Most people sent for gum surgery picture the same thing: the gums cut open, folded back, and stitched closed again. That picture is why a lot of periodontal disease goes untreated for years. LANAP uses a laser to treat gum disease instead of a scalpel, and for the right patient it is a far more comfortable way to get the disease under control. It is one of several gum disease treatments we offer, and it isn’t the right one for everyone.
What Is The LANAP Procedure?
LANAP stands for the Laser-Assisted New Attachment Procedure. It’s an FDA-cleared laser therapy performed with the PerioLase MVP-7, an Nd:YAG dental laser operating at a wavelength of 1064nm, developed by Millennium Dental Technologies, and it is the only laser protocol cleared for true regeneration of the attachment lost to gum disease. The LANAP protocol is a minimally invasive laser alternative to conventional gum disease treatment, not an adjunct to it.
The whole approach rests on one property of this particular laser: it is soft tissue selective. At this wavelength the laser energy is drawn to pigment, and diseased tissue in a periodontal pocket is darker than the healthy gum tissue beside it. So the laser removes bacteria and diseased tissue from the pocket lining while leaving healthy gum, the granulation tissue your body needs for healing, and the blood vessels and nerve endings intact. A scalpel cannot make that distinction. It cuts what it touches.
How Laser Gum Surgery Compares To Traditional Gum Surgery
Traditional periodontal surgery works. We still perform it, and for some cases it remains the right answer. But it has three limitations that matter to patients:
- The gums are cut and reflected, then closed with a suture, so there is a real recovery period
- Interdental papillae, the small triangles of gum between the teeth, are frequently lost, and gum recession follows
- Sensitivity, food packing between the teeth, and increased tooth mobility are common afterwards
There is also a limitation nobody puts in a brochure: patient acceptance is low. A meaningful number of people told they need periodontal surgery simply don’t book it, and their disease progresses in the meantime.
Laser periodontal therapy addresses all four. The benefits of LANAP that matter most in practice are simple: no cutting, no stitching, less recession, and many patients back to normal activity the next day. As an alternative to traditional gum surgery, this laser treatment removes the barrier that stops people getting treated at all.
What Happens During The LANAP Procedure
The laser fiber on the PerioLase MVP-7 dental laser is about the width of three human hairs, and it goes into the periodontal pocket rather than through the gum. The laser technology does the work a blade would otherwise do, which is what makes this a very different dental procedure from the one most patients are picturing.
- Measurement. We record pocket depth around each tooth so there is a baseline to measure against later.
- First laser pass. The laser fiber is placed into the pocket and used to remove diseased tissue and bacteria from the pocket lining.
- Cleaning the root surface. Ultrasonic instruments remove calculus and deposits from the root surface, which is what the bacteria were living on.
- Second laser pass. The laser is used again at a different setting to form a stable clot at the base of the pocket, sealing it closed against re-infection.
- Bite adjustment. The bite is adjusted so no tooth is taking excessive force while the attachment heals.
There are no incisions and nothing to remove afterwards. This laser procedure is done under local anesthetic, usually across two visits treating half the mouth each time.
Does LANAP Actually Regenerate Bone And Attachment?
This is the question worth being careful about, because it is where marketing and evidence tend to part company.
Nd:YAG energy penetrates 9 to 14mm, which is deep enough to disinfect the pocket, the remaining calculus, the soft tissue, the cementum and the dentin, without the thermal injury that would destroy the granulation tissue. A disinfected pocket with its granulation tissue intact is the condition under which new attachment can form. That’s the mechanism.
The human histology behind it is genuinely limited but real. Yukna’s 2007 split-mouth study was the first histological report in humans: six pairs of single-rooted teeth, one side treated with scaling and root planing and the other with the Nd:YAG protocol. At three months, five of the six laser-treated teeth showed new cementum and connective tissue attachment. Nevins followed in 2012 with eight patients and twelve teeth classified as hopeless, evaluated at nine months. Of the ten teeth examined, four showed regeneration, one showed new attachment, and five showed long junctional epithelium.
So the honest position is that regeneration following LANAP is documented, it does not happen in every case, and the authors themselves concluded more histological study is needed. What we tell patients is that LANAP treatment can regenerate bone and connective tissue attachment in a proportion of cases, that we cannot promise which cases, and that arresting the disease and keeping the tooth is the reliable outcome.
Who Is A Candidate For LANAP?
Laser gum surgery is not a treatment for gum disease in its early stages. Gingivitis and mild cases are managed with cleaning and hygiene, and where pockets are shallow, scaling and root planing can do just as well. LANAP is a treatment for moderate to severe gum disease, and it is particularly worth considering if any of these apply to you:
- Pockets deeper than about 5 to 6 millimeters, where deep cleaning alone often can’t reach the bottom
- Moderate to severe periodontitis with established pocket depth and bone loss
- Refractory periodontitis, meaning disease that has come back after previous periodontal treatment
- Teeth another practice has classified as hopeless
- A high smile line, where any recession from conventional surgery would show
- A thin gum biotype, which recedes more readily after being cut
- Anticoagulant therapy, since the laser achieves hemostasis without a clotting cascade
- A strong preference to avoid cutting and stitching, whether from anxiety or on principle
That last one is not a soft reason. A patient who declines conventional surgery and keeps their disease is worse off than a patient treated with a laser.
Recovery And What Comes Afterwards
Most patients describe considerably less discomfort than they expected and return to normal activity the following day. Some tissue shrinkage as inflammation resolves is normal, and where bone has already been lost, that shrinkage can reveal spaces between the teeth that the swelling was hiding. We would rather tell you that before treatment than have you discover it after.
Two aftercare points matter more than people expect:
No probing for a year. The new attachment forming at the base of the gum pockets is fragile while it matures, and a hygienist putting a probe into it can disrupt it. Cleanings continue, above the gum line only. Tell your hygienist you have had LANAP.
The restorative sequence has a timeline. Mobile teeth should be splinted, and decay and root canal treatment completed, before the procedure. Afterwards, the bite is equilibrated, a night guard is made where indicated, final restorations are placed at around six months, and orthodontics can begin at four to six months. Your restoring dentist and this practice need to be working from the same plan. LANAP doesn’t make periodontitis go away for good. As with conventional gum surgery, pockets can come back years later, especially without regular maintenance, and when they do, they can be treated again.
What Affects The Cost
Cost varies by how much of the mouth needs treating and how advanced the disease is. The factors:
- How many quadrants are treated, and whether the whole mouth or part of it
- The severity of bone loss and pocket depth at the start
- Whether splinting, occlusal adjustment or a night guard is needed alongside it
- Whether any teeth need extraction and replacement regardless
- The maintenance schedule afterwards
Insurance often covers treatment of periodontitis, though coverage for the laser protocol specifically varies by plan, and we’ll check yours before you commit to anything. We’ll give you an exact cost as part of your treatment plan at your consultation.
Schedule A Consultation
If you’ve been told you need gum surgery, or you’ve had scaling and root planing and the pockets are still there, it’s worth finding out whether laser periodontal therapy is an option for you. We’ll measure your pockets, review your radiographs, and tell you plainly what we think is achievable, including when we don’t think LANAP is the right answer.
Call our office at (347) 493-2439 or schedule your consultation online.
Frequently Asked Questions
What Does LANAP Stand For?
Laser assisted new attachment procedure. You will also see it written as LANAP laser gum surgery or laser periodontal treatment, and hyphenated as laser-assisted. They all describe the same protocol.
Does LANAP Really Work?
For arresting moderate to severe periodontitis, yes, and that is well established. For regenerating lost bone and attachment, it works in a proportion of cases, documented in human histology by Yukna in 2007 and Nevins in 2012. Any practice promising regeneration in every case is going beyond the evidence.
Does LANAP Regrow Gum Tissue?
It’s more accurate to say it regenerates attachment, the connection between tooth and bone, rather than regrowing gum you can see. Gum tissue that has already receded is a separate problem, treated with a gum graft or the Pinhole Surgical Technique.
Is LANAP Painful?
It’s done under local anesthetic, and most patients report less discomfort afterwards than they anticipated. There are no sutures and no surgical site to keep clean.
Who Is Not A Candidate For LANAP?
Patients with only gingivitis or mild disease, who don’t need it. Teeth with bone loss too advanced to hold regardless of technique. And cases where the anatomy calls for conventional surgical access. We’ll tell you honestly which category you’re in.
How Long Do Gums Take To Heal After LANAP?
The surface settles within about a week. The attachment underneath takes up to a year to mature, which is the reason for the no-probing rule.
Will Insurance Cover LANAP?
Periodontal treatment is usually a covered benefit. Whether your plan reimburses the laser protocol at the same rate as conventional surgery depends on the plan, and we’ll verify it for you beforehand. See our accepted dental insurance plans.
Is LANAP The Same As A Deep Cleaning?
No. Scaling and root planing cleans the root surface. LANAP does that too, but adds removal of the diseased pocket lining and the sealed clot that lets new attachment form.
Do You Need A Specific Laser For LANAP?
Yes. The protocol is only performed with the PerioLase MVP-7 laser, and clinicians have to be trained and certified on it. A practice offering “laser gum treatment” with a diode laser is doing something different, whatever it is called.
Can LANAP Treat Infection Around A Dental Implant?
LANAP is a protocol for natural teeth. Infection and bone loss around a dental implant, called peri-implantitis, is a different problem with its own treatment. See our page on peri-implantitis treatment.
Who Performs LANAP At Your Practice?
All our periodontists are trained in the LANAP protocol through the Institute for Advanced Laser Dentistry, the body that certifies clinicians in this protocol.
