Selective removal of caries lesions with high precision is best accomplished using lasers operating at high pulse repetition rates utilizing small spot sizes. Conventional flash-lamp pumped Er:YAG lasers are poorly suited for this purpose, but new diode-pumped solid-state (DPSS) Er:YAG lasers have become available operating at high pulse repetition rates. Microradiography was used to determine the mineral content of the demineralized dentin of 200-μm thick sections with natural caries lesions prior to laser ablation. The purpose of this study was to explore the use of a DPSS Er:YAG laser for the selective removal of demineralized dentin and natural occlusal lesions on extracted teeth.