Biolase Waterlase Express User manual

User Manual

PAGE IS LEFT BLANK INTENTIONALLY.

3
Contents
INTRODUCTION................................................................................................................... 7
1 OVERVIEW....................................................................................................................... 8
2 INDICATIONS FOR USE.................................................................................................. 9
3 SPECIFICATIONS............................................................................................................ 12
3.1 Dimensions.................................................................................................................................... 12
3.2 Electrical........................................................................................................................................ 12
3.3 Air and Water Spray ...................................................................................................................... 12
3.4 Optical ........................................................................................................................................... 12
4 EQUIPMENT DESCRIPTION ......................................................................................... 13
4.1 System Components..................................................................................................................... 13
4.2 General.......................................................................................................................................... 13
4.2.1 Laser console ........................................................................................................................ 14
4.2.2 Tablet ..................................................................................................................................... 17
4.2.3 Fiber Delivery System ........................................................................................................... 17
4.2.4 Wireless Footswitch............................................................................................................... 18
5. CONTRAINDICATIONS, WARNINGS, AND PRECAUTIONS ....................................... 19
5.1 Contraindications........................................................................................................................... 19
5.2 Warnings and Precautions ............................................................................................................ 19
6. SAFETY WITH THE WATERLASE EXPRESS............................................................... 22
6.1 Safety Measures ........................................................................................................................... 22
6.2 Safety Classication...................................................................................................................... 22
6.3 Safety Instructions......................................................................................................................... 23
6.4 Safety Features............................................................................................................................. 24
7. INSTALLATION AND SETUP ......................................................................................... 25
7.1 Facility Requirements.................................................................................................................... 25
7.2 Environmental Requirements........................................................................................................ 25
7.3 Setup Requirements...................................................................................................................... 26
7.3.1 Connecting the Laser System ............................................................................................... 26
7.3.2 Using the Remote Interlock ................................................................................................... 27
7.3.3 Installing the Handpiece Holder............................................................................................. 27
7.3.4 Installing the Tablet................................................................................................................ 28
Waterlase Express User Manual

Contents
7.3.5 Filling the Patient Water Bottle .............................................................................................. 29
7.3.6 Installing the Fiber Optic Cable Support Arm ........................................................................ 30
7.3.7 Connecting the Fiber Optic Cable ......................................................................................... 31
7.3.8 Installing the Fiber Optic Cable Retainer............................................................................... 32
7.3.9 Connecting/Disconnecting the Handpiece to the Fiber Optic Cable...................................... 33
7.3.10 Installing and Changing the Tip in the Handpiece ............................................................... 34
7.3.11 First Time Start-up ............................................................................................................... 35
7.3.12 Enabling BIOLASE CONNECT ........................................................................................... 37
8. OPERATING INSTRUCTIONS ....................................................................................... 38
8.1 Overview ....................................................................................................................................... 38
8.2 Tablet Holder - Function Control Button and LED Indicators......................................................... 38
8.3 Daily Start-up................................................................................................................................. 39
8.3.1 Initiating the Laser from OFF Status...................................................................................... 39
8.3.2 Waking the system from SLEEP mode.................................................................................. 40
8.4 Activating the Waterlase Express.................................................................................................. 40
8.5 Turning the Waterlase Express Off................................................................................................ 41
9. USER INTERFACE ......................................................................................................... 42
9.1 Icons - Denition............................................................................................................................ 42
9.2 Main Menu..................................................................................................................................... 44
9.2.1 Learning Center..................................................................................................................... 44
9.2.2 Settings.................................................................................................................................. 45
9.2.3 System Information................................................................................................................ 45
9.2.4 Maintenance.......................................................................................................................... 46
9.2.5 Session Review..................................................................................................................... 46
9.2.6 Web Portal............................................................................................................................. 47
9.3 Home (Procedures Main) Screen.................................................................................................. 48
9.4 Favorites........................................................................................................................................ 50
9.4.1 Create a Favorite................................................................................................................... 50
9.4.2 Rename or Delete a Favorite ................................................................................................ 51
9.4.3 Adjusting the Handpiece, Aiming Beam, and Illumination ..................................................... 51
9.5 Presets .......................................................................................................................................... 52
9.6 Basic Mode.................................................................................................................................... 52
9.7 Advanced Mode............................................................................................................................. 52
9.7.1 Accessing Advanced Mode.................................................................................................... 53
9.7.2 Software/Firmware/Content Updates .................................................................................... 54
9.8 System Flow Chart........................................................................................................................ 55
4Waterlase Express User Manual

5
Contents
10 CUTTING TISSUE .......................................................................................................... 56
10.1 Hard-tissue Cutting...................................................................................................................... 56
10.2 Soft-tissue Cutting....................................................................................................................... 57
11 CLEANING, DISINFECTION, AND STERILIZATION .................................................... 58
12 MAINTENANCE ............................................................................................................ 61
12.1 Daily Care of the Tablet and Console.......................................................................................... 61
12.2 Annual Maintenance.................................................................................................................... 61
12.3 Service and Calibration ............................................................................................................... 61
12.4 Tip Inspection .............................................................................................................................. 61
12.4.1 Tip Inspection Instructions (Using the Tip Cleaning and Inspection Kit).............................. 62
12.4.2 Inspecting the Plastic Ferrule .............................................................................................. 63
12.5 Tip Cleaning ................................................................................................................................ 63
12.6 Handpiece Mirror Inspection ....................................................................................................... 64
12.6.1 Removing the Handpiece Mirror.......................................................................................... 64
12.6.2 Changing the Handpiece Mirror........................................................................................... 65
12.6.3 Mirror Alignment Check ....................................................................................................... 65
12.7 Fiber Optic Cable Check ............................................................................................................. 66
12.7.1 Replacing the Protective Window........................................................................................ 67
12.8 Installing/Replacing the Wireless Footswitch Batteries............................................................... 68
12.9 Pairing the Footswitch and Laser................................................................................................ 68
12.9.1 Pairing the Footswitch and Laser ........................................................................................ 69
12.9.2 Selecting the Footswitch Channel ....................................................................................... 70
12.10 Internal Cooling Water Reservoir .............................................................................................. 71
12.10.1 Filling the Internal Cooling Water Reservoir ...................................................................... 71
12.10.2 Draining the Internal Cooling Water Reservoir .................................................................. 72
12.11 Transportation............................................................................................................................ 73
12.12 Storage...................................................................................................................................... 73
13. TROUBLESHOOTING.................................................................................................. 74
13.1 Troubleshooting........................................................................................................................... 74
13.1.1 Error Messages ................................................................................................................... 74
13.1.2 Problem/Warning Messages................................................................................................ 77
Waterlase Express User Manual

Contents
APPENDIX A – LABELS .................................................................................................... 78
APPENDIX B – ACCESSORIES/SPARE PARTS .............................................................. 84
APPENDIX C – TIPS........................................................................................................... 85
APPENDIX D – ELECTROMAGNETIC COMPATIBILITY.................................................. 87
APPENDIX E – WIRELESS EQUIPMENT COMPLIANCE STATEMENT.......................... 91
INDEX.................................................................................................................................. 92
Waterlase Express is indicated for professional use on dental patients. Procedures must be
performed only by licensed dental practitioners in a dental facility. Use of this device requires
clinical and technical training, and this manual provides instructions for use.
The Waterlase Express tablet contains video animations which demonstrate specic clinical
applications available with the device. All statements of individual claims presented are based
on references which can be viewed within the White Paper section of the Learning Center on
the Waterlase Express tablet.
CAUTION: From time to time you may see software related updates from Samsung, please
do not accept or execute software related updates without further instruction from BIOLASE
to ensure that updates will not adversely impact the use of your Waterlase Express.
6Waterlase Express User Manual

7
OverviewIntroduction
Congratulations on the addition of the Waterlase Express™ all-tissue laser to your practice! Waterlase
patented technology provides a minimally invasive, highly precise, and exceptionally gentle dental
experience for your patients, as well as unmatched results in treatment outcomes.
This User Manual is designed to help you become familiar with the operation and functions of the laser
system. Read it carefully before using the laser clinically, follow all safety instructions and cautions, and
always have it accessible as a reference.
We appreciate your commitment to better care and know your investment in this technology is a sound
foundation for the successful growth of your practice.
BIOLASE Team
Waterlase Express User Manual

1Overview1Overview
The Waterlase Express all-tissue laser is a unique Er,Cr:YSGG* solid state tissue-cutting system
manufactured by BIOLASE for use in oral hard- and soft-tissue dental applications. It sets a new
standard of affordability, accessibility, and ease of use for all-tissue lasers.
Waterlase Express utilizes advanced laser and water atomization technologies to safely and effectively
cut, shave, contour, roughen, etch, and resect oral hard-tissues, and direct laser energy to perform oral
soft-tissue removal, incision, excision, ablation and coagulation. Waterlase Express may also be used
for specic endodontic and periodontal applications.
When used for oral hard tissue procedures, the Waterlase Express laser provides optical energy to a
user-controlled distribution of atomized water droplets and hydrated surface layer of hard-tissue. The
water present in the target tissue absorbs laser radiation, resulting in explosive molecular expansion
and ablation of hard-tissue. The water in the spray provides cooling and hydration for the target tissue.
For oral soft-tissue procedures, the Waterlase Express laser applies optical energy to the soft-tissue for
tissue removal, incision, excision, ablation and coagulation, using direct laser energy. These procedures
can be done in conjunction with water, for cooling and hydration, or without water, for coagulation.
A exible Fiber Optic Cable connects at one end to the laser and at the other to a Handpiece that
delivers laser energy to the target tissue through a ber Tip. A visible light emitted from the Handpiece
head illuminates the area of treatment. Certain laser parameters may be adjusted by the user for both
soft- and hard-tissue applications. The laser is activated using a Wireless Footswitch.
A removable Tablet serves as the user interface. Through the Tablet, the user may select laser
procedures, access information on the system’s clinical performance, and view educational and
reference materials. The user may also utilize the Tablet to communicate directly with BIOLASE
customer care, educators, and peer professionals. Additional service needs are also provided
through the Tablet, but no patient data of any kind is stored on the Tablet itself or the laser system.
Waterlase Express is indicated for professional use on dental patients. Procedures must be performed
only by licensed dental practitioners in a dental facility. Use of this device requires clinical and technical
training, and this manual provides instructions for use.
If used and maintained properly, Waterlase Express will prove a valuable addition to your practice.
Please contact BIOLASE customer service at 1-800-321-6717 in the U.S. and Canada for
any service needs; if you are located outside North America, please contact your BIOLASE-
authorized representative.
In Canada, this device must be installed, operated, and maintained according to the current revision
of the guidelines specied in the Canadian standard CAN/CSA-Z386:2014 safe use of lasers in
health care.
*Erbium, Chromium: Yttrium-Scandium-Gallium-Garnet
8Waterlase Express User Manual

9
2Indications for Use2Indications for Use
The Waterlase Express may be used for the following indications:
GENERAL HARD-TISSUE INDICATIONS*
• Class I, II, III, IV and V cavity preparation
• Caries removal
• Hard-tissue surface roughening or etching
• Enameloplasty, excavation of pits and ssures for placement of sealants
*For use on adult and pediatric patients
ROOT CANAL HARD-TISSUE INDICATIONS
• Tooth preparation to obtain access to root canal
• Root canal preparation including enlargement
• Root canal debridement and cleaning
ROOT CANAL DISINFECTION
• Laser root canal disinfection after endodontic treatment
ENDODONTIC SURGERY (ROOT AMPUTATION) INDICATIONS
• Flap preparation – incision of soft-tissue to prepare a ap and expose the bone
• Cutting bone to prepare a window access to the apex (apices) of the root(s)
• Apicoectomy – amputation of the root end
• Root end preparation for retroll amalgam or composite
• Removal of pathological tissues (i.e., cysts, neoplasm or abscess) and hyperplastic tissues
(i.e., granulation tissue) from around the apex
BONE SURGICAL INDICATIONS
• Cutting, shaving, contouring and resection of oral osseous tissues (bone)
• Osteotomy
SOFT-TISSUE INDICATIONS INCLUDING PULPAL TISSUES*
Incision, excision, vaporization, ablation and coagulation of oral soft-tissues, including:
• Excisional and incisional biopsies
• Exposure of unerupted teeth
NOTE: Any tissue growth (i.e., cyst, neoplasm or other lesions) must be submitted to a
qualied laboratory for histopathological evaluation.
Waterlase Express User Manual

2Indications for Use2Indications for Use
SOFT-TISSUE INDICATIONS INCLUDING PULPAL TISSUES* (CONTINUED)
• Fibroma removal
• Flap preparation – incision of soft-tissue to prepare a ap and expose the bone
• Flap preparation – incision of soft-tissue to prepare a ap and expose unerupted teeth
(hard and soft-tissue impactions)
• Frenectomy and frenotomy
• Gingival troughing for crown impressions
• Gingivectomy
• Gingivoplasty
• Gingival incision and excision
• Hemostasis
• Implant recovery
• Incision and drainage of abscesses
• Laser soft-tissue curettage of the post-extraction tooth sockets and the periapical area during
apical surgery
• Leukoplakia
• Operculectomy
• Oral papillectomies
• Pulpotomy
• Pulp extirpation
• Pulpotomy as an adjunct to root canal therapy
• Root canal debridement and cleaning
• Reduction of gingival hypertrophy
• Removal of pathological tissues (i.e., cysts, neoplasm or abscess) and hyperplastic tissues
(i.e., granulation tissue) from around the apex
• Soft-tissue crown lengthening
• Treatment of canker sores, herpetic and aphthous ulcers of the oral mucosa
• Vestibuloplasty
*For use on adult and pediatric patients
NOTE: Any tissue growth (i.e., cyst, neoplasm or other lesions) must be submitted to a
qualied laboratory for histopathological evaluation.
10 Waterlase Express User Manual

11
2Indications for Use2Indications for Use
LASER PERIODONTAL PROCEDURES
• Full thickness ap
• Partial thickness ap
• Split thickness ap
• Laser soft-tissue curettage
• Laser removal of diseased, infected, inamed and necrosed soft-tissue within the
periodontal pocket
• Removal of highly inamed edematous tissue affected by bacteria penetration of the pocket
lining junctional epithelium
• Removal of granulation tissue from bony defects
• Sulcular debridement (removal of diseased, infected, inamed or necrosed soft-tissue in the
periodontal pocket to improve clinical indices including gingival index, gingival bleeding index,
probe depth, attachment loss and tooth mobility)
• Osteoplasty and osseous recontouring (removal of bone to correct osseous defects and create
physiologic osseous contours)
• Ostectomy (resection of bone to restore bony architecture, resection of bone for grafting, etc.)
• Osseous crown lengthening
• Removal of subgingival calculi in periodontal pockets with periodontitis by closed or open curettage
• Waterlase Er,Cr:YSGG assisted new attachment procedure (cementum-mediated periodontal
ligament new-attachment to the root surface in the absence of long junctional epithelium)
Waterlase Express User Manual

3Specications3Specications
3.1 DIMENSIONS
• Laser console (W x L x H) 9 x 18 x 12 in (23 x 46 x 30.5 cm)
• Tablet (W x H x D) 6.7 in x 9.3 in x 0.2 in (16.9 cm x 23.8 cm x 0.6 cm)
• Screen size 9.7 in (24.6 cm)
• Weight laser console (with water) 27.2 lbs (12.3 kg)
• Weight Tablet 0.9 lbs (390 g)
3.2 ELECTRICAL
Class I Medical Electrical (ME) Equipment
• Operating voltage 100 - 240 VAC
• Frequency 50 / 60 Hz
• Current rating 6A / 3A
• Main control Main Power Switch
• On / Off control Keyswitch
• Remote interruption Remote interlock connector
3.3 AIR AND WATER SPRAY
• Water type Distilled or De-Ionized only
• External air source 60-120 psi. (4.1 – 8.2 bar)
• Water 0 - 100%
• Air 0 - 100%
3.4 OPTICAL
• Laser classication IV (4)
• Medium Er,Cr:YSGG
(Erbium, Chromium: Yttrium, Scandium, Gallium, Garnet)
• Wavelength 2.78 µm (2780nm)
• Mode Free-running Pulsed
• Frequency (Pulse Rate) 5 – 50 Hz
• Average power 0.1-4.0 W
• Power accuracy ± 20%
• Pulse energy 10– 250 mJ
• Pulse duration for “H” mode (Short pulse) 60 µs
• Pulse duration “S” mode (Long pulse) 700 µs
• Handpiece head angles 70° contra-angle
• Fiber Tip diameter range (Spot size) 200 – 1200 µm
• Output divergence ≥ 8° per side
• Aiming beam 625-670 nm (red) laser, 1mW max (Laser Class 1)
• Nominal ocular hazard distance (NOHD) 5cm
• Maximum permissible exposure (MPE) 3.46 X 10⁵W/m²
12 Waterlase Express User Manual

13
4Equipment Description4Equipment Description
4.1 SYSTEM COMPONENTS
The Waterlase Express laser system includes the following*:
• Laser Console
• Tablet and International AC Adapter
(packed separately)
• Tablet Protective Covers
• Fiber Optic Cable
• Fiber Optic Cable Support Arm
• Fiber Optic Cable Retainer
• Yellow Air Tube
• Laser Protective Eyewear (3)
• Handpieces (2)
• Handpiece Holder
• Fiber Tip Starter Kit (Assorted Tips)
• Fiber Tip Holder
• Internal Reservoir Fill Kit
• Tip Cleaning and Inspection Kit
• Power Cord (1-US, 1-Int’l, 1-UK)
• Remote Interlock Plug
• Wireless Footswitch
• Footswitch Batteries
• Welcome Kit – Includes:
• Welcome Letter
• Waterlase Express User Manual
• Waterlase Express Quick Start Guide
• Laser Warning Sign
• Product Registration Flyer
• Limited Warranty
*Additional accessories, including extra Handpieces, Tips, and screen protectors may be ordered
separately from BIOLASEstore.com.
4.2 GENERAL
The Waterlase Express laser system consists of four primary components:
1. Laser Console
2. Tablet
3. Fiber Delivery System
4. Wireless Footswitch
Waterlase Express User Manual

4Equipment Description4Equipment Description
4.2.1 LASER CONSOLE
POWER CONNECTION/MAIN POWER SWITCH
The power cord attaches to the back panel of the laser console. The other end must be plugged into an
electrical power source in order for the laser system to work. The main power switch serves as a line
switch to separate the console from the main power supply (O = OFF, I = ON)
KEYSWITCH
Located on the right front panel of the laser console, the Keyswitch is used to turn the laser ON by
turning the key clockwise to a horizontal position; always use only the key provided. The key cannot be
removed while it is in the ON position. Always remove the key when the laser is left unattended.
EMERGENCY STOP
The emergency stop (red) button is located on the left front panel of the laser console. Pressing this
button instantly stops the emission of laser energy; the button will glow red to indicate the emergency
stop has been engaged and the screen will display the message “Emergency Stop Pressed.”
Figure 4.1
Power Connection | Main Power Switch
Air Inlet Connector
Remote Interlock Outlet
Internal Reservoir Connector
14 Waterlase Express User Manual

15
4Equipment Description
TABLET HOLDER
The Tablet Holder is the hinged panel located at the front of the console and includes the control panel
and Tablet Latch. The Tablet is inserted into the control panel, once in place and connected to the
micro USB inside the panel, it is locked into position by ipping the Latch over the top of the Tablet (a
thumbscrew at the rear of the latch prevents removal of the tablet).
CONTROL PANEL
The Function Control button is located in the center of the control panel; it activates the controls and
display, and is used to place the system into Ready (green), Standby (amber), or Sleep mode.
There are also two LED indicators on either side of the function control button; one indicates the
Tablet is properly installed, and the other conrms the wireless connection with the Footswitch is active.
HANDPIECE HOLDER
The Handpiece Holder cradles the Handpiece when it is not in use. It can be attached to the Tablet
Holder on the right or the left, based on user preference.
4Equipment Description
Figure 4.2
Waterlase Express User Manual
Tablet Holder/ Control Panel
Tablet Latch
Emergency Stop
Tablet
Keyswitch
Handpiece Holder
Tablet Connectivity Indicator
Function Control Button
Wireless Footswitch
Connectivity Indicator

4Equipment Description4Equipment Description
PATIENT WATER BOTTLE
This is a detachable water bottle located on the back of the console that is the water supply for the
Handpiece atomization spray. A push-button release is located on the top of the self-contained patient
water bottle that releases the bottle from the console for lling/relling with distilled or de-ionized water.
VENTILATION CHANNELS
The slots on the sides and rear of the console provide an air ow path to cool the laser system. Do
not cover or block these during use; leave a minimum of 4 inches between the laser console and any
wall or partition.
AIR INLET CONNECTOR
This adaptor on the back of the console provides the connection to a compressed dry air outlet at
60 – 120 psi (4.1 – 8.2 bar) using the yellow tubing provided.
Fiber Optic Cable
Fiber Support Arm
Ventilation Channels
Patient Water Bottle
Patient Water Bottle Release
Handpiece
Handle
Ventilation Channels
Figure 4.3
CAUTION: Moisture or oil in the air supply line will damage the laser system. Always provide
an air dryer, mist separator, and proper ltration at the compressor output to eliminate all
moisture or oil from the air source. Any damage from moisture or oil in the air line is not
covered by the system warranty.
16 Waterlase Express User Manual

17
4Equipment Description4Equipment Description
REMOTE INTERLOCK PLUG
This plug connects the laser to a door switch (not included). It will stop the laser immediately if the
operatory door is opened while the laser is in use. Although use of this feature is optional, the plug itself
must be inserted in the Remote Interlock Outlet at the rear of the console for the laser system to operate.
INTERNAL COOLING WATER RESERVOIR FILL CONNECTOR
The Waterlase Express laser system contains an internal cooling water reservoir which must be
lled prior to initial use of the laser. A reservoir ll kit is included with the system and attaches to the
connector on the rear of the console.
FIBER OPTIC CABLE SUPPORT ARM
This removable accessory supports the weight of the Fiber Optic Cable, keeping it from looping to the
ground; its use is optional, based on user preference.
HANDLE
Use the handle at the top of the console to lift, carry, or reposition the laser on a stable, at surface.
4.2.2 TABLET
The system is operated through a Tablet terminal display that has wireless remote access capability;
when Wi-Fi connectivity is activated, the Tablet allows remote access by BIOLASE for diagnostics,
software/rmware updates, and other system data requirements. No patient data is accessed. When
installed in the Tablet Holder, the Tablet will charge only if the power to the laser system is ON.
4.2.3 FIBER DELIVERY SYSTEM
FIBER OPTIC CABLE
The Fiber Optic Cable contains the optical ber together with the illumination waveguide, air tubing and
water tubing. Laser radiation is delivered from the laser to the Handpiece through the optical ber.
FIBER OPTIC CABLE RETAINER
Please note that a Fiber Optic Retainer, as described in Section 7.3.8, is included with your Waterlase
Express. This optional accessory is initially installed by your authorized Waterlase Field Service
Technician. The Fiber Optic Retainer is only installed if the Handpiece Holder is installed on the right
side of the Tablet holder. Its use is not recommended if the Handpiece Holder is installed on the left side
of the Tablet holder.
NOTE: To enable the interlock feature, call BIOLASE for instructions if necessary.
Waterlase Express User Manual

4Equipment Description
Cover
4Equipment Description
CAUTION: Repeated rapid tapping of the Footswitch may cause a system error; release the
Footswitch, wait 2 seconds, then press rmly down on the Footswitch to clear it. A system
restart is not required.
LED Indicator Status
Blue Solid The Footswitch is connecting to the laser, or has successfully
paired with the laser.
Green Solid
ON: The Footswitch is pressed while paired to the laser.
OFF: The Footswitch is not pressed, or the system is in Sleep
mode, or the batteries are dead.
Green Blinking The Footswitch batteries are low; replace the batteries.
Amber Blinking or Solid A critical error or short has occurred; the relevant error message
will appear on the Tablet screen.
18 Waterlase Express User Manual
HANDPIECE
The Handpiece is re-usable, rotatable, and detachable from the Fiber Optic Cable and must be cleaned
and sterilized between patients (see section 11). It delivers optical energy, illumination, air, and atomized
water spray to the treatment area and utilizes a variety of Tips to focus the optical energy on the
selected treatment site.
A visible light emitted from the Handpiece head illuminates the area of treatment. The visible spot of
the aiming beam should be clear, uniform, and well-dened. If the aiming beam is not present while in
Ready mode or when the laser is ring, replace the Fiber Delivery System.
4.2.4 WIRELESS FOOTSWITCH
The Waterlase Express laser will only emit laser
energy when the user presses down on the Footswitch
while the laser is in Ready mode. It is designed to
pair with the laser console using wireless technology
and is powered by two (2) AAA batteries. (Refer to
Section 12 for instructions on how to replace the
Footswitch batteries
included with the system).
The Footswitch is protected by the Footswitch Cover.
To access, press down on the Footswitch Cover.
Three separate LED indicator lights are displayed on
the top of the battery housing of the Footswitch. Figure 4.4
Footswitch
Pairing Button/
Battery
Compartment
Cover

19
5Contraindications, Warnings, and Precautions5Contraindications, Warnings, and Precautions
5.1 CONTRAINDICATIONS
All clinical procedures performed with the Waterlase Express must be subjected to the same clinical
judgment and care as with standard techniques. Patient risk must always be considered and fully
understood before clinical treatment. The clinician must completely understand the patient’s medical
history prior to treatment and exercise caution for general medical conditions which might contraindicate
a local procedure. Such conditions may include, but are not limited to, allergy to local or topical
anesthetics, heart disease (e.g., pacemakers, implantable debrillators), lung disease, bleeding
disorders, or an immune system deciency. Medical clearance from the patient’s physician is advisable
when doubt exists regarding treatment.
5.2 WARNINGS AND PRECAUTIONS
PRESCRIPTION STATEMENT
U.S. Federal Law restricts this device to sale by or on the order of a dentist or other licensed
dental practitioner.
TRAINING
Only licensed professionals who have reviewed and understood this user manual and have received
proper training on how to correctly operate the system should use this device. Procedures related to
soft-Tissue, osseous, endodontic, or periodontal surgery should only be performed by clinicians who
have training and experience in Oral Maxillofacial, Periodontal, or Endodontic surgery.
EYEWEAR
Doctor, patient, assistant, and all others inside or entering the operatory must wear appropriate laser
protection eyewear for the 2780 nm wavelength (OD 3 or greater) whenever the laser is in use. Prior to
use, inspect eyewear for pitting and cracking; do not use if damaged.
ANESTHESIA
Although in many cases anesthesia may not be required, patients should be closely monitored for signs
of pain or discomfort. If such signs are present, adjust settings, apply anesthesia, or cease treatment
if required.
TREATMENT, TECHNIQUE, AND SETTINGS
Always start treatment at the factory-installed default settings for the chosen application and adjust
as required. Closely observe clinical effects and use your judgment to determine the aspects of the
treatment (e.g., technique, proper power, pulse mode, air and water settings, tip type, and duration of
operation) and make appropriate adjustments to compensate for varying tissue composition, density,
and thickness.
CAUTION: Always check the eyewear specications as etched on the glasses to ensure they
offer the protection required for the laser wavelength.
Waterlase Express User Manual

5Contraindications, Warnings, and Precautions5Contraindications, Warnings, and Precautions
CLINICAL ENVIRONMENT
Only use this device in clinical environments that observe proper standard aseptic techniques with all
oral procedures.
HARD-TISSUE PROCEDURES
All hard-tissue (enamel, dentin, cementum and bone) procedures must be performed using air and
water spray at appropriate settings. Failure to use the spray will result in tissue thermal damage.
SOFT-TISSUE PROCEDURES
Soft-tissue procedures can be performed using two pulse duration settings H-Mode and S-Mode, either
with water for cooling and hydration, or without water for coagulation.
The S-Mode (long pulse) settings are indicated for soft-tissue applications only. Do not use S-Mode
to perform hard tissue procedures.
FLUID ENTRAPMENT AND AIR EMBOLISM
Do not direct air or spray toward tissues that may trap air or water. For example, when performing
surgical procedures the clinician should be aware of adjacent soft-tissue pockets, cavities, or channels
that may collect or entrap air. Always use high-speed suction to remove any excess uid and avoid
directing the spray into deep pockets. Do not use the Waterlase Express if it is not possible to access
the treatment site without directing air into an area that may collect or entrap air. In general, the same
care and precautions should be taken when using the Waterlase Express as are taken when using any
air and water emitting cutting device.
ROOT CANAL PROCEDURES
The Waterlase Express is better suited for straight and slightly curved canals. Great care should be
taken during instrumentation of curved canals as the endodontic Fiber Tip may break or perforate
through the wall of these types of canals. If during insertion the Fiber Tip does not advance easily into
the canal, do not force it. If necessary, pull the Fiber Tip out and use an endodontic hand le or a broach
to open the path. Do not force the Tip and/or activate the laser while moving the Tip inside a narrow or
curved canal, or through the apex. Place the end of the Tip ~2mm from the apex or from being in contact
with the wall of a curved canal. Activate the laser and spray only during the outward stroke when the
Fiber Tip is pulled towards the coronal portion of the canal.
ROOT CANAL DISINFECTION PROCEDURES
The same precautions and warnings stated above are applicable to root canal disinfection procedures.
The Fiber Tips designed for this indication are the radial emitting RFT2 and RFT3, which have a 200 µm
and a 300 µm diameter, respectively, and come in various lengths to accommodate different root canal
lengths. Effective laser root canal disinfection is performed with air and no water spray. Do not exceed
the maximum air setting (10%) for this procedure.
20 Waterlase Express User Manual