Americans may soon get far less painful cavity treatment: The government has approved a long-awaited laser to replace the dreaded drill in repairing cavities.
"We finally have what everybody's been looking for," said Dr. Robert Pick of the American Dental Association. "There isn't a week that goes by that somebody doesn't call and say . . . `Do you do lasers for cavities?' "The Food and Drug Administration this week approved Premier Laser Systems' erbium-YAG laser for treating tooth decay. The Irvine, Calif.-based company says the laser is appropriate for many of the 170 million cavities filled annually in the United States.
Premier tested the laser on more than 1,300 teeth, and only three patients requested local anesthetic. Others did report some discomfort, the FDA cautioned.
"I've always been scared of dentists," said Harry Chulamanis of West Milford, N.J., who had two large cavities filled with the laser. "I was astounded. There was no pain at all."
Dentists already use some lower-powered lasers on gums and other soft mouth tissues. But no laser has been allowed directly on teeth because of fears the high heat would damage the inner core of a tooth, explained Dr. Susan Runner, the FDA's chief of dental devices.
Premier's laser "has the potential for changing the way dental practice is handled in this country," Runner said.
Dentists said they desperately need better ways to get fearful patients to hold still in the chair.
The FDA examined studies of more than 600 teeth to declare the laser as safe and effective as a drill. It appeared to cause no side effects, and the laser patients' fillings last as long as fillings in teeth that were drilled, Runner said.
The only two limitations:
- The FDA forbade doctors from using the laser on children. The agency is concerned because the sensitive inner "pulp" forms a larger part of the tooth in children and might be penetrated by the laser, Runner said. But Premier said it has seen no problems in experimental testing of 80 children over age 2.
- Patients and dentists must wear goggles during laser treatment to protect their eyes from the intense light beam.
The laser removes a cavity without the pressure and vibration of a drill, explained Premier chief executive Colette Cozean.
Many patients will not need an injection, Cozean said.