Lasers (an acronym for “Light Amplification by Stimulated Emission of Radiation”)
Lasers have been used in dentistry since the early 1990s and are now almost standard equipment in a modern dental practice.
Originally lasers had a somewhat limited use in dental procedures but, over the past decades, their use (and usefulness) has expanded considerably.
A dental laser works by emitting light in a focused beam and this narrow beam is used to scan and sterilise as well as shape, reform or remove tissue and even bone.
The laser either cuts or vaporises the tissue or bone it contacts and replaces the need for scalpels, drills and other cutting surgical instruments. Today laser dentistry is usually associated with teeth whitening but it is also extensively used in treating many common dental issues including:
- Tooth sensitivity
- Tooth decay
- Gum disease
Many dental experts consider laser dentistry to be more effective, efficient and comfortable than more traditional methods and the use of lasers has been approved by the FDA (Food and Drug Administration) although the American Dental Association has yet to follow suit.
Two Laser Types
Depending on the individual case a dentist will use either a soft tissue or hard tissue laser or very occasionally both.
Soft Tissue Laser - This type of laser is used for minor treatments where no cutting is required. Typical uses include treating gum disease, killing oral bacteria and activating the regrowth of damaged tissue. It is also used to seal blood vessels or nerve endings that may have ruptured during the procedure. The laser also promotes faster healing than other dental techniques with many patients reporting little or no pain after the procedure.
Hard Tissue Laser- When it is necessary to cut through or reshape teeth a stronger laser is required and a hard tissue laser will be used. The powerful beam can easily cut, trim and shape harder material and is also useful for dental repairs.
Most Common Uses
Soft tissue lasers are used for gum conditions and problems with oral soft tissues while a hard tissue laser is reserved for heavy-duty treatment. Which type of laser is used will depend on the individual case but these are the most common uses of lasers in a modern dental practice.
Gum Disease. A laser is used to destroy harmful bacteria on and under the gums as well as those in infected gum pockets.
Tartar Removal. Using a laser rather than dental tools to remove tartar is easier, more effective and less stressful.
Tooth Sensitivity. A laser can seal holes in the tooth's root which is the principal cause of tooth sensitivity.
Root Canal Infection. Infections of the root canal can lead to tooth decay and tooth loss but laser treatment can prevent and treat these infections.
Filling Preparation. A laser can be used to clean debris and bacteria from the inner tooth in preparation for a filling.
Nerve Regeneration. Damaged nerve endings can benefit from laser therapy which helps with regrowth and regeneration.
Tissue Removal. Excessive soft tissue in the throat can be problematic and lead to sleep apnoea. Lasers can remove unwanted tissue to reshape the throat and improve breathing.
Denture Adjustment. Poorly fitting dentures are often due to underlying tissue which can be removed or trimmed with a laser.
Tongue Frenulum Correction. The frenulum is the piece of skin that attaches the tongue to the floor of the mouth. Issues with the frenulum can lead to speech impediments, problems with breastfeeding and tongue-ties. Lasers can be used to remove or restructure the frenulum in order to treat such conditions.
Gum Reshaping. Overgrown gums make the teeth look unnaturally short but excess tissue can be removed and the gums reshaped using laser dentistry.
Muscle Treatment. Muscle issues that impair the function of the tongue and lips are candidates for laser treatment.
Pain Relief. Cankers and cold sores can be uncomfortable and even painful. Laser treatment has been shown to help with pain relief from these conditions.
Preparation Work. Hard tissue lasers are often used to roughen the surface of teeth or remove portions of tooth enamel in preparation for tooth bonding or restorative work.
Teeth Whitening. Laser technology is used to speed up the whitening process after a bleaching agent has been applied.
Apart from the practical uses, laser technology is also commonly used in a modern dental practice as a diagnostic tool. Lasers can be used to:
- Remove samples of soft tissue for biopsy.
- View the interior of gums and teeth in detail.
- Detect possible decay and the formation of cavities.
Pros and Cons
No system is ever perfect or without criticism and this is also true of laser dentistry. While many professionals are in favour of laser treatment, and view their use as a positive technological advancement, others remain (as yet) unconvinced.
The benefits of laser treatment over traditional methods include:
- Reduced necessity for anaesthesia
- Less bleeding after procedures compared to regular dental equipment
- Minimal pain or discomfort
- No need for drilling (which many patients fear)
- Usually faster healing times than with traditional dentistry
- Creation of a sterile environment reducing the risk of infection
- Less invasive procedures than with drills or probes
- Preservation of more of the healthy parts of a tooth or gums
- More accurate results with minimal damage to healthy gums or teeth
To counter the positives there are always some negatives. These include relatively minor issues such as:
- Lasers cannot be used on teeth that already contain fillings
- Lasers are not an option for common procedures like filling cavities in awkward positions or for the removal of crowns or fillings
- Dental drills may still be required for finishing purposes after laser treatment
- Laser treatment does not totally eliminate the use of anaesthetics
It should also be noted that laser treatment can be more costly than traditional methods and this should be take into consideration when contemplating a dental procedure.
Because radiation is used in laser treatments there have been questions asked about the safety of using this technology. Dental lasers are perfectly safe when used by trained practitioners which is (or should be) the case in a modern dental practice.
Protective eye wear should always be supplied and worn during treatment but it is also important to have trust and confidence in the operator's training, qualifications and experience. It is advisable to discuss any upcoming treatment with the dentist who can answer any questions about the procedure and remove any concerns regarding potential risks involved.