Very Clinical: Teachers Learning from Students with Dr. Ash Mark

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[00:01:15] This is a production of the Veri Dental podcast network. Welcome to the Very Clinical Podcast.

[00:01:34] In about the time it takes to do an MO on three, we will entertain and amaze you with

[00:01:38] tips and tricks on regular daily dentistry.

[00:01:41] Here's Kevin and Zach.

[00:01:43] What is up, Very Clinical listeners. Welcome back to yet

[00:01:46] another episode of the very clinical podcast with me, as

[00:01:50] always, my trusty co-host, Dr. Kevin Airfryer. Kevin, what's

[00:01:54] up, man?

[00:01:55] I'm sitting here in the cold Cleveland night talking to my

[00:01:58] friend Zach in Missouri over the internet. And blasting, what a

[00:02:04] time to be alive. Yeah,

[00:02:06] yeah that's true. It's true we can you can see each other talk it's it's a new it's a whole

[00:02:11] new world. It's only world out there. It's only we could have oh never mind we'll talk about that

[00:02:15] later. Ah we got a return guest um by popular demand uh our guest tonight is a very popular

[00:02:25] dental YouTuber. His account is called All Things Dentistry

[00:02:30] on YouTube. He has more followers than the American Dental Association,

[00:02:36] Spear, Koi's, then think of another popular one, Gordon,

[00:02:41] Missouri Dental Association, Ohio Dental Association, all those things combined.

[00:02:46] Kevin, what do you think about that?

[00:02:48] I think it's fascinating and awesome and I'm glad that he's on our show tonight.

[00:02:52] Indeed. Dr. Ash Mark, all the way from Canadian. Ash, what's going on, man?

[00:02:58] Not much, guys. Thank you so much for having me. I'm super grateful to be here.

[00:03:02] And yeah, all the way from Canadian middle winter.

[00:03:06] Yeah. How is your winter still on the ground up there? Is it?

[00:03:10] Is this cold?

[00:03:11] Yeah. Oh, great question. It's been fairly mild. You know,

[00:03:15] things are changing. I'm not sure for the better, but it's

[00:03:20] been nice and warm. And then all of a sudden, boom, winter came

[00:03:23] back.

[00:03:25] So it's been chilly getting back up drinks.

[00:03:30] Kevin, what's the bit for tonight before we get into our topic with Ash?

[00:03:38] So Zach, you and I and some others were talking earlier today over the Internet about simpler times.

[00:03:48] Indeed.

[00:03:50] Gosh.

[00:03:50] So we're just going to harken back.

[00:03:52] If you could take a time machine, I think we talked about this before, but I'm going to drill

[00:03:57] it down again.

[00:03:58] Okay.

[00:03:59] Time machine back to a particular year when things were simpler, when we could not talk to each

[00:04:06] other from hundreds of miles away over the internet, what year would you go back to and

[00:04:12] why?

[00:04:13] And describe your little life back then.

[00:04:15] I'll go first since I'm bringing it up.

[00:04:17] Okay, please.

[00:04:18] The year is 1976.

[00:04:21] It is our nation's bicentennial.

[00:04:23] That means 200 years, Ash, for America. Not Ash's, though. Not his bicentennial. That means 200 years, Ash.

[00:04:25] Yeah, not Ash's though. Not his Bicentennial.

[00:04:28] Not for Canadian.

[00:04:29] Oh God, is this a question now?

[00:04:32] No, there will be no quiz. You're good.

[00:04:36] There will be no quiz.

[00:04:37] Wait a minute. Can I point out the irony that Ash is drinking a Canada Dry as we speak?

[00:04:44] That's like the most Canadian thing ever.

[00:04:46] Yeah. Let's harken back to the our nation's bicentennial.

[00:04:49] Nineteen seventy six. The summer in particular, I was 13 years old, full of life and youth

[00:04:58] riding my bike around, you know, the kind of childhood where you just left the house after

[00:05:04] breakfast, came back for lunch, went house after breakfast, came back for lunch,

[00:05:06] went back out again, came back for dinner, went out again till sundown and that was just a

[00:05:12] beautiful thing. Riding my bike around good old Highland Heights, Ohio, getting into all sorts

[00:05:17] of trouble, playing baseball in the street, kickball, football, and yes, discovering girls.

[00:05:28] What a great time, you know, no phones, no internet,

[00:05:32] no TikTok, no nothing, just you and your buddies

[00:05:35] goofing around on a hot summer Cleveland night.

[00:05:39] I would definitely take the time machine

[00:05:42] back to one of those days.

[00:05:44] And everyone is wearing red, white and blue because it was the nation's bicentennial

[00:05:49] Sure. Yeah, that's

[00:05:52] Let's see Jimmy Carter days

[00:05:54] G I think it was Gerald Ford. Okay. Okay

[00:06:00] Well Carter might have been elected in 76 gotcha

[00:06:04] so I I thought about this and the first, at first when you mentioned that this was the

[00:06:09] topic, I kind of thought of like the early O's because like that was like a really good

[00:06:15] time in my life just being single and in my 20s and just getting started on my practice.

[00:06:20] But you actually convinced me that I would definitely take over that.

[00:06:23] I would take 1988

[00:06:25] uh because that's that's me in the same era riding my bikes with my friends playing basketball after

[00:06:32] school uh a lot of a lot of Nintendo I had a Nintendo Entertainment System a lot of Super

[00:06:38] Mario with my boys pong yeah okay so that's I would go with go with 88 but

[00:06:45] basically for a pretty similar similar reason. So that's that's

[00:06:48] my year I would I'd love to spend a few months in.

[00:06:52] Not a care in the world, right?

[00:06:54] Indeed. Indeed. Good. Good time. Ash, what's your year? What

[00:06:57] are you what are you traveling back to to spend some time in?

[00:07:01] Oh, just like Zach, I'm kind of your first one was, the first thing that came to my mind was like right out of dental school, man.

[00:07:08] Like, it was, the head mounted lights were

[00:07:28] not such a thing.

[00:07:30] You're using like the old yellow light, the overhead lights.

[00:07:33] I mean, and the decision making process was fairly easy.

[00:07:36] It was like, PFM, amalgam, composite, extract, bridge. and that was about it. Maybe it won't even, yeah barely implants,

[00:07:48] they weren't even coming out. So life was clinical decision making was fairly simple.

[00:07:56] But then yeah it was a lot easier. I have to go back to like early 2000s man, it was just

[00:08:02] uh I love my children but it was so much you're just doing your thing you

[00:08:06] know traveling do dentistry yeah ash's description of dentistry there somewhere in north carolina a

[00:08:14] young doctor named mac jones is just strangely aroused hearing that max one of our uh max used

[00:08:23] to be a co-host on this show. He's he loves love some old-school

[00:08:27] Let's go multiple pfm and decisions like that

[00:08:30] my gosh, I

[00:08:32] walked away from pfms the one day when I delivered one and it was the

[00:08:37] You know in dental this is before residency in dental school. They're always talking about gold margins. It's gotta be golden. Yeah. Yep

[00:08:47] school they're always talking about gold margins it's gotta be golden yeah yep like well I want this to last I better make sure is a gold margin on the buckle well didn't that not go over very

[00:08:52] well because the lady could see it on a pre-motive oh yeah no good ah and at that time we were living

[00:09:01] in Belgium so the lab stuff we sent back to Canada and it was a very long delay between, it wasn't

[00:09:09] like, you know, instant, it was like Instagram in a second.

[00:09:12] It was like weeks to get to Canada and weeks to get back to Belgium.

[00:09:17] So cemented it down and I just thought to myself like, wow, I could do better than this and I think I can.

[00:09:26] Yeah a long time ago.

[00:09:31] So our real reason for bringing on Ash of course our our dental topic of the day is that Ash has

[00:09:39] he's had a online endodontic course before allthingsindo.ca

[00:09:46] and he's just released a follow-up course to that

[00:09:49] at the website allthingsretreats.ca

[00:09:53] and we're gonna get more into that course.

[00:09:55] He's gonna ask us with us for two shows.

[00:09:59] So we're gonna catch him on a second episode.

[00:10:01] But first we kinda wanted to talk about

[00:10:04] just the impact that teaching has had. We've got two

[00:10:07] teachers here in this group. Kevin's been doing a lot of instruction.

[00:10:11] I had a recent endo course, what about a month ago, Kevin?

[00:10:15] And then, and Ash has got his, you know, online course. Kevin also works with the

[00:10:20] 3D dentist teaching implant placement. So, yeah. So, I guess we wanted to talk about

[00:10:29] how teaching has impacted practice careers. I don't have much to say, but I'm interested to

[00:10:35] hear what these guys have to say. Ash, we'll start with you. What changed when you went from

[00:10:48] went from a you know just practicing uh practicing Dennis into more of an advisory

[00:10:54] instructional role both within your clinic and then as more of an online mentor to so many?

[00:11:08] Yeah such a great question and honestly I think I've I'm living my dream I'm not just saying that. It really is. I really like there's a few students that you know they not so much they come and go but they've got questions here and there and we're

[00:11:12] kind of rolling through a couple cases especially with brand newer dentists like graduating within

[00:11:20] 10 months and you kind of see the stuff they're trying to tackle.

[00:11:25] And I don't know if it's because of their choice or because of the situation they're

[00:11:29] in.

[00:11:30] But you know, I know what it's like to be lost, lost at sea.

[00:11:35] So I really, I love it because it gives them, it just allows me to connect and really see

[00:11:43] what's going on, but also to provide that

[00:11:46] advice and you know I don't really leave all three of us have probably made lots

[00:11:52] of mistakes and it's nice to actually share them yeah right it's nice to share

[00:11:57] that so they don't have to maybe they'll still go through it but you not do that

[00:12:00] extent or something different so you know you know, like, great exam.

[00:12:07] So in the one course, and really the newer course

[00:12:12] I'm very grateful for, but what I put in,

[00:12:14] and what, you know, top 10 things that I've learned

[00:12:18] from the first course, but also like hands on,

[00:12:21] like everyday kind of teaching.

[00:12:23] And I actually use the first one again

[00:12:25] today on my own self thinking like how can you keep learning every day it's

[00:12:31] crazy and that one was just like with regards to endos comb fit radiographs

[00:12:37] and just taking the time to take that comb fit and actually I today was I don't

[00:12:45] know if you guys know I've run into two in the last two weeks.

[00:12:49] radix distal lingual canal on a lower molar. You guys don't

[00:12:54] talk about extra extra route. Yes. Yeah, the extra. I haven't

[00:12:59] run into that yet. Or at least maybe I missed it, but I haven't

[00:13:02] run into it yet.

[00:13:04] You might have actually done it. Even know it and it turned out perfect.

[00:13:08] Maybe knock on knock on wood we'll go with it we'll go with that thought

[00:13:12] keep going though. Oh yeah yeah so like today you know

[00:13:16] and you always see online and I'm guilty myself of you know you

[00:13:20] you take the pre-operative radiograph and then they're like oh we gotta grab a

[00:13:23] cone beam I don't have a cone beam in my where I work

[00:13:25] But there everyone else seems to have one they grab a cone beam and then you can see Joyce measurements

[00:13:30] but you have to catch it at first or you're scanning everyone and

[00:13:34] Around the opportunity ability to do that. So

[00:13:37] anyways, I'm

[00:13:39] Fiddling around we get get to the cone fit

[00:13:42] I'm a little further ahead of the game during the

[00:13:45] endo than I was anticipating.

[00:13:47] So what I'm looking for is about 20 minutes of sodium

[00:13:52] epichloride sitting in prepared canals, just to

[00:13:55] make sure that not so much sitting, but them being

[00:13:57] soaked, kill bacteria, whatever.

[00:14:00] Yep.

[00:14:01] I'm like, you know what?

[00:14:02] I'm ahead of the game here.

[00:14:04] Rarely.

[00:14:04] I'm ahead of the game here. Rarely.

[00:14:05] I'm ahead of the game.

[00:14:06] Let's go ahead and take a cone fit without seeing a cone fit radiograph.

[00:14:09] Take the cone fit and staring at me in the middle is this like extra route in the middle

[00:14:16] of the...

[00:14:19] What on earth is going on?

[00:14:21] I'm like, I swear I got that.

[00:14:22] I'm like, oh my gosh.

[00:14:24] That's that little dot,

[00:14:25] the little white dot that's been staring at me.

[00:14:27] Every time I looked down the microscope,

[00:14:29] there's a little white dot there.

[00:14:30] I'm like, eh, it's probably nothing.

[00:14:33] Anyway, so taking that cone fit today,

[00:14:35] and just by happenstance, when I take the cone fit,

[00:14:38] I angle just by the nature of using a regular

[00:14:41] rim to take x-rays.

[00:14:44] I was able to just kind of save myself and then

[00:14:48] be able to tackle that. But had I kind of like, let's just, I'm going to use my, I don't use files,

[00:14:55] but for working length or for radiographs anymore, it's too much of a pain, but had I skipped that

[00:15:03] comb fit and went right to the end, which not a of us do but I have done before and burned so that you know that's

[00:15:11] one of the one lesson just taking the comb fit and then you know really I

[00:15:18] think one of the biggest things I've noticed at the end of it is taking follow up radiographs like 12 months out. And I was oh I was talking

[00:15:27] name. Is it Howard Farran? Yeah. Right. So I was listening to his stuff and many, many

[00:15:36] years ago, and he was talking about like a field goal kicker. Oh, just like the is that

[00:15:43] the Super Bowl? There was a bunch of kicks in there.

[00:15:46] Oh yeah, there was, yeah.

[00:15:47] Some long kicks, record kicks.

[00:15:50] Yeah. Yeah.

[00:15:51] And I mean, how would you know if you got the kick

[00:15:54] if you didn't see the result every time?

[00:15:56] And that is really the same with follow-up radiographs

[00:15:58] I've learned.

[00:15:59] It's just booking the patient in in six months or 12 months

[00:16:03] to get that follow-up radiograph to see if what you're doing is working. So if it's not working then

[00:16:09] you can start kind of asking yourself like hey am I doing what am I doing? Is

[00:16:14] it the right way of doing it or should I change something or is it actually the

[00:16:17] patient the biology of the patient because that plays a really interesting

[00:16:22] factor that can affect it can affect a lot of things.

[00:16:25] So those are a couple of things.

[00:16:28] I don't know, Kevin, what do you got?

[00:16:30] You're an avid teacher.

[00:16:31] When did you start actually teaching, Kevin?

[00:16:32] When was your first, when did you dip a toe in?

[00:16:36] 2019, 18, 19, somewhere in there.

[00:16:42] What I always think is I'm always learning something from whoever I'm teaching.

[00:16:47] Like the teacher also learns.

[00:16:50] So you know, in this last implant class there was some questions asked that you know, like

[00:16:56] I never thought of that before.

[00:16:57] So it makes you think on your feet and you know, you have to either provide the answer

[00:17:03] or if you don't know the answer,

[00:17:05] you have to say that you don't and that you'll figure it out.

[00:17:09] You know, we can figure this out together.

[00:17:11] But I think that guiding young dentists also, you know, piggybacking on what Ash said, if

[00:17:19] you can avoid the mistakes I made, you know, I'm going to tell you those.

[00:17:24] But you know, if you can avoid those, I made, you know, I'm going to tell you those but you know, if you

[00:17:25] can avoid those, that's great.

[00:17:27] But I also think that sometimes even if you're told what to avoid, the best way to learn

[00:17:32] never to do that again is by making a mistake unfortunately.

[00:17:36] And learning from that.

[00:17:37] But I just like, you know, teaching younger dentists and

[00:17:47] and you know, I

[00:17:48] It sounds corny I've said this before but

[00:17:50] You know dentistry has been really good to me and I just want to make sure that this

[00:17:54] Profession is left in a good place in my little corner of the world as best I can and you know

[00:17:59] That's that's part of the reason I'm motivated to do that. I

[00:18:05] That's part of the reason I'm motivated to do that. I also want to add something else too.

[00:18:07] Like I'm constantly teaching my team too.

[00:18:09] So I think that in order to have a strong team, in order to accomplish some of the things

[00:18:15] we've accomplished, I need to be a good teacher on, you know, tomorrow.

[00:18:22] We were talking off air that I have a three day workweek now and Zach

[00:18:27] asked me what would you do on the rest of the days.

[00:18:29] I do go in on Thursday in an admin role and one of those, you know, we always have a team

[00:18:36] meeting one Thursday a month and this happens to be it.

[00:18:41] And I'm going to lay down knowledge on on our team about really some

[00:18:47] philosophical things but how I see it as it applies to our little office and how

[00:18:53] we can always strive to do better. So one of the things you know you said you know

[00:19:01] Ash in taking follow-ups and all that I think when I hear that, I get a tremendous amount of

[00:19:09] satisfaction to those recall pictures. Because that's what

[00:19:13] the good ones I should say the good ones. Because your

[00:19:16] confidence. Yeah, that's that's the confidence in like, this is

[00:19:21] a profession that can kick your confidence in the groin

[00:19:24] this is a profession that can kick your confidence in the groin frequently and so anything you can do to like any

[00:19:29] attaboys you can take is worth it, you know, and so there's

[00:19:33] there's a lot to be gained from appreciating your successes

[00:19:37] rather than dwelling on the failures and that that's where

[00:19:40] a lot of those follow-ups can really help. So I'm a big fan

[00:19:43] of what you said there on that, Ash, for sure.

[00:19:47] Yeah, you know, like it is. It's such a different, I guess, I

[00:19:53] don't know, like, about different jobs, like how what

[00:19:56] you perceive from the outside is completely on the inside with

[00:20:01] this job. And I don't know about, I'd imagine, you know,

[00:20:05] like just as a funny aside,

[00:20:07] I drive a significant amount of time

[00:20:10] and a lot of driving and for a variety of reasons.

[00:20:16] I can't remember what podcast came up.

[00:20:18] It was Hugh Hefner's, I'm going down this road, boys.

[00:20:23] His last wife, I think, has a book out.

[00:20:26] It's just kind of like spilling all the beans

[00:20:27] on Hugh Hefner and all this.

[00:20:29] And just listen to her talk.

[00:20:31] And I was just kind of like,

[00:20:32] yeah, I expected it to be really crazy like that

[00:20:35] and kind of weird and whatever.

[00:20:37] And from the outside looking in, it's like,

[00:20:40] yeah, it's gonna be weird.

[00:20:41] There's scantily kind people running around all the time.

[00:20:45] You've got this 85 year old man who's marrying these really young ladies.

[00:20:49] Yeah.

[00:20:50] But our job, I don't know.

[00:20:52] Maybe it's like, it can be, it's a very stressful, but also, like you said, Zach,

[00:20:58] confidence sucking, and until you, I don't know, it took me a long time,

[00:21:05] at least a decade and a half to finally be like,

[00:21:09] go to work and be like, hey, I can control the mishaps

[00:21:16] or I know what to do when this happens or this happens.

[00:21:20] Like you're not thinking about it,

[00:21:21] but you know what I'm talking about?

[00:21:23] You're unconsciously competent. I know what to do when this happens or this happens. Like you're not thinking, but you know what I'm talking,

[00:21:25] you guys know what I'm talking about?

[00:21:26] You're unconsciously competent at that.

[00:21:30] Yes, right.

[00:21:31] You don't have to think about it.

[00:21:32] You're just doing,

[00:21:34] I know exactly what you're talking about.

[00:21:35] Yes.

[00:21:36] But it took a long time for me.

[00:21:37] Took a long time, yes, same.

[00:21:40] Yeah.

[00:21:41] So, Ash, one of the things in that you're

[00:21:47] referencing something from one of the one of the first things

[00:21:49] in your new courses is an article called top 10 learning

[00:21:53] points from teaching. And having, you know, taken that that

[00:21:57] part of your course, the rest of the 10 points are a major a lot

[00:22:01] of the 10 points and I want to hear what your guys's thoughts are on this are you could be summed up

[00:22:07] as like, avoid compounding errors. Like it's like, you're

[00:22:16] you have a thing like access to small it's like it's like you

[00:22:19] start with like that error. And then that's going to lead to

[00:22:22] another error and that and so many of your things in there were like, this

[00:22:26] is this is the first error of about 10 errors you're getting

[00:22:30] ready to make if this happens to you and compounding errors I

[00:22:33] feel like are a big problem in dentistry. It can be a problem

[00:22:37] in a crown you under prep, then your temporary breaks, then your

[00:22:41] finals too thin. I mean, I'm sure there's a an implant variation of this, but for endo, it's like your

[00:22:47] access is too small. Your isolation is not good. It's

[00:22:50] like it's compounding errors and like every step matters. So I

[00:22:55] guess I'd like to hear more from you know, Ash first then Kevin

[00:22:59] about just like because that's that's what that's what I took

[00:23:02] away from that the rest of that 10 points articles was like,

[00:23:07] here's how not to get started on a bad note.

[00:23:12] Yeah, like even I'll be honest,

[00:23:13] here's a funny story,

[00:23:15] because it just what you said, access is too small.

[00:23:18] So there goes through a stage and I think we're all,

[00:23:20] we all go through different stages in our practice

[00:23:23] of whatever it is.

[00:23:24] Like for me, you know, for Kevin, it might be something,

[00:23:28] for Zach, it might be something.

[00:23:29] For me, it was like, hey, I'm going to,

[00:23:31] I'm doing a lot of endo, like all,

[00:23:33] that's what I pretty much do.

[00:23:35] Let's make these axes a little bit smaller.

[00:23:37] I'm just gonna trial it.

[00:23:38] I'm gonna test the water, I really,

[00:23:39] cause I wanna keep up with the Joneses.

[00:23:42] How about that?

[00:23:43] Like, cause that's, that's what the expert does. Experts do.

[00:23:47] So I'll never forget, it's a Monday night. Yeah, Monday night, I'm in this one clinic,

[00:23:55] it's like eight o'clock at night. I'm like, okay, let's keep the access small. Let's get in get out boom done and I go to cone fit okay so it's like lower

[00:24:09] second molar yeah lower second molar on the right side something like that I

[00:24:13] think go to cone fit I'm like what the heck why would this cone go down well it

[00:24:18] turns out so I'm sure you guys are you've done this before where your

[00:24:24] access on a lower

[00:24:25] molar it's really tough to get if you make it too small the mesial buckle like

[00:24:31] any type of buckle if you don't open up your access enough it's really tough to

[00:24:35] get in the mesial or buckle canal I had clean and shaped and pretty much

[00:24:41] comb fit two times the mesiolingual canal.

[00:24:45] So.

[00:24:46] Oh, okay. Yeah, yeah, yeah, yeah.

[00:24:48] I hadn't actually touched,

[00:24:50] because at some point I'm not,

[00:24:52] I'm just, it's just, it's a robot-ish.

[00:24:54] I'm not looking down the scope all the time

[00:24:58] because you can, you know,

[00:24:58] once you have this access point,

[00:25:00] it just, the file goes in, no problem.

[00:25:02] You're just like, boom, boom, boom.

[00:25:04] And at some point I'm like wow this is um it's access a little too small like I

[00:25:11] need to make this a little bit bigger and that happened honestly with this

[00:25:15] case today with the Rad-X where I'm like I need to I have to hold myself back to

[00:25:20] be like you know what that moment that moment, that learning point, eight years ago, I remember how it slowed

[00:25:27] the whole process down, where it's like, holy,

[00:25:31] even clean and shape the mesial buckle now,

[00:25:34] what on earth am I doing?

[00:25:35] Okay, so that was today,

[00:25:37] because I'm like, yes, keep this small.

[00:25:39] Like, you know what, there's just a weird shape,

[00:25:41] something weird, something is weird going on here.

[00:25:44] Take the time to make the access a little bit bigger

[00:25:46] So I can actually visualize what I'm doing and then all my files go in smooth

[00:25:52] cones go in smooth

[00:25:54] Case is done smooth. Boom done

[00:25:57] And I'm sure you guys know what I'm talking about. Yeah

[00:26:01] Yeah, yeah

[00:26:03] so

[00:26:04] Kevin you you've you've done an endocourse.

[00:26:06] Talk about, or talk about like compounding errors or whatever.

[00:26:09] I would say for endo in particular, what I talk about first in terms of actually doing

[00:26:16] the procedure, and this may be a little different, is just isolating the whole quadrant so that

[00:26:21] you have an idea of the position of the teeth, buccal

[00:26:25] lingually and mesial distally so that you don't get lost.

[00:26:30] That's one error that you can make because finding the canals efficiently is a big part

[00:26:36] of everything.

[00:26:37] Huge, especially on molars.

[00:26:38] If we're talking about compounding errors, using the orifice opener in my system first, if

[00:26:45] you don't get that open, you have the potential to never getting to the apex.

[00:26:51] So taking that step and opening everything up wide enough so that you can introduce the

[00:26:55] next files.

[00:26:56] Otherwise there is a whole host of compounding errors that may happen from there, including breaking your file off because you just don't have enough

[00:27:06] coronal

[00:27:08] part of the root canal shaped to allow everything to pass through and I've certainly been guilty of that in the past.

[00:27:17] There's a whole host of those sorts of errors and in implants

[00:27:21] it's even there are so many little details and one of

[00:27:25] them would be lingualizing your incision when you when you make your flap so that you can

[00:27:31] pull all the tissue to the buckle so that you can create keratinized tissue if you don't

[00:27:35] have enough and it seems like a really simple little thing but a lot of people don't understand

[00:27:42] that concept or put it into play.

[00:27:45] There's probably 100 little details that will...you can accomplish the mission without doing those

[00:27:52] or you can have mastery over the thing by doing all of those.

[00:27:57] Some of those you've got to learn the hard way, unfortunately.

[00:28:02] It's tough on a lot of these procedures. You know I mean I having not done an implant

[00:28:05] I can't speak to it, but having done many endos

[00:28:10] that

[00:28:12] There's those little tips. There's so many of them. It's it could be difficult for the non experienced person

[00:28:19] I'm sure ash can speak to this how when he's instructing people

[00:28:23] There's a lot of things you cannot take for granted from your from your

[00:28:26] reps that you've had that you may not even think to mention

[00:28:29] to someone but it's like that's the tip that this particular

[00:28:32] person needed to hear. Yes, you know, does that happen to you

[00:28:36] Ash sometimes when it's like you almost forgot to tell someone

[00:28:39] something because you just kind of thought it was second

[00:28:41] nature. Yeah, you know, I've got such a great,

[00:28:46] you know, great points there, boys.

[00:28:48] And you know, I have this,

[00:28:52] sometimes I have some dentists come

[00:28:54] and do some hands-on training.

[00:28:56] So it's right to the,

[00:29:00] I have an operator that just is ready for extracted teeth.

[00:29:03] That's what we do.

[00:29:04] It's the extractive tooth bay.

[00:29:06] So it's ready in there.

[00:29:10] And what I've come to learn is that you just,

[00:29:13] like you guys know, you just got to do it.

[00:29:15] And I think that's a huge solution

[00:29:17] to a lot of endo problems.

[00:29:19] It's just literally,

[00:29:20] and that's what I love about endo and hate about it,

[00:29:23] but I love it because you can get the reps in without a patient attached.

[00:29:28] Imagine if you had 2,000 teeth, random, and I gave you like a month. You'd probably get sick of it, but I don't know.

[00:29:37] X unit of time. Imagine your skills going in, and then when you left that factory, you could do so many different things like break things,

[00:29:46] time yourself, retreat it, break things,

[00:29:51] repeat the break things.

[00:29:52] Apico was like, holy frick,

[00:29:54] the sky's the limit with these extracted teeth.

[00:29:56] And I wish, I remember our,

[00:30:00] I'll never forget this saying from dental school.

[00:30:02] I've forgotten lots, but what are the things,

[00:30:06] Dr. Denny Smith, whoever, the three people

[00:30:09] that are out there listening to me talk right now,

[00:30:11] other than, I guess, two more, or one.

[00:30:16] Denny Smith, he was just like really hardcore

[00:30:18] old school prosthodontist.

[00:30:20] We're talking like old school, like crazy.

[00:30:24] And he, what did he have?

[00:30:27] I didn't think he had loops.

[00:30:28] I mean, we're talking really old school here.

[00:30:29] Like everything was cast post, no, no, uh, no like metal prefab.

[00:30:35] It was all cast post, second, third and fourth.

[00:30:39] And I remember him saying, I don't know why, I don't know.

[00:30:41] He was, I didn't do well in his class.

[00:30:44] He was hard.

[00:30:44] So I remember him saying like, I don't know why, I don't know. He was, I didn't do well in his class. It was hard.

[00:30:45] So, I remember him saying like,

[00:30:49] I don't understand why dentists don't practice more.

[00:30:52] And I'm like, whatever.

[00:30:54] And it was like a passing comment that he said

[00:30:56] probably in class.

[00:30:57] And here I am, 25 years later, sitting and thinking like,

[00:31:02] looking, and I tried to remember myself back

[00:31:04] when I just got out of dental school for the first 10 years. I'm like, that's the last and I tried to remember myself back when I just got out of

[00:31:05] dental school for the first 10 years I'm like that's the last thing I want to do is extract

[00:31:09] the teeth but you can gain so much you know it's crazy so I've seen a lot of um you know a lot of

[00:31:20] students have come through like that will sit for a couple of days just to like,

[00:31:25] and start to fit like all day.

[00:31:27] It's just a shock to the teeth.

[00:31:29] And, but you know,

[00:31:30] because just learning those wants things

[00:31:34] and what happens is they,

[00:31:36] what I love about it,

[00:31:37] they run into problems

[00:31:39] and then it's easy to,

[00:31:40] it's not easy to fix,

[00:31:42] but you can describe it to them

[00:31:44] and watch them succeed through it.

[00:31:46] And they're like, I got it.

[00:31:49] So then they can memorize that pattern and move it on to real life.

[00:31:55] I think actually the key word there, nuance, there is some nuance to do in an endo and and until you get totally on board with the reps,

[00:32:05] extracted teeth, just,

[00:32:08] and also almost intentionally screwing things up

[00:32:11] so you can get yourself out of the jam.

[00:32:15] So I don't know if I've said this

[00:32:17] on one of the other times we've had you on, Ash,

[00:32:19] or not, but I'm gonna say it again.

[00:32:21] One of the most valuable,

[00:32:24] of all the really excellent content you produced,

[00:32:28] one of your older and pretty basic videos

[00:32:32] was one of the most valuable ones to me.

[00:32:34] And that is you showing how you put an extractor tooth

[00:32:37] into alginate so that then you can actually use

[00:32:42] your apex locator and not not really like cheat and see

[00:32:46] the root. You got to like do it

[00:32:48] without the visualization

[00:32:50] of that of that root.

[00:32:52] And, you know,

[00:32:55] man, I tell you, it's a boring day

[00:32:57] to go in and do some extracted

[00:32:58] teeth, but

[00:33:00] that your instructor's point that

[00:33:02] like, you know, you

[00:33:04] know, some practice when it's not a live person, not a live

[00:33:07] situation goes a long way. I mean, you take a course like an

[00:33:11] online course like yours ash or even even a live course like

[00:33:14] yours, Kevin, if the person if you told me that the person then

[00:33:17] went home and doubled down and did like 10 molars, you know, in

[00:33:23] Algenit on extractor teeth, I bet you that person would have a much better outcome the next day than, you

[00:33:26] know, the person that just took the course and it's all about

[00:33:29] our patient. Huh? It's all about the reps. Yep. Yeah, indeed.

[00:33:34] Indeed. Oh, all right. Yeah. Go ahead, Ash. Like even in

[00:33:38] residency, if we stayed for a week in the endo,

[00:33:47] that was the discipline we were for that week,

[00:33:49] you could see a huge difference as compared to like

[00:33:52] just jumping in for a day than somewhere else.

[00:33:55] It was like night and day, just the reps, remarkable.

[00:34:02] Absolutely.

[00:34:04] Guys, any other like final points from

[00:34:07] what teachings done for you or what you've gotten out of

[00:34:12] teaching? Any final takes for this week's show? I think it's

[00:34:16] made me... Go ahead, Kevin. I think it's made me a better

[00:34:19] dentist in terms of putting myself in the place of the

[00:34:22] younger dentist and trying to get to that place where

[00:34:25] you didn't know what you didn't know.

[00:34:30] You got to put yourself in that place and teach from that point on not being the expert

[00:34:35] and working that way.

[00:34:36] Like what don't you know and then putting yourself in that student's shoes.

[00:34:43] So I think it's very important.

[00:34:45] Also, you know, to not come off like a jerk.

[00:34:50] What about you, Ash?

[00:34:51] Any last teaching points on what teaching's meant to you?

[00:34:56] Oh, teaching has meant,

[00:34:58] it's given me another kind of life in dentistry.

[00:35:01] It really has.

[00:35:02] Like, I think about, I mean, I still got time to go, but in terms of my career, but if I were just doing this day in day out without actually doing that mentoring, that teaching, I don't think I'd be as happy as, you know, both hands on but also online. It just keeps your brain thinking. And it's amazing, especially

[00:35:28] celebrating when somebody gets through something. I mean, just quickly, we have a student that just

[00:35:36] first endo ever, pre-mo. And I'll be at the students in Australia.

[00:35:43] I'll be at the students in Australia. You know, we're able to just kind of like, you know,

[00:35:48] I had some tips, but, you know, I'll do like a 10 minute,

[00:35:52] a five minute, I don't know what it was, eight minute video,

[00:35:55] and I'll just put it up and then for,

[00:35:57] just to kind of give some ideas and whether or not

[00:35:59] they're helpful, but just having, I think,

[00:36:02] just having somebody else kind of like,

[00:36:05] hey, it's gonna be okay,

[00:36:08] I think makes a significant impact on somebody's life.

[00:36:10] So just to be that person is,

[00:36:13] for these students is, it's heartwarming.

[00:36:17] Yes.

[00:36:18] Awesome, awesome.

[00:36:19] Thank you guys for,

[00:36:22] thank you guys that are doing the teaching

[00:36:23] and making Dennis better that's that's

[00:36:25] awesome guys I appreciate your guys's efforts thank you guys for listening if you have not

[00:36:31] checked out the very clinical Facebook page check it out Kevin's still not charging although rumor

[00:36:36] has it this might be the year not sure Kevin you need to monetize I need some I need some money. Yeah, so we're gonna start charging, you know, a couple hundred

[00:36:47] bucks a month. We'll put Kevin's Venmo. He needs money. Please send. Thanks Ash.

[00:36:55] On YouTube, All Things Dentistry, still free. And his courses are at

[00:37:03] allthingsendo.ca and allthingsretreats.ca.

[00:37:07] Ash is also in our very clinical Facebook page

[00:37:10] if you have any questions about his courses

[00:37:14] or anything else that he's got going.

[00:37:16] So Ash, thank you.

[00:37:18] Yeah, I already answered Canada question too.

[00:37:20] Easy boy.

[00:37:23] Quits me right here alright

[00:37:26] well we're gonna let Ash get another Canada Dry

[00:37:28] and then we'll

[00:37:30] we'll start up our recording for next week

[00:37:32] thank you guys for listening and we will see you

[00:37:34] next Tuesday

[00:37:36] see ya

[00:37:38] bye