Lasers in the Centers for Dental Medicine Practice

By Robert J. Schulhof, AB, MA Math. Stat.

The Enigma of Periodontal Treatment

According to the available statistics, while over 40% of the patients in the typical dental practice need periodontal treatment less than 10% are accepting it. There are a two essential reasons for this phenomenon, periodontal treatment is either:
1. Unsalable
2. Ineffective

There have been two main modes of treatment:

1. Soft Tissue Management, usually in the form of scaling and root planning, and quarterly periodontal maintenance visits. The goal here was “maintenance”, not letting things get much worse, but was never ending. The statistics from Ora Pharma show that less than 50% of the over 5mm pockets are reduced to 3mm with 1 year of SRP’s in this fashion. Adding topical such as Arestin increased the factor to 58%, but the treatment was never ending.

It is hard to “sell” a never ending treatment and people rarely referred their friends. In those cases where the case could not be maintained the patient was referred for

2. Periodontal surgery. People who have withstood this painful experience rarely forget it. The goal is to perform flap surgery to gain better access to the calculus than possible with an SRP. The problem is that this approach ignores the bacterial component of periodontal disease and was not a final solution either.

The Laser Revolution

Centers for Dental Medicine have been in operation over 5 years now and over 75 practices have participated nationwide with just about every type of laser imaginable. In our experience lasers have saved countless lives and greatly increased income by providing a treatment that is :

• Painless
• Finite
• Effective

Painless- while it will depend on the technique and the objectives many of our clients report no need for anesthetic. In fact patients report a reduced post treatment discomfort when laser treatment is combined with SRP, compared to the SRP alone. (1)

Finite- quite some time ago, laser instructor Chris Owens pointed out that for treatment planning a laser should reduce pocket depth by 1mm per visit. Our research (2) shows that around 90% of 4-6mm pockets can be reduced to 3mm in 3 months of treatment with a virtual disappearance of bleeding. This means that with effective home care, the need for perpetual STM or surgery is eliminated.

Effective- When used along with an effective ultrasonic irrigation and SRP lasers will both kill bacteria and vaporize the diseased tissue.

Why Finite Treatment matters in the world of the Oral Systemic Connection:

Since it has been shown that the periodontal bacteria and persistent inflammation contribute to heart disease, diabetes and even cancer it is vital that we once and for all: