Message Boards
Today's Active Topics Today's Active Cases Browse Forum Categories My Recent Activity My Messages Private Groups My Marked Threads My Subscriptions
Today's Active Images Today's Active Polls Most Active Topics Global Townie Map Advanced Message Board Search Message Board Terms of Use

See the Light Dr. Glenn van As

Start Discussion More by this author (4)
by Glenn A. van As, BSc, DMD

When new dentists graduate, they face many issues as they enter into the profession. They must balance the knowledge that they obtained in dental school with the fact that newer technologies, like laser dentistry for instance, might not have been discussed during their dental school years. New graduates must balance their desire to add new technologies to their armamentarium, while paying off loans.

Although in the past, some new practitioners would begin their careers buying into a practice or building their own practice to start off, this scenario is not commonplace today. Instead, many young clinicians start out their careers as associates and are concerned about purchasing equipment that might both be expensive and not transportable to future offices should they choose to move on.


Soft-tissue lasers have decreased in price dramatically over the last three years from an average of $10,000, to now around $2,500 (Fig. 1). These diode lasers are lightweight, portable, incredibly versatile and offer a new dentist two definite advantages. A laser can help in making restorative dentistry easier, and can allow a young dentist to learn new profitable soft-tissue surgical treatments that likely are not commonly provided in his or her office at present. When young dentists realize learning how to use laser technology in their career can both be profitable and fun, it stands to reason that perhaps a diode laser should be one of the first purchases when graduating from school.

Many new graduates will enter into a longstanding practice as an associate, and find they do a fair amount of restorative treatment. In many instances, the diode laser can make restorative dentistry easier by becoming the soft-tissue handpiece. The laser can remove tissue efficiently and quickly. Class V lesions often have gingival tissue that is inflamed, thickened and overlapping the gingival margin of the caries lesion. A simple gingivectomy can make the procedure so much easier by eliminating the possibility of bleeding or crevicular fluids affecting the bond strength of composite resins (Figs. 2-4). In situations where local anesthetic is not required, a diode laser can be used in pulsed (comfort) mode, often with only topical anesthetic. Also, when deep interproximal lesions are encountered, the diode laser can be used to remove tissue to allow for ideal matrix band placement for the restoration.


In addition to making regular restorative dentistry easier, the diode laser is able to remove soft tissue around metal. This makes the diode a much safer alternative than using an electrosurge unit when dealing with excess gingival tissue around dental implants, gold crowns, braces, partial dentures, amalgam and other metallic dental materials. Diode lasers, when compared to the less expensive monopolar electrosurge units, are able to remove small amounts of soft tissue without anesthetic, are antibacterial, can be used with pacemakers, can be used in periodontal pockets and for disinfection with the root canal system in endodontics.

Tissue management during fixed prosthodontics can be one of the least enjoyable aspects of dentistry that a new grad faces. Packing cord in a double-cord technique provides for adequate retraction of tissue around margins of veneer and crown preparations. An alternative is to use the diode laser for crown troughing instead. The diode can provide for tissue management with both tissue distention and coagulation without the need for cords or hemostatic agents. In my case, in the last 12 months I have only used retraction cord twice, as per the requests of two separate patients, and yet aesthetic results are possible as seen in Figs. 4-5.

When considering the investment in purchasing a diode laser, the new graduate should consider that a significant return on investment could be seen if the clinician is willing to learn just a few new procedures. Gingivectomies are a routine and simple procedure for restorative dentistry, for gingival hyperplasia during and after orthodontics, and in combination with anterior aesthetic restorations where soft-tissue crown lengthening is required and possible without infringing upon the biologic width.

Gingivectomies are billed under code D4211 and can range in fee from $100-200. Frenectomies are a simple procedure to learn how to do and are billed under code D7960 and can be in the range of $350-500. The procedure is completed with a small amount of local anesthetic (four to six drops) in the frenum in a matter of 90 seconds or so. The healing occurs over a period of seven to 10 days by secondary intention with little post-operative discomfort. Frenectomies are routinely encountered in combination with orthodontics, diastema closures and in cosmetic cases. Fibromas are a common occurrence on the buccal mucosa, around the commissures of the mouth and on the tongue and lips. These lesions are also removed within a matter of minutes with a few drops of anesthetic, and again heal with secondary intention. Commonly billed out under code D7972, the fee can be ranging in price from $250-400 depending on the size of the lesion. Finally, oral lesions such as herpetic lesions, aphthous ulcers and venous lakes can be ablated or photo-coagulated in the latter case with the diode. The code of D7410 can provide for reimbursement of a fee in the range of $55-70. Although new graduates must be willing to educate themselves to use the diode laser for these soft-tissue surgeries, it can provide them with the opportunity to be the “laser guru” in the office, provide them with a niche within the office and a win-win situation where they are providing the treatment.

Although the initial investment in purchasing a diode laser can seem a little daunting, its abilities can be of tremendous benefit to any young clinician. In looking at lasers, you might just “see the light” and integrate this effective, safe and profitable technology into your practice.

Author's Bio
Dr. Glenn van As graduated from the University of British Columbia in 1987 and is internationally known for digital documentation of laser procedures captured with the operating microscope. He achieved Advanced Proficiency from the Academy of Laser Dentistry and received the 2006 Leon Goldman Award for clinical excellence. He is also a founder and past president of the Academy of Microscope Enhanced Dentistry.
Dentaltown Magazine
September 2025
Dentaltown Magazine September 2025 Read Current Issue Read Archived Issues
Sponsors
Townie Perks
Townie® Poll
Who or what do you turn to for most financial advice regarding your practice?
  
Site Menu
Message Boards Magazine Continuing Education Podcasts Blogs Classifieds Dental News Events Townie® Poll Ebooks Townie Choice Awards
Company Info
Contact Us Advertise With Us Howard Farran DDS, MBA Policies and Agreements
Site Help
Sally Gross, Member Services Specialist
Phone: +1-480-445-9710
Email: sally@farranmedia.com
©2025 Dentaltown, a division of Farran Media • All Rights Reserved
9633 S. 48th Street Suite 200 • Phoenix, AZ 85044 • Phone:+1-480-598-0001 • Fax:+1-480-598-3450