October 24, 2022
Incorporating the PerioLase® MVP-7™ as a Full-Practice Philosophy
Christine M. Gadia, DDS, MS
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Marty Klein
Welcome to Dentistry for the New Millennium. I’m Marty Klein, training manager at the Institute for Advanced Laser Dentistry. My guest today is Dr. Christine Gadia, a periodontist in Chicago, Illinois. Dr. Gadia completed her general dentistry training at the University of Illinois College of Dentistry and went on to receive her master’s degree in oral sciences with an emphasis in dental biomaterials. She completed her periodontics and dental implant surgery residency program at UCLA. She’s been a LANAP-trained clinician since June of 2021. Dr. Gadia, thanks so much for joining me today.
Dr. Gadia
Oh, thank you, Marty, for having me.
Marty Klein
Of course. So, as I just mentioned, you’ve been LANAP trained just a little over a year, but I want to rewind the clock a little before that to your first exposure to LANAP and the PerioLase. And if you could just tell me a little bit about how you first heard of it and what factors led you to getting trained yourself.
Dr. Gadia
Sure. I mean, I first came into laser treatment…initially I was using a diode laser and it had limited use for what I wanted to use in periodontics. So then I decided to look into lasers that could help treat periodontal disease, bone loss around implants. And there’s a lot of lasers out there, but a lot of studies have backed up the Millennium Technologies or the PerioLase. Yukna backed it. And, you know, with reading all those articles and the studies that had backed it up, I chose the PerioLase to be the one that I wanted to have for my practice. And that’s how I came about to start using PerioLase.
Marty Klein
Now, could I ask why you specifically were in search of a laser to treat gum disease in your practice? It seems like the laser part came first. Can you walk me through that thought process?
Dr. Gadia
Correct. You know, I, I have my practice for a while, you know, over about 15 to 18 years, you know, and I’ve seen patients have resective surgery, regenerative surgery. And in those cases where a lot of times we want to treat, again, a lot of these patients don’t want to go through the traditional flap surgery. They wanted something a little bit more conservative. People were reaching out, asking if we were educated or trained in laser dentistry. And a lot of it came from the public as well. So it’s between our own patients asking about laser treatment and alternatives to traditional therapy, as well as other referring patients in the general public asking us if we were laser-trained dentists that, you know, led us to bringing the laser or specifically the PerioLase into our practice.
Marty Klein
I have heard that more and more over the years. That’s really interesting to me that the patients are asking for it and they might not understand what different lasers do differently, which, you no doubt do, having used a diode before. But I’m curious if that has continued since incorporating the PerioLase. Have those same patients come in and been thankful that you now have an option for them? What has been the patient feedback in the last year?
Dr. Gadia
The patient feedback has been really positive. Whenever I now offer traditional osseous or regenerative therapy, if I feel a good alternative would be to use the PerioLase. A lot of times, because there’s no suturing, less post-operative complications, a lot of times patients tend to increase acceptance with using the laser. And I found it to be very positive. Treatment acceptance is very high with the laser. And so I’ve noted it to have a positive impact on my practice.
Marty Klein
All right. I have one other follow-up here from that early decision making and in looking at when you first came to training, you came with an additional clinician just a couple of weeks apart. So two of you in the same practice got trained essentially right away at the same time. Was that mostly your decision? Did he have a factor in that? How was the decision to get both of you trained right out of the gate?
Dr. Gadia
No, it was a decision, you know, for the both of us, I mean my associate, Dr. Mehrazarin, he attended Columbia University for his periodontics and implant surgery training. And he had exposure to the PerioLase in his training where, where I did not, but he, he was, and so we were both discussing it and thought, you know, he’s already been exposed to it. I was leading the practice into the philosophy of doing this type of laser treatment and we both decided from the perspective of having multiple doctors trained and incorporating it as a philosophy within our practice, that it was important that it was not just myself, but, Dr. Mehrazarin to be trained as well. So we could offer it to a good amount of our patients, you know, not just myself but him as well.
Marty Klein
Now it’s been about a year, a little over a year actually since you were both trained and you’ve come back for the follow-up training. You mentioned patient acceptance is higher, but I want to hear also about the clinical results. What have you seen in terms of the treatment outcomes over the last year, year plus?
Dr. Gadia
Over the last year? I mean, it’s incredible to be honest. I mean, I’ve seen improvements in inflammation. The redness, the edema has, has come down very quickly. Even after the week or two post-op, the probing depths have improved. Some of the time it’s gone from a nine millimeter to a four millimeter radiographs. The bone levels have improved. It’s something that you wouldn’t think, you know, without flapping open the area in bone grafting, you would get these types of results. But with the PerioLase you do and we’ve done multiple patients using the PerioLase with generalized periodontic treatment. We’ve treated all quadrants and in every quadrant we’ve seen positive results and now we’ve extended it to other procedures that we’ve done on our patients and we are getting positive results. So that’s very, that’s very good for our patients.
Marty Klein
That’s a very good segue. You mentioned you’ve extended it to other procedures. So, the LANAP protocol is the full-mouth periodontal disease protocol, but the PerioLase, as you’ve no doubt discovered, can do a lot more. Can you tell me a little more about how else you are using your PerioLase?
Dr. Gadia
Correct. We’re also using it for the LAPIP procedure to treat periimplantitis where in the past I’ve flapped open the area decontaminated and done and have done resective and bone regenerative procedures. And a lot of times you can get tissue shrinkage. And you know, those procedures do have some times negative side effects. With the PerioLase, we don’t have to flap open the site. A lot of times we do get bone gain, we get improvements in the tissue tone. We have decrease in the probing depths and I’ve seen it occur on multiple patients of mine. And Dr. Mehrazarin has also seen positive results. So, you know, we’ve used it to treat periimplantitis, we use it for depigmentation procedures. We have a lot of patients who have pigmented gingival tissues. We’ve used it and they’re so happy, especially those that when they smile they can see the pigmented tissue, they come to us for it and you could see the results very quickly. And the healing is incredible. So we’ve extended it to that as well, as well as disinfecting infected sockets where previously we’ve had infected teeth or where an implant has failed, we’ve extended it to that as well. So we’ve gone beyond using it for periodontal disease on teeth. And I’m positive that it can give us the results that we’re looking for.
Marty Klein
Now without getting too deep into the science, and I just want kind of a high level here, you had mentioned using a diode before and not everyone out there listening might fully understand the differences between different types of lasers. But everything that you just described of all these different uses, correct me if I’m wrong, are not procedures that you could have accomplished with a diode. Is that correct?
Dr. Gadia
Correct, that is correct. With a diode laser, I used it mainly for gingivectomy purposes. For hemostasis, for frenectomies or for biopsies, which, still, the good thing about the PerioLase is you can switch it to the diode setting and you could use it for that as well. So with the PerioLase, it’s almost like it’s a multifaceted machine. This laser can do so many things that the diode can do, but more with the diode we can’t really, you know, use that per se, that laser to regenerate bone. So there’s so much more you can do with the PerioLase than you can with strictly just a diode laser.
Marty Klein
So you found great success with your PerioLase in several different procedures and you’re in a quite a populated area, but that also means we have other doctors in your area who are also offering LANAP. Are you finding that you’re competing with other LANAP-trained clinicians, or is there enough periodontal disease to go around?
Dr. Gadia
No, I think there’s enough periodontal disease to go around. You know, I also, you know, going back to your previous question, I chose to do the LANAP procedure or purchase the PerioLase because I felt that there was only a limited amount of periodontists in our area who were utilizing it for periodontal disease treatment for peri-implantitis. And I felt it could help the growth of my practice. I felt it could help offer our patients alternatives that other periodontists couldn’t offer them. So I also saw it as a positive impact to our patients as well as the business, you know, so there are more I feel in LANAPers coming out, but I feel, you know, it’s better for them to be exposed to it too because I feel like everybody can benefit from it. You know, I don’t feel like there’s a big competition right now for us in the Chicago area, because I feel like it’s really boosting up, but I feel like we’re coming into it at the right time for the practice.
Marty Klein
So where do a majority of your patients come from? Direct marketing, or referrals from other area general dentists?
Dr. Gadia
The majority of our patients do come from referrals. I’m a largely referral-based practice, but now as time goes on, there are patients that do come from us online. And I’m seeing a larger uptick of that, of patients coming from us just from the website or just from hearsay knowing that we carry the laser because of our website and I’ve noticed an uptick in that. So it is increasing more so, but I am majority referral based.
Marty Klein
Do you feel that your referring dentists understand LANAP, or are using you as a preferred provider because of LANAP?
Dr. Gadia
Definitely, definitely some of my referrals who have noted that I do have the, the PerioLase literally on my referral it says “possible LANAP procedure” because they know that I have it now and that I used to not have it, but my referrals know now. So they literally specifically refer to me for the LANAP procedure, which is really great because now it’s more, they’re more exposed to it, they know more about it, you know, it benefits everybody because then they can talk to their patients about it as well.
Marty Klein
Yeah, I know the general dentists, and I’ve spoken with many of them on this podcast series, they always appreciate when their patients come back. Meaning they, first of all, they follow up on the referral and they get the treatment needed, and then return, as opposed to go away and never seen them again.
Dr. Gadia
That’s correct. So after we do the LANAP procedure, usually we do the first maintenance procedure, and then usually we’ll alternate with our general dentist for the maintenance. But a lot of times we’ll educate them on how we’ve treated their patients, how the LANAP procedure has helped them, and how to maintain them. Because even after we have completed the LANAP procedure, you know, we always have to monitor them and maintain them, and if pocketing or bone loss reoccurs in a specific area, that we could target that area again and that laser treatment can be done again. So we’re always, always monitoring them between us and the general dentist.
Marty Klein
Do you and your associate fight over the laser at all? Do you sometimes need to use it at the same time?
Dr. Gadia
We do. You know, what’s difficult is because I do have two locations and we have one laser, so it is getting difficult. So I am thinking of actually purchasing a second laser for those who only have one. I am thinking of getting a second one because it is difficult. You can bring it back and forth between practices, which you can, you can strap it to your car seat, but I feel it’s more efficient and more productive if each location, if you have multiple locations, has one. And then to get our hygienist trained as well because of the maintenance. So right now I’m looking into possibly purchasing a second one and even having our other associate trained as well as our hygienist. So it’s a full philosophy practice with laser treatment.
Marty Klein
When you had mentioned the potential of a second PerioLase, I was myself going to bring up the hygienist because in most states we’re approved by state board, hygienists cannot do LANAP, but they can use the PerioLase on lower power settings for non-surgical procedures.
Dr. Gadia
Correct. And I think it’s important now that it’s been a year that I’ve had the PerioLase at to think long term. You know, I think as a practice owner and you know, having multiple practices, I have to think of long-term treatment for these patients whom we utilize the laser on that it’s to their benefit that during their hygiene appointments that the hygienist is also laser trained because I think that will maintain them better for the long term. And I think that’s our goal as periodontists is to be able to maintain these patients in the long term. And I feel if we started with laser treatment, that we should have our hygienist trained. And so that’s our next step now that I’m very confident in what the PerioLase can bring to our patients, our practice, that now it’s time for hygiene to get involved, which is the next step for our practice.
Marty Klein
Well, it sounds like you were on the right track, both you and your associate and your continuing to grow and have a plan for the future. So I wish you continued success. I do want to give a plug to your website for anyone listening who would like to learn more about Dr. Gadia’s practice, and that is www.millenniumperiodontics.com. I would also like to invite anyone listening to subscribe to this podcast so you don’t miss any episodes wherever you download your podcasts. All of the episodes are available on the website, www.LANAP.com/podcast. Dr. Gadia, thank you again for sharing your story with us today.
Dr. Gadia
Thank you, Marty, for having me. It’s been a pleasure.