Understanding your Target Audience and the Importance of Laser Technology with Dr. Samuel B. Low, DDS, MS, M.ED

Host: Ladies and gentlemen, this is the Dental Up Podcast, brought to you by Keating Dental Lab, a full-service award-winning dental laboratory. Each week, you’ll learn tips and techniques from real-world dentists bringing you in-depth interviews, motivating stories, current events, and sports. Here is your special host, the senior technical advisor for Keating Dental Lab, Brandon Fetters. Brandon Fetters: Hey everyone. Brandon here. Welcome to another episode of the Dental Up Podcast. Our guest this week is graduate from the University of Texas at Houston, where he received his doctorate of dental medicine and his master of science degrees. He has received his master’s of education from the University of Florida, and has over 30 years of private practice experience in periodontics. He has become a well-respected educator, speaker, and overall influencer in the dental industry. He is currently the vice president of Dental and Clinical Affairs and chief dental officer of Biolase Incorporated, located here in Irvine, California. Currently residing in Irvine, California, please welcome Dr. Samuel Low, DDS, MS, MED. How’s it going, Dr. Low? Dr. Low: I’m doing fine. Thank you. Appreciate it. Brandon Fetters: Yeah, great to have you on the show here. We really appreciate you taking the time out of your busy schedule to meet up with us and do the podcast. Now- Dr. Low: Well, you’re very welcome. Brandon Fetters: Yeah. Out of curiosity, how did you happen to get into dentistry, and what point did you think, “I want to become a dentist?” Dr. Low: Well, now, I took a very circuitous route. Never thought about being a dentist until I was actually out of college and sort of searching for something to do. My parents introduced me to a fantastic dentist who had come back from Vietnam. From there, embraced the profession, and then went on to be a periodontist. I taught high school biology before dental school. Probably it was only natural that I would have a blend of both practice and being in academics. Then, was at the University of Florida College of Dentistry in the periodontics department, and left there as an associate dean, and then began to pursue multiple projects. I still see patients there in Gainesville, but pursue multiple projects and consulting, putting periodontics into the practice of dentistry, and recently, focusing on the introduction of dental lasers into the practice of dentistry. Brandon Fetters: Wow, that’s rather impressive. It seems like you’re used to having that busy schedule, so that would kind of play into the amount of lectures that you were doing over the past weekend that you mentioned. Dr. Low: Yes. I stay busy also looking … one of my areas is advising companies on the future of the dental profession, and where we are, where we’re going, and as it moves into a state of [flux 00:03:09], especially in the last five years with dentistry, the delivery of dentistry changing to a certain degree as the DSO methodology of practice begins to dominate where we are in the profession. Brandon Fetters: I hear you. Definitely quite involved in the technologies that are coming out nowadays. Sounds like you like to stay with the [crosstalk 00:03:34] … Sorry. Dr. Low: There’s a couple of areas that dentists must embrace and one is for sure, being able to market their practice to create the niche. The second is to adopt technologies, whether they be a digital scanning impression, a CBCT for implants, and my area that I’m closest to, and that is the utilization of a dental laser, especially in the area of crown lengthening aesthetic, crown lengthening, utilizing them for minimally invasive periodontal surgeries. Then lastly, using the erbium laser for managing implant diseases, which unfortunately are becoming more and more and more an issue, as more and more implants are being placed. Brandon Fetters: Yeah. I’m going to jump back there a little bit because you hadn’t mentioned the marketing. Are there any marketing strategies that you can particularly suggest or that you’ve used and have noticed had been successful? Dr. Low: Well, one is what I lecture about, and that is finding a particular group of patient that needs you, and can afford you, and appreciate you. Of all the generations that are out there, if we move from the elderly all the way down to millennial centennial, that generation that has by far the most susceptibility and the most success for a present and future dental practice, is that segment of the baby boomers. They are the one that own most of the wealth in the United States and they are the ones that actually have many of the significant dental conditions that we see, which ranges all the way from periodontal disease, in which two out of three baby boomers have bone loss to dry mouth. They are also the ones that are generally getting the implants. Now that we know that a good probably 20% of implants get implantitis and potentially are lost, this is a excellent group for us to focus with. Dr. Low: In marketing and in my mind it’s fine that niche patients who need you, want you and can also pay for you, and that would absolutely be those individuals born between 1946 and 1966. My other area that I begin to appreciate now more than ever is that dentists always tend to gravitate where there are also dentists. Which in my mind, if I was managing any business, why would I do that. I think my point is, is that we always go to those areas where everyone else wants to go. Then we turn around and complain because we don’t have enough patients. Dr. Low: There are a substantial number of rural areas in the United States that are totally untapped. If I was a young practitioner, that’s the first place that I would be thinking about. Plus, that’s where they’re needed. Rural dentistry in my mind is still a wide open area for success. That’s what I would advise any young practitioner who’s going to set up a practice, which as you may know, that is few and far between because primarily of the student loan debt. Dentistry is still an incredibly viable, positive, successful profession. Just don’t go where everyone else wants to go and I think you will be happy. Brandon Fetters: Yeah, creating that competition instead of like you’re saying, go out in those rural areas where people need it. I imagine you’ve come across quite a bit of that seeing that you’ve spoken in 49 out of the 50 states. Dr. Low: Actually, I just went to Idaho, so now I’m at 50/50. Brandon Fetters: Nice. Dr. Low: In creating marketing, you don’t do what everyone else does. In other words, I’m always intrigued when someone wants to send out postcards with something like free whitening with your next dental visit, which means all I’m going to get is a bunch of millennials who want white teeth, who have no money, who generally are using their parent’s credit card to pay for it. When there are so many outstanding procedures that one can do, but you’ve got to market it. You’ve got to use the right technology. You’ve got to have a website that introduces a niche. For me, if you don’t have minimally invasive dentistry on your website, then I believe that you’re going to be way behind the curve in moving forward. Brandon Fetters: Yeah, it’s interesting you mentioned the website, because I still come across quite a few doctors that don’t have them up. It’s kind of strange, they don’t have a web presence in this day and age. Dr. Low: You know the other thing that’s interesting to me is web presence. I’m on dentist websites every day. You know, they’re almost cookie cutter. They’re almost like here’s who I am, come see me. Actually your best websites are those which are compelling, which is why you should see me, drawing the patient in. Always interesting, when I don’t see any websites that really have quality, real time patient testimonial. You’ve got to have things that discriminate that why you’re different from anyone else. I do want to backtrack a moment. Dr. Low: We still believe that the number one way to get a high quality patient that you want, that is compliant and has allegiance to you, is by word of mouth. That is relationship building. Like likes like. When you find great baby boomers that demonstrate quality of care … I’m part of the Pankey Continuing Education Institute. Dr. Pankey, which is a very viable institute in Key Biscayne, Florida. Dr. Pankey always says, “Like likes like.” You find that great patient, guess what? They’re going to refer you another great patient. That’s just common sense. Brandon Fetters: Most certainly have your patients almost doing the marketing for you by that word of mouth. That’s so very true. Dr. Low: We believe again, as far as technology goes, if you see advertisements for medical care, everything you see is that which is same day surgery. You get up the next day, you can do whatever you want. That’s where laser technology comes in, especially related to periodontal procedures. If you look at something called gum surgery, I mean, let’s just think about that. Today you’re going to get gum surgery. I can’t imagine anyone saying, “You know, I can’t wait for that. I’ve been waiting with bated breath to have my gums cut open with a blade and you grind on my jaw bone.” Brandon Fetters: Oh yeah. I imagine- Dr. Low: Just give it to me. Brandon Fetters: Imagine when you hear [crosstalk 00:11:24] people say that, just they cringe. Dr. Low: I know. When you go on Google to see gum surgery, I cringe. What if you had a procedure that created the same or better results, that didn’t require blades, that didn’t require stitches, that the next day you got up and you did whatever you want, you went to work, and yet the result was the same or better than traditional gum surgery. That is for a laser periodontal surgery, whatever laser it is. It could be Biolase, where I’m associated with an [inner vine 00:12:04]. Then you know what happens, is that then people do what? Then people go and have the procedure. They don’t avoid the procedure, and before you know it, they keep their teeth. Now we’re about approach on a couple of excellent studies, one in particular done by and a very, very good group of periodontists who do excellent research. Dr. Low: We’re finally going to be able to demonstrate that yes, you do not have to have gum surgery as we know it, to save your teeth. That means then that middle class America is going to walk in and say, “I do want it and give it to me. I want to keep my teeth and I want to have form function, be able to look fantastic.” Let me give you an example. If you and I had our gallbladders removed 20 years ago, they cut you from your molar tooth to your toenail. You get your gallbladder out now, at 11 o’clock on a Friday, you’re at home at five o’clock with your feet up, probably drinking a Miller Lite and you recoup. That’s where I even somewhat, I’m reluctant to call it dentistry, that’s where really oral healthcare management should be going. Brandon Fetters: Yeah, the minimal invasive. Dr. Low: That is where it is going. You are seeing a monthly adoption of dental lasers as we know it by the dental profession. The other part that I would mention about lasers is that lasers are very holistic. I’m not talking about a mantra burning [incense 00:13:53]. They are holistic in the fact they use light. Let me give you another example. If you went in to have lens correction because you didn’t want to wear eyewear anymore, you would go in to have something called the Lasix. The Lasix is laser. It’s almost like Kleenex, isn’t it? If you had to have surgery on your eyeball, and I said, “Well, you can go to one ophthalmologist and have your eyeball cut with a blade to get to the retina, or you can go to the other ophthalmologist who has a laser, who uses a unassuming non-ionizing, very safe radiation to the eyeball, without cutting your eyeball. Which one would you want? Brandon Fetters: Yeah, it’s a pretty easy choice. Dr. Low: Exactly. Exactly. The only reason lasers can’t get adopted as quick as they should is because we in the oral health profession are very, very slow to change, and we do what we were taught in dental school. It is time to change. It’s time to rethink who we are because we are all physicians of the mouth. We do utilize science. It’s time to move on to where our patients don’t avoid us. That’s where I’m going with this. You ever heard this phrase, “I got to go to the dentist?” Brandon Fetters: Yep. Dr. Low: I got to go to the dentist. Oh geez. Oh, I don’t know. You know, I got to go. I don’t know what else, I’ve got to go, but maybe something will happen to where I don’t have to go. Procrastinate. Procrastinate. Brandon Fetters: Yeah, the situation [crosstalk 00:15:37]. Dr. Low: What we want to try to do is what? I love going to the dentist. It’s convenient. They can do it all in one day. They’re not going to hurt me. They’re going to make me look fantastic. Brandon Fetters: Yeah. It’s kind of interesting too. It makes me think about how I was watching one of your presentations online here and you had mentioned about how all the doctors, when they came in, all the dentists were kind of fearful of the laser, but after the two day courses and everything, they all left, comfortable. Just something that ran through my mind, was almost like that idea of curing ignorance toward it. Once it gets out there, more for everybody and it becomes more common. Dr. Low: Yeah. I could understand about the comment of ignorance, but we are, again, like likes like. If you didn’t experience it in dental school and you really want to do what’s right for your patients, actually a level of fear and anxiety comes in with anything new. In some ways I like that. I wouldn’t want to go to a physician, who what we called the innovator or the early adopter, that picks up the person that comes around, but at the same time agreeing with your comments, it is time to at least trust that we are moving out of the early adopter, innovator stage, into the early majority. I am absolutely convinced that laser will be the standard of care in managing gum disease. I am convinced of it because of the minimally invasive nature of it, because of the safety of it. Maybe it’s because we’re not doing a good job of introducing technology as well as we should into our dental schools. Brandon Fetters: Yeah, yeah, that’s- Dr. Low: Because you’re right, you’re exactly right. When they go into a two day laser course and they pick up that laser, sometimes they think of it as like Star Wars. It’s like a defense system. Like something’s going to zap somebody. You have to convince them that actually laser is much more safe than having a radiograph taken of your mouth, because it’s non ionizing radiation. Once [you’re 00:18:02] control it, and you appreciate the precision of it, and you appreciate the science behind it, and the fact that there are significant numbers of studies and even more coming out, that’s when the tide will change. Dr. Low: You’re also now starting to see your very, very large group practices, aka DSOs, now starting to say, “Wait a minute, we’re competing with each other.” If we’re going to be a major, major component of delivery of dental health care in the United States, then we need to get on board. You are seeing that with some of your prominent DSOs out there, like Heartland, that are now engaging in laser technology along with other areas. They’re doing an excellent job of educating the practitioner on how to use these technologies. That’s very, very positive for us, is the … I don’t really want anyone picking up any new technology unless they’ve been educated and educated correctly. Brandon Fetters: Well certainly. Dr. Low: Taking an online course to use a laser, in my mind that would not be permitted. That’s just the fact that I’m … taught high school biology before I went to dental school. [inaudible 00:19:28]. Brandon Fetters: Now along those lines, the Biolase Learning Center, is that actually located in Irvine, California? Dr. Low: Ah, yes. The primary training center for Biolase is in Irvine, because Biolase, which has probably the market as far as numbers of lasers sold in the world, is in Biolase, and actually the lasers are made in Biolase. They make them and they train them at that facility in Irvine. Although, Biolase also has other training centers including Dallas, centrally located, and in New York City. Brandon Fetters: Oh, that’s good [crosstalk 00:20:16]. Dr. Low: Most of the courses for Biolase are two day very intensive courses with followup, with access to clinicians afterwards, to ensure that any questions that you may have, because that may be the first time they’ve ever touched a laser. That’s not the first time they’ve touched a high speed handpiece, but the first time they’ve touched a laser. Biolase, like other quality techno companies, education is absolutely critical, critical, critical in this particular business to make this happen. Brandon Fetters: Certainly. Dr. Low: As we look at also key opinion leaders that are out there, I mean in other words, folks that we practitioners look up to as being credible. When they move forward, whether it be implants or whether they may [believe 00:21:17] in trays for orthodontics. The same is true for lasers and folks like Dr. Christensen. Gordon Christensen has personally told me that it is time that we need technology to try to manage periodontal disease, besides what we have been doing in the past so that middle class America, or really all classes of America can afford and also feel very receptive in going in for nonthreatening procedures. The point is, is that we’re not getting … important key opinion leaders in the world that are beginning to appreciate that laser technology is that which will actually attract more patients. Then we’re able to provide more care and then naturally we have less teeth extracted, less pain, less discomfort, and everyone looking fantastic. Brandon Fetters: Well certainly. As you were talking about that, it made me wonder about, I’m see in my notes here that you’re having an event upcoming here pretty soon in Irvine on September 20th and 21st. Can you share with us anything that you’re going to be addressing in that? Dr. Low: Sure. Biolase will have a first time symposium. That will be in San Diego in October 18, 19. Actually, I spoke about Dr. Christensen. Actually, Gordon Christensen will be the keynote for that and we’ll be exploring with the practice of dentistry, various technologies that he believes are the present and future of where we should be. Also the speakers range from not only restorative dentistry, aesthetic dentistry, we’ll have Gregg Kinzer coming in from the Spear group. We will have clinicians discussing lasers, but we’ll also have a couple of speakers that will be honing in on this whole tongue tie issue, especially with newborn’s children. You may be aware that that is a very interesting topic now, including sleep apnea. Also for the newborn using laser technology to actually correct what we call the frenums, to do frenectomies, and thus very much creates a scenario of babies with lactation issues, and being able to grow to maturity with correct jaw scenarios, decreased sleep apnea. That whole area will be investigated with this symposium. Dr. Low: We’ll also have some key opinion leaders in the area of implantitis. Dr. Don Clem, who actually practices in Fullerton, who has published multiple papers on implantitis, will be speaking on the area of lasers and management of implant disease. There’s about 12 speakers and there also will be a dental hygiene assistant track that is not just about lasers themselves, but how to manage patients that need lasers, and to be able to look at it from the dental hygiene perspective. Along with that there will be workshops. There’ll actually be a laser certification course for dental hygienists. Then there’ll be an advanced laser course in aesthetics and in managing implants. That’s coming up. It’s almost sold out. We’re looking very forward to that. That will be probably, Biolase will then probably have something similar to that on a annual basis, somewhere probably on the West Coast. This one will be in San Diego and it’ll be October 18th and 19th. Brandon Fetters: Excellent. Yeah, that sounds like that’s going to be a pretty exciting symposium there. Now obviously a big fan of lasers. What are your thoughts about CAD/CAM technologies and impression scanners? Dr. Low: I can’t imagine folks not using digital impression in the future. I used to walk into a large audience and say, “How many of you are using digital radiography?” There would be three or four hands that would raise. A couple of years later there’d be 10 or 15, 20, and a couple of years … Now I walk in, anyone who doesn’t raise their hand is afraid, is looking down at the floor, when it comes to digital radiology. I would suggest to the exact same thing that’s going to occur in digital impression and scanning. I am not going to take a stand on milling, but many practitioners will suggest to you that milling belongs in the dental lab. Dr. Low: They don’t have the chair time to do it right, but they do have the chair time to do an incredibly fantastic prep, and to also be able to digitally send that and get a fantastic restoration from that. I just can’t imagine that in the future does not include CAD/CAM and include digital impression. I also can’t imagine that dental practices or the majority will not have CBCT and also to compliment where the implant is placed, then use the technology to create the provisional, possibly even using … Dr. Low: This is where you might see 3D printing and [the least 00:00:27:37] doing the provisional. At least at this point it’s still going to be the dental lab that’s going to create the beautiful shape, the color, the contours that’s needed. Let’s face it, we especially, well, I should say anywhere in the world, aesthetics is incredibly important to all of us. Brandon Fetters: Most certainly. Dr. Low: Yes, I would agree that I can’t imagine dentistry not totally embracing that technology of digital impression. I will suggest again, to make another little sound bite about laser, the problem about digital impression is, what you see is what you get. You will find that once you do digital impression, because you don’t have a tray anymore, we’ll get granular here, because what you see is what you get, you better either use a laser for troughing, or you better use a lot of cord because you’ve got to distend that margin or you’re not going to be able to find it, [crosstalk 00:28:41] digital. Brandon Fetters: That’s very true. Yeah, certainly. Certainly very true. From a lab standpoint, I was really was excited for the digital impression age. Given the fact that we’re eliminating these extra steps of expansion, contraction with stone, and everything of that sort. Do you have any advice that you would be wanting to give toward new dentists coming into the field that are starting out? Dr. Low: Well, the first thing is no matter what you hear about maybe doom and gloom, because I do see that sometimes, it’s not. It’s an outstanding profession. For me personally, it was something that blended my cerebrum with my dexterity, but more importantly of all, if you don’t like people, get out of it, because to me, that is one of the most positive things about being an oral health practitioner and that is your relationship with people and a personal relationship with people. Sometimes we forget. We are working in a very, very, very personal part of their body. It is called their mouth. We continue to think ourselves as only as tooth docs. Dr. Low: Our dental schools now, my friends, if you graduated more than 20 years ago, our dental schools are not like that anymore. Our dental schools are creating professionals that are what I consider to be oral physicians. We are creating individuals that know heck of a lot more about medicine than physicians would ever know about dentistry. For me, I suggest, find a fantastic practice. Closing on that card, there’s one thing also I think that we have somewhat forgotten about, but not for me and my generation. That is, we relied on mentors. Find yourself at least one or two high quality mentors. Dr. Low: Dental school can give you some of the mechanics, but high quality role model mentors, that’s what can accelerate you into being successful in dentistry. My advice would be, first of all, don’t do debt unless you have to. I know you have debt, I’ll be the first to say, “You have debt,” but don’t let debt determine what you do on a day to day basis, for something that you’ve spent not just four years, but four years of college and 12 years before that. Do it right. Find the right mentor and then, like likes like, and you will become like them. Brandon Fetters: That’s excellent Dr. Low. I really appreciate it. Then almost going back and adding into what you had mentioned before, don’t go to those areas where everybody wants to be. Dr. Low: Yeah, you can say it a million times, but you know, we’re in a culture [inaudible 00:31:46]. We’re selfish. We want to spoil ourselves. Then we get there and then we almost on borderline ethics. We sometimes to keep the doors on the hinges, sometimes we are challenged to do things that maybe we shouldn’t be doing. I don’t want to see our profession go there. Smell the roses. There are wonderful, wonderful people, sorry, again in rural areas. They love you. I mean, they may pay for you with eggs and whatever, but they will love you. It’s a great place to be, is in rural America, in the practice of dentistry. Brandon Fetters: Excellent. Excellent. Well, I certainly do appreciate your time. Was there anything else you wanted to add? Dr. Low: No, your questions were great. I’m proud to be a dentist. I’m hoping that others that are coming out of dental school will feel that level of being proud, that we’re not just employees, that we do have a major relationship with patients, and that patients do rely on us for trust and wisdom. I know that we’re going to be able to continue to deliver that. No, I appreciate you for having me on the program. Brandon Fetters: Oh yeah. We completely appreciate you as well. Thank you so much, Doctor. Dr. Low: Thank you. Host: Thanks for joining us on the Dental Up Podcast show this week. Make sure to follow us on Facebook, Instagram, and Twitter, or search the Dental Up Podcast on iTunes for our weekly feed. Don’t forget to visit KeatingDentalLab.com/promo for exclusive offers. Keating Dental Lab is a full service dental laboratory and we’re nationwide. We’d love for you to send us a case so we can show you the Keating difference. If you dig what you heard, please leave a review on iTunes and we’ll be back next week.