Laser Dentistry

Laser dentistry is essentially the use of laser energy to perform various dental procedures effectively and precisely. The laser device can be used two ways, either on soft tissue which include the gums, or on hard tissues such as the bone and tooth. The success of using lasers in dentistry relies mainly on the dentist’s ability to regulate the energy output and length of exposure of the tissues to the laser. If used properly, lasers allow for specific problem area to be targeted without causing damage to the surrounding healthy tissues.

ANALYSIS

Lasers may be used to restore a tooth. Multi-surface fillings can be done with laser even without the use of anesthetics. Instead of using a drill, the dentist can laser the decay out and put tooth colored restorative material in the prepared cavity. The material will bond to the tooth well because the laser creates etched surfaces to which the filling can thoroughly adhere.

Aside from restorative purposes, lasers are also utilized for soft tissue surgeries and periodontal pocket reduction. Surgeries involving gum grafts may be performed using lasers with or without numbing the patient. Crown lengthening is also performed more easily through lasers. Crown lengthening is a procedure typically done when tooth decay extends too far below the gum line and close to the bone. It involves cutting some gum tissue and bone, followed by lowering of the gum to a level where the decay can be fully above the gum line.  This will make the coronal portion of the tooth look longer than it normally does. The healing time for regularly done crown lengthening is about five weeks, however with laser it is much shorter, about 2-3 weeks.

Lasers are also helpful in eliminating (or at least reducing) deep periodontal pockets. A periodontal pocket pertains to the space created by loosely-attached gum tissue around the tooth. These pockets are caused by gum disease that is left untreated for a very long time. Lasers can be used to sterilize and reduce pocket depth after all the plaque and tartar have been removed by routine professional cleaning. One more use of laser is in the treatment of bony infections around tooth roots. The bone can be cleaned out without reflecting the gums over it. And because the infection is treated in a closed environment, bone starts to grow back, thereby preventing the loss of tooth that it supports.

CANDIDACY

The ideal candidate for laser dentistry would be patients who need small fillings and those who have gum disease. Lasers are not indicated for restoring extensively-damaged teeth because you cannot cut a crown or prepare a tooth for a bridge using lasers. Gum disease, to some degree, can be eliminated with laser.

COMPARISON

The use of lasers in dentistry offers a lot of advantages, the best advantage is being able to perform different dental procedures without the need for anesthesia. Root canal therapy, for one, may be performed without having to numb the tooth. That is because as the laser touches the nerve, it numbs it. The dentist can go down the nerve chamber, slowly numb the tooth, and do root canal with laser. But then again, laser also has its disadvantages. It may not be as cost-effective, and also very time-consuming. It is still much easier to just administer anesthetics to do some of the procedures.

LIMITATIONS

There are a lot of other uses for lasers, but they still have their limitations. This is the reason dentists do not use it very often in a grand scale. First, it should not touch any kind of metal and therefore cannot be used to take out an existing silver filling. It cannot be used to cut crowns. Simply put, it cannot be used on anything with metal. Also on anxious patients that would like to be on laughing gas, use of laser is contraindicated.

Contrary to what most of us know, lasers are not used for teeth whitening in most cases. The claim that lasers may whiten the teeth is more of a marketing technique. What is being used is an intense white light with a filter on it that looks blue. Teeth cleaning using laser is also a misconception. You cannot clean teeth with laser. The way to go is still the old-fashioned method where the dentist or the hygenist scales the plaque and tartar off. Once the teeth are cleaned, lasers can then be used to sterilize the gum pockets. Lastly, lasers are also more time-consuming and less cost-effective.

RISKS

When it comes to risks and complications, a laser does not cause any so long as the operator knows how to use it properly. But an important thing to note is that lasers can limit the tactile sensation of the dentist. When you use laser to remove the decayed part of the tooth, the dentist will not really know whether they are still on the decayed area or if they are cutting on the sound part already. As a result, overcutting may occur if not careful.

RECOVERY

Treatments using laser generally require much shorter recovery time. In simple procedures such as tooth restoration, the patient can go back to all of his or her normal activities right after the filling is done. For more complex procedures like soft tissue surgery, recovery will still take a few days but definitely not as many days as when laser is not used.

Besides the significantly shorter downtime, lasers also allow for less trauma, less post-operative pain or discomfort, and faster healing for the patient. If there is any other procedures needed to be done, the patient can move on to the next phase of treatment faster- as opposed to waiting for weeks in the traditional way of doing it.  And for surgeries, patients do not even need a suture most of the time because laser also takes care of closing up the wound.

RESULTS

Although lasers shorten recovery time, they do not promise more immediate and longer-lasting results. The improvements are actually pretty much the same, if not a little bit better, as the traditional counterparts.

Written by Cosmetic Town Editorial Team- AA

Based on an exclusive interview with Gevik Marcarian, DDS in Encino, CA