Dentists' Perception and Usage of Laser Technology in Taif Region, KSA. Mahitab Soliman*,Ammar Alshemrani**,

Aim: This study aimed to know the degree of using and accepting laser technology in the dental field among dentists working in Taif, KSA. Methodology: A random sample of about 120 dentists working in different locations in Taif were included . A specially designed questionnaire was utilized for data gathering, which reflected some of the respondents' personal and scientific behavioral characteristics, and their acceptance of laser technology. The questionnaire included the following: the degree of acceptance of respondents to laser use in dental treatment, the availability of laser devices, the degree of awareness of respondents to the safety precautions during laser use ,the acknowledgement level of respondents of laser uses in dentistry, and finally to know the obstacles which prevented the respondents from using laser. Results: showed that more than half of dentists 53% accepted laser strongly, laser devices were found in only 9% of clinics allover Taif, only 35% of dentists had good knowledge level of laser uses, 33% had high awareness level of safety laser precautions, and finally 70% of obstacles to the use of laser were due to insufficient training and knowledge level, followed by the variety of laser types52%. Conclusion: laser application in dental procedures is not common in Taif at the present. -------------------------------------------------------------------------------------------------------------------------------------Date of Submission: 01-02-2019 Date of acceptance:18-02-2019 -------------------------------------------------------------------------------------------------------------------------------------I. Review of Literature: Laser technology has invaded different fields of medicine and is now being introduced to dentistry where dramatic changes in this scope have been made. Certainly, however, today's lasers offer an opportunity to deliver hard and soft-tissue treatments that, allow the patient to have easier experience (1,2). Principally, the aid of surgical lasers in dentistry has introduced efficient cutting of dental hard tissue, hemostatic ablation of soft tissue and also the sterilizing effect through bacterial elimination. Less powerful, non-surgical lasers have been shown to modify cellular activity and enhance biochemical pathways associated with tissue healing, help in caries detection and assist in the curing of composite restorative materials. (3,4). In particular dentists should consider a number of factors when deciding whether to incorporate laser technology in their practice or not. First they should realize that there are various types of lasers, namely; soft tissue and hard tissue treatment lasers (2,5). In addition dentists should feel free to adopt a new technology if it can be better to satisfy patients' needs, but other factors such as expenses, and experience can limit its application. (2,6). This assessment involves looking at the final risk-benefit result. Ethically laser treatment must show efficacy and an accepted risk-benefit ratio for it to be put in public use (7,8). Therefore one should keep in mind that both efficacy and effectiveness are required for the greatest confidence to be warranted. The wavelength of the light is the primary determinant of the degree to which the light is absorbed by the target tissue (3,4). Lasers produce light energy within a narrow frequency range. For most practical purposes, the light produced by laser can be considered to be monochromatic. Typically lasers are named according to the active element within them that goes through the stimulated quantum transitions, which create the light (8,9). Once the light from dental lasers is absorbed by tissues, it is converted to heat . The thermal effects of this heat depend in a great extent, on tissue composition that is the amount of water and organic / inorganic components in the tissue. The duration of exposure results in temperature increases that may cause the tissue to change in structure and composition. These changes may range from de-naturation to vaporization and or carbonization and even melting followed by recrystallization in case of hard tissue (3). Dentists' Perception and Usage of Laser Technology in Taif Region, KSA. DOI: 10.9790/0853-1802107481 www.iosrjournals. org 75 | Page Wavelengths used in Dentistry: Carbon Dioxide Lasers CO2 laser:operates at a wavelength 10. 6μm, they can be operated in gated or continuous waveform, and can be used of in a number of soft tissue applications (10,11). Neodymium Yttrium Aluminum –Garnet (Nd: YAG) laser operates at a wavelength of 10. 064μm in a high intensity waveform , like the CO2 laser the Nd: YAG laser has almost the same soft tissue applications (12). In addition the Nd:YAG laser can be used to remove incipient enamel caries, although not efficient like the other types of lasers (13,14). Erbium-Yttrium : Aluminum –Garnet (Er:YAG) , this type of laser operates at a wavelength of 2. 94μm. in a pulsed waveform. The FDA has cleared it for the use in cementum and bone and it has a variety of hard tissue applications such as; caries removal, cavity preparation both in enamel and dentine, and preparation of root canals,as well as ablation of implant biofilm (6,15-19) Erbuim , Chromuim : Yttrium Selenium-Gallium –Garnet (Er,Cr:YSGG), operates at a wavelength of 2. 78μm. with an extinction length in water 1. 0μm. it has a pulsed waveform. This type of laser has several hard tissue applications , such as; enamel etching, caries removal, cavity preparation, invitro bone cutting without melting , or alteration of calcium – phosphorous ratio, and in root canal preparation (20,21). The most encountered advantages of Er.Cr:YSGG laser are that it produces rough surface in enamel and dentine without being cracked. In dentine no smear layer remains that means good bonding as well as it is safe for pulp. (22) Argon Laser: it operates at a wavelength of 457-502 nanometers, using a pulsed or continuous waveform. Argon laser can be used in a variety of purposes including resin curing and teeth bleaching.The primary advantage of Argon laser is that , the laser operates at a wavelength that is absorbed by hemoglobin, which provides excellent hemostasis (23,24) Holmium : Yttrium Aluminum Garnet or Ho:YAG , this type of laser operates at a wavelength of 2. 1μm. and uses a pulsed waveform. It is used for soft tissue incision and ablation procedures. Its main advantages that it focuses on the surface effect on tissues. The Ho:YAG laser is less penetrating than the Nd:YAG laser, therefore it is faster in cutting soft tissue. Although it has antimicrobial effects, yet it must not be used to decontaminate implants as it may damage their surface (25). Gallium-Arsenide or Diode Laser, this type of laser operates at a wavelength of 904 nanometer (nm) and uses a pulsed or continuous waveform. It has been proved to be successful in soft tissue incisions and ablations, such as: gingival troughing, esthetic gingival contouring, gingivectomy, freenectomy, treatment of ulcers, and depigmentation of gingiva or gum peeling (26-29) Taif University is showing a special concern about the study of introducing laser technology within its health research and applied systems, by the use of soft tissue diode laser (softlase), and the ( Biolase) devices. The matter which makes it necessary to construct a field study including a questionnaire to assess the degree of acceptance and interest of dentists to use the laser and whether is it beneficial in providing high quality treatment due to its wellknown advantages over the conventional methods of treatment. The protocolwas approved by the Ethical CommitteeofTaif University. Aim of the Work 1-To define the acceptance levels of respondents for laser technology in dental treatment. 2To encounter the availability of laser devices within practices in Taif. 3-. To identify respondent's levels of knowledge and usage of laser technology. 4-To determine the degree of awareness of respondents to the safety precautions during laser using 5To clarify the obstacles for laser technology application in dental treatment. II. Materials and Methods: A random sample of dentists working in Taif; whether in the University, or governmental centers or private dental clinics was taken. A specially designed questionnaire was used to collect data, and a pre-test was conducted to check its fulfillment to the research goals. The questionnaire was composed of identified factors reflecting respondents' characteristics, their experience and training levels in the field of lasers , their acceptance level to the introduction of such technology , the safety precautions to be followed, the obstacles for laser application, and their benefits from application of laser technology. Research variables were measured by the following: 1Acceptance levels of laser technology (high level=3, moderate level =2, low level=1) 2The availability of laser devices allover Taif region. 3knowledge level of the use of laser in Dentistry ( Practice=3, to some extent=2, doesn’t practice=1). 4-Respondents' awareness level towards safety precautions during the use of laser (knows=3, to some extent=2, doesn’t know=1). Dentists' Perception and Usage of Laser Technology in Taif Region, KSA. DOI: 10.9790/0853-1802107481 www.iosrjournals. org 76 | Page 5Obstacles which the respondents face to apply the modern technology. (financial, administrative, technical, risks)