LASER DENTISTRY
Gains Momentum in Dental Schools

Publication: New Dentistry Winter 2015 Edition
Editor: Teri Stat
 
* Photos courtesy of Dr. Robert Levine at Arizona School of Dentistry & Oral Health. All cases were done at ASDOH under the direction of Dr. Levine and pre-doctoral student support.
 
Since dentists first began using lasers in the 1990's, much has been said about the technology that allows dentists to do new and better treatments in many areas of dentistry. From less pain, less blood, cleaner sites, faster healing, and greater precision, the benefits of laser dentistry are undeniable. That’s why an increasing number of dental schools have introduced laser dentistry into their curricula. But the move into dental schools hasn’t been without its challenges.
 
While there’s plenty of evidence for laser dentistry’s effectiveness over traditional methods in many areas of dentistry, there’s not enough evidence-based research into its use in periodontics. Adding a curriculum in laser dentistry also requires the buy-in from administration, as well as costly equipment. To launch a successful program, someone must champion the effort. Here we take a look at a few programs that have met the challenge.
 
 
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 U.S. that has a full curriculum-based program for our students in lasers,” says Dr. Levine, Director of Laser Dentistry at ASDOH.
 
“We’re getting to an age where we’re going to be virtual to a certain degree,” says Dr. Levine. With virtual systems like CEREC or E4D, it’s important to have clean, visible tissues with minimal bleeding. “When used properly, lasers can give us the clean sites necessary for accurate scanning with these virtual technologies. They can also help us eliminate cord packing for traditional impression procedures.”
 
Development of ASDOH’s laser program started in 2006. It took two years to complete the curriculum due to strict guidelines. Finally, in 2008, the program was approved for students. “The program would never have existed except for the support of our dean, Dr. Jack Dillenberg, a visionary in all aspects of dental education,” says Dr. Levine.
 
Lasers are being used in many dental procedures. Soft tissue lasers are used in oral surgery, such as biopsies and frenectomies. Erbium lasers can be used in many procedures without anesthesia, making them popular in pediatric dentistry.
 
“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. He uses them to remove small lesions, fibromas, and hemangiomas. “We can get minimal or no scarring when used properly.”
 
ASDOH is using low-level laser technology (LLLT) to relieve muscle and joint pain in patients with TMJ disorders. The school has also partnered with the University of Texas MD Anderson Cancer Center with hopes to use LLLT in oral cancer patients who develop mucositis after chemo or radiation therapy.
 
Most of the science shows that lasers are not any more effective than traditional means with respect to periodontal 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 studies with solid evidence-based research become available.” ASDOH is in the process of launching its own pilot study.
 
ASDOH has 20 lasers for student use. These include the erbium YAG (Er:YAG), used in both soft and hard tissue; two AMD diodes and several carbon dioxide (CO2) lasers for soft tissue.
 
A new CO2 laser called the Solea (Convergent Dental) cuts both hard and soft tissue. Dr. Levine gives a new technology a few years to prove itself before adding it to their lasers.
 
“Students love laser dentistry,” says Dr. Levine. “When they interview at our school they’re excited about learning it. They leave ASDOH with both laser proficiency and certification. It gives them a tremendous advantage in this tough job market.”
 
Dr. Levine took the school lecture program and developed it into an online training program for dental professionals. His company GLOH (Global Laser Oral Health, LLC) specializes in online laser training for current dentists. “We can efficiently train dentists at their leisure on laser science,” he says. “They can then decide whether it fits into their practice before they purchase equipment.”
 
Lasers vary greatly in cost. Smaller ones range from $2000 to $10,000 or more; erbium lasers range from $45,000 to $60,000; more sophisticated lasers run $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 laser and get used to using it in your practice,” says Dr. Levine. “When you’re ready you can buy more sophisticated ones if appropriate to your practice.”