Dr. Linden will be happy to answer any questions related to periodontics (gum disease, implants, etc.) as long as they are general in nature. He will be unable to answer questions about specific periodontal issues which would require a personal examination (unless, of course, you live in the vicinity and visit his office). Dr. Linden's answers to your questions are offered for educational purposes only, and are not intended as a substitute for professional periodontal care. Your name and email address will be kept confidential and will not be posted along with Dr. Linden's answer, nor will they be sold to third parties or used for any purpose other than to notify you that the answer to your question has been posted to this blog.
|Do some problems still require conventional gum surgery?Yes. We still use conventional procedures in some circumstances, but even during these procedures, we utilize the laser as much as possible. This reduces post operative discomfort for our patients.||9 Mar, 2010 3:56 AM|
|How soon after Laser periodontal surgery can I go back to work and family responsibilities?Laser surgery enables people to get on with their lives with minimal disruption. You might leave the office a bit "numb" but this wears off after a short period of time and you should feel little or no discomfort. Recent patients come to mind who, shortly after surgery, have traveled, made public or TV appearances or business deals, taken care of children, worked with heavy equipment, or performed as professional musicians.||9 Mar, 2010 4:02 AM|
|How long does Laser gum surgery take to perform?In many cases, we can do the treatment in one long session (2-3 hours). Sometimes, it can be split up into two sessions, usually one week apart.||9 Mar, 2010 4:09 AM|
|Will this treatment hurt?No. You will not feel anything. We use local anesthesia and will be extremely gentle. Patient comfort is our primary consideration.||9 Mar, 2010 4:19 AM|
|Does insurance cover laser gum surgery?We do not participate with any insurance plans, but typical dental insurance that covers "gum surgery" should cover you for laser surgery as well. Please check with your dental insurance carrier. We will also help you with the insurance "red tape" when you finish your consultation appointment.||9 Mar, 2010 4:23 AM|
|Can a patient make payments for the periodontal services such as laser surgery, implants or conventional surgery?Yes. We offer financing through the American Dental Association's approved financing programs. Please call our office for details.||9 Mar, 2010 4:26 AM|
|How would a periodontist determine whether I might be a candidate for laser gum surgery?By conducting a thorough clinical exam and reviewing a quality full mouth series of low exposure digital x-rays.||5 Mar, 2010 3:43 PM|
|What is the advantage of laser surgery over "conventional" gum surgery? Are the results better than conventional surgery?With laser surgery, there is no cutting or stitching of the gums, and therefore, minimal post operative discomfort. In our office, we are finding the results have been superior to the conventional therapy.||9 Mar, 2010 3:52 AM|
|Are you available to give lectures on laser periodontal surgery?Yes, as one of the first Periodontists on the east coast of the US doing this FDA approved technique, I am often invited to present Laser gum surgery to dentists, doctors, and health care workers. Check our web site under "Lectures".||9 Mar, 2010 4:28 AM|
|I am on blood thinners. Do I have to get off these medications before the laser surgery?One of the advantages of laser surgery is that patients don't have to stop their medications as with conventional gum surgery. This eliminates the risk to you of discontinuing the medications.||9 Mar, 2010 4:31 AM|
|Will I have gum recession after the laser surgery?Laser surgery does not cause any recession of the gums around the natural teeth or crowned teeth.||9 Mar, 2010 4:33 AM|
|Do I have to follow a special regimen after the laser surgery is completed?Dr. Linden will review with you at the consultation appointment the suggested regimen of cleaning, follow-up and necessary home care.||9 Mar, 2010 4:36 AM|
|I see that there are connections between heart attacks, cardiovascular disease, premature births and numerous other medical conditions with "unstable" periodontal disease. Does this laser surgery help? How about preventing infections if someone has an operation?Yes. The FDA approved Laser protocol we follow targets only the diseased tissue and specific bacteria that cause gum disease. These are the same bacteria that have been correlated with a number serious medical conditions. We also utilize the laser protocol before patients undergo hip replacement, knee replacement, chemotherapy, and other major surgeries to prevent any infection from traveling from the areas of gum disease around the teeth to other parts of the body.||9 Mar, 2010 4:38 AM|
|How much is this treatment?Each patient is different and the fee depends on the severity and extent of the disease.||9 Mar, 2010 4:40 AM|
|I understand that it is hard to determine price without seeing a patient, but if you were to compare laser to conventional surgery as an average, is it higher in cost or lower in cost, and by what percent?LANAP is not more expensive than conventional surgery. The two cost about the same, but in most cases, LANAP is preferable for the reasons discussed on http://www.drgums.com/periodontal-surgery/lanap.html.||3 May, 2010 11:50 PM|
|Is there a link between periodontal (gum) disease and heart disease?The link between periodontal disease and heart problems is well-established. Please see the Heart Disease and Stroke page of our site (http://www.drgums.com/mouth-body-connection/gum-disease-heart-disease-stroke.html) and the Periodontal Disease and Your Heart section of our blog (http://www.drgums.com/blog/category/periodontal-disease-overall-health/periodontal-disease-heart).||7 May, 2010 10:47 PM|
|Do dental insurance policies cover your services?Most dental insurance plans cover periodontal therapy. We are an out-of-network provider. However, we will fill out all necessary forms and submit them to your insurance company for reimbursement directly to you. Please check your policy for further details. We would be happy to help you better understand what your out-of-network dental benefits may be.||21 May, 2010 1:12 AM|
|How far are you located from NYC?Our New Jersey office is about half an hour away, depending on where in the city you're coming from. We'll be opening a Manhattan office soon, in addition to our NJ office.||9 Jun, 2010 5:02 PM|
|Is it ever possible to treat and heal gum pockets as serious as #6 without surgery? Thanks.If you are referring to a 6 mm pocket then the answer is yes. We can treat pockets of varying degrees depending on the clinical presentation and radiographs. We always recommend a complete oral exam and treatment plan.||14 Jun, 2010 4:18 PM|
|My orthodontist referred me to a periodontist. I had gum issues before. Can I get laser surgery or treatment even though I have braces?|
Yes it is possible to have laser treatment with braces. We would recommend a thorough clinical exam and radiographs to confirm this mode of treatment. Having periodontal issues during orthodontic treatment is a concern, but intervention is usually successful and oftentimes done with the laser.
|17 Jun, 2010 8:55 PM|
|I am missing two teeth lower teeth and am considering replacing a bridge with implants. I have been told that I will need to have bone harvested from the back of my mouth and inserted into my jaw to prepare it for implants. I will be under general anesthesia but am very nervous about this whole procedure. How painful will it be when I wake up? How difficult is recovery from this procedure?There are many different treatment options to consider when treating this area of the mouth. The anterior region of the lower (mandibular) jaw tends to have thinner bone. In many cases the ridge of bone is deficient for the placement of implants. In our office, we use local anesthesia and use either freeze dried bone (cadaver bone that is safe) or synthetic bone. We graft the sites as needed before implant placement. We would usually wait at least 3 months before the placement of the implants. We do not use general anesthesia. We do not have to harvest the bone from the back of your mouth. We try to keep the procedure as simple and conservative as possible. However, in very extreme and rare circumstances such as automobile accident cases or severe trauma, it might be necessary to refer you to a hospital trauma team. Many of those cases do require general anesthesia.||22 Jun, 2010 6:20 PM|
I had LANAP treatment and misunderstood the instructions. I brushed and flossed two days after treatment removing all of the clotting around my teeth. Will this diminish the effictiveness of the treatment? Also, is it possible to have the LANAP treatment a second time?
L.R.It is possible that there was a "disruption" of the healing process because of the premature brushing and flossing at day #2. Yes..it is also possible to have LANAP a second time. Please call us if you feel you would like to be seen and evaluated.
|26 Aug, 2010 12:48 AM|
|WHAT IS THE COST FOR LASER GUM TREATMENTThe cost for laser gum surgery can vary for each patient. After a thorough clinical exam, medical history, and review of a quality (digital) full mouth series of x rays, a final cost estimate can be discussed with the individual patient. Generally speaking, the costs of laser surgery are comparable to "traditional" flap surgery in our office.||16 Aug, 2010 1:34 AM|
|Do you have a cure for chronic halitosis?Halitosis (bad breath) can be caused by a number of factors, most often by "gum" or periodontal disease. There are also a number of medical conditions that on a rare occasions can cause halitosis. If we determine that gum disease is the cause of a patient's halitosis, we can treat it with the laser or other periodontal techniques if necessary, and provide instruction on proper oral hygiene techniques. We also want to rule out any systemic illnesses that can contribute to this problem. If necessary, we work with other medical specialists to cure this problem.||19 Aug, 2010 1:11 AM|
|I am living in Philadelphia, PA. Do you have any location near or in South NJ. And I need the cost information of the treament please.We see patients from New England down the coast to Florida. Our office is located in Northern New Jersey close to all major highways. If you live in the Philadelphia area, we are approximately 1.5 hours away. Please keep in mind, laser treatments can be done in one visit. Please see other recent answers regarding cost.||26 Aug, 2010 3:20 PM|
|If you have a bridge can you still have this treatment? And how to get rid of that smell it has?The "smell" you describe can be originating from bacteria buildup in the gums or leakage from the bridge. We routinely do periodontal treatment around bridges safely and effectively to treat gum disease.||9 Sep, 2010 2:31 PM|
|Do you offer a free initial consultation?We do not. However, senior citizens get a courtesy discount, based on the individual case and situation.||16 Sep, 2010 5:18 PM|
|What is the cost of periodontal osseous surgery?Periodontal osseous surgery is a form of traditional surgery. It’s difficult to answer that because each case is evaluated on an individual basis, based on the severity of disease, medical history, and the whole collection of clinical and radiographic data. Please call the office to discuss individual situations. We need to see the patient for a consultation before we can give a treatment estimate.||16 Sep, 2010 5:19 PM|
|How much does gum reduction surgery cost?Gum reduction surgery is a very general term which could represent a number of different procedures. We would need to examine the patient, collecting their clinical and radiographic data, to determine what procedure is appropriate. Then we could provide a cost estimate. All of the procedures we do are coded and standardized, and are covered under the average dental insurance plan. Even though we’re an out-of-network provider, our patients generally get reimbursed according to their plan. We help with filling out forms. We accept MasterCard, Visa, American Express, and something called Care Credit, which is an American Dental Association accredited financing program. We need to complete a consultation to quote a fee.||16 Sep, 2010 5:20 PM|
|I had a crown lengthening procedure done seven months ago, but my front teeth still hurt. Is that normal?It’s not uncommon to have some root sensitivity. But it has to be determined whether it’s root sensitivity or the nerve of the tooth is aggravated, etc. A number of factors could contribute to your discomfort, and it’s hard to determine without examining the patient. Generally, crown lengthening procedures increase the amount of exposed tooth surface. They’re done for a number of different reasons – aesthetic (for placing new crowns on the teeth), or for restorative reasons. Teeth can become sensitive after crown lengthening, but crowns which reduce sensitivity are usually placed on the teeth.||16 Sep, 2010 5:20 PM|
|Are there any alternatives to gum grafting?In certain instances, the laser might be able to enhance gingival (gum) augmentation, but sometimes a gingival graft might also be necessary. Using donor gingival tissue such as AlloDerm® prevents having to take tissue from the roof of the mouth. Such donor tissue isn’t rejected, so anti-rejection drugs are unnecessary. Donor tissue is very well screened, so there’s no risk of contracting hepatitis, HIV, etc. Other than gingival grafting, it is also sometimes possible to move existing gum around, thus avoiding having to take a tissue donation from the roof of the mouth. This would depend on clinical factors such as how much gum is left, and the anatomy of the mouth. The patient must be examined to determine the best treatment plan.||16 Sep, 2010 5:20 PM|
|How do you treat bone loss due to gum disease?The laser protocol enables us to regenerate bone lost due to gum disease. Traditional surgery will also give us bone regeneration in cases where the laser isn’t appropriate.||16 Sep, 2010 5:21 PM|
|How long does it take a gingival graft to heal?Everybody is different. A diabetic or a smoker will heal much more slowly. Some people have a genetic predisposition to heal extremely quickly. Typically, grafts can take several weeks to fully heal. Not that you’re feeling pain all that time, but it can take that long to feel completely normal again.||16 Sep, 2010 5:21 PM|
|How long does it take for microcirculation to develop after a gum tissue graft?You have to have blood supply within hours, or the graft will fail. The graft will continue to develop a more elaborate blood supply within days.||16 Sep, 2010 5:21 PM|
|Is a gingival graft painful?It can be, but with laser, we can laser the donor site to eliminate a lot of post-operative discomfort.||16 Sep, 2010 5:22 PM|
|Is there gum surgery for bone loss?There is, traditional bone surgery is seldom used, but we choose the laser whenever possible. It’s less invasive and gets the same result, if not better. No cutting or sutures.||16 Sep, 2010 5:22 PM|
|What is the success rate for gum grafting?It’s in the 90%’s. With very severe gum defects, the percentages come down a little bit. In each case, we conduct a clinical examination and photograph the gums to see where we’re starting. Based upon the result we think is achievable, we can predict an outcome.||16 Sep, 2010 5:22 PM|
|When a gingival graft is done and stitches dissolve does that mean that it is healing?If they are dissolvable stitches, they will dissolve whether it’s healing or not. The success of a gingival graft doesn’t necessarily hinge upon the sutures dissolving.||16 Sep, 2010 5:23 PM|
|When you have a soft tissue graft, where does the donor tissue come from?One of two different sources. The patient’s own mouth in a different location, usually the palate, or AlloDerm® from a tissue bank, which is obtained from a cadaver. Tissue banks are very heavily regulated, so donor tissue is safe. There have been no documented cases in the last 25 years of anyone getting a disease from a tissue donation like this.||16 Sep, 2010 5:23 PM|
|Are HIV patients especially susceptible to periodontal disease?Absolutely. Very severe. Their resistance is compromised, so their ability to fight off the bacteria in the mouth is greatly reduced and they suffer the consequences of that.||16 Sep, 2010 5:23 PM|
|Are some people genetically predisposed for gum disease? Yes, and we have actually seen patterns in entire families. We can’t necessarily test for this and predict it, but we have seen it clinically.||16 Sep, 2010 5:24 PM|
|Can advanced periodontitis damage the alveolar process?Yes. In this case, “alveolar process” refers either to the "tooth socket" or bone that holds the roots of teeth, or to the alveolar ridge, the jaw structure that contains the dental alveoli. Periodontitis is destruction of both of these supporting structures of the teeth.||16 Sep, 2010 5:24 PM|
|Can gum disease be controlled?Absolutely. Between professional periodontal care and good home care, it can be controlled.||16 Sep, 2010 5:24 PM|
|Can I tell if I have gum disease, or do I need a professional examination?The main things that people may notice themselves include bleeding gums, a bad taste in the mouth, bad breath; teeth that feel loose or have moved, and gum discomfort. If you have one or more of these symptoms, visit a professional (periodontist) who can determine whether you have gum disease; whether it’s moderate, advanced, or severe; and what can be done to treat it.||16 Sep, 2010 5:25 PM|
|Can periodontal disease make you sick?That’s a big question these days, because a number of studies in the last couple of years have indicated strong associations between periodontal disease and cardiovascular disease, heart attacks, and liver cancer. Now studies are looking into brain and kidney issues. The bacteria in the mouth that cause periodontal disease include, among other things, gram negative bacteria and spirochetes, and they’re very virulent; very powerful. If they circulate around the body in the blood stream, it can lead to a number of systemic illnesses.||16 Sep, 2010 5:25 PM|
|Can receding gums grow back, or is it irreversible?Generally irreversible without professional treatment. This might include gingival grafting or “lateral pedical grafting” which is moving tissue around to protect teeth, like moving a curtain around to cover windows. We now usually use laser in conjunction with all these procedures to minimize the post-operative discomfort associated with these procedures.||16 Sep, 2010 5:25 PM|
|Do you recommend the use of a perio tray for gum disease?We don’t use that as a routine procedure in our office because the therapeutic model that we follow makes it unnecessary. We use laser treatment and certain rinses. We’re not big on the perio tray.||16 Sep, 2010 5:26 PM|
|How does a mouth tray help in dealing with periodontal disease?If you mean a mouth guard, that’s a piece of plastic that fits over the teeth which prevents you from grinding and clenching them. Grinding and clenching results in what is called occlusal trauma. If you have preexisting gum disease, it makes it more destructive.||16 Sep, 2010 5:26 PM|
|How long does it take for a periodontal infection to show up on a dental x-ray?That’s a hard question to answer. Some bone defects could show up clearly on an x-ray. Others not. But if it were an acute abscess – an emergency – it would usually show up.||16 Sep, 2010 5:26 PM|
|How to stop bleeding gums?It’s also called gingivitis. If x-rays and a clinical exam confirm that the cause is soft tissue only, it can be reversed with good home care – flossing, brushing, and a good professional cleaning. If the cause is periodontitis – bone loss underneath the gum tissue – that has to be treated with the laser or other modalities. Depending on the severity, laser treatment might be able to reverse or at least stabilize the situation and regenerate new bone. We can also use the laser at an earlier stage to prevent the disease from going into an advanced stage.||16 Sep, 2010 5:27 PM|
|If my gum disease is advanced, will I lose my teeth?You may, if you are not treated. We treat gum disease all the time - early, moderate, and advanced - and we save the majority of teeth. You’re not doomed, but if you don’t seek treatment you will end up with dentures or expensive implants. We are able to save teeth now that we were extracting 10-15 years ago.||16 Sep, 2010 5:27 PM|
|In what age group is periodontal disease most prevalent?After the age of 25-30 it starts to go up exponentially, but we have seen cases of what we call juvenile periodontitis, which is a genetic form of gum disease that shows up in the late teens.||16 Sep, 2010 5:27 PM|
|Is periodontal disease contagious?Yes. Studies have indicated that it is transmissible between partners and companions, through kissing and intimate contact.||16 Sep, 2010 5:28 PM|
|Is there a connection between joint disease and gum disease?Ongoing studies are looking at the associations or potential associations between gum disease and joint and bone problems such as arthritis and osteoporosis. It’s not clear at this point whether there’s a direct association, but studies are ongoing.||16 Sep, 2010 5:28 PM|
|Is there a periodontal treatment for severe dry mouth?Usually, dry mouth is a side-effect of medications. There are medications to enhance salivary flow. In some rare cases a disease causes this condition. It can be diagnosed through a blood test. We do see an increase in periodontal disease in these patients.||16 Sep, 2010 5:28 PM|
|Is there anything a tobacco user can do, other than quitting smoking, to prevent gum disease?Quit, quit, quit! We recognize human nature, but nothing can replace quitting smoking. If you can’t quit, cutting back is helpful. Numerous studies have shown a direct correlation between tobacco use and periodontal disease. Clinically, we see it all the time. Chewing tobacco is even worse. There are documented reports of baseball players who chew tobacco and have pre- cancerous or oral cancer lesions removed.||16 Sep, 2010 5:29 PM|
|My teeth are loose because of gum disease. If my gum disease is cured, will they become “tight” again?We would have to study models of the mouth and the bite. It may be possible to stabilize them through the appropriate periodontal treatment, in conjunction with occlusal therapy (analyzing and stabilizing the bite). In many cases that’s done with crowns or occlusal guards. It’s like stabilizing the loose posts in a picket fence by connecting them. Laser treatment is mandatory in these cases to treat the gum disease.||16 Sep, 2010 5:29 PM|
|What are the side effects of periodontal disease?It can cause you to lose your teeth and suffer other illnesses, the bacteria accumulating in your mouth is uncomfortable and causes bad breath and a bad taste, you can transmit it to your partner or companion, you can’t chew your food correctly, which can cause digestive issues, and of course there are aesthetic concerns if you lose your teeth or they start spacing.||16 Sep, 2010 5:29 PM|
|What causes gum recession?Some habits can cause gum recession, such as excessive brushing with a hard toothbrush. Genetics can also cause it, and gum disease itself can cause the gums to recede.||16 Sep, 2010 5:30 PM|
|Does periodontal cleaning involve cutting the gums?No. Periodontal cleaning is not surgery or laser surgery. It is merely using some sort of hand or ultrasonic instrument to clean the teeth.||16 Sep, 2010 5:30 PM|
|What can be done about receding gum line grafts?If the graft is receding, you have to have that looked at and perhaps retreated, or maybe the tooth or the area treated weren’t very good candidates for a gum graft to begin with. If the person is a diabetic and doesn’t heal well, it’s difficult. A big plus for the laser is that we can avoid cutting and surgery.||16 Sep, 2010 5:30 PM|
|What is the effect of periodontitis on the lungs?Recent studies have indicated that there might be some connection between lung disease and periodontitis, because both involve some of the same bacteria. Laser treatment can eliminate these potential bacteria from the oral cavity, which have the potential to spread to the lungs and other sites in the body.||16 Sep, 2010 5:30 PM|
|Does the dental implant come through the gum after surgery?You can see the tip of the implant after gum surgery in some cases, but once you put a tooth on it, you won’t see it.||16 Sep, 2010 5:31 PM|
|What can you eat with temporary implant teeth?It depends on the case and the individual situation. You can eat most things. You just want to be careful with very sticky foods such as gum, or hard things, so as not to break them.||16 Sep, 2010 5:31 PM|
|Does the quality of crowns and implants vary?Yes. A few Periodontists and general dentists have tried to save a few hundred dollars by using implants from China and other questionable sources that were contaminated with lead and other impurities that are not biologically acceptable and safe. But most use high-quality FDA-approved products. Always ask your specialist what manufacturer the implants and crowns are procured from.||16 Sep, 2010 5:31 PM|
|Can I wear braces after LANAP?Yes. We do LANAP around braces; we just have the wires taken out in certain cases. We leave the brackets on but we work around them. Braces can also be initiated after LANAP treatment once clearance is given by the Periodontist.||16 Sep, 2010 5:32 PM|
|Are there any home remedies to get rid of periodontal disease?If there were, I’d be out of business. Other than mechanical removal, there are a variety of natural, organic, anti-plaque agents on the market. I don’t advocate anything in particular, but I do avoid alcohol-containing mouthwashes like Listerine. If someone wants to use that to freshen their mouth, I recommend they dilute it – not use it full-strength. Tom’s of Maine makes some interesting products. Each person gets different results from different products. One product might work for one patient but not be the best for another.||16 Sep, 2010 5:32 PM|
|Can peroxide help fight gum disease?There was a professor name Dr. Keyes, a microbiologist in the late sixties, early seventies, who came up with a mixture of sodium peroxide and baking soda that patients brushed on their gums. In the lab, it kills bacteria. But then researchers found that peroxide causes cancerous or pre-cancerous changes in the gingival gum tissue. So we stopped using peroxide. I used to put peroxide on after gum surgery with a Q-Tip. No more. Never rinse with hydrogen peroxide.||16 Sep, 2010 5:32 PM|
|Can vitamins or minerals help prevent or reverse gum disease?About 15 years ago I had a patient who had severe periodontal disease and needed a lot of treatment. She declined treatment and instead started on a regimen of about 25 vitamin supplements recommended by her dentist. A year later she lost eight teeth and needed surgery. I wholeheartedly endorse a good balanced diet with vitamin supplementation (not megavitamins) but we still do not have proof that supplements prevent or stabilize gum disease.||16 Sep, 2010 5:32 PM|
|Do you recommend any sort of natural or alternative treatment for gum disease, such as homeopathy?If a patient is using something I don’t know about, I always ask them to bring it in and show me the ingredients. As long as it doesn’t do anything detrimental, I don’t have a problem with it. Laser therapy could be considered a natural treatment in that we don’t use any external bone grafting and we use the body’s own cells to regenerate bone. We do have to anesthetize the patient, but the laser protocol is an effective and innovative procedure which can often obviate the use of traditional invasive surgery.||16 Sep, 2010 5:33 PM|
|How can I treat periodontal disease at home?Good home care, a balanced diet, professional check-ups. Also, try to reduce stress. Periodontal health is compromised when people are under a lot of stress.||16 Sep, 2010 5:33 PM|
|Is there a medicine, whether prescription or over-the-counter, which effectively treats gum disease?There’s no magic bullet. We rarely use low-dose antibiotics which can be taken long-term, such as Doxycycline. However, I am not a big advocate of long-term antibiotic usage. A short-term regimen is indicated for some patients. Laser treatment has replaced the use of long term antibiotics. Long term antibiotics can allow resistant strains of the bacteria to develop which will render antibiotics ineffective if needed for other future medical uses in your lifetime.||16 Sep, 2010 5:33 PM|
|Is there a particular brand or kind of toothpaste that you recommend for people who have or are prone to having periodontal disease?There’s a wide variety. I don’t advocate a particular brand. I like the natural products, because they contain fewer preservatives and also contain fewer artificial sweeteners and chemicals.||16 Sep, 2010 5:34 PM|
|Are there oral rinses for gum disease that do not stain the teeth?Chlorhexidine antibacterial rinse is very effective for gum disease. It does stain some people’s teeth, but not all. Smokers and heavy coffee and tea drinkers have a greater tendency to stain. It is available by prescription only. We have some patients on it long-term. Each case is different. There are many other rinses on the market that don’t stain. We have no preference.||16 Sep, 2010 5:34 PM|
|How painful is pocket depth reduction?Traditional pocket depth reduction surgery is more invasive than the laser approach, which is much more patient-friendly. Traditional pocket reduction surgery, which we performed most commonly for 20 years, is more aggressive and can be much more discomforting to the patient.||16 Sep, 2010 5:34 PM|
|How effective is ARESTIN® in treating gum disease?ARESTIN® is a powder like antibiotic that we used to place underneath the gum tissue. For many years our office used almost every injectable antibiotic product that seemed reputable and available, but we had to repeat their use every two or three months. We don’t need to do that anymore because of the laser protocol. The laser takes care of the infection and regenerates the bone.||16 Sep, 2010 5:35 PM|
|What percentage of Periodontists now uses the laser, as opposed to more antiquated methods? A majority of Periodontists still use traditional surgery for pocket reduction or gum disease, but laser use is growing rapidly.||16 Sep, 2010 5:35 PM|
|Do you ever provide emergency services on the weekend?I would if necessary, but in Periodontics, emergency care is rarely needed if the disease is controlled correctly.||16 Sep, 2010 5:35 PM|
|Can you kiss someone with periodontitis?You can, and I’m sure it happens all the time, but you risk giving it to your partner, so you might want to have it treated before you do that.||16 Sep, 2010 5:35 PM|
|After periodontal surgery my mouth had a terrible odor from the band they put around the gum.You’re referring to the packing or “perio-pack” that is used after traditional surgery. That does develop a stench after about a week (usually bacteria buildup under the packing causes this smell). Because we use the laser, we do not need to use a pack anymore.||16 Sep, 2010 5:36 PM|
|Are all periodontists qualified to perform laser gum surgery?No. Periodontists have to undergo special training which takes up to a year. This involves attending FDA-approved laser accreditation courses in which you learn the FDA-cleared protocols for laser therapy.||16 Sep, 2010 5:36 PM|
|Can I have laser dental surgery during pregnancy?Ideally, elective work should be done before the patient becomes pregnant if possible. Otherwise, we wait until after the pregnancy. But if there is an infection in the mouth, we have to take care of it, no matter what, with clearance from the patient’s physician. There is something called “pregnancy gingivitis”. If someone has preexisting gum disease and they get pregnant, it gets very much out of control. If treatment is essential, we prefer to treat during the first two trimesters, not the third. Cleanings from a trained Periodontist are recommended during pregnancy to avoid problems and infections. Laser treatment can be done as well.||16 Sep, 2010 5:36 PM|
|Can LANAP surgery remove calculus?The LANAP protocol includes the removal of calculus. The laser itself does not remove calculus. Calculus is removed with ultrasonic and various instruments.||16 Sep, 2010 5:37 PM|
|Can you cure a periodontal fistula?A fistula is a hole in the gum with an infection (pus) in it. . Sometimes we gently place a “gutta percha” point in the fistula – a rubbery material that’s used for root canal filling. It’s radio-opaque, so you can see it on an x-ray. This enables us to see where the fistula is going. If it’s going to the root of the tooth, it’s probably a root canal problem. If it’s going to the side of the root, it could be a cracked root (which the laser usually can’t treat), or gum disease. I had a recent patient with a fistula present. The front tooth had a deep pocket. I treated it with LANAP and I also went into the fistula with the laser at a reduce power setting. Periodontal fistulas respond very well to the laser. We have treated many of these types of infections with great success.||16 Sep, 2010 5:37 PM|
|Does periodontal surgery affect your equilibrium?I have never seen either traditional periodontal surgery or laser effect equilibrium. Perhaps that might come up with a patient who’s had some local anesthesia, who has low blood sugar and might tend to get dizzy after having any procedure done, or it might be caused from lying back, and sitting up too quickly. That’s called postural hypotension.||16 Sep, 2010 5:37 PM|
|How long do I have to rest after periodontal surgery? What is the recovery time?I just had a patient who had full mouth laser periodontal surgery who went to play golf right afterwards. Most patients go back to their normal routine in a few hours after the laser procedure.||16 Sep, 2010 5:37 PM|
|I just had osseous surgery for gum disease. Do I need to have scale planing too?If someone has osseous surgery, they should not need scaling and root planing in the same location.||16 Sep, 2010 5:38 PM|
|Is it OK to go swimming after periodontal surgery?I wouldn’t recommend it. If I use the laser, I would prefer that you wait a couple of hours before being under water, or getting water in your mouth.||16 Sep, 2010 5:38 PM|
|Is periodontal surgery safe for children?Absolutely, if they need it. We do laser procedures on kids before braces. We also do what we call frenectomies (removal of excess gums attachments) and some gum removal if the teeth need to be exposed.||16 Sep, 2010 5:38 PM|
|What are the side effects or after effects of gum surgery?It depends on which gum surgery. If it’s traditional surgery, you might have stitches and periodontal packing and might need to take it easy that day. If it’s laser surgery, I often have patients from out of town who hop on a plane to go home the same day, or drive three hours. The recovery from laser surgery is relatively easy. In general, laser procedures are much more easy and patient-friendly than traditional surgery.||16 Sep, 2010 5:38 PM|
|What is a dental laser?A dental laser should be a laser that’s FDA-approved for dental use. There are different types of lasers. Some can take your tonsils out. But very few lasers are FDA-approved for treating gum disease, and the number one protocol to do that is LANAP. I often combine LANAP with conventional procedures. Let’s say someone needs a crown on one tooth and I can’t do it with a laser. I’ll do that one tooth traditionally and treat five other teeth with the laser, so I don’t have to cut all the teeth. I can take teeth out, which I do all the time, laser the socket, bone graft it, and get it ready for an implant or a bridge. That will enhance the result and there will be less post-operative discomfort. So we not only do LANAP, we expand the use of laser surgery with conventional work, and minimize the amount of aggressive surgery.||16 Sep, 2010 5:39 PM|
|I am 25 and have found out I have juvenile periodonitis. I'm presently in Montreal Canada and you seem to be the nearest dentist to me who does the LANAP procedure. I'd like to get some more information on lanap and also would like to know what a consultation entails before I make the drive to your facility.|
I welcome hearing back from you
We have shifted our approach to treating juvenile periodontitis away from aggressive traditional surgery (which we performed for over 20 years with reasonable success) to the laser approach. The laser surgery results in our office have been extremely successful and the procedure is certainly more patient-"friendly" than older procedures which involved cutting and sutures. Please see our web site for more information on laser surgery. We usually perform laser surgery in one appointment.
We would need to do a clinical examination, review your medical and dental history, take a set of quality digital x-rays, and put together a custom treatment plan for your situation. If you are traveling a long distance to our office, as many patients do, and we determine that you need laser treatment, we will try to schedule it the same day or early the next day for your convenience. If you have a current digital full mouth series done in Montreal and have them emailed as JPEG attachments, then we would review them in preparation for your visit. This may shorten your initial consultation and help us properly schedule your actual treatment.
For more information, please call our office and we can help you and answer all your questions.
|24 Sep, 2010 2:46 AM|
|During my recent cleaning my teeth were probed by the hygienist and apparently there were 7mm pockets towards the back of the two molars adjacent to where my wisdom teeth are partially erupted. These are the only pockets I have and would have had my wisdom's removed earlier if I knew there was such activity but my previous dentist missed it. I have read that is extremely common to have pockets due to wisdom tooth eruption, especially if they are impacted and are pulling the tissue away from the tooth. So my multi part question is : 1. Does a 7mm pocket next to an erupting wisdom tooth necessarily mean bone loss or is there a chance bone loss has not occurred yet? Trying to figure out whether 5mm+ automatically equals bone loss. 2. There is currently inflammation due to the impaction plus whatever else terrible is going on. Is it common for a pocket to appear 7mm in depth due to tissue inflammation. 3. What usually comes first? The wisdom tooth extraction or the adjacent pocket treatment?|
As you can see I did a little research but I know my limits and am acknowledge I need best-in-class professionals on my side. Thanks in advance for your response. It is common to have periodontal pocketing and inflammation between the wisdom teeth and the adjacent 2nd molars. Most of the time, there is bone loss present. Depending on the individual clinical situation and evaluation of x-rays, our first step is to decide if removal of the wisdom teeth is necessary. If it is, then we would extract the wisdom teeth first and then treat any remaining periodontal pocket issues with the laser.
|27 Oct, 2010 9:31 PM|
|I am 43 yrs old and was told I have periodontal gum disease. I was told that I would have to have all my back teeth pulled and have the denture things done. I was told that I lost a lot of bone. I am not ready to give up my back teeth. What can I do?The only way to make a diagnosis and treatment plan for you is to see your full mouth series of digital x rays and perform a clinical exam. We can determine at that point what teeth we can save and if any need to be extracted. We do everything reasonable to save teeth. With the use of laser treatment, we are saving more teeth than we did 10-25 years ago. We are able to perform dental implants and perhaps save a few teeth as an alternative to full dentures.||8 Oct, 2010 6:41 PM|
|I recently swallowed over 90% of a molar, and didn't realize it until I brushed my teeth a couple of hours later. I'm assuming that I swallowed it while eating. It wasn't loose, nor had I had any problems with it previously. I was just told that I had osteopenia, and am wondering if that could contribute to bone loss to the effect of having teeth fall out.I am not really clear what "90% of a molar" swallowed means, but from what you describe the options might include:|
Option #1 - a fractured portion of the tooth breaking off (90% as you describe), which can be caused by either tooth decay or other dental trauma unknown to the patient without any pain or symptoms. I am assuming that the remaining portion of the tooth has been extracted by a dentist since then. Usually an x-ray of the area would reveal the situation that lead to the loss of the 90% of the tooth in question.
Option #2 - bone loss leading to a loose tooth exfoliating on its own. This is unusual if you have seen a dentist within the last 6 months or so and had a thorough periodontal dental exam. You mentioned the tooth was not loose. Sometimes a patient doesn't realize how loose a tooth can be depending on the individual situation and whether dental x-rays were taken prior to the spontaneous tooth loss. Although osteopenia can affect the bone support in the mouth, it is extremely rare that teeth just "fall out" if you have been under the care of a dentist. There are rare systemic diseases where we see spontaneous tooth loss, but the odds are extremely remote. A complete work up with your family doctor is also advisable to rule out any other conditions.
My suggestion is to visit your dentist or periodontist and have a full set of digital x-rays and clinical exam and see what is going on in your mouth. Hopefully, you will avoid this situation from happening again.
Dr. Eric Linden
|5 Nov, 2010 6:34 PM|
|I had laser gum surgery 9 days ago to remove some gum tissue that was growing over my implant posts (while we are waiting for the lab to re-do a mistake on my permanent crowns for implants). I have a horrible taste in my mouth and have really bad breath since the laser. My periodontist says he has no answer to why I have this. I need to know if this is normal after laser surgery, and how long it will take to go away. Thank you for your help. TrinaDear Trina:|
We really have not seen what you are describing after our laser procedures. We usually don't have any "bad breath complaints". Did your Periodontist look in your mouth and examine the tissues when you started having the bad breath? Was there any infection? Was there food and plaque build up all over your teeth, gums and cheeks? Do you have any other teeth which might have infection and drainage? Have you been brushing any areas of your mouth, or tongue? You could get bacteria buildup on the tongue which could contribute to bad breath. Are you taking any medications? Using any rinses? Any change in diet? Do you have any digestive problems? All these are possible explanations. Be sure to check with your Periodontist to rule out any of these possibilities.
Best of luck,
Dr. Eric Linden
|11 Dec, 2010 5:54 PM|
|I had an apico performed on #10 about a year ago. I am unhappy with the incision that was left. Can this incision be modified to be smoother with the aid of a laser? Also do lasers do deep cleaning of the teeth?It is possible that using the ND/YAG laser at the correct setting and power can affect or "soften" the incision. How much resolution is not predictable. Lasers alone cannot do a deep cleaning. The cleaning portion needs to be combined with hand instruments or ultrasonics. This is part of the LANAP protocol sequence.||28 Nov, 2010 5:07 AM|
|I am 44 years old and have advanced gum disease and now one of my lower front teeth is loose. Is it possible to save a loose tooth or must I have it extracted as I have been told?Yes, it is possible to save a loose tooth. However, this can only be determined after evaluating the clinical findings, quality x-rays, and a full dental and medical history. Sometimes we are able to use laser surgery (which is less invasive than traditional surgery) and splint the loose tooth to the adjacent teeth to strengthen it.||30 Nov, 2010 6:15 PM|
|Is tetracycline gel a good treatment for gum disease and what are the side effects?Tetracycline is an adjunctive medication useful with definitive periodontal treatment. This is an antibiotic that is specific for killing off bacteria that cause periodontal disease. However, it doesn't kill all of them. Warnings: Long term use could create resistance. Use with caution when taking birth control pills, excessive sun exposure, ingesting dairy products and cross reactivity with many other medications. Always read the warning labels when taking any medications. In summary, tetracycline alone is not an adequate treatment for gum disease.||22 Feb, 2011 4:51 PM|
|I had three teeth removed because of bad taste. I still have the bad taste. Help.I would advise going back to the dentist who extracted the teeth to make sure there isn't any infection.||11 Feb, 2011 9:52 PM|
|I was just told that I have moderate to advance periodontal disease. I started the deep cleaning and scaling, I am being referred to a periodontal specialist by my dentist. I wanted to know if laser surgery would be a better option instead. To get rid of the bad breath and to replace any bone loss and to safe my teeth and to prevent the chronic presence of the gum disease. I realize there isn’t a cure but with the right preventions can. These symptoms go away and prevent any further health problems. When you say control the gum disease does that mean you will now have healthy gums fresh breath and good oral hygiene after laser surgery or periodontal surgery? How often will I have to see the dentist after surgery? Every 3 months or every 6 months? I am totally horrified I wish that deep cleaning or surgery would fix the problem that my gums would just be healthy again...will they be healthy after this procedure? Please let me know. What is the best option for me? Thank you and waiting for your response.All of your questions are excellent. In our Laser Periodontal practice, as a first step we do a thorough clinical exam and review of a full mouth series of digital radiographs. If we determine that your gum disease requires further treatment, our first choice would be the use of an FDA cleared protocol with the laser. Assuming no other unusual factors, we would prefer to treat the disease without cutting or flapping of the gum tissue, as is done in traditional surgery. We can stabilize the disease in most cases and the use of the laser is the most effective method. In certain cases, we are forced to do traditional surgery. I would need to see you to determine the prognosis and the least invasive way to get your gums healthy again so you can maintain your oral health for many years. At the conclusion of your treatment, we would then recommend the appropriate interval for your cleanings and checkups. I hope this helps.||13 Feb, 2011 12:31 AM|
|My daughter has braces and for the past 6 months her gums are swollen. The specialist told me that he has to cut her gums. Does this happen often with braces? Will it happen again? Is cutting and sealing her gums the only remedy?It is not uncommon to have "swollen" gums during orthodontic treatment. Usually, proper oral hygiene can control this condition. However, if the gums become so inflamed that removal of inflamed gum tissue is necessary, we will use the laser and not cut the tissue. The healing is significantly faster and the post-operative experience is much easier for the patient.||23 Feb, 2011 11:45 PM|
|I have a crown on a molar that was put on 20 years ago. It was a tooth with a very large filling and when the dentist was drilling out the filling it came apart and the smell was terrible! Obviously some awful bacteria living below the filling. He had to take so much of the tooth away that he had to put a pin in the middle of the tooth to help support the crown along with adding some silver filling around the pin to mount the crown on. I now have pain around this tooth and down in the jaw. I feel that the bacteria infection stayed and is now down in the jaw. Is this likely and is the only way to fix the problem to remove the tooth?It sounds like the old crown was removed, decay excavated, and a pin placed as a core for a new crown. If you are still having symptoms, an x-ray should be taken to see if there are any root canal issues or if the tooth needs a gum procedure or possibly an extraction. It is very hard to diagnose this condition without a clinical and radiographic exam. I would go back to the dentist who did the work and get his/her opinion or seek the services of a specialist.||28 Feb, 2011 1:06 AM|
|I'm not a smoker. I do not drink coffee and have less than five cups of tea per month, yet my teeth stain at a rapid pace a month after professional cleaning. My dentist does not know why this happens. Have you seen this condition with any of your patients? Can you advise on a possible cause? I have good oral hygiene.This is a rare finding in our practice. But I would ask you the following questions: Do you use any chlorhexidine rinses? Does your diet include spices? Exotic foods?||6 Mar, 2011 4:45 AM|
|At 84 years old and with periodontal disease for the last God knows how long now, spent $4,000 in the eighties to resolve it, but it came back. Now I'm afraid I might have to leave my right arm at the D.M.D. M.S.D. And at this point of my life, when most of my money, it seems, is tied up in China, what should a Vet. do? Wait until my teeth start falling out, and make a necklace? And not only that, you're in NJ & I'm in PA. Just my luck. HeshDear Hesh: Before you make a necklace, let me try to save some of your teeth. We treat people from all over the world. PA is right next door to us. Don't give up hope.||23 Mar, 2011 6:21 PM|
|I have been diagnosed with periodontal disease. My dentist hasn't explained to me the severity of my disease. All he said was that I need to have 9 teeth removed. I need a second opinion. I would like to know whether there is another alternative and whether maybe some of my teeth can be saved. Please answer my question as soon as you can, Thanks.I'm afraid it's hard to answer a question like that without conducting a comprehensive periodontal exam, including a quality set of digital x-rays. Then we could determine what we can save and the approach that would most appropriate.||9 Mar, 2011 12:33 PM|
|I noticed a slight receding of some of my gums. I went for a check-up and the dentist said it is due to wrong brushing. She told me to floss and brush the proper way. Two of my lower teeth need a bonding material to fill the gap; others that are a little receded do not need anything as of right now. I will be 35 in two months and I am very scared of losing my teeth. Is there anything I could do to reverse in any way my recession of gums. I have to mention my teeth were clean and no cavities. There is no bleeding of gums ; they are not sensitive to cold or hot foods. I feel very frustrated and scared that it might keep on going worse. There are no issues of gum problems in my family. I do not want to let my teeth go so bad that I need a surgery. It is very expensive even with insurance. Having 2 kids is a financial challenge enough.|
I hope there are things I could do to stop recession or hopefully reverse it.
Thank youGum recession can be progressive and if not treated, can lead to tooth loss. There are periodontal procedures (if necessary) that can stop and possibly regain the lost attachment. We often use the laser with these procedures. I would recommend seeing a qualified periodontist and having a thorough evaluation. There are many factors that can lead to the gum recession which you are describing. I would certainly use a very soft toothbrush using the correct brushing technique (this should be shown to you at your periodontal visit). Don't neglect this situation. See a Periodontist.
|22 Mar, 2011 9:56 PM|
|My current dentist has me on a 3 month cleaning schedule. My gums are receding. One tooth, he says, is "hanging by a thread". How long is he going to wait before treating me for gum disease? I don't want to lose my teeth. I have a fear of dentists.It sounds like you need to see a periodontist as soon as possible to evaluate your condition. If you are fortunate at this late stage, you might be a candidate for laser periodontal surgery. Scroll down a bit on our home page and watch the video in the center column. As you'll see, this form of "surgery" is nothing to fear. It is a gentle, painless procedure which does not involve cutting or sutures, and it has been shown to be very effective in remedying the root cause of receding gums.||8 Apr, 2011 4:51 PM|
|I have recently been diagnosed with severe periodontal disease. I would like to know if removal of your teeth is the only solution. Are there any other methods out there that can help?Removal of teeth is a last resort, but in most cases, even severe periodontal disease can be arrested with professional treatment. With proper follow up care and adoption of a prescribed daily regimen, your teeth can probably be saved. But don't allow your condition to worsen. Schedule an appointment with your periodontist as soon as possible.||13 Apr, 2011 5:08 PM|
|I have been having issues with my gums. Please help me. I don't want to lose my teeth. As much as I would like to help with a written answer, that cannot be a substitute for professional periodontal examination and treatment. The sooner you have that done, the better will be your chances of not losing your teeth. Gum disease often becomes progressively more severe if left untreated, so time is of the essence. If you don't live in our area, or don't want to travel, find a good periodontist in your area who is proficient in the use of LANAP.||15 Apr, 2011 3:06 PM|
|What is the treatment for gum disease? I recently found out that my friend has gum disease. Is kissing her open mouth dangerous as far as the gum disease? What is the eventual outcome?Dental studies prove that the bacteria that cause gum disease is contagious and transferable. Your friend should be evaluated and treated as soon as possible. The laser might be a good option.||23 Apr, 2011 1:08 AM|
|Is it normal to have LANAP done before trying planing and scaling? Can dentists do scaling/planing or only periodontists?The best qualified professional to do any periodontal therapy is a Periodontist. The LANAP protocol includes scaling and root planing. In our laser periodontal practice, if a patient has a diagnosed periodontal condition, we recommend the most effective treatment to stabilize the disease. There is little research and clinical data to support scaling and root planing as a definitive treatment.||28 Apr, 2011 2:14 AM|
|I would like to know what is the warranty on dental implants and what has been the success rate on them. I would also like to know what has been the success and side effects of having the laser treatment done.Laser Periodontal Surgery is a safe therapeutic modality and very successful in gum disease treatment. It has essentially replaced over 75% of our conventional surgeries. We are currently preparing our cases for publication. There are no side effects of the laser. Implants are over 90% successful. If an implant fails before the one year anniversary, we replace it at no charge to the patient. This rarely occurs.||11 May, 2011 7:24 PM|
|I had lanap done in the entire mouth. I need to know when can I start braces. I have an overbite. Lanap was done 4 days ago on my left side. The right side was 3 weeks ago. What kind of braces do you recommend? I'm 48 years old, in good health, but I need my teeth to be pushed back, and also not to cost an arm and a leg...for how long do I need the braces? I do not care if is the old fashioned ones as long as it does the job.It is best that you consult the doctor that performed your full mouth LANAP. They should be able to explain to you what the protocol is following the LANAP procedure and the necessary clearances and time to wait before starting any orthodontic treatment.||31 May, 2011 2:07 AM|
|Do you do replacement of a lost low front tooth, and if so what's the procedure? Also, do you do the procedure in your Manhattan office? My front lower tooth fell out after being loose for some time. Yes, we do replacement of teeth. Some patients are eligible for dental implants. We place dental implants in both our Manhattan and New Jersey offices. A comprehensive exam, a review of your medical and dental history with the appropriate x-rays are required to determine if you are a candidate.||26 May, 2011 5:50 AM|
|My periodontist in Delaware is recommending conventional skin grafting to correct an area of receding gum. Needless to say I am wary of the procedure and curious to know more about laser surgery as an alternative. Would you say the cost for laser surgery is considerably higher or about the same? Is anyone in Delaware certified in this procedure? |
Thanks for your comments. Dave Dear Dave: Without knowing the details of your situation, a conventional gum graft might be the correct treatment. However, I have done many cases with the laser either in combination with the conventional procedure or as a standalone procedure. The cost in our office is the same. If you contact Millennium Dental Technologies in Cerritos, California, they can refer you to someone certified in Delaware. If you’d like to see me, it’s a quick train ride from Delaware to New York, and there are many trains a day. My office in Manhattan is a short cab ride from Pennsylvania Station. Good luck. Best Regards, Dr. Eric Linden
|21 Jul, 2011 7:06 PM|
|Can dry mouth result from osseous surgery or from aggravated TMJ problems due to osseous surgery ?There have been no documented cases that I am aware of in the periodontal literature of dry mouth from osseous surgery. The same is true of TMJ. However, dry mouth can occur if a patient has certain systemic diseases, or has been taking specific medications.||27 Jun, 2011 6:44 PM|
|Can I receive gum laser surgery without the removal of metal braces?Yes, it is possible to perform laser gum surgery with metal braces if we are presented with that clinical situation. However, it might be helpful if the wires were removed. We have done laser surgery successfully on our orthodontic cases with and without the wires.||15 Jun, 2011 10:37 PM|
|I have been diagnosed with gum disease and need to have surgery asap on all 4 quadrants. I am terrified of going through this procedure and saw your website and if I can do anything to avoid being cut open (my upper left side needs to be done from behind my teeth so the gumline would not be too high after the procedure). Is everyone a candidate for LANAP? I live in Connecticut, but would come to NYC. I am very anxious about this.Give our Manhattan office a call (212-595-5559) and speak to Patti. She will explain everything you need to know to start the process. Most of our patients qualify for the laser procedure. However, you would need to do a consultation appointment first using a quality set of digital x-rays. (If you have had these taken recently, they can be emailed to our office.) We will be open all this week, but will be closed from July 25th - August 8th. If you would like an appointment the week of August 8th, please call before Friday. Don't worry, we will figure it out. Best Regards, Dr. Eric Linden||20 Jul, 2011 4:00 PM|
|After having laser gum surgery to correct deep pockets due to bone loss, how long will it be before results are seen? Will bone actually regrow and strengthen the tooth and will the gums grow, because at this point they are receding in that area. Thanks.It would probably be best to consult the doctor that treated you with the laser gum surgery. The prognosis depends on the technique employed and the skills of the treating doctor.||26 Jul, 2011 7:37 PM|
|I have periodontitis. My dentist found two teeth with cavities. He wants to extract the two teeth and eventually all of my teeth. I would like to keep my teeth as long as I can and raise the bar on care (cleaning twice a year instead of once a year and better care at home, etc.) I would like to have the cavities filled. Please advise.It is difficult to diagnose your case without a complete oral examination and evaluation of a quality set of digital x rays. It would then be possible to give you all your options.||1 Aug, 2011 8:28 PM|
|I have been told (by an oral surgeon) that I have erosive oral lichen planus and that short of systemic steroids, there is not much that can be done, as this is a chronic condition. Do you have experience with this type of autoimmune disease and do you treat it?When we diagnose this condition in our office, we refer our patients to a specialist in Oral Medicine. This is their area of specialty and we will let them recommend the appropriate course of treatment and discuss the treatment plan with our patients.||16 Aug, 2011 1:46 AM|
|I am fifteen years old going on sixteen, and during a recent check up at my dentist they mentioned I have periodontal disease. I really don't know anything else of it, and the more I research it the more afraid I become. So far they have only talked about sealants and composites and cavities. I've been brushing regularly and flossing once a day but my teeth are becoming more yellow and the receding gums are noticeable. I'm really afraid and sad and I'm afraid to ever smile again. What should I do?I highly recommend seeing an experienced Periodontist that offers all types of therapies including laser treatment. In addition, a full mouth series of digital x rays should be taken as well. Do you have any family members that have a history of gum disease? You really want to get this disease under control as early as possible.||16 Aug, 2011 8:11 PM|
|I need periodontal treatment badly and live in NYC. I have had 2 uncomfortable, nerve racking experiences in the past, and DO NOT want to be awake for future procedures. Is sedation an option for me at your Manhattan office? Thank you.We can give you oral sedation (by mouth) which would make you quite comfortable. You would have to be escorted home after the appointment. We haven't put any of our patients to sleep in over 26 years. We don't need to take that risk when we can manage well with oral sedation. If we are able to utilize the laser therapy option, then the periodontal procedure would be very patient-friendly. Obviously, we need to see you first for a consultation and evaluation of a full mouth series of digital x-rays to determine what the most appropriate treatment plan would be for your situation.||24 Aug, 2011 5:19 AM|
|I am told I have Periodontal disease, but I do not nor have I ever had any of the symptoms I've read about. I am very interested in laser surgery if needed. My question is: Why don't I have any symptoms?Sometimes patients do not realize they have periodontal disease because they might not have the classic symptoms that you have read about. However, usually after a comprehensive periodontal exam and review of the digital full mouth series in our office, we ultimately do find that some of the signs of the disease were apparent but not considered significant from the patient's perspective. A small percentage of my patients over the last 26 years did not realize they had gum disease until they were told about it from a prior dental professional or ultimately from me.|
The customized laser surgery we perform and teach is very effective, non-invasive, patient friendly, and predictable in stabilizing the disease.
|21 Sep, 2011 10:23 PM|
|I am 63 years young and had to have all of my teeth pulled in 2009 due to gum disease which caused my teeth to separate from the bone. The teeth were held in place by the gums. I had them removed and in May of this year, after a C scan, was told that I have infection in my gums. This was no surprise because they ache. I have dentures that I can't wear for very long. (only a couple of hours per day) What would the procedure be for getting rid of the infection in my gums?What kind of CAT scan did you have? What did the radiologist see on your films? Do your dentures fit correctly? Do you have any systemic diseases? Is the mandibular or mental nerve close to your ridge with the dentures possibly causing irritation to the nerve? There are a number of reasons you could be having problems. I would have to examine you and evaluate the x rays to determine the correct diagnosis.||17 Sep, 2011 11:06 PM|
|I recently had lanap procedure. Now they want me to get a fitted teeth guard or tray. I am 70 years old and have never had a problem with grinding my teeth. My question is, do I really have to have the guard. I have trouble sleeping now and this will probably be flung across the bedroom at some point.Since I am not the treating Periodontist in your case, I cannot make this professional judgment. However, I can say that night guard therapy is very common following the LANAP procedure. Please check with the doctor who did the LANAP procedure.||26 Sep, 2011 2:05 PM|
|Generally speaking, is there a pocket depth beyond which LANAP would not be of clinical value? For instance, if I had an 11 mm pocket, would LANAP be able to reduce it?|
Also, does your office provide any form of sedation for the anxious patient, or would one have to get that from their primary care physician?LANAP and our customized laser surgeries cover a wide range of periodontal issues. We have treated teeth with 3-15 mm pocket depths. There are a number of factors that are considered when suggesting a procedure (too numerous to explain here). Each patient is evaluated and given all their options. We always attempt to treat in the least invasive way possible.
We use oral sedation in our office. You would have to be escorted by someone to and from the office.
|11 Oct, 2011 4:08 AM|
|First, a big "thank you" for hosting a forum like this to answer all our questions...|
Can LANAP be done on a "site specific" basis, vs. doing it in "quadrants" or "full mouth"?
And, are the results permanent? That is, if one maintains a proper home cleaning regimen, will the bacteria re-populate? (I ask this because I've repeatedly read that there is "no cure" for gum disease.)>First, a big "thank you" for hosting a forum like this to answer all our questions...
It is my pleasure
>Can LANAP be done on a "site specific" basis, vs. doing it in "quadrants" or "full mouth"?
Excellent question. If the full mouth protocol is followed precisely, then it is considered LANAP. Full mouth is usually indicated when there are several areas around the mouth that show disease. We do our full mouth LANAP cases in 1-2 visits maximum. They are usually completed within 7 days. Most of our patients have the LANAP done in one visit and that seems to work very well.
If we are treating an isolated periodontal area of breakdown and the rest of the mouth looks perfect, then we would call the procedure "Localized Laser Periodontal Surgery".
>And, are the results permanent? That is, if one maintains a proper home cleaning regimen, will the bacteria re-populate? (I ask this because I've repeatedly read that there is "no cure" for gum disease.)
As with any periodontal procedure we have done over the last 26 years, our goal is to stabilize the disease. If home care and professional maintenance are followed, then the odds are very high of retaining your teeth and periodontal health. We have been maintaining our patients for over 26 years and the people who followed our maintenance schedule have fared very well. The same has been true for our laser cases. In fact, the laser cases seem to do better than our traditional surgery patients. We even see this improvement 3-5 years post op. Bacteria are always present in healthy gingival crevices in normal or healthy gum tissue. If the tissue becomes diseased, the bacteria shift over to the destructive type which can cause the disease to become active again. The concept is to eradicate the disease and prevent it from another burst of activity.
The laser has been shown to be our best preventative tool to date to get rid of the disease and keep it away.
|14 Oct, 2011 5:48 PM|
|I had laser surgery July 27th for a 9 mm gum pocket (with abscess). I went for periodontal maintenance cleaning yesterday- Oct. 13th. The hygienist found drainage at the site. I was told to gently swab the area with antibiotic rinse several times a day. Is this drainage unusual after this period of time? I had not noticed any drainage or anything unusual prior to cleaning. Today the area is sore. Would like a reply on this drainage and I thank you.From your description, it sounds like the area is draining again and perhaps the periodontal defect might require additional treatment. I would recommend an updated digital x ray to see what is happening around the tooth and bone. It is difficult to diagnose in this forum without actually seeing your situation. However, I would follow up closely with the treating doctor so he or she can make the appropriate decision.||15 Oct, 2011 2:20 AM|
|I realize that everyone heals at a different rate, and can have markedly different outcomes, from a given procedure -- all dependendant on things like genetics, current state of overall heath, etc. But I am very curious about the pace, and extent, of post-operative results -- be it Localized Laser Periodontal Surgery, or LANAP.|
In other words, is it reasonable to expect a 9 mm pocket to "heal" into a 3 mm (or less) pocket ?
And, would it (the destined level of healing) happen in a week, a month, a year...? Will healing time be linear (e.g. slow in the first 5 days, faster in the next 10)...?There are many factors that determine the rate of healing that we don't fully understand. We have many cases that have healed in a matter of months and some cases took up to 2-3 years to see significant healing and bone fill. In our periodontal laser practice, we have treated diseased pockets that have exceeded 10mm+ and have seen reductions down to 3-6 mm with radiographic bone fill. However, whenever we have teeth with extremely deep pockets (like 9mm), we always explain to the patient that the prognosis is guarded but we can possibly have success if the laser protocol is followed carefully and we don't encounter issues in healing.
|18 Oct, 2011 9:15 PM|
|My dentist recommended me to a periodontist. I had the exam and he told me I would need osseous surgery on all four quadrants. He said that my regular dentist would need to do a debridement and caries control before returning for the surgery. I'm at a 5+ for advanced periodontal disease. I'm not sure what 5+ means. My question is: How soon would I need this surgery?I would have the dentist do the caries control and then I would get to the Periodontist (preferably a laser trained LANAP Periodontist) for a complete evaluation.|
You have advanced periodontitis according to the number system. However, the Periodontist can give you all the information you need.
|23 Oct, 2012 9:20 PM|
|Hallo, is there possibility for LANAP treatment in Europe? I am Slovakian. Thank U.I don't think it is available in Europe at this time.||23 Oct, 2011 8:20 PM|
|How much does this treatment cost for whole mouth?It’s difficult to offer a specific answer to such a general question. The cost of laser treatment could vary greatly depending on an individual’s condition and medical history. Please call our office, and if you choose to have a personal examination, with x-rays, etc., we would then be able to give you a fairly accurate estimate of the final cost of treatment.||2 Nov, 2011 2:07 PM|
|If I have an abscess at the bottom of a molar where I had a previous root canal done, can LANAP be used to kill the bacteria in the abscess to prevent a tooth from extraction?What kind of abscess are we referring to? Endodontic or periodontal? Or both? Generally speaking, if this abscess has an endodontic component to it, then the root canal infection has to be resolved first by conventional accepted endodontic treatment. After the endodontic therapy is completed, this area can evaluated, and based on radiographs and clinical presentation, it can be determined whether a periodontal laser procedure would be necessary.||3 Nov, 2011 1:48 AM|
|Hi. I had LANAP done about 2 years ago. I have followed up with regular maintenance appts every 3-4 months since then. They use a laser in the cleaning sessions. My question: Do I have to continue going to the same dentist for my cleanings? Would a dentist that does laser cleanings suffice? Or do I need to continue going to the office that did my LANAP?|
Thanks!I would continue with the dentist (Periodontist?) who did your LANAP. They should know your periodontal situation the best, and be best qualified to maintain you, since the original work was done by them.
|27 Oct, 2011 3:10 PM|
|Dear Dr. Linden ~|
I had laser surgery to reduce pocket depth on several teeth a couple years ago and I have since been on a 3-month cleaning schedule. I'm told that I am doing good with respect to my periodontal disease, but I was left with a smile that I am unhappy with. Two of my front upper teeth (i.e., central and lateral incisors) have receding gums and appeared to have dropped lower than the rest of my other teeth due to bone loss, as I understand it. It was suggested that my only option to improve my smile would be to get dental veneers, which I really do not want to do.
My question is: Are bone and gum grafting a possible alternative based on what I described?
GaryYes, it might be possible to achieve a better smile without the veneers. You really need to be seen clinically to see what your options would be.
|3 Nov, 2011 10:37 PM|
|Do you offer some type of payment plan for LANAP? I would like to save the few teeth I have left, mostly the front ones. I lost a lot of bone. Four of my teeth are loose. My dentist wanted to pull them, but recommended that I see a periodontist. Please help.We offer a payment program called Care Credit which is endorsed by the ADA. Please call our office for more information.||15 Nov, 2011 10:16 PM|
|Hello Dr. Linden:|
I was in my dentist earlier today and he suggested I needed Lanap to fix my gums/bones. He had an estimate of $8500 on the paper and tried real hard for me to agree to do the procedure. I am wondering is this normal amount that this procedure costs?Did you speak with a Periodontist (specialist) in gum surgery, or a regular dentist? How long has he been doing this procedure? Does he do advanced cases and have the ability and experience to do traditional work if needed? What case type are you? What geographic area of the country do you live in? The case fee varies depending on these factors and the extent of the disease. It might be wise to get a second opinion.
|22 Nov, 2011 9:36 PM|
|Please HELP! I am 35!!!! I just went to the dentist yesterday after not going for about 6 yrs. No cavities. Good, but not so good. Dentist said I have gum disease. Severe at the bottom, where she said that my bottom teeth are loose. I hadn't noticed. She sent me to a periodontist.... Can my teeth be saved????????????Sounds like you need a diagnosis and treatment plan immediately. Hopefully, you will be a candidate for the FDA-cleared Laser Protocol. It is very difficult to diagnose without examing you and doing a comprehensive exam with a quality set of digital x rays. Please feel free to contact us at one of our 2 offices.||26 Nov, 2011 2:11 PM|
|I woke up about a week ago with a toothache and now my gums are slightly swollen with little pockets between some of them. I haven't eaten anything since last week because I'm afraid to get something in between my teeth and make this worse. I have no dental insurance and currently am out of work. I was wondering about your personal opinion on getting oraMD. I've read good things about this product and would like your professional opinion on what I should do about this because the pain is getting worse. I rinse with Listerine and salt water every day and have been brushing 3 to 4 times a day hoping to halt this pain before something extreme happens. Thank you for your time.I would recommend you see a dentist as soon as possible. It is extremely difficult to know what is happening without examining you, getting an accurate medical and dental history and taking the necessary x- rays to diagnose your condition. Most rinses alleviate some of the symptoms of various dental conditions, and some oral rinses can actually make conditions worse. Many dentists take credit cards and offer payment plans if that would be helpful to you in your situation.||2 Jan, 2012 10:01 PM|
|Dear Dr. Linden,|
I had a bone graft and three implants placed on my right lower Jaw in 2007. Soon afterwards I started losing bone around them and had to have another bone graft. I continued to have bone loss and have now 6-7 mm pockets. The gum around one of the implants is often sensitive and often bleeds. My periodontist has tried several things such as cutting some muscle in the mouth that he thinks was pulling on the gums (it grew back), using Avastin, a mouth guard, Peridex, etc., but the problem continues. He has not referred me to another periodontist that is trained in LANAP. Do you do LANAP around implants? Is it effective? I was told it will just need to be done in the quadrant of my mouth with the problem because my natural teeth are OK.Yes, we treat natural teeth and dental implants with the laser protocol. We would need to see you for a consultation first to review a treatment plan. If interested, give us a call.
I look forward to helping you.
Dr. Eric Linden
|11 Jan, 2012 3:45 PM|
|I am about to go in for osseous surgery for severe perio disease, but everything I can pull up about this treatment, will not guarantee the removal of the disease, only to say that of course, maintenance is the key. But my question is, I am 50 and the possibility of more surgeries in the future to obtain the look I want, would I be better off, physically and financially just to have teeth pulled and get full dentures? I am so confused. I think my doctors are great, but maybe a little bias with the truth! Please help me decide. Thanks so much,,,, Carol Dear Carol,|
I would suggest that you get a second opinion about your plan for osseous surgery as soon as possible. I have done these procedures for over 25 years. I used to use a conventional surgical approach, but for the past six years I have used the laser approach for most cases. Both I and my patients love the alternative! The laser procedure is much less invasive, which means much less pain and faster recovery time. Again, get a second opinion before subjecting yourself to the scalpel.
|25 Jan, 2012 3:23 PM|
|Dear Dr. Linden,|
First of all I want to thank you for taking the time to answer so many people's questions! I have found your site to be very informative. I am 32 years old and at my most recent cleaning visit the hygienist informed me that I have several 4mm pockets and one 5mm with some bone loss around the tooth with the 5mm pocket. I also had some cavities that needed to be filled. Needless to say I am a little scared about my dental health, so I started doing some research on periodontal disease and came across the LANAP procedure as well as other procedures for treating periodontal pockets. When I went back for my fillings I expressed my concerns to my dentist and asked if he would suggest that I seek further treatment. I was a little surprised when he told me I just needed to floss more often and that we should re-evaluate my condition at my next six month cleaning appointment. I have also noticed that after having my teeth cleaned I have a space between two of my lower incisors that was not there before. I know that you cannot possibly provide a diagnosis without doing an exam on a patient, but I just want to know if I should get another opinion on my situation. I have been seeing this dentist for a number of years and do trust him, but I just am very concerned with my oral health. I am afraid of the possibility of losing my teeth at an early age and want to be as proactive as I possibly can be. I have found a few dentists in my area that offer the LANAP procedure, and was wondering if this procedure could possibly be beneficial for treating/reversing early gum disease.
Thank you very much for your time,
I would recommend seeing an experienced periodontal specialist in your area to evaluate your condition. It is always better to be safe rather than sorry later on.
It would be desirable if the periodontist has been trained in the LANAP procedure and has had experience using the ND/YAG laser for a few years.
Best of Luck,
Best of Luck
|28 Jan, 2012 2:51 AM|
|I am 52 and recently had gum surgery on all the upper and lower teeth of the right side of my mouth. My periodontist explained that I have bone loss but did not mention anything about how deep my pockets are. I have these gaps now between my teeth that catch so much food, and I am very unhappy about it. I have to clean these areas with piksters interdental brushes at least 2 times a day. Before I have this invasive surgical procedure done to all the teeth on the left side of my mouth, I would like to know if this is truly necessary. My periodontist strongly advises that it be done, but will the results be lasting and worth the sacrifice? Thank you for your reply. (I would not be a candidate for laser surgery, since my insurance would not cover it).I don't understand why your insurance won't cover laser periodontal surgery. Is it the LANAP protocol that was not covered? Our patients are generally covered for these FDA-cleared procedures. We have not encountered any major issues regarding coverage. I would suggest discussing your diagnosis and treatment plan with your periodontist. He or she should be able to provide you with the answers to your questions about your pocket depths. One of the major benefits of laser periodontal surgery (among many things) is that we don't end up with the spaces and gaps you have described.||28 Feb, 2012 2:55 AM|
|I am 56 years old and have pain in my last left upper molar. My dentist says a root canal will not help. Instead he said LANAP surgery might help. I have deep pockets in my mouth. Why are they saying that root canal will not help and LANAP will?Did you dentist pulp test the tooth? (A test to determine if the tooth's nerve is dying.) Did you see a specialist (Endodontist) to confirm this diagnosis? Is there any decay in the tooth? Root exposure? Root fracture?|
As you can see a thorough diagnosis is needed to give you an accurate treatment plan.
|26 Feb, 2012 2:17 PM|
|How much does pocket reduction for the gums cost?We need to do a complete clinical examination with a full set of quality digital x-rays to make a diagnosis and treatment plan. It is only then we can give an estimate of costs. Each case and patient is different and the requirements vary to achieve periodontal health.||21 Feb, 2012 11:23 AM|
|I have a couple of deep pockets (7-9mm) and I had the laser treatment which didn't work at all. In fact, six months later they had gotten a little worse. My dentist suggested the surgery in which the gum is cut back and deep cleaned. I can't afford this and was wondering if there could possibly be another alternative. There is a product called Vitapick which has a very small syringe that you fill with peroxide and salt water and then squirt the solution into the deep pockets. Would that be something I should try before going into surgery? Thanks, Kim.Did you see a Periodontist? Were they laser trained? Did they utilize the FDA cleared protocol LANAP? This is a very unusual course of events. Something else could be going on. However, it is difficult to diagnose you without an examination and x ray evaluation. We tend to avoid syringes and peroxide regimens. I cannot recall having to do a traditional cutting procedure after having treated a patient with the FDA cleared laser protocol. Please let me know how you make out.|
Dr. Eric Linden
|28 Feb, 2012 6:07 PM|
|I have to go for gum grafting. I was thinking about AlloDerm. My periodontist told me he uses Muco-graft. What is the difference? Which is better?I think your Periodontist would be the best person to ask about this. This information should have been part of your consultation appointment. It is important that all your options are discussed with the treating periodontist prior to any procedures commencing so that you have full informed consent.||28 Feb, 2012 7:36 PM|
|I currently take Enbrel and methotrexate for RA which is well controlled. I have permanent upper and lower retainers after having braces at age 36. Now, I am 51 and about 3 months ago I developed pain in the bone area under the teeth, especially affecting the teeth with the retainers. In the morning I have zero pain. The pain begins gradually after eating and progressively worsens as the day goes on as I eat lunch and dinner. After dinner my mouth is throbbing. My dentist could find nothing wrong and said my gums were healthy and my teeth were fine. I have regular checkups with my rheumatologists and she has never heard of bone pain in the mouth from the meds. I take. I am not sure who to see at this point. Hopefully you may have a suggestion. Thank you.This is a difficult case to diagnose without examining you. However, a few questions:|
• Do you grind or clench your teeth?
• Have you had a TMJ (Temporal Mandibular Joint) evaluation?
• Rheumatoid Arthritis can affect the joints around the lower jaw.
I would suggest seeing an expert in TMJ and get the necessary CAT scans and x-rays to make a diagnosis. Where are you located? I can help make a referral for you.
Dr. Eric Linden
|2 Mar, 2012 7:55 PM|
|Can in office teeth bleaching cause guns to burn off requiring a gum graft? I lost gum on white, burned area above my tooth caused by the bleaching.Yes, I'm afraid bleaching can have this effect. Needless to say, we don't practice it in our office, but we can perform gum grafts if needed.||12 Mar, 2012 5:52 PM|
|I am 65 years old, and on medication for panic attacks high blood pressure. I also have a heart murmur. I am suffering with gum disease and loose teeth. I also am a bleeder who has hemorraghed on having prior dental work. I need help that would not be surgically invasive, due to all my problems. I am hoping you can help me.Please give us a call for a consultation appointment and we can review the least invasive treatment plan possible to help you with your periodontal situation.|
Dr. Eric Linden
|6 Mar, 2012 5:58 PM|
|In spite of my twice-a-day perio gel trays, an exemplary home regimen of brushing and flossing, my hygienist tells me my gums are in great shape when I visit her every 3-4 months for teeth cleaning. BUT I STILL HAVE A FOUL ODOR. The pockets have decreased in size considerably, but the smell won't go away. What can I do to get rid of the odor completely or lessen it somehow? Please help.A couple of questions:|
1- Are you certain that you have no gum pockets deeper than 4 mm? That should be verified by a qualified periodontist to eliminate this as a cause of your symptoms of a foul odor.
2- Have you been brushing your tongue or using a tongue scraper? This is an area where sulfur containing bacteria build up and cause the foul odors.
3- Do you have any digestive issues? Acid reflux and upper gastrointestinal problems can also be a possible cause.
4- Are you taking any medications? This can also be a contributing factor.
Have the above suggestions thoroughly examined and hopefully you will find your answer.
Dr. Eric Linden
|16 Mar, 2012 1:42 AM|
|I have had 3 gum grafting surgeries (3 different areas) and now my periodontist is recommending an additional surgery for one of the areas. I am hesitant because the previous one obviously did not do well. Should another type of gum surgery be performed?Sometimes a secondary procedure is necessary to achieve the best result with grafting procedures. We inform all of our patients in our practice that multiple procedures might be necessary. |
Best of luck,
Dr. Eric Linden
|16 Mar, 2012 9:16 PM|
|My name is Toni-Ann and I’m 16. I have juvenile periodontitis but I need braces. Can I still receive the braces even though I have periodontitis?I highly recommend a qualified laser periodontist (specialist) to evaluate your condition before starting your orthodontic case.|
We have treated a large number of "Juvenile Periodontitis" cases with a specific laser protocol and they manage very well. Without any treatment, you are a high risk for tooth loss.
Dr. Eric Linden
|20 Mar, 2012 12:42 AM|
|Hi. I had LANAP last June. It was ok. Now I've been told that I need a gum graft. One of my front lower teeth is loose. Can it be still saved? The reason I did all this was to save my teeth. Please tell me, does LANAP help the gums to reattach to the tooth and also for new bone to grow? I had high hopes but now I do not know what to do next. I already spent a lot of money that I don’t have. Thank you. I do appreciate your time in regards to this matter.It is very difficult to assess your situation without seeing the pre and post-operative x rays and photos. It is possible to get some "coronal” migration of the gum tissue. However, this has not been studied enough to draw conclusions. We do see this occurring in our periodontal practice after several years of follow up with our patients. We always are looking for new bone growth from our LANAP procedures. In your specific situation, your treating Periodontist (I am assuming you had the LANAP done by a specialist?) should be able to provide you with a prognosis of the tooth in question. Did you have any of your teeth splinted together? Have you had any occlusal adjustments? Do you wear a night guard? As you can see there are a number of factors that are important for success of your treatment.|
Best of luck,
Dr. Eric Linden
|21 Mar, 2012 12:06 AM|
|I had deep pocket laser surgery three days ago. I still have pain that worsens when talking or eating! A Vicodin plus 2 Advil don't get rid of all the pain. It wakes me up 2-3 times a night. I have no idea why this is happening because everywhere it says that this procedure is "painless", including my periodontist and my dentist. Do you know any reason why I am having this much pain?I don't know what type of laser therapy you had. Was it LANAP? This is a very unusual post-operative experience. Best to call your periodontist and find out what protocol was used and how to deal with this issue.||13 Apr, 2012 9:31 AM|
|What does it mean when gums are trying to separate from teeth and how can it be fixed?This is indicative of gum disease. You should seek an opinion from a Periodontist that has the additional laser training in the FDA cleared laser protocol. After you have a thorough exam with a quality set of digital x rays, a treatment plan with all your options can be presented to you. Please read more on our web site to see what the options are to treat gum disease.||23 Mar, 2012 3:29 AM|
|I had LANAP two weeks ago on one side. The procedure went well until the end when the Dr. said he was doing the cleaning. I felt bad nerve pain with only the teeth that had fillings. Next was the drilling to adjust the bite. The pain was so, so bad. When people get LANAP, do the Dr's have to do this INTENSE cleaning and use a drill to adjust the bite? I am still in pain with severe sensitivity. Is this normal? My dentist has never heard of this. I am petrified to do the other side.The cleaning part of the procedure is not done at the end so I am a little confused about the sequence of events. If you have profound anesthesia, then you should not feel anything during the procedure. If you are still in pain, then something else is going on with your fillings, or possibly decay or root canal issues? It is very hard to diagnose without examining you.||24 Mar, 2012 9:16 PM|
|Which criteria should be followed for to decide whether a tooth should go for endodontic treatment, in which only bone loss is present?The criteria for performing a root canal are clearly stated by the American Academy of Endodontists. Generally speaking, if a tooth has decay into the nerve or is necrotic (dead) or has symptoms of severe pain which could include cold or hot sensitivity, and/or shows a radiographic periapical lesion (PAP), then root canal therapy is indicated. Teeth can be tested as well to see if they are vital (alive) or necrotic (dead). This is called pulp testing. Just having bone loss alone is not an indication for endodontic treatment. However, having bone loss would justify a consult with a highly trained Periodontal Laser Specialist certified by the American Academy of Periodontology and having additional certification in performing laser surgery with FDA clearance.||29 Mar, 2012 6:44 AM|
|I'm having a scaling and DDS says I need six laser treatments. Is this necessary?It may or may not be necessary. It's hard to say without a proper examination. I would recommend that you get a second opinion, preferably from a periodontist trained and approved in the use of LANAP (the FDA-approved laser technology revolutionizing the treatment of gum disease).||12 Apr, 2012 10:56 PM|
|How long do you have to wait after getting a receding gum surgery to get braces?Depending on the goals of the surgical procedure, the wait time can vary from 4 weeks to 3 months. If a secondary procedure needs to be done, then the wait can be longer.|
I hope this helps.
Dr. Eric Linden
|5 Apr, 2012 12:37 AM|
|During consult for LANAP, I was told it was part of the normal procedure to grind molars to adjust for occlusion. Is this true? I have gold crowns on my molars and do not wish to have them replaced due to grinding.It is part of the FDA-cleared protocol in the LANAP procedure to adjust the occlusion (your bite). I would suggest asking your periodontal specialist whether they feel you will have to replace any crowns. We very rarely have to do that in our practice.|
Best of Luck
Dr. Eric Linden
|3 Apr, 2012 5:17 PM|
|Dear Dr. Eric,|
I had a bone graft performed on tooth #18 back in April 2011. An implant was performed in January of this year. Within 3 weeks, the implant loosened and came out. It was replaced in March with a larger diameter implant (same length). Is this common? What would cause this? This was done by a well-known Periodontist here in the Boston area. Regards, Doug. BTW, impressive website.Implants can fail for no reason at all even though the success rate is over 90%. There are many factors that can possibly cause the loss of an implant. Risk factors include smoking, diabetes, poor bone quality, poor occlusion (bite), a compromised medical condition, trauma and a number of other more rare events.
The placement of the wider diameter implant is the correct approach and hopefully will lead to an improved outcome.
|2 May, 2012 3:57 PM|
|I'm getting laser gum removal tomorrow and two days after that I want to go out with my boyfriend. Will I be able to French kiss (without pain)?I would suggest you speak to your periodontist and see what they recommend. Each case is different.||18 Apr, 2012 6:19 PM|
I just came back from the dentist and was told I have advanced periodontal disease. The doctor I went to wants me to have one tooth pulled w/bone grafting. She then wants to do root/scale cleaning and then gum surgery to further clean I guess. I truly hate the dentist, hence the reason I'm where I'm at. Would laser surgery be something I could consider?I would get an opinion from a well-qualified, experienced, Laser Periodontist (specialist) that is trained in the LANAP procedure before you do anything. You should be presented with all your options.
|18 Apr, 2012 6:49 PM|
|Is there a clinic in Australia, Malaysia or Indonesia that can do the LANAP procedure?Unfortunately, it is not offered in the countries you have listed. However, as you may have noticed (if you read through our web site), we have had patients fly in for their treatment from all over the world - one of them from Thailand. Are you planning a trip to New York anytime soon?||19 Apr, 2012 1:34 AM|
|I had bone graft surgery on my upper and lower gums in Sept of 2011. Everything has healed well it appears, except from time to time I get a weird cold sensation on one part of my gum. It happens when I am not eating or drinking. Any thoughts?I am not sure from your description what type of procedure you had done other than "bone graft surgery." However, a cold sensation usually would come from a tooth. It would be advisable to have a periodontist look at this area and take a digital film if necessary and see what is going on around this area.||25 Apr, 2012 6:25 PM|
|What is the price range of this procedure?The case fee varies from patient to patient. There are so many factors that we have to evaluate, too numerous to list here. We need to do a comprehensive examination and evaluation of a recent set of quality digital films to give an accurate diagnosis and case fee. This appointment typically lasts more than an hour.||20 Apr, 2012 2:07 AM|
|I've had a bone graft to accommodate an implant. All the work completed in approximately two years. Shortly after this I had sore spots on my gums and am told by my hygienist that I have chronic Lichen Planus. Can this be the result of the bone graft surgery?Lichen Planus can be brought on by stress or trauma. The bone graft procedure is not the cause of this but merely an event that might have triggered your outbreak. You might want to consider seeking an opinion from an oral pathologist or a specialist in oral medicine if these lesions persist and become a concern.||2 May, 2012 12:49 AM|
|I just had a second bone graft surgery done 10 days ago. The stitches in my mouth taste really gross and there’s a smell that’s nasty too. My mom said it’s from the blood or because they’re getting ready to come out, since doctor said they'll be starting to fall out. But I don’t know if that's right. Can you tell me why I have that nasty taste and smell?The foul taste and smell can be from food debris, plaque, blood products, or an infection. If a periodontal dressing was used, then it can be from bacteria under that area. We usually place our patients on a Chlorhexadine rinse or warm salt rinses for this reason. Ten days is approaching the time for the sutures to be removed or start to dissolve away. Be sure to have your periodontist check this area soon.||5 May, 2012 8:56 PM|
|Is deep cleaning safe for kids with gingivitis from orthodontic braces? Starting what age is it safe to do? What is an alternative treatment? Thank you.How old is the child? If there is gingivitis, frequent cleanings are highly desirable to keep the inflammation down to a minimum. We try to avoid the use of local anesthetics if possible. We also would consider (in addition to better oral hygiene) some mouth rinses safe for children. Once the braces are removed, it will be easier for the child to brush effectively.||7 May, 2012 3:57 AM|
|My husband is going through the lengthy process of getting two implants which as you know is quite costly. We are getting lots of denials from the insurance company, but pursuing. Do you know what the rationale would be for our dentist to have done four gum treatments on the same day for two teeth? Does that make any sense? Thank you. It is very difficult to know what type of gum treatment was done on the two teeth you are referring to. Was it soft tissue grafting? Did he have a bone graft? Ridge augmentation? In our practice, it is not uncommon to perform multiple procedures on the same day depending on the needs of the patient.||7 May, 2012 2:16 PM|
|Would you recommend a full mouth debridement before LANAP?No, we do not recommend a full mouth debridement before LANAP.||7 May, 2012 6:25 PM|
|I recently had a tooth removed. I have gum recession where the tooth was removed. Can a periodontist build that back up so I can get an implant?Typically, when we extract teeth we do an immediate bone graft and laser procedure (socket preservation) around the extraction socket. If a patient has not had a socket preservation done, then an evaluation for a secondary procedure or possibly more would be necessary to build up the area for a future implant.||13 May, 2012 5:46 PM|
|I had gum grafting done Wednesday and today some of my packing on the teeth are loose should I be scared? Thanks.Generally this is not a problem. However, I would check with your periodontist in the morning and see if they want to re pack the area or leave it alone.||13 May, 2012 9:08 PM|
|I live in Naples, I am looking for a better deal and estimate for the following:|
FULL MOUTH (LL:LR:UL:UR) - D4260
Extraction-surgery - D7210 (Tooth 1; 16; 32 )
ThanksHello. How are you? Are you from Naples, Florida or Naples, Italy? I would be happy to answer your question, but I need a lot more information. For starters, here are some examples of information I would gather from a new patient. I need to know what type periodontal classification you are. Do you have pocketing around all the line angles of your dentition? How many teeth have signs of disease? Do you have any recession? Do you have furcation involvement? If so ...what class? Do you have posterior bite collapse? What is the prognosis of each tooth involved? Do you have a limited opening? Have you been given the option of a FDA cleared laser procedure (LANAP)? Are you referring to traditional gum surgery? Do you need or have you been offered bone grafting? If not...why?
Do you take any medications? Is there a family history of gum disease? Any mobility of teeth requiring splinting? Do you have a night guard? What is your general health? Are your wisdom teeth impacted? If so what is the angulation? Any teeth close to the mandibular nerve? Any history of bleeding problems? Evaluation of digital x-rays...I could go on and on, but I just want you to understand the reasons why it is unprofessional to give a quote over the internet or phone without evaluating a patient.
Each patient presents differently and fees can vary depending on many factors too numerous to list in its entirety.
By all means, I recommend getting a second opinion if you have any concerns. Concentrate on getting the best diagnosis, and a presentation of all your options that would be appropriate for your situation. In our office, we will often spend 1-1.5 hours on the consultation, examination and treatment plan. We don't encourage or recommend that anyone get a quote for treatment over the phone or the internet unless they have been examined by a qualified, laser periodontist specialist.
Dr. Eric Linden
|15 May, 2012 9:31 PM|
|I have a 7mm pocket with bone loss. I am getting surgery in #30 tooth. What is the recovery time? Do I have to change my diet?What kind of surgery? Laser surgery? The recovery is quicker and virtually painless if you have the FDA-cleared LANAP procedure. You would need to get an opinion from a certified laser periodontist who offers both the traditional and the FDA-cleared laser approach to treating bone loss and gum disease. In our practice, we utilize the laser approach whenever possible. The healing is rapid and the procedure is much less invasive. The results are equally impressive. Your diet would be adjusted according to the type of surgery and how many areas are treated.||16 May, 2012 11:04 PM|
|What gum is best to chew if you have dental implants?If the implants are finished and restored with properly fitted permanent crowns, then chewing gum of any kind should be fine. We usually recommend sugarless gum.||17 May, 2012 1:31 AM|
|Can a periodontal pocket be caused by trauma or something other than a disease process? Yes...a good question.....a periodontal pocket can be caused by the inflammatory process (disease process) and also from trauma. This means your bite, the way your teeth meet and touch, or any trauma might cause a periodontal pocket. Other possible causes include root or tooth fracture, failing root canal, dental decay below the gum line, iatrogenic dentistry, a foreign object embedded below the gum, systemic disease, pregnancy, hormonal changes, and traumatic impact to the face.|
Of course there are many other causes too numerous to mention here that can cause a periodontal pocket, but I think we have discussed the major factors.
|17 May, 2012 3:09 AM|
|My daughter has a lot of gum that shows when she smiles. I was told that she can have her gums cut around her teeth. Can this be done with your laser tech?Yes, it is possible to perform this surgery with the laser. It is one of the most common procedures we do in our office. It is much less invasive than traditional surgery. We would need to do a comprehensive examination, and evaluate a recent set of quality digital x rays to evaluate your daughter's periodontal condition and confirm that the laser approach can be done.||22 May, 2012 10:13 PM|
|My dentist wanted me to be evaluated by a periodontist for possible bone loss. I went for an evaluation and he said I had bone loss and recommended osseous surgery 4+ per quad. I have no pain, no bleeding while brushing, but chronic bad breath. I thought periodontal scaling and root planing would be done first before osseous surgery. Also, I was advised that I needed crown lengthening to prep a tooth for a crown. I am hesitant to have the surgery without trying the scaling and root planing. What are your thoughts? Thank You.This question seems to come up quite often from patients, doctors, students and residents, so I will try to explain how things have changed over the last 29 years in our approach to treating gum disease.|
First, an accurate diagnosis is necessary. Once we review the clinical information and full set of quality digital radiographs, we can determine how to treat the disease in the least invasive but most effective way possible with the best long term results.
We utilize laser therapy, which eliminates the need for separate scaling and root planing appointments and aggressive surgery (see our web site for more detailed information). We try to eliminate the need for conventional osseous surgery, when possible, and treat the entire mouth with the FDA-cleared laser approach (LANAP).
The advantages of this are to:
• Eliminate scaling and root planing as a separate procedure and eliminate the need for multiple appointments involving local anesthesia.
• Utilize the laser surgery instead of the conventional osseous surgery, where possible.
• If crown lengthening is needed, the area of conventional surgery is limited to the area in question.
We find that we can treat about 85% of our patients with the laser approach and in many cases, eliminate the need for cutting, suturing, scaling and root planing. In a worst case scenario, we can just do the conventional osseous surgery in very limited areas for crown lengthening. This comprehensive approach in treating periodontal disease makes for a pleasant post-operative experience for the patient with excellent results.
I would suggest a second opinion with a Periodontist trained in LANAP surgery.
Best of luck,
Dr. Eric Linden
|10 Jun, 2012 2:54 AM|
|I am a 42 year old man with gum recession and bad breath (the latter for 20+ years). I have a 6 unit Cercon bridge, on the right upper portion. I recently met a periodontist who said I have some bone recession near the bridge and suggested deep cleaning (not very urgent as there is no bleeding). To take a second opinion, I met a second periodontist (who practices Laser therapy). The information he gave me is as below.|
1. I have metal fillings on 2 of my lower teeth. Will it be impacted by laser treatment?
2. He said the bridge will not be affected in any way.
Can you verify this information? Also are there any aspects I have to consider before going for this?
Fillings should not be impacted by laser treatment unless there is decay or other unknown tooth issues. The bridgework should also not be affected, with the possible exception of an occlusal adjustment (bite adjustment that might be necessary following the strict LANAP protocol). Please review all the issues with your Laser Periodontist if you have any concerns. Usually, this would be discussed in your consultation visit.
|26 May, 2012 2:10 PM|
|Is it normal to still be bleeding a little bit a week after I had LANAP done when I brush/floss (carefully)?You shouldn't be flossing one week after LANAP surgery. The bleeding issue needs to be evaluated with the treating Periodontist as soon as possible.||31 May, 2012 8:22 AM|
|Can I fly two days after bone augmentation and sinus lift treatment?When we do sinus augmentation and bone grafting in our office we use the osteotome technique, which is much less invasive and puts very few restrictions on the patient's post-operative activities. However, If you have had a "traditional" "window technique" for your sinus grafting, you might want to check with your Periodontist regarding flying. The altitude changes can affect your sinuses and the variations in pressure could affect the seal or closure of the extensive wound from the traditional procedure.||5 Jun, 2012 5:18 PM|
|I have bleeding from my gums, especially in the mornings when I get up, and sometime during the day. Can you help and advise me? Thank you.You really should have a thorough periodontal exam and full mouth digital x-ray review with a qualified laser periodontist for an accurate diagnosis and treatment plan.||4 Jun, 2012 8:31 PM|
|I recently had a full series of x-rays that showed high bone loss. I do not have recession or bleeding gums and the doctor said there was no tartar buildup under my gums either. Is there medication that can fight these bacteria that are attacking my bone? If my mouth is clean and gums are in good shape, what else can I do to ward off further bone loss?You need a qualified Laser periodontist (specialist) to do an examination and recommend the necessary treatment to stop your bone loss. This might include an FDA cleared laser protocol to target the potent bacteria. Antibiotics alone will not cure this problem. The exam should include an occlusal analysis, a thorough review of your medical and dental history, and a detailed discussion of the results of the full series of digital x rays. Is there a family history of gum disease or early tooth loss and dentures?||13 Jun, 2012 7:56 PM|
|Dr. Linden - I have been advised for years that I have bone loss in my jaw. I have a clenching/grinding problem at night that I suspect is contributing to the problem. I had orthodontics 3 years ago to correct my bite as the theory was that my bone loss could be a result of my bite being so bad. The orthodontics corrected my bite. However, I did get some root resorption on one of my front teeth. While I was in braces I think I stopped clenching at night because it was too painful. However, the clenching has started again.|
My general dentist referred me to a periodontist who is recommending LANAP.
I have 4-6 mm pockets scattered throughout my mouth and my front top and lower teeth are slightly loose (I was not aware of it, but the periodontist pointed it out to me). I do not have any obvious signs of gum disease (bleeding, redness, odor, etc.). My periodontist is recommending LANAP on all 4 quadrants. I also just got a new, better night guard made by my orthodontist to try to help with the clenching/grinding issue. I am 40 years old and very concerned about losing my teeth. In your experience, is LANAP an effective treatment for periodontal disease caused by clenching/grinding?
Is LANAP safe on a tooth with very little root left due to resorption? LANAP is safe on short roots, resorbed roots, and long roots as long as the periodontist follows the protocol carefully and according to the strict guidelines. Having a new and improved night guard is a smart move. This should take the secondary occlusal trauma out of the picture.
I would also discuss with your laser periodontist the possible need for splinting your mobile teeth together. There are various ways to accomplish this. The laser periodontist can explain this to you in detail. Additionally, as part of the LANAP protocol, an occlusal adjustment is also performed at the time of surgery and at your follow up visits. Finally, LANAP is very effective in treating bone loss (periodontal disease) and when done in conjunction with occlusal therapy, can ultimately save your teeth.
|12 Jun, 2012 1:34 PM|
|How much does lanap surgery cost and is that the best solution for gum disease?The best solution for the treatment of gum disease is based on an accurate diagnosis, comprehensive examination, and review of a quality set of digital x-rays. The course of treatment can only be determined by examining the patient. The cost of treatment varies from patient to patient and according to the severity of disease. When possible, we utilize the laser approach (including LANAP), but it is important to note that we often combine different modalities of treatment customized for each patient. Treatment fees would be discussed at the consultation visit.||7 Jul, 2012 6:12 AM|
|I have a gum fistula which I'm told results from a root canal inflammation. This fistula goes flat and fills up periodically. I have no pain whatsoever on the tooth or gum. Can I just live with this? I've heard different treatments and both do not appeal to me - one, have the tooth extracted, secondly, drill through the bone to clean out the canal. Again, my question: can I just live with this? Thanks so much.From your description of this dental infection, I would strongly suggest you don't leave this alone. I would seek the opinion of an Endodontist (a specialist in root canals) and discuss your options.||25 Jun, 2012 4:42 PM|
|I was told I need conventional gum surgery for 6mm pockets. I had double hip replacements a year ago and am concerned about the potential effects of the gum surgery. Amoxicillin will be prescribed for before and after, but he won't use the laser, as he said the disease is down to the bone. Wouldn't laser be better with my hip replacements?We try to utilize laser periodontal surgery whenever possible. (Yes...it would be a more desirable method to treat your gum disease.) We routinely use the laser to treat patients who have prosthetic hips, knees, and other prosthetic body parts. Additionally, we follow the antibiotic guidelines to cover our patients to avoid any post-operative infection. We treat the bone with the laser so we are not concerned about any of the issues you have discussed.||9 Jul, 2012 6:35 PM|
|I am having a bridge replaced and having LANAP done. Should I have the bridge replaced before or after LANAP? Thank you so much!I would suggest you consult your Periodontist regarding the bridge situation. This should have been discussed at your consultation visit. However, most of the time we have the teeth temporized before we have the restorative dentist place the final bridge. Also, please check to see if you need crown lengthening. This is not part of the LANAP procedure.||10 Jul, 2012 8:54 PM|
|LANAP: The regeneration and healing time, of course, differ among patients. In your experience, what is the time range for complete healing around tooth/teeth?From the patient's perspective, the healing from laser periodontal surgery is rapid, virtually painless, and takes only a few days. From a bone regenerative perspective, bone growth continues for several years after the laser procedures are performed and followed up with close maintenance and occlusal adjustments as needed.||12 Jul, 2012 2:08 PM|
|Gum Attachment: Healing of the gum may occur within a few days. Does this mean that there also will be complete attachment of the gum to the tooth root in this period of time? In addition, where there was a 7mm pocket depth, when could ligament formation be expected to be completed, in most cases?If you are referring to epithelial attachment in the absence of a long junctional epithelium, then this could take weeks, months, and in some cases years. We also might get incremental attachment (connective tissue) over time as well. This is based on human histological studies already completed and our clinical cases over the last 7 years.|
Our clinical cases have shown radiographic regeneration with an intact lamina dura in as little as 3 months, and we also have cases that, over a period of several years, continue to show bone changes ultimately leading to an intact lamina dura with bone fill. We know we have reached our limit when we see an intact lamina dura.
It is impossible to know the exact histological changes that occur without taking block sections on our patients, but the current evidence shows changes histologically as early as several weeks.
Are you a periodontist or doctor?
|15 Jul, 2012 11:56 AM|
|How do you handle severely fearful or phobic patients? Is it possible for the first visit to be just to meet the Dr. and discuss the issue up front rather than having an examination? Yes. We can discuss your situation if you like and perform the examination another day or even that day IF you feel comfortable. There is no pressure. We will be in a relaxed and non-threatening environment.|
Please speak to my staff when you call and mention this response.
Dr. Eric Linden
|15 Jul, 2012 10:51 PM|
|Hi Dr. Linden,|
I know one needs to wait 6 months after LANAP laser surgery before probing, but how long do patients have to wait after LANAP before they can get routine cleanings done on their teeth? Thank you!
We wait 12 months to probe. We are always cleaning our patients supra-gingivally (above the gum line) throughout the post-operative period. As needed, we will instrument sub- gingivally after 3 months.
|24 Jul, 2012 4:16 AM|
|I had all my gums grafted 6 weeks ago and just started have a bad taste in my mouth. I had 6 weeks of antibiotics.You had all your gums grafted 6 weeks ago? Did you have bone grafts? Soft tissue grafts? Why were you on 6 weeks of antibiotics? Did you have any oral infections during this time? Do you have a periodontal packing in your mouth? Are you under the care of a qualified periodontist? Did you have any post-operative visits? The taste could be related to an infection in your mouth, or medications that you are taking. I strongly suggest you follow up with your periodontist as soon as possible to find out the source of your "bad taste".||25 Jul, 2012 6:27 PM|
|I had the LANAP procedure done in November and am completely happy with the results. My doctor did some grinding to correct the way my teeth "fit" together, not just the bite, but the width of the six front upper teeth. I have been wearing the retainer as instructed and was told that I could just wear it at night now. My problem is that after a couple of hours there is a noticeable gap between my two front teeth, so I wear the retainer almost all the time. Will this problem resolve itself or is there something else that needs to be done?You might want to have some of your teeth evaluated for bonding/splinting to retain the teeth twenty four hours a day in the correct position. I would suggest discussing this with your periodontist in more detail.||27 Jul, 2012 12:48 AM|
|Is it possible for an eleven year old girl to have gum disease?It is possible for an 11 year old to have gum disease. The dentition is mixed with permanent and deciduous teeth. There are conditions that affect younger teenagers that range from gingivitis (gum inflammation) to a condition that used to be called "Juvenile Periodontitis". This latter condition can affect the bone and has to be treated aggressively to prevent permanent tooth loss.|
I highly recommend a qualified, experienced Periodontist preferably with laser training to evaluate the 11 year old.
|1 Aug, 2012 2:49 AM|
|I had an apicoectomy above tooth no. 7. Then 6 months later, I had new crowns placed on teeth 7, 8, 9, and 10. Immediately afterwards, my gums flared up, especially above tooth no. 7. The gum there is very puffy and bleeds very easily. Another general dentist told me the new crown was placed too close to the bone - biologic width and whatnot. He said he would either change the crowns (which I cannot do because they're new and cost a lot) or he would fix it for me, which will most likely recess my gums. I'm very upset. Are there other options? Thank you.I'm so sorry that you are having this issue. If the crown violated the biologic width, then you might have to consider periodontal work and most likely new crowns. I would strongly suggest a consultation with a very experienced Periodontist to see what can be done. Unless you are willing to live with a very unaesthetic result – and most people are not - I would not risk gum recession as a side effect. Maybe you could speak to the dentist that did the original work and see what they suggest?||25 Sep, 2012 5:27 PM|
|I just had LANAP done four days ago and had my four front lower teeth extracted due to bone loss. I noticed a yucky white coating on my top teeth that makes the teeth look dirty. Is this normal healing? I think it looks gross and the rinse I was given does nothing to take it away. Will it go away?The coating on your top front teeth could be fibrin. This is usually white in color and is normal in many instances following LANAP. It eventually turns into normal pink gingival gum tissue. However, this could also be dead epithelial tissue or white plaque buildup. Either way, I would follow up with your Laser Periodontist just to verify you do not have any infection in your mouth.||4 Aug, 2012 8:16 PM|
|Do I need to have deep cleaning before laser surgery?If you are having LANAP, then you don't have to go through any scaling before the laser surgery. If it is not LANAP, then you should consider getting a second opinion from a qualified laser periodontist that offers the FDA cleared protocol known as LANAP.||8 Aug, 2012 2:24 AM|
|When is it too late to do the procedure?Which procedure are you referring to? If you mean laser surgery or any other gum treatment, then you need to have a periodontal exam and a full set of quality digital x-rays for a diagnosis and treatment plan. Then we can determine what teeth can be saved and treated.||10 Aug, 2012 7:48 PM|
|I've already been told I'm a good candidate for gum grafting due to the recession I'm experiencing. However, on a recent trip to the general dentist for a standard filling, he seems to have nicked the gum tissue in between two teeth - the papilla I've learn it's called - and now my tongue continues to go right there to notice the tiny gap. It's such a minute space yet very uncomfortable and nerve-wracking! If I go forward with gum grafting, which was talking about around the same tooth, can something possibly be done about this as well?Over time, the papilla may grow back on its own, depending on the severity of the injury. If you are having the area grafted, ask the Periodontist if there is anything they can do to repair the damaged papilla. It might be possible, but it's not always predictable.||14 Aug, 2012 7:43 PM|
|I have had upper dentures for years. Would I still be able to get implants even though my gums have receded?Most people can have dental implants after wearing a denture. However, you would need special x-rays and scans to determine in which areas the implants can safely be placed. In addition, a thorough oral examination and review of your medical history would need to be done prior to treatment.|
Many patients are able to discard their dentures after all the dental work is complete. The esthetic and patient comfort results are amazing.
|16 Aug, 2012 1:18 AM|
|I had two implants nine months ago. Can I now undergo scaling and root planing? Also, I had my denture. How much does scaling and root planing cost? Thanks.We need to do a complete clinical examination with a full set of quality digital x-rays to make a diagnosis and treatment plan. It is only then we can give an estimate of costs. Each case and patient is different and the requirements to achieve periodontal health vary.||24 Aug, 2012 5:06 AM|
|Yesterday I had two quadrants (osseous surgery) done using LANAP procedure. How long should I wait before having the other side done?In our office, we generally do full mouth LANAP cases in one visit. A small number of our patients have half mouth done no more than 7-10 days apart. Did you have a qualified laser periodontist perform your LANAP surgery? I suggest you speak to the treating doctor to get the information you need to understand how the LANAP protocol should be performed. A full description of LANAP is always discussed at our consultation visits and is part of the informed consent process for our patients.||24 Aug, 2012 10:12 PM|
|I was told that having deep cleaning done with a laser will help regenerate soft tissue or bone growth. Is this true?I am not sure what you understand "deep cleaning with a laser" to mean. If you are referring to LANAP, approved by the FDA if performed by a qualified Periodontist, the answer would be yes. The Periodontist should be able to verify that he or she is licensed to perform LANAP, having undergone a year of specialized training. If this is not what you are considering, I would get a second opinion before you consent to any laser periodontal treatment. Your periodontist should give you a comprehensive informed consent so you understand completely what procedure you are having done. Unfortunately, a lot of misleading claims confuse some patients.||27 Aug, 2012 6:19 PM|
|I have run out of money and need treatment. My teeth are falling out and my gums throb. What can I do? Many thanks.I am sorry to hear that you having difficulty. Do you live near a major metropolitan area with a dental school? Although it could take a lot longer to get your treatment completed, it might be worth investigating this option. Best of luck.||27 Aug, 2012 10:37 PM|
|Dear Dr. Linden,|
My dentist told me I have advanced periodontal disease. After looking at several x-ray shots she recommended that my left canine tooth be extracted and the other next to it given a root canal procedure. She then wants to do root/scale cleaning and then gum surgery to complete the treatment. In the meantime, she prescribed Clindamycin Cap/ 150mg to treat the infection with a fistula but it kept coming back. Much worse, my gum above the two teeth has begun to bleed persistently. I am taking medicines for Type 2 Diabetes (Januvia/100mg), Hypothyroid (Levothyroxine/0.05mg)High Cholesterol (Lipitor/40mg) and Coronary Heart Disease (Plavix/75mg & Aspirin/81mg; Isosorbide Mononitrate ER/60mg; Atenolol/25mg; and Losartan Potassium/50mg). I would like to come in as your patient and be evaluated for the proper procedure and due to my persistent bleeding, I really need to do this right away. Also, Would you please accept payment via credit card after my Metlife PPDO coverage runs out?Hi Cynthia. Since this is a very individualized question, we need to speak with you directly. Since you expressed interest in working with us, we emailed you at the address you provided, but the email bounced. Please call our office so that we may proceed. Thanks, Dr. Linden
|30 Aug, 2012 10:21 AM|
|I have been newly diagnosed with periodontal disease. My pockets range from 2 to 4. I am currently in orthodontics; my orthodontist is now very conservative with moving my teeth. I have a severe overjet that causes daily headaches. I need my teeth aligned, is there reason to halt orthodontics… to limit moving teeth? My periodontist did not place restrictions. What to do?If you have confirmed with your Periodontist that there are no restrictions then we can assume your gum disease is under control. Who diagnosed you with periodontal disease, the orthodontist or the periodontist? If you are confused, why don't you speak to your periodontist to get clarification or seek a second opinion?||6 Sep, 2012 2:46 AM|
|Do we need laser gum surgery every year like we do deep cleaning?It is extremely rare that we have to do either procedure every year. Is this what your Periodontist suggested? In our practice, our goal is to have our patients on a regular cleaning schedule and not have to require much more than a simple cleaning. You should be on a regular maintenance schedule with regular cleanings 3-4 times a year.||7 Sep, 2012 11:55 AM|
|Can I have a deep cleaning and regenerative surgery at the same time?What specific treatment plan were you given? What case type are you? Please provide the type of regenerative procedure suggested. Conventional? Laser? It is very difficult to answer your question without this information.||9 Sep, 2012 9:35 PM|
|I went to my dentist today for a cleaning and the hygienist told me that I have periodontal disease because she can insert the instrument in my upper left gum and lower left gum. She wanted to treat me with Arestin. I have no pain or any other indication of gum disease. As an option I asked for a prescription for medication but was told that was my only option. I get the impression they are trying to push this medication on me and I don't really need it.I would strongly suggest a consultation with an experienced, laser-trained periodontist before you do anything. They should be able to an evaluate you with a full mouth series of quality digital x rays. A diagnosis can then be made and the appropriate treatment plan can be given to you with all your options.||26 Sep, 2012 10:37 PM|
|Hello Dr. Linden, I am Kevin Trujillo and I'm 16 years old. My gums on my lower lip are reddish and one of the corners of my tooth is red. I feel my teeth are kind of loose and I don't know if it's because of that. I don't know if I can get it at such an early age I'm just really scared. Hopefully you have the time to respond to my email Dr. Linden. That would be great! Thank you.Hi Kevin. My suggestion is that you see a Laser Trained Periodontist and have a full mouth series of digital x-rays taken. Then you should have a periodontal examination. A diagnosis can then be determined and the appropriate treatment will be suggested. Is there any family history of gum disease? Early tooth loss? However, the good news is we have some really advanced laser treatments that are virtually painless. You might want to discuss this with your family. You will be fine. Don't worry.||30 Sep, 2012 1:49 AM|
|I am planning on getting implants. My doctor is contracted with Medicare and the procedure will cost me $11,000. My father will be my co-signer, since I went into bankruptcy and I have my discharge papers as well. Can you recommend any finance companies that will help me? Thank you, Marci.Hi Marci. We work with a company called CareCredit, which is a dental and medical credit card that offers a variety of convenient payment options with no-interest, 3, 6, 12, & 18 month financing. Longer period 24, 36, & 48 month financing is also available. Applying for CareCredit is quick and simple. Patients can apply online at http://www.carecredit.com, or by calling CareCredit directly at 866.893.7864. Since CareCredit is a credit card, it can be used over and over again to finance other medical procedures.||30 Sep, 2012 11:02 PM|
|Is it better to have laser surgery before pregnancy or after baby's birth? Would pregnancy reverse the condition of gum if laser surgery is done before pregnancy?Ideally it would be desirable to do your laser surgery before the pregnancy so your condition does not get worse.||1 Oct, 2012 8:32 AM|
|I have a long bridge on the lower left side, attached to a wisdom tooth. I bit on something hard six weeks ago. I have had a toothache for a month now and there's a bad odor at the tooth site. An x-ray showed no problems, but there's a deep pocket. What can be done?There could be a number of things going wrong. There is clearly an infection and you really need to be seen as soon as possible for an accurate diagnosis. You really need a very experienced Periodontist to examine you to figure this out.||4 Oct, 2012 11:44 PM|
|I had LANAP treatment about six months ago. For the past several months I've had phlegm in my mouth which causes me to keep rubbing my teeth and the roof of my mouth until sore. Could this slime be caused by something I eat or a combination of what I eat/drink, the kind of toothpaste I use, or what? Any helpful suggestions would be much appreciated. Thanks. MWThis phlegm as you describe it can be caused by an upper respiratory infection or perhaps a post nasal drip. Other causes can be mouth rinses, food, medications, mouth breathing and allergies.|
Try eliminating one thing at a time and see if anything changes. Have you been checked by your MD regarding a post nasal drip or sinus issue? Allergies?
See what happens if you follow up with the suggestions listed above.
|6 Oct, 2012 3:48 PM|
|Do you happen to know what a cold laser is? I have a patient who says he uses it at home to help with his periodontal health. If he is using it, it is NOT working. Seems hokey???I know nothing about this. Sorry.||18 Oct, 2012 10:47 PM|
|Last month I had LANAP surgery, but because I was having a problem with a tooth that my dentist thought may need a root canal I went to see another dentist about this. I told her I had just had LANAP surgery, but she probed all the pockets in my gums. I am now really, really anxious that she has destroyed the work that was done and would like your feedback on the effect this may have on my recovery. I really thank you for taking the time to look at this question and hopefully give me an answer back. Thank you.The probing around the tooth in question might not necessarily have a negative impact on healing. I would follow up with the root canal specialist and let things heal up. However, I would follow up with your Periodontist and have this area monitored closely. The x-ray from the root canal will also show how the bone is healing.||10 Oct, 2012 11:40 PM|
|Sir, I am 57 years old &and I have been chewing tobacco since 25 years. Suddenly, I have managed to stop the tobacco since 35 days with great difficulty. At present, I am without nicotine. Presently, when I feel to chew, I either chew tea powder (black) or chewing gum. Kindly please tell me any side effects of tea chewing.Honestly, not a lot of research has been done on tea chewing. You will get a lot of staining of your teeth. Can you use chewing gum instead (sugarless)? Why take a chance with tea?||16 Oct, 2012 1:48 PM|
|My family dentist has just referred me to a periodontist to evaluate pocket distal briccal #3, probing depth of 6+mm. I have no pain but fistula is present. What is this and what is the treatment? A fistula is the sign of infection. You would need to be seen for a consultation to diagnose where the fistula is coming from. The treatment plan can be determined after the x-rays and clinical exam. A good diagnostician should be able to figure it out.||22 Oct, 2012 8:49 PM|
|I have a #7 on my lower back teeth. My dentist wants to do a perio tray. Would laser be a better place to start? A perio tray is an upper and lower mouth guard containing antibiotic gel that you wear twice a day.We discontinued that treatment many years ago. We did not see any benefit beyond a few weeks. In addition, the periodontal literature and studies did not show significant clinical gains. If you have gum disease with pocketing, the laser approach is considered the most thorough way to kill the bacteria that causes gum disease.|
Have you seen a Periodontist yet? If not...I would strongly suggest it.
|26 Oct, 2012 6:56 PM|
|My gums have receded a little after extraction followed by gum grafting (eye tooth). Is this normal? Now I have spacing between the temporary tooth and gums.It is not uncommon after extractions to have the gum shrink. We routinely bone graft, laser, and soft tissue augment to avoid this result. You can speak to your dentist about relining the temporary tooth to make it look more natural.||30 Oct, 2012 4:27 AM|
|What are the side effects of LANAP?None have been reported. It is completely safe when performed by a certified periodontist.||30 Oct, 2012 5:11 PM|
|I'm missing my two superior lateral teeth. Should I get a dental bridge or something else? What do you suggest?You really need to be seen for x-rays and a full evaluation to really give you a fair diagnosis. However, the options usually are implants, bridges, or removable partial dentures.||1 Nov, 2012 6:26 AM|
|Dr. Linden, |
For someone who is young (early 20's), with a tooth slightly mobile (very slight) and a pocket of 7-8mm - what are the available treatment options and chances of treating it non-surgically? Is the best option to go to a professional periodontist straight away or have a full dental clean, practice good oral care, and wait for results? Thank you.I would suggest you go ASAP to an experienced and qualified laser trained Periodontist for a consultation. You should be able to get a diagnosis and treatment plan that would be appropriate for your condition.
|3 Nov, 2012 4:56 AM|
|What problems still require conventional surgery?A great question that is extremely difficult to answer in this forum.|
I think you would need to attend one of my 2-hour lectures at Columbia University devoted to this topic alone.
I will list a few examples:
1- implant surgery
2- gingival grafting
4- ridge augmentation
However, we use the laser in all the above procedures, but we have to use conventional therapy as well. This minimizes any post-operative swelling and discomfort experienced by the patient. The healing is also 60 times faster according to our clinical findings.
I hope this helps.
Thank you so much for your rapid response. I am having surgery Wednesday Nov. 7th. My periodontist told me that I would be having the laser surgery but my paper work said I was having the conventional surgery; therefore, I wanted to know the possible reasons for the change. I went to the office last Friday and was told by the person at the desk (the dentist was in surgery at the time) that the laser surgery would be done on the front teeth and conventional surgery on the back teeth. She did not know why. The surgical assistant called me today Monday Nov. 5 and said that was an error on the paperwork (one of several) and the surgery would be laser and not conventional.
I very much appreciate your answer. I would love to attend your lecture but I live in Lakeland TN, a suburb of Memphis,TN. I am very grateful that you have this website and you are willing to answer questions.
|4 Nov, 2012 5:18 PM|
|Can you fly two days after getting gum skin graft surgery?Yes, but we don't usually recommend it for our patients.||6 Nov, 2012 4:52 AM|
|I have a gummy smile. I want to have the LANAP surgery. Are veneers or crowns required after surgery, or can other methods like tooth bonding or Lumineers be used?Do you have existing crowns on your teeth now? If not, you might not need anything if the aesthetics look good after the laser surgery. If you either have existing crowns or anticipate new ones, then I would suggest a consultation with an experienced Prosthodontist. They can give you all your options. We always work with the restorative dentist (Prosthodontist-specialist) before we do any "gummy" smile laser/traditional cases.||11 Nov, 2012 3:44 AM|
|Hello sir, I have a gum recession (exposed root) on my central incisor and it has become a little mobile. There is no bone loss yet according to my periodontist. According to him, it's because of the higher attachment of the frenum. I underwent a frenectomy yesterday. I would like to know whether my gum will grow back. I am 20 years old and this problem is like a nightmare for me.It is hard to diagnose based on the information you have provided. However, I would suggest a consultation to get a 2nd opinion. Did the periodontist ever suggest a gum graft?||23 Nov, 2012 6:21 AM|
|I went to the periodontist and was told that I need gum grafts in all of my mouth. I went for a second opinion and the Periodontist advised bone grafting, tissue regeneration, and cut/flap surgery. I have 6 mm pockets in the front of my teeth. The back of my teeth gums is ok. I'm wondering if I could get LANAP for 6 mm pockets. It might be possible to do a laser procedure. You would need to be seen for a consult and x ray examination.||13 Nov, 2012 12:31 AM|
|I've gone through the Invisalign treatment and now I wear a full Invisalign retainer on my upper teeth every night. Will I be able to continue wearing this if I have the LANAP treatment? I wouldn't want to stop wearing it as I've invested a lot in straightening my teeth.You have to be careful after having the LANAP procedure protocol. We don't want anything to disturb the clot around the neck of the teeth. This could affect the healing and results. I would suggest not wearing the appliance for several days after the procedure. Please check with your Periodontist before having this procedure done.||24 Nov, 2012 2:56 PM|
|The gum of one of my upper molars did not re-attach on the buccal side after 4 months following LANAP, at a different periodontist's office. He did not give me a prognosis after examination. I did have a deep cleaning and was asked to return for my next cleaning in 3 months. I have researched to see whether that re-treatment could be an option. If yes, would you again charge the patient to treat that area if only re-treatment was performed? It depends on the case, circumstances and the individual patient. Did you have full mouth LANAP?||14 Nov, 2012 12:21 PM|
|When I awaken in the mornings and wash out my mouth, my saliva is red. What is the problem and how can it be corrected without operations? What if one does not have insurance? How much does it cost?The first step is to schedule an appointment with a qualified laser trained periodontist for a thorough examination and full mouth series of digital x rays. An appropriate treatment plan will be suggested to you that will address your symptoms. It is impossible to tell you here on this forum what needs to be done and what the costs might be. If it makes you feel any better, most offices offer financing. We are out of network with most dental insurance. A recent set of dental radiographs is required for the consultation. We recommend that you call the office to schedule an appointment for a full Periodontal examination and evaluation. The phone number for NJ is 201-307-0339, NYC is 212-595-5559.||28 Nov, 2012 7:49 PM|
|What pills should I avoid when I get periodontal work?This is a very difficult question to answer without knowing your entire medical history and individual situation. What kind of periodontal work is planned? Allergies? Medical conditions? Sensitivities? Too many issues to mention here on this forum.||28 Nov, 2012 12:02 PM|
|What is latest bonding technique for severe recession of four front bottom teeth? I have already had gum surgery but these teeth hurt all day long even though I use sensitive toothpaste and brush very lightly. Can bonding be done on the inside as well as the outside of these teeth? Thank you for your answer.You should see a good restorative dentist to see what they can do to bond the front teeth that are bothering you. Are these teeth loose? Are they splinted? Has the bite been adjusted on these teeth? What is the prognosis? Did a Periodontist do your gum surgery?||20 Dec, 2012 10:37 PM|
|Can 22 x-rays be taken in one visit?A traditional full mouth series does involve 22 x-rays, which can be done in one visit. Digital is the preferred method.||11 Dec, 2012 4:25 PM|
|Should you do the LANAP procedure in one visit or two? Can the whole mouth be done at once instead of going to the dentist twice? Thank you.We do full mouth LANAP cases routinely.||7 Dec, 2012 8:16 PM|
|Hi Dr. Linden,|
I have pain in all my left side teeth, top & bottom. I took doxycycline and was ok for a few months, but now it started again. I am using Sensodyne. It helps for a while but after a few hours it starts again.
You really need to come in for a consultation to see what is going on in your mouth. Antibiotics and Sensodyne are not a cure for underlying dental problems.
Please follow up a.s.a.p.
|6 Dec, 2012 8:29 PM|
|I had LANAP four days ago and some of the white stuff (I'm guessing the clot or scab) came off. How long does the clot usually stay intact? Is it okay if it falls off? There was no bleeding when this happened.|
Every patient responds differently. Since I don't know your history, I would need to examine you personally in order to answer these questions. In light of the fact that you were treated just four days ago by a LANAP-trained Periodontist, I recommend that you report the situation to him or her and ask whether you need to be seen.
|11 Dec, 2012 10:18 PM|
|How do you fix a really gummy smile? How much does it cost?A gummy smile can be corrected with either traditional surgery or with the LANAP Laser treatment. We have had excellent results! An examination and patient history are in order to determine what has caused the problem to begin with. The fee would be determined after the examination and consultation appointment.||28 Dec, 2012 4:38 AM|
|My teeth are yellow. The doctor says they cannot be whitened. They need a crown, but I don't think it's what I should do. I want to know if teeth whitening will work.I couldn't answer this question about whitening without examining you. Did you see a restorative dentist who does cosmetic dentistry? They would know right away how to get the result you want.||30 Dec, 2012 9:34 AM|
|I just recently had LANAP surgery. Am I allowed to take a few puffs of a cigarette?I always recommend to my patients who smoke to try to avoid it if possible.|
Maybe the fact that you’ve recently had LANAP surgery could motivate you to quit, since cigarette smoking is a known contributor to periodontal disease. Many of our patients have quit smoking after LANAP surgery, with positive results.
Best of luck,
Dr Eric Linden
|30 Dec, 2012 11:24 PM|
|Hello, Doctor. I have a query for you to address. I am 27 years old. I inherited tooth decay problems.I had root canal treatments done to 5 or 6 teeth. I am worried about the bad effects. I am a bride to be, so I want to know whether, with post root canal treatment, there is any way to control and avoid bad odor during kissing. Please advise. I have been taking regular care of hygiene, but am in need of extra guidance to prevent a bad odor.Your breath might be an indication of periodontal disease, which may be spread to your spouse. You should be seen and examined by a LANAP trained laser periodontist as soon as possible.||16 Feb, 2013 8:26 AM|
|My son has been a mouth breather all his life and it has caused significant problems with his teeth and gums, especially when he had his braces on. He is 21 now and still with deep pockets and also a bar across his bottom teeth. He brushes and flosses every day and rinses with Listerine. Unfortunately he has no dental insurance so the cleanings are few and far between. For Christmas we gave him the Sonicare platinum series toothbrush to help him, but with all this his breath is still bad. How long does Listerine last in his type of mouth to where the effects are still good and unfortunately the alcohol content stays in effect with his condition of deep pockets of 5 and 6mm?Listerine or any other mouthwash is just a minor help with pocket depths that you are describing. The penetration of any mouth rinse is limited just to the surfaces of the gums and not into the pockets of 5+ mm. Do all you can to get your 21 year old son to a Laser Periodontist that does LANAP. It sounds like he has an aggressive form of bone loss for his age.||18 Jan, 2013 9:04 PM|
|How much does it usually cost to have laser gum surgery done for all 32 teeth? Give an estimate to have 32 teeth done - starting price and end price. We need to do a complete clinical examination with a full set of quality digital x-rays to make a diagnosis and treatment plan. It is only then we can give an estimate of costs. Each case and patient is different and the requirements to achieve periodontal health vary.|
The best solution for the treatment of gum disease is based on an accurate diagnosis, comprehensive examination, and review of a quality set of digital x-rays. The course of treatment can only be determined by examining the patient. The cost of treatment varies from patient to patient and according to the severity of disease. When possible we utilize the laser approach (including LANAP), but it is important to note that we often combine different modalities of treatment customized for each patient. Treatment fees would be discussed at the consultation visit.
|22 Jan, 2013 5:08 PM|
|I had a crown lengthening procedure done 10 days ago. I had my stitches removed already. Am I still vulnerable to infections? May I share drinks with other people or kiss without risk (of blood transmitted diseases like HIV). Thanks so much!This surgical area is considered an open and healing wound. Yes…it is possible to transmit diseases, and until the wound heals, it is vulnerable to infection. Please follow the oral hygiene instructions that your Periodontist provided. If you have any complications or questions, please contact your Periodontist.||17 Jan, 2013 10:23 AM|
|My 21 year old son came back from the dentist and found out he has gum disease - around 6 on some teeth on the probe. We have no dental insurance and he is unemployed - we were quoted $1,700 - it might as well be a million. Anyway, how long can he wait before something must be done and what can he do in the meantime?It would be irresponsible for me to comment on his case specifically, without examining him. There could be issues that require prompt attention, but again, without examining him, I can’t say. Ideally, he should see a laser trained periodontist ASAP. There may be one in your area who offers Care Credit or Springstone, as we do. That might make it possible for your son to get the necessary professional attention despite your financial situation.||25 Jan, 2013 2:26 AM|
|It's been 30 days since I had LANAP surgery. May I eat normally now?You should be able to eat everything but I would check with your Periodontist just to be sure.||27 Jan, 2013 4:01 AM|
|I'm really scared. I am petrified of dentists and I've just been told I have periodontal disease. I've got to have root planning and I'm worried about the procedure. Will it hurt?Are you seeing a laser trained Periodontist? This mode of treatment is easier and less invasive. However, it needs to be the FDA-cleared protocol with the ND/YAG laser. Did you have a full series of x-rays with a diagnosis?||29 Jan, 2013 9:09 PM|
|I had a gum graft 19 days ago on an implant site (implant done in October). The same day as the gum graft, they put on a provisional crown. I did not look at the site until last night and when I did the entire area appears white. Does this mean the graft did not take well? When should the tissue start to appear like it is rejuvenating?If you had the graft 19 days ago on the implant site and the entire graft looks white, I would suggest that your Periodontist examine you and see if this graft area is healing normally. Color changes are not uncommon, but have it checked out to be safe.||28 Feb, 2013 7:57 AM|
|Good Day, I just recently had my first LANAP procedure (right side). No problems and completely pain free! I almost have to remind myself that I actually had this done only a few days ago. I have followed all my instructions (fluids first three days, no brushing, etc.). My concern is, I have noticed more today that I have a very thick, white-yellowish film around and on each tooth. Is this normal? I am so pleased with my results so far and can't wait to do the rest of my mouth. Thank You.It sounds like everything went well. How many days post-operative are you? It is normal in the first few days to have color changes around the neck of the teeth. This is the fibrin. Please confirm this with your treating Periodontist.||25 Feb, 2013 8:50 PM|
|I had tissue grafting a couple of times, with tissue taken from my palate. If needed a third time, can tissue be taken from the same area of my palate if it has been a couple of years?Yes, that would not be a problem.||27 Feb, 2013 2:26 AM|
|Do you use laser for gum grafting?We use it in conjunction with the graft procedure.||6 Mar, 2013 11:39 PM|
|Within four months after having used LANAP to treat three teeth, all three teeth subsequently died, became loose, and required extraction. After extraction, it was observed that the roots of each tooth treated with LANAP had several pin point scorch marks. Is it possible, and is there research to tell, if heat from the LANAP laser could be transmitted into the pulp or nerve of each tooth, causing them to die? Any research referral would be helpful.There are no negative thermal effects on the roots of teeth if the LANAP protocol is followed according to the guidelines. |
The temperatures we use with LANAP are well below the temperatures to which root surfaces are exposed, for example, in root canals. Yet even in the root canal studies, the roots and pulp were not affected by heat.
Here’s a reference for you: SPIE Vol. 188/229 16-18 JAN 1993
We have been utilizing the LANAP protocol for many years and have yet to see any of the damage you are describing.
|7 Mar, 2013 12:36 AM|
|Hello Doctor, I had my four front teeth replaced with crowns (2 of the teeth had existing crowns). It's been a year now and the gum above teeth numbers 7 and 8 is still puffy and deep red. I also feel there's been gum recession. What can I do? Is this reversible? Thank you.To answer this question responsibly, I would need to conduct a comprehensive examination, and review a quality set of digital x-rays. When possible we utilize the laser approach (including LANAP), but it is important to note that we often combine different modalities of treatment customized for each patient.||5 Mar, 2013 7:46 PM|
|Can this laser treatment treat a tooth with furcation? Also, how many treatments are required for gums that have receded, what is the waiting period for a second treatment if needed, and how many follow-up visits are required?Yes, we can treat a furcation depending on the location and extent of the bone loss. Gum recession is a different issue and needs to be addressed at your consultation visit after photos and x rays are taken. The interval between treatments depends on the case type and the patient. Follow up visits can be customized for each patient. Many of our patients travel from a long distance to have their treatment done, and we take that into consideration when scheduling them.||8 Apr, 2013 5:33 PM|
|Sir, after periodontal flap surgery, how much time is needed for recovery of gum and bone (because I want to take braces treatment after this). So please tell me how much time needed for braces treatment.It varies from case to case. Check with your Periodontist who did the surgery. He or she should know the timing.||12 Mar, 2013 5:43 AM|
|I am a 59 year old that decided to get braces over 3 years ago :-( I should be getting them off in about 8 weeks....hopefully! But I now have spaces between my teeth where the gums are missing because of the unraveling. What are my options after the braces come off for these holes in my teeth?? Thank you! PamHi Pam, I’m sorry to have to give you such a general response, but this is a very difficult question to answer without seeing you or photos of your teeth and gums. There could be a number of things to consider after having braces.||14 Mar, 2013 2:47 AM|
|Hi Dr. Linden,|
I had gum recession on my upper two canines. So I consulted a periodontist and he performed coronal advanced flap to cover the root.
It has already been two weeks and the tissue is healing. But I have a small hole between the donor site and the recipient site which is not covered by the gum and I could see the underlying white tooth surface. The size of the hole is 3- 4 mm.
It is acting as a plaque-building food trap and I am unable to brush on the hole, because the tissue is still healing and I am afraid that I could damage the healing tissue if I brush on it.
I asked the periodontist about this and he said it is normal. But the hole is completely compromising my oral health and the healing tissue.
The hole doesn't have any signs of infection or pus. I apply Chlorhexidine every night on the hole to prevent infection.
Is there anything could you suggest in order to close the hole and is it ok if I apply gum astringent (Stolin) on the hole to constrict the gum hole?
Thank you for your time.
JohnSince you are already under the care of a Periodontist, I can only advise you to continue follow up treatment with him or her. It is difficult for us to know over the internet what the actual treatment might have been, and should be going forward. To deal with your case responsibly and professionally, I would have to examine you, including taking a set of digital x-rays.
|18 Apr, 2013 8:38 AM|
|Can I get LANAP surgery done during my first month of pregnancy? I am a gum disease patient and have been advised to go for a LANAP surgery. Will it cause any problem or birth defect to my child?I would consult your physician and obtain a medical clearance. However, if it is not an emergency, we generally wait until the pregnancy is over.||26 Mar, 2013 11:23 PM|
|I go for semi regular cleanings and have always had pockets from 2 to 8. Recently, after an exam, I was told that my back teeth top and bottom on both sides have pockets from 10 - 8. My front teeth are about a 2. Can I get LANAP just on the back teeth and not the front teeth, since they are in pretty good shape, or must the whole mouth be treated with the LANAP? The idea would be to not have to spend so much money. Thank you.It’s very rare that we only treat part of the mouth, but in any case, a full mouth examination/consultation, including a current full mouth serious of digital x-rays, would be needed first, to determine the course of treatment. Each situation is different. Everybody has a customized treatment plan.||13 Apr, 2013 4:19 AM|
|I had a cone beam scan which showed infections on an implant bridge at neck #3 and 5 4 is a dummy graft. I have permanent cemented caps. My periodontist suggested flap surgery, hoping to find an opening through which to reach and clean out the infection. If he can’t reach it, he will only clean what is showing and close it up again. |
First, is it not better to get some deep cleaning with the laser around the infected area before flap surgery? Second, is this the only or best way to try to stop the infection which is spreading in my bone at the bridge of two implants? What treatment plan would you suggest?This is a very complex issue that cannot be answered by e mail. A patient exam with the necessary digital films is absolutely necessary.
However, I can say this:
• We treat peri-implantitis routinely using the ND/YAG laser.
• We don't flap nor do we scale before the laser treatment.
• Each case is different and the treatment can vary.
|2 Apr, 2013 7:17 PM|
|I'm 27 years old. My last dentist visit was in a foreign country over 12 years ago. While I have tried to take good care of my teeth, my oral health has declined recently. I've developed extreme sensitivity to either hot or cold food or beverages. Four of my bottom teeth have built up tar (never smoked a day in my life), one of which recently started to turn black. Also, my bottom gum is receding. I can't floss any longer as my gums start to bleed when I do. Please help, as I'm afraid and embarrassed. What should I do? Should I go to a regular dentist? I would seek the services of a qualified and experienced LANAP trained Periodontist in your area. They should be able to give you a diagnosis and treatment plan.||3 Apr, 2013 3:04 AM|
|Hi Dr. Linden. I’m having gum problems. Up to 50% of my gums are infected. Shall I prefer laser surgery for solving this problem? What is the cost of this surgery? Please help me out.It is difficult to diagnose you on the internet, however I would seek the services of an experienced LANAP-trained Periodontist. Each patient is different and the costs vary depending on the extent and specific case type.||3 Apr, 2013 10:41 AM|
|Do you have to be referred by a dentist to have LANAP? I have MetLife dental insurance. Do they pay any on this? About how much does LANAP cost per quadrant?No, you do not need a referral to the practice. We are out of network with MetLife dental. However, the patient may have out of network benefits with an annual maximum per calendar year. It's impossible to quote a patient over the internet. We would need to determine with a patient history, examination, and a good set of digital x-rays whether or not the patient qualifies for the LANAP Laser treatment and what the cost estimate might be.||22 Apr, 2013 6:30 PM|
|What to do if I have an abscess in my gums by my bottom tooth?I would suggest seeing a Laser trained LANAP Periodontist for an immediate evaluation.||29 Apr, 2013 11:37 AM|
|Does LANAP require a course of antibiotics?We use antibiotics for 7-14 days depending on the patient and sequence of treatment per protocol.||2 May, 2013 3:37 PM|
|I have had bone graft done on tooth # 9 and extract # 9. What is my next step? What are the results if I had tooth # 9 removed and put an implant to replace it? What is the approximate time frame for this procedure and what should the approximate charges be?It’s difficult to tell from the question you submitted what your situation is. A consultation/examination along with digital x-rays would be necessary to get a clear picture. This would also enable us to determine time frame and cost.||4 May, 2013 3:40 PM|
|Hello Dr. Linden|
I was diagnosed with advanced aggressive periodontitis and found doctor in Canada for LANAP surgery.
I would appreciate if you let me know what I have to concern about surgery and what to ask doctor before surgery?
Hi Paul. Presumably you'll be having an initial consultation with the doctor you have found. If you have any concerns or questions, you'll be able to ask him directly at that time. That’s what initial consultations are for.
|9 May, 2013 7:15 PM|