Laser holds the key to fixing tongue-tied kids

The benefits of using Erbium YAG dental lasers to treat children with Ankyloglossia was one of many indications brought to light by Albany, New York-based paediatric dentist, Dr Lawrence Kotlow, during a recent lecture tour of Australia in August.

"Ankyloglossia, or tongue ties as they are commonly known, is a potentially life threatening condition that often goes undiagnosed at birth," Dr Kotlow said. "It is also a condition you can fix using a dental laser in around 10 seconds.

"Physicians often ignore the mouth when they are diagnosing problems with the rest of the body but as dentists, we need to be aware that the mouth can give an insight into overall systemic health."

Dr Kotlow said his own anecdotal research indicated some 3.5% of children were born with tongue ties and he had established a system for categorising them as mild, moderate and severe and treating them accordingly.

"Left untreated, tongue ties lead to a range of problems. If the frenum is too tight, it can affect half a dozen to a dozen functions of the tongue and inhibit speech, eating habits and sleeping patterns for the rest of the person's life.

"Tongue ties often mean a newborn can't nurse properly which means the mother is also uncomfortable. So when you're treating a newborn you are not only treating the child, but also the mother and really the whole family because if the child has a problem it will effect everyone.

"With the laser, we can quickly and easily revise the lingual frenum of newborns without the need for general anaesthetic."

Over 200 dentists attended the seminars presented by Henry Schein company Protec in Brisbane, Melbourne, Sydney and Perth. Protec distribute the Hoya ConBio DeLight laser used by Dr Kotlow as well as other high tech dental products.

In addition, Dr Kotlow filmed a segment for television show A Current Affair that aired nationally to coincide with Dental Awareness Month.

"My goal is to try and educate dentists in early intervention and the advantages of seeing children using the laser," Dr Kotlow said. "The dentists who came along to the seminars were very interested to see what they could do with lasers that they weren't doing now."

The seminar programme comprised a 3.5 hour lecture in the morning and a live demonstration in the afternoon.

"I talk about why you use lasers in dentistry; why people are afraid of the dentist; laser physics; and a range of other topics. Then I go through 23 different procedures I use on children in my practice with lasers. It is applicable to adults as swell but as a paediatric dentist, my aim is to show my colleagues how to treat early with a laser to prevent a whole range of systemic problems from occurring throughout a patient's development and adult life.

"Lasers are quick and complications are rare. The Erbium laser has a shallow depth of penetration which promotes rapid healing and mild to no post-operative sensitivity."

Dr Kotlow said the laser is also ideal for gingival recontouring of orthodontic patients who haven't brushed properly as well as treating apthous ulcers.

"With apthous ulcers, you can get rid of the paid in around 30 seconds and they rarely subsequently reappear in that location. Lasers are safe and effective for soft tissue and 75% of the time, you don't need local anaesthetic.

"You also generally don't need to numb patients to do restorative dentistry with the laser. Another advantage is that it doesn't cause the enamel to fracture as is possible when using high speed handpieces. With the laser, you have an instrument that is very conservative. Depending on the setting, it will selectively remove enamel or dentine or decay. The laser has a numbing effect on the tooth which is the reason anaesthetic is often not required."

Dr Kotlow said that almost every dental procedure can be done with a laser and the dentists who attended the course were interested to hear of its potential to treat every age group of patients.

"My goal in talking to dentists is to make sure they understand that they are physicians of the mouth. The mouth is the mirror to the whole body. Physicians are not looking in the mouth and as dentists, we need to be aware of the role we should be playing in our patient's overall health."