Seeing what you're doing the key to laser dentistry

Following a successful presentation to a full house at the recent Masters of Dentistry Extravaganza, visiting Canadian dentist Glenn van As visited both Melbourne and the Gold Coast to again deliver his programme centred around using both lasers and microscopes in general dental practice.

"Using a laser in dentistry relies much more on visual rather than tactile control," Dr van As said. "In other words, you have to be able to see what you're doing. This is why using a laser in conjunction with a microscope is such a natural progression.

"Dentists should be using loupes as a minimum. If they're not, they would be surprised at how much they're missing. After that, it is not such a big step to go to a microscope. Not only do you see everything with a scope, you can also document your work much more easily as you can simply attach a digital still or video camera and take images without interrupting your work. In addition the ergonomic benefits of sitting in a neutral and balanced upright posture allow maximum visual acuity without sacrificing ergonomics."

Dr van As said that the combination of high magnification and the tremendous shadow free illumination afforded by microscopes was ideal for laser dentistry.

Dr van As spoke for four hours at the Masters of Dentistry program to an audience of some 80 people he estimates. Four of the five distributors of lasers in Australia exhibited at the event, providing an avenue for further information after the lecture concluded.

The programmes held in Melbourne and the Gold Coast were organised by Protec, a Henry Schein Company, who market the Hoya Con Bio range of lasers that Dr van As uses in his practice in Vancouver, British Columbia.

"Interest from the public is driving a lot of the current buzz about lasers," he said. "People are aware of the applications of lasers in vision correction and other areas of medicine, so they are very accepting and almost expecting it to be possible to use lasers in dentistry".

"From a clinicians viewpoint, dentists are finding they can do more with a laser than before or in some cases perhaps, do things better. Laser analgesia can temporarily 'numb' the tooth as you work on it without local anaesthetic and there is substantially less risk of bleeding, infection or post-operative soft tissue complications. Lasers improve a practices bottom line (ROI) and create a 'win-win' situation for both the dentist and the patient."

According to Dr van As, the combination of the laser and microscopes have combined to triple his practice's gross annual revenue in the last six years, doubling his number of new patients monthly.

His general dental practice in Canada delivers everything from restorative, C&B, children's dentistry, endo and the gamut of general procedures. The practice includes three Global surgical microscopes - one for each dentist - and five lasers including two Erbium YAG hard tissue Hoya Con Bio lasers, Ivoclar and Hoya soft tissue diode lasers and an Argon laser for curing and bleaching. He also finds the KaVo DIAGNOdent indispensable in his microdental caries diagnosis and treatment of which the laser and microscope are big pieces of the armamentarium.

"Working with microscopes has a number of advantages. Ergonomically, they keep your spine in the ideal position so ultimately you have less neck and back problems; they have a variable power range unlike loupes and can go from 2x to 24x; and as I mentioned before, they make documentation of cases very simple. I might take hundreds of photos during a complex procedure and to stop, take off your gloves and position a camera in each case is time prohibitive. By having a camera mounted on the microscope, you just click away while you work. The ability to document easily with digital video cameras hooked up to the microscope also opens up new avenues for presentation and teaching purposes."

Dr van As uses video footage shot through a microscope during his presentation and said that whereas scopes were standard equipment for endo work, they are also an asset for highly detailed cosmetics and of course for the visual requirements of laser dentistry.

"Dentists tend to find the videos very compelling when they see what's happening up close. The Australian audiences are looking to know exactly what a laser can do before they buy in - they want to know they can afford to pay it off - and they want to see how it can build their practice.

"In the USA, dentists look at lasers as a way of differentiating their practice or to market towards kids using the McDonald's principle of get the kids and the family will follow.

"In Australia however, dentists are all already busy, so they don't need a laser to get busier. They buy a laser for enjoyment and because they want new challenges and they want to practice conservative dentistry.

"They are looking at lasers to assist them to change the way they practice. They want to do comprehensive dentistry and go from the one tooth in one quadrant category to complex cases. Dentists want to go to work each day with a renewed enthusiasm for the profession and lasers and microscopes in daily practice offer that opportunity for a more fulfilling professional career."