Seeing the light

by Louis Malcmacher, DDS, MAGD

There's no question that one of the best dental meetings of the year is the Greater New York Dental Meeting, which is also the largest annual dental meeting in North America. In my 32 years in dentistry, I've never missed going to the Greater New York Dental Meeting. It is truly an international meeting with representatives from all over the world.

One of the highlights of this year's GNYDM was the introduction of new laser technology that can be used for frontline TMJ syndrome and myofascial pain. As president of the American Academy of Facial Esthetics, we have been training thousands of dental professionals over the past few years with the use of Botox and dermal fillers for dental esthetic and dental therapeutic uses. The facial esthetic part of these pharmaceuticals is always exciting to dental professionals, and it certainly draws them to live patient courses to learn hands-on use of them. What most dental professionals find surprising is the tremendous dental therapeutic aspects of Botox and dermal fillers, especially in one of the most frustrating areas of dentistry -- TMJ syndrome and myofascial pain.

I recently spoke at the American Academy of Implant Dentistry (AAID), the premier dental implant meeting in the U.S., on the topic of facial pain. As soon as I started talking about TMJ/facial pain to this group of about 1,000 dental implant professionals, I could clearly see their hands subconsciously moving to their head, neck, or shoulder areas that chronically bother them. Dental professionals probably suffer from myofascial pain more than the general population! We need to learn much more about the area of facial pain therapeutics; therefore I've been investigating the use of various technologies for frontline treatment for myofascial pain.

I've conducted extensive research on the current status of dental lasers in the U.S. market to see if there were any uses in dental pain therapeutics. Low level laser therapy (LLLT) is used worldwide by many health-care professionals for treating pain disorders. It is not well known in dentistry because of the lack of technology and instrumentation. Most of you are familiar with diode soft tissue lasers. Most of these lasers sold on the market are simply electrosurge replacements, primarily used for bloodless cutting of soft tissue very precisely. Most diode lasers are one-trick ponies – they don't do much except trim soft tissue.

A new diode laser, Epic by Biolase, raises the diode laser market to a whole new level. In addition to being an outstanding soft tissue diode laser, it brings the capability of low level laser therapy to every dental office and is a terrific adjunct to other techniques we teach in our courses, such as trigger point injections, ethyl chloride spray, and Botox injections for TMJ syndrome and myofascial pain. The laser energy promotes healing and relieves pain nearly instantly and is a great noninvasive alternative to other treatments, especially for patients in acute pain or who are needle phobic. The Epic is the only dental diode laser that is FDA cleared for pain therapy in the oral and maxillofacial areas.

If you're a dental professional, you treat patients with some form of orofacial pain every single day. LLLT is a very useful therapy that is used around the world by many other health-care professions to achieve significant results and improve the quality of life for patients.

Many dental clinicians are afraid to treat myofascial pain patients because they believe it is an all-or-nothing approach. Either you have to go all in with treatment, which could mean a major dental reconstruction to a change in the vertical dimension, or it is the nothing approach, where we just pray that the patient's pain or the patient will go away. It is time for every dentist to learn how to treat these patients using frontline techniques that will serve most patients' needs regarding TMJ syndrome and myofascial pain.

Louis Malcmacher, DDS, MAGD, is a practicing general dentist and internationally known lecturer, author, and dental consultant. An evaluator emeritus for CLINICIANS REPORT, Dr. Malcmacher is the president of the American Academy of Facial Esthetics at facialesthetics.org. Contact him at (800) 952-0521 or email [email protected]. His website is www.commonsensedentistry.com, where you can sign up for a free monthly e-newsletter.