September 14, 2020
Colin Richman, DMD
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. Colin Richman, a periodontist just north of Atlanta, Georgia. His educational background is diverse, receiving certifications and degrees from the Royal College of Surgeons in London, England, University in Johannesburg, South Africa, and the University of Connecticut. Dr. Richman is well known for his extensive research on periodontal health. He frequently lectures and teaches about complex cases and innovative techniques. Today we’ll talk about how he got started with LANAP later in his career, his involvement with the Seattle Study Club, and recent LANAP clinician survey that he co-created. Dr. Richman, thank you for being my guest today.
Dr. Colin Richman: Thank you for the invitation, Marty. It’s a pleasure.
MK: So you came on board as a LANAP trained doctor in 2011. I’d like to first start about how you first heard about LANAP and the PerioLase, and then what persuaded you to incorporate it into your practice?
CR: Well, like most other periodontists, I had heard about laser periodontics. I was aware there were a number of varying lasers, but was not sure which was the most appropriate, except that the PerioLase kept surfacing. I have been, was at the time, a director of a Seattle Study Club – and many of my periodontist colleagues who were also directors of Seattle Study Clubs – had at that time, and prior to that, incorporated LANAP into their practice, and without exception were extremely satisfied with those decisions. I then sat on the fence for a year or two and I happen to be given the longevity paper by Lloyd Tilt, which I read, and that was for me, the turning point. I was trained in evidence-based periodontics. I practice evidence-based periodontics and I believe in evidence-based periodontics. When I read that milestone paper of Lloyd’s and he demonstrated that there was equivalency in the results and the outcomes with LANAP compared to all the various traditional forms of periodontics that we were practicing, I thought that if I could get the same results that the classic techniques provided without subjecting patients to periodontal surgery, why not? And that, to me, was my turning point. And in reality, I’ve never looked back.
MK: For listeners interested in the paper you referred to, it’s Dr. Lloyd Tilt in General Dentistry from, I believe, early 2012 that’s available on LANAP.com/research for anyone listening that would like to read that. You mentioned Seattle Study Club. Tell me more about how the other directors and you play off of one another in terms of purchasing decisions, because that was certainly a big part of incorporating the PerioLase.
CR: Well, as you know, Marty, the Seattle Study Clubs are like a fraternity. We are all particularly supportive off one another, especially the directors. As you know, many of the directors are periodontists, and I think we trust each other implicitly. So when I was speaking of great results and in fact, one of our colleagues, Mark Wilson, invited me to spend a day or two in his office, seeing him perform LANAP and doing some of the patients. So I flew from Atlanta to Minneapolis. And, you know, we are just there for everyone’s benefit, and that is exactly what the laser was for us.
MK: So when you came on board starting to do LANAP you were already later in your career. You’ve been practicing periodontics for quite a while, and the PerioLase had been on the market for over 10 years. Was that a wise investment at that stage of your career? After you started using it on patients, would you say?
CR: Oh absolutely, yes! You know, like everything else, I will make the comment, I wish I had made the decision a few years earlier, but I didn’t. I am not a pioneer, I’m not an early adopter of technology. So, yes, it was a very wise decision. It was not financial based. It was more based on, and today with the same parameters if I were doing that again, it is based on what is the most appropriate technology that is current and appropriate for use for our patients.
MK: I was reading a statement that you made at the BootCamp, which is the 1st 3 days of training, is that you wanted to, “recapture people with perio”, I’m curious what you meant by that, and if LANAP ultimately accomplished that for you?
CR: By that was inferred that we wanted to get back to definitive periodontal therapy. As you know, a lot off periodontitis patients are undertreated and retained in the general dental practice without a referral out. I am primarily a periodontist. I’m trained and I know we can save virtually most teeth, and that’s what I wanted to do. I wanted to get back to treating more periodontitis, and indeed, over the years, that is what happened. That once one patient spoke to another patient, spoke to their dentist, spoke to their hygienist, and saw the value in treating periodontitis patients with LANAP when indicated, we grew the LANAP practice, and that was very rewarding.
MK: Now, when you’re trained for LANAP, there is a hands-on component. In other words, you’re treating live patients. Did that give you the skills or the confidence needed right out of the gate after your first training to do LANAP in your own practice?
CR: You know Marty, the comment to that is one of the factors that really motivated me to become involved in LANAP was not that I would find a machine on my doorstep one day, maybe read a manual, and learn by trial and error. The intense, and I’d heard about this from my colleagues, the intense five-day training programs scattered over a year, really was very motivational for me, and so their hands-on component was fabulous. I believe that’s the case with any technology that is new that one wants to incorporate. Learning from the masters is far better than winging it and learning by trial and error, because with many different forms of technology, one might never achieve the ultimate success with that technology if you don’t know what that ultimate success could be, and one is not trained by highly trained personnel themselves in that technology. So the answer – that’s a long winded answer – is: yes. It was much favorable.
MK: Over time in your practice, have you found LANAP to be consistent in its treatment modality among your patients?
CR: Not only has it been consistent, it has improved as our skills in using the technology and understanding the scope of that technology has improved. So, yes, there’s been no change and what’s being great, I think we’ll discuss this in a while, is the survey we did to poll that out.
MK: Yeah, I’d like to talk about that, actually. Clearly you’ve had a lot of success with LANAP, but I know that at one point you wanted to find out what the rest of the LANAP trained clinicians felt, and you co-designed a survey that turned into an article that should be published soon. Can you tell me just about how that article, or how the survey came to be, and then a little more about that survey?
CR: I certainly can. You know when all is said and done, we humans make decisions based on recommendations. Now, if one analyzes the situation, it’s going to be impossible to obtain scientific, randomized controlled studies supporting LANAP as a viable therapy – for all the politics, for the sponsorships, for all the costs and everything that goes with it. And yet I wanted to get the word out there that LANAP is for real and there are so many patients who would benefit tremendously from that therapy, both orally and systemically. So the next thing we have available to us in our science, we have user surveys. So I realized that if I did an independent, together with various colleagues, an independent survey satisfaction study of users of the Millennium laser, the PerioLase, it would be interesting to see how others have found LANAP to be for their practice. So, indeed, we compiled that study. There were 4 (plus myself) well-seasoned laser users, we brought in one of the directors of the periodontal program pat New Jersey, and a very competent statistician. We did the user satisfaction survey and indeed we got a very good response. As you said, Marty, that study is going to be published in due course quite soon, but what we found is that virtually every LANAP clinician who responded would do it again. Nobody regretted their decision. These are just a few of the positive responses (there were no negative responses): Everyone found that their patients benefited in the short and long term. Patient satisfaction was extreme. Patient compliance with guidelines for long-term maintenance care was excellent. And the list goes on. There were 23 questions and the list goes on and on. But the bottom line of that survey is that, you and I are convinced, that if a clinician in is about to invest in a new technology, they would like to know how their peers have fared with that technology. And indeed we showed that to the user we were all greatly satisfied with every aspect off that investment, including the return on investment financially.
MK: Sounds overwhelmingly positive. Were there any of the results that surprised you?
CR: No, because those results mimic the discussions I and our colleagues had previously had and so now we were just seeing it in appropriate data format. Then when statistics were run by a university statistician, it supported our thoughts, so we were not surprised whatsoever.
MK: Well, that’s wonderful. I know that a lot of folks are looking forward to reading the study. It’s not yet published.
CR: No, and Marty, I do want to point out this was an independent study that had no corporate involvement at all. In fact, the owners of the company were surprised when we started it, they didn’t even know it was ongoing. It is totally independent.
MK: An excellent point. Well, I want to thank you for joining me today. And for listeners who would like to know more about Dr. Richman, his website is drcolinrichman.com, and I invite you to subscribe to this podcast for a new interview each Monday wherever you download your podcasts or at LANAP.com/podcast. Dr. Richman, thank you again for your time and joining me today.
CR: Thank you, Marty. It’s a pleasure.