Expert: Mark Bornfeld DDS - 1/6/2009

Question
What do you think of the use of laser to perform a deep cleaning on the teeth?  Is it new?  Is it safe?  Is it better than the more time tested methods?  Is it more/less expensive?  Pros/Cons versus more conventional methods of teeth cleaning?  Thank you

Answer
Dear Bob,

Disclaimer: I have no personal experience with lasers in dental applications.

However, I am unaware of any periodontists who employ lasers in their practices, and I think that fact speaks volumes.

Dentists who have purchased lasers have generally made a substantial capital expenditure in acquiring the hardware, and such an expense tends to promote a psychological phenomenon known as "cognitive dissonance": the tendency to over-emphasize facts that support the technology, and to discount facts that refute its virtues.

Because of this, dentists who use lasers tend to be "true believers" who feel that they are somehow on to something that the unenlightened members of the profession somehow failed to grasp, when in fact there is little that a laser can do that much more conventional and less expensive techniques cannot.

In fact, the price tag of lasers tends to be a significant obstacle to purchasing them for most dentists, lending additional cachet to those whose budget can accommodate it. In this is the laser's primary appeal: flash and exclusivity. In the dental arena, there is not much else to recommend a laser other than to demonstrate an embrace of technology for technology's sake, rather than any true value to dental therapeutics.

That is not to say that a laser has no value in health care-- for example, it is good at certain surgical techniques that involve bladeless surgery at a distance through an optically clear medium, as is seen in ophthalmology (for example, glaucoma surgery or retinal photocoagulation in diabetic retinopathy). However, an analogous situation does not exist in dentistry. For the dental patient, the most prominent effect of a laser is to increase the cost of dental treatment.

You will do better with more traditional root planing, which has an established record of efficacy.

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY