What Is Gum Disease?

Gum disease, including gingivitis and periodontitis, is a chronic bacterial infection. Gum disease is caused by plaque, which creates toxins that damage the gums. In the initial stages of the disease, gums can become red, swollen and bleed easily. 

However, some patients have no symptoms at all. If the condition worsens, gums and bone that support the teeth can become seriously damaged and the teeth can become loose, fall out or have to be removed.(1)

How do I know if I have gum disease?

Most patients don’t realize the signs of gum disease and symptoms are not painful, so gum disease often goes undetected or ignored until severe gum and bone destruction catches an individual’s attention. Other signs can include “pink in the sink” – traces of blood when you brush or floss, gums that are red or swollen, and bad breath. Read more about gum disease causes here.

How do you get gum disease?

Gum disease has several risk factors: smoking, age, genetics, gender, and ethnicity all are important indicators. Since gum disease is a bacterial infection, it is also communicable – meaning a person with gum disease can pass the infection to others.

How prevalent is gum disease in the United States?

According to the U.S. Surgeon General, the condition affects 85 percent of American adults aged 18 and older and moderate to severe forms of gum disease affect 74 percent of the adult population.(2) Although experts vary in their estimation of the prevalence of gum disease, it is clearly one of the most common conditions in the United States. Fifty out of every 100 adult Americans have moderate to severe gum disease, 40 out of the 50 do not know it, and fewer than two of them will get treated before it’s too late.3

What is the traditional treatment option for periodontal disease?

Gum disease can be mild, moderate and severe. It also can be localized to one area of the mouth or generalized spread throughout the mouth. 

Traditional treatment options for mild disease is a deep cleaning, where the patient is anesthetized prior to this cleaning.

Moderate and Advanced periodontal disease stages have two treatment options: A traditional Surgery (after the deep cleaning) and a scalpel free laser procedure.

The traditional option involves the surgery concepts that we are all familiar with. Trimming of the gums and bone infected before suturing, and sometimes addition of bone grafts to fill defects. Our Periodontist at Envision Dental is an expert on this procedure. This traditional approach is a ressective treatment where the diseased tissues are removed either because they didn’t respond to conventional therapy or because the disease had spread too much further into the tissues.

The Scalpel Free, Laser Option is called LANAP (Laser Assisted New Attachment Procedure)

It is not a ressective surgery. It treats and neutralizes the infections and most of the time the patients end up with more and healthier tissues. In some instances we even notice bone regeneration where the patient’s own bone fills the gaps without grafts.  

What is the LANAP protocol?

The LANAP protocol, a laser periodontitis treatment, is the first and only specific periodontal protocol to receive FDA clearance for “true regeneration” and has been in widespread use by the dental community for many years. The LANAP protocol is typically performed in a dentist’s office under local anesthesia. 

Prior to the procedure, the dentist does a periodontal charting and takes X-rays to make a paper diagnosis and determine the extent of the disease . A tiny laser fiber is inserted between the tooth and the gum, and the infection and disease are cleared away without cutting the gums. 

The tooth roots are then thoroughly cleaned  and the laser is used again with a different setting to create a stable, firm blood clot to seal the pocket. The dentist treats one half of the patient’s mouth at each session or the whole mouth in one day.

What are the benefits of the LANAP® protocol in the treatment of gum disease? AND Who is a candidate for LANAP laser surgery?


Patients with moderate-to-severe gum disease can especially benefit from the LANAP protocol. The LANAP protocol is an excellent treatment option for patients who are fearful of conventional scalpel surgery. Oral sedation is also available if patients are anxious.

Do I have to stop taking my medication for LANAP laser surgery?

Because of the unique properties of the PerioLase laser wavelength, patients on blood thinners or with aspirin regimens do not have to stop taking any medications. Smoking is extremely discouraged. This would be a great time to quit!!!

Some of the primary benefits of LANAP laser surgery as compared to traditional surgery are:

  • Less pain
  • Less bleeding
  • Less sensitivity
  • Less gum loss
  • Less swelling
  • Very little downtime after treatment
  • Less Post-op infections
  • Promotes regeneration of supporting gum tissues
  • Healing is perceived to be faster and more comfortable than conventional surgery

Who can perform the LANAP® protocol to treat patients with gum disease?

Only LANAP certified dentists can perform the LANAP protocol.

What should I expect after LANAP treatment?

After LANAP treatment, your gums may be sore for a few days. Generally, the discomfort can be managed with over-the-counter medications like ibuprofen. Opioids are rarely needed.  You will be on a liquid/soft diet for two weeks to help keep your teeth stable during initial healing.  Bone can continue to regenerate for 18 months through 3 years.  During this time your LANAP clinician will schedule regular visits to adjust your bite and check your healing progress.

What training does my LANAP trained doctor have?

All dentists certified to perform the technique are required to complete Laser BootCamp®, a comprehensive hands-on, dentist-to-dentist training at the Institute for Advanced Laser Dentistry (IALD).

This training ensures that doctors are skilled and competent to perform the LANAP protocol on live patients upon return to their clinical practice offices. Laser BootCamp represents the training curriculum to be completed over a one-year period. At the conclusion of all days of training, the clinician is awarded a LANAP Proficiency certificate.

Can any laser be used for the LANAP protocol?

Only the PerioLase MVP-7 is designed to support the parameters of the LANAP protocol. If your dentist does not have the PerioLase MVP-7, then your dentist cannot perform LANAP surgery.

Will insurance companies cover the LANAP protocol?

Like with any disease condition, insurance companies usually have coverage for treatment. Periodontal disease treatment is covered by most insurance carriers, but varies by carrier and clinician. Speak with your doctor about your coverage plan.

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Sources“Periodontal Gum Disease FAQ,” American Dental Association:

  1. http://www.ada.org/3063.aspx?currentTab=1#faq
  2. http://www2.nidcr.nih.gov/sgr/sgrohweb/chap3.htm.
  3. http://www.dent.ucla.edu/bio/bio.asp?id=277 21-00-026 – Rev. A 10/23/09