Monday, March 16, 2015

Laser Dentistry - Frequently Asked Questions.

I have been fixing teeth with lasers for over a decade, yet many people are not aware of what lasers can mean to their dental care experience. I get questions all the time  (including from many dentists!) about just what do dentists do with a laser. So here is a list of the most frequent questions and answers. If you have a specific question about lasers or anything dental at all feel free to contact me with the form on the right side of this blog, or visit our website at

Does the laser replace the drill? Can you do fillings with it?
Absolutely! The laser is used to remove decay and shape the tooth for the fillings.

 Do you ever use a drill for fillings?
 The high speed drill is used to shape and polish the fillings. Sometimes  lower speed drill is used to gently remove the decay from the tooth after the initial laser preparation. This is done with special ceramic burs that only remove decayed tooth structure. The initial laser exposure actually makes the tooth less sensitive so this step is tolerated well by patients most of the time. This is not the high speed drill that most people associate with fillings being done; the laser replaces this step.The high speed drill is needed is if old silver fillings need to be removed.

Are lasers safe to use in the mouth?
Very safe. In fact the laser is less likely to cause collateral damage than a sharp metal bur spinning at 300,000 RPM or a razor sharp scalpel blade. People understandably think the laser must be hot to vaporize tissue and could damage teeth or tissue. This is not true. It actually removes enamel through a "cold ablation" process that does not cause any thermal damage at all. These lasers have been around for decades, are well researched, and have F.D.A. clearance for all procedures that we use them for.

 Can you really do fillings without numbing?
 Yes. The majority of fillings are done without a needle. Even when the tooth is numbed the laser feels much more comfortable than the high speed drill since it lacks the annoying sound and vibration.

 What does it feel like to have the laser prepare my tooth?
 Many patients feel little or nothing at all. Some patients report they feel the cold of the water spray on the tooth, but do not find it uncomfortable. Some teeth become mildly sensitive to the laser once most of the cavity is gone, but patients find this tolerable and preferable to getting a needle.Even when numb the laser lacks the noise and vibration of the traditional drill.

 When do you still need to numb someone?
 Some teeth are more sensitive than others and the patient determines if they want to get numb at any point in the procedure. The high speed handpiece is required when old silver fillings need to be removed and most of the time we will numb someone when this is needed. Larger fillings often need novocain as well. Other times it is the doctor's judgment that the patient might be more comfortable with anesthesia and he will recommend it.

 What about kids?
 Kids do great. Children experienced very little discomfort when working on primary teeth. This makes for a much less traumatic filling experience for most children.

Can you do crowns with the laser?
 Yes it can but usually  crown preparation is done with the high speed handpiece. However, the laser is used during this procedure if any filling material is placed, to help get a better impression, and to comfortably perform any gum surgery needed during the procedure.

Can the laser be used for gum surgery?
 Yes. Both lasers we have are used for a variety of gum procedures. We use no scalpels and rarely need to place a suture. The lasers are very kind to the tissue so post operative discomfort is greatly reduced. Patients who have experienced traditional gum surgery are pleasantly surprised about the lack of postoperative pain.

 Do laser procedures cost more? Will insurance pay for them?
 The gains in efficiency the of the laser allow us to charge fees that are the same as traditional techniques, and in some cases less such as some gum surgeries. The procedures are the same as done with drills, scalpels, and the like. It is how they are done that differs, therefore all procedures are submitted to insurance using traditional coding. If a particular procedure is covered under your plan it makes no difference whether a laser or a drill is used.