Global Periolaser

This is where G-PLUS comes in – we are a group of clinicians and academics (all scientists!) from all around the World. As caring practitioners we have a passion for this subject and we wish to share our positive and negative clinical experiences with others. At present there are very few independent clinician based educational resources available for prospective new laser clinicians and academic teachers wishing to learn more about laser periodontology. For anyone starting out to learn more it can be both confusing and frustrating and it is all too simple to read the bullet points from a few critical reviews and conclude that lasers do not have a role in contemporary periodontology. This website aims to put as much knowledge as possible on lasers and periodontology together in one place. As the evidence base matures we will continually update this site as a resource. Our sincere hope is that as new discoveries emerge, as more science is published that as an online community, we can form a consensus. Out of this ought to emerge the best scientifically agreed way of doing things, whilst still being open to novel approaches. In the absence of a forum how else can new discoveries emerge?

All good quality hygienists, dental therapists, dental surgeons and specialist periodontists strive to keep up to date with a rapidly evolving evidence base. By necessity as well as being health care providers it is important to be able to critically evaluate the literature and stay up to date which requires us to be scientists as well as health care providers. In an effort to promote high standards of clinical care we are in an era of evidence based clinical practice. The aspiration to promote a sound scientific approach to clinical care is desirable as so much of contemporary dental practice is based on hearsay and opinion. The process of evaluation is a slow process as it takes a very considerable effort to gather sufficient high quality studies to achieve acceptance at the level of a systematic review and meta analysis. The desire to promote high standards of daily clinical practice ought not however suppress innovation and regrettably there is a tendency to apply dual standards as on the one hand traditional non evidence based processes are readily accepted whereas newer treatment protocols face an up hill challenge to gain acceptance. High quality scientific journals are substantially over subscribed with new material and it is difficult if not impossible to get progressive narrative reviews and pilot studies published in high impact factor journals.

In respect to the use of lasers in periodontics already there are several hundred published papers in respected peer reviewed journals. Regrettably the quality of some of the studies leaves a lot to be desired consequent to small populations of subjects, inherent flaws in study design as well as at times an obvious lack of awareness of the mechanisms supporting the treatment protocols applied. For instance single tooth split mouth study designs on bacterial pocket populations are inherently flawed by design. A laser is not after all a magic wand and it's use as an appropriate adjunct to periodontal management requires careful thought and application as part and parcel of a well designed program of comprehensive care.

Quite simply, at this point in time, there aren’t enough RCTs for us to stand up from the roof tops and shout out that lasers can work well in periodontology and are a highly useful adjunct to apply along with conventional methods. How long afterall did it take to determine the same about scaling and root planing or regenerative techniques- how many publications did we need for that to become the consensus of the profession? There are other important aspects of care that can be very difficult to measure scientifically, such as patient comfort and anxiety, and these areas can impact on patient compliance with a lasting impact on long term clinical outcome. Without a doubt, more high quality research on lasers in periodontology is a necessity. This need is compounded by the recognition that there are many different types and brands of lasers, used in a variety of protocols: we can’t group all this together and formulate a consensus. So what can be done – as clinical scientists, is open our minds to the possibilities, and explore how we can develop the evidence base further founded on our observations as clinicians and see if good science can be applied to new concepts.