When you think about the use of lasers in dentistry, you may only think of teeth whitening applications but there is a growing body of evidence that cold lasers or low level lasers can be used to treat a variety of much more important issues than the color of your teeth.  There have been hundreds of studies showing the efficacy of therapy lasers for treating a variety of dental conditions. Here is a USA today article describing what a Harvard researcher found out about the effects of IR lasers on tooth enamel but that is not an FDA cleared application yet so we cannot review it on this site.

One of the most well know laser companies, K-Laser™, based their first product on a dental laser made in Italy before they adapted the product for the general laser therapy market. Today, there are lots of options ranging from class 1m to 4.  Dental therapy lasers may be low enough power level that there is no perceptible heating generated or they can be class 4 system that will generate a small amount of heat (not technically a cold laser but they are not hot lasers). Over 95% of dental lasers are less than 18 watts of power for dental applications and there really does not any good reason to have more than 15 watts of continuous power in a laser that will be used on the head.

The main 3 dental applications where laser therapy gets outstanding results:

  • Temporomandibular Joint (TMJ) Pain - Laser treatments are used to quickly reduce pain and inflammation. Cold Lasers are perfect for this application and can be used directly though the cheek so pretty much every laser we sell will work for this application. This therapy typically takes about 10 minutes per treatment for 5 to 12 treatments to give the patient relief. If the root factors causing the problem (such as grinding teeth at night) are not solved, the patient may require treatment again in the future.
  • Post-Surgical Therapies - A cold laser can be used after most dental surgical procedures to reduce the inflammation and assisted with pain control.  The laser can be used inside the mouth where the light energy would make first contact with the damaged area but in most cases, treatment through the cheek will provide the same results and the patient is more comfortable. Even dosages less than 500 joules can make a big difference in the patients recovery time.
  • Trigeminal Neuralgia (TN, or TGN) is also known as prosopalgia, tic douloureux, and Fothergill's disease and is described as one the most painful conditions known. In fact, damage to the nerve root can cause such extreme pain that this so close to the brain that there is no escaping it and so some people call it "suicide disease". In recent years, we have seen excellent results in treating this condition with higher power lasers. Because the pain level is so high, the treatment typically takes a higher dosage and so most buyers look at a class 4 laser for this condition.

Selecting a Cold Laser for Dental Applications
In general, we recommend looking at low and medium power lasers for most conditions near the eyes or on  the head including dental procedures.  Because the therapy is close to the eyes and because some of the energy is bounced around inside the head, conditions like TMJ can be treated with a less expensive and less powerful device like a TerraQuant system or Avant system.  These FDA cleared systems are great for both professionals and home users and both system have the option for a light pipe to allow the practitioner or user to focus the laser energy into a small area inside the mouth or at a trigger point on the outside of the mouth. For more serious pain conditions like TGN, we have seen good results from higher power (class 4) systems (3 to 15 watts) like the Apollo, Aspen, Nexus and Pilot. We have also had many users get good results with a class 3 systems but higher dosages seem to provide more consistent results.

One of the more important factors in choosing a system is portability. Desktop systems will give more control over the settings on the laser and present a more professional image (like the Chattanooga Vectra Genisys) but a portable system is often better for dentists because it is easy to move from one treatment room to another. Several desktop lasers can be operated off a battery pack (Chattanooga Vectra Genisys, Nexus) so they can be mounted to a cart for easy transport between treatment rooms.

Choosing a wavelength for a dental laser might be the most difficult part of the laser selection process.

  • 900 to 1000 nm (nanometer) lasers have become somewhat the standard for pain control. Both Aspen and Nexus offer systems at 980nm.
  • 800 to 850 nm is recommended for damaged nerve treatments for better long term results. Apollo, Aspen, and Pilot offer systems at about 810nm.
  • 600 to 660 nm can be the best wavelength for directly treating inside the mouth and its limited penetration depth makes is a safer option. Avant, Chattanooga, Thor and K-Laser offer systems in this wavelength.

The Avant can be a good all purpose option because it covers both the 808nm and 637nm wavelengths in one system and it does both broad and pinpoint treatments with the included light pipe.

There are well established protocols for all these conditions for all the lasers that we sell.  To see all the major options for therapy lasers on the market, look at our cold laser buyers guide.

 

Dental Laser History
Theodore Harold "Ted" Maiman, an American Physicist and graduate of the University of Colorado was the first to develop and use a laser in a dental procedure.  The first application did not go as well as they hoped, however it opened the door to using lasers for dental treatments.  By the 1990’s the use of lasers was more wide spread and dental lasers had FDA clearance by May of 1997.  The American Dental Academy (ADA) has not officially placed their seal of acceptance of laser usage; however they are “cautiously optimistic about the role of laser technology in the field of dentistry”. As technology has improved and the cost of lasers has decreased, more and more dental offices are implementing lasers in their procedures.  The applications of lasers for dental procedures have expanded the capacity for dentist to perform procedures they may otherwise not be able to perform.  Laser treatments can be pain free, which, in turn, can eliminate the need for anesthesia.   Eliminating this need also allows those, with an allergy to anesthesia, to be treated, as well as children and pregnant woman. Lasers also allow the clinician to reduce the amount of bacteria in the treatment area. Lasers can sometimes help patients to avoid a root canal when there is a minor root infection.  Some other areas where lasers are effective are: faster healing, less, bleeding, treatment of periodontal disease, sore tooth neck relief, faster ingrowth of implants and pain relief.   Lasers can be used for both Hard Tissue (tooth) and Soft tissue (gums) treatments.  The following list explains some of those procedures and how lasers work.


NON-COLD lasers in Dentistry


Blue Lasers and Lights

  • Dental fillings - Lasers are able to kill bacteria in and around a cavity
  • Teeth Whitening - the energy of the laser speeds up the whitening process by activating or heating the whitening solution.  This can also be done with IR light with an appropriate gel. Look at one of our Nexus lasers for a dual purpose system.
  • Light Cure Compounds - Many dentists use special composites to fill teeth. These composites are typically cured (hardened) using UV light. These systems do not require lasers so they are less restricted.

Hot or Surgical Lasers

  • Muscle attachment - A frenectomy performed by a laser is perfect for “tongue tied” children.  This requires a hot surgical laser. Cold laser can help with the pain of the surgery.
  •  Lesion removal - Lasers are a painless way to removal benign tumors and this treatment is suture-free and it done with a hot surgical laser.
  • Tissue reshaping - Lasers can be used to reshape tissue of the gums to expose healthy enamel correcting a “gummy smile”

Other Cool Application

  • Tooth sensitivity - Laser treatments can seal the tubules, at the root of the tooth, that cause the sensitivity
  • Cavity detection - By reading the by-products that are produced by tooth decay, low level dental lasers can detect tooth decay

With technological advances being made daily, we are only on the brink of laser treatments becoming more the norm in dentistry.  Someday, dental procedures will be lower pain with less side effects and better efficacy because of the addition to lasers to more dental offices.

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