Laser

The laser in dentistry is a recent technology but, above all, it is innovative due to its many applications and some unique and valuable characteristics.

Its fields of application in dentistry are many, just as the great advantages that the laser has.

They can be summarised as follows:

• speed of action,
• minimum invasiveness,
• absence of vibrations and annoying noises like our drills,
• less use of anaesthesia (in many cases, anaesthesia is not necessary, because of the sterilisation of the surfaces exposed to the laser action),
• etc.

Let us take a look at the advantages in the various fields.

Conservative dentistry

Conservative dentistry refers to all those treatments aimed at preserving the tooth attacked by caries, such as fillings.

In these cases the laser (specifically an erbium laser) is used has the ability to make a cavity in the tooth with great comfort for the patient. The use of anaesthesia is reduced or even unnecessary, because the laser beam in its action exceeds the speed of propagation of pain along the nerve fibres. This characteristic is very appreciatedwhen operating on children, where the fear of the dentist can finally be won. The cavity that the laser digs into the tooth is sterilised by the beam itself, thus enablingsmaller and less invasive cavities can be made, saving tooth structure.

It is very effective in the treatment of dentinal sensitivity (patients who experience unpleasant cold sensations on their teeth).

Endodontics

Endodontics is the removal of the pulp (nerve) of the tooth.

The laser enables very effective sterilisation of the root canals and thus a better prognosis of the treatment afterwards.

In this case, two different lasers with their own characteristics are used (erbium laser and neodymium laser).

Periodontology

Periodontology refers to treatments that take into account the supporting tissues of the tooth such as gingiva, bone, periodontal ligament, that can beaffected to varying degrees by inflammatory or infectious processes, caused by subgingival tartar and a person’s genetic predisposition, up to very serious cases of periodontal disease (once called pyorrhoea) leading to tooth loss.

In periodontology, the use of erbium and neodymium lasers has led to numerous clinical advantages as well as less post-operative pain.

Hard and soft tissue surgery

In many operations, such as frenulum removal (which is often performed in children undergoing orthodontic therapy), the use of the erbium laser makes it possible toshorten the operating time and reduce the use of anaesthesia; no stitches are required, no antibiotics or anti-inflammatory drugs are needed. Finally the healing time is very short (15 days, as opposed to 40 days for traditional surgery), the post-operative pain is practically nil, as is the bleeding or oedema.

The applications are many, like in gingivectomy or periodontal pockets.

Oral pathology

The laser is widely used in oral pathology from the removal of fibroids of the tongue or lips, in hyperkeratoses, mouth ulcers, even stomatitis (due to the use of chemotherapy in patients undergoing treatment for cancer).

L.L.L.T (Low Level Laser Therapy)

L.L.L.T. is another type of therapy using laser light. It literally means “low-level laser therapy“ and it was the subject of my specialisation course’s thesis.

It has to do with the treatment of pain, oedema, and the ability to accelerate the healing process of wounds of any kind, using laser light of a different wavelength than the erbium or neodymium laser, and of low intensity.

Its fields of application are infinite, and in dentistry it is widely used, especially in Northern European countries.

It consists of irradiating the affected area with the laser. The treatment is completely painless and has no contraindications (not even during pregnancy).