Laser Questions and Answers
What is a laser?
A laser is a device that converts electrical power from the wall into coherent, monochromatic, and collimated light capable of changing a target substance, such as human tissues. The tissues are modified due to thermal effects produced by the light.
Where does the word laser come from?
The laser is an acronym for Light Amplification by Stimulated Emission of Radiation.
What is it about laser light that gives it a surgical capability?
Various wavelengths differ in their affinity for a target tissue. Once identified, this affinity for a specific tissue can be used to create a laser that produces that particular wavelength. These waves of radiant energy can often pass through one tissue without changes to that tissue and still modify another deeper tissue. An example is the laser used in Lithotripsy to smash kidney stones.
What is the significance of wavelength to lasers?
Electromagnetic waves are radiant energy that is arranged by their frequency (oscillations per second) and by the wavelength (distance between the crest of a wave and the corresponding crest on the next wave). In dental lasers, they are measured in microns or nanometers. The Odyssey Diode Laser operates at 810+/-20 nm.
When were lasers for dentistry introduced?
In 1982, Directed Energy, Inc. and Pfizer introduced the carbon dioxide (CO2) gas laser for dentistry.
What types of lasers are used in dentistry?
Lasers are identified by the active medium that they use to create their energy, such as gases, types of rods, dye types, or the wavelength of the diode they use.
Solid State (rod style): Er:YAG, YSGG
Gas: Carbon Dioxide, Argon
What is a diode?
A diode is any device through which electricity can flow in one direction. When used in the old crystal radios, a diode was referred to as a rectifier. Diodes are made from semiconductor crystals that emit light when an electrical current is passed through them and the light can be focused into a small dot.
What is the diode in the Diode Laser made from?
The major component of a diode laser is the semiconductor chip or crystal. The diode in the laser is made from Aluminum, Gallium, and Arsenide, commonly referred to as AIGaAs.
What is the diode in the Waterlase MD and iPlus Lasers made from?
Er,Cr:YSGG — which stands for Erbium, Chromium doped Yttrium Scandium Gallium Garnet
How is the laser delivered to the affected tissue?
All dental diodes use a fiber optic delivery system. Diode fibers have three major components: the core, which is usually silica, quartz, sapphire, or a combination; cladding, which is the protective coating that is applied to the exterior of the core and that prevents laser energy from escaping laterally; and the jacket, which is the exterior of the fiber that helps to protect it from damage.
How safe is the Odyssey Diode Laser?
This laser is classified as a Class IV laser, which places it in the category of potentially hazardous, requiring specific safety measures when used as a dental or medical laser.
The Diode Laser has been certified to the latest safety standards applicable to medical lasers in the US and Canada including IEC 60825, IEC 60601, and the Food and Drug Administration’s Laser Performance Standard (21 CFR 1040.10 and 1040.11. Protective eyewear is included with the diode laser and special eye protection filters which mount on the doctor’s magnification systems have been purchased and are used whenever the laser is used.
All safety factors are set out in the Owner’s Manual and have been reviewed by all of our office staff.
How do I assure the safe operation of the Laser?
We have implemented a Laser Safety Program appropriate for your dental office. The plan may include the following:
- Delegation of authority and responsibility for supervision and control of the laser to a Laser Safety Officer
- Minimum Training requirements for users of the laser
- Laser security against unauthorized use of the laser
- Standard operating procedures to regulate the work environment to protect the patient and office staff from laser hazards
- For more information on the contents of a Laser Safety Plan, you can review ANSI Standard Z136.3 for Safe User of
- Lasers in Health Care Facilities.
Is the aiming beam hazardous?
The aiming beam is a Class II laser and requires special training and protective eyewear when using the laser.
Is this laser harmful to the operator, their staff, or their patient?
There is the potential for damage to the retina of the eye and to the skin on their bodies if proper safety measures are not followed. All safety factors are identified in the Odyssey’s Owner Manual.
How can damage to the skin and eyes be avoided?
Damage can be prevented by avoiding contact with the fiber tip while lasing, wearing safety eyewear designed to protect against the 810nm wavelength when using the Odyssey Diode Laser (i.e., patient, dentist, and staff) and by wearing proper garments on areas that may suffer inadvertent fiber contact. Since eyewear varies in terms of the wavelengths it will protect the wearer against, be certain to verify that eyewear has the optical density of 4+ or greater to have proper protection for the 810nm diode.
Do you need to be certified to use a laser?
No, not in most States. The Dental Practice Acts of most States have allowed dentists to be self-regulating in determining what equipment they are qualified to use. Laser dentists from around the world have established an organization the Academy of Laser Dentistry to provide laser training and to share technique information. The Academy is dedicated to providing certification training for both the dentists and their hygienists.
In addition to attending other laser training lectures and demonstrations, Dr. Rosenberg participated in this Two-day 12-hour course that included lectures on Laser Types, Physics and Safety, Laser Applications in Dentistry, an Overview of Dental Lasers available today for dentistry. There was a written examination, a verbal exam on the Soft and Hard Tissue Laser use and safety. The examination also included a three-hour hands-on practical where we had to demonstrate proficiency in the use of both soft tissue (Diode and NdYAG) and hard tissue (Biolase and Hoya ConBio Erbium) lasers on pig jaws for both soft tissue, a tooth (cavity) preparation and bone surgery. Dr. Rosenberg passed all of the parts of that program and are now certified in there use.
Currently, dental hygienists in 33 States are allowed to provide debridement and decontamination therapy using a laser. No States allow auxiliary personnel other than hygienists to use a laser.
What procedures can the Diode Laser be used for?
The soft-tissue diode laser can be used for a variety of procedures, including:
- Gingivectomy, Gingivoplasty, Operculectomy
- Crown lengthening
- Recovering dental implants
- Treating inflammation around implants
- Troughing for impressions
- Treating aphthous ulcers
- Incising and draining abscesses
- Fibroma removal and biopsies
- Sealing lymphatics in the surgical area
Other soft-tissue procedures for which the Diode Laser can be used are:
- Reducing sulcular oral bacteria and other flora
- Recontouring interproximal tissue
- Accelerating healing for split lips
- Soft tissue debridement
- Reducing hyperplasia
How is treatment with a soft-tissue laser different from conventional methods?
First, the patient’s acceptance is greater. The laser is more efficient and sometimes faster. There is less postoperative discomfort for the patient, and the bacteria levels in affected areas are reduced. Additionally, there is virtually no collateral damage to healthy tissue, and anesthesia is not necessarily required. Overall, laser dental procedures are safer, and there is a decreased healing time.
Why do most dentists who specialize in cosmetic dentistry prefer a diode laser?
The 810nm diode wavelength is the most popular laser among cosmetic dentists and their hygienists because it is easy to use, easy to transport, and easy to care for. When used correctly, the laser energy will not be attracted to the cementum or dentin found in the cervical area of the tooth, where most procedures in cosmetic dentistry are performed. Additionally, the small fiber diameters are very exacting.
Why would a dentist buy an 810nm diode laser, as opposed to a CO2 or Erbium laser?
There are several reasons. Those lasers carry a higher unit cost, and the size of the unit takes up counter space and limits portability. There is limited access within the mouth, and accessories may be costly. Additionally, precision in performing soft-tissue care may be compromised, and their use by hygienists may be restricted.
Can’t a hard tissue laser be used for soft tissue procedures?
A hard tissue laser is wavelength-specific to water and, therefore, can be used clinically on both hard and soft tissues. However, care must be taken to avoid unwanted interactions on root surfaces. For many cosmetic and periodontal indications, a soft tissue laser is more efficient.
With the Biolase Waterlase iPlus and MD, we can switch between Soft and Hard Tissue modes with the touch screen, as well as change the power, water, and air settings for the specific treatment we are providing.