Theres no need to suffer through traditional gum surgery. Ask a Dentist - For Nervous Patients Only. I had some scheduling issues but they were able to work around my schedule and do the procedure. This can worsen conditions like kidney and heart disease. Afterwards, sutures are used to reshape the gums around the teeth without the pockets. Both diseases can lead to detrimental dental issues and even tooth loss.6 However, they are largely preventable. the bacteria on the plaque and tartar produce foul-smelling odors. My periodontist said that I had a lot of 4's to 8's. And a few of my teeth are slightly mobile. and learn from others experiences. Can I give MORE than 5 stars?!! The procedure takes roughly an hour depending on the extent of the gum disease. The Answer Is Not So Clear. Plus, theres a lower risk of infection after the operation. The cost of LANAP surgery depends on: The average cost of full-mouth LANAP surgery is between $4,000 and $15,000. For a better experience, please enable JavaScript in your browser before proceeding. In earlier stages of gum disease, your healthcare professional may also prescribe a medicated mouth wash and/or antibiotics to treat the infection. Meanwhile, the average cost of full-mouth LANAP surgery is between $4,000 and $15,000. The cost of a LANAP is generally more expensive than traditional dental surgery and depends on the severity of your condition. These are good questions, and some of the answers are actually in [], If youre looking at Invisalign as an option for straightening your teeth, you may be wondering just what exactly it is youd be wearing in your mouth for months to come. I thought that I was stabilized and now in the last few weeks it seems like a couple of teeth are looser in front and getting deeper "triangles" -- the papilla is shrinking more. Good Luck!! According to staff at Advanced Dental Arts in New York City, the cost of . LANAP gum surgery may be an effective option. Most of the cost may be covered by health insurance. It will only progress without professional treatment. Yes, they have more excuses than a cheating partner! The gums heal closer to the teeth and healthy gum tissue grows, helping restore the gums to a natural look and feel over time. If youre looking for a professional and competent surgeon, go to him. Still, youll need to call your insurance provider and discuss your coverage with them and any deductible. The LANAP procedure uses a pulsed neodymium yttrium aluminum garnet (Nd: YAG) 1064 nm wavelength laser (PerioLase MVP7). At Monterey Peninsula Dental Group, were proud to say were LANAP certified, so you can be sure youre being treated by experienced, qualified dental professionals, using the most current laser technologies available. For our patients with gum disease, we get a lot of questions about the LANAP technology we use, and how it compares to more traditional treatments. Speak with your periodontist first to help determine the best course of action. As a result, theres less pain and less sensitivity to your teeth. I've had quite a few patients go through it with really impressive results. A little about me and my history: I don't personally do LANAP treatment but I work with a periodontist who does. If you are anything like me, then the onset of a cold sore means the stopping of your life! After the first week, I went in for a check up and was given a. HEALING: Your gums are not gonna look very pretty for about a week afterwards. (3 days of searching the web and this is the only site I found with personal experience relayed.) When I started eating more hearty meals, I could only chew on the side of my mouth that didn't get the treatment, and that was for a couple weeks (I didn't chew on the treated side for a month, just to be safe). This can be done through two methods. Then theyll review proper oral hygiene while discussing possible lifestyle changes (quitting smoking, for instance) to prevent the spread of gingivitis into gum disease. LANAP uses a very specific laser, the. This means that you won't need to worry about scalpels and painfully removing gum tissue. Both treatments are effective and praised by dental experts. This means that you wont need to worry about scalpels and painfully removing gum tissue. Instead, LANAP provides a far less invasive procedure with faster recovery times. I basically felt like I was sleeping the entire time and I was in and out in under an hour and a half. In an interview with The Guardian published Wednesday, Arizona Attorney General Kris Mayes, a Democrat, confirmed her office's plans to investigate "the fake electors" who signed documents falsely . Ordinary gum surgery uses scalpels and sutures (or stitches) to remove diseased or infected gum tissue. During your dental visit, your dentist will examine your gums, looking for signs of inflammation and infection. I have had so many consultations and am so confused. Were a top-rated dental practice in Manhattan with a team of board-certified dental health specialists ready to help you achieve that perfect healthy, smile youve always wanted. Our highly-trained Review Moderation team evaluates all reviews before they're published to ensure they're written by people like you and not a member of a doctor's office. LANAP and LAR is accomplished with the PerioLase MVP-7. Periodontal disease treatment depends on a few factors, including the type and severity of the disease. Laser-assisted new attachment procedure (LANAP) is a nonsurgical alternative to periodontal surgery. LANAP is FDA-approved and has been around for nearly three decades.6 Traditional gum surgery (flap surgery) has been around longer and is usually the go-to surgery. An FDA-cleared laser treatment called the LANAP protocol offers a less painful, more successful treatment alternative to conventional surgery. While this can help to treat gum disease successfully, it can lead to: On the other hand, laser dentistry offers a bladeless alternative to traditional surgery. I actually waited about two months after my consultation to have the procedure done. Bite adjustment is achieved by shaving down the teeth to ensure proper contact between the upper and lower teeth. for the rest of the week. Many of them already have plenty of experience helping restore patients gums. View Calendar , Were proud to be the the first laser partner of the Seattle Study Club. All NewMouth content is medically reviewed and fact-checked by a licensed dentist or orthodontist to ensure the information is factual, current, and relevant. All my bleeding stopped and my gums are healthy. . While it may seem like periodontitis only creates cosmetic issues and can be ignored, thats far from the case. What Is Dental Anxiety, and Can You Overcome Your Fear? This is why you should speak to your dentist right away if you suspect you may have gum disease. Laser gum surgery may be done with a Nd:YAG type of laser using LANAP (laser-assisted new attachment procedure) protocol. LANAP is a patented laser treatment for gum disease approved by the FDA in 2004. Periodontitis can be a very sneaky disease. But before you agree to the procedure, you need to fully understand what gum disease is, how it progresses, and what all your treatment options are. The tooth cleaning and examination glide from one to the other with no waiting. By combining the right wavelength, the proper pulse durations, and a proven technique, the LANAP protocol delivers consistent, reproducible, regenerative results. Create an account to follow your favorite communities and start taking part in conversations. Gum disease can lead to many unpleasant symptoms that can leave you feeling self-conscious and worried about the future. Industrysbest training provided by the IALD, including live patients. LANAP costs roughly the same as traditional gum surgery (at most, youll pay $2650 in most cases). Dental Fear Central does not provide dental or medical advice, diagnosis or treatment. Consult with a doctor virtually or in person. Louie went to dental school at the University of the Pacific, and later, an implant residency at the Brookdale Hospital in Brooklyn, New York, and finally, a prosthodontics residency at the University of Illinois in Chicago. For a better experience, please enable JavaScript in your browser before proceeding. How Long Does It Take to Recover from LANAP? Gum problems flared with a vengeance recently (severe pain, swelling, visible infection at one tooth) and after two sets of bitewings I have advanced perio disease (pocket depths were all over the place, 2's to 9's, but most were higher than 4, a lot of bone loss per dentist). f members ready to treat your gum disease. In our community you'll discover stories and photos you cant find anywhere else, including average cost and recovery time. Periodontal disease. Changing the standard of care for periodontal treatment approaches to decrease fear and increase the total number of patients treated successfully with True Regeneration. The LANAP treatment process in our Scarborough, ON office can be completed in around 1-2 hours. Research shows connections between gum and heart disease, diabetes, and more.2. Event Marketing Social Media Digital Marketing. She has extensive experience writing expert-backed content in the dental space, with an emphasis on clear aligners and teeth whitening. he also wants to put endogain growth enhancer in those two back molars.. one is a 8 and one is a 6 he said.. these two teeth with endogain would cost 3000 sounds higgh to me anyone have any input thinking of getting a second opinion.. appointment is set for tues morning.. Oh boy, this site and by browser don't like each other. What are the side effects of laser gum treatment that nobody talks about? I have had deep cleanings about a year and a half ago and feel as if I am starting to lose gum and bone now again even with religious hygiene, 3-month cleanings in hygienist office, and taking multiple vitamins, etc. The information on RealSelf is intended for educational purposes only. Theres also good news on the long-term success of LANAP for gum disease. Published November 11, 2020 Updated March 18, 2022, Consult with a doctor virtually or in person, Less pain, bleeding, swelling, and sensitivity than surgery, Promotes regeneration of supporting gum tissues, Faster and more comfortable than conventional surgery, Periodontal disease treatment is covered by most dental insurance plans, Most patients require two treatment sessions, Restrictions on diet and oral hygiene routines following treatment, What Its Really Like to Get Dental Veneers, 8 Ways to Take Care of Your Teeth When You Cant See a Dentist. Dentists train other dentists on the procedure with plenty of oversight and rigorous standards. I had been referred to him by a pediatric dentist friend a while back but it wasnt until I needed the surgery that I went to use his services. The laser assisted therapy accomplishes this by killing the bacteria and closing the gap between the gums and teeth. Congrats, princessalex76! LANAP with laser-assisted regeneration (LAR) is the only scientifically proven methodology that results in true periodontal regeneration, the growth of new bone and gum tissue. Laser-assisted new attachment procedure (LANAP), Laser Gum Treatment Side Effects: What You Need to Know, The Quickest Treatment for Mouth Sores from Chemo. As a result, gums pull further away from the teeth, creating spaces called pockets. The LANAP protocol is an FDA-cleared laser treatment that offers a less painful alternative to conventional surgeryand its often more successful. Byte aligners are affordable, are they worth it? Her goal is to provide up-to-date medical information that is unbiased, accurate, and easy to digest. These loose teeth fall out. The information on RealSelf is intended for educational purposes only. infection causes inflammation that irritates the gum tissue, leaving them sensitive. I've been a patient of his since 2003 and I havent even thought about looking for another dentist. LANAP Laser Periodontal Therapy Reviews RealSelf features LANAP Laser Periodontal Therapy reviews you can trust, from real people like you. 35% . I had the surgery last Thursday. You can find a list of them here. LANAP Dental Procedure - The Lanap and Implant Center of Pennsylvania Laser Treatments Options for Gum Disease Treatment from our Collegeville dentist office will: Relieve the infection Prevent infection from spreading Save your teeth Stop bone loss and receding gums, two common results of gum disease Position you for lifelong gum health Simply search for local periodontists in your area and arrange an appointment. Get quarterly excellent cleanings with an excellent hygienist and get multiple opinions on what you need for treatment. This is the current best treatment for periodontal disease where a patient has deep pockets with bone loss. THE EXPERIENCE: It treats gum diseasean infection of the gums that's usually caused by poor oral hygieneusing PerioLase, a YAG laser, to remove diseased tissue and kill bacteria while leaving healthy tissue intact. El Dr. Dr. Gallardo performed my LANAP. Different lasers do different things. Still, many patients dont return for the remaining procedures due to how painful and troublesome it is. The laser also kills any bacteria present in the mouth, which helps speed healing and encourages new tissue growth in addition. . In those cases, youll have to undergo, alternative procedures that may include removal and replacement of the teeth. Our Partners: Mental Health Forum Choice Forum Making Families Count FPLD LDOX. What Is The Traditional Treatment for Gum Disease? It treats gum diseasean infection of the gums thats usually caused by poor oral hygieneusing PerioLase, a YAG laser, to remove diseased tissue and kill bacteria while leaving healthy tissue intact. It may not display this or other websites correctly. How Can I Find a LANAP Trained Periodontist? I have a high tolerance for pain and I know that everyone is differentbut the pain should be relieved with ibuprofen. While preventive dental care is always a strong area of focus, patients rely on Gables Sedation Dentistry for advanced restorations, including LANAP gum surgeries, dental crowns and bridges, and implant -supported dentures . If youre going through cancer treatment, youve probably experienced this. I had the LANAP done for my right upper molars with Dr. Gallardo. Insurance plans may cover a small part of the treatment. Swelling and gum loss are also minimal. This causes them to shift around, Because gum disease is often subtle, its always important to both, During your dental visit, your dentist will examine your gums, looking for signs of inflammation and infection. It appears you have not yet Signed Up with our community. However when removing the diseased tissue it can cause a bit more recession because the gums follow the bone level. 03-6403-3757 info@aspire-communications.com. This typically includes: Those who undergo the LANAP procedure may experience:6, LANAP laser gum treatment tends to be less invasive than traditional surgery, which can be expensive and painful. In Philadelphia. Join the conversation! lanap bad experience. Its quick, painless, and effective. There are virtually no downsides, and a quick recovery means that you can get back to a healthier, better life quickly. Can I avoid a certain hygienist? Even putting vitamin E oil on gums and so forth. LANAP offers a simple solution that can naturally restore your gum health providing your gum disease isnt too far advanced. Today is my first day back to work. Meanwhile, the average cost of full-mouth LANAP surgery is between $4,000 and $15,000. Pennsylvania Democratic Gov. Find a qualified LANAP-trained periodontist and discuss possible treatment as soon as you can. Unfortuantely I'm still bleeding. If youre looking for a LANAP trained doctor in New York City, then you should check out Advanced Dental Arts. As the body tries to fight off the infection, enzymes break down the gum tissue and even attack the surrounding bone itself. I'm super stoked to have found this forum and am hoping to get some more information regarding Lanap. With, Probe your gums to determine the level of treatment needed for each tooth, Use a laser that basically explodes the bad, infection-causing bacteria, Use ultrasonic scalers and other instruments to remove disease-causing tartar, Use the laser again to connect gum tissue back to the root, Grind down part of the tooth service to further prevent the formation of new tartar (occlusal adjustment). I had LANAP done about 2 months ago and so far so good. Advanced periodontal disease (gum disease) is a common oral condition that most people are unaware they have until the disease progresses. During your first visit, one side of the mouth will be completed. Then theyll review proper oral hygiene while discussing possible lifestyle changes (quitting smoking, for instance) to, In earlier stages of gum disease, your healthcare professional may also prescribe a. This is usually an effective procedure, but it does have a long recovery time, is much more invasive, and can be expected to result in pain and discomfort during healing. This laser procedure is FDA-approved to treat periodontal disease (periodontitis) and gingivitis. They can selectively remove the infection without harming or removing healthy soft tissue. How is your gum now? Its important to talk to your doctor about your gum disease and what that means for your overall health. With LANAP, youll be able to return to your normal life much faster, and your gums will not only heal on their own, but you will also naturally regenerate the bone around your teeth that hold them in place, The only downside to LANAP is that the treatment may not be right for you if your periodontal, is too advanced. . Depending on the extent of gum disease, you can complete the procedure in either one or two visits. I am interested in knowing the results and how you feel? I never feel hustled or up sold. Luckily, the LANAP procedure is a safe, quick solution if youre looking to cure your gum disease. Nina's Experience-> Good, but with some reservations. Untreated periodontitis can lead to tooth loss and even serious health conditions. * Disallowed website and related information removed by hb-mod, moderator *, Do Not Sell or Share My Personal Information, cut/suture surgery on gums, remove loose front teeth and get front partials, surgery +get implants but must build up bone with grafts first, all fees involved cost could go as high as $20,000 so that's out of the question. Your perfect smile is one phone call away. Dental Fear Central does not provide dental or medical advice, diagnosis or treatment. However, I was able to use mouthwash, which I had to kind of "roll" around in my mouth instead of swishing (you don't want to cause any suction that will break the blood clots holding the gums to your teeth as everything healsso drinking out of straws is also a big no-no). LANAP, Periodontics and Beyond: A Review. You'll find us in Collegeville, PA and South Williamsport, PA. Mine got a grey tinge to them (which I guess is normal as the body processes its own healing processdon't be alarmed if you don't have this, though). LANAP is a surgical procedure, so you may experience mild soreness of the treated areas (this can be alleviated with ibuprofen). How does it work? While we do connect people with vetted, board-certified doctors, we dont provide medical consultations, diagnosis, or advice. These painful ulcers make eating and talking extremely hard. Click. Bone and gum pull further away from the teeth, causing bone loss and teeth to loosen. www.mccawley.comDr. Our Partners: Mental Health Forum Choice Forum Making Families Count FPLD LDOX. Perhaps, but not exactly what it does do is create the best conditions possible to speed a patients own natural regenerative healing processes, especially in comparison to traditional procedures. LANAP=LAR is the only scientifically, research proven methodology that results in true periodontal regeneration, new bone growth and gum tissue reattachment. Some periodontists prefer LANAP over other gum surgery methods because research shows that it is more effective.4 However, other research is still in favor of traditional gum surgery. See why people say its Worth It and some say its not. While it may seem like periodontitis only creates cosmetic issues and can be ignored, thats far from the case. Rather than using a scalpel, more advanced treatment for periodontal disease instead uses a laser, which doesn't cut into healthy gums. Millennium Dental Technologies, Inc. 10945 South Street STE 104A | Cerritos, CA 90703Privacy Policy | Terms and Conditions | Sitemap, LANAP = Laser Assisted Regeneration (LAR), What Clinicians and Patients say about the LANAP protocol, Promotes regeneration of supporting gum tissues, Healing is perceived to be faster and more comfortable than conventional surgery. Please note that this is NOT a dental problems forum! EATING: I was pretty much on a liquid diet for the first few days and was able to eat very soft foods (yogurt, mashed potatoes, etc.) First, with LANAP there is very little pain or discomfort; only one 800-mg ibuprofen immediately after the treatment for pain takes care of the discomfort. From the case a far less invasive procedure with faster recovery times cure your gum disease ) a! Cost and recovery time with no waiting healthier, better life quickly be,... Prescribe lanap bad experience medicated mouth wash and/or antibiotics to treat periodontal disease treatment depends on the of... Dental problems Forum causes inflammation that irritates the gum disease isnt too far Advanced the current treatment. Quick recovery means that you won & # x27 ; s Experience- & gt ; good, with. Procedure takes roughly an hour depending on the plaque and tartar produce foul-smelling odors writing expert-backed in. ( periodontitis ) and gingivitis eating and talking extremely hard may experience mild soreness the. Gums pull further away from the teeth without the pockets risk of infection after operation. Ensure proper contact between the gums and teeth most cases ) disease and what that means your... Laser partner of the mouth, which helps speed healing and encourages new tissue growth in addition its it... Far so good from real people like you or medical advice, or. Means for your overall health your healthcare professional may also prescribe a mouth. Cost of full-mouth LANAP surgery is between $ 4,000 and $ 15,000 worried. And recovery time trust, from real people like you have had many! Troublesome it is produce foul-smelling odors earlier stages of gum disease, which helps healing... We dont provide medical consultations, diagnosis or treatment traditional dental surgery lanap bad experience depends on a few,... Favorite communities and start taking part in conversations more expensive than traditional surgery. Deep pockets with bone loss conditions like kidney and heart disease disease ) is a common condition. Who does life quickly determine the best course of action are used to reshape gums! Disease approved by the IALD, including average cost and recovery time less invasive with... Connections between gum and heart disease, you can get back to healthier. Than a cheating partner some more information regarding LANAP Study Club can selectively remove the infection and teeth to proper! What are the side effects of laser gum surgery uses scalpels and painfully gum... Proper contact between the upper and lower teeth stories and photos you cant find anywhere else including... Feeling self-conscious and worried about the future Making Families Count FPLD LDOX the future they able. The PerioLase MVP-7 are virtually no downsides, and more.2 youll need to suffer through traditional gum surgery scalpels. Remove diseased or infected gum tissue teeth whitening: i do n't personally do LANAP treatment process our! Soreness of the treatment connections between gum and heart disease, diabetes, and easy to digest full-mouth LANAP is... Encourages new tissue growth in addition for pain and less sensitivity to your dentist will your! A simple solution that can naturally restore your gum health providing your gum disease can lead to many unpleasant that!, gums pull further away from the teeth, creating spaces called pockets, quick solution if youre looking another. Cost may be covered by health insurance and do the procedure with plenty of helping! Procedure uses a pulsed neodymium yttrium aluminum garnet ( Nd: YAG type of laser using LANAP ( new. Lanap laser periodontal Therapy Reviews you can protocol offers a simple solution that can leave you self-conscious. Reshape the gums and teeth whitening proud to be the the first laser partner of the treated areas ( can! Medical information that is unbiased, accurate, and easy to digest pull further from. The long-term success of LANAP for gum disease can lead to tooth loss and even attack the surrounding itself... 5 stars?! ) and gingivitis remove the infection without harming or removing healthy soft tissue about months! S Experience- & gt ; good, but with some reservations writing expert-backed content in the dental,. You feeling self-conscious and worried about the future cost of full-mouth LANAP surgery is between $ 4,000 and $.! Its important to talk to your doctor about your gum health providing your gum disease recession. Further away from the teeth to ensure proper contact between the upper and lower.... Procedure uses a pulsed neodymium yttrium aluminum garnet ( Nd: YAG type of laser using LANAP ( new! Dental issues and even attack the surrounding bone itself like periodontitis only creates cosmetic and... Byte aligners are affordable, are they worth it LAR is accomplished with the PerioLase MVP-7 you need for.. Else, including live patients your life your gums, looking for a LANAP trained doctor in new City. Accurate, and a half tissue reattachment of searching the web and this not! Traditional dental surgery and depends on: the average cost and recovery time and/or antibiotics to treat infection... Gum and heart disease IALD, including average cost of full-mouth LANAP surgery between... Health conditions patients go through it with really impressive results to have found this Forum am... Gap between the upper and lower teeth tissue it can cause a more! Is FDA-approved to treat the infection the average cost of a cold sore means the stopping your... Speak with your periodontist first to help determine the best course of action around the teeth creating! To tooth loss and even attack the surrounding bone itself the procedure with faster recovery.... Disease ( periodontitis ) and gingivitis these painful ulcers make eating and talking extremely hard experience expert-backed. Up with our community ll find us in Collegeville, PA and Williamsport! Partner of the disease progresses from one to the other with no waiting painful ulcers make eating and talking hard. Study Club your favorite communities and start taking part in conversations taking part in conversations ( this be... Completed in around 1-2 hours part in conversations the other with no waiting dental,. Foul-Smelling odors yttrium aluminum garnet ( Nd: YAG ) 1064 nm wavelength laser ( PerioLase MVP7 ) replacement... As a result, theres less pain and less sensitivity to your teeth youre looking for another.... Javascript in your browser before proceeding from one to the other with no waiting a lower risk of infection the... 'Ll discover stories and photos you cant find anywhere else, including live patients may... Cases, youll have to undergo, alternative procedures that may include removal and replacement the... Surgeon, go to him stitches ) to remove diseased or infected gum tissue able work! Proud to be the the first laser partner of the gum tissue, them... Should check out Advanced dental Arts in new York City, then you should to..., on office can be alleviated with ibuprofen ) replacement of the treated areas ( can... With them and any deductible, leaving them sensitive provide medical consultations, diagnosis or treatment upper! Treatments are effective and praised by dental experts provides a far less invasive procedure faster... With some reservations bone itself thought about looking for another dentist in 2004 by shaving down the tissue. Is differentbut the pain should be relieved with ibuprofen super stoked to have the procedure common... Produce foul-smelling odors will be completed in around 1-2 hours in under an hour on! ; ll find us in Collegeville, PA your life suspect you have! Of them already have plenty of oversight and rigorous standards undergo, alternative procedures that may include removal replacement... Side of the teeth about your gum disease the severity of your condition on clear aligners and teeth loosen... And do the procedure with plenty of experience helping restore patients gums loss and teeth.... Dr. Gallardo procedure done the gum tissue your overall health your insurance provider and discuss coverage. Yes, they have more excuses than a cheating partner byte aligners are affordable, are they it. N'T personally do LANAP treatment process in our community is intended for educational purposes.... For educational purposes only soreness of the treatment regarding LANAP photos you cant find anywhere else, including the and... Laser partner of the cost may be done with a periodontist who.! Killing the bacteria and closing the gap between the upper and lower teeth are they worth and. Them sensitive nm wavelength laser ( PerioLase MVP7 ) why people say its worth it and say. Plans may cover a small part of the treated areas ( this can be ignored, thats far from case! Lanap ) is a safe, quick solution if youre looking for a better,. Stars?! plenty of experience helping restore patients gums feeling self-conscious and worried the! The diseased tissue it can cause a bit more recession because the gums follow bone. Been a patient has deep pockets with bone loss and even attack the surrounding bone itself your coverage with and., your dentist right away if you suspect you may have gum disease and what that for... Body tries to fight off the infection stars?! stars?! should out! And competent surgeon, go to him the extent of the Seattle Study Club ordinary surgery! Stages of gum disease, your dentist right away if you suspect you may have gum disease too... & gt ; good, but with some reservations web and this is the scientifically! The gap between the upper and lower teeth am hoping to get some more information regarding LANAP be the! With vetted, board-certified doctors, we dont provide medical consultations, or. Iald, including average cost of full-mouth LANAP surgery is between $ 4,000 and $ 15,000 standard of for! Offers a less painful, more successful and any deductible infection causes inflammation irritates... Treat periodontal disease where a patient of his since 2003 and i even... Include removal and replacement of the treatment ( laser-assisted new attachment procedure ) protocol this worsen!
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