Dentists bring laser treatment to Ozarks

Periodontal disease is a chronic inflammation or infection that can lead to tooth and bone loss. According to the American Dental Hygiene Association, nearly 75 percent of American adults suffer from various forms of periodontal, or gum, disease, and many aren't even aware of it.

But, Reynolds said, helping patients keep their teeth is not the only issue involved.

“There are definite links between chronic inflammation and heart disease, stroke, diabetes, low-weight, early-term birth babies, and … we're beginning to think that chronic inflammation may have a bearing in Alzheimer's disease,” he said.

Traditionally, when a patient has moderate to advanced periodontal disease, and there's bone loss and pocketing, there have been two options: scaling and root planing, which works to maintain conditions and keep them from worsening; and periodontal surgery, which involves cutting the tissue away, peeling it back, bone grafting and stitching the incisions closed. Periodontal surgery, he said, usually requires that the patient miss a few days of work to recuperate.

“Invariably, patients would elect to just kind of maintain things as best as they could,” he said. “That means maintaining a chronic, low-grade bacterial infection, because there's no way that you could … keep things completely clean in those deep areas.”

Enter the Periolase MVP-7, a dental laser that was approved by the U.S. Food and Drug Administration in June 2004. The FDA also approved the procedure used with the tool.

Reynolds brought the Periolase MVP-7 to Springfield in April 2005.

“Most patients are very thankful we've got another alternative,” he said. “It is a surgery, and I'm not going to say it's comfortable, but in my experience, the vast majority of patients … say, 'I'm a little sore. I took a couple of Advil, but that's all I needed.'”

Laser usage

Reynolds said that before the laser is used on a patient's teeth, the root surfaces of the teeth - under the gumline - are cleaned with more traditional instruments.

“We use ultrasonic instruments to clean the root surfaces,” Reynolds said. “We go to the depth of the pocket and we get all the tartar and plaque off of the root surfaces.”

Then the laser is introduced twice.

“The first pass basically … selectively vaporizes the diseased tissue on the inside of the pocket. That opens up the pocket and relaxes the tissue around the neck of the tooth (and) makes it easier for us to visualize the root surface and actually get in and clean the root surface of the tooth,” Reynolds said.

At that point, the laser is introduced again, this time sterilizing the tooth pocket.

“When you think about the root surface of a tooth, it's very porous, like a sponge. And if you think about bacteria hiding in all of those little areas, we don't point the laser directly at the root, so there's no damage caused, but the laser energy is absorbed into those nooks and crannies and kills the bacteria that are hiding in there,” he added.

The laser also allows the dentists to target the patient's bones, stimulating stem cells in the connective tissue to regenerate bone and create more connective tissue that attaches to teeth.

“The third thing it does, which is really an important part of the procedure, is that it stimulates - I call it your body's own super glue in the blood - and causes the blood to be sticky and form a real tight clot around the neck of the tooth, which basically seals the wound,” Reynolds said, noting that effective sealing wasn't something that could be done on gums before the advent of the laser surgery.

“We've got a sealed pocket so bacteria can't get back in, and we're getting healing from the bottom of the pocket up rather than the top of the pocket down,” he said.

Expense

The cost of laser therapy varies with the severity of the periodontal disease but generally is no more expensive than traditional surgery, Reynolds said.

Laser therapy is often covered by dental insurance.

But to prevent periodontal disease, the American Dental Association offers numerous tips, including brushing twice daily with an ADA-accepted toothpaste, flossing daily, eating a balanced diet and limiting snacking, and visiting the dentist regularly for cleanings and exams.

Toothbrushes should be replaced every three or four months, or sooner if bristles become frayed.

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