What Is Laser Gum Treatment?
Laser gum treatment uses focused light energy to treat periodontal disease. Several types of dental lasers exist, but the term most commonly refers to the LANAP protocol, which uses a specific type of laser called the Nd:YAG (neodymium-doped yttrium aluminum garnet) laser. This laser operates at a wavelength that is selectively absorbed by diseased tissue and the pigments in bacteria, while passing through healthy tissue with minimal effect.
The concept behind laser gum treatment is straightforward: remove the infection without removing healthy tissue. In traditional flap surgery, the periodontist cuts the gum tissue, folds it back, cleans the roots and bone, and sutures the tissue back in place. With LANAP, the laser does the work of removing diseased tissue through a small opening between the gum and tooth, without the need for incisions or sutures in most cases.
How the LANAP Procedure Works
The LANAP protocol is a structured, step-by-step procedure typically performed by a periodontist who has completed specific training and certification in the technique.
Step-by-Step LANAP Process
The procedure begins with local anesthesia to ensure comfort. Your periodontist then inserts a thin fiber-optic tip, about the width of three human hairs, between the gum and the tooth and into the periodontal pocket.
- First laser pass: The laser light is directed into the pocket. It selectively removes diseased tissue and kills bacteria without affecting healthy gum tissue. The laser energy is absorbed by the dark pigments in infected tissue and bacteria.
- Scaling: After the first laser pass, the periodontist uses ultrasonic scalers and hand instruments to remove tartar from the root surfaces below the gumline. This step is similar to scaling and root planing in traditional treatment.
- Second laser pass: The laser is used again at a different setting to create a stable blood clot at the top of the pocket. This clot acts as a seal, protecting the treated area and providing a foundation for healing and new tissue attachment.
- Bite adjustment: The periodontist may adjust your bite to reduce excessive forces on the treated teeth, which supports healing.
How Long Does LANAP Take?
A full-mouth LANAP treatment is typically completed in two sessions, each treating one side of the mouth (two quadrants). Each session takes approximately 2 to 3 hours. The two sessions are usually scheduled about a week apart.
Laser Gum Treatment vs. Traditional Surgery
Both LANAP and traditional flap surgery aim to treat periodontal disease by removing bacteria and tartar from deep pockets and creating conditions for healing. The key differences are in how they achieve this.
Potential Advantages of LANAP
- No scalpel incisions or sutures in most cases
- Less post-operative pain and swelling
- Faster recovery, with most patients returning to normal activities the next day
- Less gum recession after healing, since tissue is preserved rather than cut away
- Reduced bleeding during and after the procedure
- The laser stimulates bone regeneration, which traditional surgery does not do directly
Important Considerations
Traditional periodontal surgery has a longer and more extensive body of evidence. It has been the standard treatment for decades, and its long-term outcomes are well documented. LANAP has shown promising results in published studies, but the volume of research is smaller.
Not all periodontal conditions are best treated with LANAP. Severe bone defects that require grafting may still need conventional surgical access. Your periodontist will recommend the approach best suited to your specific condition. In some cases, a combination of laser and traditional techniques may be used.
Who Is a Candidate for Laser Gum Treatment?
LANAP is designed for patients with moderate to advanced periodontal disease who have not responded adequately to non-surgical treatment (scaling and root planing). It may be particularly well suited for certain patients.
- Patients with moderate to severe periodontal pockets (typically 5 mm or deeper)
- Patients who want to avoid traditional surgery with scalpels and sutures
- Patients on blood-thinning medications who are at higher risk for bleeding with traditional surgery
- Patients with medical conditions that make conventional surgery higher risk
- Patients concerned about gum recession from traditional surgical approaches
When LANAP May Not Be the Best Option
LANAP may not be recommended if your periodontal disease requires extensive bone grafting or guided tissue regeneration that needs direct surgical access. Patients with certain types of severe bone defects may get better results from traditional osseous surgery. A thorough evaluation by a periodontist trained in both approaches will determine the best treatment for your situation.
Recovery After Laser Gum Treatment
One of the main reasons patients choose LANAP is the shorter and more comfortable recovery compared to traditional surgery.
Most patients experience mild soreness and slight swelling for 1 to 2 days after treatment. Over-the-counter pain relievers are typically sufficient. Many patients return to work and normal activities the day after the procedure. You will be placed on a soft diet for approximately 2 weeks to allow the blood clot seal to stabilize and the tissues to begin healing.
Your periodontist will schedule follow-up visits to monitor healing. Pocket depth reduction and tissue reattachment are gradual processes that occur over several months. Full healing and bone regeneration, where it occurs, may take 6 to 12 months. During this time, periodontal maintenance cleanings every 3 months are typically recommended.
Evidence and Effectiveness of LANAP
LANAP received FDA clearance in 2004 for the treatment of periodontal disease. It is the only laser-based protocol with FDA clearance specifically for new attachment (the regrowth of bone, cementum, and periodontal ligament around the tooth).
Published studies on LANAP have reported significant pocket depth reduction, clinical attachment gain, and evidence of bone regeneration. A 2015 study in the International Journal of Periodontics and Restorative Dentistry reported sustained clinical improvements at 9 years following LANAP treatment. However, the overall body of research is smaller than for traditional periodontal surgery, and more long-term comparative studies are needed.
It is worth noting that the quality of your outcome depends not only on the technique used but also on the skill and experience of the periodontist performing the procedure, and on your commitment to post-treatment maintenance and oral hygiene.
Laser Gum Treatment Cost
Laser gum treatment cost is generally comparable to or slightly higher than traditional periodontal surgery. LANAP typically costs $1,000 to $4,000 per quadrant, depending on the severity of the disease and the geographic area. A full-mouth LANAP treatment may range from $4,000 to $15,000. Costs vary by location and provider.
Insurance coverage for LANAP varies. Some dental insurance plans cover LANAP under the same periodontal surgery codes as traditional flap surgery. Others may not cover laser treatment specifically. Check with your insurance provider and your periodontist's office before treatment to understand your coverage. Many periodontists offer payment plans or financing options for patients paying out of pocket.
Finding a LANAP-Trained Periodontist
Not all periodontists offer LANAP. The procedure requires specialized training and certification beyond standard periodontal residency, as well as investment in the specific Nd:YAG laser equipment. When searching for a provider, look for a periodontist who has completed formal LANAP training through the Institute for Advanced Laser Dentistry (IALD) or a similar credentialed program.
A qualified LANAP provider will evaluate your condition, explain whether laser gum treatment is appropriate for your case, and discuss alternatives if it is not. Learn more about periodontists and their training on our [periodontics specialty page](/specialties/periodontics).
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