LANAP® laser gum treatment compared with flap surgery

What is LANAP®?

LANAP® stands for laser-assisted new attachment procedure. It is a surgical treatment for periodontitis that uses a specific dental laser to treat the inside of a gum pocket, instead of a scalpel and stitches used in traditional flap surgery.

The laser targets diseased tissue inside the pocket while sparing more of the healthy gum around it. It is still classified as periodontal surgery, done with local anesthetic, and it is usually considered for pockets that stayed deep after a first round of scaling and root planing.

How does the laser procedure work?

In general terms, the laser fiber is guided into the pocket to remove diseased tissue and bacteria along the root surface. The root is then cleaned, and any remaining tartar is removed with hand instruments so the surface is smooth.

A second, lower-energy laser pass is often used to help a stable clot form along the root. The gum tissue is pressed against the tooth to encourage it to reattach as it heals, rather than being folded back and stitched the way it is in traditional surgery.

Because no incision is made to fold back the gum, some patients have less visible swelling afterward. The tissue still needs weeks to heal fully, and results depend on the pocket, the tooth and how well plaque is controlled afterward.

How does LANAP® compare with flap surgery?

Both aim to make deep pockets shallower and calm the infection. Periodontal surgery gives the periodontist a direct view of the root and bone, so uneven bone can be reshaped under sight. LANAP® works without opening a flap, which may mean less tissue removed but a more limited view of the bone.

A 2018 best-evidence review from the American Academy of Periodontology found that lasers used alongside conventional therapy may add a modest benefit. The evidence wasn't strong enough to call laser treatment alone better than established surgery. Some controlled studies have found results similar to scaling and root planing alone.

In short, studies are mixed rather than one-sided. Some patients report an easier first week with LANAP®; others do just as well with traditional surgery. Either approach still depends on your home care and maintenance afterward.

Who is a candidate for laser gum treatment?

Good candidates usually have pockets that stayed deep after a deep cleaning, without bone loss so uneven that it needs to be seen and reshaped directly. An exam and X-rays show whether your pockets and bone shape suit the laser approach.

Some situations point back toward traditional surgery instead. Bone that needs to be recontoured for the gum to heal at a healthy level is one example, and a tooth with a defect better managed with periodontal regeneration is another. Dr. Comeaux will explain which fits your findings.

What is recovery like after LANAP®?

Because no flap is folded back, many patients describe the first few days as more comfortable than they expected, with some tenderness and mild swelling. You can usually return to normal activities the same day or the next.

Gums continue healing for several weeks. Cold sensitivity and some tenderness while chewing are common early on and tend to fade. A liquid or very soft diet is usually recommended for the first few days, then soft foods for a week or more, following the written instructions you're given.

A follow-up visit checks how the pockets responded. From there, periodontal maintenance visits protect the result, since results depend on ongoing care, not just the procedure itself.

What are the risks and limits of LANAP®?

LANAP® carries the general risks of any periodontal surgery: tenderness, temporary sensitivity, and a small chance of infection or incomplete healing in an area. It also has its own limits, since a laser can only reach and treat what it can access inside a closed pocket.

It is not a way to regrow lost bone on its own; any bone benefit is limited and studies are mixed on how much occurs. It also doesn't work equally well for every pocket, and some patients still need traditional surgery for pockets the laser approach doesn't resolve.

What affects the cost of laser gum treatment?

Cost depends on how many teeth and areas of the mouth are treated, which only an exam can determine. Treating one section costs less than treating the whole mouth.

• How many teeth and pockets need treatment
• Whether imaging or a repeat deep cleaning is needed first
• The follow-up and maintenance visits afterward
• What your dental plan covers, which varies by plan

Care at Perio One

At Perio One in Lafayette, Dr. Randal Comeaux, DDS, Diplomate of the American Board of Periodontology, evaluates your pockets and bone before recommending LANAP® or traditional surgery. An examination always comes before a plan.

Dr. Comeaux explains the findings in plain language, including why one approach may suit your case better than the other. Your general dentist is kept in the loop at every stage, and Lafayette-area dentists can send a referral directly.

Once treatment is complete, our periodontal maintenance program helps keep your results stable over time.

What to expect

1. Examination

   We measure your pockets, review X-rays and check whether your bone shape suits the laser approach.

2. Your options, explained

   Dr. Comeaux compares LANAP® and traditional surgery for your findings, so you can decide with the full picture.

3. The laser procedure

   The area is numbed, then the laser and hand instruments clean the pocket and root surface without folding back the gum.

4. The first few days

   Mild swelling and tenderness are common. Most people return to normal activities quickly.

5. Follow-up visit

   Your pockets are checked to see how they responded.

6. Maintenance

   Regular maintenance visits protect the result over the following months and years.

Sources

• American Academy of Periodontology: Non-surgical treatments
• Cleveland Clinic: Osseous surgery
• Cleveland Clinic: Laser dentistry

This page is general education, not a diagnosis. Your periodontist will recommend care after an examination.