Low-Level Laser Therapy in Dentistry
There are many applications of Low-Level Laser Therapy (LLLT) in the dental field but first to understand what Low-Level Laser Therapy is, we need to understand the components of the therapy.
Laser (Light Amplification by Stimulated Emission of Radiation) light is an intense, monochromatic narrowly focused. And a Laser is a gadget that emits laser light.
So, LLLT is simply a non-invasive low-intensity light source treatment that generates photons of light. The photons have unique wavelengths that allow them to penetrate through the skin, muscle tissue, body fluid, and fat up to 5cm deep. The photons effectively trigger biochemical changes within body cells. We can compare the effects therein with photosynthesis in plants. In photosynthesis, plants absorb photons through photoreceptors and trigger chemical changes.
The general effects of LLLT include:
- Pain relief
- Reduction of inflammation within a short space of time
- Acceleration of cell and tissue regeneration
Related Reading: Laser Dental Treatment In Malta: More Comfort, Faster Recovery
History of LLLT
LLLT technology has come a long way. The LLLT effects we enjoy today result from the hard work of many scientists living in different decades. Suppose we were to trace back the beginning, we’d end up in 1903 when Dr. Nils Finsen received a Nobel Prize for his ideas and contribution to treating diseases like lupus vulgaris using concentrated and focused light radiation.
Fast forward in 1960, Professor Maiman TH created the first red ruby laser. However, it wasn’t until seven years later that Mester E and his colleagues demonstrated how laser biosimulation works.
Other scientists, Whelan H, and his colleagues presented their work on LED medical applications that were in use in the NASA space station. More than 400 Phase III double-blind, random, controlled placebo trials have been completed, documented, and published as a result of their efforts.
Other Types of Laser Therapy
There are many types of Photobiomodulation Therapy (PBM). But you only need to acquaint yourself with the common and most advanced ones.
Deep Tissue Laser Therapy
In Deep Tissue Therapy, Class IV therapy lasers are used. These lasers are high powered and emit higher wattage than those used in Cold Therapy. The high power and wattage in the lasers allow the photons to penetrate deeper into the skin and tissue to offer shorter treatment times. Deep Tissue Therapy accelerates the natural healing process the body goes through.
The therapy can be used to treat different ailments ranging from chronic conditions to deep tissue problems.
LED Light Therapy
Here, only light is used. This therapy was created to hasten the healing process of scars for those who had undergone surgery. However, today it is used to treat superficial skin problems.
Generally, Red light penetrates the skin and tissues more than blue light. As such, it is preferred and, at times, combined with near-infrared lights to give it more oomph. And though Infrared Therapy and LED Light Therapy complement each other, they are often considered separate and independent therapies.
You should note that not all infrared wavelengths are ideal for use in PBM. Also, not all are great at generating heat. Now, in comparison to Red Light, Infrared digs deeper into the skin. And since Infrared is invisible, it is used in the sauna. Common Infrared lights (A, B, and C) generate heat because the human skin absorbs them fast.
Normal saunas use normal heat. And though they tend to have some health benefits, they cannot be compared to those generated by Far-Infrared. The Infrared light raises body temperature from its core, which in turn activates protein metabolism, triggers nitric oxide, and a chain of molecular processes ensue. Overall, there’s vasodilation, increased blood flow, better heart rate, and more, which improves breathing, muscle recovery, reduced stress, pain, and inflammation.
Mechanisms of LLLT
Generally, near-infrared and low-power visible light affects the body at a molecular level. For this effect to occur, the photons of light need to be absorbed by photon acceptors in the body – hemoglobin, cytochrome c oxidase, flavin, and porphyrins.
In the human body cells, the mitochondria act as power plants that convert food molecules and oxygen into energy through oxidative phosphorylation. The main photo-acceptor in the human body for red-NIR wavelength is cytochrome c oxidase. During oxidative phosphorylation, NO is produced in the mitochondria, which goes on to inhibit respiration as it binds to COX and displaces O2 from injured cells.
According to experts, LLLT photo-dissociates NO from the COX and reverses the inhibition of respiration. Because of this ability, LLLT delivered at low doses is believed to enhance cell proliferation of keratinocytes, fibroblasts, lymphocytes, and endothelial cells.
Applications of LLLT in the Dental Field
LLLT is used to treat arthritis and other conditions of the Temporo-Mandibular Joint, muscle strain and soreness including trismus (limited jaw opening), and chronic pain. In many studies, LLLT has a positive effect in relieving pain caused by the above conditions. The FDA also approves it as an appropriate treatment.
Trigeminal neuralgia is a painful condition that affects both young and old. The pain is described as shock-like, unilateral, sharp, and episodic and mostly affects the trigeminal nerve in the lips, forehead, nose, jaws, and eyes.
In many studies, LLLT has proved that it can mitigate the pain caused by the condition. Most patients in various studies show significant improvement in pain frequency and intensity.
Temporomandibular joint disorders
Oz et al. used LLLT on 20 patients suffering from myofascial pain dysfunction syndrome. They took them through ten treatment sessions and concluded that LLLT was efficient in managing pain in mandibular movements for those experiencing myofascial pain.
Burning mouth syndrome
17 patients were cured of burning mouth syndrome by Yang and Huang using laser therapy. The laser light used has an 880 nm wavelength, 3W wattage, 10 Hz frequency, and 50 ms of intermittent pulses. Depending on the area, the laser was applied over a 1cm2 area for just 70 seconds. Every patient received therapy between 1 and 7 times. The pain score (average) was 6.7, but afterward, it decreased by 47.6%. Overall, the burning mouth syndrome symptoms decreased by 80%.
Laser treatment is most efficient immediately after a dental implant is placed, and for the following two weeks. To reduce edema and pain, a dose of infrared laser treatment is recommended.
Pain from orthodontic treatment
LLLT can be used to reduce pain during orthodontic treatment. It can also be used to stimulate tooth movement. Reports show that 5.25J/cm2 of LLLT increases orthodontic mobility, and anything past 35J/cm2 causes a reduction in orthodontic mobility.
Obradovic and his colleagues treated patients with periodontal disease and diabetes mellitus using LLLT. The therapy was delivered for 16 minutes every day for five days. Moreover, they complemented it with regular periodontal treatment, which saw an improvement in their healing as well as homogenization and collagenization of gingival lamina propria.
LLLT and the whole field are expanding rapidly and promise a great breakthrough in modes of treatment for specific muscular-skeletal conditions. However, it’s still relatively new and needs more time for experts to understand its capabilities and its boundaries fully.
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