Where Do We Stand On The Use Of Lasers In Dentistry?

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.

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.

READ The Shocking Truth about Dentists: They Over-treat

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.

More Uses Of Lasers In Dentistry

Minor Surgical Procedures

Another major advantage of lasers apart from being noiseless and vibration-free is that they allow a bloodless field of surgery. The heat produced by lasers helps seal the blood vessels as they are being cut, thereby controlling bleeding automatically.

Some patients assume that lasers will lead to less pain than traditional methods of surgery, although evidence has found that this may be anecdotal at best. Certain studies have found however that the healing which takes place after a procedure performed with lasers is quicker and with less complications than other methods. This again is disputed and recent evidence suggests that while an increased rate of healing may be seen in some cases, there is no guarantee that using lasers will always accelerate the rate of healing.

Depigmentation procedures, which involve removing only the topmost thin layer of gingival tissue without exposing any of the underlying bone can be quite technically demanding when performed in the traditional manner. The use of lasers to perform the same procedure has meant that it can be performed by almost anyone without much trouble.

The lack of tactile sensation and depth of penetration variability, however, means that the fine granular control present with scalpels is not quite present and so their use is still limited in larger, more invasive surgeries.

Tooth Whitening

A number of tooth whitening products exist which use lasers to activate the hydrogen peroxide containing "whitening gel". This causes the gel to release oxygen molecules as well as dehydrate the enamel layer causing it to become lighter in shade.

Conclusion

The use of lasers in dentistry has been around for a long time now, upwards of 30 years in fact, so why is it that not every dentist is utilizing lasers in their daily practice? There are several reasons for why such a transformation in dental practices has not taken place including a prohibitively high cost, lack of sufficient training and an aversion to change.

READ The Neurocranial Vertical Distractor - How Dentists Can Fix Broken Brains

The main reason, however, is that while the applicability of lasers in dentistry is unquestionable, they have not proven to be demonstrably superior to traditional methods being use. There is not even a single procedure which can only be performed with a laser or would be much better performed with a laser or even much easier to perform.

Until such advancements can be made to make lasers integral to dental procedures, their use will always remain limited to niche procedures.