August 2010
Waterlase MD into his mixed NHS/ private practice to help shift the balance towards private dentistry uptake and is already seeing great success after just four months. Overall, it was a fascinating day
showing real wet-fingered use of lasers in the UK and also Spain where there are already 400 users of the Waterlase MD.
Diagnodent The Diagnodent is a laser (655nm wavelength) that shines a laser light in to the tooth and records the fluorescence of bacteria. In simple terms the cariogenic bacteria fluoresce far more than non-cariogenic oral bacteria so this gives us an accurate diagnostic tool for caries. Some studies say it is over 90 per cent accurate using the appropriate diagnostic protocol. This is far higher than visual or radiographic diagnosis. I have noted the Carissa claims
similar results by passing a small electric current through the damaged cariogenic tooth, but I have no experience of this tool. KaVo provides an excellent PowerPoint lecture by Graeme Milavich from Australia explaining its accurate use. The main false positives come from stain or
plaque in the fissures that ideally should be cleaned first with an air polisher (e.g. KaVo Rhondo and Velopex Aquacut). There are several benefits to the
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use of Diagnodent: • Diagnodent uses a laser to identify signs of tooth decay and therefore limits the need for invasive probes, which can be very off-putting for patients and potentially can damage the weak fissures. • It identifies caries well before other investigative techniques. This enables the dentist to treat the early caries in a minimally invasive way before the decay is able to spread. This could include diet advice, fluoride treatments, fissure sealing or micro-restorations or other treatments such as Ozone. • The dentist is able to keep records of healthy or borderline readings to monitor if caries is progressing or stable. • Children often have a fear of the dentist, due to the strange tools and apparatus used, such as needles and drills. Diagnodent helps to put a stop to the need to use such tools in the long run. • One of the most typical methods used to identify tooth decay is through the use of x-rays, which give off small waves of radiation. Diagnodent helps limit the need to use such technology that some people may be concerned about. • Not only will the dentist be able to ascertain what the results are from the Diagnodent device but also the patient, by way of an audible and visual signal. • Early detection of caries will
www.dental-practice.org
reduce the size of the fillings, reduce the likelihood of a fractured tooth or pulpal emergency, and finally reduce the cost of treatment to the patient. It also gives a very high-tech image to your practice. • Diagnodent has been found to have a success rate of 90 per cent, and this is bound to improve as the technology continues to develop. The Diagnodent works well with
a minimally invasive approach to dentistry and in particular micro- restorations with either the laser or air abrasion particularly in children, as it is rare to require local. At around £2,000, it is a very useful
diagnostic tool that will improve the caring and high-tech image of your practice and ethically increase revenue by improving the accuracy of your diagnosis.
Conclusion I hope my readers have found this series of articles useful in shedding a little more light on the confusing subject of lasers. What is your next step if you want
to find out more about lasers? I would strongly suggest you do either an introduction to lasers training course and possibly go to one of the international conferences. It is important to find out what the
various lasers can and can’t do – they vary radically in quality and in what procedures you can actually perform with a reliable clinical outcome. Expect to be doing new procedures with your lasers so not only do you have to learn how the laser works for you but also you find yourself going back to the textbooks to brush up on your dental skills or learn new dental procedures. The laser will transform the way
you practise dentistry and you and your patients will love the benefits. Welcome to 21st century dentistry.
Some useful web pages • KaVo Dental – Diagnodent:
www.cosmeticdentistryguide.
co.uk/articles/diagnodent. html;
www.kavo.com/Default. aspx?navid=40&oid=002&lid=En • SOLA – International Society for Oral Laser Applications:
http://www.sola-int.org • WFLD – World Federation of Laser Dentistry: http://www.
wfld-org.info • ALD – Academy of Laser Dentistry: http://www.
laserdentistry.org • WCLI – World Clinical Laser Institute: http://www.learnlasers. com
Oliver Harman is lead dentist for Dentics Cosmetic Dental Studio (part of Oasis Healthcare) and owner of the Harman Dental Clinic in Tunbridge Wells. He is also cosmetic dental consultant to the British Cosmetic Dental Centre in Riyadh, Saudi Arabia, a member of the American Academy of Cosmetic Dentistry and on the board of the British Academy of Cosmetic Dentistry, its Credentialing Examining Panel and the Public Relations Committee.
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