This involves patients who, despite  proper treatment and good home care and professional follow-up visits, have local or generalized areas that never respond to conventional standards, and tooth loss is expected.

These patients have serious underlying systemic (general body) health conditions, diseases, or debilitations who are, consequently, at high risk for conventional periodontal therapy.  Systemic health disease that have significant dental/oral maxillo-facial tissue effects include any blood or immune system disorder (e.g. Diabetes, Hemophilia, Acquired Immune Deficiency Syndrome).  Also, Patients with skin diseases (e.g. Systemic Lupus, Erythema Multiforme, Scleroderma).

The other half of the laser beam are “particles” of high energy photon waves.  These laser light-wave particles create ultra-sonic (sound) waves when the fiber-optic tip is activated within the tissue fluid in gum pockets.  The resulting sound waves cause sonic vibrations, or mini shock-waves, that loosen hard deposits of calculus on the surface of diseased teeth.

Unhealthy debris from sonic shock waves and pathologic proteins are then subject to vaporization, further sonic breakdown, and --most often -- removal during irrigation (rinsing) of the Gum pocket by the doctor or the hygienist.

Tissue can be removed independent of laser beam energy absorption by the target tissue.  Tissue removal in this case, is not being vaporized.  Instead, the atoms and molecules of the tissue are mechanically separated (ionized) and therefore destroyed.  This mechanical separate of tissue atoms and molecules occurs as the result of a unique phenomenon of laser photon energy -- called “plasma”.

Plasma can be seen as a brilliant orange colored halo that forms between the fiber-optic tip and the surface of the target tissue.  At the same time, a “pop” or “crack” sound can easily be heard after each pulse of the laser.  This is known as the plasma effect. 

Plasma has been referred to as a “forth state of matter”.  The plasma effect occurs from the build-up of very high pressures of air and gas, which is first  caused by very rapid temperature elevation at the laser-tip.  This small area of very high pressure, then, de-pressurizes explosively -- and causes the “popping” and “cracking” sounds (like a sonic boom).

Note that the laser beam is not in direct contact with the target tissue -- only the plasma and the resulting area of high pressure.  It is the explosive release of air pressure (like opening a shaken can of carbonated beverage) that causes the mechanical destruction of the target tissue.

Absorption of laser light by the atoms and molecules of the target tissue, leads to increased vibrations of their organized to heat, which destroys selected tissue.  Increased  absorption  of laser energy, or additional time on the target tissue, will cause molecules in the tissue to similarly increase their rate of vibrations, conversion to heat, and tissue destruction.