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A Quantum Leap in Periodontal Disease Treatment

March 27, 2023

A Quantum Leap in Periodontal Disease Treatment

Glenn Roeder, DDS

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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. Glenn Roeder, a periodontist in Los Angeles, California. Dr. Roeder earned his bachelor’s degree from the University of California at Berkeley and then went on to graduate from USC Dental School and continued there with a two-year residency program in periodontics. He’s been a LANAP-trained clinician since 2006. Dr. Roeder, thanks for being my guest today.

Dr. Glenn Roeder:
Oh, thank you for having me.

Marty Klein:
I just mentioned there you were trained on LANAP in 2006, which is almost 17 years ago. That’s longer than many of my recent guests. So, I’m real curious what piqued your interest in LANAP originally? How did you hear about it?

Dr. Glenn Roeder:
Well, it’s a little bit of a long story, but one time I was sitting around with my kids, let’s see, my son was 13, my daughter was 11 or 12, and I was looking at them. I was thinking, gosh, if they become periodontists, which they didn’t – they’re not in dentistry at all – but if they become periodontists, and they treat patients the same way I treat patients, something’s wrong with our profession. Something has to advance. So I just started doing research about different ways to treat inflammatory periodontal disease. And as the research went on, I ended up finding  Millennium Dental, which was right here in Cerritos, you know, near Los Angeles, the Los Angeles area, and I called Dr. Gregg and we spoke on the phone and he said, you know, come by and take the course. And I took the course and took the laser back and started using it right away. And I’ve just had great results and it’s really been a quantum leap in my treatment of period disease because periodontal disease was the way I was taught, the way I was trained was a resective procedure. And this is really an additive procedure.

Marty Klein:
I was going to ask if you remember any details from that phone call. What was it that Dr. Gregg – this is Dr. Robert Gregg we’re talking about – what was it that he said that made you know, or at least hope, that this was what you were thinking when you were inspired by your kids, as you mentioned?

Dr. Glenn Roeder:
I had in my mind that there had to be, like I said, a different way. And this the way he described it…at that time, they had some preliminary research on the procedure, and the way he described it, it just seemed the procedure prior to that was more like using a shotgun. And this is more like using a sniper’s rifle. You’re targeting the cause the disease, which is the bacteria.  And whatever anybody says, it’s a bacterial disease and we have to target the bacteria and the laser targets the bacteria.

Marty Klein:
Had you had any exposure to lasers at all, either in school or in your profession at that point?

Dr. Glenn Roeder:
Someone I practiced with for a little while had access to a carbon dioxide (CO2) laser that he used to use for frenectomies. And that’s it. That’s the only introduction I ever had to lasers before that.

Marty Klein:
You know, I remember hearing, especially in the 2000s when this technology was getting off the ground, before a lot of the human histology research and FDA clearances had come out, there was a healthy amount of skepticism in the profession about the treatment of periodontal disease with a laser. How would you rate your level of skepticism at that point in time?

Dr. Glenn Roeder:
Well, I think all medical practitioners, by definition, are conservative because we’re taught “do no harm”. So, I think a lot of practitioners are very reluctant to take on new technology until we’ve really been shown that it works because we don’t want to harm our patients. We just want to treat them with something that works. So yes, I had a high degree of skepticism when I went into it because I said that was the way I was trained. That’s my nature. But, I was convinced because I saw the results. I saw how the laser specifically targets the cause of the periodontal disease. It’s no longer a resective procedure. I’m not taking away infected tissue and some healthy tissue. I’m just removing the infected tissue alone and targeting only targeting the infected tissue.

Marty Klein:
Were you aware of any other periodontists in southern California doing this? This was again, a time mostly general dentists were getting trained on LANAP. So, were any of your surrounding colleagues getting interested or getting trained for LANAP at the time?

Dr. Glenn Roeder:
I knew of one other periodontist who was trained in LANAP, but I was greeted with skepticism and I was looked at as an iconoclast because I was kind of going away from, like I said, practitioners are very traditional conservative, and I was taking quite a, especially back in those days, 17 years ago, I was considered a little bit of a radical using the laser to treat periodontal disease. But the results and time has shown me to be a little ahead of my time I guess.

Marty Klein:
Yeah, I was just going to ask, have you seen that attitude change in the years since…over the last 17 years?

Dr. Glenn Roeder:
I think, yes, more and more of my colleagues have taken the course and more and more of them have the laser in their offices. More and more of them are using it on a routine basis. So, I’ve seen a slow evolution of periodontists starting to accept this laser treatment, the LANAP treatment.

Marty Klein:
So, I want to move forward in time a bit. You were, your interest was piqued, you spoke with Dr. Gregg, you came to get trained with some healthy skepticism. What was the point at which maybe after starting to treat your own patients that you thought, “this is doing what I hoped it would” or “this modality is the way that I want to address periodontal disease.” Do you recall when your skepticism became reality?

Dr. Glenn Roeder:
So yes, it’s interesting because there were a couple patients that I had done one half of their mouths with traditional resective periodontal surgery. And I was in middle of the treatment and I did the other half of the mouth with the laser, with the LANAP treatment. And the patients would say to me, you know, on the right side where you treated me, I have sensitivity, It’s hard to clean because more food gets up with between my teeth. But on the side that you did the LANAP, you know, it’s much better and you know, I don’t have sensitivity. And so, it was at that point when I, you know, it was a few cases that I said, you know, there’s something to this. And then there was, as time went on and I saw the results, after six months or a year and I saw the results, I say, I’m getting as good results I got with traditional surgery and as I did do with the LANAP, now why am I even doing the traditional surgery?  To treat inflammatory periodontal disease, I’m going to stick with the LANAP therapy. And so, I came to a point where I stopped, totally stopped doing flap and osseous-type treatment for inflammatory periodontal disease. All those cases I use the LANAP therapy for them. And the results have been as good as I had with the traditional treatment.  Have I had failures? Of course, I’ve had failures. Anybody who tells you that they haven’t had failures with the treatment has never done it. But, just about the same as I had failures with the traditional treatment.

Marty Klein:
Have you found that case acceptance has been consistent, or consistently better maybe than traditional osseous?

Dr. Glenn Roeder:
As soon as I present my cases to patients, when I tell them they have periodontal disease and I present the cases to them and I describe the treatment, I always tell them: this is the way I used to do it. Because most patients have heard about traditional periodontal treatment, you know, cutting the gums and opening up the gums. They’ve heard all that. And so I say, I used to do it this way, but now I use the laser. You see a little light go up in their eyes, they go, wow.

Marty Klein:
Now, you work in multiple practices, kind of a traveling periodontist, and I’ll ask more about that in a moment, but just while we’re on the subject of those early cases and case acceptance, since you’ve been doing this for almost 17 years, I’m curious if you have seen some of your original or just some of the early cases in terms of their long-term stability and healing over the long-term. Have you been able to follow up on some of those first few years’ patients?

Dr. Glenn Roeder:
Well, since I work in other offices, I don’t really get to see the patients at the recalls and the like, but once in a while a patient will come in for reevaluation that I treated 10 years ago or eight years ago, and I’m able to see the results and I’m very, very pleased to what I see most of the time.

Marty Klein:
Good. So, I do want to ask a little more about working in multiple offices. I want to know more about if you primarily offer LANAP in the multiple offices or other services. And if it’s primarily LANAP, it was that something that was a selling point, if you will, in in working into multiple offices?

Dr. Glenn Roeder:
So I’m a full-service periodontist, but as a periodontist I like treating periodontal disease. So, my focus is more on periodontal disease than it is, you know, placing implants. And as that most of periodontal disease is inflammatory periodontal disease. I would say most of the offices I work at, probably 80% of the treatments I do is LANAP. So is it a great selling point? Absolutely, because when the general dentists know that I’m not going to cut their patients, so to speak, I’m going to use a kind of therapy, they kind of market me as saying, you know, Dr Roeder’s coming in and he treats periodontal disease and with a laser, it’s a big marketing plus for them. So it’s been an overall plus, plus, plus.

Marty Klein:
We’ve been talking about LANAP and inflammatory periodontal disease. Have you used your PerioLase for other things around implants, for example, or any other procedures?

Dr. Glenn Roeder:
I use it to do frenectomies. It is a great instrument for frenectomies because you get very little, almost zero bleeding, zero postoperative issues. There are no sutures to take out, you know, the way we used to do frenectomies, there was a lot of discomfort afterward. But it’s fantastic for frenectomies. And then I use it a lot of times for sick implants, the LAPIP protocol, and I’ve gotten pretty good results. I would say about 70% of the cases I treat, I get a good result out of.

Marty Klein:
Well, I have to circle all the way back to your first comments about being inspired by your own children – and you mentioned they didn’t go into dentistry – but it is 17 years later. So did you make the right call with finding a better way?

Dr. Glenn Roeder:
I absolutely did. I mean it’s gives me so much more professional satisfaction because like I said before, you know, when I used to treat periodontal disease, traditional respective, and patients would come back a lot of times and they would almost, they felt that they were worse off than when they came in because air was escaping through their teeth. They had a lot of sensitivity to hot and cold. And I almost felt, I know I was helping them, but it was very depressing for them to come back. Not all of them came back, but someone came back and said, you know, Doc, I’m worse off than I were when you first treated me. And I said, no, you’re not. You’re better, you know, you can clean the area. And it was, it was kind of, you know, a little depressing. So it was nice to have, now that I have the LANAP, I don’t get that anymore. And it’s a much more personal and professional satisfaction.

Marty Klein:
Well, I appreciate your time today sharing your long-term success with the PerioLase MVP-7. I would like to invite anyone listening to this podcast to subscribe to our podcast here, if you’ve not done so already.  All of our podcasts are available at www.lanap.com/podcast. Dr. Roeder, thanks again for taking some time out of your day today to share your story with me.

Dr. Glenn Roeder:
You’re welcome.

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