May 9, 2022
Pivoting Your Practice with the PerioLase® MVP-7™
Vivian A. Roknian, DMD
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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. Vivian Roknian, a general dentist in Beverly Hills, California. Dr Roknian in earned her dental degree from Temple University.
She’s a board certified implantologist who has lectured and published both throughout the nation and internationally on topics within implant dentistry. As a leader in the industry, she has helped train over 2000 dentists in dental implant placement, dental extraction techniques, bone grafting, sinus augmentation and advanced dental prosthetics. Dr Roknian, thank you for being my guest today.
Vivian Roknian, DMD: Hi there, thank you for having me.
Marty Klein: Certainly. So you were relatively new to the LANAP family. You completed Laser Boot Camp™ just a couple of weeks ago as of this recording. So I’d like to go back in time and have you take us through when you first became aware of LANAP and the PerioLase and the journey towards deciding to get trained.
Vivian Roknian, DMD: Well. I came across some information on the LANAP early in my career, I think right after graduation. I had a lot of friends who are periodontists and it seemed like a technology that was curious for me but something that felt like it’s almost unattainable to some degree. I mean coming out of school at this point, come out with a solid close to half million in debt. And so it seemed like a very long, far away dream. As more time went by and a decade plus went by, I started working with Dr. Sharona Dayan and she is brilliant. And it was interesting to me that she really pivoted her practice altogether in the direction of the LANAP and that in general just really caught my attention. That somebody who’s so accomplished across the board would say this is what I want to devote my life to. Seeing her passion for it really caught my attention more than anything else. And it it’s exciting to me that after all this time has gone by to say that I actually know how to do this now and have a laser now. I’m having my own internal bragging rights.
Marty Klein: Now you mentioned the doctor Dayan pivoted her practice. Do you know what she pivoted from? And is that a similar way in which you hope to pivot your practice?
Vivian Roknian, DMD: Well she’s a periodontist and we originally met through having the Misch Institute as our background. She attended for implant placement surgery and then when she moved to Los Angeles actually went and opened her practice in Beverly Hills. It was curious to me that more of her practice was based on the LANAP than anything else. And in fact I even said to her, do you want to borrow one of my implant motors until your stuff arrives? And she smiled big and she said what for? I’m having a great time with my laser. (laughs) That’s pretty cool.
Marty Klein: So in your case you are very accomplished with implants, placement of implants, etcetera. Is the PerioLase something that you also plan to pivot with and treat more perio or you’re looking to save ailing implants? What’s your vision for how this fits into your practice?
Vivian Roknian, DMD: I think for both. Mostly I do have a lot of referrals in my direction for they don’t like to call them “ailing or failing implants”. Usually when I get a phone call, it’s a, the weirdest thing happened. Can I send the patient over so you can take a look?
Marty Klein: and what do they mean by that? When you see that patient, what do you see?
Vivian Roknian, DMD: Usually it’s failing, it has some sort of infection. It needs to be cleaned out and straightened up. Um it’s funny that for some docs (doctors), some of these things are bizarre or different, whereas for myself it’s fun. It’s an exciting project or endeavor to have someone’s trust and also be able to fix something that’s bothering them. And I’m super excited to have this laser help out and making it a lot easier for everybody across the board.
Marty Klein: I think you mentioned when you came to the Laser Bootcamp that previously you live and die by the scalpel and the PerioLase of course aims to save teeth versus extracting them. So that to me represents a little bit of a paradigm shift. Have you come around to looking at it that way with the LANAP protocol?
Vivian Roknian, DMD: Yeah. I at first thought, what kind of voodoo is this? But as I started to see a lot more cases and speak with my colleagues who do have the laser, it seems like a no brainer. What I’ve always appreciated about dentistry is that we call it the practice of dentistry. And as we get to learn more of it and we have more instruments or technology at our disposal, our philosophies change over time and I’m excited to, to see how, see how this adventure pans out.
Marty Klein: Now. Had you used a laser prior to this training for LANAP?
Vivian Roknian, DMD: I have, I actually have a little bitty diode laser and I originally said the same thing to them too – look folks, I live and die by the scalpel. What the heck am I gonna do with this? And interestingly enough, that little bitty laser, I use pretty much every single day. And so just with that little bitty one, I thought well if I’m using it this much, I should really reconsider and look back at the LANAP again and maybe this should be part of my world. Maybe that’s what my practice is leaning into.
Marty Klein: What kind of procedures did you use it for? And I’m assuming here it’s a diode laser?
Vivian Roknian, DMD: It is a diode laser, yes. Frenectomies, gingival troughing, implant recovery… I feel like I can just go on and on and on with each of the little pre settings on there. I don’t have them memorized, but it seems way too easy and it’s such a clean, nice, simple procedure than dealing with all the bleeding everywhere.
Marty Klein: Hmm. Well it certainly opened the door for you to look into laser dentistry in general.
Vivian Roknian, DMD: For sure. And you know, I, when I look at my practice, what really is for me at least kind of physically grueling is osseous surgery. And this was such a perfect solution to all of the exhaustion that goes into that.
Marty Klein: I mean it is (can be) physically demanding. I’ve heard from a lot of our LANAP trained clinicians that one of the benefits of doing LANAP is that it’s just less wear and tear on them physically. Is that something you hope to gain as well?
Vivian Roknian, DMD: Absolutely. I think especially as we start to get a little bit older in our practices, our bodies age in their own special ways and I’m excited with the kind of longevity that this is going to offer.
Marty Klein: I want to turn your attention back to your boot camp training experience. Its three days of training. So just like some of your first impressions as to did you feel comfortable ready to use the payroll is coming out of training? Is there anything about the training program maybe you underestimated or overestimated?
Vivian Roknian, DMD: That’s a great question because I think that when I came out of that, I thought to myself, oh my gosh, that was a lot of information. And did I catch all the information? And when it was finally time to sit down with my first patient, it was almost like playing an instrument that I’ve been playing for 20 years. It just feels so natural and so intuitively easy.
Marty Klein: Was there something about the training program that made you feel that way? Why do you think that is?
Vivian Roknian, DMD: You know, they were so nice and helpful with giving information in chunks that were easy to digest, in showing how the movements work. Getting tons of one-on-one time and showing it not just piece by piece, like every single step, but also making sure that all of us were comfortable with that step before moving forward. Being in education for as long as I have, that specific experience is very rare and so helpful.
Marty Klein: And of course you did LANAP on a patient which is not to be overlooked as part of training.
Vivian Roknian, DMD: Yeah, it was great. We got to have our own patient. And then for the post-op, we got to go and see all of the other patients who came in as well. And it was very impressive how the healing looked 24 hours out. And some of these people had the other side of their mouths done about two weeks earlier. And so impressive. The comfort that they experienced and the healing of just the soft tissue was beautiful. It was, it was kind of a moment where I thought to myself, gosh, I can’t believe I waited this long
Marty Klein: If I had a nickel for every time, every time I heard that.
Vivian Roknian, DMD: Right. (laughs)
Marty Klein: So one last question about the training experience, I understand that you had a particular dietary restriction and it’s, it’s Women’s Health Week, by the way, when this comes out. So I’d just like to find out how that played into the three days that you were with us because we serve breakfast and lunch every day and how the training team helped to accommodate that.
Vivian Roknian, DMD: Well, I think it’s probably one of the things I’ve talked about our bragged about more than anything regarding the training there. But I have celiac disease and I was diagnosed 14 years ago. Now it’s gotten a lot better, but in the past it’s been fairly difficult to find snacks or things that I can eat. So I typically travel with a lot of my own snacks. I’m on a trip right now for work and easily about a third of my suitcase is snacks and treats for me. But my goodness, the folks there found a fantastic caterer and everything was separated out. I don’t think I’ve eaten this much food since I went on a cruise before I got this diagnosis.
Marty Klein: Well, good. I’m glad, glad you felt accommodated. And we do like to make sure everybody’s needs are met regardless of what they are. So that’s good feedback to here. And speaking of nutritional needs, I noticed on your website a particular interest you have in the nutritional needs of your patients as well as the unique dental needs of patients who have had weight loss surgery or are undergoing cancer treatments. Can you tell me more about those items?
Vivian Roknian, DMD: Sure. I’ve come to learn that patients who have had a gastric bypass surgery and given the location of my practice, there was a lot of folks who have all kinds of different kinds of surgeries to help themselves feel and look their best. The content of their saliva over time would change quite a bit and their dental needs would then change, namely being a lot of periodontal disease as well as a lot of decay across the board. It seemed like it sort of moves around like wildfire. And I’ve noticed similar with patients going through chemotherapy, with the sensitivity of their gums and the xerostomia that comes along with it. And how often times even regular over-the-counter toothpaste would cause soft tissue sloughing. Those people somehow or another have found a way to find me. But each of their needs are so different and that it’s clear what direction they’re moving in. It’s a period in their lives where if we don’t stop and address it, I’ve seen so many patients lose all of their teeth just because whoever they were being treated by just didn’t know how to chase it. And I’ve learned that the easiest way to manage that is just checking out their nutrition, and having a seat with them and talking about what their diets look like and what kind of supplements they might want to consider. And even simple things as synthetic saliva to just help keep them comfortable. Oftentimes I work with a nutritionist as well, or two or three, just to make sure that these people don’t fall through the cracks and their journey.
Marty Klein: Well that’s fantastic to hear about. I remember recording a podcast with another LANAPer a Doctor Dannenberg who wrote a book about the relationship between diet and oral health. The gut and the mouth are so closely related.
Marty Klein: So for listeners that’s another podcast that you could listen to on this general subject. But back to your experience, you know, I really want to follow up with you in six months, 12 months, and I know you’re just starting out your LANAP journey here, but you have a great foundation of not only recommendation of doing this, but how it will fit into your practice. And I think that’s important. And I look forward to hearing about your LANAP and LAPIP successes as you continue.
I do want to plug your website as well for any listener that would like to know more about Dr Roknian. It’s https://www.thedocrok.com . And for any of you listening who have not subscribed to this podcast, please do so that you don’t miss any episodes LANAP.com/podcast. All episodes are uploaded there. Dr Roknian, thanks again for taking some time out of your day to speak with me today.
Vivian Roknian, DMD: Thank you. This was fun. I look forward to doing it again in the future and hopefully with more fun stories!
