August 24, 2020
A Young Periodontist’s Perspective on the PerioLase® MVP-7™ & the LANAP® Protocol
Andrew Peterson, DMD, 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. Andrew Peterson, a periodontist in Arcadia, California. Dr. Peterson received his DMD and MS degrees from the Oregon Health and Science University. He practiced in the greater Portland area until 2019 at which time he accepted an adjunct teaching position at Loma Linda University. Today, we’ll talk about how he got started with LANAP so early in his career, how it compares to modalities he learned while in school, and his results so far since his initial training just a year ago. Dr. Peterson, thanks so much for joining us today.
Dr. Andrew Peterson: Hey, Marty. Thanks for having me.
MK: So you were trained in LANAP, at least the first BootCamp about a year ago, in summer of 2019. So I’d like to start with how you first became aware of LANAP and how you got interested enough to get trained.
AP: Yeah. So while taking that teaching position at Loma Linda, I was introduced to Dr. Paul Fuentes, my partner, and he’s been LANAPing since about 2010. So he was the one who really got me interested in starting to think about using the laser as a new treatment modality compared to traditional techniques. So while being an associate, he was the one who kind of pushed me to get the training completed. So yeah, it was about June or July of last year. I took the first BootCamp and then came back about six months later after using the laser on several cases and following up on some of my results. Then taking Evolution 4, which was the six month class, and taking Evolution 5 here in the upcoming month.
MK: Previous to BootCamp, had you had any experience or exposure to lasers and specifically but either in your private practice or in school before that?
AP: In my training, it was a very traditional approach to treating periodontal disease, so we weren’t really exposed to that as residents. We actually had one faculty member, Dr. Thanik, who is a LANAPer, and he would show us some of his cases, but it was never really pushed upon us. So it’s been one those things that I’ve explored on my own after being out and, you know, with Dr. Fuentes, and having almost 10 years of case results really compelled me to take the leap into the training.
MK: You mentioned Dr. Thanik. He’s Dr. Sunil Thanik, one of our instructors at the IALD. So he was actually a good influence, it turned out.
AP: He was, he was!
MK: So you moved down to Southern California and started working with Dr. Fuentes, and so you saw his cases. Was that what were your first thoughts when you saw his cases? Was there any skepticism or any follow-up questions at us just of him before you took the training yourself?
AP: Right. Good question. So the laser got me more interested in terms of treating peri-implantitis. That’s always been kind of an interest of mine because traditional techniques and bone grafting around implant surfaces are very unpredictable at best. And so those are the questions that I really asked Dr. Fuentes and had them show me several cases and his long-term results. Not just six months or a year, but five years, seven years, 10 years and the long-term stability of these bone levels around implants was pretty incredible. I mean, better than the results of I’ve ever gotten with traditional techniques. So that’s where my interest really started. And then, you know, he was showing me more cases with treating periodontal disease, which also he was getting phenomenal results. To get good LANAP results, as I’m learning, is more about case selection, but with the right case selection and the proper diagnosis, LANAP can be a very predictable treatment option for our patients.
MK: So you told us when you first came to BootCamp that LANAP to you already represented a huge philosophical change. That you were taught in school there was surgical periodontal therapy or nonsurgical. Can you tell me more about that philosophical change? Especially now looking back a year later after having done it yourself.
AP: Yeah. I mean, with treating periodontal disease classically, and what I’m finding is, with teeth that I used to consider poor or hopeless prognosis that I typically be taking out at the time of osseous surgery, I’m now saving more teeth than I ever thought imaginable with very predictable results! It’s interesting to see what teeth that we as dentists, consider hopeless or poor, and the factors related to that prognosis. But it’s just been a huge mindset change and these patients want to come in and save their teeth. I mean, we have patients calling and asking if Dr. Fuentes and I do LANAP specifically. So it’s been it’s just been a huge shift in terms of teeth I save. What I’m finding as I practice more and more is we take out as many implants now it is we put in. So if I can find a different treatment option to save teeth even for 4, 5, 10 years, I think providing a much better service from patients than the alternative.
MK: Yes, we’re certainly seeing a wave of failed or just at least ailing implants as well. Have you used the Periolase for LAPIP or peri implantitis. And if so, what have been your results in that?
AP: Yeah, so I’m tracking probably three or four cases that treated about six months ago. What’s really interesting is we get these peri implantitis cases with a lot of inflammation in the tissue. And within two weeks, when I see him back for the first post-operative is it? The inflammation is almost nonexistent. It’s unbelievable how well the tissues look and tighten up, even after two weeks in terms of bony remodeling, I’m starting to see densification around the implant surfaces and haven’t probed any of those sites yet, I’ll wait for another six months, but radiographically seen markedly improved changes around the implants that I’ve treated so far.
MK: You clearly have had some success yourself, with both LANAP and LAPIP just in the last year and you are still relatively early in your career, at least one can hope! What I’d like to really find out, though, is why do you suppose more dentists and periodontist aren’t yet doing this? You are not that far out of school yet. You didn’t hear a whole lot about it while you were in school. So what’s missing from this picture? You’re having all this success? Why aren’t more younger dentists and periodontist doing LANAP?
AP: I think it comes down to a mindset and just being open to wanting to try new things and investing in new technologies. I feel like as dentists, we get so honed in on practicing the way we were taught and become very closed minded rather quickly. Just with talking to my faculty members when I was in training, you know, it was osseous surgery, and that’s how we’re gonna do it, and it’s just that. But it’s just being open to finding out more efficient ways to treat periodontal disease, and I think with more predictable results.
MK: You’ll be finishing your training program here this month with Evolution 5 and as I understand that you are interested in becoming an instructor for the IALD. Why is that? What would motivate you to take that next step as an instructor?
AP: Yeah, so as I’m starting to move along in my career, I’ve been starting to teach some of my buddies how to do implants in Oregon, and find out more ways where they can be more efficient with their practices and increase cash flow. And I just enjoy lecturing and teaching.
MK: I did want to pick up on something you mentioned – cash flow. And often we hear from other LANAP doctors that in addition to the clinical success, there’s also quite a nice return on investment in doing LANAP. Have you found that to be the case?
AP: I have! Traditionally, I probably book anywhere from 60 to 90 minutes to treat a peri-implantitis case, and with LAPIP, we book only 30 minutes a chair time. So I’m able to open up more chair time to see more patients, and it’s just increased the amount of patient flow I can see in any given day. With regards to treating periodontal disease, it’s interesting. As a periodontist, I find osseous surgery one of the hardest treatment modalities to do well. It probably takes about an hour per quadrant for me with classic techniques, and I can treat a full mouth of periodontal disease with LANAP in two hours with IV sedation. So I feel like we’re providing a better service for our patients. We’re bypassing the non-surgical therapy, just getting right to the point in treating the disease, and following up with these patients. It’s just it’s amazing how much more efficient we are with our time instead of the alternative way that we used to do things. When we do treat our full-mouth disease patients, we typically do it in one sitting. What I find in my other offices when I treat periodontal disease and I do half mouth one day. Sometimes they don’t come back for the second half, just with postoperative discomfort, sensitivity and what they’ve experienced while healing. So in that sense, it’s just been it’s been a much more efficient use of my time when I practice on a daily basis.
MK: I do have one final question here, and that is, if you were speaking to yourself five years ago, or just another young periodontist first coming out of school. And maybe they were not much exposed to LANAP similar to your story, what would you tell them in terms of where LANAP should fit in their practices they’re starting out?
AP: Yeah, I mean, I would tell him to pick the brains of clinicians who have been using it for a while. You know, I was super blessed to be given the opportunity to work with Dr. Fuentes, and having him is a great mentor. Like any new treatment modality, there’s a learning curve. That was kind of that six months after Evolution 3, in between Evolution 4, you really start to learn how the tissue interacts the laser and what the cases should look like. I would say, “Just ask questions and anyone is willing to share the information and knowledge with you. So don’t be afraid to go out on a limb and make a few phone calls.”
MK: Always good advice to do due diligence. So I think we can wrap it up here. I would like to give a plug to your website with you and Dr. Paul Fuentes. That’s www.arcadiaperio.com. Anyone here listening, I’d like to invite you to subscribe to this podcast for a new interview each Monday, wherever you download your podcasts or at www.LANAP.com/Podcast. Dr. Peterson, thanks for your time and being my guest today.
AP: Okay. Thank you, Marty. I really appreciate it.