Introductory Course Introductory courses are intended to be educational, informational and primarily didactic. This level of education is intended for anyone interested in lasers in dentistry. I. Introduction A. Self-graded pre-test (optional) II. Fundamentals of lasers A. Production of laser light 1. Quantum theory 2. Stimulated emission Electromagnetic spectrum Regions and boundaries Ultraviolet (1 – 400 nm) Visible (400 – 750 nm) Infrared (750+ nm) 2. Laser wavelengths C. Characteristics of laser light 1. Spatial and temporal coherency Monochromaticity Collimation Laser requirements, delivery systems and emission modes Laser cavity Active medium Pumping mechanism Optical resonator Delivery systems fixed lens and mirror articulated arm Waveguide Optical fiber Emission mode Continuous wave Chopped or gated Pulsed Summary of laser effects on tissue Reflection, scattering, transmission, absorption Photothermal effects Warming Coagulation, tissue shrinkage, hemostasis Vaporization, ablation Carbonization Photoacoustic effect Disruption Photochemical effects Stimulation of chemical reactions Breaking of molecular bonds Fluorescence Biostimulation a. Photodynamic therapy Review of types of lasers, delivery systems, special device characteristics, and clinical applications in dentistry Laser types Argon laser 2. CO2 laser 3. Diode lasers 4. Erbium lasers 5. Holmium laser 6. Neodymium lasers 7. Other lasers B. Device characteristics Wavelength Beam diameter (spot size) Power Energy density Repetition rate (if applicable) Exposure duration Total energy C. Clinical applications Intraoral soft tissue surgery Treatment of apththous ulcers Sulcular debridement (soft tissue curettage) Composite curing Tooth shade lightening Caries removal Cavity preparation
Enamel modification Illumination for caries detection Illumination for endodontic orifice location Removal of coronal pulp 12. Experimental applications IV. Laser safety Standards, organizations, and regulatory requirements for Devices and Radiological Health (CDRH) American National Standards Institute (ANSI ) Occupational Safety and Health Administration (OSHA) State and local regulatory agencies Laser safety officer Laser safety mechanisms Adverse effects reporting mechanism Eye and tissue protection Environment Proper warning sign posted Limited access Reflective surfaces minimized High volume evacuation present Laser external cooling system (if applicable) Electrical components (cords and footswitch) Gases Training L. Laser use documentation V. Infection control A. Identification and disposal of biologic hazards B. Plume hazards and precautions Sterilization Post-test examination (optional) 5.2 Standard Proficiency Course The curriculum for basic level of education in laser usage includes specific device instruction with demonstrated proficiency in didactic and hands-on knowledge. Hands-on exercises include demonstration and clinical simulation with appropriate oral tissues (e.g. cow or pig jaws), and must meet participation course guidelines. Practitioners must demonstrate competency by written and clinical simulation and examination in the safety aspects of laser use prior to using lasers on patients. This is the level of education that defines the standard of care. Dental auxiliaries are encouraged to demonstrate competency in the safety aspects of laser use. Industry representatives, researchers, and others who demonstrate and operate lasers must demonstrate competency by written and clinical simulation and examination in the safety aspects of laser use. Introduction A. Self-graded pre-test (optional) II. Fundamentals of lasers A. Production of laser light 1. Quantum theory 2. Stimulated emission Electromagnetic spectrum Regions and boundaries Ultraviolet (1 – 400 nm) Visible (400 – 750 nm) Infrared (750+ nm) 2. Laser wavelengths C. Characteristics of laser light Spatial and temporal beam coherency Monochromaticity Collimation D. Laser requirements, delivery systems and emission modes Laser cavity
II. Fundamentals of lasers A. Production of laser light 1. Quantum theory 2. Stimulated emission B. Electromagnetic spectrum Regions and boundaries Ultraviolet (1 – 400 nm) Visible (400 – 750 nm) Infrared (750+ nm) 2. Laser wavelengths C. Characteristics of laser light Spatial and temporal beam coherency 2. Monochromaticity Collimation D. Laser requirements, delivery systems and emission modes Laser cavity Active medium Pumping mechanism Optical resonator Delivery systems Fixed lens and mirror Articulated arm Waveguide Optical fiber Emission mode Continuous wave Chopped or gated Pulsed Summary of laser effects on tissue Reflection, scattering, transmission, absorption Photothermal effects Warming Coagulation, tissue shrinkage, hemostasis Vaporization, ablation Carbonization Photoacoustic effect Disruption Photochemical effects Stimulation of chemical reactions Breaking of molecular bonds Fluorescence Biostimulation a. Photodynamic therapy III. Review of laser types, device characteristics, and clinical applications in dentistry A. Laser types Argon laser CO2 laser Diode lasers Erbium lasers Holmium laser Neodymium lasers Other lasers Device characteristics Wavelength Beam diameter (spot size) Power Energy density Repetition rate (if applicable) Exposure duration Total energy C. Clinical applications Intraoral soft tissue surgery Treatment of aphthous ulcers Sulcular debridement (soft tissue curettage) Composite curing Tooth shade lightening Caries removal Cavity preparation Enamel modification Illumination for caries detection Illumination for endodontic orifice location Removal of coronal pulp Experimental applications IV. Laser safety A. Standards, organizations, and regulatory requirements for Devices and Radiological Health (CDRH American National Standards Institute (ANSI) Occupational Safety and Health Administration (OSHA)
State and local regulatory agencies B. Laser safety officer Laser safety mechanisms Adverse effects reporting mechanism Eye and tissue protection Environment Proper warning signs posted Limited access Reflective surfaces minimized High volume evacuation present Laser external cooling system (if applicable) Electrical components (cords and footswitch) Gases Training Laser use documentation Clinical simulation (specific hands-on demonstration) Laser instrument set-up and operation Delivery system Type Assembly Inspection Maintenance Sterilization standards and protocol Set laser operating parameters Test fire laser Infection control Identification and disposal of biologic hazards Plume hazards and precautions 3. Sterilization C. Treatment objective and surgical technique simulation on bovine tissues or other suitable biologic tissues or inanimate objects 1. Indications and contraindications of laser use in dentistry Alternate methods of treatment D. Discussion of treatment sequence, patient management, postoperative instructions Management of complications Surgical and healing assessment G. Post-test clinical simulation VI. Clinical summary of laser usage Pretreatment Diagnostic tests Clinical exams Tooth vitality Hard tissue tests Radiographics Soft tissue exams, including pocket depth measurement (if applicable) Other Diagnosis and treatment plan Diagnosis Treatment Possible treatment alternatives Indication Contraindications Informed consent B. Treatment Objective Laser operating parameters Wavelength Power Repetition rate (if applicable) Beam diameter (spot size) Exposure duration Treatment sequence Management of complications Surgical prognosis Treatment record Patient management Post-operative instructions C. Follow-up care Side effects and complications (if any) Assessment of treatment (with time intervals) Long-term results Healing assessment