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Tue 19 Aug 2008 04:00 AM

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Light work

No lasers in your dental practice? Here's what you're missing.

No lasers in your dental practice? Here's what you're missing.

From a start in soft-tissue applications, laser technology has now become a staple feature in the dental clinic. The units are capable of delivering pain-free perio, injection-free surgeries and happier clients - and all for an increasingly low outlay. MED takes a closer look at laser dentistry and how can it zap your balance sheet into the black.

Softly, softly

There is very little bleeding and healing time is reduced by up to 50% compared to traditional means.

The number of lasers on the market is as diverse as the procedures they perform. Early soft-tissue lasers used CO2 or argon as their active medium, but diode lasers are now replacing these units.

Both cut precisely with minimal pain and bleeding, and both can open the door to a wide range of new clinical procedures. Biopsies, frenectomies and gingival contouring - a particular boon for cosmetic dentists - can be completed quickly and effectively.

Dr Jonathan Bregman is a US-based dentist who lectures widely on the benefits of laser dentistry. "Before I started using lasers, I would push these jobs on to more experienced surgical dentists," he confides. "Now, they can all be kept in-house and performed pain-free with a topical anaesthetic."

"The main advantage is that there is very little bleeding and healing time is reduced by up to 50% when compared to using traditional means," agrees Dr Bernard Elliot, manager of the Smiline Dental Centre, Dubai.

"When you are using any blade with or without stitches it can take up to 10 days for the area to completely heal while, with a laser, three to four days is the norm."

Taking a hard line

At the other end of the scale are hard-tissue lasers, used to cut precisely into bone and dental enamel.  These units typically use the Er:YAG system, although recent years have seen the advent of ‘all-tissue' lasers, using the Er,Cr:YSGG system.

Hard-tissue lasers can help simplify treatments such as root canals, cavity preparation and enamel and dentin procedures. As a perk for patients, injections are rarely needed. Bregman estimates that 90% of the basic filling treatments he performs are now anaesthetic-free.

It's a mark of how key the units have become, he argues, that the US Food and Drug Administration (FDA) has approved laser use in children.

For Dr Jaco Smith, owner of the Dental Studio, Dubai, the chief lure of lasers is that they offer a better dental experience to patients.

"Pain-free dentistry is the key phrase," stresses Smith. "[Lasers] can take away some of that fear factor both with adults and particularly children. And that brings more people to you through word of mouth."

Beam me up

The cost of the units can be a deterrent, but laser converts argue that the technology pays for itself.Factor in the new services you can offer, coupled with shorter procedure times, and lasers can make a significant impact on the gross profit of a practice.

For example, a dentist performing eight gingival contours per month at US$150, will accumulate $12,000 on the annual spreadsheet. Similarly, a monthly schedule that includes one frenectomy at $250, one fibroma removal at $150 and a single operculectomy at $100 will total $500. After 12 months the dentist has racked up a further $6,000.

Procedures aside, lasers also provide a talking point for patients. The technology is synonymous with a high-tech, modern dental practice. Savvy dentists, says Bregman, use this association to its full marketing potential.

"Between the word of mouth and recommendations from patients... my practice exploded," he claims. "New patients came in and existing patients accepted treatments they had previously refused once they understood the benefits of the laser."

Smiline Clinic recorded a spike in demand for cosmetic dentistry, Elliot reveals. "Patients are requesting a lot more aesthetic dentistry, but now...we can use the laser to prepare the tooth and gum so that everything is in the best condition for the future prostheses and the patient will get better results."

The price of an all-tissue laser unit can be upwards of $15,000. If a laser draws around 10 new patients through the door each month, it will pay for itself several times over within a year.

If each patient accounts for the conservative income of $300 a month, a dentist could conceivably make $36,000 in gross profit per year.

In addition to the monetary benefits, there are also a lot of less tangible ones. Skilled laser dentists can shave considerable time off routine procedures - anything up to 15 minutes an hour, according to Bregman, allowing for more appointments each day.

"Laser is a plus for sure," extols Elliot. "With laser we can do a lot of difficult procedures, where before it was not possible.

"When we needed to do surgeries using blades, patients were not comfortable during the procedure, and complications arose with swelling and bleeding. This has been eliminated now."

MED TIPS: The timeline behind the trailblazers

The word 'laser' is an acronym for Light Amplification by Stimulated Emission of Radiation.

Laser technology has its roots in several basic principles of physics first described by Albert Einstein in 1917.

The first gaseous lasers were invented in 1964, one using carbon dioxide (CO2) as a lasing medium, and another using argon.

In 1968, the CO2 laser was used to perform soft-tissue surgery for the first time.

In 1991, the FDA granted marketing approval to lasers for use in soft-tissue dental surgery and the curing of composite resin dental fillings.

In 1997, the FDA first approved the use of erbium lasers for use in hard-tissue dental surgery.

In 1998, diode lasers using a gallium, arsenide and aluminum lasing medium were approved for use in soft-tissue surgery. All-tissue lasers using the Er,Cr:YSGG system also received FDA approval.

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