Periodontal Disease & Laser Therapy

Periodontal disease is a chronic inflammatory condition that affects the gums and bone that surround and support your teeth. It often develops quietly, without pain, and can go unnoticed until significant damage has occurred. Common signs of advanced disease include bleeding gums, bad breath, gum recession, and loose teeth. If left untreated, periodontal disease is the leading cause of adult tooth loss.

Periodontal disease is often treated using a combination of different procedures and techniques. Initial treatment typically involves non-surgical scaling and root planing (SRP), commonly referred to as deep cleanings, to remove plaque and calculus build-up. If disease is more advanced or does not fully resolve with non-surgical therapy, periodontal surgery may be recommended. Surgical treatment allows us to clean deeper below the gumline in areas that cannot be otherwise accessed. It may involve reshaping the bone and/or grafting back areas of bone loss to help create a healthier and more maintainable environment.

Specialized dental lasers have been shown to be particularly helpful adjunctive tools in treating certain cases of periodontal disease and peri-implantitis (disease around dental implants). The laser helps during periodontal treatment to remove calculus, kill bacteria, minimize inflammation, and promote healing. Our practice is proud to offer laser-based periodontal therapy using the Fotona LightWalker® laser. This state-of-the-art technology allows us to treat gum and bone infection with enhanced precision and minimal discomfort.

Scaling & Root Planing/Deep Cleaning

Description of the Procedure

Non-surgical scaling and root planing, commonly referred to as “deep cleanings”, are often the first line of treatment for periodontal disease. The goal of this procedure is to remove plaque and calculus build-up on the teeth, and reduce inflammation in the gum tissue. Typically, half of the mouth is treated at a time, with ~1-2 weeks between procedures.

The side of the mouth that is receiving treatment will be thoroughly numbed with local anesthesia. After we ensure you are comfortable, we begin the process of cleaning the root surfaces above and below the surface of the gums using a combination of ultrasonic instrumentation with water spray and hand instruments. In select cases, a dental laser may also be used to aid with calculus removal, decontaminate the pockets, further reduce inflammation, and promote healing. In some specific cases, we may also use concentrated, local antibiotics placed directly in the gum pocket. Your provider will discuss these adjunctive services and inform you if they are indicated in your case.

After deep cleanings are completed in all necessary sites, a follow-up appointment is scheduled for 4-6 weeks out. This gives your gum tissue time to heal after the plaque, calculus, and bacteria is removed. The follow-up visit is known as a “re-evaluation”. We will update your records with a clinical exam and new charting of pocket depths. Your treatment plan will be updated and discussed at this appointment. Depending on your healing response to deep cleanings, a secondary phase of treatment may be necessary (likely periodontal surgery) to fully control and manage your periodontal disease. Once stability is achieved, we will discuss an appropriate maintenance schedule that is personalized to manage your condition long-term.

We offer multiple sedation options for surgical procedures, if needed.

Treatment Timeline

Visit 1: Consult & Exam

Review of health history and determine diagnosis
Full periodontal charting completed
Review recommended treatment plan and answer all questions

Visit 2: Deep Cleanings (may be completed with your general dentist)

Commonly, the initial phase of periodontal treatment starts with deep cleanings to remove the built-up plaque and calculus from the root surfaces and reduce the inflammation in the gum tissue
Deep cleanings are completed in 2 separate appointments (right side and left side) that are preferably completed within 2 weeks of one another
Review post-op instructions and care

Visit 3: Re-evaluation and Treatment Planning (4-6 weeks)

Evaluate healing after deep cleanings
Full periodontal charting updated
Review updated recommendations, treatment plan, and answer all question

Periodontal Surgery

Description of the Procedure

Different techniques are used for treatment, depending on the extent of disease and specific patient related factors that may be at play. The initial steps of treatment, however, are the same. The area that is receiving treatment will be thoroughly numbed with local anesthesia. After we ensure you are comfortable, we will make small incisions at the surgical site and gently move the gums out of the way. The teeth and roots are thoroughly cleaned. If there are areas of bone loss that can be predictably repaired with a bone graft, these materials are prepared and placed. Otherwise, the bone is adjusted and smoothed to remove irregularities and improve overall bone health. A laser may be used during treatment as an additional tool to help clean the root surfaces, eliminate bacteria, and reduce inflammation. The gums are replaced and secured with stitches. Surgical treatment may result in recession, or teeth that appear longer. You may also notice increased root sensitivity after treatment, which typically improves over time.

We offer multiple sedation options for surgical procedures, if needed.

Graft Materials (if necessary)

Bone graft materials are obtained in several ways, most often from cows, pigs, or human cadavers. The donors have no positive history of known systemic disease, and blood tests are negative for any infections. The grafts are extensively tested for bacterial contaminants and processed under strict laboratory conditions known to kill all bacteria and viruses, under experimental conditions. The graft material is placed in a vacuum-sealed sterile container until it is ready to be opened during surgery. All materials used are FDA approved.

During the procedure, we also draw a small amount of your blood and spin it in a centrifuge to separate out all the good growth factors that your body naturally produces. We mix those growth factors in with the bone graft before placing it in the socket. This additional step helps to significantly enhance healing.

Treatment Timeline

Visit 1: Consult & Exam

Review of health history and determine diagnosis
Full periodontal charting completed
Review recommended treatment plan and answer all questions

Visit 2: Deep Cleanings (may be completed with your general dentist)

Commonly, the initial phase of periodontal treatment starts with deep cleanings to remove the built-up plaque and calculus from the root surfaces and reduce the inflammation in the gum tissue
Deep cleanings are completed in 2 separate appointments (right side and left side) that are preferably completed within 2 weeks of one another
Review post-op instructions and care

Visit 3: Re-evaluation and Treatment Planning (4-6 weeks)

Evaluate healing after deep cleanings
Full periodontal charting updated
Review updated recommendations, treatment plan, and answer all question

Visit 4: Periodontal Surgery

Sedation (optional) and local anesthesia
Completion of surgical procedure to treat gum disease
Review post-op instructions and care

Visit 5: Post-op (3 weeks)

Check the area for normal healing
Remove sutures
Review and update home care instructions
Additional post-op appointments may be scheduled as necessary, based on healing
‍Note: You may not see the doctor at your post-op appointment, but they are always available to answer any question if you need. Do not hesitate to ask!

Visit 6: Maintenance (every 3-4 months)

Periodontal maintenance/regular cleanings and exams (alternating with general dentist)

Final Post-Op (6 months)

Healing is not complete until ~6 months after surgery
Full periodontal charting completed to assess final outcomes of treatment
Review and adjust individualized maintenance program

Laser Therapy

Our office is home to two state-of-the-art Fotona LightWalker® combined Erbium and Neodymium laser with clinical applications for both periodontal procedures and facial esthetics. The Fotona LightWalker® lasers can offer speed, precision, and effectiveness with both hard and soft tissue applications. Postoperative pain can be minimized with many application of the Fotona LightWalker®.

TwinLight®

The Fotona LightWalker® can offer a minimally invasive treatment of periodontal disease with the TwinLight® protocol. TwinLight® periodontal surgery is fast, simple, highly effective, and can result in fast healing and excellent results in treating certain cases of periodontal disease. TwinLight® is an FDA-cleared protocol for laser-assisted new attachment procedure resulting in periodontal regeneration of the cementum (root surface), periodontal ligament, and bone.

During TwinLight® periodontal surgery, a thin laser fiber will be inserted in the pocket between the tooth and gums. The pulsed Nd:YAG laser light removes diseased tissues while simultaneously improving access to the root surface. The Er:YAG laser is used to kill bacteria and remove microbial biofilm and calculus from the root surface. Finally, the Nd:YAG laser is. Used again to coagulate and promote the formation of a stable fibrin clot to promote healing of the soft tissue.

The use of both Er:YAG and Nd:YAG laser wavelengths in one treatment harnesses the optimum wavelength of each laser. In combination, TwinLight® therapy can maximize laser-assisted surgical treatments with maximum safety and efficacy without scalpels or stitches.

You will be re-evaluated for improvements in your pocketing in 4-6 weeks after completion of your TwinLight® periodontal surgery. Typically, patients improve significantly with pocket reduction of 2-3 mm. Many patients find laser-assisted periodontal therapy to be more comfortable than traditional periodontal treatments, however, not all patients will be candidates.

SmoothLase™

SmoothLase™ is a remarkable treatment that treats wrinkles from the neck to the lower eyelid from inside of the mouth using both the Nd:YAG and Er;YAG lasers offered by the LightWalker®. It is a natural, non-surgical method to regain facial youthfulness. SmoothLase™ utilizes the concept of neocollagenesis in which laser light energy is converted to heat energy to stimulate natural development of collagen in the mid- and lower face. Collagen production takes a sharp downturn after age 30 and SmoothLase™ can help restore collagen loss and combat facial aging. SmoothLase™ tightens, tones, and lifts sagging skin and restore elasticity and can smooth wrinkles, all without a surgical face lift or injectable dermal fillers.

SmoothLase™ treatment is dependent on a patient’s age. As a good rule of thumb, a patient needs at least one SmoothLase™ treatment for every decade they are old. For example, a 50-year-old patient requires at least five treatments to achieve optimum results. Each treatment typically lasts thirty minutes with each treatment spaced out three weeks. The spacing of each treatments allows neocollagenesis to take place. Afterwards, maintenance visits are recommended every six months.

With SmoothLase™, natural facial rejuvenation can be achieved without downtime. No local anesthetic is necessary, and patients typically only experience transient tingling, warmth, and slight swelling of the tissues during and immediately after treatment.

LipLase™

LipLase™ is a non-invasive laser plumping treatment resulting in fuller lips without traditional injectable lip filler. Results can be appreciated immediately, with patients reporting fuller, smoother lips. LipLase™ stimulates collagen remodeling and initiates new collagen synthesis with the Fotona SMOOTH® modality with the Er:YAG laser.

With only a few adjusted passes with the Er:YAG laser, ideal lips can be achieved with balanced fullness and volume between the upper and lower lips and defined, crisp vermillion borders, all without needles!

If you have a history of cold sores (herpes simplex virus 1), you will need to take a prophylactic antiviral (usually Valtrex) prior to treatment.

NightLase®

NightLase® is a powerful laser treatment combining both the Nd:YAG and Er:YAG lasers to improve the airway, reducing and attenuating snoring, offering an effective and non-invasive way to lessen the effects of sleep apnea. NightLase® warms and tightens tissues in the back of the mouth and throat and in some patients, can help avoid traditional, nighttime appliance wear for patients (and their partners) to get a good night’s rest.

NightLase® works by shrinking and tightening the soft palate, which is at the back of the mouth. The laser-induced thermal energy creates microinjury to the soft palate, stimulating healing and shrinking the tissue. No local anesthesia is required, and many patients report that effects from NightLase® are almost immediate.

Each NightLase® treatment takes approximately thirty minutes, with typically three treatments spaced out one month apart. Typically, these results last up to a year. One study from 2015 found patients experienced 85% reduction in their snoring with results stable up to three years (Sippus 2015). Maintenance visits may be necessary to maximize results.

Description of the Procedure

The Fotona LightWalker® can offer minimally invasive treatment of periodontal disease with TwinLight® protocol. TwinLight® periodontal surgery is fast, simple, highly effective, and can result in fast healing and excellent results in treating certain cases of periodontal and peri-implant disease. TwinLight® is an FDA-approved protocol for laser-assisted new attachment procedure, resulting in periodontal regeneration of the cementum (root surface), periodontal ligament, and bone.

At the beginning of the procedure, the area that is receiving treatment will be thoroughly numbed with local anesthesia to ensure you are comfortable. Laser-assisted therapy is done in combination with either non-surgical or surgical periodontal treatment, so your exact treatment plan may vary slightly (we will make sure to thoroughly review the plan with you at your initial examination). Generally, a thin laser fiber is inserted into the pocket between the tooth/implant and gums. The pulsed Nd:YAG laser light kills bacteria, removes microbial biofilm, decontaminates the root/implant surface, and removes diseased tissue. It also helps with coagulation and the formation of a stable blood clot that promotes healing. Depending on the overall treatment approach, the gums may or may not need to be replaced and secured with stitches. Use of the laser can significantly reduce gingival inflammation, while avoiding gum recession that is typically anticipated after periodontal treatment.

We offer multiple sedation options for surgical procedures, if needed.

Treatment Timeline

Visit 1: Consult & Exam

Review of health history and determine diagnosis
Full periodontal charting completed
Review recommended treatment plan and answer all questions

Visit 2: Laser-assisted therapy

Laser-assisted therapy is completed in combination with non-surgical (deep cleanings) or surgical periodontal treatment
Review post-op instructions and care