By Danny Chan
It is estimated that around 6% of dentists currently use lasers in their practice. With clinical application of laser dentistry still very much in its infancy, early adopters often complain about a steep learning curve with little guidance on the technological uses and applications – beyond product manuals and online literature that barely scratch the surface.
Once a traveller on that lonely learning path, Dr Linhlan Nguyen is today a bona fide laser practitioner fully plugged into a supportive dental laser learning community. She gives her own laser dental workshops and lectures in Australia and overseas. Dr Nguyen is a returning speaker at the upcoming 8th Annual Laser & Health Academy Symposium held in Portoroz, Slovenia.
Even though the Principal Dentist of a private practice in Canberra espouses the benefits of lasers in dento-facial aesthetics (her area of expertise) to a global audience with such ease and eloquence today, it wasn’t that long ago that she was entertaining early adoption doubts.
Dr Nguyen dipped her toes into the world of laser dentistry as early as in 2009.
“That was when I took on CEREC and decided to get serious with adhesive restorative dentistry and ceramic work. Resin bonding requires absolute moisture control so I learned to use diode laser for soft tissue management.”
Even though laser soft tissue management soon became inseparable from her routine practice work, she was at the time, still unconvinced that “hard tissue laser could work properly”.
Somewhat bogged down by what she calls “misleading information about hard and soft tissue lasers”, Dr Nguyen was nonetheless impressed by what she saw in the Fotona Lightwalker. She came across the award-winning hard and soft tissue laser at Australia’s first-ever staging of Aesthetic Dentistry Conference, AesthetiCon in September 2015.
Wowed by the multiple applications that Fotona LightWalker afforded to perform aesthetic treatments as well as NightLase, non-ablative laser treatment for snoring, Dr Nguyen purchased the “universal” all-tissue laser from Innovative Medical Technologies (IMT) later that year. IMT is a Melbourne-based Fotona reseller and medical equipment company that specialises in laser products.
“I had two weeks to play with it during the Christmas break. The deeper I looked into the manual, the more I was overwhelmed by the number of applications that I could potentially use. I knew I had to seek proper education.”
Unlike some of her peers who were left to struggle on their own, Dr Nguyen received timely help. On invitation of IMT, she began to attend laser dentistry workshops that gave her the product orientation she badly needed – but it only whetted her appetite for more.
“The LightWalker offers over 80 applications. I started to get the “How” but I needed to know the “Why” for performing all those procedures.”
It was perhaps fortuitous then that around the time, the Laser and Health Academy (LA&HA) launched its inaugural Masters in Laser Dentistry program – which Dr Nguyen, through her connections at IMT, promptly signed up for.
A total of 5 modules are available through the Master’s Program, which can be completed between 12 and 36 months. Dr Nguyen took the accelerated course route, completing all of the 5 modules – which were held in different countries across Europe – within 6 months. The courses are now available in Australia through IMT, in partnership with Laser and Health Academy.
In May 2017, she joined Dr Jason Pang and Dr Johnny Chan as the three Australian dentists – among a group of eight international course attendees – to become first Graduates of the Laser and Health Academy Master’s in Laser Dentistry.
The in-depth knowledge she acquired from the different application-based modules, she says, quickly contributed to her work and practice: “When I started the Masters program, my LightWalker got busy in all aspects of dentistry.”
One of many rediscovered tools she finds useful is Fotona’s TwinLight Periodontal Treatment (TPT), a comprehensive and minimally invasive periodontal therapy that capitalises on the advantage of LightWalker’s dual laser wavelengths.
Fotona’s LightWalker AT-S boasts two highly effective laser wave-lengths: Er:YAG and Nd:YAG with energy levels up to 5 times greater than previous generation lasers. Between the two laser wavelengths, the LightWalker units cover practically all laser-assisted dental treatments – including endodontic, periodontal, peri-implantitis, tooth whitening as well as the novel NightLase® snoring therapy and facial skin treatments such as wrinkle reduction.
Dr Nguyen describes how combining the LightWalker with a formal laser education opened her eyes to new treatment methods, paving the way to higher success rates and more predictable outcomes.
“TwinLight treatment helps to achieve higher success rates in endodontics by better debridement and disinfecting the canals, sub canals as well as dentinal tubules. We carry out about five endodontic cases a week. Having high success rate is absolutely important to us,” Dr Nguyen stresses.
“TwinLight treatment is fantastic in periodontics. I have since found the ability to carry out sub-gingival debridement and calculus removal, granulation tissue removal, disinfection of the pockets and stabilising of the clots critical for success of periodontal treatment.
In the treatment of recent cases of peri-implantitis, Dr Nguyen saw much faster healing and less post-op pain in her surgical work such as removal of broken and/or impacted teeth and implantology.
She says laser use for cavity preparation, especially deep preparation, can be very conservative – and useful in avoiding pulpal exposure. “In case of pulpal exposure, pulpotomy can be done neatly.”
The clinician also uses laser to treat patients with TMD and chronic pain.
“Photobiomodulation for pain relief and healing using the Genova handpiece has been a wonder. It is applied after all of my surgical cases to minimise pain, swelling and accelerate healing. In fact, Genova handpiece has used the most in my practice.”
The Fotona Lightwalker even makes work more enjoyable, Dr Nguyen enthuses:
“I must say I did not really enjoy doing periodontal treatment previously. Seeing the results that I can achieve with the LightWalker has been a good motivation factor.”
More than just shortening the learning curve, the LA&HA Masters Program has also helped Dr Nguyen build staff and patient morale at her clinic.
“As my career advances and my patients’ basic dental health have gotten better, they expected more advanced treatment to improve function and aesthetics. Laser assisted dentistry adds another level of care to my patients. Apart from the benefits of better treatment outcomes, patients can also appreciate the way in which technology is being harnessed for their wellbeing.
“Staff working at practices that provide better training, better technologies and better care do stay with the practice longer. They take pride in staying on top of the game and ahead of the technological curve.”
For all the advantages of laser dentistry, Dr Nguyen says the main barrier to its widespread adoption lies in the lack of education and resistance to change.
“Laser Dentistry has not been given adequate attention in dental schools. Other factors I believe that are hindering its progress has to do with ego, ignorance and funding. Our dental schools should be looking into teaching Laser Dentistry. That would be my dream.”
The pioneering graduate of LA&HA Master’s Program insists that education is essential for proper adoption of laser dentistry – encouraging like-minded peers to look for reliable laser product suppliers that provide adequate technical, community and educational support.
“The LA&HA Master’s Program has given me the in depth knowledge and skills necessary to perform the best laser treatment I could possibly give patients. With the right knowledge and experience, I am able to share my skills with my colleagues.
Dr Nguyen hopes to fill the knowledge gap, even as she continues to learn and acquire new skills.
“After all, laser dentistry is like other specialties, where ongoing training and support are essential for growth. It is a lonely road when you are on your own.”