In 1997, the Food and Drug Administration approved laser use in dental hard tissues (teeth) for treatment of cavities. Different types of lasers had been used in dental applications since the early 1990's for soft tissues (gums). Dental lasers have not been widely used because of their high cost and limited applications.
A common type of laser used for treatment of dental cavities is the erbium: yttrium-aluminum-garnet (Er:YAG). The technology allows tiny layers of the tooth to be removed quietly and usually without discomfort. An injection is rarely needed. Lasers can be used for the treatment of small to medium sized cavities in adults, and has also recently been approved for children.
Unfortunately, the vast majority of dental procedures cannot be treated with the laser. Dental lasers can not remove old, broken and worn-out fillings, have difficulty removing soft dental decay (present in deep cavities), can not prepare crowns (caps), inlays, onlays, porcelain veneers or in root canal. In short, roughly 90-95% of all dental treatment cannot be treated with today's dental lasers.
Cost has also been a barrier to the routine use of dental lasers. The ER:YAG laser costs between $25,000 and $40,000. Some companies lease their lasers for a certain dollar amount per use. Either way, this will invariably mean higher cost for patients being treated with dental lasers.
Dental lasers are not the dental panacea that has been presented in the media. They do, however, offer useful applications that may be helpful to some patients. I personally take a cautious approach to new dental technologies, especially if they are attempting to replace tried and true methods. Some researchers question whether dental lasers will generate excessive heat that can damage the dental pulp. Dental lasers for preparation of cavities is a very new and potentially promising technology that will need several years of research and improvements before I will feel confident using one on my patients.