December 7, 2020
Andy Satlin, 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. Andy Satlin, a periodontist in Los Angeles, California. Dr. Satlin received his DDS from the prestigious Arthur Dugoni School of Dentistry at the University of the Paciﬁc and went on to the University of Southern California for his residency in periodontics. He serves as a certified instructor with the Institute for Advanced Laser Dentistry. Dr. Satlin, thanks so much for being my guest today.
Dr. Andy Satlin: Oh, you’re welcome, Marty. I’m glad to be here.
MK: We like to start by allowing you to tell your LANAP story from the very beginning. And in your case, you were an early adopter of the technology, especially as a periodontist back in 2003. So I’d like to first ask how you first heard about LANAP back then and how you decided that it was right for you and your practice.
AS: Interesting story, really, and sort of random in that I practice part time in Lakewood, California, which basically borders Cerritos, so very close to the training center there. I was, in fact, in the building looking to meet up with a friend of mine who practices right across the hall from the training center. As I’m looking around for his office suite, one of Dr. Gregg’s employees saw me looking around and sort of asked me if I needed directions, then asked me if I was a periodontist, because the gentlemen I was looking for was a periodontist. It just sort of turned into a little conversation. She said, “Have you heard of the laser?” In fact, I had not, wasn’t looking, hadn’t heard much of anything about this particular laser at all. She asked if I wanted to meet with Dr. Gregg, and I thought as a local periodontist looking for referrals anyway, I thought I would say hello to a local dentist. Dr. Gregg showed me some before and after X-rays, and we chatted, and I thought to myself, “Wow, you know, can I do that? Can you show me how to do that?” I don’t think I was a hard sell. I saw some interesting stuff. He told me how he was doing it. Was I skeptical? Sure. But he was never… It wasn’t a pitch. It was like, “Look what I’m doing here. And you could do it too.” And I thought, “Wow, what an amazing option for my patients.” Now, we could get into the whole conversation about lasers and my history and lasers and what was going on in medicine and dentistry. But short version is I met Dr Gregg, I saw these x-rays, it piqued my interest, and I wanted to try it.
MK: Did you realize that you were one of the earliest periodontist to do it at the time?
AS: At the time I did not. Once I completed BootCamp and did a little more inquiring, I realized that I was in fact, the second periodontist to purchase the PerioLase. There were a couple others trained, Dr. Yukna being one of them, which, because I knew he had done a study and had positive results, sort of helped me over the hump to, “Okay, I’m going to do this.” It was a funny time, 2003 lasers were not accepted by the perio community at all, and I certainly didn’t want to get in any trouble. I didn’t know if there’s anything that I wasn’t supposed to be doing with it, but I didn’t realize how few periodontists were doing it. Then, later on, I kind of liked it. I was the first periodontist in California, so I could use that when I was discussing it with patients. But very early on, I was sort of keeping it quiet. It was not accepted technology and, while I didn’t feel like I was experimenting on anybody, I didn’t want to get any backlash, either. I just thought it made sense. Anything less invasive, quicker healing, less pain, I would want that for me, and I wanted to offer that to my patients.
MK: You alluded that you had laser experience already. Were you using maybe a different type of laser previous to that?
AS: I had had a mild interest in lasers. At the UOP Dental School, they had an old Nd:YAG in the oral surgery department. So this was 89/nineties, you know, late eighties, early nineties, and it sat there collecting dust. They would take photos once in a while with the patient wearing glasses, some of the endodontists wanted to see if they could seal up fractures. It did nothing, but it was interesting to me, again, because I saw that it was going on in medicine, and it made sense that it should be at least researched in dentistry. Then in my residency at USC, we actually had a CO2 laser, so I got to use that a bunch, and again, I enjoyed it. It had limited value, but the interest was there. So I was always kind of looking around. The reality is, I had been to other seminars and seeing other pitches, and nothing out there was showing me that it could do anything faster, better and cheaper than what I had already. While I was open to it, I hadn’t seen anything that even remotely would warrant me purchasing it and bringing it into my office.
MK: And so what, then, is different about the PerioLase or the LANAP Protocol?
AS: Well, initially, it was truly treating the periodontal disease, whereas at the time the lasers available, were talking frenectomies, and little gingival re–contouring things that I could do just as well with the instruments that I had. The PerioLase was now treating periodontitis, and that was something that was, at the time, probably 75% of my practice was periodontal disease. Implants were around, but still not a major portion of my practice. Then there was some other stuff, but pocket reduction regeneration, periodontitis treatment – That’s what I was doing and that’s what the PerioLase was designed for. So right off the bat, it was something that I was interested in exploring, at least.
MK: You said earlier that Dr. Robert Gregg was showing you some of his results, and you wanted to do that too, so you got trained. Were you able to replicate or come close to those types of results? Were you satisfied with what you were seeing in your own hands?
AS: Absolutely, Absolutely. That’s a great question, because as dentists, whenever you see a lecture or try a new product or technology, whatever it is, they have, we have, a funny saying, “In my hands, this is what?” And I know now that the most important aspect of this is that we can replicate it. I’ve seen it now all over the world because I’ve been involved with the training for a long time now, but I was happy to see my own results early on, some bone regeneration and before-and-after x-rays that I could show other dentists and they could say, “Wow, that’s fantastic.” I even have an early memory of a dentist saying, “Wow, how much do you charge for that?” It was an anterior tooth, there was dramatic improvement, and that was fantastic clinical results. But I think probably the most profound change I noticed was the look on my patients’ face, when I said I had a laser option for them to treat their disease problems.
MK: And what were those looks? Just over time, tell me about some of the patient reactions you’ve had.
AS: I mean, that’s something right away, you notice. When you tell somebody they have disease or they need surgery of any kind, there’s a mild panic that goes on in their in their eyes. When you say there’s a laser option to treat it, immediate, just relaxation, because again they know, “Oh, laser! It’s gonna heal quicker. It’s going to be less invasive. I’m in good hands, its current, this doctors on top of it.” It was just a dramatic difference. I was also seeing a dramatic improvement in patient referrals. While I was doing conventional osseous surgery, I did a good job and I was treating my patients really well. I cared about them, but it’s not the kind of thing that they go and run and tell their friends that they want to recommend you to go have too. Whereas this, I noticed a dramatic change, and people recommending their family members, their hairdresser, “Oh, my brother-in-law said he needed this. I’m going to tell him to come see you.” So that was something I noticed early on too, which was really fantastic.
MK: Are there any times that you would still consider doing traditional osseous surgery?
AS: Well, not traditional in the way that I was trained per se for a full quadrant. What I do see from time to time is a localized area that might have some pre-prosthetic needs. For instance, a crown lengthening or there’s decay underneath the gums. So you know that you need to do some receptive treatment in conjunction with the disease problem. Then I could see needing to do full thickness flap and again remove some tissue. So while I’m there, yes, I’ll do a more conventional style of osseous surgery again. More, when there’s prosthetic needs, carries, that kind of thing or a localized area if there’s excess tissue that needs to be removed. But I would say from bicuspid to bicuspid, I’m never flapping that open and doing definitive osseous surgery like I was trained.
MK: So just switching gears for a moment you’d mentioned earlier, working in Lakewood, I believe that was a group practice. You now have your own practice in Los Angeles. When you moved practices, was it a help in offering LANAP to get the new office started?
AS: So absolutely, is the short version. In fact, when I went into my own practice in a very competitive market, I wanted to sort of brand myself. You’ve gotta sort of separate yourself. Everybody is doing a lot of the same things, and it was fortunately at a time when the LANAP Protocol was pretty well established, accepted, and just much more common. So I could really put it out there that I was a LANAP doc and a certified instructor and the first periodontist in California to incorporate this. It was something I could really separate myself with. When I would meet with the local referring docs and say, “Listen, everybody is doing these things, I realize. Maybe they’re not offering this, and if you have patients that have maybe been avoiding, or you sent them and they won’t do it, or they started and they won’t finish, here’s a great option.” By presenting that, I think it was a really good opportunity to sort of separate myself in a really crowded market up here.
MK: Have you seen over time more patients becoming familiar with LANAP or that just in general people coming to you seeking you out because you’re LANAP-trained doctor?
AS: Absolutely! Not just seeking me out because I’m LANAP trained but coming, asking for the LANAP treatment, I mean they will ask for it by name. Then even if they need something entirely different, something not LANAP related, they’ll just see that you have laser technology, and they’ll say, “I thought I’d see if there was something we could do with lasers that would be a little more current than what somebody offered me… So-and-so offered this.” So yes, that’s something I’ve noticed significantly, I don’t want to say too recently, it’s been a number of years now where I’ve noticed that. More and more in my private practice, people are seeking me out for LANAP. Sometimes the referring doctors will say, “Hey, could you send me some more information about that LANAP procedure? I have some patients that were interested in it,” so I think they’re seeing it, too. I know some of my referrers are seeing that. I have some customized marketing brochures that I could drop them in the mail and they could share with their patients. Yeah, definitely noticed that more recently.
MK: Are you using your PerioLase as well for other procedures?
AS: I do. I use it for two or three other things, pretty often. In particular, I use it for hemostasis on a number of different levels. Most commonly, I would say extraction sockets. When I’m treating a patient and any kind of extraction/ridge preservation, I am using it in conjunction with that, because I think it again accelerates the healing, definitely helps control the bleeding, of course, reduces the inflammation. I use biostim for larger tissue grafting procedures. If I’m doing full arch stuff or full quadrant stuff, I do biostim and have noticed an enormous reduction in swelling. Patients have noticed it as well. Certain patients where I might not have done it the first time and used the second time, they noticed a big difference. I used the diode setting a fair amount in conjunction with some cosmetic crown lengthening type procedures where I’ll use it for a soft tissue prior to a flap osseous re-contouring portion or if I want to finalize some of the aesthetic contours, gingivoplasty procedure I did recently with the diode mode, as well. So I definitely use some of the other stuff. I’ve used a lot of the procedures that we discuss in training: hemangiomas, mucus seals. I’ve done, seems like one of almost everything out there.
MK: I love how you started by saying you do two or three things and then have listed about a dozen different procedures.
AS: Right? Well, is that right? Yeah, well, three or four that I used very commonly, but I have used it for, many, many things over the years.
MK: OK. All right, fair enough. Well, I do want to give a plug to your website, which is westlosangelesperio.com, for anyone interested in finding out more about Dr. Satlin or if you are getting trained on the LANAP protocol, you might have Dr. Satlin as one of your instructors, as he is a regular instructor for us. I should point out that when you just mentioned biostim, that’s short for biostimulation, also known as photobiomodulation, which is not an FDA cleared use of the PerioLase, but a use that is common to many practitioners. For anyone listening here who has not yet subscribed to the podcast, please do so, so that you don’t miss any episodes. All of the episodes are available at lanap.com/podcast. Dr. Satlin, I want to thank you both for your service as an instructor with the IALD and for joining me today as my guest.
AS: Oh, I appreciate it, Marty. It was a pleasure.