Trying to make a decision for my perio

[Slydell1]

I have severe perio. My front 4 bottom teeth are particularly bad. I’ve had 4 consultations ranging from root scale to lanap treatment plans. I’m trying to use what little money I have wisely. Would it make more sense to have lanap, splint the teeth and hope for the best? Or go the root scale route and hope for the best. Is it worth the money to get lanap if it won’t save those 4 teeth? Would the money be spent wiser with traditional, cheaper method and using the money to get a decent replacement. I know above all the perio needs to be under control. Thank you for any and all information

 

[Gordon]

I can't find a single published paper on the effectiveness of LANAP, which is a bit disturbing. It could be the best thing since sliced bread or not, without decent studies it's impossible to tell.

Splinting teeth generally buys a bit of time, it's not a cure for the problems. Root planing and pocket surgery is proven to be effective but there are limits to what it can do...

Without even seeing you there's no way I can advise you as to what's the best option for you I'm afraid. However, two things:
1) If you smoke, stop. Continuing to smoke you may as well just set fire to your savings, because all periodontal treatment will fail
2) If you have any lip or tongue piercings, remove them now or again you're wasting your money

Apologies if you don't smoke and don't have piercings

 

[blackhound]

I can tell you my experience with LANAP was a very good one.

I had the LANAP procedure done about 6 to 7 years ago. Before LANAP I had multiple teeth with double digit pockets. One tooth had a 12mm pocket with pus at the bottom. Post LANAP that tooth probes at 2mm. My teeth don't bleed with flossing or probing. My probing depths are 1, 2 and 3mm. I have one tooth with a 4mm pocket.

Before I self-referred to a perio I went though multiple rounds of root planing and scaling at the general dentist's office. It did nothing because they could not get to the bottom of the pockets and clean them out so the bacteria were never eradicated.

A couple of things right off the bat. If you do decide you want LANAP please make sure you have a perio who is trained in the protocol and is using the correct type of laser. LANAP uses a very particular type of laser designed especially for the protocol. The after care instructions are crucial. They are difficult to follow in terms of diet and not being able to brush your teeth but absolutely necessary. The followup appointments are also critical as well as committing to regular hygiene appointments and consistent home care of flossing and brushing.

Happy to answer any questions you have about my LANAP experience. I wrote it up in detail in my journal.

I have severe perio. My front 4 bottom teeth are particularly bad. I’ve had 4 consultations ranging from root scale to lanap treatment plans. I’m trying to use what little money I have wisely. Would it make more sense to have lanap, splint the teeth and hope for the best? Or go the root scale route and hope for the best. Is it worth the money to get lanap if it won’t save those 4 teeth? Would the money be spent wiser with traditional, cheaper method and using the money to get a decent replacement. I know above all the perio needs to be under control. Thank you for any and all information

 

[Slydell1]

I can tell you my experience with LANAP was a very good one.

I had the LANAP procedure done about 6 to 7 years ago. Before LANAP I had multiple teeth with double digit pockets. One tooth had a 12mm pocket with pus at the bottom. Post LANAP that tooth probes at 2mm. My teeth don't bleed with flossing or probing. My probing depths are 1, 2 and 3mm. I have one tooth with a 4mm pocket.

Before I self-referred to a perio I went though multiple rounds of root planing and scaling at the general dentist's office. It did nothing because they could not get to the bottom of the pockets and clean them out so the bacteria were never eradicated.

A couple of things right off the bat. If you do decide you want LANAP please make sure you have a perio who is trained in the protocol and is using the correct type of laser. LANAP uses a very particular type of laser designed especially for the protocol. The after care instructions are crucial. They are difficult to follow in terms of diet and not being able to brush your teeth but absolutely necessary. The followup appointments are also critical as well as committing to regular hygiene appointments and consistent home care of flossing and brushing.

Happy to answer any questions you have about my LANAP experience. I wrote it up in detail in my journal.

Thank you for the info. I read he uses the perio lase mvp-7. Out of all the consults I’ve had, I feel most comfortable there. Unfortunately he’s also the most expensive. I’m glad to hear your experience was positive. I can honestly say, out of all the research I’ve done, I’ve only read one bad experience. It had to do with misaligned jaw and occlusion problems. With my sever perio I’m led to believe that one root scale procedure might not be enough. And if I go that route it could add up as well. I’ve pretty much decided to go with lanap. Just wanted to get some opinions first. I also want to reach my goal of not smoking for 3 months so my body’s healing functions are up to speed. In the meantime I’ve started really practicing my home care. Thanks again.

 

[Dr. Daniel]

Hi,

I will be more blunt than @Gordon: As far as I know, laser does not really work.
Glad to read it helped you @blackhound , maybe it was suitable to n your case, but there is no evidence it is working as a general rule.
As Gordon said, splinting will improve your quality of life for a few months/years but will not deal with the source of the problem and eventually the teeth’s condition will deteriorate.

 

[Slydell1]

Hi,

I will be more blunt than @Gordon: As far as I know, laser does not really work.
Glad to read it helped you @blackhound , maybe it was suitable to n your case, but there is no evidence it is working as a general rule.
As Gordon said, splinting will improve your quality of life for a few months/years but will not deal with the source of the problem and eventually the teeth’s condition will deteriorate.

Thank you for your reply. So do you think it a more cost effective and better option to go with root scale treatment?

 

[blackhound]

I had terrible perio problems and went through the root scaling multiple times and it did nothing to stop the progression of the disease because there was no way they could get to the bottom of the pockets because the pockets were so deep. They placed Arestin in the pockets (which was expensive) and that also did nothing. I was being faced with do nothing and loose my teeth or figure out something else. I knew the traditional perio surgery involved cutting and stitching the gums and lowering your gum line significantly. I wasn't up for the deformity or the additional problems of having the roots exposed and needing gum grafts, etc. (I lost almost no gum height after LANAP. The bit of loss that I noticed was actually from my gums being in a healthy state and tight against the teeth instead of ballooned from inflammation.)

I ended up at this particular perio via a co-worker who had terrible gum issues and had the LANAP with good results so I thought it was worth a try.

One of the things that was impressed upon me by the perio was that if you as a patient don't rigorously adhere to the post-op protocol you're pretty much screwed. And that was hard! But totally worth it.

I only had one tooth with minor mobility and that tightened up after the healing process so not really equivalent experience to your problem. And yes, the home care is key with perio issues as are the 3 month hygiene appointments. For the first year the hygiene was done at the perio's office and now I do half/half between perio and general dentist.

The most heart pumping moment for me was the one year appointment where the teeth are probed for the first time since the surgery. I was really scared the numbers weren't going to be good. I can't tell you the sheer feeling of relief when the hygienist started charting and the numbers were 1, 2 and 3.

I just wish my experiences with general dentistry were as good as my perio experience.

And as with everything medical/dental, the degree of comfort you feel with the practitioner is a really big deal. Whatever you decide, I hope you have the best of luck.

Thank you for the info. I read he uses the perio lase mvp-7. Out of all the consults I’ve had, I feel most comfortable there. Unfortunately he’s also the most expensive. I’m glad to hear your experience was positive. I can honestly say, out of all the research I’ve done, I’ve only read one bad experience. It had to do with misaligned jaw and occlusion problems. With my sever perio I’m led to believe that one root scale procedure might not be enough. And if I go that route it could add up as well. I’ve pretty much decided to go with lanap. Just wanted to get some opinions first. I also want to reach my goal of not smoking for 3 months so my body’s healing functions are up to speed. In the meantime I’ve started really practicing my home care. Thanks again.

 

[Dr. Daniel]

Thank you for your reply. So do you think it a more cost effective and better option to go with root scale treatment?

I cannot know without seeing you.