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Dr. Chris Walinski neeDeD something more. he Was in a professional rut anD WanteD a Change—something to bring exCitement baCk to his Dental praCtiCe.•

The take-awaysLasers enable you to perform more procedures, so you don’t have to refer as many cases to specialists.Lasers can add excitement to the practice for you, your staff and your patients.

WEB EXCLUSIVE For more charts from the survey and an article about the medical and dental laser offerings from Technology4Medicine, visit dentalproductsreport.com.

exClusive survey

See Some GPs still may be resistant to incorporating lasers into their practice, but laser experts say they’re missing out on increased productivity and improved patient perception.

by R e n e e K n i g h t

The liGhT

25%of respondents use lasers in their clinical practice. –February 2009 DPR Lasers Survey

The Styla™ MicroLaser from Zap Lasers is designed

for soft-tissue applications and is described as

lightweight and balanced. For a video and more

laser details, check out dentalproductsreport.com.

DeNtaLPRODUCtsRePORt.COM | March 200930

CliniCal 360°

March 2009 | DeNtaLPRODUCtsRePORt.COM 31

CliniCal 360°exClusive survey

Photo courtesy of Caspar Benson/Getty Images

that’s why Dr. Walinski turned to lasers in 2001. he didn’t know much about the technology then, but was hop-ing the hard- and soft-tissue lasers he purchased would give his practice the extra oomph it needed.

turns out, they did. “lasers completely transformed my

practice, my staff’s enthusiasm and my personal satisfaction with my profes-sional life,” Dr. Walinski said. “i often receive feedback from other dentists in the same funk that i was in who are desperately seeking a viable option to reenergize their lives.”

regardless of the reason, 25% of gen-eral practitioners responding to Dpr’s latest exclusive survey report (see “about this Dpr survey,” p. 37) have at least one laser in their practice, with 17% of those who don’t making plans to buy one in the next year. many first-time laser buyers turn to diodes to perform soft-tis-sue procedures, with 63% of our survey respondents who own a laser indicating they own a diode (see “What you already have,” upper right).

those clinicians who have lasers are using them for a variety of procedures, including gingival troughing, gingival contouring and sulcular debridement (see “What you’re doing,” below left). but this only scratches the surface of what lasers can do in the operatory.

What’s in it for you Dental lasers aren’t new. they’ve been a minimally invasive treatment option since the 1990s, and manufacturers have improved on the technology, with

new options and upgrades continuously released to the market, said Dr. robert gregg, president of millennium Dental technologies (www.millenniumden-tal.com). as lasers have developed, the number of clinical uses has also grown, but many gps are still resistant to make the investment. forty-seven percent of our survey respondents indicate they don’t plan to purchase a laser because they don’t do enough procedures that would benefit from a laser.

With the right training and dedica-tion to continuing education, clinicians can perform a variety of procedures with a laser, even procedures they may have referred to a specialist before, said Dr. phil hudson of the spokane Center for advanced Dentistry (spokanead-vanceddentistry.com). from multiple soft-tissue procedures to endodontic applications to biostimulation that pro-motes quicker healing, the possibilities for laser use are vast (see “opportunity awaits,” p. 36). and that means adding more services and productivity to your practice, whether you invest in a soft-tis-sue laser strictly for soft-tissue proce-dures, a hard-tissue laser for procedures involving teeth and bone or a dual-wave-length that does it all (see “learning the laser language,” p. 37).

Seeing the return on investmentafter Dr. hudson incorporated lasers into his practice, he saw the soft-tissue surgical side grow from a small percent of his practice’s gross production to well above 25%, he said. he performs proce-dures in a bloodless field that are more conservative, less invasive and also are more comfortable post surgically with shorter healing times.

Cosmetic procedures, endodontic procedures, periodontal procedures all are possible in his off ice now (see

“lasers by specialty,” p. 35). he’s been using lasers for nearly 20 years and is confident that if dentists begin to per-form the procedures they’re currently ignoring, failing to see or referring out to specialists, they can dramatically increase their productivity.

“i can’t think of a dental specialty that couldn’t benefit from access to lasers,” said Dr. hudson, who is a visiting clini-cal instructor for the hoya College of Clinical laser Dentistry. “but any gp who goes down the list and recognizes how lasers can be used in specialty practices should be thinking, ‘Well wait, why can’t i provide these services in my own practice? Why do i need to refer patients? Why can’t i do it myself?’ gps with lasers tend to refer to specialists with far less frequency because they’re able to provide more of those procedures in their own office.”

adding lasers to your list of dental tools not only gives you the capability to perform new procedures, it also boosts your confidence that you can do them successfully, said Dr. Will gianni of Zap lasers (zaplasers.com). fibroma removal, frenectomies and gingivec-tomies are some of the minor surgical procedures gps can perform with lasers with little to no anesthetic, post-opera-tive pain, bleeding or need for sutures.

Your patients love them they may not know exactly what lasers are used for, but patients know they want them as a treatment option. Dr. Walinski, who is a consultant for biolase technol-ogy (biolase.com), said it’s common for patients to come to his practice just because they know he uses lasers, and if the service they need is simple and a laser isn’t necessary, they’re often dis-

WhaT YoU’rE doIng

Which procedures do you perform with a laser?* (multiple responses allowed)

Gingival contouring� �� 86%Frenectomy� �� 69%Troughing/gingival retraction�� 67%Fibroma removal�� 56%Sulcular debridement�� 44%Source: February 2009 DPR Lasers Survey*Only asked of those who indicated they use a laser in their clinical practice.

MYTh BUSTIngThere are plenty of misconceptions about laser dentistry that either are keeping you from getting in the game or holding you back from effectively using the laser you finally decided to invest in. Here, our laser experts debunk some of those myths.

01 Lasers are too expensive.

Dentists often just look at the price tag rather than at potential ROI, Dr. Phil Hudson said. Yes, the laser may seem expensive, but calculate how much increased productivity and additional revenue the laser can bring into your practice before you make your final decision.

For all nine myths debunked by our laser experts, visit dentalproductsreport.com



WhaT YoU aLrEadY haVEWhich types of laser(s) do you have in your practice?*

Diode 63%Nd:YAG 20%Carbon dioxide 17%Er:YAG 14%Er,Cr:YSGG 14%

Source: February 2009 DPR Lasers Survey*Only asked of those who indicated they use a laser in their clinical practice.

The FoX diode laser from Technology4Medicine has 3 wavelengths: 810 nm, 980 nm and 1064 nm. For details on this and other offerings from the company, check out the Web Exclusive at dentalproductsreport.com.

appointed. they ask questions about the type of laser he has and his training background. they’ve heard about the benefits and they know if you’re using a laser, you’re likely using the most current technology in other parts of your practice as well.

simply put, lasers are a huge draw. “it seems patients understand the ben-

efits much better than we give them credit for,” Dr. gianni said. “almost all patients understand that lasers can make proce-dures more precise, less painful and more efficient than conventional means. When you incorporate soft-tissue lasers into all of your dental procedures, your patients will know you pay attention to details and are looking out for their best interests.”

they also like the fact that they don’t have to go to a specialist, Dr. gregg said. patients would much rather have all their treatment done in one place rather

than spend extra time going to another practice, where chances are they will feel a little uneasy because they don’t know the doctor and staff treating them.

“patients treated by gps don’t like to be referred to specialists,” Dr. hudson said. “they’ve established a trust rela-tionship with their dentist over a period of time. When a gp says he or she needs to refer, patients become apprehensive and ask, ‘Why can’t you do it?’ With

lasers, we can. and we can do it well. We can do it right there in a comfortable set-ting with which the patient is familiar and where the patient has trust in the team.”

remember, your patients know people regardless of the experience patients have in your practice, they’re going to talk to family, friends and co-workers, Dr. gianni said. if they’re blown away by the services you offer and the fact that they didn’t expe-rience much if any pain during their visit, that’s what they’re going to talk about.

that’s why it’s important to edu-cate your patients about what you’re doing and to ask them about their experiences before they leave, said gail s. siminovsky, executive direc-tor of the academy of laser Dentistry (laserdentistry.org).

offer them educational brochures and talk with them about the benefits lasers offer and how lasers relate to the procedure you just completed.

and if your patients seem happy, don’t be afraid to ask them to refer fam-ily and friends to your practice.

“internal marketing is really a won-derful tool,” siminovsky said. “When

LaSErS BY SpECIaLTY

With the capability to take a variety of procedures and make them minimally invasive as well as easy for you to successfully complete, lasers can bring a host of benefits to your patients and your practice. Here’s a run down by specialty of some common uses for lasers in dentistry:

% of dentists who use lasers are satisfied with their return on investment. Source: February 2009 DPR Lasers Survey

Periodontics Soft-tissue crown lengthening Sulcular debridement GingivectomyLANAP (laser-assisted new attachment procedure)

Cosmetic/Restorative Ovate pontic design Gingival recontouring Tooth whitening Frenectomy

endodonticsSterilizes the canalIncision and drainage Pulpotomy Hemorrhage control

OrthodonticsMakes local anesthetic unnecessary for soft-tissue proceduresFacilitates orthodontic treatment planningGingival contouring and shaping



YoUr LaSEr WISh LISTWhich type of dental laser are you planning to purchase in the next year?* (multiple responses allowed)

Soft-tissue 58%Dual-wavelength 21%Hard-tissue 5%

Source: February 2009 DPR Lasers Survey*Only asked of those who indicated they do not use a laser in their clinical practice and are planning to purchase one in the next year.

you use a laser and patients are happy and they share their positive experi-ence with family and friends, those patients are the best marketing tool for your practice.”

get the word out once you decide investing in a laser is right for your practice, you need to let people know about it. many of you already are, with 64% of survey respondents who use lasers promot-ing it in their marketing efforts.

starting with existing patients and word of mouth are great tools, but there are other ways to get your message out.

siminovsky recommends contact ing local media and

suggesting an educational piece about lasers. use any coverage as a

way to market yourself and announce that you have a laser. this will help set you apart from gps in your area who don’t.

While lasers can be a great prac-tice builder, don’t buy a laser and then promote it if you don’t plan to

fully integrate the technology into your practice, Dr. gregg said. all too often clinicians buy a laser, don’t get the proper training but still use the fact they have a laser to draw people to their practice. the laser sits in their closet, never meeting its full potential. that approach won’t benef it your patients or increase your practice’s productivity.

Don’t think you can use a laser to save a failing practice, Dr. hudson said. lasers should be integrated into successful practices to have the most immediate effect.

Why some gps still aren’t buying it there are a lot of reasons gps don’t want to use lasers beyond simply not knowing how much they can do, Dr. gregg said. if a dentist is happy with how his practice is going, he may not want to take the risk that comes with such a large investment. expense, lack of education and staff resistance are other factors that may keep clini-cians from that first laser purchase.

others are worried lasers won’t live up to the hype; they’ve been burned with products before and don’t want it to happen again.

“Change equates with risk and people are generally risk averse,” Dr. gregg said. “if i don’t have to change, i don’t have to deal with risk. that’s a really key psychological awareness we have to think about. if i’m making

money and don’t want to take a risk, i’d rather not change or spend money on something if it’s not going to do something for me that’s not different than what i’m doing now.”

Why you might want to reconsider all it took was a 20-minute booth presentation at the american Dental society meeting nearly 20 years ago and Dr. hudson was hooked; he knew he wanted to add lasers to his practice. he wanted to be on the leading edge of dentistry and offer the best there is for his patients.

now, like many other laser dentists, Dr. hudson can’t imagine practicing without them.

from keeping patients more com-fortable to adding more speciality procedures to your list of services, there are many reasons to buy a laser. but before you make that purchase make sure you do your research.take advantage of hands-on learn-ing opportunities, such as the alD’s 16th annual Conference and exhibi-

tion set for april 22-25 at the green valley ranch in las vegas.

from diodes to erbium lasers, there are different lasers that are good at different things; you need to determine which best f its your practice (see “your laser wish list,” p. 35) . and once you do, it will bring excitement back to dentistry for you and your staff, while providing your patients with minimally invasive treatment, Dr. Walinski said.

“i would encourage every doctor not to be afraid of this technology and realize it is here to stay,” Dr. gianni said. “the sooner they start to learn about the various applica-tions, the better their practices and patients will be for it.” •Renee Knight is an associate editor for Dental Products Report. Contact her at [email protected].

aBoUT ThIS dpr SUrVEY

The February 2009 DPR Lasers Survey was e-mailed between Jan. 20, 2009, and Jan. 26, 2009, to 1,264 general practitioners in the United States. The survey was completed by 148 GPs, for a response rate of 12%.

LEarnIng ThE LaSEr LangUagE

Ever wonder how a laser gets its generic name? The mate-rial contained in the center of the laser, or the optical cavity, determines it. The cavity’s core is comprised of chemical elements, molecules or compounds and is called the active medium. It can contain a gas, a semiconductor or a solid crystal. Carbon dioxide is a gas laser, the semiconductor lasers are called diodes and crystal lasers are designated with acronyms, such as Er:YAG, Er,Cr:YSGG or Nd:YAG.

The active medium’s stimulation generates a specific wavelength of non-ionizing radiation, with each wave-length having a different effect on dental structures. While all available dental lasers can be used for soft-tissue procedures, only erbium lasers can be used on hard tissue. The wavelengths are categorized in three groups.

Here’s the breakdown:

01 Diode and Nd:YAG. These wavelengths are

delivered with small optical fibers sometimes coupled to various tips. Their laser energy targets the pigments in soft tissue and pathogens as well as inflammatory and vascularized tissue. They have no interaction with healthy tooth structure.

02 Carbon dioxide. These lasers easily interact with

free water molecules in soft tissue as well as vaporize the intracellular water of pathogens.

03 Erbium lasers (Er,Cr:YSGG and Er:

YAG). Sometimes referred to as all-tissue instruments, the energy from these lasers can interact with soft and hard tissue because of the short pulse durations and the maximum absorption in water.

Source: Academy of Laser Dentistry (laserdentistry.org)

The VersaWave® from HOYA ConBio is an Er:YAG all-tissue laser that can perform a variety of hard- and soft-tissue procedures. For details, check out conbio.com.

The VersaWave® from HOYA ConBio is an Er:YAG all-tissue laser that can perform a variety of hard- and soft-tissue procedures. For details, check out conbio.com.

opporTUnITY aWaITSPlease indicate your level of agreement with the following statement:

“ I have been able to expand the number and type of services I provide since using a laser.”*

42%Somewhat agree

25%Strongly agree

19%Somewhat

disagree

3%Don’t know

11%Strongly disagree

Source: February 2009 DPR Lasers Survey

*Only asked of those who indicated they use a laser in their clinical practice.

of dentists who use lasers promote it in their marketing efforts and of those, 38% consider it a primary point when marketing their practice. Source: February 2009 DPR Lasers Survey

%





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