Ep. 749 - Why Every GP and Hygienist Should Be Using a Dental Laser

Your practice already owns a laser — so why is it sitting in a closet collecting dust?

Dr. Robert Convissar is a pioneer in dental laser technology and one of the foremost authorities on clinical laser application worldwide. One of the first general dentists to incorporate lasers into everyday practice — beginning in 1989 — he brings over four decades of hands-on experience with CO2, diode, Nd:YAG, and erbium wavelengths. He serves as Director of Laser Dentistry at New York Hospital Medical Center of Queens, has authored four textbooks including the landmark Principles and Practice of Laser Dentistry (now in its third edition, with a foreword by Gordon Christensen), and has published more than a dozen peer-reviewed papers translated into eight languages. His clinical work has been featured on NBC-TV News, CBS-TV News, and the WABC Radio Network.

In this conversation with Dr. Phil Klein, Dr. Convissar makes the case that the single greatest barrier to laser adoption is not cost — it is the near-universal absence of adequate training. Drawing on decades of lecturing worldwide and fielding daily follow-up questions from course alumni, he explains precisely why CO2 is the wavelength of choice for non-surgical laser periodontal therapy, what the ADA and AAP clinical practice guidelines actually say about wavelength selection, and why most dentists who shelve their lasers were set up to fail from the moment of purchase. The episode is a thorough, evidence-grounded walkthrough of how to integrate non-surgical laser periotherapy into a general practice workflow — clinically, financially, and operationally. Beyond periodontics, Dr. Convissar also covers the laser's role in gingival troughing, soft tissue biopsy, peri-implantitis, clear aligner adjunct procedures, and residual ridge management.

Episode Highlights:

• Why the ADA and AAP clinical practice guidelines explicitly exclude diode, Nd:YAG, and erbium wavelengths from non-surgical periodontal pocket therapy — and why CO2's preferential absorption by sulcular epithelium makes it the evidence-supported standard of care for pocket decontamination after SRP.
• The critical sequencing protocol: laser non-surgical periotherapy is always performed after a full course of quadrant scaling and root planing, followed by a two-week reevaluation period — never concurrent — and why deviating from this protocol predictably leads to treatment failure.
• Patient selection criteria for laser periotherapy: why poorly controlled diabetics, heavy smokers, and immunocompromised patients require modified expectations rather than exclusion, and why six millimeters is the evidence-based pocket depth threshold beyond which surgical referral is indicated (per Rella Christensen's landmark study).
• The revenue model for non-surgical laser periodontal therapy: because no ADA procedure code exists for this service, it is billed as a non-covered, out-of-pocket fee — with full-mouth treatment packages ranging from $5,000 to $10,000 in metro markets, substantially outpacing the reimbursement ceiling on D4341 quadrant SRP alone.
• What a defensible laser training program must include: a minimum two-day format, exposure to at least two wavelengths from at least two manufacturers, hands-on completion of no fewer than a dozen procedures on pig mandibles (including frenetomy, gingivectomy, soft tissue crown lengthening, periocpocket decontamination, and biopsy), and a 75-question multiple choice examination — and why company-sponsored seminars do not meet this standard.

Perfect for: general dentists considering laser adoption or looking to move an underused device off the shelf, dental hygienists in laser-permitted states exploring non-surgical periotherapy, and any clinician interested in expanding their perio protocol with a revenue-generating, evidence-backed adjunct.

If you have been waiting for a clear, no-hype framework for integrating laser dentistry into your practice — from clinical rationale to patient conversation to ROI — this is the episode to bookmark.