1

Einstein’s “Splendid Light”: Origins and

Dental Applications
JOHN G. SULEWSKI

Humankind’s fascination with the properties of light and described light as being composed of a stream of tiny par-
its applications in medicine can be traced to ancient times. ticles that travel in straight lines and bounce off objects
Developments in physics at the beginning of the twentieth that they strike.6 Pierre Gassendi, a French philosopher,
century laid the foundation for laser theory postulated by scientist, astronomer, and mathematician, described his
Albert Einstein, culminating in the invention of this special particle theory of light (published posthumously in 1658
form of light in 1960. Soon thereafter, researchers began to in Lyon, France, as part of the six volumes of his collected
explore possible applications of laser technology in medical works, the Opera Omnia), in effect introducing to Euro-
and dental treatment. pean scholars the atomism view of the universe identified
The medicinal use of light for diagnostic and therapeutic by the ancient Greek philosopher Epicurus (341-270 bce)7
purposes dates from antiquity. Light allowed early physi- (Figure 1-1).
cians to observe skin color, inspect wounds, and choose a Gassendi’s work influenced English physicist Sir Isaac
suitable therapeutic course of action. Heat from sunlight or Newton (1642-1727), who described light as “corpuscles”
campfires was used for therapy. Greeks and Romans took or particles of matter that “were emitted in all directions
daily sunbaths, and the solarium was a feature of many from a source”8,9 (Figure 1-2). Newton proposed the theory
Roman houses.1 Ancient Egyptians, Chinese, and Indians of particle dynamics, which later would be developed to
used light to treat rickets, psoriasis, skin cancer, and even describe the behavior of particles reacting to the influence
psychosis.2 of arbitrary forces.10 The particle view of light differed from
The ancient Egyptians, Indians, and Greeks also used that of French philosopher and scientist René Descartes,
natural sunlight to repigment affected skin in patients with who in his 1637 Discourse saw light as a type of “pressure,”
vitiligo by activating the naturally occurring photosensitizer which foreshadowed the postulation of the wave theory of
psoralen, found in parsley and other plants.3-5 In the eigh- light11 (Figure 1-3).
teenth and nineteenth centuries, European physicians used In 1665, English scientist Robert Hooke suggested his
sunlight and artificial light to treat cutaneous tuberculosis, wave theory of light, likening the spread of light vibrations
psoriasis, eczema, and mycosis fungoides.3 These and other
applications of light were precursors to the invention and
subsequent use of optical amplifier devices that generate a
special form of light—lasers—in the medical field over the
past several decades.
This chapter examines the efforts of select laser pioneers
in dentistry and summarizes current intraoral clinical appli-
cations of lasers.

Early Published Theories of Light

Philosophers and scientists long pondered the nature of
light: Was it composed of particles, waves, pressure, or some
other substance or force?
In his Book of Optics, published in 1021, Persian math-
ematician, scientist, and philosopher Ibn al-Haytham • Figure 1-1  Greek philosopher Epicurus (341-270 bce).

1
2 CHA P T E R 1  Einstein’s “Splendid Light”: Origins and Dental Applications

A B
• Figure 1-2  A, Sir Isaac Newton (1642-1727). B, Title page from Newton’s work Opticks, 1704.

to that of waves in water: “every pulse or vitration of the

luminous body will generate a sphere, which will contin-
ually increase, and grow bigger, just after the same man-
ner (though infinitely swifter) as the waves or rings on the
surface of the water do swell into bigger and bigger circles
about a point.”12 The wave concept subsequently was proved
experimentally by Scottish physicist James Clerk Maxwell,
who in 1865 proposed an electromagnetic wave theory of
light and demonstrated that electromagnetic waves traveled
at precisely the speed of light.13

Development of Quantum Theory

The previous theories, useful as they might have been before
1900, did not entirely or satisfactorily describe the charac-
teristics of light observed by the scientific community: Light
behaved as particles in some cases and as waves in others.
This context of inquiry led to the field of quantum theory.
On December 14, 1900, German physicist Max Planck
delivered a lecture before the German Physical Society
(Deutsche Physikalische Gesellschaft) in which he theo-
rized that light consisted of discrete and indivisible pack-
ets of radiant energy that he named quanta. He described
what eventually became known as the elemental unit of
energy (E), as E = hv, where h is a constant of nature with
the dimension of action (= energy × time, with a value of
6.626 × 10−34 joule-second), subsequently called Planck’s
• Figure 1-3  René Descartes (1596-1650). constant, and v is the frequency of radiation. Planck’s theory
was published late in 1900.14-16 Eleven years later, British
physicist Ernest Rutherford contributed to quantum theory
 CHAPTER 1  Einstein’s “Splendid Light”: Origins and Dental Applications 3

when he postulated a planetary model of the atom based paper on photoelectric effect was the first that Einstein pub-
on his experimental observations of the scattering of alpha lished during his annus mirabilis (“extraordinary year”), in
particles by atoms. In his view an atom comprises a central the scientific journal Annalen der Physik in 1905; his other
charge surrounded by a distribution of electrons orbiting papers that year treated Brownian motion, special theory
within a sphere.17 of relativity, and matter and energy equivalence (E = mc2).
Danish physicist Niels Bohr synthesized Rutherford’s Notably, Einstein himself regarded his light quantum paper
atom model with Planck’s quantum hypothesis (Figure 1-4). as the “most revolutionary” of those that he had published
In a series of papers published in 1913, Bohr proposed a in 1905. He was awarded the 1921 Nobel Prize in physics
theory in which electrons revolve in specific orbits around a for this paper. Hallmark and Horn22 stated that Einstein’s
nucleus without emitting radiant energy. He described the light quantum theory was so radical in comparison with
stable, “ground state” of an atom, when all of its electrons other contemporary theories of light that it was not gener-
are at their lowest energy level. Bohr also theorized that an ally accepted until American physicist Robert A. Millikan
electron may suddenly jump from one specific orbital level performed additional experiments in 1916 to support the
to a higher level; to do so, an electron must gain energy. theory.
Conversely, an electron must lose energy to move from a Einstein’s 1905 paper made the case for the particle nature
higher energy level to a lower energy level. Thus an electron of light. In 1909, Einstein made his second significant con-
can move from one energy level to another by either absorb- tribution to laser theory by publishing the first reference in
ing or emitting radiant energy or light.18,19 physics to the wave-particle duality of light radiation, using
It was in this burgeoning milieu of nascent quantum Planck’s radiation law. Einstein stated: “It is my opinion
theory that Albert Einstein made three significant contribu- that the next phase in the development of theoretical phys-
tions. First, in 1905, Einstein developed his light quantum ics will bring us a theory of light which can be interpreted as
theory: “In the propagation of a light ray emitted from a a kind of fusion of the wave and emission theory. … Wave
point source, the energy is not distributed continuously structure and quantum structure … are not to be consid-
over ever-increasing volumes of space, but consists of a ered as mutually incompatible. … We will have to modify
finite number of energy quanta localized at points of space our current theories, not to abandon them completely.”21,23
that move without dividing, and can be absorbed or gen- British mathematician and physicist Banesh Hoffmann fan-
erated as complete units.”20 Singh21 points out that this cifully characterized the quandary for many early twentieth-­
century physicists regarding the apparent wave-particle
duality of light: “They could but make the best of it, and
went around with woebegone faces sadly complaining that
on Mondays, Wednesdays, and Fridays they must look on
light as a wave; on Tuesdays, Thursdays, and Saturdays, as a
particle. On Sundays they simply prayed.” 24
In 1916-1917, Einstein made his third important con-
tribution to laser theory by providing a new derivation of
Planck’s radiation law,25-27 with vast implications. As he
wrote to his friend Michele Angelo Besso in 1916, “A splen-
did light has dawned on me about the absorption and emis-
sion of radiation.”21 Indeed, his new idea provided the basis
for subsequent laser development.
Based on quantum theory, two fundamental radiation
processes associated with light and matter were known
before Einstein’s new derivation: (1) stimulated absorption,
a process in which an atom can be excited to a higher energy
state through such means as heating, light interaction, or
particle interaction; and (2) spontaneous emission, the process
of an excited atom decaying to a lower energy state spon-
taneously, by itself. Einstein’s breakthrough was the addi-
tion of a third alternative: stimulated emission, the reverse of
the stimulated absorption process. In the presence of other
incoming radiation of the same frequency, excited atoms are
stimulated to make a transition to the lower energy state—
more quickly than in spontaneous emission—and in the
process release light energy identical to the incoming form
of light. The emitted light has the same frequency and is in
phase (i.e., coherent) with the stimulating radiation wave.
• Figure 1-4  Niels Bohr and Albert Einstein in 1925. Stimulated emission occurs when there are more excited
4 CHA P T E R 1  Einstein’s “Splendid Light”: Origins and Dental Applications

atoms than atoms that are not excited (i.e., more atoms in near a transition where the gas absorbed and emitted
upper of two energy levels than in lower level), a condition light. This was the first evidence that stimulated emission
called population inversion. Einstein also showed that the existed.35,37 In his 1939 doctoral dissertation, Soviet physi-
process of stimulated emission occurs with the same proba- cist Valentin A. Fabrikant had envisioned a way to produce
bility as for absorption from the lower state.28-31 Hey et al.32 a population inversion, writing that “such a ratio of popula-
summarized the significance of Einstein’s insight as follows: tions is in principle attainable. … Under such conditions we
would obtain a radiation output greater than the incident
For over 35 years this stimulated emission process gained
hardly more than a cursory comment in quantum mechan-
radiation.”35,36,38
ics textbooks, since it seemed to have no practical application. Nevertheless, the works of Ladenburg and that of Fabri-
What had been overlooked, however, was the special nature kant were isolated incidents. Another impediment to laser
of the light that is emitted in this way. The photons that are development after Einstein was two world wars, although
emitted have exactly the same phase as the photons that induce World War II then actually accelerated research toward laser
the transition. This is because the varying electric fields of the development. Efforts of physicists were diverted from per-
applied light wave cause the charge distribution of the excited forming fundamental research to helping propel technology
atom to oscillate in phase with this radiation. The emitted pho- that would help win the war. Afterward, the sophisticated
tons are all in phase—they are coherent—and, furthermore, equipment developed for the war effort became military
they travel in the same direction as the inducing photon. surplus, and physicists accustomed to low budgets received
At this point, it should be clarified that the term photon some of this equipment as they resumed their research.
was not used by Planck, Bohr, or Einstein up to the time
of Einstein’s 1916-1917 papers. American chemist Gilbert Masers and Lasers
Lewis33 apparently was the first to use the term when he
argued, in a letter to the editor of Nature magazine in 1926, The impact of the wartime research focus on laser devel-
for the need for new nomenclature to describe discrete units opment is exemplified by the work of American physicist
of radiant energy: Charles H. Townes at Bell Telephone Laboratories in Man-
hattan and later at Columbia University, which he joined
It would seem inappropriate to speak of one of these hypo-
thetical entities as a particle of light, a corpuscle of light, a light
in 1948 (Figure 1-5). In 1941, Townes was assigned to
quantum, or a light quant, if we are to assume that it spends work on a military radar project. Modern radar, a system of
only a minute fraction of its existence as a carrier of radiant using transmitted and reflected radio waves for detecting a
energy, while the rest of the time it remains as an important reflected object to determine its direction, distance, height,
structural element within the atom. It would also cause confu- or speed, was developed in the 1930s, when systems used
sion to call it merely a quantum, for later it will be necessary to radio waves about a meter long and could not discern much
distinguish between the number of these entities present in an detail. During the war, the military was interested in devel-
atom and the so-called quantum number. I therefore take the oping a radar system that used much higher radio frequen-
liberty of proposing for this hypothetical new atom, which is cies to attain greater sensitivity, tighter radio beams, and
not light, but plays an essential part in every process of radia- transmitting antennas small enough to fit on an airplane.
tion, the name photon.
Townes began working on microwave frequencies of 3, 10,
The following accepted definition appears in the Ameri- and 24 gigahertz (GHz).35 Although none of these systems
can Heritage Dictionary34: was used in battle, Townes’ experience with the 24-GHz sys-
tem, interest in microwave spectroscopy, and use of surplus
photon n. Physics. The quantum of electromagnetic energy,
regarded as a discrete particle having zero mass, no electric
equipment guided him toward subsequent development.
charge, and an indefinitely long lifetime. In 1951, at the spring meeting of the American Physical
Society in Washington, D.C., Townes proposed the con-
Decades followed Einstein’s 1916-1917 articles on stim- cept of a maser, an acronym he and his students coined for
ulated emission before significant progress was made in microwave amplification by stimulated emission of radia-
laser development, both theoretically and practically, in the tion. He indicated that the “primary object of the work that
1950s and 1960s, partly because of the outlook and training led to the maser was to get shorter wavelengths so we could
of physicists at that time, as suggested by American physicist do better spectroscopy in a new spectral region.”39 Townes
Arthur L. Schawlow and later observers. Schooled in the elaborated on April 26, 1951: “I sketched out and calculated
idea that “thermodynamic equilibrium,” a state of energy requirements for a molecular-beam system to separate high-
balance, was the normal condition of matter throughout the energy molecules from lower [-energy] ones and send them
universe, these scientists tended to believe that population through a cavity which would contain the electromagnetic
inversion was merely an unusual event or brief permutation, radiation [photons] to stimulate further emission from the
not something particularly significant.35,36 molecules, thus providing feedback and continuous oscilla-
However, the 1920s and 1930s were not entirely bereft tion.”40 On May 11, Townes sketched the idea in his labora-
of discovery and insight. In 1928, German physicist Rudolf tory notebook, dated it, and signed it “Chas. H. Townes.”
Ladenburg indirectly observed stimulated emission while In February 1952, his colleague and brother-in-law Arthur
studying the optical properties of neon gas at wavelengths L. Schawlow also signed the page.35,36
 CHAPTER 1  Einstein’s “Splendid Light”: Origins and Dental Applications 5

They subsequently published their influential paper in Phys-

ical Review in 1958.42
Meanwhile, another American physicist, Gordon Gould,
a Columbia graduate student in 1957, asked whether opti-
cal pumping could excite light emission. He recorded his
ideas in nine handwritten pages of a laboratory notebook,
with the first page titled “Some rough calculations on the
feasibility of a LASER: Light Amplification by Stimulated
Emission of Radiation”—the first time the term laser was
used. Gould had his notes notarized on November 13,
1957, which he saw as a necessary step in applying for a pat-
ent. His patent defense efforts were finally recognized after
30 years of delays, challenges, and litigation.35,39,43
The Schawlow and Townes paper stirred a number of
organizations to conduct additional research into optical
masers as follows35:
• In September 1958, Townes and Columbia University
received funding from the U.S. Air Force Office of Sci-
entific Research to pursue investigation of a potassium-
vapor laser.
• Schawlow began to work with crystals (including syn-
thetic pink ruby, composed of aluminum oxide doped
with chromium atoms) at Bell Labs, which was inter-
ested in developing the technology to expand the trans-
mission capacity of Bell’s communications network.
• Ali Javan and William R. Bennett, Jr., also at Bell,
• Figure 1-5  Charles H. Townes with a ruby microwave maser ampli- worked on employing an electrical discharge tube filled
fier developed for radio astronomy in 1957. (Courtesy Alcatel-Lucent with helium and neon gas.
USA.)
• Gould had joined the Technical Research Group (TRG)
in Manhattan, a military contractor that secured fund-
On his return to Columbia University after the April ing from the Pentagon to research the potential military
1951 conference, Townes and postdoctoral fellow Herbert applications of a laser, including communications, mark-
J. Zeiger and doctoral student James P. Gordon commenced ing targets for weapons, and measuring the range to tar-
work on building a maser. They began to experiment with gets. Gould’s group explored the potential of a laser using
a beam of ammonia molecules, a compound familiar to alkali metal vapors.
Townes from his work on the 24-GHz radar system. It was • Westinghouse Research Laboratories in Pittsburgh had
known that ammonia molecules absorb microwaves at a fre- an Air Force contract to examine solid-state microwave
quency of 24 GHz, causing the nitrogen atom of that mol- masers. Irwin Wieder and Bruce McAvoy explored the
ecule to vibrate. Initial success was achieved in late 1953, characteristics of ruby using bright tungsten lamps and
when Gordon saw evidence of stimulated emission and (unsuccessfully) pulsed light sources.
amplification from their device; then, in early April 1954, • IBM entered the laser race with Peter Sorokin and Mirek
they achieved the desired oscillation.35 They reported their Stevenson at the T.J. Watson Research Center in York-
success in a late paper presented at a meeting of the Ameri- town Heights, N.Y.
can Physical Society on May 1 and then in a short paper Numerous other companies also had joined the quest
published in the journal Physical Review.41 for building the first laser, including aerospace company
While on sabbatical from Columbia University in 1955, Hughes Research Laboratories in California, which was
Townes worked with French physicist Alfred Kastler at the under a maser development contract with the U.S. Army
École Normale Supérieure in Paris. Kastler developed the Signal Corps. The Corps became interested in developing a
technique of “optical pumping,” a process by which light is more practical version of a previously developed ruby solid-
used to raise (or pump) electrons from a lower to a higher state microwave maser, one that could serve as a low-noise
energy level, as a new way to excite materials for microwave microwave amplifier aboard an airplane. American physicist
spectroscopy.35 Townes recognized that optical pumping Theodore H. Maiman, who joined Hughes in 1956, and
might excite the optical energy levels necessary for an optical his assistant, Irnee D’Haenens, were assigned to the proj-
maser. In fall 1957, Townes and Schawlow, a postdoctoral ect. Their task was daunting; the existing desk-size device
fellow under Townes at Columbia until he joined Bell Labs weighed 2.5 tons. They succeeded in developing a 4-pound
in 1951, proposed extending maser principles to the infra- version, but the continuing need to incorporate cryogenic
red and visible regions of the electromagnetic spectrum.36,39 cooling of the device limited its practicality.
6 CHA P T E R 1  Einstein’s “Splendid Light”: Origins and Dental Applications

Nevertheless, Maiman used this experience with • White and Rigden developed the 632.8-nm-wavelength
ruby in his later work on the laser. Some investigators, HeNe laser at Bell Labs in 1962.51
including Wieder at Westinghouse as well as Schawlow • Also in 1962, Rabinowitz, Jacobs, and Gould demon-
and others at Bell Labs, had dismissed ruby as an unsuit- strated the optically pumped cesium laser at TRG.52
ably inefficient laser material, but their calculations were • Further in 1962, Hall and colleagues of the General
based on inadequate data. Maiman conducted his own Electric Research Center (Schenectady, NY) developed
investigation and found that ruby could indeed be suit- a cryogenically cooled gallium-arsenide (GaAs) semicon-
able, provided that it could be optically pumped with an ductor laser.53
intensely bright light source. His calculations showed that •  The year 1964 marked the demonstration of the
a pulsed flashlamp would provide enough light to excite neodymium-doped yttrium-aluminum-garnet (Nd:YAG)
a ruby laser. His experimental laser design ultimately was laser by Geusic, Marcos, and van Uitert at Bell Labs.54
elegant, incorporated in a device that could fit in the palm • Patel developed the carbon dioxide (CO2) laser at Bell
of the hand: a ruby rod 1 cm in diameter and 2 cm long Labs in 1964.55
placed within the coils of a small flashlamp, and an alumi- • Also in 1964, Bridges of Hughes Research Laboratories
num cylinder with reflective interior surface that slipped developed the argon ion laser.56
around the lamp to reflect light toward the ruby rod. • Silfvast and colleagues at the University of Utah con-
The ends of the rod were polished flat, perpendicular to ducted extensive research with metal-vapor lasers in the
the length of the rod and parallel to each other. Maiman mid-1960s.57
applied a reflective silver coating to both ends and then • Sorokin and Lankard developed the dye laser in the mid-
removed the silver from the center of one end, to allow 1960s.58,59
a transparent opening for the laser beam to escape and • Ewing and Brau of the Avco Everett Research Laboratory
subsequently be detected. The apparatus was connected (Everett, Massachusetts) were the first to demonstrate
to a separate power supply.35 three excimer lasers: krypton fluoride, xenon fluoride,
On May 16, 1960, Maiman and D’Haenens aimed the and xenon chloride lasers.60
laser cylinder toward a white poster board. They started fir- •  Madey of Stanford University demonstrated the free
ing the flashlamp with pulses of 500 volts (V), gradually electron laser on January 7, 1975.61
increasing the voltage to produce progressively more intense • Schawlow and one of his students even concocted a Jello-
light flashes, and measured the laser’s output tracing on an O laser by firing a ruby laser into a bowl of Jell-O doped
oscilloscope. Finally, with the power supply set above 950 V, with the organic dye rhodamine 6G.35,39
the oscilloscope’s trace surged, a red glow filled the room, During a July 7, 1960, press conference announcing his
and a brilliant red spot appeared on the poster board. After accomplishment, Maiman identified five potential uses for
9 months of intense effort, Maiman accomplished his goal, the laser:
and the laser was born. In so doing, he beat out Bell Labs, 1. The first true amplification of light
TRG, Westinghouse, IBM, Siemens, RCA Labs, Massachu- 2. A tool to probe matter for basic research
setts Institute of Technology’s Lincoln Laboratory, General 3. High-power beams for space communications
Electric, and all others in contention.35,36,39,44 Maiman sub- 4. Increasing the number of available communication
mitted a paper reporting his evidence for a ruby laser to channels
Physical Review Letters, the leading U.S. journal for pub- 5. Concentrating light for industry, chemistry, and medicine
lishing new physics research. Its editor, Samuel Goudsmit, The accuracy of his insight was affirmed in subsequent
rejected the manuscript, apparently not appreciating the discoveries and applications; only his third prediction has
breakthrough Maiman had achieved, perhaps mistakenly not been put into regular use.35 A few years later, when
believing it was just a follow-up to previously published commenting on the outlook for medical applications
work on masers. Maiman then submitted his report to the of the laser, Maiman foresaw the use of the device as a
British weekly journal Nature, which accepted it immedi- “bloodless” surgical tool, in the treatment of malignancies,
ately and published it on August 6, 1960.45,46 and as a dentist’s drill.62 He cited the interconnection of
Other laser types followed36,39,46: blood vessels to relieve arterial blockage as one example of
• Sorokin and Stevenson demonstrated the solid-state ura- successful experimentation. He also discussed microsurgi-
nium laser in November 1960.47 cal laser equipment capable of destroying individual red
• Javan, Bennett, and Herriott demonstrated the first gas blood cells, as well as a laser destroying single genes and
laser, a helium-neon (HeNe) laser emitting at 1.15 μm, other tiny masses, with practically no effect on surround-
in December 1960 at Bell’s Murray Hill, New Jersey, ing tissue.63
laboratory.48
• In 1961, Johnson and Nassau at Bell Labs demonstrated Lasers In Dentistry and Oral Surgery
a 1.06-μm laser from neodymium (Nd) ions in a host
crystal of calcium tungstate.49 Soon after his invention was demonstrated, researchers
• Also in 1961, Snitzer of American Optical (Southbridge, began to examine Maiman’s vision of the laser as a useful
Massachusetts) built an Nd laser in optical glass. 50 instrument for medicine. Their efforts laid the foundation
 CHAPTER 1  Einstein’s “Splendid Light”: Origins and Dental Applications 7

for the present clinical use of lasers in ophthalmology, neu- dentists, we feel that this is a profitable area for research, espe-
rosurgery, urology, gynecology, gastroenterology, general cially in the treatment of caries and perhaps even of calculus.
surgery, cardiovascular surgery, orthopedics, esthetic/der- The dentist and especially dental histopathologist and electron
matologic/plastic surgery, otorhinolaryngology, oral surgery microscopist must work with the biologists and the physicians
and the engineers engaged in laser research. The purpose of this
and dentistry, and veterinary medicine. This section briefly
cooperative study is to develop flexible, effective and safe laser
outlines select pioneering efforts in the application of laser instrumentation needed for laser dentistry. Dentists should be
technology to dentistry and oral surgery and then summa- active in this program, not wait until other disciplines do the
rizes the types of lasers and current range of intraoral clinical work for them.
applications. (See also Chapter 2.)
To find new and effective methods of removing car- Almost 2 decades later, a dental practitioner heeded
ies, pioneering examinations into the interactions of ruby Dr. Goldman’s call to develop what became the first laser
laser energy with tooth structure were reported in the mid- designed specifically for general dentistry. Michigan den-
1960s.64-72 Investigators discovered that the ruby laser tist Dr. Terry D. Myers joined with his ophthalmologist
could vaporize caries, but that the high energy densities brother Dr. William D. Myers, himself among the first to
caused irreversible necrotic changes in pulpal tissues. Years incorporate a laser into his ophthalmic practice, in explor-
later, the development of erbium (Er) laser wavelengths ing the advances in lasers, electronics, and optics to produce
and CO2 lasers operating at 9300 and 9600 nm, better a device appropriate for the dental operatory. In contrast
suited to the clinical requirements for cavity preparation with a medical laser adapted for dental use, their instru-
without the detrimental effects on pulp, led to further ment would be designed for the specific needs of the dental
investigations.73-84 practitioner. It would feature an easy-to-use control panel
Early intraoral soft tissue investigations were conducted that selected safe and effective operational parameters for
using the ruby laser.71,85,86 The development of the CO2 the lasers’ numerous clinical indications. It would be por-
laser with its ability to ablate soft tissue with minimal hem- table, with a self-contained cooling system, requiring no
orrhage led to studies in oral surgery.87-99 Other groups of special electrical hookups, and would be simple to set up
workers followed up with soft tissue studies involving the and maintain. It would have built-in self-diagnostics, auto-
Nd:YAG laser.100-103 clavable or disposable components, and a flexible fiberoptic
Other researchers examined the photopolymerization delivery system to facilitate intraoral access and provide the
of dental composites104-109 with the argon laser, the pos- necessary tactile feedback to which dental professionals are
sible use of Nd:YAG lasers in the welding of prosthetic accustomed.
devices and gold alloys,107-110 and the application of vari- Currently, a number of laser wavelengths are used in
ous lasers in endodontics.111-113 An extensive survey of oral surgery and dentistry, including two CO2 wavelengths,
the published scientific research and clinical reports on Nd:YAG, argon, various diode wavelengths, two Er wave-
the use of lasers in dentistry discusses the first experimen- lengths, and potassium titanyl phosphate (KTP). Applica-
tal uses in 1964 through the numerous clinical applica- tions include the following117-121:
tions into 2000.114 • Soft tissue procedures: gingivectomy/gingivoplasty,
Otolaryngologists, oral surgeons, and periodontists uvulopalatoplasty, excision of tumors and other lesions,
were among the first practitioners to use medical lasers incision/excision biopsies, frenectomy, removal of
intraorally to perform a variety of soft tissue surgical hyperplastic/granulation tissue, second-stage recovery
applications. On May 3, 1990, the first laser designed of implants, guided tissue regeneration, and treatment
specifically for general dentistry, the dLase 300 Nd:YAG of periodontal disease, aphthous ulcers, herpetic lesions,
laser, developed by Myers and Myers, was introduced in leukoplakia, and verrucous carcinoma
the United States.115 This event marked the beginning • Control of bleeding in vascular lesions
of the clinical use of lasers by dentists—a development • Arthroscopic temporomandibular joint surgery
anticipated by a pioneer in laser surgery, Leon Goldman • Caries diagnosis and removal
(1905-1997). • Curing of composites
Goldman had been reporting on the biomedical • Activation of tooth-bleaching solutions
aspects of the laser since 1963 and had published find- • Caries diagnosis and removal
ings on the effect of the laser on dental caries, teeth, and • Root canal debridement and preparation
other tissues as part of his early research. Concerning the • Osteotomy and osseous crown lengthening
prospects of laser applications in dentistry, Goldman116 • Detection of subgingival dental calculus
wrote in 1967:
Although the possibilities of the development of laser dentistry
Many professional societies are dedicated to the use of
appear to us to be excellent, there has been too little interest lasers in medicine and dentistry (Table 1-1). All have inter-
in the clinical and applied phases of laser dentistry by den- national representation, and some have links to their compo-
tists and dental research groups. … These studies at present nent societies or country representatives. Affiliated selected
then indicate that a significant portion of the laser laboratory journals of interest to dentists who use lasers in their practice
should be devoted to the field of laser dentistry. Unlike many include the following and are listed in Table 1-2.
8 CHA P T E R 1  Einstein’s “Splendid Light”: Origins and Dental Applications

TABLE
1-1 Professional Societies Dedicated to the Use of Lasers in Medicine and Dentistry

Organization Web Address Year Formed

Academy of Laser Dentistry [Link] 1993
American Society for Laser Medicine and Surgery [Link] 1981
Deutsche Gesellschaft für Laserzahnheilkunde [Link] 1991
Japanese Society for Laser Dentistry [Link] 1989
Society for Oral Laser Applications [Link] ca. 2000
Laser Institute of America [Link] 1968
SPIE* (an international society for optics and photonics) [Link] 1955
World Association for Laser Therapy [Link] 1994
World Federation for Laser Dentistry [Link] 1988

*Originally founded as the “Society of Photographic Instrumentation Engineers.”

TABLE
1-2 Selected Journals of Interest to Dental Laser Practitioners

Years of
Journal Web Address Publication
International Journal of Laser Dentistry [Link]/eJournals 2011-present
Journal of Biomedical Optics [Link]/[Link] 1996-present
Journal of Dental Lasers [Link] 2007-present
Journal of Laser Applications [Link]/subscriptions/jla 1988-present
Journal of Laser Dentistry [Link] 1992-present
Journal of Oral Laser Applications [Link]/journals/jola/[Link]?journal_name=jola 2001-2010
Journal of the Japanese Society for Laser [Link]/browse/jjpnsoclaserdent 1990-present
Dentistry
Journal of the Laser and Health Academy [Link]/en/journal 2007-present
Laser International [Link]/epaper/issues/product/33 2010-present
Laser Journal [Link] 2003-present
Lasers in Medical Science [Link] 1986-present
Lasers in Surgery and Medicine [Link] 1980-present
Optical Engineering [Link] 1962-present
Photochemistry and Photobiology [Link] 1962-present
Photomedicine and Laser Surgery [Link] 1983-present
surgery/128
Zeitschrift für Laser Zahnheilkunde [Link] 2004-2008

Conclusions laser wavelengths and clinical applications as they apply to

dentistry, extending the vision of Maiman and other pio-
Fifty years after their initial experimental use in dentistry, neers. The growing number of dental laser practitioners,
and almost 25 years after their practical introduction into propelled by the increasing body of evidence concerning the
the dental operatory, lasers are becoming more common- safe, effective, and appropriate use of lasers in dentistry, will
place and even routine, either as adjunctive treatment continue to advance the application of Einstein’s “splendid
methodologies or as stand-alone additions to the dental light” in their operatories, to the benefit of patient and prac-
armamentarium. Researchers continue to investigate new titioner alike.
 CHAPTER 1  Einstein’s “Splendid Light”: Origins and Dental Applications 9

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