The Laser Connection –Toward a Kinder, Gentler, Periodontal
by Robert J. Schulhof, AB, MA Math Statist.
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 with the advance of
laser gum surgery and gum treatment, and our understanding of the
disease, laser periodontal treatment can be accomplished painlessly,
quickly, and with your cooperation, can be kept in remission.
At each appointment, we will perform a typically painless gum disease
laser "decontamination" which includes tracing the laser
around the gumline 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). Periodontal laser surgery and treatment
does 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. Periodontal disease laser treatment,
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
(PMT) where your 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 laser treatment for gum disease will
do more than save your teeth and sweeten your breath. It may be
the best way to reduce your CRP (21), lower a factor called "glycated
hemoglobin"(HbA1c) which can reduce the risk of diabetes, (4)
and, if you are diabetic, greatly increase your life expectancy
(5). If you are an expectant mother it can reduce your chance of
a pre-term birth by a factor of 7 (6).
Our unique non-surgical laser treatment for periodontal disease
protocol will be less costly and less painful than traditional periodontal
surgery or even your co-pay on a one-day stay in the hospital. Since
periodontal disease is now recognized as a systemic infection it
is likely that in the future your medical insurance would cover
some or all of the costs of periodontal treatment. In the meantime,
you can be assured that the protocol we have developed will be a
worthwhile investment in your total health as well as your dental
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 an hs-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.