We are proud to offer most procedures without local anesthesia (No“Shot”). It is amazing to see many children sail through the experience of receiving dental treatment without fear and with lots of fun! We love to do treatment with our Biolase Waterlase Er,Cr:YSGG laser.
WHEW! THE EXPERIENCE OF NO SHOT
It is a joy to see children of all ages experience dentistry without the stress of anticipating the dreaded “shot” of local anesthesia. For many procedures this technology allows us to give little to no local anesthesia, to let your child avoid getting a “shot.” For our procedures, your child will sit in our comfortable dental chair after picking a movie to watch. Then they will pick the smell they would like in their nose (if your family opts to use nitrous oxide to further help them relax). After they pick their smell, our amazing assistants will take time to show them exactly how the laser sounds and works so it will not be surprise to them. When it is the dentist’s turn to play, we will show them quickly again and then use a specialized technique developed by Dr. William Chen of the Chen Laser Institute to condition the tooth with Low Level Laser Therapy (see below) to achieve laser analgesia. During the first part of the procedure the laser will sound very much like a toy airplane (a “drone”). When we switch modes to remove decay, then it sounds like loud popcorn popping, or a woodpecker. We may still need to use our Special Toothbrushes: our Water Whistler and Mr. Shaky, but we will end with our drone laser settings. Then it’s time to put the filling in!
SO MANY POSSIBILITIES: WHAT CAN THE LASER DO?
This laser is extremely versatile. With different settings it can work on both soft tissue like your gums, frenums, and the pulp, and hard tissue like your teeth. This means we can use it for fixing cavities and also for soft tissue procedures (see below).
GET THOSE SUGAR BUGS: CAVITIES: Cavities on the tops, sides, or fronts of teeth can be done with the Waterlase laser. Many of these procedures can be done without local anesthetic. Some cases (it depends on the patient and the tooth) may need a small amount of local anesthetic.
A SUGAR BUG PARTY: LARGE CAVITIES NEEDING “BABY ROOT CANALS” (PULPOTOMIES):
For deep cavities which extend into the blood vessel/nerve area (pulp), a simple filling is not the best course of treatment. For these teeth a “baby root canal” is needed. These can be done with the laser and many patients will not need anesthesia.
LIPS AND TONGUES HUGGING THE MOUTH TOO TIGHTLY: FRENECTOMIES: Some children come into the world with lips and/or tongues which are tied very tightly to their mouths. For these mouths, the Waterlase is a blessing. Laser frenectomies in general are much more comfortable than the traditional cutting and suturing technique of years past. Other types of lasers have high heat as a byproduct and thus cause a little thermal damage, like a bad “pizza burn” on the surgical site for a few days to a week. The Waterlase has a revolutionary cooling system which allows us to remove the tissue without pain and with little-to-no pizza burning. This means less pain, and easier and faster healing.
FEEDING PROBLEMS: For very young children this can be a problem for creating latching on for breastfeeding or bottle feeding and can lead to trouble feeding. For those infants a laser frenectomy can be relatively painless and can lead to easier and better feeding. Some young children may not be candidates for this procedure with the Waterlase. You can come visit our team to hear more.
SPEECH ISSUES: In some children the tight tongue tie can cause speech problems. For those children a speech pathologist can examine them and determine if a tongue release (frenectomy) could help them make progress in their speaking abilities.
GAPS BETWEEN THE UPPER FRONT TEETH: In older children and teens a tight upper lip tie can lead to a gap between the two top front teeth. Sometimes an orthodontist can close the gap without any issues, but sometimes the lip tie is too obstructive. Then we can use the laser to move the position of that frenum up so that the lip tie is no longer forcing those teeth apart.
GUM RECESSION ON THE LOWER FRONT TEETH: Just as some children and teens have a tight upper lip tie, some have a tight lower lip tie. Unlike the upper, though, a tight lower lip tie can pull hard on the thin, fragile gums on the bottom and cause the gums on the bottom teeth to creep down and make the tooth look longer (gum recession) and cause sensitivity. Over time the gums can keep creeping down and create a big periodontal disease problem when the person gets to be in the 20’s, 30’s, or 40’s. For these kids we can move the lip attachment down and ameliorate the lip’s pull on the gums.
GUMS ARE TAKING OVER AFTER BRACES! GINGIVAL REMODELING: Sometimes it is difficult for our friends with braces to brush their teeth really well with the braces on. This can lead to consistent inflammation in those gums. In some people this consistent inflammation causes the gum tissue to overgrow – the gums look larger and more “puffy” close to the teeth. Often after the braces come off the gums go back to normal, but sadly not for every person. Then we can use our laser to give your child that beautiful gum line back by carefully shaving away that extra gum tissue.
SICK TOOTH DIAGNOSIS: PULP TESTING. When a child begins having pain with a tooth and we know the tooth is very sick, we need to know just how sick. There are some tools on the market used to test teeth, but they can hurt, so we hesitate to use them with kids. With the laser, though, we can test the tooth with a minimum of discomfort.
MAGIC LIGHT: HOW DOES THE LASER WORK?
HOW IS THAT EVEN POSSIBLE? GENERAL PRINCIPLES OF LASER PHYSICS: This cutting-edge technology uses a frequency of 2780 nM. At this frequency of light the photons of energy are attracted to water preferentially, and to a lesser degree into hydroxyapatite, the organic matrix of tooth structure. This allows our laser at different settings to deliver controlled bursts of photons to several possible places. First, to the water in the soft tissue to cause tissue removal; second, down the crystal matrix of the teeth to affect the pulp and cause laser analgesia; or third, directly focused on the organic crystal matrix of the tooth to cause hard tissue removal.
CAN YOU REALLY AVOID THE “SHOT?” HOW THE LASER HELPS AVOID LOCAL ANESTHESIA
When done correctly, this technique allows us to use principles of Low Level Laser Therapy (LLLT) to achieve laser analgesia for the teeth of many patients. The laser delivers photons of energy to the tooth at a level which does not cause tissue damage. This energy travels down the hydroxyapatite crystals in the tooth to the pulp where the nerves live (reference 1). The energy affects the pain nerves (un-myelinated c-fibers) and inhibits their ability to talk to the brain (de- polarizes the Na-K gate and prevents the creation of an action potential) (reference 1).
Additionally, it may also have other biochemical effects which can promote the health of the tooth (reference 2).
--Reference 1: Tanboga I, Eren F, Altinok B, Peker S, & Ertugral F. (2011). The effect of low level laser therapy on pain during dental tooth-cavity preparation in children. European Archives of Paediatric Dentistry, 12 (2), 93-95.
--Reference 2: Verma SK, Maheshwari S, Singh RK, & Chaudhari PK. (2012). Laser in dentistry: an innovative tool in modern dental practice. National Journal of Maxillofacial Surgery, 3 (2), 124-132.