trends in dentistry

22 MARCH | APRIL 2008 dpreuropeReader Service 21

Name: Dr Liam JonesLocation: Kilrush, Ireland Years in practice: 9Area of speciality: General practice

What is your overall impression ofthe FDI Dental Ethics Manual? I liked the manual. I found it well laid outand informative. Despite being aconcise book it covers all areas ofdental ethics in enough detail to get thepractitioner interested again in an areathat, as pointed out in the book, can beoverlooked as a subject in many dentalschools.Was there an aspect of the manualthat you found particularly applicableto your daily practice of dentistry?There were a number of well chosen,diverse case studies in the book. Thesewere cleverly located and thoroughlydiscussed and gave the reader differentperspectives on possible everydayproblems.

Would you recommend this to fellowdentists? Not only would I recommend it to mycolleagues but to all dental students aswell.Do you feel there are important areasthat were not covered in the manual? This is not a big reference tome, and assuch offers only broad brush strokes ofguidance in such complex areas asresearch ethics. Are the dental ethics described inthis manual universally applicable? Certainly the principles and ethos of thebook are universally applicable.Colleagues will need to apply the ideasin the book in accordance with theirlocal regulatory guidelines.

“This is not a big referencetome, and as such offersonly broad brush strokesof guidance in suchcomplex areas asresearch ethics” Dr Liam Jones, Ireland

Name: Dr Per Olov LinanderLocation: Verkstadsgatan, SwedenYears in practice: 35Areas of specialty: Paediatric dentistry, dental phobia

What is your overall impression of the FDI Dental Ethics Manual? It’s well suited to make this a way of natural thinking, especially for our youngerdentists .Was there an aspect of the manual that you found particularly applicable to yourdaily practice of dentistry? I think all aspects are very applicable.Would you recommend this to fellow dentists? Absolutely!Do you feel there are important areas that were not covered in the manual? Of course there is! The book raises a lot of important issues. Are the dental ethics described in this manual universally applicable? Yes, I think so.

Mythbusting Laser DentistryHard tissue lasers cut slower than high speed burs.This can be true for laser systems that deliver the laser beam through an opticalfibre delivery system. To protect the expensive fibre, the laser energy must bekept low. But laser systems, like Fotona’s Fidelis III range, utilize an articulatedarm and advanced technological solutions, such as VSP Technology, that allowthe laser to deliver much more energy for efficient laser drilling. This meansthat these lasers can cut at comparable and higher speeds than conventionalhigh speed burs. In fact, a recent paper has described the use of a very noveland accurate way to determine ablation speeds. The study shows that a hardtissue Er:YAG laser delivered through an articulated arm (Fidelis Plus III,Fotona) cuts 3.7 times faster through dentine and 5 times faster throughenamel than an Er,Cr:YSGG laser delivered through an optical fibre (WaterlaseMD, Biolase). Another study determined that the same Er:YAG laser deliversdrilling (ablation) speeds that were higher than that of a high speed bur.Lasers have limited uses (some work strictly on soft tissue, others onlyon hard tissue).This is not entirely true. Laser systems that incorporate two laser types canwork very effectively on both soft and hard tissue. This is because each laser’swavelength is ideally suited to work on each tissue type. For example, Fotona’sFidelis Plus III is indicated for more than 45 procedures, virtually replacing thedentists entire traditional toolkit with faster, more efficient and effectivetreatments. Even more, many treatments simply cannot be performed with theconventional toolkit.Lasers are 100% painless.Most patients (90%) feel no discomfort at all during Er:YAG laser treatments .Fidelis III lasers are thus predominantly used without anaesthesia, but certainsituations and certain patients require local anaesthesia. A topical anaestheticsuffices for some soft tissue procedures and larger hard tissue procedures mayrequire a local injection. Nevertheless, patient comfort is dramaticallyimproved (no needles, no noise, no vibration, no numbness), thus reducingdentist and staff stress. Where no anaesthesia is used, patients can receivetreatments in all four quadrants during the same appointment. Fewerappointments and faster treatments mean more free chair time.Lasers are a bad investment.Lasers are not inexpensive, but this is the same for every investment in yourfuture. If you understand the benefits of lasers, return on investment is crystalclear. With less need for anaesthesia more treatments in multiple quadrantsduring shorter visits can be performed, increasing per-visit production. Duallaser systems allow you to treat more conditions efficiently and less invasively— even ones you were previously not able to treat. Combined with morepatient referrals and added exposure by setting your practice apart from others,it is easily understood that lasers are indispensable to a modern practice.

References1. J. Diaci, J. Laser Health Academy, 2/1 (2008). http://www.laserandhealth.com [Accessed at 10/3/2008].

2. J. Grgureviç et al., Lasers Surg. Med. 36, 347–350 (2005).

3. K. Matsumoto et al., J. Clin. Laser Med. Surg. 14(3), 123–127 (1996).

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