Gum disease begins when a film called plaque accumulates on the teeth. Certain strains of bacteria that live in this plaque damage gum tissue and bone. Your body tries to fight this infection with an inflammatory assault, sending white blood cells to the area to destroy the bacteria. This inflammation causes the tissue to bleed easily when you brush or floss. This stage of the condition is called gingivitis.
If the infection and inflammation persist, what results is a chronic inflammatory condition in which the gums and bone around the teeth are slowly destroyed, many times with no awareness or symptoms. At this stage, it is called periodontitis.
The biggest risk factors are ineffective home care, poor nutrition, and smoking. Periodontitis has been linked to an increased risk of heart disease, diabetes, stroke, and other serious medical conditions. In short, healthy gums are the gateway to a healthier body.
Gingivitis can be reversed with regular professional cleanings and excellent home care. It is also important to eat healthy foods such as fresh fruits and vegetables. These types of foods have important anti-oxidants and phytonutrients your body needs to remain healthy.
Once your condition has progressed to periodontitis, surgical intervention is often necessary to eliminate the deep pockets which develop between the teeth and gums. If these pockets persist, they allow bacteria to organize even more colonies and this often leads to tooth loss.
Traditional gum surgery involves cutting away some of the gum tissue, and reshaping the bone underneath. LANAP is a less invasive technique using a specialized laser to destroy the bacteria which caused the disease, and alter the tissue so that it has the opportunity to heal. The use of laser preserves more tissue than traditional scalpel surgery, and results in a faster and less painful recovery.
A. Depth of pocket is measured under anesthesia
B. Laser selectively removes infected pocket lining
C. Ultrasonic instruments clean root surfaces
D. Laser disinfects pocket and creates blood clot
E. Tissue is compressed against the tooth
F. Bite is adjusted through selective grinding
G. Healing results in new attachment after 12 months
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 on average.
The mouth is numbed, just like 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 of the teeth. Then the teeth are cleaned very thoroughly 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.
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 don’t touch together as heavily on the treated side. 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.
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 bite guard will be fabricated to stabilize and immobilize the teeth while you sleep. It is important to wear these night splints, as we humans have the 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 the 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.
-LANAP (one side of mouth)
Prescriptions for swelling and pain
-LANAP (other side of mouth)
Same as above
-1 Week post-op visit
Splint loose teeth together
Begin modified brushing
NO flossing or electric toothbrush
-1 Month post-op visit
Light cleaning/polishing of teeth
Resume brushing and flossing
Impressions for biteguard
-2 Month post-op visit
Light cleaning/polishing of teeth
Deliver biteguard (wear every night)
-3 Month maintenance visit
-6 Month maintenance visit
-9 Month maintenance visit
-12 Month maintenance visit
-1 Year re-evaluation
Full periodontal charting, x-rays
Assess need to retreat any persistent or non-responsive areas
Discuss direction of future treatment
Including any recommended restorative, cosmetic, or orthodontic care
The cost of laser surgery is generally slightly more than traditional surgery, and will depend upon the severity and complexity of your condition. At your initial consultation, we can identify your specific situation, and give you an estimate of what your cost would be.
For further information about the LANAP Protocol, Visit www.millenniumdental.com.