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LANAP & Periodontal Disease – Everything You Need To Know

Treating periodontal disease is essential if you want to prevent gum recession and tooth loss. Traditionally, invasive flap surgery was the only way to prevent periodontitis from worsening. LANAP is a relatively new procedure which not only treats gum disease in a less invasive way but can help the body regenerate tissues damaged and destroyed by the disease.  It can reverse the effects of gum disease, unlike current treatments. 

But what is LANAP and how does it work? 

This post explains what LANAP is, what to expect during surgery and the recovery process. We also compare LANAP to the more traditional flap surgery used to treat periodontitis. 

LANAP & Periodontal Disease

What Is LANAP?

LANAP, which stands for Laser-Assisted New Attachment Procedure is a modern treatment used to treat moderate to severe and advanced cases of periodontal disease (also referred to as periodontitis and sometimes gum disease). 

(Find out about gum disease – get an uncomplicated overview of what gingivitis and periodontitis are)

LANAP uses a specialized laser to selectively remove bacteria and infected tissue from around the teeth. It also stimulates the growth and repair of the structures which hold the teeth in place.  It is less invasive than traditional procedures used to treat gum disease but isn’t widely available yet. 

How Does LANAP Work? 

LANAP, employs a medical laser that emits a focused light source to treat or remove tissue infected by gum disease-causing bacteria and stimulate the growth of new tissues including bone, cementum (the outer surface of the tooth root) and periodontal ligaments (tether the teeth to the bone). 

The Laser

Laser stands for Light Amplification by Stimulated Emission of radiation.

To explain what this is – if you think of the light which comes from a lightbulb – it has many different wavelengths that spread out in many different directions.  The light emitted from a laser is a specific wavelength, it is a very concentrated, narrow beam of high-intensity light. 

This laser light can be focused accurately on a tiny area, making it a very powerful and precise tool. It can be delivered via fiber optics to treat areas of the body that are often difficult to access such as under the gum line. The laser fiber is very tiny, 0.3-0.4 µ, about the size of human hair. 

Several different types of lasers are used in medicine. They all have different characteristics that perform different functions. The laser used for LANAP is a Neodymium:yttrium-aluminum-garnet (Nd:YAG) laser which can penetrate deep into the gum tissue and can cause blood to clot quickly. 

What Does The Procedure Involve?

The procedure is usually carried out at the dental office under local anesthesia. Unlike conventional treatment for periodontal disease, there is no need to cut the gums and pull them back from the teeth and roots. 

The tiny fiber optic containing the Nd:YAG laser is inserted into the periodontal pocket between the tooth and gum. Short pulses of light are focused on the gum tissue. When tissue and cells infected by bacteria are touched by the light, heat is created. The heat from the laser does several things. It

  • Selectively removes diseased tissue (it leaves healthy tissue intact and unharmed)
  • Eliminates bacteria
  • Alerts the user that tartar (calculus) is present. It can then be removed from the tooth roots using the laser and special scaling tools and techniques
  • Creates a fibrin clot that connects the gum to the root surface and seals the pocket. This prevents bacteria and food debris from getting into the wound site so that it can heal. The fibrin clot allows the growth of new tissues that hold the teeth in place including bone and connective tissue. 

At the end of each treatment, post-surgical advice will be given along with recommendations for oral hygiene and dietary advice to enable quick healing and recovery.

How Long Does LANAP Surgery Take?

In general, LANAP treatment is completed over two appointments. One-half of your mouth is treated per appointment. Each session takes between 2 and 3 hours. 

Following the initial procedure, you will typically attend two follow-up appointments to ensure the gum is healing correctly. 

How Long Does Recovery Take?

In most cases, you’ll be fine driving yourself home (or back to work) after the procedure. The recovery period is often less than 48 hours, so you can expect to resume your regular activities within a couple of days of the procedure.

You’ll be given a prescribed course of aftercare, which may include regular cleanings, prescribed medications, and a modified oral hygiene routine.

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The Pros and Cons of LANAP

Advantages of LANAP

There are many benefits to LANAP when compared to traditional surgical procedures. These include

  • No cutting or pulling back of gums
  • No placement of sutures or surgical glue. 
  • Decreased postoperative discomfort compared to flap surgery
  • Better wound healing
  • Regeneration of structures which hold the teeth in place
  • Little gum recession

Disadvantages of LANAP

Whilst there are many benefits to this procedure and it is FDA-approved, it is not readily available in dental offices. Just like with any surgical procedure, it does carry some potential risks. 

  • Incomplete treatment of gum disease
  • Pain
  • Infection
  • Some side effects of the surgery may be unknown. 

Is LANAP Safe?

The radiation used is non-ionising so does not have the same long-term risks as other forms of radiation. 

What To Expect After LANAP Surgery?

Following surgery, you may experience some bleeding, swelling or pain and discomfort. Depending on the advice of your surgeon you may need to follow a slightly modified diet and follow specific oral hygiene to allow the gums to heal without dislodging the fibrin clot. The fibrin clot will gradually change color from white to pink. 

Who is a Candidate for LANAP?

Most people with gum disease are suitable for LANAP even if they have diabetes, are pregnant or are taking medication such as paracetamol or blood thinners (warfarin, heparin and newer anticoagulants).  

How Much Does LANAP Cost?

LANAP surgery costs between $2,000 and $8,000 in the USA. The cost of the procedure depends on how many areas need treating. 

What Are The Alternatives?

LANAP is in its infancy and some dentists are preferring to continue with traditional ways of treating gum disease until more knowledge and experience of using them to treat gum disease has been documented. Treatments include 

  • Scaling – a non-surgical treatment to disrupt plaque and tartar (hardened plaque) above and below the gum line.
  • Root planning – a non-surgical treatment to smooth out your tooth roots. This helps your gums reattach to your teeth.
  • Flap surgery (pocket reduction surgery) – a surgical procedure to eliminate or reduce the pocket itself by cutting and lifting the gum tissue away from the tooth root so the periodontist can clean the root and surrounding infected tissue. 

You can find out more about how periodontal disease is treated here. 

Frequently Asked Questions

Can LANAP Regrow Gums?

Unlike flap surgery, only infected tissue is removed. Healthy tissue and bone are left intact. The fibrin clot helps support the remaining tissue so the gums can grow back into their original position. In some cases, gum grafts or bone grafts may also be required. 

How Effective is LANAP?

Scientific studies have shown positive results for the effectiveness of LANAP in the treatment of periodontal disease. The following has been shown:

  • LANAP to have a success rate of 87.9%  
  • Less tooth loss following laser surgery compared to traditional surgery
  • The regeneration of tissue which attaches the gum, tooth root and bone
  • Less recurrence of periodontal disease

 

Sources

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