Angie Wallace, RDH
Answers to some of the most frequently asked questions about 810 Nanometer Dental Diode Lasers.
What is a Dental 810 Nanometer Diode Laser?
Lasers are categorized based on their wavelength on the electromagnetic spectrum. All dental lasers specifically use a single or narrow-range wavelength that interacts with oral tissues. An 810-nanometer diode laser is one such type, and its energy is attracted to dark-pigmented tissue, making it ideal for targeting bacteria within periodontal pockets and inflamed gingival tissues. The diode laser beam is delivered to soft tissue with a fine fiberoptic tip which allows for tactile feedback for the operator.
Besides periodontal treatment, these lasers offer various applications in dentistry, including:
- Act as THE soft tissue dental handpiece.
- Tissue cutting for procedures like incisions, frenectomies, and crown lengthening.
- Laser-assisted periodontal therapy (LAPT) to reduce bacteria in infected periodontal pockets.
- Photobiomodulation (laser-assisted biomodulation) promotes healing and reduces inflammation.
- Treatment of Aphthous ulcers and viral cold sores.
- Hemostasis (blood clotting) to control bleeding around restorative treatments.
How Does It Work?
The laser's attraction to dark pigmentation allows it to target the pigmented oral bacteria within the mouth. The absorption of heat causes bacterial coagulation which disables further cell division. It is crucial to wear protective eyewear due to reflected laser energy with the correct wavelength specification. Not all safety glasses are created equal, so ensure yours are designed specifically for 810-nanometer diode lasers. Lasers come with 3 pairs of safety glasses.
Is Laser Dentistry Safe?
Dental hygienists often consider lasers to be safer than traditional tools like scalers and curettes due to their precision. Here's why:
- Scalpels can remove hundreds of cell layers, while electrosurgical devices can remove more than 1,000 cell layers. In comparison, lasers can target single-cell layers, minimizing unnecessary tissue removal. 810-nanometer lasers have no visible effect on teeth or bone.
- Lasers offer different modes like tip contact and non-contact, allowing for precise control of energy delivery to the tissue and minimizing tissue burning.
- Settings are adjusted based on the patient's specific needs. For instance, lasers might need lower settings for patients with darker gingival tones due to their increased melanin content or their local red blood cell population.
Training is paramount for safe laser use. Understanding how different settings and techniques influence tissue interaction is crucial. The amount of absorbed energy is dependent on Power, Pulsing, and the hand speed of the laser operator.
What Dental Procedures Can Be Performed with an 810-Nanometer Diode Laser?
Here are some examples of how dental hygienists and dentists can successfully utilize 810 nanometer diode lasers:
For Hygienists:
- Debridement within diseased periodontal pockets (LAPT)
- LBR for reducing inflammation for simple gingivitis treatment
- Treatment of Aphthous ulcers and virus-caused cold sores
For Dentists:
- Frenectomies
- Gingivectomy
- Crown lengthening (soft tissue)
- Tissue troughing for crown preparation, scanning and retraction
- Fibroma removal
- Lasting hemostasis before and after procedures
Does Laser Dentistry Hurt?
Patient comfort depends on several factors:
- Patient Tolerance: Some patients are just more sensitive than others.
- Procedure: traditional procedures requiring anesthesia will still require it when using a laser.
- Laser Settings and Technique: Using the lowest possible settings to achieve the treatment goal and proper technique will minimize discomfort.
Using a laser in a periodontal pocket often doesn't require anesthesia because the targeted necrotic tissue lacks functioning nerve endings. Additionally, adjusting settings like using a pulsed mode (laser on/off cycles) allows for tissue cooling between pulses while reducing discomfort both before and after the procedure.Here are some tips for minimizing discomfort during laser procedures:
- Explain the sensation of warmth to the patient and encourage them to communicate any discomfort.
- Adjust settings like power or use a pulsed mode.
- Move the laser slowly to allow proper tissue interaction.
- Use a cross-hatching motion to ensure even coverage.
- Stop periodically to cool the tissue with a gentle stream of air.
- Post-operative pain is virtually eliminated due to the absence of inflammatory changes for the typical 8-day period of healing. Additionally, the remaining nerve pain receptors for pain have been coagulated and are non-functional for several days.
Remember, the goal is to allow the laser energy to interact with the tissue effectively, not to force a cutting action. Unlike most other dental instruments, laser fibers are only end-cutting.By understanding these key points, dental professionals can leverage the benefits of 810-nanometer diode lasers to provide safe and effective treatment for their patients.