided into 3 categories for efficient, intuitive use. Three photobiomodulation (PBM) adapters are included so clinicians can take full advantage of their new dental laser.

The key to this entire process is a mitochondrial enzyme called cytochrome c oxidase, which is a chromophore that accepts photonic energy of specific wavelengths when functioning.1 Cell physiologists have determined that optimal use of PBM is in the range of 4 to 6 J/cm2 of energy, although the therapeutic window appears to be significantly larger than that range.

 This allows the mitochondria to reenergize the cell. Lesser amounts have no effect, and greater amounts have been found to stimulate endorphins.

Each cell and everyone may react differently to energy, thus it is important to find what works for the patient so you can then continue to treat at that level. One study has shown that every person produces endorphins after surgical procedures—some produce more than others, some produce less than others. The interesting portion of this study is that narcotics inhibit our natural production of endorphins.

 Approved PBM treatments include treatment for postoperative pain on surgical areas, TMDs, erosive lichen planus treatments for oral mucositis, and others that are associated with pain management.

Endorphins are the body’s natural painkillers, and they are released in the hypothalamus and pituitary gland in the response to pain or stress. Long-distance runners are notorious for pushing their bodies to release endorphins to run faster and go longer distances. The Federal Drug Administration recognizes the use of PBM only for pain management.

 This could include treatment for postoperative pain on surgical areas, TMDs, erosive lichen planus treatments for oral mucositis, and other areas that are associated with pain management (

One of the most dramatic cases I’ve treated with PBM to date centered on a patient who presented to my office with a numb tongue. She felt as though it was swollen, and she could not talk correctly. She went to numerous physicians, and none gave her any encouragement to regain feeling back in her tongue. One physician told the patient to carry an EpiPen and to use it if her tongue got extremely swollen. The patient had a biopsy done on the lingual of #29 several months ago. I decided to apply PBM on the dorsum and ventral side of the tongue.

PBM is used by the dental profession to decrease pain, pretreat for orthodontics, treat erosive lichen planus, paresthesia, angular cheilitis, aphthous ulcers, temporomandibular disorders (TMDs), and prevent infections.

After 1 treatment of PBM, the patient could feel a “tension being removed from her tongue.” She had a total of 5 treatments, recovered all feeling back in her tongue, and her speech was normal again.

A second example of a use of PBM is for patients who have a TMD. The patient will likely have pain in a specific site on the masseter. Treatment is to overstimulate the site with over 12 J of energy at the specific site that has the most pain. Next, treat acupuncture points around the ear, then treat the lymph nodes in the head and neck on each side of the face (submandibular and clavicular sites) with 6 J of energy. Treatment for TMD is not a 1-and-done, like most cases of PBM are. These treatments can take over 6 sessions that take place 4 to 5 days from one another.

We’ve only touched the surface of the number of uses for PBM. Some may consider this voodoo dentistry, but it does work, and there are numerous sources in literature and in-person education including the Academy of Laser Dentistry (laserdentistry.org). PBM is a game changer, as it is easy to do and can easily help change your patient’s health.

1. Dompe C, Moncrieff L, Matys J, et al. Photobiomodulation-underlying mechanism and clinical applications. 

2. Hoisang S, Kampa N, Seesupa S, Jitpean S. Assessment of wound area reduction on chronic wounds in dogs with photobiomodulation therapy: a randomized controlled clinical trial. 

 2021;14(8):2251-2259. doi:10.14202/vetworld.2021.2251-2259

3. Hosseinpour S, Tunér J, Fekrazad R. Photobiomodulation in oral surgery: a review. 

 2019;37(12):814-825. doi:10.1089/photob.2019.4712

4. Azeemi STY, Rafiq HM, Ismail I, Kazmi SR, Azeemi A. The mechanistic basis of chromotherapy: current knowledge and future perspectives. 

. 2019;46:217-222. doi:10.1016/j.ctim.2019.08.025

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PBM can be a game changer in your practice. It is easy to perform and can easily help change your patient’s health.

Different Uses of Photobiomodulation in Your Practice

Dr. John Flucke is in private practice in Lee’s Summit, Mo. He also serves as technology editor for Dental Products Report magazine and keeps an active blog filled with thoughts and tidbits on the world of technology at blog.denticle.com.

We now live in a world where data is king. A long time ago—1597, to be exact—Francis Bacon, in his 

, stated “knowledge is power,” and I can hardly think of a more profound statement. Today we are swimming in data, and there is no way the amount of data will not continue to increase.

Along those same lines, I firmly believe that “he who understands the numbers controls the world.” I say that for the simple fact that almost anything can be understood if there is a way to break it into numerical values.

The most successful companies are those that measure and comprehend the numbers of their business and industry. Most of these successful entities are managed by the numbers, because you simply cannot run a successful enterprise on a whim. What gets measured gets improved. Numbers provide a guide to the journey of a business, and you cannot reach a goal—even one that is easily attainable—if you have no way of measuring your progress.

This can be summed up nicely with a quote from Lewis Carroll’s famous work, 

, where Alice meets the Cheshire Cat at a fork in the road and asks him which way to go, noting she doesn’t care where she winds up:

Cheshire Cat: “Then it doesn’t much matter which way you go.”

Cheshire Cat: “Oh, you’re sure to do that, if only you walk long enough.”

The funny part about that quote is most dentists I know are great walkers! We tend to sort of wing it when it comes to business decisions, then we get frustrated when things don’t work out like we hoped they would.

Having current, reliable data is the best way to make informed business decisions. Bigger companies employ people to crunch their numbers. However, most dental offices do not have the luxury of a metrics department. Our offices generate an incredible amount of data but lack the capacity to properly use that information.

What can a dental practice do to be able to properly run itself as a small business? The challenge is finding a way to optimize use of your practice data. That solution is called Jarvis Analytics.

Jarvis Analytics is an incredibly powerful tool to help unlock the power behind the numbers of your practice. It’s true that you must understand the numbers, but it is just as important to know which numbers are important to understand. One of the great things about Jarvis Analytics is it was designed by people who truly understand what needs to be measured in dentistry, both from the clinical and the operational perspective in the forms of key performance indicators.

After trying out the company's analytics software, here are the impressions for the Jarvis Analytics Test Drive conducted by John Flucke, DDS.