A Dental Discussion With Dr. Doug Lowy

What is your dental background and experience? 

I have been practicing periodontics since 1988. Prior to obtaining my periodontal specialty training at The University of Connecticut and DMD degree from The University of Louisville, I practiced Clinical Psychology for two years at the Cave Run Comprehensive Care Center in Morehead, Ky. I strongly believe that patient comfort and great patient experiences in the office are extremely important and key to patients completing their treatments and eliminating their disease.

I also teach part-time as an assistant professor of periodontics at the University of Louisville. Presently, I am course director of a hands-on course that teaches sophomore dental students how to conduct gum examinations and perform deep cleanings. I was the 2002-2003 distinguished faculty award nominee in the category of excellence in teaching.

What procedures and dental technology/treatment methods do you specialize in and why do you use them? Please discuss the Chao Principle surgical technique you are now offering.

Chronic conditions such as diabetes, heart disease and periodontitis are at epidemic numbers in our country. We know that periodontitis is a serious disease because of its association with heart disease, stroke, diabetes, osteoporosis, low birth weight and premature births. Unfortunately, only 3% of patients who initiate periodontal treatment end up completing it.

As health care practitioners, we need to offer procedures that are less invasive, less painful and scary.

Gum recession is one of the most noticeable symptoms of gum disease. As gums recede, they expose an increasing amount of the tooth crown and root. For a patient suffering from gum disease, gum recession can affect one or many teeth, causing a wide range of symptoms including sensitivity, inflammation of gum tissue, root exposure, and cavities. In addition to the health concerns posed by gum recession, there are also aesthetic concerns for patients.

Dr. Chaos pinhole surgery technique treats gum recession with a minimum of discomfort. After the patient is numb, a tiny pinhole incision is made near the gum line. Specially designed instruments then loosen the gums so they can be draped back to their normal position. Without the need for cutting and suturing, the gums can then be stabilized with collagen material. Patients experience minimal discomfort with the pinhole procedure as compared to grafts that require donor tissue from the palate. In addition, multiple sites can be done at one time since we do not have to rely on donor tissues.

We also offer LANAP (Laser Assisted New Attachment Procedure) to attempt new bone growth, decrease periodontal bacteria and periodontal pockets - spaces between the tooth and gum that harbor bacteria. Since the laser only targets disease tissue and leaves healthy tissue alone, recession of the gums is minimized. The laser that we use for the LANAP protocol, (PerioLase) was approved by the FDA in 2004. The University of Louisville was selected as a LANAP research center and has conducted valuable and important studies.

Both the Pinhole Surgery Technique and LANAP are patient-friendly, minimally-invasive procedures that often do not require pain medications. Since we have been using both procedures, our patient acceptance rates have skyrocketed.

What holistic dentistry methods do you practice?

Holistic dentistry focuses on the entire person; not just the teeth and gums.

We know that periodontal disease is caused by certain dangerous bacteria. We also know that many factors can influence the progression of the disease. These factors include smoking, grinding and clenching, genetics, stress, medications, diabetes, oral hygiene and other systemic diseases. Some of the risk factors can be controlled and some cannot. We can control smoking, grinding, stress, medications, diabetes and correct oral hygiene practices. To treat a chronic disease like periodontitis, we as health practitioners need to focus on the entire person and their lifestyles. Very often, our patients decide to modify their lifestyles to a much healthier one. We have to do a better job at informing and coaching our patients. My enlightened medical colleagues tell me that 70% of all diseases are preventable by a healthy diet and exercise! That's as holistic as you can get.

What trends do you see in your field?

Less invasive and friendlier procedures like LANAP and The Pinhole Surgery Technique. There is a definite trend away from the amputation procedures which cut too much healthy gum away toward the regenerative procedures like LANAP.

More emphasis on treating grinding, clenching and occlusal disharmonies. These problems can accelerate periodontal disease by weakening the surrounding tissues and bone. We refer many patients back to their family dentist for bite guards.

More patients are on multiple medications for chronic conditions such as high blood pressure, high cholesterol, obesity and diabetes. It also appears that these conditions are occurring in younger and younger patients.

As people are living longer, they are keeping their teeth longer. Even questionable teeth can be saved for years with periodontal treatment. Extraction forceps are the main cause of tooth loss.

Just five years ago, 95% of my referrals were from family dentists. At present, 75% are from family dentists with 25% coming from word of mouth and the internet. Patients are becoming better informed and seeking out a periodontist with advanced technologies. This is a win-win as it allows our office to meet and communicate with family dentists that we have never had a relationship with as well as dentists from the surrounding states. The family dentist receives a letter detailing the diagnosis, prognosis and periodontal treatment plan. They also receive a letter when the patient completes active treatment. It is important for periodontal patients to be seen on a frequent maintenance schedule for checks and cleanings.

With our help, patients can adopt healthier lifestyles to deal with all chronic diseases.

What are the main concerns your patients ask about?

Time, pain and cost - not necessarily in that order.

More treatment can be performed at one appointment using procedures such as LANAP and Pinhole Surgery. Patients like the convenience of not having to keep coming back for multiple treatment appointments.

While treating periodontal disease is an important goal, we assure patients that their experience in the office is equally important. Minimizing discomfort using procedures like LANAP and Pinhole help accomplish this. We offer a range of sedation experiences depending on the level of dental apprehension which is one of the most common anxieties. No patient should have to experience the white knuckle anxiety when there are so many sedation options.

LANAP and Pinhole are expensive procedures as advanced technology and costly materials are used. Our fees for these procedures are more than the traditional cut and sew periodontal procedures. However, we do take most insurance plans and are happy to file a pre-determination with the insurance company.

What has been the highlight of your career?

My son, Jeremy is a first-year periodontal resident at the University of Louisville. It is very satisfying knowing that he will care for people who need our services.

In my office, when a patient completes treatment and says thank you for saving my teeth or you made it easy for me because it did not hurt; those little comments all add up to be the highlights.

Where is your dental practice located ? Anything else you'd like readers to know?

The office is located in the east end of Louisville at 2015 Herr Lane. Our telephone number is 502-425-9285. Lots of good information can be found on our website: www.louisvilleperio.com

Treating periodontal disease is easier and less expensive if it is caught early. Make sure that your family dentist does a thorough gum examination using a periodontal probe to check for pockets and radiographs to look for evidence of bone loss.

Lifestyle changes such as diet and exercise, smoking cessation, managing stress, good oral hygiene are all important for controlling some of the most dangerous and chronic diseases of our time. If you are going to treat periodontal disease or any other chronic disease, why not make the commitment to adopt an overall healthy lifestyle?

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