The Very Dental Podcast Network Very Clinical: $18,000 Tips and Other Laser Myths with Dr. Bob Convissar
In this throwback episode Zach and Kevin feature Dr. Bob Convissar, a pioneer in laser dentistry with over 32 years of experience. He's a prolific author, lecturer, and practitioner who began his career after graduating from NYU in 1980 and acquiring a unique, century-old dental practice in New York City
The main topic is the ABC's of Laser Dentistry, starting with a critical distinction between true lasers (like CO2 and Erbium) and devices often called lasers but primarily used as hot glass tips (like diodes). Bob explains that diodes, which can operate at extremely high temperatures (750∘C to 1500∘C), work thermally, creating a burn, while CO2 and Erbium lasers are absorbed by the water in soft tissue and vaporize it at 100∘C.
He emphasizes that the CO2 laser is the best option for general dentists doing soft tissue work, as it creates a much smaller zone of necrosis (thermal damage) than ElectroSurge or diode lasers, leading to better healing. He also offers a crucial financial perspective, arguing that while a CO2 laser may have a higher initial purchase price (around $30,000), its lack of expensive disposable tips makes it a more cost-effective long-term investment than a cheaper diode laser (like a Picasso) with high operating expenses (potentially $18,000 in tips per year).
For a multi-faceted approach, he recommends dentists invest in a CO2 laser, a modern air abrasion unit, and a Photobiomodulation (PBM) laser (around $2,000 to $3,000). PBM lasers are purely palliative and can be used for pain management, like treating TMJ issues or for analgesia on deciduous teeth, and for promoting healing after invasive procedures.
Finally, Bob stresses that the most crucial factor in laser dentistry is training, advising listeners that any course focusing on only one manufacturer or wavelength is likely a sales pitch, not a comprehensive educational seminar. He promotes his widely used textbook, Principles and Practice of Laser Dentistry
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