Objectives:
- Gauge your initial understanding of lasers and their usage.
- Discuss the benefits of how lasers can help with desensitizing.
- Summarize the effects of lasers on tooth surface including dentin and cementum.
- Reflect on today’s laser safety standards and regulatory requirements.
So many people experience sensitive teeth and are looking for ways to make it go away. In the past we were told that sensitivity was due to toothbrush abrasion. But if we really look closer, we know toothbrush bristles will not damage the teeth, like we once were taught. So, why do we have dental hypersensitivity?
What causes dentinal hypersensitivity?
As gums start to pull back and expose the dentin (a surface under the gums), sensitivity may occur. This very soft layer is what makes up the tooth root and has tubules that lead to the tooth nerve. When you eat something too cold or hot or sweet, these tubules send signals to the nerve, causing pain. Many times, this occurs with clenching and grinding of teeth.
Can sensitive tooth pain go away? Yes. In some cases, tooth sensitivity goes away on its own, especially if it’s due to a recent dental procedure, such as a filling or root canal. If tooth sensitivity lingers and doesn’t go away, it might be due to worn enamel or exposed tooth roots. In these cases, treatment may be required to address the issue.
How can you treat tooth sensitivity?
What other ways can you stop sensitive tooth pain? Treatment depends on the cause. If lingering tooth sensitivity or discomfort occurs, a dentist may need to rule out any serious conditions so they can recommend appropriate treatment. Other options may include using a desensitizing toothpaste, maintaining good oral hygiene, using a soft-bristled toothbrush, watching what you eat (especially acidic foods), using fluoridated dental products, and avoiding teeth grinding. If you grind or clench your teeth, use a mouth guard at night and see your dentist regularly.
Some dental procedures may help reduce sensitivity, including the use of:
- Dental bonding to cover exposed root surfaces
- Fluoride varnishes applied to the exposed root surface
- Dentin sealers applied to the exposed root surface
But what works great every time is a laser!
Laser root desensitization
Laser root desensitization is an efficient tool for the immediate treatment of tooth hypersensitivity. Laser desensitization can give immediate relief from sensitive teeth and can be done without any anesthesia. The procedure “seals” off microscopic openings in the dentin that lead to the sensitive nerve tissue and directs the laser energy into the sensitive areas. The laser suppresses the potential of the nerve fibers by eliminating the tubules.
What are some effective delivery techniques, and why do we treat these areas? Many products claim to stop sensitivity, but these are temporary at best, and many times they don’t even work at all. Using state-of-the-art techniques such as a laser allows us to provide patients with a better alternative with great and sometimes even permanent results.
How can we use lasers to treat sensitivity?
Diode laser treatment can be used in a noncontact mode through a series of settings to help desensitize the areas. There are other lasers that can be used to desensitize as well although we are only discussing diode lasers in this article.
Using a fluoride varnish (any brand will work) prior to using the laser allows the laser to help “push the fluoride” into the tubules of the teeth. Paint on the fluoride as needed throughout the procedure.
Remember laser safety, which is always mandatory with any laser treatment. Here are a few steps that should always be followed.
Tips for laser desensitizing
- Use the correct wavelength.
- Use specific glasses for the clinician, assistant, and patient.
- Use an HVE—not a saliva ejector—to remove any plume of toxins.
- Understand the settings.
- Document the laser, settings, and time of the laser usage into the patient’s chart.
Laser protocol for desensitizing
This is a great way to start and know that you can adjust as needed.
- Use the laser fiber as an uninitiated tip in a noncontact mode, placing the fiber 2 mm above the area that you are lasering.
- Pretest: check to see what area is sensitive and can be done with air/touch. Determine if you can move in vertical movements and/or horizontal movements, like cross-hatching over the area to get laser interaction to completely cover areas that are sensitive.
- Place a thin layer of fluoride varnish (any brand that is preferred) on areas as needed with a brush.
- Use a diode laser in 30-second intervals, using all these settings one after another, 0.3W, 0.4W, 0.5W, 0.6W, 0.7W, and 0.8W CW.
- After you have completed all the settings, you can retest the area with air/touch and repeat as needed even if you need to start again at the same appointment.
- The desensitizing procedure will last differently for each patient. Some will need you to retreat at each appointment and maybe schedule appointments in between. Some patients will let you know that they are doing great and still don’t have any sensitivity after the procedure is completed.
Final tips and takeaways
Confirm the recession, determine what is causing the recession, and consider what options the patient will have … and, of course, consider if using a laser is the best option. Use the laser to treat the areas and make sure the patient knows that it may not be a one-and-done treatment. Let the patient know what to expect after the laser treatment is finished and tell them that they may need additional treatment down the road.
Editor’s note: This article first appeared in Clinical Insights newsletter, a publication of the Endeavor Business Media Dental Group. Read more articles and subscribe.
