Dentistry has changed tremendously over the past decade to the benefit of both the clinician and the patient. One technology that has become increasingly utilized in clinical dentistry is that of the laser. A laser is an acronym for Light Amplification by Stimulated Emission of Radiation. 

A laser is a device that utilizes the natural oscillations of atoms or molecules between energy levels for generating coherent electromagnetic radiation usually in the ultraviolet, visible, or infrared regions of the spectrum. It is a device that produces a high intensity of a single wavelength and can be focused into a small spot.    

Applications in Dentistry:

1. Intraoral soft tissue surgery

  • Ablating, incising, excising, coagulating 
  • Laser-assisted uvulopalatoplasty 
  • Treatment of the pathologic condition
  • Sulcular debridement 

2. Hard tissue application

  • Caries removal, inhibition, detection 
  • Cavity preparation 
  • Surface modification
  • Tooth bleaching 
  • Calculus removal 
  • Bone ablation and cartilage reshaping 
  • Dentin desensitization 
  • Analgesia

3. Dental materials

  • Composite curing, bracket bonding 
  • Alloy welding 

4. Endodontics

5. Other application

  • Laser diagnostic 
  • Instrument sterilization 
  • Bio-stimulation.

Uses of Lasers in Periodontics

  • Treatment of Dentine Hypersensitivity with Lasers: Dentine hypersensitivity is characterized by short, sharp, pain arising from exposed dentin in response to stimuli typically thermal evaporative tactile, osmotic or chemical and which cannot be ascribed to any other form of dental defect or pathology. The mechanism of laser effects on dentine hypersensitivity is thought to be the laser-induced occlusion or narrowing of dentinal tubules (Lan and Liu 1995), as well as direct nerve analgesia, via pulpal nerve system. It has been hypothesized that the laser energy interferes with the sodium pump mechanism changes the cell membrane permeability and/or temporarily alters the endings of the sensory axons. 
  • Laser Deepithelization for enhanced regeneration of periodontal tissues: Successful treatment of periodontal defects to obtain new attachment continues to represent a serious therapeutic challenge for a predictable result in periodontics. Historically, many techniques have been tried to retard epithelial down growth. The laser wound on skin and gingiva causes a delay in reepithelization because of factors such as reduced inflammatory response and less wound contraction.
  • Depigmentation with Laser: Gingival and cutaneous melanin pigmentation is often a source of an aesthetic problem. The intensity and extent of pigmentation vary widely among individuals. Various methods suitable for the removal of pigmentation from the gingiva have been described. Among them are cryotherapy, gingivectomy and argon laser irradiation. In addition, several lasers are used for ablation of cutaneous pigmented lesions and oral lesions.
  • Esthetic gingival procedures: Lasers can be applied in esthetic procedures such as recontouring or reshaping of gingiva and in crown Lengthening. With the use of some lasers, the depth and amount of soft tissue ablation are more precisely and delicately controlled than with mechanical instruments. In particular, the wound healing is fast and favourable owing to the minimal thermal alteration of the treated surface. 
  • Nonsurgical pocket therapy Conventional root debridement: In periodontal pockets, the exposed root surfaces are contaminated with an accumulation of plaque and calculus, as well as infiltration of bacterial endotoxins into the cementum. Usually, in the Initial phase of periodontal therapy, debridement of the diseased root surface is nonsurgically treated by mechanical scaling and root planning, primarily by using manual or power-driven instruments. However, complete removal of bacterial deposits and their toxins from the root surface within the periodontal packets is not always achieved with only the use of conventional mechanical therapy, I have found all such condition laser therapy as useful.   
  • Teeth Whitening: Quality low intensity soft tissue lasers are outfitted with special attachments that can be used to speed up the lightening process.
  • TMJ Pain: A patient who has their mouth open for an extended period of time may experience myofascial pain, TMD symptoms, jaw stiffness, and earaches. Quality lasers can quickly reduce pain and inflammation of the temporomandibular joint with low-level laser therapy (LLLT). LLLT regenerates damaged nerves and blood vessels to provide an analgesic effect for pain management.

So why lasers:

1. Avoids the stress of drills and needles

2. Reduces stress and fear of going to the dentist

3. Minimally invasive

4. Faster healing pattern

5. Fewer chances of drug interactions

6. Fewer chances of cross infection

7. Reduces the number of patient visits and treatment settings

So get over the fear of painful needles, blood-filled mouths, long periods of discomfort and welcome to the world of painless dentistry.