When I try to teach dentists about being efficient, we always seem to get into a conversation about tissue control and hemostasis. Some use a laser, some use cord, some use Expasyl or Traxodent with a Comprecap; there are lots of methods to try and control bleeding in the sulcus. I use a laser most of the time, but that is not my tip.

The problem is not that the tissue is bleeding, but why is it bleeding? What actually caused it? I find that when doctors are prepping, the first thing they want to do is chase all that interproximal decay out of the tooth. Where, most of the time, is that decay located? Correct...subgingival! Well what happens when we prep subgingival? Correct again...we cause the tissue to bleed.

My tip is: Don't cause the bleeding and then try to stop it. Control the tissue first, then chase the decay. Rough out the prep supragingival first. It doesn't matter if there is still decay there. I know it's tempting to go after it, people! I'm one of you, remember? Don't do it. Get the ideal supragingival prep design done first. At that point, use your laser to remove the excess tissue or pack your two cords to move the tissue away from the decay. Once you have the tissue controlled, then go ahead and remove the remainder of the decay.

You will be amazed at how much less you will cause tissue to bleed. The use of magnification at this step helps tremendously also. My tip for this week is to control the bleed before it happens. It's one more way to be more efficient!