Lasers have transformed our everyday lives, especially in healthcare. These intense beams of light of a single wavelength have revolutionized all manner of diagnostics and treatments, from general surgery to cosmetic therapy.

Dentistry has also been influenced by the laser revolution. Here are just a few of the areas where they’re growing in use and popularity.

Early disease detection. Laser instruments can take advantage of “fluorescence,” the tendency of bacteria to “glow” when exposed to certain wavelengths of light. This is proving more effective in detecting early tooth decay in pits and fissures (very tiny areas in a tooth’s biting surface) than traditional needle-like probing instruments called dental explorers. Newer lasers can now detect the same fluorescent qualities in soft tissues, which may reduce the detection time for oral cancer and make the difference between life and death.

Dental caries treatment. Lasers have become an alternative to the dental drill in treating teeth with dental caries (decay). Although with larger cavities lasers are somewhat slower than the conventional drill, they truly shine when it comes to early enamel caries and small cavities because they can be quite precise in the amount of tooth structure they remove. This feature allows them to be less invasive than a dental drill.

Periodontal treatment. Periodontal (gum) disease is an infection caused mainly by bacterial plaque and calculus (hardened plaque deposits) that have adhered to tooth surfaces. Lasers are emerging as an alternative to conventional periodontal (gum) surgery to treat voids or spaces below the gum line called periodontal pockets that have formed because of gum tissue detachment as supporting bone is lost. With their ability to target and destroy infected tissue without damaging nearby healthy tissue, lasers can achieve similar outcomes as traditional techniques but with less tissue damage and discomfort to patients afterward.

Research and development into laser technology continues to perfect these and other applications that promise to make dental procedures less invasive and more comfortable for patients.

For some kids, having a cavity or two is just part of growing up. Not for Giuliana Rancic. When she was a child, the TV personality didn’t have a single cavity — and she still doesn’t. But for her husband Bill, co-star of the Style Network reality show Giuliana and Bill, it was a different story. A cavity-prone kid, he was never certain what a visit to the dentist might hold in store. “I can still remember the anticipation,” he recently told Dear Doctor magazine. “I always hoped I would get out of the checkups without a cavity!”

Why do some people get more cavities than others? There are a number of factors at work, but to understand it better, let’s look at how tooth decay occurs.

How Cavities Form
Cavities — also called dental caries — are small pits or holes in the teeth that are caused by tooth decay. Tooth decay itself is a chronic disease that can flare up when plaque isn’t kept under control. A thin, bacteria-laden film, plaque sticks to tooth surfaces both above and below the gum line, and can build up in the absence of effective oral hygiene.

Of course, everyone has bacteria in their mouth, both “good” and “bad” (pathogenic) types. But when the bad guys outnumber the good, trouble can start. When you consume sweets, plaque bacteria process the sugars and release acid as a byproduct. The acid eats into tooth surfaces, causing decay — and cavities that need filling. Left untreated, decay can work its way into the tooth’s pulp, resulting in infection and pain. Eventually, treatment might involve a root canal — or, in the worst case, extraction.

What can you do if you seem to be prone to cavities? One effective way to fight tooth decay is by maintaining good oral hygiene. Brush at least twice daily, for at least two minutes each time. Use a soft-bristled brush and a dab of fluoride toothpaste to clean all around your teeth. Most importantly, floss above and below the gum line, every day. And just as important, don’t forget to have regular dental checkups every six months.

A Healthy Balance
Another cavity-fighting strategy is eating a balanced diet. Avoid soda, sugary “energy” drinks and sweet treats — but if you choose to consume sugar, have it with meals instead of between meals. This will give your saliva, which has natural cavity-fighting properties, a chance to work.

“It’s all about maintaining a healthy balance,” Giuliana told Dear Doctor. And Bill agrees: “I love nuts and fruit for a healthy snack,” he said, adding that he’s meticulous about brushing and flossing. And when the couple smiles, you can see how those healthy habits pay off.

Dental implants provide a number of advantages as a tooth replacement system, like durability and imperviousness to decay or gum disease. Bone naturally grows and attaches to the titanium posts, strengthening the attachment over time, and they don’t cause damage to adjacent teeth. Best of all, an implant and its crown’s life-like appearance can rejuvenate a person’s smile, transforming their appearance and self-image.

But it takes time to complete treatment with dental implants — months of healing and sufficient bone growth to anchor the implant before affixing the permanent crown. If the natural tooth requires extraction first, this may add another step — and more healing time — to the process.

In recent years, though, patients who meet certain criteria are able to shorten the time after a tooth extraction with “immediate” implants. In this case, rather than waiting for the socket to heal following a tooth extraction, the implant is placed directly into the socket immediately after the extraction. Immediate implants thus combine tooth extraction and implantation into one procedure.

For the best results, the extraction must be done very carefully to avoid as little damage as possible to surrounding tissue and bone. It’s also important for the implant to be completely immobilized within the bone with no movement at all. It will stabilize further as bone growth (or ossification) occurs over time.

It’s also possible to attach a provisional crown to the immediate implant for aesthetic purposes. This isn’t the permanent crown that will be affixed after bone growth around the implant; for that reason it’s made in such a way that it doesn’t contact its counterpart tooth in the opposing jaw. Although the implant is completely immobilized mechanically, it’s still not ready for the full forces of normal biting and chewing. After two to three months, the implant should be fully integrated with the surrounding bone and ready for the permanent crown.

Immediate implants are best for the more visible front teeth that encounter less biting force than back teeth. The technique not only reduces healing time, but enables patients to gain an “immediate” aesthetic benefit — and something worth smiling about.