Ron Combs, Associate Editor
With the Food and Drug Adminstration`s approval of the first laser device for treating tooth decay, patients can look forward to relatively painless procedures and no anesthetic, no grinding sensation or whirring noise of a hand-held drill and spending considerably less time in the dental chair.
Dr. James Pelagalli, who practices in Cleveland, Ohio, envisions a new generation of patients free of dental phobia and a totally new image for dentists. He believes that patients will seek out dentists who are using the new laser technology.
He points to time-savings for both patient and dentist as a primary factor.
"Conservatively, let`s say a doctor does three simple restorative procedures a day. With the new laser, these procedures can be done in about 10 minutes instead of the usual 30 minutes or so because, in most cases, the patient needs no anesthetic. This means that the patient is in the chair for a shorter time and the dentist saves about one hour for the day."
Hailed by the FDA as "medicine for the 21st century," the Erbium-YAG laser, made by Premier Laser Systems of Irvine, Calif., was approved after testing and study showed it to be as safe and effective as the standard high-speed drill.
In a position paper about the FDA announcement, the American Dental Association said it could not "attest to the safety and effectiveness" of the product. The ADA said the company and FDA had not supplied the association with relevant studies. Various lower-powered lasers have been available to dentists for a decade to perform soft-tissue procedures.
But, as Dr. Susan Runner, FDA`s chief of dental devices, explains, "No laser has been allowed directly on teeth until now because of fears the high-heat would damage the inner core of the tooth." She adds that Premier`s laser, which is marketed under the brand name Centauri, "has the potential for changing the way dental practice is handled in this country."
The clinical testing of the Centauri laser began in 1993 and involved 1,410 procedures. In one study, more than 500 cavity-ridden teeth were treated without any damage to the nerves or blood supply of teeth. A second study pitted laser against drill, and she noted that "few laser-treated patients needed anesthetic."
There is some inconvenience for the patient, dentist and dental assistant - all must wear goggles to protect their eyes from the laser`s light. Also, the laser`s $39,000 price tag probably means higher prices for restorations. An intensive one-day training course is required.
Five dentists who conducted Premier`s FDA-required testing currently are offering patients treatment with the new laser.
Initial training centers have been established in five states. For more information about the laser training, contact Premier Laser Systems at (800) 544-8044.
