Using Lasers to Improve Comfort
The increase in adverse anesthesia reactions demands exploration of alternative treatments
Dental phobia and anxiety are extremely common in today's society, with some studies suggesting that up to 60% of people are affected by this phenomenon.1 As the number of people with dental phobia has increased, the demand for alternative sedation services during dental procedures has also increased. Unfortunately, the number of adverse reactions associated with some types of anesthesia, including pediatric sedation, is increasing as well.
A 2013 survey from the University of Virginia reported that children are at a higher risk of adverse events related to anesthesia than adults and noted that approximately 35% experienced an adverse reaction when placed under general anesthesia.2 Although these adverse effects vary greatly, they can include nausea, vomiting, neuropathic symptoms, oversleeping, irritability, and in cases involving an overdose, respiratory failure, seizures, dysrhythmias, and cardiovascular collapse.2 Given the trauma and severity of these effects, we must seek alternative methods to manage pain.
As practitioners, our main considerations should be the quality of the care we deliver and the safety and well-being of our patients. The development of trust greatly depends on the level of safety and comfort that a patient feels. Equally important is the intensity of the pain or trauma that an individual has experienced while at the dentist in the past. To improve patient satisfaction, we want to reduce the unpleasant experiences, especially those as traumatic as a medical emergency.
When asked in a recent survey about sedation and anesthesia practices, 75% of responding dentists confirmed that they had indeed experienced some type of sedation-related medical emergency.2 As dentists seek ways to improve patient outcomes, they are looking for approaches that will not only improve care but also patient safety. In addition to incorporating mock-emergency procedures and having a dental assistant present when administering anesthesia, many dentists are seeking out treatment options that are less invasive and may not require anesthesia.
Key advances in technology have provided safe and reliable options that utilize virtually pain-free methods to improve patient outcomes. For example, the use of dental lasers can be particularly effective for a variety of procedures. When compared with a scalpel, the benefits include quicker healing times and less bleeding.3 Using this method, dentists are often able to perform minimally invasive procedures without the use of local anesthesia.
The US Food and Drug Administration first approved lasers for use on children and adults in 1977. Since then, many indications for dental lasers have been approved. This has revolutionized dental care by providing procedures with little or no discomfort, which has always been paramount in dentistry.3 Lasers can be used on both soft and hard tissues and, in many procedures, can eliminate the need for drills. The benefits of lasers are numerous, including the ability to regenerate damaged blood vessels, reduce inflammation, lessen tissue damage, and remove tumors. Lasers are able to seal nerve endings and blood vessels while they penetrate tissue, which is why most patients experience minimal or no postoperative pain.4
With the growing number of adverse events and emergencies resulting from anesthesia and sedation, especially among children, we must advocate for the adoption of safer alternative treatments. Implementing treatments such as advanced laser therapy that reduce dental pain and anxiety is of the utmost importance in reducing the need for anesthesia.
About the Author
Samuel B. Low, DDS, MS, MEd, is the chief dental officer of Biolase.
References
1. Foley KE. So many people are afraid of going to the dentist psychologists don't know how to quantify it. Quartz. March 8, 2017. https://qz.com. Accessed March 29, 2019.
2. Vanderbilt AA, Husson MM. Current sedation and anesthesia practices among dentists: a statewide survey. Oral Health Dent Manag. 2013;12(4):
230-236.
3. Margolis FS. Are dental lasers for kids? Dental Economics web site. https://www.dentaleconomics.com/articles/print/volume-100/issue-7/features/are-dental-lasers.html. Published July 1, 2010. Accessed March 29, 2019.
4. Gotter A. What is laser dentistry? Healthline web site. https://www.healthline.com/health/laser-dentistry. Updated February 2019. Accessed March 29, 2019.
