Painless, drill-less, injection-less fillings...

For years, the only way to remove cavities from a tooth so a filling could be placed was with a dental drill. Since the dental drill uses mechanical energy to cut into the tooth, the tooth must be anesthetized with an injection. The Powerlase AT is a new tool which uses laser energy to cut into the tooth, eliminating the need for anesthetic and injections in many cases. This type of dental laser is called a Hard Tissue Laser, since it is designed for use on teeth and bone. We also have a Soft Tissue Laser in our office, which is designed for use on the gums. These two lasers utilize different wavelengths of light which are best suited to these different types of tissues.

How does it work?

The Hard Tissue Laser uses small bursts of laser energy combined with water to remove tooth structure in small increments. The laser energy creates tiny, micro-explosions which nibble away at the tooth to remove the decay. This process is called ablation, and is painless because of the extremely short duration of each laser burst. It is the small amounts of water which are present inside tooth structure which the laser energy reacts with. This is why the Hard Tissue Laser cannot be used to remove old fillings or dental work because the metal and porcelain out of which these restorations are made of do not contain any water for the laser to react with. The Hard Tissue Laser is not quite as fast as the dental drill, but the fact that it does not require a patient to be numbed makes up for its slower speed. Many people hate the noise which the dental drill makes, and the Hard Tissue Laser eliminates this because the only noise it makes is a popping sound.

Can the Hard Tissue Laser be used in all situations?

Unfortunately, the answer is no. The Hard Tissue Laser is best suited for small to medium size cavities which have not yet grown close to the center (nerve) of the tooth. As described earlier, the Hard Tissue Laser cannot be used to remove old fillings from a tooth, and it is not used for preparing the tooth for a crown, inlay or onlay since the laser leaves a very rough, uneven tooth surface making it impossible to manufacture a restoration with a tight fit. The rough surface left by the Hard Tissue Laser is excellent for bonding composite resin fillings. The Hard Tissue Laser is an excellent tool for removing small areas of decay quickly and painlessly without the need for anesthetic, but requires early identification and diagnosis of dental cavities in order to be used. We use it very frequently on children, eliminating the need for an injection and an unhappy child.

Here is a link to the patient education section of our cosmetic dentistry website which you may find helpful. There is a lot of information there for you to browse through and to answer any questions you may have, and was designed by a dental education company whose tools are used in our San Jose cosmetic dentistry office to help our patients understand their treatment options. Some of the information there may be a bit outdated because the dental field is always evolving, but the general concepts of dentistry are nicely described and illustrated.

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