Is it time for dentistry to replace the drill?

Status quo 👉 That’s our dental drill. They haven’t REALLY changed too much in a FEW HUNDRED YEARS. Yes, they spin faster. They shoot out water and air and light. Some are electric. But this basic concept of a metal bur cutting tooth is older than those VHS hygiene tapes you found cleaning out your stock room.

Air driven. Electric. Just missing the belt-driven.

So…why haven’t we come up with something better?

You might say, “it ain’t broke so don’t fix it”

I’ll grant you that…to an extent. And to be completely honest with you, I still like my dental handpiece. By now, after years of experience, it really does feel like an extension of my hand. I’m comfortable with it. I’m actually pretty darn good with it.

BUT….

What if there was a better way to cut teeth and a better way to remove decay?

A better way to remove decay? What does that even mean? If you remove it, isn’t that mission accomplished? Perhaps that is what we’ve always assumed.

Is it time to re-think the bur block?

The bacterial problem with the burs in our drills is that they are NOT antibacterial; they simply stir the bacterial pot inside our preps. The mechanical problem with our burs is that they cause micro fractures in tooth structure. Imagine a cutting instrument that remedies both of these problems. Enter hard tissue dental lasers, the Solea laser for me. They kill bacteria on contact and do not micro fracture teeth.

Now you might be thinking, “but do these improvements REALLY matter”? These micro fractures and these bacteria we leave inside teeth haven’t been an issue up to this point. Oh really? At least in my own experience practicing day to day, I’m regularly perplexed at why some teeth “blow up” and need endo. Or why a tooth with a small occlusal resin dramatically shattered. Yes, there are many possible explanations. I’d simply like to argue that (1) bacteria are often blamed as the culprit and that perhaps laser bacterial sterilization during tooth preparation would reduce these problems and (2) the micro-fractures introduced by our burs compounded over thousands of chewing cycles may be contributing to some of the tooth fractures we see. We seem pretty quick to blame silver fillings for fractures. Maybe we need to look a little closer…

Ultimately, if we have a new instrument that, all else equal, solves two significant problems we face on a daily basis (bacteria and tooth fracture), shouldn’t we at least give it a chance?

Maybe you’re not convinced because yes, a laser does currently cost a lot more than a handpiece and, yes, you’re going to sort of have to learn to prep again, but as Steve Jobs says, THERE IS ONE MORE THING.

No shot. No drill. No numb face.

Lasers create an analgesic effect that in almost all cases eliminates the need for injections. So, now you’ve got an instrument that kills bacteria, doesn’t fracture teeth AND eliminates the needle. For me, this was when the scales undeniably tipped….and when I decided, YES, it’s time to replace my handpiece. Two years and three lasers later I haven’t regretted my decision for a single moment.