Gum disease awareness: putting patient education first

Transcription: 

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. Sunny Drake, a periodontist in Salem, Oregon. Dr. Drake earned her degree in dental hygiene before continuing on to her dental degree at Oregon Health and Science University School of Dentistry. She continued in specialty training at the same university, earning a Certificate of Advanced Education in Periodontics and Implantology, as well as a Master of Science in Periodontology. Dr. Drake, thank you so much for being my guest today.

Dr. Sunny Drake: Thanks, Marty. I appreciate the invite.

Marty Klein: You first came to training on the LANAP® Protocol in 2012, so I’d like to start your LANAP® story at the very beginning. How you first became aware of LANAP® and then your decision-making process to get trained.

Dr. Sunny Drake: So when I graduated Perio, from OHSU in 2012, I had a classmate who was a second year when I was a first year, Dr. Sarah Nguyen, and she had kind of expressed interest in lasers throughout her training. We discussed them quite a bit, did we believe in it or not, and whether we wanted to do it or not. And when she got out (she was ahead of me), she went and received the training, and had nothing but positive things to say about it and kind of her belief in it. We also had an instructor, Dr. Sunil Thanik who came in a couple of times a month to help mentor us, and he’s also LANAP® trained. I think I had people around me that really had seen success using this for their patients in their practice. I wanted to differentiate myself in Salem when I came down there because there wasn’t a periodontist in the area at that time that was LANAP® trained. There were a couple of general dentists, but no perio. And I thought, “Well, we’re the experts in perio. I should probably check this out,” and when I went for training, I was really impressed. I think I went with the first ever Army/Navy group that had first been trained, that was sort of my class down there in California, and it was really awesome to see that it was being accepted by the US military as well as sort of becoming more mainstream than maybe it had been before.

Marty Klein: Yes, that was the U. S. Army at the time they sent, I want to say a dozen of their residents and periodontist to get LANAP® trained, that was the very first one back in 2012.

Dr. Sunny Drake: Yeah, it was kind of exciting.

Marty Klein: And since then, the U. S. Navy has come on board, I would point out. Dr. Thanik is one of our instructors, so he’s a good one to have been exposed to at that point.

Dr. Sunny Drake: Right?

Marty Klein: If I have my timeline, correct, I believe you worked at a group practice then. But then, just maybe two months later, opened your own practice. So I was curious how that transition worked. If you became LANAP® trained still working at the group practice, and if so, what did they think about it?

Dr. Sunny Drake: So I did work for a company up here that was kind of, like you said a group practice, a big corporation, and I think Dr. Nguyen also worked there for a little while. I had plans in the beginning to either work with somebody to become part of a private practice and eventually not be in group practice. I can’t say being in the group practice was a big incentive for me to become LANAP® trained. I sort of made my mind up, and I worked at the same time consecutively the group practice and with my perio practice up until about July of, I want to say, 2013, I did both. Then eventually my private practice took off, and I didn’t need to work with the group practice anymore. The group practice, though, because of Dr. Nguyen, was already on board with doing LANAP® and having LANAP® available to their patients. It was just hard to share a laser.

Marty Klein: Yeah, you do need a PerioLase® to do LANAP®. And if there was only one there, that’s a problem.

Dr. Sunny Drake: Yeah, that was the challenge.

Marty Klein: I want to start talking about some of the results that you saw because you had some great colleague, and with Dr Thanik at the school, influence. But what did you start to see when you started doing LANAP® for yourself?

Dr. Sunny Drake: You know, I come from the traditional perio, traditional general dentistry background, where be super skeptical before you believe in, or buy into anything. So I was cautious, and I had told my patients that in one year if this isn’t as fabulous as we think it is, then we’ll do a revision for you, no charge. What I found was over time, I wasn’t doing revisions. I wasn’t even doing that many revisions at all, and I started using the laser more. In addition, to the LANAP® Protocol with other procedures and other issues with perio than just gum disease. So I was pretty happy with the fact that I had invested in LANAP® and invested in myself to bring this into my practice, because it was a win-win. It was a win for the patients because things and cases that you may not have done traditional perio surgery were actually having improvement or better than you expected. Patients were happy because they, some of them, quite a few of them, are quite afraid of surgery. So I was impressed at how well it works. You know, you get promised a lot of things when you wanna buy into a new dental product or tool, and then you start using it. You realize either it doesn’t work in your hands or it didn’t do what you thought. I didn’t find it to be the case with LANAP®.

Marty Klein: Did the GPs in your area, at least the ones who were not LANAP® trained themselves, did they understand it enough to send you referrals?

Dr. Sunny Drake: Some yes, some no. I want to say that it’s kind of a mixed bag. Some were definitely like, “Oh, this is great, she’s got the laser!” I still have a couple of those referrals. Even now, I have one general dentist whom I worked really closely with. She sends me patients just for biostim because the oral surgeon will take out her patients’ wisdom teeth and sometimes they’ll have paresthesia and I’ll be doing just biostim and help them get sensation back. She was 100% on board with understanding the technology and what it could do. Others were skeptical so, yeah, it’s interesting. I feel like for the most part, it’s pretty positive. There were a few people that were not really understanding it. I think for the most part at least, it was beneficial and quite a few did understand.

Marty Klein: You talked about biostim for a moment just a little while ago, which stands for biostimulation. It’s not an FDA-cleared procedure, but the PerioLase® is FDA cleared from many other procedures, including LAPIP™ for Peri-implantitis and another value-added procedures. Do you use your PerioLase® for additional dental procedures?

Dr. Sunny Drake: Oh yeah, definitely. I’ve had several cases of LAPIP™. I regularly do frenectomies with it. I have a couple orthodontists who send me patients for just doing frenectomies with the laser because they perceive it and their patients perceive it to be less painful than with a blade. I use a lot with socket grafting. I personally like that; I love the laser.

Marty Klein: Say that again, you (what?) the laser?

Dr. Sunny Drake: Oh, I love it. Love it. Big heart.

Marty Klein: Well, that’s actually a good segue. February, in addition to having Valentine’s Day (there’s the heart segue) is also Gum Disease Awareness Month, and I noticed on your website you have some lengthy and great information on the mouth/body connection and periodontal diseases linked to diabetes, heart disease, pregnancy, respiratory diseases, osteoporosis. I’d like you to talk, if you can, a little bit about your view of the role of oral health as it pertains to overall wellness.

Dr. Sunny Drake: I appreciate the opportunity to answer that question. I feel that as periodontists, we’re in the best position to speak about this. I am always educating all the time, when patients come in, about how the mouth of the body are connected. They’re not separate. You know, dental insurance, it is terrible, and medical insurance is sometimes not much better, and patients will say, “Well, they’re just teeth.” Well, no, they’re not just teeth.

Taking care of your oral health really impacts your ability to have health in other areas, especially when you’re talking about finding pathogenic bacteria in the brain that potentially came from the mouth, when you’re potentially finding issues with the heart that potentially came from the mouth when you’re realizing now, I think the connection even as far as COVID is concerned.  Someone would potentially have increased risk of getting COVID because of having pathogenic bacteria causing increased inflammatory mediators, and that making more a risk of potentially getting that respiratory illness. I think the mouth and the body are connected, and total body health does include taking care of your health. Perio is all about that comprehensive sort of treatment, which is what I love about my job.

Marty Klein: Why do you think that’s less understood or less accepted as obvious by the general patient population?

Dr. Sunny Drake: Well, that is a million-dollar question. I’ve been thinking about that for over 20 years because of my background in dental hygiene. I think that’s when I really first bought into that and started to understand oral health in connection with total body health. I think it is scientifically complicated enough that when you start talking inflammatory mediators, people’s eyes glaze over and they look at you like, “What do you mean, TGF beta?” <blink>. You have to kind of bring it back to something they can easily understand, which is just inflammation in general, and if you poked your arm and your arm bled, would that be normal, right?  No, it’s not normal. I think, just the overall education, maybe of patients in general and their experiences in life with dentistry and hygienists and general dentists make someone either more receptive of believing this is true or not. I think it comes down to basic science. And so, unfortunately, I feel like my primary role, being a periodontist, is educator first, surgeon second, maybe a business owner third. But a lot of it does come back to just being able to explain in less technical, less high chemistry/biology terms, something to a person so they can kind of get like, “Wow, a toothache leading to an abscess could put you in the emergency room.” You know, that still blows people away even now.

Marty Klein: Yeah, I had one dentist put it to me…the phrase was “I wish gum disease hurt more, because if it hurt more, maybe people would take it a little more seriously, earlier.”

Dr. Sunny Drake: Oh, boy, that’s so true. I said that to a patient just last week. He’d had a tooth on the other side that needed a root canal and he says, “Well, you know, that really bothered me, but this hasn’t bothered me at all.” Here’s this tooth on the other side with class 3 mobility, which means flopping in the breeze, but it didn’t bother him at all. I think there is a pain factor that makes it somewhat difficult for patients to grasp how severe perio can be and not be currently hurting them.

Marty Klein: Well, for anyone listening, who would like more information just on the Gum Disease Awareness Month topic, you can go to fightgumdisease.com. We also have a Facebook page, facebook.com/fightgumdisease. We’re always posting information there. I will also plug your website, as I mentioned, it also has a lot of information on there. For anyone who wants to know more about your practice, that’s the place to go to which is Drakeperio.com. Dr. Drake, I want to thank you for joining me and sharing your experience with me today.

Dr. Sunny Drake: Oh, thank you for the invite. I really love this field, and I enjoy the comprehensive nature of being a periodontist. Thank you for inviting me.