Laser Dentistry and Dental Hygiene
How dental lasers improve treatment outcomes in dental hygiene
Friday, March 17, 2023
Now more than ever, there is a greater concern about oral microbes and what dental professionals can do to protect themselves and their patients. To begin, let’s start with the patient and their oral hygiene homecare. When patients aren’t thorough with their personal oral hygiene, biofilm communities increase, and the oral tissues become inflamed. Visibly, we see healthy pink tissue become red and inflamed and exhibit bleeding upon brushing or flossing.
There is a plethora of clinical studies to support the use of diode lasers as an adjunct therapy to scaling and root planning and other hygiene procedures. In a 1998 study, 50 patients exhibiting periodontal disease were randomly divided into two groups. Prior to treatment microbiologic samples from the deepest periodontal pockets were collected and then again 6 months post treatment. The control group received scaling and hydrogen peroxide rinse and the test group received scaling followed by treatment with a diode laser. As far as the total bacterial count is concerned, long-term bacterial reduction was achieved in 100% of the lasered patients, whereas only 58.4% of the control group showed improvement (i.e., bacteria reduction).1
As this study shows, using a diode laser as an adjunct therapy to scaling and root planning can have a statistically significant difference in the treatment outcomes. This is where diode lasers such as the Gemini™ and Gemini EVO™ lasers shine. Using the right laser at the proper setting, diode lasers emit photonic energy that can reach the depth of the periodontal pocket disrupting dangerous biofilm, reducing the bacterial load resulting in reduced bleeding on probing, pocket depth reduction and ultimately improved clinical outcomes.
Why are diode lasers a good choice for dental hygiene?
It all has to do with biofilm. Scaling and root planning removes the calcified biofilm attached to the root surfaces of the teeth. But a great majority of the pathogenic bacteria responsible for this disease are embedded in the adjacent soft tissue of the periodontal pocket.2 Left untreated, this dangerous bacteria can penetrate the lining of the pocket epithelium to a depth of 0.5 mm (500 microns) and become scaling and root planning resistant.3 Through the inflammatory process or the bodies host response, bacteria can enter into the bloodstream, causing even more damage throughout the body.
Diode lasers, such as the Gemini and Gemini EVO lasers, can reduce the bacterial load, allowing the body’s immune system a better opportunity to heal. Additionally, lasers like the Gemini EVO have been used to stimulate gum tissue, promoting healing and potentially regeneration.
Common Dental Hygiene Procedures for the Gemini Laser Family
The Gemini and Gemini EVO diode lasers offer a multitude of settings for different procedures, but the possibilities for hygiene are rather exciting. It’s important to note that procedures such as Laser Bacterial Reduction (LBR) and Sulcular Debridement can be done alone, but often, they are performed together. When performing LBR, scaling and root plaining and sulcular debridement together, the process is often referred to as Laser-Assisted Periodontal Therapy.
Bacterial Decontamination or Laser Bacterial Reduction (LBR)
Bacterial Decontamination can be performed prior to any hygiene procedure or in conjunction with sulcular debridement. Similar to a pre-procedural rinse, bacterial decontamination or LBR, has been known to reduce the risk of cross-contamination within the mouth during hygiene procedures and certain dental procedures. Typically, a full mouth decontamination or LBR can be performed quickly between five to ten minutes.
Ultradent’s Gemini and Gemini EVO diode lasers are ideal instruments to aid the dental hygienists in treating periodontal diseases and assist in maintaining the patient’s long-term oral health. You can learn more about using your new Gemini or Gemini EVO diode laser here.
Sulcular debridement is an advanced dental procedure performed by dental hygienists using a laser, such as the Gemini or Gemini EVO diode lasers, to target harmful bacteria and diseased tissue in periodontal pockets. This procedure involves removal of diseased tissue from within the periodontal pockets, and reduction of the bacteria load, in order to promote healing.
Anytime inflammation is present a diode laser should be considered as an adjunct therapy to the prescribed hygiene treatment plan. Inflammation means bacteria is present eliciting a host response which is destructive to the supporting tissues. The Gemini or Gemini EVO laser can be used in conjunction with the following hygiene procedures to ensure improved treatment outcomes:
- Prophylaxis (D1110) when less than 30% bleeding on probing is present
- Gingivitis Scaling (D4346) when greater than 30% bleeding on probing is present
- Scaling and Root Planing (D4341, D4342)
- Periodontal Maintenance (D4910)
Photobiomodulation Treatment (PBMT)
PBMT has been shown to work in a dental office setting. Frequently, patients report temporary pain relief, faster healing, and other benefits from PBM therapy. It’s not uncommon for patients to experience some discomfort during an extensive dental procedure. Many dentists and dental hygienists offer PBMT to patients who suffer from TMJ or experience muscle pain from keeping their jaw in an open position for an extended amount of time. Learn more about how to relieve pain after dental procedures here.
Online Continuing Education for Dental Hygienists
Ultradent hosts a wide variety of free online continuing education for dentist and dental hygienists. For more information on qualified laser dentistry CE courses, click here.
In the state of Utah, dental hygienists must obtain at least 30 hours of qualified dental continuing education every two years. As a dental professional, keep in mind that every state has a different hour requirement. Take a look at the chart below to see information on your state.
What can dental hygienists do in their state?
Just as CE requirements vary, each state defines the scope of practice for dental hygienists including which states allow the hygienist to use a laser and specific rules and regulations around the use of lasers. Please refer to your specific state for rules, regulation, and training requirements.
- Moritz A, Schoop U, Goharkay K, et al. Treatment of periodontal pockets with a diode laser. Lasers Surg. Med. 1998;22;302-311.
- Borrajo JL, Garciavarela L, Castro GL, Rodriguez-Nunez I, Torreria MG. Diode Laser (980 nm) as Adjunct to Scaling and Root Planing Photomedicine and Laser Surgery; 22 (6) 509-512 (2004)
- Periodontology 2000, Vol. 28, 2002, 106-176; Jorgen Slots, Miriam Ting;