My Experience with Laser Dental Drill for Cavities

After a permanent worsening of my tinnitus after having a small cavity drilled in December, I looked for a laser dentist.

I have interproximal cavities (or class II caries) - cavities between the teeth.

The Fotona Lightwalker laser is able to drill cavities between teeth, deeper cavities as well as replacement of old fillings. It cannot go through amalgam/silver fillings due to reflections it will cause.

It can be of use for root canals too.

I came well prepared with earplugs and earmuffs. Not the heaviest (which I should have done). I suffer from TMJ and having heavy earmuffs pressing on your TMJ while having your mouth open for 30 minutes is asking for TMJ related tinnitus, so i decided to bring -23 dB earplugs with a 3M Peltor Optime I earmuff.

For lasering you need to wear special goggles with thick frame - this causes the earmuffs not to seal fully. I noticed this halfway. Everything sounded louder then I expected. My advice is to wear good earplugs underneath just in case.

The compressor of the laser sounds like a loud air-conditioning unit - I suspect about 60 dB.

The laser itself together with the suction is loud. I suffer from some loudness hyperacusis. I find it louder then your regular handpiece drill. Suction is a must with laser because it uses water for better guidance/result of the laser.

The laser itself has several modes which can lower/increase the volume. To go through dentine the volume is quite loud. Popping sounds and the suction tube. I'd suggest 75-80 dB together. I did not notice occlusion from the water hitting the teeth as there is no brute force water spray.

After the filling was done the filling has to be smoothed/polished/drilled. It sounded like an ultra sonic cleaner to me and had to cut it off instantly. The dentist tried to smoothen it with the handpiece drill afterwards which sounded better.

The pros are that you can protect yourself with earplugs at least for the laser drilling part. Bring the Peltor X5a and a pair of earplugs. If you notice your earmuffs don't seal, stop the treatment and use your earplugs.

I'd say the laser and suction is no difference from the handpiece electric drill and suction in sense of loudness. If your dentist can use the electric drill without suction, that would be my suggestion.

 

I also need to book a filling for myself. I have hyperacusis & tinnitus. Do you prefer electric vs. laser drill? Did you have another permanent worsening after using the laser one?

 

I did a total of three laser ones. None of them even caused me a tiny spike.

The last one caused me to get irreversible pulpitis (pain requiring a root canal). This was an extremely small filling. I don't know if it was the laser that caused it or the fact that the tooth was worked on in general, but it's a complication of the treatment which shouldn't have happened for such a minor filling.

I looked online extensively but I didn't find any other case of pulpitis caused by the laser. It might have been a complication that happened randomly.

Because of the pain after filling last week I replaced the filling with the traditional electric drill as i lost my faith in the laser. Hoping this would help with the pain. I absolutely hate the sound of the drill, even though less loud then air driven drill, way too loud for comfort. Could be my misophonia too. Luckily the dentist was understanding, did 3 seconds on 3 seconds off (5 sec was too tough for my ears) and only using the suction during that 3 seconds on. In total it was 3 minutes of drilling.

Logically spiked, the spike lasted until today, but was manageable. No worsening.My spikes always last 7-8 days and I live from spike to spike because of the sensitivity of my tinnitus.

My luck, changing the filling didnt help, pain still there, next week the root canal scheduled, again with the traditional electric drill.

The laser is supposed to be safe, but proven therwise for me. I am now facing the root canal and pain for a week without trying to take ototoxic painkillers. I know this is not helpful for you, but I will not opt for a laser filling again, but for Tinnitus it's the best solution.

The electric drill is a lot faster then the laser though.

 

What are you looking at? Laser or electric drill? Are there any other options? I broke a tooth that needs to get filled, but don't want some really loud machine in there, as my tinnitus gets real bad from noise exposure. I could see going to get a filling and come out deaf. Which would be game over.

 

Did you wear any type of earplugs? I'd love some kind of earplug that would help block outside noise, but also help allow the drill noise to be able to more easily escape compared to a traditional earplug.

 

I had 6 teeth worked on in 3 sessions over the last 2 years. Laser plus abrasion for removal with low speed drill for shaping at the end. I wore foam earplugs plus defenders. I had a spike each time that lasted a couple of days with no permanent worsening. The drill is by far the worst part so we minimized that last step to the max extent possible. We also scheduled me with no patient in the adjacent chair.

 

My tinnitus has been the kind that gets worse with loud noises, because loud noise is how it got started. Although my tinnitus also got a lot worse when I got COVID-19 for a week, and then got even more worse a month after that when I had the flu for a week.

It seems like people say electric drills are quieter than pneumatic. And it seems like there are people that have had some issues with laser.