One of the most important components of all laser education courses is laser safety education, compliant with the American National Standards Institute (ANSI) standards, ANSI Z136.1 "Safe Use of Lasers" (2014) and ANSI Z136.3 "Safe Use of Lasers in Health Care Facilities" (2014). Understanding and adhering to these guidelines will keep both patients and practitioners safe when lasers are used in the dental practice. Compliance with these regulations is extremely important but does not have to be complicated. Compliance can be broken down into four simple steps, so ANSI standards for laser safety can be implemented easily in every dental practice.
ANSI sets the general and clinical standards that define the requirements for the safe use of all types of lasers (Z136.1) and the safe use of lasers specific to health-care facilities (Z136.3). The Laser Institute of America (LIA) serves as the secretariat for the ANSI Laser Safety Committee and publishes the required laser standards and documents. Although ANSI provides laser safety recommendations, it does not have any regulatory powers to enforce these guidelines. The Occupational Safety and Health Administration (OSHA), however, has general authority to regulate workplace safety, and it relies on the recommendations described in ANSI Z136.1 and ANSI Z136.3. The objective of the standards is to provide reasonable and adequate guidance for the safe use of lasers in general and the safe use of lasers in health-care facilities such as dental offices.
The ANSI standards classify lasers and laser systems according to their relative hazards and specify appropriate controls for each classification (table 1).
Lasers used in dentistry for bacterial decontamination or ablation techniques are Class 4 lasers. Class 4 lasers are high-powered and can pose a hazard to the eye or skin from direct-beam exposure. ANSI Z136.3 defines key safety protocols to be followed to keep all laser operators, auxiliaries, and patients in the dental office safe.
In compliance with ANSI Z136 standards, any facility where a Class 4 laser is in use requires a laser safety officer (LSO) to oversee the laser safety program. The LSO is the one person in each facility who has been trained in laser safety and is responsible for the laser safety program. The LSO's primary responsibility is to monitor the control of laser hazards and ensure compliance with the guidelines established by ANSI Z136.3. The LSO is accountable for ensuring that all team members, including front-office staff, have received the recommended training.
The LSO does not necessarily have to be a clinician; any team member can perform the duties with the required training. However, choosing a highly engaged team member is always best. Some states require that all Class 4 lasers and associated LSOs be registered with the state.