Re: Laser dentistry!

From: Steven Bornfeld (dentaltwinnospam_at_earthlink.net)
Date: 11/26/04 

Date: Fri, 26 Nov 2004 13:42:25 -0500

StovePipe wrote:
> ... Not any more.... my Laser is dead. It will be resurrected when my
> penny pinching gang of patients realize that if they want me to support
> them, they must support me... I cannot afford to fix it, and the Biolase
> rep doesn't even want to fix it... He wants to replace it with a more
> modern one. If you WANT Laser treatment, PAY for it. Then decide if it
> is hype or real for yourself. That said:

        Well, this is the basis for my objection to the laser. It is marketed
as something that will distinguish your practice as "cutting-edge", and
that this will give you a hugh competitive advantage.
        I am old enough to remember when Oringer was touting the advantages of
electrosurgery over cold steel. I remember seeing one of my professors
heating up a Dycal placing instrument in a flame, applying it to the
gingivae, and calling it a "poor-man's electrosurgery".
        Personally, I had heard much more about soft-tissue surgery early on,
and hard-tissue cutting with laser only considerably later. I would
think perio surgery would be a pretty good indication, but then I'm not
aware of any local periodontists who use a laser.
        In any case, this is obviously a very expensive piece of hardware.
What kind of warranty are they offering you? Obviously it's not
enough--though I'd think it would be pretty trouble-free with no moving
parts.
        I always wondered how in an age of managed care a dentist with a
$30,000 laser could compete with a dentist with 7 or 8 handpieces for
$300-$500/ a piece. I'm sure the right person would be able to make it
work, but your experience was my fear.

Steve

>
> The Laser is pulsed (flashes and not continuous), with water spray at
> the same time, like the dental turbine that it replaces and resembles.
> The beam has water sprayed in front of it and this 'exploding water' is
> what does the cutting/cleaning, according to one school; the other
> school believes that the water exploding as Laser energy is absorbed is
> merely a characteristic if this system, and it is still the Laser beam
> of coherent light that does the therapy. The WaterLase's claim to faim
> is a light frequency in the infra-red that is absorbed by enamel and
> dentin. Thus it cuts enamel and dentin, as well as oral tissues and
> bone. The bur or drill bit is replaced by a similar sized rod of
> zirconium or other synthetic crystal. Look on the BioLase site for some
> pictures.
>
> Surguries ( mucco-gingival and osseous ) are said to be very well
> tolerated and healing is said to be quicker. I NEVER did any surgeries
> WITHOUT local anesthetics given previously. I don't believe in forcing
> patients to submit to this type of procedure. I HAVE done surgeries with
> anesthetic and in some cases, I HAVE found that from the dentists' point
> of view, it IS easier to do.
>
> I have personally 'drilled' into teeth that were very deeply involved
> with caries and have had quite good success in finishing them without
> the need for ansethesia. As the tooth is irradiated/sprayed, it enters a
> state of relative analgesia, where, even though you feel what is going
> on, you don't feel pain.
>
> One can remove older fillings after soothing the tooth with a continuous
> irradiation of 2 minutes or so before attacking it with the regular
> turbine. This works, but not always. However, it is never a situation
> where things go well, and then, all of a sudden, BANG!!! Excrutiating
> pain. It comes on gradually, and you will have time to tell the dentist
> to stop.
>
> Once or twice I have taken the Endodontic points into canals that were
> symptomatic and soothed them within 10 minutes or so.
>
> I have not had any demonstrable success using the Laser in Periodontics,
> but others have said that they do.
>
> The major problem with these types of instruments is the lack of
> scientifically based studies showing superiority of the Laser versus
> well-admisistered traditional treatments. Most of the published studies
> or case descriptions have been in Dentistry Today and Dental Town.
>
> My own feeling: many treatments are easier with the Laser, since there
> are no moving parts, you can wall off a lesion from the adjacent teeth
> or gingival tissues and blast it relatively painlessly, without
> disturbing the adjacent tissues. Is this worth the price of a Laser? Not
> if you are trying to pay for it exclusively on the increased revenues
> that this treatment is supposed to bring you. This is why I am not
> getting my own Laser fixed anytime soon or even ever. The sad bottom
> line is that people appreciate this type of treatment, but they are not
> willing to pay for it (at least around here).
>
> What this all means to you: Hurry up and give it a try, as your own
> dentist just might wake up as I have and come to the same conclusions
> and decide to turn it off one day when it breaks.
>
> If you have any specific questions about Laser treatments, ask and I'll
> get back to you with what I know. It's just that lately, all hell is
> breaking loose in my little clinic, (maybe you heard the rumbling of the
> tectonic plates... so, it may be awhile befor I can get back to you.
>
> I hope SFawks chimes in with his experiences with the Laser. He has a
> more modern version of the same Biolase laser.
>
> cf: http://www.biolase.com
>
> YMMV, JMO, not responsible for lost and stolen items, one cross to a
> prisoner, etc etc etc etc......
> SP

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  • Re: Laser dentistry!
    ... my Laser is dead. ... If you WANT Laser treatment, ... The beam has water sprayed in front of it and this 'exploding water' is ... or case descriptions have been in Dentistry Today and Dental Town. ...
    (sci.med.dentistry)
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