The full impact of the COVID-19 pandemic on the medical community is not yet fully known. The guidelines for the dental industry are evolving, but the considerations are clear – reducing the risk of virus and bacteria transmission between patients and staff and patient-to-patient will become a top priority in the post COVD-19 environment.
There are several important comparisons between the use of the Solea® all-tissue dental laser and the traditional drill that practices should be aware of as they prepare to open their doors again.
Water spray is a significant factor in aerosolization and splatter in a dental practice, which can cause the spread of harmful viruses, such as the common cold and influenza viruses, herpes viruses, pathogenic streptococci and staphylococci, among others.
Most drills utilize 1 to 4 water ports that are driven by air pressure of ~38 psi and water flow of ~30-60 ml/min (Cavalcanti 2005). Solea utilizes air pressure as low as 10 psi and water flow as low as 10 ml/min. This is ~74% less air pressure and ~67-83% less water flow when compared to drills. Based on these factors, the risk of aerosolization and splatter causing transmission of viruses, including COVID-19, is significantly lower with Solea than the drill.
Hard Tissue
Solea vaporizes tooth structure using thermal energy as opposed to the mechanical process of conventional drills. During laser treatment, the surface temperature of the tooth reaches more than 1,200° C without transferring heat to the surrounding tissues. Viruses and bacteria are destroyed at temperatures above 60° C which means Solea kills any virus or bacteria with which the beam comes in contact.*
In contrast, surface temperatures increase by only 11° C when using the drill, allowing viruses and bacteria to survive. Furthermore, a drill cuts by mechanical means with a bur rotating up to 400,000 RPM which has shown to project material more than 18 inches outside of the oral cavity, potentially spreading harmful contagions.
Soft Tissue
As a CO2 laser, Solea has inherent hemostatic properties (Olivi 2009), (Niemz 2003) and delivers energy that serves as a sterilizing agent by eliminating viruses and bacteria. This is extremely important for treating periodontal disease and peri-implantitis, where the pocket harbors millions of viruses and bacteria. Lasers have been widely used in such applications and have a history of successful performance.
Dentists may be required to change PPE more frequently post COVID-19, possibly needing to change PPE every time they leave an operatory. This represents a new procedural burden
The common practice of injecting a patient, leaving that operatory, and working in another operatory before returning to the original patient may become a primary challenge for providers. It is further exacerbated in situations where patients must be seen over multiple visits for problems in multiple quadrants.
Solea allows dentists to treat cavities in all four quadrants in one session and perform several soft tissue procedures, all without the need for local anesthetic. Working without anesthesia inherently creates efficiencies by reducing procedural steps and enabling four-quadrant dentistry. Not having to wait for patients to get numb allows the dentist and staff to stay in one operatory from start to finish without down time or an additional change of PPE.
Solea provides dental practices significant benefits for both hard and soft tissue procedures as compared to the traditional drill, especially in a post COVID-19 environment. This all-tissue dental laser significantly reduces aerosols and splatter through less water flow and air pressure, kills viruses and bacteria wherever the beam comes in contact, and can reduce PPE usage and enable efficiencies to save time and money.
As practices begin opening their doors, Solea should be considered as a likely safer option than the drill for dentists and their patients.
*Surmised based on known surface temperatures of 1200 degrees Celsius
REFERENCES
Ando Y, Aoki A, Watanabe H, Ishikawa I. Bactericidal effect of erbium YAG laser on periodonto-pathic bacteria. Laser Surg Med 1996;19(2):190-200.
Cavalcanti BN, Seraidarian PI, Rode SM Water flow in high-speed handpieces: Quintessence International vol 36 (5) 2005
Miyazaki A, Yamaguchi t, Nishikata J,Okuda K, Suda S,mOrim K, Koboyashi T, Yamazaki K, Yoshikawa E, Yoshie H. Effects of Nd:YAG and CO2 laser treatment and ultrasonic scaling on periodontal pockets of chronic periodotitis patients. J Periodontol 2003;74(2):175-180.
Niemz MH, Laser Tissue Interaction: Fundamentals and Applications, Springer 2003.
Olivi G, Genovese MD, Caprioglio C. Evidence-based dentistry on laser paediatric dentistry: Review and outlook. Eur J Paediatr Dent 2009;10(1):29-40.
Russell AD, Lethal effects of heat on bacterial physiology and structure. Sci Prog 2003;86(1-2):115-137.