Just browsing through this forum and found this thread and wanted to add this thought: I don't think erbium penetrance in the dental market is going to increase significantly until we see:

1) Better ability to cut, especially without anesthesia, which FOTONA/Lares seems to be moving toward

2) Sub 50K price point, which along with #1 above, will make it easier to achieve ROI

3) Better post-sale follow up other than “how many tips are you buying this month”.

I could be wrong, but the pushback I get from most dentists is the same old thing: “cuts too slow”, “too much sensitivity”, “too expensive to buy/maintain”. And I have to agree. While those of us who have used this class of lasers for years now have “the knack”, all of us have been where potential new users are right now. In order for a technology to take off, potential buyers have to see enthusiasm from not only salespersons, but other users as well.

Hi David,
Sometimes I still have problem ablating teeth without a shot. Please direct me to those threads ? Thanks.
Ken

HI Dave,

IT has been a while since I saw this topic broached. My success rate has increased since I had the National laser upgrade put into my Waterlase. Dave, can you elaborate on some newer laser”anesthesia” techniques you employ with the Waterlase (no the MD) since the time that we trained together in Stu's office.
Thanks,

Robert Tracey

Guys, this is all moot now. Hate to say it, but BioLase is dead and Hoya is on life support, thanks to Fotona. No dentist new to lasers is going to pay what Biolase and Hoya are commanding when Fotona will sell them a dual wavelength laser with superior technology for $71K. The only problem with Fotona is that they have NO research on the perio technique that Joel “Fotona” White is advocating, basically a rearrangement of LANAP protocol steps. The have no cred, no depth, and no research in their perio arena, and that’s going to get them into trouble. They definitely are not Millennium in terms of their corporate knowledge or training practices, and their blatant “piggybacking” on LANAP protocols leaves a bad taste in my mouth.

Unless Hoya or Biolase does some radical redesign, I think we’re seeing the last of their generations. Biolase doesn’t have the money to design a new laser, and Hoya doesn’t seem to be so inclined. Which is a shame, because as good as the Fotona is, the unit is big, loud, and difficult to move. Nonetheless, I think it’s pretty well positioned to rule at least the erbium segment of the market and is going to keep Millennium busy wagging fingers…

Yes,
Fotona is a very good piece of machine!
Now , we’re having Doctorsmile from Lambda and Waterlase100 in Hong Kong.
Don’t know much about the down grade waterlase100 but they seem to be trying to sell them cheap to compete.:mad:
Ken

@mherndon 54560 wrote:

Biolase is the worst company I have ever dealt with, bar none. And they know I feel that way and I think they know they deserve it.

And I do have to wonder about the guys that taught for them at their training for so long, all the while telling how great Biolase was and then jumping ship and saying the same thing about the new Lares. It would seem to me that the credibility is at stake here. For a short time I was sort of on the inside with Biolase but when I saw the BS and the Bucks over Substance approach I bailed immediately. My credibility (however small it may be..!!) is not for sale. I must say though, those that do sell their credibility loose it.

Just some thoughts…

Hi Michael,
Mark Colonna here. I met you at a Biolase course in SF a few years back. Just want to comment on a couple of things. First, it’s not about the bucks! I actually take offense to that comment. The Waterlase IS a good machine. The Lares/Fotona machine is better, especially at hard tissue applications with the Er. I can gaurantee you that my credibility is in place, and my integrity. I don’t make these choices lightly, but with a lot of time and research before I act. Just ask those that I have taught, and are teaching. I place emphasis on that. You say we say the same things about the Lares, but we don’t. It is a completely different laser in so many ways, AND a privately held company. The laser has tremendous versatility that the Waterlase doesn’t have, especially in hard tissue as I stated earlier.

Biolase has treated a lot of people badly. I have even had some internal struggles with them in the past, which I won’t go into, but have kept quiet about, being a “company guy”, hoping that they would “pull out of it” as far as their sprial, both in Customer Service and Sales. I don’t need to say more. I also have seen the “inside” of Biolase, probably more than most, and I agree with you about some of the substance in lieu of sales, which is their bottom line. I can say this though, that Bill Brown is a exemplary person, and it was for him I stayed as long as I could. It was a very difficult decision, on a personal basis for me, not professional. I am sorry though, you feel that way about us “trainers”, but you really should back up what you say with some substance. It’s not about the bucks I say again…because, trust me here, one makes MUCH more bucks in the office than training or speaking. We do it because we believe in it, laser dentistry. It’s our passion. It’s where we WANT to spend our time, and our OWN RESEARCH DOLLARS, that fund our science and research on how the laser functions in various ways. Not paid for by a manufacturer, although it’s tempting to have them pay for it, we don’t because we want to remain independent. Means more. Ahh I digress.

Michael, please have all the facts in place before you lump us “trainers” into a catagory. It does no good for laser dentistry. All I can do is speak for Dr. Barr, myself and Dr. DiVito. It’s not about the “bucks”, it’s about making dentistry better for our patients, and the Lares/Fotona laser does just that, and THAT is why I switched camps.

Sincerely,
Mark

PS..If you found a guitar, say a Gibson, that performs, and sounds better than the one you currently have been endorsing, would you switch to that guitar, because you feel it gives you better quality to your recordings, and how you want your music to sound? My music is laser dentistry, when it comes to laser. I found a better instrument in which to jam with….

Hi Mark..

I had completely forgotten that I had posted this message about Biolase. I can see your point of view and for that I would like to publicly apologize to you and anyone else that was offended by my remarks, particularly Bob and James…

James Jesse is a different story. I fully admire the guy (we have known each other since childhood). Jim came to me early on and we had some very good discussions about what was going on at Biolase, including the need for solid science to back up their theme and promotions of their product. We both agreed that the science was not there and that the company was more interested in sales than the credibility of their product and company from a user supported system. Truly, Biolase is the worst company I have ever dealt with and they know this and continued to behave that way towards me and many others consistently over a long period of time (3 years +) despite always pledging to do otherwise.

Jim had protected his credibility by being out front about the issues to me and tried to get the idiots to honor their users more effectively. Again, he was proactive and that is to his credit. Another fellow (no name here) was a different story and the last time I saw him it was obvious that he was not very interested in seeing me or discussing the issues. That kind if thing is what I am referring to regarding credibility.

One has to be very careful when they align themselves along company lines. There is a conflict of interest in a situation like that unless there is the science to back it up. I am speaking of periodontics, not restorative, but even that applies. For example, the debris field left by cutting tooth structure with the hydrokinetics of this laser creates a number of problems from lower bond strengths unless removed (and you have commented on how your desire is to use no handpieces) to an inhibition for fibroblast migration across that debris field. I will go on to say that the company and the training course that I went to was trying to promote a 30-40% stronger bond with the laser, when in fact, it is reduced. The promotion of no pain was also sometimes yes and a lot of times no. If my laser was different and not as good as yours, then they should have switched it out for a better one. This was proposed not only by me but by Jim Jesse as well. The company refused and I continued to have problems for over a year.. finally it settled down and I did not change my technique. It was unbelievable that while they got me into this so I could help promote it, the left me hanging. I have, because of that, been very out front about this in all of my lectures and presentations to groups. I just state the facts in what I experienced.

My comments are that, while I could find used for this laser in periodontics and those uses were primarily resective (other than Brad Deans ideas which had merit to a point… the debris field is a problem though), the company was irresponsible to me as a customer and if you ask around you will find that it is not just me.

Again, when ever one aligns himself with a particular product and that product has quality control issues, which Biolase clearly does, and then does not make it clear that unless the company moves in a more positive direction they will leave, resigns some of their credibility because they are, as you say, a “company man”. The continuance of promotion over substance is an issue regardless of how nice someone might be.

Finally when those folks move on to somewhere else, those of us that see this can’t help but realize that the company man just went to another company, and the analogy of promoting one guitar and then another is a very poor one. Playing different guitars for tone and whatever reasons is a far cry from doing invasive procedures on patients for a fee. Burt Press once said to a graduating class: “You are now a member of a very small group of humans that are licensed to preform invasive procedures on your fellow humans. NEVER forget that huge responsibility.”

Within that context, integrity is king. Just because someone “believes” something works does not make it work. Evidence based dentistry should be the driving force. Integrity is not just telling people what you believe to be true, it is making sure that what you are telling them is, in fact, true. The dentist down the street that gives a recommendation that he believes to be correct does not absolve him from the responsibility to make sure that it is, indeed, supported in the literature and is actually a correct recommendation given all the parameters. One can only do this by continuing to be a serious student of the science of dentistry, and Periodontics is the science basic to all of dentistry. So, learn it. Study it. Read the research and also realize that the body of evidence lies within the profession of periodontics, not within the empirical enthusiasm of dentist that “believe” in what they are doing. You cannot just regurgitate the company lines over and over to assist in promotion of a product just because the company says to say this or that and to NOT say that or this, if you catch my drift. Credibility should never, as a professional, be for sale to promote a product. Truthfully, I have been appalled at some of the nonsense I have heard at the Biolase mini lectures at trade shows. Some of those folks have no shame in their ignorance.

Do not get me wrong. I am not anti laser. Quite the opposite actually, and I have been discussing this with my periodontal colleagues. Understanding wound healing as I do, I can see a protocol that gives success, and a laser is at the center of that. But it is not the magic wand of the laser that provides the success as much as it is the entire approach. This makes complete biological sense and that is where the success comes from, the laser is only a tool in the process. I look forward to upcoming multi center studies and can see a very positive result in the rather difficult task of moving laser technology forward in the view of the periodontal community. But it must be the science that drives it.

But I am and will continue to be critical of “Company men” when it applies. Dentistry is a wonderful profession and it is a wonderful privilege to provide that care in a creative and compassionate way. But the responsibility is huge and there are many that are quite concerned about some of the directions the profession has taken.

In ending this, I would like to say that I found you to be very sincere. You are a good speaker and have put a lot of your time and effort into the promotion of lasers in dentistry. The same thing goes for Bob, and I have stated above my sense about my friend James. No matter how it hurts and how it makes you feel, touting the wonders of a particular product is a risky business. If it turns out to be a good thing, then you are ahead of the game and everyone pats you on the back. If it turns out to not be a good thing (Biolase), then a part of you will go down with the ship. Jumping to another in just another risk. In my mind it is better to maintain some caveats along the way whether the company likes it or not, for you are the professional in dentistry, not them. No stated caveats and caution, the risk is much higher. This is what I was speaking of. James understood this risk and placed those caveats where they should be. Others did not do that as well and take more of a hit. That is the breaks of the game, Mark.

And, by the way, the same thing applies to music. You put yourself on the line when you perform and when you place your art carefully in a record.

I would be delighted to see you again somewhere along the way, although you might not feel the same way. Same for Bob, and most certainly for James. I do admire all of you. My caution is as stated above at some length. Risky business, being a company man.

Most sincerely,

Michael W. Herndon, DDS
Amsterdam Fellow
Certificate: Implant Assisted Reconstructive Dentistry emphasizing Periodontal Prosthesis
Department of Advanced Periodontics, Department of Periodontal Prosthesis,
School of Dental Medicine, University of Pennsylvania, 1993.

Editorial Board Member, Journal of Implants and Advanced Clinical Dentistry

Founding Member, San Francisco Academy of Advanced Dental Education

Past guest lecturer, Department of Advanced Periodontics, Loma Linda University