Ryan Schettig

Laser Regulation and safety in general dental practice

Summary: The use of lasers in dentistry follows the general safety guidelines for the use of lasers
in other specialties of medicine and surgery. The safe use of lasers extends to all people who
might be exposed either on purpose or on accident. In the UK dentists using lasers underwent
inspection from the health authority personnel and was often just an assessment by a laser
protection advisor. New laws require the practitioners to do things such as demonstrate the
physical barriers to safeguard safety and record and audit the unwanted side effects associated
with laser use. Unlike other countries the UK has no requirement for formal or continuous
training in the use of lasers in dentistry.
The legal aspects of laser use in dentistry fall under the general use of lasers as there are
no specific rules that apply to the dental field. There also must be a compliance with the
protective equipment such as the goggles used meeting country wide standards for use with
lasers. The U.S. as well as many other countries have followed the recommendations of the
International Electro-technical Commission and the U.S. has government regulations on the use
of lasers.
Lasers are divided into four classes with the strength of each going up in ascending order.
Class one lasers are found in CD players and pose no implicit risk to the naked eye. Class two
lasers are lasers that are found in laser pointers they pose very specific risk to the eye when
viewing. Class three are what are known as soft lasers in the medical field and require
protective eyewear and training in order to operate them. Class four is the class where all surgical

dental lasers are located these lasers can cause serious eye damage, flash fires, and serious skin
damage.
The laser has many risks associated with it. These risks include optical, skin, non-beam,
and laser plume risks. The majority of optical risks are attributed to operator error. Shorter
wavelengths will impact the retina and longer wavelengths will impact the retina. The damage
can lead to color blindness scarring and distortion of vison. The skin risks include possible
ionizing effects that may be pre-cancerous and skin burns. The non-beam risks include things
such as physical damage from the moving parts of the laser and electrical. The laser plume risks
result from the gas that is emitted from the intense heat on the target area. The plume can be
serious and cause nausea and breathing difficulties.
Safety measures are taken to minimize the risks occurrence and these measures can be
put in categories which are: environment, laser protection advisor (LPA)/laser safety officer
(LSO), access, laser safety features, eye protection, test firing, local rules, and training. The
environment must be a controlled area. Only personnel directly involved in the laser delivery can
be involved. There also must be warning signs that specify the risks, the interior of the room
must be non- reflective, the access ways must be monitored, and there must be a fire extinguisher
nearby. As for the safety officers the LPA serves as an advisor and the LSO has duties such as
confirming the classification of the laser and training the workers in safe use of lasers. The safety
measure access goes over that non-authorized access should be easily controllable and that doors
must be locked during laser emission. The built in laser features are things such as an emergency
stop button and remote inter-locks. The safety measure of eye protection states that all personnel
must wear appropriate eye protection during operation. Test Firing allows the operator to know
whether the laser is in working condition before operating on a patient. Local Rules must be set

up. These rules are a document that cover basic procedures of the laser and include things like
management of incidents and accidents. Training, all of the staff members should be trained in
the safety aspects of using a laser.
The exposure of non-target tissue can result in permanent damage and anyone operating
the laser should be properly trained. Employers have to establish a safety policy in order to
prevent risks from arising. With the lack of consistent regulations the general approach to safety
should be to protect the patient and the staff.
Comparison- Are lasers more dangerous than classical dentistry methods?
This article covers a main question in my research and that question is whether lasers are more
dangerous than classical dentistry methods. This article provides information on the dangers of
the laser which is perfect for my research. My research is headed towards using this information
in the comparison of the laser to the classical dentistry methods to see if the laser is truly the best
dental instrument.