Friday, September 19, 2014
Aphthous ulcers are among the least worrisome oral manifestations we see, yet they can be the most painful for our patients. A small cheek bite, an accidental dig from the toothbrush, a transient scrape from a tortilla chip…and your patient is facing a week of debilitated eating, drinking and speaking.
Salt water rinses used to be the best fix we could offer, along with Zilactin which provided only temporary relief. Those treatments essentially told the patient he or she would simply have to let the ulcer heal over time.
Considering their applications in periodontics, surgery and restorative dentistry, dental lasers have a more exciting and wider appeal, but they also can be a powerful tool for dealing with that pesky canker sore. Relieving a patient’s pain is of course a bonus for both your patient and your practice.
This past year I have been using Solea, a CO2 laser that cuts hard and soft tissue and fits into numerous clinical situations. Using such a powerful technology for something as simple as an aphthous ulcer might seem overreaching, but that’s exactly what I did when I got a call a call from a friend of mine letting me know he had a “gnarly” canker sore. It proved to be the right approach for this patient.
The aphthous ulcer was right on his front lip, and he could hardly eat anything much less talk. I told him to come in, and that we would be able to fix it in about 30 seconds.
Once he arrived at the office, we brought him back and took a look. The sore simply looked painful, and it hurt to even peel his lip back to take a look. We set Solea to the soft tissue setting, and turned off any water spray.
At that point we just traced over the lesion with the laser until we got a scarred look to the surface. We did not have to use any anesthesia at all, and there was only a touch of bleeding in one spot.
We sent him home immediately after treatment, and he was gracious enough to come back a few more times to document healing. When asked about his pain level, he said he noticed immediate relief. The last time it hurt was right before the laser, and he was able to eat and drink with no sensitivity after that.
At 24 hours, the lesion was still there but had flattened out.
By day three the ulcer was noticeably smaller.
By day five very little evidence of the lesion remained.
Using settings specific to your machine, a diode laser also is capable of accomplishing this same treatment. While this might not be the most dramatic dental procedure, or the most unusual clinical case, we were able to use laser technology to quickly heal our patient and at the same time we generated some good will for the practice.
People rarely talk to friends and family with excitement about having a filling for a cavity. But spend 30 seconds using a laser to immediately relieve a patient’s pain, and he or she will become an instant fan of your office.