Laser Applications in Dentistry

The application of lasers in dentistry opens the door for dentists to perform a wide variety of dental procedures they otherwise may not be capable of performing. Dentists using lasers in dentistry have become adept at incorporating the state-of-the-art precision technology into a number of common and not-so-common procedures.

Soft Tissue (Gum) Laser Dentistry Procedures

* Crown Lengthening: Dental lasers can reshape gum tissue (soft tissue laser) to expose healthier tooth structure. Referred to as crown lengthening, such reshaping provides a stronger foundation for the placement of restorations.

* Gummy Smile Correction: Dental lasers can reshape / sculpt gum tissue to expose healthy tooth structure and improve the appearance of a gummy smile.

* Root Canal Therapy - Lasers help in meticulous disinfection of the root canals thereby reducing the failure rate considerably. Lasers also help considerably in re-treatment of root canals where inaccessible accessory root canals create problems. Lasers also help in rapid resolution of periapical (beyond the tooth root tips) infections, granulomas and cystic lesions.

* Muscle Attachment (Frenula): A laser frenectomy is an ideal treatment option for children who are tongue tied (restricted or tight frenulum) and babies unable to breast feed adequately due to limited tongue movement. A laser frenectomy may also help to eliminate speech impediments. Laser frenectomies can be carried out in case of high labial frenum attachments causing separation of the central incisor teeth too.

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

* Benign Tumors: Dental lasers may be used for the painless and suture-free removal of benign tumors from the gums, palate, sides of cheeks and lips.

* Tongue Tie correction - High lingual frenum (attachment of the tongue to the floor of the mouth), also called tongue tie can lead to slurred speech in children. These fibrous attachments can easily be removed using lasers without any difficulty, under topical anesthesia.

* Aphthous ulcers / Cold Sores: Low intensity dental lasers reduce pain associated with aphthous ulcers / cold sores and minimize healing time. Lasers can be used to reduce the discomfort and pain in relation to herpetic lesions also.

* Nerve Regeneration: Photobiomodulation can be used to regenerate damaged nerves, blood vessels and scars.

* Sleep Apnea: In cases where sleep apnea is a result of a tissue overgrowth in areas of the throat (which sometimes occurs with age), a laser assisted uvuloplasty or laser assisted uvula palatoplasty (LAUP) procedure can be performed to reshape the throat and relieve the correlating breathing problems associated with sleep apnea.

* Teeth Whitening: Low intensity soft tissue dental lasers may be used to speed up the bleaching process associated with teeth whitening.

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

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

* Dental Implants: Biostimulation to help better bone integration of dental implants and also help in implant recovery in cases of peri implantitis (inflammation of the peri - implant bone and soft tissues - ie the periodontium)

* Periodontal Surgeries: Apart from providing provisions for bleeding free periodontal surgeries, lasers effect biostimulation to help healing and regeneration of periodontal tissues after periodontal procedures. There are no scalpels, sutures or postoperative pain involved.

* Periodic Oral Health Maintenance: Periodic (usually once in 3 months) laser assisted bacterial reduction (LBR - Laser Bacterial Reduction) procedures help in curing / controlling recurring gingival and periodontal infections in patients who have the genetic prediliction to these infections or are medically compromised predisposing the patients to the recurrence of these infections at periodic intervals.

* Dental Caries (Decay) Detection - A major diagnostic application of low power lasers is the detection of caries, using fluorescence elicited from hydroxyapatite or from bacterial by-products. Laser fluorescence is an effective method for detecting and quantifying incipient occlusal and cervical carious lesions, and with further refinement could be used in the same manner for proximal lesions. Photoactivated dye techniques have been developed which use low power lasers to elicit a photochemical reaction. 

* Dental Caries Prevention - In combination with fluoride, laser irradiation can improve the resistance of tooth structure to demineralization, and this application is of particular benefit for susceptible sites in high caries risk patients.

* Oral Precancerous and related lesions - Management if Oral submucous fibrosis, leukoplakia, lichenplanus etc. 

* Depigmentation of gingiva - brown or blackish colored gingiva can be turned pink

* Orthodontic exposure of teeth in children - eg. incisors which are prevented from eruption due to fiibrous barriers

* Oral Malignancies - laser-initiated photochemical reaction is photodynamic therapy (PDT), which has been employed in the treatment of malignancies of the
oral mucosa, particularly multi-focal squamous cell carcinoma. While direct effects of PDT destroy the bulk of tumour cells, there is accumulating evidence
that PDT activates the host immune response, and promotes anti-tumour immunity through the activation of macrophages and T lymphocytes.

* Incision and Excision biopsies - no scalpels, sutures or postoperative pain.

* Pericoronal flap excision - to remove the tissues causing impediment to eruption of teeth - especially the canines and the third molars.

* Management of trismus (restriction in mouth opening due to muscle spasm)



Hard Tissue (Tooth) Laser Dentistry Procedures

* Cavity Detector: Low intensity soft tissue dental lasers may be used for the early detection of cavities by providing a reading of the by-products produced by tooth decay.

* Dental Fillings/Tooth Preparation: Hard tissue dental lasers may eliminate the need for a local anesthetic injection and the traditional turbine dental drill. Lasers used in dental filling procedures are capable of killing bacteria located in a cavity, potentially leading to improved long term tooth restorations. However, dental lasers are not appropriate for the replacement of amalgam fillings, onlays or crowns.





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