Club Life: Dr Lauralee Nygaard

At a young age, Lauralee Nygaard’s father challenged her to go as far as she could. Professionally, that has played out through her 25-year-old private practice and being recognized for doing the best connective tissue grafts in her area. She is also one of the first two female directors in Seattle Study Club. On the personal front, Lauralee took dad’s advice a bit more literally, having traveled with her family to all 50 states in the U.S.

From important lessons in leading, including taking some tough but important feedback, to building the practice of her dreams, Lauralee talks about the influencers in her life, finding balance (hint: never missing a family dinner), and the power of compassion and connection with patients.

Dr Lauralee Nygaard, periodontist and Meridian Dental Study Group director since 1998

Q Tell us about getting started—what brought you to dentistry and periodontics?

When I was probably 10 years old my dad asked me what I wanted to be when I grew up, and I told him I wanted to get married and have four kids. Then he asked how I planned to feed those four kids if my husband ever dropped dead of a heart attack. To that, I told him I’d probably be a nurse. And he asked why I would be a nurse when I could be a doctor. I will never forget that moment. I don’t even think my dad meant to impart wisdom, but in that moment, I recognized my dad expected me to go all the way. Like that was the only option. 

As long as I can remember I wanted to be a physician—particularly a pediatric physician. I was particularly good at sciences, loved studying biology, and it seemed like the natural progression. When I was a senior in high school, my mom gave me a book about the first female surgeon in America. As I read her story, I realized I didn’t want that. Because obviously, as the first female surgeon in America, she faced huge amounts of sexism. She was basically married to the hospital, and I really didn’t want that—it wasn’t that I didn’t love the work; I didn’t want what you had to do. Aptitude testing was popular in my high school, so I took an aptitude test and dentist and mortician were identified as two ideal professions. I took the test two more times, trying to answer the questions differently, and kept getting dentist at the top of the list. We had several family friends who were dentists. I kind of liked their lifestyle and thought maybe I’d be a dentist. That was the extent of my understanding of dentistry. 

I started as a biology major and was so sick of biology by my second year that I switched to journalism—ended up with a liberal arts degree and a minor in photography, just eight credits shy of my bachelor of science in journalism. I applied to dental school and got in, but at the interview they assumed I was there to apply for dental hygiene (couldn’t help getting a little pissed off—I mean, they sent me the letter, someone there knew who I was). 

By my second year in dental school, I thought I’d made the biggest mistake of my life. I could do the tooth classes, but my passion wasn’t there. I absolutely love studying about diseases—the medical-based stuff in dentistry was what I loved. About that time, Dr Peter Nordland, a periodontist in La Jolla, California, took an afternoon off from practice in the 1980s and came to my dental school to lecture on aesthetic periodontal plastic surgery procedures. He was doing ridge augmentation using connective tissue grafts and it was mind blowing. It was the most beautiful thing I’d ever seen. I didn’t even know it was possible biologically to do what he showed. I literally left that lecture knowing I wanted to be a periodontist when I grew up. And from that moment on in dental school, I worked as hard as I could to be at the top of my class to get the best scores so I could go right from dental school into periodontic residency because I knew that’s what I wanted to do. And I really haven’t looked back.

Drs Peter Nordland and Lauralee Nygaard

That day inspired me to dream of building a practice that would be known for aesthetic periodontal plastic surgery procedures. Having been in practice for 25 years—a practice I built from literally nothing—I have a reputation in the region for doing the best connective tissue grafts. I am proud of those humble beginnings, and recognize that one inspiring, by chance moment with a dentist directed the path of my life. 

Q Where did you go to school?

Dental school was Loma Linda University, with undergrad at Pacific Union College.

Q What are your big influences in life?

I think my dad has been an influence certainly because he had high expectations. He always said go as far as you can. I would say my family: my husband and my kids are certainly big influences in my life. And another big person in dentistry who’s in Seattle Study Club is Joy Millis. She presented at a study club meeting and I asked her to come visit my practice. My whole goal was to bring her in and have her tell me who I should fire in my office—because something wasn’t right and I just didn’t know how to fix it. She spent three days with me, actually stayed with my family, and at the end of those three days sat me down and told me I was the problem. That was a life changing moment for me, and to this day I am so grateful for her honesty. There are very few people willing to be honest, and that truth telling really sparked the beginning of me learning how to lead and do the business thing really well. We became very good friends, and she was definitely a big influence.

Q So where did you go to learn how to be a better leader?

I studied every great business outside of dentistry I could—it became my passion. I’m an avid reader, and I literally saw all the greats—Southwest Airlines, Nordstrom, Ritz Carlton, Four Seasons, Starbucks, Zappos—and read every book I could get my hands on about businesses that were wildly successful. My goal was to provide exceptional patient experience. I wanted to give great care, but I really wanted to impact people’s lives and bring about change. If I have a personal mission, it is to make people’s lives better. Be something that positively touches people’s lives. 

One thing I’ve learned about myself is I’m actually really good with people. I didn’t know that in the beginning. I was 16 years old when I graduated high school, and when you’re a 16-year-old high school graduate you don’t really learn people skills. I didn’t understand that until many years later. The academic stuff was super easy and I was bored, which is why I graduated early. But I really missed out on learning how to do the interpersonal thing. 

When I was faced with trying to grow this practice, connect with patients, lead my business, and have a study club, my weakest skill set was being good with people. One of the most pivotal books I read was Winning with People, by John Maxwell. He basically teaches that charisma is not a gift; it’s a learned skill. I had always thought it was a gift—I would be the nerd in the corner watching the gifted people at a party, wishing I could be like that. Truth is—anybody can be like that. All you have to do is care more about people than you care about yourself and get good at asking questions. That’s what charisma is. My desire to get out of the painful situation in my practice and do something better made me willing to be uncomfortable enough to handle the hard work and stretch. Yeah, stretch. People who know me would never guess that about me—they think I’m super social. I think this is part of why dentists go into dentistry—you can be close to people, but not be close to people. You can be very intimate and close with a lot of protection for yourself.

Q What’s keeping you up at night these days?

Not much. When you get older, much less keeps you up at night.

Lauralee’s Alaskan catch of the day is silver salmon.

Q Based on what you’ve shared about your start, what has been the most challenging aspect of the dental industry, and how has it changed in the 25 years you’ve been in practice? 

I find the most challenging thing in dentistry is being good at business as a private practice owner. It’s much more challenging today on two fronts—the overhead is much slimmer than it used to be, so you have to be a lot more business savvy to be profitable, and patient expectations are at a level that is way different than 25 years ago. I think the level of communication and expectation-setting talent you need today is exceedingly more difficult than it was 25 years ago.

What has not changed in dentistry as much as I wish it had is sexism. I presented a beautiful case at the International Society of Aesthetic Plastic Surgeons, and someone came to tell me after my presentation that it was a great case for a girl. I honestly think he genuinely meant that as a compliment. But what he doesn’t understand is I don’t need the qualifier because I’m a girl. I just need the respect that I’m your peer as a dentist. 

When I first joined Seattle Study Club—I’m one of only two original women in the network—there were a lot of blue blazers and khaki pants. There was no family involved then, and my husband, who attended my first symposium with me, wasn’t thrilled about not being allowed to even come into the exhibit area. He long ago recognized I need my study club people, and I’m glad to see the organization evolve as dentistry is starting to look different. I think that’s a really good thing.

Q Why do you think patient expectations have changed, and where do we go from here?

Dr Google and social media. There is less respect for my education, expertise and knowledge than there once was. I don’t think we can go back to how it used to be, but we combat it by building relationships. I think I’ve been very successful in my business in part because I’m very relational with patients. I had a patient who came in during the pandemic shut down. I asked how she was doing and she just lost it—she’s a small business owner who had to lay off 300 people. She sobbed for five minutes straight. And I told her I understood how hard it had been, but assured her she wasn’t alone. I encouraged her to talk with somebody because none of us can just stuff it inside and not process, and I gave her the name of a clinical psychologist I’ve worked with. She wrote me a letter and told me how much that conversation changed her life—because I took the extra time and gave her the things she needed. 

I think if somebody really believes you are their advocate, that you’re on their side, such a connection trumps everything else. Caring, compassion and community is so needed in the world today. As long as dentists continue to be relational with their patients, any irritations with this age of information remain mild. 

Q What’s your driver behind what you do? What’s your big why?

I love to take care of people. I love to make people’s lives better.

Q Those who take care of people often forget to take care of themselves. How do you balance your own self-care? 

Oh, I learned that the hard way. I had a stroke when I was 35. That experience taught me it wasn’t enough to take medication, change my diet, or exercise—I had to have life balance. I was never taught that, never understood that until then, and it’s something I am really mindful of now. When talking to young clinicians, I stress how important it is to work on that balance. 

For me, what fills my tank up the most is reading and walking. And my favorite coffee stand is a huge treat for me. In the winter I like to ski, and in the summer we’re on the lake. You know, little things like journaling, getting out in nature, and spending time with my family make a huge difference.

And I’ve learned to ask for human connection when I really feel like I’m off. Asking a friend to meet for coffee, or picking up the phone and just calling someone for a chat—I think these points of connection are really important.

Q What have you learned about yourself in 25 years in practice? 

I’ve learned to be comfortable with change—that you can’t grow unless you become comfortable with the uncomfortable. And like I said earlier, I have learned I’m surprisingly good with people (I didn’t think that was my giftedness).

Q The pandemic brought about so much change. What has surprised you the most about this past year?

It was a really good year for us. My youngest went off to college. My husband and I decided to downsize, and we’ve moved into our dream retirement house on a lake, which is amazing. And I would say I learned I don’t have to be in control for things to be okay.

Q Are there any absolute must-dos in your daily routine? 

Dinner with my family—we never miss it. Never. And I actually cook scratch-made food.

The Nygaard family.
Nygaard goodness — flourless baking.

Q You said earlier that when talking with young clinicians you tell them about the importance of self-care. If you could look back and talk to a young Lauralee, what would you tell her?

I would tell her the goal isn’t to take care of everybody, that it’s never about aspiring to see all the patients—you aspire to see the ones who value what you can provide. It’s essential to know what you can do, know what value you bring, and find the people who appreciate that value. And saying no is sometimes the right or best move! 

One of the biggest things I’ve learned, and it helps with life balance, is that I can’t care more about someone’s teeth than they do. My job is to figure out what they value in their health, and then identify and provide whatever I can to help them achieve those goals. 

Q With that idea of finding people who value what you bring, how do you discern that in practice? What’s your process?

Well, it’s silly, but if people don’t fill out their paperwork online, before their appointment as requested, I don’t see them. If you don’t do what I asked you to do before you get in the practice, then you’re not a good fit. I’m not afraid to say to somebody that this may not be a good time for them. I don’t want to coerce people to come in—if someone doesn’t want to come, then let’s just not do it. 

I’ve learned that people, in many arenas, are being manipulated to make decisions and do things. And when I say, hey, maybe you don’t want to do this, let’s just end it right now, for some it gets their attention and we can talk about their goals and what we need to do. Because if it’s not right, if they’re not helping me, I don’t want to see people who are unhappy or don’t want to be here. 

I’m pretty open with my team on this issue. If someone comes in and isn’t behaving in a hygiene appointment, my hygienist has the room to assess that today may not be a good day, get them rescheduled, and walk them out the door. Because if you’re not going to be nice as a human being and you think we’re somehow forcing you to do something, go see somebody else. I don’t need that in my life.

That takes a lot of courage because there is fear that if they leave I’m not going to have any business. But the opposite happens—I’ve learned when you make a boundary with an adult, that you might take something away from them, all of a sudden they start acting like an adult. And I don’t mean that in a nasty way. It’s just saying I’m not here to convince you teeth are important—that’s not my job. My job is to help you achieve your health goals, and if you don’t care if your teeth aren’t in great shape, I don’t either. If I have a patient willing to do a root planing but not willing to come in every three months, I tell them not to do the root planing, that I’m not the practice for them. I can’t help a patient keep their teeth if they’re not going to do what they need to do. Do I lose patients? Yes. But I gain a lot more.

That’s a hard position to find—we dentists are generally not good at this kind of thing because we want to be liked by all of our patients. And we’re not good at saying no. When you’re in a profession of helping others, you feel good about yourself when you help someone—your esteem is tied to your performance with helping people. So when I don’t help that person, I fail and feel bad about myself. My lesson here has been to view my role as an educator, facilitator and coach—to find out what’s important to them and how can I help them get there.

Q What are you most proud of with your career or your practice? 

I don’t know—I’m not sure I have I achieved it yet! My practice is larger than I thought I could ever accomplish, so achieving the practice of my dreams and doing the procedures I want to do means I’m truly doing what I love every day. Another thing I’m really proud of is I’ve learned how to lead. And I have a phenomenal team—when patients tell me daily that my team is just amazing, which makes the practice like no place they’ve ever been—that just makes me extremely proud.

Q How do you define your philosophy for patient care?

My own journey after my stroke helped me realize the mouth is truly the command center for your overall systemic health and your entire wellbeing. I talk to patients not just about their gums, but about eating clean, staying away from sugars and things that are bad for them—more of a wellness approach to whatever their health goals might be. If a patient wants to achieve oral health, long term oral health success is not just about seeing the dentist or brushing or flossing teeth. I mean, they can do it that way, but they’re going to work a lot harder. Most people, by the time I see them, have spent years without success. They are a lot more receptive by the time they get to me, have lost teeth, or have had treatments fail. They’re frustrated, usually, and they’re often open to a broader approach. To  summarize, the way I treat people in terms of their oral health is really a global interdisciplinary approach to establishing oral health as an avenue for wellness.