Arizona School of Dentistry & Oral Health
As lasers have become an integral part of medicine over the past 10 to 15 years, Dr. Robert Levine wondered about their usefulness in dentistry. “We use them in ophthalmology and many surgical procedures. My feeling was why not in dentistry?
So Dr. Levine co-developed a full curriculum-based program for students in lasers at the Arizona School of Dentistry & Oral Health (ASDOH). “We are the only school in the US that has full curriculum-based program for our students in lasers,” says Dr. Robert Levine, director of laser dentistry at ASDOH.
One reason it’s had a difficult time moving into dental schools is because there’s not enough evidence-based research to substantiate claims for the effectiveness of laser periodontial therapy. So much is anecdotal.Yet there are so many other procedures that lasers can do to support high quality dentistry. I HAVE READ THERE IS EVIDENCE IN PERIO PROCEDURES?
WHEN DID YOUR LASER PROGRAM START? WAS IT DIFFICULT TO GET THE PROGRAM APPROVED? DO STUDENTS START WORKING WITH LASERS IN YEAR ONE OR LATER? The development of our laser program started in 2006. It took 2 yrs to complete the curriculum,due the strict curriculum guidelines that were necessary to follow. The program was approved for the students in 2008. The laser program would never have existed except for the support our dean,Dr. Jack Dillenberg,a visionary in all aspects of dental education.
“We’re getting to an age where we’re going to be virtual to a certain degree,” says Dr. Levine. With all the virtual systems (EXAMPLE?) Cerac, E4D, it’s very important to have clean visable tissues with minimal bleeding. Lasers when used properly can give us nice the clean sites necessary for accurate scanning with these virtual technologies. They can also help us eliminate cord packing for traditional impression procedures. says Dr. Levine.
Lasers are being used in a variety of dental procedures. Soft tissue lasers can be used in oral surgery, such as biopsies and frenectomies. The Erbian laser can be used in many procedures without anesthesia, so they have become popular in pediatric dentistry.
A new CO2 laser called the Solea (Convergent Dental), cuts both hard and soft tissue. DO YOU HAVE THIS? Whenever a new technology arrives on the scene we prefer to give it a few years to prove itself before bringing it into our armamentarium. We may test it for a period of time before making our final decision.
Low-level laser technology is being used to relieve muscle and joint pain in TMJ disorders as well as in post-cancer treatment, such as when patients develop mucositis after chemo or radiation therapy. We are partnered with MD Anderson and hope to utilize this technology to support this post treatment sequelae in their oral cancer patients. Lasers are also used post surgically to get more oxygen into the tissue so it heals faster and better.We are using LLLT to support TMD problems. ARE YOU DOING THIS?
There’s a wide range of procedures that we can do a lot faster and a little more efficiently with a laser, says Dr. Levine. “I use them to remove small lesions, fibromas, hemangiomas. We can get minimal or no scarring when used properly.”
Most of the science does show that lasers are not any more effective than traditional means in respect to Perio Therapy. says Dr. Levine. You can’t just use lasers without traditional perio treatment. It might allow us to get better results. Only time will tell as more University studies with solid ERB become available. We are in the process of launching our own pilot study in the next few months.
ASDOH has 15 lasers for student use. These include the Erbium YAG laser (Er:YAG), which is used in both soft and hard tissue. It allows us to do certain hard tissue procedures very efficiently. WHAT OTHER LASERS DOES THE SCHOOL HAVE? We have a variety of soft tissue lasers. Both Diodes and CO2 Lasers.
WHAT IS THE LASER CENTER? Our Laser Center is part of our Oral Research Division. We do our complex cases and laser research projects in this center.
“Students love it,” says Dr. Levine. “It opens up the door to something new. When students interview at our school they are excited about laser dentistry.The students leave ASDOH with both laser proficiency and certification certificates.In this very tough job market they have a tremendous advantage over those graduates not receiving this level of training.Our students are heavily involved in public health and treating the underserved population base.Being able to take some of the smaller portable units out into this arena is a tremendous advantage in providing the best possible treatment. We also have a large special needs center which depends heavily on the tissue management which lasers can help to provide.
Dr. Levine took the school lecture program and developed it into an online training program for dental professionals. We used ASDOH Laser curriculum as as format His company Gloh ( Global laser Oral Health) specializes in online laser training for current dentists. “We can efficiently train dentists at their leisure on laser science.We use a system called Articulate Studio.Audio voice overs. They can then decide whether it fits into their practice before they purchase equipment. Be a educated consumer is our motto.” Participants also earn continuing education credits.These CE Credits are University Cerp Recognized.
Schools must get out there and open these technologies up and explain it’s not the only way but it’s new and allows us to provide new and better treatment in many areas, says Dr. Levine. We are getting ready to make our online program accessible to universities across the country.
At the end of the fourth year we give students the opportunity to take the online program.Its give them a further review in laser science before graduation. We have also work out special deals with certain companies to provide these graduating Doctors ,Lasers and Protective Loupes at discounted rates.
Lasers vary greatly in cost. Smaller ones range from $2000 to $10,000 or more; Erbian lasers range from $45,000 to $60,000; more sophisticated ones are $75,000 to $80,000. Soft tissue CO2 lasers run $25,000 to $40,000.
“I tell new graduates to start out with a smaller one and get used to using it in your practice. When you’re ready you can buy more sophisticated lasers if appropriate to your practice, says Dr. Levine.