Lasers, digital radiography, computer controlled local anesthesia, CAD CAM milled crowns, nano filled composites and various other catch words abound in the dental literature, advertising and marketing. High tech is what people seem to want, both the dentist and the patient. But technology comes with a price for everyone so we must pick and chose what we, as practitioners of the healing arts find useful ,or even necessary to best treat our patients today. There's some great stuff out there. But just because it's available doesn't mean that it will make us better able to treat patients. Most often it represents a novel way to treat a condition that we can treat by other means. Sometimes it gives us a truly better way to do things and occasionally it allows us to do things that we couldn't do before. To give some examples, lasers that "cut" teeth do have some use for small cavities and a few more rare things that we do and have the benefit of not requiring "novacaine". But they are quite expensive ($50K+) and this cost in some way has to flow down to the patient one way or another. But we do have alternatives, like air abrasion, that are much cheaper and just as effective, not to mention the good old standby drill. Soft tissue lasers ($5-30K) allow us to do things that we can do with a scalpel or radiosurgery, but they are somewhat less traumatic for the patient and so the post op course of healing is sometimes easier. There are lasers to help us detect decay earlier ( $2-3K)  and therefore the filling can be much smaller than if we wait until it can be found with our trusty explorer (aka "dental pick") which only costs about 10 bucks.But that means less tooth structure removed so this is good in the long run. Digital radiography has come a long way in the last several years in terms of quality and has the significant benefit of less radiation and ease of storage and transmission to other offices or to insurance carriers. But the cost is high, about $30-50K or more depending on the size of the office This is one technology that all offices will eventually have though. You will see dentists marketing for " One visit crowns". What this means is that they've invested $120-150K in a CAD CAM device that once an impression is taken digitally ( no goopy stuff in your mouth) a computer driven program can mill the crown out of a block of porcelain like stuff and be delivered the same day. It's very cool technology but it also has some limitaions because color variation within a given restoration is very limitted and sometimes the stregth of metal is required which it cannot fabricate. I have a close friend who has one of these gizmos and he's an excellant dentist so I'm sure he does beautiful work with it and I've seen some nice restorations in a few of  my patients mouths that were as nicely fitting as any. But as I said earlier you can't leave your brain at the door when you walk in with this technology. I had a patient come in the other day who lives in a southern city for 9 mos. a year and when she came in recently for a checkup she proudly announced to my hygienist that the office she goes to down south is "high tech, state of the art in every way". She had done a crown with their CAD CAM  equipment over the winter. When I saw the thing in her mouth the first thing I asked her was " are you catching food between your teeth back here?" Of course I knew the answer. There was space about 2mm wide between her back teeth and the crown didn't even cover the whole prepared tooth. A truly ugly restoration! That was a touchy one to deal with diplomatically but I managed. The point is you can own this great technology but you better know how to use it properly or you'll cause people more harm than good, even though you may be charging them more for the privilage. I guess the bottom line is that we have all of this wonderful stuff available to us and we have to decide which is worth the investment of dollars and time to educate ourselves to use properly and we have to ask ourselves, will my patients be better off if I have this technology or just my bottom line?