Definition and Overview

Laser dental treatment refers to any dental procedure that uses laser energy.

Laser (light amplification by stimulated emission of radiation), which emits monochromatic light (has only one wavelength), is a powerful, high-intensity light that provides a more precise input and outcome when used in a wide variety of procedures. Unlike traditional light that is composed of several wavelengths that overlap each other, laser produces a more coherent and more targeted beam of light that travels in a parallel line.

Laser technology has been in use in the healthcare industry for many years and for a variety of reasons. It produces a defined wavelength that can be customized or adjusted depending on the type of procedure being performed and the desired results. In dermatology, laser energy is used to treat scars, remove or significantly reduce the appearance of hair, and smoothen skin by stimulating the production of collagen or removing dead skin cells. In dentistry, the use of laser began in the early 1990s. However, even if it’s already been quite some time since it has been introduced in this field, it’s still a subject of controversies particularly when it comes to its level of safety and effectiveness.

According to American Dental Association (ADA), the Food and Drug Administration (FDA) has approved the use of laser for the following dental procedures:

  • Curettage – This refers to the debridement of the gingival sulcus, which refers to the “space” in between teeth that are just slightly higher than the gum line. When a person develops periodontal disease, the sulcus can become a pocket, which means it becomes rather deep.

  • Reduction of bacteria – The mouth is composed of both good and bad bacteria. Over time, when the teeth are not properly maintained and oral care is poor, the mouth becomes more acidic, increasing the chances for more bad bacteria to multiply. Further, the changes in the gums, for instance, can worsen the situation. Laser, through the heat or energy it generates, can eliminate or reduce bacteria as a form of teeth protection. However, various studies say that results are rather inconsistent.

  • Wound healing – Lasers can also be used to speed up the healing process. When lasers are set on low energy, they can cause a variety of biochemical reactions. However, recent outcomes of studies about this have been mixed.

  • Root planing – Root planing is one of those dental procedures that are showing a more positive response to laser. This is a comprehensive dental cleaning procedure that targets the roots of the teeth, especially the areas where pockets have already formed.

  • Caries diagnosis – Caries simply means tooth decay. A certain type of laser can be used for fluorescence, which makes the process of detecting problems in the teeth’s enamel much more effective and efficient.

  • Ablation of hard tissue – Laser can also be used for ablating or removing layers of enamel and dentin.

  • Endodontics – Endodontics refers to the treatment of inflamed or infected root canal.

Laser has also been used for other reasons including teeth whitening and reshaping.

Who Should Undergo and Expected Results

Laser treatment is typically recommended for people who:

  • Are afraid of drilling – Many dentists are now using laser to ease the worries that come with a variety of dental procedures particularly those that are carried out with the use of drills. Laser may be used alone, or dentists may have to rely on only a few drills.

  • Need laser-marketed procedures – These include root planing and scaling, root canal (endodontics), and teeth whitening. In teeth whitening, laser is used to stimulate the active ingredient used in teeth whitening products (bleach). Laser doesn’t really make the teeth whiter, but it hastens the process.

  • Don’t like stitches or sutures – Lasers may be used to reduce the dependency on common surgical tools for incisions, among others. The heat would be enough to open and access layers of soft tissue, minimizing the risk of excessive bleeding in the process.

  • Develop dental disease due to bacteria – Bacteria are some of the most common reasons why people develop oral health problems. Laser can sterilize the affected area of the mouth and prevent the growth and spread of bacteria.

Laser may also be applied to:

  • Reduce the pain caused by sores (cold and canker sores)
  • Increase movement by severing muscle attachments
  • Reshape the teeth in preparation for impressions or fitting of an oral appliance
  • Remove a tissue sample for biopsy

The effects of dental laser can vary depending on how it’s used, the diagnosis, and the patient’s response to the treatment. Sometimes lasers are used alone, while in many cases, they are used in conjunction with traditional dental techniques, equipment, and medications. However, laser has certain limitations. For instance, it cannot be used on teeth that have already been filled or those that have a huge cavity, in which case a new crown has to be fitted.

How Does the Procedure Work?

A special machine is used to emit laser. This equipment allows the dentist to control the wavelength depending on the needed application or the desired result. Patients who are about to undergo dental laser treatment do not require intensive preparation other than telling the dentist if they have allergic reaction to laser, if they have a blood disorder that may prevent clots from forming (and may result in excessive bleeding), or if they have already gone through certain dental procedure or has medications that may have a negative reaction to laser.

During the actual procedure, the patient’s eyes are covered with special goggles as a form of protection. Only the section of the mouth to be treated is exposed to laser to further minimize the thermal damage. It may take a few sessions for certain procedures to achieve the desired results.

Possible Risks and Complications

The risks and complications of laser for dental treatment are still vague since there’s not enough evidence available or the results are inconclusive or mixed.

Like any laser procedure, there’s the possibility of thermal damage to the soft tissues. The risk of bleeding is still there, but it’s relatively low since laser promotes blood coagulation.

References:

  • http://www.ada.org/en/about-the-ada/ada-positions-policies-and-statements/statement-on-lasers-in-dentistry
  • Consumer Guide to Dentistry: ''Laser Dentistry: Enhancing Dental Treatment with Lasers.''
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