By Dr. Mehmood Asghar
As oral health awareness improves, more people are realizing that looking after their oral hygiene is key to maintaining good health. However, some patients still cannot fathom the thought of stepping foot into the dentist's office – even if they have an excruciating toothache – due to dental fear.
A study published in BMC Oral Health shows that over 83 percent of patients with irreversible pulpitis suffered moderate to severe dental anxiety, with 13 percent having a specific dental phobia. Similarly, an ADA Health Policy Institute survey showed that over 22 percent of the respondents didn't visit their dentist due to dental anxiety. Dental fear remains a significant barrier preventing patients from seeking dental treatment, even when they're in pain.
Minimally Invasive Dentistry – A Game Changer
Considering the higher cost of restorative treatment and the subsequent agony faced by patients with dental fear, dentists utilize various non-invasive dental treatments that minimize the need for extensive tooth removal, thereby ensuring tooth conservation and reducing pain and discomfort. Among them, topical fluoride-based remineralization agents like silver diamine fluoride (SDF) and dental lasers have shown promising results.
Recently, an interesting study was published by Hasan et al. (2021) in Scientific Reports, which compared the efficacy of SDF sub-ablative low-energy erbium, chromium, yttrium, scandium, gallium (Er, Cr: YSSG) garnet-based lasers in preventing teeth cavities. Thirty extracted primary teeth with dentine caries without pulpal involvement were used in this study and equally divided into three groups:
Group 1: SDF application followed by sub-ablative low-energy Er, Cr: YSSG laser
Group 2: SDF application followed by photopolymerization for 40 s
Group 3: SDF treatment alone
The mean surface hardness of the treated teeth was measured to evaluate the remineralization potential of each experimental group. Their results showed that SDF application plus laser treatment showed the highest mean surface hardness, followed by SDF plus light curing and SDF treatment alone.
The results of this study highlight the importance of lasers in enhancing remineralization and minimizing the need for invasive and expensive restorative dental procedures.
The authors of this study concluded that while the silver and fluoride ions in SDF have a combined effect in restoring the mineral content of decayed dentine, laser treatment enhanced surface hardness by causing dentine ablation and increased fluoride infiltration, leading to dentinal tubule occlusion. The current study offers a ray of hope for individuals suffering from dental anxiety, as it highlights the potential of lasers in providing non-invasive dental treatment and enhancing the remineralization efficacy of topical fluoride products.
Lasers In Dentistry Overview
A laser is a device that emits high-energy light. Lasers are not new to dentistry; they've been around since the 1990s. Despite that, many dentists haven't incorporated lasers in their practices – mainly due to their high costs. However, as dental laser systems become affordable, many dentists are now deciding to take the plunge.
Lasers find a wide range of uses in dentistry, from teeth whitening to surgery and cavity preparation. Dental lasers offer various benefits over the conventional dental restorative and surgical techniques:
- Minimally invasive – only the damaged or infected tissues are removed, sparing the healthy ones.
- Precision – dental lasers offer superior accuracy and precision compared with conventional surgical techniques.
- Improved Healing – dental lasers cause less tissue inflammation compared with conventional surgical procedures. As a result, they offer faster healing with minimal scarring.
- Decreased Risk of Secondary Caries – the high energy emitted by the lasers during cavity preparation leads to dentinal tubule occlusion, thereby significantly reducing the risk of post-operative sensitivity and secondary caries formation.
A Ray of Hope for Anxious Dental Patients
Perhaps, the most significant advantage of dental lasers is their aid in treating apprehensive and fearful patients. For example, many patients with dental fear are afraid of the sound of the dental drill - which keeps them restless during restorative procedures. This problem can be overcome with lasers. Dental lasers do not produce any sound; as a result, they can help relax frightened dental patients. Another common dental anxiety is the fear of pain. Although dental lasers do not provide an analgesic effect, they quickly seal off the dentinal tubules during cavity preparation or soft tissue surgical procedures and help reduce peri- and post-operative dental pain.
The study by Hasan et al. (2021) shows that besides minimizing post-surgical inflammation and discomfort, dental lasers also substantiate the remineralizing effect of topical fluoride-based agents such as SDF – evident through increased surface hardness compared with dentine specimens treated with SDF treatment alone. The combined use of SDF with dental lasers combines the best of both worlds: Minimally invasive dental tissue remineralization coupled with soundless, high-precision, and complication-free restorative treatment. A perfect combination for dental anxiety patients. This is also good news for dental professionals; dental lasers help take the fear of dental treatment out of anxious patients, allowing them to seek dental treatment worry-free and painlessly.
References: ADDIN EN.REFLIST Hassan, M., Bakhurji, E., & AlSheikh, R. (2021). Application of Er, Cr: YSGG laser versus photopolymerization after silver diamine fluoride in primary teeth. Scientific Reports, 11(1), 20780. https://doi.org/10.1038/s41598-021-00204-x
Author: Dr. Mehmood Asghar is a dentist by profession and an Assistant Professor of Dental Biomaterials at the National University of Medical Sciences, Pakistan. Dr. Asghar received his undergraduate and postgraduate dental qualifications from the National University of Science and Technology (NUST). He is also currently pursuing a Ph.D. in Restorative Dentistry from Malaysia. Apart from his hectic clinical and research activities, Dr. Asghar likes to write evidence-based, informative articles for dental professionals and patients. Dr. Asghar has published several articles in international, peer-reviewed journals.