Episode #536: The Power of Lasers in Your Practice, with Joy Raskie

Lasers have been around since the ‘90s. It’s time to bring them into your office! To demystify lasers and dispel the myths around them, Kirk Behrendt brings in Joy Raskie, CEO of Advanced Dental Hygiene, to highlight the importance and advantages of utilizing lasers in your practice. Every practice needs this innovative tool! To learn about lasers, Joy’s courses, and how to get started, listen to Episode 536 of The Best Practices Show!

Episode Resources:

• Joy’s email: [email protected] 
• Joy’s Facebook: https://www.facebook.com/advanceddentalhygiene
• Advanced Dental Hygiene: https://advanceddentalhygiene.com
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Links Mentioned in This Episode:

Lasers in Hygiene course: https://advanceddentalhygiene.com/courses

Main Takeaways:

Understand why using lasers is important for your practice.

Learn how to verbalize the benefits of lasers to patients.

Know the different types of lasers you can use.

There are other uses for lasers than hygiene.

Using lasers can be very profitable.

Quotes:

“Lasers are important in dentistry for numerous reasons. Doctors can use them instead of a blade or a scalpel. I know a lot of misconceptions with people is they think, ‘Oh, wow. Lasers are painful.’ They're actually not painful. Sometimes, doctors, when you're doing surgery, you have to numb a patient up. If you use a laser instead of a blade or a scalpel, you may have to use topical or no anesthetic because it doesn't go as deep. In hygiene, you use it to kill bacteria. And a lot of times, you can use it pre-cleaning, you could say, and there's no pain at all associated with it. When I started incorporating lasers, patients’ feedback was, ‘Hey, this was not as sensitive when you cleaned my teeth,’ which was, in my opinion, a better experience in my chair.” (3:04—3:55)

“I don't think a lot of people realize that lasers have been around since the ‘90s. So, they’ve been around for 30 years. And I think that over the last two or three years, more and more offices are incorporating them, especially in every single hygiene chair.” (4:38—4:53)

“There are three types of lasers. You have soft tissue lasers, hard tissue lasers, or therapeutic lasers. Hard tissue lasers are pretty much erbium CO2. Doctors point the light at a tube, and it cuts through tooth, and it cuts through bone. Those lasers are typically $80,000 to $140,000. You have to use that laser a lot to get your return on investment. What I specialize in is soft tissue lasers. Obviously, soft tissue, that's what us hygienists use. And doctors use it to cut gum. Soft tissue laser diodes, typically, also can be therapeutic lasers. You can put different attachments on and treat TMJ, or you don't use a fiber and you can treat pain, inflammation. You can accelerate healing. Even dental assistants can use some of these lasers for biostimulation or pain reduction, which happens in a lot of procedures that we do in the dental office.” (5:04—6:08)

“What we did in our office to incorporate lasers easily was we incorporated a consent form. We had a printed-out consent form. The patient got it when they arrived. They read about it, just a one-pager. And when they came back to see me, I would ask them, ‘Hey, were you able to read the consent form? Do you have any questions about lasers? I'm really excited to use lasers today.’ So, that was an easy way to incorporate it. I would use it prior to the teeth cleaning on every single patient.” (6:32—7:00)

“I know if hygienists are listening, you're like, ‘What? You're adding a new service and a new tool?’ The laser bacteria reduction, the procedure that's done prior to the teeth cleaning, takes about four minutes. And you're like, ‘Okay. Well, I have an hour,’ maybe some of you have 45 minutes, ‘How do I add that in?’ I found if I took down the chitchat, so I got my patient in, I went through their health history — a lot of times, pre-laser, I would be talking about, ‘Oh, did you go on vacation?’ I tried to do that while I was performing the laser treatment. So, that would be an easy way. Cut the chitchat and put it in there.” (7:46—8:21)

“If you're adding [the laser] to SRPs, I would say that would be maybe two to three minutes per quadrant. So, if you have a half-mouth SRP come in, you're probably spending about five, maybe six minutes extra at the end of the appointment doing that. Before laser, I would use Arestin. I would use a localized antibiotic. I would have to get those out. I would have to prepare that. I would have to insert it into each and every single tooth area. I feel that when I got my laser, I was probably spending about the same amount of time doing that.” (8:22—8:58)

“Usually, if an office incorporates laser, if they want to make money doing it, you make money in hygiene. Dentists use a laser instead of a blade or a scalpel. So, if you're doing a gingivectomy or a gingivoplasty, or you're doing a crown prep and troughing, you're using a laser but not charging more money for it. It’s just the tool. Just like you don't charge more to use a blade or a handpiece, you don't charge more for a laser.” (9:16—9:45)

“When I started out using lasers 10 years ago, we charged $35 for this. And I find offices are still charging in the 30s for this if they're maybe newer, maybe in the Midwest. After about a year-and-a-half, we increased that fee to $44. I find if you're maybe in Minnesota, Iowa, Colorado, Texas, kind of up and down the middle of the U.S., in the 40s is a really good, typical fee. Now, when I go teach over in New York, Maryland, Virginia, or I teach in California, you can almost double that fee. Nobody is charging even $50. For a laser bacterial reduction on the coast, you're probably $65 to $95.” (10:21—11:09)

“If you're charging out the laser for the deeper cleaning, the SRPs where you're going in and pulling the infection out of there, these usually take longer. They're single sites. If you're just doing one single site, let's say a D4910 comes in. You just have one single five-millimeter, and you don't want to put them through the SRP, I would say you would charge a typical fee that you would for Arestin. So, $50. Now, if you're going to do a whole quadrant, which most of us hygienists are doing the quadrant care, I charge $100 to $125 a quadrant because my SRP fee was $350. So, I thought $350 plus the $100. A patient is walking out spending $450 per quadrant.” (11:10—11:55)

“A lot of offices that are more insurance-based, they have to write off all these fees. So, they're having to write off a lot of that quadrant care. Where they can make more money where they charge the patient is with laser. I would find most offices in the middle of the U.S. are charging $225 per quadrant. I see up towards $350 to $500 a quadrant on both coasts. So, if you think of $500 a quadrant, you could be making $2,000 with laser just on perio.” (11:56—12:29)

“Hygienists and doctors can utilize a laser to treat cold sores and canker sores. So, the patient comes in in pain. You use the laser. It does not hurt the patient. If anything, they leave pain-free. So, that's a really good procedure. It’s less than five minutes, and a lot of offices are charging $200. You can also charge that out to insurance, and insurances are even giving you money back. I've heard insurances giving back $125, $150 back for this as well.” (12:35—13:09)

“Before we even got lasers, my boss had an Electrosurge. And probably some of the dentists listening to this podcast are still using and loving their Electrosurge. It’s a really powerful tool. But the problem with Electrosurge is you can't use it around metal. You can't use it around implants. But with a laser, you can use a laser around implants. There are so many studies out there that lasers are safe.” (13:49—14:11)

“[Doctors] can use a laser to uncover an implant. They just want to make sure that they take breaks around the tissue because a laser is going to produce a lot of heat. So, if it’s a lot of tissue that you're trying to take off, remember, it’s heating up. It’s heating up. I like to use a word in my class called laser sunburn. We don't want to give our patients a laser sunburn where if you're outside in the sun too long, your skin would have too much sun radiation. If you use a laser on a piece of tissue too long, you can cauterize the tissue. You can cause black tissue charring. Those are all unwanted effects. But if you have the right training and use lasers safely, they can totally be used around implants, and even with peri-implant mucositis. So, even hygienists can use a laser around infection around an implant.” (14:26—15:15)

“All 50 states have a certain law around lasers. If you're a doctor, pretty much, you can do whatever you want with any tool you want. So, you can use laser. Most states don't require training for a doctor. There are certain states that do require training for doctors.” (16:17—16:37)

“In Texas, dentists and hygienists have to have a 12-hour live CE certification. You can do that online. We do live 12-hour webinars where we do hands-on. Out of the 12 hours, three of those hours have to be hands-on training. And they specifically say utilizing what the hygienist is doing. So, even the doctors have to get trained in hygiene. That way, if a hygienist comes to the doctor, ‘Hey, I have a question,’ the doctor can answer that. Now, Colorado is another one that requires eight hours of education. And you have to have hands-on training. They don't require it to be live, so you could have part online, as long as you have hands-on training on the device. California is one that requires appropriate training. And West Virginia, October 7th of 2022, they started allowing hygienists to use lasers.” (16:39—17:46)

“Out of the 50 states, hygienists can use lasers in all of them except Georgia, New Jersey, Mississippi, Louisiana, and Pennsylvania. They don't allow lasers. And I think that's it. Other than that, hygienists can use lasers. You have to look at your State Dental Practice Acts. Look at the rules, or reach out to me on my website, advanceddentalhygiene.com, and I can tell you what your rules are.” (17:47—18:17)

“If you have a laser and you're not using it in your practice, why not bring it out? Bring it into hygiene. I have some free courses on my website, “Lasers in Hygiene”. We have “Treating a Cold Sore with Diode Laser Therapy”. It’s like $8. Go to these introductory courses. See if your hygienists are intrigued by the laser. If they're not excited about watching these free CE — you get CE for them, most people walk away with, ‘Wow, I could actually utilize this!’ Come see me. Get trained and utilize that laser. If you buy a laser and you go through the training that the laser company gives you and you still don't feel confident, spending $500, $600 to get a certification and to actually utilize that is going to be tenfold.” (24:37—25:29)

“If you utilize the laser for a laser bacterial reduction, meaning before the teeth cleaning, if you have eight patients a day and you use it on half of them, you're going to make that $7,000 back within three months by doing one single procedure on half of your patients on a four-day workweek.” (25:33—25:53)

Snippets:

0:00 Introduction.

1:32 Joy’s background.

2:48 Why lasers are so important in dentistry.

3:56 Resistance to incorporating lasers.

4:54 Types of lasers.

6:08 An optimal way for hygienists to incorporate lasers.

7:26 How long laser procedures take.

9:00 How much you should charge for laser treatments.

12:30 Other uses for lasers.

13:34 Using lasers around implants.

16:04 Who can and can't use lasers.

18:49 What lasers may look like in the future.

20:27 Joy’s certification and verbalization training courses.

24:30 Last thoughts on lasers.

Joy Raskie, RDH, Bio:

Joy Raskie, RDH, is the CEO of Advanced Dental Hygiene, specializing in hands-on dental laser education. As a world-renowned lecturer, she conducts live and online laser training courses, as well as in-office consulting. She has been practicing as an RDH in Colorado for 17 years. Her passion for lasers led her to obtain a fellowship and two associate fellowships through World Clinical Laser Institute, and advanced proficiency in dental lasers from the Academy of Laser Dentistry. Her goal is to boost excitement and confidence in incorporating dental lasers into daily practice.