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  Periodontitis (gum disease) therapy with laser Periodontitis (or periodontal inflammation) usually develops in those who incorrectly or irregularly brush their teeth, but unfortunately there are people who prone to it or can be caused by immunological problems. The first sign of it is gingivitis.
The mechanical cleaning of the inflamed gum (calculus removal, polishing, smoothing of rough filling or crown edge) might be sufficient in many cases to reduce the inflammation, if it doesn’t happen, deep, inflamed gum pockets develop around the teeth and their mechanical cleaning is not enough anymore. The inflammation deeply hidden in these pockets starts to produce cells that begin systematically destroy the bone around the teeth. Therefore these teeth – without treatment or with delayed treatment – sooner or later get loose and then removed. The typical symptoms of periodontal inflammation are the gum bleeding during toothbrushing, bad breath, red swollen gum, loose teeth and pain that occurs occasionally, perhaps at biting/chewing. On an X-ray the destruction of the bone can be spotted, and the bag shape can be detected along the side of the root.
The process of the treatment: Ozone is the byproduct of the laser, we use this against bacteria. The laser beam gets sent to every area of the pocket, even the deepest point via optic fibre. The high power laser beam destroys the deeply hidden bacteria, evaporates the infected tissues and by its bio-stimulating effect it starts growing bone-cells. Bone growth is now enabled in the inflammation-cleaned, disinfected bag, which can result in solidification of the tooth. The laser treatment is always preceded by a thorough mechanical cleaning which includes a calculus removal, polish and closed curettage. The laser treatment is absolutely painless as it is done in anaesthesia. The laser beam needs to be swept around a tooth about 2-3 times, 30-40 seconds each. If the whole mouth needs to be treated, it is done by every half arch, ie the whole mouth is treated in a total of four occasions (it is needed because of the distribution of the anaesthesia).The treatment (by tooth or by quadrant) needs to be repeated about 2-3 times to achieve the best result which needs to be maintained, this why it’s very important for the patient to maintain their oral care as instructed and to have the treatment repeated in every six months. Unfortunately complete healing of periodontal disease cannot be achieved, only a well maintained and decreased tooth inflammation.
The limitations of the laser treatment: Unfortunately, there are limitations of the laser treatment, acceptable results can be expected only with appropriate indications. In some cases there is an immunological disease behind which unfortunately cannot be treated by laser treatment as in these cases the bone destruction is not primarily the consequence of the inflammatory tissues and bacterial activity around the tooth. Occasionally there is not even calculus or inflammation but the bone still decays around the tooth. The bone disintegration develops without any inflammation, mainly because of the failure of the immune system. The lifetime of the teeth can be extended by laser therapy, but the expected results are not as high. Sometimes the bone disintegration reaches the level where the tooth only kept in place by the inflamed tissue as the healthy, stimulateable bone has disappeared. In this case unfortunately there is no way to save the tooth. In the prevention of periodontal diseases the main objective remains: reaching and maintaining the best possible oral hygiene. The key to achieve the long-term successful treatment is to have the problem controlled in every 3-6-12 months and perform regular professional treatment. Only well-motivated patients are likely to succeed.
Application of a diode-laser meets several goals of the periodontal therapy at the same time: reduction of inflammatory areas, elimination of the epidermis and the creation of a new grip and creation of the conditions of bone regeneration. Gingivitis (and then future periodontal disease) can be experienced with irregular, jammed teeth. Thorough cleaning cannot be carried out easily with irregular teeth, so plaque can develop quickly, causing gingivitis. The regular line of teeth can be set by orthodontics, so gingivitis and periodontal diseases can be avoided and/or eliminated. In severe cases the affected area gets surgically opened and the root cleaning can be carried out directly. Leaving the cleaned surfaces free the gum lobe gets stitched back pushed towards the root ends. Thus the bare tooth surfaces can be cleaned easier, however this solution is aesthetically worse. The laser cleaning technology was invented to avoid this surgery, plus it is more convenient for the patient, painless, doesn’t affect the aesthetics of the tooth neck, yet striking results can be seen.
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