Periodontal Laser Surgery (mouth, sensitive, procedure, bacteria)
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To everyone who had the LANAP procedure done, now that it’s 2019, how is everyone fading?
I was just told I needed the procedure this morning. And it had a $7500 price tag with no insurance coverage. FML
I have certain areas with 8-10 gum pockets. And an infection. I went in for a routine cleaning and cane away with this prognosis and no cleaning. They said to wait and do cleaning all at once with the LANAP. I can schedule it 2 weeks from today they said. Clearly my infection wasn’t a rush for them to clear up.
As I've stated LANAP was a waste of my time. My insurance covered it (maybe he billed differently).
Fast forward last year:
I went to the periodontist and had a deep cleaning. He said there were only 1-2 trouble spots he'd watch and do lanap on them IF NEED BE at a later date. He's very conservative in his approach. He suggested I do the usual: water pik, electric toothbrush and dedicated flossing.
Quote:
Originally Posted by Patee333
The thing is it was my dentist who was going to perform the LANAP in his office with his equipment. My out of state friend immediately said that’s a red flag because no dentist would or should have that equipment because it costs a gazillion dollars. So they try to jack up the cost of the treatment to recoup the expense.
The dentist also said that there was a lot of post op maintenance involved. He’ll have to adjust my bite, I’ll need a night guard for life and maintenance cleaning every month. It just sounded like a huge life changing ordeal and expense that I cannot afford.
Do not go to a regular dentist. Read reviews online for a periodontist and visit one for a screening. They will create a plan of action. I even saw two before I settled on one. My dentist and perio work together now with me alternating cleaning but my general dentist does NOTHING perio related.
If you never had surgery before they usually recomend a deep cleaning to see if that will shrink the pockets. Most of my pockets shrunk after the deep cleaning except for a back one near the wisdom so sadly I had to have them removed to help my mouth heal.
Periodontist here. Just giving my input since it seems like there is a lot of confusion going on here:
1) Traditional periodontal surgery (osseous surgery) WORKS. By "works", I mean it reduces periodontal pockets so that you can keep your teeth for a greater amount of time. This has been documented by decades of research. How it "works" is from a top-down approach - basically we are cutting away gums an bone until the pocket shrinks or disappears. The downside is that now your tooth is longer and more exposed, which is unesthetic and can leave them sensitive to cold/hot. Still, it works. When I was a resident we used to tell patients "longer teeth or teeth no longer".
2) While osseous surgery is a "resective" approach, other forms of treatment such as Guided Tissue Regeneration are a "regenerative approach". Instead of cutting gums and bone away, the goal is to use biomaterials and surgical techniques to regenerate lost bone, cementum, and connective tissue. This is MUCH more difficult, expensive, and technique sensitive than osseous surgery.
3) Why would either of these treatments not "work"? First you have to understand that periodontitis is NON-CURABLE. Once you have it, you have it forever. As such, you can always have relapse. Second, successful surgery requires very precise case selection, especially for regenerative treatments. They will not work on just any periodontal pocket or tooth. Unfortunately, many patients/dentists wait until the disease is too far advanced before going/referring to a periodontist, thus making the likelihood of successful surgery a crapshoot. For example, the research is abundantly clear that osseous surgery works best when the pockets are 6-8mm. Almost everyday I see a patient who has 9-10+mm pockets and has been getting "deep cleanings" every three months for a couple of years. Now they finally show up to me with loose, painful teeth and expect me to perform a miracle. Not gonna happen. Third, long-term periodontal success relies on meticulous oral hygiene, which is a huge problem for patients. Lets face facts - 99% of patients have periodontal disease because their hygiene sucks. Less than 1% of periodontal disease is caused by true genetics, so don't blame it on your parents. They didn't give you bad teeth, they gave you bad oral hygiene habits. After treatment, you are expected not only to brush better than you were, but now you must brush much better than the average person, when you were way below average to start with. Almost everyone fails in this regard. It has also been proven that patients need to come in every 3 months for professional cleaning to help maintain bacteria levels, yet only 10% of patients are consistent with that schedule they might do it for the first year but inevitably almost all of them taper off - "My insurance only covers two cleanings a year, so that's all I want". This is the #1 reason why we see relapse of successful surgery. Patients drop a few grand on surgery but won't pony up to pay for a couple extra cleanings per year and don't change their oral hygiene habits. Patients fall back into their old habits. Furthermore, if you are a smoker, I can almost guarantee you this will not work long-term.
4) About LANAP - If your definition of success is the shrinkage of periodontal pockets, then the long-term data suggest that LANAP is no more effective than traditional periodontal surgery. It can be a great alternative compared to osseous surgery when considering the amount of invasiveness. Again, case selection and early detection is the key. Unfortunately, some doctors think LANAP is the cure for everything. When all you have is a hammer, everything looks like a nail. I have seen LANAP do some pretty amazing things. I have also seen some spectacular, expensive failures - some due to doctor issues, some due to patient issues.
Ok, so I was told by the dentist I have stage 4 periodontal disease, I've got pockets to 8mm not all teeth, but enough and in all four quadrants. Hygienist said it's possible my other pockets could be deeper as they kept hitting calculus around the teeth making it problematic to measure.
So they tell me I need to go see the periodontist and have them tell me my options or else I'm basically going to lose my teeth. I'm still waiting to hear back from the periodontist I was referred to, perhaps they've been told I was concerned about costs and don't want to waste their time as maybe they feel I won't be able to pay for any of the options in the first place.
So in the meantime I'm doing research and I find this thread, along with some web sites which concern me because on one hand I'm being told that it doesn't have to be more expensive by a guy in Colorado, and that it LANAP has worked well by three different people (dentist who is an Institute of Advanced Laser Dentistry Instructor with private practice in San Luis Obispo, CA, periodontist with private practice limited to periodontics in Roswell, GA, and a clinical professor of periodontics at University of Maryland Dental School in Baltimore with a private practice in Yardley, PA.) These four have given me hope that MAYBE I can save my teeth and maybe afford to do so.
I do accept full responsibility for the condition of my teeth and I'm not going to blame anyone except for one dentist who I don't feel explained everything that needed explaining and may have done a less than excellent job on of my teeth but that's neither here nor there.
I'm going to link (hopefully) to one article from Inside Dentistry which talks about the experiences with LANAP by the three dental professionals I mentioned, and then to one who is the dentist in Colorado so you can read what they say.
The Dentist in Colorado says that it can be $175-300 per quadrant for the average cost of non-surgical laser gum treatment depending on what individual laser dentists choose to charge. So is he full of it? Or is he not talking about LANAP but something else? He is referring to this laser gum treatment as an option alongside traditional gum surgery and gives costs for that as well.
So if anyone (bart0323?) can shed any light on this or give some insight I'd be all ears. As of right now I have no clue what might actually be an option for me, considering everything seems well out of my price range in which case I'm not sure if I should join a fight club someplace and have teeth knocked out for free instead of paying a dentist for each one. I can't discount that skill and experience can play a major role in how well any job is performed as I'm in IT and I know first hand that less experienced/skilled people can make a mess of things. That being said, I know patients need to do more to keep their teeth maintained that they did before and it's their lack of doing so that got them in the mess they are in now (me included) so that must be factored in as well but you can't rightly blame the "procedure" if the "patient" doesn't do their job.
In any case, bless you all, I do hope your teeth serve you well and that you do what you must to take care of them. I've already started doing PSA's in the office to tell the others to get regular checkups or end up in my shoes if they aren't there already.
Thanks for the lecture, you sound just like all the many periodontist's that I have visited for the last 25 yrs.
Had full mouth gum (osseous) surgery back in 1999-2000, Dec. 99 top teeth, Jan. 00 bottom teeth for insurance purposes. Can't recall my out of pocket cost, but I think back then the total was about $3000 for my part? That lasted 18 years and pockets got deeper again mainly on back upper left teeth, even though I always had 4 cleanings per year.
May 2018 complete mouth LANAP surgery: out of pocket cost-$4950. Price was 6G minus 5% for cash, and my insurance only paid $750 since that periodontist that periodontist reimbursed me as does not accept insurance. Told him then, I hope I can get 18 yrs out of LANAP like the cut and lower the gum surgery.
Now in August, 15 months after the LANAP, periodontist tells me tooth 12 pockets too deep, tooth 13 dummy tooth (bridged between 12-14, tooth 14 abscessed and never got root canal, just yearly antibiotics, would do root canal if it could be saved, tooth 15 cavity under bottom of tooth that can't be accessed due to location at junction of roots to base of tooth. So goodbye 4 teeth soon. Can't afford implants since I am now on fixed income. I feel like the periodontist should have only recommended that I do the LANAP on the lower teeth. Hindsight is more accurate right.
Anyway, the entire dentistry field is a money making racket in my opinion. As an example, if your root canal fails, then just pay to have it re-done. Never heard of a dentist or perio or endodontist getting sued for malpractice because they tell you you could have recurring problems upfront.
Shopping for 4 tooth partial now and will have no ability to chew on back left side of my mouth for awhile. Lucky me!
Too bad we all that have periodontal issues don't have $30-$50,000 laying around to get the hybridge or full mouth implants.
At least I have some teeth that still work...ha ha ha!
.... I feel like the periodontist should have only recommended that I do the LANAP on the lower teeth. Hindsight is more accurate right.
...Anyway, the entire dentistry field is a money making racket in my opinion. As an example, if your root canal fails, then just pay to have it re-done. Never heard of a dentist or perio or endodontist getting sued for malpractice because they tell you you could have recurring problems upfront.
Why didn't you tell the periodontist this would only work on your lower teeth??
Well toofache32, I went to a different periodontist first and was quoted over $7000 for the LANAP plus that one said I would need a bone graft, implant, etc. So I got a 2nd opinion, this one that did my surgery but didn't indicate that I needed a bone graft. So two factors, one he was over $1000 less costly and felt as though he could save these same upper back left teeth that I am now having issues with. Remember, I have been going to these schisters for many many years. And was told by my regular dentist, plus 2 periodontists that LANAP would solve my problems, the sad thing is I believed him.
He told me it would help my whole mouth...so I got half scammed, if that makes sense.
as an aside: Read that Paul McCartney was told by his dad told him when he was 21 to have all his teeth pulled and get dentures. Dad told him it would save him a lot of trouble later on. Of course he didn't follow the advice, but now I'm not so sure that old man McCartney might have been onto to something.
Non-surgical treatment means Scaling and Root Planing. $175-$300/quadrant is a reasonable fee.
About the dentist's web page you posted - I do not know them or anything about their work. I will say the following:
1) This dentist is NOT a periodontist. Periodontics is a recognized specialty field from the American Dental Association, just like Orthodontics and Oral and Maxillofacial Surgery. They are advertising themselves as a "Laser Dentist". There is no such thing. I own a laser but that does not change my title. This person is a general dentist who owns a laser. I do not know them. They may be very good at what they do.
2) Based on the website, it appears this dentist is NOT providing LANAP. I say this because their description of laser gum treatment sounds like Laser Assisted Periodontal Therapy, or LAPT. It is basically scaling and root planing with some decontamination using a very basic, low-cost laser. In some states, hygienists are allowed to do LAPT.
To advertise as doing LANAP, you must be certified by the LANAP people and own a LANAP-specific laser. I do not see that anywhere on this web page. The LANAP laser and training cost over $100K, so there is no reason a doctor would invest that much into training and not advertise it. I may be wrong. I am just going by what I see on the doctor's web page
I wanted to thank you for taking the time to go over some of the material and pointing out some important things.
I did think it odd that LANAP was not mentioned at all as you say the certification and machine cost thousands so not to advertise the fact that you're certified and have the equipment/knowledge would seem very odd.
Thanks for the lecture, you sound just like all the many periodontist's that I have visited for the last 25 yrs.
Had full mouth gum (osseous) surgery back in 1999-2000, Dec. 99 top teeth, Jan. 00 bottom teeth for insurance purposes. Can't recall my out of pocket cost, but I think back then the total was about $3000 for my part? That lasted 18 years and pockets got deeper again mainly on back upper left teeth, even though I always had 4 cleanings per year.
May 2018 complete mouth LANAP surgery: out of pocket cost-$4950. Price was 6G minus 5% for cash, and my insurance only paid $750 since that periodontist that periodontist reimbursed me as does not accept insurance. Told him then, I hope I can get 18 yrs out of LANAP like the cut and lower the gum surgery.
Now in August, 15 months after the LANAP, periodontist tells me tooth 12 pockets too deep, tooth 13 dummy tooth (bridged between 12-14, tooth 14 abscessed and never got root canal, just yearly antibiotics, would do root canal if it could be saved, tooth 15 cavity under bottom of tooth that can't be accessed due to location at junction of roots to base of tooth. So goodbye 4 teeth soon. Can't afford implants since I am now on fixed income. I feel like the periodontist should have only recommended that I do the LANAP on the lower teeth. Hindsight is more accurate right.
Anyway, the entire dentistry field is a money making racket in my opinion. As an example, if your root canal fails, then just pay to have it re-done. Never heard of a dentist or perio or endodontist getting sued for malpractice because they tell you you could have recurring problems upfront.
Shopping for 4 tooth partial now and will have no ability to chew on back left side of my mouth for awhile. Lucky me!
Too bad we all that have periodontal issues don't have $30-$50,000 laying around to get the hybridge or full mouth implants.
At least I have some teeth that still work...ha ha ha!
I don't have $30-$50,000 laying around either. I do have $10 to spend on a toothbrush and some floss. Funny thing - I use them the way I'm supposed to and I don't have gum disease. Maybe if you had done that 25 years ago you wouldn't be in the situation you are now. But yes, blame the periodontists who have helped you keep your teeth for so long.
I don't have $30-$50,000 laying around either. I do have $10 to spend on a toothbrush and some floss. Funny thing - I use them the way I'm supposed to and I don't have gum disease. Maybe if you had done that 25 years ago you wouldn't be in the situation you are now. But yes, blame the periodontists who have helped you keep your teeth for so long.
C'mon now Bart0323, that was a little bit of a low blow there. I have always brushed and flossed, perhaps on the flossing part, not as much and as often as necessary. However, all of us folks that were delinquent in our oral hygiene created an entire profession for dentist's like you to specialize and make the mega bucks!
I won't get into a pissing match w/ you sir, as I'm a grown man and accept my own responsibility regarding my periodontal issues. Other than the cost of the equipment, why is the cost so exorbitant on common routine dental procedures? Dental cleaning at regular dentist cost me about $125, cleaning at periodontist office about $175...gimmie a break.
If you are/were a successful periodontist, you certainly have a lot more than $30-$50,000 available if you needed it for a health issue.
Going to an endodontist soon to see if I can save tooth #14 and to get a 2nd opinion about trying to save those 4 teeth? There's a quick grand or so if he feels it can be saved.
What gets me is that all these dental professionals seem to think that everyone should have these big bucks to spend on these procedures and I just don't have it.
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