Putting off retirement with the PerioLase® MVP-7™

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. Jill Hayes, a periodontist in Louisville, Kentucky. Dr. Hayes earned her dental degree, graduating 1st in her class, from the University of Louisville and her periodontics certificate from the University of Kentucky in Lexington. She’s a solo practitioner and serves as a Certified Instructor with us at the IALD. Dr. Hayes, thank you so much for being my guest today.

Jill Hayes, DMD: My pleasure. Thanks for asking me.

Marty Klein: Well you first trained on LANAP® in 2010, so it’s been over a decade now. And I’d like to go back to just before that point when you first heard about the protocol and then the sequence of events leading you to be trained.

Jill Hayes, DMD: What happened in my case is a fellow periodontist who was already trained actually called me up and said, you need to come see this, come to my office and see me using the PerioLase® and just come see. And at that time in the Perio world, lasers were not thought of very highly. So I said, okay, I would like to come. And so I did. And I saw and I trusted him. And then I started looking into the PeiroLase a little bit deeper and noticed Dr. Yukna was involved with it and I had a lot of respect for Dr. Yukna and looked at his research and you know, I was basically blown away by it and then just went ahead and decided to go and train and see what this was all about.

Marty Klein: We do hear that a lot about a colleague was the first person to introduce you to the PerioLase®. Were you skeptical at first or what did this colleague show you that made you really want to look into this?

Jill Hayes, DMD: Well, he actually was working on a patient and he showed me some before and after pictures and x-rays and I just… I got to see it with my own eyes. And so I decided to just to take a closer look at it. The patient was very gratified by having the procedure done. This was the second side that they were doing. So he had already had the first side done and was just raving about it. So that really caught my attention.  At this time I had been a periodontist for 20 years and I was doing quite a bit of traditional osseous surgery and you know, the patients don’t really care for that treatment. It’s painful, it doesn’t look good. Sometimes you would do half their mouth and they would never come back to get the other side done and it just wasn’t treatment that I could feel comfortable doing anymore. So I was very open to looking at something new.

Marty Klein: You also mentioned that the AAP had a critical stance of lasers at that time. Did that make you also skeptical? And, and has that changed in within your profession in the last decade?

Jill Hayes, DMD: Yes. That definitely had an effect because all of my peers were pooh-poohing lasers, so to speak. So yes, I was skeptical. As a matter of fact, I’m the president of the Perio Society in Kentucky and so I was very quiet about what I was doing to be honest with you. I was the first periodontist in Louisville to, you know, to have the PerioLase®. So once I got it, I did my thing, I treated patients and I really didn’t say anything until after the year; I waited until a year to probe. And so once I started seeing my one-year results, I literally started calling some of the other periodontists in town. And I said, you need to look at this. It’s for real. This really does work. And I actually brought a speaker to the Kentucky Perio society meeting. And of course everybody sat there and looked at, you know, like, like he had two heads of course. But you know the proof is in the pudding, right? So when you see the patients coming back, and the tissue is the healthiest tissue I’ve ever seen, and the patient’s teeth are tight and the patients say, oh my gosh, it feels so good, I can eat. I haven’t lost my teeth. My gums don’t bleed and they’re happy. And they’re telling other people about it. You can’t go wrong with that. People never told anybody about traditional osseous surgery other than how awful it was. So the patients really, they’re so appreciative of this treatment. They love this treatment. As a matter of fact, we had somebody come in the office not too long ago and said, ‘I hear that miracles happen in your office’ and I absolutely loved that. I’m like, yes, miracles do happen in our office. We have patients now that have saved their teeth for 10 years. They went to other people, they wanted to take teeth out and they still have them because they came and did the LANAP® Protocol and they still have their teeth. So it is it’s a miracle and it’s such a joy. It’s a joy to go to work now.

Marty Klein: That is the kind of word of mouth that you want, not the opposite. I do want to follow up on one item that you mentioned in there, just because not everyone listening might understand the part about waiting a year to probe. Can you explain more about why you did that and why that’s advisable?

Jill Hayes, DMD: Well, you know, the soft tissue heals pretty much immediately almost in front of your eyes. You can see the laser literally taking away the inside lining of the pocket where the inflammation is. The purple tissue literally changes in a week. They’re pink, but the bone takes time to heal. Just like if you broke your leg, the soft tissue heals fast, but the bone takes time to heal. So it’s the same way in the mouth. We have to give time for the bone to heal. And of course, it’s all going on down underneath the pocket, you know, down underneath the focus area. So I don’t like to probe until it’s been after a year. Usually it ends up being about 14 months by the time we get the three month cleanings in there, it ends up being right about 14 months. That’s what I have leaned towards is about a 14 months post-op where we do check the healing, check the a new x-ray so that we can compare the bone and just see what type of healing that they’ve had. So that’s what we do.

Marty Klein: And have you followed patients over the course of the last decade? You said you waited a year to probe. And you explained that a little bit. Tell me about what happens in the years to come, the long-term results, if you will.

Jill Hayes, DMD: Well I still have a lot of patients in my practice that we started with in 2010. And as a matter of fact, the very first person that I did, he’s still coming around and he still has all of his teeth. So, yeah, the results are incredible. Occasionally you might find a patient that needs to be retreated in an area here or there in the mouth because it is, you know, 90% successful. So that means you might have a spot here or there that might need to be retreated. What I find is that the really deep, deep pockets, like say, 10 millimeters or greater, sometimes those are the ones that need more treatment. Because if you think about it, it’s easier for a six or seven millimeter pocket to go back to the three millimeter normal range than it would be for a 10 to 12 millimeter pocket going back to the normal range. And so all that is explained to my patients upfront. We actually wait for three years before we do any re-treatment in my office. Because the studies have shown that LANAP® can heal for up to three years. So if they have an area that’s not totally beautiful and perfect we just keep them on the three-month maintenance. And every patient in my practice, my hygienist; I actually bought a laser for my hygienist to use as well. And I have two hygienists and they’re both trained to use the PerioLase® and every single maintenance [appointment for periodontal patients]. We use the PerioLase® as well just to keep the bacteria count down to give them the most enhanced capability that they can, [in order] to get the healing that we are expecting to get.

Marty Klein: I did want to ask about that, meaning your hygiene department also using the PerioLase®, not for LANAP®, but on lower-level settings were allowed by state board, which it is in your state. I noticed that you purchased a second PerioLase® four years after the first. Does that second unit stay in your hygiene room?

Jill Hayes, DMD: Yes, it does. It stays there all day long. They use it. So as I said we use the PerioLase® on every single maintenance patient and then they [hygienist] can also use it. Sometimes the patient will have a sore area or a sensitive tooth. And so I have shown them how to do the desensitization and how to use it to do biostimulation which the patients are thrilled over. I mean you can have someone where their TMJ is really flared up and just shine the light on in a non-contact manner. And on a certain setting on the PerioLase®. And it’s just basically instant relief. It’s amazing.

Marty Klein: That’s another area I wanted to get into because I understand you have a special interest in neuropathy or treating numbness of the nerves. And I do need to fit in before we get too far down this road that the use of the PerioLase® for biostimulation or photobiomodulation is an off-label use. It’s not one that is cleared by the FDA for nerve paresthesia. But I would like to hear your perspective or your experience in using it for that purpose.

Jill Hayes, DMD: Well, I have used it many times, especially like after I have done a certain type of surgery, for example, maybe a gum graft around the mental framing area. I have used it in a post operative manner there just to help. Because sometimes those areas get swollen and that kind of presses on the nerve and then the patient gets a little concerned; and I just pretty much explained to them right off the bat when we do the surgery, that if this happens, don’t be concerned about it because we can help that to go away very quickly. So there’s really no problems with if you get an area that’s swollen, the PerioLase® can help with swelling just immediately. Like, like I said a minute ago, you basically get immediate relief from the swelling and so that’s going to help that swelling. If it’s pressing on the nerve, that’s gonna help the nerve to feel better of course. So, I do have some other patients that have come to me that have had third molars removed and they’ve had some long standing neuropathy and just using it in that manner as well. Again, it helps at all to get better. That’s all I can say is it helps it get better.

Marty Klein: I understand that’s not the only thing that you use your PerioLase® for outside of LANAP® of course. Can you tell me about some of the other VAPs (or value-added procedures) that you use your PerioLase®? I understand you use your PerioLase® almost every day.

Jill Hayes, DMD: Yes, I do. I do. One of the most exciting things is when you have an extraction and you use it in the socket. So a lot of times I’ll do a bone graft in the socket and you can use the PerioLase® to help to decontaminate the area. And also it’ll stop the bleeding because of the homeostasis setting. And the patients come back and they tell me that they do not and did not have any pain. And that is very exciting to think about taking the tooth out, and you know doing a bone graft, so sometimes you have a flat, sometimes you don’t, but sometimes you have stitches, sometimes you don’t. For the patient to come back and say they don’t have pain. And sometimes I’ve seen them the very next day; it’s not like I’m seeing them two weeks down the road the very next day and they don’t have pain. So when I use the PerioLase® for LANAP®, I have the best way for me to do it these days. I have come to this realization is, I do half of their mouth on Monday and the very next day I do the other half. And since I’ve been doing that, I have not had one person not return for the second side. So that tells you right there that they’re not having a lot of pain if every single person is coming back.

Marty Klein: Right, coming back the next day, then that would otherwise be perhaps the most painful day after traditional surgery.

Jill Hayes, DMD: Oh, yeah, exactly. When I was doing traditional osseous surgery, I can guarantee you I did not want to see my patient the next day. They would not be happy.

Marty Klein: Well, I did want to ask, but I think you’ve already covered this. But I do want to point out for the listeners when you and I were setting up this interview, I found it interesting that you divided your career in periodontics into two parts. You said you practiced for 20 years before the PerioLase® and you’ve had my PerioLase® for 11 years, almost like that was a turning point in your career. Is that a fair statement?

Jill Hayes, DMD: Yes, it is, every day is a joy. And I can’t even tell you just how much fun it is to go to work now. It doesn’t matter what’s on the schedule, it’s gonna be a great day because this has literally turned to my entire world upside down for the good. It really has, it’s easier on me as a practitioner. It’s so much easier on my patient. I mean, I tell them there’s really two bad things about it. One bad thing is I have to get you numb, the other bad thing is you have to be on a special diet for a week. That’s pretty much it. And this treatment is also easier on my assistants because they don’t have a bunch of instrument trays to clean. It’s easy to clean up. The expense, really, I don’t have a lot of expense, you know, the initial expense of the laser and then the fiber, but it’s just… I can’t even tell you, like I just said, it’s a joy now to go to the office.  I’m 62 years old and everybody around me is looking at retirement and I’m like, why would I want to retire? I love what I do, I love what I do, I work three days a week and it’s perfect. If I do want to take a week off, I can take a week off. It’s just made my life so much easier to concentrate on all the great things that I can do with the laser. So that’s what I’ve decided to do. And it’s just been such a joy.

Marty Klein: Hopefully it’s a joy to for the residents coming out of your alma mater at University of Kentucky. They’re getting LANAP® exposure and most of the way trained just as part of their periodontal residency.

Jill Hayes, DMD: Yes, I think that is awesome. It’s just really great.

Marty Klein: Well, Dr. Hayes, I want to thank you for your enthusiasm. I also want to point out to our listeners if anyone would like to know more about your practice. If you search on Facebook for “Periodontal Care Center”, you can find more about Dr. Hayes and her Louisville, Kentucky practice. If you are not yet a subscriber to this podcast, please do so. Or head over to LANAP.com/podcast for all of the previous episodes. Dr. Hayes, once again, thank you for being my guest today and sharing with enthusiasm your experience with us.

Jill Hayes, DMD: Thank you. Thanks for having me. Have a great afternoon. Bye-bye!