Periodontal (gum) disease is a multifactorial condition that is caused by microbes. The bacterial component includes the microbes that live in the debris in our mouth, including soft tissue biofilm and plaque, as well as in and on the hard deposits like calculus (aka tartar). The extent of the disease depends on the host immune response. The individual’s immune system creates a hyperactive inflammatory reaction to these irritants that destroys connective tissue and bone and leads to gum disease with eventual loss of teeth. The latest research in periodontal disease, indicates that adopting the new, cutting-edge laser technology can provide bacterial decontamination, repair and regeneration of the gums during your routine hygiene or deep cleaning appointment.
To be clear, moderate and advanced periodontal disease cannot be reversed or cured. However, its effects can be mitigated with deep teeth cleaning (scaling & root planning). Dental laser is often used alongside these procedures.
How is Gum Disease Diagnosed?
An xray of your teeth can easily reveal bone loss, but the most standard test to diagnose periodontal disease is called a perio chart. You probably have already had a perio chart as this is routinely done during your prophylaxis appointment. It’s when your hygienist ‘pokes’ your gums with a ruled periodontal probe and ‘shouts’ numbers. Those numbers measure the pocket depth, and generally 1mm, 2mm, and 3mm pocket depths are associated with healthy gums and any number above 4 may indicate the start of a disease. Gum bleeding on probing and gum recession are taken into consideration, as well as patient’s health history, such as smoking or diabetes.
Periodontal disease is prevalent among a lot of adult patients, and if untreated can lead to bone and tooth loss all the while being asymptomatic for the individual.
How Do We Prevent and Treat Gum Disease?
The best way to prevent and halt gum disease is by removal of the mechanical irritants, such as plaque and calculus, but also by addressing the underlying infection and bacteria that causes it. At home, this is done with meticulous oral hygiene routine, that ideally, should include thorough brushing and flossing after each meal. Teeth that have been properly cared for with good oral hygiene habits will have less plaque and calculus on them.
In a dental office, removing the irritants is done with hand and ultrasonic scaling - the usual protocol most dental offices offer during their routine cleaning appointments. Ultrasonic powered scalers use ultrasonic (sound) frequency to create micro vibrations at the tip and disrupt debris and tartar from the tooth, without disturbing its structure. Hand scaling takes advantage of the tactile sense of the clinician and in addition to removing debris, it also planes and smoothes root surfaces.
This is where well-maintained dental restorations come in handy. Good fitting restorations with well adapted margins and no overhangs are more cleansable. And well aligned bite and tight contacts between the teeth prevent food impactions and growing bacteria. Finally, regular dental checkups help ensure your teeth and restorations are in good shape and do not contribute to bad periodontal health.
How Do We Treat Gum Disease with Dental Laser?
The first line of treatment in periodontal disease patients is the non-surgical scaling and root planning therapy also known as deep cleaning or SRP.
At Acton Smile Hub, we couple our dental laser with an ultrasonic and hand scaling for your scaling and root planing appointments.
The treatment is done in two appointments, each side of the mouth separately, usually no more than two weeks apart. Local anesthesia will be utilized at each appointment.
The first step is laser gum curettage, to remove all the diseased gum tissue. After this, an ultrasonic scaler will be used to remove the tartar and plaque from your teeth, above and below the gum line. Next, hand scaling is done to ensure all the debris is removed and the root surfaces have been planed and smoothened.
The hygienist may choose to use the laser again, in isolated areas with deeper pockets. Laser therapy in deeper pockets has been proven to help with tissue healing and re-attachment.
Finally, the gums are irrigated with a medicated, antimicrobial solution to remove any residual debris and aid in healing. You hygienist will counsel you over appropriate nutrition and discuss best oral hygiene protocols.
In susceptible patients, the clinician may use the laser in a manner that provides laser bacterial reduction and decontamination. This prophylactic laser setting aims to reduce Covid pathogens, minimize aerosols, and reduce bacteremia in susceptible patients.
How Does Laser Dental Therapy Actually Help Treat Gum Disease?
Note that neither hand, nor ultrasonic scaling will directly destroy periodontal bacteria. The bacterial load is diminished however by removing the debris inhabited by these microbial colonies.
You may ask if a course of antibiotics may destroy these pathogens, but studies of topical and even systemic antibiotics have unfortunately shown they are not helpful in the treatment of gum disease.
This is where dental lasers can help - the underlying periodontal bacteria can now be addressed and destroyed directly through laser bacterial reduction or laser decontamination. In addition, a soft tissue dental laser can alter the host immune response by reducing the infection and helping repair and regenerate the tissue.
In summary, dental lasers help kill periodontal disease bacteria and prevent gum disease; provide minimally invasive dentistry with no need for scalpels, incisions or sutures and they stimulate tissues to produce collagen, repair and regenerate faster.