September 6, 2022
Making Periodontal Treatment Worth the Long Drive
Kyle A. Malloy, 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. Kyle Malloy a periodontist in Medford, Oregon. Dr. Malloy earned his dental degree at Oregon Health and Science University and continued his training there for his residency in periodontics and implant surgery. He actively lectures on topics ranging from soft tissue grafting to dental implant surgery, to full-mouth implant reconstructions. He’s been a LANAP-trained clinician since July of 2021. Dr. Malloy, thanks for taking time out to join me today.
Dr. Kyle Malloy:
Yes, thank you for having me.
Marty Klein:
So as I mentioned, you trained with LANAP and the PerioLase just about a year ago. So, relatively new to the LANAP tribe, so to speak. Do you remember how you were first exposed to LANAP and the PerioLase and what led from there to get trained?
Dr. Kyle Malloy:
Sure. I mean my first experience really was in residency, although limited and mostly related to you know, literature review. So we read all the papers from Yukna, Nevins, Mellanig things about how the Millennium laser was able to treat patients and the comparisons that it had to more traditional surgery, regenerative surgery. In addition to having a few of our private practice faculty members that would come in, you know once or twice a month, who were utilizing it in their private practice and kind of get some of their experience. So most of it was obviously what we read and then just hearing from others on their experiences. But it was interesting to me because one of the reasons I wanted to get into perio was for the future and the development of treatment versus more traditional general dentistry or prosthodontics which that was the background. My family, both my father and my grandfather were prosthodontists but I was intrigued in the surgical and regenerative side of things. And then as I learned more about that with the experiences I was having with LANAP information just again, the future of treatment for patients. And I thought was really much more wide open and perio and that was what drove me there. So that was the basis of starting with it later on. Then, as an associate, one of the offices I was in brought in the Millennium laser and got to see how it was working for the patients. And then soon after that is when I purchased my own practice and reached out and inquired about getting trained. So I had to bring it in and share with my patients.
Marty Klein:
So you mentioned your exposure in residency with the literature. Did your university or dental school use any lasers at all?
Dr. Kyle Malloy:
Not really. I mean I know they had a laser. They had a CO2 laser. But you know that’s totally different. And so my hands-on experience was really none during residency which was frustrating. We were hoping that we would have the more experience. And I think slowly things will go that way. But literally it was just related to reading and secondhand knowledge of experiences of others.
Marty Klein:
So you fast forward, as you mentioned, you now bought your own practice, I believe early 2021. And this was something that sounds like you knew you were really interested in based on all the background that you had. What were your initial expectations bringing it into your practice as something to offer for your patients?
Dr. Kyle Malloy:
Well, one was the ability to offer something different than just traditional options of osseous surgery or guided regenerative procedures. And so one thing with a perio office, especially purchasing an office and taking over one that had been established in the same location for about 30 years, because I had a lot of patients that we’re continuing on that had had numerous rounds of resective or regenerative surgery in the past. And at some point, you just can’t keep doing that. And so I wanted to really have another option available to offer those patients. In addition, the kind of geographic location I’m in, I’m in a pretty small area in southern Oregon where we have a small metro population. But I serve patients that drive from 3-4 hours away each direction to come see me. So something there where we would have reduced risk of postoperative complications and a simpler procedure that can get patients treated in a shorter period of time rather than quadrant by quadrant of typical surgery. And so my expectations were really that, that I would have another option that would be beneficial if not superior in some ways to other procedures to be able to offer my patients right away. And that’s what I’ve found so far.
Marty Klein:
It sounds like, and correct me if I’m wrong here, but it sounds like the patients already in that practice, and really in your area weren’t already exposed to LANAP. They maybe hadn’t heard of that before, didn’t know that was an option. What was your experience in educating your patient base on this type of procedure?
Dr. Kyle Malloy:
Some of them had we’re familiar with it or knew somebody just neighbor or friend that had some treatment, especially, again, being in southern Oregon. We’re getting a lot of people moving out of California moving up and so more dense population down there and patients there were exposed to it. But here, the vast majority of my patients were not, so once they heard there was another option – and really when you presented in a way of you can have this procedure, traditional surgery, verse the LANAP procedure – I don’t find very many people that are eager to opt for the first option or this traditional option. And so it’s been one to also explain and introduce this to my referring offices who many of them are much more familiar but not having it as an option previously. Now are excited that it’s available.
Marty Klein:
I read that while you were in residency, you worked on some medically complex patients. And I’m curious if you’re finding that the PerioLase makes certain treatments easier for medically compromised or medically complex patients?
Dr. Kyle Malloy:
Definitely. And that’s going back again. In addition to treating patients that have those complexities, a lot of them here live very far away from where I am. So minimizing potential risk, especially those who are on blood thinning medications for numerous different issues. Those who have been treated long time for osteoporosis with bisphosphonates rather than injectables that are anti-resorted drugs. The risks that are associated along with those medications and potential postoperative issues with patients on blood thinners. That was a challenge. And that’s something that makes me feel much more comfortable treating patients and patients as well. A lot of them who are on these blood thinners, they’re on them for a reason. And some of them are leery to want to come off for a period of time. Although it’s short, it’s still something that’s of concern for them. So when they hear that this option doesn’t require them to alter those medications again, they feel much more comfortable. And those that are then driving home 3-4 hours. I’m not concerned that they’re gonna have an issue that would be difficult to manage over the phone.
Marty Klein:
So as of this recording, you’re about a year out from your initial training, you’ve come back for all of your follow-up training and you’re at about the one-year mark. So I’m curious if you’ve started to see the one-year results from some of your earliest patients and clinically what have you seen in the last year?
Dr. Kyle Malloy:
I’ve seen really very impressive results. And that’s again, one of the reasons I wanted this other option. So one of the biggest things I’ve noticed, not only long-term, but initially is just how it affects and reduces the inflammation instantaneously almost. I mean that’s one of the biggest things for me is seeing that the number of sites that are bleeding and overly inflamed are not only reduced at that first-week visit when you’re checking on them, but you’re seeing that with those that are being compliant, you know, at 12 months it’s the same. And one of the things that I keep hearing over and over from my patients is that they don’t see the bleeding, but more than that they just said, my mouth feels great. My mouth has never felt like this before because they’ve typically had periodontal disease for an extended period of time and they just, we are in awe of that sensation of I don’t have that feeling anymore. Or I have another patient the other day that said, you know, my significant other says my breath no longer smells in the morning when I wake up and that’s a huge thing in that relationship. So the reduced pocket levels, the reduced inflammation and obviously the number of sites that are bleeding coming down to very healthy levels is what’s really impressed me over the time.
Marty Klein:
I made reference already that you completed your follow-up trainings. You come back for a day at six months and then a final day at 12 months and you’ve completed both of those. Were there elements of the training protocol or the training continuum that you found beneficial or helped you along the way get better results?
Dr. Kyle Malloy:
Definitely, the follow-ups, you know, the first week, the BootCamp, the three days when you’re down there, you get a lot of information, you go back, you’re flipping through your notes and you’re getting to work and then seeing how it’s going and there’s a learning curve to everything. There’s not a real steep one here, but you follow the plan and it works. But when you come back for those separate evolutions four and five, the opportunity that you have to not only interact with the instructors that are there to pick their brain about how they’re doing things or any small nuances or improvements that I can make on my technique but talking with the others in the class, what their experiences have been, how they’ve been utilizing it and then you know what other outside of just the traditional LANAP and LAPIP protocol is the bulk of what I do, those other options that are out there. As far as treatment. I mean one case in particular, I had a patient who was the grandson of one of my really great referring offices, he’s in orthodontics and developed a gigantic abscess on number 8. He was sent to the endodontist and they tested the tooth was vital but they took a cone beam and there was the tooth was basically held in by his ortho brackets. So if it wasn’t that I’m not sure that tooth would have ever made it to my office. But when I saw it I said, well, this is very challenging. But I don’t see another option other than using the laser here to treat this. And last I checked we were two months out and I mean we’re getting significant bone fill and the tooth is still vital. And so again those experiences to know that this is an option that we can still utilize this laser outside of the traditional full-mouth LANAP protocol. I mean I see this tooth and I’m waiting for the six-month point to see where we’re at and I’m gonna be really expecting very impressive results.
Marty Klein:
Yeah. A lot of people don’t realize that – although the PerioLase is marketed mostly for full-mouth LANAP as you mentioned, and LAPIP the Peri implantitis protocol, that it can be used for what we call VAPs, or value-added procedures. But there’s so many other ways that you can use the PerioLase for almost every patient you see or have you done that more and more? You mentioned one great example there.
Dr. Kyle Malloy:
Yeah, I mean, you know a few we’ve got a patient that will come in and we’ll mention that they’re just starting to feel a tingle that a cold sore might be coming on. Well, we’ll treat that really quick. I mean I haven’t really even been charging anybody for any extra little ones like that. I just if I’m in the middle of it I’m right there might as well help them out using it for frenectomies or for fibroma removals. It’s a little bit of a slower process than using a scalpel or a blade but definitely a lot cleaner and really easy on the patient. So working through the list of all the different value-added procedures that are there, which is very extensive. But as they come along I’m finding more and more ways to use this all the time.
Marty Klein:
Wonderful. I did want to bring up one other topic here and that is that I read that you have a long family history in dentistry which is, I don’t know how unusual it is, but yours seem to be pretty extensive. Can you tell me a little more about that?
Dr. Kyle Malloy:
Sure. Yeah, definitely I come from a long history. So my father’s retired now but he’s prosthodontist and he spent an entire career in the Air Force retiring as a Colonel. Both of my grandfathers were also Air Force dentists, one being a prosthodontist and a general dentist. And my grandmother was a dental hygienist. So I come from a long line of dentistry and in particular down one side of the family of prosthodontics. And so it was always kind of in my blood, as I always tell people, they ask how you get into dentistry, and my story is kind of different. I say, well I tried to avoid dentistry because I wanted to do my own thing, but as I was making my way through college and trying to decide what exactly it is I wanted to do, you know, everything that I liked working with my hands, helping people, the potential of being your own business owner, the art and science of that. You know, everything was kind of pointing back to dentistry. It helped that I did have that background and that experience having worked in the dental lab for my dad and other experiences brought me back to that. And so that history has been there. And although like I said, as long history was in the more restorative realm, you know, I ultimately went perio. And a lot of that was along the lines of what we’re talking about today was the potential of the future for that field. The regenerative aspect of healing and bringing back, you know, live tissue around teeth rather than the resective treatment of the past was intriguing. And then getting into the lasers and the ability to do similar regenerative procedures with a different technology. That’s what brought me here and that background of everything else is that comes along with dentistry, you know, all led to this.
Marty Klein:
Wow. That’s such a great path that you’ve taken and if I may tie something up with a little bow here, the Air Force is about to be trained, or at least 16 of their periodontists are about to be trained on LANAP. So something that your family might find special interest in after the Army and Navy are already offering LANAP in those branches. The Air Force is next, training them in November. So…
Dr. Kyle Malloy:
Yeah and that’s exciting. I know obviously, I never was in the Air Force but you know the things I would hear from my dad was some of the challenges was, you know, treating some of these patients in the military when they have limited time available. A lot of them don’t want to have, especially in the Air Force, pilots, anything given to them as far as anesthetics or drugs that would impact their ability to do their job and provide the service that they provide. And so again here we have this option that can be done in a shorter period of time in relation to much more expensive traditional treatment and is only followed with ibuprofen. So, you know, it’s something that I think is gonna well serve the Air Force.
Marty Klein:
Good. Well, we’ve brought it full circle. I appreciate all of your success and your time today. I do want to plug your website. Should anyone want to find more about Dr. Malloy’s practice in Medford, that’s www.malloyperio.com. And if you’re listening and you have not subscribed to this podcast, please do so wherever you downloaded this one. Or head over to www.lanap.com/podcast . All of our previous episodes are there. Dr. Malloy, thanks again for taking the time out of your schedule today.
Dr. Kyle Malloy:
Of course. Thank you so much.