All about Lasers in dentistry
Laser is the phrase used for Light Amplification by Stimulated Emission of Radiation. A laser is a device that generates a precise beam of light concentrated with energy. The radiation is mostly of a well defined wavelength designed to perform specific functions without altering or damaging the neighbouring tissues.It is an exciting modern technology with good clinical outcomes, kinder to soft tissue and excellent for wound healing. Most popular application of lasers in clinical dentistry is for Crown lengthening, Gingivectomy, Gingivoplasty, and frenectomy. In modern dentistry lasers have given us the opportunity to simultaneously remove the diseased soft tissues, target the bacterial infection and stimulate wound healing as well. Rest assured, our team of periodontists at Smiline dental hospital are trained in using lasers safely and effectively.
Lasers vs the scalpel
Proper understanding the pros and cons of traditional versus laser therapy will make an easy decision in deciding on the best overall treatment option for periodontal or gum disease.
The major advantages of laser therapy over conventional scalpel is lower tissue inflammation and hemostasis. Compared to the use of traditional scalpel, lasers can cut, ablate, easily reshape the soft tissue in the mouth causing little pain and bleeding with need for few or no sutures. Post treatment discomfort is less with lasers and hence patient satisfaction. Local anesthetic may or may not be necessary during laser treatments. Sometimes topical anesthetic may suffice. Traditional surgery involves using the scalpel for more invasive cutting of the soft tissue to reshape and reposition the gums and suturing to hold the soft tissue together during the healing phase. Patients need anesthesia during the procedure.Healing takes longer and patient experiences longer period of discomfort during recovery. However laser surgery is costly and not all cases of periodontal disease can be treated especially when disease is severe.
Laser technology and its benefits for treating gum disease
Very little bleeding
Often patients with gingivitis experience severe gum bleeding and bone loss due to the gum infection. Therefore, it is essential to remove bacteria from the teeth and gingival pockets. Modern
laser techniques provide the benefit of not only destroying the harmful bacteria on the gums and tooth roots but also killing them by their bactericidal effect. Due to greater hemostasis there is less bleeding and swelling
of gums.
Customisation to the patient needs is easy
Radiation wavelengths of the laser can be well designed to suit the level of the periodontal disease designed to perform specific functions without altering or damage to
the neighbouring tissues. Lasers can be targeted at the soft tissues with precision and accuracy..This allows the dentist or periodontist ample control over the treatment process for the desired patient outcome.
Shorter healing time
Laser treatment helps in cutting, ablation and reshaping the oral tissue easily and hence inflicts little trauma to the gum, tooth, and surrounding areas. This means healing time is drastically
reduced compared to traditional surgery. Patients will recover quicker and the whole process will be much faster. Daily activities can be resumed within 24hrs of the laser gum treatment. Recovery and healing times are shorter.
Hence less discomfort and more patient satisfaction.
Less Invasive therapy
Laser treatment is very precise and can target and remove only infected gum tissue without the need for the healthy tissue to be taken away. Lasers are less invasive. Equipment like a dental
handpiece are not necessary which reduces the pressure that patients feel, which means there may be no need for anesthesia. The less need for anesthetics is especially useful for medically compromised patients The overall
result is a procedure that is less painful and comfortable for patients. Patient may feel more at ease,cooperative and relaxed during the treatment. Because of the less invasive nature of the laser therapy post operative
symptoms like bleeding, pain and swelling are limited.
Preserves healthy parts of the teeth
During cavity treatment, precision of the laser technology gives the dentist an the opportunity to preserve the healthy parts of the teeth. Preserving any healthy oral tissue
in individuals with severe oral infections can bring about stronger cliinical outcomes.
Minimizes risk of bacterial infection
Lasers annihilate bacteria.Due to the requirement of fewer tools for the procedure,lasers help in sterilizing the work area and lower the risk of bacterial infections. Laser
therapy helps offer better clinical results with shorter treatment times while reducing discomfort and the need for more invasive therapies. Thus lasers can control the spread of harmful bacteria and limit tooth loss and
may even eliminate the need for further gum disease treatment such as gum surgery. Laser periodontal treatment is maximally effective at destroying harmful bacteria on your gums and tooth roots. The incidence of reinfection
is lower than with traditional techniques.
Less soft tissue damage
Besides stimulating gum regeneration, lasers can cause less damage to the oral soft tissues.Due to this they cause less gum recession.Most of the gum disease treatments involve excision of
considerable amount of gum tissue so as to effectively bacteria within the periodontal pockets.Receded gums may mean your smile ruined during the healing period. This may mean your smile will be ruined for a time during
healing.Laser therapy generally leaves your smile intact mostly when the periodontal pockets are not very deep.
Are there any risks with Laser therapy?
- Inappropriate wavelength and/or power levels during periodontal treatment can result in thermal damage to bone and tooth structures like pulp causing more harm than good.
-Though lasers are showing potential for the removal of calculus from a diseased root surface,but there is also risk of damage to the root surface.
-In periodontal pockets excessive ablation of root surface and gingival tissue occurs and hence destruction.
The Laser Therapy Procedure
Before the start of the dental treatment, a dentist or periodontist, will anesthetize with a local anesthetic to numb the treatment area.A soft tissue laser is then used to access the infected pockets and kill all the diseased tissue and bacteria within the pockets.The healthy surrounding tissue is not affected by the laser.Once the entire infected tissue is removed and the root is exposed.A dental instrument called ultrasonic scaler is then used to remove the calculus and smoothen the root surface.This process is known as “scaling and root planing” or “root debridement.In certain situations, the dentist may apply a gel or membrane called PRF to promote healthy tissue regeneration.Lastly, laser is used to warm the stem cell that contains blood in the pocket, which creates a seal of tissues against the tooth root.Reduction of the pocket depth can prevent bacteria from reentry due to secure attachment of the gums to the teeth. The entire treatment usually is completed in about two to three hours and can be completed in a single visit.
However In more complex cases, an extra visit may be essential. Post lasers, the healing of the gums is based largely on the activity of the fibroblasts, keratinocytes and immune cells.In few days after the laser surgery, the epithelial cells start to migrate towards the borders of the lesion, while the fibroblasts proliferate and ultimately creating a new junctional epithelium. Laser technology accelerates the healing process by increasing the motility of the keratinocytes (with a consequent faster epithelization), increasing the proliferation of the fibroblasts (with consequent extracellular matrix synthesis) and by early angiogenesis
The many uses of Lasers in Periodontal treatment:
-Diagnostic use:
Laser as preventive therapy: A laser toothbrush can provide an antibacterial effect in the mouth using an irradiating low output laser beam.
Laser in nonsurgical pocket therapy: Sensitive and time consuming therapy,laser Bacterial Reduction (LBR) is a simple nonsurgical procedure to eliminate or, at least, reduce the number of viable bacteria in the gingival sulcus. Calculus removal:Lasers are now being used for the removal of the calculus on the root surface. Not only does the laser remove the calculus on the root surface, but it also alters the cementum surface in such a way that it makes it favorable for fibroblast to attach, creating a new epithelial lining.Lasers to treat sensitive teeth:Low-level laser therapy (LLLT) is known to be effective in the treatment of hyperemia and inflammation of the dental pulp by its anti inflammatory, analgesic and cellular action..
Laser in surgical therapy: Laser Assisted New Attachment Procedure (LANAP) is a relatively new treatment option that helps remove plaque and calculus, while limiting bacterial infection to help fight periodontitis by gingival tissue regeneration rather than resection.The LANAP works quickly and effectively and reduces the time at the dentist’s clinic during the procedure as well as greatly speeding up the recovery process. LANAP helps to remove infection causing bacteria in a safe and painless procedure that promotes epithelial and periodontal fiber attachments in the affected area.Other uses of LANAP include removal of caries and preparation of teeth for restorations or crowns.Laser is used to remove the epithelial lining of the sulcus as well as junctional epithelium,biopsy and excision of soft tissue pathologies.
Soft tissue application: Gingival soft tissue procedures: Laser is generally accepted and widely used as a tool for soft tissue management.With lasers the most popular procedures such as Crown lengthening, Gingivectomy, Gingivoplasty & frenectomy can be carried out with less bleeding and pain. Lasers can cut, ablate, easily reshape oral soft tissue,little or no anesthesia and with a few sutures.Lasers can also help in esthetic recontouring or reshaping of gingival crowns.
Periodontal pocket treatment: One of the possible advantages of laser treatment of periodontal pockets is the removal of sulcular epithelium. It can also protect the underlying connective tissue by causing necrosis or carbonization.By stimulating stem cells in the tissues to form new connective tissues, bone, and collagen lasers help in faster wound healing
Osseous surgery: Lasers also improve the comfort of both patients and surgeons by markedly reducing the noise and eliminating the grinding of the bone tissue.
Lasers in implant therapy: Precision cutting ,improved hemostasis,less patient discomfort during the treatment,favourable,quick healing after abutment placement puts lasers at an advantage in Implant treatments.
Post Laser care :
-Maintaining a good oral hygiene program after you undergo any type of periodontal therapy is critical to avoiding a recurrence of the inflammation. Brushing and flossing regularly after an initial period of gentle treatment of the gums improves healing for irritated gums.
-Avoid or stop smoking to reduce the risk of future infections, and
- Follow any specific instructions from your dentist or dental specialist as closely as possible.
-In addition to slight swelling,some tenderness or temperature sensitivity, is to be expected after the laser treatment.Relief from these symptoms can be brought about by the dentist’s prescription of over the-counter pain reliever medication and sticking to a diet of soft foods.
Lasers are safe and efficient for periodontal bone surgery when used in conjunction with conventional mechanical periodontal treatment.Find out now about the possibility of laser treatment for gum disease at Smiline dental hospital.Our expert periodontist will be able to answer all your queries and offer the best advice.
