06AS4312

Lasers in Dentistry
by Donald J Coluzzi, DDS and Michael D. Swick, DMD
Abstract
This article describes how laser instruments can be used for a
variety of dental procedures. The fundamentals of laser physics
and tissue interaction are explained and an overview of the
different characteristics of individual instrument types is given.
Some examples of clinical treatment cases are shown.
Learning Objectives
After reading this article, the reader should be able to:
discuss basic laser science,
list the different features of individual devices, and
describe the differences in tissue interaction when exposed
to different laser wavelengths.
Laser use in dentistry is sometimes considered to be new
technology, but it actually began in 1989 with the introduction
of the first laser designed specifically for dentistry.1 The medical
community began to incorporate lasers for soft-tissue procedures
in the mid-to-late 1970s, and oral surgery added the technology
in the early 1980s. Several authors have explained the benefits of
carbon dioxide laser treatment of oral conditions.2,3 Clinical
applications continue to increase, making laser use one of
dentistrys most exciting advances with unique patient benefits.
This article will provide an overview of lasers for the practitioner
who is considering adding such a device to his or her dental
armamentarium.
Laser Fundamentals
The word laser is an acronym for Light Amplification by
Stimulated Emission of Radiation. After a study of each of these
words, the scientific rationale for the use of lasers in dentistry
becomes clear.
Light is a form of energy that travels in a wave and exists as a
particle. This particle is called a photon. Photons are the
smallest units of energy known to man and are generally
regarded as having zero mass or charge. Light is just a small
portion of a greater arrangement of photonic energy called the
electromagnetic spectrum. The electromagnetic spectrum has
basically no inherent upper or lower bounds, and consists totally
of photonic particles that have different energy levels or bundles
of energy. These photons range from gamma rays, which have
high energy values greater than 100,000 electron volts, to radio
waves, which have very low energy values.
A wave of photons has three basic properties:
Velocity, the speed of light.
Amplitude, the vertical measurement of the height of the
wave, from the zero axis to the peak of the wave. This
describes the energy of that wave, expressed in joules. In

dentistry, a useful quantity is a millijoule, one thousandth

of a joule.
Wavelength, the horizontal distance between any two
corresponding points on the wave. This is typically
measured in meters; the shortest measured wavelengths are
gamma rays (about 1x 10-11 meters); the longest are radio
waves measured at approximately 500 meters. In dentistry,
useful wavelengths are in the range of 500 nm to 10,000
nm or billionths of a meter, with experimentation being
done in the ultraviolet range (190nm to 400nm).
Laser light, is distinguished from ordinary light by the following
two properties:
Laser light is generated as only one color, a property called
monochromaticism. Dental lasers may emit visible or
invisible light.
The waves of laser light are coherent. Each wave is identical
in physical size and shape.
This monochromatic, coherent wave of light energy emerges
from the laser device as a precise collimated beam and a
uniquely efficient source of energy. In comparing laser light to
white light, we find that a 100-watt electrical bulb will produce
about 20 watts of white light and 80 watts of heat. If we were
to filter out all but one wavelength, red for example, we would
be left with a few microwatts of pure red light. A laser, on the
other hand, can convert the 100 watts of electrical power to 80
watts of heat and 20 watts of pure red light or 20 million more
times than the white light. This is why we can derive
therapeutic applications for laser energy.
Amplification by stimulated emission of radiation is a process
that occurs inside the device, and was postulated by Albert
Einstein in 1916.4 The chemical elements, molecules, or
compounds in the core of the laser comprise the active medium,
which is either a solid, liquid, gas, or semiconductor in dental
lasers. This core is surrounded by a pumping mechanism that
supplies the initial photon energy, either in the form of an
electrical current or by the use of a rapid strobe lamp. The
photons are now stimulated and, with the aid of mirrors, are
amplified by reflecting and resonating within this chamber,
ultimately producing laser light. The amplifying mirrors are
needed because optical gain in the active medium is very low,
approximately 1%. Semiconductor lasers, however have high
optical gain, in the 30%60% range, and do not require mirrors
for amplification. The resultant monochromatic, coherent light
beam is then focused by means of a small opening in one end of
the device, and is emitted.
It is important to note that the commercially available dental

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instruments all have emission wavelengths ranging from 488

nm to 10,600 nm and are all nonionizing radiation. This is to
be distinguished from ionizing radiation, which is mutagenic to
cellular DNA components.5
Four dental lasers emit visible light: the argon laser has a 488nm blue color and a 514-nm blue-green color; the frequencydoubled Nd:YAG, which has a green color of 532 nm; a lowlevel (nonsurgical power) therapeutic device with a 635-nm red
light; and another low-level caries detector with a similar red
color at 655 nm.
All other laser devices emit invisible laser light in the near,
middle, and far infrared portion of the electromagnetic
spectrum. There is one low-level laser with photons in the range
of 810 nm. The other surgical instruments are, in ascending
wavelength order: from 800-nm to 830-nm diode, with a
semiconductor active medium of aluminum, gallium, and
arsenide; 980-nm diode with a similar active medium of
indium, gallium and arsenide; 1,064-nm Nd:YAG, where YAG
is a crystal of yttrium aluminum garnet, doped (in laser
language this means coated) with the chemical element
neodymium; 2,970-nm Er, Cr:YSGG, which is a crystal of
yttrium scandium, gallium, garnet doped with erbium and
chromium; 2,940-nm Er:YAG, where the doping agent is
erbium; and 10,600-nm carbon dioxide.6
The argon surgical laser are no longer available as dental
instruments, and the 532-nm and low-level laser devices are
currently not sold in the United States.
With this understanding of the physics of laser light generation,
the clinician can begin to choose from several devices with
different features for the needs of the practice.

Delivery Systems and Emission Modes

Some instruments use small, flexible glass fibers to deliver
energy, while others use more rigid, tube-like devices. The
shorter wavelength instruments, like argon, diode, and
Nd:YAG, have small, flexible glass fiber-optic delivery systems,
with bare fibers that are usually used in contact with the target
tissue. The technical challenges of conducting the longer
erbium and carbon dioxide wavelengths are demanding, and
some manufacturers have chosen to use semiflexible hollowwave guides or rigid sectional articulated arms to deliver the
laser energy to the surgical site. Some of these systems use
additional small quartz or sapphire tips, that attach to the
operating handpiece; other systems simply are used out of
contact with the tissue. In addition, the erbium family of dental
lasers uses a water spray for hard-tissue procedures. The water is
typically switched off for soft-tissue surgery.
Dental lasers have two basic emission modes: continuous wave
and free-running pulse.
Continuous wave means that the laser energy is emitted as
long as the laser is activated. This produces constant tissue
interaction. Carbon dioxide, argon and diode,
semiconductor lasers operate in this manner. There are also
2

variations of the continuous-wave lasers, called gated lasers.

Gating can be accomplished by mechanically closing the
opening of the mirror, by use of a shutter, within the laser
chamber or by rapidly turning the current on and off in the
case of diode lasers, thereby preventing laser light
transmission. A "super-pulsed" carbon dioxide laser is one
that helps to minimize some of the undesirable residual
thermal damage associated with continuous-wave devices.
With free-running pulse, very short bursts of laser energy,
in the scale of a few ten-thousandths of a second, emanate
from the instrument. Nd:YAG, Er:YAG, and Er,Cr:YSGG
devices operate as free-running pulsed lasers.
Because all lasers have a thermal effect on the target tissue, the
dental practitioner must pay attention to the interaction effect
during surgery to ensure that unwanted heat is controlled.7

Tissue Interaction and Safety

Different wavelengths have different absorption coefficients
based on the varied composition of human tissue.8 Water, which
is a universally present molecule, is most interactive with the
two erbium wavelengths, followed by carbon dioxide.
Conversely, the shorter wavelength lasers, including argon,
diode, and Nd:YAG have a higher degree of transmission
through water, which varies by wavelength, 980 nm having the
highest water absorption in the current group of near-infrared
lasers.
Carbon dioxide,
followed closely
by the erbium
family, is highly
absorbed by the
apatite crystal that
forms the
structure for teeth
and bone. There,
lower interaction
of the wavelengths
of around 1,000
nm and below
exist; a case
similar to water.
However, argon,
diode, and
Nd:YAG do have
a high affinity for
blood components
such as
hemoglobin, and
tissue pigments
like melanin;
whereas the longer
wavelength laser
light has little
interaction with the color of tissue.

Of course, human dental hard and soft tissue is a combination of

all these substances. In the treatment of dental soft tissues, the
practitioner has the choice of any available wavelength and
different devices, because all of those mentioned will have
absorption in one or more of the components of those tissues. The
"best" hard-tissue laser device, however, is presently found in the
erbium family. The currently available continuous wave of the
carbon dioxide laser produces too long an exposure time and heat
buildup for removing dental hard tissue; the very short freerunning pulsed erbium lasers easily ablate layers of calcified tissue
with minimal thermal effects.
In addition to unique absorptive optical properties, all
wavelengths have different depths of penetration through tissue.
The erbium family of lasers is essentially absorbed on the surface
of the target material, whereas the diode devices can reach several
thousand layers deeper into the tissue.
With this knowledge, the clinician is able treat a variety of dental
pathologies using different laser devices. The underlying principle
of using the least amount of energy or power to perform the
treatment objective is of paramount importance.9 The primary
interaction of a laser and dental structures is photothermal; that is,
laser light is absorbed and raises the temperature of the target
tissue.10 At 100 C the inter- and intracellular water boils away,
causing either soft-tissue ablation or explosive expansion and
disruption of hard tissue. If the laser energy continues to be
absorbed by the tissue, carbonization occurs and with it the
possibility of significant tissue damage. Both target and nontarget
tissue are subjected to these harmful effects. The laser
parametersenergy, beam diameter, and duration of exposure
must be carefully monitored to produce a successful treatment
result.
Many safety regulations govern the operation of a dental laser,
including the presence of a designated safety officer; an oral
environment with limited access and minimal reflective surfaces;
the use of wavelength specific protective eyewear for the surgical
team, the patient, and any observer; high-volume evacuation of
the laser plume; and normal adherence to infection control.11,12

Advantages and Disadvantages

One of the main benefits of using dental lasers is the ability to
selectively and precisely interact with diseased tissues. Lasers also
allow the clinician to reduce the amount of bacteria and other
pathogens in the surgical field,13-15 and, in the case of soft-tissue
procedures, achieve good hemostasis with the reduced need for
sutures.16,17 The hard-tissue laser devices can selectively remove
diseased tooth structure because caries have a much higher water
content than healthy tissue, and water is the primary absorber of
that wavelength of laser light.18,19 These same devices show
advantages over conventional high-speed handpiece interaction of
the tooth surface.20-22 Osseous tissue removal and contouring
proceed easily with the erbium family of instruments.23,24
Accessibility to the surgical area can sometimes be a problem with
the existing delivery system, and the clinician must prevent
overheating the tissue and guard against the possibility of surgical

produced air embolism that could be produced by excessive

pressure of the air and water spray used during the procedure.
There are some disadvantages to the current dental laser
instruments. They are relatively high in cost, require training, and
the "end-cutting" emission of the energy. Since a majority of
dental instruments are both side and end cutting, a modification
of clinical technique is required. Also, no single wavelength will
optimally treat all dental disease. One additional drawback of the
erbium family of lasers is the inability to remove metallic and
cast-porcelain defective restorations. Moreover, studies have shown
that the lased enamel has a good potential for bonded restorations
as long as they are subsequently etched with acid.25

Examples of Clinical
Procedures
Soft-tissue excisions are
easily performed with a
laser. The targeted lesion
is grasped with forceps or
a similar instrument, and
the laser beam is directed
toward the connection
with the healthy portion
of the tissue. Keeping in
mind that the rate of
ablation could vary with
the composition of the
surgical site, the clinician
should be careful not to
tear any structures but
rather allow the laser
energy to do the work. As
pointed out previously,
sutures are not usually
necessary, and the wound
will heal well by
secondary intention.
Figures 1 through 3 show
an erbium: YAG laser
removal of a fibroma, and
Figures 4 through 6 show
an Nd: YAG laser frenum
revision.
Soft-tissue retraction and
removal for placing
restorations and implant
fixtures also spotlight the
usefulness of a dental
laser. When the proper
parameters are used, final
impressions for the
restorative procedure can
be taken immediately,
with confidence that the
tissue will remain at its

Figure 1

Preoperative fibrous lesion.

Figure 2

Erbium:YAG excision immediately after surgery.

Figure 3

Ten-day healing of an erbium: YAG laser removal.

3

treated height and contour (Figures

710).

Figure 4

Figure 8

Preoperative fibrous lesion.

Crown preparations troughed with

980-nm diode laser.

Figure 5

Figure 9

Nd:YAG removal of frenum tissue.

Immediately after insertion.

Figure 6

Two-week healing after Nd: YAG

removal of frenum tissue.

However, different wavelengths

absorption characteristics and depths
of penetration play significant roles in
the treatment plan. Many prescription
medications can cause fibrous gingival
overgrowth around teeth, and the
removal of that tissue can be
accomplished by using the shorter
wavelength lasers that have minimal
interaction with dental enamel and
cementum. Conversely, removal of the
gingival tissue to uncover an implant
would be best done with the longer
wavelength devices, erbium and
carbon dioxide, because their energy is
essentially absorbed on or near the
surface as well as being reflected off of
a metallic structure, and that would
prevent or at least minimize heat
buildup and transfer to the metallic
implant fixture.

Crown lengthening procedures, either

for esthetic improvement or for
retrieval of additional tooth structure
for restoration placement, also
demonstrate the lasers precision.
Once again, the argon, diode, and
Nd:YAG instruments can easily
remove soft tissue with very little
tooth interaction, and the erbium
family will remove bone to remodel
and restore the periodontium. The
tissue removal must be carefully
planned so that biological width is
Figure 10
maintained. If bone is removed with
One week postoperatively.
the erbium instruments, the water
spray must be switched on. Figures 11
through 14 demonstrate an
erbium:YAG laser used for osseous removal in an open flap crown lengthening
procedure. (Photos courtesy of Glenn van As, DMD)
Some laser instruments are indicated for removal of diseased sulcular epithelium for
the initial treatment of periodontal disease. This procedure is done in conjunction
with normal scaling and root planing, and produces a significant bacterial reduction.
The laser devices used must have a thin enough contact fiber to place on the softtissue lining the pocket, and the laser energy would be less than half that of a usual
surgical excision procedure. Figures 15 through 17 show a diode laser used
adjunctively for bacterial reduction in periodontal maintenance.

Figure 7

Preoperative. Replacement of
rowns 21 and 22 with cerec crowns.

Caries removal, tooth preparation for restoration, and removal of defective composite
filling material can be accomplished with erbium lasers. In analyzing the absorption
coefficient of these wavelengths, the principle being that, the higher the water
content of the target tissue, the easier the ablation will be. Diseased tooth structure

Figure 11

Figure 15

Preoperative. Determination of inadequate biologic

width for crown lengthening.

Post-orthodontic treatment.

has lighter water content than healthy

enamel or dentin, so the laser would
thus be able to interact selectively
with the caries. On the other hand, if
there is a surface where the fluoride
ion has widely replaced the hydroxyl
group, the laser energy will have to be
increased to be effective. Figures 18
through 20 show an erbium:YAG laser
removing caries and preparing a tooth
for a composite restoration.
With the addition of thin flexible
glass tips, the erbium family can be
used in endodontic procedures;
however, the currently available endcutting energy output cannot shape
the sides of the canals. The ability to
significantly reduce root canal system
bacteria is a tremendous advantage of
the laser, and further delivery system
development will enhance the devices
utility.26

Figure 12

Figure 16

Erbium:YAG laser used to remove bone

and establish new osseous contour.

Postoperative gingival recontouring.

Figure 13

Figure 17

Six-week postoperative with tissue healed.

One-week postoperatively.

Additional dental treatments use laser

energy. Curing composite resins with
visible argon laser emission of 488-nm
results in a deeper cure and improved
physical properties of the restorative
material.27 Tooth-whitening agents can
be accelerated by various laser
wavelengths; the catalyst simply needs
to interact with the light, whether
visible or invisible. There is one device
that uses a visible red beam to detect
fluorescence of dental caries and a
sensor that detects the difference
between the laser light reflected from
sound and diseased tooth structure.
This sensor can translate that
difference into a numerical relative
value, which can greatly aid the

clinician in assessing the need for treatment.28

There are lasers in development that will be used for new applications. For example, a
deep blue light laser, approximately 380 nm, is being developed for selective removal
of dental calculus and caries;29 the experimental 9,600-nm carbon dioxide very short
pulse laser produces enamel hardening for increased caries resistance.30

Figure 14

Eight-week postoperatively.
Immediately after new crown cemented.

Conclusion
There are several resources for more information on lasers. The Academy of Laser
Dentistry (www.laserdentistry.org) is the only active unbiased international
organization of clinicians, researchers, and academicians for laser dentistry. Journals
such as Lasers in Surgery and Medicine and Photomedicine and Laser Surgery offer
clinical and research studies. As with all dental materials and instruments, the
practitioner must use clinical experience, receive proper training, become very familiar

with the operating manual, and proceed within the scope of his or her practice.31
Because of the varied composition of human tissue and the differing ways that laser
energy is absorbed, there is no one perfect laser. However, all of our patients
continue to agree that the dental laser is a wonderful instrument.32

Figure 18

3-weeks postoperatively.

Disclosure
Donald J. Coluzzi has no financial involvement with any laser manufacturer. He
purchases all laser devices and supplies used in his practice. He conducts
informational and training courses for HoyaConBio Lasers and The Institute for
Laser Dentistry and receives an honorarium for those courses. He is also a part-time
educational consultant for Hoya ConBio.
Michael D. Swick DMD is a trainer for Sirona on the SIROLaser dental laser for
which he receives a per diem. He has been a trainer and consultant for BioLitec
laser company, HoyaConBio Lasers, and the Institute for Laser Dentistry.
Figures 1 through 3 show an erbium:YAG laser removal of a fibroma. (All photos
by the authors, except where noted.)

References:
Figure 19

Preoperative. Erbium:YAG laser

placement for caries removal.

1. Myers TD, Myers WD, Stone RM. First soft tissue study utilizing a pulsed Nd:YAG dental laser.
Northwest Dent. 1989; 68:14-17.
2. Frame JW. Carbon dioxide laser surgery for benign oral lesions. Br Dent J 1985; 158:125-128.
3. Pick RM, Pecaro BC, Silberman CJ. The laser gingivectomy. The use of the CO2 laser for the
removal of phenytoin hyperplasia. J Periodontol. 1985;56:492-494.
4. Einstein A. Zur Quantum Theorie Der Stralung. Verk Deutsch Phys Ges. 1916;18:318.
5. Myers TD. Lasers in dentistry: their application in clinical practice. J Am Dent Assoc. 1991;122:4650.
6. Miserendio LJ, Pick RM, eds. Lasers in Dentistry. Chicago: Quintessence; 1995: Chapter 2, pages
27-38.
7. Manni JG. Dental Applications of Advanced Lasers. Burlington, MA: JGM Associates; 2004:1-15 to 118.
8. Wigdor H, et al. Lasers in dentistry. Lasers Surg Med 1995: 16: 103-33.
9. Dederich D. Laser tissue interaction. Alpha Omegan. 1991; 84:33-36.

Figure 20

Tooth preparation complete.

10. White JM, Goodis HE, Kudler JJ, et al. Thermal laser effects on intraoral soft tissue, teeth and bone
in vitro. Third International Congress on Lasers in Dentistry. Salt Lake City: University of Utah
Printing Services; 1992: 189-190.
11. American National Standards Institute: American National Standard for Safe Use of Lasers in Health
Care Facilities, Z136-3, 2002. Orlando, FL. The Laser Institute of America, 2002.
12. Piccione PJ. Dental laser safety. Dent Clin North Am. 2004;48:795-807.
13. Moritz A, Gutknecht N, Doertbudak O. Bacterial reduction in periodontal pockets through
irradiation with a diode laser: a pilot study. J Clin Laser Med Surg. 1997;15:33-37.
14. Miyazaki A, Yamaguchi T, Nishikata J, et al. Effects of Nd:YAG and CO2 laser treatment and
ultrasonic scaling on periodontal pockets of chronic periodontitis patients. J Periodontol.
2003;74:175-180.
15. Ando Y, Aoki, A, Watanabe, H, et al. Bactericidal effect of erbium:YAG laser on periodontopathic
bacteria. Lasers Surg Med. 1996;19:190-200.
16. Wilder-Smith P, Arrastia AM, Liaw LH, et al. Incision properties and therm0al effects of three CO2
lasers in soft tissue. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79:685-691.

Figure 21

Two-weeks postoperatively.

17. White JM, Goodis HE, Rose CL. Use of the pulsed Nd:YAG laser for intraoral soft tissue surgery.
Lasers Surg Med. 1991;11:455-461.
18. Hossain M, Nakamura Y, Yamada Y, et al. Effects of Er, Cr, YSGG laser irradiation in human
enamel and dentin. J Clin Laser Med Surg. 1999;17:105-109.

Continuing Education
Test Questions
1. The word LASER is an acronym for:
19. Hibst R, Keller U. Experimental studies of the application of the
Er:YAG laser on dental hard substances: I. Measurement of the
ablation rate. Lasers Surg Med 1989(4):338-344.
20. Glockner K, et al. Intrapulpal temperature during preparation
with the Er:YAG laser compared to the conventional bur: an in
vitro study. Lasers Surg Med 1998; 16(3) 153-157.
21. Aoki A, Ishikawa I, Yamada T, et al. Comparison between Er:
YAG laser and conventional technique for root caries treatment in
vitro. J Dent Rest. 1998;77:1404-1414.
22. DenBesten PK, White JM, Pelino J. The safety and effectiveness
of an Er:YAG laser for caries removal and cavity preparation in
children. Med Laser Appl. 2001;16:215-222.
23. Watanabe H, Yoshino T, Aoki A, et al. Wound healing after
irradiation of bone tissues by Er:YAG laser. In: Wigdor HA,
Featherstone JDB, Rechmann P, eds. Lasers in Dentistry III. San
Jose, CA: SPIE; 1997:39-42.
24. Ishikawa I, Aoki A, Takasaki AA. Potential applications of
Erbium:YAG laser in periodontics. J Periodont Res. 2004;39:275285.
25. Martinez-Insua A, DaSilva Dominguez L, Rivera FG, et al.
Differences in bonding to acid-etched or Er:YAG-laser-treated
enamel and dentin surfaces. J Prosthet Dent. 2000; 84:280-288.
26. Stabholz A, Zeltser R, Sela M, et al. The use of lasers in dentistry:
principles of operation and clinical applications. Compend Contin
Educ Dent. 2003;24:935-948.
27. Powell Gl, Blankenau RJ. Laser curing of dental materials.
Dent Clin N Am 2000; 44(4): 923-930.
28. Tsuda T, Akimoto K, Ohata N, et al. Dental health examination of
children from nursery schools in Toyko using the DIAGNODENT caries detector. In: Ishikawa I, Frame J, Aoki A, eds. Lasers
in Dentistry, Revolution of Dental Treatment in the New Millennium.
Amsterdam: Elsevier Science BV; 2003: 187-189.
29. Rechmann P. Dental laser research: selective ablation of caries,
calculus, and microbial plaque: from the idea to the first in vivo
investigation. Dent Clin North Am. 2004;48:1077-1104.
30. Featherstone JD, Fried D, McCormack SM, et al. Effect of pulse
duration and repetition rate on CO2 laser inhibition of caries
progression. In: Wigdor HA, Featherstone JD, White JM, Neev J,
eds. Lasers in Dentistry II. San Jose, CA: SPIE; 1996:79-87.
31. Myers TD, Sulewski JG. Evaluating dental lasers: what the
clinician should know. Dent Clin North Am. 2004;48:1127-1144.
32. Weiner GP. Laser dentistry practice management. Dent Clin North
Am. 2004;48:1105-1126.

a. Light Absorption through Spectrally Emitted Radiation

b. Light Amplification by Stimulated Emission of Radiation.
c. Lumen Amplification through Simultaneous Electronic Reduction.
d. Light Activated by Spontaneous Energy Radiation.

2. Wavelength is:
a. motion in a fixed direction.
b. the time of one complete revolution of a wave of light energy.
c. the horizontal distance between any two corresponding points on
the wave.
d. the velocity of the laser light.

3. What type of light energy emerges from the laser device?

a. natural light with parallel colors.
b. natural light in many directions at once.
c. An invisible beam only.
d. Monochromatic coherent wave.

4. Commercially available dental instruments all have

emission wavelengths ranging from 488 nm to
10,600 nm, and are:
a. all invisible to our eyes.
b. In the range from gamma rays to radio waves.
c. all nonionizing radiation, which is mutagenic to cellular DNA.

5. Which of the following delivery systems are discussed?

a. small flexible glass fibers.
b. rigid, tube-like deviwave guides.
c. semiflexible hollow wave guides
d. all of the above.

6. Dental lasers have which basic emission modes?

a. continuous wave only.
b. free-running pulse only.
c. alternating current pulses.
d. continuous wave and freerunning pulse.

7. Water, which is a universally present molecule, is most

interactive with:
a. the two erbium wavelengths.
b. carbon dioxide lasers.
c. diode lasers.
d. Nd:YAG lasers.

8. The primary interaction of a laser and dental

structures is:
a. photoionizing.
b. photothermal.
c. photoinitiating.
d. photochemical.

9. Laser parameters include:

ANSWER SHEET
1.

6.

2.

7.

3.

8.

4.

9.

5.

10.

a. energy.
b. beam diameter.
c. duration of exposure.
d. all of the above.

10. As with all dental materials and instruments:

a. dental lasers can be used by anyone, regardless of his or her
experience.
b. the Dental Practice Act does not define any responsibilities of the
practitioner.
c. the practitioner must use clinical experience, receive proper
training, and proceed within the scope of his or her practice.
7
d. all dental lasers have identical tissue interaction.

Lasers in Dentistry
by Donald J Coluzzi, DDS and Michael D. Swick, DMD
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2. The questions were relevant:
4 3 2 1 0
3. The course gave you a better understanding of the topic:
4 3 2 1 0
4. Rate the overall value to you:
4 3 2 1 0
5. Would you participate in a program similar to
this one in the future on a different topic of interest?
_____ Yes _____ No
Any additional comments: __________________________
______________________________________________
______________________________________________

2 CE
CREDITS
Course Fee $55.00

For Internal Purposes Only:

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