Dr. Dandu Siva Sai Prasad is a Periodontist and a laser specialist. He completed his BDS in 2013 from Adhiparasakthi Dental College and Hospital, Melmaruvathur, Chennai, Tamil Nadu, India, where he developed an interest in the field of Periodontics based on his observations during patient follow-ups in his internship. Later, he completed his MDS at Mamatha Dental College, Khammam, Telangana, India. He has eight and a half years of experience as an Associate Professor at CKS Theja Institute of Dental Sciences, Tirupati, Andhra Pradesh, India.
In this interview with Dr. Lakshmisahithi Tanneru of MedBound Times, Dr. Dandu Siva Sai Prasad discuss the importance of his specialty and his clinical experiences.
Part 3 of the conversation includes specific cases where conventional still preferred, long-term results, and how success of treatment is determined in periodontics, pain management, limitations of laser therapy, cost, accessibility of lasers and future of lasers in research.
Dr. Lakshmisahithi Tanneru: Are there specific cases where a conventional approach is still preferable to laser treatment? How does laser therapy show its results in the long term, and on what basis does the success of treatment depend?
Dr. Dandu Siva Sai Prasad: From my clinical perspective, I always use lasers as an adjunct to conventional therapy. For example, during flap surgery, I first degranulate the unhealthy granulation tissue using a conventional method, followed by laser application to further remove tissue and access the underlying area. In many cases, lasers are preferable to conventional approaches.
In most periodontal flap surgery cases, initial degranulation is performed using curettes, followed by laser degranulation for more precise tissue removal.
When considering long-term outcomes in periodontics, success largely depends on the patient’s adherence to maintenance therapy. If a patient strictly follows oral hygiene instructions after laser therapy, the results will be significantly better. However, poor maintenance negatively impacts periodontal health, regardless of whether a laser or conventional method was used.
Ultimately, in periodontal procedures, the success rate depends more on the patient's commitment to maintenance therapy than on the treatment method itself.
Dr. Lakshmisahithi Tanneru: How does laser treatment impact pain management and anesthesia requirements during periodontal procedures?
Dr. Dandu Siva Sai Prasad: When lasers are applied, pain decreases because they help reduce the production of bradykinin, a natural pain-eliciting chemical, while also increasing the release of natural pain relievers like endorphins and enkephalins. This allows for effective pain management during periodontal surgical procedures.
Dr. Lakshmisahithi Tanneru: Are there any risks or limitations associated with laser treatment in periodontology? How do lasers minimize damage to surrounding healthy tissues compared to conventional tools?
Dr. Dandu Siva Sai Prasad: Lasers should be used only by trained and qualified dental professionals. Improper handling or incorrect tissue settings may lead to tissue damage and thermal burns in healthy oral tissues. Additionally, failure to use proper safety precautions, such as wearing protective eyewear, can result in corneal damage for both the patient and the dentist in the event of accidental laser exposure. Laser treatment is contraindicated in patients taking photosensitive medications and has certain limitations for patients with pacemakers and pregnant women.
The laser tip precisely targets the affected area, making it more effective for accessing deeper periodontal pockets than mechanical tools. In contrast, the working end of a mechanical tool is broader, increasing the risk of lacerating surrounding healthy tissue. By targeting only the affected area, lasers minimize damage to adjacent healthy tissues compared to conventional methods.
Dr.Lakshmisahithi Tanneru: How does the cost of laser periodontal therapy compare to conventional treatments? Do insurance providers cover laser treatments, or is it considered an elective procedure?
Dr. Dandu Siva Sai Prasad: The cost of laser treatment is always higher compared to conventional methods because the equipment and machinery are more expensive. Since lakhs are spent on instruments and machinery, the procedure is designed to precisely target the affected area, yielding better results. As a result, laser treatment costs are typically double that of conventional treatments.
To my knowledge, in India, there is no insurance provider covering the full cost of dental treatments. Some insurance companies offer coverage for dental procedures, but laser treatments are not explicitly mentioned. Since these are active procedures, introducing insurance coverage for laser gum treatments could be beneficial in the future as part of a dental awareness program.
Dr. Lakshmisahithi Tanneru: Is laser technology widely accessible in dental clinics, or is it still limited to specialized centers?
Dr. Dandu Siva Sai Prasad: Laser technology is widely accessible in dental clinics across cities. It is not limited to specialized centers; however, hard tissue lasers are available only in select centers. In contrast, soft tissue lasers are commonly available in most dental clinics, and almost every periodontist has access to a dental laser for consultations or in their own clinics.
Dr. Lakshmisahithi Tanneru: How do you see laser technology evolving in periodontal care in the coming years? Are there any emerging research or innovations that could further enhance the effectiveness of lasers in dentistry?
Dr. Dandu Siva Sai Prasad: The evolution from traditional methods to laser dentistry marks a significant advancement, enhancing patient comfort and precision in cutting and infection control. As technology advances, laser dentistry holds a promising future in periodontology, benefiting patients with its precise and effective approach.
Emerging research includes low-level laser therapy (LLLT), also known as photobiomodulation (PBM), which enhances tissue healing, reduces inflammation, and alleviates pain. PBM stimulates cellular processes without generating excessive heat or causing tissue damage. Another innovation is photodynamic therapy (PDT), based on the antimicrobial PDT principle, which is used for both cancer-related and non-cancer-related oral conditions. This non-invasive approach effectively eliminates pathogenic microorganisms, making it particularly beneficial for targeting periodontal microbiota.
The mechanism behind PDT involves the release of reactive oxygen species (ROS) through photosensitizers upon irradiation. ROS disrupt bacterial growth by causing DNA damage and interfering with cellular metabolism. Ongoing research aims to improve laser effectiveness while addressing challenges such as high costs and lack of insurance coverage. Additionally, the integration of artificial intelligence with laser technology is expected to shape the future of dental treatments, enhancing both efficiency and patient comfort.
MedBound Times extends a heartfelt gratitude to Dr. Dandu Siva Sai Prasad for sharing insights about his journey in educating and raising awareness about lasers benefits over conventional approach and his journey of interest in the field of Periodontology. We appreciate his time to educate and inspire our readers.