Filling Without the Drilling
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Do you dread visiting the dentist, especially when you know
you have a cavity that needs attention? Relax. Your days of needles,
drills and numbness are over. Lasers will make your trips to the
dentist pain-free.
By Dr. Rodger Kurthy |
Everyone is familiar with the sound of the dentist's drill,
and the involuntary reaction that comes with it - it's a safe bet that
more than a few armrests on dentists' chairs have been left in shreds
by patients expressing their discomfort.
But rest assured, today's dental technology is moving ahead as
rapidly as that in any other field, and it looks like the days of the shot,
the drill, and the numb, swollen jaw may soon be a thing of the past.
The latest tool in the fight against tooth decay is one more suited in people's
imaginations to fighting Imperial Forces in a Star Wars movie - the laser.
Until recently, dental lasers could not be used to fix cavities. They were strictly
for use on gum disease or other soft tissues. But that has all changed.
Now there is the new Biolase Waterlase - what some like to call The Water Laser.
This laser sprays out a computer-controlled spray of air and water. The laser
energy beam is specifically absorbed by the water, and when the microscopic water
particles are activated, it is these activated water particles that remove the
cavity - all without needing a needle or the drill - and usually with no pain
at all.
Have you ever needed a crown or a root canal? If so, it was most likely on a
tooth that had a large old silver/mercury filling in it. And you probably needed
it for one of two reasons: either the old filling got tooth decay (a cavity)
under it, or the tooth cracked and broke.
Laser treatment can help prevent both of these scenarios. The laser sterilizes
the tooth while removing the cavity. Instead of an old silver/mercury
filling, a tooth-colored filling is "bonded" to the tooth. The tooth
is actually stronger after the filling is placed inside than it was before.
Since the laser sterilizes the tooth, there is less chance of bacteria
causing more tooth decay under the filling in years to come. Therefore,
there's less chance of needing crowns and root canals.
Problems with broken teeth may also be a thing of the past thanks to
the laser. Do you know how fast the average dental drill spins? Faster
than a Corvette. The average dental drill spins at about 300,000 rpm.
A Corvette "red lines" at
only 6,000 rpm. The turbines in dental drills are the fastest turbines
in the world - much faster than even jet engines.
Because of this speed, the drills can cause micro-cracks in teeth. We've all
seen a little crack in glass become larger and larger over time. Imagine your
teeth having very small cracks. You chew with these teeth day after day. Sometimes
those cracks become larger and the tooth breaks. Before long, a crown or a root
canal is needed. Laser treatment, on the other hand, does not cause any vibration
or cracking of the teeth, and won't inadvertently lead to crowns or canals.
Another advantage of the move toward laser technology is something called "microdentistry." Lasers
are providing dentists with the precision needed to work on much smaller
areas on the teeth. Cavities are softer than healthy tooth structure.
Lasers preferentially remove softer structure before hard structure,
as opposed to drills, which take away everything in their path.
Additionally, fillings done with lasers are much smaller. Old school silver/mercury
fillings have a minimum size requirement. As a result, even for a small cavity,
dentists have to drill a large hole in the tooth. But bonded fillings only require
that the cavity is removed, and they don't have to be any larger than that.
Dental lasers can also be used to treat gum disease, canker sores, and other
problems in the mouth. Dentists are even starting to use lasers to perform root
canals - good news for anyone who has sat, fists clenched, through the old-fashioned
version.
The laser is no longer a weapon seen only in sci-fi films, it's a modern tool
that is having a positive impact on present-day healthcare.
How Lasers Detect Cavities
Ever wondered, during a visit to the dentist, why such
a large filling is required when you were pronounced cavity-free
on your visit six months ago?
This is a very common scenario. Most cavities start way down inside
the grooves and pits of the teeth, where the dentist can't even
see. Until the cavity is about one-third the width of the entire
tooth, you really can't see it on an x-ray. So by the time the
dentist knows it's there, it's often already quite large. In fact,
sometimes cavities are detected so late that root canals are already
necessary.
Laser technology may change all this. Some dentists are now using
laser scanners to find ultra-small cavities, up to 10 years before
they would be detected by traditional means. A laser beam can find
cavities that are the size of the tip of a pin, and can routinely
fix them with no shot and no pain. |
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How to Prevent Cavities From Spreading
Ever seen a soft mushy cavity? It looks like a hole in
a tooth, and it's usually stained a dark color. As a dentist removes
the decay, the hole gets deeper, the decay gets harder, and the
color gets lighter.
So how does the dentist know when the entire cavity has been removed?
The answer is that often, the dentist doesn't know. Even the best
dentists used to leave some decay here and there - it was impossible
to tell if all the decay was gone.
But now, the dentists are using something called "calories indicator" stain.
This is a dye that stains only tooth decay. When the dentist feels
all the decay is gone, he can paint this die on the tooth for a
few seconds, and rinse it off with water. The die doesn't stain
healthy tooth, but it does stain tooth decay. This allows the dentist
to see where the remaining decay is, and to remove it. |
About the Author: Dr. Rodger Kurthy graduated
at the top of his class from Fairleigh Dickinson University in 1978,
completed a hospital residency at Newark Beth Israel Medical Center,
and has been heavily involved in numerous areas of clinical research
and new product evaluation for the last 25 years. He has had many articles
published, is interviewed regularly on both radio and television, and
lectures frequently to dentists all over America. Because of Dr. Kurthy's
long-time role in educating dentists as well as the public, Dr. Kurthy
has often been called "America's Dentist."
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