Lasers for Pain-free Dentistry

Chris writes "Australian researchers say that frequency-doubling a femtosecond laser is the way to pain-free dentistry. Using two different Ti:sapphire sources it was found that the 400 nm second harmonic gave the best results. Lasers have long been touted as pain-free replacements for the dreaded dentist's drill. However, the hardness of dental tissue has demanded high-energy pulses for drilling. Previous attempts have resulted in unacceptably slow removal of tooth enamel, and have also damaged teeth. These previous efforts caused shock waves, vibrations and also heated up the tooth's softer tissue, causing significant pain to the patient. Because femtosecond pulses are so short, heat conduction effects are virtually eliminated."

Comments

The problem isn't the drill...

[Dalroth]

The problem isn't the drill, or at least it never was for me. Sure, the drill is uncomfortable, afterall the dentist is generally pushing the thing around violently inside your tooth. That's annoying. It's the nerves that are the problem! First of all, there's the shot of novocaine (which is quite traumatic in and of itself). Then there's the drilling. Oops we hit the nerve (like the laser will never do the same thing?) and the novocaine wasn't as strong as we'd have liked. Time to do another shot of novocaine RIGHT DOWN THE CENTER OF YOUR NOW OPEN TOOTH (yes I did go through that). HOLY FUCK THAT HURT. I can't feel anything now.

Drill or no drill, it's the nerve stupid!

Re:No drill dentistry...expensive?

[Garin]

I can't give you a detailed comparison. I'll tell you what I've learned so far though.

First, some background. My education is physics and mathematics. My wife is a dentist. About two years ago, I attended a lecture by a visiting professor who was doing work building things like dental lasers -- the so-called sub-picosecond-pulse lasers. It was an excellent lecture and he really knew his stuff. Naturally, I came home all abuzz, and started talking to my wife about it.

It turns out that many dentists think the lasers may be cool and all, but they'll probably never use them for drilling out teeth. Cutting softer tissue, sure, but not drilling the actual tooth. She says that a huge part of the drilling process is feel. While you're drilling, you can feel when you're drilling softer, infected enamel and dentin versus hard, clean tooth. Taking that feel away would severely compromise her ability to be sure that she's drilled out all the decay, without drilling out too much of the tooth and possibly compromising its integrity or perforating into the pulp.

My wife has left for her office already, so I can't get her to comment directly. I'd love to hear from any other dentists, though. What do you think? Is feel really that important when you're drilling?