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LASER = Light Amplification by Stimulated Emission of Radiation

Lasers are an exciting advancement in the field of dentistry, now well-established in the dental armamentarium for both soft tissue and hard tissue procedures. Multiple types of dental lasers exist, each with unique properties which have significant differences in their individual benefits and limitations.

Core Properties that determine benefits and limitations:

  • Type
  • Wavelength
  • Pulse
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DENTAL LASER TYPES

There are 4 common laser types in dentistry: Diode, Nd:YAG, Erbium, and CO2 each with a unique laser-tissue interaction based on wavelength. Laser types are named after the active medium – the actual component that produces the laser energy when stimulated. The 1064 Nd:YAG wavelength is produced by Neodymium-doped Yttrium Aluminum Garnet.

Dental Laser Wavelength


Light is measured in wavelengths. Dental laser wavelengths are

  • Diodes 830-1,064nm
  • Nd:YAG 1,064nm
  • Erbium 2,790-2,940nm
  • CO2 9.3-10.6nm

Each wavelength interacts with tissue differently: The 1064 wavelength passes through water and Hydroxyapatite; but is absorbed in melanin and hemoglobin.

laser-absorption
laser-pulse

Dental Laser Pulse Differences

The three primary pulse modes in laser dentistry have profound differences on how the laser energy (heat) affects the tissue.

Continuous: Laser energy is always “on”; potentially damaging heat can build in the tissue quickly. Continuous mode is like placing your finger over a candle flame and holding it there.

Gated Mode: A half on/half off exposure to laser energy; ability of the tissue to absorb the heat is limited. Gated mode is similar to slowly passing your finger through a candle flame, eventually it will be burned.

Free Running Pulse: Very short bursts of laser energy; adequate time between each pulse to allow the tissue to absorb and dissipate the heat to minimize thermal damage. Free running pulse is similar to rapidly moving your finger through the candle flame. There is plenty of time for the momentary high heat to be absorbed without harm.

DENTAL LASER SAFETY


Every dental laser requires attention to laser safety!

  • Eye Protection – The patient, clinical staff and any observers must wear protective eyewear specific for the wavelength being used.
  • Plume Control – Laser procedures create a plume that may contain hazardous chemicals and microflora.
  • Sharps – Scored laser tips of quartz fibers are considered sharps and need to be disposed of as such.
  • Warning Sign – Warning signs need to be in a visible place and access to the operatory limited.