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Laser Dentistry was supposed to be the painless, noiseless future we should be living in already. So why aren't we?

The word "laser" is actually an acronym that stands for Light Amplification by Stimulated Emission of Radiation. It is important to understand that lasers have some unique properties that make them so versatile and lend tremendous potential to their use in the medical field.

All of the light that is emitted by lasers is one single phase, one single wavelength and non-divergent in nature. That means that the light can be focused on a very tiny area without damaging any other vital structure nearby.

Lasers have been approved for use in dentistry since 1994 and have successfully been used in a wide variety of situations.

Tooth Decay

Tooth decay or dental caries is extremely common all over the world. In fact, it is difficult to find people who have never had a cavity filled or any kind of tooth decay in their lives. The traditional way of removing decayed tooth material involves the use of mechanical instruments whose use is accompanied by a large amount of noise, water and vibration to the tooth.

Lasers that are capable of removing tooth structure can help in cavity preparation without any of the above. They also have the added advantage of leaving behind a sterile field of work.

The disadvantage, however, is the fact that dentists do not have any tactile feedback while preparing the cavity and that they are unsure as to the depth of penetration of the lasers.

Root Canal Treatment

Root canal treatment is one of the areas that hold the most promise for the use of lasers in dentistry. A root canal involves locating all the canals present in the tooth, shaping them and enlarging them, disinfecting them and then finally filling them with a biocompatible material.

Lasers can help in the shaping and enlarging step but as mentioned earlier, they travel in straight lines, while a root canal is almost always curved in at least two dimensions. This means that their use is limited to a select few circumstances.

Disinfecting root canals is another matter, though. Several studies have found that disinfectants that are activated through lasers are very effective. Another technique that involves the use of acoustic waves being produced by lasers to disinfect the canals, called photodynamic therapy, has also shown very encouraging results in studies.

The only thing that dentists worry about is the increase in temperature that takes place with the use of lasers. This can be extremely detrimental to the tooth being treated, as well as the surrounding ligaments and gingival fibers.

Advances have been made to incorporate the use of low energy lasers which do not cause an increase in temperature. Once again the inherent property of lasers to leave behind a sterile field is very desirable in disinfecting the root canals.  

Gum Treatment

The use of lasers as a method to aid in disinfection of the root surfaces and aid in the elimination of pockets in both surgical and non-surgical circumstances has also been investigated. While lasers were found to be effective in disinfecting clean root surfaces, they were not very effective in actually removing the tartar and diseased tissue themselves.

None of the things achieved by use of lasers in gum treatment were things that could not be achieved through traditional methods. A lot of dentists found this to be advocating change for the sake of change rather than having any demonstrable value.

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