Minimally-Invasive Laser Treatment for Gum Disease - Markham Woodbine Dental

What is Gum Disease?

Gum disease – also known as periodontal disease or periodontitis – is an oral infection associated with damage to teeth-supporting tissues such as gums, bone and the ligament that anchors teeth to the bone (periodontal ligament). The infection is caused by an imbalance of disease causing bacteria, parasite and fungi.

While gingivitis is inflammation of the gums around the teeth, periodontitis occurs when the bone below the gums become inflamed or infected. The gums will start to recede away from the teeth and form deep gum pockets that readily collect plaque and bacteria. Because these pockets are very difficult to keep clean (even professionally), more inflammation and subsequent bone loss occur. Loss of bone in severe cases leads to tooth loss.

Symptoms of Gum Disease

  • Bad breath that won’t go away
  • Red or swollen gums
  • Tender or bleeding gums
  • Pain during chewing
  • Loose teeth
  • Sensitive teeth
  • Changes to the bite
  • Receding gums or longer appearing teeth
  • Premature tooth loss

Early Treatment Matters

Gum disease is a chronic infection that can be managed if treated early. Like most chronic medical conditions, there is a spectrum of disease progression from mild to moderate to severe gum disease. Treatment success is largely dependent on early diagnosis and treatment.

We highly encourage our patients to take early to moderate periodontitis seriously, as this stage is often asymptomatic, but is the best time to treat the condition and prevent damage to the supporting structures around teeth.

Once gum disease becomes symptomatic (pain, swelling, loose teeth), or the disease has progressed to a severe stage, the damages are not easily reversible and the success of using any type of gum disease treatment (including surgery) is unpredictable.

Gum Health is Linked to Overall Health

Your gums are not isolated from the rest of your body.

The same bacteria found in patients with gum disease are found circulating in the bloodstream.

Patients who have diabetes or cancer are more susceptible to infections and an increased load of bacteria in the bloodstream can worsen the respective conditions.

When these bacteria are found in the heart, they can contribute to form atherosclerotic plaques that lead to heart disease and heart attacks.

When these bacteria are found in the joints, they can contribute to rheumatoid arthritis.

When these bacteria are found in the brain, they can contribute to the development or worsening of Alzheimer’s disease.

Gum disease in women is particularly detrimental during pregnancy, as studies show a correlation between gum disease and low birth weights.

As gum disease has a negative impact on many health conditions, it is important not to ignore it.

Minimally Invasive Laser Treatment for Gum Disease

Biolase Waterlase REPAIR™ Treatment

Compared with conventional open flap surgery, the REPAIR™ Protocol using the Biolase® Waterlase laser is a minimally invasive treatment for moderate to severe chronic periodontitis. Local anesthetic will be administered as part of the treatment.

The Biolase® Waterlase is an Er,Cr:YSGG 2780nm Class IV laser specifically designed for use on oral soft and hard tissues. The REPAIR™ protocol involves using laser energy via special tips to reach, decontaminate and remove diseased gum, bone and tartar on root surfaces. Biologics such as Emdogain®, an enamel derivative matrix protein, can be applied during the surgery to encourage better healing and tissue regeneration.

The surgery site is then stabilized by a transparent tissue adhesive. If there is tooth mobility, occlusal adjustments or splinting of teeth for stabilization may be required for best treatment results.

Using the Biolase Waterlase iPlus Laser

Advantages of Minimally-Invasive Dentistry

12 Months Post

6 Months Post

Less Pain/Discomfort

Compared to traditional open flap surgeries, the REPAIR™ Protocol is a scalpel-free, suture free treatment.


The treatment time is faster when compared with any open flap surgery.


Multiple sections of the mouth can be treated at the same time, including a full arch.

Fewer Complications

Less damage to the gum and bone. Less likely for gum recession after surgery.

Comprehensive Periodontal Program

Treating gum disease requires a comprehensive approach and follow-up.

At Markham Woodbine Dental, we offer comprehensive treatment planning, minimally invasive treatment options and diligent maintenance after treatment is complete.

We offer Diode Laser Bacteria Reduction Therapy (no surgery, no freezing required) and Ozone Therapy as part of your regular cleaning and follow-up visits to reduce gum inflammation and to maintain healthy gums.

What’s Your Concern?

Is laser treatment for gum disease a NEW type of treatment?

  • Lasers have been used in dentistry, including periodontics, for over 50 years
  • The Biolase Waterlase iPlus laser has been on the market since February 2012
  • The REPAIR Perio treatment is a well-researched and FDA approved protocol for treating gum disease

Is the Biolase Waterlase REPAIR Perio Treatment painful?

  • Local anesthetic is provided to fully numb the area prior to treatment
  • Most patients take 1-2 tablets of Advil or Tylenol after the procedure
  • Prescription pain medications are often not required after treatment

How does the Biolase Waterlase REPAIR Perio Treatment compare with traditional periodontal therapy?

  • REPAIR is a safe, fast and minimally-invasive treatment
  • REPAIR is a scalpel-free and suture-free treatment
  • REPAIR has equivalent clinical results compared to the newest methods of traditional open flap surgery (ref: Journal of Periodontology, July 2020)

What are the benefits of the Biolase Waterlase Laser REPAIR Treatment?

  • Can treat gum disease in as little as 1 treatment session (1-2 hours in many cases)
  • Superior patient reported outcomes (less swelling, bruising, and bleeding) and faster procedures times – with equivalent clinical results compared to the latest open flap surgery techniques (ref: Journal of Periodontology, July 2020)
  • Can prevent tooth loss and the need for other costly procedures such as implants or dentures
  • Can reduce bleeding, swelling, bad breath and other side effects of gum disease
  • Most patients are back to normal light activities within 24-48 hours after treatment

What are the side effects of the Biolase Waterlase REPAIR Perio Treatment?

As with any surgery, the side effects of REPAIR Treatment include: mild bleeding, mild swelling, minor pain/discomfort at the treatment site, and temporary tooth sensitivity

What is Emdogain(R) biologics and is it absolutely necessary to use?

  • Emdogain is a mix of enamel matrix proteins that, when applied to a clean tooth root surface, forms an extracellular matrix that stimulates cells and processes that are fundamental for periodontal regeneration
  • Emdogain has been on the market for over 20 years and is backed by extensive and long-term clinical documentation used in over 2 million patients and in over a thousand scientific publications
  • The use of Emdogain is not absolutely necessary, but improves healing and treatment results when used in conjunction with surgery
  • Please click here to download the Emdogain Patient Brochure
  • Please see below for a video on how Emdogain works:

What precautions do I need to take after Biolase Waterlase REPAIR Perio Treatment?

  • Avoid any strenuous exercise, alcohol consumption, brushing, flossing/water flosser use for one week
  • Avoid smoking for 6 weeks after treatment for best results
  • A salt water rinse three times a day for one week is highly recommended
  • A complete procedure post-op instructions form will be provided prior to treatment

What follow-up appointments are required?

  • One week follow-up (additional follow-up appointments may be required on an individual basis based on healing)
  • Three-month follow-up and cleaning with diode laser-assisted bacteria reduction
  • Six-month re-evaluation, x-rays and cleaning with diode laser-assisted bacteria reduction

How do I know if I’m a good candidate for Biolase Waterlase REPAIR Perio Treatment?

  • The REPAIR Perio treatment protocol is indicated for patients with mild, moderate and severe chronic gum disease
  • You may not be a good candidate for REPAIR Perio treatment if you have uncontrolled diabetes, wounds that do not heal, are taking high doses of steroids, are taking an anticoagulant (blood thinner), have a bone disease, being treated with radiation or other treatments that make it hard for you to fight an infection, or have experienced problems in the past after surgery
  • A full medical history and dental exam is required prior to REPAIR Perio treatment

What are the fees associated with the Biolase Waterlase REPAIR Perio Procedure?

All fees are based on the Ontario Dental Association Recommended Fee Guide for the current year. Most dental plans cover the Laser REPAIR treatment. For individual coverage information, our office will send a pre-determination to your dental insurance company prior to your treatment.

Testimonials From Patients

From Vincent

Hi, my name is Vincent and I have been a patient with Dr. Zhang for about two years. I have always been very satisfied about her work. Let me share to you something that really bother me for many years, I had gum recession for quite a while, and this is a really delicate operation I was in pain and doctor Zhang suggested that I get what we call” the pinhole surgery” which is a type of operation to solve the gum recession problem and it’s  very delicate and she is almost one of the few ones in Canada to do this and she has done it beautifully. My gum are good I’m not in pain anymore and I suggest everybody who has that problem to consult with Dr. Zhang.

From Mark

I was suffering from gum recession and tooth root exposure for long time, just regular maintenance and conventional cleaning, until Dr. Didi Zhang suggested PST (Pinhole Gum Surgery) around mid 2019. Not really paid attention to it initially, and changed my mind eventually after I saw some videos about comparison of old way to re-grow the gum and PST’s. Don’t want to repeat the same mistake as my parents to save the gum and tooth in time.

It took about one and half hours to complete the whole surgery at noon, just like another tooth job without any pain. Then took the second day off with three ice bags to cool down the cheek. The pinholes disappeared and gum are pulled down as planned. The family can tell the difference right away in my mouth about the current improved gum and untouched side.

Although I can’t brush the area for weeks to ensure no impact to the surgery site, I’m very glad that I made the right decision to do it, and really appreciate Dr. Didi Zhang careful introduction to this process and perform it professionally.

From James

My name is James, and I had recently undergone Pinhole procedure with Dr. Zhang, and I am very satisfied with the results.

Prior to the procedure, I was experiencing recession on my lower gums, and was suffering from sensitivity, to the point that I went for tooth filling as a temporary solution for the sensitivity.  Dr. Zhang has recommended the Pinhole Gum procedure as a permanent solution to my gum recession and tooth sensitivity problem.  After the procedure, my gums have been restored to its normal state, and the sensitivity is now gone.

The procedure only took about an hour and a half, and after a day, I was back to my regular routine.  My gums was healed completely after 3 weeks, by just following Dr. Zhang’s instructions.

Thank you, Dr. Zhang for recommending the Pinhole Gum Procedure.  Now, my gum problem has been resolved permanently.

Contact Us

Tel: (647) 370-2340


Working Hours:
Monday – Tuesday: 09:00 am – 07:00 pm
Wednesday: Closed
Thursday – Friday: 09:00 am – 07:00 pm
Saturday: 09:00 am – 06:00 pm

8787 Woodbine Ave. Suite #130
Markham, ON L3R 9S2