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AUDIO - HSP #277 - Alan Miller
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VIDEO - HSP #277 - Alan Miller
Hear from the founder how and why AMD lasers are both affordable and efficient.
Founder and President Alan Miller (Alan Miller Designed - AMD) launched Picasso in 2009 and forever changed the dental laser industry. Over the past five years Picasso laser technology has been loved, celebrated, and endorsed by clinicians, hygienists, universities, hospitals, dental clinics, and patients around the world. Picasso laser technology has won numerous industry awards, while Alan Miller and AMD LASERS have also been recognized by non-dental associations for innovation, design, technology, and company growth. AMD LASERS rapidly grew and became recognized as the industry leader in soft tissue laser technology. The Company was purchased by DENTSPLY in 2011, expanding its product distribution network around the world.
Miller expressed the company's thoughts on this organizational change. "This is a great outcome for our customers and our company.In taking AMD LASERS private again, we can go back to our roots, focusing on the entrepreneurial spirit that made AMD LASERS one of the fastest growing and most successful companies in the dental laser industry,” he mentioned. “DENTSPLY is a fantastic company with some of the most talented people I have ever met.They did a great job converting AMD into a very sophisticated operating company and couldn’t thank them enough for furthering the interest in dental lasers,” Miller added.
Quality, value, and support set AMD LASERS and its product offering apart from the competition. This is a testament to the Company’s commitment to providing not only the best dental lasers but also the education, service and support that the dental profession rightfully demands and expects.
Howard Farran, DDS, MBA, Founder and CEO of Dentaltown, said the following regarding the continued viability of AMD LASERS, “Alan Miller in laser dentistry is like other high quality, low cost, genius pioneers from a variety of other industries that have launched products that we as consumers know and love. Alan figured out how to make an exceptional laser at an affordable price for every dentist. Alan is by far the coolest guy in dentistry and I can’t wait to see what he does next!”
Howard: Hey, it is a huge honor. I am at the Greater New York Dental meeting, in Manhattan, and I am not blowing smoke, this is one of the coolest, smartest guys that I have ever known in dentistry. I have always said that you and, another one is, Jim Glidewell ... I have always called you guys the Herb Kelleher of dentistry because, when I got into dentistry, it seems like all the companies wanted to make the most expensive, complicated way to do anything.
Alan: Yeah, yeah.
Howard: My dad always said, "God gave you a brain and two eyes, and you keep one eye on your customer and one eye on cost, and he gave you a three-pound brain to figure out how to drive down costs so your customer has the freedom to afford what he has." You take people like my mom and her three brothers, not one of them had one tooth left when they got out of high school.
Howard: In Parsons, Kansas, because that is how it was back then. You went to the dentist, and the only thing they could afford was to pull it. I have always had the most respect for people who use their brain to squeeze down the cost, and you did it, first, with diodes.
Alan: Yeah, the Picasso.
Howard: When I got out of school, in '87, a YAG laser was $50,000, and what did you sell them for?
Alan: When the first Picassos came out, about $3,500.
Howard: How did you squeeze all that cost out? You are a Hoosier, from Indiana. How the hell did a Hoosier from Indiana ... ?
Alan: I don't know. Hoosiers can do anything.
Howard: How did you do it, though? Let me say this. When you first got into diodes, what was the average price of a diode?
Alan: About $12,000.
Howard: Yeah, so how did you squeeze 75% of the cost out of a laser? How did you do that?
Alan: The first thing I did, before I even designed a laser, was listening to what dentists really wanted. They wanted a soft tissue laser that didn't break the bank. They knew that they were going to use it, day in and day out, but, quite frankly, at those high price points, it made it a niche product. The first thing was listening to dentists saying, "We want it, but it has got to be more affordable." Then it was, I think, maybe my brain works a little bit differently. It was really pretty easy to look at the current technology was ... It was expensive, Howard, because there were so many parts to it. There was so much wiring. This stuff was developed with low manufacturing volumes in mind. Think about hundreds of parts inside of these boxes that took a lot of labor cost to put them together, and you go, "Gee, we can fix this." Look at automobiles. Look at what you can get for $12,000. You can buy a whole frigging cars, and that is only because they mass produce them, right? Why not take the same approach with high technology?
It was a real leap of faith for me, to say, "You know what? I am going to buy the parts to make this thing work in huge volumes," and with that volume pricing I got, I was able to bring down the cost of the materials to put them together. Of course, the design I did, with the Picasso, was to make it very modular, so instead of hundreds of pars, if you were to take one part, you will see a few, and it is quick disconnects. There is almost no labor. It was really listening to what people wanted and taking a leap of faith that you can really build a better mouse trap, and that is all it is. Clinically, it does the same thing.
Howard: What year did you come out with that?
Alan: The first Picasso came out in 2009, early 2009.
Howard: Most people don't know this, but I was the absolute first patient Alan had, for laser hair removal. He took that Picasso and seared off every hair I had. Thank you for that. I know that you have done it, again, with hard tissue. Picasso was a soft tissue laser. What kind of laser is that?
Alan: The Picasso is a diode.
Howard: Diode laser, which means electrical, an electrical ...
Alan: Yeah, there is no moving parts in it, very expensive to manufacture, number one-selling laser in the world. A hundred countries. Can you believe this? The first advertising I did was with you, June of 2009. Here we are, the number one laser company in the world, over 100 countries. Pretty much everybody else is out of the business. God bless them. I don't shed a tear, but can you believe this, inn six years? It has been an amazing ride.
Howard: You came and advertised with us, with my good buddy, Pete Janicki. He was your buddy, right?
Alan: He sure was. Everybody loved Pete.
Howard: Before he broke off, and now he is with ... what's the ... Gold Dust Dental Lab, with his wife Jenn, doing lectures with all kinds of famous townies. This guy, here, I think, is one of them. Anyway, lots of them. Now you did it with ...
Alan: Hard tissue, yeah.
Howard: Hard tissue, Erbium WAG. A lot of guys, when I talk to guys, later, they get confused between diode YAG ... Erbium would be the crystal that makes the laser light?
Alan: Yeah, it sure it. Lasers, it is all about what wave length the laser fires at. Erbiums, this one is at 2,940. That is nanometers. That is a wave length. Our Picasso is at 810. At this wave length, the lasers love water, so if we introduce a little bit of water spray with the laser, it makes the laser capable of hard tissue. When I say hard tissue, Howard, I mean cavity preps, I mean bone, I mean things that a diode is simply not capable of. These lasers are. Let me tell you what they can't do. They can't cut through old amalgams. They can't cut through ceramics. They will cut through composites, but they don't operate well on metal. I don't want anybody to get confused. Picasso is strictly soft tissue. The new LiteTouch is for cavity preparations, bone, and they do work well on certain soft tissue procedures.
Howard: This laser is $50,000?
Alan: Fifty. I know that it sounds like a lot, but ...
Howard: Oh, right.
Alan: Quite frankly, it is nearly half of the cost of other hard tissue lasers out there, on the market.
Howard: Are you able to say their names, or is that not polite?
Alan: I think that there is a couple of key players.
Howard: Again, you are half the price, but I want to get to specifics. No one is going to pay $50,000. They are going to lease it. Is that lease going to be ... ? What percent give you $50,000? In reality, these guys are alone. My motto is you're all alone, no one practices alone with Dentaltown. What percent hand you $50,000 versus leasing?
Alan: If they do hand me $50,000, I hand it right back to them and say, "Take a business class from Howard [Friend 00:06:42], actually take the $50,000, invest it, and lease the stuff, because, honestly, it is going to run you $30 to $40 a day, and then you have a solid return on investment if you take it on a lease. Why not take that cash and ...
Alan: Put it towards something else that is ...
Howard: That will raise your return on equity.
Alan: Yes, of course.
Howard: On your standard lease, who are you working with? Are they usually done, three-year leases, four-year leases ... ?
Alan: Five years is pretty typical.
Howard: Sixty months. What would be the payment?
Alan: It is about $1,000 a month.
Howard: Okay, $1,000 a month. Can I tell you why this excites me, me, personally? These dentists keep doing sealants, these pediatric ... forget amalgams, composites, everything. Sealants, you take this technology, that is, you acid-etch enamel, and you put resin on enamel or dentin, and you bond to dentin. Then they take these pits and fissures that are filled with plaque, shit, debris, Oreos, Doritos, and they pour acid on top of this, and then they rinse, and they put bonding agent on pits and fissures filled with shit. Then, in one year, every research article published, on the planet, says that at least 40% are failed, and, then, in two yeas, at least 80%, and none of them have ever lasted three. What is even more insidious is that we fight this gram negative anaerobic, can't live in oxygen, so when you put this partial sealing over the tooth, and then it gets a leak, and the bugs get under, and you are inhibiting all this here, the decay mushrooms.
Howard: You are the number two or three [inaudible 00:08:14]. Then the sealant, you are only getting paid $25, $27, or $28 for a sealant. My homies that have the hard tissue laser, they take that kid without a shot and ...
Alan: Without a shot, in both cases.
Howard: They clean out that pit and fissure, so now you don't have pits and fissures filled with crud, debris, plaque, decay, and bacteria. Now they are acid-etching dentin and enamel. They are putting sealant and HEMA and resin on there. They are putting a occlusal composite or an amalgam, and now they are billing out $150.
Howard: If the least payment was $1,000 a month, and you upgraded a sealant to an occlusal composite, which, in this town, is $250, and then, the kid, you want to do it and have it all fail in two years, or have 95% of them still working at five years. It is a no-brainer.
Alan: It really is.
Howard: It is really a no-brainer.
Alan: Yeah, but I ...
Howard: Do you do brain transplants? When a dentist says to you, "I don't understand. I still do sealants," when a dentists tells me that he still does sealants, I say, "Maybe you should turn in your license and go home." At some point, you have got to say, "I don't know how I graduated, and maybe I really shouldn't be a doctor."
Alan: You can get away with telling them that. I probably wouldn't.
Howard: Sealants are dead. They're dead.
Alan: I agree.
Howard: There is 5,000 pediatric dentists, and if I was you, I would go after the pediatric ... I think that we should put on a hard-tissue laser class, Dentaltown should, at the casino, at Talking Sticks, and lead it with the pediatric dentists.
Alan: Yeah, yeah, that's perfect.
Howard: Because if I wanted to touch this profession and leave it better, one of the first places I would go after is, can we get the 5,000 pediatric dentists to quit doing sealants?
Alan: Yeah, for sure.
Howard: They are also the standard of care. When people go to the Board, and you have got some stupid ass, old pediatric ... "I still do sealants," oh, my God, really? Really?
Alan: Really? The hard tissue?
Howard: What do you think about doing that? What do you think about coming out to Phoenix ... ?
Alan: I have always said it, hard tissue laser for pediatric dentists is a no-brainer. First of all, you don't have to get them numb, which means these kids come in, and they have got cavities all over. Why in the heck would you get one side numb, do them, send them home, put mom and dad through the headache to bring them back, two weeks later? Hard tissue laser, all four quadrants, done. Little Joey, little Sally, they are not getting a shot. They are super quick because the enamel is not real thick on kids, as we know. It is the perfect place for a hard tissue laser.
I will tell you that I don't like over-selling product. I am like you. I say it the way it is. Occlusal preps, on adults? All these hard tissue lasers are slow. If you have got a busy practice, stay away from it. You are still going to have your high-speed drill, but it is the class 3s, class 5s and incisal edges, bone and the soft tissue that I love it for, but I don't want to over-sell the technology. I think that is a mistake that has been done by other companies. We don't over-sell. We like to set the expectations here and deliver here. Everybody is happy.
Howard: A good businessman always under promises and over develops, and you have been a good businessman since the very beginning.
Howard: I am, I think, like I say, I think that ... Look at how the dentists all get together and [inaudible 00:11:47] stuff. Now all the talk is that everybody wants the same-day crown. I have been a dentist for 30 years, and it is funny, because when a patient breaks their teeth, for 30 years, all I have ever heard was, "How much does it cost? Will my insurance? Can you find this out? Will I get approved by CareCredit?" All they talk about is how much is it going to cost. That is half the questions.
Howard: Then they go into, "Am I going to get a shot? Is it going to hurt? Can you put me to sleep? Do I need nitrous oxide?" This is a game-changer.
Howard: Where you are not having to give a shot, and you know what? In 30 years, do you know how many people have asked me, "Can you do it in the same day?" Two. It is like every decade and a half, I hear this question, but the dentist, that is all they hear. Everybody wants the same-day crown. What I say is that you want to have a game-changer in dentistry, make it affordable ...
Howard: That is what you always say. Make it available, be open when they others ain't, have your office where the others ain't, be where they ain't. Don't graduate from dental school and go in downtown L.A. Drive an hour from L.A., and go out where there is nobody there. It is like, in downtown Atlanta, above the Galleria, there is more specialists than you can even count, but you drive an hour from Atlanta, in any direction ...
Alan: It's empty.
Howard: There is towns of 4,000 that don't have a single specialist.
Alan: Howard, you need to ... You know that I love dentistry. Thirty years, working with you guys, your family? I know that you have got the same questions and the same concerns that I do, with dentistry. If I were to ask any dentist, pull one off the street, here, walking off the aisles, "What is your exit strategy?" They would look at me like, "What are you asking me? I don't speak French. Exit strategy? What the heck are you talking about?" Dentistry has changed. You know this. You can't operate your practice and expect to sell it for a bazillion dollars and retire anymore. The exit strategy for dentists has got to change. They have to get educated more on balance sheets and buying assets and not having liabilities and don't buy products that are liabilities. It is crazy.
Invest in anything that is going to make you money. Stay away from the liabilities. Then your exit strategy should be, the extra money you are making, invest it and diversify, right? Get outside of dentistry. Get into commercial real estate. Invest in stocks. Do something different, but there is no end of light for these guys. I do, "How can you operate thinking that you are going to be 90 years old, and still doing dentistry without a game plan? You have got to have an exit strategy." I think that technologies are great, but they have got to be assets.
I had somebody over at the booth. He said, "I really want to get one. I am brand-new. I am just opening a practice." I said, "You have got to be kidding me. You are already in debt. You are still trying to figure things out. Look at things as assets and liabilities." I said, "I am not going to sell you a hard tissue. You don't need to spend $50,000 right this second. Get a Picasso. It's $3,000." He said, "You're not going to sell it to me?" I said, "No, I want you to walk before you run because it is not for everybody."
You know this, but the bottom line is, you are a godsend for dentistry. You help people. You need to give a business class to, really, every dentist out there because I think that they really could use your guidance, your expertise, on how to operate a business. Even though it's a practice, and they love practicing dentistry ... that's great. Take care of your patients, but, man, there has got to be an exit strategy at some point. Right?
Howard: You make this stuff affordable, and you have been very good at squeezing the cost out of soft tissue lasers, now hard tissue lasers. You have got to be available. You have got to be open before 8:00, after 5:00, but you have got to have a pain-free shop. We had a 60-year-old dentist that walked in, the other day. He is just retiring. I said, "You are 65. Come tell the kids what is your advice." He said, "You have got to get down to a pain-free shot." Dentistry is about hurting people. What excites me about lasers, though, hey can ... What do lasers and tattoos have in common? I have always noticed.
Alan: You get the tattoo, first, and then you have got to get it off when you are about our age, with a laser.
Howard: Anybody that ever gets a tattoo, you come back in five years, and they have got another one. Every one of my friends who had got a laser, five years later, they got another one.
Alan: Oh, sorry.
Howard: Then they got another one. Then they got another one. Who was that guy on the other day? Him and his wife, they bought a laser. We did a podcast with them. To stop them arguing with each other, they had to buy another laser because they were starting to marriage-fight over stealing the laser, so now they have his-and-her lasers. I think that a big part of dentistry, I think, the biggest part, is affordability. That is all I hear from the patients. Next is availability. "They are not open," whatever, but how does this contribute to more pain-free dentistry? How does this contribute to less shots?
Alan: The reality is, the hard tissue laser, because it is a laser interacting with water, in almost ... most cases, you don't have to give a shot. It is truly amazing.
Howard: Then how long is the average shot time?
Alan: Yeah, now we're talking ...
Howard: When a dentists gives an average shot, how long do they let it soak in? What do they average?
Alan: A couple of ... probably five minutes because they down in the other operatory, doing a check, screwing around and checking their Facebook.
Howard: They're busy, yeah. If a laser is slower, but you don't have to wait for the anesthetic to soak on it, if the average dentists is numbing up with subcatane and setting a timer for four, or lidocaine and setting a timer for eight, that is eight minutes that you could be sitting there, working on the tooth.
Alan: Oh, yeah, for sure. Yeah, turn it on. Get going.
Howard: Who would be your most ... ? Look out there. There is thousands of people. Who do think is the best fit? Who's the best target tomorrow? Describe the red flag scenario that you think this would be the best match for, at $1,000 a month, for 60 months.
Alan: Yeah, definitely pediatric dentists, it is a no-brainer. If you don't have one, they should. Why wouldn't they? It's a no-brainer.
Howard: Why, a pediatric dentist?
Alan: Because they are going to be doing multiple quadrant dentistry without giving shots. They don't have to reschedule patients. They don't have to turn over the chair, and you know what? It is better dentistry. You get away from the sealants. You have get a better etching, and you have got a decontamination factor with the laser. It's a no-brainer.
Howard: Who's is your number-one product champion, pediatric dentist?
Alan: We just launched this thing yesterday, so who do you suggest?
Howard: Josh [Rehn 00:18:19].
Alan: Josh Rehn. Yeah.
Howard: How about we do this? How we will do a challenge? We will get John Rehn to come to Phoenix. Dentaltown will put on the course. You will work with him to see if he can do that, and maybe he recommends someone else, but I like John Rehn.
Howard: He is a good old boy in Mississippi, and that is a boy ... He is the coolest guy I know in pediatric dentistry, and you would love him.
Howard: I think that you should get Josh Rehn to come to Phoenix, and we should focus this thing on pediatric dentists, and then the lecture we should film so whoever doesn't want to come see it in person live or whatever, then we could put the course on Dentaltown.
Alan: That is a great start, but, I will tell you, if you are a GP, and you're doing implants or a little bit of ortho, these lasers rock. I mean seriously.
Howard: Can you tell us why, about that? What does a laser have to do with implants and ortho?
Alan: The cool thing is, for implants, it is safe around metals so you can uncover the implant, but if you are dealing with peri-implantitis, these things are awesome, cut through bone, remove granulation tissue. It is absolutely phenomenal. You are not dealing with heat.
Howard: Can I ask you an uncomfortable question? This is dentistry uncensored, and I am known for asking the politically incorrect, uncensored deal. There are lasers out there like LANAP.
Alan: Mm-hmm (affirmative).
Howard: They say that if you put this laser in the periodontal pocket, it is going to kill bugs, and a lot of doctors in dental surgery have eight years of college, you took microbiology, say, "Yeah, but wouldn't other lasers also do that? Do they have the only laser that kills bugs?"
Alan: No, of course not.
Howard: Yeah, that sounds obvious. The problem we have with implants is that, if you lost all your teeth from streptococcus mutans, cavities, and then they put implants on the lower anterior, on bone, and then all the manufacturers are telling us, "Oh, we have a 98% five-year success rate," but they cherry-pick that. They don't pick the patients that lost all their teeth from periodontal disease, P.gingivalis, and implants placed in the maxilla. Now the success rate might swing 10, 20, 30 the other way.
Howard: If someone lost teeth from periodontal disease, and they got peri-implantitis, you are saying this LiteTouch Erbium HAG laser would help with that?
Alan: It's fantastic. I will always tell you, a Picasso, for $3,000, will help with that. Now, you can't cut through bone, but a diode is fantastic at removing granulation tissue and decontaminating the implant, and the site. In fact, Gregory Crissman, who I think you know, put out two fantastic articles all about Picasso lasers being used for peri-implantitis treatment.
Howard: Can you tell him that I want to do an hour podcast with him on that alone? Can you line that up?
Howard: Okay, let me give you my card. I am Howard at DentalTown.com.
Howard: I am, I am.
Alan: Really? I don't know how to get hold of him.
Howard: No, I want you to write a note to yourself, to remember, because that would be an awesome podcast, because ... No, peri-implantitis is getting bigger and bigger and bigger
Alan: Yeah, it's huge.
Howard: Because dentists, in the early day, weren't differentiating between, "Oh, she lost all of her teeth because she had a ton of cavities that turned into root canals, she didn't have the money, and then you did implants on her, and they were perfect," and they got confused with the lady who lost it all from gum disease, and now they put all these implants in, and it is an issue. You are saying that a $3,000 diode laser ...
Alan: They work great.
Howard: Is good for peri-implantitis.
Alan: It's great. It's fantastic.
Howard: Gregory Crissman is a friend of both of ours, for decades, and he wrote two papers on this?
Alan: There is lots coming in, from around the world.
Howard: Yeah. Anybody you have got on this, any of your products, I want to talk to them on the show. You said ortho?
Alan: Ortho. Fantastic. Look, anytime you are moving teeth, what are you also moving? Tissue, right? Even though it is a hard tissue laser, it is fantastic at removing soft tissue, so uncovering teeth, operculectomies, frenoctomies. If you have got a diastoma, you have to get rid of that tissue, period. It is also a great etching device, so lots of little things. Aphthous ulcer treatments, so guys doing ortho, you get canker sores all over the place? Erbium laser is perfect for treating those. Desensitizing teeth, also perfect with Erbiums. They work, really well. You are going to find it is not a one-trick pony. You may be reaching for the Erbium, or the LiteTouch, throughout the day. If you are a GP that is doing a little bit of ortho, maybe you are not placing implants, but you are uncovering implants, and you are doing cavity preps, you are seeing some kids, this is like a Swiss Army knife, for your practice. You may not use it 100% of the time, but you may use it for different types of applications. That is what I really like about this product.
Howard: You did it, again. When you came out, the soft tissue lasers were $12,000, and you debuted at, what was it, $3,500?
Howard: $3,500. Now you are saying that hard tissues are about $100,000.
Alan: They really start around $80,000 and go up to about $115,000.
Howard: They are $80,000 to $115,000, and that is what I see, even, here, at this deal, and leave it to my man, my main homie, to debut it at $50,000. If someone is listening to you, and they want to get either of these two lasers, where would they go?
Alan: Easy. AMDLasers.com.
Howard: AMDLasers, and AMD stands for Alan Miller ... ?
Howard: Alan Miller, you're Alan Miller. DesignLasers.com. My girl, Camie, wants to know if it will remove her gang tattoos, her gang member tattoos. It's tear drops. They're filled in, solid. I don't know what that means.
Alan: You poor thing. You poor thing. It worked on hair.
Howard: I don't know that means. I guess that means there's dead people.
Alan: They work pretty well on hair.
Howard: I think that those filled-in tear drops, she actually killed someone. I'm not sure. Hey, Alan, yeah, give me Gregory Crissman ...
Alan: I absolutely will.
Howard: If you want to do a target deal, I think, we should do that.
Alan: No, no, you guys know and support the townie meeting every year.
Howard: No, I'm not talking about the townie meeting. I'm talking about in Phoenix. Phoenix, there is 3,800 dentists in that metro, and there is an Indian reservation right by our dental office called Talking Stick Casino, so we have been putting courses on there ...
Alan: Oh, really? I didn't know.
Howard: They have been doing really good. Yeah, townie meeting is an annual meeting ...
Alan: All right.
Howard: But we like to do monthly meetings at the Indian reservation.
Alan: Oh, I'm sorry. You know that I'd love to come out.
Howard: Yeah, and we could drink all night at the Indian reservation. That sounds fun.
Alan: You know that you and I could do that.
Howard: Hey, thank you, seriously.
Alan: Thank you, Howard.
Howard: For making dentistry affordable. Thanks for using your brain to drive down costs so that Americans have the freedom to afford to save their teeth.
Alan: I appreciate that. Thank you for everything you do, my friend.
Howard: All right, buddy.
Alan: Thank you.