Hard Tissue Lasers

I recently read an abstract of an article entitled "Maybe for the New Millennium", published in the Journal for Dentistry, volume 26, 1998, pp 649-656. This article compared patients perceptions and acceptance of two methods of preparing teeth with conventional mechanical preparation and Er:Yag laser preparation.

The interesting point in this article was that the laser took longer to prepare teeth versus conventional mechanical preparation (7.5 versus 4.3 minutes).

If we apply the same logic of dental economics that the laser and plasma curing light manufacturers use in demonstrating cost of overhead reduction, we could argue that hard tissue lasers have an additional overhead cost. The time of preparation difference per procedure is 3.2 minutes at $200 per hour overhead cost equals over $10 per procedure. Since we are limited to low production operative procedures that bill at a lower rate than crown and bridge procedures, the true cost is even greater.

Air abrasion is another technology that suffers from this economic analysis. Preparation time with air abrasion, in my hands, requires at twice as much time. Not having to wait for the onset of anesthesia, however, is a tremendous benefit. Many of the preparations that I do with air abrasion, I also would have done with a high speed drill without anesthetic. Despite these shortcomings, I would not practice without air abrasion. Air abrasion has all of the patient comfort benefits at one-tenth the cost. So, who needs a hard tissue laser?