The US Food and Drug Administration (FDA) has approved over 30 separate dental procedures in which lasers can be used. They include cutting cavity preparations in teeth, removing soft tissue sores with surgery, and even preparing teeth for a root canal.
Using lasers in dental care may be the biggest advancement in dental technology in 50 years. A recent issue of the Journal of the American Dental Association reported that 82 per cent of dental patients surveyed felt that lasers should be a part of the dentist’s treatment equipment.
For further information
To understand why lasers are so ground-breaking, just talk to the dentists who began working in the late 1950s and early 1960s. At that time, the old slow speed, belt-driven hand drill with a steel bur was replaced. The new device used compressed air to produce cutting speeds of greater than 150,000 revolutions per minute. Lengthy and often painful procedures were shortened. A modern era of dentistry was launched.
Today’s dentists use a vastly improved version of the air rotor-driven drill to cut through teeth and (at slower speeds) bone. This rotor, along with modern local anesthesia (painkiller), has done much to reduce the pain of tooth repair. However, the lips, gums and face may feel ‘frozen’ for some time after dental work is done. In rare cases, patients are allergic to the local anesthesia or have uncomfortable side effects. More recently, using gas like nitrous oxide (laughing gas) combined with oxygen to relieve pain has come back into favour. Intravenous medications are also used in some offices for analgesia (pain relief) and to remove the fear of dental procedures.
Dentists must control three other problems created by these high-speed air rotor-driven cutting instruments. These tools create heat, vibration and sound. This can kill vital tooth pulp or crack the enamel structure of the tooth. As a result, a root canal or cap (crown) may be required. In extreme cases, the tooth can be lost. Certainly no one enjoys hearing the high-pitched whine of the hand drill as it cuts tooth structure.
One problem with the earlier versions of dental lasers was that one type of laser cut hard tissue and another, the soft tissue (gums). Some new lasers can do both. Although cutting hard tooth structure with a laser is slower than with a high-speed air-driven hand drill, everyone, especially children, may benefit from less noise and heat.
An example is the Waterlase® YSGG laser. It reportedly eliminates the vibration and destructive aspects of the heat that comes from cutting tooth structure and bone surrounding and holding teeth in the jaws. The laser’s work is done without noise, other than a start-up thump. Of course, lasers do produce heat. However, it is only in a very small area of affected tissue. It is not spread through the entire tooth. Water spray works with YSGG laser energy to produce an effect known as hydrokinetics, a patented cutting tool.
Lasers can eliminate various types of soft tissue problems in the mouth and oral region. Painful lesions like canker or cold sores are no match for laser therapy. They can be instantly removed, often without using medication to stop pain. Tissue cut by lasers heals faster and seldom results in scarring. Since the laser clots blood, there is little or no bleeding at the site. Without blood in the way, a surgeon can see better when using a laser to make incisions. Lasers can be used to take a piece of soft tissue from the mouth to test in a lab (called a biopsy). There is no need for stitches afterwards, or for a return visit to have them removed.
Another benefit to using lasers in dentistry is the painkilling effect. This has proven very helpful when treating children with decayed teeth. With lasers, there is no need for local anesthesia in many procedures. No shot, no drill, no pain! Injections are still a dreaded part of dental care for anxious patients. Most patients are happier with a treatment that lessens or eliminates the need for a shot.
It is reasonable to be concerned about safety, especially when we think of star wars military technology being used in health care. Modern dental lasers focus on a very small working area of less than two millimetres. The patient and dental staff wear specially designed safety glasses to protect the eyes.
Lasers have become common in many areas of health care. Only recently has technology evolved to allow them to cut hard structures like tooth and bone in dental offices. These machines operate quietly with no vibration and less heat than previous tools. They reduce or eliminate the need for painkillers. Dentists and patients are taking notice. You may find that a laser is already being used in your dentist’s office. If you are interested in the technology, or have concerns or questions, just talk to your dentist.