On building a family legacy, deemed the “dentsists” Planzos sisters Drs. Penny, Lea and Melena spoke to us about running their individual and common dentist practice. The practice which started with their father, Dr. Thomas Planzos who built Impressive Dental Care has now operated and expanded into multiple divisions thanks to his three daughters; Penny, Lea and Melena. Born and raised in the Bay Ridge Community, although all three daughters left Brooklyn to pursue their passions in dentistry, they are now back to continue their father’s legacy. Together, the Planzos dentists have been helping and improving lives and smiles as both mentors to colleagues and compassionate doctors to their patients. A true success story built on family values, community and working together for a bigger purpose. Here is their success journey.
Tell me about your decision to go into medicine and how it emerged.
Penny: Our dad is a general dentist. He’s been practicing for over thirty years; it is truly a blessing that we are able to work together now. He was our inspiration to go into dentistry. It was always presented as a happy field for us. He was always excited and took pride in his work, and we would watch his lectures as kids. From before we even knew what it meant, we always said we wanted to be dentists. When we were in dental school, we each chose a different specialty and went at it from there.
Melena: Dental school is four years after college. You can become a general dentist, and some states in the US don’t even require a residency so you can work straight out of school. In New York, where we live and practice, a one-year minimum general practice residency, after dental school is required. If you do general dentistry, you can do any facet of dentistry, but you’re not specialty trained in a certain procedure. We chose to do a specialty so that we can practice at a really high level in a concentrated field. We each chose a different specialty within dentistry. I chose orthodontics, Penny chose prosthodontics, and Lea chose periodontics. They’re three different specialties of dentistry that require three years of additional training after becoming a dentist. That’s how we differentiate ourselves from a general dentist. We are able to now incorporate our specialties in working together.
How has getting trained in three different specialities helped you work together?
Lea: It’s pretty rare to have three sisters and have three specialists that work full-time together. A lot of offices are multi-specialty practices, but the specialists do not treatment plan cases together. We are able to see the patient at the same time, which allows us to clearly communicate our goals to the patient and to each other. Ideas are not getting lost in translation and the patient is not being sent from one specialty office to another and waiting for doctors to communicate.
Melena: An example is that if someone comes in now and they want to re-do their smile, before we put veneers or crowns on someone, maybe they have gum disease that was undiagnosed or missing teeth that we need to replace with implants. Lea places implants. I do orthodontics and Invisalign®. Orthodontics would put the teeth in the proper position before the treatment. The nice thing about is that when we have a patient and a plan, we each jump into a treatment plan. We are preventing a patient from being sent to one office for an implant, to another for orthodontics, etc. We find solutions to problems in a shorter span of time. The patient also feels motivated and well taken care of, which is our main goal.
Penny as a Prosthodontist what have you noticed that patients are moving towards nowadays aesthetically?
Penny: We have a mix of people who come in right away wanting veneers but also a lot of people who want to maintain their natural teeth. It really depends on what the patient needs. With Invisalign® and orthodontics like what Melena does, we can provide a much more conservative option to straighten out teeth for people who want to keep their natural shape and size of their teeth. Maybe patients are missing teeth and want implants. If a patient comes in with a goal of looking and feeling better, we’re the ones who determine how to make that happen, and we present them with different treatment plans to get them there. We present them with multiple options, such as Invisalign® and veneers, or an implant vs. a bridge. Sometimes the patient comes in thinking they need or want one thing, but when we evaluate them, we realize that that’s not what they need. Sometimes we say that part of their treatment before their veneers is going to be orthodontics, and after they’re done with that they’re surprised and they love the way it looks and don’t want to have veneers done after all.
When we talk about veneers, we describe them as a contact lens that goes over the tooth that helps them change size, shape and color of teeth. Depending on the position and health of the teeth, restoring a smile with veneers can be simple or complicated. If the teeth and the gums are healthy and the patient is looking to reshape, recontour, and change the color of the teeth, the process is more straightforward. However, If the teeth are super crowded, you would have to cut them more to bring them into their right position. In that situation we may recommend that a patient have orthodontics completed first to unravel crowding, so that we can be more conservative in how much tooth structure we need to cut. Likewise, if the teeth are very flared the preparation would need to be more aggressive to prep them back into proper position, so we may recommend orthodontics to reduce the flaring, first. That’s where a lot of our integration with orthodontics and periodontics comes in. You can’t just slap a veneer on a tooth. Sometimes, there’s more that we have to do before we get there. Also, before placing veneers, or cosmetic restorations, we need to make sure that the gums are healthy. Periodontal disease is low grade chronic bacterial infection in the gums that causes inflammation and bone loss around teeth. It’s often a silent killer of teeth and people don’t know they have it. You have to treat that before anything else.
Melena: We learn from each other so much. I start to think about what Lea or Penny would want. If I know that the final goal is to have veneers done, then I may position the teeth through orthodontics differently so that it could avoid cutting more tooth. We can determine whether or not we can position the tooth orthodontically to change the height of the gums or by periodontal procedures by adding or removing gums. We would do things in a certain way to prepare for the end goal, which is why the communication is always very important.
Lea on creating a partnership with patients, can you elaborate more on what that looks like?
Lea: First and foremost, our main goal in terms of the partnership is that we want to establish a dental home for our patients where people will come to us throughout their lives for anything that they need and bring their families and friends. More specifically, talking about what I do as a periodontist, periodontal disease happens to be a chronic condition, much like diabetes. Most of my patients that come to me to treat gum disease have to see a periodontist for the rest of their lives because the bad bacteria repopulate and reestablish themselves under the gums every three months. Every patient with the disease has to see a dentist every three months for a check-up or a cleaning. When I do a gum surgery, just purely to treat gum disease, it’s not necessarily a lifetime cure. The patient is still susceptible to progression of gum disease.
This isn’t only about going to a dentist. We want to establish a baseline of dental health. We want them to take what we tell them home. Much like a car needs maintenance, teeth need to be maintained. You can’t get a new set of veneers or dental implant and disappear because now you’re looking good. You need to go in for a follow-up and a routine dental care.
Impressive Dental Care is opening a second location, Melena how is that looking like right now?
Melena: Our second location is now ready and we will be moving next week! It is a practice limited to orthodontics. It was an existing orthodontics practice that I purchased and have been renovating a new state of the art facility to transition to. It is a really modern and swanky setting and I am so excited to be in the new place. Most of the clientele are younger patients and teens, although I do treat many adults as well. The orthodontics practice is more of a fun environment, rarely any blood or needles, or any of the “scary stuff.” The difference between the multi-specialty practice and the ortho practice practice is that the multispecialty practice has four chairs and appointment times are much longer and usually more involved. The way an orthodontics practice is set up is an open bay setting with many chairs side by side, in a large room. I am able to see a few patients at a time, with a much quicker turnaround time. In the orthodontics practice, appointments are much briefer, at fifteen to twenty minutes each and there is much more volume.
For adult orthodontics and even for teens, I am currently using mainly Invisalign® which is a truly sophisticated product. As an orthodontist with advanced training, I am able to use this technology and manipulate tooth movement very precisely. In the orthodontics practice, we use the iTero digital scanner, so we are able to quickly and efficiently scan patients, instead of making conventional impressions. I also do plenty of cases with conventional braces as well.
I would love to know more about the innovative services that you are offering and what differentiates you from other clinics?
Penny: The fact that all three of us are under the same roof is very important. We’re all differently trained and will be able to give our input on the patient and the problem. We’re also considered the experts of each procedure that we’re going to be doing. In terms of the technology that we use, we have a CBCT x-ray machine that uses 3-D imaging technology and allows us to see the jaws in every direction. We use this to plan out our cases and map out the nerve and anatomical structures so that we can precisely and safely place implants. Sometimes we take the scan and realize the patient has poor bone and so implants aren’t for them, or they need bone grafting. It’s a really important tool for us.
Lea : We can also use the CBCT scanner to view wisdom teeth and as imaging for root canal issues. It is also used to view pathology and we often times send scans for review and diagnosis to a radiologist. Another innovative service we offer is laser periodontal surgery. Purchasing the laser was a really big investment on my part and I had to travel to California three times to be trained in its use. It is used for people who have gum disease or bone loss and infection around their implants. The way we advertise it is that there is not an incision with a blade and no sutures or cutting. A lot of times, people seek me out because we provide that service. The procedure is a patented protocol called LANAP®. A lot of people want that for treatment of gum disease because it’s a lot less invasive and we can do the whole mouth in one day. It’s still considered surgery but it creates a more aesthetic outcome and a more positive patient experience. Sometimes I have to see a patient for a traditional periodontal flap surgery, but a lot of the times it stops patients from needing the surgery.
Penny: Another great piece of technology we have allows us to make crowns in one day, like the Cerec Omnicam®. We can see the patient, prepare the tooth for a crown which means drill a margin around the tooth, digitally scan the tooth preparation, design what the crown will look like on a computer screen, and our milling machine makes the crowns and allows us to insert it on the same day. Otherwise, we would have to make an impression of the prepared tooth with impression material or putty and make a temporary crown for the patient. The impression would be sent to a dental lab and would take two weeks for the final crown to be made. It saves the patient a second visit and a lot of time. Another digital scanner that we use for implant and other cases is called the 3ShapeTRIOS® that we use to make impressions of multiple teeth or implants without the need for conventional impression material.
Melena: It’s basically digital dentistry, making digital scans of teeth with an intraoral camera. We’re not using traditional impression material anymore to make impressions for the most part, unless it’s necessary for a specific case. Even for Invisalign®, we use the ITERO Element® digital scanner. It’s a motivational tool because we can do a “smile simulation” and show people a rough draft of how their teeth will look when they are straight. It sells the case because it gets people motivated.
When it comes to growing the practice, what system do you have in place for that?
Lea : We do stay on top of the latest technology with continuing educational courses. This year there wasn’t too much of that in person because of COVID, but we took advantage of opportunities to attend virtual courses. We always attend the national meetings for our specialties. We’re up to date with the latest technology. We even fly internationally to learn more too.
How many years have you been in practice now?
Melena : Lea graduated from the University of Pennsylvania School of Dental Medicine in 2013 and Penny and I graduated from the same program in 2016. After 4 years of dental school, each of us trained in our respective specialties treating patients for three years at Columbia University. Especially being young women, it’s taken a lot of perseverance and confidence to gain the trust of our patients and even employees. Initially, I thought that the hardest part was going to be getting through all of the schooling and becoming a specialist. I found that the hard part was actually the business aspect and having to manage staff and things other than the dentistry. I was thrown in to the business side of things on my own with the new ortho practice, and initially it was hard to put new systems in place with an existing facility and staff.
Lea : For me, starting out at my dad’s practice, I did all the implants from the beginning. For treating gum disease and grafting, I was searching for those types of patients within his practice. Initially, it was tough finding enough patients at my dad’s clinic to work full time, so I was hustling. I was working four or five jobs to meet my financial needs to pay my educational loans, which are really high. Through advertising and word of mouth and through our existing patients, I am able to work full days Monday through Thursday and our office has always been closed on Fridays and weekends.
Penny: It helps to have a base, but Lea had to do it from scratch. Melena bought an existing practice but she had to build it because it wasn’t a four day a week practice, it was a two day a week practice, and now she’s building up the fifth day. For me, my dad needed help right away and was holding out on getting an associate, so I was busier sooner. We’re a Monday to Thursday office from nine am to seven pm.
What does success represent for you all respectively?
Drs: Success to us is people valuing the services that we provide, and sending their family members or their friends. Did we make someone happy? Did they have a positive experience leaving our office? Will they recommend us to someone else? We like how we can make someone confident from treatment. It’s nice for us to feel that we can continue our dad’s reputation in the industry.
Where do you see the clinic in the next five years with your practices?
Melena: We hope to be thriving in the next five years in our practices and personal lives. There is always room for self-improvement and personal growth. We are very excited to see what the future holds for us and for the practice as a whole.
I would love to know what is the success of your relationship? Is it the communication?
Lea: I think we were just raised to be close. We didn’t have a choice to not get along as a family. We have a big fat Greek family and lots of cousins that we are very close with. We want to see each other be happy and successful, and we are each other’s biggest cheerleaders. We’ve always had each other’s backs, even as kids.
How do you find balance with such a hectic business and personal life?
Penny: It is tough sometimes to separate work from our personal lives because we genuinely enjoy what we do, and we literally bring it home with us. Our mom cooks dinner for all of us every night, so we leave the office late together and go to our parent’s house after work. Lea has two children, a three-year-old girl and an eleven-month-old boy and we love to see and play with them. We cherish our weekends, and try to sneak in vacations and getaways whenever possible to get that escape. We are all married, and thankfully our husbands all get along and are very close, too. We love to vacation, especially traveling to Greece in the summers.
Photo Credit – Stephanie Poulos
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