CO2 v. Diode in Soft Tissue Surgery

I’ll admit it - my dental training didn’t teach me much about lasers. But when your school says you’re certified in something, you trust that, right?

Turns out, there was a lot I didn’t know. The past year has been humbling and eye-opening.

Let’s Talk Lasers (In Human Terms)

In the simplest sense, a laser is a beam of focused light – made possible by some seriously cool physics. When we talk about surgical lasers, we mean a beam of light that can cut soft tissue.

Two types of lasers often mentioned in frenectomy procedures are:

• Diode laser (~1 µm wavelength)

• CO₂ laser (~10 µm wavelength)

I won’t go deep into the physics (I’m still learning too), but here’s what you need to know:

They Don’t Work the Same

💧 CO₂ lasers are absorbed by water and ignore blood. Since our soft tissue is mostly water, CO₂ lasers make a clean cut with very little collateral damage.

🩸 Diode lasers, on the other hand, are absorbed by blood – not water. This makes them great for coagulation (stopping bleeding), but not for cutting.

So how do people use diode lasers for surgery?

The Diode Trick: It’s Not Really a Laser Cut

The diode laser beam travels through a tiny glass fiber. But here’s the kicker: the tip of the fiber is blackened with ink - intentionally.

Why? To stop the laser light from coming out. Instead, the black tip absorbs the light, heats up (to over 1000°F!), and burns through tissue.

That’s not a laser cut. That’s a hot glass knife.

So technically, when using a diode for cutting, you’re not doing laser surgery. You're doing cautery - using heat to burn and cut tissue.

I’ve Been There Too

I used to use a diode for frenectomies. I had solid training, and I used it well. But I now realize I was misled about what that tool actually was.

Diode tools come with too much unnecessary heat damage for this type of procedure. Especially for babies and young children, that matters.

The Bottom Line

If you want soft tissue surgery done with a true laser - choose a CO₂.

If you want soft tissue surgery done with a hot-tip cautery tool - choose a diode.

Knowing the difference matters.