Laser Treatment

Dental Diode Lasers

Dental Diode Lasers (DDLs) in Orthodontics

The laser was first postulated by Albert Einstein in 1916. He suggested that portions of the electromagnetic field could be stimulated, thus producing amplified light. Thus, the acronym LASER stands for Light Amplification by Stimulated Emission of Radiation. Various scientists have brought this technology forward to the point where dental applications were envisioned, and first tested in 1964. Since then, tremendous advances have occurred, and we are now seeing lasers in dentistry for both hard and soft tissue applications.

Today, the soft tissue laser has been universally accepted as a tremendous adjunct to soft tissue therapies, offering an extremely precise, pain-free method for manipulating oral tissues. Diode lasers are finding their way into today’s top orthodontic practices, helping doctors manage common soft tissue problems associated with patients in braces, like through routine-

Laser-facilitated access for bracket placement
Gingivectomy - to improve access for oral hygiene
Esthetic gingival recontouring - following the removal of braces
Exposure of impacted or unerupted teeth
Frenectomy - to manage space between the upper incisors
Hemostasis – to create a dry field for bonding braces
Operculectomy
Fiberotomy – to reduce the tendency for shifting of teeth following orthodontics
Fibroma removal
Treatment of apthous ulcers and herpetic lesions
Exposure of TADS (temporary orthodontic anchorage devices)

A variety of dental diode lasers (DDLs) are available to orthodontists. Current DDLs operate in three wavelengths: 810, 940, and 980 nanometers (nm), and each has different effects on soft tissue. Table 2 shows these wavelengths tendencies for absorption in three compounds: hemoglobin, oxyhemoglobin, and water. As Table 2 depicts, the 940 nm diode laser accounts for the highest overall absorption by hemoglobin, oxyhemoglobin, and water, making it highly effective for both clean surgical incisions (low carbonization) and excellent hemostasis; for common soft-tissue laser procedures in orthodontics, the 940 nm diode dental laser works best.

Table 2

All current DDLs provide laser energy in both Continuous Wave (CW) and Pulsed (P) modes. Uninterrupted continuous wave laser energy does not allow for thermal relaxation of the tissue, while pulsed modes allow for thermal recovery (cooling) between energy pulses

Pulse-mode lasers are necessary to deliver a comfortable surgical and post-surgical experience for patients; patients treated with selectable-pulse-mode lasers regularly report no discomfort with soft tissue laser procedures, since there is little-to-no evidence of thermal damage when performing soft tissue procedures with this technology. Most soft tissue laser procedures can be performed with only topical anesthesia. When a topical anesthetic is inadequate, a local anesthetic may be needed, but this is rarely necessary.

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Serving the Providence, Rhode Island area including Cranston, Coventry,
East Greenwich, Johnston, North Kingstown, Warwick, and West Warwick areas

500 Tollgate Road, Warwick, Rhode Island (RI) 02886 • 401.739.3900 fax 401.739.8626

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FAQ

Diode Laser FAQ

How does the dental diode laser work?
The laser emits concentrated energy in the form of a light beam. This beam vaporizes matter. The dental laser delivers a narrow pulsed beam and each pulse vaporizes only a specific number of cell layers within the circumference of the beam. This gives the operator precise control over the laser.

Why is the dental laser different than conventional treatment?
The dental laser is unique because it can be used as a surgical instrument without the unwelcome post-surgical side effects. The laser stops bleeding and seals lymphatic and nerve endings, thereby avoiding inflammation and the usual discomfort that is associated with inflammation.

To summarize, the dental laser is:

essentially painless
faster and more efficient in many cases
less invasive; precise and conserving of healthy tissue
sterile (laser tip sterilizes itself in operation)
bloodless in most cases
safer

Do patients feel pain?
The majority of patients report no pain. A few report mild discomfort.

Is anesthesia required?
With some laser procedures no anesthesia is necessary, while with others only topical anesthesia is required. In rare cases, when a topical anesthetic is inadequate, a local anesthetic may be needed.

Why is pain reduced so greatly?
The dental laser delivers pulses of energy too short to trigger a neural response.

What are dental applications of the diode laser?

COSMETICALLY: One common application is the use of the diode laser to reshape the architecture of the gums:

In some cases, portions of gum tissue that are covering up healthy tooth structure are removed. This creates an enhancement of the smile by uncovering (elongating) the teeth and reducing the amount of gum tissue that shows when a person smiles.
In other cases, the laser is used to create symmetry, balancing gum tissues that are visually crooked and not level with the horizontal (smile) plane.

SOFT TISSUE MANAGEMENT: The laser is also being utilized in dental hygiene. The ability of the laser to kill bacteria in periodontal pockets (around teeth) and to rid those pockets of sick and infected tissue has enormous potential, not only as a means of arresting the progression of periodontal disease, but as a fast and simple prophylactic course of action.

REMOVAL OF DECAY: Removal of decay (cavities) from teeth.

SURGERY:

As a surgical instrument, the laser makes extremely accurate incisions.
Most patients report little-to-no discomfort during and after laser procedures.
The virtual elimination of bleeding during surgery gives the orthodontist a clear view of the operating field and reduces the risk of infection for the patient. This greatly enhances healing and speeds up recovery for the patient.

DESENSITIZING TEETH: Another advance is the capacity of the laser to desensitize teeth.

Is the laser safe?
Absolutely, in every way, when used with good clinical judgment.

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Serving the Providence, Rhode Island area including Cranston, Coventry,
East Greenwich, Johnston, North Kingstown, Warwick, and West Warwick areas

500 Tollgate Road, Warwick, Rhode Island (RI) 02886 • 401.739.3900 fax 401.739.8626

STATE OF THE ART CARE

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To Schedule a Complimentary Examination Click Here

Serving the Providence, Rhode Island area including Cranston, Coventry,
East Greenwich, Johnston, North Kingstown, Warwick, and West Warwick areas

500 Tollgate Road, Warwick, Rhode Island (RI) 02886 • 401.739.3900 fax 401.739.8626

STATE OF THE ART CARE

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Testimonials

Testimonials - Diode Soft Tissue Laser

Recently, one of my 8-year-old patients, Aaron M., required a labial frenectomy. After performing the (laser) procedure, his father asked me if Aaron could play soccer that evening, and I told him that there would be no problem. When I called his father the next day, he informed me that not only was Aaron able to play soccer, but that he had not experienced any discomfort nor required an analgesic.
Aaron M.

Biolase ezlase 940 diode laser Amanda R., a sophomore in high school, required a gingivectomy for gum tissue overgrowth due to poor oral hygiene. And, when asked how she felt following the procedure, Amanda responded, “That was neat. I didn’t even feel anything.”
Amanda R.

After performing a gingivectomy with a Biolase ezlase 940 diode laser, my 12-year-old patient, Samantha C., was asked by her mother how she felt, and Samantha responded, “Great. I didn’t feel a thing.” The next day when I called to follow-up, Mrs. C. told me that, “Samantha played with her friends from the moment she got home, and she never once complained about discomfort.”
Samantha C.

After exposing two unerupted upper canines (“eye-teeth”) with our diode laser, Kellie M., a 12-year-old patient, stated, “I was nervous (before the procedure), but it turned out to be really easy… I didn’t actually feel a thing.”
Kellie M.

Timothy L., age 13, had been up the previous night with dental pain. The operculum overlying the erupting lower right second permanent molar was large and swollen. After administering a topical and local anesthetic, the excess tissue was carefully removed with a Biolase ezlase 940 Laser. Due to the cauterizing effect of the laser, there was no bleeding and no discomfort reported during the procedure. When I spoke with his mother the following morning to see how Tim was doing, she replied, “Like a different child.”
Timothy L.

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Serving the Providence, Rhode Island area including Cranston, Coventry,
East Greenwich, Johnston, North Kingstown, Warwick, and West Warwick areas

500 Tollgate Road, Warwick, Rhode Island (RI) 02886 • 401.739.3900 fax 401.739.8626

STATE OF THE ART CARE

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Alan C. Smith, DDS, MSD

Dental Diode Lasers

Dental Diode Lasers (DDLs) in Orthodontics

FAQ

Diode Laser FAQ

Videos

Testimonials

Testimonials - Diode Soft Tissue Laser