What Is LANAP Laser Surgery?
LANAP stands for Laser-Assisted New Attachment Procedure. It is a periodontal treatment protocol that uses a specific laser, the PerioLase MVP-7, to treat gum disease. The laser operates at a wavelength that targets pigmented, diseased tissue and bacteria while passing through healthy tissue without damaging it.
Traditional gum surgery (flap surgery) involves cutting the gum tissue away from the teeth, cleaning the root surfaces and bone, and then stitching the tissue back in place. LANAP achieves similar goals without incisions or sutures. The laser energy removes the infected tissue lining the periodontal pockets, kills bacteria, and stimulates the bone and remaining tissue to regenerate.
LANAP was developed by periodontists Robert Gregg and Delwin McCarthy and received FDA clearance in 2004. It is the only laser-based periodontal protocol with FDA clearance for true regeneration, meaning new bone, new cementum, and new periodontal ligament attachment.
How LANAP Works and Who It Helps
LANAP is designed for patients with moderate to severe periodontitis who have periodontal pockets measuring 5 millimeters or deeper. It may be a good option for patients who are anxious about traditional surgery, those with medical conditions that make healing from surgery more difficult, or patients who prefer a less invasive approach.
How the Laser Targets Disease
The PerioLase MVP-7 is a free-running pulsed Nd:YAG laser. It operates at a wavelength of 1,064 nanometers. At this wavelength, the laser energy is absorbed by dark-pigmented tissue (which is diseased and inflamed) and by melanin-containing bacteria. Healthy, light-colored tissue reflects the laser energy and remains unharmed.
The laser also creates a stable blood clot at the base of the periodontal pocket. This clot acts as a natural barrier, sealing the pocket and providing a scaffold for tissue and bone regeneration. This is fundamentally different from traditional surgery, which relies on sutures to hold tissue in place.
Who Is a Good Candidate
LANAP may benefit patients who have moderate to severe gum disease with pocket depths of 5 mm or more. It is often recommended for patients who have health conditions like uncontrolled diabetes, bleeding disorders, or those taking blood thinners that make traditional surgery higher risk. Patients with dental anxiety may also prefer LANAP because it is less invasive.
LANAP may not be the best choice for patients with very mild gum disease (gingivitis or early periodontitis), where scaling and root planing alone is usually sufficient. Your periodontist will evaluate your specific situation to determine if LANAP is appropriate.
What to Expect: Before, During, and After LANAP
The LANAP procedure is typically completed in two visits, each treating one side of the mouth. Each session takes about 2 to 3 hours.
Before the Procedure
Your periodontist will perform a full periodontal examination, including pocket depth measurements and X-rays. You will discuss your medical history, current medications, and treatment goals. If you are taking blood thinners, your periodontist may coordinate with your physician, though LANAP's ability to promote clotting makes it more suitable for these patients than traditional surgery.
You will receive local anesthesia to numb the treatment area. Most patients do not require sedation, but it may be available if you prefer it.
During the Procedure
The periodontist inserts a thin fiber optic tip, about the width of three human hairs, between the tooth and the gum tissue. The first laser pass removes the diseased tissue lining the pocket and kills bacteria. The fiber is moved around each tooth to treat the full pocket.
Next, the periodontist uses ultrasonic scalers to remove tartar (calculus) from the root surfaces. Because the laser has already removed the diseased tissue, the root surfaces are more accessible.
A second laser pass at a different energy setting stimulates the bone and remaining tissue, creating a stable fibrin blood clot that seals the pocket. The clot serves as a biological bandage and a foundation for regeneration. No sutures are needed.
After the Procedure
Most patients feel mild soreness rather than significant pain. Over-the-counter anti-inflammatory medication is usually sufficient for comfort. You can eat on the day of surgery, but you will need to follow a soft food diet for 1 to 2 weeks to protect the blood clots forming in the treated pockets.
Your periodontist may place a temporary bite adjustment if your teeth have shifted due to bone loss. This helps distribute chewing forces evenly during healing.
Recovery Timeline After LANAP
One of LANAP's main advantages is its shorter, more comfortable recovery compared to traditional gum surgery.
First 24 to 48 Hours
Most patients return to work and normal activities within 24 hours. Some mild swelling and discomfort are normal. Avoid hard, crunchy, or spicy foods. Do not brush or floss the treated area for the first few days. Use the prescribed antimicrobial rinse instead.
Weeks 1 Through 4
Gradually resume normal brushing with a soft-bristle toothbrush after 7 to 10 days. Continue eating softer foods for the first 2 weeks. The blood clots in the treated pockets are critical for healing, so avoid vigorous rinsing, using straws, or anything that could dislodge them.
Your periodontist will see you for a follow-up visit at 1 week and again at 1 month to monitor healing.
3 to 12 Months
Bone regeneration and tissue reattachment continue for 6 to 12 months after LANAP. Your periodontist will measure pocket depths at follow-up visits to track improvement. Studies show average pocket depth reductions of 2 to 3 millimeters over the first year.
Periodontal maintenance visits every 3 months are essential during this period. These visits include professional cleaning of areas that are still healing and monitoring for any signs of disease recurrence.
LANAP Cost Factors
LANAP tends to cost more upfront than traditional gum surgery, but the reduced need for follow-up procedures and faster recovery can offset the difference.
A full-mouth LANAP procedure typically costs $2,000 to $8,000. Treatment of a single quadrant may range from $1,000 to $2,500. The wide range reflects differences in disease severity, geographic location, and the provider's experience. Costs vary by location and provider.
Dental insurance may cover part of the cost, as many plans cover periodontal surgery. However, some insurers still classify LANAP as an alternative or experimental procedure and may reimburse at a lower rate. Check with your insurance provider before treatment. Ask your periodontist's office for a pre-authorization to determine your expected out-of-pocket cost.
Many periodontists offer payment plans or work with third-party financing companies like CareCredit. If you are comparing LANAP to traditional surgery, factor in the potential savings from fewer missed work days and a faster return to normal eating.
When to Ask About LANAP
Consider asking your periodontist about LANAP if any of the following apply:
- You have been diagnosed with moderate to severe gum disease with pocket depths of 5 mm or greater
- You have had scaling and root planing but your pockets have not improved enough
- You are anxious about traditional gum surgery involving scalpels and sutures
- You have a medical condition or take medications that increase surgical risk or slow healing
- You want a treatment with a shorter recovery period and less post-operative discomfort
- You have been told you need multiple quadrants of periodontal surgery
Find a LANAP-Certified Periodontist Near You
Not all periodontists are trained in LANAP. The procedure requires specialized certification through the Institute for Advanced Laser Dentistry. Use the MySpecialtyDentist.com directory to search for a periodontist in your area and ask about their training and experience with LANAP laser surgery.
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