Jeffrey B. Dalin, DDS, FACD, FAGD, FICD
I realize that this is not digital U nor is it diagnostic U but it is one of the newer, high-technology instruments that we can add to our armentarium: the diode laser. Historically, you would use a scalpel or an electrosurgery unit to work on soft tissue. Diode lasers are available that allow us to work faster, more efficiently, and more predictably than ever before!
Light that we typically live by is incoherent. It is scattered, generally unfocused, and includes all of the visible colors we are familiar with when looking at a rainbow. Laser light is produced when light is amplified by the stimulated emission of some kind of radiation — thus, the acronym laser. Laser light is coherent, generally targeted, and of one color or wavelength. Laser light can be used to accurately measure distance; report the speed of your car; carry telephone, video, and Internet communications around the globe; and produce high-quality music from CDs.
A diode laser works by creating an intense beam of light energy. This energy is converted to heat within the tissue because of its high affinity for pigmentation (hemoglobin and melanin) and causes tissue vaporization with little collateral tissue damage. Rarely will you see bleeding or post-operative discomfort because the blood vessels, lymphatics, and nerve endings are sealed off when tissue is removed. The specific absorption characteristics of lasers used in dentistry require that one always be mindful of the benefits and the dangers that lasers represent.
Some indications for use of a diode laser are tissue retraction for impressions (yes U you can throw away that retraction cord!), abscess incision and drainage, biopsy incision and excision, exposure of unerupted teeth, fibroma removal, frenectomies and frenotomies, gingivectomy, gingivoplasty, hemostasis, implant recovery (this type of laser does not spark or damage surrounding metal), lesion removal, pulpotomy, sulcular debridement, tooth whitening, and treatment of aphthous ulcers.
Feature, function, and benefit typically go hand-in-hand with price. Features to consider are: weight, portability, ease of use, safety of use, and handling of accessories. Some of the diode laser units to look at are: the Diodent by Continuum, the Diolase ST by ADT, the TwiLite by Biolase, the Opus 5 or Opus 10 by Opusdent, and the SmilePro 980 by Biolitec. These units are all quite small and lightweight (thus easily portable), with a thin handpiece that is connected to the unit by a thin, flexible fiber. They all tend to be simple to operate. As with any newly developing technology, you should attend a number of continuing education courses to fully understand and safely use any laser.
Technologies are constantly changing and progressing. This especially applies to laser dentistry. Learn the technology U then evaluate the products that are out there U and see if you feel that you can integrate this new technology into your practice.
Jeffrey B. Dalin, DDS, FACD, FAGD, FICD, practices general dentistry in St. Louis. He also is the editor of St. Louis Dentistry Magazine and spokesman and critical-issue-response-team chairman for the Greater St. Louis Dental Society. His address on the Internet is www.dfdasmiles.com. Contact him by email at [email protected], by phone at (314) 567-5612, or by fax at (314) 567-9047.