Lasers in Dentistry
Steven D. Spitz, DMD
Interest in dental lasers for both dentists and patients has grown in recent years, as lasers make dental procedures faster, more efficient, less invasive, and show improved esthetics. Given the great benefits of utilizing lasers in dentistry, it is surprising that there isn’t one in every dental office.
Lasers are expensive, require training and confidence to utilize, and have been confusing as to their use and mechanics, swaying dentists away from the technology. Early marketing of lasers told dentists that lasers would replace drills, and anesthetics would no longer be necessary. While these statements can be true, they are not complete. Lasers perform any procedure that can be done with a drill or a scalpel, and usually better; however, not everyone has the ability or the training to do all procedures. Many practitioners found that they would not, and should not, do every procedure without anesthetics as suggested, especially when taking the patients’ comfort into consideration. The actual procedure of preparing teeth with the laser proved to be slower than a traditional handpiece and there were no procedures exclusive to laser use, until now. Recently, three lasers came to market that changed the laser playing field.
Millennium Dental created the Laser Assisted New Attachment Procedure (LANAP,www.lanap.com) the first laser procedure on the market that could be completed exclusively with their Nd:YAG laser, PerioLase® MVP-7™, much like Lasik eye surgery is exclusive to one machine. The LANAP protocol is a patient-accepted, evidence-based laser gum disease surgery, developed with the purpose of helping patients save their natural teeth and avoid the fear and pain associated with traditional gum surgery. This is actually changing the laser landscape.
Following that example, BioLase has recently provided a similar reason to purchase their WaterLase laser (www.waterlase.com), specifically the “repair” protocol. The WaterLase Er,Cr:YSGG perio-protocol utilizes a step-by-step procedure that helps manage early, moderate, and severe chronic periodontitis. This protocol is broken into pre-surgical, surgical, and post-surgical phases. During the pre-surgical phase, the patient has a comprehensive periodontal evaluation. Supra- and subgingival biofilm and calculus are removed, and oral hygiene compliance is initiated and evaluated as part of the phase I treatment.
During phase II, a surgical treatment plan is developed, which encompasses single or multiple teeth sites, a quadrant, or half-mouth, depending on the number of indicated sites. Immediate post-surgical procedures include light teeth-brushing with soft bristles and using mouth rinse rather than brushing if discomfort exists. There should be no probing for at least 3 months. At this time, a supragingival scaling is completed.
The new modified CO2 laser from Convergent Dental (Solea, www.convergentdental.com) has also changed the scope of lasers by making hard tissue dentistry just as fast or faster than conventional techniques in a virtually noiseless and mostly anesthesia-free environment. Solea’s innovative technology is combined with familiar controls, so clinicians can easily transition from using the drill to using the Solea laser. Also, a simple touchscreen facilitates the operating process, as it allows Solea users to select the desired tissue(s) for optimal beam speed, precision, and patient comfort.
With the recent advancements and further progress expected in the future, it is an exciting time to be using hard and soft tissue lasers.