Laser Periodontal Therapy (LANAP)
Traditional gum surgery involves cutting away some of the gum tissue and reshaping the bone underneath. Laser periodontal therapy (LANAP) is a less invasive technique using a specialized laser to destroy the bacteria, which cause the disease, and alter the tissue so that it has the opportunity to heal. The use of the laser preserves more tissue than traditional scalpel surgery, and results in a faster and less painful recovery.
How LANAP Works:
- Depth of pocket is measured under anesthesia.
- Laser selectively removes infected pocket lining.
- Ultrasonic instruments clean root surfaces.
- Laser disinfects pocket and creates blood clot
- Tissue is compressed against the tooth
- Bite is adjusted through selective grinding
- Healing results in new attachment after 12 months
Your Surgical Visits
Usually, we treat one-half of the mouth at a time. The surgical visits are ideally made one to two weeks apart, and take about two to three hours each visit on average.
The mouth is numbed as if you were having a filling or crown done. Sedation is available if you prefer. The pockets are then measured while you are numb, so that more accurate measurements can be made without causing discomfort.
A first pass is made with the laser removing the infected pocket lining and allowing better visualization of the roots using ultrasonic instruments, which have tips that vibrate very quickly, loosening up any deposits on the teeth and flushing them away with an irrigating solution.
A second pass is made with the laser, disinfecting the pockets and sealing them up through the formation of a stable blood clot. The bite is then adjusted to minimize destructive, uneven biting forces on the teeth.
The First Few Days After LANAP
Most people experience some mild soreness of the treated areas for the first few days. The tissue will appear discolored around the teeth, similar to what a scab looks like when you get it wet. It is very important NOT TO BRUSH or pick this away, as this fibrin barrier is what allows the gums underneath to get a head start creating a new attachment to the teeth.
Your bite will feel different, as if the teeth do not touch together as heavily on the treated site. This can feel imbalanced at first, but the teeth will quickly adapt. After both sides have been treated, and as further refinements are made, your bite should feel stronger and more stable than ever, and more comfortable.
Continuing Follow-Up Care
As the gums heal, the teeth will shift and your bite will need to be adjusted several times over the first few weeks, even for the first year and beyond. Although it seems counter-intuitive, inadequate adjustment is what is usually responsible for soreness or sensitivity following LANAP.
Three to six weeks after your surgery, impressions will be made of your teeth and a biteguard will be fabricated to stabilize and immobilize the teeth while you sleep. It is important to wear these night splints, as we humans have a tendency to periodically clench our teeth and jaws during sleep. This clenching can produce extremely damaging forces which can delay or prevent healing.
Professional cleaning is recommended every three months for the first year and re-evaluation of your condition will be done after twelve month visit. Most people with gum disease remain at risk for the rest of their lives, and would benefit from having their teeth cleaned every three months indefinitely.