Kidstown Dental has become known for compassion and expertise in pediatric laser dentistry, frenectomies, myofunctional therapy, growth and development guidance as well as for a whole child, comprehensive approach to sleep and airway issues in children. Dr. Amy Luedemann and her team integrate the newest technologies with proven methodologies to create the best possible experience for children. Dr. Amy considers lasers to be the “key piece to achieving optimal results for our sweet patients and our business!”
Benefits of lasers in pediatric practice
Dr. Amy was introduced to hard and soft tissue lasers in 2009, as an associate in a private pediatric dental practice, where she became passionate about doing “no-shot” laser dentistry. She said, “I am so passionate and believe in laser technology so much that if I were to be told that I could no longer practice without using lasers, I would simply rather not practice. I strongly rely on the precision, efficacy, and the high success rate, not to mention the gentleness for the patient that the LightWalker brings to my practice.”
“I strongly rely on the precision, efficacy, and the high
success rate, not to mention the gentleness for the
patient that the LightWalker brings to my practice.”
Now, with 12 lasers between her home and office, Dr. Amy shares that the Fotona LightWalker laser has become one of her most leaned-on lasers. “It is so fast and so versatile — the best of both worlds.” Because the LightWalker laser has both an Nd: YAG and Erbium YAG, it can achieve deep soft tissue penetration and be minimally invasive, but also has fast, hard-tissue applications. The clinician is able to use the laser in lieu of a drill for dental decay. There is no direct contact with the tooth so no uncomfortable vibrations, and little-to-no heat with the Erbium YAG, so no need for anesthetic and no unnecessary heating damage to the nerve. Also, lack of friction and microfractures leads to better outcomes, improved comfort, and significantly less risk of recurrent decay. The wide range of applications includes operculectomy, gingival recontouring, pulpotomy, pulpectomy, frenectomy, shot-free laser-assisted extractions, and extensive healing applications via photobiomodulation and high-level laser interventions. She says, “The life-changing non-invasive laser treatments have really become my passion.”
Airway and LAFTR
A significant event impacted Dr. Amy deeply and changed her focus. A family brought their only young child, who previously had a mild sleep apnea diagnosis, for a simple checkup. Kids-town Dental’s comprehensive processes include an assessment of all patients for tongue tie and signs of sleep and airway issues. This child had an undiagnosed tongue tie, a known marker for sleep apnea. Shortly after this first visit, and before the child could get the help he needed, the child passed away from SIDS. This was so heartbreaking that she focused on helping children with these issues as early as possible and educating other healthcare providers. She’s been on the radio, podcasts, and is in process of writing her first book, all with the goal of widely sharing her knowledge. Dr. Amy also helped develop and co-teaches a comprehensive, advanced 2-day laser pediatric dental course 2 times per year in her practice to educate new laser users.
Newborn babies’ sleep issues often get chalked up to sleep regression, being fussy, or disliking sleeping on their back, but often these are signs that are being missed, says Dr. Amy. Generally, when it comes to airway issues in kids, a pediatrician or ENT will only offer four options, none of which are root-cause solutions. The first option usually is to watch and wait. As a second option, if they are concerned, but the patient doesn’t yet qualify for surgery, they offer a steroid nasal spray to shrink the lymph tissues. This does not address why they are enlarged, and parents rightfully don’t want to keep their kids on steroids for long periods of time. The third option is cutting the tonsils and adenoids out, “to Roto-Rooter® the airway,” as Dr. Amy calls it. This also is not a root-cause solution, and often no one tells parents adenoids regrow frequently. Research shows that within 2 years, the relapse of sleep issues is extremely high. If the airway is small, it can still collapse on itself. The last option is a CPAP/BiPAP. In the long run, neither of these options addresses the whys. Why is the airway weak? Why are the lymph tissues enlarged? Why is the child underdeveloped in this way?
The airway is the space in front of the spine behind the jaws. If the child has underdeveloped jaws, the airway will also be underdeveloped and weak, more prone to breathing and sleep challenges over time. Feeling tired during the day, poor school performance, and ADHD are only some of the many symptoms of a child suffering from airway issues. Guiding the child’s growth from the youngest age possible is a root-cause solution. Dr. Amy shares that she prefers starting with a root-cause, non-invasive, healthy fifth option — a cutting-edge laser treatment that she has trademarked, called LAFTR, which stands for “laser assisted functional therapeutic release.” Using the specific, unique wavelength of laser energy that the Fotona Nd:YAG offers, LAFTR offers the deepest penetrating wavelength yet known. At targeted intensities in a specific sequence, it can accomplish a number of positive and healing effects. LAFTR is a “no-touch” laser procedure that releases tensions in the fascia and activates idealized function of the cranial nerves, nervous system, fascia, and muscles. It also has a happy side effect of releasing endorphins, or feel-good hormones, and reliably puts the patient into “ventral vegas.” The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation by Dr. Stephen Porges, explains how powerful of a tool that is!
Kidstown Dental often consults for “re-treat” on poorly done or reattached tongue ties. Dr. Amy shares a sweet email from a patient who had received a frenectomy in another practice with a laser that does not use water and works with heat. The family came to Dr. Amy months after the surgery, thinking they needed a second surgery because the child was still suffering with feeding, speech, and sleep. Dr. Amy did three of the non-surgical treatments of LAFTR paired with interdisciplinary bodywork and functional help, and they were able to achieve life-changing results without any further surgery. Now, he is 3 years old and is sleeping and eating normally and speaking in full sentences. Dr. Amy shares, “Only a few years ago, this child would have likely ended up with multiple surgeries, increasing the risk of scar tissue, oral aversions, and trauma, and still end up in a variety of therapies, like speech and occupational therapy. I am so glad we can finally help families with this simple, elegant, yet powerful laser intervention.”
Dr. Amy explains how to avoid a surgery if the child has signs of tongue tie and even the look of a posterior tongue tie. “Sometimes a frenum can look short and tight, and the patient may present with a lot of tongue-tie symptoms, but it may not actually be a true physical restriction. LAFTR is a great tool to use for differential diagnosis, particularly of posterior tongue tie. For example, the genioglossus muscles are airway dilator muscles under the tongue, and the frenum lays just over these muscles with lots of fascia connected to and around it. When patients have an airway issue, their genioglossus muscles are going to be contracting to dilate that airway open, and the frenum will be necessarily shortened artificially. So a short frenum on the initial exam may be indicative of an airway challenge. When the patient’s frenum is cut, the body will generally form the new frenum to be just as short and tight as the previous frenum, and then it often gets classified as ‘reattached.’ But LAFTR instantly releases all the artificial tension in the fascia, making it supple, and sometimes the frenum will lengthen 2-3 times compared to how it appeared on initial exam. A true physical restriction of the lingual frenum doesn’t lengthen because the fibers of a true tongue tie are different from simple fascia in a normal frenum. This is why we use this tool prior to any non-reversible cutting procedures.”
As an innovator, Dr. Amy set up the third interdisciplinary clinic in the United States at Kidstown Dental, utilizing an osteopath and an internationally board-certified lactation consultant (IBCLC) in-house. When the frenum is obviously restricted, usually there is also restricted fascia in the floor of the mouth and all around the frenum restriction. If you don’t prepare the patient by releasing the extra “noise” or facial restrictions upstream and downstream of the physical restriction, you’ll likely have a more aggressive surgery, more potential for bleeding, pain, more contraction during healing, and more scarring. You will not only be cutting the fibers of the frenum, you’ll be cutting fascia around it too to get the full range of motion. “Using the laser in the LAFTR protocol, which we do for every single frenectomy in 5 minutes, we are able to get the frenum clearly visible, releasing the other tensions non-surgically around it, for a faster, easier, more effective, and more comfortable frenectomy surgery.”
No-shot dentistry with lasers
Dental visits can be painful, uncomfortable, and scary, with anesthetic injections and loud, vibrational drilling. Lasers make even comprehensive restorative dental needs much more comfortable. The laser allows earlier cavity detection and minimally invasive caries removal. When prepping a cavity, the laser enables you to gently remove the infected tooth structure quickly while effectively disinfecting it before restoring it. There is no smear layer filled with bacteria, no microfractures, and the nerve is not insulted by overheating it, all of which results in a significant decrease in the chance of leaving decay or recurrent decay.
Dr. Amy explains, “When I trained to use hard and soft tissue lasers, I was told that I could charge my patients more for using the laser technology by telling them for x amount I can do things the old fashioned shot/drill and fill way, or for an extra amount, I can do it with a laser with all of these benefits. That never made sense to me. Because of my own frightening childhood dental experiences, once I learned that doing dentistry for kids without shots and with lasers was a superior standard that gives superior outcomes, I could never go back to the old fashioned way. I invested in a hard tissue/soft tissue laser from day one, and I experienced double digit growth every year of my practice until the pandemic, even without marketing. I attribute it primarily to the community’s response to our use of lasers. Almost all of our referrals are from other healthcare providers or friends of current patients, who will drive or fly from long distances for the opportunity to have their children treated with lasers. Our 6th year of practice was a 55% growth year, which our financial advisor shared is extremely uncommon!“
She says, “You can reignite your passion and excitement for dentistry once you embark on laser dentistry. The choices are so endless!”
Amy L. Luedemann, DDS, is a native Houstonian who has been involved in providing dental care since 1990. She started as a dental assistant and went on to put herself through school until she reached her ultimate goal of becoming a pediatric dentist, where her two loves – children and dentistry – come together every day.
In her practice of pediatric dentistry, Dr. Luedemann has become well known for her compassion and expertise in pediatric-laser dentistry, frenectomies, myofunctional therapy, MyoBrace, ALF as well as her comprehensive approach to sleep and airway issues in children. She has a passion for integrating technologies and methodologies to create the best possible environment and experience for each family and child in her care.