Laser dentistry

Dental lasers use a focused beam of light to cut, reshape or treat tissue. They have real uses in dentistry, and they have been oversold. This page explains what they genuinely do and where the evidence is thinner than the marketing.

How a dental laser actually works

A laser is light of a single wavelength, delivered in a tightly focused beam. It does its work by being absorbed by something in the tissue — water, pigment, or mineral — and converted to heat at that exact point.

That is the whole principle, and it explains both the strengths and the limits. A wavelength absorbed strongly by water and pigment cuts gum tissue efficiently and passes through enamel doing very little. A wavelength absorbed by the mineral in a tooth can remove decay but is poorly suited to soft tissue.

This is why there is no single dental laser. A practice with one laser has a device suited to one family of jobs, and it is a fair question to ask which.

What lasers are used for

Different wavelengths suit different jobs, and no single laser does everything.

Soft tissue work — this is where lasers are most established. Reshaping the gumline, removing a small growth or a tight frenum, exposing a partly erupted tooth, or trimming gum for a crown. Compared with a scalpel, a laser seals small blood vessels as it cuts, so there is usually less bleeding, often no stitches, and frequently faster healing.

Gum disease — lasers can remove inflamed tissue and disinfect a gum pocket alongside conventional deep cleaning. The evidence that this adds meaningfully to well-done conventional periodontal treatment is mixed. It is an adjunct, not a replacement. See gum care and periodontics.

Cavity preparation — certain hard-tissue lasers can remove decay without a drill, with less vibration and sometimes no anaesthetic. They are slower than a drill for larger cavities, cannot remove old fillings or crowns, and the drill is often still needed to finish and shape the restoration. For small cavities, air abrasion achieves much the same drill-free experience — which is what we use here.

Whitening — a light or laser is sometimes used to activate the bleaching gel. The evidence that the light adds anything beyond what the gel does on its own is weak. It does not make whitening safer or longer-lasting. See teeth whitening.

Jaw joint pain — low-level laser therapy is offered for TMJ discomfort. Some studies show short-term relief; the overall evidence is limited, and it is not a first-line treatment. See TMD and jaw treatment.

Cold sores and mouth ulcers — low-level laser is sometimes used to shorten an episode. The evidence here is modest and the effect, where reported, is measured in days rather than a cure.

Advantages, where they apply

• Less bleeding and swelling for soft-tissue procedures
• Often no stitches
• Reduced need for anaesthetic in some procedures
• Less noise and vibration than a drill
• Lower risk of infection at the surgical site

Limitations, honestly

• Lasers cannot remove metal fillings, crowns or old restorations
• Larger cavities still need a drill, at least to finish
• Many procedures still need anaesthetic
• Some situations are unsuitable depending on the tissue involved
• A laser does not improve the quality of a diagnosis or a treatment plan. It is a tool, and a good result depends on the practitioner using it appropriately

Anyone offering laser treatment as reason in itself to have a procedure is putting the tool ahead of the need.

Where the marketing usually overreaches

These are the claims worth treating with caution, whoever is making them:

• "Laser whitening is better." The gel does the whitening. Light activation has not been shown to add much.
• "Laser gum treatment replaces a deep clean." It does not. It is used alongside conventional treatment, where it is used at all.
• "Laser dentistry is pain-free." Some procedures need less anaesthetic. Some need the same. Comfort varies between people and between procedures, and no honest practice promises the outcome in advance.
• "Laser kills all the bacteria." It reduces the bacterial load in a treated area. That is not the same claim.
• "It is a laser, so it is safer." A laser directs concentrated energy into tissue. Used badly it can cause thermal damage that a scalpel would not.

How to compare the options

Safety, and what a session involves

Dental lasers are classed as radiation-emitting devices and their use is governed by state radiation safety legislation as well as by professional standards. In practice that means:

• Everyone in the room wears protective eyewear matched to that laser's wavelength. Ordinary safety glasses are not sufficient, and this includes you.
• The area is isolated and reflective instruments are managed, because the beam can reflect.
• High-volume suction manages the plume produced when tissue is treated.
• The device has a controlled key and standby state so it cannot fire unintentionally.

For a soft-tissue procedure, you can expect a local anaesthetic in most cases, a smell during treatment that surprises people the first time, little or no bleeding, and a white or grey film over the treated area for several days while it heals. That film is normal and is not an infection. Aftercare is generally salt-water rinses, soft food for a day or two, and avoiding smoking, alcohol and spicy food while it settles.

At Victorian Dental Group

Our drill-free approach for suitable small cavities is air abrasion, which removes decay with a fine particle stream rather than a laser — no vibration, no heat, often no needle. Our imaging is digital: on-site OPG, digital X-rays and intra-oral cameras.

If you are asking about a specific laser procedure, ask us directly whether it is available here or whether we would refer you — soft-tissue laser surgery and laser periodontal treatment are commonly provided by periodontists and oral surgeons, and we refer to registered specialists where a case warrants it. We are a general dental practice and hold no specialist registration.

Training

Dental lasers require specific training in the safe use of the relevant wavelength, and are regulated as a radiation-emitting device. Ask any provider what training they hold for the laser they use.

Three more questions worth asking anyone proposing laser treatment:

1. Which laser, and which wavelength? The answer should be specific and should match the job.
2. What would you do if you did not have it? If there is a straightforward conventional alternative, the choice should be explained on its merits rather than on the equipment.
3. What does it add to the cost, and what am I getting for that?

Questions we are asked

Is laser treatment covered by health funds? Funds pay against item numbers for the procedure, not for the instrument used. Where a laser version attracts a higher fee, the difference is commonly out of pocket. Ask for it in writing before you agree.

Is it safe in pregnancy? Soft-tissue laser procedures are generally considered low-risk, but elective treatment is usually deferred. Tell us if you are pregnant or may be, and we will discuss timing.

Can children have laser treatment? Some soft-tissue procedures, yes — a tight tongue or lip frenum being the most common. It is assessed case by case, and a referral is often the right answer.

Does it hurt less? For some soft-tissue procedures, less anaesthetic is needed and there is often less swelling afterwards. That is not the same as no discomfort, and individual experiences vary.

Read more about our clinic, drill-free fillings or dental technology.

Victorian Dental Group — 291 Wattletree Road, Malvern East VIC 3145 · (03) 9088 5808 · Monday to Friday, 8:00am–5:00pm · book online

This page is general information and does not replace advice from a registered dental practitioner about your own circumstances. Please see our Disclaimer.