Overview: What This Guide Covers
This guide gives a balanced view of LANAP, the laser-assisted treatment for gum disease, including what the evidence supports and where it falls short. It is written for patients weighing LANAP against traditional periodontal surgery.
LANAP stands for Laser-Assisted New Attachment Procedure. It uses a specific wavelength of light from the PerioLase MVP-7 laser to remove diseased tissue around the tooth root while preserving healthy gum tissue. The U.S. Food and Drug Administration has cleared the protocol for true periodontal regeneration, meaning new bone, cementum, and periodontal ligament can form in treated areas [1].
Choosing between LANAP and traditional flap surgery is rarely a simple decision. Your bone loss pattern, overall health, insurance coverage, and access to a trained provider all matter. This guide walks through each of those factors so you can have a more informed conversation with your periodontist.
Key Information About LANAP
LANAP is a regenerative periodontal procedure that uses a free-running pulsed Nd:YAG laser to selectively remove infected tissue from deep gum pockets without cutting or stitching the gums. It is one of several treatment options for periodontitis, a chronic infection that damages the bone and tissue supporting the teeth [1].
How LANAP Works
The laser energy targets the dark-pigmented bacteria and diseased tissue inside the periodontal pocket while leaving healthy pink tissue largely intact. After the laser pass, the periodontist removes tartar from the root surface with ultrasonic and hand instruments. A second laser pass then forms a stable fibrin clot that seals the pocket and supports healing.
Because no scalpel cuts or sutures are used, the gum tissue is not flapped away from the tooth. This preservation of soft tissue is one reason patients often experience less recession and a more cosmetically stable result compared with traditional surgery [1].
Documented Advantages
Patients who undergo LANAP typically report less pain, less swelling, and faster return to normal activities than after open flap surgery. The minimally invasive nature of the procedure also tends to produce less post-treatment gum recession, which matters for cosmetics and for long-term root sensitivity [1].
LANAP is the only laser-based protocol that holds FDA clearance for true periodontal regeneration. This is an important distinction. Many lasers can reduce pocket depth, but FDA-cleared regeneration means new attachment tissues can form on previously diseased root surfaces [1].
- Less post-operative pain and swelling in many cases
- Minimal gum recession, preserving esthetics
- No scalpel incisions or sutures
- Often performed in two appointments (one per side of the mouth)
- Faster return to work and normal eating for most patients
- Suitable for patients on certain blood thinners after medical clearance
Limitations and Honest Tradeoffs
The research base for LANAP is smaller than for traditional flap surgery, which has decades of peer-reviewed outcome data. The American Academy of Periodontology continues to evaluate laser therapies and emphasizes that long-term, multi-center studies remain the standard for fully establishing any regenerative protocol [1].
LANAP also requires specialized equipment and certification. The PerioLase MVP-7 is the only laser cleared for the full LANAP protocol, and providers must complete training through the Institute for Advanced Laser Dentistry. Access can be limited in smaller markets, and not every periodontist offers it [1].
- Smaller evidence base than traditional flap surgery
- Higher provider fees in many markets due to equipment costs
- May not be covered or may be partially covered by insurance
- Not ideal for cases needing extensive bone recontouring or grafting
- Outcomes depend heavily on operator skill and case selection
- Requires a provider trained and certified in the LANAP protocol
What Patients Should Know Before Choosing LANAP
LANAP is generally considered for adults with moderate to severe periodontitis, typically with pocket depths of 5 mm or greater and visible bone loss on x-rays. It is not used for routine cleanings or for very early gum disease that can be managed with non-surgical care [1].
Who Tends to Benefit Most
Good candidates typically have generalized moderate to severe periodontitis, intact gum tissue, and bone defects that can respond to regeneration. Patients who want to avoid sutures, who are anxious about traditional surgery, or who have medical conditions that complicate healing are often interested in LANAP.
Patients with controlled diabetes, certain cardiac conditions, or those taking specific anticoagulants may still qualify after medical clearance. Your periodontist will coordinate with your physician when appropriate.
When LANAP May Not Be the Best Fit
LANAP is not ideal for every situation. Patients with severe horizontal bone loss, large bony craters that require grafting, or cases that need crown lengthening and reshaping of the bone may do better with traditional surgical approaches. Smokers and patients with poorly controlled diabetes may also see reduced regenerative outcomes regardless of technique [1].
- Aggressive horizontal bone loss across multiple teeth
- Cases needing bone grafts or guided tissue regeneration membranes
- Crown lengthening or esthetic gum recontouring
- Active heavy smokers without a cessation plan
- Uncontrolled systemic conditions affecting healing
Preparation and Timing
Before LANAP, most periodontists perform a comprehensive evaluation including full-mouth probing, x-rays, and sometimes a 3D cone-beam scan. Non-surgical therapy such as scaling and root planing may be completed first to reduce inflammation and bacterial load.
LANAP is usually scheduled in two visits, treating one side of the mouth at each appointment. Plan for two to three days of light activity after each session. Avoid hard, crunchy, or sticky foods for about a week to allow the fibrin seal to mature.
What to Expect During and After LANAP
The LANAP procedure follows a defined sequence and is performed under local anesthesia, so you are awake but the area is fully numb. Most patients describe the experience as comparable to a deep cleaning rather than a surgery.
Step by Step
After numbing, the periodontist measures each pocket and marks the depths. The laser fiber is then placed gently into each pocket to remove diseased tissue and bacteria. Next, ultrasonic scalers and hand instruments clean tartar and bacterial film from the root surfaces.
- Step 1: Probe and document pocket depths
- Step 2: First laser pass to remove diseased tissue and bacteria
- Step 3: Ultrasonic and hand scaling of root surfaces
- Step 4: Second laser pass to form a stable fibrin seal
- Step 5: Occlusal adjustment if biting forces are damaging supporting bone
- Step 6: Home care instructions and follow-up scheduling
Recovery and Healing
Many patients return to work the next day. Mild soreness, a metallic taste, and slight gum tenderness are common in the first 24 to 48 hours. You will be asked to eat a soft diet for about a week and to avoid brushing the treated areas vigorously while the seal stabilizes.
Healing of the supporting bone and attachment tissues takes months. Your periodontist will typically reassess pocket depths and bone levels 6 to 12 months after treatment. Ongoing periodontal maintenance every 3 to 4 months is standard to protect the result [1].
Cost Factors and Insurance Considerations
LANAP fees vary widely by region, provider experience, and the number of teeth treated, and some insurance plans treat it differently than traditional surgery. Costs vary by location, provider, and case complexity.
In many markets, full-mouth LANAP runs higher than basic scaling and root planing but is often comparable to, or somewhat more than, traditional periodontal flap surgery when the same number of teeth are treated. Equipment investment and required certifications contribute to the fee structure.
Insurance coverage is mixed. Some plans reimburse LANAP under codes for periodontal surgery. Others classify laser-assisted procedures as alternative or investigational and pay only the equivalent of traditional surgery, leaving the patient responsible for the difference [2]. Ask the office for a pre-treatment estimate and a clear breakdown of out-of-pocket cost before scheduling.
- Number of teeth and quadrants involved
- Severity of bone loss and pocket depth
- Need for adjunctive procedures such as occlusal adjustment
- Provider experience and certification level
- Local market rates and regional cost of care
- Insurance plan coding and reimbursement policy
When to See a Periodontist vs. a General Dentist
See a periodontist when gum disease has progressed beyond what a general dentist can manage with cleanings alone, or when laser-based regeneration is being considered. Periodontists complete three additional years of specialty training after dental school focused on the diagnosis and treatment of gum and bone disease.
- Pocket depths of 5 mm or greater on multiple teeth
- Bleeding gums that persist despite good home care
- Loose, shifting, or separating teeth
- Gum recession that is worsening over time
- Family history of severe gum disease or early tooth loss
- Interest in laser-based options like LANAP
- Need for bone grafting or guided tissue regeneration
Find a Qualified Periodontist
If you are weighing LANAP against other treatments, the most important step is finding a periodontist with documented training, transparent outcomes, and certification in the protocols they offer. Browse the periodontics page to learn more about the specialty and to connect with credentialed providers in your area.
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