Prevention of dental caries in partially erupted permanent teeth with a CO2 laser

The purpose of this study was to determine the effect of CO2 laser irradiation in the prevention of pit and fissure caries in immature molars with covering opercula.

In pediatric dentistry, it is not unusual to find partially erupted immature permanent teeth, especially with opercula. Conventional dental caries prevention is not effective in these cases because of the immaturity of tooth substance and the presence of the opercula, which accumulate a substantial amount of plaque.

The CO2 laser was used on 22 immature erupting molars with opercula. In each case, we first cut the operculum with a CO2 laser in a 2- or 3-watt continuous mode. Then, the occlusal surface was irradiated spot by spot along the pits and fissures of the molar using a CO2 laser in a 2-watt pulsed mode with 0.2 sec of irradiation time (average power, 0.3 watt; pulse width, 10 msec; repetition time, 15 Hz; energy density, 15 J/cm2). Each of the studied teeth was clinically examined for dental caries for 3 years.

It took less than 2 min to cut the operculum, and there was no bleeding. The irradiation imparted acid resistance to the teeth without any discomfort to the patients. The patients did not complain of any pain after the procedure. Only two of the studied teeth developed dental caries during the observation period.

We conclude that a CO2 laser might be an effective mode of treatment in the prevention of pit and fissure caries in partially erupted permanent molars covered with opercula.