In this episode of the Smile Reconstruction Podcast, Dr. Tanner Townsend and Dr. Josh Muir of Montana Center for Implants & Dentures discuss how LANAP and LAPIP laser therapy may help patients preserve their natural teeth and dental implants. They explain the warning signs of periodontal disease, how laser treatment differs from traditional gum surgery, and how the PerioLase MVP-7 works to target bacteria around teeth and implants. The conversation also covers potential bone regeneration, treatment recovery, long-term maintenance, and the cost differences between laser therapy and full-arch dental implants. Throughout the episode, Dr. Townsend and Dr. Muir emphasize the importance of exploring treatment options and seeking a second opinion before deciding to remove teeth that may still be saved.

Dr. Tanner Townsend — 0:05

Welcome back to the Smile Reconstruction Podcast. I’m your host, Dr. Tanner Townsend, along with my always handsome and fabulous co-host, Dr. Joshua Muir.

Dr. Josh Muir — 0:15

It’s a great day.

Dr. Tanner Townsend — 0:16

It’s a great day.

Well, today we’ve got a cool topic with some cool technology that we’re going to discuss.

So we’re going to talk about saving teeth before extracting them, specifically when you have periodontal disease or teeth where you’ve lost a lot of bone and the teeth are loose.

And we’re going to talk about this laser therapy that we’ve been learning about and we’re starting to do in our office.

So, Dr. Muir, let’s first talk about someone with gum disease. What are some signs that you need to get your gum disease or periodontal disease looked at in the first place, and how would you even know?

Dr. Josh Muir — 1:00

Yeah. So the first thing, you’re probably going to feel something if you’re having something go on with your gums.

Now, our gums are attached to our teeth, so it might feel like it’s your teeth, might feel like it’s your gums, but it’s that system. And the gums are going to be red and inflamed instead of pink. They’ll look angry instead of happy.

And so those are some of the things we look at. If your gums bleed when you’re flossing or brushing, that can also be an indication.

Dr. Tanner Townsend — 1:30

I think those are all things you need to look out for.

So let’s say, hypothetically, you know you have some issues now. You’ve been to the dentist, and they’re like, “You need to have all your teeth taken out.”

Should you go get a second opinion first? What should you do? What would be your process?

Dr. Josh Muir — 1:46

Okay, so I would never tell someone to not get a second opinion, but I would really look at, if your dentist is telling you you need all of your teeth out, I would look in the mirror and say, “All right, are most of my teeth broken down, chipped, dark, visible holes and decay in them?”

If that’s the case, then yeah, you can get your teeth out. They probably need to come out.

But there are cases where someone just has a little mobility on all of their teeth or most of their teeth, and those are the cases where sometimes the answer used to be, “Okay, take those teeth out.”

But now what we’re saying is, “Put on the brakes a little bit, and maybe we can save those teeth.”

And so that’s one where absolutely get a second opinion.

Dr. Tanner Townsend — 2:31

Now, are there different levels to how much the teeth are moving to where this should be done, and how much bone loss?

Dr. Josh Muir — 2:38

Yes. What we’re talking about is a little wiggle. If they’re flopping around, if they’re bouncing and you can press them—

Dr. Tanner Townsend — 2:46

You bite down, see them all move.

Dr. Josh Muir — 2:48

Yeah, that’s going to be a little bit more iffy.

It doesn’t mean don’t get a second opinion, but it’s going to be really guarded. I would say you may not be able to save them anyway.

Dr. Tanner Townsend — 3:00

Okay, so we kind of already talked about this next one, but let’s roll in.

What is this laser treatment? It’s often referred to as LANAP or LAPIP laser therapy, and how is it different from traditional gum surgery where we do scaling and root planing below the gums with a flap and all that stuff?

Dr. Josh Muir — 3:20

Let’s talk about the traditional treatment first.

And this, even once we purchased the equipment, even once I was at the training and so on, I was really surprised to learn some of the really in-depth details about this procedure.

So the traditional way to treat gum disease or periodontal disease, and typically periodontal disease, we think of that as bone loss underneath your gums.

So it’s bone recession and gum recession, and it creates some pocketing in your gums.

So if you’ve ever had your dentist say they’re calling out numbers, three, five, six, nine, eight, those numbers are the depth of the pocket between your gums and your tooth.

And so what it used to be is we would go in. We call it scaling and root planing, and it’s still a very common procedure.

But what we used to do is we would go in, and where the bacteria would hide, right in the little rough spots on your tooth, we would scrape that layer off, and then you would come in for these maintenance appointments regularly to keep those things off.

But what we’re saying now is you don’t have to do that. You don’t have to go through all of that scraping in the same way.

Now, if it’s a little more severe, sometimes what happens is the bone would become uneven around the teeth, and in those cases, there was what we call a flap surgery where we get you numb.

I hate to use words like this, but we peel the gums off of the tooth and off of the surrounding bone, and we smooth the bone all around there.

Then we close the gums. We put stitches all the way across, and now it’s got to heal.

What that does, though, that also causes more recession.

What we’re saying now with this LANAP protocol, and it’s pretty amazing, this is Laser-Assisted New Attachment Procedure.

The old way was just clean it up.

Dr. Tanner Townsend — 5:26

The—

Dr. Josh Muir — 5:27

The new way is not only clean it up, but attach the gums and bone back to the tooth where you’ve had that recession.

And you do that in a way using the laser where there is no flap, there is no cutting, there are no stitches, and as a result, you end up having much less trauma on it.

You’re going to be more comfortable as you’re healing, and because you don’t disturb the outer part of the root as much, you are going to grow some bone around there in many cases.

Dr. Tanner Townsend — 6:04

Wow, that’s incredible.

So a lot less pain is kind of what you’re getting at. That’s incredible.

So what is LAPIP? And you kind of alluded to it already, but how is it different than LANAP?

Dr. Josh Muir — 6:18

Yeah. So LAPIP, Laser-Assisted Peri-Implantitis Procedure.

So this is a procedure that’s very similar, but it’s created to help implants that are heading down the road of failure.

So if we can nurse those implants along and change the bacteria load around those and clean them up, so that they can either grow more bone or just be in a more healthy position, then you can keep those for the rest of your life.

Dr. Tanner Townsend — 6:46

Oh, that’s incredible! That’s going to change our practice and also several patients’ lives.

Dr. Josh Muir — 6:51

Yeah, and don’t get me wrong, I love placing implants.

I mean, we actually depend on patients losing their teeth, but absolutely, if we can keep our natural teeth, I mean, that’s what I would want in my own mouth if I had a choice.

Dr. Tanner Townsend — 7:04

Yeah, totally.

So what is the laser? The laser is called a PerioLase MVP-7, and why is this laser the laser we use for this procedure?

Dr. Josh Muir — 7:17

So the laser works by using a specific wavelength of light, and that light targets dark-pigmented bacteria around our teeth and in our gums.

What’s amazing is it doesn’t affect the tooth, it doesn’t affect certain other parts around our tooth.

It only targets certain pigments, and so because of that, it’s very specific on what it’ll do.

So you can even use it to disinfect around a tooth.

So even if you don’t have the bone loss or the mobility, wiggly teeth, you can use this to just help with gum disease, and you can target those bacteria.

And if you get rid of the bacteria, then your gums go back to normal. They’re not swollen anymore.

Dr. Tanner Townsend — 8:08

Wow, that’s incredible.

So is there anything in addition? So it saves the teeth by the pigment essentially attacking the stuff in the pigment?

Interesting. So it helps the tissues. Can it actually help you grow new bone?

Dr. Josh Muir — 8:27

Yeah. So that’s the amazing part.

And historically, I don’t know if this is what they were trying to do or if this is just what happened and they observed.

But basically, if you clean the surface of the tooth without destroying it by scraping, which is sometimes done with scaling and root planing, if you can leave that surface intact and create a safe environment for growth, yes, that bone can grow back in and fill in the spaces.

Now, one of the key things, though, is we’ve got to stabilize your teeth so they’re not wiggly.

So sometimes we call that splinting the teeth together.

So if you’ve got one tooth that’s wiggly, we can splint it to the adjacent teeth, just for stability, and then we can do this procedure around that tooth, and it will likely grow bone.

Dr. Tanner Townsend — 9:20

Wow, that’s incredible!

So you just have it be splinted for several months after, or—

Dr. Josh Muir — 9:25

We’ll adjust it.

Typically, loose teeth come from your occlusion, with how the top and bottom teeth hit together, and if it’s hitting harder on one area versus another, then that tooth will likely become mobile and loose over time.

Dr. Tanner Townsend — 9:41

Interesting.

Can the laser therapy save a dental implant? We’ve already kind of talked about how it can with LAPIP.

What were some of the things that you learned in your course, like the cases that are eligible for being saved?

Dr. Josh Muir — 9:58

Yeah. So there are different types of problems with implants.

Now, if an implant is ever mobile, it can’t be saved. It’s done.

If an implant is ever in a situation, or a tooth, to be honest, if it’s ever in a situation where some infection has just wiped out all of the bone around it, it’s not going to regrow all of that bone.

But what will often happen is the bone around an implant or a tooth will start to decrease or recede, but it doesn’t go the full thickness from tongue to cheek.

It goes kind of in a dish shape, so just right against the implant, it loses some bone there, and that’s the bone that you can regrow.

So there’ll still be bone past that, but just right up against the implant, it’ll lose some, and we can regrow that nowadays.

Dr. Tanner Townsend — 10:55

That’s pretty cool, if I do say so.

So how do we know if, let’s say I have gum disease, I have periodontal disease, how do I know if I’m a candidate for this treatment, for the LAPIP or LANAP treatment?

Dr. Josh Muir — 11:10

Yeah. So number one, I would say still make sure you’re working with a general dentist.

You need to be getting your cleanings. You need to have some idea of the treatments or the status of your teeth.

But once a dentist says, “Hey, we’re going to recommend that you have the scaling and root planing,” that’s when I would get a second opinion.

Now there are only about, I think there are only three of these lasers in the whole state, and so it’s not a very commonly done treatment in Montana.

But across the country, around the world, there are a lot of these that have come up, and it’s been in existence for about 20 years or so, even longer.

And so it’s not a new procedure, but it’s taken a while to really take hold.

But now’s the time.

So if your dentist is telling you, “Hey, you need these other procedures, scaling and root planing. You need to lose all of your teeth,” even though they look good, then this is where you get a second opinion.

Dr. Tanner Townsend — 12:11

That sounds great.

So does this hurt? We kind of talked about how it’s a lot less pain, but how much pain am I really going to be in after this?

Dr. Josh Muir — 12:20

Yeah. So typically, what we’ll do is we’ll see patients two days in a row.

On the first day, we do the procedure. The next day, we touch base with them. We see if we need to do any adjusting, and they feel great.

And that is just what the patients say.

“How are you doing today? I know that was a lot yesterday.”

“I feel great.”

Really.

And so I know everybody’s going to experience it differently, but it shouldn’t be something that’s painful, and that’s really attributed to we’re not attacking the gums, we’re attacking that dark-pigmented bacteria that’s inside the gums.

Dr. Tanner Townsend — 12:59

Wow, that’s just incredible that it can be that specific on the target.

How many appointments does it take? Is it really just one time?

So you had mentioned just a second ago it was just one time, and you see the next day and check and see how you’re doing.

Dr. Josh Muir — 13:13

Yeah. So we typically do one side of the mouth, and then we have you come back after a couple weeks or so, and we do the other side of the mouth.

So we almost always split that up just so you have one side that you can chew on well while you’re adapting to the other side while it’s healing.

So as far as number of appointments, as far as treatment goes, it’s just once per side.

Dr. Tanner Townsend — 13:40

Great.

Dr. Josh Muir — 13:40

And yeah, so you’re only going through this one time, you’re only getting numb once, but you do need to go through these maintenance appointments, and they can be three months apart, six months apart, depending on the case.

But just like regular dental cleanings, you’d still need to go through those.

And so whether that means you’re going to go back to your general dentist, and they’ll take it from there, or whether that means you’re going to continue to come and see us over the years, and we’ll just maintain it for you, so you don’t have to have the whole procedure redone.

You just have to have those maintenance appointments.

Dr. Tanner Townsend — 14:15

Wow, how long do the results typically last with this? Is it something that’s going to last for a long time?

Dr. Josh Muir — 14:20

It’ll last a long time, and sometimes those maintenance appointments you can also call touch-ups.

We’re just touching it up here and there.

“Hey, this area is a little bit inflamed. Let’s touch that up.”

We’ll use the lasers a little bit more right there.

Dr. Tanner Townsend — 14:36

Wow.

So in terms of saving your teeth with LANAP versus taking out all your teeth and doing something like an All-on-4, which we do both in our office, what’s your rough cost difference that you could expect as a patient?

Dr. Josh Muir — 14:52

Gotcha.

So easily half the price if you’re doing the LANAP protocol for your full—it’s going to be half the price of the full-arch treatment.

Now, with that being said, doing the full mouth is half the price of one arch of the implant treatment.

So realistically, it’s about 25%.

Dr. Tanner Townsend — 15:16

So it’s a lot cheaper.

Dr. Josh Muir — 15:17

It’s a lot cheaper. Yeah.

Dr. Tanner Townsend — 15:18

And so, do you think it’s a better idea to save your natural teeth rather than go the implant route?

Dr. Josh Muir — 15:24

The thing is, there are points at which it doesn’t make sense to save them.

And this patient earlier today, on the lower teeth, it’s like, yeah, there’s enough of these that have problems.

You’ve got recession. You’ve got large decay on multiple teeth. You’ve got defects in your gums and in your bone.

So on the lower, let’s take those out. Let’s clean up that infection. Let’s put implants in, and let’s take you in a different direction.

Not worth trying on those.

Dr. Tanner Townsend — 15:54

Yeah. Well, I think that answered a lot of my questions.

Just the things that I learned just there from your course were fantastic.

I think this is going to be a fantastic procedure for our office.

And like you said earlier, we’d always rather save teeth.

And there’s a point where it doesn’t make sense to save the tooth. Let’s take the tooth out.

But when we can save it, might as well.

And let’s do it for a fraction of the cost and get you to have those teeth last longer. That way you can use them the way God intended you to, and then we have the backups of the implants at that point.

Dr. Josh Muir — 16:29

And one cool thing is with this procedure, it doesn’t harm anything.

Dr. Tanner Townsend — 16:34

No.

Dr. Josh Muir — 16:35

So you can have it done, and worst-case scenario—

Dr. Tanner Townsend — 16:38

It doesn’t work.

Dr. Josh Muir — 16:38

Your tooth is still wiggly, but it does clean up all of the bacteria around it.

You no longer have infection. You’re going to have more stability in your gum tissue and less pain.

Dr. Tanner Townsend — 16:48

Yeah.

Dr. Josh Muir — 16:49

That’s the worst-case scenario.

Dr. Tanner Townsend — 16:51

No, that sounds pretty awful to me.

Dr. Josh Muir — 16:53

Yeah, sounds like a great round.

Dr. Tanner Townsend — 16:55

Yeah. Well, I think that’s it. I’m excited for this treatment.

And so, if you have questions and you know that you have gum disease and you know that you’re probably on the route to lose those teeth, come into our office at Montana Center for Implants and Dentures and get a second opinion.

Let’s talk through the options, and we’ll have everything on the table.

We’ll talk about saving your teeth with LANAP and LAPIP and the All-on-4, and what option really makes sense.

Because for some people, it’s going to make sense to take the teeth out, and other people, it’s going to make sense to save them.

And so let’s just talk through what those options are, and we’ll figure it out together.

Anything else you’d like to add with that?

Dr. Josh Muir — 17:35

Just that even with this procedure, we still offer free consults, and that would be part of it.

We’re just happy to talk to you and help you make the right decision for you.

Dr. Tanner Townsend — 17:47

Yeah. So with that, we thank you for joining us for today’s episode of the Smile Reconstruction Podcast, and we will catch you all in the next episode.

Dr. Josh Muir — 17:55

Thank you so much.