Right on Time

Laser-assisted gum therapy restores healthy smile.

Most modern watchmakers spend their time repairing watches instead of actually making them. At 65 years of age, Cameron* is just old enough to remember when it was the other way around and watchmakers were considered true artisans.Stock photo from iStockphoto.com.

“My grandfather was a watchmaker and so was my father,” Cameron says. “I learned the trade from them and actually made a few watches myself when I first got into the business. After a while, though, I mostly just repaired high-end factory-made watches.”

Even while doing mostly repairs, Cameron always maintained his great appreciation for the skill that went into making a handmade timepiece. That’s why he has a collection of them that dates back more than two centuries. Not surprisingly, Cameron runs his life in a very timely fashion as well.

“I tend to be very precise in everything I do,” he says. “For example, I’ve always had my teeth cleaned every three months – like clockwork – because I had periodontal disease and knew I had to go in more often than most people to keep my gums and teeth healthy.”

Diligence aside, Cameron recently began to question the quality of care he was receiving during those cleanings. The development of an infection under a lower molar that had to be pulled is what sparked his concern.

“I thought it was really odd that I would get an infection when they were allegedly treating me for gum disease at the time,” Cameron explains. “When I had to have four more bottom teeth pulled and a bridge placed, I became even more suspicious.”

Cameron’s suspicion lingered for more than a year. Finally, after retiring and moving from Michigan to Florida, he sought some answers after his wife read an article in Florida Health Care News about a procedure to treat periodontal disease.

“The article was about Dr. Farag and the LANAP® procedure to heal infected gums,” Cameron says. “I was intrigued by the information and made an appointment at Advanced Dentistry of Fort Myers.”

Repair with LANAP

“When I first saw Cameron, I did a complete oral examination on him, as I do on all of my new patients,” explains Joseph H. Farag, DMD, of Advanced Dentistry of Fort Myers. “This includes x-rays, an oral exam and a personal consultation. I determined through those x-rays that Cameron had advanced stages of periodontal disease.”

Periodontal disease is an inflammatory progression that can become a chronic or an acute problem. The American Academy of Periodontology (AAP) estimates that between 50 and 75 percent of Americans have some form of periodontal disease, some through no fault of their own.

“Being a smoker, Cameron was already at a high risk of developing periodontal disease,” notes Dr. Farag. “Based on the severity of the pockets and the bone loss he had along his gumline, he was the perfect candidate for the LANAP treatment option.”

When healthy gums adhere closely to the teeth, they don’t become loose in the jawbone. When people develop gingivitis, a mild form of periodontal disease, the gums become irritated, red and swell. They may even bleed a little bit when brushing.

As periodontal disease progresses, the bone is lost around the tooth, bleeding when brushing increases and pockets around the teeth develop. If left untreated, gingivitis may lead to a second, more serious stage called periodontitis.

A surgical procedure in which the infected portion of the gums is cut away and the gums are sutured can be performed to repair the effects of severe periodontal disease, but research studies show that a laser-assisted dental gum treatment such as LANAP is superior to conventional surgery in a number of ways.

LANAP, which stands for laser-assisted new attachment procedure, is an FDA-approved, two- to three-hour-long periodontal treatment in which the entire gumline is treated by making three passes across the gums with a special dental laser and sonic equipment.

During the first laser pass, the energy from the laser kills any bacteria in the gums, vaporizes the diseased gum tissue and dehydrates the tartar on the tooth, making it brittle and easy to remove. This is also the step during which the diseased lining of the tissue is removed.

During the second phase, the tartar is removed with a vibrating, fine-tipped, ultrasonic instrument, while the pockets are flushed with an antimicrobial substance that stops the growth of new bacteria.

Finally, during the third pass, an antimicrobial seal is created that prevents re-infection and releases growth factors from blood cells that help regenerate the attachment between the gums and the teeth.

The entire procedure, Dr. Farag emphasizes, is painless. So is its aftermath.

“The great thing about the LANAP procedure is the speed of recovery and the tissue response,” Dr. Farag educates. “It doesn’t take weeks or months. It literally takes just a couple of days, which is truly amazing.

“When the bacteria or the tartar or the insult that is causing the inflammation and infection is removed from the tissue to the point where it’s sanitary, which is what the laser does, the tissue heals ever so quickly.

“The analogy I use with patients is, say you cut yourself while working in the garden or just because you work with your hands a lot. You get that cut and if you don’t clean it and don’t put NEOSPORIN® on it, you’ll go for days and it will burn and get irritated.

“It will eventually heal, but it will take a lot longer, and you’ll feel it. But if you get a cut and you clean it, sanitize it, disinfect it and routinely put an antimicrobial on it and keep it clean, it will heal very quickly without pain and without scarring.

“That’s what LANAP does. It cleans, disinfects and sanitizes, and the body just heals up really quickly afterward, which is something that is very hard to do in the mouth because our mouths are not a clean environment. They’re filled with bacteria.

“And when there’s that constant flow of bacteria in the mouth, it just makes it harder for the gums to heal. But when you remove the bacteria and the tartar and the plaque, they heal quickly.”

Follow-Up to Good Health

As is typically the case, Cameron’s LANAP procedure was completed in one day. That would not have been the case had he opted for traditional surgery, which regularly results in a recession of the gums, according to Dr. Farag.

“LANAP is a much faster, more effective and safer method of treating gum disease,” he concludes. “But a procedure such as this is really just the first step along the road to good oral health.

“In order to keep the gums healthy, people need to keep their teeth clean. That requires daily commitment. Without that commitment, a treatment such as LANAP is not going to be effective long term.

“That’s why, when we sit down with someone and discuss treatment options for gum disease with them, I want to be assured that the patient is committed to taking care of their teeth. Patients need to be committed to keeping the teeth healthy long term in order for any treatment to be effective.”

Patients are encouraged to have their teeth cleaned regularly, brush and floss daily and be aware of any sudden changes to their oral health. Dr. Farag adds that many times, such as with Cameron, patients are diligent about home care, yet have no idea of the extent of their situation.

“I have patients tell me they brush and floss at home and still get the pockets where the bacteria sit. This was the case with Cameron. He thought he had it under control, but sadly, that was not the case.”

Getting Back to Normal

Dr. Farag advised Cameron that periodontal disease is not something that just goes away without proper treatment and then follow-up care.

“He has to maintain good brushing habits at home and keep his appointments, or it will recur,” Dr. Farag stresses. “He seems committed to doing that.”

Part of Cameron’s treatment plan includes wearing a night guard in order to preserve his bite.

“His teeth were shifting position due to significant bone loss,” Dr. Farag explains. “Once we hold those teeth in their proper position, they will all heal as a unit. We stabilize the teeth by doing this.”

Cameron says he is more than pleased with the care Dr. Farag and his staff have provided.

“Dr. Farag is really informative, and he knows what he is doing,” Cameron asserts. “I know that he is not lying to me, and I trust him. That goes a long way compared to the care I used to get in Michigan.

“I recommend Dr. Farag to anyone. The LANAP is really great, and there was no pain at all involved. I’m happy with my results!”

*Patient’s name withheld at his request.
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