The use of lasers in dentistry is increasing as more and more practitioners learn of the benefits that lasers can bring to their patients. Some of the benefits that lasers can offer in dental treatment are a decrease in postoperative pain, a decrease in the need for injected anesthetic, and improved soft tissue management in restorative procedures. When hard-tissue lasers are used to remove caries, there is the benefit of conservation of tooth structure as the laser is much more precise when compared to the high-speed drill.
Anything that we can do for our patients so that they may have a more positive dental experience is a win-win situation for everyone involved. Patients who have little to no postoperative discomfort are more likely to follow through with the treatment recommendations that we make, and they will also be more likely to refer their family and friends.
However, sometimes clinicians shy away from incorporating lasers into their practices as any new technology can be intimidating. I have used soft and hard tissue lasers in my practice for a little more than 5 years. Before I incorporated lasers in my practice whenever I came across an article or advertisement about lasers in dentistry I was a little skeptical. How could it be possible to remove caries from a tooth without injected anesthetic and have the patient not be in pain? How could soft tissue be removed without bleeding? How could the practice afford the cost of a laser? These were just a few of the many questions that I had.
I did not personally know any dentists who were using lasers so that I could ask them about their experiences. There also were not many university-based continuing dental education courses related to the use of lasers in dentistry. The dental laser companies were a good source of information to answer my questions about incorporating lasers into my practice. Now I know many clinicians may be wary of relying on the laser manufacturers for information, but their representatives and the clinicians who lecture for them can supply you with a great deal of clinical and financial information on how to incorporate lasers into your practice. I have attended lectures, meetings, and laser trainings that were organized by BIOLASE through the World Clinical Laser Institute. I attended some lectures and meetings even before I purchased a laser and had the opportunity to meet other dentists who were already using lasers. Many of the clinicians who lecture and train for the laser companies are very fine practitioners who have much wisdom to share in the area of laser dentistry. I have also attended university-based continuing education on lasers, but these courses are difficult to locate.
The first laser I used in clinical practice was a diode laser, the LaserSmile by BIOLASE. This laser is used for soft tissue procedures and laser teeth bleaching with a specific gel. About 6 months later I began to use a hard tissue laser, the Waterlase MD by BIOLASE. I can tell you that even after over 5 years of use I still am amazed everyday at what I can accomplish with this technology. Yes, it is possible to remove caries from a tooth without injected anesthetic and have the patient not be in pain. Many soft-tissue procedures can be performed without bleeding.
The key to success with laser technology is a strong commitment to training. All dentists possess the clinical skills to use lasers, but need to learn the clinical applications for the technology and how to apply the technology to accomplish the treatment objectives. In other words, with a carious lesion the treatment objective is to remove the caries and restore the tooth. Whether you use a high speed handpiece or a laser you still must remove the caries and restore the tooth. The manner in which the caries is removed, high speed drill or laser, is the only difference.
In future posts I will write about basic laser physics and how it relates to the clinical applications of lasers in dentistry. Lasers can be a very effective technology that can improve our the care and experiences of our patients.
Cynthia Jetter, DMD, owns a private laser dentistry practice with her husband, Donald W. Jetter, DMD, in Voorhees, New Jersey.