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Laser Assisted Gum Treatments

What is Gum Disease?

Gum disease begins when plaque (a film of bacteria) accumulates on and around the teeth. This often is first noticed as bad breath or hali- tosis. Your body fights this infection with an in- flammatory assault which causes the tissue to swell and to bleed easily when brushing, floss- ing, or even when eating in more advanced cases. This stage of the condition is called gin- givitis. Gingivitis is reversible with regular pro- fessional cleanings and excellent home care including daily flossing.

If the infection and resulting inflammation per- sists, a chronic inflammatory condition results in gum and bone destruction around teeth, often without you even knowing this disease process is happening Pocket formation occurs and al- lows the spread of bacteria deep along the root surface of the teeth. The longer the pockets persist, the deeper the pocket becomes ulti- mately leading to tooth loss. At this stage, the condition is called periodontitis or periodontal disease.

Periodontitis Treatment Options

A thorough medical history review and perio- dontal evaluation are the first critical steps in determining the severity and extent of gum and bone loss. An assessment of risk factors (e.g. age of onset, smoking, uncontrolled diabetes) is necessary to determining the appropriate course of action.

Treatments options include:

- Deep cleaning (scaling and root planing)
- Pocket Reduction Surgery
- Bone Grafting Surgery
- Laser Assisted Periodontal Therapy (LAPT)

What is LAPT?

LAPT involves the use of a specific type of laser to treat infections around teeth. The la- ser emits short pulses of energy of specific frequencies to remove infected tissue and to kill the bacteria causing the infection. The la- ser is extremely safe and the recovery is short and often pain-free.

How LAPT Works

1. Laser selectively removes pocket lining
2. Ultrasonic and hand instruments clean root 
surfaces
3. Laser disinfects pocket and seals the wound
4. Tissue is compressed against the tooth
5. Healing results in new attachment

Who could benefit from LAPT?

People with a history of:

1. Unresolved deep pockets
2. Previous deep cleanings
3. Multiple localized antibiotic treatments
4. Previous periodontal surgery treatment
5. A compromised medical history
6. Cold sensitivity due to gum recession

Treatment Benefits

1. Remove infected tissues and bacteria (even in deep sites)
2. Creates a seal around the teeth to allow for shrinkage of the pockets
3. Predictable reduction in pocket depths
4. No sutures necessary
5. Post-operative discomfort minimal
6. Recovery time is short 
Your Surgical Visits

For generalized periodontitis, we often treat one half of the mouth at a time. The surgical visits are ideally one to two weeks apart to prevent reinfection of the treated side by the untreated side. Each appointment takes about two hours.

For localized periodontitis or refractory sites treatment, the treatment is usually done in one visit.

Local anesthetic is necessary to ensure you are comfortable while the doctor is treating the deep infected sites. Sedation options are avail- able to assist you in being comfortable during therapy.

The First Few Days

Some mild soreness of the treated areas is expected during the first few days. The tissue may appear discolored around the teeth. This is normal and it is very important NOT to brush or pick this away, as this fibrin barrier allows for creation of a new attachment to the teeth. The recovery is often short.

Your bite may feel different and imbalanced at first. The teeth will quickly adapt. Over time, your bite should feel stronger and more stable.

Continuing Follow-Up Care

As the gums heal, the teeth will shift and the bite may need to be adjusted several times during the first year.

A strict and regimented follow-up protocol is necessary to ensure optimal results. Professional cleaning may be advised one month after completion of therapy and then every three months for the first year. Your response to treatment will be completed after 6 to 12 months.

People with a history of gum disease remain at risk for the rest of their lives, and would benefit from having their teeth cleaned every 3-4 months, indefinitely or as directed by your doctor.

Conclusion

Laser Assisted Periodontal Therapy is a safe modality of therapy to address perio- dontal disease. After eliminating the bacte- ria causing the bone and gum tissue loss, it helps create an environment for the sur- rounding tissues to attach back to the tooth surface. The outcomes are predictable and recovery time is typically short. Patient re- sponses to treatment and the clinical results have been very positive.

Through a comprehensive examination of your periodontal presentation, your doctor can help you decide if this therapy is right.

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