Very Dental Classics: Finesse, Panache, Elan with Dr. Bart Schultz

[00:00:00] [SPEAKER_01] This is a production of The Very Dental Podcast Network. This is The Very Dental Podcast. Welcome to The Very Dental Podcast, where you'll find entertaining and relevant conversations with visionaries, clinicians, and your friends in the dental space.

[00:00:26] [SPEAKER_01] Now, here's your host and benevolent leader, Dr. Alan Mead. Very Dental people, welcome to another episode of The Very Dental Podcast. I'm your host, Alan Mead. Sometimes I say Dr. Alan Mead, and then sometimes I get criticized for saying Dr. Alan Mead because I'm flouting my doctor credentials to a bunch of other doctors. So then I'll just say Alan Mead. Understand, I took that criticism to heart, people.

[00:00:54] [SPEAKER_01] I am a doctor, but I'm not going to brag about being a doctor. I'm just, you know, just the way it is. Joining me for the...he's been on a bunch of times. My best friend from dental school, Dr. Bart Schultz. Bart, how you doing?

[00:01:05] [SPEAKER_00] Yeah, very good, Al. Thanks for having me.

[00:01:07] [SPEAKER_01] Now, Bart, I did say Dr. Bart Schultz because I feel like the audience needs to know that you have credentials. By now, if they think I don't have credentials, then they clearly don't care because they've been listening for a while. But I feel like the...do you think it's important to be introduced as doctor in front of other doctors and dental professionals?

[00:01:27] [SPEAKER_00] I'm not technically a doctor. I just slept at a Holiday Inn last night. Yeah. You know, technically we're not doctors. This will bring in some bad comments, but PhDs are really doctors. Medical doctors and dentists kind of have their, you know, kind of a glorified master's degree.

[00:01:44] [SPEAKER_01] But it's a doctorate level. I remember we were hooded. You remember that we were hooded?

[00:01:47] [SPEAKER_00] Mmm. I remember being de-hooded. Or hooded.

[00:01:52] [SPEAKER_01] Well, I remember there was controversy because the hooding ceremony, we had to pick who, what instructors, what professors we wanted to hood us. I remember we had Dr. Rich Nadeau and I can't remember who...it was probably Dr. Ziegler. It was Dr. Ziegler. Yeah. Okay. So, I mean, and they, you know, took the purple like little thing. They called it hood, but it wasn't really hood. It was like a little collar thing.

[00:02:20] [SPEAKER_01] And they put...that's...I very barely remember that actually. It's funny. I don't remember. But I do remember that the hygiene graduates at the same time were super pissed that they didn't get to have a hooding ceremony. Oh, boy. But it wasn't a doctorate thing. Like a doctorate is when you get the hood. I've worked really long and hard for that stupid hood. I'm getting my hood. There was lots of abuse. Yeah. There was lots of abuse for getting the D-ass degree.

[00:02:46] [SPEAKER_01] Yeah. Yeah. Yeah. I mean, nowadays you listen to the...you listen to recent graduates and it doesn't sound like there's nearly as much abuse. Although I think it depends on the institution.

[00:02:56] [SPEAKER_00] Does everyone always say that, you know, what I did walking to school uphill both ways? Yeah. No, it's just no, right? They were two 50 year old dudes. Are you 50...you're 50...if you're not 50, you're 50 like in a few days or something. I am not...I am not 50 nor will I ever be 50. He's not...he's not crossing that line. That's not happening. I need reading glasses and I refuse to participate. Yeah. So I just put my glasses on my forehead. Yeah.

[00:03:21] [SPEAKER_01] That's...well, I mean, there's a funny thing about that too though, because you remember when you first started, like soon after we had our hooding ceremony and we got our licenses, you had yours earlier than I did because I was a super senior. They liked me so much. They wanted me to stick around for a little while. That was free too. They didn't charge you up the first time. Yeah. It cost nothing. It's just a bonus. Total bonus. Yeah.

[00:03:46] [SPEAKER_01] So we got our licenses and then we went to work in like probably the first day we worked. You're not old enough to be a dentist, are you? Yeah. Because we had the baby face thing going. That's why, you know, it's just a matter of...I just remember feeling...everyone treated you like you were very young. You were too young. You couldn't possibly know what you were doing. And to be perfectly honest, I didn't know what I was doing. So that is probably real too. It takes time.

[00:04:13] [SPEAKER_01] It does. But now that we're 50, are we...do you think we're...what do you think? Are we on the end of our career? Are we like just hitting our mid-stride, mid-career stride? Where are we at 50 years old?

[00:04:25] [SPEAKER_00] The glide slope into the ground. I think age and what you want out of your career is a little bit of a mindset. You know, I practiced for a year and a half in northern Wisconsin with an older doctor that hopefully is not listening to this because he's still alive. But they were barbaric. The things...I mean, this dentist, one of them glued teeth separating the roots.

[00:04:55] [SPEAKER_00] Dr. Frankenstein. I remember that. Putting the teeth back into other patients' mouths from the tooth extraction jar.

[00:05:01] [SPEAKER_01] He collected teeth from extractions and then he could use them as pontics is what you're saying.

[00:05:05] [SPEAKER_00] Yeah. Yeah. And you know what? I mean, I think that seemed unreasonable to a new recent graduate. But...

[00:05:12] [SPEAKER_01] What kind of graft would that be? That is that...it's not autologous. Autologous is your own tissue. So what is it? Is it xenograft?

[00:05:20] [SPEAKER_00] It's xenograft. An autograft.

[00:05:23] [SPEAKER_01] An autograft. An autograft.

[00:05:24] [SPEAKER_00] Yeah. Xenograft, I think, is an animal graft.

[00:05:26] [SPEAKER_01] Okay. Okay. So an autograft is someone else's tooth basically cut off and used as a pontic.

[00:05:34] [SPEAKER_00] Yeah. I mean, a couple of years ago, there was a machine they were selling to grind up teeth. Teeth. For bone graft. Yeah. Bones. Yeah. I'm not sure that it was required that they were the patient's own teeth, but I don't know. I didn't mention that part. Yeah. I wasn't interested.

[00:05:51] [SPEAKER_01] Well, I'm not going to lie to you. I have a few times, particularly on the lower anterior, where I will...if I'm taking a periodontally involved tooth out and I'm going to splint, I will literally...I'll cut that tooth. I'll cut the root right off the tooth. I'll seal it up with composite. And I've used that as a...but it's...but I will say this. It is the patient's tooth. It's a great...I'll give them that. It actually is a pretty good treatment. I am. Sandblast that bugger. And those things will last for longer than you need them to.

[00:06:16] [SPEAKER_00] And if I didn't use it that way, I would use it in the patient's Essex, which is better than a composite. Yeah. Yeah.

[00:06:22] [SPEAKER_01] But yeah. Well, shade match anyhow, you'd assume. Yeah. You know, particularly if they're cigarette smokers, they get that, that just about perfect that shade match.

[00:06:30] [SPEAKER_00] It's a...but again, it was the patient's teeth. So, so, uh, I mean, a youthful dentist, uh, next to, uh, the other thing in this, in this practice, I noticed that boy, the amalgams were really dark black in color. Uh, and I thought, wow, we should set up a program for polishing amalgams. Yeah. Cause, uh, I know that doesn't really get done in the profession very often, but these were really black and scuzzy and rough. Yeah.

[00:06:55] [SPEAKER_00] And then I realized they were using a miracle mix, which I think, which I think is a really a temporary material.

[00:07:02] [SPEAKER_01] Yeah. Miracle mix was, it w it was amalgam. I, I remember, uh, one of our classmates went to a practice where they were using miracle mix for a core material and, uh, and they, the people liked it because it's very radio opaque because it's glass iron with amalgam particles mixed into it from other people's

[00:07:18] [SPEAKER_00] teeth probably. But, uh, they were using this as really what I would say is a permanent restoration in the, in, of course the, um, the, um, miracle mix was worn way below the occlusal table. Yeah. And, you know, and my thought is I learned a lot.

[00:07:34] [SPEAKER_01] GC still has a website for it. Miracle mix. Of course. Yeah. It's metal reinforced crown and core buildup silver alloy reinforced glass ionomer restorative amalgams from Chinese children's, uh, pitot teeth. Maybe, but, but what's horrifying about, well, I mean, what's interesting is it is supposed to be a core material. It's not supposed to be a restorative material, but they probably wore the same way that glass

[00:07:55] [SPEAKER_00] ionomer wears as a restorative material, which is really quickly. These patients, most of them needed a, probably an indirect restoration to really make the tooth healthy. And yeah. Yeah. And I think someone came in with a broken tooth, you know, you'd slap some of this material in place just to stabilize things. So you get them back, you know, and patients might not move on with care, but I think, I think sometimes dentistry, even today, uh, we're afraid to have conversations with patients about, about what they should do and what they can do.

[00:08:23] [SPEAKER_00] Um, and, uh, and then we're stuck with this, you know, difficult process of watching these, these, uh, these people kind of struggle.

[00:08:33] [SPEAKER_01] So I, you and I talk about something and I'm not sure if we've talked about it on the podcast before. I think it'd be a good thing to talk about. Um, I, I got a couple, I got a couple of topics in my brain, but, but along those lines, how often, I mean, you do a lot of really complex treatment plans, treatment plans that have a lot of maybe steps to them, phases to them, you know, where, where you're removing a lot of teeth, grafting, waiting for healing and implants, this sort of thing in where they,

[00:08:59] [SPEAKER_01] it has to be phased out over time or, or if it, even if it's not phased out over time, there's surgical, you know, there's a surgical part of it and then a restorative part of it, or, or what have you. And you, you've told me multiple times that the patient that you, you put beautiful grafts in and they're healing great and they're doing great. They, you've spent a lot of time with them, sometimes sedated, maybe sometimes not, but you've, you know, you've, you're moving on to the, maybe the, the implant placement stage or whatever. The patient sits down in the chair, they're happy to see.

[00:09:29] [SPEAKER_01] And they say, what am I here for now? What am I here for now? And, and that's got it. That's gotta, I, every time it happens to me, it's gotta really happen to you, especially when you have, you've taken a lot of time to phase this stuff out, doing a lot of big treatment plans. It's gotta just be like a knife in the heart on some level when the patient just does no idea what they're there for whatsoever.

[00:09:48] [SPEAKER_00] I think it's, they must trust you cause they're there. That's good. I think it's even simple things of a couple of crowns. I often say to patients, you know, we're, we're, this is the treatment we're doing today. And then I'll say, is this something you don't want to do today? I say it because I want them to be able to really buy in and have me out. Um, so I've had some medical things that I've talked about with you before, but I mean, I think I have a pretty proactive view of the things that the doctors are doing for me.

[00:10:15] [SPEAKER_00] Like I'm paying attention to the things they're telling me I'm listening. Uh, and I'm not the smartest guy, but I, I also pay attention to a lot of things. And I don't know. I mean, if someone was telling me to do these things for my teeth and it might be four or five or $2,000, I, I guess I would, I would listen. Dentistry is complicated that it's sometimes hard for people to understand what we do.

[00:10:40] [SPEAKER_00] Um, and maybe medicine's the same way, but they, they, they embrace getting their knees done. Yeah. Uh, or their back surgery that may not get better pain wise, but yeah, I don't, I don't know. I don't, you're right. I spend that time.

[00:10:55] [SPEAKER_01] What's frustrating to me is that a patient, even though you've like, you know, you've sat down, you've had, uh, I just, I just did a podcast a couple of weeks ago about this or last week about, uh, the big talker, the guy who, the guy who comes in and he's, he's a big guy. He's a big talker about, uh, about getting stuff done right. He can't do it right this second, but he knows. And this is the person that you've had multiple, you've had multiple consults with. And over the years you've put together multiple big treatment plans that they've never really followed through with that sort of thing. I sometimes think to myself, they have no idea what I'm proposing.

[00:11:25] [SPEAKER_01] I, I have, I have literally explained it to him in as small words and as few words as possible. And they really don't know what, what we're doing. Sometimes I, sometimes I think they just, it's, it's like when someone says you, you've had a, we, we, we, we tell them they've had a root canal and they translate that into, they don't have a root of their tooth anymore. And I mean, I understand my tooth anymore. Yeah. Yeah, exactly. I understand.

[00:11:49] [SPEAKER_01] I understand on some level, I don't know how important it is for the patient to thoroughly understand what treatment is going on for the treatment to work. But it would be nice for them to understand what we've done for them in a lot of cases. So that I don't even know how to say it. I just, I think the, you know, my question is, do they, do they not care or do they really not understand? Or is it a little of both?

[00:12:17] [SPEAKER_00] I don't use the term root canal because technically, technically they have a root canal or multiple root canals. I use the term tooth disinfection. So I try. That's a much, I like that better too. I try to say, you know, the tooth has an, an effective process from trauma, decay, you know, whatever it is, we're going to remove that infective process, you know, by removing that dead dying tissue. I think they, and, and so I say, you, you really need to do this infection.

[00:12:47] [SPEAKER_00] And then I kind of do the air quotes, a root canal. Oh boy. I'm really nervous. You know, listen, you're going to do great. We're going to make you feel comfortable, you know, with sedation discussion or just using good anesthesia. But you're going to be comfortable. And, uh, and I think once they understand what you're doing, I think they feel more comfortable. Now, I'm not sure they remember in a month or two weeks when they come in.

[00:13:11] [SPEAKER_00] Cause I think they hear, well, $1,500 insurance will be 300.

[00:13:19] [SPEAKER_01] Okay. Yeah, no, that's right.

[00:13:22] [SPEAKER_00] They don't want to, they don't want to seem dumb or. Yeah. And I don't think they're dumb. I think they just don't. I think, I think Americans don't pay attention to anything now. It's overload.

[00:13:35] [SPEAKER_01] I also think that it might be a, uh, it might be because they trust you. They trust the person enough that they're like, okay, this is what he says I need. I'm going to go ahead and do that. I trust that he does it. And so, and I think that's good, but I do like patients to have an idea of what's going on.

[00:13:54] [SPEAKER_01] You know, one nice thing about, um, crowns, like, like the regular workflow of a crown or an onlay or something like that, where you prepare the tooth, they're in a temporary and they have to come back a second time. They kind of get that. In other words, what I'm putting in here, I'm going to replace this temporary with the final one. Cause it sort of makes sense. It's, it's, it's easier for them to make sense of that particular procedure. And honestly, maybe a filling isn't so hard. You take out the rotten part, you stick a new part in there. It looks like a tooth. And that's, that maybe is all they need to know.

[00:14:23] [SPEAKER_01] Maybe there's other, but like an implant or a root canal, uh, a bridge. Oh man, a bridge. That's, that's like, I mean, that's, that's like brain surgery to try and explain in some cases without some kind of a model or whatever to show them. And typically I, I, uh, oh man, this is the thing about being 50. I got, I got no time. I got no, no patience for that. I will generally let my assistant do that. And that's probably a fault of mine. I know you are much better about that than I am.

[00:14:49] [SPEAKER_01] I just, I got, I, in those consults, I am so itching for my, my, I want my hygienist. It's the only time in the world that I want my hygienist to come tell me that I need, I have an exam that I have to do.

[00:14:59] [SPEAKER_00] So I've got to the point that we try to do a consultation or even the complicated case where we've done the initial consultation to do their phase one or their box one. If you're a spear guy or gal, um, and, uh, we've got the disease eliminated and now we're moving on to maybe, you know, an implant or even some crowns. I even like to do a second and third consultation almost yearly to kind of bring them back up to speed of where, where we are.

[00:15:26] [SPEAKER_00] Cause they've kind of forgotten that this was a, a couple of year process. This is where all on four, which I don't know that I agree with terminal dentition and removing a bunch of bone, but this is where that's easier for them is, is that they're in and they're out and they're done and they've moved on and they've got a nice result. I wonder about force control and pair of things about that.

[00:15:48] [SPEAKER_01] Do you? Okay. So this is, uh, send hate mail to, uh, there's no chance. No, there's no chance that an all on four patient understands how much bone you're going to be taking away.

[00:16:00] [SPEAKER_00] And I, and I doubt they have that consultation that way. I think they tell them you're going to be done happy and we're going to get your teeth tomorrow.

[00:16:06] [SPEAKER_01] What they tell you is you have teeth in the same day that you have surgery, which sounds pretty great. And I, and maybe the patient wouldn't care how much bone you're taking away, but I do feel like you, I feel like we're obliged to explain what kind of stuff we're doing. I really do. And I, I, I have a lot of friends who do a lot of that stuff. And I just, I've always wondered like, how does the informed consent go? And I'm not sure that they, I mean, you'll see these guys showing pictures of, of basically an entire alveolus of the upper sitting on a tray. And they think that's really cool.

[00:16:34] [SPEAKER_01] I'm like, man, if a patient saw that, holy shit.

[00:16:37] [SPEAKER_00] We're certainly shifting gears, but you know, all on four was really designed for the mandible. Yeah.

[00:16:43] [SPEAKER_01] You know that because, because he didn't want to graph, he didn't want to graph. Yeah, exactly.

[00:16:46] [SPEAKER_00] Well, it is more cleansable. The upper I think is because it's simpler and faster, but I mean, I think teeth should be in the back. I think having posterior teeth where we generate lots of force makes sense, you know, but I'm not here to knock all on four. I'd say that their consultations offer a solution quickly. My sometimes treatment plans take longer, which adds more complexity of just patients remembering what we're doing. But that might also require more and multiple bone grafts to do the things that they want to do.

[00:17:15] [SPEAKER_01] When you bone graft, when you, when you place a bunch of bone graft material into the sinus area, does their head get heavier? Hmm. I don't know. So what I really want to know is like, if you, if you did like the right side and you just, you just pounded in a bunch of graph material on the right side, does their head lean until you can get the other one done? Can you, is there like, I'm curious. We, we make a foot lift for them.

[00:17:37] [SPEAKER_00] No, I mean, I will tell you. I'm sorry, doc, but without my lift, I can't walk in a straight line. We, we've, we've done, I've done hundreds, more than 500 sinus grafts. And, uh, uh, I find it very, very predictable, easy, simple, um, to get lots of bone and, and really.

[00:17:56] [SPEAKER_01] Is it shocking how much bone you can get in that sinus? Sometimes I remember watching you do one and I'm like, it doesn't stop. It's not stopping. There's more, there's more.

[00:18:05] [SPEAKER_00] I kind of think with a CT scan evaluation, but I kind of think, you know, eight to 10 millimeters of, uh, excuse me, eight to 10 CCs of maybe four. It depends if you're doing a multiple implants, four to 10 CCs of bone per side, you know? Um, and, uh, whatever you push up there, you're going to get a little bit of regression back. But so my, my goal is I'd like someone to have a 12 to 15 millimeter implant in the posterior. Yeah. Um, you know, basically right up to the eyeballs. Yes.

[00:18:32] [SPEAKER_00] And so, I mean, but I'm not afraid of a sinus graft. I think it's a really predictable, easy procedure. Um, it, uh, it works really well. And, uh, it is kind of a, as Mitch Day would say, if anyone remembers Mitch Day, Dr. Day, shout out to you wherever you are. Uh, finesse panache, Elon. Yeah, that's right. Yeah.

[00:18:53] [SPEAKER_01] So, you know, you know, the, the, the very first time I met Mitch day, I was a sophomore as a sophomore. God, it could have been a junior, but I think I was a sophomore. And remember when they would send us down in the oral surgery department to, to, uh, to assist, uh, the, the seniors that were going through the rotation. And, and at one point there's, they're taking wisdom teeth out on someone, upper whizzies. And, uh, the, the, whoever was, whoever was doing the surgery, I've told the story on the podcast. It's just too good not to tell.

[00:19:21] [SPEAKER_01] Um, whoever's doing surgery is having a really hard time to upper wisdom teeth. And so, so you got to know that for an oral surgeon who is taking out a lot of wisdom teeth, you give a relatively straightforward upper wisdom teeth. And that's like, that is literally like, that's the easiest thing they could ever do. Micro seconds. Exactly. So Mitch gets in there. Crazy Dental already has some of the lowest prices on dental supplies anywhere, but you know what's even crazier? Free shipping.

[00:19:47] [SPEAKER_01] Head over to crazydentalprices.com, load up your cart, and use coupon code VERYSHIP. That's VERYSHIP for free shipping on every single order. Plus, every time you use that code, CRAZY Dental kicks back support to the Very Dental podcast network. Save money, get free shipping, and support the show. Use code VERYSHIP today. And he, he asks, this is so horrible. It's not, I shouldn't have, it's too late, we've already used his name.

[00:20:14] [SPEAKER_01] Uh, he asks which corner of the room, and, and I didn't know what he was asking. He said, you know, this way or this way. And, uh, I pointed to a corner of the room not knowing. He, he popped the root out, or he popped the tooth out, and it did. It went, you know, flying to the corner of the room. And it was all I could do. I was just observing. I wasn't even desisting. I was just observing. It was all I could do to not reach out to try and grab it, like as a reflex, because he popped the thing off. Of course, he was showing off for everyone in the room, for sure. But that's, you gotta figure oral surgeons could probably do that all day long.

[00:20:42] [SPEAKER_00] Dr. Day was an excellent instructor in dental school. He was fantastic. He made you feel confident and good. I mean, he's a guy that should be teaching dental students. He scared me.

[00:20:51] [SPEAKER_01] He scared the hell out of me. But then again, everyone scared me. I was just scared. I was just walking around scared constantly. So that was kind of where I was, um, with, with all that. He was not happy with, he's the one I had to tell. Remember when I burned my hand, I was, uh, I was working at the coffee shop and, and, uh, I was, I was steamed. It's like my first day or second day at the coffee shop. I was steaming, uh, some apple cider.

[00:21:15] [SPEAKER_00] It was fall. So it was probably one. Is that a thing? Do you do? Was that just your creation or is that something? No, no, no. No, no.

[00:21:20] [SPEAKER_01] No, that's what, that's how you, they want hot apple cider. So you'd put it in the steamer. And of course I over steamed it and I burned my hand. It, it, it ran right over the thing, burned my hand, burned it pretty bad actually. Like I, I couldn't sleep except I, I literally went to sleep with a, like a bag of frozen corn in my hand is the only way I could sleep because it hurts so bad. And so I go in, that's my first three days of oral surgery rotation or something like that. And I have to explain to, to Mitch day that I, I'm not going to be able to really participate because I burned my hand at the coffee shop. But I, he didn't suffer fools really.

[00:21:51] [SPEAKER_01] And I was the fool at that time. I remember feeling pretty, pretty terrible about that actually. So yeah, that was a, it's maybe not the best choice I ever made, uh, working in the coffee shop at that point. But that was, that was a whole other thing. So you, you had the best job though, when you were, uh, well, you had a couple of jobs in dental school. You, you drove a tow truck. If I remember correctly, you drove a tow truck in Minneapolis, St. Paul area in the winter time.

[00:22:13] [SPEAKER_00] I did. I, I towed for, uh, people for an Amoco gas stations or Amoco gas stations that triple A people would call in. So I never towed someone who was parking in the wrong place. Uh, I did loss prevention. Uh, that was the worst job ever. Uh, not because, uh, not because you catch people or they'd get, prosecuted, but it was extremely boring. Yeah. Watching people.

[00:22:38] [SPEAKER_01] What, what, like what, what, uh, when you did find someone like, did you, did you find people that were, that were stealing stuff or trying to steal stuff?

[00:22:46] [SPEAKER_00] What were you supposed to do? Uh, so you had to really, uh, if I remember this right, you had to know what they, what they had taken, uh, where it was on their body and you had to verify they didn't pay for it. Cause some people actually shop, uh, by putting things in their pockets and they get a professor, they pull it out and pay for it. My son, my son likes to do that.

[00:23:05] [SPEAKER_01] So don't put it in your pocket. Yeah.

[00:23:06] [SPEAKER_00] Yeah. So, uh, most, most shoplifters I think don't steal like a candy. They, they steal expensive things. Like, yeah. Yeah. Like, uh, there was a time that, uh, some of the electrical outlet, uh, GFI components were a couple hundred dollars. That was always a place they would steal things. They would steal router bits. Uh, lots of shoplifting happens from, you know, uh, theft of workers, workers stealing it. Yeah. Um, but drills and things like that. So you had to watch them.

[00:23:36] [SPEAKER_00] Um, and even then, if you didn't really know, they didn't want you, Menards didn't really want you, uh, you know, uh, harassing people about this. That being said, I, I don't know that they do anything about shoplifting now. I think it's probably a career choice. Yeah.

[00:23:51] [SPEAKER_01] So, so I, uh, I, I, it does make you wonder what, and I always, I, you know, we had someone else that I want to say one of our other classmates did the same thing. Like, or she was some, she was like a security guard or something. If I remember correctly, I can't remember exactly, but.

[00:24:06] [SPEAKER_00] I remember that. I don't remember who that was.

[00:24:09] [SPEAKER_01] I can, I, I, I don't know. I, I remember who it was, but I, I don't want to, uh, I don't want to, I don't want to say any names cause I can't remember exactly. But I, I also am like having a job in dental school. I mean, I didn't do anything until I was a senior cause we, we had less classes, you know, it was all basically just clinical stuff at that point. But, uh, again, I, in it, I didn't make enough money to make it even worth really doing. It's not like it's not, I think I made six bucks an hour if I was lucky and tips, uh,

[00:24:36] [SPEAKER_01] uh, and sometimes they would require you to stay up late and clean like clothes. That was not a great choice. I did it on the weekends a lot. It wasn't as bad, but on the other hand, you know what? Now there's no job you could get that would make a dent in anything. I mean, like, well, you get more loans cause what's, you know, cost of living when you're talking a hundred grand a year or more in loans, what's, you know, what's, what's beer money? Jeez.

[00:25:01] [SPEAKER_00] So, I mean, you get more money for jobs in the twin cities now, I mean, substantially more, but you're right. I mean, you're not going to earn 50,000 or 90,000. Um, I, I don't, I'm not sure, you know, when, when we talk about tuition at the U of M and I'm sure it's, it's pretty standard around the country is, I don't know how you pay that money, pay that money back. I don't know.

[00:25:24] [SPEAKER_01] Well, and, and I think, I think, uh, your options coming out of school are, are different now than they were. I mean, like there were a fair amount of people that went right into an associateship with the idea they're going to buy. There might've been some people at startups. I know I can think of three of us that bought within the first year. Um, I know Todd Johnson did. I did. And Paul, Paul Thomas did hot dog, hot dog, hot dog Johnson. Yeah. He K Thomas. Yeah. Yeah. I know. So all three of us did.

[00:25:53] [SPEAKER_01] And I, I thought I was special. Like I thought I was the guy and I'm like, Oh no, everyone else did too. So yeah, it was a lot of people. I don't think, I mean, there is a few people there. There are like, I, I had a guest on the show a few weeks back, a guy who does a podcast all about, you know, practice ownership. And there's some people who are really gotten into that kind of practice ownership. I will say, I'll bet it leans pretty heavily that they have military backing. Like they, they, they did the, an, uh, uh, an armed forces thing where they got, you

[00:26:22] [SPEAKER_01] know, they got most of their tuition probably paid for them.

[00:26:24] [SPEAKER_00] It's just a tough debt position to be in by any standard. So ROTC or whatever you want to call it for the military. So they, they pay your tuition off after four years of service. Does that work the same today with tuition? I think so. 400,000.

[00:26:39] [SPEAKER_01] I think it does. So why would you, why wouldn't you just, I mean, that's what you do. I feel like that's what you try. I don't know if they have that much available anymore, but geez, I don't know.

[00:26:49] [SPEAKER_00] That would, that would, that would make a lot more sense today than it did when tuition was a hundred thousand for four years.

[00:26:56] [SPEAKER_01] Yeah. No, I agree. I agree. That's, it's an interesting, interesting concept. So I wanted to, this is something I want to talk to you about. We talked about it a little bit before. So listeners, I'm going to try and find for the show notes, a couple examples of this, maybe on Instagram or Facebook, but it's one thing, the way that we market to potential patients is, is different. It's quite different than the way that dentists selling a service or a product to other dentists do.

[00:27:26] [SPEAKER_01] I feel like, I feel like a lot of the marketing for courses or procedures or instruments or services or whatever. I mean, it's very easy to appeal to a dentist sense of financial wellbeing, basically talking about how, if you do this, you'll, you know, your pro your profits will skyrocket. If you do this, you know, what do, what do, you know, what are the richest dentists, you know, do blah, blah, blah.

[00:27:56] [SPEAKER_01] And there's, I mean, there's no shortage of, of advertising that uses that kind of appeal to the avarice. Basically dentists like, like all people like to make money. And if you can say that by doing this, you're going to, your, your office will be way more profitable. Your office will make more money, all this stuff. But some of the ads are really fucking gross. I'm sorry, but some of the ads are super gross. Um, and it's, it's a matter of, it's, it's one thing to, to, to send that to a dentist,

[00:28:24] [SPEAKER_01] but I always wonder what would patients think about some of this stuff, the way that we advertise to each other about this stuff? Cause I mean, on some level, a patient, I think the patient is supposed to believe, or we're supposed to let the patient believe, or we're supposed to let the patient know that we have their best interests at heart in that, you know, obviously in dentistry more so than in medicine, we have to talk about money with patients for sure.

[00:28:50] [SPEAKER_01] So patients generally think that we are, we're money grubbing bastards as it is, I think on some level. And I mean, like it, you have to go to great lengths to, to let them know that you're not or to let them know. But, but the reality is when they see an ad like this, or when they, if they were to ever see something like this, what would they think? Do you know what I'm, does that make sense what I'm saying? Or am I just talking in circles?

[00:29:10] [SPEAKER_00] No, I don't think you're talking to circles, but I mean, the question might be, is I look at this and say, okay, let's, let's talk about being more proficient at taking wisdom teeth or surgical extractions. Lots of dentists, general dentists don't take out wisdom teeth. Lots of dentists refer that out, which is fine. I don't refer a lot of surgery out. I have trained and practiced and learned, and I think I do a very effective, if not maybe

[00:29:38] [SPEAKER_00] a better job now, I mean, that's, that's an opinion, but the question is, do they need the wisdom teeth removed? You're selling them a service that they benefit or need or should have. I don't like to use the word need, but should have. So if I do that and I do it in a way that makes it better, I think, you know, patients don't want to go to someone else. You have a better understanding of your insurance. You have a better relationship. If you can do the care and do really well at it, I think, and by the way, I think patients

[00:30:08] [SPEAKER_00] should have this care. Extractions of wisdom teeth may be debatable, but how about a crown? If you become better at it. So does the house need the new roof or are you just putting in a new roof because insurance will pay for it? I mean, so I see it both ways. I mean, certainly going to Spear is a moneymaker for Spear in many ways. They, they do well.

[00:30:31] [SPEAKER_00] Um, I think the things that Spear teaches you is a way not to necessarily prep a crown a certain way or to, uh, but, but to diagnose and have conversations with patients and show them the possibility. Spear is not all about veneers. I don't think LAVI is all about veneers. I think you treat people as a person individually. So I'm less hung up on it.

[00:30:55] [SPEAKER_00] Now I will say that, I mean, the, the, the world of marketing now is, is all about profitability. Maybe the reality is these companies that promise you more revenue. Do they guarantee you more revenue?

[00:31:08] [SPEAKER_01] No, of course not.

[00:31:09] [SPEAKER_00] Your ability to implement those things has probably more to do with you and your communication skills with people. If you're going to be successful, you know, uh, but here's the other thing though.

[00:31:19] [SPEAKER_01] Some of it, like, like on some level, I, I know Spear has done some marketing that talks about, you know, make you not only will you enjoy working more, it'd be more profitable. And that's, that seems less gross to me. I think then in some cases, it's just a matter of, of, uh, when it's a business practice versus, you know, adding new procedures or adding a new way to look at things or whatever.

[00:31:38] [SPEAKER_00] I, I, um, when I started my evolution of jaw, uh, TMJ type pain and sleep, I took a bunch of courses through the AACP American Academy of cranial facial pain. Great, great organizations, by the way. Um, anyone who's doing that should be a member because they're the, they're the people kind of speaking out for people who want to do this. But most of the people I was taking the courses with were talking about how they were in roller skates all day. They hated dentistry. They wanted to get out of dentistry. Oh, I just want to do something else. And I'm thinking, God, I, I don't really hate dentistry.

[00:32:07] [SPEAKER_00] I, I really enjoy what I do. I want to offer this facet to me, but I don't want to stop doing crowns or implants. I, I don't want to give that up. And I looked and, and I heard their stories and again, hate mail goes to Bart Schultz, but it seemed that a lot of them were, you know, working for multiple insurance companies and, and running their tails off that way. Um, that would be challenging to see 86 patients a day and, and trying to see multiple patients. I'm definitely not built that way.

[00:32:36] [SPEAKER_00] And if I had to practice dentistry that way, I would, I would definitely look for a different solution. I think you don't have to practice dentistry that way. And that's a scary endeavor. I mean, maybe that's a different podcast.

[00:32:45] [SPEAKER_01] Well, it's interesting too, is that there's a level of profitability too. Like, like, uh, when you run like that, mind you, if it's, if you're running that way, because you take a lot of insurance, that's one thing. But I mean, if you're seeing a ton of patients and you have no downtime because you're seeing a ton of patients, you're, you know, that's, that's a way to make money. There's no two ways about that. It's, it's harder on your body and it's harder on your soul maybe, but it's a, like, I don't, I don't run that way. I have to tell you that there was a time in my career where I did run two chairs all

[00:33:12] [SPEAKER_01] the time and, uh, and, and I always had multiple hygienists and everything like that. And I was taking a lot of drugs to be honest. What's it, what's interesting is I feel like I slowed that down after I got out of treatment and I don't remember if that was like a requirement by my therapist or not, but, but I, I run pretty slow now compared to how I used to. And maybe there's a correlation there. I don't know. It might be something to look at after 20 years.

[00:33:36] [SPEAKER_00] Joy and stomach lining are important and valuable and somewhat irreplaceable. So, I mean, and again, what, what do you need? Do you need the $300,000 wakeboard boat? Maybe. And if it brings you joy, you should, you should have it. Um, but I don't know that society's weird now. Um, it is, it is.

[00:33:55] [SPEAKER_01] And I have to tell you that there is something that there's something about like, I feel, I feel weird that I don't need that much. Like, like on some level, I, in comparison, I make as little at this as anyone, you know, or anyone listening to this. I guarantee you, I'm not throwing numbers out there, but I make my production is tiny in my, but I also, I also don't have debt. Like a lot of people do, whether that student loans at or building giant building debt or whatever.

[00:34:21] [SPEAKER_01] And so I don't need that much because I don't have, I'm not that far in debt and I'm not that, and I kind of like that on some level, but, and that's just been, I've had an aversion to debt from the very beginning. And I think that was, I've told you this before. It's because I, because of the practice that I bought, like I didn't go into big debt for it, but also the practice I bought sort of trained me to not, not expect too much of patience.

[00:34:48] [SPEAKER_01] And so I, it's, I mean, literally it's, I, I, it was a great deal and taught me a bunch of bad habits that continue to, to gall me this day up to this day. But, but I'm like, I do have to say though, you don't like, if you can build a life where you don't need that much, it's kind of great actually. Like I just, I just had a week off cause my assistant took a week off. I'm like, okay, so I'm not going to work. It was, it was not even, I didn't go anywhere. Great. I rode my bike a lot and not much else. You, you recharged your battery though. And that's much, not as much I would have liked.

[00:35:18] [SPEAKER_00] Yeah. Better weather maybe, but still. Well, I mean, there, there's a, what brings you joy? I like to woodwork and I, there was this router mechanism table that I really wanted. I drove to the twin cities and went to this woodworking show and boy, I really wanted this and I didn't buy it. I was like, I don't really need it. And then I drove to Milwaukee, had a family reunion a couple weeks later and the woodworking show was traveling around the country and it was in Milwaukee and I bought it. And I was like, oh yeah. It's like, okay.

[00:35:47] [SPEAKER_00] It's meant to be. Yeah. And no kidding. It sat in my garage on open for like seven months. Yeah. Uh, and, and, and, and maybe there's some things that I think about like, you know, boy, it's the want, it's the want that we really, we really excite us. Yeah. You know, and I try to teach my children that we want everything. And I think your wants, you should pay for with cash and your needs and you only need a little bit.

[00:36:13] [SPEAKER_00] You can borrow and, uh, and maybe, you know, and does, does all the extra things bring you happiness? And if it does great, do it, you know? Um, and, and maybe that curbs some of the things in life. I mean, I, I enjoy dentistry. There's some of the difficult patients and some of the BS of the world and the dynamics that, that frustrate me, but, uh, I don't think I would want to give up dentistry. There are days you and I talk about, let's just buy a coffee shop. Yeah.

[00:36:40] [SPEAKER_00] My assumption on in a coffee shop would be riddled with craziness too.

[00:36:44] [SPEAKER_01] It's probably a bunch of assholes that come in and don't like, you'll make a coffee for them and they'll, uh, they'll complain about it too. I mean, I don't know. I, and I have to say that like, I can talk a pretty good game about patients driving me, but I don't know, man, my patients are relatively normal. My team is relatively normal. I have compared to a lot of what I see in social media and just hear about, I feel like I'm, I'm, I'm blessed. Like I have, I have very little of that kind of thing. It doesn't mean I don't get burnt out on it and all that stuff either, but I definitely

[00:37:13] [SPEAKER_01] feel like I, I have a pretty, uh, a pretty, pretty easy go of it.

[00:37:19] [SPEAKER_00] We remember the worst of the worst. Yeah. Right. We do. We remember the difficult patient that was frustrated about money and, and truthfully, that's not very many people. And so we kind of make our decisions in life of what we should do based on the, the, the, the obscure things that we kind of remember. And that's probably not how we should do things.

[00:37:37] [SPEAKER_01] No, that's right. My dad always says that it's like, you can, you know, you can do a procedure 99 times perfectly. And the one time it goes wrong is the time you're going to remember. And that's exactly right. That's, that's kind of in the, in the one, the one patient that's snarky to you or the, and like, that is, that is very real. That's probably, it's probably human. I mean, like real to the point where I think everyone probably does that.

[00:37:58] [SPEAKER_00] So I bought my daughter a shirt and it says sarcasm is my love language. My daughter is 15 years old and, uh, and, uh, her sarcasm is so witty and so sharp that, uh, you know, I, I love my children dearly. I'd like to murder my son weekly. My daughter don't have that problem, but, but her sarcasm is challenging and, and maybe the people snarkiness isn't their snarky. Maybe it's just their weird witty sense of humor.

[00:38:25] [SPEAKER_00] And, and maybe you and I, I'm uncomfortable because they're mad at me, but maybe they're not. I, so, and maybe we should learn to compartmentalize about things of, you know, things that are out of control. That's hard. Yeah. We care. That's a good thing. That's a good aspect to have in life. Right.

[00:38:42] [SPEAKER_02] Mm-hmm. Mm-hmm.

[00:38:44] [SPEAKER_01] Something you were saying, uh, like the, your, your router, how it was the, the, there was a certain thrill of, of the, of the want. There was a certain thrill of, I mean, like, like you were thinking about it a lot when it was something that you wanted, that it was, there was an anticipation aspect to it. I didn't want it. I needed it at that point. Yeah. I need it. I can't live without it. I'm, I'm notorious for, for having lots of wants and I, I'm much better now about,

[00:39:11] [SPEAKER_01] about not falling into that than I used to be. Man, I used to just, I'd go to, you remember you were there, I'd go to the midwinter and I'd buy stuff. It didn't help that I was, I was kind of messed up.

[00:39:21] [SPEAKER_00] I think you bought, I think you bought a Sam articulator and sold it for like $14.

[00:39:26] [SPEAKER_01] No, that was, I was sober as a judge then. That was, that was long after I, that was long after I, uh, I got clean. I, I, I bought an articulator. I think it might've been at Spear. And now I was, I got it before that I got it before I did Spear. I just didn't use it. And so I sold it. And of course what happens is now I'd like to have a back, you know, now I wish I hadn't sold it, but I wasn't using it.

[00:39:47] [SPEAKER_00] And the Sam articulators, the Sam three is like a, it's like a piece of artwork.

[00:39:51] [SPEAKER_01] Yeah. I mean, they're, they're all, it was really nice. It's really, it's really good. And that's what they use at Spear and all this stuff. But of course I'd sold it. I sold it for, I'm sure I, I'm sure my ass on it. Yeah, exactly. Cause I do that all the time for everything. I, but yeah, the midwinter was the best was when stuff would show up weeks later that I hadn't even remembered I'd ordered, but it was something I had to have while I was there. I was not in a great mindset, but now I'm finding myself that that shelf is not as full as it used to be.

[00:40:17] [SPEAKER_01] And also like when I buy stuff, like the main things that I've bought lately are like, I use like crazy my, the mountain bike, the, you know, that sort of thing. I use it all the time. And so on some level, that's super gratifying that I bought something that could have been, could have been the thing that sat in my garage unused. It could have been that thing and it wasn't. So that was pretty great. Like it wasn't really a gamble. I was riding a lot and everything like that, but, but lo and behold, that is a, there's

[00:40:44] [SPEAKER_01] something like the gratitude for having something that you wanted and that you actually use. That's a big deal. Like what a funny thing to get all excited about. But like, I do use that damn bike all the time. I love it. It's fantastic. And so it was a good buy. It was really expensive and it was totally worth it. And did I want it? Yeah. I never even had that much anticipation for it. I walked into the store, not knowing it was going to be there. And lo and behold, I fricking bought it. It was almost an impulse buy.

[00:41:10] [SPEAKER_00] Difficult today is you probably can't get bikes as easy.

[00:41:12] [SPEAKER_01] Yeah, no, exactly. Exactly. Right now in this particular time during the pandemic with this, all this crazy like supply chain stuff, I was lucky to get a damn bike.

[00:41:23] [SPEAKER_00] So the void in our lives that we look to fill, I mean, and this is maybe in our practice or in our relationship with our spouses and, you know, whatever it is. Is it, is it the consumerism or that I need to do implants? I need to make more because I got to fit in or match up to the Joneses. Yeah. Do I got to buy my kid another new iPhone because I got to match up with the Joneses? I mean. Another horse trailer. Another horse trailer. Right. You know, who doesn't need six horse trailers and 36 horses?

[00:41:52] [SPEAKER_01] Yeah, exactly.

[00:41:53] [SPEAKER_00] You know, so that's, that's maybe the things, what brings us joy and brings us happiness. I never went to Panky. I did lots of Dawson courses and, but the cross of life, you know, good, you know, work, family, God and play. I, I, I kind of think about those things. I'm not perfect. I have a lot of faults. But I, but I try to think about, you know, there's this balance of things we should, we should do and, and I think that fills some of the voids in our, in our life that we're looking for.

[00:42:21] [SPEAKER_00] And yeah, you, I don't think your bike's really expensive because you seem to use it daily.

[00:42:26] [SPEAKER_01] Yeah. No, that's, that's like, honestly, it's one of the only purchases I've ever made like that. You know, that I, that I felt like was a, was a good buy and I'm grateful to have it. I'm grateful to have the time literally to use it when I can like having that week off. Boy, I wrote a lot this week, heard a lot this week.

[00:42:42] [SPEAKER_00] My father passed away this past, this past month and I had done his dentistry, I don't know, 15 years ago, maybe 20 years ago. I did, you know, a bunch of implants, full mouth rehab, crowns, bridges, veneers. And the end of his life, he had some paralysis, a stroke and eating was, was challenging, just swallowing. And I, I felt good about doing his dentistry because had he been left in the condition that

[00:43:09] [SPEAKER_00] patients kind of go to, he would have, he probably would have choked to death a long time ago. Yeah. And, uh, and he enjoyed food. Yeah. Right up to the last. He really did. So the $50,000 of dentistry, if I bring this around $50,000 dentistry that lasts someone's 20 years and they get to enjoy things. It's really not that expensive. No, it's not. If you break it down for a 20, 30 or 40 years, your bike, whatever it is, is, is insignificant. And it's like buying a seasons back to the past of the ski hill. Right. And you go, you use it 46 times.

[00:43:38] [SPEAKER_00] It's not really that much money. No, it's nothing. That's just it.

[00:43:41] [SPEAKER_01] It's the, it's the roll of the dice as to whether or not you use it, but still it's, it's actually really, it's a point well taken. So, I mean, honestly, for someone who wants to take something home with that, try and make the purchase like my bike instead of like your router. And I, sometimes it's hard to know, like, or the Sam articulator, maybe hard to know what kind of purchase it's going to be. But it is funny because honestly, dentists overwhelmingly are really high earners.

[00:44:06] [SPEAKER_01] Like, like, I can't believe I'm saying this, but we just buy expensive stuff, man. Like we, we kind of, a lot of us kind of can, you know, and kind of, a lot of them kind of do. Like, I always love how you, like you, you drive the used, the most used car. I know I kind of do too. But you have what you have a, you went to Arizona to get your car.

[00:44:29] [SPEAKER_00] I had, I bought it in Arizona and I, it was probably a cartel, a cocaine chipper or something. I bought a Denali and had it shipped in from Arizona. But I paid cash. It's got this neat compartment in it. I don't know where that came from. What's all this white powder in the, the, the windows are tinted a hundred percent, but I paid cash, you know, and, uh, and, uh, it's a, it's a, but you also didn't buy it brand new either. I mean, I'd like, actually, I'd like a Tundra.

[00:44:57] [SPEAKER_00] I I've kind of fallen in love with these Tundras, these Toyotas and, uh, but it's easy not to buy one of those. Cause there are none. Yeah. There's no new vehicles.

[00:45:05] [SPEAKER_01] There's no new cars anywhere.

[00:45:07] [SPEAKER_00] Exactly. I mean, I look at cars as a tool. Uh, it's a piece of equipment that, that I use and, you know, I don't fault someone

[00:45:14] [SPEAKER_01] who's a car person. Who's got a really fancy car. I don't really fault that, but, but it's just not my thing.

[00:45:19] [SPEAKER_00] Al and I have a mutual friend who, who cars are his thing and buys lots of new cars. Uh, and that's his, that's his deal. I think it's crazy, but he likes it. So you know what brings the joy? Do it. I've pissed away money on a lot of other stuff too.

[00:45:35] [SPEAKER_01] So there you go. You know, that's sort of the story. Well, I tell you what, Bart, this was good. I think, I think let's leave it go. We'll do this again sometime soon. We got, we got your microphone figured out so we can, we can, uh, we can do this again, but this was good. I didn't know exactly where it was going to go. And I think it went, I went okay.

[00:45:51] [SPEAKER_00] So thanks for being on bar. We'll talk to you soon. Thanks for having me.