Integrating CO₂ lasers in dental education: Addressing safety, compliance, and curriculum

CO2 all-tissue lasers offer advanced technology for dental procedures, allowing minimally invasive techniques, reduced bleeding, faster healing, and less discomfort.1, 2 However, integrating this technology into a dental school presents challenges, particularly regarding regulatory compliance, safety, curriculum development, and faculty privileging.3, 4 The primary issue was the absence of an established framework for safely introducing laser technology in an academic setting.5 Ensuring faculty meet certification requirements adds complexity. The challenge is to introduce CO2 lasers in a way that adheres to safety regulations and prepares faculty and students for future clinical applications. The solution involves a three-phased approach focused on safety, policy development, faculty privileging, and preclinical curriculum design (Figure 1). Since clinical use of CO2 lasers is planned for later, the focus is initially on safety, faculty training/privileging, and preclinical education. Laser safety and compliance protocols must be established in accordance with institutional guidelines and ANSI standards (Phase 1). A designated laser workgroup, comprised of stakeholders—laser safety officer, clinic risk officer, facility management, faculty, clinic administration, and technology leadership—collaboratively developed protocols to establish safe operational environments. The protocols include faculty and staff laser safety certification, safety signage, and protective eyewear policy. Institutional policies are developed to define the roles and responsibilities for operating lasers, managing equipment, and documenting laser procedures, with faculty practice implementation completed concurrently to facilitate privileging. A preclinical curriculum was designed to provide students with a solid foundation in CO2 laser technology (Phase 2). Developed by the laser workgroup and reviewed and approved by stakeholders—academic leadership, the curriculum committee, and the university office of the registrar— this curriculum ensures alignment with institutional standards and educational goals. The curriculum was divided into two stages: theory and hands-on (Table 1). Didactically, students are taught the basic principles of laser physics, tissue interactions, and the mechanisms by which CO2 lasers operate. Emphasis was on safety protocols, wavelength-specific eye protection, tissue handling, and safe laser operation. Faculty-supervised hands-on training includes operating CO2 lasers on extracted teeth, pig jaws, and chicken breasts allowing students to familiarize themselves with laser settings, ergonomics, different laser-tissue interactions, and safe practices. Competency is achieved by successfully passing a written examination and hands-on assessment (Table 2). Clinical application of CO2 lasers is planned for future implementation once preclinical training is fully integrated (Phase 3), aiming to allow students to perform laser-assisted procedures clinically under faculty supervision. The implementation of CO2 lasers in the dental school curriculum yielded valuable lessons. This gradual integration of laser technology was instrumental in prioritizing safety throughout the process. However, faculty privileging presented significant challenges, as the process is time-consuming. Balancing the demands of faculty development with the introduction of new curriculum elements added implementation complexity. The development of safety policies and protocols proved time-intensive but essential for ensuring compliance with safety standards. Notably, faculty practice implementation was completed concurrently to facilitate privileging (Figure 2). Looking ahead, the College must focus on expanding laser availability for more frequent hands-on practice, addressing ongoing faculty training needs, and planning for future clinical implementation. The authors would like to acknowledge the support of the Ohio State University College of Dentistry Laser implementation team: Dr. Shereen S. Azer, Lisa Howard, Craig Ramsey, Dr. Elisandra Reyes-Perez, Dr. Stephanie Walker, Yvonne Young, and Tabatha Zutell. The authors declare no conflict of interest.