Academy of Laser Dentistry

J O U R N A L O F L A S E R D E N T I S T R Y | 2 011 V O L . 19 , N O . 3
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C L I N I C A L R E V I E W A N D C A S E R E P O R T S
Figure 5: Application of low-level laser to
the submandibular lymph nodes
Laser irradiation is applied to
the apex of each root for analgesia
and again after the tooth has been
prepared for reduction of pain and
inflammation, as shown in Figure
6. Distraction techniques are
recommended to help the patient
deal with the mental fears or
anxiety surrounding the dental
appointment. Dental analgesia does
not seem to be as effective in
permanent teeth because of the
increased size and sensitivity of the
dental pulp; however, it has been
shown clinically to be effective for
pain relief during crown cementations
and decreased sensitivity
during scaling appointments.
Nausea and Gagging
Application of the laser to the P6
(Pericard 6) acupuncture point on
the wrist can decrease or eliminate
the nausea and gagging some
patients feel during impressiontaking
or X-ray procedures. As
shown in Figure 7, the P6 is located
on the underside of the wrist,
approximately 1 inch from the
distal palmar crease (approximately
the width of the distal
thumb phalanx). 23 For patients who
are extremely nauseous or anxious,
application to three acupuncture
points in the wrist can be effective;
Ross and Ross
Figure 6: Promotion of analgesia via LLLT
for primary tooth restorations
H7, LU9, and P6 are the parasympathetic
calming points and
stimulation of these points can be
very effective in reducing anxiety.
A 1998 report in the British
Journal of Anaesthesia investigated
the effectiveness of laser irradiation
to the P6 acupuncture point on postoperative
vomiting. In the laser
stimulation group, the incidence of
vomiting was significantly lower
(25%) than in the placebo group
(85%), and the patients were quite
receptive to the painless procedure. 24
Uptake and Elimination of
Anesthesia
Based on the mechanisms of PBM
therapy’s ability to increase blood
circulation, 4 the author has found
that there is an increase in uptake
and elimination of anesthesia. PBM
is applied to the submandibular
lymph nodes and the site of injection
after the injection and upon
completion of the dental appointment,
for uptake and elimination,
respectively.
Implant Placement
Three papers indicate that PBM
can reduce inflammation following
implant placement, help speed the
integration of the implant into the
bone, and improve the quality of
the bone around the implant. A
study using rabbits utilized Raman
spectroscopy and electronic
microscopy to investigate the effect
of infrared light on the loading
time of dental implants, and found
Figure 7: A graphic diagram of three
parasympathetic calming acupuncture
points for reduction of nausea and
gagging. Courtesy of Donald J. Coluzzi, DDS.
Adapted from Atlas of acupuncture points. Point
locations [Internet]. Published by
www.AcupunctureProducts.com, 2007. [Cited
2009 Dec 28.] 39 p. Available from:
http://chiro.org/acupuncture/ABSTRACTS/
Acupuncture_Points.pdf.
a significantly greater amount of
mature bone, a better distribution
of bone, and more organization of
bone after laser irradiation, when
compared to the control group that
received no laser irradiation. 25
Another study used rats to
examine the effect of laser therapy
on bone and demonstrated that the
laser group had an abbreviated
initial inflammatory response and
a rapid stimulation of bone matrix
formation at 15 and 45 days. 26 An
earlier rabbit study showed that
bone healing is improved and those
authors concluded that it is
possible to reduce the loading time
of implants in the mandible of
humans from 4 months to approximately
2 months and 24 days, and
in the maxilla, from 6 months to 4
months and 6 days. 27
Orthodontics
Orthodontic treatments are lengthy
and often painful for many patients.
As mentioned previously, Gerbi et
al. have shown that PBM irradiation
on bone increases osteoblastic
proliferation, collagen deposition