September 28, 2020
Alan Farber, DDS
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. Alan Farber, a periodontist on Long Island, New York. Dr. Farber earned his DDS degree from the University of Texas in San Antonio and Periodontal Degree at the University of Pennsylvania, School of Dental Medicine. He serves as an assistant clinical professor in periodontics at Stony Brook School of Dentistry, among other educational appointments and positions. Today we’ll talk about his road to using the PerioLase MVP-7 for the LANAP protocol, his use of it in multiple practices for both teeth and implants, and his focus on education with the International Association of Dental Specialists. Dr. Farber, thanks for being my guest today.
Dr. Alan Farber: Well, thank you, Marty, for having me.
MK: Well, we’ll start in our usual way. You first came to training on the LANAP protocol in 2014. So let’s think back to before that point and how you first became aware of LANAP and what pushed you to get trained.
AF: I was very well aware of it. I was hesitant, like most of us in the beginning – newer technology, waiting for the science, and waiting for the research. What started me looking into it was a few things: one being a director of the Seattle Study Club, I had a lot of friends and colleagues that were adapting the LANAP protocol. They were all people I respect in the industry, in the periodontal industry and oral surgery and they said, “Alan, you need to try this. You need to, as we say, sometimes drink the Kool Aid.” So I started doing some research into it, and even a friend of mine – who is not even a dentist – was starting to hear about LANAP. He said, “Alan, do you have a laser in your perio practice?” This is a very good friend who’s in the business world, but not even a dentist, and I’m like, How did you hear about this? Between the two of those situations I said, you know, I have to really do my due diligence and investigate. Should I take on this newer technology into my practice? So I began about a year of meetings and talking to multiple periodontists that had adapted the LANAP procedure and made the decision to go for it.
MK: How did that friend find LANAP? Did he did he answer your question? How he had heard of it?
AF: He is a big internet surfer, and researches everything. He was told he needed periodontal surgery, conventional surgery, he was looking for alternatives, and that’s how he came about the find.
MK: And had you used any other lasers up to that point?
AF: I’ve had a little experience with CO2 lasers and diode lasers, but not anything extensive.
MK: So you did your due diligence, came to training, received your PerioLase. How did it go right away?
AF: A little scary at first because, as for those of you know, the procedure is not to do any probing for the first nine months to a year. So we’re all waiting nervously to see how our results were. That was the only thing that you know, those nine months of doing multiple cases. I’m saying to myself, “What if this really doesn’t work. I’m really in trouble.” So the answer was the results were great. The interesting part was I went to see a lot of my referring dentists, who sent me isolated periodontal procedures, not too many full-mouth cases, and when I introduce them to LANAP, they said, “Wow, I think I have some patients I can send you.” So my practice, which had evolved from initially almost all periodontal treatment, then implants, then maybe even more than 50% implants, all of a sudden I started practicing periodontics and saving more teeth (which is the reason I went into perio), and the results were great. I mean, we did a lot of cases, actually, I was purchasing a lot of fibers and you know they last quite a quite a long time. So what it did for me was swung my pendulum back to why I went into periodontics in the first place was to save teeth, and it really changed my practice and still has. We’re still treating a lot of periodontal disease & saving teeth longer. We’re seeing problems now, as we all know, with dental implants, so to me, if we can save the tooth, realistically, let’s do it! Patients really accept the protocol, even patients that had conventional surgery in the past, their eyes light up when they hear the word laser. To me, it’s just really enhanced my practice and my life.
MK: I do want to clarify just for anyone unfamiliar with the fiber comment, the fiber is the delivery system from the laser to the mouth. So the more cases you see, the more fiber you go through and therefore need to purchase more. You mentioned a lot about implants there. Did you start using the PerioLase for LAPIP peri-implantitis treatment right away? Have you done much of that since?
AF: I did not do a lot of it initially. We were kind of instructed during the training, to perfect the procedure first on teeth, and I tried to follow my instructors. Ray Yukna was one of them, I have a lot of respect for him. So I hesitated in the beginning and did mostly periodontal treatment with the LANAP treatment. Then we gradually increased to doing more LAPIP procedures. My practice I’d say is probably 80% perio with LANAP treatment and 20% LAPIP treatment. But we are seeing very positive results with the intriguing peri-implantitis.
MK: So since that time, meaning when you first were trained, you’ve grown in terms of purchasing two additional PerioLase units and also had two of your associates trained to do the LANAP procedure. I know that you work out of two offices currently. So can you tell me a little bit about that decision process to expand your LANAP offering in that way?
AF: Well, in the beginning, we were actually moving the laser from one office to another and as the number of patients seeking treatment and accepting treatment increased, we found that it didn’t make sense not to purchase another laser. My two associates have been with me for many, many years. One is actually a partner in a large practice in Manhattan. I said, “This is the way to go, Chris. You need to get involved with this.” His whole group in Manhattan proceeded to get trained with it, so they ended up purchasing lasers. Then my other associate, she got trained because it didn’t make sense for not the whole team to be practicing the same way. So we’ve now gone almost exclusively for treating periodontal disease using the PerioLase. Of course, we do other surgery, but it made more sense to have multiple lasers in the practice.
MK: So the patient demand must be there to have three of you do LANAP with three different PerioLase units. That’s a lot of production capacity.
AF: Yeah. In the beginning, part of my hesitation, Marty, was I was doing more implants than perio treatment or 50/50. One of the hold backs to purchasing and the investment was I’m wasn’t really practicing that much perio – a full-mouth perio that is. After purchasing it and talking to my referrers, explaining the procedure, all of a sudden I started getting more referrals for full-mouth perio treatment. I would say, my 1st 2-3 years I did more periodontal treatment with the PerioLase than in the past five years altogether. So been a big boost to the practice & the investment in these other lasers was worth it, obviously. I wouldn’t have done it otherwise.
MK: Yeah, they must have paid off. I want to switch gears a bit. You certainly have a concentration on education, outside of your private practice. I mean. You mentioned Seattle Study Club, you’re on faculty at Stony Brook, and you also have heavy involvement in, and I’d like for you that tell us a little more about, the International Association of Dental Specialists or iADS. On top of that, you went through the certified instructor program with the IALD. So can you tell me a little more about your passion for education and about the iADS?
AF: Absolutely. Thank you for asking. Well, I’ve been running a Seattle Study Club for about 23 years now, so I really enjoy that. I really enjoy working with my group of general dentists and interdisciplinary dentistry. Then I started a Spear Study Club – just because I had so much free time (laughter). Then, teaching the perio residents for the last 23-25 years. It’s gotta be more than that, maybe 30. I wanted to help them to learn the LANAP protocol, and I thought, if I could get certified as an instructor, I can help bring that to Stoney Brook. We’re still working on that, but I did go through the training with the IALD, which was fantastic. I really thought after going through BootCamp and then Evolution four and five that I was an expert in LANAP, but that’s not true. It’s just the beginning. It’s sort of like dental school – you don’t know what you don’t know until you get out and keep going for more learning. So becoming an instructor was challenging but rewarding. I did learn a lot more about using lasers and using the PerioLase multiple ways, so that was fantastic. We’re still working on Stoney Brook, but that’s another story. From there, I’ve always enjoyed speaking with different specialists across the country, and about 20 years ago I started an open email LISTSERV and it just grew by itself to over 400 members. Then in November, we decided to launch iADS, International Association of Dental Specialists. It’s an online community and it’s open to all dental specialists. We just wanted, initially, to limit it to certified specialists. Then once we get our foot very established, we’d like to then incorporate general dentists to work together with specialists. That’s what our goal is, to help general dentists and specialists worked together to help patients.
Right now, we’ve set up the online community to help all dental specialists: We have webinars, virtual cocktail hours, and coffee hour, and it’s been growing fantastically. We’re now in a few countries, as well. Ultimately our goal is to really help educate the public about why they should see a specialist, when they should see a specialist. Because I feel, unlike our medical colleagues who have really helped educate the public, in the dental world most patients do not understand. They don’t even know what a periodontist is, half the people you speak to, let alone a prosthodontist, or endodontist…oral surgeon I think they know. So that’s what we’ve been working on and growing, and it’s been a new adventure, starting in a whole new community for specialists. The advantage now between social media, Facebook, Instagram, and other sources of social media really help us grow and we’re branding ourselves. The goal here is to help specialists, general dentists, and patients by having the best interdisciplinary care for them.
MK: The website for the iADS is theiads.org for anyone interested in learning more. You mentioned that it’s primarily, or maybe completely online, and a few different online services that are available. We’ve been doing a lot of online learning over this spring and summer of 2020 with COVID-19 really prohibiting in-person learning. What have you have observed in that area? Have dentists been more willing to accomplish their continuing education online? Is there part of that that might stick around?
AF: I really believe so. It’s interesting that you ask that question. When we launched iADS in November, our goal was to have live webinars, where people could participate and ask questions, so nothing pre-recorded, and we started with that premise. The one positive thing out of COVID is dentists and patients became or accepting of Zoom meetings and other virtual meetings, so it really helped us grow together as a community. We would meet every day for coffee hour at 12 o’clock, and we grew together and help one another get through COVID. It was a big support for the iADS. Now with my restorative doctors and colleagues, we also had Zoom meetings and helped each other during this time. Even patients now, I’ve been meeting with my new patients before they come in we do it what we call a medical dental history interview ahead of time. I get to meet my patients before they even walk in the door, so I think that’s here to stay. I do miss meetings and seeing you in person, Marty, at perio and AO meetings, and my friends. I do miss social part, but I think that this is helpful. We can now save a lot of travel time, and I can go to a lecture in Italy if I want. I mean, I’d rather go to Italy for the pasta, but I think it’s here to stay. I think there’s a lot of positives to it.
MK: Good. I appreciate and respect your expertise and thoughts in that point. I also want to point out your website for anyone wanting to know more about your practices on Long Island. And that website is LongIslandperio.com. I invite you the listener to subscribe to this podcast so that you don’t miss any episodes if you haven’t already. We’re available wherever you download podcasts or also at LANAP.com/podcast. Dr. Farber, thanks again for joining me and being my guest today.
AF: Thank you, Marty. It’s been a pleasure.