Last week, I attended a lecture a colleague of mine gave on using lasers to treat gum disease. I was simply astonished at what he is achieving in his periodontal practice with laser technology!

Lasers have been in the dental field for a number of years now. They are being used for fillings, crown & bridge, soft tissue surgery, and for treating gum disease. In this post, I’ll be focusing on the last of these applications.

Periodontal Disease - The Challenge We Face

When I say gum disease, it’s important to understand which type of gum disease I’m referring to. Let’s first distinguish between the two major types of gum disease: gingivitis and periodontal disease.

Gingivitis is non-destructive inflammation of the gums caused by bacterial plaque. It is treated with a dental cleaning and attentive home care. The gum pockets around the teeth do not get deeper, and the underlying bone is unchanged.

Periodontal disease also involves inflammation of the gums, but is accompanied by destruction of the soft tissue attachments and the underlying bone. This destruction of bone and soft tissue attachments results in deeper gum pockets around the teeth. Deeper pockets allow the bacteria to burrow deep out of reach of floss, toothbrush bristles, and even mouthrinse.

To demonstrate, let’s look at some pictures of a model.

In these first pictures, we see relatively normal teeth and gums. The teeth are clean, the gum tissue is right at the level it should be, and the underlying bone provides ideal support for the teeth.

These next two images demonstrate how all of this changes with periodontal disease. First, note the debris and tartar attached to the teeth. Next, you’ll notice the gumline is somewhat receded and some of the root surface is exposed. When we take the model gums away, the underlying bone destruction is very apparent.

The end result of periodontal disease is complete loss of the teeth.

There have been a number of different methods used to treat periodontal disease over the decades. Up until the advent of lasers, non-surgical scaling and root planing (often referred to as a “deep cleaning”) or surgical therapy have been the answers. These have certainly been effective answers, but surgical involvement in particular comes with its drawbacks. These include post-op swelling and discomfort, temporary limited function and restricted diet, and often expensive fees.

Now, lasers are changing the game. Since lasers are a relatively new feature in the dental world, their use also comes with a wealth of questions. Here are 5 things patients should know about lasers to treat gum disease:

1. Results so far have been outstanding!

The goals for treating periodontal disease are: first, manage the bacteria causing the disease. Second, reduce the gum pockets to allow patients to keep their teeth and gums clean. Third, establish a firm home care regimen and check-up schedule to ensure proper management of the disease.

Case results in last week’s presentation demonstrated incredible reduction of pocket depth, less inflammation, and more stable teeth. Clinicians have achieved these goals in the past with conventional surgery.  But now, laser technology is making the process more thorough and predictable. There are a lot of technical details I could go into. The bottom line is I’ve seen the case results, and laser therapy works!

2. Outcomes are dependent upon proper patient home care

This is a point that has not changed with the advent of laser technology. Dentists and periodontists can use all of the latest in technology and techniques to treat periodontal disease, but it will always come back if patients don’t do their part.

This includes brushing, flossing, using a Water Pik, and attending routine dental visits. There are other factors that greatly exacerbate the risk for periodontal disease. Patient’s who smoke or who have poorly managed diabetes cannot expect optimal results from treatment. Success depends upon the body's ability to heal itself. Smoking and diabetes both greatly inhibit the body’s healing mechanisms.

3. No incisions or stitches

Patients are always happy to hear this news! One of the biggest patient benefits of laser therapy is the lack of cutting and stitches.  This is because laser therapy is micro-surgery.  Lasers focus on the bacterial problem of periodontal disease, and new laser technology allows this without incisions. This leads us to the next point.

4. Less discomfort, quick recovery

Less invasive surgery often translates to less post-op discomfort and faster recovery time. After conventional periodontal surgery, patients can expect a fair degree of swelling and soreness following surgical manipulation of their gums and bone. Often there is also soft tissue or bone grafting involved, which can add another layer to the recovery process.

Following laser therapy, patients are able to resume normal activities the very next day! Some patients have reported increased cold sensitivity of the teeth. However all of these patients reported their cold sensitivity resolved completely within 2 weeks following the procedure.

5. Less costly than conventional therapy

Periodontal disease can be expensive to treat. Perio surgery is a fairly specialized field, especially when it comes to bone grafting and soft tissue grafting. Grafting materials are also quite expensive. While there are still times when bone and soft tissue grafting are needed, laser therapy helps minimize the necessity of their use.

All of these factors result in reduced cost to perform the procedure, and therefore reduced cost to the patient.

In fact, during the lecture we were shown a patient’s treatment plan with fees. Their office presented a plan for conventional surgery and a plan for laser therapy. In this patient’s case, cost of laser therapy was nearly half that for conventional surgery!

Conclusion

Laser therapy is here to stay. For the purpose of treating gum disease, clinicians are already achieving outstanding results. Patients experience less discomfort and quicker healing times with cutting-edge treatment that costs less than conventional surgery.

Technology in dentistry is changing at an astonishing rate, and it is only going to speed up! Laser therapy for gum disease is very different now than it was only five years ago. I was glad I got to attend this presentation to learn more about what is available to help my patients.