What Is LANAP and How Does It Treat Gum Disease?

LANAP — Laser-Assisted New Attachment Procedure — is a minimally invasive surgical treatment for moderate to severe periodontal (gum) disease. Instead of cutting away diseased gum tissue with a scalpel the way traditional surgery does, LANAP uses a specific wavelength of laser energy to target and remove infected tissue while leaving healthy tissue intact. The result is a procedure that can address the same severity of gum disease as conventional surgery but with less bleeding, less post-operative pain, and a faster recovery for most patients.

If you’ve been told you have periodontitis and a dentist or periodontist has recommended surgery, LANAP is worth understanding before you decide on a path forward.

What Gum Disease Actually Does to Your Mouth

To understand why LANAP works, it helps to understand what periodontitis is doing under the surface. Gum disease starts as gingivitis — inflammation caused by bacterial plaque along and below the gumline. When gingivitis goes untreated, the infection deepens. Bacteria colonize the space between the tooth root and the surrounding bone, forming what clinicians call a periodontal pocket.

Healthy gum tissue fits snugly against the tooth with a pocket depth of 1–3 millimeters. Once pockets reach 4–6 mm or deeper, routine cleaning no longer reaches the bacteria at the base. The immune system responds to the chronic infection by destroying the bone and connective tissue that hold the tooth in place. That’s the mechanism behind tooth loss from gum disease — it isn’t the bacteria themselves pulling teeth out, it’s the body’s inflammatory response to persistent infection eroding the supporting structures.

By the time most patients in Long Beach arrive looking for answers, they may have noticed bleeding when they brush, gum recession that makes their teeth look longer, loose teeth, or a dentist at a routine cleaning flagging pocket depths that didn’t exist a few years ago. Some patients have no noticeable symptoms at all, which is part of why gum disease is often caught late.

How the LANAP Protocol Works, Step by Step

LANAP uses the PerioLase MVP-7, a free-running pulsed Nd:YAG laser with a specific wavelength (1064 nm) that has a high affinity for the pigmented bacteria and diseased tissue inside periodontal pockets. The wavelength is selectively absorbed by the dark, pigmented bacteria and inflamed tissue — and largely ignored by the healthy pink tissue nearby.

Here’s what a LANAP treatment actually involves:

• Pocket measurement. Before any laser energy is applied, the clinician uses a periodontal probe to map pocket depths around every tooth. This gives a baseline and identifies which areas need treatment.
• First laser pass. A thin fiber-optic probe — roughly the diameter of three human hairs — is guided into the periodontal pocket alongside the tooth. The laser pulses remove diseased and infected tissue and kill the pathogenic bacteria in the pocket.
• Ultrasonic scaling. After the first laser pass, ultrasonic scalers and hand instruments remove calculus (tartar) deposits from the root surface. These calcified deposits harbor bacteria and prevent the gum tissue from reattaching cleanly to the tooth.
• Second laser pass. The laser is used again, this time at a different setting to stimulate a blood clot at the base of the pocket. This clot acts as a biological seal, protecting the cleaned area and creating the conditions for new connective tissue attachment to form.
• Bite adjustment. If any teeth have excessive biting forces that could disrupt healing, the bite is adjusted so all teeth close evenly.

The entire process is completed under local anesthesia. Most patients need two appointments covering opposite sides of the mouth — typically scheduled about a week apart. Because there are no incisions or sutures, patients usually leave with gauze rather than stitches.

LANAP vs. Traditional Gum Surgery: The Practical Differences

Traditional osseous surgery (sometimes called flap surgery) involves making incisions in the gum tissue, folding it back to expose the roots and underlying bone, cleaning the area, reshaping bone if needed, and suturing the flap back into place. It’s an effective, well-documented procedure with decades of evidence behind it. But the recovery is real: sutures stay in for 1–2 weeks, a soft-food diet is required for several days to weeks, and post-operative swelling and discomfort are common.

LANAP outcomes research — including a 2018 study published in the Journal of Periodontology — has demonstrated comparable clinical improvements to osseous surgery in pocket depth reduction and clinical attachment levels, with some data suggesting greater bone regeneration in certain cases.

The practical differences patients usually care about most:

• No scalpel, no sutures. LANAP doesn’t require incisions into the gum tissue.
• Less gum recession. Traditional surgery sometimes results in the gumline sitting lower than before. LANAP tends to preserve more of the existing gum height.
• Faster return to normal activity. Many patients return to desk work the next day. Post-operative instructions still include a modified diet for the first few days (soft foods, nothing hard or crunchy), but the restrictions are generally shorter-lived than with traditional surgery.
• Reduced bleeding during the procedure. The laser cauterizes as it works, which minimizes bleeding.
• Not for every case. LANAP works best for patients with moderate to severe periodontitis who have adequate remaining bone. It isn’t appropriate for all anatomical situations, and a clinician needs to evaluate x-rays and probe depths to determine whether it’s the right fit.

Who Is a Candidate for LANAP?

LANAP is designed for patients who have been diagnosed with Stage II, III, or IV periodontitis — meaning pocket depths typically in the 5 mm or greater range and radiographic evidence of bone loss. Patients with earlier-stage gum disease (gingivitis or mild periodontitis) can usually be managed with scaling and root planing, which is a deep-cleaning procedure done without surgery.

Good candidates for LANAP also tend to be medically stable. Because LANAP produces less bleeding and doesn’t require cutting, it’s often discussed as an option for patients who take blood thinners, have diabetes (well-controlled), or otherwise have medical histories that make conventional surgery riskier — though this should always be evaluated in consultation with both the treating dentist and the patient’s physician.

LANAP requires commitment to follow-up care. Gum disease is a chronic condition, not a one-time fix. After LANAP, patients typically enter a supportive periodontal therapy schedule — usually professional cleanings every 3–4 months rather than the standard every 6 months — to prevent recurrence. The laser procedure addresses the existing infection and creates conditions for reattachment, but it doesn’t change the patient’s susceptibility to future disease. Consistent home care (brushing twice daily, daily interdental cleaning) and regular professional maintenance are what keep the results stable over years.

What to Expect at Spring St. Dentistry

Dr. Anthony Hoang and the team at Spring St. Dentistry in Long Beach offer LANAP for patients diagnosed with periodontitis who are looking for an alternative to conventional surgical approaches. The process starts with a periodontal evaluation — probing depths charted around every tooth, a full set of radiographs reviewed for bone levels, and an assessment of contributing factors like bite force, tooth mobility, and systemic health history.

From there, Dr. Hoang will walk through whether LANAP is appropriate for your specific situation, what the procedure itself involves, and what the recovery timeline looks like. If LANAP isn’t the right fit for your case, he’ll explain why and discuss what the alternatives are. The goal of that consultation is to give you enough information to make a decision you actually understand — not to push you toward a procedure.

If you decide to proceed, LANAP at the practice is typically completed over two appointments, with follow-up visits scheduled at 1 and 3 months post-treatment to assess how the tissue is healing and confirm the pocket depths are responding.

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Frequently Asked Questions About LANAP

Is LANAP painful? The procedure itself is done under local anesthesia, so patients don’t feel the laser during treatment. After the anesthesia wears off, most patients describe post-operative discomfort as mild to moderate — often less than they expected. Over-the-counter pain relievers are typically sufficient for the first day or two. Some sensitivity to temperature in the treated teeth is common for the first week.

Does insurance cover LANAP? Coverage varies widely by plan. LANAP is typically billed under periodontal surgical codes, which many dental insurance plans cover at least partially. The billing codes used depend on the specifics of what was done and the number of teeth or quadrants treated. It’s worth having the office verify your benefits before the procedure so there are no surprises.

How long does the LANAP procedure take? Each appointment covers half the mouth and usually takes about 2 hours. So the full-mouth treatment spans two 2-hour appointments, typically a week apart.

Can gum disease come back after LANAP? Yes. LANAP treats the current infection and can stimulate reattachment, but periodontal disease can recur if home care slips or professional maintenance is skipped. Patients who follow a 3–4 month periodontal maintenance schedule and maintain good daily hygiene have the best long-term outcomes.

How is LANAP different from other dental lasers? Not all dental lasers are the same. LANAP specifically refers to the protocol using the PerioLase MVP-7 Nd:YAG laser. Other dental lasers use different wavelengths and are used for different purposes (whitening, cavity preparation, soft tissue procedures). The specific wavelength used in LANAP is what allows it to target pigmented bacteria selectively. Clinicians who perform LANAP undergo specific training and credentialing in the protocol.

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Ready to find out whether LANAP is right for your situation? Schedule a consultation or call Spring St. Dentistry at (562) 420-8578.