Sunday, March 31, 2013

Is That A Laser Or Are You Just Glad To See Me?


Advances in the development of various lasers, especially for use on human tissues, can benefit dental and medical patients in many ways. But dentists can't quite get rid of the drilling hand piece or scalpel because lasers aren't that versatile just yet. An acronym, the word laser stands for Light Amplification by Stimulated Emission of Radiation.

Lasers get their powers from light, also known as electromagnetic radiation. Light is made up of massless photons which travel pretty fast- 186,000 miles a second or 700million miles an hour, in a vacuum! The light in lasers, for them to work properly, must be restricted down, by choice, to a monochromatic (one color) concentrated beam, that is coherent, which means that all of the photons have the same amplitude and wavelength. After being energized through a gain medium and a population inversion is achieved, the beam is collimated, say,  along an optical fiber, and, after being focused, the laser can then be put to use.

The basic uses of lasers are their abilities to thermally heat up (to cut or vaporize) the tissue areas on which they are focused. There are lasers of a certain energy that are optimal in treating soft tissues, like skin and gums, and others that are better at influencing hard tissues, like enamel, dentin, and bone. The light of a laser can be pulsed or be delivered as a continuous stream. The first one created, a ruby laser, was introduced in 1960. It used a synthetically-produced ruby crystal as its gain medium. It was used in range finding by the military and also for drilling holes in diamonds. Lasers were first used in dentistry in 1994.

Lasers can be employed to clean the pockets around the roots of the teeth (Laser Curettage). Forming a better attachment between the tooth root and the bone is another use (LANAP). Filling materials placed in or on a tooth can be "cured" and hardened with a laser more quickly. The teeth whitening process can also be debatably enhanced. Gum tissues can be contoured and some surface biopsies can be performed with a laser with very little bleeding seen afterward (hemostasis). There are about 30 applications in which lasers can be used, and that number will surely grow as the technology advances. High-volume air suction gets rid of the smoke and vapors, and water streams are used to cool the areas undergoing lasing in the mouth. There are things in Dentistry that lasers can't do, like remove old fillings, shape or polish new fillings, prepare teeth for crowns, or obviate the need for anesthesia, among other things.

Soft tissue lasers can cost about $4,000 out of the box. New hard-tissue lasers can run around $40,000. Extensive training in their use is required. Less than 10% of dentists in the U. S. use them. One type of laser cannot do everything. The FDA is one of several governmental agencies that are tasked with clearing and verifying that the lasers used in the U. S. are manufactured consistently and function properly for the safety of patients and for the safety of the operating teams. The American Dental Association has yet to give its Seal of Approval on a laser system.

May you have many...precisely-calibrated, zap-um-good...smiles!

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