When we were planning our new office location a few years ago, the dental equipment and supply company we worked with offered us a dental laser unit to sweeten the deal. We were thrilled to have them throw in an $85,000 freebie, but didn’t quite know what to do with it at first. All we knew was that it had lights that flashed, buttons to be pushed, and a cool futuristic look. We dusted it and hung our jackets on it for 6 months before I finally decided to take the plunge and try to figure out how to use the thing.
That plunge has been quite an education. I initially took a few courses offered by Biolase, the manufacturer of our laser. I learned some useful information specific to our unit, but found that many of the claims they made seemed to over-hype what the laser could do. I then joined the Academy of Laser Dentistry, an international association of dentists who use or want to learn about lasers, and proceeded with their coursework. Over two years I completed their courses in laser safety, regulation, fundamentals of laser science, dental applications of lasers, and study of the many different types of lasers used in dentistry. I obtained both a laser safety officer and laser proficiency certification, and began to finally put our laser into use. What I have found is that although the media hype exaggerates the capabilities of lasers in dentistry, when used properly and as indicated lasers can be a fantastic tool to enhance our dentistry.
Uses for lasers in dentistry
Dental lasers function by using laser light energy to affect tissue. Most commonly, either soft-tissues (gum tissue, lesions, muscle bands) are shaped, coagulated or removed, or hard-tissues (tooth structure, decay, bone) are shaped or removed. There are other cases where different lasers at very low-energy are used to reduce inflammation and swelling, and some to help detect tooth decay inside the tooth. Each of the above categories of laser use requires different types of laser energy, and no one unit can do them all well or safely (despite the claims of manufacturers).
Types of lasers used in dentistry
The different types of lasers are based upon what the laser uses to emit its light energy (and thus what properties that light energy possesses). An argon laser uses argon-ion gas, a CO2 laser uses compressed CO2 gas, a diode laser use semi-conductors, and our office laser uses Er:Cr:YSSG (erbium, chromium, yttrium, scandium, gallium, garnet) to produce its light energy. All the above have different properties and thus different applications that they are best used for. Ours is one of only two that are considered dual-purpose lasers in that they can be used well for both soft-tissue and hard-tissue applications.
Does a laser provide pain-free dental procedures?
So what claims are exaggerated? The top one is that lasers are pain-free. While it is very true that there is less pain with lasers, probably only about 40% of the time at most can laser procedures be done without numbing the site first. I still read ads claiming the end of needles because of laser dentistry - just not true. The other common claim is that they are faster. In most cases lasers are not faster and can sometimes be slower (although better trumps faster in my book).
The best advantages of lasers in dentistry
That brings me to what is best about lasers. They kill bacteria and other pathogens as they work, so there is less chance of post-operative infection and less need for antibiotics. They coagulate tissue very well, and so less bleeding means less contamination of the field for improved visibility and lack of interference with bonding procedures. The ability to coagulate tissue also reduces the need for the placement of sutures. Lasers are also kinder to the tissues and so there is less swelling, less soreness, and faster healing following treatment.
In summary, dental lasers are not the perfect solution to every dental procedure we do. On the other hand, I find myself being thankful every day that I had the laser handy; its been a great option to have available for me and for our patients.