Seeing healing results with the LANAP® Protocol once thought impossible

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. Ryan Tracy, a general dentist in Clinton, Mississippi. Dr. Tracy is a lifelong clinician at the age of 19. Dr. Tracy became one of the youngest applicants ever admitted to the University of Mississippi Medical Center School of Dentistry. And upon his graduation from dental school, Dr. Tracy opened his private practice in his hometown of Clinton. He’s a lieutenant colonel with the Mississippi National Guard and became a LANAP®-trained clinician in 2013. Dr. Tracy, thanks for being my guest today.

Ryan Tracy: Yeah, thanks for having me, Marty. Really appreciate it.

Marty Klein: So, as I mentioned, you’ve been a LANAPer for going on a decade, so I’d like to go back to the start of the start before that even, you opened your practice out of dental school, like I mentioned. So, let’s start your story from that point. Was perio a part of your practice really in those, in those first years before Lin App?

Ryan Tracy: Not in the very first few years. I was lucky enough in about the fourth year of my practice to hire a very, very sophisticated hygienist, and she had a lot of experience in perio and really pressed me to up our game and, and I put a lot of faith in her, and she designed our initial perio program and executed it with a plum, as they say. And just really showed me what was possible. And of course, that definitely helped our eventual adoption of LANAP®. But, I have to give her the credit of bringing that part to our practice.

Marty Klein: Why, why do you think it was important to her at the time?

Ryan Tracy: Well, she had definitely seen the benefits of it in her past career, and was a big advocate for patients, very adamant to me that this was a need for patients and that, to not do it was a little bit of an abdication of our responsibility. And I agreed, I mean, she made an excellent case, and like I said, we implemented it and it was very successful at a kind of, what I think of as a phase one perio level with just scaling root planning and basic management of the disease. And it really helped our patients. I mean, even at that level, pre LANAP® it was just such a benefit to our patients. And, and the things I learned during LANAP® training further emphasized to me how important perio care is for overall health and overall care of our patient.

Marty Klein: So, it was a bit like a proof of concept that the need is there and the patients are accepting of getting their periodontal disease under control. So, I mean, LANAP® is not the only possible treatment. So, tell me how LANAP® and the PerioLase® entered the arena.

Ryan Tracy: Yeah. Well, of course, when you start doing perio in your general practice, you’re obviously gonna find some cases that scaling root planning is not appropriate for. So, we were referring those to a periodontist. And I quickly learned from my hygienist, and I would joke that there’s two kinds of patients when it comes to going in for reflected flap Osseous surgery, the kind that won’t go and the kind that won’t go back <laugh>. So, we would have some success in referring for a quadrant or two, but a lot of times we found out after that first visit, their experience was not an overall positive one. And this wasn’t specific to any periodontists in our area. We referred to several and it was just the nature of the beast. We have excellent periodontists in our area, but just the nature of reflective flap surgery is something that patients don’t find really attractive.

So, it was something that we always felt like was a barrier, and our periodontist’s kind of agreed and, and knew, knew that we were having that experience. And so, when some of our local periodontists were adopting LANAP®, they began, of course, to educate their refers, me included. And one, one early adopter in our area called me several times and said, “You got to send me a patient.  I want to educate you on this so you can know how to prep ’em for it. And of course, I was very interested, asked a lot of questions, and one of the things I’ve never really been a big fan of is I don’t like to reflect a flap. It’s just not something I really prefer to do. So, I had always wanted to consider an option to treat these types of cases in-house, but I just felt like conventional periodontal surgery was something that wasn’t going to be effective in my hands, and really was a little further down the rabbit hole than I wanted to go from an operational perspective, <affirmative>.

So when they started to bring this up, I immediately started asking, yeah, well, do you reflect a flat for this? And they said, no. And I said, well, wow, you know, and he was explaining to me the basics of the protocol. And so I referred a couple patients and the patients came back with, of course we were very eager, how was it? <affirmative>. And they said, you know, it was a non-issue. It was just almost, you know, nothing to it is what they kept saying. So, you know, after a few months as we start to see the healing process occur in those patients and the periodontium repairing itself, we were just like, wow, this is kind of crazy. So again, my periodontist kept saying, it’s so easy, you know, and, and we’re having success. And one day I just heard him saying how easy it was for about the fifth or sixth time, and I thought, well, if it’s so easy, why am I not doing it? So, I looked up Millennium on the internet and called and got some initial information, and of course we had a due diligence process. Uh, but at the end of that my hygienist and I had decided that it was something we wanted to do and kind of jumped in with both feet.

Marty Klein: Was that periodontist aware that you were getting trained? Was he supportive of it, or a little jealous that now he just lost a referrer?

Ryan Tracy: Well, I don’t remember, honestly. You know, I mean, there were still obviously things we referred to him for down the pipe. I don’t remember what his initial reaction was or if he was even aware of it, to be honest. But, you know, there were other things that we referred him for. So, we didn’t sever that relationship. It was still a good relationship.

Marty Klein: And there’s no shortage of Perio in general?

Ryan Tracy: Oh, absolutely not. Absolutely not.

Marty Klein: Oh, so you decided to, to investigate this for yourself, had you used any lasers at all prior to this?

Ryan Tracy: No, none. I had used a laser pointer <laugh>, but you know, other than that, no. And, you know, really the due diligence period for LANAP® in just making this decision was, was very interesting because so much of what LANAP® promises to do, you know, at least from, from my education, we were just told was impossible. And so, the skepticism level was very high on my part and my hygienist part. So, something we decided to undertake was we googled LANAP® providers around the country, and we compiled a list of 35 LANAP® providers, none of which were named supplied by Millennium. We purposefully avoided those because we were pretty skeptical, you know, healthy skeptics. So we called these people that were in no way recommended by Millennium. And I just asked them, does it work? I asked a real simple question, does it work?

And of about the 20-22 people, I think that called us back, they said, yeah, it, it works. I mean, it legitimately works. And I said, it is kind of half what they’re promising is true, 75%. And they were like, Nope, a hundred percent of what they say is true. And I was just blown away. I just thought, this is crazy. This is an absolute crazy proposition that this company is holding out there. And it’s even crazier to me that it’s being confirmed universally by people who are using the protocol. So, we bought it.

Marty Klein: That’s a case study and due diligence, if I’ve ever heard one

Ryan Tracy: Yeah. Well, you know, when it comes to money that you’re gonna spend in your practice, it’s not a small investment. And also something that you’re gonna expose your patients to you, it’s not a small investment you’re asking your patients to make either. So, you know, really doing the work to make sure that this was what was first off best for the patient. And then of course, what was also productive for the practice was important. But when you get a hundred percent, and it was literally a hundred percent not, not one person that I spoke to at that time said that it was anything less than exactly what Millennium said it was. And that was definitely my experience too, over the next 10 years since I, since I initially got it was, yeah, I mean, it, it does what you guys say it does.

Marty Klein: Well, don’t, don’t get too far ahead of us of, of our story here. So, you had, uh, quite high expectations, but you’re feeling good about going into training. Uh, you go to the training. Did you feel comfortable and confident that you’re ready to start treating your own patients with a laser that, I mean, you’ve only ever used a laser pointer before. So <laugh>, was it as easy as the, uh, periodontist told you it was?

Ryan Tracy: Yeah, it really, yes. I mean, the procedure could not be more straightforward, and the training is world class. I mean it’s just really well thought out, really well prepared, really well executed. The information is thorough, you know, from a theoretical background to a pragmatic implementation of the laser from stem to stern, the training, you know, I left there, I think it was three days of training, if I’m not mistaken. And I really felt like I was ready to, ready to roll that I could do this. And it just, it’s very evident once you go through the training that this is not an operationally complex procedure. There’s really not a huge learning curve for this. It’s very straightforward and, and easy to implement.

Marty Klein: All right, so you, you do, so you implement it in your practice. Let’s, let’s go over the next year or two. You start seeing some results. Did they live up to what you expected?

Ryan Tracy: Yeah. And the, you know, the interesting thing about LANAP® is after you take the leap there, it’s per the protocol, you know you do have a, an elapsed period of time there that’s somewhat significant before you can assess the case. You know, you really,  don’t want to go probing sub gingivally to assess too quickly. So, it takes a little bit, you know, during that, uh, period between when you initially treat some people and are waiting to assess those first results, it was, you know, like, wow, it was a lot of anticipation. But I remember when we got our first patient back, I’ll never forget this case, it was an older lady in our practice, longtime patient number 30 was just, I mean, huge fercal involvement, you know, lots of bone loss on the distal root. And I said, you know, let’s, let’s give this a try.

This seems like a perfect situation. Well, even, you know, like an initial recall through her post-operative period at the four week mark pre-op, this tooth was highly mobile. And even at four weeks, it was just tight as a drum. I mean, almost no mobility at all. It was just astonishing. And of course, over the next year, we literally saw bones start to regenerate in the furcation and up the distal side of the distal root. And my hygienist and I were just sitting there going, this is nuts. And you know, we were so elated, you know, we would do some radiographic examinations over the course of that first year and, and looking at the probe depths, and we would get so excited. The patient was kinda looking at us like we were crazy. And I had to tell her, you know, like, you don’t understand. They taught us this was impossible. Like we were taught this can’t happen. So, we are just kind of beside ourselves that this is what we’re observing in our very first case. And we had that experience over and over. I mean, you know, probably on some of the most recent cases I did, it still strikes me that way. Like, wow, you know, this is, so, this is still amazing what the difference between what I’m actually doing in my practice and what I was told was possible in dental school.

Marty Klein: And, and your hygienist must be jumping for joy at this point.

Ryan Tracy: Oh, absolutely. Yeah, absolutely. I mean, it is so important to consult your hygienist because obviously, you know, she was a big proponent of perio to begin with, but if you don’t have buy-in from your hygienist, it can change stuff. And, and so go through that journey with them and they’ll see they’re educated professionals as well, and you present them with the data that you’re discovering and they’ll, they’ll get it. And boy, once they do it is on, because they get very excited about it. You know, knowing that no longer do they have to have conversations when they discover an eight or a nine-millimeter pocket depth. We’re not talking about undesirable things. You know, we’re talking about very cost effective, very clinically effective options for them that restore health rather than kind of admit defeat.

Marty Klein: Yeah, no, for sure. This is, this is great to hear all of the clinical outcomes you’re seeing. And of course you mentioned how you wanna do right by your patients. You also mentioned the investment component having put out a decent amount of money to get this rolling in your practice. So of course, return on investment is also important. Did you find that that followed, or can you speak a bit about how the return on investment went after incorporating this?

Ryan Tracy: Yeah, definitely. There was an initial time when you’re kinda like, okay, let me get my feet underneath me and let me see how this is working. And,  but as we show those first results, even from that first case that I just described, boy, your confidence level just skyrockets. And from that point on, we were recommending it all the time. And once you understand, you know, what LANAP® is capable of, not every case by any stretch of the imagination, but more and more cases start to seem LANAP® appropriate or LANAP® appropriate. So, we just started recommending it to basically, if they had sixes or above, you know, generalized sixes, we were saying, Hey, look, you need to be thinking about this and kind, uh, you know, cause this has a, this has a real good shot of getting you back to threes and twos. And for the record, we have seen thirteens go back to three and two.

So yeah, all sorts of pocket depths will resolve to crazy numbers. And I know people who have not done this. That sounds like I’m a lunatic, but that’s the truth, that you will see that type of bounce back. It’s, it’s absolutely mind-boggling. But yeah, the return on investment was unbelievable because we had a lot of backlog of perio. What we discovered when we had the laser was, you know, we started looking, who has not accepted treatment for phase two perio? Who have we sent to the periodontist that just didn’t wanna go? And it was a lot of people, a lot of people, and like I said, even people that had gone but hadn’t finished up their treatment at, in the periodontal setting. So, we immediately upon seeing those first results were mentioning to them at their next recall visit.

And as soon as we were telling them, this is not what we have presented to you before, there’s no cutting, there’s no stitching, you know, there’s no pain. And for the first 50 patients I did I kept a log in my computer and they’re in my office, the first 50 patients that I got back, I asked them, what was your level of post on scale of one to 10? What was your post-op level of pain? And I got the answer one and zero for all of the cases except one where I got a three reported. So, I got so bored with asking the question because it was always zero or one for all intents and purposes that I became a hundred percent confident in telling my patients, you’re not gonna have post-op pain. You’re just, you’re not. And that’s remained true throughout my practice with LANAP®.

So the return on investment is there, I mean, your first year with it, you will easily, easily make back the money that you spent on the laser, if not, if not close to double. And you know, in our case it was, it was well over what we had paid for it. So, and then from there on, it’s, you know, there’s just really no expenses associated with the procedure. You don’t have any lab, you don’t have a, you know, any sort of significant supply investment. It’s really a very low to almost no cost procedure that, you know, for no investment. And from a  patient perspective, how I used to tell my patients about why they should make this investment is I would say, look, you know, we got one of two choices here. We can do an LANAP® and we can have a very high probability of preserving your teeth for a number of years, or we can kind of continue down this road and over those same number of years, pull a number of teeth and construct you some sort of replacement. You know, the cheapest replacement we can offer you is a denture, but it’s by, I still feel this way today. It is the best value I offer my patients. There’s just no way around it. It is by far the single most valuable option I offer my patients of, of anything including an occlusal, you know, I think an occlusal is a, is a worse deal than, than a case of an LANAP®, honestly.

Marty Klein: Well, it’s very clear your enthusiasm for this and, and for your patients. I mean, just, I started by asking about return on investment and you told me about pocket depth reductions and patient acceptance and, it’s just so clear that it works on both cylinders for your patients and, and also for your practice. I am curious though; you’ve been doing this almost 10 years. Have you seen some long-term results?

Ryan Tracy: Yeah, absolutely. I mean, it really does hold, there are a handful of patients that we may have treated twice in 10 years, but the vast majority of them have just been where the results have held long term. And so many patients. It’s funny, you know, we think of cosmetic dentistry being this life-altering thing for patients. For a lot of patients, the LANAP® is just as impactful. I have had a number of patients that at the mark where we kind of gauge the depth of disease and we realized they see the difference in the radiographs, they see the difference in the probe depths, and they just kind of, you know, I had a grown man baseball coach break down and cry in my office because he thought, wow, this has worked. And I’m, you know, I’ve been told for the past several years I’m headed towards dentures and now I’m not.

And he was, it was just life-altering for him and so many other patients. And that’s, that’s the exciting part of dentistry. And that’s the part where you really see this is so important to people. You know, it’s just, it’s about more than, I mean, of course the disease element of it is a crucial importance, but it’s about more than that. This is about quality of life for your patients. And they get it. They really will get it. And they feel confident when you feel confident. And what you see is when the results are happening very repetitively and very predictably, and they’re lasting for a good number of years and, you’re not having to touch it again, other than regular types of periodontal maintenance and regular, routine recall type stuff, you know, it’s just, it’s a win-win. It is the best thing you can do for your patients, and it’s an absolutely phenomenal thing to do for your practice.

Marty Klein: Well, I want to thank you for your time today, and like I said, your enthusiasm shines through and, hopefully if anyone listening is, is thinking about doing this, they won’t have to call 25 other providers, but just listen to your words in this podcast representing all of them. If anyone listening here would like to hear from other LANAP® clinicians their experience, we have, over 50 podcast episodes already out there. You can listen to them at www.lanap.com/podcasts or of course, subscribe to this podcast anywhere that you downloaded this one. Dr. Tracy, again, thank you for your time, uh, today and joining me for your LANAP® story.

Ryan Tracy: Oh, thank you, Marty. It’s been pleasure. I appreciate the opportunity.