Treating Herpes With Laser Therapy
An alternative treatment for herpes labialis infection is the diode laser. This treatment option alters cell and tissue function, and decreases healing time.
An alternative treatment for herpes labialis infection is the diode laser. This treatment option alters cell and tissue function, and decreases healing time. Based on dental hygiene practice acts and appropriate education and certification, dental hygienists can be assets in the use of diode lasers for the treatment of herpetic lesions.
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Decreasing Severity of Herpes Simplex Virus
Laser therapy should be conducted at the first sign of a herpes simplex virus (HSV)-1 outbreak. With laser therapy, the healing time for a herpes lesion may be reduced by 10 days to 14 days and the resultant pain/discomfort should decrease. When treating herpetic lesions, the tip of the laser must be a noninitiated tip. This provides the laser’s light energy, compared to initiated tips, which provide heat energy and are often referred to as “hot tips.” Each tip must be individually autoclaved before use and disposed of afterward; they are single use. A noninitiated tip provides a more dispersed laser beam, enabling greater surface area coverage of the herpetic lesion. In contrast, an initiated tip is used for periodontal therapy, in which a hot tip is needed to burn off the diseased tissue and microbial products in the pocket.
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Evidence of Efficacy
Evidence demonstrates the efficacy of laser use in the treatment of herpetic lesions. In a double-blind study, Brignardello-Peterson used a low level laser on 60 patients; the control group received no laser therapy. Results showed a reduction of healing time for participants receiving laser treatment for a herpes labialis lesion. Participants reported less pain and a reduction in lesion size, compared to the group that did not receive laser therapy.
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Safety Comes First
As with any device that emits radiation, clinicians must follow all safety rules applicable to laser use. The Association of Perioperative Registered Nurses (AORN) has established recommended safety practices when using a laser for patient care. Every dental practice that uses a laser for direct patient care should have an employee identified as its laser safety officer. The AORN recommends that all equipment be located on one cart, including the laser itself, eye protection (patient and operator), evacuation system, signs, and masks. An organized laser therapy cart promotes efficient operation and can help to prevent any untoward effects on patients or clinicians.
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Risk of Skin Damage
Compared with providers, patients are at greatest risk for skin damage. As the laser produces thermal energy, patients are susceptible to soft tissue burns. The operator controls and minimizes any potential burn by consistent monitoring of laser settings and appropriate direction of the laser beam. Dark skinned individuals may not be ideal candidates for laser treatments due to their higher melanin pigmentation. The greater melanin level will absorb more of the laser beam, making these individuals more prone to burning and skin damage, regardless of the setting. Mustached or bearded men, or women with any stray hairs in the mouth area could result in burning because the laser beam is drawn to the facial hairs, burning them and thus the skin.
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Scope of Practice
Dental hygienists interested in using laser therapy must ensure it is within their state practice acts. The Academy of Laser Dentistry has a map demonstrating which states allow the use of laser therapy by dental hygienists. Sixteen states have a written policy that explicitly allows laser use by licensed dental hygienist. Thirty states have a range of regulations, from no mention of laser use, to stipulating the use of lasers by dentists only, to allowing dental hygienists to use laser therapy only for gingival curettage. The remaining four states are either developing a policy or simply do not allow dental hygienists to use laser therapy in any circumstance.