LANAP: More Beneficial for Aesthetics than Respective Surgery?

I have been doing Lanap in my office for over 3 years. It has far exceeded my expectations.

Yes, Lanap leaves for better aesthetics compared to traditional Osseous surgery. LANAP is a minimally invasive surgery. If I had Moderate to severe Perio in my mouth at least I would want my DDS to advise me of the option. Wouldn't you?

lanap. The laser is just an incision tool. You still need to debride the roots. This would be difficult in the posterior without laying a flap (which is not part of the lanap procedure). Those who use it seem to like it, but very few periodontists subscribe to it. We have no serious evidence in the literature that compares the two procedures. I would advise you attend the California Society of Periodontists meeting in NAPA in the spring. Dr. Ray Yukna,periodontist, a proponent will show his six teeth, and Dr. Dough Diederich a periodontist with a PHD who has studied laser-light tissue interaction, will give you a different opinion.

This year 43% of Periolase owners have been Periodontists in the general population the ratio of GP/Perio is less than 5%. All have had a 6 month money back guarantee no Perio has ever exercised that right, though most admit they started with the intention of returning the periolase. Yukna will show 12 teeth not 6, that happen to be the 4th largest human histological split mouth study with a control in the periodontal literature that showed 100% NEW CEMENTUM MEDIATED ATTACHEMENT TO THE ROOT SURFACE IN THE ABSCENCE OF LONG JUNCTIONAL EPITELIUM, on the control SRP 0% had this finding. The Cal Soc. of Perio sounds like it will be a very interesting meeting.

To imply that the ND:YAG is just an incisional tool is to not understand laser physics. It has a Therapeutic index for killing P. Gingivalis that is off the chart. See the Harris article. http://www.biomedicalconsultants.com/HarrisYessikLSM04.pdf

The fact that a laser can kill pG is no supprise. The question is does it matter . Is this procedure more benefical that a flap procedure? We just do not know. We just do not have the comparative clinical trials. Regardless of the ratio of GPs to Perios using the Lanap procedure, most all periodontists do not use it. We aready have reports of collateral damage with the laser that cannot be ignored. Be careful doing any curretage procedure in the anterior if thin facial tissue is present. It sounds like this JohnDDS represents the laser company.

Yes, killing P. ging is important. I would assume it matters since the laser is VERY effective in destroying Black pigmented anaerobic bacteria. (that would be the RED complex) You know the ones that have been postulated for causing Periodontal disease. No reports of collateral damage by any Periolase users. My disclosure: I am a full time practicing dentist I do not own any stock in Millennium Dental nor have I ever received a % of sales or a commission on any laser sold. I have been a dentist 20 years and have been using the laser over 3 years. The results I have seen with my patients have far exceeded my expectations. So Yes in my opinion LANAP is more beneficial than a flap procedure.

Treatment of periodontal disease is a treatment of a disease process, not simply a resective modality. While there are certain steps that require mechanical debridement of the root surface, a scaler is not the only instrument that may be employed. However, NOT eliminating the bacterial component, NOT conditioning the root surface, and NOT attenuating inflammatory cytokines most often leads to refractive periodontal disease. The suggestion that the efficacy of lasers in periodontics and oral implantology is not literature based is a reflection of U.S. academic shortcomings. As a board member of the Society of Oral Laser Applications (SOLA) based in Vienna, Austria, the European literature is replete with the references that you are searching for. As usual, our international colleagues are far ahead of us when it comes to advances in minimally invasive dentistry. Treatment must change from a concept of mechanical manipulation of tissue to that which is biologically based. Old habits may die hard, but evidence based dentistry is something that I look for when I make a decision as to the modality of choice. RJM

Our international colleagues are far ahead of us when it comes to advances in minimally invasive dentistry. Dr. Miller very well said! IMO the periodontal community lacks leadership, in the fight against periodontal disease, with the use of lasers.

Nonsense. Show me one radomized controlled clinical trial study that demonstrates the laser is better that conventional periodontal surgery. I have lots of evidence of collateral damage with the laser sent to me from many peridontists. I suggest you contact the American Academy of Periodontology and ask them when their new position paper is coming out on the use of the laser in periodontal therapy, and read it. In the mean time, please give me one university based randomized controlled clinical study that is evidenced based that shows you are better off with the laser in treating peridontal disease than convention methods. Until we have such a study I would advise dentists to look for a less expensive marketing tool.

Jerry Lanap has been in the periodontal literature over 10 years. Why don't you show me the lit disproving the FDA claim that says "New Cementum Mediated Attachment to the Root Surface in the Absence of Long Junctional Epithelium. BTW How many Lanaps have you done?

I agree with Jerry, You have to open it up to treat the condition. Treating in the dark ie. with a laser is stupid.

Stupid is as stupid does. You don't know, what you don't know, do you?

The AAP is preparing its membership for a soft landing. This is off their web site Are there potential benefits to using lasers in periodontal therapy? Limited research suggests that the use of lasers as an adjunct to scaling and root planing (SRP) may improve the effectiveness of this procedure. In addition, when the lasers are used properly during periodontal therapy there can be less bleeding, swelling and discomfort to the patient during surgery. Again IMO LANAP is superior to SC/RP and equivalent to surgery in pocket reduction and superior to both in maintenance of clinical attachment levels.

If you were a patient, would less bleeding, less swelling and less discomfort, be important to you?

The AAP is terrified of GP's with lasers. And the AAP has every reason to be afraid of GP's having an effective tool for treating moderate to severe gum disease. With only 3% of the US population (for the last 50 years) buying the services of periodontists--who have a monopoly on the treatment of gum disease you understand--if they were traded on NASDAQ, they''d be delisted!! Gastric surgeons weren't too thrilled when Barry Marshall, MD figured out that 90% of gastric ulcers could be cured with 2 weeks of tetracycline and antacids. Wonder what those surgeons are doing now? Orthopedic surgeons called Richard O'Conner, MD a quack when he did the first knee arthroscopy in the late 50's. The orthopods ran Dr. O'Connor out of the hopitals to practice in West Covina Osteopathic Hospital. Fact is, not all orthopods have the 3-D spatial relation skills to perform arthroscopy, so there was a real threat for many.

To the clinicians stating that the literature does not support the use of lasers in refractive periodontal disease: It is obvious that you have not read the Journal of Oral Laser Applications. Every one of the studies is university based, with many of the papers originating from the University of Vienna and Aachen; the heart of laser research in the world. The suggestion that the AAP is the end all in periodontal research is to close yourself off to all of the valuable studies from some of the top international research venues. Most of what we do in both periodontal and implant surgery actually originated in Europe. Once again, our international colleagues are reinventing how we treat periodontal disease and the instrumentation to accomplish it. In fact, the AAP is now ready to acknowledge the efficacy of laser based solutions in difficult periodontal cases. In a few years, when most of you are using some type of laser wavelength as a part of your normal surgical armamentarium, think back on how resistant the specialties were to change in the face of superior results. RJM

Would it be possible to exchage contact information with you Jerry? I'm not sure if this website permits that. I am in need of consultation and you seem to have the information I need. I am with the University of South Florida

Jerry- I can be reached at [email protected] or [email protected]. Thanks.

A new laser procedure called Laser-Assisted New Attachment Procedure does away with cutting and stitches. It removes deteriorating gum tissue, restores the height of the tissue around the teeth, reduces the patient's pain and discomfort, closes the disease-produced pocket between gums and teeth, and lets healing proceed apace. Thanks to LANAP our gums can be treated without pain now.

Rachel, Very well said! For those skeptics I must admit I was just as or more skeptical than you, when I first looked at the Periolase. You might even have called me a doubting Thomas. I referred a patient to my periodontist (one of the best in LA, teaches at USC) I knew this patient needed his teeth removed it was confirmed by the perio that he needed implants, and for all the training I had it was a good recommendation. But the patient didn’t agree he searched for an alternative and found the creator of the LANAP procedure, & had the LANAP done. That was 10 years ago; those loose teeth that I knew needed to be removed are still there and firm. So every 3 months this guy would come into the office I couldn’t deny it had worked for him. So I started to look into it, because as you know Periodontitis is the #1 cause of tooth loss in adult Americans. And I being a dentist, by definition a dentist doesn’t exist without a patient, and after asking my patients what they wanted from me, the usual response over and over again was “I WANT TO KEEP MY TEETH”, “I WANT TO KEEP MY TEETH”, “I WANT TO KEEP MY TEETH”, so for me it was a patient driven search. So my journey took me to Dentaltown an online community where 40,000 dentists are signed up and discuss things like perio. Being a doubting Thomas I searched out “The Guy” you know the one “The guy” who always has something negative to say about every procedure or dental product you know “the guy” who always says “it didn’t work for me”. Well after many years of looking for “The Guy” I still haven’t found him. Still looking. Fortunately the two knuckleheaded Gp’s that developed the LANAP protocol practice nearby so I would refer my hopeless cases to them every time it got harder and harder to refer, they would always try and sell me a laser, but I DIDN’T WANT A LASER!, I wanted to help my patients keep their teeth. Then after seeing and understanding Ray Yuknas HUMAN histology, the FDA clearance that says “NEW CEMENTUM MEDIATED ATTACHEMENT IN THE ABSENCE OF LONG JUNCTIONAL EPITHELIUM” the CRA 9.7 out of 10, never finding “THE Guy” on DT to say anything negative about the procedure or the laser, not being able to refer to anyone who had the laser, seeing my anecdotal case walk in the door every 3 months, I decided, I too wanted to help people keep their teeth. The rest is history you can go on this site to see my x-rays you would be shocked at what my perio readings are 12mm bleeding suppurating pockets going to 2mm healthy sulci, again INCREDIBLE RESULTS time after time. This is why I have NO problem recommending to my colleges this procedure. So you can continue to sit around while your patients lose their teeth & waiting for more dog studies. Good luck with your wait.

Howard I see you are interested in LANAP. If you click on my name "johndds" it will take you to one of my websites. Since you are in Florida you may be interested in seeing the past President of the Florida Periodontal Society Tom McCawley DDS Ms. He will be the first video on the left side. Enjoy :-)

So what are the downsides of Lanap? Are there risks or possible complications?

With any surgical intervention there are always risks involved. A thorough informed consent should be given prior to LANAP. I have been fortunate that in the 3 plus years that I have been doing LANAP, I have not encountered any. Though, at the training center that has 10 times the volume of patients, and first time students, I have only heard of two cases of bone sequestration around two teeth. If you consider, it is a common occurrence with traditional Osseous then it's not so bad. Another case was a gentleman that had a bleeding disorder that fortunately was controlled with the ND;Yag. Also sensitivity is a common occurrence after the procedure, that in a month usually goes away. I will post your question on a private Lanap forum and see what is posted. At your service, John

We had a very different experience. Unfortunately we are having difficulty finding anyone who can answer our questions. Is there anyone that is willing to talk with someone who may have a valid and legitimate situation with a very newly trained LANAP dentist?

As one of the many Americans who has severe perio I just recently heard of LANAP the other day. So I'm online researching the pro's and con's. I have started the surgery for implants with my periodontist, also involving bone grafts. And as most of us patients are finding out, Dental Insurance will have nothing to do with implants. I still have a a ways to go with several more surgerys if I decide to go that route, but am at a crossroads as to what direction to take. The LANAP sounds promising, and yes, less evasive. Cost? I have no idea. Either way dental insurance will not cover it. At 57 I too would like to keep my teeth. Regards, Larry

Larry, You can call Millennium and find a Lanap practitioner in your area and have a consult.

Larry, My next door neighbor had the LANAP surgery done a few years ago in Southern California, she had excellent results, had her whole mouth done, it cost her $3,000.00 dollars, not covered by ins., no pain, less evasive, eating 2-3 hours later. I'm all for it, hope this helps you. Kathy

Kathy, Can you give me the name of the doctor who did the LANAP. Thanks Lily

Hello Lily, If you click on my name "johndds" it will take you to my website. I am in Southern California. To your health, John

I wish the LANAP was more affordable, In my area in north California is between $6,000. to $7,000 for the whole mouth which my insurance does not cover it at all. Lily

Lily Send a letter to your dentist and make an offer. & or look into a monthly agreement that is comfortable for your budget.

Kathy, Since I last posted I went to see a dentist in Denver to consult with about the LANAP surgery. I do plan on having the surgery, right now I am playing the standard dental insurance game. As in, what will they cover. My implants would have run close to 15K....again insurance won't touch it because of the word "implants". Lanap is approximately 4K. I realize that this surgery is not 100%. But from all I've read and discussed I feel its the best thing for me to do. Amazing at all the hoops insurance companies make us jump through! Regards, Larry

Larry, I have been a dentist over 20 years and i have never seen dental "insurance". Usually I see dental plans. What I mean is that "insurance" is supposed to be there when you most need it, when you have a catastrophic loss. Most dental plans have $1k - $2K maximum per year. When dental insurance started in the 60's it was $1K max same as it is today. Back then a crown was less than $50 now they are over $1000. The premiums over the years have gone up but the benefits have remained the same. I don't understand people who do not go to the dentist because they do not have "insurance". When was the last time someone used restaurant insurance to pay for a meal? Or car insurance to buy a new car? Or grocery insurance to buy groceries? It's all about values. If you value your teeth and smile then you will invest in yourself. As you have found out a full mouth treatment with lanap cost less than bone grafting and an implant for just one tooth. 32 to 1 not a bad deal. Oh and they are yours and you did not get screwed with titanium.

I am an individual with chronic perio problems and am researching LANAP. The treatment sounds promising! I'm in Denver, and was just quoted $10,000 for the procedure. Larry, I see you're also in Denver. Would appreciate it if you could refer me to the doctor who is quoting 4,000. Thanks, D

Interesting article in JOP Conclusion: Implant loss was significantly associated with periodontitis. Ong et al., J. Clin. Periodont, 35, 5, 438-462. http://www.joponline.org/doi/abs/10.1902/jop.2009.080594

I enjoyed this editorial Where is Periodontology Heading? Are we moving away from our primary professional competencies to become implantologists? Is this a positive change? International Journal of Periodontics and Restorative Dentistry September/October 2008 Volume 28 , Issue 5 Yvonne de Paiva Buischi, DDS, PhD http://www.quintpub.com/journals/prd/abstract.php?iss2_id=285&article_id=3543&article=1&title=Guest%20Editorial%20%20Where%20is%20Periodontology%20Heading

America’s Insurance Industry Considers The Oral Systemic Link. I have had medical insurance cover LANAP :-) Good article http://www.compendiumlive.com/article.php?id=2516

Jerry you said "I would advise you attend the California Society of Periodontists meeting in NAPA in the spring. Dr. Ray Yukna,periodontist, a proponent will show his six teeth, and Dr. Dough Diederich a periodontist with a PHD who has studied laser-light tissue interaction, will give you a different opinion." It was this last weekend How did it go?

At the AAP Annual meeting in Washington State last year, I was told by one of our periodontists that an officer in the CSP told him that Dr. Dederich would put this LANAP thing to end “once and for all” at this meeting. Is that what happened?

JohnDDS, You are right, I did get my verbiage wrong in regards to dental "insurance". And yes, my plan allowed for about $1400 per year. If one could, and had the time, do a surgery in December, then if another is needed do one in January. I did not have that option. During the last couple of weeks I've had two surgeries using the LANAP laser procedure. I would love to come back in a year and tell of my results, what ever that may be. Regards, Larry

Hi, I am scheduled to have Lanap in three weeks. I have severe perio disease, which I have been battling since my early twenties. From what I understand of traditional gum surgery, there is the probability of additional bone loss, in addition to more exposed root that causes sensitivity, longer looking teeth, stronger probability of cavities, etc. With Lanap, my expectations are that I will not experience these residuals. I would be willing to share with users of this site my experience, my progress, and my opinion, if interested. Brenda

Hello Brenda, Your opinion and experience would be greatly appreciated. John

I live in Connecticut and according to my research, there are currently only three dentists in this state that perform Lanap. I will be seeing Dr. Adamidis in Newington. He has prescribed 500mg amoxicillan (4x a day for 8 days); I am not sure if this is a standard prior to lanap or because I have a current infection, and 800 mg ibuprofen to be taken immediately prior to the procedure to minimize swelling. He has also recommended that I have splinting on my bottom teeth, a night guard, and a smoker's tray. All together the cost is $5,000 ($4,000 for lanap). I am not sure if I will go through with the splinting as only one tooth on the bottom is very wiggly. I read (on the Internet) that it is difficult to care for teeth that are splinted. Instead, I may ask if he would shave down the tooth which I hope would tighten it as my mouth heals. I definitely need the night guard and if I have not successfully quit smoking by the time of the appointment, I will invest in the smoker's tray, which cost $170. For any CT residents, Dr. Adamidis and his staff are very knowledgeable, friendly, and non-judgemental.

Brenda, As you have found out less than 1% of dentists offer LANAP. IMO it is a tragedy, since it has been in the literature for over 12 years, & has FDA clearance to reverse gum disease. IMO I would recommend you have the loose tooth splinted. You can always have the splint removed later. John

Hi, John, Thanks for your advice. Approximately, in your opinion, what is a reasonable amount of time that a splint would be necessary? Again, I've read some pretty icky things, including changing the bite, the spacing between teeth, and the difficulty in keeping the area clean. I have also read that there are different splinting techniques. Are you familar with the titanium trauma splint? IMO it is definitely a tragedy - there needs to be more advertisement of this procedure. I was advised a couple of years ago to have gum surgery and this year nearly did it - I had to do something. Thank God, my research brought the info of LANAP. I am very confident that LANAP in conjuction with a night guard will if not improve, at least prevent the condition from worsening with very MINIMAL SIDE EFFECTS. I appreciate that your respond to my posts. Quick update - I was advised to start taking the antibiotic the day of the surgery. Enjoy. - Brenda

Brenda, You are fortunate to have found a LANAP dentist. I have not seen your case though, what you have read about splints may be referring to splints used to reduce fractures of the Jaws. Those ate completely different than the ones used for splinting teeth. With today's use of bonding the splints match the teeth. It is the same material we use to do tooth colored fillings. Best, John

Hi, This morning I had the LANAP procedure. Here is the lowdown of my experience. Appt. was at 8:30 a.m. for the right side of my mouth - given several novacaine shots, which was the worst part of the experience. Around 9:00 a.m. the dentist used the laser to destroy the diseased tissue - this was probably the longest part - then the dentist used a water vibrating scaler to remove the calculus. This part (although I was very numb) I experienced minor discomfort - reminded me of the root and scaling procedure. The dentist asked me several times if I needed more novacain, but I opted for the slight discomfort. Then, the most quickest part of the procedure, the dentist used the laser to seal the gum tissue. The dentist started lanap at nine and I was finished by 11:00. POST-OP I purchased from the dentist for $25 Tooth & Gums Tonic that I will use to rinse my mouth with, starting tomorrow, twice a day (morning and night). I cannot eat, floss, or brush the right side for one week, preferably two. I was given two prescriptions: 800mg motrin and amoxicillan. As for pain, I am still numb, so right now I am not experiencing any pain. Will keep you posted on that. If you have any questions, please post them. Have a great day!

Pain level from LANAP - zero - yesterday I had slight discomfort - took a hydrocodone tablet that I had left from another dental procedure. Today no pain what-so-ever - went to work! :-)

I too have been amazed at how little discomfort patients have after LANAP. The first 6 months I was a little confused. I had been a dentist for over 18 years and used an electrosurg the day after patients were in significant pain. With the LANAP procedure. Evan though it is an aggressive procedure patients usually they tell me on a scale of 1-10 with 10 being the strongest pain they have ever had they tell me it is a 2 two the day after LANAP. I have had a few 4s but I've also had 0 zeros. After asking around why? I found out that the laser singes the nerve endings not allowing the pain response to register. Nice benefit along with reversing the #1 cause of tooth loss. Thanks for sharing your experience. :-)

About 2 years ago I had my whole upper teeth redone with crowns and 2 bridges. However I now have a some deep pockets allowing for the start of gum disease in my front teeth. Th dentist reffered me to his priodontist which had me do a deep cleaning and scale. that cost me 1,000.00. Now I don't see them getting much better I have to go back and I bet there gonna advise to me to have gum surgery. But I have been looking into the LANAP procedure and I am going to have that done verse the traditional scalpal and stich thing. Who wouldn't want that done instead of bieng put to sleep. Seems like a no brainer but i guess only time will tell right.

Hi, I think it is very important that I continue to give updates on the lanap procedure, because from what I have seen from other posts at other sites. And that is - nothing, people post that they are going for lanap and write that they will post their experience and don't. This tells me they more than likely had a great experience, because what really motivates people to speak out is when things go wrong or are painfully. On 8/11/09 I had the right side of my mouth lanap-ed. As I wrote in a previous post there was NO discomfort. However, for approximately three days following the procedure, I experienced discomfort in a front tooth that had severe bone loss, so much so that I needed to take vicoproferin for 3 days. I felt as though I could feel that tooth healing and I have to tell you that tooth looks and feels 100 percent better. This is a tooth that my dentist would have pulled out - needed to pull out - he had already pulled one tooth that had severe bone loss and that tooth had a lot more bone than the front one. I forgot to mention that following lanap, the dentist will adjust your bite by shaving down the teeth. This is a very important part of the procedure and makes a huge difference. For approximately one week following lanap, my gums had a white substance with black spots on them and some gunk between the teeth. This wasn't visibly noticeable to people, that I am aware of, because no one had commented on them and I did not feel self-conscious about it. I did have the second procedure on 8/26/09 and will write that experience in a seperate post. Brenda

The second procedure (8-26-09) did not go as well as the first. I had a lot more discomfort during the procedure and needed additional novacain. Afterwards, I think this was because there was a different hygentist assisting and wasn't using the water in the same fashion. Just a guess though that I will mention to the dentist. I asked the dentist for a prescription of vicoproferin, because on the left side of my mouth I have a couple of areas with deep pockets and severe bone loss and from my first experience I needed it. I am very thankful that I did. I am having severe pain in the lower gum area since. I am expected to go the dentist on 9/1/09 for a continued bite adjustment and a fitting for a bite guard, but I will be calling first thing Monday. The pain medication handles the pain and I can function normally. During the procedure there was a loud bang in my mouth that caused both myself and the dentist to jump. The dentist said that that sometimes happens when there is a filling near the root. I hadn't called him sooner, well, because I was fearful of a root canal or having a tooth pulled. Also, I am very sensitive to my body and am hoping that, as in my first experience, I am just experiencing the wonderful healing magic of lanap. It may also be that my bite is still badly off. The dentist said that if my bite was adjusted years ago, I probably wouldn't have the severe bone loss that I do. Also, the pain is most severe in the morning when I awake. None of my other teeth have discomfort and I have the same look to my gums as the first procedure. Irregardless of the outcome from that pain, I would still strongly recommend lanap and the dentist that performed it. I would also strongly recommend lanap instead of the root and scaling procedure. I have had this procedure done several times, which has caused severe gum recession - more tooth is exposed. I had very little - hardly no gum recession with lanap. Please excuse any grammar and mispellings. Brenda

I hope you have the oportunity to go to the AAP this year. lloyd Tilt will be speaking on Sunday he will show his 10 year data. I guess in Perio 10 years is considered innovative? IP2: INNOVATIONS IN PERIODONTICS SESSION 2 10:15 - 11:45 am http://perio.org/meetings/am/2009AdvanceProgram.pdf

Dr. Adamidis, the dentist who performed my LANAP is phenomenal! (I wrote about my lanap experiences in previous posts). I was scheduled to see him today for a one week follow-up visit, but had called yesterday because I was experiening severe pain in my lower left jaw. Dr. Adamidis extended my appointment time today to address this issue. Before performing LANAP, he recommended that I have a splint on my lower left teeth, which I decided not to have done. Today, I got the splint, a night guard, and more bite adjustment. A huge improvement in the pain. My next appointment is this Tuesday for a follow-up and any necessary adjustments. Plus, he is creating dental trays for when I smoke for FREE. He really is a caring and passionate dentist with his patients best interests in mind. The freebie is because he understands the difficulty in quiting smoking (not that he smokes) and I just couldn't afford it on top off all the dental work that I had done. Pretty cool. Following Tuesday's appointment, I will be dentist office free until November when I go for a cleaning. My teeth and gums feel and look great.

Brenda, I really want to thank you for taking the time to post in detail how your LANAP experience went. I just discovered I have severe perio with some deep pockets (2s to 9s), one very loose front tooth that's ready to fall out, obvious infection (just had an absess appear one morning and rupture that afternoon, ewww). Several other teeth that have a bit of mobility. And bone loss. I have been scouring the web for info on LANAP and you are correct: people post about going in for it but few follow up, so I also take that as a sign there are no complaints. (Regrettably successes eldom get posted.) I have my LANAP consult tomorrow. First time in my life I can't wait to get to a D.D.S. I live in a tri state area. Had to call Millenium for a list of dentists. (Note: Millenium really should publish that on their site with a locator based on zip code. Some people might be skeptical about calling thinking there is a catch to it or sales pitch. No catch or pitch, it was straight to business of giving me a list of dentists. But having to call might deter people from pursuing locating a dentist.) Anyway, in my state the nearest LANAP dentist is 90 minutes. If I cross the state line and get nearer the large metro city in that state, there are 3 dentists within 45 minutes of me who have completed all 5 days of training with Millenium. (I wanted that part confirmed.) I was also given info as to how many years they have been doing the procedure. Each one is 5 yrs, so I'm comfortable with that. I discussed options with my dentist. I didn't want cut/suture, so not knowing there was an alternative allowed a case of mild perio to get to severe stage. My own dentist is skeptical and critical of the procedure, but with all due respect to him, I have to do what's best for me. I want to avoid dentures if possible. Mostly I really just want to keep as many of my own teeth as I can. Thank you again and please keep posting, Brenda! It's appreciated and no doubt many more are reading your journey! P.S. Forgive any typos, have never had so much as a toothache, and this gum pain that recently hit me is wicked bad!

Hi, Janie, Thanks for thanking me. I have great news for you. I too have a front tooth with severe bone loss and for the last year had an infection in that tooth that root and scaling, two injections of antibiotics directly under the gum, and two oral doses of antiobiotics couldn't clear. After LANAP that infection is now gone! That gum area before lanap was angry looking and puffy and now it is pink - the infection was eraticated during procedure. You will be amazed by the difference in look and feel and the immediate improvement in mobility (mine was very wiggly, too) and tightness. That tooth is on my right side and after lanap for approximately three days there was a lot of soreness and throbbing, enough for me to want to take something stronger then what lanap dentists usually prescribe. Your dentist will more than likely prescribe 800mg motrin that you will have to take before the procedure and a couple of days after whether or not you experience pain. You may want to consider asking for vicoproferin - its motrin with vicodin. The motrin alone wasn't getting at the discomfort. And, if you don't need it just take the straight motrin prescription. I had absolutely, not even throbbing, in those areas that had lots of bone loss but had good mobility. Also, if you don't have any overbite, the dentist may suggest a splint. This wasn't possible for me and in the end it wasn't necessary. So you may want to wait to see how it heals. I did get a splint the other day on my lower front teeth (and a night guard) in hopes of eliminating excrutiating pain that I am experiencing on my left upper and lower side. Unfortunately, the pain still exists, which sucks. I hope its gone tomorrow - keep your fingers crossed for me. If not, I'll be calling the dentist, again. I wonder if its nerve damage. Anyway, I don't think its from lanap - no issues on the right side, which has the most bone loss. Best of luck and keep us posted!!

At the AAP don't forget to catch Ray Yukna on Saturday 1 pm this is the Corp sponsered program. then again you can see him 2pm. MILLENNIUM DENTAL TECHNOLOGIES Outstanding Clinical and Human Histologic Outcomes with the PerioLase® Nd:YAG Laser Speaker: Raymond A. Yukna The Laser-Assisted New Attachment Procedure (LANAP™) using the Nd:YAG laser in a specific patented protocol has been evaluated as a single visit treatment of periodontal pockets with the goal of obtaining new attachment. Clinical success is supported by human histology showing new cementum and new connective tissue attachment. Then Monday at 10:15. CTS1: LASER APPLICATIONS: AN EVIDENCEBASED APPROACH TO CLINICAL PRACTICE 10:15 - 11:45 am Program Track: Treatment of Inflammatory Periodontal Diseases Moderator: Timothy P. Walsh Speakers: Bobby L. Butler, Henry Greenwell, George E. Romanos, Raymond A. Yukna Lasers have been used in dentistry for many years. Historically, lasers have been shown to be used primarily for soft tissue procedures. The clinical benefits of lasers have led to FDA clearance for numerous uses of such in periodontics and implant dentistry. Educational Objectives: • Understand different laser wavelengths and their interactions with hard and soft tissue, including the applications of varying wavelengths and treatment protocols to treat periodontitis. • Discuss tissue biotypes and case selections for open and closed crown lengthening. • Demonstrate long-term success for treating failing implants with lasers.

Hi, Janie, Just wondering how you made out with your consult. You're right on the mark about Millennium needing to have a more user friendly method of locating area dentists that perform lanap. I was wrong on the earlier number that I had given for Connecticut dentists. Millenium has an option for an individual to be e-mailed lanap dentists nearest your zip code. I had requested this after I had lanap for research purposes - plan to run an article on the procedure for an internal newsletter. Millenium provided four dentists in addition to the three I found on the internet and did not include the dentist that performed lanap for me, which is a real shame since he is such a great dentist. My dentist is not near where I live, but he was the second in this state to become certified and has been performing the procedure for six years. So Millennium, if you're reading, just post all the approved lanap dentists on your website. Gosh they're not performing an abortion or an illegal medical procedure. Anyway, I hope none of my previous posts relating to pain discourage future lanap patients. This pain is not related to lanap, but to a TMJ condition. I had an emergency appointment with my dentist today, and since he was out of the office, I saw his colleague. She examined my gums and teeth and confirmed that this is not related to gums or teeth based on her examination and my description of the pain. The dentist is confident that the pain level will continue to improve. I just have to say how wonderful my dentist is - he called me from home on his day off this evening to check on me and speak with me about my experience. Like, wow! He is patient and not wallet motivated and he truly cares about his patient's dental health. I am truly lucky that I landed in his office. Enjoy!

Hi Brenda, Thought it was high time I post back. I had a great consult with the LANAP D.D.S. He was great! Neither condescending, judgmental, nor self-important. He’s near my age, and when he walked in he introduced himself by his first name only. I liked him right then! ;D He spent a full 90 minutes with me, looking over x-rays, explaining the procedure, options for partials (not thrilled there), and patiently answering my questions. He did say my teeth looked really good, no build-up at the gum line on x-rays, no cavities. He said with the degree of perio disease I have (stage 4, shock!) he would expect to see some tooth issues. When I asked how my teeth could be so good but my gums bad he feels it is an aggressive bacteria strain in my gums. I am a smoker too. No mention of a smoker's tray came up (I forgot to ask). It's time to get serious about quitting. Know I'm just going to continue to have issues and others if I don't ditch this awful habit. So he fitted me for a partial last week. Wish there were more cosmetically attractive options in partials. Those that seem sturdiest have that metal ring that shows. I’ll have a temporary ‘flipper’ so have time to decide down the road. He concurred with my regular dentist that 4 of my upper front teeth are not salvageable, lack of bone. It's kind of demoralizing. When he made the tray mold he was super careful to not do anything that would cause that really loose front tooth to come out. It's not seated in bone at all, just holding on by a thread I guess. He did it himself, rather than hygienist. He used filling material to bond to adjacent tooth, then put a bit of wax in the gaps and coated with petroleum jelly first. He did a great job, tooth didn’t budge! Another bummer, I will not have beautiful "after" teeth like in all the 'smile' photos in the offices. Despite that, both dentists agree: save all the teeth I can. (Don't want dentures till it just can't be avoided.) I had been blessed with nice straight teeth, lucked out too, never needed braces like my siblings. Now they are shifty and gapped in front. He'll try to cosmetically fix what he can, fill in gaps. Bone grafts and implants are just not economically feasible. And he didn’t mince, there is possibility I may lose a tooth here or there as time passes. This is buying me hopefully another 10-15 yrs of my own teeth. (I’ll do my part to prolong it!) Guess anything is better than now, I avoid opening my mouth when I smile or laugh I'm so self-conscious. Next week I have LANAP scheduled 3 days apart. I asked for that time frame. He was going to do it further apart, but that would have meant a much longer time on antibiotics. This way I’m on a single round (I hope!). Don't do well with those, and avoid taking them at all costs. Haven't met one yet that didn't make me woozy, nauseated, just ill-feeling in general. Doxycycline is the one he'll use. Will stock up on yogurt before hand to avoid secondary infection. Dreading the round of antibiotics more than the LANAP. No mention of ibuprofen to be taken beforehand. If it hurts I'll ask him about the Rx you were given. I just want this infection out of my body! Pardon my grossness, but near the loose front tooth where I had the absess a couple weeks ago I see pus oozing now. *shudder* Dab it with peroxide on a q-tip when it appears, hurts there. It just turns my stomach to know that's in my gums. I'm rinsing often, switching between straight peroxide, baking soda or warm saltwater. Brush/floss several times a day. Tried using my new water pik but think it's defective. The darn head goes shooting off as soon as I turn it on, even tho it's seated correctly on the handle. If it wasn't so irritating when that happens it would be comical. ;) The infection is beginning to just drag me down physically, if that’s possible. My gums don't hurt as bad (I'm keeping my routine up and it brings relief). But past ten days or so I feel it between my ears. Almost like fluid or an earache, but not quite. Also have general malaise, very slight nausea at times, just overall feeling under the weather. Maybe a low grade fever (haven't checked temp). I am in good general health, rarely get ill, but this past week find I need a nap during the day. Sleeping when the sun is up seems like such a waste of perfectly good daylight, but that's how run down I feel. Suppose that’s getting in my bloodstream so a severe gum infection can cause this?? This will be my last post I bemoan my situation. Pain symptoms came on so suddenly, am still in the ‘absorbing it all phase’. Know there are many out there with little to no options. We struggle for sure, but am blessed I can have this opportunity. Insurance will cover almost half, the other half I financed through a medical credit card, if paid off in a year there is no interest. I hope travel will not be impeded? I plan to have about ten days recovery time and take a trip for two weeks. I've been so looking forward to it. A break from other big stressors of this year. I hope between the LANAP and partial I do alright, and certainly hope any ill effects from antibiotics are gone by then! I’ll keep you posted, for benefit of any potential LANAP patients reading!

Hi, Janie, I'm glad you've seen a LANAP dentist and I'm sorry to hear about your discomfort and his diagnosis. I am not a dentist, but do you absolutely need to have your teeth pulled? I have severe bone loss in several teeth and the LANAP dentist did not pull my teeth - did not even recommend pulling teeth. Get another opinion - ask the dentist about the possibility of a splint. He will shave your teeth after lanap, which will tighten the tooth. You wrote in an earlier post that you have pocket depths of 2 to 9. Several of my teeth were measured with 10s, 11s, and 12s. I echo again - none of my teeth were pulled, except a molar by my regular dentist who doesn't believe in lanap. The lanap dentist didn't think that was necessary. This dentist should have put you on antibiotics immediately. Yeah, the side effects sucks, but you have an active infection that your immune system is unable to eliminate. Your malaise could be related to the infection, but it may also be related to the stress (depression) about your dental situation. Have you ever heard the expression "What you think about, you bring about." Your body has a natural ability to heal itself, you just have to believe it, live it. Do some research on the law of attraction. In my early twenties, my dentist tested my saliva and found that I carry the bacteria that was identified to cause periodontal disease. He pretty much gave up all hope then - it was just a matter of when. That negative attitude resonated with me throughout my dental history. But my attitude has now changed - my new dentist believes that I will have my natural teeth the rest of my life and so do I!!!! Please keep us posted so that we can support you and help keep you positive!

I was just recommended LANAP by my dentist because I have a lot of pockets around 4-6 and scaling in their office didn't seem to work. I know it's expensive, but the cost seems to vary by thousands of dollars ($3k - $10K, from what I've seen). Did any of you get more than one consultation/cost estimate before signing up for the procedure? Why is there such a cost delta? Also, does anyone else know how insulin resistance, PCOS or pre-diabetes affects or contributes to gum disease?

Rebecca, Click on my name, then click on LANAP and your health, then cost of gum surgery. If you have any questions after seeing those pages let me know. Hope this helps, John

Cavitron cleaning and extraction of two teeth were far more painful than than the laser. Dr. Louis Yang in Torrance is extremely diligent, hardworking, and is a well-informed state-of-the-art professional. For the LANAP procedure, you will be totally satisfied. No pain guarantee, but pain is certainly 80% less than conventional curettage. Happily healing, robin