Laser Dentistry: Enhancing Dental Treatment

Medically Reviewed by: John Ifantis, DDS

Laser dentistry can be a precise and effective way to perform many dental procedures. The potential for it to improve dental procedures rests in the dentist’s ability to control power output and the duration of exposure on the tissue (whether gum or tooth structure), allowing for treatment of a highly specific area of focus without damaging surrounding tissues.

If you consider yourself somewhat of an anxious dental patient and are seeking extreme safety and comfort, you might consider looking for dentists who have incorporated laser techniques into their practices and treatments. It is estimated that 6 percent of general dentists own a laser for soft-tissue applications, with that number expected to increase over time.

As the applications for dental lasers expand, greater numbers of dentists will use the technology to provide patients with precision treatment that may minimize pain and recovery time.

Benefits

• Procedures performed using soft tissue dental lasers may not require sutures (stitches).
• Certain procedures do not require anesthesia.
• Minimizes bleeding because the high-energy light beam aids in the clotting (coagulation) of exposed blood vessels, thus inhibiting blood loss.
• Bacterial infections are minimized because the high-energy beam sterilizes the area being worked on.
• Damage to surrounding tissue is minimized.
• Wounds heal faster and tissues can be regenerated.

Types of Dental Lasers

The Food and Drug Administration (FDA) has approved of a variety of hard and soft tissue lasers for use in the dental treatment of adults and children. Because dental lasers boast unique absorption characteristics, they are used to perform specific dental procedures.

• Hard Tissue Lasers: Hard tissue lasers have a wavelength that is highly absorbable by hydroxyapatite (calcium phosphate salt found in bone and teeth) and water, making them more effective for cutting through tooth structure. Hard tissue lasers include the Erbium YAG and the Erbium chromium YSGG.The primary use of hard tissue lasers 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, the removal of small amounts of tooth structure and the repair of certain worn down dental fillings.
• Soft Tissue Lasers: Soft tissue lasers boast a wavelength that is highly absorbable by water and hemoglobin (oxygenating protein in red blood cells), making them more effective for soft tissue management. Commonly used soft tissue lasers include Neodymium YAG (Nd:YAG) and diode lasers, which may be used as a component of periodontal treatment and have the ability to kill bacteria and activate the re-growth of tissues. The carbon-dioxide laser minimizes damage to surrounding tissue and removes tissue faster than the fiber optic method.Soft tissue lasers penetrate soft tissue while sealing blood vessels and nerve endings. This is the primary reason why many people experience virtually no postoperative pain following the use of a laser. Also, soft tissue lasers allow tissues to heal faster. It is for this reason that a growing number of cosmetic dental practices are incorporating the use of soft tissue lasers for gingival sculpting procedures.

Some dental laser technology has been developed that can be used to generate both hard and soft tissue laser energy, depending upon the patient’s needs.

In addition to the lasers used for cutting and shaping hard and soft tissues, other laser types are specifically designed for viewing the insides of teeth and cells using Optical Coherence Tomography, a non-invasive imaging technique. Other lasers provide energy and specific proteins that help move messages between cells to match the body’s natural ability to use light spectrums to heal damaged cells.

Hard Tissue (Tooth) 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.
• 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.
• Apicoectomy: Some dental practices utilize dental lasers to assist with endodontic treatment(s). One such application is with laser-assisted apicoectomy (also known as “root end surgery”), a common endodontic procedure designed to treat infected root canals while avoiding tooth extraction. The laser precision allows dentists to access gum tissue, remove infected or inflamed tissue and excise the very tip of the tooth root, while minimizing discomfort and recovery time. A primary objective of dental restoration is the preservation of as much natural tooth as possible. Dental lasers used in root canal treatment afford dentists the precision to effectively restore dental health while avoiding tooth removal.

Soft Tissue (Gum) Procedures

• Crown Lengthening: Dental lasers can reshape gum tissue (soft tissue laser) and bone (hard 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: Dental lasers can reshape gum tissue to expose healthy tooth structure and improve the appearance of a gummy smile.
• 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.
• 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.

Other Applications

• Viewing Tooth and Gum Tissues: Optical Coherence Tomography is a safer way to see inside tooth and gums in real time.
• 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.
• Cold Sores: Low intensity dental lasers reduce pain associated with cold sores and minimize healing time.
• 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.

Lasers represent an innovative and more precise technology for specific hard and soft tissue applications. If you choose a laser dentist, you may find that you feel more comfortable and less anxiety during your treatments.

The Future of Dental Lasers

Dental procedures may soon be performed quicker, more effectively and more comfortably thanks to the growing popularity of laser dentistry. Laser (Light Amplification by Stimulated Emission of Radiation) technology has been used in various types of medical procedures for years. An increasing number of dental offices around the world will use dental lasers as the technology continues to improve and its cost decreases.

Dentists may use dental lasers during a professional dental cleaning to remove tartar and as a replacement for the traditional root planing procedure, which is currently performed using a surgical instrument called a curette that can damage surrounding tissue. Eventually, dental lasers could make it possible for dentists to access any part of a tooth, replacing the need for the traditional dental drill. This may help to relieve the fear and anxiety many people experience when they go to the dentist. 

[updated December 6, 2021]

 

About the Reviewer

John Ifantis, DDS, is a highly trained and experienced Chicago-area dentist with 20+ years’ experience proudly serving the dental needs of his community. In practice in the Morton Grove area since 2005, Dr. Infantis – a New York native who attended St. John’s University in Jamaica, Queens, before completing his Doctor of Dental Surgery degree at Marquette University in Milwaukee – has completed hundreds of hours of postgraduate education under the tutelage of some of the top specialists in the fields of dental implants, endodontics, orthodontics, laser dentistry, microscopy and sleep apnea.

Dr. Infantis has a passion for adapting to the latest advancements and modern techniques in cosmetic and restorative dentistry to provide his patients with the very best in care. He routinely attends industry meetings focused on the latest trends in dentistry and is a member of various dental associations, including the American Dental Association (ADA), the International Congress of Implantology (ICOI), the American Academy of General Dentistry (AACG), the Academy of Gp Orthodontics, the Chicago Dental Society (CDS) and the Illinois State Dental Society (ISDS). 

To learn more about Dr. Ifantis and his Morton Grove-based practice, IFANTIS DENTAL CARE, view his complete bio.