Below, I’ve entered a rough draft of a letter to be sent to the Academy of Laser Dentistry. All critiques, corrections , and criticisms are welcome to help refine this before sending.
It was great meeting with all of you yesterday.

President
Tony Hewlett, DDS
Stanwood, WA
360-629-4597
Fax: 360-629-6382
tony@drtony.net

President Elect
Steven Burman, DMD
Manalapan, NJ
732-972-9950
Fax: 732-972-9952
drillnfill@aol.com

Executive Director
Gail S. Siminovsky, CAE
Coral Springs, Florida
954-346-3776 x 202
Fax: 954-757-2598
laserexec@laserdentistry.org

Dear Leadership of The Academy of Laser Dentistry,

I am writing you today, to inform the leadership of the Academy of Laser Dentistry, regarding a current situation affecting laser dentistry in Michigan. If this situation is allowed to stand, there is no doubt in my mind, that it will adversely affect the practice of laser dentistry not only in Michigan but around the world. This situation sets a precedent of allowing insurance companies to dictate how procedures are preformed, as well as, with what instrumentation.

To bring you up to date, I’d like to present a little background information.

In Michigan, there currently are approximately 17 general practice dentists who use the Periolase and perform Laser Assisted New Attachment Procedure (LANAP). As you know, this procedure is patented and FDA approved. There also are four periodontists in the state who use the laser and also perform the procedure. The ADA has opined that the correct ADA coding for this procedure is 4260 (need to attach reference letter for this and reference here)

Over the last couple of years, eleven of the general dentists, have been placed under ‘random focused review’ by Delta Dental of Michigan with more being added each year. No specialist has been placed under this review. These dentists have been placed under ‘random review’ even though they have had prior approval of the procedure and met all of Delta’s guidelines and requirements for codes 4240 and 4260 (attach reference here)

During this ‘random’ focus review, each dentist has been required to submit all of the relevant notes and records regarding three ’random’ cases which all ‘just happen’ to involve codes 4240 and 4260. Upon review, Delta Dental has been either denying claims or disallowing them based on the new ADA position paper on lasers (see attachment). ‘Denying a claim’ allows the dentist to charge balance to patient and ‘Disallowing a claim’ prevents the patient from being charged for a procedure that has already been preformed by a participating dentist. Delta has decided, based on the release of this ADA postion paper, laser use in periodontics is ‘invesigational’ and thus not a covered benefit. They also have gone back and denied or disallowed 4260 and 4240 cases preformed before release of this new ADA paper.

These denials, not only set the bad precedent of reducing the amount of patients who can afford this proven procedure (place reference to Yukna/Tilt studies here) but also set a precedent of allowing insurance companies to dictate, to dentists, what instruments they can use to do certain procedures. This causes my colleges, and myself, great concern as it relates to laser dentistry.

While I am sure that, reading between the lines of this letter, you can see a potential turf war between periodontists and general dentists regarding the use of lasers in dentistry, and you should know there is more going on behind the scenes with connections within Delta Dental and former partnerships with periodontists, that really isn’t the primary concern of the affected general dentists here in Michigan. Our concern really stands with the ability of our patients to receive laser procedures, the freedom to use lasers in our practices, and the precedent this sets if allowed to stand.

Allowing this policy to stand, most certainly, will cause other insurance companies to adopt policies which are similar and will be detrimental to the advancement of the use of lasers in dentistry. It doesn’t take much imagination to see how the same policy could be put in place regarding lasers in endodontics or any other field of dentistry.

This fight also really has nothing to do with what anyone’s beliefs or history with Millennium Dental Technologies and LANAP, but really deals with the larger picture regarding the availability, and ability, to use lasers in dentistry to provide patients with the best care possible.

As a longstanding member of the Academy of Laser Dentistry, I am asking for your support for in fighting this obviously poor precedent being set regarding lasers in dentistry.

My colleges and I believe there are several ways you can support us and the use of lasers in dentistry:

1.Development of a position paper relative to the use of lasers in dentistry as equal or better than other traditional modalities.

2. Write to Delta Dental and the ADA regarding the inaccuracies in the ADA’s position paper that led to the ‘investigational label’ of LANAP and other problematic areas with in the paper (Yukna study was triple blinded and the study was second largest of its kind at that time, and other problems with the ADA paper relating to physics and various wavelengths in general).

My colleges and I thank you for your time and look forward in engaging with you to reverse the bad precedent being set in Michigan regarding laser dentistry.

Professionally yours,