Lasers in Dentistry When thinking of lasers, many of us picture a science fiction movie character wielding a laser weapon capable of melting or destroying property (or people, or even aliens) at great distances. While certain laser technology can indeed cause this type of damage, we must remember that they are specifically engineered for that purpose. Most lasers, including those used in dentistry, are engineered and designed to perform special functions without changing or damaging the surrounding tissues or materials. Think, instead, of the lasers used around us everyday, such as those found in the barcode scanners at the grocery store or those that make CD music possible. Lasers deliver energy in the form of light. Depending on the intended result, this energy travels at different wavelengths and is absorbed by a "target." In dentistry, these targets can be enamel, decay, gum tissue, or whitening enhancers. Each one absorbs a different wavelength of light while reflecting other wavelengths. No measurable effect is seen beyond the intended target site. Lasers are very specific in regard to the wavelength produced. This means that there must be a different laser for each type of procedure that you want to complete. There is little or no sound associated with laser treatment, a pleasant treat for the dental patient who has experienced the whine of the dental drill. As technology advances, we hope to see lasers which can be used for several related treatments combined into one convenient machine. There are currently four areas of dental care that are enjoying the benefits of laser technology: Cavity removal can be accomplished with two currently available (and FDA approved) laser machines. Both have the ability to remove decay within a tooth, and prepare the surrounding enamel for bonded fillings. The need for anesthesia is greatly reduced or eliminated over the traditional methods. Laser energy dramatically reduces the bacteria found in dental decay, and has been demonstrated to enhance the tooth's ability to "heal" in situations where "deep cavities" had existed. There are, however, several limitations to laser decay removal including the inability to adequately remove silver fillings, onlays, and crowns. Curing, or hardening bonding materials is another area where lasers have become important. These lasers drastically reduce the time it takes to finish a filling, and create what some researchers have shown to be a stronger restoration. Whitening teeth can be accomplished with special solutions that are applied to the tooth surface in the dental office and activated by laser energy. Color changes of several shades is possible in a very short time. When combined with at-home tray based whitening systems, dramatic changes can be seen in even the most difficult cases. Periodontal, or gum related care is the fourth area benefiting from laser technology. Lasers are currently used for recontouring or reshaping gums (often described as "plastic surgery for the smile"), removing extra or diseased gum tissue associated with the use of certain medications or periodontal disease, and removing the bacteria in periodontal pockets to promote healing. Healing time and post operative discomfort can be significantly reduced over the traditional surgical methods. Dental lasers have been shown to be safe and effective for treating both children and adults. Very specific equipment and training are required to incorporate this technology into the dental office, and many dentists are becoming involved in providing laser care. Research with the technology and design enhancements with the machines themselves are proceeding at a staggering pace. We look to the future with great excitement as the use of laser energy in dentistry expands to include many more procedures. Microabrasion: High technology Decay Removal Another technique for removing decay while reducing the need for anesthesia is called microabrasion. While there are a number of different machines available to dentists, they all work on the same principle, and can greatly enhance a patient's dental care experience. Microabrasion is a procedure involving a fine stream of particles aimed at the decayed portion of a tooth. These particles are often silica, aluminum oxide, or even baking soda based. They are propelled toward the tooth by air or bottled inert gasses through a handpiece, and remove small particles of decay as they strike the tooth's surface. These particles are then "vacuumed" away through the use of the suction system as with the traditional methods. A "rubber dam" technique is often used when this system is used, and involves using a thin latex sheet to isolate the tooth from the patient's lips and tongue. Microabrasion is also frequently used to prepare a surface for bonding or sealants. While frequently described as creating a "dusty" taste, many patients enjoy the absence of sound associated with this technique. It is virtually silent as it removes areas of decay. There are, however, limitations in its use including the inability to remove any metallic restorations like silver fillings, onlays, or crowns.