Dental lasers: possibilities and benefits.

Journal of the Massachusetts Dental Society It is surprising to realize that laser use in dentistry dates back to Dr. Leon Goldman’s initial experiments on dental caries in 1964. For when the topic comes up in conversation among dentists today, the response is typically, “They are still too new,” or “I’m going to wait.” During the past 40 years, dental lasers have slowly been making headway into the arsenals of dental offices. As we look back over laser dentistry’s storied past, we see almost as many “learning experiences” as successes in treating dental hard and soft tissues. Absorption of laser energy is what effectuates the desired result of tissue ablation or removal by thermal or photoacoustic means. Most early experiments using lasers on soft tissue were successful to a degree. Hard tissue, however, offered completely different results. In many cases, dental lasers caused pulpal necrosis and enamel cracking due to heat generated during treatment. The wavelengths tested had a high affinity for pigmented tissues, and since the only pigmented tissue in a normal tooth is the dental pulp, it stands to reason that pulpal tissues absorbed the heat and became necrotic as a result. During the 1990s, dental applications for the erbium family of lasers were developed. The wavelengths from erbium lasers have a high affinity for water and hydroxyapatite but are not absorbed especially well by pigmented tissues, thus providing the solution to the hard-tissue dilemma. Rather than absorption into the dental pulp that was seen with other wavelengths, erbium laser energy was absorbed primarily by enamel, dentin, and water. Today, we are very fortunate to be able to add not only soft-tissue lasers to our armamentaria, but hard-tissue wavelengths as well. The benefits of using a laser versus conventional modalities are numerous and varied and depend on whether the target tissue is hard or soft. Most of us are aware of the norm when discussing hard-tissue responses, so this article will only cover the differences using a hardDental Lasers: Possibilities and Benefits