Lasers have been used in dentistry since 1994. They represent an exciting development in dental technology, helping dentists effectively provide treatment and perform a variety of procedures. For example, lasers are very effective at killing bacteria during procedures such as root canals and scaling of the gums, they reduce pain and bleeding after biopsy procedures, and they even reduce pain from mouth ulcers, such as canker and cold sores.
Aphthae are ulcers that typically occur on the inside of the mouth: lips, cheeks, and areas under the tongue are usual locations. These lesions are very common but the cause is unknown. Some of the predisposing factors are emotional stress, lack of sleep, deficiencies in vitamins/nutrients (such as iron, folic acid, vitamins B1, B2, B6, B12 and vitamin C), the menstrual cycle, and certain foods like coffee and chocolate. Aphthae can vary in size, number, and duration, but in all cases they are uncomfortable.
Herpes labials also known as cold sores can be caused by Herpes Simplex Type-1 (HSV-1) (about 95%) or Herpes Simplex Type -2 (5%) It is estimated that over 60% of population are infected with the HSV-1 but only 10-30% of the infected people will actually develop recurrent oral-facial infections. Most people contract the virus in childhood from close contact with family of friends who carry the virus. The virus can be transmitted by kissing, sharing cups, eating utensils, towels or even sharing eye glasses with an infected person.
The main symptom of HSV-1 is the outbreak of fluid filled blisters at the site of infection, most commonly on the lips or nose. Initial symptoms may include itchiness with increasing pain as the sores develop. Other flu-like symptoms can be associated with an outbreak—fever, headache, tiredness, and sore muscles. The blisters disappear on their own within about 10 days, but the virus simply becomes dormant and will reside in the ganglia of the nerve until the next outbreak is triggered.
Common triggers include stress, illness, lack of sleep, menstruation, extreme exposure to sun or wind. Most people can tell when the outbreak is about to occur. A tingling sensation can be noticed at the beginning, known as the prodrome state. This is the period when a person is particularly contagious.
There are no cures for aphthae or herpes simplex. The treatment for aphthae consists of different medications to reduce discomfort and accelerate the healing process. Such medications include local anesthetic gels to reduce pain, antibacterial rinses, or topical steroids. Treatments for herpes include topical use of anti-viral drugs like Acyclovir or Dentavir which help speed up the infection cycle by hastening the end of the outbreak. If used during the prodrome phase, it helps to prevent the development of the blisters. Other medications include systemic drugs such as Valacyclovir (Valtrex) or Fanciclovir (Famvir).
Aphthae—studies have shown that patients that have laser treatment on their aphthae sores get immediate pain relief, faster healing and lower recurrence rate in the future.
Herpes Simplex-1—Patients that have laser treatment during the prodromal period of the virus will have healing within 48 hours. If treated in later stages when blistering and crust appears, 90% of patients will be cured within 48 hours and all patients within four days. At this stage, two to four treatments will be required. Studies have shown that patients with HSV-1 who receive treatment with laser have fewer recurrences in comparison to conventional treatments.