October 26, 2020

Long-Term LANAP’ing in the Rural Midwest

Tom Schoen, DDS

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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. Tom Schoen, a general dentist in Wabasha, Minnesota. Dr. Schoen attended St. John’s University and then went on to attend the Minnesota School of Dentistry. He currently serves on the board of DentalTown magazine. Dr. Schoen, Thank you for being my guest today.

Dr. Tom Schoen:  Thank you. It’s good to be here.

MK:  We’ll start in the usual way. We’d like to allow you to tell your LANAP story from the beginning. You first came to training in 2006, which in our world is still somewhat of an early adopter. So tell me about how you first became aware of LANAP, and then what pushed you to get trained?

TS:  I became aware of LANAP on DentalTown. There was a lot of discussion and a lot of presentations of people getting really great results. I had friends and we were going to a meeting in Chicago (Dr. Danny Melkers, who’s the periodontist for Bill Strupp, and Mike Melkers, who does a lot of lecturing now worldwide). We went to Chicago and I met with a group of my DentalTown colleagues. In between the two lectures, Dr. Bob Gregg came in and talked about an hour about LANAP, and my colleagues and I all decided we were going to do this. So we all signed up at the same time. That way we could do our training together and move forward with this. That’s how I was introduced to LANAP, and it’s been a really, really good choice for me.

MK:  You mentioned DentalTown was a big reason that you came on board at that time. What was the consensus about LANAP back at that time in 2006? And how has that, or has that, changed over the years?

TS:  The consensus at that time was that people were presenting really good results and that there were a lot of naysayers coming in saying, “Show me the research, show me the research. Show me the research. We can’t possibly adopt this because there’s not enough research.” What was interesting is that they never downplayed the results that LANAP got, they simply said “There isn’t enough research, and so we’re not sure that it works the way that people are presenting, but definitely, those are nice results.” So they weren’t upset about the results. They were more upset that you could do the same thing with scaling and root planing and those type of comments. I think that there’s still some of that, but there are far less naysayers and far more people who have experienced LANAP with their periodontists and understand the treatment it is. I think the tide has turned significantly with LANAP and practitioners acceptance of the procedure from a DentalTown standpoint.

MK:  Do you think they’ve recognized the FDA clearances, the human histology, has the research now gotten to the point where you hear less of that?

TS: I think part of it is that. Part of it is the more and more acceptance of it, with dental schools teaching that to their graduate students and also the acceptance of more and more periodontists actually doing the treatment and getting excellent results. So the combination of the two, I think, has led to more acceptance of the procedure and less resistance to it.

MK:  So getting back to your own experience, did you have any challenges first implementing LANAP at that point?

TS:  Before I went and purchased this, I did a lot of research. I looked at my practice, where it was going, who my clientele were, who had needs, and what the problems were in my practice. One of the problems in my practice was I was in a small rural area. It was an hour to get to a periodontist, and when I did send patients who needed surgery to the periodontist, over 50% of them did not go and of the other 50%, only about 10% of them proceeded with the surgical procedure. So my patients weren’t getting better. I did a lot of scaling and root planing of these patients, but the end result was I still was dealing with disease that was progressing on these patients, and more and more tooth loss that I felt wouldn’t be necessary if the patients would take on a surgical procedure and get their dentition stabilized. The challenge was to say, “Can I get this in a small town?” The first thing I did is I asked my periodontist, “Can you do this? I know my patients would go for this. They don’t want to be cut and sliced and diced. But I think we could convince him to do this. It’s gotta be better than what I’m offering my patients now.”

They absolutely refused and said, “We will never use lasers. It is not acceptable treatment and it is something that you’re cheating the patient. They need the surgical procedure and they should get the surgical procedure. Waving a magic wand is not going to help them.” I knew that there were enough people that needed the help, who I could convince to get the help.  If I brought this technology into my office I could help a lot of people that were on the road to losing their teeth. The numbers were there. That that helped me right away because there were people that simply because of distance, because of fear, because of whatever reasons they had they did not go ahead and get the surgical procedures at the periodontist. So I went and brought it in.

Getting my staff to get on board was fairly easy because they saw the results right away. Within six months to nine months, we saw that this really does work. This is really amazing. The patients love this. The comments of the patients, “I can chew again. I never thought I would… I didn’t know how bad I was until I got better.” All of these comments really, really let your staff know that this is something different than anything they had ever seen before. When that happens, when you talk about it, the body language of everybody in the office just backs up that this is really a great thing. Almost 100% of my patients who refused to go to the periodontist accepted this treatment, jumped on board and got the treatment.

I had a significant amount of treatment in my practice right away, which was really good for return on investment because it brought in the funds to make the purchase and the return on investment was very good. It was covered in six months. After that, I had a machine that essentially was paid for that I could do these procedures and profit from them. I use the laser for endodontics, tissue gingivectomies, troughing for crown and bridge. I use it for multiple things, and there are lots of different ways you can use this, besides just LANAP. It’s the most valuable player in my office and gets a lot of playtime. Every day I get my laser out for different things that are needed to make my dentistry better and easier.

MK:  So you’re saying the MultiVariable Pulsed -7 should really be Most Valuable Player?

TS: Absolutely!

MK: Yeah, when you had talked about your closest periodontist an hour away, and so your patients just not going to the trouble to go see the periodontist, that is a whole reason unto itself to be able to offer this in house. I am curious: you mentioned that periodontist or a close periodontist not really believing in lasers at all. Is that still the case?

TS:  Actually, about three years ago, one of the practitioners went and got training for LANAP and that periodontal group now offers LANAP as a choice in their menu. They’ve been very happy with it, and now I have some competition an hour away.

MK:  There’s no shortage of perio out there.

TS:  Yes. The issue right now is that I’ve pretty well cleaned up the people in my practice, so word of mouth is bringing people in, a couple a month, that need and want to procure this. They show up at my door, we take care of them, and then they bring in patients. It’s been very good for a continuous growth of my practice. People are driving up to an hour – hour and a half, one we have drives three hours, and one drives four and half hours to avail my service. The only reason they come to my office is because I offered LANAP.

MK:  It is good to hear that even after 14 years, you’re still using your PerioLase MVP-7 and you’re consistently having new patients and new cases.

TS:  Yeah, right now my son has joined my practice. He just graduated from the University of Minnesota and he is in my practice now, which means we have capacity to do this. So we are orchestrating a Facebook campaign with LANAP out to area communities, raising the awareness of that as a choice and me as a practitioner with a lot of experience to be available so that they don’t have to have their gums cut away. That there is an alternative. So we’re starting that, and I expect that it will be a very, very, very positive thing for a lot of people, and will bring patients into our practice. I would say over half of my practice right now is not from people in my small town, but in neighboring communities.

MK:  And since you’ve been practicing with LANAP for so long, can you comment on the consistency of results over the years? Does it consistently work for you?

TS:  Absolutely. Even the ones that don’t follow up, do poor, get lost, come back five years later. 100% of them are better off than when we did the initial LANAP, they have gotten better. They do a little backsliding, but they’re still ahead of where they were five years before or 10 years before. So everyone gets better initially, and the pocket depth changes are amazing. The maintenance is required, as with any person with periodontal disease. Periodontal maintenance is an important part just because it’s about bacteria, and eliminating bacterial growth in the biofilm is so important. For the people that have maintained their periodontal maintenance in the 14 years, we have held 16 millimeter pockets at bay. Those people still have their teeth, they’re healthy, the tissue’s pink, there are three millimeter pockets, and they’re chewing on everything. It’s amazing, you know? I mean, is it gonna break down after five years? Then it was is gonna break down after 10 years? Now I’m approaching 15 years, and it just keeps getting better. It doesn’t get worse. It gets better. So the pocketing is stabilized. We see increase in bone density over the years, and they’re periodontal health is good! I’m very, very pleased. It’s been a wonderful thing for our patients.

MK:  Well, I thank you for sharing your story with us and certainly wish you continued success. We’ll have to follow up in five years on our own to see how your 20 year patients are doing! I do want to mention your website. That’s schoendentistry.com. I invite our listeners to subscribe to the podcast if you have not already, so you don’t miss any episodes wherever you download podcasts or at LANAP.com/podcast Again, Dr. Schoen, thanks so much for joining me today.

TS:  Thank you. Marty.