Top 3 laser procedures you can put into your practice right now
Dr. Chris Walinski lets you know what you can and should be performing now with your dental lasers.
You’ve finally made the plunge and find yourself unboxing a brand new laser in your office. But, now what?
The realization that you’re not really sure what procedures you will use it for is setting in and you’ve forgotten much of what the sales person told you it could do. Thankfully, there are a few procedures you can get started with right away, to help you get your laser “sea legs” and reap the benefits of laser dentistry. Just about all dental lasers that are available these days offer a number of presets to get you on your way a lot quicker than the days where you had to calculate energy per pulse and spot size. (No wonder laser adoption has taken so long!)
Laser or no laser, most dentists are familiar with the general principles of recontouring marginal gingiva for either cosmetic or functional reasons. Whether your previous experience is with a scalpel, electrosurge or (gasp!) a bur, all the basic rules remain the same. Allow for an acceptable biologic width, and do not create a reverse gingival architecture in the finished tissue margin. If the tooth to be treated requires 2 mm or less of tissue removal, the technique is pretty straightforward, especially with the correct laser tip/fiber, using the GV preset on your laser.
Somewhere along the way, laser dentists adopted the term “troughing” to designate a procedure to create a small space around the margins of a crown preparation similar to placing retraction cord. This too is a fairly simple laser procedure you can do reasonably well right out of the box. Regardless, it would behoove you to start off by troughing posterior preps until you are more comfortable with the effects of your laser on such delicate marginal tissue. Once again, presets will be invaluable and keep you out of trouble.
It always amazes me how things are invisible until you start looking for them. This is especially true with irritation fibromas in the mouth. Before purchasing my first laser, I would have sworn that my entire patient base represented no more than one, or possibly two fibromas. Incredibly, once I became aware of this soft tissue anomaly, barely a week would pass without seeing yet another one. A very simple procedure made even easier if you: 1) Use your laser to mark the margin of the fibroma circumferentially to give yourself a definite line to follow; and 2) Use a tissue pickup instrument to create tension on the tissue to be removed, which in turn will make quick work of excision. Because of the gentle action of the laser and hemostasis achieved, no sutures or dressing are required!
Must read: BIOLASE unveils new BIOLASE Learning Center to provide comprehensive dental laser continuing education to dental professionals
Christopher J. Walinski, DDS, is Associate Professor Director of Laser Dentistry, Dept. of Restorative Dentistry, The University of Tennessee Health Science Center, College of Dentistry.