Not long ago, shooting lasers inside a person’s head seemed like a bad idea.
But things change. Laser technology, once the tag line of science fiction, now glows at the tip of Thomas Turner’s drill.
“It’s an erbium chromium YSGG hard and soft tissue laser,” the Mesa dentist says. Better known as the Waterlase MD, it’s the latest weapon in the battle against tooth decay: mending cavities, and performing drilling procedures with less whine and vibration — and often, with no anesthesia.
SHOOTING YOUR MOUTH OFF
Lasers are not just for dentistry. Diagnostic lasers have scoured the surfaces of teeth for several years, probing for cavities, Turner explains. But BIOLASE Technology’s Waterlase MD, which he uses today for a porcelain inlay and gum reshaping on receptionist Rhonda Oclair, uses energy and water to cut teeth and gums.
“The advantage it offers is a cleaner cut,” Turner explains. Most dentists learn their craft on air-driven turbine drills, which rotate as fast as 500,000 RPMs. “You can crank electric drills up fast, and they work very well,” Turner says, “but you get a lot of torque in the process. That can leave micro fractures, which can add to the sensitivity of the tooth. With the laser, there’s no vibration, so that’s easier on the tooth. There’s no heat or pressure, either. People sometimes feel a slight cold sensation, but that’s the water.”
The laser drill resembles a standard dental drill until you turn it on. Then the tiny quartz tip glows red, and tiny water jets spray around its end as a soft rattle is heard. It’s much easier on the ears than the whine of a conventional drill, and there’s no pressure because it doesn’t touch the tooth.
The advantages extend beyond comfort. The laser cauterizes as it cuts, greatly reducing postoperative swelling. “It has a lot of technical advantages,” Turner explains. “The biggest one being that you can do fillings without Novocain.”
SET ON "STUN"
Sure, lasers are cool. But can you trust them enough to say “ahh” without anesthesia? Turner says, in most cases, you can. “Look at the cross section of a tooth,” he explains. “The nerves and blood are in the center, the porous dentin is around it, and the enamel on the outside. Ninety percent of cavities get into the dentin, which has pathways straight to the nerve.
“For some reason, the energy of the laser disrupts the normal nerve pathways to the brain. It doesn’t trigger those nerves.” That’s enough solace for someone leaning back under the dentist lights?
“Oh, I give them the option,” he says. “I look them in the eye and say, 'You’re going to feel sensations. If you need a shot, I’ll give you a shot, no problem.’ Seventy-five percent of them don’t. And the rate is even higher with kids.”
About 150 Arizona dentists now use the laser drill. The transition isn’t easy. For Turner, it required 50 hours of out-of-state training and $85,000 for the equipment. But the upside, he says, is in the work he doesn’t have to do.
“In gum and bone surgery, you traditionally have to make an incision to pull the gum away from the bone,” he says. That incision requires time to heal and a follow-up appointment to finish the work.
“In many instances, the laser allows you to leave the gum in place,” he says. “Less swelling, less pain. You don’t need the follow-up appointment, you can move right on to the restorative work. That’s better for everyone.”