1. Before bringing the patient back to the clinic, make sure current photos are in chart and displayed on the computer screen. Make sure you know why they are getting a Frenectomy (upper, lower, braces, etc.)
2. 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
- Tray Checklist
- Cheek retractors
- Numbing Gel
- Lidocaine in Syringe (Just in case/set aside)
- Cotton tip applicators
- 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.
3. Going to get your patient. Approach the patient by name and greet them. 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.
4. Lay the patient back and 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.
5. 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.
6. 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.
7. 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.
8. 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).
9. 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.
10. Depending on the size of the frenum, you made need to use the Mathieu to hold the extra tissue while it is being removed (Cotton pliers can also be used so have both available).
11. When the procedure is done, make sure to take after photos 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. Go over instructions to pull the lip away from the tissue while it is healing so it can heal properly. Answer all questions and concerns before the patient leaves. A follow up appointment may be scheduled if needed.