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LANAP in the Real World by Dr. Howard Farran, DDS, MBA

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Categories: Laser Dentistry;
LANAP in the Real World

by Dr. Howard Farran, founder, CEO and editor-in-chief of Dentaltown magazine
Each Howard Speaks article is written by Dr. Howard Farran with the assistance of AI. Every piece is developed, reviewed, and refined under Dr. Farran’s direction to ensure it reflects his authentic voice, insights, and experience.
LANAP (laser-assisted new attachment procedure) inspires fierce loyalty in some clinicians, healthy skepticism in others, and considerable curiosity among those still on the fence. Spend enough time talking to dentists who use it, and you’ll hear a recurring theme: it’s not a magic wand, but when done right, it changes practices and saves teeth.

General dentists and periodontists who’ve used LANAP for years describe excellent clinical results, high patient acceptance, and, in many cases, strong practice revenue. One GP with seven years’ experience still “loves it” and calls it his favorite procedure. Another says LANAP paid for four kids’ college tuition. Some periodontists credit it with changing the way they practice entirely.

Patients are often more willing to accept LANAP than traditional osseous surgery; one clinician cited acceptance rates above 90% compared to about a third for conventional approaches. The appeal is obvious: no scalpel, no sutures, less downtime, and the ability to treat the whole mouth in one or two sessions. For some patients who refuse traditional surgery, it’s the only treatment they’ll say yes to.

Economically, many report that once the laser is paid off, the return on investment is solid. Some GPs do $40–70k annually in LANAP cases; others see fewer cases in leaner years but still call it worthwhile. The catch is that initial costs of $60k–$100k for the PerioLase MVP-7 plus training are significant. Millennium Dental Technologies claims that one patient a week can cover financing, but this depends entirely on your patient base, marketing, and commitment to keeping cases in-house.

On the clinical side, success depends heavily on case selection, protocol discipline, and patient compliance. Relapses happen, often tied to skipped maintenance visits or nightguard neglect. Some operators emphasize that poor outcomes are often due to breaking protocol, inadequate periodontal knowledge, or insufficient chair time.

LANAP has an FDA 510(k) clearance for “true periodontal regeneration,” new cementum, periodontal ligament, and alveolar bone on previously diseased roots, backed by human histology. That’s a unique claim in dentistry. However, critics point out that the supporting histology studies are small (around 10 teeth each) and that meta-analyses conclude LANAP is equivalent to scaling and root planing in clinical outcomes. The debate often boils down to how much weight to give anecdotal experience versus the current evidence base.

Supporters argue that while more large-scale research would be welcome, existing studies, plus extensive positive clinical experience, justify its use. They also note that many surgical modalities in dentistry and medicine took decades to build a “preponderance of evidence,” yet were adopted based on early data and clinical need. Skeptics counter that if LANAP results are as dramatic as claimed, robust multi-center trials should already exist.

That debate isn’t just academic; it reflects the larger tension in evidence-based dentistry between published science, clinical expertise, and patient preferences. As one veteran GP put it, “Science is important, but it’s one part of the decision-making process. Patients have their own goals, finances, and fears. Sometimes LANAP is the only bridge between doing nothing and losing teeth.”

Regarding patient communication, LANAP dentists find that clear, non-technical explanations are most effective. Position it as a minimally invasive way to control gum disease, save teeth, and promote natural regeneration, without the cutting and sewing of traditional surgery. Show before-and-after images. Emphasize the comfort and fast recovery. However, don’t oversell; it’s not a cure-all, and it still requires meticulous home care and regular maintenance visits.

From a workflow standpoint, LANAP is labor-intensive. You’re in one operatory for two hours or more per session, and it’s not something you hand off to a hygienist. Some view this as a downside compared to high-turnover procedures like single crowns, but others describe it as their “most relaxing” procedure once they get into a rhythm.

Alternatives exist. Competing lasers like Fotona’s LightWalker offer Nd:YAG and Er:YAG wavelengths at lower cost, with the erbium providing calculus removal, smear layer elimination, and hard-tissue capabilities. LANAP is proprietary; you can’t alter the protocol and still call it LANAP. For some, the exclusivity and branding are part of the appeal; for others, it’s a limitation.

There’s also LAPIP, LANAP’s cousin for peri-implantitis. It uses the same PerioLase laser to detoxify implant surfaces and stabilize tissues. The evidence here is thinner, mostly consisting of case series, but some clinicians find it a valuable way to save failing implants without resorting to explantation.

If you’re considering LANAP, the practical advice from experienced users is consistent:

Be ready to invest, not just in the equipment and training, but in marketing, patient education, and maintaining strict adherence to the protocol.

Understand perio biology inside and out. The laser is a tool, not a substitute for fundamentals.

Manage expectations. Even with LANAP, poor home care, smoking, and systemic risk factors will sink your results.

Integrate it into your practice flow. If your schedule and office dynamics can’t accommodate two-hour blocks and post-op maintenance, it’ll end up gathering dust.

And don’t forget the human side. One GP tells of extracting two maxillary centrals from his own father early in his career, his first time seeing his dad cry. That moment changed how he framed conversations about “hopeless” teeth. For patients terrified of losing teeth, LANAP can be a psychological lifeline as much as a clinical one.

In the end, LANAP sits at the intersection of high-tech dentistry, patient psychology, and evolving evidence. For some, it’s the most rewarding procedure they do. For others, the jury’s still out. But if you’re the kind of clinician who thrives on new technology, enjoys surgical precision, and wants a minimally invasive option to offer perio-surgery-averse patients, LANAP might be worth your serious look.

Just remember: the laser doesn’t do the work—you do. And in this procedure, as in all of dentistry, skill, science, and patient trust are what truly drive outcomes. 
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