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Dental Health  (Expert Forum)
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Is laser repair of microscopic enamel cracks worth it?
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Questions in the Dental Health forum are answered by Dr. Jerome Tsang and Dr. Jerome Bogin. Topics covered include bridges, cavities, crowns, and x-rays.

Is laser repair of microscopic enamel cracks worth it?

by Jordy, Feb 05, 2007 12:00AM
I have naturally soft/poor enamel, and so the wear down has resulted in years of expensive restorative work (bondings, crowns, etc.) However, several of my most recent years' problems were the long-term result of my dentist's almost constant compulsion to tweak at my teeth in some random, expensive way over the years. A lot of his work that he insisted would save my teeth actually resulted in the major procedures I probably would have needed anyway (major root canals, crowns, apicos, etc.) Well now, at my latest cleaning the other day, they tested my teeth with some kind of machine that was NEVER used on me before, and detected a couple of microscopic cracks in my remaining enamel on a couple of teeth, and now want me to pay $110 a tooth minimum for him to laser them away. I have a gut feeling this may do more harm to my very sensitive enamel than good. Any opinions on whether this is worth it? Oh, despite all, I'm NOT "regular" cavity prone.

Down the road I'm likely to need bonding or crowning on those remaining teeth anyway.  I'm tired of these expensive procedures that don't seem to help in the long run and likely cause more harm than good.  The few teeth in question do not hurt at all and have no sensitivity, and look very strong and white in appearance.  Can this laser repair actually damage abnormally delicate enamel?  Is there enough industry history of good result to warrant me taking this risk?

by Jerome Bogin, D.D.S. , Feb 05, 2007 12:00AM
I wish I could give you some expert advice in this area but I know not of what you speak. I do not have any experience in laser dentistry, as a matter of fact I am going to a lecture tonight on this very subject.I think the machine that your dentist used was the Diagnident. If this is correct the machine detects surface decay. My gut reaction is to leave the teeth alone but I can not give you a definitive diagnosis in this forum.
Member Comments (2)

by mike1105, Feb 05, 2007 12:00AM
To: jordy
Keep in mind I have never seen you. This is a general response to some issues you brought up., not a recommendation based on a diagnosis. That said, If it were me, knowing what I know ( i am a dentist) I would not proceed with this treatment. practically every adult tooth has "craze lines" which are microscopic fractures in the enamel. they re normal. they do not cause pain. a larger fracture that may weaken the tooth may cause pain, but these are usually due to some speific traumatic incident (like biting on an ice cube, a bone or even the presence of a large fiilling in the tooth that can weaken the enamel wall)- I've got to be honest with you-- this laser treatment for "microscopic fractures" sounds like a crock. I do not like to bash my profession, but dentists are always looking for ways to increase their bottom line-- they are bombarded at trade shows and in periodicals with ways to do that--usually in the form of some new technology. I am wary of a laser technique that can fix crackes in the enamel. If it is a "craze line" (usually only visible under UV light or bright light) it probably does not need treatment. If the fracture is larger, it most likely needs to be restored with a dental restoration. I could go on and on......but i think you get my drift. I'd have your teeth and your dental situation evaluated by another dentist in the form of another opinion-- you should get a referral from a friend or family member (someone you trust).
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