Laser replaces scalpel in treating gum disease

By BOB MASSEY

Feeling Fit Correspondent

Dr. Joseph H. Farag holds out his hand and prepares to run a dental laser across the exposed flesh.

The laser would look like a dental pick, except for the thin optical fiber sprouting from the tip and ending in an ominous red glow.

This light, the Port Charlotte dentist explained, is like the laser sighting on a gun. The laser itself is invisible to the naked eye, the only tell-tale sign of its activation being a low rattle when Farag presses a foot pedal.

The machine does so as he passes the laser across his hand -- with no results.

The Millennium PerioLase is made to flow through healthy tissue, only reacting when the beam is absorbed by pigmented tissue or infection.

Farag removes a business card, black ink on white stock. He passes the laser over the white area. Again, no reaction.

"Now watch this," he said.

As soon as the beam touches the ink, it sputters to life, blinking like a strobe light and leaving a wake of fine smoke. A tan streak is all that is left of the ink, yet the card stock is still intact.

Welcome to modern laser gum treatment -- far improved from the methods of the past.

The target is periodontal disease, in which bacteria infiltrates the narrow channel between the root of a tooth and the surrounding gum.

Problems begin because the bacteria are not accessible by either toothbrush or dental floss. As the bacteria adheres to the root, the body's immune system can no longer discern the difference between the two -- so it treats the entire tooth root like a foreign object to be eliminated.

The result is usually a loosening of the tooth as the body attempts to push it out -- and sometimes even bone loss.

With traditional gum surgery, the gums have to be cut and pulled down for a dentist's instrument to be able to "scale and plane" the tooth -- remove the bacteria and clean the root.

Then the gums had to be put back together and treated with packing while they healed -- a complicated and painful process.

The laser has changed all that.

Farag acquired the neodymium-doped yttrium aluminum garnet (commonly referred to as Nd:YAG) in 2006. The difference between his laser and the carbon dioxide (Co2) type: The Nd:YAG is near-infrared, so it's invisible to the naked eye.

"The Co2 is a cutting and burning laser," he added. "It's very aggressive and causes more trauma to the tissue from heat. The Nd:YAG leaves the healthy tissue intact, while the other cuts through everything. It's not as targeted and specific."

With a diameter of only about three human hairs, the Nd:YAG can slip in that critical space between the root and the gum, cutting away infected tissue, removing the bacteria and allowing for an ultrasonic device to clean the area thoroughly. The laser is also used to cause the blood to clot when the procedure is finished.

This type of laser gum treatment requires only local anesthesia, and leaves the patient with very little discomfort afterward, Farag said.

"Perhaps the best part of the Nd:YAG is that it promotes the body to rebuild," he said. "In some cases, the bone can actually grow back."

Joseph H. Farag, DMD, practices at Port Charlotte Dental Care, 3441 Conway Blvd., Port Charlotte. For more information, call 941-764-9555 or visit www.drfarag.com.