The Diode Laser in the Orthodontic Setting
By Dr. Stan Presley DDS, FAOS, FAGD

The usefulness of the diode laser is becoming obvious in orthodontics. Before the laser’s applications were known, orthodontic practitioners would often request that the patient’s overseeing primary dentist perform tooth crown exposures, gingivectomies and frenectomies for them. This put delays on the smooth progression of orthodontic treatment and placed a burden upon the patient or parent in making additional dental appointments for the suggested procedure.

By having a diode laser in an orthodontic practice setting, this inconvenience can all be avoided. The orthodontic applications are primarily involved in the cutting and removal of soft tissue. The ideal laser for this is one of the lasers in the Picasso™ family. This is due to the small size of the Picasso and the quickness at which it can be set up to perform a cutting procedure. FDA clearance has been issued for all potential orthodontic uses, including, but not limited to gingivectomy, frenectomy, crown exposure of an impacted tooth and excess tissue removal around a bracket or tooth when a bracket is being placed. 

Simply turn on the laser, place a disposable tip in the handpiece, initiate the tip with ink, fire the laser to melt the ink, and off you go. I start at 1 watt of continuous power and begin the tissue shaping process. By observing how the tissue responds to the tip, I can increase or decrease the power to get a clean, uncharred cut. In literally seconds, the offending tissue is removed and I can finish the orthodontic visit.  Although you will hear how anesthetic is unnecessary, I always place 3% Carbocaine™ in the area. My view is strictly patient oriented. If my patient feels something after I said that it will be painless, then I have lost their confidence and given them a bad experience. It’s just too quick and easy to administer anesthetic painlessly.

The laser allows these procedures to be quick and easy. There is no bleeding to cloud your vision of the area. There is no post operative pain and no need to prescribe analgesics. The healing is fast due to the biostimulation of the adjacent tissue and no other means of tissue removal comes close to what we have as dentists when we elect to use the laser. The convenience of being able to use a laser during a bracketing appointment is unparalleled. The case will advance smoothly if all brackets have been placed at their proper positions. If tissue can quickly be removed on a premolar to bond the bracket in a bloodless field at the proper position, then weeks have been cut from the treatment time by not having repositioning issues.

This is why I call the laser handpiece the new soft tissue handpiece in dentistry. The diode laser is in so many dental practices because of its convenience in use, smallness in size and the low cost of purchase and upkeep. Do yourself and your practice a favor and get involved with diode lasers. Your future’s so bright that you’ve got to wear shades!