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Lasers in Dentistry

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					     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.

				
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