Becoming a laser dentist

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Marty Klein: Welcome to Dentistry for the New Millennium. I’m Marty Klein, training manager at the Institute for Advanced Laser Dentistry. And today we’re speaking with Dr. Todd McCracken from Denton, Texas. Dr. McCracken has used nearly all types of dental lasers in his 23 plus years as a board-certified, private practice general dentist. He’s achieved Masters status with the Academy of Laser Dentistry and serves as a certified instructor with the Institute for Advanced Laser Dentistry. Here, we’ll talk about how he got into laser dentistry, break down what a dentist should look for when entering the field, and explain when and how he uses lasers clinically in his practice. Todd McCracken, thanks so much for joining us today, first of all.

Dr. Todd McCracken: My pleasure

Marty Klein: I just want to go back to your beginnings with the PerioLase® and LANAP®. Can you think back to how and when you got started and tell me a little bit about your decision to adopt the technology and even how you heard about it to begin with.

Dr. Todd McCracken: Well, my decision was based on the fact that I was looking for a technology to treat perio that was my most specific reason for buying my first laser, because I really didn’t have a good program in my practice to treat perio other than traditional flap surgery, and it was not very popular with the patients. So that’s how I got involved in lasers to start with. I got the opportunity to see the technology being developed by the founders of the company by being involved in the Academy of Laser Dentistry. We were all looking for the same type of result and happened to notice that Drs. Gregg and McCarthy were coming up with some outstanding results with their new device that was designed for treating perio and a protocol. It was not necessary for me to reinvent the wheel. Instead, I decided to invest with them because they were having significant success in treating periodontal disease.

Marty Klein: Now I understand the PerioLase® was not your first laser when you bought it in 2002. What was your experience with lasers up to that point?

Dr. Todd McCracken: I went to a program in 1997 in order to purchase, well not really to purchase, just to see laser technology being used to treat perio, and was pretty impressed with the preliminary results, which were nothing like what we’re seeing today. So I bought my very first machine, which is no longer on the market today, which is the Pulse Master from American Dental Technologies and the same device that the founders of this company had started out with and decided to follow that wavelength in order to treat perio. That led to their development of the PerioLase®.

Marty Klein: So, you mentioned the Pulse Master specifically. What is it, then, about the PerioLase® that was different from its predecessors? Or, in other words, why do you think PerioLase® has withstood the test of time and is still being used now two decades later?

Dr. Todd McCracken: Well, the PerioLase® was designed and developed for a very specific protocol. I think one of the things they found in the early days is that the current devices of the time were not powerful enough and the settings were not appropriate in order to get consistent results in treating periodontal disease. So most of those devices didn’t have the ability to have a varied pulse the way this particular machine does, that became very significant. We also found over time that most of devices on the market were underpowered to try to accomplish to treat periodontal disease.

Marty Klein: I understand that you have also incorporated several other types of lasers over the years into your practice. So for those that aren’t familiar or are relatively new to laser dentistry, can you give me an overview of the lasers, plural, that you use and maybe what different types of procedures can be accomplished?

Dr. Todd McCracken: Sure, over the years, I have seen other applications besides treating perio that would be beneficial. Although I do have to say that periodontal being the most prevalent disease in the world today is still the number one reason I chose to use lasers and probably the number one reason to include lasers in your practice. But the technology, depending on wavelength, could be used to do a lot of other things. There’s hard tissue lasers, and I’m using an erbium now for that. We can use it to re-contour bone. We can use it to treat tooth decay. We can use it for biopsies and things like that. It’s a completely different device, different wavelength, and different target tissues, but a useful device.

I would say that the number one reason to buy a laser really needs to be evaluated in the scope of what’s going to add something to your practice that you’re not already doing. In other words, is it going to give you a return on your investment? Because there’s a lot of technology out there that you can invest in and spend a whole lot of money in and it not necessarily have a big impact on your practice. It’s not going to necessarily bring you new patients or give you new procedures, and thereby it ends up being a device that gathers dust over time and a frustration for the practitioner that spent all the money. So I really need to ask when you’re looking at lasers and shopping for lasers, “What can it add to my practice that I really want to treat?” I would definitely say that hard tissue lasers could be used to treat bone, hard tissue, and white lesions such as leukoplakia. The PerioLase®, Nd:YAG lasers, could be used to treat inflamed tissues and infection to a much greater degree in much greater depth than your erbium lasers can.

As far as the support from the manufacturer and that sort of thing. It’s very important to find a program that’s gonna give you adequate training in order to use the device effectively for your patient base. That was the main reason I got into laser education almost 20 years ago, now.  It was because in those days we really didn’t have practitioners who had a degree and had patient-based teaching us on how to use the laser technology on our patients. And so that’s another very critical point to establish before you purchase the device is what’s the training going to be like? Is it going to give you what you need to go back to your practice and be able to safely and satisfactorily treat your patient base?

Marty Klein: So also, what I’m hearing, then, is there’s no one way or right way to start out as a laser dentist. It just it depends? It depends on what you want to accomplish. Is that a fair statement?

Dr. Todd McCracken: Sure, it depends on what you want to accomplish, and I think it’s also important to realize that as much as there is a difference in wavelength, there’s also a difference in how companies handle the education side of things. Don’t assume, because maybe in the past you had a bad educational experience with lasers that they’re all that way, because otherwise you may very well shortchange yourself as a practitioner and your patient base from opportunities that could provide them solutions to problems that they’ve had for a lifetime.

Marty Klein: How often do you use lasers in your practice?

Dr. Todd McCracken: I know it’s gonna sound crazy, but I use them every day on pretty much every patient for different things.

Marty Klein: Wow, on every patient.

Dr. Todd McCracken: Pretty much, every patient. There might be a few cases where I’m just doing an exam or consultation. But typically even for TMJ case, I might use it for biostimulation, which is huge in giving the patients some relief from pain. Use it for tooth sensitivity issues, pulp exposures, you name it. For all the usual techniques that I might offer a patient I typically have some way that I’ve incorporated laser technology in there because it gives me a better result for the patient.

Marty Klein: Sounds like you couldn’t practice without them, basically.

Dr. Todd McCracken: No, I can’t imagine what it would be like to practice without my lasers. I will say that we live in an era where more and more practices are finding the need to differentiate themselves from everyone else. Some of that is because of corporate dentistry, because they’ve saturated the market on almost every corner of the country with McDonald’s-style dental care, and the only way to overcome that, I would say, especially as a small practitioner, single practitioner office or a small group practices to offer techniques and technology that sets you apart from everyone else. Laser technology is still one of those things that can definitely play a good role in that to separate a practice from what the corporates down the street are doing. Everyone seems to be doing implants now and, so that just doesn’t help differentiate you from everyone else. But if you can help patients with disease states that are difficult, and in the past they didn’t have any hope or answers, laser technology can certainly accomplish that and set you far apart from everyone else.

Marty Klein: Excellent. Well, Dr McCracken, thanks so much for being here today.

Dr. Todd McCracken: It’s great to be here. Thank you so much.

Marty Klein: You can also visit LANAP.com and click on the Research tab at the top to download Dr. McCracken’s article regarding LANAP® and Orthodontics.