Laser, a powerful tool for periodontal disease treatment

Author: Xie Chengjie, Deputy Director of the Periodontology Department, Haizhu Square Branch, Southern Medical University Stomatological Hospital, Associate Chief Physician

Reviewer: Chen Ke, Director of Haizhu Square Campus of the Stomatological Hospital of Southern Medical University, Professor, Chief Physician

Do you have bleeding gums? Do you have sensitive teeth? Do you feel that your teeth are getting weaker and weaker when you bite? Oh, you are most likely suffering from periodontal disease. This is not a "getting angry" or a small problem that can be solved by taking some medicine. Periodontal disease needs to be treated in the hospital. You may wave your hands when you see this, "I know, to treat periodontal disease, you have to wash your teeth first! Oh, I can't stand that, it's so sour and painful, no no!" So, today I will introduce you to high-tech - laser, which is a powerful tool for treating periodontal disease.

Laser and periodontal abscess

When the gums swell up, it is hard to sleep and eat; to make matters worse, the dentist will use a knife to cut the abscess, insert an instrument into the abscess and cut around it, and then flush it with a lot of liquid medicine to flush out the pus deep in the abscess. Due to the presence of pus, the effect of anesthetic will be discounted. Therefore, this process is really painful, and many patients shed tears! Fortunately, the whole process is not long, and a fast dentist only needs 1 to 2 minutes to complete it. The dentist finally finished it with the encouragement of "just bear with it". This is the most common "periodontal abscess incision" in dental treatment, and the name alone makes people tremble.

Is there an alternative treatment? Yes! That is laser. In different laser treatment modes (Figure 1), laser has the functions of anesthesia, cutting, disinfection, hemostasis, and physical therapy [1]. First, use the laser to illuminate the abscess (note that there is no syringe here), and it will have an anesthetic effect; then use the laser to cut the abscess (note that there is no blade here), and under the irradiation of the laser, the tissue inside the abscess is divided and the pus flows out smoothly; finally, use the laser to stop bleeding and perform physical therapy on the wound. The whole process is painless and very comfortable.

Figure 1 The biological action principle of laser (copyright image, no reproduction allowed)

Laser and periodontal scaling

The core of periodontal disease treatment is to scrape away the calculus and plaque inside the gums and on the surface of the tooth root. In order to ensure the thorough removal of pathogens, dentists usually need to use a scaler to repeatedly scrape and plan the root surface until it is smooth. As the saying goes, "toothache is really terrible." Even under anesthesia, patients may still feel sore and tender at the root of the tooth, especially those who are sensitive to pain, who will show a tense state with clenched fists and straight legs. This process is not pleasant!

Nowadays, laser-assisted periodontal scaling has become increasingly common [2]. The anesthetic effect of laser is achieved through irradiation, which prevents patients from feeling nervous when seeing the syringe, and reduces the pain threshold of patients to a certain extent. The laser penetrates deep into the gums and irradiates at 360 degrees, which can not only kill bacteria deep in the tissue and avoid excessive and repeated scaling, but also irradiate narrow gaps that are difficult to reach with conventional instruments, thus making up for the omissions of conventional instruments. At the same time, the laser performs physical therapy on the tissue while sterilizing, which can activate the regenerative ability of periodontal ligament cells and promote tissue regeneration and healing (Figure 2). This treatment process is comfortable and painless, and it also has a regenerative effect. Isn’t it amazing?

Figure 2 Laser-assisted periodontal treatment: disinfection and sterilization of periodontal pockets, promotion of tissue regeneration and healing (copyright image, no reproduction allowed)

Laser treatment for special populations

Periodontal disease is a chronic disease that increases with age, that is, the incidence rate is higher and the condition is more serious in middle-aged and elderly patients. This is related to the lack of timely dental treatment when the elderly are young and the decline in their ability to clean their mouths with age. Therefore, elderly patients need more comprehensive periodontal treatment. However, the systemic condition of elderly patients may have an impact on periodontal treatment. Many elderly patients suffer from hypertension and cardiovascular diseases, and take antihypertensive drugs and aspirin for a long time, which limits the use of traditional anesthesia during periodontal treatment and increases the risk of intraoperative bleeding and difficulty in stopping bleeding after surgery. Some elderly patients have pacemakers or heart stents installed, so it is not appropriate to use ultrasonic periodontal therapy devices during treatment. At the same time, during traditional treatment, bacteria enter the heart with the blood, and it is easy to form bacterial emboli adsorbed on the heart stent.

In addition to the elderly, pregnant women are also prone to periodontal problems. Affected by hormones during pregnancy, the gums are prone to bleeding and swelling, and some patients even develop gingival tumors during pregnancy. Removal of gingival tumors or traditional scraping during pregnancy can easily make pregnant women nervous and fearful, increasing the risk of miscarriage; bacteria mixed in the blood can easily cause the risk of infection, and pregnant women are not suitable for routine antibiotics. They can only rinse locally to reduce inflammation, which affects the efficacy [3].

There is another type of dental anxiety patient (Figure 3). They will feel extremely anxious when they hear the sound of dental turbines or see various dental tools. They are particularly afraid of seeing a doctor even if it is just a minor problem like bleeding gums. This often delays the best time for treatment [4].

With the advent of dental laser treatment, high technology has brought good news to this type of patients. Laser can achieve painless anesthesia, sterilize and perform physical therapy at the same time, greatly reducing the concentration of bacteria entering the blood; during treatment, there is no vibration caused by traditional instrument treatment, which effectively relieves the patient's tension and allows the treatment to be completed smoothly.

Figure 3 (copyright image, no reproduction allowed)

After the above introduction, I believe everyone has some understanding of the unique effects of laser. In the future, laser will become more and more popular and no longer be so "mysterious". It will become a regular treatment project that benefits the public! So, don't be afraid of dental treatment anymore. Laser makes your periodontal treatment comfortable, painless and efficient. Come to the dental hospital and try it!

References:

[1] Robert A. Convissar (ed.), Zhao Ying (translator). Oral Laser Principles and Technical Practice [M]. 2nd edition. Shenyang: Liaoning Science and Technology Press, 2019.

[2] Qin Ziyue, Chen Wu. Application of laser in the diagnosis and treatment of periodontal diseases[J]. Chinese Journal of Practical Stomatology, 2020, 13(12): 709-714.

[3] Liao Yangyang, Xiang Shaowen, Xie Chengjie. Comparison of the comfort effect of Er:Cr:YSGG laser and traditional surgery in the treatment of gingival tumors[J]. Chinese Journal of Aesthetic Medicine, 2022, 31(7): 96-99.

[4] Liao Yangyang, Xie Chengjie, Yang Xi. Er:Cr:YSGG laser treatment of periodontitis in patients with dental anxiety: a case report and literature review[J]. Chinese Journal of Laser Medicine, 2021, 30(1):22.