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November 2008 | Web Exclusive Laser Love
I think many hygienists – and their patients – will feel that way about the diode laser in the near future. Just as it took some time and experience for people to accept the extra cost and obligations of using a cell phone, it will also take a trial period and excellent education for both the hygienist and the consumer to embrace this new technology. In the end, everyone will see the laser is now an essential part of keeping our patients mouths healthy. At least, that has been my experience.
I couldn’t help but be both excited and intimidated when my employer decided to make the investment to obtain a laser for the office and train the hygienists in the practice to use it. However, in my initial training session while I learned about the physics of the laser, I didn’t feel at ease with either using the machine on a patient or integrating the new treatment plans with our existing schedule. Fortunately, a second training – with Gloria Monzon, a registered hygienist and laser education expert – provided me with the tools I needed to make this transition a comfortable and critical part of my practice. What Gloria provided, through lecture, clinical simulation and hands-on training, was not only technique, but also invaluable lessons in time, patient and financial management for different procedures. It soon became clear that I, a dental hygienist for the past three decades, was going to have to think outside the box. I’m sure I’m not the only hygienist who allowed patients to return for recare appointments based on their promises to improve -- promises which never materialized. I always wanted to give them another chance to turn their oral hygiene and periodontal disease around. What hygienist hasn’t told a patient: “You don’t have to take care of all your teeth, only the ones you want to keep”? In our office, the protocol was to treat periodontal disease with scaling and root planing (SRP), the industry standard. Now there is a new tool and treatment for the tissue that is getting results that far surpasses SRP alone. This therapy is less invasive, more comfortable and a more easily accepted option for patients who are reluctant to visit a periodontist. Contrary to the supposition that periodontists will feel threatened by the hygienist’s use of the laser, the periodontist to whom we refer was so enthusiastic about the technique, she attended Gloria’s class herself and bought a laser for her own office.
Once I began using the laser, I was easily won over. My first patient was a woman whose oral hygiene was generally good, but who had an isolated, but alarming, 8-mm pocket. I used the laser to curettage and reduce bacteria in combination with scaling and root planing. I’d barely started the procedure when I noticed results, with the tissues shrinking slightly and becoming less inflamed even as I worked on her. By the fourth appointment – one visit less than I originally estimated – the pocket had shrunk to 3-mm with no bleeding. She was thrilled and so was I. I recommended she continue with laser therapy at each recall appointment. Remarkably, two years post treatment, her x-rays showed the defect had started to fill in with bone. I felt so comfortable using the laser I even treated my own mother, who has PFMs on all her upper anterior teeth. Though she has great oral hygiene, her mouth breathing was causing inflammation. Since she started laser treatment, she claims her tissue feels different and healthier than ever before. Naturally, she also says “Nobody could ever clean my teeth as well as you do, Patti.”
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