Teaching the LANAP® protocol to University Residents

January 4, 2021

Teaching the LANAP® protocol to University Residents

Dolphus Dawson, DMD, MS, MPH

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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. Dolphus Dawson, a periodontist and associate professor of Periodontics at the University of Kentucky College of Dentistry in Lexington, Kentucky. Dr. Dawson received his dental degree and Certificate of Advanced General Dentistry training from the University of Louisville, Kentucky. He then received his Certificate in Periodontology and MS in oral biology from the University of Kentucky, and later completed a Master’s of Public Health from the University of Kentucky College of Public Health. Dr. Dawson, thanks for being my guest today.

Dolphus Dawson, DMD:  Thank you, Marty. Glad to be here.

MK:  Well, we will get to your role in teaching students at UKCD in a moment, but I first want to go back to the beginning to find out how LANAP first came on your map and the process by which you got trained back in 2013.

DD:  Thanks, Marty. Yeah, it came on my map or radar, hard to believe it’s been since 2013 now, but in the division of periodontology we had the [PerioLase] MVP laser at that time and I was interested in and it, of course. But the opportunity came about for me to go through and become trained on LANAP, and so I jumped on that opportunity and haven’t looked back, so to speak.

MK:  Had you heard much about LANAP prior to that? It sounds like it kind of fell into your lap at the university. But did you have any preconceived notions about what you were getting yourself into?

DD:  Not really, because I knew about lasers in general. My background was in biomedical engineering, and I was sort of familiar with lasers from an industrial standpoint. So I always had an interest in lasers, but really had no prior experience and using other types of lasers and dentistry. And so I kind of approach it with the blank slate. You know, I think that worked out really well.

MK:  Now you had worked in private practice as well as at the VA I believe before coming on board at UKCD. What was that transition or decision like to go back into academia?

DD:  It was a definitely a big change. I always – even through my residency – had an interest in academia, but then went in private practice for a number of years, solo practice and also teaching at the VA, and then became part time faculty at UK. As time went on, I made the choice to come back as full time. When I did, there was an opportunity at that time to join the college in clinical research. The VA was an interest.  My father had been a distinguished Air Force pilot, had a long military career, so I always enjoyed working with the vets and wanted to serve and help in that kind of way. But as I migrated back to the college, then I joined full time and did clinical research for about 10 years. Later on, I became the Associate Director for the Delta Dental of Kentucky Clinical Research Center, so that gave me a different perspective. Going from private practice to full-time clinical research was quite a change. Then I continued to evolve, if you will, back to perio full time and eventually became graduate programs director.

MK:  Do you miss anything about private practice dentistry?

DD:  Well, I always enjoyed the work and the autonomy in private practice. But I enjoy helping the vets. There are just a whole lot of needs that are out there, that can’t always get fulfilled, but you always try to help. I enjoyed all that, but really, I think blending all that experience there to teaching and doing what we do here kind of brings it all together. I miss parts of it, but I actually bring those parts here because I not only teach, but I see my own patients here. So I have that private practice side of it as well. I think it’s kind of all come together nicely.

MK:  OK, well, that’s a good segue. You mentioned the UKCD’s faculty practice. Is that where you started using the LANAP after you got trained, at first?

DD:  Yes, exactly. So following my training, it was just a natural home. I knew exactly where everything was at and just began using LANAP in my practice, here as faculty. That just was a natural progression. Definitely, it is something that was very different because a lot of our clinical skills rely on some tactical sense, and it’s a different way of thinking, sort of a paradigm shift, if you will. We hear that term a lot, but it is quite different. I was able to do that in a friendly environment here.

MK:  Well, somewhere along the way here it was decided for UKCD to incorporate LANAP into its curriculum. I believe that was the plan for quite a while, but it did take some intervening years to get that going. At what point in there was it decided that you would be the one teaching students there?

DD:  Well, yes, you’re right. It took quite a quite a bit of time for this to evolve. Actually, once I started going through the training process myself, just learning how to use the laser, I was quickly interested in it. I thought this would be a great opportunity for residents, for our folks to learn how to do this, and what better environment to do it than in an academic teaching environment? I was interested, so I started pushing and really trying to make that happen. Fortunately I was working with Dr. Al-Sabaagh, our division chief, then the administration, the college, and, of course, working with Millennium. We jointly and collaboratively (and you’re right. It took quite a bit of time to develop on get off the ground), but we got there and became one of the early programs, I think, to train residents in LANAP.

MK:  What do you think is necessary for an institution like yours – and I know there are others out there that want to get LANAP included in their curriculum – what’s the secret sauce to getting it to happen?

DD:  Well, certainly persistence, dedication, I think, because it does take time to work through the administrative process and really get buy-in from the college. I think the idea of keeping it as its own educational entity, wrapped in itself that it’s its own process. That’s nice because I think colleges, certainly, and other folks are probably worried about various things, conflicts, and how to handle things monetarily. I think we worked out a really nice process where all that is taken off the table and you really focus just on the education to train the residents in the protocol. That works out really nice. Inside the educational program, it’s a lot of work, no question. I have to carve out time to make sure that we can keep things on track and keep things going. With everything else going on, it’s always logistically challenging, but it’s been rewarding for sure.

MK:  And I should point out that you are the only certified instructor with the IALD on staff there, so it does fall on your shoulders to do all of the training, both didactic and clinically. I want to hear a little more about that, the experience of training residents on LANAP. You’ve gone through our training in California. What is it like to bring that experience to the university? And how is that going?

DD:  Well, it’s going very well. Naturally going from a trained LANAPer, so to speak, to evolving into an instructor is its own learning process. I’m familiar with that because I’ve done that in many different roles, clinical research and others where you have to walk that pathway. But training residents in that there’s a natural interest there are keenly interested in it to begin with, so the motivation is easy. Carving out the time and doing logistics is the challenge and balancing everything. Because here we have to do everything we must do for CODA (Commission on Dental Administration), for competencies and requirements, and those sorts of things. This is extra. It’s working it in above everything else and alongside everything else we’re doing. Residents, if left to their own wishes, would probably just as soon do this all day long, so I have to balance it out. From a program director’s perspective, I have to balance everything with all the other things they must do. So that’s probably the biggest challenge. Getting their attention and getting their interest, well, that’s easy. They want to do it. It’s just the logistics of getting all the training part worked in with everything else they must do.

MK:  You mentioned the residents wanting to do LANAP all the time. That sounds like it’s coming across very well or something that they’re not only interested in, but maybe seeing results from. Has that been your experience how the residents are seeing clinically the healing results from LANAP?

DD:  Yes, I think so. You know, with the educational environment that we have, they’re seeing very nice results. There are, of course, folks that don’t return or there’s times it’s tough to keep the folks coming back because they move or they’re just in a student program, so logistically, following them can be a challenge. I think they see the value of not only the procedure but the results, and they appreciate that and understand it once they start doing it. So I think that works out really well.

MK:  I should point out to listeners that for residents that go through this training at the university, they receive probably 90% of the training that they would need to become a LANAP-trained clinician after graduation, but they still have to finish their training with the IALD afterwards, just for those final pieces and to become fully certified. I will say, though, that your graduated residents over the last few years have been extremely eager to have their training completed. In fact, your completion rate is, I believe, the best there is. So maybe that’s a testament to you and/or your residents. But they are finishing their training, at a higher rate.

DD:  Well, that’s great. Excellent. That’s very good to hear. I think it just reflects on, like I said, the excitement that the residents have to do this, to learn this, to take this with them out into private practice. I’m a big believer in having multiple tools in your toolbox, so to speak, and I think the residents really understand that, and they appreciate having this opportunity, really to do something like this. I’ve had one resident in the past couple years that completed the full training and told me that when they went out on interviews, this was one of the things that the interviewer saw as icing on the cake and really saw this as a plus. When you’re comparing yourself to a lot of highly qualified candidates, maybe something like this can jump out for you and it did for this particular person. So it’s nice to hear. It’s not something that I necessarily expected or anticipated; it’s just something nice to hear as folks move through the process.

MK:  Certainly good for us to hear too. That is the idea, the little something extra to bring to private practice. I want to turn the attention back to your courses of study, which in your duration of schooling was partially in public health and specifically, epidemiology, which is a word we’ve all heard a lot of in 2020 here. So I’m therefore curious if you can talk a little bit about that course of study and how it has shaped your career?

DD:  Well, certainly I had the opportunity and really wouldn’t have been able to do it unless I had some really great mentor: My primary clinical research mentors, Dr. John Novak, Dr. Terry Novak, and then also Dr. Eversole. That was my fortunate time to be in the Center for Oral Health Research, here in the college, in which I had over 10 years’ experience. That got me into public health. I did my Master’s of Public Health while I was doing clinical research, but it really helped me better understand public health issues, focus on these oral health challenges, and just the concept really, of taking things from the bed, to the bench, bedside, and back if you think about it from those terms. Tackling these problems that we have in oral health, and there are a lot of issues. So we had significant time and work on studies that looked at periodontal disease and oral and systemic linkages and relationships, things such as host modulation, looking at the effect of dietary supplements, such as fish oil, on periodontology, looking at areas of Alzheimer’s disease and so forth. What I got from that was the importance of really big public health issues that we can have an impact on and help the part of a solution. I think that gave me a much better appreciation, and certainly now as a program director, to try to shine the spotlight on these issues. Like you said, we’ve had a really tough year with 2020 and COVID. Our public health colleagues have not had the support they need, and they need to have a lot more, so hopefully we can turn the tide but also help support these efforts – just fight these sorts of challenges that we’ve been facing.

MK:  I did want to clarify one item, that just maybe it’s just for me, but you said something about the bed to the bench. Can you clarify what you meant by that?

DD:  Yeah, you know, we can say the chair or the bed to the bench and then back again. As a clinician, you’re constantly trying to solve patients’ problems and take care of the issues for them and come up with treatment options. But to do that, you have to have the clinical research, the science and the discovery, really, to tackle that problem in a systematic way and then bring these options for therapy back to the chair or back to the bed and really come full circle, if you will. I think that’s a big part of what my career has been, is trying to blend those things together to try to do those sort of things, and that’s a challenge. So that’s really that concept I think in public health and dentistry are natural fit, and when you bring the research side into it, it can tackle a lot of these challenges that we face.

MK:  Well, I certainly want to thank you for your years of study in this area, and your participation, of course, with the IALD as a Certified Instructor, helping to bring LANAP to more residents coming out of school. You’re an integral component of all of that. So thank you on behalf of the IALD for everything that you do at the University of Kentucky. I would like to remind any of our listeners here to subscribe to this podcast to hear more from various different instructors and other LANAP trained doctors. Wherever you download your podcasts, you can subscribe or at lanap.com/podcast. Dr. Dawson, again, thank you for taking the time out and sharing your expertise with me.

DD:  Thank you, Marty. Greatly have enjoyed it.