Laser Assisted New Attachment Procedure (LANAP) in New York City

Laser dentistry is an extremely effective method of treating periodontal (gum) tissues, and one of the most advanced procedures is called Laser Assisted New Attachment Procedure (LANAP). It is an FDA approved procedure that is backed by clinical research.

Many people already have or will develop some degree of gum disease during adulthood. They will often have gingivitis, a relatively mild form of gum disease that is entirely reversible with improved oral care at home and by having their teeth and gums professionally cleaned. However, without professional dental care during these early stages, the disease will progress into periodontitis, a far more serious form of gum disease.

What is Gum Disease?

Gum disease develops when a sticky biofilm called plaque, accumulates over tooth surfaces. Plaque contains bacteria, including some that are harmful, and these can infect the gums, promoting an inflammatory response from your body. The inflammatory response causes gum inflammation so that when you brush or floss your teeth, your gums are more likely to bleed easily.

As the disease worsens, gums begin to look increasingly red and swollen and eventually pull away from the teeth creating deep pockets between the teeth and gums, called periodontal pockets.

These pockets create an anaerobic environment that is perfect for disease-causing bacteria to thrive, creating more infection and inflammation, eventually leading to tooth loss. If you have severe periodontal disease, you may notice teeth have already begun to feel mobile or loose.

Advanced gum disease has also been connected with heart disease and diabetes, respiratory disease and dementia. It is a particular concern for pregnant women because some studies have linked periodontitis with low birthweight babies and premature birth.

Treatment for gum disease focuses on removing infected tissues from deep in the periodontal pockets, eliminating as much infection as possible. Once the infection is reduced, the body can fight periodontitis more effectively, and the gums begin to fit more snugly around the teeth as gum reattachment occurs.

Disadvantages of Traditional Treatment for Gum Disease

Conventional gum surgery removes diseased tissues with a scalpel, after which the gums are stitched closed. While effective, a scalpel is less precise and may result in more of the tooth roots becoming exposed, creating a less aesthetically appealing and less healthy outcome. As the gums heal, there is a risk of infection and post-operative bleeding, and recovery can be prolonged and painful.

When tooth roots are exposed, there is an increased risk of caries, since tooth roots are not covered by hard tooth enamel. Instead, tooth root surfaces are coated with cementum, a far softer substance that is more easily eroded or brushed away.

Why Choose LANAP?

LANAP is a surgical procedure that helps your body fight infection more effectively by creating an environment where unhealthy or diseased tissues are removed accurately while leaving healthy tissues intact.

Laser surgery is carried out using an ND: YAG laser, a wavelength that enables a periodontist to precisely target diseased gum tissue, removing it more accurately.

Treatment is minimally invasive, allowing for a more comfortable healing process. Once we have created a healthier environment, your gums can begin to reattach around your teeth, a process that will take about a year to complete fully. After LANAP, there is no need for stitches afterward.

Because we only remove unhealthy tissues, a greater volume of healthy tissue is preserved. The LANAP procedure aids the healing process, as any concerns about post-operative complications such as bleeding are eliminated. Other unwelcome side-effects such as post-operative swelling are reduced, so recovery time is shorter and more uneventful.

Sometimes it’s possible to treat the entire mouth during a single visit, and there is little or no downtime afterward. People can often return to work or continue with everyday activities straight after treatment because the gums haven’t been cut and stitched.

To summarize, the benefits of choosing LANAP include:

• Minimal bleeding
• Less discomfort and sensitivity
• Less post-operative swelling
• Reduced risk of infection
• Promotes tissue regeneration
• Preserves the maximum amount of healthy gum tissue
• More comfortable healing and less downtime following surgery

No Need to Stop Medications Before LANAP Surgery

Increasing numbers of people need to take medications that include anticoagulants like aspirin and must stop taking these essential medicines for up to a week before conventional gum surgery. With LANAP, there is no need to stop taking these medicines because the laser allows the tissues to heal more quickly, removing concerns about post-operative bleeding resulting from taking anticoagulants during traditional gum surgery.

What is the Process for LANAP?

When you receive any form of treatment at our dental office, we want to make sure you remain as comfortable as possible, numbing your mouth before we begin LANAP treatment. If you feel particularly anxious, ask us about sedation options to help you relax more fully.

• Once your mouth is numb, we measure the depth of periodontal pockets around the teeth receiving treatment. We set the laser to the correct wavelength and carefully remove the infected tissue inside the periodontal pocket. The laser begins to loosen calculus or tartar from around your teeth and tooth-root surfaces.
• We thoroughly clean your teeth and exposed tooth root surfaces using fine-tipped ultrasonic instruments during the next stage. Ultrasonic instruments have tips that vibrate fast, loosening calculus deposits on teeth so we can flush them away by irrigating the treated areas with a special solution. Thoroughly cleaning your teeth helps to prepare your tooth roots so your gums can reattach more easily.
• After the periodontal pockets, your teeth and tooth roots are thoroughly cleaned, we use a different setting on the laser to close the treated areas while simultaneously disinfecting periodontal pockets. Instead of stitches, the laser energy helps the body to create a blood clot, creating a fibrin barrier or matrix that protects these surfaces, preventing infection and aiding the healing process. The fibrin barrier also prevents post-operative bleeding and is the body’s natural bandage.
• Once LANAP therapy is complete, we will check your bite, making sure teeth meet evenly and adjusting them where necessary. Adjusting your bite avoids any unwanted biting forces on teeth. To stabilize teeth further, we may temporarily splint them together, creating an environment where the forces affecting your teeth and gums are more controllable, allowing for healing to proceed more comfortably and predictably.

What to Expect After LANAP Surgery?

Reduce your physical activity during the first few hours after treatment. It is perfectly normal to feel some soreness around the treated areas during the first few days after LANAP therapy or notice slight bleeding. The gums around your teeth could appear discolored as the gums heal beneath the fibrin barrier.

Avoid touching the fibrin barrier and do not brush it as it must remain in place during healing, and as the gums start to reattach to your teeth underneath. These blood clots are an important part of laser surgery and must remain undisturbed.

If you develop a temperature, a fever or are in excessive pain or experience prolonged bleeding, please contact our dental office immediately so we can help you.

Cleaning Your Mouth After LANAP Therapy?

We will provide specific instructions on cleaning your mouth following surgery and, if necessary, can provide antibiotics or antimicrobial mouth rinse.

• Most people experience minimal discomfort, but taking ibuprofen or Advil for the first twenty-four hours after therapy can help reduce any swelling.
• Do not rinse your mouth or spit for the first twenty-four hours, after which you can rinse your mouth gently using an antimicrobial mouth rinse.
• Alternatively, make a warm salt water rinse using half a teaspoon of salt dissolved in warm water and rinse your mouth gently every three hours.
• You mustn’t brush or floss the surgery site until we tell you it is safe to do so.
• It is important to continue cleaning untreated areas normally by brushing and flossing your teeth.

After LANAP therapy, you will need your teeth professionally cleaned every three months for the first year, after which we will reassess your oral health and provide you with an updated preventive dental care plan. Often, people with advanced gum disease will benefit from more frequent dental cleanings for the rest of their life, so we may suggest you continue having your teeth cleaned every three months.

What to Eat After LANAP Therapy?

During the first twenty-four hours, you will need to stick to a liquid diet. For the first week, choose softer, nutritious foods like cottage cheese, yogurt and eggs. Avoid hard foods and anything containing nuts or seeds that could become stuck around the surgery site, and any spicy foods that could irritate your gums. Make sure you drink plenty of fluids.

What to Expect After the First Two Weeks?

A couple of weeks after LANAP therapy, you may notice your teeth feel tender or sore, and these feelings may last up to one year. The sensations are perfectly natural and are due to the ligaments and bone regenerating around your teeth. Although these are signs that these tissues are healing, they may also be due to a slight imbalance in your bite that will need further adjustment at your next visit.

Several weeks after surgery, we will need to see you again for a follow-up appointment to make a nightguard to stabilize your teeth during sleep. A nightguard also helps to immobilize teeth, preventing any clenching and grinding during sleep that could prevent healing.

LANAP is an excellent treatment for advanced gum disease, but another form of this therapy is increasingly used to treat infected dental implants.

Treating Peri-Implantitis with LAPIP

Dental implants are a popular solution for tooth loss, but some people will suffer implants complications. Although made from inert materials, the tissues around dental implants can become infected with a disease similar to gum disease, called peri-implantitis. The infection caused by peri-implantitis develops just underneath the gum line and can cause bone loss around the implant.

As gum and bone are destroyed, it can expose the implant post, and in some cases, the implant loosens and fails and must be removed. Peri-implantitis can be caused by inadequate oral hygiene or might be due to systemic disease, aging, or because of medications.

Before LANAP therapy, peri-implantitis was usually treated with periodontal surgery to remove the infection and replace missing tissues. Sometimes it was necessary to remove the implant and wait for the area to heal before replacing a new dental implant. Now, there is a procedure called Laser-Assisted Peri-Implant Procedure (LAPIP) and which is similar to LANAP.

LAPIP can treat the infection caused by peri-implantitis without the need for stitches. It is often possible to halt the progression of peri-implantitis and even regenerate new bone around the implant. LAPIP is the only laser treatment to receive FDA approval for treating failing dental implants.

Just like LANAP, LAPIP uses a specific laser wavelength to remove severely infected tissue from deep around a dental implant, leaving healthy tissue unharmed and more able to regenerate. The procedure is very similar, as is the recovery and healing process.