Exploring the Science of Light Therapy in Dentistry with Dr. Grace Sun

Hi everybody, I'm Dr. Sanda Moldovan, periodontist and nutritionist. Welcome to the Holistic Dentistry Podcast, the show that gives you the tips and tools to detoxify your mouth for a healthier body as we explore together the root cause of disease. Remember, you're not healthy until your mouth is healthy, so take care of it in the most in a natural way. Hi everyone. Welcome to another episode on the Holistic Dentistry Show. I'm your host, Dr. Sanda Moldovanova, integrative periodontist and nutritionist. And today we're going to be talking about light therapy, but light therapy not just for pain, but for regeneration and home use of light therapy. And today with me, I have definitely an expert in light therapy, Dr. Grace Sun, whom I known for many years, and she was actually the one to introduce me to my first laser photobiomodulation and laser therapy. She is practicing in Beverly Hills for quite a few years now, and she's very, very talented, not only providing patient care, but also doing dental lab and laying her own porcelain. She is a Master of the Academy of General Dentistry and Master Educator of General Dentistry and Master Educator of the Academy of Laser Dentistry, having served two terms on Academy of Laser Dentistry Board of Directors. Now you sit on the board as president-elect. Dr. Sanda Moldovanova Moldovanova is also an Accredited Fellow of the American Academy of Cosmetic Dentistry and Academy's first female Accredited Fellow. Yay! Where she served 7 years at ACD Professional Education Committee. She is a published author and recipient of several awards. You lecture also internationally for laser and cosmetic dentistry, holding mastership status with the International Congress of Oral Implantology, ICOI. You've been advocating for low-level laser therapy and photobiomodulation, a red light therapy, both for procedure-related applications and as part of a self-care program. So you've been incorporating PBM therapy or photobiomodulation and acupuncture into an interdependent treatment modality that greatly serves the needs for your patients for pain relief. So I'm super excited, Dr. Sanda Moldovanova, to have you on the show today. Welcome.

Thank you for having me here. I'm very glad. I have a chance to share my knowledge and my enthusiasm about getting everybody healthier, happier.

Yeah. So, so tell me how you started in photobiomodulation, 'cause I remember I met you like 20 years ago and I think you already had photobiomodulation in your office.

Right. You know, I'm a general dentist, so, and since my artistic background and I really like to provide a beautiful smile. And so you, you mentioned that I'm, Stack my own porcelain. Yes, that's just something I wanted to do and provide patient that have a happy smile. At the same time, I feel it's very important have the whole patient experience to the ultimate. So, I want them feel better and whatever I do when they walk out, they feel good. So, I incorporate whatever's best for the patient. At that time, since I'm cosmetic dentist, I start with the argon laser. That's many years ago. That time, and it's for laser whitening, but obviously argon, you can do soft tissue surgery. And so that's my first laser. At the same time, I know about low-level laser therapy for pain relief. We did, we didn't have that in the US. At that time, it was, I learned and I got from Europe. I have several units to start using in the office just patient experience and just for when I do surgery or whatever, I want them feel, have a better chance to heal. So incorporate many other laser over the years. So that's what's first, and then Nd:YAG and Erbium YAG, CO2, and diode. So I got, just you have all these toys, you have one, you want one more because I just know different wavelengths does different things and how the body respond to the light and the special, the spectrum does different things. And then because I know the low-level laser therapy is beneficial for us, then I want to know more. I got into more and more, just still learning to today. I have not done learning still. There's still more to learn, but just like, just the intention is provide the best service for the patient. So that's part of the, I think, one element important to be part of it as a service you provide to the patient.

I remember 20 years ago, I think I got this laser. You were a distributor for this laser from Hungary, and it had a little probe, and that laser was so awesome. As a matter of fact, I still have it. But that little probe, you could actually put it at the apex of each tooth. And treat it. And that was more than just the low-level laser. I think that also had maybe some— no, it was a laser, not just a red light therapy, because there's a difference, right, between red light therapy and a laser.

So today, you, you, you can see how popular the red light therapy. You have red light panels and all that. So at least we know the spectrum, the energy and the red light zone is very easily can adapt and absorb by the body. And, and the level, the whole thing is cosmetically, people are driven. Red light therapy is better for the skin? Wonderful. It's better for hair growth? Wonderful. Recovery from the sports? Wonderful. So that's why those are very popular and it's more LED-based because LED construction-wise is very different. Just light-emitting diode. It's different from the surgical diode that you use, but diode is just the technology using semiconductor. And so it's very small and you can produce the emitting the light, the red light range. But the process is once like immediately being excited and released, like spontaneous. One is more like stimulated. That's more like amplified in a way. It's more like laser process. So, so the diode laser, it will be different from the LED per se. But for general consumer-wise, LED definitely it's safer, much safer, and it's not like can cause problem. But anything is you need to know, always protect your eyes. So eyes is the organ that's really just welcome any lights come in. Yeah. So sometimes we don't know how important to really regular how much you're taking and what kind of light that goes in your eyes. Well, at least we know today they say, okay, before you go to sleep, you want a good night's sleep, stay away from your phone. Because that's a blue light. What's the blue light? It will affect your sleep because blue light is what the morning you're supposed to get that to get you awake and wake you up, not at the nighttime start looking at your phone. So interesting that goes in our life every day. Our whole life, it's depend on the light, period. No light, no life. So how to recognize the light and make the light work on your side. I think that's light therapy is part of it. Can come, you know, I can say that's kind of part of it to understand light, what you can use the light for your benefit.

Now, when you talk about photobiomodulation. Yes. Is that the same thing as those LED light panels that are out on the market?

In a way, you can say yes. Okay. So you use a photonic energy. That's the P, PBN. That's the first word. B is biology, bio, just our body. Okay. It's modulation. Modulation in a way is like make the change. So use a photonic energy to work on your body and creates a change for For what? Okay, so that's the part. If it's therapeutic, so modulation is basically you want to have a therapeutic window. It's not enough, it's not going to work. It's too much, creates a different effect. So that therapeutic window, and that's very important part of to recognize how much dosage you need and all that. So most of the— LED, you see the panel, you've had a lot of lights. It's now how efficient that light is, how much light's wasted, how— because you need to have— it's different on your— how close the lights to your— the subject. It makes a difference, you in contact or not in contact. And if it's just red light, really just more how far it can go. So it can only go into 3 or 4 centimeters per second. And that's only working on what, you know, the range, the light, because we, our body receive red and infrared, near infrared very well. And about, you can go the deeper wavelengths, means longer wavelengths can go even like to a deeper area. So panel really, it's at least what you see, usually it's red light because at least that's visible. You know it's there. So you have better alarming whether it's have too much, that's where you don't look at the, into the eye. But infrared, you do not know as much. So if you have infrared, you need to be more aware of protect your retina, protect your eyes per se. So, so certain things that we should be aware of your device, what you're using, what's in that range of the light, whether that's something should be educated to some degree and how much the output is and what's the intention and what's the sign you have too much or not enough. So all this is a science to it. But yes, this LED, you usually, it's not as efficient. So a lot of time it might not creating too much damage. And I hope just no one just looking to the light for what, you know, that they know, okay, it's for my skin. And but visible, usually your eye will blink when it's too much. They would close it. You know, you're not being just no reason to keep your eyes open. Yeah.

Yeah. Now what happens with the photons, right? So the photons get emitted from this device, and what happens at a cellular level?

Well, the cellular level, because we receive the light, the light go into something, they, they like, they need to meet up something. So for us, for PBM, for red light therapy, we are looking at the organelle of the mitochondria inside the cell. So that particular organelle, it's our, we call it like power plant that we learn in high school biology. So that's where you produce ATP. That's all the like energy currency. So we need energy to survive. Like, so it's like, I was thinking, you know, like, all right, so That is important part. It's actually mitochondria is being used more and more today, the term, and why it's so important for your health, you know, so, and longevity, all that. It's the organ now has been recognized a little bit more, but they are really important part of the red light therapy. So that it's like in the cell, we have the multiple organelle mitochondria depend on what type of tissue. Like we said, muscle or skeletal muscle or our brain or anything require constant work, working all the time, like heart muscle and all that. It's like they have, they must, that tissue has a lot of mitochondria because they don't stop. They can continue to work. So that has tremendous of a, like, they will have several thousands and some are smaller amount depending on the tissue. So how the cells will be more effective when you have light goes on it. So doesn't that energy come from the food we eat, right? So, okay, you would look at that where the energy come from. So you see that if we go back to review, which chemical process create how much energy. So glycolysis and, or, you know, okay, that's 2 ATP. Krebs cycle, 2 ATP. Okay, now we go to, okay, respiratory chain, that creates 34. My God, that is a lot more powerful that part works. Now, Mitochondria, the respiratory chain, really have a special— they have different complex. So one complex have the cytochrome c oxidase, and that's where the red light and infrared goes right there. So that part gets excited. They get, you know, make the machine turning much faster. ATP synthase. It's turning and spilled out a lot more ATP. So we suddenly become being energized just from the light itself. So skip a lot of other steps and make the most efficient way to produce ATP. When you energized, the whole body works more efficiently.

For sure.

It's not, not miracle. It's just like, you know, you got super diet, you have super food, you have all that. Just get some super light, you're fine.

I love it. Now, what kind of procedures do you use light therapy for in the office?

Well, it's a, it's a, I look at light therapy, it's a care. It's general, like, first of all, it's come from your heart. You really care for the patient. You want the best experience for the patient. So to me, it's anything required, you know, the anesthetizer injection of fillings or even root canal or scaling, anything, or pain, the jaw muscles and all that. It's something a patient I wanted make them feel when they walk out my office, they feel much better than when they walk in. So—

What about like neuropathic pain, like burning mouth pain?

Someone already have neuropathy, that neuropathy can be created from chronic situation, chronic inflammation goes on for long time. It's not managed and to that. Or from injury. So dental injury, we could create that, like impact the tooth, you try to remove at oral surgery, could be creates a little bit side effect and have, you know, cause our like trigeminal neuralgia per se.

Yes.

Okay. That's a part of a dental problem, and we could help to provide the, a better chance instead of pharmaceutical management to help patient get better. It is a longer process. There's a difference how much healing time takes and how much your body respond to it. So for a chronic situation, you need to be Patient. Be patient and consistent. Realize the chronic takes time to get there. So when you want to recover, also takes time to get back. So there is a time investment. It's different from an insult from dental procedure or a surgical procedure. That usually get much faster recovery. And so there's a different healing process. There's a different signal cells that need to send to this nuclear to start transforming different things, send the different factors to amend the whole situation. So I think it's so complex, our body. It's like too many. It's just amazing. I really thought it's amazing. Life, it's amazing.

Yeah.

So it's like no one formula or fits everybody. So it's for a healthcare provider. I think our role is to help patient recognize the complexity. It's not like magic wand or it's not one factor. It's a multifactorial involvement for things to happen and for things to go somewhere. It is look at it, a lot of part we can do, but a lot of part patient need to know they are part of the team to get themselves better. And it's a, you know, it's a whole picture. It's, I think we should be an educator to share that with the patient.

Yes, for sure. Now, and I know you actually have some units that you've developed yourself. For people to be able to use at home? Because 20 years ago we didn't have these. Like, people had to do it at the dental office.

You're right. So, since we are busy, right? You're busy, I'm busy, we're busy with family, we're busy with practice, we're always busy. So, for some reason, we got COVID pandemic situation, make everybody slow down.

Yeah.

So we got, I got extra time. So I developed that during the COVID because I suddenly have time. I said, oh my God, it's perfect. I have some time to go through this project. Great. So I got into the thing that I have in my mind for many years and I need a bit better. So I want to get into what's the next step. So I developed my unit at that time and looking toward that, oh my God, this is what we can do. And so I developed unit. During that time, I was very lucky. I'm located in Los Angeles, right? So it's not too far from UCLA.

Yeah.

So UCLA do have this East and West Integrated Medicine, the medical center. So from that, I was able to be certified, become a dental acupuncturist.

Amazing.

So that was designed, it's for pain, to control the pain for orofacial pain. So that I just combine my units with different attachment, how to do it. And because this is safe to do, I use LED technology and, uh, Luckily, I got patent on my two product to basically to help people how to, I try to teach like healthcare provider and they can help the patient to utilize as a home device because some of the process, not progress, it's not you coming to the office doing one time, you finish. Especially chronic situation, you need to provide that energy, you know, maybe every other day or depend on the situation and to assist the whole process. Besides the energy, we can do that obviously holistically. We look at everything they need to, their dietary, their sleep pattern, and everything is part of the healing process need to be in place. At least we should give them that advice. We do the part we can and patient understand the whole scenario, what's involved to get themself better. So that's, I think we are educator in the way and you are educator and I'm educator. So we see things, we're trying to help the patient. It's not just we see them for 1 hour, the problem will be gone. It's really, especially chronic, it's a, that type of care, but I do design the unit and some units I design for myself that you're familiar with some of the unit, like it will go to light and we have different attachment for different delivery system inside the mouth. And there's certain thing you do outside the mouth. For outside the mouth, you can do muscular or even you treat trigeminal neuralgia, you will treat intra-orally and extra-orally. And for if it's Anyone's that interest to do that, you can basically try to trace where the nerve distribution, the V1, V2, V3, at least you know this, or the facial nerve distribution. But now, trigeminal neuralgia, that's something we dentists should feel comfortable to treat. Because, you know, trigeminal nerve is dental nerve.

Yeah, exactly.

So we should know the distribution. And where, where do you do the injection for dental injection? Intraorally. So that's a part of the area you need to treat. You know, not just the symptom, the distribution. You get to the foramen where you can get in there. So for the nerve, you need a longer wavelength. So it's not just red light, really. You need to go to the near infrared, 810 or 940, 980 to treat the nerve tissue. So for example, so that's part of the range. What vitamin you need, A, B, C, D, E, and it's just like the whole thing is part of you. Okay, which wavelengths do you need? That's applied to surgery too, you know. So hard tissue, you know, bone, tooth, and or gum, you know. So it's like you need to see how you work together. So recognize the light, you know. So it's a light therapy. You gotta know the light.

Yes. And let me see, was that device that you have in your hand earlier, was that the Oral IQ? I love it.

Yes, that's Oral IQ. So this very interesting product. For example, this one, if you see, if you can see that goes through my hands, this got actually purplish light. So purple light, it's really in a way, it's like if you want to see your light, you always use a reflective way to see your light, not directly. So reflected, for example, you can use your phone. That will be a panel to look at your light, nature of light. But this is kind of purplish. So it's red and blue. So then I changed to just like only red and infrared now. But interesting, I have third light. You can see, you don't see anything, doesn't penetrate through because this is blue. So blue, it's very interesting. I incorporate that during COVID We try to use some, how can we do some antimicrobial?

Yeah.

So I add, so I got to add antimicrobial light in there. So as add to it. So for dental use, for any wound opening, the wound that you want to add the blue light to it to control the—

So you can switch basically with this device that you have that looks like a flashlight, basically you can switch from different lights. Yes. Okay.

You can have a selection of it. So, like I want to put in my mouth, for example, and I could, you know, go into the mouth directly, put where I want it. You know, so that's, for example, if I go quickly, I say I'm going to treat trigeminal neuralgia. So the injection will become from here. I go there intraorally, treat it. And you would, or some of the lower, I would treat the mental nerve here. I'll treat, you know, so you can kind of trace where the foramen is if you still remember your anatomy. And so my point is just you can have different device to provide what you want and then have different things. Like I really got into like burning mouth syndrome per se, or xerostomia, dry mouth.

Yeah.

Okay.

So does that work for this?

Yes, absolutely. So xerostomia, you will obviously get to your 3 major, salival gland, parotid gland, sublingual, submandibular. You can treat extraorally, fine. Then we can treat intraorally. So intraorally, so for example, you can— I can use this device. So this will be a device you can go directly to the mouth and treat where you want it.

Does this light up lateral? Is that what that is? It's a lateral light?

Laterally, also you can influence. Also this From photoacupuncture, you do need to have that contact. So you need contact and you need to manipulate the fascia layer. Okay. So you need to have actually stretching your fascia layer to create that beneficial effect. But this, you can go sublingual. So remember the salivary gland, the 3 major, then we have like hundreds and thousands, you know, that minor salivary glands throughout the whole mouth. So you can stimulate all that. Underneath the tongue, and if we— I learned from TCM, the Chinese medicine, the tongue, if we want to treat this 3 tongue, have top and the bottom, you have meridian points and also sublingually, this we call jīng jīng yǔ yè in Chinese. That's really just the fluid, golden fluid, J fluid means the fluid will come out from there. That's where you need to stimulate. So with this, it's very easy to stimulate the points where you want it underneath the tongue. So those are designed for a lot of reasons because some for like you can go into the nasal cavity, pre-sinusitis. And you can— so just different delivery system that I designed for the application we try to do. And for like TMJ, we can also, or like acupuncture point, I have a very specific point you can actually manipulate better. So I like anti-gagging. You don't want to gag, you treat this point or treating here. So you can, or just treating the TMJ muscle like a the point, not just trigger point. Interesting trigger point, it's almost 95%, depend on which studies, but it's a high percentage, it's the same as acupoints. So you can treat that area with technique, not just the light. The light itself shines it, you will already help the circulation and get the metabolic waste out of there or activate your lymphatic system is important as well. Adding—

What do people— let's say somebody wants to get this and use it, do you have like a little map that you give people or a little mini course?

I do. I developed a map. That's why I use the map. I think it's up there. You can get— I think they're gone. That's a map.

You can get it tonight on Oral IQ or inside— it's not yet up there.

The Oral IQ has, I designed that if they get to the, the Oral IQ LLC, that's my company. If you right here, right here. So that company, you can request the map, but that's what I clinical for clinical exam. If I do orofacial pain and I also home care and things like that. I will have a— this is what I draw, and I will draw where the problem is and show them which the area they need to treat. And I usually treat them in the office and show them how to do it and give them time to see how they respond. And very easy. So if TMJ, you would do some range of motion. To see, you know, how much is that and treat it and see how is that besides how they feel, whether the muscles more relaxed. And so you can kind of engage that the palpation that we do the examination. I basically will examine from the acupoint of view. So I check the trigger point, trigger point or acupoint, which points need to be, it's tight, needs to have the painful response. So those are the area we're going to target. So you can do this, the whole area or you can focus on the points. So I usually teach people, they can even do the self-exam where points, it's like we call ashi point. Ashi point, it's more of a, that's a new modern way to describe the acupoint. Means that's the point can generate the painful sensation. So it's a trigger point. So they can release by— usually you do the axial loading and do a little twisting and then scan. And so those are the action you can help to— you can say, okay, I see the fascia system there. I can see the lymphatic system will be activated. So it's just very interesting. Whole body is connected in one. And we added the light. Okay, we know that light will help the circulation. The light can help to, you know, increase the energy. The body can do its own job, you know? So those the thing we look at it, you know?

I see. So how long does it take for somebody to actually feel a difference? Like let's say with TMJ, can somebody feel a difference after one treatment? Yes.

That's what I usually would like to— first of all, we know that the history, you know, so then we'll see how they respond. What they have previous, what treatment work for them, when do they feel the relief. Do they have, I will ask, do they ever had acupuncture, you know, in that area? So I want to know a little bit more and the, when did they start, so the history and what they feel. But for me, the immediate things will be in that probably I can find out in the first 30 minutes. We can go through the treatment protocol. I will do the exam. I know which point, what I'm going to have the— start the treatment. And the range of motion usually it's a good guideline, give you some number to go by. And that you should be able to see the difference. So that will be Few points I'll point out. And depend on the patient, sometimes I have them do it themselves. Sometimes it's certain patient, they cannot perform things that well. And then we will do the treatment. And that's, then after I usually give it about 20 minutes, 30 minutes, come back to check.

Now, when it comes to dry mouth, what kind of results do you see with that? Light therapy?

And actually, when we treat this in the office, after you probing around, go through the one cycle, they feel the saliva is already coming out. Wow. That's incredible. It's immediate. Means those are still alive. You just have to tickle the right spot.

Because there's really no good treatment for xerostomia, for dry mouth. And this is incredible that it's just, you know, light therapy.

We just have to imagine, so some part is not working well, but the other part might work well. So that's why you have to utilize the whole mouth. And yes, we do have the 6 places, you know, 3 pair of the major salivary gland. And then we have to look at besides that, what else? So you look at all this, it's— you will find a place that works. And then the light therapy eventually will help the inflamed area gets— start getting better. But the response, it's a very— it's immediate. Just how much.

Yeah, just how much you're putting. What about somebody, let's say they have a sensitive tooth, right? They just had a filling. The tooth is now sensitive to cold. If they use the, you know, I see the— you have this little special ones. If they use it on the tooth, do you see an improvement? And there's—

Well, that will be, that's a good question. As a dentist, we examine, is the bite off? It's what's going on.

You're right.

Yeah. You know, if it's a patient, you know how deep that filling, the lesion was and what kind of the action is, it's your own patients or patient got a problem and came to your office, ask for answer. So if you can review what's going on or something you see ahead of time already, pre— know there's a potential problem. But the diagnosis is definitely number one and find out why and how, what will be the correct action to take care of that. On the symptom-wise, and is that sensitive to cold or just sensitive to bite or down on certain things? And but if it's a some kind of inflammatory response during the procedure or it's a pre— the lesion and have that problem, the tooth being sensitive for a while. And that whether that's got pulp cap or whatever procedure's been done or not, and what kind of inflammatory stage, is it reversible or not reversible? So those, you know, the pulpal condition, do we know completely or not? But you could, do a little bit testing, see what it, how they respond to. If they not respond, get some relief, well, first of all, you obviously bite need to be the first thing to look at it. If they just had the restoration, and so then look at whether the whole mouth is, have enough support for the whole occlusion, or this person is really—

Yeah, if everything's good. Would light therapy help usually calm down the nerve or it's really not meant for that? It's meant more for other—

Well, that's depend on the inflammatory condition. It's what it's— but you will see this does increase the blood circulation. So, so whether that's favorable for that particular situation or not, if that tooth is in a condition really calls for irreversible pulpitis, that it's not going to reverse it. So it's, if it's reversible on the lower end of inflammation, yes, we have better chance to reverse it. Yeah.

Makes total sense. Amazing. I love this little light therapy. And it's so compact. I'm going to have to take one for the office.

Absolutely. It's on your way.

Awesome. I love it, Dr. Sanda Moldovanova. And I know you're offering a discount code. We're going to put it down in the show notes. And the website is theoq.shop.

Two website. One is theoq.shop. Okay. The other one is pbntpro.com. PBNT means PBM. We already learned the three words. The T means treatment or therapy. So pbntpro.com, that will be another website. But buying the product, it's more like the OQ.shop. And so, or just search for Oral IQ LLC, that will lead you to that. And last thing I wanna share, this will be a gift for you. This is a product I designed for myself because practicing for so long as a dental professional, we working with the hands all the time. I developed carpal tunnel syndrome. So I got trigger finger. It would not move. I have to help it. So I say, okay, I got to take care of myself. But you're working all the time. I cannot put my light there. So I developed the wearable. So this is the wearable. So this is very good. I designed it for the purpose so I can continue to work and not stop, you know, still working. But I'm doing therapy for myself, but this I also use for patient because this is Buddhist triangle at 3 spots. We have the Heart 7, Lung 9, and the PC 6. These 3 points creates a Buddhist triangle. So if you work on this part, has a calming effect. So I put this on the patient. At the same time, this deliver the energy. So 2 places you can deliver energy to the vascular system, one sublingual, and one's right here at the wrist. So the energy can trans— so it's a subcutaneous intravascular PBN. So it can be provided here and there. So that's how I designed this.

I love that. How long do you wear it? Can you wear it for hours?

It's a 15-minute cycle. So 2 cycles, 30 minutes should provide you a good dose. When I'm working overtime, then I also wear that. It's because it's the inside. Inside is where you're taking in the energy, provide to your body. Yang side is you actually going outward energy. So this is energy coming to the body.

That sounds amazing. I definitely always need more energy.

We all do, right?

Grace, this has been so enlightening. You are just like a wealth of information with all the lasers, with all the PBM. I'm so impressed with these products you've created. Yes, I'm excited to try them and You know, I highly recommend anybody like that wants to try something that does not have side effects, try light therapy.

Yes. Thank you. Thank you for having the chance to chat with you.

Okay. Thank you so much, Dr. Sanda Moldovanova. And everyone else, check out the light at Dr. Sanda Moldovanova's website below. Until next time. Thank you. Thank you.

Bye.

Thank you so much for joining me this week. Please make sure you check out the show notes for any links mentioned in the show. If you like today's show, please invite your friends to listen as well. That would mean a lot to me. Do you have a question you'd like me to answer? Message me on Instagram @DrSandaMoldovanova. This is Dr. Sanda Moldovanova, and remember, your mouth is the gateway to your health, so take care of it in the most natural and best way possible.