Gain Without the Pain 
    
By Philip Raphael
Staff Reporter

Painless dentistry? That's what Richmond's Dr. Dave Kapusianyk is providing his patients after adopting a drill that uses laser light and water.
 
Before walking into the Richmond dental office of Dr. Dave Kapusianyk for the first time you anticipate the familiar sights and smells of a traditional surgery setting.

Think of dental assistants clad in medical-type smocks of various, calm-inducing hues, and the occasional waft of fluoride permeating from the treatment rooms that lurk beyond the welcoming front counter plastered with mirthful messages about dental health.

Taking a seat in the restrained comfort of the patient's waiting area you expect the sensory exploration to continue, especially if you happen to be a white-knuckled patient who is loathe to visit the dentist even when toothache pains near unbearable, black-out magnitudes.

You wait... and wait to hear that well known, and feared, high-pitched whine of the dentist's air turbine-driven drill, its business end spinning freely, then slowed as it bores mercilessly into fresh tooth enamel and its underlying pulp.

Still in the waiting room, you continue to listen. And listen.
Where's the drill? Where's the high-pitched whine? Where's the door?
You try to relax, remembering that implied fear can be more harmful to your psyche than an explicit confrontation with the "enemy."
Still nothing.
Could the treatment rooms be soundproofed?
Finally, the answer comes for these sounds of silence, and it is presented in the smiling form of Dr. Kapusianyk who calmly explains the reason is clearly stated on the front door of his surgery-Minoru Laser Dental.

You see, Kapusianyk has seen the light-laser light, that is-and for the most part that has allowed him to put aside his drill and adopt a virtually pain-free way of treating patients without traditional drilling, and the sometimes even more painful course of freezing injections that precede.

"A good percentage of patients are reluctant to visit their dentists," he says. "I just want to change the way people feel about going to see their dentist."

Kapusianyk has been practicing dentistry for more than 20 years and believes that one day all dentists will offer a laser option. So far, he is one of a handful in the Lower Mainland with the equipment, which goes under the brand name Waterlase.

Kapusianyk explains that unlike conventional drills that require physical contact with the tooth's surface during drilling, the Waterlase system emits a ruby-coloured laser light from the tip of a traditional-looking hand held drill while a small stream of water flows past the tip.

"What the laser does is agitate the water molecules to the point where they travel at the speed of sound and strip away minute layers of the material it is directed towards," Kapusianyk says.
In this application, tooth enamel, the hardest substance in the human body, is "shaved" away, and most patients do not feel any discomfort. Gone is the awful whine of the drill, replaced by the rhythmic tapping of the laser as it transfers energy to the water.

Since there is no actual contact with the tooth, except for the water molecules, there is none of the vibration or heat build up associated with a regular drill. And therefore no anesthetic is required.
"Most patients feel nothing," Kapusianyk says, adding individual cases can differ, but an overwhelming number of those who have tried the space aged technique rave about the results.
"They don't experience pain, don't have a numb lip, and can go and eat their lunch right afterwards."

Plus, the laser procedure results in a cleaner surface for a filling to adhere.
"Think of it like sawdust being left behind when you use a drill," Kapusianyk says. "The laser strips away small layers without leaving any debris that could prevent a clean, bondable area."
Always on the lookout for innovations in the industry, Kapusianyk said he "lucked out" when it came to discovering the Waterlase system.

He was attending a lecture on the use of microscopes last December when the speaker mentioned to him the benefits of the laser in virtually pain-free dentistry.
With his curiosity piqued, Kapusianyk did some research on the Waterlase product and travelled to San Diego to learn more at a dentistry conference.

He was so impressed by the results other dentists were getting from the equipment he ordered one of the $75,000 units and started offering it to his patients in January. Since then he has performed 700 fillings with the device, numerous root canals, and even a crown.
He has also used it to help heal the sockets left behind after extracting teeth.
Kapusianyk uses two other laser devices in his surgery, one that can check for cavities in teeth, and another that works on healing gums.

Kapusianyk says there are still some procedures when the good old fashioned drill still is preferable, such as tooth polishing, which requires a degree of friction. 

Mark Patrick Photo