The Laser Connection Toward a Kinder, Gentler, Periodontal Treatment
By John W. Hammer, DDS, FAGD Periodontist
Until recently the only periodontal therapy available was deep cleanings and in more advanced cases, surgery. More recently, antibiotics were added to kill the bacteria. Such treatment made a lasting impression on those who went through it. However, the periodontal disease often came back again, creating the belief that the disease can never be cured. The good news is that now with lasers, and our understanding of the disease, treatment can be accomplished painlessly, quickly, and with you cooperation, can be kept in remission.
At each appointment, we will perform a typically painless laser decontamination, which includes tracing the laser around the gum line of each tooth, quickly, killing the bad (anaerobic) bacteria. It has been shown that laser decontamination is more effective than antibiotics. In addition, there are no strains of bacteria resistant to lasers (16). Lasers do not create resistances to medicines you may need some day and they do not suppress your immune system as antibiotics can.
We will then send you home with your special oral hygiene products, rinse and nutritional supplements. When you return the next week for your first deep cleaning you will be in much better shape, have less bleeding and sweeter smelling breath.
At the next appointment you may receive some topical anesthetic to avoid any possible discomfort. A laser decontamination followed by the use of a special gentle scaler will occur in order to make sure your roots are clean. It is only when the roots are decontaminated that the gums can re-attach to the roots of the teeth. We will then use the laser to go around each pocket to vaporize the diseased tissue and treat the roots to allow better growth of new tissue and bone (18). Pocket depth will normally decrease by 1mm per visit. We will perform a refreshing irrigation of the tissue and then your visit is complete. The laser actually helps minimize the discomfort of the cleaning and you should feel fine the next day. You may have two to four of these visits, depending upon the depth of the original pockets and how your tissue responds.
If you have advanced pockets of 6mm or more you may have a few more painless visits where only the laser is used. This whole process should take no more than a month or two, after which you continue with your home care until your first periodontal maintenance visit where you progress will be measured. This process will work 90% of the time for moderate cases of the disease, defined by
4-7 mm pockets. Deeper pockets can exist because of diseased teeth, broken down restorations and poor bite relationships. Bone grafting, soft tissue grafting and other more costly treatments might be required.
The Benefits of Treatment
Recent research has shown that curing your periodontal disease will do more than save our teeth and sweeten your breath. It may be the best way to reduce your CRP, lower a factor called glycated hemoglobin (HbA1c), which can reduce the risk of diabetes, and, if you are diabetic, greatly increase your life expectancy. If you are an expectant mother it can reduce your chance of a pre-term birth by a factor of 7.
Get Checked and Get Tested
The first step is to come see us for a complete periodontal examination and if you do have periodontal disease, to have a CRP test to assess your risk of heart attack and stroke and an HbA1c test to see if you are in danger of becoming a diabetic.