A heady introduction to lasers

Aug. 1, 2001
Power scalers are used both before and after laser use.

Power scalers are used both before and after laser use. They're used first for deposit removal and after laser use to flush the area with an antimicrobial solution.

You're probably wondering why I'm writing about lasers and what I know about this subject. You guessed it; I don't know anything about lasers. I've actually avoided the subject, not knowing where to start. The sum total of my experience was hearing skeptical oral surgeons say lasers are just expensive scalpels.

Now that I'm writing about lasers, I'll blame it all on Mary Lynne Murray-Ryder. It all started when she was president of the Maine Dental Hygienists' Association and invited me to speak at their annual meeting last year. You see, Mary Lynne uses a laser and is a member of the Academy of Laser Dentistry. She's as excited about lasers as I once was about power scalers. It's hard to put a lid on that kind of enthusiasm.

Anyway, Mary Lynne picked me up at the airport last June, and we drove to the meeting site about an hour away. I wasn't exactly held hostage, and I did ask her to tell me about her experiences with lasers, so I can't say I was coerced in any way. She was so enthusiastic that I figured it was time I finally learned something about lasers. When I confessed that I knew nothing about lasers and should take the time to learn, she quickly told me the annual meeting for the Academy of Laser Dentistry would be held in Tucson, Ariz., in March 2001, right in my back yard. No excuses now.

I figured the Academy of Laser Dentistry (ALD) was like all the other professional organizations, where you just pay your dues and go to the meetings. Not quite. Mary Lynne is one of many dentists and hygienists who go through several rigorous certification levels to achieve mastery in their use of lasers. Not only do they have certification in safety and general use of lasers, they also have testing on specific lasers.

The meeting provided hands-on courses, certification exams, user group meetings, lectures, product information, and workshops.

The organization was founded in 1993 as three laser organizations merged: the International Academy of Laser Dentistry, the North American Academy of Laser Dentistry, and the American Academy of Laser Dentistry. The ALD is now one of the largest international organizations devoted to laser dentistry and hygiene. Its focus is on clinical education, research, and the development of standards and guidelines for safe and ethical use of laser technology. ALD publishes a quarterly journal with interviews, research, case reports, product information, and news on upcoming meetings.

At the start of the four-day Tucson Conference, John G. Sulewski, director of education and training for The Institute for Advanced Dental Technologies, presented a seminar titled, 'Making the Most of the 8th Annual Conference and Exhibition: A Practical Orientation for Attendees." He explained the history of the organization and some of the differences between lasers and their many uses. There isn't just one laser that does it all, thus the many choices. Currently, there are 6,000 lasers in surgical practice worldwide. Prices range from $5,000 to $40,000, with the Erbium hard-tissue laser being the most expensive. Off-label uses of lasers include hard-tissue anesthesia, desensitization, bio-stimulation for wound healing, and pain relief, especially from aphthous ulcers and herpes lesions. Sulewski also provided a checklist for evaluating lasers and a four-page research bibliography — just to get us started on our reading!

FDA approval has been given to various lasers for many intraoral procedures. The hygienists involved with ALD use lasers for soft-tissue disinfection and curettage. Power scalers are used both before and after laser use. They're used first for deposit removal and after laser use to flush the area with an antimicrobial solution. Anesthesia is not routinely needed, and bleeding is minimal.

The meeting participants and presenters were very enthusiastic about laser technology and its place in dentistry. I doubt anyone skipped out on the lectures to grab some pool time, since the meeting rooms were always full. Dr. Joel M. White, president-elect and a faculty member at the University of California, San Francisco, put into perspective the need for more research in this area. He said, "The plural of anecdote is not data!"

Case reports are an important part of evidence-based patient care when combined with controlled clinical trials. There are currently 5,000 articles on lasers, 10 percent of which deal with soft-tissue use, and 25 percent of all the laser articles are published in peer-reviewed journals. The research is growing in this area, and we are sure to see more controlled trials in the future. Many laser studies are published in medical journals, since lasers are used so widely in medicine today, specifically ophthalmology and dermatology. More are needed in dentistry.

I won't make a fool of myself by attempting to explain the science behind lasers. Instead, I'll suggest that those of you who are using lasers or are interested in learning more about the potential for lasers in dental hygiene contact ALD at (954) 346-3776 or visit www.laserdentistry.org for information on courses and consultants.

Three hygienists were featured on this year's program and are great resources for laser information: Nora Raffetto, Teri Gutierrez, and Gloria Monzon. Ms. Monzon also speaks at hygiene meetings and has authored a workbook for laser certification. You may want to mark your calendars for next year's meeting in San Diego, March 13-16, 2002. This group is very open and welcoming of new members and those like me who just want to learn more about lasers.

Trisha E. O'Hehir, RDH, BS, is a senior consulting editor of RDH. She also is editor of Perio Reports, a newsletter for dental professionals that addresses periodontics. The Web site for Perio Reports is www.perioreports.com. She can be reached by phone at (800) 374-4290 and by e-mail at [email protected].