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There are many different areas of our day to day lives that have been improved by lasers. The treatment of periodontitis (aka gum disease) has been revolutionized by advances in laser technology. Laser gum surgery is a reasonably new procedure that is quickly amassing a reputation as one of the best ways to treat the disease.
To ensure our patients have complete peace of mind when they visit Dr. Choi, we have compiled a comprehensive guide to periodontitis and laser gum surgery for your convenience.
Dr. Choi and his team are more than happy to answer any questions you may have regarding any aspect of your dental health. Feel free to give him a call at (214)592-0692 for a no pressure chat to see if laser gum surgery is the right treatment option for you.
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Periodontitis is the technical term for what is more commonly known as the second stage of gum disease. It is a degenerative condition that specifically attacks the soft tissues of the gums and the underlying bones that hold your teeth in place. Gum disease is mainly something that effects people in their 30’s and 40’s, but it can strike anyone of any age.
There are many causes of gum disease, some of the more common ones are:
However, despite there being several potential causes, poor oral hygiene is by far the most common cause of the disease. Plaque naturally builds up on our teeth over time. A proper dental hygiene routine removes this plaque before it becomes an issue.
If the plaque is not removed, the bacteria inside it multiply and cause what we know as gum disease. To further add to the complications, if plaque is not removed, it turns into tartar. Tartar has a rough surface which promotes the build-up of even more plaque. The cycle often continues getting progressively worse over time.
Many people who have gum disease are unaware that they have the condition at all. It is often painless, and discomfort resulting from the disease directly is uncommon. However, there is a long list of symptoms that can easily be spotted to diagnose the condition:
There are 3 stages to gum disease: gingivitis, periodontitis, and advanced periodontitis. Each is more severe than the last.
When gum disease reaches the periodontitis stage, irreversible damage is being done to the body. The tissue that is holding the teeth in place (and the supporting bone structure) is being degraded and weakened. Indentations start to form at the bottom of the teeth. These indentations are food trap and promote plaque build-up beneath the gum line. At this stage, gum disease can only be treated by a dentist.
If left untreated, the gum disease can progress to advanced periodontitis which starts to create more severe issues. The damage that was being done to the tissue and bone is massively increased, and they are both now starting to be irreversibly destroyed. Teeth will become very loose, and tooth loss is usually immanent.
Laser gum surgery, aka Laser Assisted New Attachment Procedure (LANAP) is the latest treatment option for people with periodontitis. The inner workings of the procedure are highly complex, but here we will give a general overview of what patients can expect to take place:
The first step in the process aims to remove the bacteria that is located at the base of the tooth in question. This is done through the use of a high-powered dental laser with extreme precision. The laser is incredibly small and is the thickness of three human hairs. This precision allows for the dentist to only target the affected areas, minimizing damage to healthy tissue.
Once the dentist is able to access the root of the tooth, the scaling procedure can then begin. This allows the dentist to remove the plaque and tartar that has built up below the gum line (which is causing damage to the tissue and bone). This is conducted with a precision ultrasonic tool.
Once the dentist is confident that all the plaque has been removed, a smoothing procedure begins. This part of the process is aimed at reducing the amount of future plaque build-up that may occur by removing rough spots (that are inherently susceptible to build up). This greatly reduces the risk of future infection, provided that the patient maintains a proper dental hygiene routine.
Once the cleaning and smoothing have been completed, the dentist will seal the area that has been worked on. This is done with a laser to create a small blood clot using the stem cell containing blood that surrounds the area being worked on.
When complete, this clot creates a natural barrier, which will prevent germs and bacteria causing infection. After this has been done, the patient will be free to leave immediately. The non-invasive nature of LANAP means that minimal discomfort will be felt after the procedure.
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Traditionally, before laser gum surgery, there were two main methods dentists used to treat Periodontitis.
Scaling and root planing (commonly known as SRP) was one of the methods. This involves the dentist performing a thorough deep cleaning of the teeth, paying special attention to the areas uncovered by receding gums. This stops the build-up of plaque and tartar, and with a proper dental hygiene routine, can allow for regeneration of the gum tissue. This method can only be used in certain cases, in advanced stages of the disease it is often not a viable treatment option.
The other treatment method that is traditionally used is gum flap surgery. This is a surgical procedure that involves the dentist making incisions into the gums above each tooth. The dentist then cleans underneath the gum flap that has been cut, and re-attaches the gum. This procedure is much more invasive than SRP or LANAP and comes with a reasonably long recovery time. As such, gum flap surgery is reserved for the most serious stages of the condition.
WHAT ARE THE BENEFITS OF LANAP?
The main reason that LANAP is causing such a storm in the dental world is because of the numerous benefits it provides over the other traditional methods of treating periodontitis. Here we will list just some (of the many) benefits patients can expect to receive.
Some of the other treatment options for the disease are much more invasive and can cause some discomfort. Due to this, general anesthesia has previously often been required when treating periodontitis.
Furthermore, due to the precision nature of LANAP causing minimal discomfort for the patient, general anesthesia is not required and a local anesthetic is used instead. This means that once the procedure is completed, you are free to go about your day as per usual (instead of feeling sluggish and sleepy). This makes it perfect for people who have busy schedules that need to be able to speak and function normally soon after the procedure.
When treating Periodontitis with LANAP, patients are exposed to much less discomfort during the procedure than would be experienced with traditional treatment options. The lack of cutting (that would be required for gum flap surgery) means no uncomfortable invasive sensations will be experienced during the procedure.
After the procedure, discomfort is also dramatically reduced. Because no incisions are being made during LANAP, the body is able to naturally heal quicker and easier. This results in much less swelling and bleeding than traditional treatment methods (although some bleeding and swelling is to be expected).
Because the lasers are able to target the infected areas with pinpoint precision accuracy, the amount of damage that is done to tissue is drastically reduced compared to other surgeries. This combined with the fact that there are no incisions to recover from means that patients recover quickly. Patients who receive LANAP treatment are able to fully heal in time frames that in the past would have been impossible.
We believe in complete transparency when it comes to our patients treatment options. We feel the need to make our patients aware of the information below.
As we mentioned at the very start of this page, LANAP is an incredibly new treatment option that is very much still in its infancy compared to other treatment methodologies. As such it is still not recognized by The American Academy of Periodontology (AAP) as a proven method of treatment. They state on their website that:
“At this time, there is insufficient evidence to suggest that any specific laser wavelength is superior to the traditional treatment methods of the common periodontal diseases, such as periodontitis.”
Despite not being officially recognized by the AAP, there is no evidence to suggest that they are against the procedure that we are aware of. While recognition is seemingly a matter of time, the procedure is in our opinion is too new to get the AAP’s stamp of approval. Despite this, countless laser gum surgery procedures are conducted on a daily basis across the country, and evidence of success is growing by the day.
If you think you might have some symptoms of gum disease, you should book an appointment with Dr. Choi as soon as possible. The severity of the condition worsens with time. The longer you leave the issue, the greater the risk of irreversible damage.
It is important to remember that most cases of gum disease are caught and treated within the gingivitis stage. This means no invasive surgery (or LANAP) is required, and a good cleaning combined with an improved dental health routine can treat the condition. However, without a professional examination, it is not possible to determine how far the condition has progressed. If you feel you are experiencing symptoms of gum disease call Dr. Choi immediately at 214-592-1630.
In the vast majority of cases, your insurer will cover laser gum surgery. This is because dental insurers provide coverage for the procedure (periodontitis treatment), as opposed to covering the tools used for the treatment (the laser). The way the dentist treats your periodontitis is of no consequence to most insurers. Nearly all patients will find themselves covered for LANAP. That being said, we always strongly recommend you contact your insurance company before undergoing any form of dental procedure (including LANAP) to double check you have sufficient coverage for the treatment.
The amount of time LANAP treatment takes varies from patient to patient. The severity of the infection is the main determining factor. Because LANAP is a whole mouth procedure, it is usually completed in two or more visits with around a week of healing time in-between. One side of the mouth will be completed on the first visit, and the other side of the mouth will be completed on the second visit. Dr. Choi will be able to give you accurate timeframes after he has conducted a full dental examination and gives his assessment.
This is the most common concern that many people have when they hear about laser gum surgery. The idea of having high-powered lasers pointed at your gums is understandably something that can cause anxiety.
As we mentioned previously, general anesthesia is not required for this procedure because it is nearly entirely painless. You may feel a slight warmth when the laser is doing its job, and a slight tingling sensation in the tooth during other parts of the procedure. But apart from this, there will be no discomfort or pain at all. It is one of the most peaceful surgical options dentists have at their disposal. Many patients are surprised at just how easy the procedure is.
After you have had laser gum surgery, there are several things you should do to ensure your body has the best chance of a speedy recovery (and to reduce the risk of infection). The most important thing to do is to not smoke. Smoking drastically reduces your bodies capability to heal. It can result in the healing process being delayed, which in turn increases the risk of infection.
Most people are advised to not brush or floss their teeth for 7 to 10 days after the procedure. Dr. Choi will advise each patient individually on this, as this is not a one size fits all piece of advice. It is also recommended that you avoid eating hard or sticky foods for the first few days after treatment. Try and eat a soft diet if possible, to help the healing process along.
Full recovery times vary from individual to individual. LANAP is a surgical procedure and as such, some healing time is to be expected. For the first 3 to 4 days after the treatment, most patients will notice some swelling, and possibly a little discomfort. This is totally normal and to be expected. However, if you are concerned about swelling you should immediately contact Dr. Choi who will be able to advise you on your specific situation. The discomfort can often be removed by over the counter pain medication like Ibuprofen.
The cost of LANAP varies dramatically from patient to patient. Several factors need to be taken into account, and as such cost is calculated on a case by case basis. It is not possible to give an accurate quote without a full dental examination to identify the severity of the issue.
This is a question that can only be answered after a consultation and dental examination with Dr. Choi. LANAP is a powerful treatment option that is applicable to the majority of periodontitis cases. However, there may be situations where one of the other traditional treatment options are more suited to your individual case.
In our opinion, the AAP not recognizing LANAP as a viable treatment option is a temporary situation. We fully expect them to approve and recognize the treatment in the near future. Countless LANAP procedures are conducted across the country each and every day. The real world evidence for the procedure’s efficacy is becoming greater by the day.
We feel it is important to point out that the AAP has not said anything negative about the surgery that we are aware of. It is seemingly an issue that is derived from a lack of evidence due to the technology (and the treatment) being so new. All dental lasers that Dr. Choi uses have been FDA approved, and have been issued 501(k) clearances.
That being said, it is the patient’s responsibility to decide if they are comfortable undergoing a treatment option that is not recognized by the AAP. Traditional treatment options are always available if that is a patient’s preferred choice.
Dr. Choi and his team fully understand that many people feel a little (or a lot) of anxiety when it comes to dental treatments. The combination of noisy drills, the bright lights, and a dentist poking around in your mouth is understandably uncomfortable for many people.
Dr. Choi prides himself on being one of the most compassionate and caring doctors in the whole state of Texas. His calm demeanor combined with his many years of experience relaxes many of his patients who put their trust in him. He is a board-certified surgeon who takes his time with every step of every procedure, ensuring maximum comfort for each and every patient.
Lasers have been used in dentistry for many years now. The first procedures were conducted way back in 1994. Ever since then, they have been in the hands of dentists for the benefit of their patients.
The most common use of lasers for dentists in their day to day lives is undoubtedly for curing fillings. Once a filling has been applied, a powerful laser is used to harden the outer edge of the soft material. This allows the patient a little more leeway with what they can and can’t do with their mouth after the filling (and it also dramatically speeds up the total curing time). Note: The laser dentists use to cure fillings is totally different to the laser that is used during laser gum surgery. It is much, much larger.
Other applications of lasers can be found less frequently, but are still regularly utilized in other areas of dentistry. Tooth whitening, for example, is a common procedure that makes use of lasers. The energy from the laser activates the bleaching agent that is applied to the tooth, which in turn whitens the teeth.
All in all, dentists and lasers go hand in hand. Dr. Choi has extensive experience in using dental lasers for all manner of treatments, including LANAP. With him and his experienced team, you will be in good hands.
CALL 214-592-1630 TO SCHEDULE A CONSULTATION OR