Lasers have been used in dentistry since 1994 to treat a number of dental problems. Yet, despite FDA approval, no laser system has received the American Dental Association's (ADA) Seal of Acceptance as an alternative to more traditional treatment. This seal ensures dentists that the product or device meets ADA standards for safety and effectiveness, among other things. The ADA, however, states that it is cautiously optimistic about the role of laser technology in the field of dentistry. These lasers are different from cold lasers used in phototherapy to relieve headaches, pain and inflammation.
Still, some dentists are using lasers to treat:
Carbon dioxide lasers
Diode lasers wavelengths in the 810–1,100 nm range are poorly absorbed by the soft tissues such as the gingivae, and cannot be used for soft tissue cutting or ablation. Instead, the distal end of diode’s glass fiber is charred (by burned ink or by burned corkwood, etc.) and the char is heated by the 810-1,100 nm laser beam, which in turn heats up the glass fiber’ tip. The soft tissue is cut, on contact, by the hot charred glass tip and not by the laser beam. Similarly ND:YAG lasers are used for soft tissue surgeries in the oral cavity, such as gingivectomy, periodontal sulcular debridement, LANAP, frenectomy, biopsy, and coagulation of graft donor sites. The Nd:YAG laser wavelength are partially absorbed by pigment in the tissue such as hemoglobin and melanin. These lasers are often used for debridement and disinfection of periodontal pockets. Their coagulative ability to form fibrin allows them to seal treated pockets. The CO2 laser remains the best surgical laser for the soft tissue where both cutting and hemostasis is achieved photo-thermally (radiantly).
Carbon dioxide laser
Erbium lasers are both hard and soft tissue capable. They can be used for a host of dental procedures, and allow for more procedures to be done without local anesthesia. Erbium lasers can be used for hard tissue procedures like bone cutting and create minimal thermal and mechanical trauma to adjacent tissues. These procedures show an excellent healing response.  Soft tissue applications with erbium lasers feature less hemostasis and coagulation abilities relative to the CO2 lasers. The new CO2 laser operating at 9,300 nm features strong absorption in both soft and hard tissue and is the newest alternative to erbium lasers.
Laser surgery is a type of surgery that uses a laser (in contrast to using a scalpel) to cut tissue. Examples include the use of a laser scalpel in otherwise conventional surgery, and soft-tissue laser surgery, in which the laser beam vaporizes soft tissue with high water content. Laser resurfacing is a technique in which covalent bonds of a material are dissolved by a laser, a technique invented by aesthetic plastic surgeon Thomas L. Roberts, III using CO2 lasers in the 1990s.The CO2 (carbon dioxide) laser remains the gold standard for the soft tissue surgery because of the ease of simultaneous photo-thermal ablation and coagulation (and small blood capillary hemostasis). Laser surgery is commonly used on the eye. Techniques used include LASIK, which is used to correct near and far-sightedness in vision, and photorefractive keratectomy, a procedure which permanently reshapes the cornea using an excimer laser to remove a small amount of the human tissue. Types of surgical lasers include carbon dioxide, argon, Nd:YAG laser, and Potassium titanyl phosphate, from among others.
Dental diode lasers, sometimes called soft-tissue lasers, are ideal for procedures that involve cutting or contouring oral soft tissues.
The carbon dioxide laser has been used for soft tissue surgery.
The Nd:YAG laser has both soft and hard tissue applications.
Erbium lasers (Er,Cr:YSGG and Er:YAG) interact with the water of soft and hard tissue.
Our Biological Dentistry™ approach to diagnosis, treatment and prevention is the logical result of our investigations into why conventional treatment with the drill causes pain, necessitates the use of anesthetic, and causes unintended damage to surrounding healthy tissue – negative consequences that have long been accepted for lack of a better solution. A fresh look at the anatomy and physiology of teeth and oral soft tissues showed us there could be a more biologically friendly way to treat them.Tooth enamel naturally contains up to 5% water; dentin and bone up to 25%. Years of BIOLASE research led to discovery of a water-energizing 2,780 nm YSGG laser and a handpiece that delivers air and water in precise proportions – both BIOLASE patented – that combine to symbiotically excite water molecules from both the handpiece spray and inside the target tissue. The result is an effective biological micro-ablation of tooth structure. The atomized spray of water and air continually re-hydrates the tooth, preventing heat and pain. We named this technology WaterLase©.
A graph of the absorption of various wavelengths of laser energy in water shows that erbium laser energy is absorbed at a rate 300% greater than YSSG laser energy.On hard tissue, an erbium laser will quickly vaporize the water naturally present in dentinal tubules and enamel prisms and damage the tooth, without the use a far greater amount of water spray than the YSGG laser. This additional water at the tissue surface means less energy is being absorbed by the hydroxyapatite and enamel, significantly reducing the cutting speed of the erbium laser.On soft tissue, the erbium laser's higher absorption by water means that it draws more blood and fluid to the surface, dehydrating the tissue and obscuring the field of view.The physics of the YSGG wavelength is perfectly balanced to remove enamel and dentin, and to surgically cut and coagulate soft tissue.
Fotona's dental lasers are the ideal tools for all soft-tissue treatments. Unlike conventional oral surgery techniques, dental lasers allow soft-tissue treatments without the need for a scalpel or sutures. Surgical procedures are precise, bloodless and pain-free thanks to the simultaneous coagulation effect that occurs during laser-tissue interaction.
Laser therapy is not a foreign concept to most dental practitioners as many practitioners include surgical lasers in their arsenal of high-tech equipment. Low-level lasers are a subset of the laser family that elicits a cellular response from the cell, as opposed to a photothermal effect, resulting in improved healing, pain reduction and a reduction in inflammation. Low-level lasers frequently use similar wavelengths to surgical lasers; however, use a significantly reduced power and a larger tip diameter.