ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Er:YAG Lasers Are Less Likely Than Rotary Burs to Cause a Patient Discomfort During Caries Excavation When No Anesthesia Has Been Administered
Clinical Question Are lasers less likely than rotary burs to cause a patient pain during caries excavation when the patient has not received anesthesia?
Clinical Bottom Line For patients in need of caries excavation who will not allow or have contraindications to the use of local anesthetic, Er:YAG lasers are less likely than rotary burs to cause a patient discomfort.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 18353012Dommisch/200826 adults with 102 carious lesionsRandomized Controlled Trial
Key resultsDuring caries excavation, non-anesthetized patients (n=16) reported their perceived pain using a visual analogue scale. 75% of the patients reported no pain when treated with the Er:YAG laser (average score of 1.6), but only 20% of patients reported no pain when treated with a rotary bur (average score of 3.4). Regarding vibrations during caries excavation, 30% of patients perceived the rotary bur as uncomfortable (average score of 6.5) and 90% of patients perceived the laser treatment as comfortable (average score of 1.1).
Evidence Search "Lasers, Solid-State"[Mesh] AND caries
Comments on
The Evidence
Validity: This randomized control trial had adequate compliance and completion rate, and the groups were treated the same. There were no recall biases or competing interests. The number of subjects was small (n=16). Perspective: Er:YAG lasers seem like a reasonable approach to caries excavation for non-anesthetized patients who are concerned with discomfort. This randomized control trial did not address the cost difference concerning laser versus traditional excavation techniques. It also does not address the accessibility of patients to dental offices that utilize this Er:YAG equipment.
Applicability Caries excavation is one of the most common procedures in dentistry. For the very small percentage of patients who either refuse local anesthesia or who have contraindications to its use, the Er:YAG laser may be an effective way to remove caries while reducing or eliminating patient discomfort.
Specialty/Discipline (General Dentistry)
Keywords caries excavation, pain, lasers
ID# 2881
Date of submission: 04/01/2015spacer
E-mail fieldsm@livemail.uthscsa.edu
Author Megan Fields
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Mark Littlestar, DDS
Faculty mentor/Co-author e-mail littlestarm@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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Comments on the CAT
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