How Are Lasers Used in Dentistry?

Lasers have been used in Dentistry for over 30 years. There are both hard tissue lasers – used for drilling teeth or bone, and soft tissue lasers – used primarily for treating periodontal disease and recontouring gum tissue.

At our office, Dr. James R. Donley of Lumbertown Dental Wellness, has incorporated the use of the soft tissue diode laser in conjunction with several aspects of his hygiene therapy. The hygienist often uses it while cleaning your teeth to destroy the bacteria and disinfect the gum tissue. In addition, it is helpful when treating a variety of gum and bone diseases. This laser can also be used to help contour tissue around the gumline if it is too short or traumatized. It can also be used to lengthen the margin on a crown preparation if the gum tissue is covering part of the margin on the crown. 

The American Dental Association recognizes that as much as 70% of the adult population has some type of gum disease and they have proven the diode laser to be a safe and effective way to kill bacteria and viruses that occur in the gum tissues. 

Diode Lasers

At our office, we have the HOYA ConBio DioDent II Diode Laser as shown below. Dr. Donley also uses it for restorative procedures such as gum troughing for making cleaner impressions for crowns – particularly in areas where the decay has gone below the gumline. Doctor also likes to utilize the laser for recontouring gum tissue for esthetic veneers when the gums may have grown down slightly longer than they should. We have also used the laser for helping to treat cold sores and canker sores as well as correcting tongue-tie in children.

The DIAGNOdent Laser

Another type of laser that we utilize in the office is the DIAGNOdent laser for early decay detection.

This instrument is used daily when we do our new patient exams, when we are checking on leaky fillings or inspecting the deeper grooves on the tops of teeth for decay. We have found this diagnostic tool to be extremely useful in differentiating a “sticky groove” from actual decay.

How does the DIAGNOdent work?

It can measure laser fluorescence within tooth structure which is usually elevated in proportion to the amount of decay. When we see a specific reading on the digital meter, in addition to making a buzzing sound, we know that the tooth has broken down and the enamel has decay.

As shown in the drawing below, instead of simply relying on an explorer “sticking” into the groove when we check the top of the tooth, we have a measurable activity that we can monitor over time and safely and confidently treat our patient’s teeth early and accurately, thereby keeping any necessary restoration to an absolute minimum. We use it for early detection of decay and then follow that up with utilizing a very thin micro-bur called a fissurotomy bur to remove only enough tooth structure to remove the decay.

The left diagram below shows a conventional dental explorer “sticking” in the top of a groove on a back tooth. Dentists are taught that a stick usually means “a filling is needed.” On the right, we see how the laser can identify decay deeper in the tooth and give us an idea before drilling – of the extent of the decay. In addition, after we go in to clean out the tooth, we can also utilize it to double check and make sure we got all the decay out and left it as conservatively treated as possible.

Be sure to ask Dr. Donley about these technologies when you come in for your next dental visit! Using the Diagnodent means early detection. No anesthetic is needed at all to use this piece of equipment. It gives us the opportunity to “FIX” things early, using a very conservative fissurotomy bur to clean out the grooves instead of needing to drill out more of the tooth.