As a dental professional, one of the most common emotions I encounter in my office is anxiety. Specifically, the anxiety surrounding the treatment of gum disease. For decades, the standard treatment for moderate to severe periodontal disease involved scalpels, sutures, and a recovery period that many patients found difficult. It is no wonder that so many people put off necessary care.
However, dentistry has evolved significantly. In my practice, I have embraced advanced technology to make your journey to oral health smoother, faster, and much more comfortable. If you have been told you need periodontal treatment, you might have heard about a procedure called LANAP surgery.
I am Dr. Steven Rifkin, and today I want to walk you through exactly what to expect from this revolutionary laser gum treatment. My goal is to demystify the process so you can feel confident and empowered about saving your teeth.
Why I Choose Laser Dentistry for My Patients
Before we dive into the step-by-step details, it is important to understand why this technology is a game-changer. LANAP stands for Laser Assisted New Attachment Procedure. Unlike traditional osseous surgery, which often requires cutting the gums to access the root surface, LANAP uses a specific wavelength of light to target the disease.
In my experience treating patients, the difference in their reaction is night and day. With traditional surgery, patients often brace themselves for a week of discomfort. With LANAP surgery, many of my patients go back to work the very next day. It allows me to target the bacteria causing the infection without harming the healthy gum tissue. This preservation of healthy tissue is vital for the long-term stability of your teeth.
The Consultation: Where It All Begins
Your journey starts before the actual procedure day. When you come into my office for a consultation, we will take digital X-rays and use a small probe to measure the pockets between your teeth and gums. In a healthy mouth, these pockets are shallow. When gum disease (periodontitis) sets in, these pockets deepen, trapping bacteria and tartar that you cannot reach with a toothbrush.
During this visit, I look for signs of bone loss and inflammation. If I determine that you are a good candidate for laser treatment, we will discuss the specific benefits for your case. I believe in total transparency, so we will also go over your medical history to ensure there are no contraindications.
The Day of the Procedure: Step-by-Step
Many patients ask me, “Dr. Rifkin, what does it actually feel like?” The honest answer is that it is remarkably uneventful for most people. Here is a breakdown of what happens when you sit in the chair for your LANAP surgery.
1. Local Anesthesia
Just like getting a filling, I start by numbing the area. Your comfort is my top priority. While the laser itself is not painful, we need to ensure you don’t feel anything while I am working around the roots of your teeth. Because the procedure is so much less invasive than traditional cutting, the amount of anesthesia required is often less, and the “numb” feeling wears off more comfortably.
2. The First Pass of the Laser
Once you are comfortable, I use the PerioLase MVP-7 instrument. This is a tiny optical fiber, about the thickness of three human hairs. I insert this fiber gently between the gum and the tooth. This is the first pass.
The laser energy is specifically designed to target darker pigments. Since the bacteria that cause gum disease and the diseased tissue are darker in color than your healthy pink gums, the laser selectively vaporizes only the infection. It leaves your healthy tissue intact. This step also helps to kill the bacteria deep inside the pocket.
3. Cleaning the Roots
After the laser has removed the diseased tissue and bacteria, I use ultrasonic scalers. These are small instruments that vibrate to loosen and remove the hard tartar (calculus) from the root surfaces. Because the laser has already done the heavy lifting of opening up the pocket and killing bacteria, this cleaning process is very thorough.
4. The Second Pass of the Laser
This is the step that makes LANAP surgery truly unique. I go back in with the laser for a second pass. This time, the goal is not just cleaning, but healing. The laser warms the stem cells in the bone and creates a sticky seal of blood specifically around the tooth.
This clot is crucial. It acts as a natural band-aid, sealing the gums against the tooth root. This creates a closed environment where your body can start to regenerate bone and tissue without new bacteria getting in.
5. Compressing the Tissue
Finally, I gently compress the gum tissue against the root surface. Unlike traditional surgery, I do not need to use sutures (stitches) in the vast majority of cases. The natural fibrin clot created by the laser holds everything in place.
Recovery: The First 24 Hours
The immediate recovery is where my patients are usually the most surprised. When the anesthesia wears off, you might expect significant pain, but most patients report only mild discomfort. This can typically be managed with over-the-counter medication like Ibuprofen.
Because there are no incisions and no stitches, you won’t have the swelling or bleeding associated with cutting the gums. However, you might notice a slight change in the color of your gum tissue immediately after; it may turn white or gray initially. This is perfectly normal and is just a sign of the healing clot.
Important Note on Oral Hygiene: For the first 24 hours, you should not brush or floss the treated area. We want that blood clot to stay stable. I usually prescribe a special antimicrobial rinse to keep the area clean without mechanical disturbance.
The First Week: Diet and Care
During the first week following your LANAP surgery, your diet will need to change. This is perhaps the most challenging part for some patients, but it is temporary and essential for success.
I recommend a “mushy” diet. Think about foods that require no chewing or can be swallowed easily. This prevents food particles from dislodging the seal we created. Great options include:
- Yogurt and cottage cheese
- Scrambled eggs
- Smoothies (avoid using a straw, as the suction can disturb the clot)
- Mashed potatoes
- Applesauce
You will need to avoid anything crunchy, spicy, or very hot. No chips, nuts, or popcorn. After about a week to ten days, I will usually clear you to start introducing soft solids back into your diet, like pasta or fish.
Long-Term Healing and Regeneration
One of the most exciting aspects of this treatment is what happens beneath the surface months after you leave my chair. Traditional surgery is often “resective,” meaning we cut away tissue to reduce pocket depth. While effective, this can lead to gum recession and sensitive teeth.
LANAP is “regenerative.” This leads me to a critical data point that highlights why I advocate for this method.
Data Point 1: According to studies and FDA clearance data, LANAP is the only laser protocol scientifically proven to achieve true periodontal regeneration. This means it creates new cementum, new periodontal ligament, and new alveolar bone on a previously diseased root surface.
This regeneration doesn’t happen overnight. It takes your body months to rebuild that bone structure. During your follow-up visits, we will monitor this progress. You might not “feel” the bone growing, but over time, your teeth will become more stable, and the deep pockets will shrink as the gums reattach naturally.
Addressing the Prevalence of Gum Disease
If you are reading this and feeling embarrassed about needing surgery, please know you are not alone. Gum disease is incredibly common, and it is not always just about brushing habits; genetics and other health factors play a role.
Data Point 2: The Centers for Disease Control and Prevention (CDC) reports that approximately 47.2% of adults aged 30 years and older have some form of periodontal disease. That number jumps to over 70% for adults 65 and older.
By seeking out LANAP surgery, you are taking a proactive step that nearly half the population needs. You are prioritizing your total body health, as gum disease has been linked to heart disease, diabetes, and other systemic issues.
For more in-depth information on the link between gum health and systemic health, I recommend reading this article from the American Academy of Periodontology. It explains why treating your gums is about much more than just your smile.
Comparing LANAP to Traditional Surgery
To help you visualize the difference, I often use this comparison in my office. Imagine you have a splinter deep in your finger that is causing an infection.
- Traditional Surgery: We would make a cut in the finger to open it up, remove the splinter, clean out the infection, and then stitch the finger back together. It works, but it hurts, and you might have a scar.
- LANAP Surgery: We use a special light to vaporize the bacteria and infection around the splinter, slide the splinter out, and then seal the finger back up with a natural clot. The finger stays intact, looks the same, and heals faster.
While this is a simplified analogy, it captures the essence of why patients prefer the laser approach. There is less recession (gum shrinking), less sensitivity to cold and hot temperatures post-surgery, and a much lower risk of post-operative infection.
What About the Cost?
I know that cost is a major factor for my patients. Generally, the cost of laser surgery is comparable to traditional surgery. While the technology is more advanced, the time I spend with you is often more efficient. Furthermore, because the recovery is faster and requires fewer prescription medications, the “hidden costs” of missed work and post-op care are often lower.
Most dental insurance plans provide coverage for periodontal treatment regardless of the method used (laser vs. scalpel). In my office, we always check your benefits beforehand so there are no surprises.
Is LANAP Right for You?
While I am a huge proponent of this technology, it is not a magic wand for every single dental issue. It is specifically designed for moderate to severe gum disease. If you have perfectly healthy gums but just need a cosmetic adjustment, or if you have a different type of oral infection, different treatments might be required.
However, if you have been told you have “deep pockets,” if you have noticed loose teeth, or if you have bleeding gums that do not improve with better brushing, you are likely a prime candidate. Even patients who take blood thinners or have diabetes—who might be risky candidates for traditional surgery—can often undergo LANAP surgery safely because of its hemostatic (blood-stopping) nature.
Moving Forward Toward Health
I hope this guide has helped alleviate some of the fear associated with gum surgery. In my career, I have seen too many patients lose teeth simply because they were afraid of the treatment. With modern laser protocols, that fear no longer needs to be a barrier.
The technology is precise, the recovery is manageable, and the results can save your natural teeth for a lifetime. If you are experiencing symptoms of gum disease, do not wait until it hurts. The earlier we catch it, the more predictable the outcome.
I am Dr. Steven Rifkin, and I am here to help you achieve the healthy smile you deserve. Let’s get your oral health back on track, comfortably and effectively.
