Dr Linhlan Nguyen shares her experience as student and teacher of laser dentistry

By Danny Chan

It is estimated that around 6% of dentists currently use lasers in their practice. With clinical application of laser dentistry still very much in its infancy, early adopters often complain about a steep learning curve with little guidance on the technological uses and applications – beyond product manuals and online literature that barely scratch the surface.

Once a traveller on that lonely learning path, Dr Linhlan Nguyen is today a bona fide laser practitioner fully plugged into a supportive dental laser learning community. She gives her own laser dental workshops and lectures in Australia and overseas. Dr Nguyen is a returning speaker at the upcoming 8th Annual Laser & Health Academy Symposium held in Portoroz, Slovenia.

Even though the Principal Dentist of a private practice in Canberra espouses the benefits of lasers in dento-facial aesthetics (her area of expertise) to a global audience with such ease and eloquence today, it wasn’t that long ago that she was entertaining early adoption doubts.

Dr Nguyen dipped her toes into the world of laser dentistry as early as in 2009.

“That was when I took on CEREC and decided to get serious with adhesive restorative dentistry and ceramic work. Resin bonding requires absolute moisture control so I learned to use diode laser for soft tissue management.”

Even though laser soft tissue management soon became inseparable from her routine practice work, she was at the time, still unconvinced that “hard tissue laser could work properly”.

Somewhat bogged down by what she calls “misleading information about hard and soft tissue lasers”, Dr Nguyen was nonetheless impressed by what she saw in the Fotona Lightwalker. She came across the award-winning hard and soft tissue laser at Australia’s first-ever staging of Aesthetic Dentistry Conference, AesthetiCon in September 2015.

Wowed by the multiple applications that Fotona LightWalker afforded to perform aesthetic treatments as well as NightLase, non-ablative laser treatment for snoring, Dr Nguyen purchased the “universal” all-tissue laser from Innovative Medical Technologies (IMT) later that year. IMT is a Melbourne-based Fotona reseller and medical equipment company that specialises in laser products.

“I had two weeks to play with it during the Christmas break. The deeper I looked into the manual, the more I was overwhelmed by the number of applications that I could potentially use. I knew I had to seek proper education.”

Unlike some of her peers who were left to struggle on their own, Dr Nguyen received timely help. On invitation of IMT, she began to attend laser dentistry workshops that gave her the product orientation she badly needed – but it only whetted her appetite for more. 

“The LightWalker offers over 80 applications. I started to get the “How” but I needed to know the “Why” for performing all those procedures.”

It was perhaps fortuitous then that around the time, the Laser and Health Academy (LA&HA) launched its inaugural Masters in Laser Dentistry program – which Dr Nguyen, through her connections at IMT, promptly signed up for.  
A total of 5 modules are available through the Master’s Program, which can be completed between 12 and 36 months. Dr Nguyen took the accelerated course route, completing all of the 5 modules – which were held in different countries across Europe – within 6 months. The courses are now available in Australia through IMT, in partnership with Laser and Health Academy.

In May 2017, she joined Dr Jason Pang and Dr Johnny Chan as the three Australian dentists – among a group of eight international course attendees – to become first Graduates of the Laser and Health Academy Master’s in Laser Dentistry.

The in-depth knowledge she acquired from the different application-based modules, she says, quickly contributed to her work and practice: “When I started the Masters program, my LightWalker got busy in all aspects of dentistry.”
One of many rediscovered tools she finds useful is Fotona’s TwinLight Periodontal Treatment (TPT), a comprehensive and minimally invasive periodontal therapy that capitalises on the advantage of LightWalker’s dual laser wavelengths.

Fotona’s LightWalker AT-S  boasts two highly effective laser wave-lengths: Er:YAG and Nd:YAG with energy levels up to 5 times greater than previous generation lasers. Between the two laser wavelengths, the LightWalker units cover practically all laser-assisted dental treatments – including endodontic, periodontal, peri-implantitis, tooth whitening as well as the novel NightLase® snoring therapy and facial skin treatments such as wrinkle reduction.

Dr Nguyen describes how combining the LightWalker with a formal laser education opened her eyes to new treatment methods, paving the way to higher success rates and more predictable outcomes.
 
“TwinLight treatment helps to achieve higher success rates in endodontics by better debridement and disinfecting the canals, sub canals as well as dentinal tubules. We carry out about five endodontic cases a week. Having high success rate is absolutely important to us,” Dr Nguyen stresses.

“TwinLight treatment is fantastic in periodontics. I have since found the ability to carry out sub-gingival debridement and calculus removal, granulation tissue removal, disinfection of the pockets and stabilising of the clots critical for success of periodontal treatment.

In the treatment of recent cases of peri-implantitis, Dr Nguyen saw much faster healing and less post-op pain in her surgical work such as removal of broken and/or impacted teeth and implantology.

She says laser use for cavity preparation, especially deep preparation, can be very conservative – and useful in avoiding pulpal exposure. “In case of pulpal exposure, pulpotomy can be done neatly.”

The clinician also uses laser to treat patients with TMD and chronic pain.

“Photobiomodulation for pain relief and healing using the Genova handpiece has been a wonder. It is applied after all of my surgical cases to minimise pain, swelling and accelerate healing. In fact, Genova handpiece has used the most in my practice.”

The Fotona Lightwalker even makes work more enjoyable, Dr Nguyen enthuses:

“I must say I did not really enjoy doing periodontal treatment previously. Seeing the results that I can achieve with the LightWalker has been a good motivation factor.”

More than just shortening the learning curve, the LA&HA Masters Program has also helped Dr Nguyen build staff and patient morale at her clinic.

“As my career advances and my patients’ basic dental health have gotten better, they expected more advanced treatment to improve function and aesthetics. Laser assisted dentistry adds another level of care to my patients. Apart from the benefits of better treatment outcomes, patients can also appreciate the way in which technology is being harnessed for their wellbeing.

“Staff working at practices that provide better training, better technologies and better care do stay with the practice longer. They take pride in staying on top of the game and ahead of the technological curve.”

For all the advantages of laser dentistry, Dr Nguyen says the main barrier to its widespread adoption lies in the lack of education and resistance to change.

“Laser Dentistry has not been given adequate attention in dental schools. Other factors I believe that are hindering its progress has to do with ego, ignorance and funding. Our dental schools should be looking into teaching Laser Dentistry. That would be my dream.”  

The pioneering graduate of LA&HA Master’s Program insists that education is essential for proper adoption of laser dentistry – encouraging like-minded peers to look for reliable laser product suppliers that provide adequate technical, community and educational support.

“The LA&HA Master’s Program has given me the in depth knowledge and skills necessary to perform the best laser treatment I could possibly give patients. With the right knowledge and experience, I am able to share my skills with my colleagues.

Dr Nguyen hopes to fill the knowledge gap, even as she continues to learn and acquire new skills.

“After all, laser dentistry is like other specialties, where ongoing training and support are essential for growth. It is a lonely road when you are on your own.”

 

From complete fit out to online training, industry experts join forces to provide end-to-end solution for your surgery’s sterilization needs.
 
By Danny Chan
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Infection control and sterilization may not be the first things that come to mind when building a practice. Nonetheless, it is important to note that any mistakes from the outset – whether in terms of steri room design, setting up disinfection control protocols or workflow – can prove to be more costly than initially thought.
 
We have all read media reports of surgeries being forced to close due to insufficient hygiene procedures and failure to comply with minimum standards. It’s easy to conjecture how such incidents could have been prevented with better planning or by installing the right equipment and so on. Yet how far can you vouch for the hygiene standards of your practice prevailing in an audit today? For that matter, do you know what a fully compliant sterilization room is or isn’t?
 
Keeping abreast of changing sterilization regulations may not be as simple as it sounds. Meanwhile, failure to comply can incur hefty penalties. In extreme cases, you may lose your practice licence for good. Instead of guesswork, wouldn’t it be safer to employ a team of industry experts that can align your surgery’s hygiene practices with prevailing safety standards?
 
Henry Schein Halas (HSH) have partnered with Ritespace Steri Solutions (RSS) and Prof. Laurie Walsh to do just that. Newly launched in Australia, Total Steri Solutions provide an all-encompassing service to help secure sterilisation compliance and workflow for your practice.
 
Check your blind spots
 
Total Steri Solutions was birthed out of the observation about the rising incidence rate of Australian surgeries that fail to comply with sterilization standards leading to forced closure and the increased scrutiny by Dental Associations both in Australia and around the world. Led by Henry Schein Halas, discussions with Prof Laurie Walsh and subsequently Ritespace Steri Solutions took place with an aim to develop a unique solution package that addresses all the compliance issues – many of which may be hidden in the dentist’s peripheral vision.

There are several pitfalls that make Australian dentists stumble in the area of sterilization compliance, says Andreas Schulz, Total Steri Solutions Lead:

“One common blind spot relates to proper storage and documentation – where to store, find, fill in and maintain the correct protocols and procedures. The other one is unexpected staff turnover resulting in constantly having to retrain new personnel on sterilization protocols, while lacking the educational resources or skilled trainers for the task. Unexpected breakdowns due to wrong usage of equipment or protocols can also cause dramatic outcomes.”

Perhaps the most common problem stems from a lack of focus, Andreas adds:

“Most dental surgeries focus on issues like creating customer satisfaction, great “in chair” experiences and attractive marketing. Those time-consuming activities can distract you from the rather complicated sterilization issues that often get compromised, whether knowingly or otherwise.”

What’s in the package
 
Total Steri Solutions effectively draw on industry-leading expertise representing every field of dental sterilization: Disinfection equipment, instruments and consumables supply (HSH); steri room design, build and construction (RSS); as well as sterilization compliance protocols and workflow (Prof. Walsh). Together, these field experts help take the hassle and guesswork out of sterilisation room design, certification and maintenance.
 
“It’s a unique peace-of-mind package that guarantees clients a state-of-the-art, fully certified and audit-ready work environment,” says Total Steri Solutions Lead, Andreas Schulz. Indeed, you would be hard-pressed to simply locate a similar offering on the market – not to mention the end-to-end services that are included in the package.
 
Here is what you can expect from a Total Steri Solutions (TSS) setup:

• Customised and purpose-built sterilisation room – fully compliance tested and certified
• State-of-the-art equipment
• Fully compliant workflow including tracking*, recording and storage of data
• Installation and handover over in a single weekend limiting practice downtime
• Operating Lease ensures a 100% tax-deductible monthly payment fixed over 5 years
• App for compliance information, document storage, access to information, videos and training
• Online compliance and work flow material and workbook presented by Prof. Laurie Walsh
• Automated monthly consumables packages included in payment plan
• 5-yearly renovation for ongoing compliance

 
*Dependent on chosen equipment.
 
App to get you started
 
One of the most unique aspects of the TSS package lies in the use of a purpose built app, which allows the customer to create a bespoke steri room design, in collaboration with the TSS team.
 
The interactive app provides a digital platform upon which experts from the Henry Schein and Ritespace team may design a fully complaint workflow based on your input. Incorporating all the proposed design, equipment and technological elements, an elevation drawing may be created to offer you a pre-visualization of how the space would look like.
 
Based on a unique leasing model, the app can even calculate the estimated monthly fees covering: Rental costs of all the equipment and technology; ordering of consumables (which is done automatically); and accessing online training resources on sterilization compliance and certification.
 
All relevant costs are automatically rolled into a fixed, 100% tax-deductible monthly price – calculated for a period of 5 years. The package is renewable at the end of every 5-year period, upon which the steri room would receive another round of renovations to maintain optimal workflow and compliance.
 
All in a weekend’s work
 
Upon confirmation, it would take approximately 6-8 weeks for all the hardware and services to be shipped onsite. And here is the deal clincher: Complete fit out and installation of the steri room all takes place within a single weekend! By working during the surgery’s closing hours, this exclusive feature is designed to save on exorbitant downtime costs – which even based on conservative estimates is pegged around $15-20K.
 
Responsible for the physical design and build of the steri room, Ritespace is the solutions partner that makes this fast, hassle-free turnaround a reality. Armed with over 40 years of collective experience in dental practice renovations, the team at Ritespace is one of few fit out firms that has a clear understanding of the current standards in infection control and instrument re-processing.
 
“There are some very strict guidelines pertaining to flooring, lighting, plumbing, positions of sinks, electrical standards and the entire workflow. Even our cabinetry designs incorporate elements of infection control,” says Simon Bubear.
 
“With the assistance of Professor Laurie Walsh, our whole steri design concept is built around ensuring complete compliance. Our combined expertise and methodical approach to meeting high sterilization standards certainly allow dentists to feel confident about our fit outs.”  
 
A typical fit out includes demolishing an existing steri room before re-installing a brand new state-of-the-art sterilisation room – including equipment, cabinetry, lighting, flooring, ceiling, plumbing, heat extraction, air con filters/outlets, eventual 3-phase output and painting. Depending on your requirements or preference, the equipment range may include: Thermo disinfector, ultrasonic bath, lubrication machine, autoclave, RO system, software, data logger, etc.
 
“Given that we have all trades under one roof here at RiteSpace and dedicated teams of tradesmen that build dental practices every day, we have no problems in guaranteeing complete turnaround in one weekend,” says Simon.
 
Full customization. Full compliance. No compromise.
 
On average, Andreas confirms, TSS is able to work on 8 separate installations throughout Australia on any given weekend. Remarkably, even as each fit out design and layout is fully customizable, every single installation will be fully compliant with current infection control standards and sterilization requirements. This is, after all, the solution’s main selling point.

“We work hand in hand with Prof. Laurie Walsh on the correct translation and execution of all involved products, work flow, services and space-related aspects to finalize a solution package that fully complies and addresses current standards and requirements,” Andreas emphasizes.

“Total Steri Solutions effectively minimise most factors of risk, human error and training deficiency to offer a proven end-to-end solution to maintain ongoing safety and compliance.”

“This has been, from inception, the major selling point of Total Steri Solutions that we make no bones about. For a package that delivers such critical services to the dental profession, TTS is truly unlike any other product on the market today.”