Dr Jason Pang talks dental lasers

Estimated reading time: 7 minutes

An enthusiastic user of dental lasers in his practice, Dr Jason Pang is also a teacher and advocate of this cutting-edge technology. By Frank Leggett

Advances in laser technology are happening at an astonishing rate. Recent applications have seen the use of lasers expanded to include photobiomodulation. Here, lasers are used to speed up healing, reduce pain and decrease inflammation after surgery. Another promising area is using lasers to treat the microbiome. This type of laser therapy can positively affect people’s overall systemic health.

For Dr Jason Pang, dentistry and lasers go hand in hand. His practice, located in the Sydney suburb of Neutral Bay, is called Cosmic Smile Laser Dental. His tool of choice is the LightWalker ATS, an Er:YAG and Nd:YAG laser made by Fotona. 

The LightWalker allows him to provide a wide range of restorative dentistry with little or no anaesthetic along with single visit root canals. He can even use it to treat snoring.

“It’s twice as effective being two lasers in one,” says Dr Pang. “The Erbium provides shallow cutting and cold cuts teeth. The Nd:YAG is designed to penetrate deeper and to target coloured chromophores such as haemoglobin and melanin. It cuts and coagulates beautifully.” 

Learning the ropes

Since the Fotona company is Slovenian-based, Dr Pang travelled to Ljubljana in 2016 to undertake a master’s course in laser dentistry at their Laser and Health Academy. He was among the first cohort to complete the course.

“The LightWalker is unique in that the duration of the pulse can be modified,” says Dr Pang. “A short pulse allows for very cold cutting that won’t set off the nerve of the tooth. Longer pulses distribute heat into the soft tissue and provide more coagulation. To have such a wide range of cutting options is incredible and has applications for many procedures.”

After completing this training, Dr Pang followed it up with a masters in laser dentistry at the Catholic University of the Sacred Heart Rome in 2019. In June of 2022, he returned to Rome to teach the course. Dr Pang also teaches a LightWalker training program for novices in his practice.

“I have local and international dentists and doctors visiting to do the course,” he says. 

Additionally, he teaches two modules of the Laser and Health Academy master’s course in Canberra. The course can be accessed online and includes the photobiomodulation module, focusing on treatment for snoring. “The other module is a hands-on overview of everything laser,” he adds.

Early adopter

When Dr Pang graduated in 2002 from the University of Sydney, laser dentistry was still in its infancy. He worked with his dentist father, Dr Henry Pang, for a few years and purchased his own practice in 2007. The original owner had joined a practice down the road with the intention of increasing the turnover and then selling to a corporate. Dr Pang started his business with one chair and the existing fit-out. He digitised the practice, added a couple more chairs and began the process of building up client numbers. 

“It was fairly slow, especially as we are located on the second floor of a commercial building with no passing foot traffic,” he recalls. “I had to aggressively market my practice. I advertised in newspapers and in nearby businesses. Local hairdressers and GPs had TV screens in their waiting areas and I would place ads on them. I joined the Exceptional Practitioners Group that provided information about the business side of dentistry, rather than the clinical side, and learned a lot that way. Slowly, I built up client numbers.”

It wasn’t until 2009 that Dr Pang purchased his first laser. This tool, which would eventually become an essential part of his dentistry, initially left him pretty underwhelmed. While the marketing promised the world—closed-flap crown lengthening, easy preparation of teeth, painless soft tissue cutting, no sensitivity, no anaesthetic—the reality was very different.

“I used it for a year and it was okay, just very under-powered,” he says. “Despite my best efforts, I still had to use anaesthetics for my patients. It was good for soft tissue cutting but pretty average for cutting bone. I used it with small fillings but it just couldn’t do everything I wanted it to do. The problem was that the technology was new and didn’t live up to expectations.”

All that changed in 2015 with his purchase of the highly effective LightWalker laser. Dr Pang considered it such a paradigm shift that he rebranded his practice as Cosmic Smile Laser Dental.

Technology today

These days, the technology has advanced to the point where a laser is the most multi-functional tool in the dentist’s armoury. At the same time, drills still have a central role in the quick and efficient preparation of teeth. Even if a filling is completely done using a laser, a drill and bur is still required for reshaping and for adjusting the occlusion. The laser’s strength is in all the other procedures it can undertake.

“A laser can be used for crown lengthening, gummy smiles, uncovering implants, tongue ties, mucoceles, fibromas, hemangiomas, gingival pigmentation, pulp capping and more,” says Dr Pang. “It’s fantastic for needle-phobic patients as it allows you to treat them without anaesthetic. I can pop off veneers and remove crowns without damaging them. Prosthodontists send me cases when they need multiple crowns removed as I can do it in a fraction of the time it takes them.”

Expanding applications

One area where Dr Pang has been seeing very positive results is photobiomodulation. It can be used to treat conditions as diverse as burning mouth syndrome, cold sores, trigeminal neuralgia and to ease TMJ soreness after long root canals.

“Dentists use photobiomodulation around the mouth and head but doctors can use it in all areas of the body,” says Dr Pang. “It’s the recommended treatment for management of oral mucositis, one of the painful side-effects of chemotherapy and radiotherapy. It works really well on herpes simplex, shingles, facial palsies and viruses that affect the nerves. It’s an amazing technology that taps into the body’s ability to heal itself.”

Another surprising area where Dr Pang has had good results with a laser is in the treatment of snoring. While it’s still unproven if it can improve sleep apnoea, he has seen some improvements in that area as well.

“I use a laser to do a heat treatment at the back of the throat,” he says. “There’s a long-term positive effect, which is collagen production, but there’s also some tissue shrinkage and tightening. 

Essential tool

Dr Pang’s plans for the future include presenting more training sessions on laser use and exploring how laser therapy can help with preventive procedures. Treating the microbiome with lasers has incredible potential.

As he says, “We know the microbiome is involved with cardiovascular disease, diabetes, pregnancy and has a strong correlation with rheumatoid arthritis, Alzheimer’s, Parkinson’s, depression and a lot of chronic inflammatory diseases. The physical benefits for this type of therapy are very exciting.”

From a purely dental perspective, lasers can be effectively used with various procedures, saving time and reducing the need for anaesthetics. Any dentist contemplating adding a laser to their practice may undertake Dr Pang’s one-day course that explains the full range of soft tissue and hard tissue options. From completing root canals in a single visit to providing almost painless frenectomies, there’s much to be explored with this cutting-edge technology.

“At my course, I explain why this tool is so versatile and how to use it in a variety of situations,” says Dr Pang. “I train endodontists, paediatric dentists and dental surgeons. The professional who gets the most out of it, however, is the general dentist due to the range of procedures they undertake on a daily basis.”