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August 2009 | Dental Products Report The take-aways Pulse out perio Diode lasers help clinicians take a more advanced, efficient approach to treating periodontal disease.
The Odyssey Navigator laser tip outside the pocket
Ivoclar Vivadent’s Odyssey Diode Lasers represent the latest diode laser technology. (ivoclarvivadent.com) As a culture, we are much more informed about health care issues than ever before. Not only has the Internet brought virtual libraries into every home, but with this easy access to information comes a seemingly insatiable curiosity. The pharmaceutical industry is flooding the media with ads for ailments we didn’t even know we had, and prime time TV even has a show devoted to weight loss. People are finally getting the message and embracing it—we do have control of our health issues. There is an opportunity for dentists to engage the public’s curiosity and concerns about health. Dentists truly interested in helping their patients are primed to take advantage of new technologies, such as lasers, and advanced techniques to reach people interested in optimizing their health. The oral-systemic link Too many dentists are failing to recognize and use the current research linking periodontal disease to greater health issues. We, the doctors of the mouth, too often fail to expand our expertise to the rest of the body. By increasing our knowledge, we can expand the scope of services offered. And educating our patients leads to an increased demand for services that benefit their health and well being. Research links periodontal disease to systemic health issues, such as stroke, diabetes, premature babies, low birth weight babies1, heart disease and cancer2. It’s not something you can ignore The link to systemic disease is provided by a portal for the oral bacteria into the bloodstream—the bleeding gums. While dentists diagnose periodontal disease and document it with probings, for many simply providing the insurance-required sulcular measurements is sufficient. However, by not acknowledging and recording the areas of bleeding on probing, that portal is being ignored. And if it is ignored, it is not being treated. The goal of periodontal treatment should be not only to reduce gingival pockets to 1-3 mm, but also to eliminate bleeding on probing and cleaning. If a six-month recall is not meeting this goal, then we have to do something else; recommend shorter recalls or move more patients into progressive therapy. Advanced treatment modalities are available over traditional hand scaling, specifically ultrasonic and piezo-electric scalers, and soft-tissue lasers. Truly understanding the disease process warrants an examination or our approach to treatment. Where lasers fit in Advances in technology have allowed us to approach the disease process more progressively and effectively. While the scaling and root planing technique has been widely taught and used rather universally, it is not without its drawbacks. Mechanical instrumentation is technique sensitive; success is largely dependant on the practitioner’s skill and experience. During scaling, a bacterial-laden smear layer is produced and left on the root surface.⁶ The technique invariably results in incomplete elimination of microflora, and recolonization quickly occurs.⁷ Alternatives include ultrasonic scalers that result in disruption of the biofilm and lasers that have a bactericidal effect. Lasers are suggested as an adjunct to either hand or ultrasonic scaling. Laser technology is at the forefront in dentistry as a tool that effectively fights periodontal disease. The benefits of the laser in periodontal therapy are multi-faceted. Lasers can be used for sterilization, ablation, hemostasis and biostimulation.⁸ Benefits of laser-enhanced periodontal therapy over mechanical instrumentation alone include bacterial elimination at a much higher level,9 and bactericidal and detoxification effects in sites that mechanical instrumentation cannot reach. With the laser, there is no smear layer production, while ablation of the inflamed epithelial lining promotes periodontal tissue healing.8 CONTINUED ON NEXT PAGE
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