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AUDIO - HSP #274 - Tom Hirsch
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VIDEO - HSP #274 - Tom Hirsch
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• The early days of Isolite
• How Isolite was born from necessity
• The importance of reducing cost of labor
Dr. Thomas Hirsch is the inspiration, co-founder, and clinical developer of the Isolite® dental isolation systems. He has operated his private dental practice for over 35 years in Malibu, CA, and specializes in cosmetic dentistry and full mouth reconstruction. He also served for ten years as an instructor of clinical dentistry at the University of Southern California. Dr Hirsch stays on the cutting edge of dental technology by continuing his education in the ever-advancing fields of dentistry. He has incorporated many new technologies in his unique practice, including CEREC dental restorations, cone beam 3-D scanning, guided implant surgery, and most recently is one of 60 dentists in the world to offer pinhole gum rejuvenation, a technology for coronal repositioning of the gingival apparatus in areas of gingival recession. Dr. Hirsch completed his education at the University of Southern California, where he received both his B.S. and D.D.S. degrees. He travels to numerous conferences annually, sharing his extensive knowledge of applying the Isolite advantage in clinical applications with dentists around the world. He remains integral to product development and clinical applications, and is an active member of the Board of Directors for Isolite Systems.
http://www.isolitesystems.com/
Howard: We're here at the Greater New York and you are one of my idols for many, many years.
Tom: Howard, the feeling is mutual.
Howard: This is Dr. Tom Hirsch, who's actually the dentist inventor of Isolite.
Tom: Isolite, yes I am.
Howard: Isolite is very interesting, because I don't know if it's just because I'm 53 and I have to use readers, but at first you start using magnification. You do a lot higher quality dentistry when you do magnification. Every endodontist will say when he looks through a microscope the quality went higher.
Tom: Absolutely it does.
Howard: Labor having the assistant try to retract the tongue and suction all the time. You built Isolite which is a retraction device, but flooded the area with light, so that you can actually see with your loops. I've had the same assistant for 20 years. My first assistant was Jan. She's still there 20 years later. What she loves about the Isolite, is instead of just standing there retracting and suctioning, when I use the Isolite she says, it's better isolation. It's flood with light and I can see, but she can be entering the notes. She's working instead of just standing there. This is all because of you. Tell us this Isolite story.
Tom: Well Howard you know you can effectively use your team with Isolite which is really nice. How this all came to pass was based out of need for me.
Howard: What year? Take us back.
Tom: The year was 1985.
Howard: '85.
Tom: 1985 I came up with this crazy idea. This was when the fiber-optic hand-pieces first came out. The way this whole thing was born was quite interesting. I've got one of the first fiber-optic hand-pieces. It was Midwest Americans fiber-optic hand-piece. It had a light box. It had this long cable that for me in my office had to drape across the floor. I love the fact that I could really see what I was doing in the mouth with the light from the end of the hand-piece. I was proud of my work.
I did a great job. I'd sit there. I'd push the chair back. Bang, bang. I'd roll over the fiber-optic bundle. I'd say oh, that hurt. I'd look at it and I'd immediately lost half of my fiber-optic bundle. Then I'd bring the chair back the other way and the whole thing was gone. I'm just stupid enough that I couldn't train myself not to roll my chair over my fiber-optic bundle. After the first six fiber-optic bundles at $300.00 a pop, back in 1985. It's maybe equated to $1000.00 today. I said, there's got to be a better way. One day I'm looking in my operatory. Light box is over there, patient is here.
Lights there. Patients here. Why is the light there and the patients here? I'm going to put a light inside the mouth. That's how it came to pass with the idea. I talked to my brother. I said, Jim, he's an industrial designer.
Howard: He's Tom Hirsch too?
Tom: He's Tom Hirsch too, but his name is Jim.
Howard: Okay, your brother is Jim Hirsch. His wife's the one, she's . . .
Tom: His wife is now our CEO of the company.
Howard: Right. What's her name?
Tom: That's Sandy. Sandy Hirsch.
Howard: Sandy Hirsch, and I love her to death.
Tom: She's a doll.
Howard: She's been adorable for 20 years.
Tom: You know she has been.
Howard: I'm sorry, I actually thought that was your wife.
Tom: No, not my wife.
Howard: That's your brother's wife.
Tom: That's my brother's wife, yeah. She runs the company. Keeps us solvent. Made sure that we got through the hard times. She did a great time. She can squeeze a nickel so hard that you know what happens there. She does a great job doing that which actually got us over the finish line to the goal line where we made a great touchdown. I've loved Isolite and its worked well for us. That's how we got the light inside the mouth. It came over Thanksgiving dinner 15 years ago, when Jim came in. He comes with this light in a block of acrylic with wires hanging out the end of it. We plug this thing in. It's in his mouth, because he shaped it to put in his mouth.
Plugs this thing in. Light is flowing down from the roof of his mouth. That lasted for about 30 or 40 seconds until the acrylic got so hot that it scorched the roof of his mouth. He had this massive pizza burn on the roof of his mouth. That's how it started. From there we expanded it out to incorporate the light into a bite block. Into a tongue retractor and a throat protector and cheek retractor.
Howard: I want to ask you and Hogo I wish you would join in this conversation. You know how humans are very extremist. They don't seem to be moderates at all. Every wise great man that ever went before us always said moderation is the key. Moderation is the key. Most people are just extremists. There are people who believe that they've heard so many times that you cannot do posterior composites out of rubber dam. Then when you tell them Isolite, it's like it's not a rubber dam. Their mind just goes mrr, mrr, mrr. You can't do a root canal without a rubber dam. I'm going to ask you two great minds, do you think you can do a posterior composite with Isolite and not a rubber dam?
Hogo: I did for 10 years. I was just never a rubber dam guy, but I needed isolation. I'm one of those guys that don't do amalgams. I do all composites and CAD cam. Isolite saved my life.
Howard: Do you think you can do a posterior composite without a rubber dam with an Isolite?
Tom: Not only do I think, I do them on a daily basis and they work well, as long as you keep the area isolated, you keep it dry. You're going to get great results with your composites. If you get any moisture contamination, it's going to fail, it's in the toilet. That's just the way it is. It's got to be dry.
Howard: Do you see the mental error that some of these people . . .
Tom: Absolutely.
Howard: That just like well you have to have a rubber dam. You get on Dental Town and said that you did, it's okay, that if you did a posterior composite out of rubber dam, you're a bad person.
Tom: Herein lies the beauty of this whole thing, is that we are now Isolite, Isolite is now in a number of dental schools across the United States. A few years back I made the decision to donate two Isolites per chair per school to every school in the United States. We made a massive donation.
Howard: Oh my god. How many was that? How many dental schools are there, 56?
Tom: There are 60 dental schools in the United States right now.
Howard: 60 dental schools right now.
Tom: There's new ones that are coming up as we speak, but there's about 60 schools in the United States. What we did, we divided them into three tiers, because I can't outfit everybody all at the same time. We divided them into three tiers, so now we can go to the dental schools and we gave them the offer of a free Isovac system, not the Isolite system, but a free Isovac system. That's the one that doesn't have the light that plugs right into the end of their HVE hose.
Howard: It does not have light?
Tom: It does not have the light. It goes right into their HVE hose. They get two systems per chair, per school. If a school has 500 chairs, they can have a 1000 Isovac systems. That way the students get trained on this and really it becomes the students dental assistant. You know what it was like in dental school. Your fumbling. You don't have enough hands to do everything.
Howard: A one week rotation with the dental assistant.
Tom: Right.
Howard: For the whole four years there.
Tom: This is just like having a dental assistant for the student. It makes it really nice for them.
Howard: Okay, talk about in terms for you, is a lot of it international? Every single country on our podcast. Every single country that iTunes measures gets checked off. What is Isovac? What is an Isolite? How much are they? How do they buy these? What is the website? Talk specifics.
Tom: Specifically we have three different systems. Our premier system is the Isolite system. We then have the Isovac system and our third system is the Isodry system.
Howard: Isovac, Isolite, Isodry.
Tom: Isodry.
Howard: OkaY.
Tom: Okay, the Isolite has all the bells and the whistles. It's got the light. They all utilize the same mouthpiece, so functionally speaking they all evacuate. They have a nice soft bite block that keeps the mouth open. It keeps the tongue out of the way. It keeps the throat obdurate, so nothing goes down the throat. It protects the cheek. In the last 14 years I've not cut a tongue or a cheek or dropped anything down the throat in 14 years.
Howard: You're saying it's good enough for Endo too? They're not going to swallow an Endo file?
Tom: They will not swallow an endo file, but my position on Endo as a company is that standard care dictates that we use a rubber dam when we're doing endodontic procedures. That's just standard of care. As a spokesperson for the company. That's what I maintain. Now, that being said a lot of dentists do endodontic procedures without a rubber dam. If you're not using a rubber dam, you have to have something that will protect the patient's throat and keep them from swallowing the sodium hypochlorite and hopefully not a file. The Isolite will do a good job with that, but that's not what I recommend it for.
Howard: Okay. How much are these three different systems?
Tom: Okay, so the three different systems including 100 disposable mouthpieces, starts out the Isolite system is about $2000.00 per operatory for the system. The Isodry system which is exactly the same as the Isolite system, minus the light goes out for about $1100.00 for the system. Then the Isovac system that fits on the end of the HVE hose, we sell those in a pack of three at $900.00 for a pack of three including the mouthpieces. Now the difference between the Isolite, Isodry and the Isovac is the Isolite and the Isodry have removable heads that you autoclave between every patient. You'll get six of these heads in a system.
The Isovac is an entire unit within itself that goes on the end of the HVE. The Isovac system has three of the heads. Each one needs to be autoclaved between patients, so that's why we go ahead and have three. One in use. One in the drawer and one in the autoclave.
Howard: Where I want to bring the focus on pricing. I have an MBA from Arizona State University and I've seen the finances of a thousand dental offices in the last 30 years. You continually see labor 27, 28, 29%. You routinely see a dentist working two chairs, with two assistants and two hygienists. They'll have a floater assistant. They're paying a floater assistant. These are huge wages.
Tom: Huge.
Howard: Then I'll go into offices and they'll have an Isolite and instead of the assistant like you say just frozen there or suctioning the whole time, the dentist is primarily working there while she, she can be helping, but she's multi-tasking. She's doing other stuff. If an Isolite got rid of the cost of a floater assistant or an extra assistant, the return on investment is 100:1.
Tom: It's huge. That's exactly what it does. The Isolite . . .
Howard: I can see why it would be so valuable in dental school. At dental school, even when they're charging $100,000.00 a year tuition, can't afford to give everybody a dental assistant.
Tom: No, not at all. Not at all. Isolite becomes another employee in your office. It's a $2.00 per patient employ, $2.50 per patient employ, because the mouthpiece is disposable. We use it once. We discard it. Never want any risk of any cross contamination, so that's why I made the decision to go in that direction. I becomes your $2.00 or $2.50 per patient dental assistant. My full-time assistant is there getting everything, as we know, she's there getting everything set up ahead of the procedure. She's there to rinse and evacuate if I need her to, but I really don't need her to do that. I pick up an HVE whenever I want or a three way syringe and clean everything off.
I don't need her to retract the tongue or evacuate. As you said she can be in the other room taking x-rays, pouring models, ordering. Actually the dental assistant has the busiest job in the office. They're the hardest worker. My primary assistant has been with me 16 years. I go to do a procedure and for whatever reason, I don't stick an Isolite in there. She says, "Doc what are you doing? Put the Isolite in?" Why, because it makes her job easier and it makes my job easier too.
Howard: Yeah. How has your company done? What percent of dentists do you think now are using this?
Tom: You know I think we have just touched the tip of the iceberg with Isolite right now. I'd say 15-20% of the dentists in the United States are using at this point in time, which still leaves us a wide open market.
Howard: That's huge I mean. 15-20%. You know I've always said in dentistry, you can sell 1% of any market anything, at any price.
Tom: Yeah, yeah.
Howard: I remember when I got out of school in '87, 1% of the dentists bought a $50,000.00 Yang laser. They didn't sell 1001 and the company went away. No, to have 15-20% among a highly educated market means that it's the real deal, because, you can fool 1% of the dentists with eight years of college.
Tom: Sure you can.
Howard: Some people think that you can fool up to 5%, but you can't fool 6%, 7%, 8%. If you're 15-20. It has to be the real deal.
Tom: It's the real deal. Honestly I have to give Dental Town kudos for that. This has really been interesting over the years. Where Dental Town has allowed us to go ahead and expand our market, because this is dentists-to-dentists talking. What do you think about this? What do you think about that? Well, you know what? I like this. I don't like that. We've had the county awards for the last nine, ten years now, eleven? It keeps going and going. It's been real nice in that aspect.
Howard: I'll pulling up the Dental Town app right now. I'm going to do the search button. I just want to tell you Isolite, I-s-o-l-i-t-e. I-s-o-l-i-t-e. Did I spell it right?
Tom: Yes, you did, yeah.
Howard: I just did a search for Isolite and you can't even see how many threads. You could literally read threads about this for four or five hours. Your fans love it.
Tom: You know, it's dentist to dentist.
Howard: Have you replied on any of these?
Tom: I don't personally reply to them, but yeah way back in the beginning, we have. In the very beginning.
Howard: Do you have a SmartPhone? You should download the Dental Town app.
Tom: I'll do that.
Howard: Do you have your SmartPhone with you?
Tom: Yeah.
Howard: Here give me your SmartPhone. Do you have the app on there?
Tom: No.
Howard: Pull up your camera. I'll have Ryan take a picture. I'm throwing him under a bus. Then he's got to download the Dental Town app. Then you've got to do a search for Isolite. Under each one of those Isolite ads, you've got to drop a picture of us talking and saying, Howard. . .
Tom: Okay.
Howard: Because you have raving fans. They would love to hear from the founder.
Tom: I'll do that.
Howard: Here Ryan, do you have the camera? Here take a picture on his phone, so he can take a, I think it's kind of like a big fraternity. They would be touched that . . .
Tom: It is a big fraternity. It's a big fraternity.
Howard: They would be touched if the dentist who invented this thing download the app and posted it on the threads.
Tom: Here's the deal. The thing that's nice about Dental Town, is it is the real deal. Nobody is selling anybody anything.
Howard: Yeah.
Tom: I'll tell you cute stories as a matter of fact. This is 14 years back. 14 years back, my buddy Dave Niebergall that I went to dental school with, he's on Dental Town all the time. He's reading these things. Hey, I'm going to make a posting here. Dave makes a posting telling us how great Isolite was. You know what, we get response to this, (sniffing) this doesn't smell right. It sounds like somebody's buddy is posting something. The dentists are smart enough to know if something is hitting the fan. If it smells like shit, it is shit.
Howard: I would say the key to Dental Town is transparency.
Tom: That's exactly right.
Howard: If you're the dentist and the owner of the company says, hey I'm a dentist. I own the company. As long as you're totally transparent, they're all cool.
Tom: Absolutely.
Howard: If you didn't disclose you were the founder of Isolite or whatever, then they would say stinky.
Tom: Oh they would.
Howard: I think, I know you've got to get back to your booth, because you're out there talking to real customers. I just want to tell you that from the bottom of my heart, I thank you for all that you've done for dentistry, for me personally. When I first got Isolite I had vision, but now, what year did it first come out?
Tom: It came out in 2002.
Howard: I would say now that it's 2015. Like you say I need the light. I need the light and my magnification and the suction. I just think you're one of those few in dentistry who left the playground, better than you found it.
Tom: Thank you so much. What we want to do is we want to make Isolite standard of care. That's the goal. That's the company goal is to make Isolite standard of care for dentistry, for procedures, for dental schools to allow everybody to work in a much better working environment where at the end of the day we're not frustrated by fighting the tongue and fighting the saliva and saying oh god way back when I didn't really get the isolated that I really needed back there. It got contaminated. We all go through this stuff. It's kind of the moment of truth as you're working in the mouth and let's say you're getting ready to cement a crown.
You've etched, you've primed, you've bonded this thing. Now you're getting ready to put your crown in. The patient swallows and here comes a flash of saliva coming up. Now the thing is re-contaminated. You've got your crown loaded with cement. Moment of truth. What do we do? Blow it off, dry it and stick it on and cure it and hope for the best, or do we go back there and we clean it off? We go back there and clean it off, but it's time consuming, because now you've got to get the cement cleaned out of the crown. You've got to re-bond the tooth. That's another 15 minutes doing all that crap. Now with the Isolite it's there and we just don't get contamination period.
Howard: Now do you lecture on this?
Tom: No, I don't. I don't. Only at the booth.
Howard: Does any dentist have a lecture? Is that even a CE course material?
Tom: I don't know that there's a CE course.
Hogo: [inaudible 00:17:34] might have a little problem being the founder of the product. We probably could swing it though.
Tom: You know what we end up doing . . .
Howard: Because, we have two issues going on. The insurance companies really haven't raised our fees.
Tom: No, no.
Hogo: We're allowed to do training videos, so we can do a training video on Isolite.
Howard: You should do a training video, because insurance isn't raising our fees. Every trip of this third rock from the sun, the inflation is going up. We see the overhead has been drifting up for 25 years.
Tom: Oh yeah.
Howard: Labor, what I tell dentists is, the only thing dentists will focus on lowering the overhead by putting a lock box over the thermostat or trying to order gauze online, or whatever. Labor is the 400 pound gorilla.
Tom: Yeah, it is.
Howard: Your labor variance could be your entire supply costs. These dentists will worry all about their sundries, like who's cheaper Patterson, Burkhardt, Shine. Should I be online? It's like dude your labor is 29%. The guy across the street from you is 24. If you got your labor from 29 to 24, that'd be like you having your labor at 29 and having Patterson donate all your supplies for free.
Tom: Yeah.
Howard: Labor is the one and no offense to you, but Isolite is more of a play on labor than isolation and light? I mean you should call it the Labor Isolite.
Tom: Yeah.
Howard: You should change the name to, because really if this means you don't need that floater assistant, then it's huge.
Tom: Not only that, not only is it the assistance labor, but it's the dentist's time. It's your time in the mouth, in the procedure, in the operatory. I will take your schedule and your time and reduce the amount of time that you spend on procedures by about 25%. I'll make you, not that you're working faster. Not that you're trying to do anything faster, but the flow goes faster, because one, the patient is wide open. They are well lit. They're dry. You go, you work in the mouth. I start prepping and I don't stop until I'm done prepping. I retract the tissue. I'll take the Isolite out of the mouth, if I have to check my occlusion, my occlusion reduction.
I'll put it right back in. We'll take our impressions. When we do that we'll put that in for a double bit, then we remove the Isolite and have them close down. Your total time is just reduced by 25%, because A. The patient doesn't need to sit up, spit out, rinse, talk to you. You're focused on what you're doing. Ergonomically speaking for you. Turn the patient towards you to where you have the best visibility with your best ergonomics. That's what ends up happening with that aspect. You're just focused and it goes faster. Not because you're trying to, but just because it does.
Howard: What's your brother's wife's name again? Mrs. Hirsch.
Tom: Sandy.
Howard: You tell Sandy hello for me. I think she's absolutely adorable.
Tom: Sandy, Howard says high.
Howard: Seriously congratulations on your invention. I've enjoyed it for decades and thank you for coming by the booth and talking to my homeys.
Tom: Thank you very much and just from the bottom of my heart I have to thank Howard and Dental Town for everything they've done and created to make a forum that the dentists can have access to for whatever information they need on a peer-to-peer basis, which is wonderful.
Howard: You're a peer. You're a real dentist. You should make a training video. Who cares if it doesn't get an AGD credit or ADA credit. I think if someone, if they could see the real dentist founder and you made a video about all the uses and they're thinking in their walnut brain, my labor is 28%. Why do I have a floater?
Tom: Let's do it.
Howard: I think a training video, I think you should do it.
Tom: Let's do it, yeah.
Howard: I think if you put a training video on Dental Town, you'd have more individual dentists watch it, than three days at the Greater New York Dental Meeting.
Tom: That's a heck of an idea.
Howard: I believe that for sure. How many dentists do you think will actually walk by the booth at the Greater New York and you'll talk to one-on-one?
Tom: One-on-one? I might get 100.
Howard: Yeah.
Tom: I might get 100.
Howard: The neat thing about Dental Town is it's 365 days a year. You'll go to bed and while you're sleeping, you'll be talking to dentists from here to Kathmandu.
Tom: I just have to tell you one more thing. I'm a wet finger dentist. I'm in my office four days a week, except when I'm going out traveling to shows. Why? Because, I love it. Dentistry is so much fun. Any of you guys that are working make dentistry fun. Make it easy. Make it enjoyable. That's what you do. If you do that, you last a long time. I'm going to be 70 in a couple of weeks. I'm planning on going for another 10, 15 years, just because it's fun.
Howard: Man you look awesome. You're 70-years-old.
Tom: No, I'm 69.
Howard: Are you 69, you're going to be 70?
Tom: 70 in a couple of weeks.
Howard: When I see threads on Dental Town that say, I want to retire in five years. I want to retire when I'm 50. I see those red flags as burn out disease.
Tom: Yeah, they're burned out.
Howard: What would you think if a fireman was saying, I never want to put a house on fire.
Tom: Put a fire out.
Howard: A policeman saying, I never want to catch a bad guy after age 50.
Tom: Yeah, no, no.
Howard: What is money and age 50 have to do with a fireman not wanting to put out a fire? A police not wanting to get, if you told me I was never going to pull a set of wisdom teeth again, I think I'd cry.
Tom: Yeah.
Howard: Why are you still liking it at 69 and these guys want to be retired by 50?
Tom: It's enjoyable. I go in there and there's really, I kind of say this tongue-in-cheek, but I don't think in the last 43, 44 years of doing dentistry, I've worked a 100 days where I actually call it work. We've all had those days that have been really bad, really hard and difficult. For me most of my days are in there, somewhat relaxed, enjoyable and concentrating on what I like to do. I love it. It's fun. It's just fun to go to work.
Howard: I don't understand why would you not want to get a patient out of pain.
Tom: Yeah.
Howard: Why would you not want to fix a cosmetic emergency?
Tom: Absolutely.
Howard: Why when they come in and they need you. What's going on when the dentist doesn't feel good helping this person? Do you think it's financial stress? Do you think they're looking at it wrong.
Tom: I think they're looking at it wrong. I think you're right with that one. I think there's a financial stress, where they think I've got to do this. I've got to make money. Yeah, we all have to pay our bills. Yes we all have financial obligations that we have to do, but at the end of the day, it's what you do for your patients, as you said to help them. To take care of them. I go in any time a patient calls and they have an emergency, whether it's an aesthetic emergency or dental painful emergency. I'm there. Being available for your patients really makes your practice grow. If they know they can count on me, so they come.
I've got some friends where they question the emergency on weekends. If it's an emergency in the patient's mind, it's an emergency.
Howard: I want to . . .
Tom: Thank you.
Howard: I want to tell you and Hogo one story, why I have to get a training video.
Hogo: Let me get a picture again.
Howard: I don't want to tell the country, because I don't want to make the country feel bad. As we know there's 220 countries and 20 of them kind of do dentistry like we do. 200 countries are more poor. I've seen this in three different countries in very, very poor countries. There's no dental assistants. A lady comes in. She's wearing a veil, sari and she exposes and is concerned. She shows the dentist a spot. He numbs it up. He's preparing it. When he goes to the bonding agent, he puts the bonding agent on it and she did not like the taste, so she sat up, swished, spit in the bucket. Then she went back.
He went to the next step. Then he cured it. She didn't like that taste. She sat up, rinsed and spit in a bucket. Then went back. Then he put on the composite, light cured, then finished it. I'm just standing here . . .
Tom: Ooh.
Howard: Wow, I've seen this three different countries.
Tom: Wow.
Howard: The point I'm trying to make is there's no dental assistants in poor countries.
Tom: No.
Howard: There's really not that much or I haven't seen. I think Isolite is a huge return on investment in rich countries where labor is very expensive, but it's even clinically mandatory, a minimum in poor countries. I hope that dentists watching around the world realize that contamination is everything. If you're doing composites, that's why I like amalgam. That's why I don't like dentists bad-mouthing amalgam in rich countries, because then poor dentists in poor countries, hear rich dentists in a Star Wars America bad-mouthing it. They switch to composite, but they don't have the isolation. They don't have to join us. Amalgam is so technique forgiving.
Tom: It's very forgiving. It's very, very forgiving.
Howard: You can be the worst clinical dentist in the world and probably get a C+ or B- on your amalgam.
Tom: Yeah, absolutely, absolutely. It's going to stay.
Howard: Isolation in other continents is pretty scarce and you could really have a big help there.
Tom: Well, what we're doing right now, actually we've gone international. About two years ago we'd gone over to England, the Benelux. We're now in Belgium, Luxembourg, the Netherlands, England, France, Spain, Germany, Austria, Australia, so we're branching out internationally.
Howard: Those are all the rich countries that can do isolation.
Tom: Yeah, yeah, yeah.
Howard: Those are the rich countries who would like it and labor.
Tom: Even so not necessarily the rich countries. There are the countries that dentists don't have assistants.
Howard: Wow.
Tom: The ones that don't have the assistants, this becomes their dental assistant.
Howard: A training video . . .
Tom: You are right though it is the rich countries too.
Howard: My point in all this is that, he's a dentist, he's a homey. He should do a training video.
Hogo: We should do that, showing all different ways you can use it.
Tom: That'd be great. We'll do it. Let's just set it up.
Howard: Thanks man.
Tom: Howard, appreciate it. Howard.
Howard: Thanks guys.