by 
By Heidi Arndt
Have you considered?
Lasers have been utilized in the medical and dental environment for years. There are many benefits to utilizing lasers in dentistry compared to traditional treatment methods, or to enhance current treatment modalities. Technological advances have and will always evolve, and as clinicians seek to offer their patients the most up to date, technologically advanced treatment options, they should consider the use of a diode laser in the practice.
For treatment of periodontal disease, a diode laser is used as an adjunct to non-surgical periodontal therapy. This is performed as the dental laser tip is methodically maneuvered within the sulcus, in short overlapping strokes to aid in the destruction of the bacteria by creating an environment that the bacteria will not thrive.
Incorporating laser treatment
There are many ways to incorporate laser treatment into a dental practice. For use in the dental hygiene operatory the laser is used for bacterial reduction. With the growing knowledge of the etiology of periodontal disease, we want to focus on incorporating additional resources to our non-surgical periodontal therapy to ensure that we are reducing the bacterial load which will contribute to reducing the inflammatory response associated with periodontal disease.
In addition to bacterial reduction, lasers can also be utilized in guided-tissue regeneration, laser-assisted periodontal therapy and bio-stimulation. When introducing a new technology to patients, it is always recommended to inform the patients of clinical and radiographic findings, as well as incorporating a comprehensive medical history to assist in obtaining all necessary information to assess the patient’s risk for periodontal disease. With this information, you can begin to educate the patient on the newest ways to prevent, treat or maintain the current state of their oral cavity.
It is important to know that currently there is no long-term systematic research to support the use of lasers as an adjunct to non-surgical periodontal therapy, but we do know that there are clinicians utilizing diode lasers in accordance with their state dental hygiene practice acts with successful outcomes, such as increased wound healing and positive tissue outcomes. We truly believe future research will show the positive benefits of incorporating the diode laser as an adjunct to scaling/root planing, periodontal therapy and gingivitis therapy.
Explaining the service
Currently, there are no CDT codes specific to laser use, but it is possible to still provide the service by explaining to the patient that insurance does not currently recognize the procedure, which is often the case with newer technology. With our commitment to using the most up-to-date technology, we do are providing narratives to the respective insurance providers so they may understand the ever-evolving landscape of oral healthcare.
Without a specific CDT code available, many dental groups are using the D4999 (Un-specified Periodontal Procedure Code) to bill the procedure to the patient. As mentioned before, dental insurance is not recognizing a benefit for bacterial reduction at this point, which requires the dental group to pass the cost onto the patient.
Lasers and ROI
You may wonder if there is a true Return of Investment (ROI) to incorporating the diode laser into the dental hygiene operatory, and it is important to note a few things before considering your ROI.
- No. 1: Do you have a strong and current periodontal therapy protocol in place for your practice? Is your team committed to recognizing periodontal disease and gingivitis at the earliest point? With more than 50 percent of the U.S. population suffering from periodontal disease, you should see multiple periodontal patients/day in your practice for scaling/root planing and/or periodontal maintenance. Then also consider how many gingivitis patients would also benefit from laser use.
- No. 2: Is your team comfortable and committed to discussing out-of-pocket expenses with your patients? As mentioned before, insurance does not offer a benefit for bacterial reduction using a diode laser. You will need to pass the fee onto your patient for this procedure.
- No. 3: Commit to getting your entire team laser certified and educated on how to use the laser, and how to communicate the benefits of laser use to your patients. A strong training program and a supported implementation process will ensure your team is comfortable and confident with bring a laser into their standard of care.
Lasers are here to stay. We encourage all dental hygiene teams to look at the benefits of lasers and how they can integrate into their current practice.
If you have questions of how to integrate lasers into your dental group, please contact us today:
www.enhancedhygiene.com or [email protected]
Annaji, S. (2016). Efficacy of Photodynamic Therapy and Lasers as an Adjunct to Scaling and Root Planing in the Treatment of Aggressive Periodontitis – A Clinical and Microbiologic Short Term Study. Journal of Clinical and Diagnostic Research. doi:10.7860/jcdr/2016/13844.7165
Blayden, J., & Mott, A. (2013). Soft-tissue lasers in dental hygiene. Ames, IA: Wiley-Blackwell.
Convissar, R. A. (2015). Principles and Practice of Laser Dentistry. St. Louis, MI: Elsevier Mosby.
Fontana, C. R., Kurachi, C., Mendonça, C. R., & Bagnato, V. S. (2004). Microbial reduction in periodontal pockets under exposition of a medium power diode laser: An experimental study in rats. Lasers in Surgery and Medicine, 35(4), 263-268. doi:10.1002/lsm.20039
Harris, D. M. (2004). Laser antisepsis of Phorphyromonas gingivalis in vitro with dental lasers. Lasers in Dentistry X. doi:10.1117/12.549028
