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In this issue: Hello from Jeanette | AAP Consensus on Lasers | Laser Fire Hits the Philippines | Laser Safety Manual | Column of Illumination | University Relations | New Dentist's Viewpoint on Lasers | Just A Dentist |
CONTEST! ALD Signature Cocktail | Quick Poll
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Communications Committee Co-Chair
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Jeanette K. Miranda, RDH, BSDH
Co-Chair, Communications Committee
Chair, Auxiliary Committee
Welcome back to Lightwaves! Dr. Steve Parrett and I hope you had an enjoyable summer with abundant sun and fun. The Fall Lightwaves edition is packed full of information. Please take a few minutes to check out the new format. We continue the articles from our friends in International Affairs; there is another question in our segment, The Column of Illumination; please take the time to answer our Poll Question; and don’t forget to submit your video for ALD’s Signature Cocktail Contest. We have added a new column -- a Case Study from one of our Advanced Proficiency III Candidates.
ALD is growing and we want to meet the needs of our members. Please let us know if there are any topics you would like in YOUR newsletter.
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Report from the American Academy of Periodontology's Consensus on Lasers: A Member's Viewpoint
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Laura Braswell, DDS
Diplomate American Board of Periodontology
Mastership Academy of Laser Dentistry
It was with excitement and guarded enthusiasm that I went to hear about what my Academy had to report from its Consensus Committee that will be published in the future. It came down to a review of the literature with limited inclusion criteria. For laser treatment of periodontitis, they looked at only randomized controlled trials (RCTs) with ≥ 3 months duration and 10 or more patients, moderate to severe periodontitis (mean PD > 5 mm) and aggressive or chronic diagnosis in patients 18 or older through March 2016. The review compared surgical and non-surgical therapy. After reviewing 475 articles from 4 journal databases, they only included 28. Laser wavelengths evaluated were diode (808 to 980 nm, 0.8 to 2.5 W), Nd:YAG (1064 nm, 1.0 to 2.0 W), Er:YAG (2940 nm, 2.5 W) and CO2 (10,600 nm, 2.0 W). Clinically, they assessed changes in probing depth, clinical attachment level, gingival recession, bleeding on probing, bone defect fill, and microbial composition. Patient-centered outcomes included discomfort, esthetics, function, and treatment costs.
Two RCTs assessed found that diode lasers combined with SRP showed clinical improvement and reduction in pathogens in the nonsurgical treatment of aggressive periodontitis, yet felt that evidence is “lacking” and the level of certainty is “low”. Fifteen RCTs assessed lasers in the treatment of chronic periodontitis which were reported as having no statistically significant differences between SRP vs SRP + lasers. Their analysis seemed to favor diode lasers but described the evidence as “weak”. Nonsurgical treatment in Type 2 Diabetics (1 RCT) revealed significant reductions in PDs and gain in attachment when treated with SRP + diode lasers compared to SRP alone; expert opinion supported this recommendation even though evidence was found to be lacking and the level of certainty was low. Four studies looked at surgical treatment of chronic periodontitis and seemed to favor open flap debridement with an Er:YAG laser; again, expert opinion supported this recommendation even though evidence was found to be lacking and the level of certainty was low.
In summary, although “not conclusive”, some evidence suggests that adjunctive use of Er:YAG or Nd:YAG lasers is superior to conventional periodontal therapy alone in PDs > or equal to 7 mm. As an adjunct, laser therapy may provide a “modest” additional benefit (< 1 mm) in clinical improvement in PDs and attachment compared to traditional therapy, but “current evidence is inadequate” to conclude that laser therapy alone is either superior or comparable to traditional therapy.
The AAP suggests that we need more standardized studies that include patient preference and patient-centered outcomes with the best cost-to-benefit ratio. As the Academy of Laser Dentistry, we need to come up with standardized evaluations that can be used by companies and individuals to meet this challenge. It is only through solid research that we will be able to show the scientific and clinical community what we all know is true; laser therapy is a worthwhile addition to traditional periodontal treatment.
Author’s Note: Thank you to Mr. John Sulewski who also attended this AAP meeting and helped with this summary viewpoint.
ALD's Note: We anticipate a follow-up report when the AAP publishes a consensus report in its entirety. We praise the AAP for suggesting the need for including patient preference and patient centered outcomes, and cost-to-benefit ratios as criteria. Dr. Braswell suggests the ALD devise standardized evaluations that can be used to meet the current challenge. If you would like to serve on the ALD’s Presidential Task Force to come up with these “standardized evaluation “ criteria, kindly contact Dr. Hoopingarner, drhoop@drhoop.com.
Dr. Laura Braswell is a long-time ALD member and periodontist, practicing in Atlanta, GA. To reach Dr. Braswell send an e-mail to laurabraswelldds@gmail.com.
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INTERNATIONAL RELATIONS
Laser Fire Hits the Philippines
Celebrating the 1st Philippine Study Club at East Avenue Medical Center - Center for Laser Dentistry
Maria Noemi G. Pato, DMD, MHA, FICD
Department Chair
Center for Laser Dentistry
East Avenue Medical Center
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It has been two years since the partnership between Dr. Judith del Rosario-Yap, one of the first Filipino laser dentists, and Dr. Maria Noemi Pato, Chair of the EAMC - Department of Hospital Dentistry was forged to create the very first laser dentistry training center in the Philippines.
Our mission is to provide a venue for Filipino dentists to learn about Laser Dentistry. It is a sad fact that laser dentistry remains undeveloped in the Philippines because there is no formal training available. Almost 10 years ago laser companies were introducing their products, but eventually pulled out of the market because laser dentistry was not practiced.
We both envisioned that laser training must follow international standards so we decided to seek the help of the Academy of Laser Dentistry to guide us in this endeavor. We were so elated when a simple email to ALD was answered with such great fervor. In a matter of a few weeks, our mentors, Dr. Raminta Mastis and Dr. Arun Darbar, answered our call and flew to the Philippines to facilitate the very first Introductory Course in Laser Dentistry on November 2015. Our mentors provided the spark to light our passion about laser dentistry. Filipino dentists have been seeking knowledge and skill to provide better treatment options for their patients and found lasers to be an amazing tool.
The unwavering support of ALD provided the much-needed push to formally spread laser education in the Philippines. Our accreditation as a Study Club last February 24, 2016, allowed us to carry on with our mission and gave credence to our training programs. Introductory courses are offered bi-annually and slowly, but surely the number of participants have grown. There are now around 130 dentists who have participated in our Introductory Courses. We plan to provide the Standard Proficiency Course as well.
We are grateful for support that the Academy of Laser Dentistry has generously provided. We look forward to future projects together.
Find other ALD Affiliated Chapters and Study Clubs
here.
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NEW MEMBER BENEFIT
Laser Safety Manual DIY
The Academy of Laser Dentistry (ALD) has established a Laser Safety Manual with customizable templates and general guidelines to aid members in developing a laser safety program. An office Laser Safety Manual helps ensure the safe use of lasers and laser systems in dental applications and in protecting the health and safety of patients, staff and the environment.
This manual is designed with the requirements of a non-institutional dental setting in mind. As an adjunct manual to the ANSI Z136.3–2011 document, the ALD manual provides the guidelines and customizable templates to assist the dental practitioner in the development and implementation of a laser safety program.
We are pleased to provide our members with tools to grow your practice!
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Column of Illumination
Our team of qualified laser geeks are here to answer questions you have related to dental lasers. The answer to this edition’s question was provided by
Angie Wallace, Co-chair Regulatory Affairs for ALD.
How do I know if my hygienist can legally use a laser in my state.
Knowing your state regulations for scope of practice is important. The Academy of Laser Dentistry (ALD) is currently working on a regulatory project that provides information on each state’s Scope of Dental Practice. ALD’s website provides immediate links to each state’s regulations. It is your responsibility to know your
state’s regulations. ALD is working with the American Association of Dental Boards to further understand regulators approach to dental laser education and the requirements for re-licensure for practitioners that use lasers. We will keep you informed as information is available. You may also contact us by email with your questions and we will help you.
Have a burning question? Submit it to
academyoflaserdentistry@gmail.com
and look for the answer in an upcoming issue of
Lightwaves
. Due to space limitations, we may not be able to answer all of the questions here, but we will post the question and answer on the ALD
Facebook
page. #aldask
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UNIVERSITY RELATIONS
New Dental Technology as a Mandatory Part of Dental School Curriculum - A Member's Perspective
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Natalia Elson, DDS
Clinical Assistant Professor
Department of Cardiology & Comprehensive Care
New York University College of Dentistry, New York, NY
We live and practice in fast growing technology era. Dentistry is not an exclusion. Nowadays, our patients are aware of all innovation in dentistry and they start looking for offices that can offer it. On the other hand, we as dentists, benefit from these innovations.
Are we as educators doing enough to prepare our students for a challenging future? Some US Dental School and Post graduation programs are implementing new technology courses in their curriculum like Laser, CAD/CAM, Dexis etc. But in most cases it is didactic elective course. To fit a new course in existing school curriculum is not so simple and sometimes is not even possible.
The biggest challenge is current support from ADEA. We need to build up strong necessity for new technology education and show and prove to ADEA for future recognition. How to start and what to do? To paint a big piece of art, one should start from imagination, be patient, then put stroke after stroke. The same is true in the education field. I personally voluntarily started with lectures about basic laser knowledge to students in my clinic, then I gave these lectures to faculty and saw a growing interest. ”Growing interest” is a key.
Now I am planning to start elective didactic class for D4 students. The next step will be to make a series of lectures to the graduating class and school Faculty, then implement this education into NYUCD Advanced Education in General Dentistry (AEGD) program. When the interest in Laser Dentistry spreads, the time for curriculum will come.
In our school we have a CAD/CAM training for our students. That is why my goal is to create not just a Laser program, but a New Dental Technology program which will include all innovations that better prepare our students for the future.
I am an optimist! But Dental schools need the support of manufacturers and organized dentistry institutions to succeed.
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A RECENT GRADUATE'S PERSPECTIVE
New Dentist's Viewpoint on Lasers
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Dr. Alex Kusek
Sioux Falls, SD
As a recent graduate, I quickly realized how different private practice is to dental school. One of the main differences is the freedom each dentist gets to decide, not only what materials and instruments they may choose to perform a procedure, but also how they will be performing the procedure. Until I was taught and shown otherwise, many of the ways which I have been practicing were taught by faculty at school. Unfortunately, the presence of laser dentistry was not part of this teaching
At my university, laser dentistry was relegated to a five minute discussion in a semester long Periodontal course. To say that lasers were not regarded in a positive manner in that brief period would be an understatement. Luckily, I had mentors who were well experienced in laser dentistry and had been using it successfully in their practice for a number of years. I was able to see how each procedure could benefit from the use of lasers and how well the patient responded.
As a new dentist, lasers provide me with more consistency, faster procedure times, and less trauma for the patient. In my opinion these are all crucial aspects in becoming a dentist that my patients will value and trust. Patients in today's society value technology and love seeing that we're willing to invest our money back into them by providing them with part of the new era of dentistry and being on the cutting edge.
Patients are also becoming more savvy in deciding what kind of dentist they want.
I think it's important to follow the trends of society, especially as they relate to dentistry. Regardless of your stance, there seems to be an explosion of new dental products hitting the market every year. From charcoal-activated toothpaste to at-home whitening lights to the numerous new electric toothbrush brands introduced; people are putting an extreme value on their appearance and health of their teeth. They also want results now. In my opinion and brief experience, laser dentistry gives you these results in your practice. While personal referrals will always be what drives a practice, I envision in the near future, as the public becomes more aware of lasers, the question will grow from, "
Are they a good dentist
?" to "
Do they use lasers?
".
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Just a Dentist - How Continual Learning and the ALD Shapes Perspectives. A Member's Perspective
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Steve Parrett, DDS
Chambersburg, PA
Is that a bad thing? Where does it say we all have to be some special type of dentist? Well, I mean besides in all of the marketing information we get from the scores of companies trying to get our business (bucks?), trying to make us into someone unique to the public. The fact is, we all went to dental schools where we pretty much got the same basic dental education. It is after dental school where we began to differentiate ours skills and interests in various treatments and services we could offer our patients.
This is where things get interesting. Now, you have the option to see a cosmetic dentist, implant dentist, sleep apnea dentist, laser dentist, sedation dentist...I am sure the list can and will be expanded. Like many of you, I have taken the one day or weekend courses for Botulinum toxin administration, Conscious Sedation, Sleep apnea, Invisalign/Clear aligners, laser dentistry, medical management of caries and periodontal disease. There are many others that I just did not have time to attend since I also have a family and a full time private practice. No doubt, there will be more to come in other areas, many well worth considering, I am sure. I think it is a good thing to expose your mind to as many areas of new and old dental treatments that are available to help you find your niche and better ways to treat your patients. However, It is not necessary that you confine your practice to the area that attracts your interest; just hone your skills in a special area to make you better in all disciplines of dentistry. One way to take advantage of the expertise gained through taking multiple courses in a particular area is to search out colleagues in your area who have done just that. Locally, I have one colleague who chose to explore the uses of Botulinum in relation to facial esthetics and I would not hesitate to recommend him as a resource for patients who are interested in exploring that option. Another colleague has done some in depth study of the problem of sleep apnea and how, as dentists, we can ethically and clinically participate in treating this problem when appropriate. I have given her name as a resource for patients who I felt could benefit from this treatment. Likewise, I have received referrals from other general dentists for treatments such as laser frenectomies for tongue tied or diastema challenged patients. It is great when we can all work as a ‘community’ and not as competitors.
Of the aforementioned courses, I did choose to concentrate on lasers as well as a few others. I currently have in my office the following laser wavelengths: 10,600 nm, 2940 nm, three 810 nm, 850 nm, 660 nm, 655 nm, 450 nm. Granted, these all have special purposes and abilities to provide treatment or accomplish special tasks. Two of the wavelengths mentioned are actually part of high tech instrumentation that allows me to provide more sophisticated treatments unrelated to cutting teeth or gums. One laser is part of a system that allows me to detect caries activity at a microscopic level, well ahead of when I would otherwise have been able to detect caries activity clinically by any method I was ever taught to use before now. Another is part of a technology that allows us to digitally scan a tooth or even a full arch of teeth and save it in a computer program for multiple uses. Do I consider myself a ‘laser dentist’ or promote my practice as such? No, it all just sort of evolved and due to my involvement with the Academy of Laser Dentistry, I was prepared to learn about ALL lasers. I constantly keep an open mind for finding the tools that would just help me be a better all-around dentist. Thanks to the relationships I formed with other members of the Academy and the annual course offerings at the ALD annual meeting, my knowledge and experience continues to grow.
I have to say, the basic knowledge I gained through ALD has allowed me to evaluate many other innovations coming into the dental profession, not just ‘laser treatments’.
I do not see anything wrong with promoting services or treatments that you have spent extensive hours learning in more detail. However I feel it is imperative to keep abreast of new and groundbreaking findings that go well beyond what we learned in dental school, or after, that allow us to expand our abilities to improve treatments for our patients continually. My association with ALD has done this, but I still consider myself ‘just a dentist’, though maybe a better one than I would have been.
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Check the ALD
Facebook page for poll results. #aldpoll
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Which laser procedure is used most often in your office?
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CONTEST!
Create the ALD 25th Anniversary Signature Cocktail
Jeanette K. Miranda, RDH, BSDH
Let’s have some fun! We have a BIG anniversary coming up in April of 2018 and we're putting on our party hats. The ALD 25th Anniversary Conference needs a signature cocktail. We are reaching out to all ALD members to put on your mixology hat and create an amazing cocktail that will be remembered for years.
To enter the contest, submit a 1-2 minute video of yourself creating the drink. The contest will be open through December 15th and a winner will be announced in the 2018 Winter issue of Lightwaves. Send the link to your video to
academyoflaserdentistry@gmail.com.
Video Guidelines:
- Drink can be non-alcoholic
- Show yourself creating the drink
- Include the the ingredients of your drink
- Give your drink a name
Judging Criteria:
- Creativity and excitement
- Title (get creative!)
- Taste
- Ease of preparation
With your video submission, include the recipe, name of your drink - alcohol not required.
In the video above, I am creating my very special cocktail. I encourage all of you to send us your very creative, delicious concoctions.
In addition to having the honor of winning the first official ALD signature drink contest, the first-place winner will receive a $125 gift card and the second- place winner receives a $75 gift card. If you have any questions, please contact me a
jkmrdh@gmail.com.
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The
Academy of Laser Dentistry believes patients and practitioners deserve the benefits of tomorrow's dentistry today. We have been helping dentists improve results and reduce discomfort in dentistry with laser technology for over two decades.
The ALD is an international professional membership association of dental practitioners and supporting organizations dedicated to helping dentists grow their practice and improve the health and well-being of patients through the proper use of laser technology.
- Not yet an ALD member? Learn more about the benefits of membership.
- Already an ALD member? Make the most of your membership today.
Contact us:
Phone: 954-346-3776
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