Complementing dental treatment with lasers

LASER (Light Amplification by Stimulated Emission of Radiation) technology has been used in various types of medical procedures for years. Oral surgeons incorporated the technology into the practice in the early 1980s. Since then, a countless number of instruments have been made available for dental practice and more are in the pipeline. An increasing number of dental clinics around the world will use dental lasers as technology continues to improve and its cost decreases.

Laser tissue interaction. Once the light from dental lasers is absorbed, it’s converted to heat. The thermal effects of this heat depend in large part, on tissue composition and length of time the beam is focused on the target tissue. Dental lasers can be used to cut, incise, and ablate hard and soft tissues.

Dental lasers may be categorised into three basic groups. (1) Soft tissue lasers, (2) Hard tissue lasers and (3) Non-surgical lasers such as Diagnostic or Photo-disinfection lasers.

Hard tissue lasers

Hard tissue lasers have a wave length that is highly absorbable by calcium phosphate salt found in bone and teeth, making them more effective for cutting tooth structure. The primary purpose of hard tissue laser is to cut into bone and teeth with extreme precision. Hard tissue lasers are often used in the “prepping” or “shaping” of teeth for composite bonding, removal of small amounts of tooth structure and the repair of certain worn down dental fillings.

Soft tissue lasers

Soft tissue lasers have a wave length that is highly absorbable by water and haemoglobin, making them more effective for soft tissue management. Soft tissue lasers penetrate the soft tissues while sealing blood vessels and nerve endings. This is the main reason why many people experience no post-operative pain following laser soft tissue procedures. These also allow the soft tissue to heal faster especially in the case of gingival procedures.

Some laser types are used for diagnostic purposes, specifically designed for viewing the inside of teeth using optical coherence tomography as non invasive imaging technique.

Advantages of Laser Dentistry

•Good control of bleeding and improved visualization of the surgical field.

•Many laser procedures can be performed with less injectable anaesthesia.

•Procedures performed with soft tissue dental lasers may not require sutures(stitches).

•Bacterial infections are minimized because the high- energy beam sterilizes the area.

•Damage to surrounding tissue is minimized.

•Initial post-operative discomfort and swelling are reduced.

•Wounds heal faster and tissues can be regenerated.

Hard tissue (Tooth) Laser Dentistry procedures

•Dental Fillings/Tooth preparation: Hard tissue dental laser may eliminate the need for a local anaesthetic injection and the traditional turbine dental drill but is not appropriate for the replacement of amalgam fillings, onlays or crowns.

•Tooth Sensitivity: Dental lasers may be used to seal tubules (located at the root of the tooth) that are responsible for hot and cold tooth sensitivity.

•Cavity Detector: Low intensity soft tissue dental lasers may be used for the early detection of cavities.

Soft Tissue(Gum) Laser Dentistry Procedures:

•Depigmentation of black gums: Black pigmentations of gums can be successfully removed by soft tissue dental laser.

•Gummy Smile: Dental lasers can reshape gum tissue to expose healthy tooth structure and improve appearance. It is also used for anterior gingival recontouring and gingivectomy.

•Muscle Attachment (Frenula): A laser frenectomy is an ideal treatment option for children who are tongue tied. It may also help to eliminate speech impediments.

•Crown Lengthening: Reshaping of gum tissue provides a stronger foundation for the placement of crown and bridge prostheses.

•Soft tissue Folds: Dental lasers may be used for the painless and suture-free removal of soft tissue folds often caused by ill-fitting dentures.

Other Dental Laser Applications

•Cold Sores: Low intensity dental lasers reduce pain associated with cold sores and minimize healing time.

•Temporomandibular Joint Treatment: Dental lasers may be used to quickly reduce pain and inflammation of the jaw joint.

•Teeth whitening: Soft tissue dental lasers can be used to speed up the bleaching process associated with teeth whitening.

•Benign Tumours: Dental lasers may be used for the painless and suture-free removal of benign tumours from the gums, palate, sides of cheeks and lips such as fibromas and papillomas.

•Surgical exposure of impacted tooth and uncovering of an implant.

•Removal of coronal pulp as an adjuvant to root canal therapy and periodontal treatment.

•Optical Impressions: CAD/CAM technology uses computerized laser systems to assist with fabrication of custom restorations, such as inlays, onlays, and crown and bridge prostheses. CAD/ CAM technology eliminates the need for intraoral impression materials and instead, laser scanners take an optical impression of a prepared tooth and dental arches.

Lasers offer many useful clinical applications for dentists in the diagnosis and treatment of patients, as long as the clinician receives the proper training to use this technology safely and effectively.

Dental laser treatment is available at MEM, and for more information contact, Dr.Saji Abraham, Consultant in Orthodontics and Dentofacial Orthopedics, Middle east Medical Center, Hidd.Tel 17464848.