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LASER THERAPY

Laser therapy in oral healthcare provides a more comfortable experience. At our practice, we are able to deliver a precise treatment that is minimally invasive, more comfortable, quicker, and provides more stunning results. Laser therapy may need minimal anesthesia and some procedure may not even needle a needle stick. Laser therapy is beneficial in many areas of dental care such as managing gum disease, teeth whitening, fixing cavities, mouth sore healing, burning mouth treatment, and also in jaw pain management.

How does laser therapy work?

Lasers produce intense beams of light at specific wavelengths. When the right wavelength at the right intensity is used at the correct anatomical location for the right amount of time we can stimulate repair, resolve inflammation, and reduce pain. In Dentistry two types of lasers are used. They are hard tissue and soft tissue lasers depending on the wavelength.

One of the primary mechanisms is the effect of light on cytochrome c oxidase and consequently the unbinding of nitric oxide and release of ATP leading to improved cellular function. For anti-inflammatory effects, we have found a measurable reduction in PGE2, TNF Alpha, and IL-6 in the synovia surrounding damaged tendons and for analgesia, high-intensity lasers over nerve supply can inhibit fast axonal flow. In addition, high-intensity single point lasers can release trigger points and treat acupuncture points instead of needles.

Who can benefit from laser therapy? 

There are wide applications of laser therapy in orofacial disease, disorders, and oral condition. This is basically a non-pharmacological therapy that can benefit without any significant side effect. Conditions such as oral lesions, mucositis, burning mouth syndrome, facial pain are known to be chronic. The management of these conditions can be complex. Medical management may have side effects and surgical management may not provide much benefit. Such conditions can benefit from laser therapy. Additionally, conditions such chronic periodontal conditions, and tissue inflammation and inflammatory conditions may benefit from therapy.  

Low-level Laser Therapy

Photobiomodulation (PBM Therapy) previously known as Low-Level Laser Therapy (LLLT) is the application of a special range of light over injuries or lesions to improve wound and soft tissue healing, reduce inflammation and give relief for both acute and chronic pain.  Beneficial in the treatment of TMJ/ Facial Pain disorders, Burning mouth, Oral Mucositis, Oral Lichen Planus.

  • 2019 – Multinational Association for Supportive Care in Cancer (MASCC) guidelines recommend PBM treatment for the prevention of oral mucositis. Click here
  • 2018 – National Institute of Health and Care Excellence (NICE) guidance for the UK NHS recommends laser therapy for oral mucositis. Click here
  • 2017 – UK NIHR funded RCT on the Clinical and Cost Effectiveness of Low Level Laser in the Management of Oral Mucositis in Head and Neck Cancer Irradiation, 10 NHS hospitals, 380 patients in progress. Click here
  • 2017 – Low Level Laser improves survival of head and neck cancer patients. Click here

TMJ/TMD and Oral Pain Management

Between 5-12% of people in the United States experience pain associated with TMJ disorder.  Until recently, it was typically treated with injections, physical therapy, night guards, and anti-inflammatory medications that could have side effects when used over long periods of time.

Now there is an effective therapy with the use of laser technology. The Laser helps to temporarily increase your blood circulation as well as to relax your jaw muscles. The treatment takes approximately 5-10 minutes for each area, so it’s fast and convenient. Depending on the jaw problems a series of treatments may be indicated to achieve intended results.

Laser therapy is shown to be effective for jaw muscle pain and inflammatory conditions of the jaw. Laser therapy is usually done once a week or in severe conditions, twice a week for a period of 6-8 weeks. Studies show that the benefits are felt after about 3-4 weeks of treatment.

References:

  1. Maia, ML; Bonjardim, LR; Quintans Jde, S; Ribeiro, MA; Maia, LG; Conti, PC (Nov–Dec 2012). “Effect of low-level laser therapy on pain levels in patients with temporomandibular disorders: a systematic review”. Journal of applied oral science : revista FOB 20 (6): 594–602. doi:10.1590/S1678-77572012000600002. PMID 23329239
  2. Kulekcioglu S, Sivrioglu K, Ozcan O, & Parlak M. Effectiveness of low-level laser therapy in temporomandibular disorder. 2003;32(2):114-8. PMID: 12737331 Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12737331?dopt=Abstract
  3. Fikácková H, Dostálová T, Navrátil L, & Klaschka J. Effectiveness of low-level laser therapy in temporomandibular joint disorders: a placebo-controlled study. 2007 Aug;25(4):297-303. PMID: 17803388. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17803388?ordinalpos=164&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
  4. Mazzetto MO1, Carrasco TG, Bidinelo EF, de Andrade Pizzo RC, & Mazzetto RG. Low intensity laser application in temporomandibular disorders: a phase I double-blind study. 2007 Jul;25(3):186-92. PMID: 17696035 Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17696035?ordinalpos=174&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
  5. Fikácková H, Dostálová T, Vosická R, Peterová V, Navrátil L, & Lesák J. Arthralgia of the temporomandibular joint and low-level laser therapy. 2006 Aug;24(4):522-7. PMID: 16942435. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/16942435?dopt=AbstractPlus
  6. Carrasco TG, Mazzetto MO, Mazzetto RG, & Mestriner W Jr. Low intensity laser therapy in temporomandibular disorder: a phase II double-blind study. 2008 Oct;26(4):274-81. PMID: 19004308. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/19004308?ordinalpos=12&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RV
  7. Núñez SC, Garcez AS, Suzuki SS, Ribeiro MS. Management of mouth opening in patients with temporomandibular disorders through low-level laser therapy and transcutaneous electrical neural stimulation. 2006 Feb;24(1):45-9. PMID: 16503788. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/16503788?dopt=AbstractPlus
  8. Kulekcioglu S, Sivrioglu K, Ozcan O, & Parlak M. Effectiveness of low-level laser therapy in temporomandibular disorder. 2003;32(2):114-8. PMID: 12737331. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12737331?dopt=AbstractPlus
  9. Mazzetto MO, Hotta TH, & Pizzo RC. Measurements of jaw movements and TMJ pain intensity in patients treated with GaAlAs laser. 2010;21(4):356-60. PMID: 20976388. Retrieved http://www.ncbi.nlm.nih.gov/pubmed/20976388
  10. Pinheiro AL, Cavalcanti ET, Pinheiro TI, Alves MJ, Miranda ER, De Quevedo AS, Manzi CT, Vieira AL, & Rolim AB. Low-level laser therapy is an important tool to treat disorders of the maxillofacial region. 1998 Aug;16(4):223-6. PMID: 9796491. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/9796491?dopt=AbstractPlus
  11. Pinheiro AL, Cavalcanti ET, Pinheiro TI, Alves MJ, & Manzi CT. Low-level laser therapy in the management of disorders of the maxillofacial region. 1997;15(4):181-3. PMID: 9612167. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/9612167?dopt=AbstractPlus