Very Dental Extra: Building a Big Case Practice with Dr. John Nosti

[00:00:01] [SPEAKER_00]: This is a production of The Very Dental Podcast Network.

[00:00:10] [SPEAKER_00]: Sometimes you just can't get enough Very Dental. Sometimes you need a little bit more.

[00:00:16] [SPEAKER_00]: Now is one of those times. Welcome to The Very Dental Extra. Very Dental people,

[00:00:23] [SPEAKER_00]: welcome to another episode of The Very Dental Extra. And Very Dental Extra is being brought

[00:00:28] [SPEAKER_00]: to us, commercial-free, by our friends at Ivoclar. And so I want to introduce my co-host guest,

[00:00:36] [SPEAKER_00]: someone who I've been aware of for years and years but have never had on the podcast. I'd like to

[00:00:41] [SPEAKER_00]: welcome Dr. John Nosti. John, how are you doing? Great, Alan. Thanks for having me out today.

[00:00:45] [SPEAKER_00]: I appreciate it. Yeah. So John, I mean, like, I feel like I've known him because social media

[00:00:50] [SPEAKER_00]: makes it like that, you know. Back in the day, it was Dentaltown, and now social media makes you

[00:00:55] [SPEAKER_00]: know people. But so I, before we did this, I went to my Facebook group. I went to the Very Dental

[00:01:01] [SPEAKER_00]: Facebook group and said, okay, what do John and I need to talk about? What should I tell John or

[00:01:06] [SPEAKER_00]: ask John about? Now, I have some accolades from some of my listeners. So I'm going to give them

[00:01:10] [SPEAKER_00]: to you here. First off, his photography is off the hook. And I think his patients are only the

[00:01:16] [SPEAKER_00]: beautiful people. But ask him about sunset photo shoots. That's from Dr. Melissa Zettler. So that's

[00:01:22] [SPEAKER_00]: the first one. Second one, this is you'll love this one. My friend who's taken all the Spear

[00:01:27] [SPEAKER_00]: courses say his course has been the cheat code she needed to implement all she has learned from

[00:01:32] [SPEAKER_00]: Spear. That came from Dr. Gary Holzklot. And then finally, a friend of the show, Dr. David Rice says

[00:01:39] [SPEAKER_00]: John is a tremendous clinician and person. So I feel like, I mean, you're coming to a bunch of

[00:01:46] [SPEAKER_00]: listeners that are you've got we're rooting for you, John, we're rooting for you. So welcome to

[00:01:51] [SPEAKER_00]: the show. Thank you so much for having me. And that's awesome. I appreciate all those nice

[00:01:55] [SPEAKER_00]: things. So John is in New Jersey, and I'm going to find out your practice is in Mays Landing.

[00:02:01] [SPEAKER_01]: Is that correct? Yeah. So Mays Landing and Linwood, New Jersey, those are my two office locations. But

[00:02:08] [SPEAKER_01]: being on Dentaltown, the like 99% of the cases that I posted on there were all done out of my

[00:02:14] [SPEAKER_00]: Mays Landing office. Okay. So you got two locations. Now, I don't know a ton about New Jersey. So I

[00:02:19] [SPEAKER_00]: went again to my local New Jersey people. And apparently there is a controversy that New Jersey

[00:02:27] [SPEAKER_00]: people it kind of lets people know where you're really from in New Jersey. So is it pork roll or

[00:02:33] [SPEAKER_00]: Taylor ham? Okay, smiling. So that is that, which is it for you? Growing up, it was Taylor ham.

[00:02:42] [SPEAKER_01]: Mm-hmm. But now it's pork roll. So and that goes to show I grew up in North Jersey,

[00:02:48] [SPEAKER_01]: where really the only product you bought at the supermarket was called Taylor ham. It was by the

[00:02:55] [SPEAKER_01]: company Taylor. Okay. But the products pork roll, but you still called it Taylor ham because it said

[00:03:02] [SPEAKER_01]: ham on the label and it was Taylor. So Taylor ham. Got it. South Jersey, where I live now,

[00:03:07] [SPEAKER_01]: I've lived since 1990, everybody calls it pork roll. Okay. What is it?

[00:03:14] [SPEAKER_01]: So it's so funny you ask. My faculty members at Clinical Master, we got together one time,

[00:03:21] [SPEAKER_01]: we're hanging out and it's like, what would be a food of New Jersey? So they'll all talk about

[00:03:28] [SPEAKER_01]: where they're from, Mississippi, California, whatever it may be, Florida. And at first,

[00:03:33] [SPEAKER_01]: I'm like, well, Italian food. And then I pause, I'm like, no, wait a minute. It's a pork roll,

[00:03:38] [SPEAKER_01]: egg and cheese sandwich. That's New Jersey. And they're like, well, what is it? I'm like, well,

[00:03:43] [SPEAKER_01]: it's kind of like it's a circular product. It's not like Canadian bacon that's from Canada. It's

[00:03:51] [SPEAKER_01]: the same shape, but the taste is uniquely different. It's not ham. It's more like smoky pork

[00:03:58] [SPEAKER_01]: taste. But I have to tell you, when you're going to a football game on a Saturday morning or

[00:04:05] [SPEAKER_01]: Sunday morning, or you had too much to drink on a Friday night and you need the quick hangover fix,

[00:04:11] [SPEAKER_01]: there is nothing like a pork roll, egg and cheese sandwich. In the morning, you put it on a bagel

[00:04:17] [SPEAKER_01]: and at night or in the afternoon, you could put it on a Kaiser roll, seeded roll.

[00:04:22] [SPEAKER_00]: So basically New Jersey's finest.

[00:04:24] [SPEAKER_00]: Oh yeah, definitely.

[00:04:27] [SPEAKER_00]: That's awesome. Okay. So knowing that you're from New Jersey, you say you grew up in New Jersey,

[00:04:32] [SPEAKER_00]: where did you go to dental school?

[00:04:34] [SPEAKER_01]: I went to dental school at the time it was called the University of Medicine and Dentistry of New

[00:04:38] [SPEAKER_01]: Jersey. So UMDNJ, which is now the Ruckers School of Dental Medicine or Ruckers Dental School.

[00:04:44] [SPEAKER_01]: So I graduated there in 98 and sometime before 2010, I believe they changed the name to

[00:04:54] [SPEAKER_01]: Ruckers Dental School.

[00:04:57] [SPEAKER_00]: So Kyle, we're contemporaries. I graduated in 1997. You look way younger than me though. I'm

[00:05:01] [SPEAKER_00]: just going to say that right now. It's just a kid. So we were contemporaries. When we got out

[00:05:06] [SPEAKER_00]: of dental school, the cosmetic revolution was in full swing at that point. They were still,

[00:05:16] [SPEAKER_00]: implants were still pretty, they weren't really teaching a lot of implant dentistry in dental

[00:05:20] [SPEAKER_00]: school where I was in Minnesota. If you were lucky, you kind of got to take a special class

[00:05:25] [SPEAKER_00]: where you learned a little bit about, you certainly weren't going to place any, you might see a

[00:05:28] [SPEAKER_00]: prosthodontist restore them, but you got out and immediately, I mean, well, Hornbrook still had

[00:05:33] [SPEAKER_00]: the serious mullet. Let's just say that. That was just the timing of it. And he was everywhere.

[00:05:40] [SPEAKER_00]: And that was just kind of, and Empress was in all these materials and stuff. So you remember those

[00:05:45] [SPEAKER_01]: days?

[00:05:46] [SPEAKER_01]: That's actually what got my start in teaching cosmetic dentistry was joining the Hornbrook

[00:05:51] [SPEAKER_01]: group and being a faculty member with them. But yeah, I mean, do you remember graduating dental

[00:05:56] [SPEAKER_01]: school? I think when we graduated, the biggest topic at the time was do posterior composites

[00:06:02] [SPEAKER_01]: work. You remember that? I mean, you go for a whole day and like, the whole topic in CE

[00:06:11] [SPEAKER_01]: was just on bonding and can you bond to dent? That was a whole day. Now it's like 10 minutes.

[00:06:18] [SPEAKER_00]: Yeah. And the other thing is what I remember if early dental town, you could, the biggest,

[00:06:24] [SPEAKER_00]: there were two big battles. It was neuromuscular dentistry and composite versus amalgam. And these,

[00:06:32] [SPEAKER_00]: we'd go around and around and around about this for just constantly, it's funny now at the time,

[00:06:38] [SPEAKER_00]: it was, it was, uh, it was like politics, man. It was, it was hardcore stuff, but you're right.

[00:06:43] [SPEAKER_00]: It was, I mean, we were kind of in the, in the edge of all that stuff. That was, that was back

[00:06:47] [SPEAKER_00]: in, back in the day before, I mean, in a lot of the, a lot of the modalities, implant modalities

[00:06:51] [SPEAKER_00]: stuff didn't really exist or if they did, they were so they were kind of out there. So, but,

[00:06:55] [SPEAKER_00]: but cosmetics were a real thing. So I'm curious about that when you graduated, how did you know

[00:06:59] [SPEAKER_00]: you wanted to get into that kind of stuff and how did you get, you know, what's funny is, um,

[00:07:03] [SPEAKER_01]: I didn't know I wanted to get involved in cosmetic dentistry. Actually, I wanted to be

[00:07:08] [SPEAKER_01]: involved in, uh, temperament, jubilator joint dysfunction and more so oral facial pain.

[00:07:15] [SPEAKER_01]: My senior year in dental school, we had, we had a whole year of oral facial pain as part of our

[00:07:21] [SPEAKER_01]: program. I, I think it might still be there at UMD or Rutgers, but I, but I know it went down

[00:07:27] [SPEAKER_01]: to like a month or a two month period. But then when I got to my residency, we drew straws as

[00:07:33] [SPEAKER_01]: to who was going to take over the TMD patients from the, from the residents before. And, um,

[00:07:41] [SPEAKER_01]: I drew the shortest straw, even though I said I wanted it, give me it. And yeah,

[00:07:46] [SPEAKER_01]: yeah. I was involved in treating the TMG patients, uh, and my residency actually assisted

[00:07:51] [SPEAKER_01]: in an open joint surgery with an oral surgeon. Yeah. Terrible. Wow. Um, you know, and it's

[00:07:58] [SPEAKER_01]: kind of funny, um, that, that experience right after the patient came out of surgery,

[00:08:06] [SPEAKER_01]: she was doing phenomenal pain-free felt great. She had this completely worn dentition

[00:08:12] [SPEAKER_01]: and she was living on her splint. And so we tried to get her off of it and she couldn't get off of

[00:08:17] [SPEAKER_01]: it. So she had to keep going back to it. I knew nothing about restored. I mean, what did you know

[00:08:22] [SPEAKER_01]: about restorative dentistry when you're a resident? I know nothing, not a thing, not a thing. We were,

[00:08:27] [SPEAKER_00]: we, we dental school just made us. We knew just absolutely dangerous. And so I had this,

[00:08:32] [SPEAKER_01]: I thought it was a genius. I had this bright idea. I go to the oral surgeon and I'm like,

[00:08:36] [SPEAKER_01]: listen, I got an idea. She's got this worn dentition. I said, I think it makes sense if

[00:08:41] [SPEAKER_01]: I can cut away the posterior aspect of the splint and take a bite registration,

[00:08:48] [SPEAKER_01]: mount her models there, do a wax up and then restore her to this position. Give her a new,

[00:08:54] [SPEAKER_01]: give her a new occlusion, this and that. And his response was, John,

[00:08:58] [SPEAKER_01]: this whole year I really thought you were a bright guy, but that is about the dumbest thing I've ever

[00:09:03] [SPEAKER_01]: heard. So I know crazy, right? So now in my residency, they gave us a thousand dollars

[00:09:12] [SPEAKER_01]: and five days vacation to take any continuing education seminar you want it to do. And I knew

[00:09:18] [SPEAKER_01]: nothing about Dawson or Panky that were like the big wigs at the time. So I said, well,

[00:09:23] [SPEAKER_01]: a thousand dollars in five days, I'm going to go to Hawaii. Why not? Right. So I found this,

[00:09:30] [SPEAKER_01]: you know, this CE course that was, they were giving and it was like, you know,

[00:09:34] [SPEAKER_01]: eight to 10 o'clock in the morning each day, you know, just enough to do whatever.

[00:09:39] [SPEAKER_01]: And ironically, I met a dentist there and I don't know his last name. His name was Glenn,

[00:09:45] [SPEAKER_01]: stuck with me. And Glenn said, listen, you're a resident, you don't know anything. I highly

[00:09:51] [SPEAKER_01]: recommend you take Brock Rondeau's course on orthodontics. And I was like, okay. So I went

[00:10:00] [SPEAKER_01]: and took Brock's one day, his one day intro before I signed up for his whole continuum.

[00:10:05] [SPEAKER_01]: And on the first day, Brock, you know, gave lectures and he showed examples of this,

[00:10:10] [SPEAKER_01]: the same thing that happened in my residency, putting people on this occlusal splint.

[00:10:15] [SPEAKER_01]: And then he would cut away the splint and then orthodontically move their teeth to where a

[00:10:19] [SPEAKER_01]: splint provided them. And then I'm there in the audience, I'm questioning him back and forth.

[00:10:25] [SPEAKER_01]: Like I was so annoying to him, you know, I must've asked him 10,000 questions on it.

[00:10:29] [SPEAKER_01]: And then I said, he was like, finally, he was like, why are you asking so many? You're such

[00:10:33] [SPEAKER_01]: a young guy. You seem like a pessimist about this. What's the problem? And I'm like, well,

[00:10:38] [SPEAKER_01]: let me tell you a story about this oral surgeon in Pennsylvania.

[00:10:43] [SPEAKER_01]: Terrible thing.

[00:10:44] [SPEAKER_01]: So from there, I just went into occlusion and TMD. And it was probably, it was in 2002. So now four

[00:10:51] [SPEAKER_01]: years out of school, three years out of my residency, I had about 300 to about 500 hours

[00:10:59] [SPEAKER_01]: of TMD and occlusion under my belt. I was a maniac. And finally, I pick up a journal, pick up

[00:11:06] [SPEAKER_01]: a magazine, whatever it was. And David Hornbrook had an article in there and it was a retracted

[00:11:13] [SPEAKER_01]: black background before and after of like eight to 10 veneers. And I was like, holy crap,

[00:11:19] [SPEAKER_01]: my dentistry doesn't look like this. I want my dentistry to look like this.

[00:11:25] [SPEAKER_01]: Yeah, exactly.

[00:11:25] [SPEAKER_01]: Like who's this guy? And signed up for the Hornbrook group. Fast forward three years later,

[00:11:32] [SPEAKER_01]: I was asked to be a mentor with them and be a faculty member. Started actually being one of the

[00:11:40] [SPEAKER_01]: first people to lecture for them besides, there was the big three was Mark Montgomery, David

[00:11:46] [SPEAKER_01]: Hornbrook, and Ron Ritzko. And they put me in front of the stage to close a really easy lecture at

[00:11:54] [SPEAKER_01]: end of the appointments. But I was involved in basically every anterior veneer course they taught

[00:12:02] [SPEAKER_01]: from 2005 to 2009. And then when the Hornbrook group ceased to be in existence, we became

[00:12:10] [SPEAKER_01]: Clinical Mastery Series. So David, Jason Olitsky, myself and another guy, Mike Smith, we actually

[00:12:17] [SPEAKER_01]: started Clinical Mastery back then. And here we are 15, 16 years later. David left about a year

[00:12:25] [SPEAKER_01]: or two years in. I don't think it was building fast enough. It was a very slow build. But here

[00:12:33] [SPEAKER_01]: we are now. And as some of the people on your Facebook group posted, we're basically the

[00:12:41] [SPEAKER_01]: cliff notes of restorative dentistry. Like, cheat code.

[00:12:46] [SPEAKER_00]: ISKRA Sure. Sure. The cheat code for all the big... And what's really cool... Okay. So for one thing,

[00:12:52] [SPEAKER_00]: Dave Hornbrook and I are friends. He's been on the show a bunch. And I mean, I love the guy. And it

[00:12:58] [SPEAKER_00]: does not surprise me that you kind of got your start with him at all because he was it. Back when

[00:13:03] [SPEAKER_00]: we got out of dental school, he was it. I do think that everyone... There's got to be more places for

[00:13:08] [SPEAKER_00]: people to learn. So it's the more the merrier, let's be perfectly honest. I've done lots of

[00:13:14] [SPEAKER_00]: spear stuff and of course, COIS. All these people are amazing. But implementation of those things

[00:13:19] [SPEAKER_00]: is difficult. It's like on some level, there's a lot of people like to soak the stuff in. But

[00:13:26] [SPEAKER_00]: where the rubber meets the road is where it really comes in. It sounds like that's kind of one of

[00:13:30] [SPEAKER_00]: your specialties. I'm going to come back to that. I'm going to come back to that because I got another

[00:13:32] [SPEAKER_00]: great quote. Because I mean, not only are you an educator, but you're a clinician and you see

[00:13:38] [SPEAKER_00]: patients. And I have another friend that was already mentioned before, Dr. David Rice. He says,

[00:13:45] [SPEAKER_00]: when I asked what we should ask you, he said, if I'm a younger me who hasn't learned the lessons,

[00:13:50] [SPEAKER_00]: I'd want to know how he built a practice on big case dentistry. So many who don't believe it's

[00:13:55] [SPEAKER_00]: possible for them. What would he say to that? I'm curious about that because your Facebook does have

[00:14:00] [SPEAKER_00]: a lot of quote unquote big case dentistry. And you've literally described where you came from

[00:14:05] [SPEAKER_00]: and basically starting out with a worn dentition, that sort of thing. I'm just curious, what would

[00:14:10] [SPEAKER_00]: you tell someone who's like, I would like to be someone who's doing big case dentistry?

[00:14:12] [SPEAKER_01]: I think just kind of going back a little bit too, you hit it really the nail on the head. When we

[00:14:19] [SPEAKER_01]: came out of school, there were no websites. People had a yellow pages ad and cosmetic dentistry was

[00:14:27] [SPEAKER_01]: just starting. So we didn't have any real big cases in our practice or no one's coming in

[00:14:35] [SPEAKER_01]: really asking for it, let's say that. So how I built it was simply having conversations with

[00:14:41] [SPEAKER_01]: patients and a lot of my cosmetic quote unquote cosmetic dentistry early on my career, I would say

[00:14:49] [SPEAKER_01]: almost all of it was all functionally driven. Was patients who had a lot of direct restorations

[00:14:55] [SPEAKER_00]: present, patients who had worn teeth? I'm going to stop you there. Worn teeth are one of the

[00:15:03] [SPEAKER_00]: greatest ways to... I mean, worn teeth, you got to know how to handle them. But the reality is like,

[00:15:08] [SPEAKER_00]: do you remember when we got out of dental school, the idea of opening someone's bite?

[00:15:13] [SPEAKER_00]: If you talk to a dental student or something like that, you couldn't possibly do that. You'd wreck

[00:15:18] [SPEAKER_00]: them. Their mandible would fall off or something like that. You couldn't do that. You'd never do

[00:15:24] [SPEAKER_00]: that. And I think, and I mean like anyone with a practice like mine or yours, patients come in

[00:15:31] [SPEAKER_00]: and they've got completely worn out teeth. And it's the easiest thing in the world to just add

[00:15:38] [SPEAKER_00]: tooth structure back on some... I mean, for those people that aren't doing like big case stuff,

[00:15:42] [SPEAKER_00]: you can open them up and you know what? If they don't do well with it, you can

[00:15:48] [SPEAKER_00]: refund their misery. But I mean, we just didn't even know anything when we were kids.

[00:15:53] [SPEAKER_00]: You would never do that back in the late 90s. It just wasn't a thing.

[00:15:57] [SPEAKER_01]: It's so funny, the departure or let's say what's another word I want to say about it?

[00:16:01] [SPEAKER_01]: Just how far apart removable PROS was from fixed PROS when we were at school.

[00:16:09] [SPEAKER_00]: Yes. Yes.

[00:16:10] [SPEAKER_01]: Totally different PROS. It's like, you know, removable PROS, you got people who are coming in,

[00:16:14] [SPEAKER_01]: their dentures are worn to crap. They're all worn down. And what do you do? Just give them big teeth

[00:16:19] [SPEAKER_01]: immediately and not even... Don't test it. Just shove it right in there. And then fixed PROS,

[00:16:26] [SPEAKER_01]: God forbid you open vertical. And if you do it, you got to do it maybe slow. You got to test it

[00:16:32] [SPEAKER_00]: out because they might die. Put them in a splint for five months that they wear all the time

[00:16:37] [SPEAKER_00]: that opens them a millimeter and a half. No, I know what you're talking about. It's exactly...

[00:16:41] [SPEAKER_00]: A hundred percent.

[00:16:42] [SPEAKER_00]: It is funny too because every denture case is a full mouth rehab. Hello? I mean, it is. It's

[00:16:47] [SPEAKER_00]: exactly... But we didn't look at it that way at all. And they got the same jaws,

[00:16:53] [SPEAKER_00]: whether they got teeth in them or not. It's like the same joint.

[00:16:56] [SPEAKER_01]: Absolutely. So what I would tell someone who's starting out early on is really get good at

[00:17:01] [SPEAKER_01]: comprehensive dentistry. And believe it or not, I feel people have so much more of advantage

[00:17:09] [SPEAKER_01]: than what we had when we were younger. Now there's cameras and everybody, they're great.

[00:17:15] [SPEAKER_01]: When we were younger, you had a Polaroid camera if you wanted to take anything. And then you had

[00:17:22] [SPEAKER_01]: a Yoshiko Dental Life 35 millimeter that you had to expose film.

[00:17:27] [SPEAKER_00]: And you got your film back and most of the photos were terrible. So you had to... I totally remember

[00:17:33] [SPEAKER_00]: that stuff. That was the whole thing. You had to take a lot of photos. I don't know that my dad...

[00:17:37] [SPEAKER_00]: I worked with my dad. My dad had a film camera and that was a thing. I never even had a film

[00:17:40] [SPEAKER_00]: camera because there was no way I would have had the patience for that at all. And now literally

[00:17:45] [SPEAKER_00]: you can take a card full of all the photos you can want and it's so easy. And you don't even have

[00:17:51] [SPEAKER_00]: to know anything about photography, which would be me. Hello. And you can take these amazing photos.

[00:17:55] [SPEAKER_01]: You're exactly right. Get a camera. You can get a point and shoot. And if you want to get a DSLR,

[00:17:58] [SPEAKER_01]: you could do that too. It autofocuses. And really, I tell people for a new patient exam,

[00:18:05] [SPEAKER_01]: there's a couple of photos that are key. One of the three best photos on a new patient exam

[00:18:11] [SPEAKER_01]: are a maxillary occlusal picture, a mandibular occlusal picture, and then a retracted out of

[00:18:17] [SPEAKER_01]: occlusion. And that's a huge percentage of my conversation with patients. And I know what

[00:18:23] [SPEAKER_01]: everyone's saying. Well, I have an intraoral camera that a USB that I plug in. That's fine.

[00:18:29] [SPEAKER_01]: But then you're going to take like eight different pictures of teeth. And you're subconsciously

[00:18:36] [SPEAKER_01]: conveying to that patient that you have eight different problems versus one occlusal picture

[00:18:42] [SPEAKER_01]: that you could say, you could zoom in and zoom out of it, but you're conveying it's

[00:18:46] [SPEAKER_01]: one complex system. So really get good at diagnosing, understanding the comprehensive

[00:18:54] [SPEAKER_01]: dentistry conversation, understanding the importance of a new patient interview.

[00:19:00] [SPEAKER_01]: I know it kind of sounds goofy, but understanding patient's language and understanding how to

[00:19:08] [SPEAKER_01]: communicate with them. Like are they someone who's motivated by preventing consequences?

[00:19:13] [SPEAKER_01]: Or are they someone who's motivated because they want cosmetics? And if you talk differently to

[00:19:19] [SPEAKER_01]: those people, they're not going to listen to you. I got to say too, if you haven't done an interview

[00:19:25] [SPEAKER_00]: like that, and I'm not going to lie to you, I do better some days than others. But if you haven't

[00:19:30] [SPEAKER_00]: done an interview like that, where you let the patient guide it. And like I talked to Mike

[00:19:36] [SPEAKER_00]: Milkers a couple of weeks ago and he was talking about goals. What are patient goals? And I always

[00:19:39] [SPEAKER_00]: think saying that is so cheesy. Patients don't come into my office with goals. But the reality

[00:19:44] [SPEAKER_00]: is in a lot of cases, if you lead them to how they think about their teeth and how they're,

[00:19:49] [SPEAKER_00]: they'll tell you a lot. You don't have to talk that much in that interview. A lot of times you

[00:19:54] [SPEAKER_00]: can figure out what they value and what, you know. And it's funny because comprehensive dentistry

[00:20:01] [SPEAKER_00]: doesn't always mean you're spinning 28 teeth either. Like comprehensive, like from anywhere

[00:20:06] [SPEAKER_00]: from, you know, I don't know. It's, I will say this early on in my career when people would talk

[00:20:12] [SPEAKER_00]: about comprehensive dentistry, I just felt like everyone, and that was the dental town thing. You

[00:20:16] [SPEAKER_00]: know, if you weren't doing full mouth rehabs and who even are you? That sort of thing. And you're

[00:20:19] [SPEAKER_00]: just like, man, I'm definitely less than that. But the reality is you can treat your patients

[00:20:23] [SPEAKER_00]: pretty comprehensively. You know, sometimes it takes them all to get there or sometimes, you know,

[00:20:28] [SPEAKER_00]: but you're right. Like the orthodontists, you know, orthodontists don't really treat teeth.

[00:20:33] [SPEAKER_00]: They treat faces and they treat jaws a little bit. But the bottom line is they're looking at

[00:20:37] [SPEAKER_00]: this big picture and we're terrible about that. We look at like an MO cavity, you know, like a lot.

[00:20:42] [SPEAKER_00]: And of course you got to treat that. But the big picture is kind of, it's really important. And I

[00:20:47] [SPEAKER_00]: do like the fact that you're not going too crazy on the, like the three photos that you take.

[00:20:52] [SPEAKER_00]: First off, you can snap them off quick and you can have my big monitor in no time. So you can

[00:20:56] [SPEAKER_00]: have the conversation, but also you're right with an SLR cameraman. You can zoom in way more than

[00:21:02] [SPEAKER_00]: you ever, I mean, like I got microscopes in the office and you can do pretty darn close from an

[00:21:06] [SPEAKER_00]: occlusal, you know what I'm saying? You can show them a lot.

[00:21:08] [SPEAKER_01]: You know, and you can ask them about their smile and how do they rate their smile? And that opens

[00:21:12] [SPEAKER_01]: up the conversation about things. But you know, once you get a couple and then you have to document

[00:21:19] [SPEAKER_01]: your cases. And I said people all the time, you know, learn the AACD series of photographs and

[00:21:25] [SPEAKER_01]: take all of those on your case. And you know, when I was first starting out, you know, the AACD

[00:21:31] [SPEAKER_01]: series is 14 photos before and after. So starting out, I'd put them in a photo album and I would

[00:21:37] [SPEAKER_01]: mix them all up. So it didn't look like it's the same case. And then it's like, I'm showing you

[00:21:41] [SPEAKER_01]: before and afters of the same patient. And then when I got two people, I would alternate the

[00:21:47] [SPEAKER_01]: photos and the cases. And so then it looked like I had 28 cases, but you know, you have that in

[00:21:52] [SPEAKER_01]: your office. But then when my partner and I had enough of those cases documented, that's when we

[00:21:59] [SPEAKER_01]: went out and we got a website and you know, we didn't get a website until like 2004, I think,

[00:22:05] [SPEAKER_01]: maybe 2005 around there. And that was still cutting edge at the time, you know? So you don't have to

[00:22:12] [SPEAKER_01]: have it all over your website right now. And to tell you the truth, the majority of my cases early

[00:22:19] [SPEAKER_01]: on in my career came out of my hygiene chair. And that's where I think a lot of people starting out,

[00:22:25] [SPEAKER_01]: they're going to come out of your hygiene chair. So they're patients, you don't have to market,

[00:22:28] [SPEAKER_01]: you don't have to spend a dime, just get educated on how to do the dentistry, how to do the conversation

[00:22:34] [SPEAKER_01]: and then how to do it. Because I personally feel if you don't really know how to do the dentistry,

[00:22:40] [SPEAKER_01]: you're not going to be confident in your treatment plan and presentation to the patient.

[00:22:44] [SPEAKER_01]: So, you know, learn how to do a comprehensive exam. I don't know it sounds goofy, but learn

[00:22:50] [SPEAKER_01]: how to do a comprehensive exam, learn how to communicate, take photos, then learn how to do

[00:22:54] [SPEAKER_01]: the dentistry, get the dentistry done, you know, document the dentistry. And then once you have a

[00:22:59] [SPEAKER_01]: couple of cases, start throwing them up on your website, start throwing them on your social media.

[00:23:03] [SPEAKER_01]: And then pretty soon people will start looking for you and they'll start coming for those cosmetic

[00:23:09] [SPEAKER_01]: cases. Because, you know, I gave a lecture one time early on in my career and I think it was at

[00:23:15] [SPEAKER_01]: the AACD meeting and I had eight patients up on the screen, eight headshots. And I asked which

[00:23:23] [SPEAKER_01]: one of these patients came in because they wanted a smile and which one did I talk to them about the

[00:23:29] [SPEAKER_01]: dentistry they needed? And I had people raise their hand and there was like four females and

[00:23:35] [SPEAKER_01]: four males. And everybody always thinks it's the females who want a dentistry.

[00:23:40] [SPEAKER_01]: But ironically enough, seven out of those eight patients were functionally driven cosmetic

[00:23:46] [SPEAKER_01]: dentistry. And the one case that actually wanted it was a guy who was like 70 years old and no one

[00:23:53] [SPEAKER_01]: ever picked him, you know? But that's what happens, you know? So you don't have to market for it.

[00:23:59] [SPEAKER_01]: You just have to follow those steps, build up your photo album, build up your cases,

[00:24:04] [SPEAKER_01]: you know, know how to do it and then put it out there and then people will come for you.

[00:24:08] [SPEAKER_01]: It'll get there. Yeah.

[00:24:11] [SPEAKER_00]: Yeah. Here's a question too. Let's say someone's like me where they've got a pretty conventional

[00:24:17] [SPEAKER_00]: recall-based general dental office and they're like, okay, I really want to up my cosmetic game.

[00:24:23] [SPEAKER_00]: You said most of your cases come out of hygiene. Now the question is this, a couple things. First

[00:24:27] [SPEAKER_00]: off, let's say I've been in this office for a while and I've been doing hygiene exams and we've

[00:24:33] [SPEAKER_00]: made sure that perio is under control and maybe we've put a couple of crowns in. But how do you

[00:24:43] [SPEAKER_00]: change that relationship? You know what I'm talking about because, okay, I got patients in

[00:24:47] [SPEAKER_00]: my office I've seen for 26 years, you know? And on occasion, someone you've known for 22 years all

[00:24:53] [SPEAKER_00]: of a sudden decides they want to do something. It's kind of amazing, right? Sometimes it comes

[00:24:58] [SPEAKER_00]: right out of nowhere. The most amazing thing too is if you talk to them about orthodontics and

[00:25:01] [SPEAKER_00]: they're just like, well, because they see. But in any case, when you've got someone in hygiene

[00:25:05] [SPEAKER_00]: that you've known for a hundred years and you know that, and everyone's got these people that have

[00:25:09] [SPEAKER_00]: seriously worn teeth and you can tell that this is not the time for them. They got kids in school.

[00:25:15] [SPEAKER_00]: But how do you approach that? How do you let them know that A, if you ever wanted to do something

[00:25:20] [SPEAKER_00]: and B, how do you change them from that recall patient to a patient who's more serious about

[00:25:24] [SPEAKER_01]: potentially cosmetic or- You know what? I think there's two answers to that. So first is the

[00:25:28] [SPEAKER_01]: patient. And because I know this exists out there, people who are listening,

[00:25:33] [SPEAKER_01]: they've had these patients who are in their chair. This is always what they're concerned about.

[00:25:37] [SPEAKER_01]: There's patients in hygiene. They go take a course. They finally learn how to do it.

[00:25:42] [SPEAKER_01]: And now how do they tell the person they've been talking to for 10 years that everything's fine?

[00:25:47] [SPEAKER_01]: How all of a sudden do they breach that subject that there's a problem? And the little white lie

[00:25:54] [SPEAKER_01]: that I lived on even early on in my career is this, your teeth look different to me now

[00:26:01] [SPEAKER_01]: than they did six months ago. Does that mean that the person looks any different? Absolutely not.

[00:26:08] [SPEAKER_01]: It's just to you who's now more educated, more aware, you're looking at them differently.

[00:26:15] [SPEAKER_01]: You're looking at them differently, sure. And honestly, when I've said that,

[00:26:17] [SPEAKER_01]: I've never had a patient go, my teeth have looked like this for my whole life. They don't. They go,

[00:26:22] [SPEAKER_01]: really? What's wrong? And then you go into the where and stuff like that. So that's one part of

[00:26:28] [SPEAKER_01]: the equation. Then the other part of the equation is someone who you might have talked to,

[00:26:34] [SPEAKER_01]: maybe it's years ago. And if I've talked to someone once, twice, I'll never have the conversation

[00:26:42] [SPEAKER_01]: again because I don't want them to feel like I'm a used car salesman. I don't want them to

[00:26:48] [SPEAKER_01]: feel pressured. They sense that. You see headshots galore in my reception room. You

[00:26:54] [SPEAKER_01]: see photo books. You know that I'm the guy to do this. So I let the wall speak for themselves.

[00:27:01] [SPEAKER_01]: But even for someone who doesn't have that, even if you've had the conversation,

[00:27:04] [SPEAKER_01]: how do you switch them? And I found is if even if you've never done a new patient interview

[00:27:11] [SPEAKER_01]: and you have those patients now who are in your recall, it's never too late to do the

[00:27:16] [SPEAKER_00]: patient interview now. That's the hard, you're exactly right. But it's like, it is a hard broach

[00:27:23] [SPEAKER_00]: because the new patient interview is a very different interaction than your recall or

[00:27:29] [SPEAKER_00]: whatever. And on some level, you almost have to be like, Hey, I've known you for a really long time,

[00:27:34] [SPEAKER_00]: but you know what? You were here when I got here. I will say that. That's a classic because I have

[00:27:39] [SPEAKER_00]: a ton of patients that were literally here when I bought the office. And I'm like, we never really

[00:27:43] [SPEAKER_00]: did this. One of those things, but how is that? How would you do it? How would you, how would you

[00:27:48] [SPEAKER_00]: approach people like, Hey, you know, I got, we should take a big picture. Look, how do you do

[00:27:52] [SPEAKER_00]: that and not seem like you're honestly, since our first off, if they've been for that long,

[00:27:57] [SPEAKER_00]: they already like you. So they're probably gonna get, they're probably gonna go along with it,

[00:28:00] [SPEAKER_00]: but it's like, yeah, how do you do it without being awkward? And I have to say it really,

[00:28:04] [SPEAKER_00]: every time I've tried, it doesn't end up being awkward at all. They're usually interested.

[00:28:08] [SPEAKER_00]: And if they're not, it's no big deal. Absolutely. So I always like, I try to always focus on

[00:28:13] [SPEAKER_01]: positive. I'm a positive guy. So I was like in the positive and I'll say to someone's like,

[00:28:18] [SPEAKER_01]: you know, listen, we've known each other for a long period of time or wow. You've,

[00:28:22] [SPEAKER_01]: I have some patients who've been in the practice longer than I've been there.

[00:28:25] [SPEAKER_01]: So I'll say, you know, I know you've been in the practice for a long period of time.

[00:28:29] [SPEAKER_01]: I just, I want to make sure that I'm not only meeting your expectations, that I'm exceeding

[00:28:35] [SPEAKER_01]: them. And then based upon that, can I ask you a few questions and then whatever the questions,

[00:28:43] [SPEAKER_01]: right? You know, I've never asked, I don't think I've ever asked you this, you know,

[00:28:47] [SPEAKER_01]: we've known each other for so long. How can I ask you, how would you rate your smile on a scale of

[00:28:51] [SPEAKER_01]: one to 10? So good. It's so good. I love that. So, you know, I could do that. I guess the reason

[00:28:56] [SPEAKER_00]: I say that I love that is that I could totally do that. And it wouldn't, it wouldn't even be weird.

[00:28:59] [SPEAKER_01]: Anybody can, I'm no smarter than anyone, you know? And I think what, you know, you talked about Mike

[00:29:06] [SPEAKER_01]: Melchers before, Mike's big on communication. One of the things that I feel that I really excel at

[00:29:12] [SPEAKER_01]: is getting to know people, but really communicating with people, you know, meeting them where they're

[00:29:19] [SPEAKER_01]: at and just not coming off pretentious. I don't have a huge vocabulary. I don't try to, you know,

[00:29:28] [SPEAKER_01]: anyone who is, comes into my office, you know, I might ask them what they do for a living,

[00:29:34] [SPEAKER_01]: but just to communicate with them, not to money grab them. And people who say that they're in

[00:29:40] [SPEAKER_01]: construction, I'm like, oh, that's great. My dad's a plumber. I grew up, or he was a plumber. You

[00:29:44] [SPEAKER_01]: know, I grew up my whole life, you know, working summers with my dad and I really have a construction

[00:29:49] [SPEAKER_01]: mind. I said, let me explain dentistry on a construction level. And people get it, you know?

[00:29:55] [SPEAKER_01]: People get it. You can, you know, comparing dentistry to construction, like house building

[00:29:59] [SPEAKER_00]: or cars, they get it, you know? It's what's, what's funny too about that is that like,

[00:30:05] [SPEAKER_00]: first off the older I get, the more I'm actually interested in what these people do and what

[00:30:10] [SPEAKER_00]: they're like. It is funny. Cause I, I there's people I've known for a long time that I've been

[00:30:15] [SPEAKER_00]: their dentist and I've had it, but, but like sometimes all of a sudden we'll get off on a,

[00:30:19] [SPEAKER_00]: on a tangent and I'll, I'll realize something about them I never knew. And all of a sudden

[00:30:22] [SPEAKER_00]: we'll talk about that for a long time. And sometimes I can relate it to dentistry,

[00:30:26] [SPEAKER_00]: but sometimes it's just like, you just get a deeper connection. Oh, absolutely.

[00:30:29] [SPEAKER_00]: And, and a, you kind of can see where they're coming from, what they might value be.

[00:30:33] [SPEAKER_00]: I mean, like, it's just kind of fun. It's interesting, keeps it interesting. And I,

[00:30:38] [SPEAKER_00]: I'm telling you that that is the advantage of being in a practice for a long time. You know,

[00:30:41] [SPEAKER_00]: this too, I mean, it's like, I got, I got people I've known since they, I got adults that I've

[00:30:46] [SPEAKER_00]: known since they were kids. It's crazy. And, and, and even with that, I'm still learning stuff about

[00:30:52] [SPEAKER_00]: them too. And it is, it's the communication has to be, it can't be forced. And I mean, I, I,

[00:30:57] [SPEAKER_00]: for someone new that's not sure what that means, I don't, I don't know how to suggest it except

[00:31:04] [SPEAKER_00]: don't try too hard. Right? Like, like act, talk to them like a person, not like a patient, you know,

[00:31:12] [SPEAKER_00]: don't, don't, I don't, it's very difficult because it always came kind of naturally to me. Dental

[00:31:16] [SPEAKER_00]: school was torture until we got to patients and all of a sudden I got to talk to people like

[00:31:20] [SPEAKER_00]: normal. And that was better for me. But, but the reality is it's like, yeah, you just talk to him

[00:31:24] [SPEAKER_00]: like a normal person. Don't, don't talk to him like a dentist. And I do have to say the construction

[00:31:29] [SPEAKER_00]: thing, like if they could see you doing construction, it's going to help you a lot.

[00:31:34] [SPEAKER_00]: Like if they, if they, if they look at you like in, you know, scrubs and someone in an OR or

[00:31:39] [SPEAKER_00]: something like that, but if they look at you like someone who could be doing construction,

[00:31:43] [SPEAKER_00]: or in my case, we have a horse farm who could be shoveling manure. That's a good thing. They look

[00:31:47] [SPEAKER_00]: at you like a real person then. And it's a big, it's a good thing. So yeah, that's, I don't know.

[00:31:51] [SPEAKER_00]: I just kind of going off on the communication thing, but it's true. You got to be a human too.

[00:31:54] [SPEAKER_00]: That's true.

[00:31:55] [SPEAKER_01]: You have to be approachable. You have to be a human being and, you know, just,

[00:31:59] [SPEAKER_01]: just talk to people like you, like you want to be talked to, you know, you know, one of the things

[00:32:05] [SPEAKER_01]: that I, I kinda always close with not, not always, cause it's not needed for everyone,

[00:32:11] [SPEAKER_01]: but when someone's trying to make up their mind about something and I could tell, like I might've

[00:32:16] [SPEAKER_01]: given them like one or two options of what to do. And you could just see that they're kind

[00:32:21] [SPEAKER_01]: of sitting there and they're, and I, and, you know, I say, listen, you don't have to make up

[00:32:24] [SPEAKER_01]: your mind now. Like this is, I gave you a lot of information. I want you to go home and think about

[00:32:28] [SPEAKER_01]: it. And there's two, there's two pointers that I want to hit on this for, for everyone listening.

[00:32:34] [SPEAKER_01]: The first thing I say to someone is I'll never say if they're my mother,

[00:32:39] [SPEAKER_01]: you know, I don't care how, how much older the woman is than me, but I will say, if you're my

[00:32:44] [SPEAKER_01]: older sister, if you're my family member, if you're my younger sister, if you're my little

[00:32:49] [SPEAKER_01]: brother, this is what I would do for you. And that goes such a long way. I, I don't know if

[00:32:57] [SPEAKER_01]: you've ever used that, but that goes so far. Cause then people go, I was just going to ask if like

[00:33:02] [SPEAKER_01]: your wife needed this or your, your dad needed this. And it's funny when I, you know, if someone's

[00:33:07] [SPEAKER_01]: like 30 years older than me and I say, you know, if you're my older sister, they'll be like, oh,

[00:33:12] [SPEAKER_01]: older sister, I could be your mother. And I'm like, well, I'm not going to say that, you know,

[00:33:16] [SPEAKER_01]: if you're my older sister, this is what we do. And it just lights them up. That's.

[00:33:21] [SPEAKER_00]: I have an older sister. I use that all the time. It's exactly right. All the time. I don't have,

[00:33:25] [SPEAKER_00]: I don't have, I don't have any brothers, but I use my older sister a lot. And, and honestly,

[00:33:30] [SPEAKER_00]: that is very effective. And it also, the other thing is, especially if it's true,

[00:33:34] [SPEAKER_00]: if this is what you would do on your older sister, that's very helpful. I mean, you can,

[00:33:38] [SPEAKER_00]: it's not a ploy if it's, if it's what you really do for your older sister. And, and the funny thing

[00:33:43] [SPEAKER_00]: is, is I literally referred my, my older sister for ortho a year and a half ago. And, uh, and it's

[00:33:49] [SPEAKER_00]: one of these things where, you know, it was not super pleasant experience. Like I didn't want to

[00:33:55] [SPEAKER_00]: tell her that, but I'm also like, you are my older sister and this is what you need to do. It is,

[00:33:59] [SPEAKER_00]: it's just sort of funny. It sort of works out that way. Yeah. That works out, that works out. And

[00:34:03] [SPEAKER_01]: then while you're, uh, two things I'll say while you're explaining things, um, don't say to

[00:34:10] [SPEAKER_01]: someone, does that make sense? Um, because you know, a lot of people, and I do say to other

[00:34:17] [SPEAKER_01]: dentists, does that make sense? Because then the onus is on the participant to understand what I

[00:34:21] [SPEAKER_01]: explained. And I might not have explained it well. I've obviously explained it where it makes sense

[00:34:25] [SPEAKER_01]: to me, but it might not make sense to that person. But I don't want to put the onus on me. Same

[00:34:30] [SPEAKER_01]: thing to patients. So after I explain something, I'll say, did I explain that well? And patients

[00:34:37] [SPEAKER_01]: might say, no, can you explain that again? And then the challenge that the dentist now has is

[00:34:42] [SPEAKER_01]: to come up with a different way to explain it. Yeah. So that they get it. And then after you

[00:34:48] [SPEAKER_01]: have talked to your patient and done everything, the last thing to do is say, what other questions

[00:34:55] [SPEAKER_00]: do you have? Don't say any questions. Yeah. Not, do you have any questions, but what,

[00:35:03] [SPEAKER_00]: what else, what else can I answer for what other questions? Yeah. What are the questions you have?

[00:35:07] [SPEAKER_01]: Make the assumption that they have it. I kind of joke, my wife and I joke around, we go to this

[00:35:12] [SPEAKER_01]: local butcher and every time we go there, they, you know, they don't go, is that it? Like you get one

[00:35:18] [SPEAKER_01]: thing. They don't go that it, is that it? They go, okay, what else? And then you start thinking

[00:35:22] [SPEAKER_01]: to yourself, Oh, what else do I need? Well, obviously. Yeah, exactly. Give me some of that

[00:35:28] [SPEAKER_01]: pork roll. Would you, that's a four more things that you didn't need, but you spend more money.

[00:35:35] [SPEAKER_01]: So, but do that to your patients say, what other questions can I answer for you or what other

[00:35:39] [SPEAKER_01]: questions do you have? And when patients literally go, I have no other questions and you go great.

[00:35:45] [SPEAKER_01]: Then say, if something comes up, when you leave the office, you know, write it down, call my office.

[00:35:49] [SPEAKER_01]: One of my team members would be happy. I got another one for you too. Once they said that

[00:35:53] [SPEAKER_00]: you will have more questions before, you will have more questions and you need to,

[00:35:58] [SPEAKER_00]: you can call me or you can contact us anytime because you will don't feel bad about it. You'd

[00:36:02] [SPEAKER_00]: be nuts not to have more. And I literally just did that with a consult. I did it about an hour ago

[00:36:06] [SPEAKER_00]: and it warmed him up cause he didn't really want to talk. He was, he was, dude was coming in.

[00:36:11] [SPEAKER_00]: He needed, you know, he's, he was embarrassed about his teeth. He was kind of, I think his

[00:36:16] [SPEAKER_00]: wife kind of dragged him in and, and I think I was able to kind of, kind of take him out of it.

[00:36:21] [SPEAKER_00]: But I said, don't worry, you're going to have more questions and we'll talk about it. Don't

[00:36:24] [SPEAKER_00]: worry about that part. So it was, it's, it's nice to just make it disarming, make them know they

[00:36:29] [SPEAKER_00]: can ask anything too. So I, the one other thing I love is when the patient comes in

[00:36:34] [SPEAKER_00]: in for treatment, the classic thing is like, you know, they show up in your chair and they ask

[00:36:39] [SPEAKER_00]: you, what are we doing today, doc? I never want them to do that. I want them to know.

[00:36:42] [SPEAKER_00]: So I like to ask them, so what are we doing today? What's your understanding of what we're

[00:36:46] [SPEAKER_00]: doing today? And then they say, I don't know. You're the doctors. No, no, no, no, no, no,

[00:36:50] [SPEAKER_00]: no. We talked about this. What are we doing today? And that is, it's an education for you and it's an

[00:36:55] [SPEAKER_00]: education for them. And if they can tell you roughly what you're going to do that day,

[00:36:59] [SPEAKER_00]: you did a good job, right? Like it lets you know that they kind of heard it. It's important too

[00:37:03] [SPEAKER_00]: because, cause they don't always hear what you, what you think there or your hope, you hope

[00:37:07] [SPEAKER_00]: they're hearing. Cause it's like drinking from a fire hose a lot of times as a patient. So.

[00:37:11] [SPEAKER_00]: Absolutely. Yeah. So John, we're obviously going to do this again. We're having a pretty good time

[00:37:16] [SPEAKER_00]: here, but you know, I have a Clara asked us to talk a little bit about some, some, some stuff

[00:37:20] [SPEAKER_00]: too. So I'm going to just like abruptly change gears because I have a car. If, if everything

[00:37:26] [SPEAKER_00]: goes the way I'm expecting, it's going to be like late September when this comes out and I have a

[00:37:30] [SPEAKER_00]: car has a, has a product that probably restorative dentists need to kind of hear about, but we were

[00:37:35] [SPEAKER_00]: laughing a little bit earlier cause we were talking about curing lights and in dentistry

[00:37:39] [SPEAKER_00]: and curing lights have like this weird history. First off, wildly important to what we do.

[00:37:45] [SPEAKER_00]: Like, like if you're using, I mean, unless you're doing all cast gold and amalgam,

[00:37:50] [SPEAKER_00]: you need to, you need a curing light. You need to get, and, and the reality is curing lights so

[00:37:56] [SPEAKER_00]: much of the time for dentists have been like, just, we tuck that stuff in at the last second

[00:38:01] [SPEAKER_00]: or, or, you know, we've just spent all this money and I'm just going to go to eBay and, you know,

[00:38:05] [SPEAKER_00]: I'm going to spend a hundred bucks and if it breaks down, it's fine. I'll just get another

[00:38:08] [SPEAKER_00]: one and that sort of thing. So John, are you an eBay curing light guy? I am not. I'm shocked.

[00:38:14] [SPEAKER_01]: Shocked. I tell you. Yeah. And I'm not an Amazon curing light guy either because, you know,

[00:38:20] [SPEAKER_01]: what we found is, you know, purchasing those hundred, $200 lights on Amazon that they claim

[00:38:26] [SPEAKER_01]: is a five second cure. Sure. It's got a five second timer. The output that those lights are putting

[00:38:34] [SPEAKER_01]: out are typically less than 900 milliwatts. So if you remember when, when we graduated school,

[00:38:41] [SPEAKER_01]: the best curing light on the market was probably putting out 600 milliwatts. 600. Right. 600 was

[00:38:46] [SPEAKER_00]: the number and it was that big box with a bunch of cords and, and you'd cure a composite for

[00:38:52] [SPEAKER_01]: what felt like an hour. Oh yeah. It was like 30 seconds per increment. You know, now everybody

[00:39:00] [SPEAKER_01]: wants to bulk fill and they're not using a bulk fill composite yet. They're using a light that's

[00:39:06] [SPEAKER_01]: not getting enough energy to the composite. And you know, we do the, you think it's cured because

[00:39:11] [SPEAKER_01]: you can, you know, explore, scale her and it looks like it's hard, but it's not hard. And how

[00:39:17] [SPEAKER_01]: do we know this? Because when you look at the mass amount of studies done, you know, in dentistry on

[00:39:23] [SPEAKER_01]: posterior residents, you know, you're looking at the success rate is six years on average. You know,

[00:39:30] [SPEAKER_01]: you're looking at all the problems that, that are associated with it. Posterior sensitivity,

[00:39:35] [SPEAKER_01]: recurrent decay, you know, voids everything, you know, what they're applying to that or

[00:39:41] [SPEAKER_01]: attributing it to is the curing light. It's just lack of polymerization. You just got it. You got

[00:39:49] [SPEAKER_00]: to have light, man. And one of the things about curing lights is like, okay, so a lot of people

[00:39:53] [SPEAKER_00]: have these offices, these huge offices with multiple operatories. And so they want to have

[00:39:57] [SPEAKER_00]: a curing light in each operatory. So the story is, of course, if you're going to do that,

[00:40:01] [SPEAKER_00]: then I just kind of cheap out on it. Cause I mean, you're going to have a, you need one for

[00:40:05] [SPEAKER_00]: each light and each operatory, and you've just spent a bunch of money on the, you know, the,

[00:40:09] [SPEAKER_00]: the cameras and the scanners and all that. And like, you know, the composite light is a small

[00:40:14] [SPEAKER_00]: item and we can, you know, and like the classic things, like it's great, it's disposable 200

[00:40:18] [SPEAKER_00]: bucks. I just buy another one. They're not putting out the light. They, and, and even if

[00:40:22] [SPEAKER_00]: they're putting out the light, when you first get them, they're there, I mean, it, it fades over

[00:40:27] [SPEAKER_00]: time quickly. And I'm going to suggest that most dentists are not great about checking what kind

[00:40:32] [SPEAKER_00]: of output they're doing. I mean, there's a lot of good ways to do that, but the reality is we're

[00:40:36] [SPEAKER_00]: lazy and we're used to stuff. And like you said, it, you can't tell with your eyes if it's cured,

[00:40:43] [SPEAKER_00]: right? Like you can't really, like, it seems like it's cured and that's pretty good. And, and so,

[00:40:49] [SPEAKER_00]: I mean, both you and I are talking about, okay, so we are both, we're kind of into spending money

[00:40:54] [SPEAKER_00]: on the curing light. And frankly, you know, they're movable enough. You know, if you've got

[00:40:58] [SPEAKER_00]: 12 operatories, you don't need to have 12, you know, $1,800 curing lights. They are relatively

[00:41:05] [SPEAKER_00]: easy to carry at this point. Most of the time they're wireless and stuff, but I, so I understand

[00:41:09] [SPEAKER_00]: the downside. Yeah. They're expensive. The good ones are expensive. The ones that are durable

[00:41:13] [SPEAKER_00]: and last are expensive. A lot of curing lights have some really like a lot of functions and kind

[00:41:21] [SPEAKER_00]: of features that are, are pretty cool. Maybe not necessary depending on the dot, but I think a lot

[00:41:27] [SPEAKER_00]: of us would like to go, okay, what I'd like to do is I'd like to get a curing light that I can count

[00:41:31] [SPEAKER_00]: on the output of, of the, of the light it's durable in the, in the outputs going to be consistent over

[00:41:37] [SPEAKER_00]: the life of the light. It's not that expensive. You know, it's when he sings where it's not,

[00:41:42] [SPEAKER_00]: it's, it's like there, it is funny curing lights sort of have this,

[00:41:45] [SPEAKER_00]: there's like two separate price points, you know, there's, there's the Amazon price point

[00:41:50] [SPEAKER_00]: and then there's like, Whoa, this thing's awesome. It's amazing, but it's $1,800 or whatever. And I

[00:41:55] [SPEAKER_00]: got to tell you, I have, I have some pretty expensive curing lights and I have no regrets,

[00:42:00] [SPEAKER_00]: but what's interesting is, is what's being released. I think if this time's the way I'm

[00:42:05] [SPEAKER_00]: hoping it's, I think it's coming out in October, I mean, October 1st and, and the, the, the

[00:42:11] [SPEAKER_00]: I have a car has a series of lights that the blue phase lights and the blue phase lights have been

[00:42:15] [SPEAKER_00]: around for a while. And the ones that are out there are very feature rich. They have a lot

[00:42:19] [SPEAKER_00]: of different timers. They have a lot of different, uh, they have some really cool

[00:42:22] [SPEAKER_00]: functions and I, I, I highly encourage you to check those out, but what they're releasing is

[00:42:28] [SPEAKER_00]: called the easy cure. So John, tell me what, tell me what you know about the easy cure.

[00:42:33] [SPEAKER_01]: So the easy cure, one of the benefits of this light, it's going to come out as a cheaper price

[00:42:38] [SPEAKER_01]: point. You know, it's probably like half the amount of money of these expensive curing lights. So

[00:42:42] [SPEAKER_01]: it's like $900, I believe is the curing light. It's always going to give out a high output,

[00:42:48] [SPEAKER_01]: which is like 1200 milliwatts, which is more than enough. You're going to need to

[00:42:53] [SPEAKER_01]: cure any bonding agent, you know, cure through a pretty thick amount of porcelain for to cure

[00:42:59] [SPEAKER_01]: your cement, um, even cure your posterior residence. So it's got a great amount of output.

[00:43:04] [SPEAKER_01]: Um, you know, and it's, and it's inexpensive if you would like, if you're someone who has seen me

[00:43:10] [SPEAKER_01]: on dental town and, you know, posted in the cosmetic section, the tack and wave technique

[00:43:15] [SPEAKER_01]: to insert veneers, it's got a stylist that you can pull out, put a tack tip in. So you could do

[00:43:21] [SPEAKER_01]: the tack part of it. So it's got an high enough energy in order for you to do that. And then

[00:43:26] [SPEAKER_01]: you could put the regular stylist on and then you could do the, you can do the wave with the

[00:43:32] [SPEAKER_01]: regular stylist, you know, afterwards. So it's got a lot of great things to it. Um, it's going to cure

[00:43:39] [SPEAKER_01]: multiple materials. So it's got a poly vision. So because it has that, but it just doesn't have

[00:43:45] [SPEAKER_01]: the bells and whistles that the other lights have to it. It's, it is, it is funny. I mean,

[00:43:51] [SPEAKER_00]: they're feature rich, but, but what I'm saying is I got to tell you, I actually told, told the

[00:43:55] [SPEAKER_00]: folks that I have a clarinet, like, you know, here's the thing you guys have figured it out.

[00:43:58] [SPEAKER_00]: Cause most dentists are kind of like me. They want something that works. They maybe don't need

[00:44:03] [SPEAKER_00]: all the features in the world. And they like the idea that the price point is not going to kill

[00:44:06] [SPEAKER_00]: them every time. Cause I mean, when you need a new curing light and you're a guy that has spent

[00:44:12] [SPEAKER_00]: money on curing lights and they don't last forever, right. I mean like they, they, they can

[00:44:15] [SPEAKER_00]: last a good long time, but it's the kind of thing where, you know, I also don't want to buy a new

[00:44:20] [SPEAKER_00]: air compressor, but sometimes you have to write something. So like what, what easy care is,

[00:44:27] [SPEAKER_00]: is it's it, the price point is very attractive, but it still gives you the stuff that you need.

[00:44:31] [SPEAKER_00]: It's a, I dunno, I think it's a really, it's a really smart move. I suspect other manufacturers

[00:44:35] [SPEAKER_00]: are going to run into this because I think a lot of, a lot of dentists run into that. I don't want

[00:44:39] [SPEAKER_00]: to spend 1800 bucks on a curing light, you know, it's a, but, but to get the quality, you almost

[00:44:44] [SPEAKER_00]: had to, this is definitely the price point is there with all the quality. I think it's, I think

[00:44:48] [SPEAKER_00]: it's a really interesting product. And so it's coming out and hopefully we'll have a chance to

[00:44:52] [SPEAKER_01]: talk. Have you had a chance to use it yet? We've talked about it. Okay. You know, to me,

[00:44:59] [SPEAKER_01]: it's, it's basically a, a stripped down version of their power cure light or their blue phase light,

[00:45:06] [SPEAKER_01]: which is great because to tell you the truth, even on the power cure light, I use some of the

[00:45:11] [SPEAKER_01]: enhancements on it, but I don't use all the enhancements like on their power, their power

[00:45:16] [SPEAKER_01]: cure light earlier. I said, poly vision, I meant to say, um, poly wave technology. Yeah. Poly wave,

[00:45:23] [SPEAKER_01]: the power cure lights got poly vision and that's basically like lane assist. So if you're,

[00:45:28] [SPEAKER_01]: if you're curing it and your hand moves a little bit away from the target, the, the light will

[00:45:33] [SPEAKER_01]: actually increase the energy. So if you're missing the target and it compensates for that,

[00:45:39] [SPEAKER_01]: and if you move totally away, like too far away from the tooth, then it just,

[00:45:44] [SPEAKER_01]: it beeps and it shuts off to let you know, like, Hey man, you're out of the way.

[00:45:47] [SPEAKER_00]: It gives you a haptic. It's like, it's like my wife's car. It's like my wife's car. If you're,

[00:45:51] [SPEAKER_00]: if you, if you, if you zone out and you're in the lane, it'll be back. Exactly. Exactly. And

[00:45:56] [SPEAKER_00]: then actually it'll, I think my wife's car will actually move me back. Probably, probably the

[00:45:59] [SPEAKER_00]: hearing light will not actually move you back to the tooth. That's a bit much to ask. I think

[00:46:03] [SPEAKER_00]: it's a five grand. They're going to, they're going to come with that now. I mean, exactly, exactly.

[00:46:09] [SPEAKER_00]: Well, when you, you said something before we were recording, like a lot of dentists, uh, have their

[00:46:13] [SPEAKER_00]: assistants cure and I'm guilty of this some of the time. And it's really funny because literally in

[00:46:17] [SPEAKER_00]: the last couple of days, I'm like, you know, it wouldn't be that hard for me to just cure.

[00:46:21] [SPEAKER_00]: Cause I know exactly where it needs to go. I know that, I know that we're working so fast,

[00:46:25] [SPEAKER_00]: but the reality is getting a good composite cure is really important. And we don't, we do this stuff

[00:46:32] [SPEAKER_00]: all the time and it's so commonplace. We don't think about that, but it is really important to

[00:46:35] [SPEAKER_00]: make sure in it. Okay. Just do yourself a favor. If your assistant is doing the curing and God

[00:46:41] [SPEAKER_00]: loved the assistance, I'm not, I'm not saying anything bad about them, but you take a look,

[00:46:45] [SPEAKER_00]: look right in that blue light, even though you're not supposed to, but look where they're having it.

[00:46:48] [SPEAKER_00]: A lot of times they don't have, they don't have the same viewpoint of where you're working as you do.

[00:46:54] [SPEAKER_00]: So I'm saying what I'm saying is, yeah, I think probably you should be hearing. But the other

[00:46:58] [SPEAKER_00]: thing, the other thing it's worth remembering, you can't over cure composite. Like if you,

[00:47:03] [SPEAKER_00]: if you put it on for three minutes, it's not going to hurt anything, but if you put it on for,

[00:47:08] [SPEAKER_00]: you know, two seconds or it's under cured, that's where all the problems are over.

[00:47:11] [SPEAKER_00]: There's no such thing as over curing a composite. So those are things that you got to remember when

[00:47:16] [SPEAKER_00]: you're using it and having a light with a good strong output is really important. Putting in

[00:47:20] [SPEAKER_00]: the right place and having good strong output makes a huge difference. Whether you're, whether

[00:47:24] [SPEAKER_00]: you're bonding in a crown or you're doing posterior composites or injury, you just,

[00:47:28] [SPEAKER_00]: you have to. And frankly, when you're done, then have your assistant go back in and, and,

[00:47:33] [SPEAKER_00]: and give it 20, 30 seconds of surface to just because you can't put the light right over the

[00:47:39] [SPEAKER_01]: tooth. You know, you can't move it millimeters away from the tooth, you know, no lights really

[00:47:44] [SPEAKER_01]: put out, you know, they don't get hot like they used to when we were younger, you know,

[00:47:49] [SPEAKER_01]: because they're all led now. So, you know, Oh God, remember that? Remember the big fans,

[00:47:55] [SPEAKER_00]: big fans on the OptiLux, the thing was, it was awesome. It's fantastic. You knew,

[00:47:59] [SPEAKER_00]: you knew you were getting some light during when it started to get a fan kicked on your

[00:48:02] [SPEAKER_00]: hair's blowing back horn. Yeah, absolutely. Really blown back for him. I'm sure. Exactly.

[00:48:09] [SPEAKER_00]: All right. So I will have all kinds of details about this light and actually I'll have details

[00:48:14] [SPEAKER_00]: about all their lights in the show notes because it's, it's a, it's hard to, it's like kind of one

[00:48:20] [SPEAKER_00]: of the less sexy things equipment wise. You know? Yeah. You want to talk about the new scanner. You

[00:48:24] [SPEAKER_00]: want to talk about the, you know, new electric hand pieces and all that stuff, but the curing

[00:48:28] [SPEAKER_00]: light is vitally important because we're all using it all the time. So it's definitely worth

[00:48:32] [SPEAKER_00]: a look. And this new product is probably, probably going to be attractive. I suspect

[00:48:36] [SPEAKER_00]: you'll see manufacturers coming out with a similarly price point quality light, because

[00:48:42] [SPEAKER_00]: I think a lot of dentists are getting bit by the eBay lights and stuff like that.

[00:48:46] [SPEAKER_00]: Yeah, it's a big problem. It is, it is. Okay. John, we've gone for almost an hour. I feel

[00:48:52] [SPEAKER_00]: like we just got started for one thing. You got to throw in a plug for clinical mastery,

[00:48:56] [SPEAKER_00]: but I want to have you back on so you can, we can talk top to bottom the curriculum there because

[00:49:01] [SPEAKER_00]: I think, uh, I think you gotta go see John. You gotta go see the clinical mastery guys. Cause

[00:49:06] [SPEAKER_00]: they're gonna, they're going to bring up. We talked about knowing how to treat the teeth. Once you,

[00:49:10] [SPEAKER_00]: once you've, you're seeing the problems and that's where they can, they can help. So give

[00:49:14] [SPEAKER_01]: a quick plug for clinical mastery. We'll have you come back on and go deep next time.

[00:49:18] [SPEAKER_01]: What I'll tell everyone is all of our courses are hands-on. So occlusion one to occlusion four,

[00:49:23] [SPEAKER_01]: I mean, occlusion one, we teach you from start to finish how to prep and finish a 10 unit veneer

[00:49:28] [SPEAKER_01]: case or 10 unit, all ceramic case. And we teach you about the when and why about CR occlusion two,

[00:49:36] [SPEAKER_01]: we teach you how to open vertical and how to prep and finish a full mouth rehabilitation.

[00:49:41] [SPEAKER_01]: Then occlusion three, we teach you that new patient interview that I took.

[00:49:46] [SPEAKER_01]: And why do we teach you in occlusion three and not one and two? First, how to do the dentistry

[00:49:52] [SPEAKER_01]: so that your cop interview the patient. You can get them to say yes. And we teach you all about

[00:49:57] [SPEAKER_01]: that. And then occlusion four, we basically bring full mouth reconstruction. And that's when patients

[00:50:03] [SPEAKER_01]: are missing teeth and how to do the process side of anything from, you know, missing a dentureless

[00:50:10] [SPEAKER_01]: quadrants to totally missing teeth and how to do that from start to finish. And it's basically all

[00:50:16] [SPEAKER_01]: process. And it's just fun. You know, the bottom line is our mantra is rock the drill. And when you

[00:50:22] [SPEAKER_01]: understand what it means to rock the drill, that's a lot of fun. John, this was a blast.

[00:50:27] [SPEAKER_00]: I can't believe that it took me 10 years to get here, but we did it. So John, thank you a ton for

[00:50:32] [SPEAKER_00]: being on. This was great. And I would like to thank Ivoclar for supporting the show and bringing

[00:50:37] [SPEAKER_00]: the new products for us. It's fantastic. We'll definitely have to do this again very soon.

[00:50:41] [SPEAKER_00]: And I thank you for being on. Thank you so much for having me on. Have a great day.