September 10, 2025 • 36 mins
Periodontal disease is the silent epidemic. Dr. Tanya Dunlap, Vice President of Perio Protect, joins us to discuss how gum health affects overall health and why a simple score can alter patients' understanding of their risk.
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Episode Transcript
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Regan Robertson (00:00):
Listeners, doctors, hygienists, assistants, what would happen?
Close your eyes with mefor a quick second here.
Imagine what it would be like ifyour patients could easily understand
their periodontal health just aseasily as you understand your blood
pressure or your cholesterol score.
(00:20):
That would personally blow my mind.
You know, I've been in dentistryfor, uh, a decade and a half and I am
still learning new things every day.
And one of my favorite thingsabout our upcoming guest is, you
know how much I love to bring youreally high quality people that are
passionate about solving a problem.
And on everyday practicestoday we have Dr.
(00:44):
Tanya Dunlap.
She is the Vice President ofPerio Protect, uh, which I
think you've been at since 2005.
Dr. Tanya Dunlap (00:51):
Yeah, 20 years now.
Regan Robertson (00:52):
20 years now.
So you're well in the passion category,you know what you're talking about, and I
cannot wait to jump in and really discussthe benefits of, uh, the health benefits
of it, but also, you know, the overallwellbeing benefits of what it means to
be able to connect with our patientsand communicate in a way that does that.
(01:13):
Aha, I understand that this is importantand that there is a solution to it.
Dr. Tanya Dunlap (01:18):
Right.
Regan Robertson (01:18):
So could you tell us a little bit about your background and,
and what, why, why periodontal health?
Dr. Tanya Dunlap (01:25):
Well, this was not an anticipated, uh, career path.
Um, and it's a long story, but I willsay one of the things that really
made it possible for me tounderstand better the every
day, I'm not a dentist, right?
I'm a PhD. So just that everydayclinical experience was working on
(01:49):
controlled clinical trials, testingPerio Protect as an adjunct to scaling.
Versus scaling alone and reallykind of getting into the nitty
gritty of clinical trial design.
I was the, um, researchliaison for the company.
There was independent contractors forstudies and independent statisticians,
and we had a periodontist onthe team also for, for consults.
(02:12):
Um, it was a really good time andfun to, to kind of be part of this
team and to see what they were doing.
So that's where I got my chops and that'show I really became the go-to person
to understand what Para Protect is.
And if you are listening andyou don't know what Para Protect
is, it's an adjunct home care.
Um, it's a tray that is cleared by thefood and drug administration to liver
(02:36):
medication really deep below the gum line.
And when we say really deep,we mean up to nine millimeters.
So it is great for patients who'vegot, you know, shallow pockets and
gingivitis and chronic inflammation.
It is excellent for patients whoneed really complex treatment plans
and you wanna maintain them betterat home between office visits.
That's what we're about.
Reducing the infection, the inflammation,even reducing pocket depths, um,
(03:00):
between office visits and you just usethis tray, it's custom a, it's got an
internal peripheral seal so that yourmedication doesn't leak out and you
just wear it 10 to 15 minutes at a time.
The primary antimicrobial.
It's kind of a fun story.
Do you wanna hear it?
I do wanna hear it.
Okay.
So I know all about this 'cause myfather was the person who created this,
uh, medical device and so I was in thebackground as he was working on this
(03:23):
for longer than the company was around.
Regan Robertson (03:25):
And your father is a dentist?
Is that He's
Dr. Tanya Dunlap (03:27):
a dentist, that's right.
Yep.
His name is Dwayne Kel.
And he created this trayinitially for his mother.
She ended up needing periodontal surgery.
She was an advanced, um, case, and so,you know, sent her out for surgery.
She comes back, he says, you look great.
We're ready for the next one.
She said, oh, we're not ready.
I'm not doing it.
You gotta find another waybecause I'm, I'm not gonna go.
(03:49):
This was before lasers, beforeGBT, before all the easier things.
And so he, uh, he, she looked athim and she said, I promise you.
I will do whatever you wanna try and, andwe'll come back and we'll see if it works.
But you've got to find some other way.
And it it, to be clear, noteverybody can avoid surgery.
(04:09):
You have deep vertical defects,you have ulous tissue down there,
doesn't respond to anything topical.
Your scaling's not gonna touch it.
Lasers would be helpful.
Um, but sometimes you need surgery inher case because she wouldn't do it.
Um, he created a variety of.
Delivery methods to get themedication deep below the gums.
(04:30):
And originally he was trying touse tetracycline because it was an
bacterial based infection, right?
Everybody knows antibioticsare these wonder drugs against
bacterial based infections.
But it was the design of thetray that was the first part.
And that took a long time to figureout, because if you just use a
vacuum form tray, it leaks outand it doesn't get deep enough.
And so he figured out howto create this custom seal.
(04:53):
And there there's some,uh, real crafting to that.
Then within that sealed system, so theseal, there's a seal all the way around
the internal peripheral edge and a shortextension, and that works like a gasket,
prevents the medication from leaking out.
He added, at the time, hydrogenperoxide a gel because he wanted what
he called the propulsion agent to see.
(05:14):
This is back in the experimental daysbefore it even went to FDA, um, and ex to
seek how deep they could get it, right?
Yeah.
I mean this was, he was just.
Trying to solve a problem for hismom and his other patients, and he
started to get really good results.
He got it cleared through the Foodand Drug Administration, so now it
is a prescription medical device.
So it, it applies to HSAs and FSAsand all the things that, and he can
(05:38):
legally take it to market at the time.
So he's talking to a patient one dayand he says this, you are doing great.
Excellent job at home.
Just keep it up.
And she said.
Do I need that liquid medication anymore?
And he said he kind of stopped and hesaid, um, the liquid was the antibiotic.
How long haven't you had it?
Oh, I've been without thatfor weeks, maybe months.
(06:01):
And then he realized it wasn't theantibiotic, it was the hydrogen
peroxide that was actually thebeneficial therapeutic agent.
So then he like scraps everything,goes back to the drawing board, goes
back to the literature, and startsinvestigating how can this be?
And it turns out.
Hydrogen peroxide and the primaryantimicrobial that we've tested
(06:22):
all these years and recommendis just 1.7% hydrogen peroxide.
So it lightens your teeth.
But not, not, it's not like a Wow.
Overnight.
I need side on it.
It is, yeah.
Yeah, it is.
But it does two things.
It debrides bacteria and so every timeyou use this tray, the tray pushes
them, the tray's just a delivery device.
It pushes medication deep it youpeel off another layer of cells, just
(06:45):
like if you had an onion and therewere layers, you peel it off, but.
What's really important is as it'sbubbling up, you know, like if you
have a brown, if you have brown bottleperoxide and you have a cut on your
hand and you pour it, what happens?
Reagan?
Regan Robertson (06:56):
Yeah, it does.
It bubble.
It thises up.
Dr. Tanya Dunlap (06:58):
I know, right?
Exactly.
And it's almost foamy sometimes,depending on how big your cut is.
This gel's very different.
What's happening when it's bubbling up?
It's releasing oxygen becauseyour hydrogen peroxide is
turning into oxygen and water.
Now when you have, yeah, yeah.
When you, when you have a cuton your hand and you put a
little bit of perio gel on it.
It doesn't foam.
(07:18):
It's a very different formulation.
It has a slow, constant releaseof the oxygen and water instead
of that kind of explosive.
Yep.
And what that means clinically is you'regetting a consistent release of oxygen.
So this matters when you are trying totreat the bacterial based infections below
the gums, because the deeper you get inthe pocket, the less oxygen there is.
(07:39):
And then you have Ana, an anaerobicbacteria, specifically gram-negative
oblig, anaerobics, proliferating.
So when this tray can deliver themedication, then the oxygen really deep.
You change the environment and thatis the, the way you are really able to
get this long-term health and healing.
(08:00):
Because when you put oxygen down deep,it's toxic to your gram-negative robes,
but it also creates the right conditionfor healthy bacteria to repopulate.
And that's what we want.
Regan Robertson (08:10):
No way.
Okay.
So are antibiotics still used todayas part of that decision process?
Yes.
Dr. Tanya Dunlap (08:16):
Okay.
Antibiotics are still usedtoday and they can be helpful.
They could be taken systemicallyand sometimes they're applied
locally and sometimes they,they do have a positive effect.
The problem is, is they wear off andthe bacteria tend to repopulate, and
patients rightly so, cannot, they can't.
(08:36):
They just physically can't.
Clean deep below their gums at home.
So we often wanna blame patientsas professionals, right?
They're not doing whatthey're supposed to do.
And most of them aren't flossing.
Most of 'em aren't.
And if, if they are, theydon't have great technique.
But floss is gonna have betterplaque control for cariology
than it will better biofilm.
Control for gingivitis orperiodontitis Your toothbrush, rinse
(08:59):
and floss, can't get deep enough.
That is why you need Well, yeah,
Regan Robertson (09:03):
and it wouldn't, it wouldn't make
sense to just take antibiotics.
You've got resistance, youknow, or, or allergies.
Uh, that's right.
Then if you're, you know, then, thenyou're out completely with that.
Uh, I, but I have anignorant question for you.
I love very much how you arereally clinically nerding out.
So if you're listening right nowas a doctor or clinical, this
probably makes a lot of sense to you.
To me, this is all very newfrom the clinical aspect, so.
(09:27):
It's also exciting.
So if you are a patient that is, um, maybein the gingivitis stage, is it something
that you continue, like you have thistray and you just continue it, like as a
preventative for the rest of your life?
Or do you use it sporadicallywhen things pop up?
How does it, how, how does thatconversation come about with the patients?
Yeah,
Dr. Tanya Dunlap (09:47):
so ideally you're gonna be using it.
For life.
I personally think it's asimportant as a toothbrush.
I've been using it almostevery day for 20 years.
Mm-hmm.
Some people stop for a while,the bleeding comes back, they
start using their trays again.
But the ideal situation is we getyou healthy and we keep you healthy.
Yeah.
And the disease goes into remission.
And if, I mean, let'sjust look at the stats.
(10:10):
47% of American adults over the age of30, they're young, have already lost bone.
They have chronic periodontitis
Regan Robertson (10:18):
over 30.
Dr. Tanya Dunlap (10:19):
Over the age of 30, by the time we are 65, 70% of US adults
have lost bone 'cause of the infections.
Regan Robertson (10:28):
When did this, when, so Perio Protect has been around since when?
Dr. Tanya Dunlap (10:32):
2005.
Yeah.
Regan Robertson (10:34):
So this is a, to me, this is a travesty.
Like that's ridiculous.
That number is ridiculous.
Dr. Tanya Dunlap (10:40):
It is.
And the reason it can get outtacontrol like this is because this
is a disease that doesn't hurt andthat we haven't taken so seriously
because it's just a little bleeding.
Yeah.
And you don't see it.
You might see it when you brush yourteeth, but most of the time you're
swallowing all of this and you havethis chronic infection in your gums and
it's very common, but it's not healthy.
And so you asked at thebeginning of this show.
(11:03):
How do we, how do we distill thisdown so patients can understand it?
Right.
Well, let's talk first about howimportant it's, if you leave these
chronic infections untreated ingingivitis or periodontitis stages,
it makes it much harder for a typetwo diabetic to manage blood sugar.
It can,
Regan Robertson (11:18):
that blows my mind.
Keep going.
I just thought, I, I heard that theother day and I was like, wait a minute.
Back up.
Like, these are discussions I don'tthink we're having, um, in a clinical
setting as much as we should.
Dr. Tanya Dunlap (11:30):
And we, and we need you.
You hit it on the head when you open.
We need ways to do it quickly and tobe able to capture their attention and
do it in ways people can understand.
But it, if you have cardiovasculardisease in your family or you personally
have high blood pressure, this chronicinfection in your gum can actually
trigger arterial inflammation.
(11:51):
It contributes to the progression,not cause yet, but progression
of dementia and Alzheimer's.
There are some cancers that are associatedwith, I mean, there's just so many things.
So if you had a, even if youhad a fingernail that was
chronically infected mm-hmm.
It would bug you.
You would, you would want to do something
Regan Robertson (12:06):
about that.
Right.
Yeah.
There, there have been like thesecornerstone moments in my life where
a clinician will explain something tome and I clock it like it makes sense.
And one I don't remember, so I can'tattribute Maybe Michelle Hudson.
Yeah.
Want, there was a clinician thatsaid if you have a bleeder, even one.
It's not just a bleeder, treatit like an open wound if you
(12:28):
had That's exactly right.
Okay.
That like, clicked in my head and Irealized, 'cause I have heard, I've
heard that Oh, it's just a, you know,you just got a bleed one bleeder
and, and you just roll over it.
Not knocking my own clinical team,but I mean, I, I can see how it
can get glossed over so easilyand we don't take it seriously.
(12:48):
Right.
Dr. Tanya Dunlap (12:49):
It's easy to, to not take it serious.
And, and I like to throw upthese pictures on a big screen
of gingivitis and periodontitisand say, what do you all see?
And then they'll, they'll describeall the things they see clinically.
And I'll say, we alsosee chronic oral wounds.
You are practicing everyonelistening In dentistry, you are
practicing chronic oral wound care.
(13:09):
When you treat patients withgingivitis and periodontitis, you
are running a chronic oral woundcare center out of your operatories.
Regan Robertson (13:17):
That sounds disgusting.
It's, I mean, it doesa chronic open wound.
Dr. Tanya Dunlap (13:23):
It is.
It's chronically infected.
It's a chronic burdenon the immune system.
It might be low grade, but look,your immune system is like a battery.
Mm-hmm.
There's only so many things that can behooked up to it before it's power fades.
So you can do something aboutthese infections in your gums.
Right.
Let's unplug that chronicsource of infection and let
your body focus on other areas.
Regan Robertson (13:44):
This reminds me a lot of the, uh, the heart attack gene by Dr.
Yes.
Pasley Bale and Amy Jonin.
I think that was maybe like 2016 or 2017.
My eyes were opened up into whatchronic inflammation can do, and
then it was still several yearsbefore I was able to go through my
own health journey and understand,um, my own health from a systemic.
(14:05):
Point of view.
Right.
Uh, what are you, I, I'm very curious,what does the, um, adoption rate
look like for those who are puttingPerio Protect in, in the practice?
And what sort of objections do you hear?
Because it's easy.
It's easy for me, or it's easyfor you, especially since you've
been in Perio Protect to say,oh yeah, this is a no-brainer.
Like this is, this is, ofcourse we should have this.
(14:26):
What are some of the things that you'veheard that make people say, ah, you
know, I don't know, they don't need it.
Or like, you had me therewith the slow release.
Uh, because I have heard, uh, andagain, I don't remember where, but I
have heard like if you just take somehydrogen peroxide and put one of those
little Christmas tree looking flossythings and just go between your teeth.
Yeah, I've heard that.
(14:46):
So like.
Does that, like, that wouldn't bethe same because that's an instant
release versus a slow release.
So That's right.
Maybe be my eyes and ears.
What have you heard over, over your,you know, years with Perio Protect
and, and some of the objections?
Dr. Tanya Dunlap (15:02):
Right.
Well, for some, some patients, exactlysay, why can't I just use a rinse?
Why can't I just rinse?
Why can't I put hydrogenperoxide in my water flosser?
Or put some gel on there, interinterproximal brush and brush.
Um, so the number one problem with a rinseis that it just doesn't get deep enough.
Your interproximal flosserwould get deeper than a rinse.
Yeah.
But it still needs contact time.
(15:23):
So this is the partabout hydrogen peroxide.
It has to be held in placelong enough to be effective.
And I can't speak about otherformulations, but the, the gel that we
have tested in, in the perio tray needs 10minutes of contact time in order to, so.
A little bit.
Your bacteria live in a living film,a biofilm, and there's could be
(15:46):
hundreds of different species in there.
And they're all communicating.
And what one bacterial, um, speciesis producing as a byproduct,
another one uses as a food source.
It's totally fascinating and complicated.
It's covered in a layer of slime.
They call that a matrix.
You need time to be ableto cut through the matrix.
(16:07):
Antibiotics.
Can't do it.
Well, this is why when you place anantibiotic, you do it when you do
scaling because an antibiotic can'tcut through that layer of slime.
Well, chlorine based productsand peroxide based products
can, but it takes a little time.
We need 10 minutes to be able tocut through the matrix, the slime,
and then penetrate the bacterialcell walls of, and you're just
doing the exposed surface layer.
(16:29):
We want you to wear the tray for15 minutes because then you get
almost all the oxygen benefits.
You can go longer.
It doesn't help you, but youneed at least 10 minutes.
So most people are like, am I gonnahave to do this for the rest of my life?
And I, and I say, that'sanother objection.
I say, you get to, this is a way, it's
Regan Robertson (16:44):
not that long.
Dr. Tanya Dunlap (16:46):
So you tie it to something you do.
If you ever, um, read Atomic Habits.
Regan Robertson (16:50):
Oh, yes.
I love atomic Habits.
Oh, how you stacking?
Let's have it stack this.
That's right.
You're gonna stack your habits.
Exactly right.
Dr. Tanya Dunlap (16:57):
So I, you know, I tend to wear my trays in the
morning when I'm getting ready.
Some people are reallyritualistic about that.
Every shower before you shaveand shower, if you're a guy,
um, I've, I have a new puppy.
I've been wearing my trayswhile I'm walking this dog.
Uh, you know, there's all thesedi different things you can do.
To stack the habits andmake sure you do it.
And the thing about Perver Protectis that there is a level of clean
(17:19):
you didn't know you could get to.
And if you do, you use this fora while and your mouth feels,
this is what patients say.
They'll say, my mouth justfeels so clean and my breath
is so fresh, which is all true.
I personally think the freshbreath is nicer than whiter teeth.
Uh, 'cause you know, with this, youdon't even wake up with morning breath.
Those of you who are part ofthe profession and you take
(17:41):
great care of your mouths.
I know you do.
You won't even wake upwith morning breath.
But, um,
Regan Robertson (17:45):
but if somebody, but from a patient perspective, if somebody
told me, do this 15 minutes and you'regonna wake up without morning breath.
Dr. Tanya Dunlap (17:53):
You can.
That's the
Regan Robertson (17:54):
best marketing campaign I can think of.
Dr. Tanya Dunlap (17:56):
You can, yeah.
We say you can get closerto the ones you love.
'cause sometimes you can smellpeople before you can see 'em.
Right?
Like they, right.
Regan Robertson (18:03):
Yeah.
I've not known, like I didn'tknow before, uh, joining dentistry
what it was, but they're, yeah.
I've, I've been, and you, you can almostsmell them coming towards you and then
you have to be around it and it's,it's painful and it's uncomfortable.
Dr. Tanya Dunlap (18:15):
It's uncomfortable for everybody.
Like if you're on an airplane and youknow what that is, you Yeah, yeah.
It's, I, I have to stop myselffrom telling, talking about it
on an airplane because I knowthere's a really good solution.
Um, so I think for patients, when theyfind out how comfortable it is, how
easy it is to use the side effects,you know, you can drink as much red
(18:35):
wine and coffee as you like, and youare gonna have really white teeth.
You just do it 10 to 15 minutes a day.
Um, but the rinse doesn't get deep enough.
I think from the professional side,what most people are concerned
about is if we put patients in PerioProtect and then they need restorative
work down the line, what happens?
Or if a patient has really seriousperio but also has restorative
(18:57):
needs, what do we do first?
And so we just talk throughthose different scenarios with
people to help them understand.
But you want it not
Regan Robertson (19:02):
to be bleeding first, I would assume.
Dr. Tanya Dunlap (19:05):
And, you know, sometimes you end up with really complicated
situations, but best case scenario, youget the Perio Foundation, but you also
want to address those restorations too.
And, and people have limited money.
So how do you figure that part out?
And so we often work aslike an office consultant.
Um, we've been doing this for a long time.
We have treatment protocols, we have, um,experts you can talk to, periodontists
(19:28):
too, that will also weigh in.
Um, and so we do as muchas we can to be helpful.
Regan Robertson (19:33):
Is this, is this a product that is direct to consumer
or only through dental practices?
Dr. Tanya Dunlap (19:38):
It's only through the dental practice.
So that trade is, um, clearedby FDA as a prescription medical
device, so it does require thatcomes through the dental office.
Then they get it.
'cause it's made specifically for them.
And some docs will,
Regan Robertson (19:52):
consumers could be educated and drive this, because I
think if consumers really new, um,preventative health, you know, is such
a, it's not just a hot, trendy topic.
It's such a critical topic right now.
And healthcare in Americahas, is just, um, feels like
it's on fire in so many ways.
There was one thing I don't wanna glossover here that you said that was highly
(20:12):
intriguing to me and that's that itgets in and gets the bad stuff, but it
does not, uh, not only does it not harmthe good, but it allows an environment
for the good bacteria to thrive.
And I know with antibiotic, I mean,imagine, I don't know if you're
working on this, but what if wewere able to do this at a gut level,
Dr. Tanya Dunlap (20:27):
right?
Yes.
The gut is totally.
The next frontier.
Everybody's looking at it, right?
Leaky gut.
I hope everybody's looking at it because alot of people sleep just sits in your gut,
Regan Robertson (20:37):
right?
I
Dr. Tanya Dunlap (20:38):
mean, yeah.
Regan Robertson (20:39):
Wow.
Wow.
So you, you, you do, so it, it doestruly allow the good bacteria to thrive.
Dr. Tanya Dunlap (20:47):
It does.
Because you are adding thisoxygen, you're, it's all about
the environmental conditions.
So you change the environment, you changethe kind of bacteria that can thrive and
look, we're never gonna be able to get ridof all the bacteria and we don't want to.
You want a healthy microbialimmunity that lives in a symbiotic
relationship with the host.
That's what we're after.
Regan Robertson (21:07):
What are the doctors, uh, I want, I'm gonna give
you a second to think about this.
I don't wanna put you on the spot, but,but the doctors that you've seen that
have implemented this in, in practice, isthere anyone that's particularly memorable
or you think is doing a really goodjob with this, explaining the benefits?
Dr. Tanya Dunlap (21:21):
I am, and I do wanna get back to like the easy way to explain
it to patients, but there are two orthree that come really front to mind.
Michelle IES in Jacksonville, Florida.
Yeah.
Her office is so in tune to PerioProtect and the benefits and the patients
talk to each other in the waitingroom and say, you don't have that yet.
(21:42):
You should totally get it.
This is why.
Then they come back and ask for it.
Right.
That's that's exciting.
We have another doc in Chicago, a team Dr.
Joseph and Eileen Zel.
They're a terrific, um, team andtheir patients, they're, they're
truly honing in on root cause, right?
And making sure people understand thisand really going above and beyond.
(22:07):
So there are other drugsyou can put in these trays.
So the hydrogen peroxideis what everybody knows.
It's branded as perio gel, and it's 1.7%hydrogen peroxide, low concentration,
all the things we've talked about.
There are other drugs you can putin there and they've documented
bone stabilization and they're nowbeta testing some medication that
we are offering for, um, patients.
They haven't been para protect patientsbefore, but they have such serious
(22:30):
sensitivity that it's miserable to come.
So we've got this new option that it'sgonna be released here soon, um, that
people can use to desensitize and it'sgetting great, uh, patient reviews so.
Re one of the best parts of my job,Reagan, is getting to know these
clinicians who care deeply abouttheir patients and their teams.
(22:52):
They want good culture in theiroffice too, but really care deeply
about their patients and they'redoing this for the right reason.
'cause they want to end those chroniccycles of infection and inflammation.
And as you mentioned, it is hard totalk to patients about that, right?
Yeah.
So we created, it's takenme a while to do this.
I have been, uh, doing market.
(23:12):
I'll call it market research, but really,um, focus groups since 2018, and I have
been talking to people saying, how muchbleeding is it okay to have in your mouth?
Like, how many set?
Because, well, you chart this, right?
As a dental professional, you charthow deep their pockets are, whether
they're bleeding, clinical attachmentloss, as often as you do that, okay?
(23:32):
So let's say your patient has 168possible bleeding points, right?
They, you don't have wisdom teeth.
You have a hundred sixtyeight, six six per tooth.
How many is it okay to have?
Is it okay to have 30?
Is it okay to have 16?
Is it okay to have five?
A lot of people wanna say zero.
And I say yes, that's ideal.
Yeah, but I don't think you'regonna get every person to zero.
(23:53):
We should try for it.
We should.
Yeah.
Um, zero would be the ideal, but,but what's, you know, what's healthy.
No one knows.
Regan Robertson (24:02):
We don't know.
How can we.
No, I think that the goal, thegoal is to keep the inflammation as
low as possible, so That's right.
And we know, I think we, I mean, I lovehow I say we know, I've been told and
educated that hormones can change it.
So if you have hormonefluctuations That's right.
That, that can change it.
Um, I mean, personally I know I'vehad a visit where I had bleeders
(24:22):
and I was like devastated andthen the next time I had none.
And yeah.
And it was, you know,the hormones changing.
Can, can play a factor to it.
So.
I wonder if perhaps the right sincenobody maybe has the term for what
the right answer is, I think theright answer is zero, but maybe
it's, it's a pattern over time.
So making sure that people aregetting in for their, you know,
(24:43):
their annual That's right.
Don't even get me started on whocame up with six months and why
they came up with six months.
I, I, if I could see mine everymonth, I probably would, but
that's because I'm a weirdo.
So
my hygienist has an air, what is it?
Air Max prophy or whatever.
You even know what they have.
Oh, she's amazing.
Yeah.
So I, I, I know I'm an odd ball there, butit, I. I just am so pleased that you and
(25:08):
Perio Protect, but you know, Kim Koch andall of the others in, in our world right
now that are focusing on the systemiclevel of care and, and preventative
health is just, I can't say enough how,how much it means, um, you know, to,
to our world and our future generation.
So if we, if we also set the expectationthat, you know, zero is where you want
(25:29):
to be at, that starts to, you know,you can reinforce that Strat over time.
Dr. Tanya Dunlap (25:34):
And you need to be able to do that quickly because it
is hard to get people's attention.
So what we ended up doing, and I wanna beclear here as I don't wanna be dismissive.
Um, the a a P has set up 10% or less ofyour sites are considered healthy, right?
You want a zero of the, or there's astandard, there's a professional standard.
Yeah.
But when you talk to patients, you'relike, well, what do you, what do you
(25:55):
think 16, 17 sites, is that healthy?
And they're like, eh, so.
In focus groups, we'vecome down to 10, 10 points.
Bleeding points.
You can do 10% if you want, but10 points, 10 or less we consider
healthy and zero is ideal.
And so we did this whole campaignlike, what's your number?
We even had scrub caps that say,what your, what's your number?
And I was like, I'mgiving these to people.
(26:15):
It's not a pickup line.
We want them to ask a questionlike, what's your number?
Regan Robertson (26:19):
So the number is not your pocket depth.
I, no, I have, what's your gum score?
And I was like, well, that'sgotta be your pocket depth.
Dr. Tanya Dunlap (26:28):
What's your gum scores?
How many bleeding points you have?
Because how do you know if you're healthy?
It doesn't, you know, it's doesn't hurt.
Nothing's, you know, yourteeth aren't mobile yet.
You can mask your bad breath and youmight see some blood when you gloss
especially, or, or brush, but you're like,ah, it's not doing that all the time.
(26:49):
Right?
So here's how we did it.
We created a gum score with anumber on the numbers, the number
of bleeding points, and we use thatjust like you did for blood pressure.
Like how do you know if your bloodpressure is in a normal range?
Regan Robertson (27:00):
It's, you've got your number, your top and your bottom.
That's right.
You, you look at the coloredchart that say, there you go.
You know, on the wall.
Am I in, in range, out of range.
That's right.
Dr. Tanya Dunlap (27:09):
Or your cholesterol or
Regan Robertson (27:10):
blood sugar or whatever it is.
Right.
Dr. Tanya Dunlap (27:13):
So wouldn't that
Regan Robertson (27:13):
be great to have that as a little poster on the wall too?
Like a little color coded?
What's your gum score?
Just like your blood pressure.
You could even, that'sright, you don't do that.
You should do that.
'cause that would be mimicking, right?
Dr. Tanya Dunlap (27:24):
So we have this whole campaign rolling out.
You don't even know that.
But yet you.
Regan Robertson (27:28):
No, no, I came, no listeners.
I came into this blind.
Like I come into most of my interviewsintentionally so that I can be
just as curious and, and maybeignorant as you are, uh, with a
little bit less clinical knowledge.
But no, I didn't know that.
But that would be, I, I can't wait.
I can't wait to see this campaign roll
Dr. Tanya Dunlap (27:44):
out.
Well, I will give you theless than a minute, five point
presentation for a patient.
Okay?
So you come in, let's say you have 48bleeding points, Reagan, when you come.
So we do the whole thing and, and then.
As your hygienist or your professional,I would say I'm concerned that
you have a high gum score.
It's 48.
That means there's 48 areas in yourgums that are infected and bleeding.
(28:06):
Now, the ideal score would be zero,but we wanna get you under 10.
So we're trying to move from 48 underto 10, as close to zero as we can.
The third point is so important.
I know you're trying hard at home.
Yeah.
The problem is that your toothbrush rinseand floss just doesn't get deep enough.
That's why we prescribe Perio Protect.
This is a special tray that's madejust for you that will gently deliver
(28:28):
the medication deep so that themedication can fight that infection.
You just wear 10 to 15 minutes a day.
Not only are you gonna havehealthier gums, you're also going
to have wider teeth and superfresh breath and then stop talking.
'cause you told 'em a lotrightly that go along with it.
All of it.
Yeah.
Right.
Let it sink in because then they'llcome up with questions and, and if
some people say, I need to think aboutit, there's two routes you can go.
(28:51):
This is no sales pitch, no pressure.
We don't, we're not trying tolike sell anybody anything.
We just give them the information thatwhat do you think is the best care?
And they get to choose it.
So if they say, I need to think aboutthis, I would say, I'm really glad you are
gonna con, continue thinking about this.
It's, it's important'cause this is not healthy.
What can you do differently nowat home to improve your health?
(29:12):
So.
What can they do differently?
It's up to them and I silently,awkwardly wait for them to
answer right it, that it can be
Regan Robertson (29:19):
painful, but it's really, it's important to let the brain
process what it's heard and see you getnervous, you know, we fill the space.
But allowing when you say suchan important anchor statement
and you deliver it with thatcare of this is really important.
Um, yeah, it painful for you,but it really does a service
for the patient to allow thatsilence to sit for a little bit.
Dr. Tanya Dunlap (29:40):
And then you also get some judge by what they say as to what
is their dental acumen, because theymight say, oh, I'm gonna floss every day,
or I'm gonna brush twice, or whatever.
And you say, terrific.
That is a good first step.
We're gonna document that and we'llscore your gums when you're in next time.
In the meantime, you hand 'em a brochureand you say, not gonna floss there.
Well, even if they do,it's not gonna matter.
It's not gonna get deep enough.
(30:01):
Right.
Regan Robertson (30:01):
That and you know, that piece said that to
your four step process there.
I was gonna say, do you know howamazing it's gonna feel to be like,
this isn't, you could even say,you know, this isn't your fault.
Like you could brush That's right.
And floss several times a day andyou're still not gonna get deep
enough that that like takes thatpressure off that person and middle.
That's the idea.
Because people
Dr. Tanya Dunlap (30:18):
who are defensive, like they can't hear you.
You know, though.
They, it, they're closed off.
They can't understand what you're sayingand you are like right there with them.
'cause you want better results for them.
Yeah.
And it's not your fault.
They want better results andhonestly, it's not all their fault.
Uh, sometimes that'snot their fault at all.
And so to be able to say that and then.
(30:40):
What are you gonna do differently?
That's good.
Let's, let's start there andwe'll score your gums next time.
Take this brochure.
Let me know if you have any questionsbefore your next appointment, and
you just go two different routes.
My, my main concern for you is theinfections around your, your, uh, crowns.
We've been monitoring those.
We want your crowns to lastas long as possible, and they
will with healthy tissue.
Or, my main concern is that thischronic infection in your gums is gonna
(31:04):
make it harder for you to manage yourblood sugar as a type two diabetic.
You just stop talking becauseit's, it's totally up to them.
They get to decide what they,what they do and don't do.
But they can't make adecision if they don't know.
Regan Robertson (31:16):
No, and, and it's un and it's not fair for them not to know.
I think that's Heather and it, forme, the travesty, like I said before,
it, they don't have this as an option.
Then, and they, and they're stuckto just brushing and flossing
and we, we know that that's notgoing to do what it needs to do.
That's, that's unfortunate.
And it's not that thisis the only solution.
There are other solutions, but thereare, to me, um, you know, if I have
(31:38):
an opportunity to prevent surgery,perhaps, uh, you know, and be in
that preventative space or to prevent
Dr. Tanya Dunlap (31:42):
bone loss in the early stages.
Regan Robertson (31:44):
Yeah.
Or.
Dr. Tanya Dunlap (31:45):
To prevent the infection around the implants that you just put in.
Right?
All of these things are good reasons.
Regan Robertson (31:50):
Oh, that is some of my favorite discussions of all is how are
you gonna take care of this investmentthat you have just put in your mouth.
Yeah.
Those crowns are though some, thereare some dentistry, which we know
is a serious investment, so It is.
That's right.
You want to keep the, the tissuearound it really healthy, but you
have to have those conversations.
Dr. Tanya Dunlap (32:07):
Right.
And we hope, um, if anyone tries outthe gum score that it will get your
patient's attention so that theyaccept treatment that they need.
Whether it's higher protector not, it doesn't matter.
Yeah.
I mean, I want that, butyou know what I mean.
It's important that patientsunderstand that that chronic
infection needs attention.
Regan Robertson (32:30):
Tanya, your passion for this is, is incredible.
And uh, I am really thrilled to announceI did not forget, but I held it off.
Listeners, uh, you are going to bepresenting for free so anyone can attend.
That's right.
This coming, um, September 30th.
So, clinical CalibrationInstitute is hosting a mastermind
session with you to dive deeper.
(32:53):
Into this topic.
I just came up with that on the fly.
I'm just so clever.
Uh.
We're gonna dive deeper intothis topic, and, and it is, it's,
it's really gonna be, you know, aproduct agnostic mastermind session.
So it's, you get CE for it, it's aGD compliant, and I just cannot, I
can't believe that you're gonna, I'mreally excited that you're gonna do
this, and I know that you're gonnado this because of your passion and
(33:14):
all of the education that you have.
So this will be September30th open to everyone.
I think it's 1:00 PM EST. So if you,uh, listeners, if you wanna hear.
Tanya, go deeper into this.
Go to clinical calibration.com and youwill see an area to sign up for it.
Is there anything that youwant people to know about this
particular mastermind session?
Dr. Tanya Dunlap (33:34):
So bring your questions.
We will have images, so you'll getto see case studies as we go through.
We can talk about as much research as you.
I used to be the research liaison, so Ireally, I love talking about that, Dale.
I spent four years of my life on it.
So bring your questions.
You know, we'll talk light up.
And, um, it'll be a moment for you toreally explore the options for your
(33:58):
patients, for your practice and decideif this is something you wanna try out.
There's no cost, right?
So it's, it's an easy, it's an easy entry.
Regan Robertson (34:05):
Wow.
Well, thank you so much.
If people want to, uh, get in touchwith you in the meantime, because I
know you're gonna go register clinicalcalibration.com, but other than that,
how can people get ahold of you?
Dr. Tanya Dunlap (34:16):
So, uh, the easiest way is support@perioprotect.com,
but if you get my actual nameand number, it's T Dunlap.
So T for Tanya Dunlap,LAP at Perio Protect.
That's a really easy way,um, to get ahold of me.
Regan Robertson (34:31):
Thank you Tanya, so much for sharing your passion.
Thank you Reagan, and helpingimprove all the patients.
Dr. Tanya Dunlap (34:36):
Thank you very much for your interest and for this time.
I've really enjoyed it.
Listeners, doctors, hygienists, assistants, what would happen?
Close your eyes with mefor a quick second here.
Imagine what it would be like ifyour patients could easily understand
their periodontal health just aseasily as you understand your blood
pressure or your cholesterol score.
(00:20):
That would personally blow my mind.
You know, I've been in dentistryfor, uh, a decade and a half and I am
still learning new things every day.
And one of my favorite thingsabout our upcoming guest is, you
know how much I love to bring youreally high quality people that are
passionate about solving a problem.
And on everyday practicestoday we have Dr.
(00:44):
Tanya Dunlap.
She is the Vice President ofPerio Protect, uh, which I
think you've been at since 2005.
Dr. Tanya Dunlap (00:51):
Yeah, 20 years now.
Regan Robertson (00:52):
20 years now.
So you're well in the passion category,you know what you're talking about, and I
cannot wait to jump in and really discussthe benefits of, uh, the health benefits
of it, but also, you know, the overallwellbeing benefits of what it means to
be able to connect with our patientsand communicate in a way that does that.
(01:13):
Aha, I understand that this is importantand that there is a solution to it.
Dr. Tanya Dunlap (01:18):
Right.
Regan Robertson (01:18):
So could you tell us a little bit about your background and,
and what, why, why periodontal health?
Dr. Tanya Dunlap (01:25):
Well, this was not an anticipated, uh, career path.
Um, and it's a long story, but I willsay one of the things that really
made it possible for me tounderstand better the every
day, I'm not a dentist, right?
I'm a PhD. So just that everydayclinical experience was working on
(01:49):
controlled clinical trials, testingPerio Protect as an adjunct to scaling.
Versus scaling alone and reallykind of getting into the nitty
gritty of clinical trial design.
I was the, um, researchliaison for the company.
There was independent contractors forstudies and independent statisticians,
and we had a periodontist onthe team also for, for consults.
(02:12):
Um, it was a really good time andfun to, to kind of be part of this
team and to see what they were doing.
So that's where I got my chops and that'show I really became the go-to person
to understand what Para Protect is.
And if you are listening andyou don't know what Para Protect
is, it's an adjunct home care.
Um, it's a tray that is cleared by thefood and drug administration to liver
(02:36):
medication really deep below the gum line.
And when we say really deep,we mean up to nine millimeters.
So it is great for patients who'vegot, you know, shallow pockets and
gingivitis and chronic inflammation.
It is excellent for patients whoneed really complex treatment plans
and you wanna maintain them betterat home between office visits.
That's what we're about.
Reducing the infection, the inflammation,even reducing pocket depths, um,
(03:00):
between office visits and you just usethis tray, it's custom a, it's got an
internal peripheral seal so that yourmedication doesn't leak out and you
just wear it 10 to 15 minutes at a time.
The primary antimicrobial.
It's kind of a fun story.
Do you wanna hear it?
I do wanna hear it.
Okay.
So I know all about this 'cause myfather was the person who created this,
uh, medical device and so I was in thebackground as he was working on this
(03:23):
for longer than the company was around.
Regan Robertson (03:25):
And your father is a dentist?
Is that He's
Dr. Tanya Dunlap (03:27):
a dentist, that's right.
Yep.
His name is Dwayne Kel.
And he created this trayinitially for his mother.
She ended up needing periodontal surgery.
She was an advanced, um, case, and so,you know, sent her out for surgery.
She comes back, he says, you look great.
We're ready for the next one.
She said, oh, we're not ready.
I'm not doing it.
You gotta find another waybecause I'm, I'm not gonna go.
(03:49):
This was before lasers, beforeGBT, before all the easier things.
And so he, uh, he, she looked athim and she said, I promise you.
I will do whatever you wanna try and, andwe'll come back and we'll see if it works.
But you've got to find some other way.
And it it, to be clear, noteverybody can avoid surgery.
(04:09):
You have deep vertical defects,you have ulous tissue down there,
doesn't respond to anything topical.
Your scaling's not gonna touch it.
Lasers would be helpful.
Um, but sometimes you need surgery inher case because she wouldn't do it.
Um, he created a variety of.
Delivery methods to get themedication deep below the gums.
(04:30):
And originally he was trying touse tetracycline because it was an
bacterial based infection, right?
Everybody knows antibioticsare these wonder drugs against
bacterial based infections.
But it was the design of thetray that was the first part.
And that took a long time to figureout, because if you just use a
vacuum form tray, it leaks outand it doesn't get deep enough.
And so he figured out howto create this custom seal.
(04:53):
And there there's some,uh, real crafting to that.
Then within that sealed system, so theseal, there's a seal all the way around
the internal peripheral edge and a shortextension, and that works like a gasket,
prevents the medication from leaking out.
He added, at the time, hydrogenperoxide a gel because he wanted what
he called the propulsion agent to see.
(05:14):
This is back in the experimental daysbefore it even went to FDA, um, and ex to
seek how deep they could get it, right?
Yeah.
I mean this was, he was just.
Trying to solve a problem for hismom and his other patients, and he
started to get really good results.
He got it cleared through the Foodand Drug Administration, so now it
is a prescription medical device.
So it, it applies to HSAs and FSAsand all the things that, and he can
(05:38):
legally take it to market at the time.
So he's talking to a patient one dayand he says this, you are doing great.
Excellent job at home.
Just keep it up.
And she said.
Do I need that liquid medication anymore?
And he said he kind of stopped and hesaid, um, the liquid was the antibiotic.
How long haven't you had it?
Oh, I've been without thatfor weeks, maybe months.
(06:01):
And then he realized it wasn't theantibiotic, it was the hydrogen
peroxide that was actually thebeneficial therapeutic agent.
So then he like scraps everything,goes back to the drawing board, goes
back to the literature, and startsinvestigating how can this be?
And it turns out.
Hydrogen peroxide and the primaryantimicrobial that we've tested
(06:22):
all these years and recommendis just 1.7% hydrogen peroxide.
So it lightens your teeth.
But not, not, it's not like a Wow.
Overnight.
I need side on it.
It is, yeah.
Yeah, it is.
But it does two things.
It debrides bacteria and so every timeyou use this tray, the tray pushes
them, the tray's just a delivery device.
It pushes medication deep it youpeel off another layer of cells, just
(06:45):
like if you had an onion and therewere layers, you peel it off, but.
What's really important is as it'sbubbling up, you know, like if you
have a brown, if you have brown bottleperoxide and you have a cut on your
hand and you pour it, what happens?
Reagan?
Regan Robertson (06:56):
Yeah, it does.
It bubble.
It thises up.
Dr. Tanya Dunlap (06:58):
I know, right?
Exactly.
And it's almost foamy sometimes,depending on how big your cut is.
This gel's very different.
What's happening when it's bubbling up?
It's releasing oxygen becauseyour hydrogen peroxide is
turning into oxygen and water.
Now when you have, yeah, yeah.
When you, when you have a cuton your hand and you put a
little bit of perio gel on it.
It doesn't foam.
(07:18):
It's a very different formulation.
It has a slow, constant releaseof the oxygen and water instead
of that kind of explosive.
Yep.
And what that means clinically is you'regetting a consistent release of oxygen.
So this matters when you are trying totreat the bacterial based infections below
the gums, because the deeper you get inthe pocket, the less oxygen there is.
(07:39):
And then you have Ana, an anaerobicbacteria, specifically gram-negative
oblig, anaerobics, proliferating.
So when this tray can deliver themedication, then the oxygen really deep.
You change the environment and thatis the, the way you are really able to
get this long-term health and healing.
(08:00):
Because when you put oxygen down deep,it's toxic to your gram-negative robes,
but it also creates the right conditionfor healthy bacteria to repopulate.
And that's what we want.
Regan Robertson (08:10):
No way.
Okay.
So are antibiotics still used todayas part of that decision process?
Yes.
Dr. Tanya Dunlap (08:16):
Okay.
Antibiotics are still usedtoday and they can be helpful.
They could be taken systemicallyand sometimes they're applied
locally and sometimes they,they do have a positive effect.
The problem is, is they wear off andthe bacteria tend to repopulate, and
patients rightly so, cannot, they can't.
(08:36):
They just physically can't.
Clean deep below their gums at home.
So we often wanna blame patientsas professionals, right?
They're not doing whatthey're supposed to do.
And most of them aren't flossing.
Most of 'em aren't.
And if, if they are, theydon't have great technique.
But floss is gonna have betterplaque control for cariology
than it will better biofilm.
Control for gingivitis orperiodontitis Your toothbrush, rinse
(08:59):
and floss, can't get deep enough.
That is why you need Well, yeah,
Regan Robertson (09:03):
and it wouldn't, it wouldn't make
sense to just take antibiotics.
You've got resistance, youknow, or, or allergies.
Uh, that's right.
Then if you're, you know, then, thenyou're out completely with that.
Uh, I, but I have anignorant question for you.
I love very much how you arereally clinically nerding out.
So if you're listening right nowas a doctor or clinical, this
probably makes a lot of sense to you.
To me, this is all very newfrom the clinical aspect, so.
(09:27):
It's also exciting.
So if you are a patient that is, um, maybein the gingivitis stage, is it something
that you continue, like you have thistray and you just continue it, like as a
preventative for the rest of your life?
Or do you use it sporadicallywhen things pop up?
How does it, how, how does thatconversation come about with the patients?
Yeah,
Dr. Tanya Dunlap (09:47):
so ideally you're gonna be using it.
For life.
I personally think it's asimportant as a toothbrush.
I've been using it almostevery day for 20 years.
Mm-hmm.
Some people stop for a while,the bleeding comes back, they
start using their trays again.
But the ideal situation is we getyou healthy and we keep you healthy.
Yeah.
And the disease goes into remission.
And if, I mean, let'sjust look at the stats.
(10:10):
47% of American adults over the age of30, they're young, have already lost bone.
They have chronic periodontitis
Regan Robertson (10:18):
over 30.
Dr. Tanya Dunlap (10:19):
Over the age of 30, by the time we are 65, 70% of US adults
have lost bone 'cause of the infections.
Regan Robertson (10:28):
When did this, when, so Perio Protect has been around since when?
Dr. Tanya Dunlap (10:32):
2005.
Yeah.
Regan Robertson (10:34):
So this is a, to me, this is a travesty.
Like that's ridiculous.
That number is ridiculous.
Dr. Tanya Dunlap (10:40):
It is.
And the reason it can get outtacontrol like this is because this
is a disease that doesn't hurt andthat we haven't taken so seriously
because it's just a little bleeding.
Yeah.
And you don't see it.
You might see it when you brush yourteeth, but most of the time you're
swallowing all of this and you havethis chronic infection in your gums and
it's very common, but it's not healthy.
And so you asked at thebeginning of this show.
(11:03):
How do we, how do we distill thisdown so patients can understand it?
Right.
Well, let's talk first about howimportant it's, if you leave these
chronic infections untreated ingingivitis or periodontitis stages,
it makes it much harder for a typetwo diabetic to manage blood sugar.
It can,
Regan Robertson (11:18):
that blows my mind.
Keep going.
I just thought, I, I heard that theother day and I was like, wait a minute.
Back up.
Like, these are discussions I don'tthink we're having, um, in a clinical
setting as much as we should.
Dr. Tanya Dunlap (11:30):
And we, and we need you.
You hit it on the head when you open.
We need ways to do it quickly and tobe able to capture their attention and
do it in ways people can understand.
But it, if you have cardiovasculardisease in your family or you personally
have high blood pressure, this chronicinfection in your gum can actually
trigger arterial inflammation.
(11:51):
It contributes to the progression,not cause yet, but progression
of dementia and Alzheimer's.
There are some cancers that are associatedwith, I mean, there's just so many things.
So if you had a, even if youhad a fingernail that was
chronically infected mm-hmm.
It would bug you.
You would, you would want to do something
Regan Robertson (12:06):
about that.
Right.
Yeah.
There, there have been like thesecornerstone moments in my life where
a clinician will explain something tome and I clock it like it makes sense.
And one I don't remember, so I can'tattribute Maybe Michelle Hudson.
Yeah.
Want, there was a clinician thatsaid if you have a bleeder, even one.
It's not just a bleeder, treatit like an open wound if you
(12:28):
had That's exactly right.
Okay.
That like, clicked in my head and Irealized, 'cause I have heard, I've
heard that Oh, it's just a, you know,you just got a bleed one bleeder
and, and you just roll over it.
Not knocking my own clinical team,but I mean, I, I can see how it
can get glossed over so easilyand we don't take it seriously.
(12:48):
Right.
Dr. Tanya Dunlap (12:49):
It's easy to, to not take it serious.
And, and I like to throw upthese pictures on a big screen
of gingivitis and periodontitisand say, what do you all see?
And then they'll, they'll describeall the things they see clinically.
And I'll say, we alsosee chronic oral wounds.
You are practicing everyonelistening In dentistry, you are
practicing chronic oral wound care.
(13:09):
When you treat patients withgingivitis and periodontitis, you
are running a chronic oral woundcare center out of your operatories.
Regan Robertson (13:17):
That sounds disgusting.
It's, I mean, it doesa chronic open wound.
Dr. Tanya Dunlap (13:23):
It is.
It's chronically infected.
It's a chronic burdenon the immune system.
It might be low grade, but look,your immune system is like a battery.
Mm-hmm.
There's only so many things that can behooked up to it before it's power fades.
So you can do something aboutthese infections in your gums.
Right.
Let's unplug that chronicsource of infection and let
your body focus on other areas.
Regan Robertson (13:44):
This reminds me a lot of the, uh, the heart attack gene by Dr.
Yes.
Pasley Bale and Amy Jonin.
I think that was maybe like 2016 or 2017.
My eyes were opened up into whatchronic inflammation can do, and
then it was still several yearsbefore I was able to go through my
own health journey and understand,um, my own health from a systemic.
(14:05):
Point of view.
Right.
Uh, what are you, I, I'm very curious,what does the, um, adoption rate
look like for those who are puttingPerio Protect in, in the practice?
And what sort of objections do you hear?
Because it's easy.
It's easy for me, or it's easyfor you, especially since you've
been in Perio Protect to say,oh yeah, this is a no-brainer.
Like this is, this is, ofcourse we should have this.
(14:26):
What are some of the things that you'veheard that make people say, ah, you
know, I don't know, they don't need it.
Or like, you had me therewith the slow release.
Uh, because I have heard, uh, andagain, I don't remember where, but I
have heard like if you just take somehydrogen peroxide and put one of those
little Christmas tree looking flossythings and just go between your teeth.
Yeah, I've heard that.
(14:46):
So like.
Does that, like, that wouldn't bethe same because that's an instant
release versus a slow release.
So That's right.
Maybe be my eyes and ears.
What have you heard over, over your,you know, years with Perio Protect
and, and some of the objections?
Dr. Tanya Dunlap (15:02):
Right.
Well, for some, some patients, exactlysay, why can't I just use a rinse?
Why can't I just rinse?
Why can't I put hydrogenperoxide in my water flosser?
Or put some gel on there, interinterproximal brush and brush.
Um, so the number one problem with a rinseis that it just doesn't get deep enough.
Your interproximal flosserwould get deeper than a rinse.
Yeah.
But it still needs contact time.
(15:23):
So this is the partabout hydrogen peroxide.
It has to be held in placelong enough to be effective.
And I can't speak about otherformulations, but the, the gel that we
have tested in, in the perio tray needs 10minutes of contact time in order to, so.
A little bit.
Your bacteria live in a living film,a biofilm, and there's could be
(15:46):
hundreds of different species in there.
And they're all communicating.
And what one bacterial, um, speciesis producing as a byproduct,
another one uses as a food source.
It's totally fascinating and complicated.
It's covered in a layer of slime.
They call that a matrix.
You need time to be ableto cut through the matrix.
(16:07):
Antibiotics.
Can't do it.
Well, this is why when you place anantibiotic, you do it when you do
scaling because an antibiotic can'tcut through that layer of slime.
Well, chlorine based productsand peroxide based products
can, but it takes a little time.
We need 10 minutes to be able tocut through the matrix, the slime,
and then penetrate the bacterialcell walls of, and you're just
doing the exposed surface layer.
(16:29):
We want you to wear the tray for15 minutes because then you get
almost all the oxygen benefits.
You can go longer.
It doesn't help you, but youneed at least 10 minutes.
So most people are like, am I gonnahave to do this for the rest of my life?
And I, and I say, that'sanother objection.
I say, you get to, this is a way, it's
Regan Robertson (16:44):
not that long.
Dr. Tanya Dunlap (16:46):
So you tie it to something you do.
If you ever, um, read Atomic Habits.
Regan Robertson (16:50):
Oh, yes.
I love atomic Habits.
Oh, how you stacking?
Let's have it stack this.
That's right.
You're gonna stack your habits.
Exactly right.
Dr. Tanya Dunlap (16:57):
So I, you know, I tend to wear my trays in the
morning when I'm getting ready.
Some people are reallyritualistic about that.
Every shower before you shaveand shower, if you're a guy,
um, I've, I have a new puppy.
I've been wearing my trayswhile I'm walking this dog.
Uh, you know, there's all thesedi different things you can do.
To stack the habits andmake sure you do it.
And the thing about Perver Protectis that there is a level of clean
(17:19):
you didn't know you could get to.
And if you do, you use this fora while and your mouth feels,
this is what patients say.
They'll say, my mouth justfeels so clean and my breath
is so fresh, which is all true.
I personally think the freshbreath is nicer than whiter teeth.
Uh, 'cause you know, with this, youdon't even wake up with morning breath.
Those of you who are part ofthe profession and you take
(17:41):
great care of your mouths.
I know you do.
You won't even wake upwith morning breath.
But, um,
Regan Robertson (17:45):
but if somebody, but from a patient perspective, if somebody
told me, do this 15 minutes and you'regonna wake up without morning breath.
Dr. Tanya Dunlap (17:53):
You can.
That's the
Regan Robertson (17:54):
best marketing campaign I can think of.
Dr. Tanya Dunlap (17:56):
You can, yeah.
We say you can get closerto the ones you love.
'cause sometimes you can smellpeople before you can see 'em.
Right?
Like they, right.
Regan Robertson (18:03):
Yeah.
I've not known, like I didn'tknow before, uh, joining dentistry
what it was, but they're, yeah.
I've, I've been, and you, you can almostsmell them coming towards you and then
you have to be around it and it's,it's painful and it's uncomfortable.
Dr. Tanya Dunlap (18:15):
It's uncomfortable for everybody.
Like if you're on an airplane and youknow what that is, you Yeah, yeah.
It's, I, I have to stop myselffrom telling, talking about it
on an airplane because I knowthere's a really good solution.
Um, so I think for patients, when theyfind out how comfortable it is, how
easy it is to use the side effects,you know, you can drink as much red
(18:35):
wine and coffee as you like, and youare gonna have really white teeth.
You just do it 10 to 15 minutes a day.
Um, but the rinse doesn't get deep enough.
I think from the professional side,what most people are concerned
about is if we put patients in PerioProtect and then they need restorative
work down the line, what happens?
Or if a patient has really seriousperio but also has restorative
(18:57):
needs, what do we do first?
And so we just talk throughthose different scenarios with
people to help them understand.
But you want it not
Regan Robertson (19:02):
to be bleeding first, I would assume.
Dr. Tanya Dunlap (19:05):
And, you know, sometimes you end up with really complicated
situations, but best case scenario, youget the Perio Foundation, but you also
want to address those restorations too.
And, and people have limited money.
So how do you figure that part out?
And so we often work aslike an office consultant.
Um, we've been doing this for a long time.
We have treatment protocols, we have, um,experts you can talk to, periodontists
(19:28):
too, that will also weigh in.
Um, and so we do as muchas we can to be helpful.
Regan Robertson (19:33):
Is this, is this a product that is direct to consumer
or only through dental practices?
Dr. Tanya Dunlap (19:38):
It's only through the dental practice.
So that trade is, um, clearedby FDA as a prescription medical
device, so it does require thatcomes through the dental office.
Then they get it.
'cause it's made specifically for them.
And some docs will,
Regan Robertson (19:52):
consumers could be educated and drive this, because I
think if consumers really new, um,preventative health, you know, is such
a, it's not just a hot, trendy topic.
It's such a critical topic right now.
And healthcare in Americahas, is just, um, feels like
it's on fire in so many ways.
There was one thing I don't wanna glossover here that you said that was highly
(20:12):
intriguing to me and that's that itgets in and gets the bad stuff, but it
does not, uh, not only does it not harmthe good, but it allows an environment
for the good bacteria to thrive.
And I know with antibiotic, I mean,imagine, I don't know if you're
working on this, but what if wewere able to do this at a gut level,
Dr. Tanya Dunlap (20:27):
right?
Yes.
The gut is totally.
The next frontier.
Everybody's looking at it, right?
Leaky gut.
I hope everybody's looking at it because alot of people sleep just sits in your gut,
Regan Robertson (20:37):
right?
I
Dr. Tanya Dunlap (20:38):
mean, yeah.
Regan Robertson (20:39):
Wow.
Wow.
So you, you, you do, so it, it doestruly allow the good bacteria to thrive.
Dr. Tanya Dunlap (20:47):
It does.
Because you are adding thisoxygen, you're, it's all about
the environmental conditions.
So you change the environment, you changethe kind of bacteria that can thrive and
look, we're never gonna be able to get ridof all the bacteria and we don't want to.
You want a healthy microbialimmunity that lives in a symbiotic
relationship with the host.
That's what we're after.
Regan Robertson (21:07):
What are the doctors, uh, I want, I'm gonna give
you a second to think about this.
I don't wanna put you on the spot, but,but the doctors that you've seen that
have implemented this in, in practice, isthere anyone that's particularly memorable
or you think is doing a really goodjob with this, explaining the benefits?
Dr. Tanya Dunlap (21:21):
I am, and I do wanna get back to like the easy way to explain
it to patients, but there are two orthree that come really front to mind.
Michelle IES in Jacksonville, Florida.
Yeah.
Her office is so in tune to PerioProtect and the benefits and the patients
talk to each other in the waitingroom and say, you don't have that yet.
(21:42):
You should totally get it.
This is why.
Then they come back and ask for it.
Right.
That's that's exciting.
We have another doc in Chicago, a team Dr.
Joseph and Eileen Zel.
They're a terrific, um, team andtheir patients, they're, they're
truly honing in on root cause, right?
And making sure people understand thisand really going above and beyond.
(22:07):
So there are other drugsyou can put in these trays.
So the hydrogen peroxideis what everybody knows.
It's branded as perio gel, and it's 1.7%hydrogen peroxide, low concentration,
all the things we've talked about.
There are other drugs you can putin there and they've documented
bone stabilization and they're nowbeta testing some medication that
we are offering for, um, patients.
They haven't been para protect patientsbefore, but they have such serious
(22:30):
sensitivity that it's miserable to come.
So we've got this new option that it'sgonna be released here soon, um, that
people can use to desensitize and it'sgetting great, uh, patient reviews so.
Re one of the best parts of my job,Reagan, is getting to know these
clinicians who care deeply abouttheir patients and their teams.
(22:52):
They want good culture in theiroffice too, but really care deeply
about their patients and they'redoing this for the right reason.
'cause they want to end those chroniccycles of infection and inflammation.
And as you mentioned, it is hard totalk to patients about that, right?
Yeah.
So we created, it's takenme a while to do this.
I have been, uh, doing market.
(23:12):
I'll call it market research, but really,um, focus groups since 2018, and I have
been talking to people saying, how muchbleeding is it okay to have in your mouth?
Like, how many set?
Because, well, you chart this, right?
As a dental professional, you charthow deep their pockets are, whether
they're bleeding, clinical attachmentloss, as often as you do that, okay?
(23:32):
So let's say your patient has 168possible bleeding points, right?
They, you don't have wisdom teeth.
You have a hundred sixtyeight, six six per tooth.
How many is it okay to have?
Is it okay to have 30?
Is it okay to have 16?
Is it okay to have five?
A lot of people wanna say zero.
And I say yes, that's ideal.
Yeah, but I don't think you'regonna get every person to zero.
(23:53):
We should try for it.
We should.
Yeah.
Um, zero would be the ideal, but,but what's, you know, what's healthy.
No one knows.
Regan Robertson (24:02):
We don't know.
How can we.
No, I think that the goal, thegoal is to keep the inflammation as
low as possible, so That's right.
And we know, I think we, I mean, I lovehow I say we know, I've been told and
educated that hormones can change it.
So if you have hormonefluctuations That's right.
That, that can change it.
Um, I mean, personally I know I'vehad a visit where I had bleeders
(24:22):
and I was like devastated andthen the next time I had none.
And yeah.
And it was, you know,the hormones changing.
Can, can play a factor to it.
So.
I wonder if perhaps the right sincenobody maybe has the term for what
the right answer is, I think theright answer is zero, but maybe
it's, it's a pattern over time.
So making sure that people aregetting in for their, you know,
(24:43):
their annual That's right.
Don't even get me started on whocame up with six months and why
they came up with six months.
I, I, if I could see mine everymonth, I probably would, but
that's because I'm a weirdo.
So
my hygienist has an air, what is it?
Air Max prophy or whatever.
You even know what they have.
Oh, she's amazing.
Yeah.
So I, I, I know I'm an odd ball there, butit, I. I just am so pleased that you and
(25:08):
Perio Protect, but you know, Kim Koch andall of the others in, in our world right
now that are focusing on the systemiclevel of care and, and preventative
health is just, I can't say enough how,how much it means, um, you know, to,
to our world and our future generation.
So if we, if we also set the expectationthat, you know, zero is where you want
(25:29):
to be at, that starts to, you know,you can reinforce that Strat over time.
Dr. Tanya Dunlap (25:34):
And you need to be able to do that quickly because it
is hard to get people's attention.
So what we ended up doing, and I wanna beclear here as I don't wanna be dismissive.
Um, the a a P has set up 10% or less ofyour sites are considered healthy, right?
You want a zero of the, or there's astandard, there's a professional standard.
Yeah.
But when you talk to patients, you'relike, well, what do you, what do you
(25:55):
think 16, 17 sites, is that healthy?
And they're like, eh, so.
In focus groups, we'vecome down to 10, 10 points.
Bleeding points.
You can do 10% if you want, but10 points, 10 or less we consider
healthy and zero is ideal.
And so we did this whole campaignlike, what's your number?
We even had scrub caps that say,what your, what's your number?
And I was like, I'mgiving these to people.
(26:15):
It's not a pickup line.
We want them to ask a questionlike, what's your number?
Regan Robertson (26:19):
So the number is not your pocket depth.
I, no, I have, what's your gum score?
And I was like, well, that'sgotta be your pocket depth.
Dr. Tanya Dunlap (26:28):
What's your gum scores?
How many bleeding points you have?
Because how do you know if you're healthy?
It doesn't, you know, it's doesn't hurt.
Nothing's, you know, yourteeth aren't mobile yet.
You can mask your bad breath and youmight see some blood when you gloss
especially, or, or brush, but you're like,ah, it's not doing that all the time.
(26:49):
Right?
So here's how we did it.
We created a gum score with anumber on the numbers, the number
of bleeding points, and we use thatjust like you did for blood pressure.
Like how do you know if your bloodpressure is in a normal range?
Regan Robertson (27:00):
It's, you've got your number, your top and your bottom.
That's right.
You, you look at the coloredchart that say, there you go.
You know, on the wall.
Am I in, in range, out of range.
That's right.
Dr. Tanya Dunlap (27:09):
Or your cholesterol or
Regan Robertson (27:10):
blood sugar or whatever it is.
Right.
Dr. Tanya Dunlap (27:13):
So wouldn't that
Regan Robertson (27:13):
be great to have that as a little poster on the wall too?
Like a little color coded?
What's your gum score?
Just like your blood pressure.
You could even, that'sright, you don't do that.
You should do that.
'cause that would be mimicking, right?
Dr. Tanya Dunlap (27:24):
So we have this whole campaign rolling out.
You don't even know that.
But yet you.
Regan Robertson (27:28):
No, no, I came, no listeners.
I came into this blind.
Like I come into most of my interviewsintentionally so that I can be
just as curious and, and maybeignorant as you are, uh, with a
little bit less clinical knowledge.
But no, I didn't know that.
But that would be, I, I can't wait.
I can't wait to see this campaign roll
Dr. Tanya Dunlap (27:44):
out.
Well, I will give you theless than a minute, five point
presentation for a patient.
Okay?
So you come in, let's say you have 48bleeding points, Reagan, when you come.
So we do the whole thing and, and then.
As your hygienist or your professional,I would say I'm concerned that
you have a high gum score.
It's 48.
That means there's 48 areas in yourgums that are infected and bleeding.
(28:06):
Now, the ideal score would be zero,but we wanna get you under 10.
So we're trying to move from 48 underto 10, as close to zero as we can.
The third point is so important.
I know you're trying hard at home.
Yeah.
The problem is that your toothbrush rinseand floss just doesn't get deep enough.
That's why we prescribe Perio Protect.
This is a special tray that's madejust for you that will gently deliver
(28:28):
the medication deep so that themedication can fight that infection.
You just wear 10 to 15 minutes a day.
Not only are you gonna havehealthier gums, you're also going
to have wider teeth and superfresh breath and then stop talking.
'cause you told 'em a lotrightly that go along with it.
All of it.
Yeah.
Right.
Let it sink in because then they'llcome up with questions and, and if
some people say, I need to think aboutit, there's two routes you can go.
(28:51):
This is no sales pitch, no pressure.
We don't, we're not trying tolike sell anybody anything.
We just give them the information thatwhat do you think is the best care?
And they get to choose it.
So if they say, I need to think aboutthis, I would say, I'm really glad you are
gonna con, continue thinking about this.
It's, it's important'cause this is not healthy.
What can you do differently nowat home to improve your health?
(29:12):
So.
What can they do differently?
It's up to them and I silently,awkwardly wait for them to
answer right it, that it can be
Regan Robertson (29:19):
painful, but it's really, it's important to let the brain
process what it's heard and see you getnervous, you know, we fill the space.
But allowing when you say suchan important anchor statement
and you deliver it with thatcare of this is really important.
Um, yeah, it painful for you,but it really does a service
for the patient to allow thatsilence to sit for a little bit.
Dr. Tanya Dunlap (29:40):
And then you also get some judge by what they say as to what
is their dental acumen, because theymight say, oh, I'm gonna floss every day,
or I'm gonna brush twice, or whatever.
And you say, terrific.
That is a good first step.
We're gonna document that and we'llscore your gums when you're in next time.
In the meantime, you hand 'em a brochureand you say, not gonna floss there.
Well, even if they do,it's not gonna matter.
It's not gonna get deep enough.
(30:01):
Right.
Regan Robertson (30:01):
That and you know, that piece said that to
your four step process there.
I was gonna say, do you know howamazing it's gonna feel to be like,
this isn't, you could even say,you know, this isn't your fault.
Like you could brush That's right.
And floss several times a day andyou're still not gonna get deep
enough that that like takes thatpressure off that person and middle.
That's the idea.
Because people
Dr. Tanya Dunlap (30:18):
who are defensive, like they can't hear you.
You know, though.
They, it, they're closed off.
They can't understand what you're sayingand you are like right there with them.
'cause you want better results for them.
Yeah.
And it's not your fault.
They want better results andhonestly, it's not all their fault.
Uh, sometimes that'snot their fault at all.
And so to be able to say that and then.
(30:40):
What are you gonna do differently?
That's good.
Let's, let's start there andwe'll score your gums next time.
Take this brochure.
Let me know if you have any questionsbefore your next appointment, and
you just go two different routes.
My, my main concern for you is theinfections around your, your, uh, crowns.
We've been monitoring those.
We want your crowns to lastas long as possible, and they
will with healthy tissue.
Or, my main concern is that thischronic infection in your gums is gonna
(31:04):
make it harder for you to manage yourblood sugar as a type two diabetic.
You just stop talking becauseit's, it's totally up to them.
They get to decide what they,what they do and don't do.
But they can't make adecision if they don't know.
Regan Robertson (31:16):
No, and, and it's un and it's not fair for them not to know.
I think that's Heather and it, forme, the travesty, like I said before,
it, they don't have this as an option.
Then, and they, and they're stuckto just brushing and flossing
and we, we know that that's notgoing to do what it needs to do.
That's, that's unfortunate.
And it's not that thisis the only solution.
There are other solutions, but thereare, to me, um, you know, if I have
(31:38):
an opportunity to prevent surgery,perhaps, uh, you know, and be in
that preventative space or to prevent
Dr. Tanya Dunlap (31:42):
bone loss in the early stages.
Regan Robertson (31:44):
Yeah.
Or.
Dr. Tanya Dunlap (31:45):
To prevent the infection around the implants that you just put in.
Right?
All of these things are good reasons.
Regan Robertson (31:50):
Oh, that is some of my favorite discussions of all is how are
you gonna take care of this investmentthat you have just put in your mouth.
Yeah.
Those crowns are though some, thereare some dentistry, which we know
is a serious investment, so It is.
That's right.
You want to keep the, the tissuearound it really healthy, but you
have to have those conversations.
Dr. Tanya Dunlap (32:07):
Right.
And we hope, um, if anyone tries outthe gum score that it will get your
patient's attention so that theyaccept treatment that they need.
Whether it's higher protector not, it doesn't matter.
Yeah.
I mean, I want that, butyou know what I mean.
It's important that patientsunderstand that that chronic
infection needs attention.
Regan Robertson (32:30):
Tanya, your passion for this is, is incredible.
And uh, I am really thrilled to announceI did not forget, but I held it off.
Listeners, uh, you are going to bepresenting for free so anyone can attend.
That's right.
This coming, um, September 30th.
So, clinical CalibrationInstitute is hosting a mastermind
session with you to dive deeper.
(32:53):
Into this topic.
I just came up with that on the fly.
I'm just so clever.
Uh.
We're gonna dive deeper intothis topic, and, and it is, it's,
it's really gonna be, you know, aproduct agnostic mastermind session.
So it's, you get CE for it, it's aGD compliant, and I just cannot, I
can't believe that you're gonna, I'mreally excited that you're gonna do
this, and I know that you're gonnado this because of your passion and
(33:14):
all of the education that you have.
So this will be September30th open to everyone.
I think it's 1:00 PM EST. So if you,uh, listeners, if you wanna hear.
Tanya, go deeper into this.
Go to clinical calibration.com and youwill see an area to sign up for it.
Is there anything that youwant people to know about this
particular mastermind session?
Dr. Tanya Dunlap (33:34):
So bring your questions.
We will have images, so you'll getto see case studies as we go through.
We can talk about as much research as you.
I used to be the research liaison, so Ireally, I love talking about that, Dale.
I spent four years of my life on it.
So bring your questions.
You know, we'll talk light up.
And, um, it'll be a moment for you toreally explore the options for your
(33:58):
patients, for your practice and decideif this is something you wanna try out.
There's no cost, right?
So it's, it's an easy, it's an easy entry.
Regan Robertson (34:05):
Wow.
Well, thank you so much.
If people want to, uh, get in touchwith you in the meantime, because I
know you're gonna go register clinicalcalibration.com, but other than that,
how can people get ahold of you?
Dr. Tanya Dunlap (34:16):
So, uh, the easiest way is support@perioprotect.com,
but if you get my actual nameand number, it's T Dunlap.
So T for Tanya Dunlap,LAP at Perio Protect.
That's a really easy way,um, to get ahold of me.
Regan Robertson (34:31):
Thank you Tanya, so much for sharing your passion.
Thank you Reagan, and helpingimprove all the patients.
Dr. Tanya Dunlap (34:36):
Thank you very much for your interest and for this time.
I've really enjoyed it.
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