1. The bacteria need an environment in the mouth conducive to growth such as someone:

 -Who has poor oral hygiene

 -Who has crowns or bridges or other types of extensive work in their mouths (more places for bacteria to hide out of reach)

 -Who has receding gums (research has shown these areas are more prone to colonization of bugs)

 -Who has had periodontal treatment with a periodontist but does not regularly see the periodontist for supportive periodontal care

2. The bacteria must attain sufficient numbers or concentration to trigger an immune response and the associated inflammation

Professional care such as the revolutionary LANAP (Laser Assisted New Attachment Procedure) can eliminate existing risk factors without the invasiveness and fear associated with traditional gum surgery and bone grafts but an appropriate maintenance plan and understanding on the part of the patient needs to be part of the equation for a lifetime of healthy smiles.

Most patients we speak with are not happy with their mandibular or “bottom” dentures. The children of elderly parents assume that their mothers and fathers have accepted their “plates” since they don’t seem to complain.   Many tell us that their parents dental health condition is just a sign of the times and places they grew up in. Unfortunately they dont know any better! The widespread use of denture cream is one indication that these prostheses are inadequate for many denture wearers. Our patients that come in wearing conventional dentures claim that they cannot eat many foods, particular those that are hard or tough. This forces them to change their eating habits in unhealthy ways and in turn creates nutritional patterns that are poorer than that of people with natural teeth. In an article written in The Miami Herald dated February 19, 2010, Poligrip denture cream accounted for more than $520 million in sales last year alone! GlaxoSmithKline will stop making and marketing Super Poligrip Original, Ultra Fresh and Extra Care products in the United States. Apparently the zinc in the formula has caused neurological damage and blood problems in denture wearers, allegedly crippling some.

 With the safe and simple placement of only 2 implants, lower dentures have been shown to be superior to conventional dentures in randomized and non-randomized clinical trials that ranged in duration from 6 months to 9 years. The patients in these studies are significantly more satisfied with 2-implant over dentures than with new conventional dentures. Implant over dentures are incredibly more stable, and chewing various foods is significantly easier.

There is also preliminary evidence that this improves their nutritional state. Such improvements may have a strong positive impact on general health, particularly for senior adults who are vulnerable to malnutrition. Call us at 305.447.1447 to schedule a free implant consult to learn more about these important developments in our population.

LANAP is a  U.S. Food and Drug Administration-approved patented protocol for the treatment of periodontitis, or gum disease.  This is how Wikipedia ,the online encyclopedia, describes the technique…

After LANAP, most patients experience new root surface coating (cementum) and new connective tissues (periodontal ligament) formation (collagen) on tooth roots, preventing tooth loss. Pocket depth reduction is excellent and comparable to that achieved by conventional resective osseous or pocket reduction surgery, but without the gingival recession normally associated with osseoussurgery. Significant post-operative reduction in gingival indices, gingival inflammation, and bleeding on probing are also desirable results of LANAP.

The patient experience is also generally positive. As LANAP is tissue-sparing and contrary to the old fashioned resective paradigm, patients enjoy a smile with minimal post-operative recession and attendant disfigurement or root sensitivity. Minimization of post-therapy gingival recession also reduces the future risk of root caries/dental decay of the tooth root. Through the natural analgesic biostimulatory effects of laser irradiation, patients usually have minimal post-operative discomfort. This discomfort is easily controlled through the use of Non-Steroidal Anti-Inflammatory Drugs (over the counter NSAIDs) such as Ibuprofen.

With normal three month periodontal recall and maintenance, the LANAP-provided new attachment is remarkably stable and resistant to future periodontal breakdown. Patients are encouraged to improve and maintain standards of oral hygiene to prevent further active periodontitis.

Old school detractors do exist and tend to feel that LANAP does not succeed in its surgical result. According to the American Academy of Periodontology: “In conclusion, The Academy is not aware of any randomized blinded controlled longitudinal clinical trials, cohort or longitudinal studies, or case-controlled studies indicating that “laser excisional new attachment procedure (or Laser ENAP)” or “laser curettage” offers any advantageous clinical result not achieved by traditional periodontal therapy. Moreover, published studies suggest that use of lasers for ENAP procedures and/or gingival curettage could render root surfaces and adjacent alveolar bone incompatible with normal cell attachment and healing.” However, when considering this information, this 10 year old undated statement by the AAP was made in August 1999 and has since been rendered irrelevant by additional peer reviewed publications, namely the Yukna manuscript of human histology published in the International Journal of Periodontics and Restorative Dentistry in 2007, and the Harris article in General Dentistry in November 2004.

According to the United States Federal Drug Administration: ENAP is not LANAP (see k030290 reference below). Also LANAP is not “laser curettage” or “sulcular debridement” but is a surgical procedure when compared to non-surgical curettage or debridement.