LANAP surgery, Part 1.
The sheer number of injections threw me a bit. I think there were a total of 4 (maybe 5) in the maxillary and 4 in the mandible. The entire quadrant had to be completely numb all the way out to the midline. The perio tested a few spots on the mandible -- the center front teeth and the premolars -- and they weren't completely numb after the first 2 shots so he shot up the nerve that comes across the front of the lower jaw to finish.
I was sweating bullets over those lower jaw shots. That anxiety just never leaves. But the perio is a total pro and I could barely feel the shots, which was good, and he totally respects my preferences for good old lidocaine. In fact he had my file marked "Lidocaine Only". Apparently using Septocaine for perio work is quite common which isn't surprising when you consider the length of the procedures and how invasive they can be (think 'implants'). They want patients deeply numb for longer than normal appointments.
I started at 9:30 a.m. and was done just past 11:30 a.m. Halfway through there was a 5 minute break which benefited everyone I think. The worst part of the actual procedure was having my jaw open for so long. They tried a bite block but that just made the spasm worse. I think I will take a 2mg valium for the second half of the procedure to try and keep the jaw from spasming out so hard.
The first step in the process was a sounding to the bone. Apparently that is different than just taking a pocket measurement. They record the depth to the actual bone defect.
Then the first pass of the Periolase laser kills the bacteria by specifically targeting the highly pathogenic black pigmented bacteria The laser is able to vaporize these bacteria and any diseased tissue inside the pocket without carving out big chunks of your gum tissue.
That first pass also opens up the gum pocket so the root surfaces can be cleaned down to the bone defect. That was the part that actually took the most time and was the most 'vigorous' part of the procedure.
After that was done the laser pulse was changed and passed under the gums again to form a blood clot. The clot seals the gum to the squeaky clean root/tooth surface so the healing and regeneration can begin.
The Lidocaine had started to wear off by the last laser pass (which felt like a sharp sting along the deeper pockets) but nothing I couldn't deal with. I'm sure if I had said the numbing was wearing off he would have shot me up again but I'd rather just suck it up for a few minutes than deal with another set of shots and a numb face. I'm sure that's not for everyone, but that's how I roll.
The last step was to minimize the occlusal trauma with selective grinding. The perio told me that the teeth with the largest pockets are generally the teeth with the worst occlusion. The constant banging from an ill fitting bite makes a bad situation worse.
The occlusal adjustment was probably the biggest surprise. My teeth have always closed 'heavy'. I don't have pain from a high bite, they just really seem to close .... heavy. Can't really explain it any other way. Now the right side of my mouth actually feels normal and the left side (yet undone) feels way too heavy.
The gross part -- I can't brush my the unaffected side for 24 hours. The LANAP treated side can't be brushed for TWO WEEKS. No Oral B for over 6 weeks. I have the Periogard rinse which will have to substitute for those 2 weeks. OMG YUCK.
Liquid diet for 3 days. Mushy foods for the next 7. And then I do it all over again. On September 3rd I go back for my 2 week checkup and the second half of the procedure.
All I can say to anyone with perio disease, if you have the option of LANAP, take it. I've been fighting gum pockets for decades and this actually the first time I feel like I have a chance to win.
Your Perio sounds amazing!! total keeper there! So happy you got so many answers !
