Very Dental: Dr. Mike Mansell Becomes a Civilian

[00:00:01] This is a production of the Very Dental Podcast Network. This is the Very Dental Podcast.

[00:00:17] Welcome to the Very Dental Podcast, where you'll find entertaining and relevant conversations with visionaries, clinicians, and your friends in the dental space. Now here's your host, Dr. Alan Mead.

[00:00:29] Very Dental people, welcome to another episode of the Very Dental Podcast. I'm your host, Dr. Alan Mead. Today, my co-host, Dr. Mike Mansell. Mike, how are you doing?

[00:00:38] Doing great. How about you?

[00:00:40] I'm good. So, Mike was on the show a couple years ago. We had taken a course over at Cosminent together, and that's where we got to know each other.

[00:00:47] And I think we went out to eat... Where did we go? Was it... I probably dragged you to someplace Japanese if my memory suits me.

[00:00:56] No, actually, it was a small bar off the...

[00:01:00] Oh, it was. It was like a sports bar or something like that.

[00:01:03] Yeah.

[00:01:03] I remember. I ate something that had a pretzel bun. That's what I remember.

[00:01:08] Yeah.

[00:01:10] So, Mike, at the time, I think you were still teaching in a residency in the military. Is that what you were up to?

[00:01:20] I had just stepped away from it to do a new job for Army's Future Command.

[00:01:26] Okay. Okay.

[00:01:27] So, it was definitely a little bit of a change at that point.

[00:01:31] Okay. So, you were changing then, and then last year, about last year at this time, another change. Tell us a little bit about that, Mike.

[00:01:37] Well, I retired from the Army after 24 years of doing the dental side. I decided it was... Actually, I think the Army more decided it was time for me to move on.

[00:01:51] Yeah. But, yeah, I got out, retired, and it was interesting because the Army was all I ever knew.

[00:01:58] Mm-hmm.

[00:01:59] You know, I went from high school to West Point, to intelligence, to the dental school, and back to the Army. So, I mean, really, the Army is the only reference point I ever had.

[00:02:09] That's right. You were kind of... As a dental student, you were a little bit of a non-traditional student because you had been out and seen some things in the world by the time you got to dental school.

[00:02:18] Yeah. And that was... I think it made dental school easier for me.

[00:02:23] Oh, for sure.

[00:02:25] You know, it was one of those... I had a family, I had my son, and it was very clear to me that I was not going to be the number one A student that a lot of those guys were shooting for.

[00:02:34] It was more like, hey, at the end of the day, we're all at DDS, and I'll have doctor in front of our name. So...

[00:02:40] That's true. But I got to tell you, I've always said this. I've probably said it on the show before, and I truly believe it.

[00:02:47] So, I went to Minnesota, the dental school. I literally didn't know anyone in Minnesota when I went there.

[00:02:51] I left Michigan to go to Minnesota for dental school, showed up, and I met some people. I lived in the Cy Omega house, so I knew a few people.

[00:03:00] But literally, my only... I didn't know anyone outside of the School of Dentistry in Minnesota, like, practically the whole time I was there. I do have one great story.

[00:03:10] So, it turns out a friend of mine who we... I don't think I've ever told this story on the show. He and I, we were in advanced biology in high school together.

[00:03:18] In advanced biology in the Midland Public Schools is two hours a day. And at the time, the teacher was probably the best teacher I've ever had in my entire life through all of...

[00:03:27] Through high school, college, you know, dental school. He was... He's a great man, Dr. Lee... Or Mr. Lee Kosky. He might as well be a doctor.

[00:03:35] But anyhow, he was a great teacher. And so, we had advanced biology two hours a day in high school. And we were... We got to know each other.

[00:03:42] I didn't know him real well. I'm literally walking in Stadium Plaza in Minneapolis, right? It's basically the campus area of...

[00:03:49] It's where all the, you know, just off-campus bars and restaurants were in Minnesota. I look up and I see Greg. I'm pretty sure it's Greg.

[00:03:56] But I, like, did a triple take. I'm like, Greg Trebs? So, by chance, like, literally, right when I started dental school, a buddy of mine from high school

[00:04:05] was going for a graduate degree in biomedical engineering at Minnesota at the same time.

[00:04:12] So, the first two years of dental school, I had one person I knew that was outside of the School of Dentistry.

[00:04:16] And it was Greg. And he literally lived, like, three blocks from the Siomega house.

[00:04:20] And so, our thing was we homebrewed beer a bunch. We would do that a lot.

[00:04:24] And we'd go out after we homebrewed beer to the Vietnamese restaurants at about 1.30 in the morning.

[00:04:30] That was pretty cool. But besides that, I didn't know anyone outside of dental school.

[00:04:34] So, imagine I had no family. I wasn't married. I wasn't dating anyone. I didn't have any kids.

[00:04:37] I didn't have a dog. I didn't have a goldfish. I had nothing.

[00:04:40] But I had no connection outside of dental school. And so, my – it's no wonder I got as psychotic as I did in dental school

[00:04:48] because I just didn't have any frame of reference except the school.

[00:04:52] And, of course, they didn't – I didn't – I got beat up in dental school, man.

[00:04:56] I got – you know, I took everything to heart. They weren't – you know, the instructors, most of them weren't particularly kind.

[00:05:02] They were tough on you. They were sort of breaking you down.

[00:05:03] And I didn't know anything about that. So, I really did not rely well.

[00:05:07] I think having a family, like, man, a wife and kids or a husband and kids or just even being married

[00:05:16] or having someone outside of dental school that can kind of give you a frame outside of the school and dental system

[00:05:23] is a really smart move if you can do it because you had to maintain – you had to do the things that were required of you

[00:05:30] when you have a family, when you have something outside of school.

[00:05:34] I didn't. So, every failing I had in school, I could just sit there and take personally for entire weeks at a time and stuff like that.

[00:05:40] Whereas, you know, your family needed you and they didn't need you just as the dental student.

[00:05:45] So, you feel like having a family was a benefit to you. Is that what I'm hearing?

[00:05:49] Oh, definitely. You know, it keeps everything in perspective when you have that – for some reason, I just remember histology

[00:05:57] and I hated it. And it was the worst class. And I remember – I don't know. I don't think I failed,

[00:06:03] but I got, like, maybe a, you know, probably the worst grade I've ever seen.

[00:06:07] People did poorly in histology. Yeah, right.

[00:06:09] Oh, yes. Yes, I know.

[00:06:11] I remember.

[00:06:12] I came home and, you know, my son comes running up to me and all he wants to do is play.

[00:06:15] And I'm like, you know, I guess that the world doesn't really care that I just did bad on a histology test.

[00:06:21] No, the world doesn't care. You're right. I agree. But it's also like if you don't have something to pull yourself out of that,

[00:06:27] you can sit there and think the world cares about histology a lot.

[00:06:31] I remember histology, we had two – it was a – you know, it was a – I want to say it was like two quarters worth or something.

[00:06:39] So, we had two big exams on it.

[00:06:41] The second exam, a buddy and I would go in. We'd go into the histology lab to study.

[00:06:45] And we came to realize that, of course, histology, you're supposed to be looking in a microscope at what they're pointing at.

[00:06:51] But the reality is you were allowed to take the slide out.

[00:06:54] So, we would look at growth section.

[00:06:57] So, we'd take the slide out and we could look at it. We would identify what it was.

[00:07:00] We did better looking at the glass slides in like a light outside of the microscope than we did when we were looking at what they're pointing in microscopes.

[00:07:09] So, yeah, we sort of missed the point on histology, which was microscopic identification of things.

[00:07:13] It seemed like we did better when we – oh, this is the jejunum.

[00:07:16] I remember that. The jejunum looks like – yeah, I just remember histology being a little outside the box for me because it was survival.

[00:07:23] You were just like, oh, my God, I just need to get through this.

[00:07:26] You know, I remember that vividly.

[00:07:27] And gross was the same way for me too.

[00:07:29] I had people who loved gross anatomy.

[00:07:30] I just got through it. I just got through it.

[00:07:33] See, I liked anatomy because I work out a lot.

[00:07:35] And I kind of – you know, you're like, okay, when I work out, here's the muscles I'm using.

[00:07:43] So, did you have cadavers?

[00:07:45] Oh, yeah.

[00:07:46] Did you have to dissect them or were they dissected for you?

[00:07:49] Nope. Started from scratch.

[00:07:50] Oh, wow. So, you did dissect them. Okay.

[00:07:52] Oh, yeah.

[00:07:53] So, it was –

[00:07:53] I remember.

[00:07:54] My partner was a – I'll never forget.

[00:07:57] She was a young Indian girl and she hated cutting things.

[00:08:01] So, I was – you know, I was the butcher in there, man.

[00:08:04] I just –

[00:08:04] You got to get into it, yeah.

[00:08:05] Oh, yeah.

[00:08:06] So, it was –

[00:08:07] I just remember –

[00:08:07] That was one of my favorites.

[00:08:08] I remember that, first off, our cadaver, God bless her.

[00:08:13] She was a 93-year-old woman and she just died of old age, right?

[00:08:16] So, she didn't have – there wasn't any – like, that was the pathology report.

[00:08:19] She just was – and so, a little old lady, her muscles were so – you know, she just didn't have any muscle tone.

[00:08:27] And so, all the structures we're looking for were tiny.

[00:08:30] Everything was tiny.

[00:08:31] And you give three or four of us who don't know anything about dissection at all a bunch of tools.

[00:08:37] And we're trying to do the best we can.

[00:08:39] And so, what I remember is you'd come back for the exams and they – the anatomists that were giving the exams would find the structures on the other side where we hadn't, like, completely decimated everything.

[00:08:50] So, we – there were a lot of structures in our poor cadaver that only got found for the exam because our technique was not good.

[00:09:00] Had we been doing surgery, they would not have survived.

[00:09:03] Let's just say that.

[00:09:04] Yeah.

[00:09:04] So, actually, I think my instructor said, thank God you're a dentist because I don't know what you would do if you're a surgeon.

[00:09:11] So, that shows you my skills, but it was fun.

[00:09:14] Yeah.

[00:09:14] Yeah.

[00:09:14] I didn't – you know, after about – oh, I don't know.

[00:09:17] After six weeks or so, people started to realize, put the scalpel down because you can only do bad things with the scalpel.

[00:09:23] Yeah.

[00:09:23] Blunt dissection.

[00:09:24] Your patient is already dead.

[00:09:26] So, blunt dissection is okay.

[00:09:27] It's a little slower, less likely to remove anything really important.

[00:09:30] But I don't – I don't look back on that with fondness.

[00:09:34] That was part of the hazing process, too.

[00:09:36] And we were in with medical students, too.

[00:09:38] So, we all felt inadequate about everything.

[00:09:40] You know, the medical students thought they were the coolest – that was a hot mess.

[00:09:43] Actually, at one point, the dental students were the top 25 people in anatomy versus the medical side was so upset about that.

[00:09:53] Oh, I bet they were.

[00:09:54] I bet they were.

[00:09:55] I mean, that would be a verdict.

[00:09:56] Yeah.

[00:09:57] But you're saying about stories, you know, I went to dental school a little bit later, and I realized I was old when one of the students from one of the upper class came to me and was like, did you play hockey?

[00:10:08] I said, yeah, I did.

[00:10:10] He goes, I remember going to watch you when I was little.

[00:10:13] I was like, oh, my God.

[00:10:15] Oh, my God.

[00:10:16] That is rough.

[00:10:18] That's rough.

[00:10:19] That hit me right in the heart.

[00:10:20] I was like, okay.

[00:10:21] So, I was kind of the father of the class everyone would, you know.

[00:10:26] Okay.

[00:10:26] So, we have a good friend of mine.

[00:10:29] His name is Dr. Jim Nickman.

[00:10:30] He's a pediatric dentist, and he's kind of a – in Minnesota, he's sort of a big deal in, like, the pediatric dentist associations and stuff.

[00:10:37] Great guy.

[00:10:38] He was older than us, but he had been – like, he'd worked for – I want to say he worked for Texas Instruments for 10 years or so.

[00:10:43] He had a wife and a daughter at the time and all that.

[00:10:46] And I sort of think to myself, he probably came out – his mental health probably came out a little bit better than the rest of ours because he had that – I don't know.

[00:10:53] I think being a little older – those people seem to keep it together a little better than the rest of us did.

[00:10:58] Yeah.

[00:10:59] It was just really – the hardest thing was just getting back to the studying, remembering how to study.

[00:11:04] Yeah.

[00:11:04] That was the part, but –

[00:11:05] That's real, too.

[00:11:06] That's real because if you had – if I had to study right now, the way that I technically had to study back then, I don't know how well I would do.

[00:11:12] Oh, yeah.

[00:11:14] No.

[00:11:15] I mean, social media and just the internet in general has killed my – any kind of, like – I have no – I'm trying to think of the word.

[00:11:25] What's the word I'm looking for?

[00:11:25] I have no concentration.

[00:11:27] I don't have – I can't stay on topic.

[00:11:30] I can't read – I can barely read a book.

[00:11:33] I can't even watch, like, a TV show without going away from it.

[00:11:36] I have the attention span of a flea.

[00:11:39] So, it's – so, I don't know how well I would do in school.

[00:11:42] I would need it to be sent to me in 30-second videos, like TikTok.

[00:11:46] Oh, yeah.

[00:11:46] I think that's what I'd mean.

[00:11:48] Well, the funny thing was I went through right when Google was – I don't – maybe it was there a long time before me, but it seems like that was when everyone started using it.

[00:11:56] Okay.

[00:11:56] So, I'm in the books, and everyone's like, oh, this is this, this.

[00:12:00] I'm like, how the hell are you that far in the book?

[00:12:02] Yeah.

[00:12:03] And they're like, oh, you just do this, and they go type it in online, and I'm like, huh, how about that?

[00:12:08] Yeah.

[00:12:09] So –

[00:12:10] I've been playing around with AI stuff lately, like a lot of – and I'm going to tell you what.

[00:12:15] I don't – I think the way that learning is going to happen is forever changed, because I said this a couple episodes ago.

[00:12:21] I'm convinced that, you know, you can sign a pledge saying that you won't use AI for creative blah, blah, blah, but they're never going to be able to tell.

[00:12:29] Yeah.

[00:12:29] How they'll be able to tell is that this person is writing way too well.

[00:12:33] Well, AI writes just so much better than regular students do.

[00:12:36] You're going to have to write more poorly than your cheated AI answer will allow for.

[00:12:40] It's crazy.

[00:12:41] Well, the funny thing about AI is, like my daughter, she's in college right now, and she's trying to go to dental school.

[00:12:47] And I was watching her write a paper – actually, it was last night.

[00:12:52] And she's talking to the computer, and I'm like, what are you doing, dictating?

[00:12:56] She's like, no, I'm doing it with AI.

[00:12:58] I'm like, what do you mean?

[00:12:59] She's like, see, we talk to each other, and it kind of gives me an outline, and then I write my paper.

[00:13:06] And I'm like –

[00:13:06] That's wild.

[00:13:07] What is going on in life here?

[00:13:09] Yeah.

[00:13:10] Yeah.

[00:13:11] I've helped my kids with some stuff using it.

[00:13:16] Like at one point, oh, for an astronomy class, we had to do like – we had to argue two different sides on a debate.

[00:13:24] And I mean, I kind of knew – I kind of knew – Sean and I worked on it a bit, but we fed what we had into Gemini, Google Gemini.

[00:13:35] Google Gemini came away with way too good.

[00:13:38] Like we could never do a debate there.

[00:13:39] They were like way better than he and I ever would come up with on our own.

[00:13:42] So it's a little scary.

[00:13:44] I don't think it raises the level of actual intellectual development.

[00:13:48] I think it raises the level of how well you can cheat, basically.

[00:13:52] I think that's –

[00:13:52] Yeah.

[00:13:52] More or less, I think.

[00:13:55] I don't know.

[00:13:56] So I do have some questions, though.

[00:13:57] So you finished up last year, December.

[00:14:00] What did you do from – I mean, after leaving the Army?

[00:14:06] Like you finished up – what was your last like thing in the Army?

[00:14:09] And then what did you transition to?

[00:14:12] So probably the last year, I was down at Futures Command for three years.

[00:14:17] So I was kind of away from dentistry a little bit.

[00:14:19] Okay.

[00:14:20] So the last year, I came back and just was doing dentistry and got two of the docs underneath me at the clinic.

[00:14:29] And kind of – they had just gotten out of dental school.

[00:14:31] So it was a great kind of a mentoring thing.

[00:14:33] They would ask me questions.

[00:14:34] Kind of made me think a little bit more than I was used to thinking since being the residency director.

[00:14:40] So it was good.

[00:14:40] Yeah, yeah.

[00:14:41] And really just got back in the swing of things and then retired and went into a practice with a guy that I had been moonlighting with for, gosh, 12 years.

[00:14:51] I see.

[00:14:53] Just doing the associate thing.

[00:14:55] And then did that for the last year and then just actually switched to a practice that is probably two seconds from my house.

[00:15:04] Okay.

[00:15:05] Okay.

[00:15:05] So even closer.

[00:15:06] There you go.

[00:15:06] Nice.

[00:15:06] Yeah.

[00:15:07] So, yeah, it's been really just a learning process for me going from that military structure to the civilian structure and seeing how different the mentality of approaching dentistry is between the military side versus the civilian side and the insurance and all the other stuff.

[00:15:29] Okay.

[00:15:29] Dig into that a little bit.

[00:15:30] How are the patients different?

[00:15:32] Like how do you – are there different patient interactions or not really?

[00:15:35] I figure in the military they don't miss appointments very often.

[00:15:38] I'm guessing – I'm guessing – I could be wrong about that.

[00:15:42] The difference with the military – there's – okay.

[00:15:45] So there's two main differences.

[00:15:46] You don't have to worry about treatment plans in the Army.

[00:15:48] Okay.

[00:15:49] So you don't have to sell them like, you know, A, you need A, B, C, and D.

[00:15:53] You know, it's going to cost this.

[00:15:55] You're going to out-of-pocket this.

[00:15:56] No.

[00:15:56] It's just you need A, B, C, and D, and you're going to come in next Tuesday, Thursday, and the following Wednesday.

[00:16:01] Oh, my God.

[00:16:02] That's a dream come true.

[00:16:04] Oh, it was.

[00:16:04] And you get spoiled.

[00:16:06] I mean, you get so spoiled.

[00:16:08] And so the interactions were very – I don't want to say directed, but, you know, they – toward the end of my time there, I started seeing a whole bunch of higher-ranking people who realized the advantage of getting military dentistry.

[00:16:24] You know, getting it for free.

[00:16:26] You know, some of these young guys come in, and they don't understand that, wait a minute, I can get orthodontics.

[00:16:31] I can get anything I want for free until, you know, they're getting out, and then they realize, wait a minute, I should have done all this in the Army.

[00:16:37] Yeah.

[00:16:38] So very different mentality versus the outside, where it's more of a, how much is this going to cost me?

[00:16:46] What's my out-of-pocket?

[00:16:47] Do you take my insurance?

[00:16:49] Yeah.

[00:16:49] And, God, I didn't realize how many insurances were out there, which is really – you know, that's one of my biggest issues right now.

[00:16:57] But, yeah, it's just a different patient interaction because animals feel like there's a higher level of trust in the Army and the armed forces as to what you're doing for them.

[00:17:08] It's kind of a strange thing to think because I know just on the outside now people are like, oh, you're a military dentist.

[00:17:14] How was that?

[00:17:15] You know, thinking, boy, you were doing some bad work because a lot of these people are.

[00:17:19] That's the thing.

[00:17:20] That was, oh, God, I just throw that amalgam in there and patch him up and get him ready for battle.

[00:17:25] I'm like, no, that's not how I understand it.

[00:17:27] That's not how we're telling –

[00:17:29] And the funny part about it is I'm in a retirement community primarily because I'm still near Fort – they call it Fort Cabazos now, but Fort.

[00:17:36] So, you know, all these guys would come in, like the older Vietnam-era guys, and they'd be like, oh, you're just going to take all my teeth out like they did when I went to Vietnam.

[00:17:44] And I'm like –

[00:17:45] Yeah, yeah, yeah.

[00:17:46] No, we're in a little bit different era of dentistry at this point.

[00:17:49] Yeah.

[00:17:50] But it's awesome.

[00:17:52] Getting those retirees and those vets, oh, it's just –

[00:17:56] It's just such a fun opportunity to talk to them and get their experiences.

[00:18:01] Yeah, yeah.

[00:18:02] You know, I'm at that transition time.

[00:18:04] I was a non – like we were pre-9-11 to post-9-11.

[00:18:09] So really the only war people that we knew are the Vietnam people.

[00:18:13] And then now you've got all the post-9-11 people.

[00:18:15] And just to hear the stories and just to be – you know, they're the greatest patients.

[00:18:19] They were being able to take care of them.

[00:18:23] You know, sometimes like I had a World War II vet over the course of time.

[00:18:28] And, you know, he was just the greatest guy.

[00:18:31] He would come in and talk to me for an hour and then I'd tell him, yeah, we actually have to do something on your mouth today.

[00:18:37] And, you know, his wife would be there saying, you know, be quiet.

[00:18:40] He's got to work on you.

[00:18:41] But, you know, and at the end, you know, you do like a two-surface composite.

[00:18:46] And he's like, you know, I'm going to pay you out of pocket for this.

[00:18:49] So here's – you know, he's trying to give you – I'm like, listen, for what you did for our country, don't even worry about it.

[00:18:54] You know, just being able to do that for them has been such a blessing in my life.

[00:18:58] But, yeah, it's just such a – it's a different world.

[00:19:02] I don't think people on the outside understand what good dentistry they're doing in the services right now.

[00:19:08] And it's really cutting edge.

[00:19:11] I mean, they got anything digital, you name it.

[00:19:14] So –

[00:19:14] Well, you were – yeah, that's the thing.

[00:19:16] Like when we were – when we talked when we were at Cosmic, you were like doing all kinds of digital stuff.

[00:19:20] Like everything – like everyone had – you had access to all the highest of high-end stuff, you know.

[00:19:27] And that's interesting.

[00:19:29] I think a lot of people that – I think a lot of people would think the opposite.

[00:19:33] Oh, they're just making do with what they can.

[00:19:34] I'm like, no, that's not really how it works.

[00:19:36] The other thing is they forget that a lot of the research done on materials and all that stuff is a military base.

[00:19:42] You know, they do that stuff.

[00:19:43] That's like – that's kind of where a lot of it comes from.

[00:19:45] Yeah, in fact, the Air Force has one of the best research programs out there down at Lackland.

[00:19:52] And yeah, all the residencies.

[00:19:54] I mean, gosh, we got about nine residencies doing research.

[00:19:58] Yeah.

[00:19:58] It's all good.

[00:19:59] I mean, it's high-quality stuff.

[00:20:01] One of the endodontists that I refer to did residency in the Navy.

[00:20:04] Oh, really?

[00:20:04] So he's got – I got no complaints there.

[00:20:06] He knows what he's talking about there too.

[00:20:07] Yeah, I mean, military endodontists are probably the best because, gosh, he knows they get enough opportunities.

[00:20:13] Yeah, they do.

[00:20:14] Yeah, they do.

[00:20:15] Yeah.

[00:20:16] You know, they don't – they are probably the best because it's, you know, on the outside, you know.

[00:20:20] You refer to the endodontist and the person comes back the next day and they're like, well, that guy's really expensive.

[00:20:25] Yeah.

[00:20:26] So you end up doing an endo that you're like, oh, this is not working out real well.

[00:20:30] Yeah.

[00:20:30] But –

[00:20:30] Yeah.

[00:20:31] So, yeah, our specialties are top-notch.

[00:20:34] And, you know, I was in charge of the digital dentistry, getting it transitioned into the Army and the Air Force, you know, tri-services.

[00:20:40] And, you know, we were actually probably ahead of the game a little bit in terms of networking and some of the stuff you're seeing with, like, Serona and this stuff.

[00:20:49] I mean, I hate to say this.

[00:20:51] So a lot of the ideas and a lot of the stuff that they manufactured and designed is actually aided by the military telling them, hey, you know, we can't do this the way you do it on the outside.

[00:21:02] We need it A, B, C, and D.

[00:21:04] And next thing you know, their next product coming out is designed exactly like that.

[00:21:09] That doesn't surprise me, though, because the military stuff, my understanding is that they cut through a lot of the BS.

[00:21:17] Yeah.

[00:21:18] It's got to work and it's got to be repeatable.

[00:21:21] It's got to be teachable to the people you're working with, stuff like that.

[00:21:24] So that does – actually, that makes a lot of sense, to tell you the truth.

[00:21:27] That's kind of cool.

[00:21:27] Yeah, and a lot of, like – so, for example, the PrimeScan, I don't know if you remember back to a few years ago with the VA when they went through the big infection control issues.

[00:21:36] Sure.

[00:21:36] And we had to be able to wipe down every piece of whatever we used.

[00:21:40] Well, you know, we couldn't use a keyboard.

[00:21:43] So, you know, we told the Serona engineers, we're like, we need to have everything wipeable.

[00:21:47] Then, you know, PrimeScan comes out six months later and everything's wipeable.

[00:21:51] I found out that it was due to the government saying we couldn't do this.

[00:21:55] And they actually listened to us and that's how PrimeScan came around.

[00:21:59] Well, military buys a lot of CERECs.

[00:22:00] Let's just say that.

[00:22:01] Yes, we do.

[00:22:02] Yes, we do.

[00:22:03] But, you know, it was always funny because when we were doing it, everyone was like, oh, you're a Serona guy, you're this and that.

[00:22:08] And I said, no, I'm just looking for the best thing out there.

[00:22:11] And we needed support.

[00:22:13] You know, you think about it.

[00:22:14] The Army's a 24-7.

[00:22:15] When you look at – we're around the world.

[00:22:17] We're in the desert.

[00:22:18] We're in, you know, the Orient, all that stuff.

[00:22:22] And, you know, when we need something, we've got to be able to call somebody and do it.

[00:22:25] And Serona was big enough to handle that.

[00:22:28] And people on the outside, I guess they don't understand the extent to which customer support comes into things when they're buying stuff.

[00:22:38] People buy stuff and they're like, oh, it's terrible.

[00:22:40] I can't get hold of anybody.

[00:22:41] I can't do this and that.

[00:22:42] And I'm like, well, now you know why I went with this company.

[00:22:46] Yeah, yeah.

[00:22:47] So that's been good for me.

[00:22:48] It really taught me some of that.

[00:22:49] Just pretty good away from that.

[00:22:51] Did the fact that you could do indirect restorations chair side, so in other words, you could skip the temporary phase like with the actual CEREC.

[00:22:58] Was that a big mover in the military?

[00:23:00] In other words, like cutting out an appointment or not necessarily?

[00:23:03] Oh, yeah.

[00:23:05] Well, readiness.

[00:23:06] It's all readiness.

[00:23:07] Exactly.

[00:23:08] Soldiers got to be able to go.

[00:23:10] Well, you know.

[00:23:11] You've got a busted tooth.

[00:23:12] You've got a busted tooth and you can actually put a crown on it or an onlay on it the same day versus a big giant amalgam, you know, cusp replacement amalgam and stuff.

[00:23:22] Or prep it and have them come back in two weeks after the crown's done or whatever.

[00:23:27] Like, yeah, it makes a lot of sense.

[00:23:29] I mean, if you've got a readiness mindset, that does make a ton of sense.

[00:23:33] I suspect the CEREC probably has advanced the way that it has partly because the military was in early and deep.

[00:23:40] Oh, yeah.

[00:23:42] And honestly, I hate to say this.

[00:23:44] It almost made me a worse dentist.

[00:23:46] I mean, I got so into doing posterior composites off scans and mills that when I got out, I remember I didn't have a mill at my office and I had to do a posterior composite.

[00:23:57] I'm looking at this thing and I'm like, oh, my gosh, I don't even remember how to do these things.

[00:24:01] How do we do this again?

[00:24:03] I mean, and a lot of what people are paying really good money for is learn how to mill and print posterior composites from a scan.

[00:24:12] I mean, that's like the big mover.

[00:24:13] Like, I'm literally seeing ads for certain places saying, you'll never have to do a direct composite again and all this because they're essentially printing composites or whatever.

[00:24:21] I think that's hilarious.

[00:24:22] I mean, I like posterior composites, but I understand if that's not how you're doing them, it's a weird thing.

[00:24:27] Oh, it is.

[00:24:28] You can be a little bit more certain of the shape and strength of your contact when you're milling or printing that way, too.

[00:24:36] Oh, yeah.

[00:24:36] It gives you a lot of control.

[00:24:38] And, you know, I've obviously, I mean, I don't think I'm the greatest dentist in the world, but I'm doing pretty good posterior composites now.

[00:24:44] But I keep thinking to myself, gosh, we're light curing this thing for, you know, depending on what you're using, you know, 10 to 20 seconds, how many increments are you doing?

[00:24:52] And I'm like, you're telling me that there's no voids in there.

[00:24:55] There's no, you know, on, you know, uncured resin at some point.

[00:25:00] And, you know, the printed and the milled stuff.

[00:25:04] Yeah, there is no, you know, it is what it is.

[00:25:07] Yeah, you're processing it on the desktop instead of processing it in the mouth.

[00:25:11] I mean, there's what posterior composites are.

[00:25:13] I mean, there's a lot of places you can introduce errors.

[00:25:16] There's no doubt about that.

[00:25:17] It's not to say that they don't work, but there's probably more places to introduce errors for sure.

[00:25:22] It's interesting.

[00:25:24] And then the kicker to it is there's so many materials out there that, you know, you can, you know, you're like, well, this guy, you know, this young lady doesn't bite his heart.

[00:25:32] I can go to this material or this guy's, you know, from the island of Samoa and has a head three times bigger than mine.

[00:25:37] I'm going to, you know, do zirconia.

[00:25:39] I think we'll do zirconia on him.

[00:25:41] Yeah.

[00:25:42] So, you know, and that was great about the military is we had all that.

[00:25:45] And, you know, on the outside, I'm learning, well, you got to kind of stay focused on what your materials are because you're paying for it now.

[00:25:53] You're paying for that.

[00:25:54] Yeah.

[00:25:54] You're paying to make sure you've got it.

[00:25:55] That's exactly right.

[00:25:56] But interesting.

[00:25:57] The other thing about the military is there's actually a diversity of patients too.

[00:26:00] Like you, you, you do see the guy from Samoa.

[00:26:04] You do see, you know, the, the kid from the upper peninsula of Michigan.

[00:26:07] You do see the kid from, you know, downtown Boston.

[00:26:11] You see all that stuff.

[00:26:12] And so you get a lot of, I mean, that's, that's interesting.

[00:26:15] I, I pride myself on the fact that my practice in Saginaw is probably, probably more diverse than most anyone listening to this, this podcast.

[00:26:23] You don't think of central Michigan as particularly diverse, but my practice really is.

[00:26:26] I love that.

[00:26:27] But I will say that I probably can't hold a candle to the military.

[00:26:31] I mean, you got to figure, you got, you got a little everything in the military.

[00:26:33] Oh yeah.

[00:26:34] I mean, you know, it's so funny that you say that because it was always the, you had such a diverse level of care among the patients that it was like, you get the ones that were like, you know, you'd think they'd be in Beverly Hills getting, you know, porcelain veneers that were white.

[00:26:50] And everything's got to be perfect to the guy who comes in with nubs and brown.

[00:26:54] And you're like, you do this wonderful full mouth rehab on him.

[00:26:58] He looks a million bucks and it's like, Hey, what do you think?

[00:27:00] And he's like, eh, that's good.

[00:27:02] Yeah, that's fine.

[00:27:03] I got stuff to do.

[00:27:04] It's like, sit back down.

[00:27:05] I'm cutting all those out and putting those.

[00:27:06] That's right.

[00:27:08] Refunding your misery.

[00:27:09] You jerk.

[00:27:10] Yeah.

[00:27:11] So it's, um, but yeah, the, I mean, gosh, you know, you're doing dentures, you're doing, you're just doing everything and you can pick and choose what you want to do.

[00:27:18] And it's just such a, I mean, I think for any young dentist, I would always tell them go to the military because they, they'll pay for your dental school.

[00:27:26] You know, I had that coming out of dental school and, um, just the, the experience you gain and the people that you're around, you know, it's just a huge group practice.

[00:27:36] So, you know, if I would have gone out and started a practice on my own, I got, you know, I wouldn't have known anything.

[00:27:43] I would have been dangerous.

[00:27:44] So, uh, I get that.

[00:27:46] So what's interesting is, is that are, are the slots that, that, that are available for that military scholarship where they'll, where they'll pay for everything?

[00:27:56] Are those slots getting harder?

[00:27:58] I mean, it's harder to get those slots now.

[00:28:01] There's not as many of them, I'm guessing.

[00:28:02] And I think the other thing is now that cost is so like, I don't think many people that I went to dental school with thought much about the cost.

[00:28:09] They showed up at the loan office every quarter, like I did and signed on the dotted line.

[00:28:13] But, you know, they had an operative quiz.

[00:28:15] They had, they had histology.

[00:28:17] They were like, they weren't thinking about it.

[00:28:19] And which is, which is reckless, but it was $18,000 a year when I was in dental school.

[00:28:25] Now it's a hundred thousand dollars a year or more.

[00:28:28] And, and so my question is, you know, now I feel like the pressure to get into those spots with military pays for your dental school.

[00:28:35] It's gotta be, it's gotta be more, more competitive.

[00:28:39] I think, is that, is that your understanding?

[00:28:41] Yeah.

[00:28:41] I think they're maxing out their, um, every year now they're, they're hitting their max, which, you know, when I went in, it wasn't that way.

[00:28:48] Interesting.

[00:28:49] Interesting.

[00:28:58] I have a very hard problem with that, but, um, and then I think they are, some people are realizing, you know, military is a great way to go.

[00:29:06] And the, a lot of the schools, the teachers are former military.

[00:29:11] Yeah.

[00:29:11] So, you know, they'll, they're more willing to talk to the kids about it.

[00:29:15] And, um, yeah, I always tell, you know, people look at it.

[00:29:19] If it's not you, it's not you, but don't not look at it.

[00:29:22] Yeah.

[00:29:23] Don't discount it.

[00:29:24] And, um, yeah, we, we would, the spots are getting a lot more competitive.

[00:29:29] Yeah.

[00:29:29] It has to be.

[00:29:30] Yeah.

[00:29:31] I mean, I'm going to put this out there.

[00:29:32] The fact of the matter is there's like, there's like this, there's like several things pointing dentistry in this weird spot.

[00:29:39] And I'm, I don't, I don't care if people are upset that I talk about it because it, because it really makes me worry about the profession a little bit.

[00:29:46] First off, how much it costs to go to dental school.

[00:29:48] If you like, there is no way in a million years, I would recommend anyone look at dental school without going to the military.

[00:29:55] I mean, there's you, it is not worth, I don't care how good the school, first off, all the schools like to brag about how good they are.

[00:30:02] Dude, you're a dental school.

[00:30:03] You have, you can't teach enough to make someone worthwhile in dental school.

[00:30:07] They're going to learn everything they know after they get out.

[00:30:10] And they, you know, they, they, they learn some hard knocks in real life.

[00:30:13] The reality is if that were me, I'd rather learn it in the military where they could, where they can support me and help me.

[00:30:20] And, you know, the reality is you just don't, I laugh because I thought the university of Minnesota, we had just a pathetic clinical.

[00:30:28] We had so little clinical experience compared to what like my dad had had and stuff like that in 1968 or whatever.

[00:30:34] And honestly, we're killing it compared to what they're coming out with now.

[00:30:38] And they're, they're paying, you know, five times as much as I did or more.

[00:30:41] I mean, probably a lot more in some cases for way less clinical experience, way less.

[00:30:46] And, you know, that's wrong.

[00:30:47] That's just wrong.

[00:30:48] I mean, their inflation has been everywhere, but, but, but nothing's gone up in cost the way that school has.

[00:30:54] I mean, in dental school, professional schools in particular.

[00:30:57] So that's a mess.

[00:30:58] That's, that's just wrong.

[00:30:59] So, yeah.

[00:30:59] And I actually, I've been doing some teaching for Serona at some of the universities when they, when they buy new equipment.

[00:31:06] And I went to one of the schools and I started, you know, asking some of the professors, what does the tuition get you?

[00:31:13] Yeah.

[00:31:14] Now, a few of them chuckled.

[00:31:15] They're like, not a whole lot.

[00:31:17] Yeah.

[00:31:17] And I started doing that.

[00:31:18] I'm like, so wait a minute.

[00:31:19] So you're telling me that let's just say off the top, I have $40,000.

[00:31:23] You know, what, what do I walk away with?

[00:31:26] And they're like, well, you walk away with the ability to probably do single tooth dentistry.

[00:31:30] Yeah.

[00:31:30] I said, that's interesting.

[00:31:32] We started talking about, so let's just say, cause I'm, you know, looking at, I feel like knowing what I know about dental school right now.

[00:31:39] Cause I have some friends going through it.

[00:31:41] They, um, they're still teaching amalgams, you know, they're still teaching all that stuff.

[00:31:45] And I'm thinking if I'm a private practice guy and I'm trying to stay up with what's going on, I need a young person coming out that at least understand some digital dentistry.

[00:31:55] Yeah.

[00:31:56] And do all this.

[00:31:57] And the, they were saying, no, that's too expensive.

[00:32:00] And we started going through some stuff.

[00:32:01] And I said, you know, if you, if you take that $40,000 and you get rid of some of the garbage that you're teaching these guys, you could reduce the tuition and add that money back in by every kid leaves with a scanner at the end.

[00:32:13] Cause scanner prices are coming down.

[00:32:15] I mean, yeah, give them a medit scanner.

[00:32:17] And this is how you're going to teach the kids.

[00:32:19] You're going to scan their stuff.

[00:32:20] They're going to send it to you.

[00:32:21] You know, there's so many different ways you can do it now.

[00:32:24] And, you know, these guys, some were in their seventies and early eighties and they were like, yeah, that ain't going to happen.

[00:32:59] Yeah.

[00:33:00] But the kids still don't really use it.

[00:33:02] I don't know.

[00:33:03] I don't know how that works.

[00:33:04] I haven't really checked.

[00:33:05] So, but I mean, the cost is insane.

[00:33:06] The literally the, the, the, the amount of debt they come out with kind of hobbles them on some level, unless you're in the military.

[00:33:15] So the idea of a kid coming out and, and who just graduated from dental school going in and buying a practice is really, I mean, I know that banks will loan to young dentists because they're a good bet.

[00:33:28] Except at some point, you know, at what point do you not want to come out of dental school, buy a practice and be in, in the hole a million and a half dollars.

[00:33:34] At some point your entire life is like, well, this is just, this is just the debt that I'm going to carry for the rest of my life.

[00:33:40] This is how life's going to be.

[00:33:41] I'm going to have this giant debt that I'm working on paying down.

[00:33:44] That's just how life is.

[00:33:45] That's just wrong.

[00:33:45] It's not right.

[00:33:47] And then what they offer up instead, the DSOs are looking to, to bring these kids in and chew them up and spit them out.

[00:33:54] You know, it's like, and I'm not, I can't say everything about all DSOs.

[00:33:58] It's not fair because there's a lot of different kinds of DSOs.

[00:34:01] Let's be honest.

[00:34:03] Even when I got out of dental school, there were, there were, they called them group practices back then.

[00:34:07] They were not called DSOs back then, group practices.

[00:34:09] And they're like, like in Minnesota, Minneapolis, there's a, there are several park dental and metro dental.

[00:34:13] They have all kinds of branches, huge groups, you know, and, and you could learn a lot of stuff there, but boy, oh boy, they were, they, they ground you into dust.

[00:34:22] And I don't know how, I don't know how much advanced dentistry you were doing versus just, just cranking it out.

[00:34:27] I don't know.

[00:34:28] I'm not sure.

[00:34:28] But so the options for a new dentist to have a lifestyle and a life aren't great.

[00:34:35] And you're in debt like crazy.

[00:34:37] I mean, and this is you and I who are mid to late career dentists bitching about this.

[00:34:41] We kind of dodged that bullet, but you actually saw some younger dentists coming in from dental school and saw what kind, what, what they knew because you were working on actually educating them.

[00:34:51] Tell me about your background.

[00:34:52] Tell me about that.

[00:34:54] Well, I was a residency assistant director, director for 12 years.

[00:34:58] And, um, it was very interesting because we would get those right out of dental school.

[00:35:05] We'd get a few that have been in the army to, you know, two or three years.

[00:35:08] And then we'd get some guys who were older.

[00:35:10] I mean, I'm talking, you know, had a practice for 10, 12, 15 years, decided to come in the military for numerous reasons.

[00:35:19] Yeah.

[00:35:19] So I saw that.

[00:35:20] So they had, so they had actually practiced outside of the military.

[00:35:23] Yeah.

[00:35:23] And, um, it was always interesting to see the dental school kids always knew enough to be dangerous, but at least they knew, you know, I don't know what I don't know.

[00:35:33] So the two to three year guys came in and their skills were better because obviously they had that experience and, and we're doing it, but their, their knowledge level of why they were doing things wasn't there.

[00:35:44] Yeah.

[00:35:44] Then older guys, those were the ones that were tough because they were the, I've done thousands of crowns like this and, you know, blah, blah, blah, blah, blah.

[00:35:51] And I'm like, well, you know, that's great.

[00:35:53] They're still, you're doing it wrong.

[00:35:56] Yeah.

[00:35:57] And they didn't want to hear it.

[00:35:58] And that was always the, the challenge of the older guy was, you know, they got in their ways and they were set.

[00:36:05] And it was such a wide range, but the kids coming out of dental school, it really depended on the dental school they came out of because, you know, some of the bigger name dental schools have trouble getting patients because of where they're at.

[00:36:18] And, you know, some of the, I don't want to say like university of Buffalo where I went, we had a great patient pool.

[00:36:24] It was, it was never had a problem with it.

[00:36:26] But then I hear some of the places that some of these other guys were coming from, you know, they were, you know, I did one crown.

[00:36:32] The rest I did on a type of that.

[00:36:34] Yeah.

[00:36:34] You're like, huh?

[00:36:35] Okay.

[00:36:36] You gotta be kidding me.

[00:36:36] Yeah.

[00:36:37] Yeah.

[00:36:37] And then, you know.

[00:36:38] How many times have you given anesthesia?

[00:36:40] Oh, I know.

[00:36:41] It's like, oh my God, that's, it's like scary.

[00:36:44] Like, that is a skill set.

[00:36:45] I mean, I can, I remember the first time I gave anesthesia on a patient, it was scary and horrifying and everything like that.

[00:36:50] But I mean, like I did it a lot of times after that.

[00:36:52] Yeah.

[00:36:53] I still, I still, I still was not, you know, even when I graduated from dental school, anesthesia was a challenge.

[00:36:57] I mean, it's, you know, I still go through streaks where I miss blocks, not as often as I used to, but you know what I'm saying?

[00:37:03] Like, like the reality is it's all.

[00:37:04] So, I mean, my dad graduated from University of Detroit in 1968, mind you.

[00:37:11] And I'm going to tell you what, they saw some freaking patients, man.

[00:37:14] They saw patients and they did, you know, they, they did.

[00:37:17] And I don't think the patients paid much or anything at all to be seen there.

[00:37:21] I remember in Minnesota, like we were, we had to work out their, their payment plans and stuff as a student.

[00:37:25] I'm like, come on, I don't even know how to do dentistry.

[00:37:28] Why are you, why are you showing me this stuff?

[00:37:29] So you'd spend that much time in treatment planning, trying to make sure that they knew what they had to pay.

[00:37:33] And you're just like, really?

[00:37:34] These people are willing to come and sacrifice three hours per appointment with me.

[00:37:38] And we're going to sit here and we're going to spend more time working out their payment plan than we are me working on them.

[00:37:42] Give me a break.

[00:37:43] Yeah.

[00:37:43] And that, that's been a, that was an eye opener for me doing some of the teachings at colleges was, you know, I asked him, I said, so, you know, you're building this new clinic.

[00:37:52] You know, is it your patient population?

[00:37:54] They said, no, the Dean thinks that we'll make more money if we have more chairs.

[00:37:57] Ah, and I'm like, wait a minute, but that, that, that doesn't make a lot of sense if you can't put a butt in the chair.

[00:38:04] Yeah.

[00:38:04] Yeah.

[00:38:05] It doesn't make sense.

[00:38:06] But yeah, learning anesthesia was one of the more interesting things in the residency.

[00:38:10] Cause like, you know, like you said, the kids coming out of dental school, I remember having to hold someone's hand cause it was shaking so much.

[00:38:17] That's how little they had done.

[00:38:19] Yeah.

[00:38:20] I'm sitting there and the patient's staring at me and I'm like, okay, I gotta, I gotta remain calm, but I'm sweating.

[00:38:26] Yeah.

[00:38:26] Yeah.

[00:38:27] So it was, it was interesting, but you know, it was always at the end, at the end of the two years that I had them.

[00:38:32] Um, honestly, I, I, there was probably out of the 12 years I was there and usually some, some are six to eight graduates a year, maybe two of them.

[00:38:43] Or, you know, I was kind of like, boy, I really don't know if they're at the level they should be.

[00:38:48] So that's a pretty good ratio.

[00:38:49] That's a really good ratio.

[00:38:51] Yeah.

[00:38:51] Yeah.

[00:38:51] And, uh, you know, a lot of them actually went on to do, uh, you know, become residency directors and, and do other things in leadership roles.

[00:38:59] So it was really rewarding for me to see, you know, that, that lineage go on.

[00:39:04] And, um, and you know, one of them, Richard, Richard Lowe has been on your podcast a few times.

[00:39:08] Great, great guy, great dentist.

[00:39:10] And, you know, they get out and they're, you know, they're, I don't want to say experts, but they're so far ahead.

[00:39:15] They're raring to go.

[00:39:16] Yeah.

[00:39:17] Yeah.

[00:39:17] And there's other guys in the military that, you know, I'm like, boy, if you got out, you could just do a consulting business for what you're doing.

[00:39:23] I mean, it's, yeah, their level of knowledge is, is unbelievable, but you know, cause we don't have to worry about the finances.

[00:39:30] That's where I think dentistry is going to get kind of caught up because kids are now seeing, wait a minute on Instagram.

[00:39:37] If I'm not doing all on four, I'm not a dentist.

[00:39:39] Yeah.

[00:39:40] Yeah.

[00:39:40] And I'm like, wait a minute.

[00:39:42] No, I, there's that.

[00:39:44] I want to finish up with that because that's real.

[00:39:46] Like you and I talked about the social media thing and I do believe I have to say, I'm, you know, I'm old, I'm old.

[00:39:51] I shouldn't be affected by the stuff, but I totally am.

[00:39:53] I mean, I have no desire to do all on four, but the fact of the matter is this was, this was a fringe procedure.

[00:39:59] Not that long ago, not fringe is to say that it's a bad procedure, but it's just like, it was limited because frankly, there's just not that.

[00:40:06] It doesn't seem like to me that there's many people that could or would go through that.

[00:40:10] But then if you look on Instagram, everyone's doing it all the time.

[00:40:13] And if you're not doing it, what are you even doing?

[00:40:15] And I'm just like, there's a part of me that goes, okay, first off, a lot of these teeth I'm seeing out there look like they could be.

[00:40:20] They're functional, useful teeth.

[00:40:23] And I mean, yeah, the treatment plan, I understand a lot of what people say about it, that they're, you know, they didn't get to the point they are taking care of them and all this stuff.

[00:40:34] I'm like, man, that's still a big step.

[00:40:35] It's still a big step.

[00:40:37] And then, and of course, you know, a lot of people will don't even sugarcoat it.

[00:40:40] They say, I want to be doing this procedure because it's very profitable.

[00:40:43] It's very, it's, it makes a ton of money and it's, and you know, you get people into financing.

[00:40:48] They get, they only have to accept one thing because one thing is this big, huge thing.

[00:40:53] And they just sign on the dotted line and make it happen.

[00:40:55] And I'm like, I guess that's good, but I don't feel like, I don't feel like everyone should be doing that.

[00:41:00] A, because it takes a certain surgical set, but also I don't, there's gotta be a limit to the number of patients that are going to need that or do that.

[00:41:07] I mean, I, I, I don't know.

[00:41:10] Well, you know, the one thing I would say in the army, we got to see a lot of results, which is great because, you know, the new, new procedures come out, they're trying them.

[00:41:19] You know, we, we were making a move to Holland for, and then they would go down range.

[00:41:24] And if it broke, how do you fix that thing?

[00:41:28] You know, that's a tough thing to do in the field.

[00:41:31] Yeah.

[00:41:31] So now I, you know, I look at it from our side now, the civilian side of things.

[00:41:35] And I see these young guys doing them and I'm like, you know, in 10, 15 years, where are these things going to be?

[00:41:41] And what's the patient's next step when let's say that implant now is failing or practice and they think, oh, well, you're just going to replace this thing for free.

[00:41:50] And you say, well, no, you're going to have to pay.

[00:41:53] Yeah.

[00:41:53] Almost have to, you know, get it done.

[00:41:56] I think that's going to be an eye opener for a lot of people when, you know, some of this stuff, 10, 15 years from now, it's, it's going to be a, an interesting time.

[00:42:05] And I figured I'd just learn how to, you know, fix these things versus put them in.

[00:42:09] Yeah.

[00:42:10] Being a specialist of the, oh, that's still, though, that's a tough gig.

[00:42:13] Cause the other thing is like, like you said, I mean, I have patients that, that had, had the top of the top, you know, perioprost in the late 1970s, which is a roundhouse bridge on, you know, five or six teeth.

[00:42:25] You know, the finest porcelain fused to metal restorations that exist.

[00:42:28] Just, I literally just, this is so awesome.

[00:42:31] I literally prepped, prepped one of the, we didn't remove the bridge.

[00:42:37] Cause honestly, I'm not sure I wanted to know what was going on, on all those abutments.

[00:42:41] I prepped the bridge, put a big ass chamfer margin on it, took a polyvinyl impression of it, sent it to my lab.

[00:42:48] My lab made like a PFM taco crown as a porcelain repair over this, this, this bridge.

[00:42:55] Cause I'm like, she wanted nothing to do with how much it would cost to fix it.

[00:42:59] I wanted nothing to do with what the hell's underneath there.

[00:43:01] I really don't want to know.

[00:43:02] She's dentally pretty healthy for the most part, but I'm like, I don't know that this is a case I want to start over on.

[00:43:07] So yeah, we just did what we had to do.

[00:43:09] We did this and I'm going to tell you if I had to do it again, I would do exactly what we did.

[00:43:14] Cause it turned out so good.

[00:43:15] My lab, I have a lab guy literally in the same building now who just, he was so proud.

[00:43:19] He came in to see it when we seated and stuff.

[00:43:21] It was, it was awesome.

[00:43:22] It was fantastic, but it was problem solving.

[00:43:24] It definitely was not, it wasn't going to make the next sphere lecture.

[00:43:27] Let's just say that.

[00:43:28] That was, that was some, uh, some, some necessity that we came up with.

[00:43:33] It was fun though.

[00:43:34] It was cool.

[00:43:34] But I mean, like I look at that, you're exactly right.

[00:43:36] I mean, this is, we don't actually know.

[00:43:39] And I know a ton of people who are really good at this stuff.

[00:43:41] I mean, I, Steve Vorhold, we got Danny domain.

[00:43:44] We've got all these guys who are like top of the top that who've designed this stuff, but I don't, I, not everyone is as good a surgeon as those guys either.

[00:43:52] Well, the problem I see is to do that, you got to know how to do a denture.

[00:43:57] Yeah.

[00:43:57] I mean, yeah.

[00:43:58] Yeah.

[00:43:58] A lot of kids, I say kids now, you know, I feel so freaking old, but the.

[00:44:06] You don't make a denture, you make one denture in dental school and it's usually, uh, you know, your, your mentors there with you the whole time.

[00:44:12] Yeah.

[00:44:13] So on the teeth, we're, yeah, exactly.

[00:44:14] So, you know, they don't really learn all the, the intricacies of, of the denture.

[00:44:19] And yet now we're taking those same principles, put them into a fixed process and now you're adding different forces on it.

[00:44:24] But I just don't think there's a lot of knowledge as to how to do it.

[00:44:28] They know how to do it, but they don't know what they're doing.

[00:44:32] I don't know if that makes sense, but you know, it just, it just scares me.

[00:44:35] You know, I, you know, I, all the power in the world to you if you can do them, but yeah.

[00:44:40] I don't know.

[00:44:41] Philosophically speaking, I don't, I don't think I'm ever going to be able to.

[00:44:45] I feel, I feel like there will come a time where, where the profession wants to maybe tap the brakes on that deal.

[00:44:51] Just because the other thing is, is that, that I don't think it as dentists, we're doctors.

[00:44:58] We're supposed to be looking out for our patient's best interest.

[00:45:00] And I have a really hard time thinking that, you know, a 40 year old person with a really tough dentition, they've got a lot of living to do.

[00:45:09] And if you go in there and chop off all their alveolar bone and put in this beautiful restoration, they got another 40 plus years.

[00:45:15] They got to live on that thing.

[00:45:16] And maybe, maybe it's awesome.

[00:45:18] Maybe it's perfect.

[00:45:18] I don't know.

[00:45:19] And, and people who know the surgery better would probably poo poo my concerns, except, you know, you're never, if you're skeptical of something, you're almost never in the wrong on that deal.

[00:45:28] Like, like if you feel a little skeptical, how concerned you go, Ooh, I hope that works out.

[00:45:32] And you know, 25 years from now, that sort of thing.

[00:45:33] You're probably never in the wrong to be asking that question.

[00:45:36] I feel.

[00:45:36] Yeah.

[00:45:37] Well, it's funny.

[00:45:38] It seems like the, the more progress we make in dentistry, the more we seem to go back to the original principles.

[00:45:43] You know, you look at bonding agents, you know, we got, we got, now we got self-etched, but now everyone's like, well, you should still etch the enamel.

[00:45:49] Yeah.

[00:45:50] Okay.

[00:45:50] So you're still back to a two, two, three step process that we were trying to avoid with universal.

[00:45:55] Optibon solo seems to still be the gold standard, which came out like 20 years ago or something like that.

[00:46:00] Yeah.

[00:46:01] So I see as we move forward, we almost move backwards and it's, you know, we're doing better.

[00:46:06] We got way better materials, but you know, I look at zirconia crowns, you know, it's like, okay, you have to prep it almost like a gold crown.

[00:46:12] A gold crown.

[00:46:13] Exactly.

[00:46:13] Well, I like that.

[00:46:14] I'm fine with that.

[00:46:15] That's a pretty great deal, but yeah.

[00:46:17] It's just kind of ironic that the better we get, the principles are still the same.

[00:46:22] No, they are.

[00:46:23] They are.

[00:46:23] And I think that's where, that's where I think the residencies that, you know, we ran our, my guys through or, you know, what I see in the military.

[00:46:32] I think that's probably the biggest benefit was the instructors had the experience to say, Hey, I've been around long enough and you got to know the principles.

[00:46:40] And yeah, I hope we don't lose that.

[00:46:42] That that's my biggest, uh, my biggest fear going forward is we're going to get Instagrammed out of principles.

[00:46:49] Yeah.

[00:46:49] No, I, I agree.

[00:46:50] I agree.

[00:46:51] I, and that's, I think that's a, what is also funny is that you and I, when you and I say that about social media or Instagram or whatever, I suspect that there's an entire generation of dentists that just roll their eyes as old guys that don't know any better.

[00:47:04] Maybe they're right.

[00:47:05] But I also think maybe they're wrong.

[00:47:07] I'm sure I probably just ruined your following of young people.

[00:47:10] No, not really.

[00:47:11] We got, we got, we got people of all ages and I'm sure that I've, I've complained enough about social media and you know, what really is funny about is I can complain about all I want, but like I've got Instagram, Facebook open on my, on my window here.

[00:47:22] It's not like I'm not, I'm not on it too.

[00:47:23] And I, to say that I think something that is really important is to understand that whether or not you, you doom scroll all day or you're just using, we're influenced by that stuff.

[00:47:34] You know, we're, we're literally like when you and I were in dental school, digital photography barely existed.

[00:47:40] If, if at all, like I honestly, I think, I think the first digital camera I ever had was in the late nineties and it, it used, it used a floppy disk.

[00:47:49] You put a floppy disk and wrote to a floppy disk.

[00:47:52] They weren't, they weren't doing, you know, like, so, so if you took photos of your dentistry, it was film and you didn't even know if the photo came out until you had it processed.

[00:47:59] I mean, like just, I mean, like, so the reality is like, you can use your phone and take way better photos of them, than anyone.

[00:48:07] Just so yeah, technology has changed a lot.

[00:48:10] The fundamentals of dentistry haven't, I think people want to say they have, they haven't really changed that much.

[00:48:15] We still have to stick with the fundamentals a little bit.

[00:48:17] And, and yeah, you can brand yourself and you can show, show off on Instagram, but just remember that's always, that's the highlight reels.

[00:48:24] That's not real life.

[00:48:25] Everyone's, everyone's got, everyone's got those big turds that show up in their schedule too.

[00:48:29] And bad stuff happens to everyone.

[00:48:31] Well, the irony is, you know, you think about where we met, was it the, the Cosmodent anterior composite course?

[00:48:36] Yeah.

[00:48:37] And you know, how many anterior composites have you done prior to that?

[00:48:40] And then you do theirs and you're like, ooh.

[00:48:43] Yeah.

[00:48:43] Yeah.

[00:48:44] I mean, you'd think, you'd think you wouldn't go to a course on anterior composites and be able to learn much after being a grizzled veteran.

[00:48:50] You're like, oh, they're doing this completely differently than the way I did it.

[00:48:53] And, and honestly, there's good in both of those, but having more, having more tricks up your sleeve is always a good deal for a dentist.

[00:49:00] I think, I mean, if you, even if you don't change everything that you do, you learn, you know, from a buddy and dentist, those guys, those guys know it better than anyone.

[00:49:08] And watching what they do is pretty impressive.

[00:49:10] Even if I don't do exactly the same thing all the time, I, you know, you've got, you've got the arrows in your quiver.

[00:49:16] I think that's really important.

[00:49:17] And God knows that Dennis, he gets more emails from me about, hey, how do you get rid of this?

[00:49:22] You know, and it's, it's just a, you know, those little skills and that, that sort of artistry and dentistry is, is, is unbelievable.

[00:49:29] And I keep laughing when I see these things on social media.

[00:49:32] I'm not a big social media guy, but everyone shows it to me.

[00:49:35] And I'm like, the guy who did that, if those are porcelain veneers, you know, he's got a great lab.

[00:49:41] So, you know, where's his lab?

[00:49:43] It's probably not the dentist, but the dentist gets the credit.

[00:49:45] You know, it just cracks me up.

[00:49:46] I'm like, well, you know, I wish I could find that one.

[00:49:49] So that's another, that's a whole other podcast for you.

[00:49:52] Yeah.

[00:49:52] Yeah.

[00:49:52] The industry.

[00:49:54] Cause you know, I think that we're getting less and less of those people.

[00:49:58] I can't find anyone who does, you know, just the Phelps.

[00:50:01] Stack ceramics.

[00:50:02] Yeah.

[00:50:02] Yeah.

[00:50:02] It's hard.

[00:50:03] And then it's expensive.

[00:50:04] I got, I got a guy, my, my guy who's in the building with me, um, understands digital,

[00:50:08] but also is really, really aspires to be kind of an artsy, uh, ceramics guy.

[00:50:13] So I have a little of everything, but, but that's not common.

[00:50:16] It's usually one or the other.

[00:50:17] And in the, in the, you know, someone who takes the time to stack Phelps bathic, that's,

[00:50:20] that's pretty old timey stuff in a lot of cases for a lot of folks, you know,

[00:50:24] it is beautiful though.

[00:50:26] It is.

[00:50:26] It's beautiful.

[00:50:27] Hard to put out a lot of numbers with that, but it is beautiful.

[00:50:29] There's no doubt about that.

[00:50:30] And then try to, you know what I've learned too, is if you try to cut off an old, perfectly

[00:50:35] bonded Phelps pathic veneer, you're in for a day.

[00:50:40] Yeah.

[00:50:40] So I'd rather cut off zirconia than that.

[00:50:43] Which is also a blast too.

[00:50:45] That's good.

[00:50:45] As well.

[00:50:46] You get the sparks, you can do s'mores.

[00:50:48] Oh yeah.

[00:50:49] Yeah.

[00:50:49] Yeah.

[00:50:49] S'mores, little fireworks.

[00:50:51] You're thinking to yourself, you know, the safety glasses sort of make a lot of sense

[00:50:54] at this point.

[00:50:55] I don't think I'm heating up the tooth with all that heat.

[00:50:58] Is it?

[00:50:58] Nah, nah, nah, it's fine.

[00:51:00] It's fine.

[00:51:01] No harm, no foul.

[00:51:02] All right, Mike, this was fantastic.

[00:51:04] I actually have to go back and see patients here.

[00:51:05] I'm literally at my office.

[00:51:07] Oh, nice.

[00:51:08] But this was cool.

[00:51:09] And honestly, let's have you back on because there's more to talk about, but I'm glad we

[00:51:12] got this.

[00:51:13] I'm glad we got this talking about and congratulations on moving through into new things.

[00:51:17] I mean, you're still a dentist.

[00:51:19] You're just a different kind of dentist.

[00:51:20] So it's kind of cool.

[00:51:21] So it's been a great transition.

[00:51:23] The army blessed me and my family.

[00:51:25] Unbelievable.

[00:51:25] I can't, you know, God's been great to us.

[00:51:27] So I can't really complain about anything.

[00:51:29] That's awesome.

[00:51:30] That's awesome.

[00:51:30] Well, happy holidays coming up and we'll catch you again soon.

[00:51:34] All right.

[00:51:34] Thanks.