What Is LANAP Laser Gum Treatment?
LANAP is a laser-based procedure used to treat moderate to severe gum disease without traditional scalpel surgery. The acronym stands for Laser-Assisted New Attachment Procedure.
Gum disease, also called periodontitis, is a chronic infection that damages the gums and the bone that holds teeth in place [1]. When non-surgical treatments like scaling and root planing are not enough, periodontists may recommend surgery to clean deep pockets around the teeth.
LANAP is one alternative to traditional flap surgery. Instead of cutting the gums open with a scalpel, the periodontist uses a specific dental laser to remove diseased tissue and bacteria from the pocket. The healthy gum tissue and tooth structure are left alone.
The protocol was developed in the early 1990s and has been refined since. It is performed by periodontists or general dentists who have completed the required training. You can learn more about specialist care on the periodontics page.
How the LANAP Laser Works
LANAP uses a free-running pulsed Nd:YAG laser at a wavelength of 1064 nanometers, which is selectively absorbed by pigmented tissue and bacteria. This selectivity is the core idea behind the procedure.
Diseased gum tissue is darker and more pigmented than healthy tissue because of inflammation and bacterial activity. When the laser fiber is passed into the periodontal pocket, the energy is absorbed by the diseased tissue and bacteria while the healthy pink tissue is largely spared.
After the laser pass, the periodontist uses ultrasonic and hand instruments to remove tartar from the root surfaces. The laser is then used a second time at a different setting. This second pass is meant to seal the pocket with a stable fibrin clot, which acts as a biological bandage between the gum and the root.
Step-by-Step Procedure
A typical LANAP appointment treats one half of the mouth in a single visit, usually under local anesthesia. The full mouth is generally treated across two sessions.
- Pocket depths are measured to map disease severity around each tooth.
- The laser fiber is inserted into the pocket to remove diseased tissue and reduce bacteria.
- Tartar is removed from the root surfaces using ultrasonic and hand scalers.
- The laser is applied a second time to help form a stable blood clot at the base of the pocket.
- The tissue is compressed against the tooth; sutures are typically not needed.
- Bite adjustments may be made to reduce pressure on healing teeth.
Clinical Applications
LANAP is used primarily to treat moderate to severe chronic periodontitis, where pocket depths exceed what scaling and root planing alone can resolve. It is also used in select cases around dental implants.
Moderate to Severe Periodontitis
Periodontitis is staged by pocket depth, bone loss, and attachment loss. Patients with deep pockets, typically 5 millimeters or greater, often need surgical intervention because instruments cannot reach the bottom of the pocket during routine cleanings [1].
LANAP is one option for these cases. It is sometimes called a regenerative procedure because the manufacturer has FDA clearance for marketing claims of new attachment in qualifying cases. Outcomes still depend on disease severity, oral hygiene, smoking status, and overall health [1].
Peri-Implant Disease
A related protocol called LAPIP uses the same laser system to treat peri-implantitis, which is inflammation and bone loss around dental implants. The principles are similar: selective removal of diseased tissue and bacteria without raising a surgical flap.
Evidence for laser treatment of peri-implant disease is still developing. Patients considering this option should ask their periodontist about expected outcomes for their specific case.
When LANAP Is Not the Right Choice
LANAP is not appropriate for every case. Patients with very advanced bone loss, mobile teeth that cannot be saved, or specific anatomical issues may need traditional flap surgery, bone grafting, or extractions followed by replacement options.
Evidence and FDA Clearance
LANAP holds FDA clearance for periodontal regeneration claims, but clearance is not the same as approval, and evidence quality varies across studies.
FDA clearance is granted when a device is shown to be substantially equivalent to an existing legally marketed device. FDA approval, by contrast, requires premarket review of clinical safety and effectiveness for new high-risk devices. Most dental devices, including periodontal lasers, are cleared rather than approved.
The LANAP protocol is the laser periodontal therapy with the broadest manufacturer-supported clearance language for true periodontal regeneration. Independent research, including human histology studies and clinical trials, has examined attachment gain and pocket reduction after LANAP. Results have generally been favorable, though sample sizes in published histology studies have been small and longer-term comparative trials are still being added to the literature.
Major professional bodies, including the American Academy of Periodontology, recognize lasers as one tool in the periodontal treatment toolkit. The AAP advises that the choice of treatment should be based on the individual patient, the severity of disease, and the evidence supporting a given approach [1].
Benefits and Limitations
LANAP offers real advantages over traditional flap surgery for some patients, but it is not a universal replacement and has trade-offs that should be discussed with a periodontist.
Advantages Compared to Flap Surgery
The main advantages of LANAP are tied to the absence of scalpel incisions and sutures.
- Less gum recession. Because healthy tissue is preserved, there is typically less visible recession after healing.
- Reduced post-operative pain. Many patients report less discomfort than with traditional flap surgery.
- Shorter recovery. Most patients return to work and normal eating within 1 to 2 days, compared to a 2 to 4 week soft-tissue recovery often associated with flap surgery.
- Safer for some medical conditions. Patients on blood thinners or with certain bleeding disorders may tolerate LANAP better than scalpel surgery; coordination with the prescribing physician is still required.
- Tissue preservation. The procedure does not require lifting the gum away from the bone, which means less disruption of the surgical site.
Limitations to Consider
LANAP is not a substitute for daily oral hygiene and ongoing periodontal maintenance. Without consistent home care and regular professional cleanings, gum disease can return after any treatment [1].
- Limited provider access. The procedure requires a specific laser system and proprietary training, so it is not offered everywhere.
- Cost can be higher upfront. Some practices charge more for LANAP than for traditional surgery, though pricing varies.
- Not universally applicable. Severely mobile teeth or significant bony defects may still require traditional surgery, grafting, or extractions.
- Ongoing maintenance required. Quarterly periodontal maintenance visits are typically recommended long-term.
Cost and Insurance Coverage
LANAP typically costs $1,000 to $4,000 per quadrant, putting total full-mouth treatment in a range that is broadly comparable to traditional gum surgery. Costs vary by location, provider, and case complexity.
Fees depend on the severity of disease, the number of teeth involved, the geographic market, and the experience of the periodontist. Some practices bundle initial scaling and root planing, follow-up visits, and maintenance into the quoted fee; others bill these separately. Ask for an itemized treatment plan in writing.
Dental insurance often covers a portion of periodontal surgery under standard surgical procedure codes. Coverage for laser-specific add-on codes is less consistent. Many plans will reimburse based on the equivalent traditional surgical code, leaving the patient to pay the balance. Medical insurance occasionally contributes when gum disease is linked to a documented systemic condition, but this is rare. Confirm coverage directly with your insurer using the procedure codes your periodontist plans to bill [2].
Financing options offered by many practices include in-house payment plans, third-party medical credit lines, and Health Savings Account or Flexible Spending Account payments.
Finding a Provider and Questions to Ask
Not every periodontist offers LANAP, and protocols vary in execution. A short list of questions can help you compare options and choose a provider with the right training and case experience.
Credentials to Look For
LANAP is performed by board-eligible or board-certified periodontists, or by general dentists who have completed the required training. The training program is offered through the Institute for Advanced Laser Dentistry, which is the educational arm associated with the laser manufacturer.
- Specialty training in periodontics from an accredited residency.
- Documented LANAP certification through the manufacturer's training program.
- Active case volume; periodontists who perform the procedure regularly tend to be more efficient.
Questions to Ask at Your Consultation
- How many LANAP cases have you completed in the past year?
- Why are you recommending LANAP over scaling and root planing or traditional flap surgery for my case?
- What outcome should I expect in terms of pocket depth reduction and attachment gain?
- What is the total cost, including follow-up visits and maintenance?
- How will insurance be billed, and what is my estimated out-of-pocket cost?
- What does the maintenance schedule look like after treatment?
- What happens if the procedure does not achieve the planned outcome?
Find a Periodontist Near You
If you have been told you need gum surgery and want to explore laser options, start by finding a credentialed periodontist in your area. Browse the periodontics page to see specialists by location, read patient-facing profiles, and book a consultation. Bring your most recent dental X-rays and a list of medications to your first visit.
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