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When thinking of lasers, many of us picture a science fiction movie
character wielding a laser weapon capable of melting or destroying property
(or people, or even aliens) at great distances. While certain laser
technology can indeed cause this type of damage, we must remember that they
are specifically engineered for that purpose. Most lasers, including those
used in dentistry, are engineered and designed to perform special functions
without changing or damaging the surrounding tissues or materials. Think,
instead, of the lasers used around us everyday, such as those found in the
barcode scanners at the grocery store or those that make CD music possible.


Lasers deliver energy in the form of light. Depending on the intended result, this energy travels at different wavelengths and is absorbed by a "target." In dentistry, these targets can be enamel, decay, gum tissue, or whitening enhancers. Each one absorbs a different wavelength of light while reflecting other wavelengths. No measurable effect is seen beyond the intended target site. Lasers are very specific in regard to the wavelength produced. This means that there must be a different laser for each type of procedure that you want to complete. There is little or no sound associated with laser treatment, a pleasant treat for the dental patient who has experienced the whine of the dental drill. As technology advances, we hope to see lasers which can be used for several related treatments combined into one convenient machine.

There are currently four areas of dental care that are enjoying the
benefits of laser technology:

Cavity removal can be accomplished with two currently available (and
FDA approved) laser machines. Both have the ability to remove decay within a
tooth, and prepare the surrounding enamel for bonded fillings. The need for
anesthesia is greatly reduced or eliminated over the traditional methods.
Laser energy dramatically reduces the bacteria found in dental decay, and has
been demonstrated to enhance the tooth's ability to "heal" in situations
where "deep cavities" had existed. There are, however, several limitations
to laser decay removal including the inability to adequately remove silver
fillings, onlays, and crowns.

Curing, or hardening bonding materials is another area where lasers
have become important. These lasers drastically reduce the time it takes to
finish a filling, and create what some researchers have shown to be a
stronger restoration.

Whitening teeth can be accomplished with special solutions that are
applied to the tooth surface in the dental office and activated by laser
energy. Color changes of several shades is possible in a very short time.
When combined with at-home tray based whitening systems, dramatic changes can be seen in even the most difficult cases.

Periodontal, or gum related care is the fourth area benefiting from
laser technology. Lasers are currently used for recontouring or reshaping
gums (often described as "plastic surgery for the smile"), removing extra or
diseased gum tissue associated with the use of certain medications or
periodontal disease, and removing the bacteria in periodontal pockets to
promote healing. Healing time and postoperative discomfort can be
significantly reduced over the traditional surgical methods.

Dental lasers have been shown to be safe and effective for treating both children and adults. Very specific equipment and training are required to incorporate this technology into the dental office, and many dentists are becoming involved in providing laser care. Research with the technology and design enhancements with the machines themselves are proceeding at a staggering pace. We look to the future with great excitement as the use of laser energy in dentistry expands to include many more procedures.

Microabrasion: High technology Decay Removal

Another technique for removing decay while reducing the need for
anesthesia is called microabrasion. While there are a number of different
machines available to dentists, they all work on the same principle, and can
greatly enhance a patient's dental care experience.

Microabrasion is a procedure involving a fine stream of particles aimed
at the decayed portion of a tooth. These particles are often silica,
aluminum oxide, or even baking soda based. They are propelled toward the
tooth by air or bottled inert gasses through a handpiece, and remove small
particles of decay as they strike the tooth's surface. These particles are
then "vacuumed" away through the use of the suction system as with the
traditional methods. A "rubber dam" technique is often used when this system
is used, and involves using a thin latex sheet to isolate the tooth from the
patient's lips and tongue. Microabrasion is also frequently used to prepare
a surface for bonding or sealants.

While frequently described as creating a "dusty" taste, many patients
enjoy the absence of sound associated with this technique. It is virtually
silent as it removes areas of decay. There are, however, limitations in its
use including the inability to remove any metallic restorations like silver
fillings, onlays, or crowns.

Laser Q and A

Are Lasers new to dentistry ?
No. Lasers have been used in general dentistry for many years. Recent advances in the technology have made it possible for lasers to be used in individual dental offices. Some of the dental laser products are similar or identical in design to those which have been successfully used for more than 25 years in Operating Rooms of hospitals around the world. In these Operating Rooms, lasers perform intricate and sensitive surgical procedures in the fields of ophthalmology, neuro-surgery, Ear/Nose/Throat (ENT) and dermatology.

Are Lasers safe?

Yes. In the hands of a qualified trained dentist, lasers are very safe. As with any device used in the dental practice, the dentist must undertake the appropriate training and there are several laser dentistry courses and instructors dedicated to this cause. The primary safety measure required during laser surgery is protective eyewear.

In some cases, when compared to traditional devices, dental lasers can actually minimize the risk of damage to lateral tissue, based on the precise and specific control over power output, time and spot size. This concise control is unique to lasers, and in the right hands, actually makes the laser a safer tool, hence the success of medical lasers in the extremely sensitive areas of neurology and ophthalmology. It is imperative to have this type of control to minimize the risk of damaging healthy delicate tissues of the tooth and gums.

Laser light is much more efficient that conventional light sources, in that lasers produce an intense and narrow, concentrated beam of light comprised of a single wavelength. In contrast, traditional light sources encompass a continuum of light comprising the entire spectrum including infrared (heat) and ultraviolet. As lasers are capable of producing the exact wavelengths required, the same energy can be delivered using a laser with lower power in a shorter period of time, hence less heat and potential damage to surrounding tissue.

In certain procedures, when compared with electrocautery and high speed curing lights, lasers can actually provide a safer environment for the patient. Even though lasers are somewhat new to the general dental practice, medical lasers were introduced in the 1960's and the safety of medical lasers is substantiated by several years of qualified research and many published reference papers. The FDA has approved several different hard and soft laser dentistry applications, including use on adults and children.

Will there be pain experienced in laser dentistry?

No. In most cases, pain is either eliminated entirely or significantly reduced as a result of the lasers selective, precise control. With laser dentistry, one of the fundamental advantages is the minimal requirement for anesthetic. When performing many of the procedures, the laser kills bacteria in the mouth, eliminates bleeding through coagulation, and reduces pain, in many procedures to the degree that no anesthetic is required. Lasers also promote faster healing which minimizes the discomfort associated with the healing process.

What are some of the benefits of laser dentistry?

There are several. It's important to recognize that the technology offers benefits to the patient as well as the dentist. Here are some of the primary benefits;

Benefits for the Dentist Benefits for the Patient
- Practice growth and differentiation
- Precise incision, excision and ablation
- Quality of work;
- Increased bond strength
- Higher tensile strength
- Reduced micro-leakage
- Clean, clear operative field
- Reduced stress
- Cleaner procedure, no harmful plume
- Greater through-put (of patients)
- No arcing to metals
- Incremental Revenue (more referrals)
- Greater efficiency (more procedures/visit)
- Fiber delivery provides greater access
- Visibility in oral cavity (Argon)
- No vibration
- Minimal anesthetic requirement
- Higher profile
- Minimal or no bleeding
- Faster healing
- Reduced post-operative infection
- Minimal or no anesthesia
- Minimal pain, inconvenience, discomfort
- Less time in chair
- Precise wavelength minimizes probability of thermal damage to surrounding healthy tissue.
- Less fear, anxiety, stress - No drill sound
- Conserves tooth structure
- Whitening - single visit procedure and no risk of absorption of harmful chemicals by the gums
- No needles, no drill, no pain !

What types of procedures can be performed with a Laser?

There are a variety of different lasers approved for use in dentistry. These lasers produce unique wavelengths, each of which are designed to have specific reactions when contacting hard and soft dental tissue. Some lasers can support multiple wavelengths within a single unit, hence are capable of delivering the optimal wavelengths for multiple procedures (i.e. - soft tissue management, curing and whitening are all optimized at different wavelengths).

Some of the procedures which are performed by dental lasers include;

Caries Removal/Cavity Preparation - Class I-IV - 96% Anesthetic Free
Laser Etching
Laser Whitening (approx.1hour)
Laser-assisted Soft Tissue Curettage
ENAP - Excisional New Attachment Procedure
Aesthetic Contouring
Ginigival Troughing - Eliminates Need to Pack Cord
Gingival Retraction
Implant Exposure
Sulcular Debridement
Root Planing
Aphthous Ulcers
Oral Lesion Therapy
Diagnosis - Trans-illumination for detection of caries micro-fractures
Caries Resistance
Bacteria Elimination and Delayed Re-population
Tissue Fusion - Replacing Sutures
Crown Lengthening
Laser Assisted Flap Surgery
Removal of Granulation Tissue
Composite Curing
- Ceramic Onlay
- Ceramic Crown
- Ceramic Laminates/Veneers
- Posterior/Anterior Composites




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