Dental fear and anxiety are common problems in children and adolescents, with some estimates putting the incidence as high as 20 percent. Though dental fear and anxiety can develop from a wide range of factors, one of the major causes is simple conditioning: the patient has learned from a friend or family member or a previous dental experience that a visit to the dentist can cause pain and discomfort. 

For pediatric dentists, this can lead to patient management problems, including physical reactions such as crying or screaming, psychological responses such as upset or panic and general lack of cooperation. Such behaviors can compromise treatment outcomes, create stress among staff members and lead to discord with parents. Diminished patient satisfaction can also have a negative effect on practice growth and profitability.

For patients, fear and anxiety can have serious health consequences. While the consequences of poor oral health are well known, a less recognized concern is that childhood dental fear and anxiety can persist into adulthood: an estimated nine to 15 percent of Americans adults – or 30 to 40 million people – put off seeing the dentist for this very reason. In adulthood, poor oral health has been linked to life-threatening problems such as cardiovascular disease, dementia, and respiratory infections.

Using a minimally invasive, patient-friendly dental laser in your practice can change all of this.

Laser dentistry requires little to no anesthesia and avoids the noise and vibration of drilling. The result is happier patients and parents, better outcomes, and perhaps most importantly, a healthy relationship with dentistry that can last a lifetime.

In addition to pain-free routine visits, laser dentistry also has other applications in pediatric dentistry, including procedures such as frenectomies and pulpotomies with faster healing and recovery.

I have been using dental lasers in most aspects of my practice, “Jungle of Smiles,” in Laguna Hills, Calif., since 2009. The use of dental lasers has enabled me to grow my practice, improve patient health outcomes and build a patient base that is happier and more receptive to continued care. The testimonials of satisfied parents who have written to me to tell the story. 

“Both of my girls can’t wait for their next appointment,” writes one parent. Adding, “Not many people say that about the dentist.”

“My daughter is shy and was very nervous about the dentist,” writes another. “But [she] got her entire exam done without a single tantrum or tear!”

About Dental Lasers

Lasers (the word “laser” is an acronym for “Light Amplification by the Stimulated Emission of Radiation”) have been used in dentistry since the early 1990s. In 2013, the American Academy of Pediatric Dentistry recognized the judicious use of laser dentistry for infants, children, and adolescents. Indeed, laser dentistry is on its way to becoming a standard in pediatric dentistry.

Lasers work by delivering energy in the form of light. In dentistry, the laser acts as a hard and soft tissue vaporizer. Hard tissue lasers are used for the teeth, while soft tissue lasers are used for periodontal and oral surgery. New all tissue lasers such as BIOLASE’s Waterlase all-tissue product line perform both functions.

Lasers offer many advantages over traditional pediatric dentistry tools. First and foremost is that they require minimal if any anesthesia. Since the laser itself can act as an anesthetic, the dreaded shot is avoided. Finally, because they seal exposed blood vessels, they also reduce bleeding and accelerate healing.

The use of dental lasers also can significantly improve a practice’s profitability by increasing efficiency. With traditional tools, valuable time is lost injecting patients, waiting for an anesthetic to take effect and controlling bleeding.

Lasers can be an effective tool in increasing the efficiency, ease and comfort and of pediatric dentistry in the following applications and more.

Routine Dental Care

Lasers are used in routine pediatric dental care for the removal of decay. The laser light assists in detection by causing decayed areas to fluoresce. Because laser detection is more sensitive than traditional visual and tactile techniques, it detects decay at an earlier stage, thus resulting in treatments that involve smaller areas of the tooth.

Lasers are also used to remove decay and prepare the surrounding tooth structure to receive the filling. Unlike traditional drilling methods, laser preparation is limited to a precise area, which means that destruction of the healthy tooth structure is minimized; also, the laser conditions the enamel and dentin to strengthen the bond between the tooth and the filling. Finally, the minimal need for anesthesia and the lack of vibrations and drilling noise reduces fear and anxiety.

Frenectomies

Ankyloglossia, also known as tongue-tie, occurs when an unusually short, thick or tight band of tissue (the lingual frenulum) tethers the bottom of the tip of the tongue to the floor of the mouth.

Occurring in up to 10 percent of babies, tongue-tie and lip-tie are associated with breastfeeding difficulty in 25 to 60 percent of cases. The inability to breastfeed can be a major source of maternal stress; indeed, the risk of postpartum depression increases threefold in mothers who are unable to breastfeed. Tongue-tie can also interfere with the infant’s ability to eat solid foods and can even impact speech development.

The most common treatment is a frenectomy, a surgical procedure to remove the frenulum. Traditional frenectomies require general anesthesia, which can lead to cognitive issues and other complications in young children and is a growing concern. By contrast, laser treatment requires minimal anesthesia; it also reduces bleeding and speeds the healing process, allowing babies to feed immediately after the procedure.

The pain, bleeding, and prolonged healing time associated with traditional frenectomies – as well as the fact that they are often performed in a hospital – causes many parents to forgo the procedure. Laser frenectomies can be performed in the dentist’s office with topical anesthesia on children as young as three weeks old with no stitches and a complete recovery time as short as three days.

Pulpotomies

The pulp space is the part of a healthy tooth that is filled with soft tissues such as nerves, blood vessels, and connective tissue. 

With a large cavity, bacteria in the decay can damage the pulp, which may lead to a toothache. Commonly referred to as a “baby tooth root canal,” a pulpotomy is the surgical removal of an inflamed pulp space in a child’s tooth that has been compromised due to untreated cavities and decay. Bacteria are removed from the pulp space in order to prevent or alleviate an abscess or infection.

Laser technology is used for pulpotomy as an alternative to formocresol, a toxic chemical that has carcinogenic and mutagenic properties. A study published in the Journal of Endodontics showed that the success rate of laser pulpotomy was significantly higher than that of formocresol pulpotomy and that the permanent successors of the laser-treated primary teeth erupted without any complications.

Pulpotomies and frenectomies formerly required specialists, but with dental lasers both procedures can be performed in the office, offering patient convenience as well as opportunities for practice growth.

Incorporating Laser Dentistry Into Your Practice

Though the demand for pain-free dentistry has led to significant growth in the use of dental lasers, many pediatric dentists still haven’t incorporated them into their practices, either because they have not experienced laser education, because of expense or because they have the perception that training can be time consuming. With recent advances, however, lasers are more affordable and simpler to use than ever, making now the time to tap into their benefits.

Whether it’s a sophisticated and powerful system or a lightweight, inexpensive soft tissue system, just about any dental practice can incorporate a laser to increase efficiency and ease patient worries. Training and support for these systems is widespread and easy to access, and BIOLASE even offers built-in step-by-step animated guides for each laser procedure.

By replacing shots, drills, scalpels, and sutures with patient-friendly lasers, pediatric dentists now can deliver the highest level of patient care with maximum patient satisfaction.