Gingivectomy

1. Before bringing the patient back to the clinic, make sure you prepare your station for everything that you might need

Laser Checklist

• Place new laser tip and make sure it is scored correctly

• Have foot pedal in ideal place for the Doctors accessibility

• Protective eye wear

• Articulating paper

Station Checklist

• Cheek retractors

• Numbing Gel with cotton tip applicators

• Lidocaine in Syringe (Just in case/set aside)

• Surgical Suction

• Large/Small mirrors

• Small Cup with 2-4 mm of water in the bottom and 10 micro-brushes. Place them on the tray so they are easily accessible for you as an assistant.

If you have all of these things you are ready to ROCK AND ROLL! It is better to be over prepared than unprepared.

2. Going to get your patient. Approach the patient by name and greet them. Before taking them to the clinic, take progress/before photos. Even though they had photos at the debond, you want accurate, current photos! This also helps you and the doctor decide what teeth need soft tissue contouring.

PHOTOS NEEDED: Facial smiling photo, close up smiling photo, and center bite with cheek retractors.

Once the photos are loaded, walk them back to the clinic and get them seated. Make sure they are comfortable, blanket, etc. Ease as much stress or concern as you can, and explain the process so there are no surprises.

3. Place cheek retractors (no driangles are needed). Have the pt bite on the small suction during this process. Before placing the gel make sure that it is ideal timing to start your procedure with Dr. time and the schedule.

4. Use air syringe to dry the tissue and apply numbing gel in designated area. Let the topical gel sit for five minutes. While it is sitting, make sure the gel is staying in designated area and not traveling to other parts of the mouth (tongue, throat, etc. It will make the patient uncomfortable). After it has been five minutes, using the surgical suction, remove the topical gel.

5. Once the topical gel is removed you may remove the cheek retractors and make the patient comfortable. Continue to let the gel absorb for 5-10 minutes. During this time make sure the patient does not drink any water or rinse unless it is absolutely necessary.

6. After it has been 5-10 minutes since the gel was removed you are now ready for the doctor to come over. Make sure you have gloves and a mask ready for the doctor. The doctor will sit at the head of the chair and the you (the assistant) will have the surgical suction at hand on the left side of the patient, or wherever the doctor specifies for convenience (If more anesthetic is going to be given have it ready for him at this time).

9. Before the procedure begins, make sure the pt has protective eye wear and any others within the area. Let the pt know that they should not feel anything, but if they start to feel something past tolerance to raise their hand and the procedure will stop and more anesthetic can be given (have the lidocaine syringe ready).

10. When the procedure begins, the assistant will follow behind the laser with the surgical suction. Lightly hover the gum tissue, catching any smoke, smells, etc. Also be aware of the area and use the wet micro-brushes as needed to clean up or be ready to hand the doctor one when asked for. Your number one job is to stay out of the doctors line of sight, but to also catch any smell with the suction from the tissue. The smell can be alarming to the patient, so whenever the doctor is using the laser, you should be suctioning!!

11.. When the procedure is done, make sure to take after photo, the same photos that were taken at the beginning, and go over all oral hygiene care and instructions.

Instruct the patient to keep the area clean and give Chlorhexidine mouth rinse if needed. It will take up to 5-7 days for the tissue discoloration, pain, etc. to go away but some patients it can be up to 14 days.

12. Scan the patient for a new clear retainer if needed and schedule the patient to come back for the new retainer, and also a follow up for final full records (all photos). At this apt we will check the tissue to make sure it has healed properly.