Changing the Landscape of Dentistry with Soft Tissue Lasers

Special Guest: Alan Miller (Founder of AMD Lasers)

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Dr. David Hornbrook interviews Special Guest Alan Miller,  founder of  AMD Lasers,  gives a full bio and overiew of Dental Lasers, the growing technology/evolution and how they can make your practice more effecient and fun.

Soft Tissue lasers make a doctor’s life a lot easier and more efficient. They are safe around metals, they control bleeding, but ultimately, it’s the patient that benefits and the ability to go in and have a laser pose a scalpel or electro cautery is a huge benefit for patients

“I’ve always looked at dental products as, you know, there’s products that doctors want and there’s products that dentists need and there’s products that can make a dentist’s life easier and more fun.”

-Alan Miller

For more information on AMD Lazers Visit:  www.amdlasers.com

Podcast Transcription:

Dr. Hornbrook:

Hello. It’s Dr. David Hornbrook for our weekly podcast here at Dental Up. If you haven’t listened to a podcast in the past we do this every Tuesday, we have the most amazing guests, we have a lot of fun. Live, very candid, no outline, as you’ll uh … you’ll hear today you’ll uh … Be a little different than some of the dental podcasts you’ve heard about in the past. We’re available at dentalup.xyz, our new website, if you wanna see or hear some of the, the videos or podcasts we’ve done in the past. We’re excited because we’ve Keating Dental Lab here in beautiful Irvine, California. Keating Dental Lab is a full service dental lab that I’ve had the pleasure of working with now for over 6 months as a Director of Clinical Education and Technology. We’re having a lot of fun here, doing some amazing, cool things, but today we’re in for a special treat. Um I have uh, uh a special guest. Some of you know him, and some of you will get to know him much better

in 30 minutes from now. Um, but it’s Alan Miller from AMD Lasers and um, for those that have picassos, picasso lites, I know you’ve seen ads for them.

You have friends that have them, if you don’t already have one you should and by the time we get done with this I would hope that you’re going to be calling AMD Lasers and ordering yours, but AMD, the AM is Alan Miller. Welcome Alan, I appreciate you spending time with us today.

Alan Miller: Thank you Dr. Hornbrook. It’s a-

Dr. Hornbrook: Dr. Hornbrook?

Alan Miller: Dr. Hornbrook.

Dr. Hornbrook: Wait a minute that’s ridiculous. Call me David throughout, Alan-

Alan Miller: Thank you.

Dr. Hornbrook: You know, again, we’ve been friends and-

Alan Miller: It’s great to be here.

Dr. Hornbrook: It’s awesome-

Alan Miller: Yeah.

Dr. Hornbrook: It’s awesome, you know, it’s so nice to be able to talk to, to people that are obviously a huge influences in our field and also great friends of mine and so I appreciate it. We’re live in-person today, we’re together, soon we have to do this off-site, but Alan lives in Newport Beach, 15 minutes to get over here?

Alan Miller: Yeah, it’s about 15 minutes.

Dr. Hornbrook: Fifteen minutes, quick drive over?

Alan Miller: Quick drive for once.

Dr. Hornbrook: Yeah, so it’s kinda nice to stay in your own time zone for a change.

Alan Miller: For 48 hours.

Dr. Hornbrook: Yeah (laughs).

Alan Miller: At least.

Dr. Hornbrook: You know I tell people I travel about 100 days a year, and there’s not that many people that beat me, but Alan is one of them, and he has a crazy, hectic schedules and I appreciate you spending time.

Alan Miller: Thank you.

Dr. Hornbrook: So you, you know, I didn’t give you an outline. You said what we’re going to talk about and I said I don’t know yet, but um I absolutely want to

talk a little bit about your past. We’ve known each other for probably 20 years, 15 to 20 years and, and you know we’ve seen lasers dentistry industry totally change. You know when I do my all-day lectures I say, you know, I got trained in 1995, that was 20 years ago from Don Coluzzi and my diode laser was $49,000 at the time and I would tell my friends, “you gotta go buy one,” and they’d say, “$49,000? I mean you could buy a Mercedes for $49,000,” then and now we’re looking at lasers that are under $5,000 that are actually much better than, than what we had in 1995 that we can’t get parts for. So let’s talk a little bit about, you know, you’re evolution and history up to where you are now and I want to talk then where do you see lasers going in dentistry?

Alan Miller: Well I guess the, that I’m pretty fortunate almost 30 years in medical and dental technologies. I’m kind of that nerdy guy, you know, you’d probably beat up in high school-

Dr. Hornbrook: (laughs)

Alan Miller: Or chased around, but I was the guy in the chess club and the computer club and started a science club and I loved technology, and, you know, I’ve always looked at dental products as, you know, there’s products that doctors want and there’s products that dentists need and there’s products that can make a dentist’s life easier and more fun; and fortunately I got my start in the dental world with Accucam, almost-

Dr. Hornbrook: Hell yeah.

Alan Miller: Twenty-five years ago.

Dr. Hornbrook: I still have mine in a closet somewhere, you know, even if it probably doesn’t work I’m, I’m like every other dentist, I don’t use things, but I refuse to throw them away, you know they’re my-

Alan Miller: Yeah.

Dr. Hornbrook: Closet.

Alan Miller: It’s a good product.

Dr. Hornbrook: Yeah.

Alan Miller: And I’ve been in lasers now since the 90s, and you know, good history of working with hard tissue laser, CO2, uh of course diode soft tissue lasers, and whenever I looked at these technologies I found that geez, people really love them. It’s a … It makes a doctor’s life a lot easier. You know, they’re safe around metals, they control bleeding, but ultimately, it’s the patient that benefits and the ability to go in and have a laser pose a scalpel or electro cautery is a huge benefit for patients. I guess the biggest issue was lasers were expensive, just like you were-

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: Fifty thousand dollars is a crazy amount of money to pay for, you know, soft tissue laser that you need to use daily.

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: Yeah, who wants to pick up a scalpel or electro cautery when you can pick up a laser and it can cut and cauterize at the same time? So being the techie that I am, I looked at the technology and figured out there’s only a few players out there. You know, everybody buys the same components really from the same manufacturers and everybody assembles these things, and it was just a matter of making the product um easy to manufacturer with as few moving parts and possible, and put these things together much like you would approach the automobile industry.

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: And [abrupt 00:05:19] price down to, you know, under $3,000 when I first launched the product.

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: And that’s really what exploded the laser market was making these things affordable for everybody-

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: So just like you would have a dental drill in each operatory, my vision and goal worldwide was to put a laser not just in each office, but to put a laser hand-piece in each operatory, that way if you have easy access to it hygienists can use it in most states, and if it’s readily available it becomes a true adjunct to your practice; and it’s amazing the number of procedures that can be used with soft tissue dental lasers, but the reality is there’s, there’s always a top 10 and fortunately for dentists and hygienists, those top 10 procedures really do kind of make it fun and take the stress off the, the dentists and the patients, and it adds a whole new dimension to dental practice.

Dr. Hornbrook: Yeah and I agree, and you just made several points. One is, and we can all relate to this, if the technology is right near you you’re going to use, if it’s down the hallway and it needs to be plugged in and you need to find the foot pedal and drag it down that hall, you’re not going to use it; and you know in a laser and when you introduce your picasso, you know, your picasso lite it … under 3 I mean the cheapest laser on the market prior to that was 12 or 13, like the navigator and-

Alan Miller: Yeah.

Dr. Hornbrook: And the odyssey, that’s a huge difference if I have 4 operatory and I’m gonna spend $40,000 on lasers or $11,000 on 4 lasers-

Alan Miller: Yeah.

Dr. Hornbrook: That you’re using all the time because you know what I find is that I use it on so many things and being accessible, right, the … on my operatory … in my … in each operatory is finding more uses for it. Um which is so cool. So let’s … You’re talking about the top 10, we’ll go together if, if, if a dentist was at one of your booths at your show and say, you know, “what are the top things I’m going to use this for?” What would they be?

Alan Miller: I would say number one is laser troughing.

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: So, you know, packing cords is not healthy for the patient. It’s tough to get a perf- perfect impression every time, especially if you’re doing multiple units, and we have a lot … I would say half of our customers buy the laser just for laser troughing especially if they’re using a [cerec 00:07:46], or any kind of scanner, you gotta get the margins right-

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: You gotta get them clean and dry to get the scan done, so I would say without, without a doubt-

Dr. Hornbrook: Yeah.

Alan Miller: That’s the number one procedure.

Dr. Hornbrook: Yeah and, and I would agree with you as well. I … you know, I haven’t packed cord in over 10 years, there’s just no reason to, but there’s times that I need to isolate that margin and I can either take the cord out and soak it in hemostatic agent and pack it in there and sit for 5 minutes, but we know that’s traumatic to the tissue and the patient; or I can grab my diode and the tips are 200, 300, and 400 micron?

Alan Miller: That’s correct.

Dr. Hornbrook: Okay, so 2 or 300 micron that’s thinner than a pair of [dental probe 00:08:22]-

Alan Miller: Yeah.

Dr. Hornbrook: So I can go in between the tissue and the margin, and the other cool thing is it … the more blood, the better it works (laughs), because it’s actually attracted to hemoglobin so it’s gonna stop [inaudible 00:08:33], no post-operative pain. I get great isolation and again time saving, and better impressions.

Alan Miller: Yeah.

Dr. Hornbrook: Yeah, especially with-

Alan Miller: Yeah, for sure.

Dr. Hornbrook: Being here 2 days a week at Keating-

Alan Miller: Yeah (laughs).

Dr. Hornbrook: And seeing some of the impressions, I want to personally deliver a picasso lite to uh each of our docs. Number one, so what would be a number two?

Alan Miller: I would say gingivectomy.

Dr. Hornbrook: Okay.

Alan Miller: And, you know, anybody that place veneers or crowns, you’ve gotta get the tissue correct, right? You gotta get the correct [inaudible 00:09:01]

Dr. Hornbrook: Yeah, that’s part of the smile design.

Alan Miller: Yeah obviously you need to check biological width and make sure you’re, you’re doing the right, the right thing for the patient, but the reality is you’ve gotta use a laser for these procedures. You know just … It’s, it’s unbelievable that anybody wanna put a scalpel or electro cautery to a patient, especially on the anteriors, for any kind of cosmetic procedure because you know the effects. You get a lot of swelling, you get a lot of bleeding, but with electro cautery you can end up with a lot of necrosis.

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: The nice thing about the picasso lasers or any really soft tissue diode laser and I’ll speak for the whole industry-

Dr. Hornbrook: Right.

Alan Miller: Is it gives you predictable tissue response because the area of necrosis is so minimal. It’s kind of where you caught is where the tissue stays.

Dr. Hornbrook: Yeah, absolutely.

Alan Miller: Which is nice so if you place a crown or a veneer you don’t have to worry about that patient showing ugly margin-

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: You know, 6 months down the road. So I’d say gingivectomy would probably be number 2.

Dr. Hornbrook: Okay and that’s how I got into it. In the 90s, I was using an electro surge, you know, as you said heat makes the cut, you get trauma because of the heat, and you get the zoning necrosis and you don’t know really where that margin is gonna end up. So I got into it on that side. Um so … let’s go through a few more-

Alan Miller: Okay.

Dr. Hornbrook: So we’ve got gingivectomies, some [inaudible 00:10:20] troughing so we don’t have to pack cord, we get acc- more accurate impressions-

Alan Miller: Implant recovery-

Dr. Hornbrook: Yeah.

Alan Miller: Has become a huge thing. Anybody place an implants or uncovering implants uh … you’ve gotta use a laser. They’re safe around metal, which is-

[crosstalk]

Dr. Hornbrook: They can use them around implants, I think that’s what doctors are concerned about. Can I use this diode around-

Alan Miller: Yeah, in fact uh you look at guys like Doctor [inaudible 00:10:43] or any of the implant lectures or um educators out there, they’ve all got picasso lasers for a reason-

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: Safety use around implants, it’s not gonna hurt the implant or [necrose a bone 00:10:58] if you touch the implant, but to get that tissue off the implant or really for peri-implantitis, they’re using lasers now. Um, safe around all metal-

Dr. Hornbrook: Yeah.

Alan Miller: And there’s so many guys who are placing implants or you know going for the final seeding, you’ve-

Dr. Hornbrook: Yeah.

Alan Miller: Gotta get the tissue just right, a picasso laser is just perfect.

Dr. Hornbrook: Yeah.

Alan Miller: And with that, you know, just not implants, but they’re safe around all metals-

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: So our biggest group of picasso customers are actually orthodontists.

Dr. Hornbrook: Yeah, I was gonna say-

Alan Miller: So-

Dr. Hornbrook: Huge.

Alan Miller: Yeah.

Dr. Hornbrook: My orthodontist sends the patient over to me [inaudible 00:11:35] that teenage patient just doesn’t have good oral hygiene. Tissue gets [hypertrophied 00:11:39] and I’m going in there and just sculpting the tissue and-

Alan Miller: Yeah.

Dr. Hornbrook: You know when you see the electro-surge hit the metal, and wel-

Alan Miller: Oh yeah.

Dr. Hornbrook: Welding itself to the metal-

Alan Miller: (Laughs)

Dr. Hornbrook: You know, I’m yanking it off or getting my craftsman pliers and cutting that off so-

Alan Miller: Yeah, hypoplastic tissue, straight off ortho brackets is really nice, but it’s kind of a little headache procedure as well-

Dr. Hornbrook: Right.

Alan Miller: Like what do you do when you have an old amalgum and the decay goes [inaudible 00:12:03]-

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: Right? It’s … You don’t want to get an electro cautery there and trim tissue because again you might touch that old amalgum.

Dr. Hornbrook: Right.

Alan Miller: And it’s a pain in the butt because you’ve gotta get it out of there and you’ve gotta get tissue removed. It’s perfect, pick up the laser in about 10 seconds, remove that issue. There’s no bleeding, pull that old amalgum out-

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: And you’ve gotta a dry field, so what used to be a 25 minute headache procedure trying to control bleeding, it’s 10 seconds with the laser-

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: And everybody’s happy. Same thing with matrix vans, I mean, how many guys put a matrix van on and they’ve got a little bit of tissue or a bleeder and they’re … what do you do?

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: You know, it’s just a headache. With picasso, you just pick it up and maybe 5 seconds, 10 seconds, you’re getting that little extra tissue out of there. You’re controlling bleeding and you move on with your procedure and have a happy day instead of a stressful headache day.

Dr. Hornbrook: Yeah, absolutely. So … a couple of other things I want to say so I, I am a picasso lite and I have 4 of them. One here in my clinic at the dental lab and I can … I can not imagine practicing without it. If I had to list the 5 things I could not live without. You know, number one is my [loops 00:13:16] because teeth don’t look like teeth unless I look through a [loop 00:13:19], right? Second is my dental assistant because I couldn’t find anything in my office if she wasn’t there-

Alan Miller: (Laughs)

Dr. Hornbrook: Third would be my picasso lite, I mean I just … If you took it away from me the quality of my dentistry would be inferior, and it’s just … even if it was $20,000 it, it would worth it to me, but you know, $3,000, 3500 bucks, I mean it’s a slam dunk. Um you know I have about 9 different lasers in my office from different manufacturers, and since 1995, and there’s only 2 that I can still get parts for, you know-

Alan Miller: Mm-hmm (affirmative).

Dr. Hornbrook: And I wanna talk to you a little bit about, or at least the audience a little bit about. You know these big medical laser companies come and dabble in dentistry and they realize there’s not enough of us and they move out. You know, [HOYA 00:14:01] was a good example, [inaudible 00:14:04] companies that came through-

Alan Miller: Mm-hmm (affirmative).

Dr. Hornbrook: And they said no we’re not selling enough, and we made this purchase so this laser can’t get parts and one thing that I love about your company, all you do is make lasers.

Alan Miller: That’s all we do.

Dr. Hornbrook: Yeah, so you’re going to be around, you know, I can get disposable tips, I can get maintenance involved. You know those are all important to me, I think that’s important for the audience to know. You’re going to be around to service their needs and educate them and get parts for them in the future.

Alan Miller: Yeah, it’s pretty amazing the picasso line has been out for 6 years now.

Dr. Hornbrook: Yeah.

Alan Miller: It still dominates the market, still number one selling laser in the history of dental lasers. Period. Around the world. We’re approaching almost 80 countries-

Dr. Hornbrook: Wow.

Alan Miller: You can find picassos in, and little countries never heard of-

Dr. Hornbrook: (Laughs)

Alan Miller: But it’s … It, it always is an honor for me when I fly around the world and we do a product launch uh, in a new country. [inaudible 00:15:02] response a year later and I’ve donated now I think over 500 units worldwide-

Dr. Hornbrook: Wow.

Alan Miller: To monasteries in Greece-

Dr. Hornbrook: Oh, wow.

Alan Miller: Missions down in South America, children’s health clinics around the world, universities, hospitals, just to promote laser dentistry-

Dr. Hornbrook: Mm-hmm (affirmative).

That’s awesome.

Alan Miller: So you know we’re fortunate at AMD lasers to have such a great following, just out here domestically, but also worldwide-

Dr. Hornbrook: Yeah, that’s awesome.

Alan Miller: And it, it’s just not the product. I think it’s more the culture that myself and my employees have, which is to treat people right.

Dr. Hornbrook: Right.

Alan Miller: You know, it’s … None of these products are perfect-

Dr. Hornbrook: Right.

Alan Miller: Including ours, you know, we have issues, you know maybe like Keating probably never does-

Dr. Hornbrook: (Laughs)

Alan Miller: Because it’s a great product, but when people need something, we’ve got a motto of the answer is yes.

Dr. Hornbrook: Yeah.

Alan Miller: You know, what can we do to take care of ya? And that has created such a great cult-following, you know-

Dr. Hornbrook: Right.

Alan Miller: Culture of, you know this is just not a great laser company but it’s, it’s good people to work with-

Dr. Hornbrook: Yeah.

Alan Miller: And, you know, occasionally I still get to go out to some of the domestic trade shows and it is so much fun to see the effects of a dream 10 years ago making lasers affordable for everybody and seeing people come up and you know, hug. You know-

Dr. Hornbrook: Yeah.

Alan Miller: Let’s hug. You know, me and the employees-

Dr. Hornbrook: Right.

Alan Miller: Because the picasso lasers made their life fun. They bring their friends over to buy a product, they purchase more lasers, kind of like yourself. You know they start with 1 and very quickly they get 1 for their hygienist, and then they figure out “gee, let’s just put one in every operatory because it really is a needed item,” but it’s the same effects worldwide.

Dr. Hornbrook: Yeah, that’s awesome.

Alan Miller: Yeah this fall I think we’re launching Lebanon, Israel, I’ll be in Egypt, of course, Dubai, for a relaunch I’ll be in Asia. We’ve got some really good distributors throughout Asia, I’ll be back in Vietnam uh Malaysia, Singapore, um I think Thailand again; and I mean it’s a worldwide product-

Dr. Hornbrook: Yeah, that’s awesome.

Alan Miller: And, and this plight, even though I bought the company back from Dentsply.

Dr. Hornbrook: Yeah, le- let’s just mention that.

Alan Miller: Okay.

Dr. Hornbrook: It’s the company you started-

Alan Miller: Yeah.

Dr. Hornbrook: You sold to Dentsply. Um-

Alan Miller: 2011.

Dr. Hornbrook: Right, and then you just got it back last summer, right?

[crosstalk]

Alan Miller: Last summer, they gave me the opportunity to purchase the company back-

Dr. Hornbrook: Yeah.

Alan Miller: And kind of continue the vision that I had and, you know, Dentsply is a great company. Um there’s some advantages of being a family-run business-

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: Just like Keating.

Dr. Hornbrook: Yeah.

Alan Miller: That you can make decisions move-

Dr. Hornbrook: Right.

Alan Miller: Very quickly and um yeah, it, it’s a great relationship because Dentsply still distributes the product in Canada, Australia-

Dr. Hornbrook: Uh-huh.

Alan Miller: India, and they do a great job and they really believe in it.

Dr. Hornbrook: Yeah, good. When, when are you gonna enter Mexico cause right now you can’t sell in Mexico?

Alan Miller: We’re working on it. [inaudible 00:18:05]

Dr. Hornbrook: Good because I have a lot of friends, as you know, that are just … You know, they want me to order them one and take it down there, but you told me I couldn’t do that and I don’t want to get anyone in trouble. So we’re talking about the diode laser cause there’s going to be people that are listening to this that don’t even really understand what that is. So soft tissue lasers there’s the erbium, there’s the [IndiA 00:18:22], [chromium A 00:18:24], um CO2 and Diode, is that about it?

Alan Miller: That’s about it.

Dr. Hornbrook: So briefly talk about that technology as well and why you focused on diode.

Alan Miller: Well I think the reality is the uh the dentistry can be broken down in 2, 3 categories as I see it. Hard tissue, which allow the hard tissue lasers the erbiums can also perform some of the soft tissue procedures. Typically those products are around $70,000.

Dr. Hornbrook: Yeah, which is a huge investment.

Alan Miller: Yeah.

Dr. Hornbrook: For anybody.

Alan Miller: And a lot of people found out that the hard tissue lasers they’re great for some procedures like class 3, class 5 and [inaudible 00:19:09]. They’re great for the kids, you know, they cut really well-

Dr. Hornbrook: You’re talking about hard tissue?

Alan Miller: Hard tissue.

Dr. Hornbrook: And [enamel 00:19:16].

Alan Miller: And it’s great for bone. So-

Dr. Hornbrook: Right.

Alan Miller: Hard … You know crown lengthening, they work really well. The problem is they all are kinda slow on occlusal preps on adults-

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: So a lot of people I think have been frustrated with hard tissue lasers over the last 20 years-

Dr. Hornbrook: Yeah.

Alan Miller: Because the way that they’re promoted and marketed isn’t reality, I mean-

Dr. Hornbrook: Yeah.

Alan Miller: If you have a busy practice you’re gonna hate a hard tissue laser.

Dr. Hornbrook: Yeah, you st-, st-, still need a hand piece.

Alan Miller: Still need a hand piece.

Dr. Hornbrook: I have one and I don’t use it for tee- tooth at all.

Alan Miller: Now the soft tissue lasers, really the diodes, dominate the market, because they’re a lot less expensive to manufacture and it makes more affordable for dentists; and I would say, you know, in that category you got CO2 lasers and diodes.

Dr. Hornbrook: Okay.

Alan Miller: CO2 lasers are really good lasers. It’s a niche market in dentistry. You can cut fairly fast with a CO2 laser, it’s non-contact which kind of throws some people off-

Dr. Hornbrook: Right.

Alan Miller: But uh, you know, they’re good lasers. You can find them in the [inaudible 00:20:19] market, you can find them in the aesthetic laser market, and that’s really both the erbiums for hard tissue and the CO2 all come for the aesthetic market-

Dr. Hornbrook: Okay.

Alan Miller: And you put a dental hand piece on them [inaudible 00:20:30].

Dr. Hornbrook: So aesthetics you mean like skin resurfacing and things like that-

Alan Miller: Exactly, exactly.

Dr. Hornbrook: So if, if … So if there wasn’t … How much is a CO2 laser?

Alan Miller: They’re typically 25 to $45,000-

Dr. Hornbrook: Okay.

Alan Miller: So that’s why it’s in [inaudible 00:20:44]

Dr. Hornbrook: Yeah, 10 to 20 … So let’s say I was Bill Gates and money was not an issue and I had the option of a CO2 or diode. What would the CO2 people say, why there’s is better than a diode? What … Is there advantages of that?

Alan Miller: You know I think they would just look at it as apples and oranges. I think a clinician when they use them both are gonna say, they both got the job done-

Dr. Hornbrook: Right.

Alan Miller: And I can tell you that some of the most successful dentists out there that money is no limit are picasso customers.

Dr. Hornbrook: Yeah.

Alan Miller: I mean they can buy any laser they want and they come back and I think it’s just a great value I mean for what you get with the education and all the accessories and the … quite frankly the ease of use with the picasso lite cause there’s really only 3 buttons on it-

Dr. Hornbrook: Yeah (laughs).

Alan Miller: It’s hilarious. I was gonna put one button on it, but you know it’s probably-

Dr. Hornbrook: I only use 1 button.

Alan Miller: (Laughs)

Dr. Hornbrook: (Laughs)

Alan Miller: But just you know, my first unit to picasso had 8 presets. You can program, you know, the intervals and the durations and this thing will cook your breakfast

Dr. Hornbrook: Right (laughs).

Alan Miller: And very quickly people said “make it easier,” so-

Dr. Hornbrook: Yeah.

Alan Miller: You know picasso lite has 1 button for speed-

Dr. Hornbrook: Right.

Alan Miller: If you want to cut fast, hit it. One for comfort, you know, that’s the happy face-

Dr. Hornbrook: Right.

Alan Miller: And the third button is everything else. So that’s your hygienist using it for [perio 00:22:06], you know back to that top 10 we talked about that’s your [inaudible 00:22:10]-

Dr. Hornbrook: Yeah.

Alan Miller: That’s uh cauterizing, uh, you know, you name it. You’re gonna use that last button for everything, so it’s super easy to use, and it’s super affordable. So guys said, “money is no object.”

Dr. Hornbrook: Still buying.

Alan Miller: They’re still buying picasso lites-

Dr. Hornbrook: Why not?

Alan Miller: Because it’s easy to use and it’s a great thing for the buck-

Dr. Hornbrook: Yeah.

Alan Miller: You know, why buy 1 CO2 laser when you could put picasso lite in every single operatory?

Dr. Hornbrook: Yeah.

Alan Miller: To me that’s just good business sense.

Dr. Hornbrook: Yeah and, and in the stage you mentioned this earlier, and I wanna, I wanna address this. The states the hygienists can use it um I truly believe when I say this any time I give my presentations, I believe the use of the laser is the standard of care in the treatment of [periodontal 00:22:49] disease. I absolutely believe that, and fortunately in California, where I practice, my hygienist can use it. So the biggest mistake I ever made was 15 years ago, showing it to my hygienist-

Alan Miller: (Laughs)

Dr. Hornbrook: Because then it became her laser-

Alan Miller: Yeah.

Dr. Hornbrook: Right now to think, “oh shoot, do I wanna spend another 25 grand,” (laughs) which I couldn’t afford at the time, right? And now it’s real easy to say yeah, absolutely I’m going to get you one in each room. So let’s … So there’s 2 things I want to address with this, one is education, um I know that, that your site amdlasers.com has a whole it’s under literature I think or-

Alan Miller: Clinical.

Dr. Hornbrook: Clinical-

Alan Miller: Clinical, it’s got literature, it’s got how-to videos-

Dr. Hornbrook: Yeah, which even if one of our listeners had a different manufacturer of a diode laser, they could go to that, and they’re going to be educated-

Alan Miller: Yeah, and a lot of them do, because you know [inaudible 00:23:34] used to be in the business-

Dr. Hornbrook: Right.

Alan Miller: And I think we had a big impact on their laser business, so they’re-

Dr. Hornbrook: Oh they couldn’t compete with (laughs) your lasers?

Alan Miller: (Laughs), but you know, we have a lot of navigator-

Dr. Hornbrook: Yeah.

Alan Miller: And honestly customers that go and look at our site, we, we encourage it. All these how-to videos are 2 to 3 minutes each-

Dr. Hornbrook: Yeah, and they’re very well done.

Alan Miller: Yeah.

Dr. Hornbrook: [inaudible 00:23:55]

Alan Miller: Kudos to, yeah, Doctor [inaudible 00:23:57] did a great job.

Dr. Hornbrook: Cause you know, I just got a new laser for my associate, my new associate and she hadn’t really be exposed to laser dentistry so you know it comes with a master series DVD, is that what it’s called?

Alan Miller: Right on, yeah, 6 [CE 00:24:10] credits-

Dr. Hornbrook: Yeah and it’s amazing-

Alan Miller: And certification for that-

Dr. Hornbrook: The quality of the-

Alan Miller: Yeah.

Dr. Hornbrook: Video, and kudos to you and you know there’s also a literature support-

Alan Miller: Yeah, all-

Dr. Hornbrook: Section because

Alan Miller: All of the articles are on there-

Dr. Hornbrook: I still, still have doctors say, “oh you can’t use a [inaudible 00:24:21], it’s not proven.” It’s like dude, it … Or dudettte depending on if it’s a woman, right-

Alan Miller: (Laughs)

Dr. Hornbrook: Um is there’s all kinds of literature for this and, you know that-

Alan Miller: Yeah.

Dr. Hornbrook: As well as I do, and doctors need to be exposed to that. They need to see that there’s great literature in the treatment of [periodontal 00:24:38] disease. So we’re getting bone regrowth, elimination of pockets, sterilization of the pockets-

Alan Miller: Yeah.

Dr. Hornbrook: Where are we right now in perio, would you say?

Alan Miller: I’d say we’re at a crossroads. More than half of the states have approved lasers for use with the hygienists. I think there’s an overwhelming um conclusion that lasers are here to stay for perio-

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: And that diode lasers, specifically, are becoming commonplace as a [adjunct 00:25:12] to treating type 2, type 3, type 4-

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: Perio disease. I, I do like the Millennium product.

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: The periolase is a Nd:YAG-

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: From Millennium Technologies right here in California. It’s expensive, you know it’s over $100,000-

Dr. Hornbrook: Yeah-

Alan Miller: It’s a lot of training and they’ve got uh I think good training how to use that product for type 4-

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: Patients. I know a lot of periodontists love that product. I think my approach has been, you know, let’s, let’s try not to get the patient to a type 4-

Dr. Hornbrook: Right.

Alan Miller: Let’s look at how do we treat them type 2, type 3 and use picasso lasers as an [adjunct 00:25:50] to everything else. It’s not on a magic bullet.

Dr. Hornbrook: Right.

Alan Miller: You know and I hear it all the time-

Dr. Hornbrook: Don’t tell my hygienist that. She would say-

Alan Miller: I know.

Dr. Hornbrook: It’s a magic bullet.

Alan Miller: I hear it all the time, “Alan, it’s a miracle device. I’ve had patients with 5’s and 6’s they’re now 2’s and 3’s and it’s because of your laser.” I think it’s more of a … It’s a piece of the puzzle.

Dr. Hornbrook: Right.

Alan Miller: You still have to [inaudible 00:26:10] the scale-

Dr. Hornbrook: Right.

Alan Miller: You know, the laser is good to decontaminate the pocket. It’s great for removing the [inaudible 00:26:17] tissue, but you also have to have patient compliance.

Dr. Hornbrook: Right.

Alan Miller: And it has to be put into a program that makes sense to the patient, and it has to be marketed to the patient correctly-

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: From the office. So it’s really about treatment planning and setting expectations uh not only clinically, but also financially for the patient-

Dr. Hornbrook: Right.

Alan Miller: And I think uh it’s gonna be commonplace. It’s gonna be standard of care because it works.

Dr. Hornbrook: And patients, you know, the general public loves the word laser, right? Whether it would be laser skin resurfacing or, you know, laser … We put these pictures in this room the other day and the person uses a laser, you know laser picture straightening thing, whatever it is. You know, laser tattoo remover, you know; you get your eyes lasered, laser this-

Alan Miller: Yeah.

Dr. Hornbrook: Laser that, and, and if you use patient’s love of lasers and if it’s actually doing something for them I mean that’s huge marketing. You know I have patients at my practice that wh- where they move out of town, or another state first thing they call is “can you find me hygienist that has a laser?”

Alan Miller: Yeah.

Dr. Hornbrook: Cause they’ve seen it in their own mouth. Where … You know every 3 or 4 months that pocket bleeds and they use the solution and a water [pick 00:27:22] and all that stuff, and it still bleeds. And we’re going over there with the laser and we’re getting healing. The patients appreciate that.

Alan Miller: And that’s the other thing I’m seeing a lot more of is hygienist actually going through with the laser and decontaminating each pocket before they go in and probe-

Dr. Hornbrook: Mm-hmm (affirmative).

Alan Miller: Because think about this, you’re going probe into a 5 or 6, full of bacteria, and then the next pocket over is healthy with no bacteria.

Dr. Hornbrook: Oh yeah we’re going cross-contaminating.

Alan Miller: It’s cross-contaminating. It is.

Dr. Hornbrook: [Oh, it’s bad 00:27:50]

Alan Miller: So the hygienists have figured out, a lot of hygienists throughout their lecturing on lasers. In fact we’ll be at RDH coming up in 2 weeks-

Dr. Hornbrook: Oh okay.

Alan Miller: In Las Vegas.

Dr. Hornbrook: Oh good.

Alan Miller: At Caesar’s, and AMD Lasers is supporting all the hand’s on programs with picasso and picasso lites.

Dr. Hornbrook: Okay, great.

Alan Miller: So any hygienists that are looking for more information or hands-on, they’re gonna be attending RDH. Come find us, we’ll be in the-

Dr. Hornbrook: Okay.

Alan Miller: Technology Pavilion.

Dr. Hornbrook: That’s 2 weeks from now?

Alan Miller: Two weeks from now.

Dr. Hornbrook: Oh, okay. Yeah, doctors that are listening um might be an opportunity to send your hygienists to learn how to utilize lasers in your offices. So I mentioned, as a practicing clinician that has a practice, only 4 days of [inaudible 00:28:29] there’s no way I would let my office be laser-free. I mean it’s just not gonna happen.

Alan Miller: One question I get asked a lot is “what is the learning curve for these lasers?” Because the word laser can be intimidating.

Dr. Hornbrook: Right.

Alan Miller: I would say on average, just because I’ve been in thousands of dental offices around the world and I’ve met … fortunate enough to meet great dentists-

Dr. Hornbrook: Right.

Alan Miller: From everywhere. I would say most guys and gals take it out of the box take it out of the box, they look at the quick start guide. They put the laser together in a couple of minutes. They practice on a hot dog or some lunch meat-

Dr. Hornbrook: Yeah.

Alan Miller: And they’re on their first patient-

Dr. Hornbrook: Yeah.

Alan Miller: It’s kind of one of those things, walk before you run, and then they watch some of the how-to videos and before they know it they’re using it for [fibroma 00:29:13] removals-

Dr. Hornbrook: Right.

Alan Miller: They’re using it for [venus length 00:29:17] procedures-

Dr. Hornbrook: Right.

Alan Miller: Which is amazing. They’re using it for all the surgeries, so think [frenectomies 00:29:22]-

Dr. Hornbrook: And [inaudible 00:29:24] removal-

Alan Miller: Yeah.

Dr. Hornbrook: And exposing teeth that are going to be extracted.

Alan Miller: Exposing teeth you know, back to the orthodontist, exposing teeth is so simple-

Dr. Hornbrook: Right.

Alan Miller: And a [perculectomy 00:29:32], what do you do with that third molar that keeps getting infected-

Dr. Hornbrook: Oh, yeah.

Alan Miller: Boom, pull out your picasso, picasso lite. A minute later you’re finished and there’s no bleeding or swelling.

Dr. Hornbrook: Yeah.

Alan Miller: So all the surgeries, it makes life a breeze, and it also gives the opportunity to keep the patient right there with a doctor instead of referring the patient out.

Dr. Hornbrook: Oh yeah. Yeah and some things, I don’t know if it’s FDA approved for this, desensitization of cementum. It’s freaking awesome. Also uh when you have direct pulp exposure. Pulp exposures that are still vital teeth, you get that little pink-

Alan Miller: Yeah.

Dr. Hornbrook: Blood.

Alan Miller: Perfect.

Dr. Hornbrook: What we do in the past, we try to put [Dycal 00:30:13] to stop the bleeding. You know I use my diode now. I just zap it, it’s sterilizes the area instantly. It neutralizes the, the bleeding or eliminates the bleeding, cauterizes that. That ain’t go right with the direct pulp cap, whether you use TheraCal from Bisco or whether I do it [inaudible 00:30:29] agent. If you wanna use [Dycal 00:30:30] I guess you could, but that’s huge for me-

Alan Miller: Yeah, yeah.

Dr. Hornbrook: It, it-

Alan Miller: It’s one of the 100 procedures that you find out you can use with these lasers.

Dr. Hornbrook: Yeah and as you get into lasers, this is for my listeners, um go to amdlasers.com and go to procedures. Wh- wh- what’s it called again?

Alan Miller: Clinical.

Dr. Hornbrook: Clinical.

Alan Miller: And then you got how-to videos.

Dr. Hornbrook: And how-to because you know [inaudible 00:30:48] we kinda … we don’t have time to go deep into it, but the patient comes in and says, “I don’t know if I can do my impressions today because I got this little cold sore.” [inaudible 00:30:57] to go in there and just zap it and all of a sudden all the pain goes away and if it’s viral or bacterial in origin, it kills the bac- bacteria in the virus. Healing is amazing, and those are just little gifts we can add to our patient, you know whether it’s in hygiene or with the doctor.

Alan Miller: Yeah.

Dr. Hornbrook: So I’m gonna wrap up. Where do you see … it, it’s amazing that we’re already at the 30 minutes-

Alan Miller: (laughs)

Dr. Hornbrook: It’s crazy.

Alan Miller: We need 30 more minutes.

Dr. Hornbrook: We never have these in-depth conversations. Usually we’re, you know talking about-

Alan Miller: Having fun.

Dr. Hornbrook: Other things. Some of you know I’m an avid dirt bike rider and, and [inaudible 00:31:31] and I go to the Imperial Sand Dunes which is about 2 and a half hours east of San Diego and Los Angeles, largest sand dunes in North America; and I ride motorcycles and quads. Last 5 years I got into [razor 00:31:42] which is like a Yamaha Rhino, but better, sorry for all you Yamaha Rhino owners-

Alan Miller: (laughs)

Dr. Hornbrook: Very intense, crazy off-road and Alan joined me in that um-

Alan Miller: You’ve cost me a lot of money.

Dr. Hornbrook: Yeah, I have [inaudible 00:31:57].

Alan Miller: I mean now I have 2 [razors 00:31:57] and a big trailer and-

Dr. Hornbrook: Yeah.

Alan Miller: Dirt bikes and 4-wheelers. Thanks a lot David.

Dr. Hornbrook: We have fun though.

Alan Miller: We do, we have a great time.

Dr. Hornbrook: Always have fun, always have fun. So-

Alan Miller: Yeah.

Dr. Hornbrook: Let’s, let’s wrap up. Again, I want to thank you for being here. Um we could spend another hour on this, wrap up, where do you see laser dentistry going? You know, as someone asked me the other day, “do you think that, that some day we won’t have any hand pieces and it’ll all be laser?” I mean some day, but where do you see laser dentistry going in the future?

Alan Miller: You know I think I’ll look at the products we’re working on over the next 5 years. Next year, we’re gonna see multi-use lasers, so different wave lengths that can do a number of different procedures in a practice. I don’t wanna give away too much, but I think we’ve got some ground-breaking technologies-

Dr. Hornbrook: Well, I know you’ve-

Alan Miller: Coming up.

Dr. Hornbrook: Shared with me a little bit and I won’t share it with the audience, but stay tuned because there are some very, very cool things that are happening in the horizon with AMD and lasers in general-

Alan Miller: Yeah.

Dr. Hornbrook: You’re on the cutting edge. So, wh- what else?

Alan Miller: I think education. Not … always look at this stuff, David, is technology is one thing, but if you don’t have education and support, you know, who cares about these products? They’ll end up in your closet, but I look at the number of clinicians lecturing for AMD whether it’s implants, or restorative or preventative, the educational lasers over the next 5 years is amazing. I think we’re supporting close to 500 CE events this year alone.

Dr. Hornbrook: Wow.

Alan Miller: Next year we’re gonna be almost at double that amount. So you know I think just the general dentists out there, and also of course the specialists are gonna get a good education on lasers. Not only if they already have one and what else they could use it for, but still the I would say the dentists that haven’t pulled the trigger yet. The 50% that don’t have lasers, are gonna have a very good reason to go out and purchase uh-

Dr. Hornbrook: Yeah.

Alan Miller: Picasso, picasso lite.

Dr. Hornbrook: Yeah.

Alan Miller: So, new products in the pipeline both hard tissue. We’ve got a CO2 coming. We’ve got a new family member to the picasso line coming-

Dr. Hornbrook: Yeah, good.

Alan Miller: Which is really exciting and yeah I think AMD Lasers, we’re looking at how can we really improve the worldwide distribution and we’re already all over that-

Dr. Hornbrook: Yeah.

Alan Miller: So-

Dr. Hornbrook: Good.

Alan Miller: Looking forward-

Dr. Hornbrook: Cool.

Alan Miller: To some fun things in laser dentistry in the next 5 years.

Dr. Hornbrook: And, and I’ve enjoyed watching you over the last 10 plus years and see the products change and develop and become better and see your growth. I’m proud of you, as, as your friend, I’m very proud of you.

Alan Miller: Thank you.

Dr. Hornbrook: Excited for you and the future. So we’re gonna go ahead and wrap up. Um you’ve got some great resources, not only the information we’ve shared with you in the last 30 minutes, but um whether you have picasso or you have another brand of laser or you’re deciding is this something I’m gonna make a step into. Go to amdlasers.com and look at some of the things you can do, and if you doubt either one of us look at the literature review. There’s unbelievable reports whether it be perio whether it be … as far as eliminating necrosis or some of the downfalls of surgery, not using a laser I mean. Find that, that out for yourself and I know you’ll make a purchase. So we’re gonna wrap it, thank you Alan very much.

Alan Miller: Thank you, Dr. Hornbrook.

Dr. Hornbrook: Dr. Hornbrook?

Alan Miller: (Laughs)

Dr. Hornbrook: You can call me … You never call me that-

Alan Miller: Thanks David.

Dr. Hornbrook: You call me a bunch of other names, not even David, I just I can’t repeat most of them. Um so this is the conclusion to our podcast with Dental Up, I invite you on amdlasers.com. Go to keatingdentallab.com, keatingdentallab.com, see some of the great products and some of the things we’re doing educational wise here at Keating and then our new website dentalup.xyz, where we’re gonna be talking about some of the things we’re doing in media. I just filmed about, in the last 2 months, about 40 little vignettes, little videos, whiteboard videos, as well as some clinic videos. Um very fun, all free and so be sure to, to look at those. Anyway I hope I see ya soon at one of the meetings and thanks for listening.

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