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Lasers take the pain out of a trip to the dentist's office

Attention dentophobics (all ye who fear visits to the dentist): Your days of dread may be over. Dr. Harold Stanley said the new American Dental Laser in his Clearwater office can remove tooth and gum decay and perform a host of other dental procedures _ all without scrapers, drills or even Novocain.

"We're really thrilled," Stanley said. "The laser has opened up a whole new world of dentistry."

Stanley is one of at least two dentists in the Tampa Bay area who is using the laser to treat patients, according to American Dental Laser Inc., the Birmingham, Mich.-based company that sells the instrument.

Since the Food and Drug Administration approved its use last year, more than 350 U.S. dentists have purchased the instrument, including 30 in Florida. About 150 more lasers have been sold outside of the United States.

And many more dentists are on a waiting list to buy the $50,000 lasers, the company said.

The lasers are being used to treat gum disease, sterilize teeth and act in place of anesthesia.

American Dental Laser last year won FDA approval to use the laser on gums and other soft tissue; its application for use on teeth initially was denied, pending additional evidence.

Until the FDA gives its approval, the company cannot market the laser for use on teeth. But some dentists said they are using the laser anyway to sterilize and clean out cavities.

But the new technology has stirred some heated debate in the normally sedate dental industry. Some dentists say the laser has not been tested enough and warn that patients may not receive proper treatment. They also say the treatment can be more expensive, costing the patient an additional $25 or more just to turn on the instrument.

"Lasers do hold great promise, but it's just too soon to know the effectiveness of lasers over conventional, proven methods," said Paul Amundsen, a spokesman for the American Academy of Periodontology. "We are urging further study. . . . There is not enough information available yet. Six months to a year after a procedure has been done, we may learn that proven methods would have been best for a patient."

The Florida Board of Dentistry recently appointed a committee to study the safety of lasers, said Dr. Donald Cadle, a New Port Richey dentist who is chairman of the board. "We have some concerns, but we have not regulated their use," he said. "We're just beginning to explore some of the scientific data."

But Dr. Robert Reed, a Tampa dentist who has practiced for 40 years, scoffed at such concerns. "It takes a long time for them to accept anything," the 66-year-old dentist said.

He said the laser opens a new world of treatment for patients who are allergic to anesthesia, have hypertension or blood problems or are just needle-shy. It also promotes healing and reduces the amount of time in the dentist's chair, he said.

Lasers will revolutionize the dental industry in the '90s just as the high-speed drill did during the '50s, Reed predicted. "It's going to blow their minds," he said. "It's going to change the face of dentistry."

The laser, an acronym for "light amplification by stimulated emission of radiation," was developed more than 30 years ago. For years, the word conjured up a space-age image of a light beam strong enough to slice through steel.

But by changing the power source, scientists have been able to adjust the strength of lasers and adapt them in recent years for delicate use. Lasers today are used to remove diseased body tissue, to correct eye problems such as retinal detachment, to scan and "read" the price codes on groceries.

Two Michigan brothers _ a dentist and an ophthalmologist _ conceived the idea for American Dental Laser in 1983. Terry D. and William D. Myers, wondering whether an ophthalmic laser could be used in dentistry, began experimenting on extracted teeth. Later they worked with laser experts in California to develop the instrument.

The power source for the laser weighs about 80 pounds and is about as large as a medium-size suitcase, allowing a dentist to move it easily around the office. The laser beam is carried through a thin optical fiber encased by a protective cord. The dentist aims the fiber by using a handpiece that is about the size and shape of a pen.

"It's so small and easily directed," Stanley said. "You could run it along your arm, vaporizing every hair or leaving the ones you want."

The laser shoots pulses of light so rapidly they do not trigger sensations of pain. Each pulse is so brief that in a given second, the light is off more often than it is on, said Bob Dalton, spokesman for American Dental Laser. Also, the laser uses only 1 to 3 watts of power, compared with 10 to 100 watts for other lasers, he said.

"There's no danger of the heat being built up," he said. "With our laser, it's impossible to destroy the pulp," or gum beneath the teeth that carries the blood vessels and nerves.

Proponents of laser dentistry also say the laser seals off blood vessels that may be cut during treatment, reducing the risk to the dentist of diseases transferred by blood, and sometimes the procedure encourages healing.

Lasers can be used to remove scar tissue and treat mouth sores such as canker sores, cold sores, denture sores and small benign tumors called fibromas.

But the greatest benefit to the patient still is the lack of pain.

The laser can act as a local anesthetic, numbing the tooth for root canals or fillings. Diseased gums that are numbed and cut away in traditional treatment can be vaporized by lasers without needles, stitches or pain medications, proponents say.

"Children are big on it because they don't have to get that shot," Stanley said.

Many adults also rejoice at the prospect of no shots, scrapers or drills. Barbara Moore of Belleair, a patient of Stanley's for more than 15 years, recently underwent gum therapy. The first portion of her treatment was done with the conventional scraping method. After Stanley obtained the laser, he used it to complete the last three portions of her treatment.

"After the first part, I had a very sore, aching mouth for several days," she said. "But the treatment with the laser was much more comfortable, and he didn't even use Novocain. And the best part is that there was absolutely no discomfort after the treatment. . . . It's wonderful! I wouldn't go back to the other way for anything."

In Dr. Reed's south Tampa office last week, William "Dave" Rochell leaned back in the chair and prepared for laser treatment on his gums. The collection of deposits and bacteria in the gums is a common problem that, if left untreated, can lead to loss of teeth.

Reed turned on the machine and aimed the lighted "wand" in Rochelle's lower left jaw. He vaporized the calculus, or deposits, on the gum and teeth and the bacteria that caused them.

Afterward, Rochelle, who has had prior periodontal work in the traditional method, rubbed his jaw and said he felt no soreness.

"It's a lot better than what they've been using," he said. "It's not like taking shots."