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Confessions of a laser dentist

Dr. Jacques Doueck

I want to make it clear. I love my laser, I use it every day and I would never give it up.With that being said…I need to give you some history. I have been a dentist since 1977. I was certified by the Academy of Laser Dentistry in 1998 and I have been using hard and soft tissue lasers since then.

My soft tissue laser gets excellent results with periodontal disease and I use it for my CEREC and Crown and bridge impressions. But as far as preparing teeth for fillings my hard tissue laser takes a back seat to my AquaCut, which uses hydroabrasion to prep teeth without the need for injections. People have high expectation. They expect laser dentistry to be painless. Unfortunately, when it comes to using the laser for cavities, my experience has been disappointing. When a hard tissue laser is used to prep enamel on the biting surface of molars it needs a lot of energy and my patients feel it. In contrast my AquaCut sprays a slurry of water and powder and gently and effectively cuts through the enamel without the need for anesthetic. Before AquaCut there was air abrasion.

I have always been a fan of air abrasion as a gentle way to prep molars teeth for class I cavities. The air abrasion handpiece blows a powerful air stream of tiny aluminium oxide particles out of its tip onto the tooth. The tiny particles bounce off the tooth and blast the decay away. The problem with air abrasion is the excess powder and “dust” got everywhere. The incorporation of water to make a slurry change everything. An added feature of the AquaCut is the simplicity of design. There is no motherboard in fact there is no electric power involved–everything runs by air pressure. The engineering of this unit has many benefits over the air abrasion systems. The disposable tips are inexpensive and easy to replace. The powder comes in cartridges and is easy to replace. The repairs are so simple that I just call the technical support hot line and they walk me through in less than 5 minutes.

The AquaCut is ideally suited for minimally invasive dentistry. The amount of powder, water and air pressure are precisely within your control. By using the correct pressure and powder/water flow you can cut very conservatively preserving more healthy tooth structure. My favourite benefit is the elimination of airborne powder. With the old air abrasion system the patient, the assistant and the room would be covered with a layer of powder. AquaCut has changed all that. My patients know us as the high tech office. I tell them, “AquaCut is the next level beyond laser. We can clean out your cavity without a shot, without a numb lip and without the drill. AquaCut works by spraying your tooth with a slurry of abrasive and water to remove decay from a tooth without using a dental drill. It works like a powerwash removing graffiti from walls” I enjoy the delightful reaction of my patients. They have their fillings done with no shot, no numb lip, and knowing that their dentist is on the leading edge of technology. The company says that the AquaCut is an alternative to the drill. I would go one step further and say the AquaCut is an alternative to the laser for prepping teeth for cavities with no shots and no drilling.

confessions of a laser dentist
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