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Practice Solutions: AMD LASERS by Ron Kaminer, DDS

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by Ron Kaminer, DDS
Dr. Ron Kaminer is a 1990 graduate of the State University of New York (SUNY) at Buffalo School of Dental Medicine. He maintains two offices in New York which focus on laser, aesthetic and minimally invasive dentistry. He lectures worldwide on topics related to lasers and minimally invasive dentistry, and is founder of the masters of lasers training program in New York. Dr. Kaminer is also the medical director of AMD LASERS and is a clinical consultant for numerous dental manufacturers. He lives in Hewlett, New York, with his wife and three children.

My love for lasers
It was 23 years ago when I stumbled upon the Biolase booth at an American Academy of Cosmetic Dentistry meeting. This was three years after I'd graduated from dental school. It's not hard to impress a recent graduate, but I was particularly intrigued by a laser that could cut hard tissue.

My mentor, Dr. Chuck Liebow from the University of Buffalo, got my feet wet with a CO2 laser during my junior year in dental school, and I had been a laser guy ever since.

But a hard-tissue laser? Now, that was a different animal. After two days at the meeting and plenty of deliberation, I purchased my first hard-tissue laser.

Little did I know how that purchase would change my dental career.

Since then, I've established the "masters of laser" training program in my native New York, and have gone on to educate thousands of dentists on how to use the hard-tissue laser.

I have lectured around the world and written numerous articles on lasers. I love seeing doctors I've trained go on to teach and train others. I have witnessed expanded procedures with lasers over the years. This, and the increasing number of dentists who want to learn and incorporate lasers into their practices, reflects an incredible transition on the laser front.

Er:YAG laser energy is preferentially absorbed by water and hydroxyapatite, making it a great hard-tissue cutter (e.g., enamel, dentin, bone, composite, etc.), but also good on soft tissue as well. Utilizing technology that incorporates water and air, Er:YAG lasers are often able to cut through tooth structure with reduced (and sometimes no) local anesthesia. Due to less heat buildup than traditional rotary instrumentation, properly used Er:YAG lasers are kinder to tooth structure and bone. Both hard- and soft-tissue surgical procedures exhibit better healing than with traditional modalities. In addition, the patient experience is typically outstanding as well.



Slow adoption
A number of factors were responsible for the slow adoption of the hard-tissue laser.

The first factor, of course, is cost. Hard-tissue lasers were, and still are, quite expensive. Most hard-tissue lasers today cost anywhere from $70,000 to $100,000.

Despite the number of procedures one can do with Er:YAG lasers, the cost is still prohibitive for most offices. Most dentists cannot justify that kind of expense.

For the most part, hard-tissue lasers are large pieces of equipment. With space at a premium in most offices, the size of the laser can be a deterrent.

Generally, a clinician can use the high-speed handpiece less often, and usually the patient experiences far less pain with a hard-tissue laser, even without anesthetic. Er:YAG lasers do allow us to do routine operative in many situations without the need for local anesthetic, as long as the dentist is trained properly.

A note on training
In the early days, training was done exclusively by sales reps. It was only after a number of years that early innovators started training dentists on the proper clinical use of the hard-tissue laser.

Even with training, some dentists had trouble repeating similar procedures in a short time. This led to dentists publicly expressing that hard-tissue lasers did not work as claimed. Those opinions prevented some dentists from venturing into this technology.

Finally, customer support and technical issues further hampered this adoption curve. With improper use of the laser (usually due to lack of training) came breakdown of units. Slow response to service calls made for angry clinicians. Sales reps who made promises they couldn't keep just to get a sale, often transitioned to other jobs and were nowhere to be found after a purchase was made.

From this bleak start, it's easy to imagine the uphill battle that the laser industry has had to conquer over the past 20 years.

Despite the aforementioned negatives, the advantages of using an Er:YAG laser in operative dentistry, oral surgery, perio surgery, endodontics, and a variety of other procedures can't be denied.

The potential for further penetration into the dental market exists, with solid education and fixing some of the issues that historically have kept dentists away from this technology.

A positive development is that AMD LASERS has helped solve the education problem by offering comprehensive education from some of the best clinicians in the world. Innovation helps too. In collaboration with Syneron Dental lasers, AMD LASERS is launching the Litetouch into the U.S. dental market.

The Litetouch is an Er:YAG laser that has some unique characteristics that help solve many of the issues previously described with hard-tissue lasers. It's smaller in size, lightweight and much more portable than previous hard-tissue lasers. The cost is smaller, as well. Other features make for a shallower learning curve than with previous lasers.

The Litetouch is not magic, but with proper training, clinicians will be able to do a variety of dental procedures in an effective, efficient and minimally invasive manner. We've seen the industry and lasers themselves come a long way over the years. The evolution continues!



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September 2025
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