July 19, 2021
Tatyana Ruzhinskaya, RDH
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 Tatiana Ruzhinskaya, a registered dental hygienist in New York, New York. Tatyana earned her bachelor’s degree at Brooklyn College and her Dental Hygiene Degree at NYU. She’s been practicing hygienist for the last 11 years in Manhattan. Tatyana, thanks so much for being with me here today.
Tatyana Ruzhinskaya, RDH: Thank you for having me, Marty. It’s a pleasure to actually be on a podcast and talk about the laser.
Marty Klein: Very good. Well I want to start with a little bit about yourself. How long you’ve been working at the practice that you work at now and then…at what point in there were you exposed to the PerioLase?
Tatyana Ruzhinskaya, RDH: I graduated NYU Dental Hygiene School in 2010 and literally as I graduated probably it was May 20th and by May 30th I was already working with Dr. Bertman at Advanced Dental Arts. He did not use the PerioLase at that point. It’s important to say that patients are very important in our practice and dental hygiene is very important in our practice. He’s not one of those doctors that is ready to extract teeth, he’s there to save teeth, just like all dentists should be doing. At some point he came across this periodontist in New York City who has been having great results during the LANAP treatment. And at some point Dr. Bertman wanted to have this laser in the office. He got trained, we purchased the laser, and we started using it in our office since that time.
Marty Klein: OK. And was he doing LANAP for a time before you got trained for other procedures? Or did everyone get trained at the same time?
Tatyana Ruzhinskaya, RDH: No. So he was the first one to get trained, and then it took some time. I believe we maybe we weren’t aware of the program for hygienists at that time. Maybe there was no program for the hygienist at first. I’m not sure to be honest, but I got trained in 2018.
Marty Klein: OK, So what was first your impressions of the PerioLase before you got trained yourself? Just seeing what Dr Bertman was doing with the LANAP protocol?
Tatyana Ruzhinskaya, RDH: Well, in the beginning it’s difficult to believe that a laser can accomplish what it does. That it cannot only eliminate gum disease but also regenerate bone. We go to school for two years as hygienists and we’re learning about periodontal disease and bone loss. We learned that once you lose bone there is no way of getting it back, it doesn’t regenerate. We learned that the only way is you can treat periodontal diseases by doing scaling and root planing, by doing osseous surgery. Your only treatments are to slow down the process, that eventually gum disease progresses and you will lose those teeth. So when I first heard about the laser and that it can actually regenerate bone that’s been lost, it was honestly, I was very skeptical at first, you know? It’s hard to believe that it goes against everything we’ve learned in school. But as we started using the laser and we started seeing the results, we started seeing follow up x-rays after one year, four years, eight years, because we do see these patients for the last 11 years. Right? So once we start seeing the results, it’s just even today, I’m still mind blown. My mind is still blown.
Marty Klein: What results do you mean? Just skip ahead a little bit, but tell me about some of those results.
Tatyana Ruzhinskaya, RDH: So we’ve had patients who have come in and they have loose teeth, hopeless loose teeth that look like, you know, if they have gone to any other dentists, they would suggest extraction and implants. We just take these cases on and we recommend doing LANAP. They come back four weeks later and the teeth are solid. You look at the x-rays and then you look at the patient and you’re you just can’t believe it because the teeth really get solid. The patient goes from having loose teeth to having strong teeth in their mouth. The patients report that they can eat much better, that they can chew, that they feel more comfortable chewing their food. It’s like music to our ears because we really love to see those results.
Marty Klein: Of course. So tell me about the training experience when you were being trained on the PerioLase. How did it go and then were you able to start using the PerioLase yourself right after that?
Tatyana Ruzhinskaya, RDH: Yes. Well, the training was pretty great because the doctors were amazing and they were there to share their experiences to share information with us, to answer all of the questions that we may have had to kind of show us the results of the cases that they’ve had in their practice. We got to use the laser during class, during our training. So that was very, I felt confident after the class that I can use the laser in the office as well. Yes.
Marty Klein: I do want to break in here just for those listening and clarify something. LANAP itself is a doctor-dedicated surgical procedure. When a hygienist, such as yourself, gets trained to use Periolase it’s not to do the LANAP protocol but it’s for other lower power settings, as regulated by state board…and not all state boards allow for laser use by hygienists, but many do. So I’d like to give you a chance to talk about some of the uses that you are allowed to use and that you have used since getting trained with the PerioLase.
Tatyana Ruzhinskaya, RDH: I use the laser, for example, if I see bleeding during a cleaning, if there’s areas with inflammation and it looks like more than the usual bleeding that you see during cleaning. I would use the laser in those areas. It gets rid of any gum tissue that’s been infected and gets rid of any inflammation in the area. I also use the laser after scaling and root planing. So once I scale I use the laser in the end to get rid of again any bacteria that may be remaining, any gum tissue that’s been infected. And it gives us great results when patients come in for their follow ups.
Marty Klein: And just I want to break in on that, we call that LPD or Laser Pocket Disinfection.
Tatyana Ruzhinskaya, RDH: Yes. I also use the laser when patients have aphthous ulcers those as we all know those are very painful and very uncomfortable, and they take about 7-10 days to go away. So patients are very uncomfortable. But we’ve been seeing great results using the laser around those aphthous some ulcers it makes them go away much quicker. I’m not saying that it’s going to disappear the next day but the pain is decreased and it makes the aphthous ulcers go away much quicker.
Marty Klein: Cold sores/herpetic lesions. Do you treat those?
Tatyana Ruzhinskaya, RDH: Cold sores? I actually, right just before I came on to speak to you Marty. I just had a patient and she came in and she said, “You know I have an event coming up. I have this cold sore on my lip. I felt it coming on yesterday and I really need to get rid of this as fast as possible.” I just treated the cold sore for this patient. We used the laser around the cold sore and it makes it go away much quicker and less painful.
Marty Klein: I understand as well that you had a chemotherapy treated patients suffering from oral mucositis. Can you tell me about that patient how you helped?
Tatyana Ruzhinskaya, RDH: Yes. So this patient is actually our neighbor. He’s he lives right next to the office and we’ve been seeing him for a while and unfortunately he has been diagnosed with cancer. He called us, desperate. He said “No matter what I do, I have these cold sores, I have those oral mucositis in my mouth, after each chemotherapy treatment. Nothing helps. I can’t eat, I’m suffering.” It makes his life really miserable. So he said “I really want to try if we can do something. Do you guys have any solutions?” So we told them to come in and we can try the laser for him and see if that relieves his pain and his discomfort. He called us the next day crying because he said, “I’ve been suffering for months and this is the only thing that has helped me.” After each chemotherapy treatment, he just comes in to treat the mucositis, and it’s making his therapy much, much easier.
Marty Klein: It’s got to feel good when you can really help someone.
Tatyana Ruzhinskaya, RDH: Oh my God! We are like, in the office, we were all so happy. We were, like, high fiving each other here.
Marty Klein: Now I understand you work in a quite a busy office. You have multiple doctors and I’m sure you’re not the only hygienist probably. How many PerioLase units do you have? And how do you manage using them between all of you?
Tatyana Ruzhinskaya, RDH: So we do have only one unit. I know that Dr. Bertman is certified in LANAP. We do have another doctor that is certified. Usually Dr. Bertman concentrates on doing different types of work. So we do have only one doctor that actually uses it for LANAP. He’s here, I want to say, Mondays and Thursdays. So he’s using it two days a week, and I get to use it the other days so I’m excited about that.
Marty Klein: At least you’re not fighting over it!
Tatyana Ruzhinskaya, RDH: No, we’re not. We’re not.
Marty Klein: We often say that the hygienist is, in a way, the gatekeeper of perio, or you might see it first in a cleaning appointment and then recommend that the patient speak to the doctor about maybe LANAP. I’m just curious if your experience having been trained to use the PerioLase yourself, does that help in identifying good candidates for LANAP and help you speak to patients more confidently about it?
Tatyana Ruzhinskaya, RDH: Yes, absolutely. I do believe my training and my experience using the laser makes it much easier for me to speak to the patient and to make them confident in the decision to use the laser for their treatment.
Marty Klein: Have there been any challenges in getting patients to accept laser pocket disinfection?
Tatyana Ruzhinskaya, RDH: I would say yes, because a lot of the patients, they usually go to other offices, and they never have to pay anything out of pocket, so at first they are kind of hesitant. But once you explain to them the benefits of it that it gets rid of bacteria and infection. Especially nowadays people are more receptive to doing treatment that minimizes the amount of bacteria in their mouth, so they’re really open about it.
Marty Klein: So it’s a cash procedure, out of pocket. So that must mean it’s at least somewhat of a new revenue stream for the practice.
Tatyana Ruzhinskaya, RDH: Yes. Absolutely.
Marty Klein: All right. Well, as we wrap up here, just want to ask you if there’s anything that we didn’t cover? Any advice maybe to other hygienists whose office might be adding a PerioLase and the importance of getting trained as a hygienist.
Tatyana Ruzhinskaya, RDH: I really do think that after…at first it’s just like I said, you have a lot of skepticism at first, but once you go in there and you look at the results, it’s gonna be very surprising and very shocking because the teeth that may look like they’re loose and need to be extracted, you can actually save those teeth and save your patients the trouble of doing surgery and implants. It’s very rewarding, you know, as a hygienist to see that periodontal disease can be treated and reversed.
Marty Klein: Well, I want to give a plug to your practice’s website. That’s advanceddentalartsnyc.com. Also for any of you listening who have not yet subscribed to the podcast, please do so that you don’t miss an episode. All of the previous episodes are available at lanap.com/podcasts. Tatyana, thanks so much for taking time out of your practice day to talk with me today.
Tatyana Ruzhinskaya, RDH: Thank you so much Marty. This has been very pleasant!