Laser therapy: Is it for you?
Jo-Anne Jones, RDH, answers questions concerning periodontal laser therapy performed by dental hygienists.
Lasers can be highly beneficial for dental patients undergoing periodontal therapy. But if you're a dental hygienist and unfamiliar with lasers, where do you start? What's the best laser to get, and where do you get trained? To get answers to these and other questions, I spoke with Jo-Anne Jones, RDH. Here's what she had to say.
Interview with Jo-Anne Jones, RDH
AA: Jo-Anne, tell us more about your hygiene career and when you started implementing laser therapy.
JJ: At the commencement of my dental hygiene career, technology was very limited. I am superexcited to see what we have to offer our patients today and the scientific support of new technologies proven to improve treatment outcomes. I began implementing laser therapy into clinical practice approximately 15 years ago. At that time, we were beginning to understand the huge role chronic inflammation plays not only in oral disease but also in systemic health.
AA: How has the laser changed the way you view dental hygiene?
JJ: The laser provides an opportunity to address the inflammatory component of periodontal disease as well as the bacterial aspect. To know that the technology not only improves treatment outcomes but also has far-reaching benefits on overall health is so gratifying.
Forty years ago, when I began practicing, each patient was essentially treated in a similar manner, with very little differentiation in the components of the treatment plan performed. Historically speaking, we used to view periodontal disease solely as a bacterial-induced infection. The periods of exacerbation and remission were perceived as the result of the patient’s abilities or lack thereof with home care. Now we understand that it is a chronic inflammatory disease that is very dependent on host response and possesses a strong correlation with systemic health.
It is important to note that the laser is one of the adjuncts to our debridement procedures that enhances treatment outcomes. It should never be positioned as a mono-therapy or stand-alone therapy.
AA: Do you feel laser training is a good fit for new graduates?
JJ: Yes, I do. Someone once asked me how I remain so enthusiastic about the profession of dental hygiene after so many years. My answer is simple. It is due to the commitment to lifelong learning. This is the key. Embracing new concepts to better equip us as health-care professionals to serve our patients’ needs is invigorating. To improve both health and general quality of life for another human being is such a gift for us to be able to provide.
Secondly, we all practice in a pretty competitive environment. Being laser certified provides new graduates with an additional skill set to include on their resumes. The inclusion of soft tissue lasers in periodontal therapy continues to increase, with many practices looking for dental hygienists who have been certified in the use of the diode laser.
AA: What are the biggest practice benefits to periodontal laser therapy?
JJ: There are a number of benefits. First of all, we have a public that is comfortable with the concept of laser therapy as they have been exposed to it in so many facets of medicine, esthetics, etc. It is a natural expected evolution in dentistry.
The laser is supported by science and we have the confidence that our recommendations are evidence based. The studies support the reduction of P. gingivalis, a prominent keystone pathogen. P. gingivalis is an anaerobic, Gram-negative bacterium involved in the onset of inflammation and tissue destruction during periodontal disease. Numbers of P. gingivalis are relatively low in the healthy oral cavity but are drastically increased in the presence of inflammation. What makes this so important is the fact that it has the ability to advance periodontitis by altering the entire bacterial colony, rendering the biofilm more destructive. This results in destruction of the tissues locally as well as a systemic implication of alteration to the entire host defense mechanism. The end result is a compromised or impaired immune response, leaving an individual with difficulty in fighting infection. For this reason, it is critical to effectively address this pathogen. Diode laser treatment has been shown to clinically reduce bacterial numbers and proportion of Aggregatibacter actinomycetemcomitans (A.a), another known periodontal pathogen.
Laser bacterial reduction has the ability to delay the recolonization of bacterial colonies. Also, the laser has the ability to increase the number of spindle-shaped fibroblasts, which provide superior adhesion of sulcular epithelium. Interestingly enough, 0.12% chlorhexidine has an inhibitory effect on fibroblast formation.
These are just a few of the reasons that the laser has a beneficial influence on today’s periodontal therapy programs.
AA: What advice would you give new graduates and experienced RDHs?
JJ: As far as the laser is concerned, embrace it! Understand the science. Understand that the laser is one of a number of therapies we need to consider as part of the comprehensive treatment we are offering our patients today.
Generally, it is important to understand the critical role we play as dental hygienists. We are practicing in one of the best times. We have the science and the technology to be proactive in treating a chronic inflammatory disease that, if not treated, may place our patients at risk of systemic disease. This is a huge responsibility and one we cannot take lightly. Even greater still is the huge opportunity that exists to impact another person’s life in a positive way. Our profession is so gratifying when we really encompass all of who we truly are!
Amber Auger, MPH, RDH, is a hygienist with experience in multiple clinical settings, including facilities abroad. Amber obtained a master's degree in public health from the University of New England and a bachelor's in dental hygiene from the University of New Haven. Auger is a key opinion leader for several dental companies, speaker and published author, and can be contacted through her website at amberaugerrdh.com.