The Tissue Tells the Story

April 5, 2021

The Tissue Tells the Story

Shalom Mintz, DDS, MS


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. Shalom Mintz, a periodontist in New City, New York, just outside Manhattan. Dr. Mintz earned his DDS degree at Stony Brook School of Dental Medicine and his periodontics specialty certificate and Master’s of Science degree at Rutgers School of Dental Medicine. He serves as a certified instructor with us at the IALD. Dr. Mintz, Thank you for being my guest today.

Shalom Mintz:  Great afternoon, Marty. It’s my pleasure and honor to be with you today. How are you?

Marty Klein:  I’m well, thank you for asking. I want to go all the way back to the beginning of your LANAP story. You were trained, I know, in 2015, but I’d like to hear how you first became aware of LANAP and the journey to decide to incorporate it into your practice.

Shalom Mintz:  So my journey started maybe 10 years before that, it’s been reading articles and just seeing what LANAP and what lasers can do. And my biggest thing is, I’m a medical professional, health care professional, and I want to give my patients the best care that’s out there. I was always intrigued and just drawn toward laser therapy, where we can do things less invasive and yet get better results. After I finished residency, I’ve always wanted this machine, but in the beginning I worked for other people and they weren’t interested; they weren’t believers in it. It took me a few years to convince one of my bosses the machine’s worth it to invest in, and he wasn’t really on board 100%. I actually called Anthony, my sales rep, and I said, “You know, I have no place where I’m working that’s interested in this machine. But it’s such a great machine. I want to buy it, anyways.” I gave him my deposit, ready to sign the papers, and then, after speaking with my boss, I realized that he wouldn’t even let me charge for surgery. He would just put it down as like a scaling and root planing, and there’s no way I can even pay my monthly payments with that. I know it’s a surgery, but if he’s not buying into it, it won’t work. So I told Anthony to hold off. He kept my deposit because I knew I was gonna get it. It was just a question of when. It took me a few more years and then I got my boss on board again. We purchased the laser and it’s been amazing from day one. After we had it for about six months, we wanted to buy two more machines, because initially we had one machine in in Brooklyn where I used to work, I still do work, and I would bring it up on weekends to Rockland County in my office to use it over the weekend when it was not being used in Brooklyn. But after we had it for maybe six months were like, “This is an amazing machine. It’s crazy to have to schlep it back and forth” So that’s been my journey. It’s been a great journey, and I’m very happy and proud to be part of Millennium.

Marty Klein:  So that was a 10-year process, took a lot of persuasion…it seems you almost were a rebel at that point wanting to do it anyway. But then it seems like it worked out very quickly. Did that boss ever come around to understanding and seeing the light, so to speak?

Shalom Mintz:  Yeah, it was probably about one week, when he saw his first post-op! I have a picture that I like to show people. I call it an “LANAP Works” because people are out there with one of two philosophies. People who are not believers, either they just believe it doesn’t work or they just don’t want to spend the money on it. So I have a patient and I have a bunch of them. But one of them, it’s like black and white. I did the surgery on half the mouth. I know the protocol says that we usually do whole mouth in one shot, most of my patients prefer splitting it so they do the right side/left side. They have a place to eat and a place to chew. Both of them are proper for the protocol, but a lot of practitioners pushing full mouths. From a business perspective it’s easier, but I’d like to just do half the mouth at a time. So when they come back a week later for the second half, and they have fire truck red gums on half and coral pink, perfectly healthy gums on the half that was treated one week ago, there’s nothing like this before. We’ve seen periodontal patients for so many years, and you do the surgery, they come back, the sutures are still in, the gingiva’s inflamed, and yeah, it’s healing nicely, but just not great. Versus coming in now, a week later, where you see half the mouth is coral pink, half the mouth is a fire truck red, patients that they had no pain afterwards, it felt great from the second they left the office – there’s just nothing like it.

So I have a picture of a facial shot where you just see fire truck red on the right side and coral pink on the left side. I use that picture when I give lectures to show people that this stuff works and once people see it they’re a believer. When I introduced it to Rockland County in my office, my hygienist was practicing for over a decade, maybe two decades by then, and she was hesitant. She’s like, “This stuff doesn’t work. How am I going to tell patients about it if I don’t think it works?” She came back to me maybe a couple weeks later, she would see my post-ops for me to polish and then a month later start perio maintenance and she’s like, “This is ridiculously crazy. This stuff works and you’re getting results that are better, and patients are reporting to me better than I’ve ever seen before.” And she eventually retired. The next hygienist came on – same disputes, same debates and my response was, “In one week, you understand.” And a week after that she’s like, “Oh my gosh!” And she tells me now, “I’m looking through charts from previous patients who had the work done years ago. I’m just looking at the numbers and I can’t believe they’re taking 10, 11, 12 millimeter pockets and then down to the healthiest 4 I’ve ever seen and tight gingiva!” They become believers once they see it.

I know I have this debate with a lot of dentists, and actually, one of the ways I got Dr. Rubin on board was I told him, “Is it worth it for you to spend your monthly payment on the laser? Whatever the number is going to be, just to say three words, I use lasers. I do LANAP. Are those words worth $1,000 a month, $3,000. What value is that?” And that’s when he signed the papers. He’s like, “Yeah, just to say it, it’s worth it.” And my big debate with Dr. Rubin and all the practitioners who are debating whether or not this is something to do, I tell them, “Look, this histology shows were better than doing old fashioned cutting and sewing. But let’s at least give me the fact that we’re equal,” and some practitioners will agree to it, and some won’t. Once they agree that it’s equally as good, then we’re going to start having conversations, “Look, it’s done on one or two visits. There’s no sutures afterwards. There’s no pain. There’s no recession. There’s so many other benefits to the machine.”

Some practitioners don’t want to do it because finances. One person, a noted person I met by Greater New York Dental Meeting, this has to go back maybe 3-4-5 years ago, and I don’t want to say his name. He tells me it doesn’t work this and that, and I said to him, “Okay, at least tell me it’s equally as good,” and he’s going on and on and on. Then I tell them I have a question, “If the machine costed $10,000. Would you buy one?” His response is, “If it was that price, I would buy two.” I responded, “If it doesn’t work, why do you want to spend that much money on machine if it’s garbage?” and he just walked away! So people know it works. They’re not going to spend $110K, $120K, whatever the number is, plus training and taking off to go do it. They know it works. It’s really, I feel terrible for the people who are the laymen, not the dentists. I’m talking about the person who needs osseous surgery to fix potential disease, and the American Dental Association, the American Academy of Periodontology are not coming out and saying, “This is the best out there.” Look, I have a family member who just went and got her eyes lasered to correct her vision so she shouldn’t have to wear glasses anymore, and I don’t think she even thought for one second to go to that surgeon who’s doing it for 30 years, who still is cutting the cornea open to get access and fix the lens. She’s not thinking of that. She wants to know who’s doing laser surgery. Why? Because laser surgeries are the best way to do things. It’s least invasive, least postoperative discomfort, and fastest to getting you back on your feet and healing. So why is it different in the mouth? It’s really a shame American Academy of Periodontology and American Dental Association, whose people who are on the boards there are using LANAP, some of them are LANAP clinicians. It’s just a shame. It’s a disservice, in my opinion, to the people out there for, you know, for the American Association to not be having this on the page saying, “This is the way to go.”

Marty Klein:  Meanwhile, it sounds like you’re coming into the practice as a hero because even, you know, Dr. Rubin agrees to do it in order only to say that there’s a laser in the practice and not much more. Your hygienist is very skeptical, and then you’re able to show both of them that look at this. It actually works and rattle off all these other benefits for the patients. That’s gotta feel pretty good.

Shalom Mintz:  Yeah, and the best thing that the feeling is that I’m giving the patients the best care and I understand the hesitation. It’s over $100,000 for the machine, so there’s going to be hesitation. But the bottom line is we’re able to give patients the best possible care that’s out there, and that’s really what they deserve. So I’m just happy that I’m able to help the patients, independent of the practice being able to grow, I’m just, you know, for me, my main thing is, give patients the best care that’s possible.

Marty Klein:  You mentioned the cost of the package, which includes the equipment, including the laser and the training. Tell me a little bit about the business side of using your PerioLase and the number of visits that patients need to make for LANAP versus traditional methods.

Shalom Mintz:  Well, that’s a great question. So, from a business perspective, the return on investment is amazing. Before I had the laser, you tell a patient you have potential disease. They are referred from their dentist, so they know that they have a problem. They don’t know what it entails. They don’t know if they’re losing teeth or not. They don’t know how much it costs. They just know they have to go to periodontist. In the past it was okay to get deep cleaning first, it takes a couple of visits, then you have to wait a month for healing. Then we’re going to reevaluate it. But from experience, you’re gonna have to get surgery and we have to cut the gums. We trim them down. We have spaces now where the papilla used to be, and then you increase chances of sensitivity and root cavities, not high percentage, but it’s still there. And the patient’s response was, “I don’t know. Let me do the deep cleaning. I’ll see if I used to want to get the surgery. It sounds painful. When should I do it? I have work. I can’t take off.” Now, I tell the patients exact same spiel of what’s periodontal disease, how we can treat it the old fashioned way, but, you know, with lasers now we don’t have to do the cutting and sewing. Most of the time the responses are, “Okay. When can we start? When can I do it?” It just allows me to practice dentistry, which is what I’m here for. If I wanted to practice business, then I would have gotten business degree, and granted, I don’t take care of the finances, but when I’m explaining the disease, I still get that question of “Do I really need it? What happens if I don’t get it?” Now, it’s just, “When do I start?”

Other advantages from a business perspective is that once you have the machine, I would never buy this machine to do other types of procedures, but once I have it, I use it for laser assisted ridge preservation, and patients love it. Even if I’m taking out a tooth and an immediate implant, I can simply take some laser energy, put it into the socket, and that will enhance the healing. I take out the third molar, I can send them home, I can put gauze there for them to bite on it, but I can also take the laser and use it as a biostimulator and stimulate the socket to heal, form a clot for them. They’re basically 24 hours in the healing, and patients love it. Just the fact that when I’m explaining procedures, I tell them, “Yeah, and what I’m gonna do is when I’m done, I’m gonna just laser it a little bit. The side effects are that you heal faster and you have less bleeding and significantly less pain.” It’s a no brainer. When I do surgeries for connective tissue graft from the roof of the mouth, I take a piece from the palate. My number one emergency complaint was that “I’m bleeding from the palate or I have pain on the palate.” Since I had the laser, I learned that you can use the laser the same way we quote unquote, “glued” the gums down to the tooth to reposition them after osseous surgery. I can just make a flap on the palate, borrow piece of connective tissue and use a laser to quote unquote “glue it down” and not have to use stitches. And when I started doing that, I almost never get complaints about bleeding. I think maybe in five years, less than five time, I’ve had to suture the palate. My emergencies for the palate now became, “Oh, Dr. Mintz. I’m so sorry for bothering you. I completely forgot I had surgery a couple of days ago, and by mistake I ate potato chips and I poked my roof of my mouth, and now I’m bleeding. What should I do?” It’s just the fact that they forgot that they had surgery two days ago is crazy when the biggest complaint was pain from the palate and I don’t have that anymore.

Marty Klein:  Now, do I understand as well that you’re having some patients referred to you from other periodontists?

Shalom Mintz:  I don’t get too many of those. I have patients who hunt me down from the internet, or hear about it from friends, and I have a lot of cases that people came in. They said they were told all their teeth have to come out and they want a second opinion. I said, No problem. You know what’s the worst thing that we do if we LANAP the area? Nothing. So if it doesn’t work, we can always take the teeth out. And I have so many cases where patients were told all your teeth have to come out, half the teeth have to come out, and they still have all their teeth in the mouth today. Patients now are telling me, “Oh, if it’s just money, no problems, no pain involved to just do it. And if it doesn’t work, you can always take it out.” I have cases that it’s a miracle how some teeth are in the mouth. There’s practically no bone left – on molars to boot – where they’re chewing, and they just somehow these teeth are staying in the mouth and patients are happy, 2-3-4-5 years. They have no issues with it.

Marty Klein:  Well, it’s no wonder you now have three PerioLases. It seems like it’s on all the time from all these patients and you know, ways in which you’re using it.

Shalom Mintz:  Yes, actually, by Dr. Rubin. There’s another associate there and he brought his own PerioLase. Now there’s three there.

Marty Klein:  And all stemming from you fighting the good fight and insisting that your office gets it! Seems like you were the only one to believe in it at first, but now you have everyone rallying behind you.

Shalom Mintz:  Yeah, once I became a LANAPer I know Anthony was always bothering me to become an instructor, so I have to be very appreciative to Anthony to help me speak with Dr. Rubin and then eventually get me on board as an instructor. I’m able to help even more people from a perspective of getting other dentists to understand the greatness of LANAP and what we can do with our laser. And most importantly, we have histology to back us up. Even when I tell people I say, “Look, I also do other procedures that I was trained specifically not with lasers, just other surgical procedures,” and I tell them “Just signing up with a company. You’re becoming part of a family and you know, I get emails “You only eat kosher. So do you want us to get your kosher food?” They are taking such great care of me. That’s when I was a student and as an instructor, it’s nothing I’ve ever even asked for. It’s just that when you’re part of a family, you don’t ask the spouse or a kid or a parent for something. You just get it. And this is really how I felt since the day one when I signed on board 5-6-7-10 years ago, where everyone there is just making sure that you’re happy. If I ever have any questions with the laser, I just call up and usually on the spot they send me to the person who can help me and I’m answered almost right away. It’s just the company itself. I don’t eat food that’s not kosher, but I can walk into that office and I’m teaching and just smells like there’s an entire restaurant there for you. And it’s just so well taken care of, they’re family. That’s really what it is.

Marty Klein:  Well, those are kind words and we do try to treat all of our customers as family, as part of the tribe. And your enthusiasm certainly shines through, and I want to thank you for sharing your experiences. I also want to give a plug to your website for anyone listening that would like to learn more about your practice. It is I also want to ask our listeners here if you’ve not subscribed to the podcast to please do so, or you can see all of the episodes of the podcast that we’ve recorded so far. They’re up at Dr. Mintz, thank you again for being my guest today.

Shalom Mintz:  My honor, Marty, have a fantastic day.