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

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 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

Michael,
Thanks for the reply. I appreciate your point of view, and hopefully you mine. I am fortunate that I haven’t espoused what Koolaid Biolase had. I always have tried to show science in what I have taught in our classes. With Lares, the nice thing is that the research on Er:YAG is plentiful, BUT like any other lit, you must get through some of it to get to the real science to see if indeed it has been correctly (the laser) used for it to be valid. Example: You say that the bond studys show decreased bond strengths. I would agree with some of the existing lit concluding this, however, if you read methods of how they obtained their data, it is flawed and erroneous conclusions are made.

Lasers continue to be a hot topic, and more research is needed. I have always prided myself on being above the frey when it comes to presentation of my materials to give all the wavelengths a fair shake. What is interesting though, with bonding in particular, is that the YSGG shows a decrease due to a number of differing factors, vs. Er:YAG, and alot of this is due to the way the physical characteristics of the machines work. Fotona has worked very hard to to achieve these goals, and continues to do hard research to improve their products based on scientific discovery. That is one of the many reasons I have aligned with them, with the encouragement of Jim Jesse as well.

Hope your New Year is a good one. I would love to see you again sometime Michael. You are one of the good guys in our profession, and I thank you for that!
Sincerely,
Mark

Jeff, I am new to Periolase. I was just referred a patient for bleaching/whitening.
Can you please give me the details of the procedure or refer me to a source?
Thanks
Val