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Howard:
|
It is a very huge honor today to have one of my rock star endo idols. You really are. In your website is a rootcanalrockstar.com. This is Charles Goodies from Albuquerque, New Mexico. You practice out there with my dental friend in the world Craig Steichen lives.
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Charles:
|
Yes Craig is a great guy.
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Howard:
|
We went through dental school together and he knew I couldn’t set up my removable dentures because I just was horrible at it. He would do mine and when I would turn it in the instructor goes “Man that is just perfect Howard. I’m going to give you an A. Tell Steichen he did a good job.” True story. Craig Steichen did all my removable lab work. I first heard of you back I think it was in the 80s. When did you get out of school?
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Charles:
|
I got out in ‘91 and we met I think back in 95.
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Howard:
|
95? Well that’s part of being 53 your brain can’t remember. I got the CRS I can’t remember shit.
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Charles:
|
Me too.
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Howard:
|
You were a pioneer in the rotary endo. Let me read your bio. Dr. Goodis received his DDS from the University of Michigan. His GPR residency at the University of Minnesota and ha endodontic residency at the University of Connecticut. His undergraduate major at the University of Michigan was mechanical engineering which really explains your fascination with rotary instruments.
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Charles:
|
Just a frustrated engineer that keeps wanting taking care of his stuff.
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Howard:
|
This background combined with his vast experience in endodontics which led to the development of Edge Endo. His endodontic supply company sells heat-treated NiTi rotary riles and thermal obturators for less than half the cost to promote excellence in endodontics. You got out of endo school in 96.
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Charles:
|
Endo school in 96 yeah.
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Howard:
|
When did you start experimenting with … First of all what on your journey after endo school did you decide in the middle of Albuquerque “I’m going to make my own endo file.”? Was it during a Peyote trip on a mountain top while [I’ll coming 00:02:10] with Craig Steichen?
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Charles:
|
With him and Peter Fonda who’s the … they were in New Mexico. What was that … darn it! I’m trying to remember.
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Howard:
|
I remember but ...
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Charles:
|
The actor.
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Howard:
|
Basically …
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Charles:
|
Anyway ….
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Howard:
|
Charles Goodis before he got into rotary he’s 100% Greek and he was the one who introduced that if you spray Windex on your endo files just like John’s [inaudible 00:02:39] he sprays Windex inside his crowns before he seats them that’s why John [Kois 00:02:44] is good at crowning bridge. Did you see that movie My Big Fat Greek Wedding?
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Charles:
|
Yes I did.
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Howard:
|
Did you find it insultory or funny?
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Charles:
|
Not at all. I found it very true.
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Howard:
|
Do you ever use Windex at home for purposes that are not …?
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Charles:
|
I really don’t. I try to not use Windex anymore.
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Howard:
|
That movie took Windex out of your kitchen cabinet.
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Charles:
|
Yes.
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Howard:
|
What on your journey out of endo school made you … or did you start thinking about it during endo school?
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Charles:
|
A little bit during endo school. We first met you went down and visited John McSpadden back in ‘95 and that’s when I first met you. I was working in John’s practice while I was 'in my endo residency school and he was just designing the Quantec file. Obviously this goes back 20 years ago. As we all know John’s really brilliant. Just being able to talk with him, see how he was launching it and the …
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Howard:
|
The Quantec?
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Charles:
|
Yeah the Quantec.
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Howard:
|
Tell the story because I just lectured in Tennessee twice this year. When you go to Tennessee a lot of those old guys well kept you and they go “Tennessee we invited rotary endo.” They’re claiming that to their homie John McSpadden and … where is he at Tennessee? Not Charlotte, it’s Chattanooga.
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Charles:
|
I think he’s still in Chattanooga.
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Howard:
|
Is that true? Did John McSpadden invent rotary in Chattanooga?
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Charles:
|
John was involved with a company called Quality Dental and they with … we’re all losing our Derek Heath who was an engineer …
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Howard:
|
Derek Heath?
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Charles:
|
He was an engineer. Derek started Quality Dental. Dr. Harmeet Walia went down there. He was the head of endo at Marquette. I’m trying to remember where he’s at right now.
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Howard:
|
What’s his name?
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Charles:
|
Dr. Harmeet Walia
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Howard:
|
How do you spell that her …
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Charles:
|
Don’t hit me too hard.
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Howard:
|
Harmeet …
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Charles:
|
Harmeet M-E-T and then Walia, W-A-L-I-A.
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Howard:
|
Sounds Arabic.
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Charles:
|
He’s Indian.
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Howard:
|
I was close. I was on the other side of the world.
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Charles:
|
Sweet man, wonderful person.
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Howard:
|
He was a dentist and Derek Heath was the mechanical engineer?
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Charles:
|
Harmeet was an endodontist. He ran the program at Marquette. I think he’s running the program at University of Florida right now. He saw orthodontic NiTi, orthodontic wire was switching to NiTi he saw that and he went down to Tennessee and met with Derek Heath and they produced the first NiTi endodontic file and they did some test.
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Howard:
|
They did it at Marquette or they did it in Tennessee?
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Charles:
|
I believe the test were done at Marquette but it was manufactured at Quality Dental at Johnson City, Tennessee.
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Howard:
|
Johnson City, Tennessee. Is that a suburb of Chattanooga?
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Charles:
|
Chattanooga is more towards the west. Johnson City is towards the Smoky Mountains.
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Howard:
|
I’m pretty sure Al Gore invented it.
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Charles:
|
Yeah if it was.
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Howard:
|
He did this after the internet or before the internet?
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Charles:
|
I think he did this during. From what I know John again a lot of this is just me here … you know the old stories how it start. I think John had his practice in Johnson City at the time from what I understand. He knew Derek Heath. I think Derek, he was manufacturing files up in New Jersey. From what I understand is John said “Hey why don’t you come down to Tennessee and manufacture?” John and him started really working closely with files. Harmeet came down. Dr. Walia introduced NiTi files and then John saw that and I think John and Derek thought, “Hey wouldn’t this be great to start making rotary files.” John already had the …
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Howard:
|
The first NiTi used in endo was actually hand files?
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Charles:
|
It was hand file.
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Howard:
|
That was Quality Dental at Johnson City. Then McSpadden came and said …
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Charles:
|
McSpadden came and then …
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Howard:
|
he already had the McSpadden condenser?
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Charles:
|
Yup.
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Howard:
|
What was that?
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Charles:
|
It was a compactor. What it was the flute [trended 00:07:06] in a reverse direction so when you would spin it … while the gutta-percha was in there it would melt it naturally, compact the gutta-percha down into the canal. If the flutes were going in a clockwise direction, it would pull the gutta-percha out. John came up with a going in a counter clockwise direction so when it spun it would actually melt the gutta-percha before put it down.
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Howard:
|
By the way the most successful people make a religion out of availability. I want to thank you for coming by.
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Charles:
|
Thank you brother.
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Howard:
|
You’re the CEO of the company. You came by my house on a Saturday morning. When I got out of school in 87 I was having some endo problems. I called McSpadden. He said, “Just fly to Chattanooga and stay with me. Stay at my house.” I’m like, “Are you serious?” He’s, “Yeah. Pick me up.” I think it was a Rolls Royce.
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Charles:
|
yup.
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Howard:
|
Pick me up in a Rolls Royce at the airport. I’m like, “Okay I’m a 24 year old punk ass kid.”
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Charles:
|
John knows how to roll.
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Howard:
|
I fly to Chattanooga, didn’t even know where it was on the map and he picks me up on a Rolls Royce. He told me on the drive back to his house that it was necessity is the mother of invention. He’s a moose of a man. I’m 5’7”. He’s got to be 6’6”. He could be a linebacker for Michigan. He said, “I couldn’t get my fingers back [inaudible 00:08:23]. I was trying to make it all through instruments and hand pieces because … I am 5’7” and when I was little I grew up 5 sisters. I always knitted and crocheted. I had the fingers for dentistry and he didn’t. He said this whole thing was out of a necessity of invention.
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Charles:
|
His work is just beautiful. When I met you, John had already … I don’t know what all these names are escaping me all of a sudden because I’m trying to think of …
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Howard:
|
How old are you? I’m 53. How old are you?
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Charles:
|
I’m 50.
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Howard:
|
You’re 50 well 3 more years buddy you won’t remember your name.
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Charles:
|
Then Tulsa Dental bought out …
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Howard:
|
Ben Johnson started with an obturator.
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Charles:
|
That’s [when I went with 00:09:10] with Ben.
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Howard:
|
Ben Johnson started with an obturator. He was another amazing pioneer that I called 24 years old and Ben Johnson the same thing. Then he goes, “You got there Phoenix. They got Southwest Airlines it cost you 100 bucks hopping airplanes.”
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Charles:
|
He’s the one who come up with the profile.
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Howard:
|
Come also stay at my house. I’ll go in there and this is just a dumb ass kid out of dental school. He was hand rolling those obturators. He noticed that gutta-percha …
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Charles:
|
Where did you think that talent come from?
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Howard:
|
Rolling joints I would say.
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Charles:
|
I haven’t talked to him about that.
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Howard:
|
He noticed that the gutta-percha in his bottom drawer that it got rolled that he could roll on a file and he’s just obturator. How did he make the … that was in Tulsa which is why they call it Tulsa Dental products. How did he go from Thermafil obturators into NiTi files? How did he make that from?
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Charles:
|
From what I understand is he got to know Derek also. Tulsa Dental and Quality Dental merged. John came up with the original profile 0406 with the large radial lens and they also worked with Dr. Herb Schilder to come up with the series 29 and it was … that’s when I got into endo school right when that was …
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|
Howard:
|
Schilder was Boston?
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Charles:
|
Yeah. Obviously very, very famous and very influential endodontist. They came up with that. Tulsa Dental and Quality Dental merged. Again, I hope I’m getting all these stories right. Ben, Derek and john we should bring them in so they go “Oh Chuck messed that story up.” I think we’re getting pretty close to it. Then Tulsa Dental was bought out by DENTSPLY.
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Howard:
|
Then where were you in this journey? You were John McSpadden’s associate. You’re in Johnson City.
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Charles:
|
I would fly in every weekend while I was in endo school. I would either fly or drive down from Connecticut. I’d take …
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Howard:
|
What city was that in?
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Charles:
|
Hartford. It’s in Farmington but I would go to the Hartford airport, fly down the Delta connect in Atlanta.
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Howard:
|
You’re probably still an obnoxious Patriots fan?
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Charles:
|
no, I’m originally from Detroit so I’m a …
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Howard:
|
They have a few good games this year.
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Charles:
|
We refer to Detroit Lions as the rebuilding since 1957 Detroit Lions so yes I am.
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Howard:
|
who was their best running back of all time?
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Charles:
|
Barry Sanders.
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Howard:
|
From where I grew up in Wichita, Kansas. Born and raised in Wichita.
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Charles:
|
I didn’t know that.
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Howard:
|
He’s the most famous guy in Wichita.
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Charles:
|
I know he went to Oklahoma State but no I didn’t know that.
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|
Howard:
|
In Wichita when you say Barry Sanders, you had to make the sign of the cross.
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Charles:
|
He was smart enough to get out before his knees went bad and plus the Lions weren’t going anywhere anyways because he knew they were rebuilding since 1957.
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Howard:
|
You started flying from Hartford to Johnson City?
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Charles:
|
By then John had his practice in Chattanooga. I’d fly down from Hartford connect in Atlanta. Atlanta back up to Chattanooga and then I’d work there on weekends doing endo.
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Howard:
|
On patient?
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Charles:
|
Yeah on patients.
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Howard:
|
John’s practice was open on Saturdays and Sunday s?
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Charles:
|
Yeah when I was working there.
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Howard:
|
[crosstalk 00:12:44]
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|
Charles:
|
Do we have the cat in the view now?
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|
Howard:
|
Was it Friday’s or Friday, Saturdays and Sunday s?
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Charles:
|
I would fly down on Friday s so it would be Saturday and Sunday. I’d work Saturday and Sunday.
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Howard:
|
He was open Saturday and Sunday.
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|
Charles:
|
Yeah.
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Howard:
|
The other genius endodontist in Manhattan Barry Musikant. The first thing that got my attention to him he was talking about his Safe Sider file but I’m sitting here looking at his website noticing it was open 7 days a week and I thought, “You’re just a businessman from A to Z.”
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Charles:
|
Particularly when you’re in Manhattan where they’re … I’m trying to remember there’s over 100 endodontist. There may be more than that. There’s like 7 in Albuquerque maybe 12 in the whole state of New Mexico. There’s maybe 100 to 150 in Manhattan. You need to stay sharp.
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Howard:
|
You know what’s interesting about Manhattan if all 7 billion earthlings lived in the same density as Manhattan, we would all fit on New Zealand.
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Charles:
|
That’s amazing.
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|
Howard:
|
All 7 billion people in the land mass of New Zealand if we lived like they did in Manhattan which is the most amazing city in the world. You’re flying down there to do endo on Saturday and Sunday what is it for money because you knew this was the hotbed of endodontic religion or …?
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|
Charles:
|
By the time I finished my endo residency … by the time you got paid for the flights because I had to get my southern dental boards also by the time I would say I probably broke even and I knew I was going to end up breaking even it was more just for the experience to be around someone like John.
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Howard:
|
In Connecticut you already were the McSpadden and Ben Johnson were kind of thinking outside the box.
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|
Charles:
|
You have to pick a research project in endo school so mine was NiTi files were just … it was funny my mentors Dr. Larz Spangberg and Dr. Kamran Safavi in endo UConn.
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|
Howard:
|
What are their names?
|
|
Charles:
|
Dr. Larz Spangberg.
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|
Howard:
|
How do you spell that L-A-R-I-S?
|
|
Charles:
|
With an S and then Spangberg. Spangberg is a very famous endodontist. His research is just amazing. He’s got 300 maybe 400 papers published. Dr. Kamran Safavi he now runs the program because Dr. Spangberg is retired. They just threw all these … like all of us back then in ‘96 rotary files are just thrown on us and I was similar to like John like my head hurts when I do hand filing. I jumped on rotary files like it was the greatest thing in the whole world.
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|
Howard:
|
Dude I did my first root canal in ’86 and from 1986 to when I did my switched to rotary I had a blister on my thumb because I was doing this 2 or 3 or 4 molars a day and I always had a numb little blister.
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|
Charles:
|
There was no way I was going to keep doing that. Particularly my hand felt like it was going to fall off so I go I really love endo but I’m going to have to retire at 35 if I don’t use rotaries.
|
|
Howard:
|
I got 5 sisters and a gay brother so I have to get a lot of mani-pedis because the options are you want to go to a movie? No. you want get mani-pedi? Okay, let’s all do that.
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|
Charles:
|
I haven’t but if you want after this, let’s get a mani-pedi.
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|
Howard:
|
I had more mani-pedis with one of my 5 sisters, my gay brother and I remember one time I was getting a mani-pedi and the little Vietnamese chick said, “Oh you’re a guitar player. I can tell by your blister.” I’m like, “No that’s from root canals but I get what you’re saying.”
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|
Charles:
|
That’s what I did my research project.
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|
Howard:
|
Was on rotary file?
|
|
Charles:
|
On rotary file. They just hit the streets in the endo programs. From then I remember I drove down to Johnson City. Derek Heath who was running Quality Dental …
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|
Howard:
|
Does he still run it?
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|
Charles:
|
No, he doesn’t. He now has his own again in Johnson City a DNS Dental for Derek and Steve … Derek Heath and Steve Treadway are now partners and they run DNS Dental in Johnson City.
|
|
Howard:
|
Steve Treadware?
|
|
Charles:
|
Treadway.
|
|
Howard:
|
Is he a dentist?
|
|
Charles:
|
I don’t believe he’s a dentist.
|
|
Howard:
|
Its 2 engineers?
|
|
Charles:
|
Yeah.
|
|
Howard:
|
Is that what they are mechanical engineers?
|
|
Charles:
|
They’re just really been able to …
|
|
Howard:
|
When did you start your own file?
|
|
Charles:
|
Then again due to research project, going down, flying down with John then eventually opened my practice in Albuquerque, New Mexico.
|
|
Howard:
|
Is that where you’re from?
|
|
Charles:
|
No, I’m originally from Detroit.
|
|
Howard:
|
You’re from Detroit City so you [inaudible 00:17:29] out of the weather?
|
|
Charles:
|
Really love New Mexico. I did Indian health service for a few years up on the Montana Canadian North Dakota border. We get down to …
|
|
Howard:
|
Montana Canadian yeah.
|
|
Charles:
|
I remember for 30 days it never got above -30 and then when it got to -5 I thought it was a spring day.
|
|
Howard:
|
You know straight north of Phoenix is Calgary and it’s about a 20 hour drive. You go up around the Grand Canyon through Bryce Canyon, salt land. That’s the prettiest drive. Flying in an airplane it just doesn’t do credit. You just got to drive that.
|
|
Charles:
|
The temperature will drop …
|
|
Howard:
|
You decided that you want to live in Albuquerque?
|
|
Charles:
|
Yes.
|
|
Howard:
|
No family just …
|
|
Charles:
|
No because I …
|
|
Howard:
|
Were you already married at what time?
|
|
Charles:
|
no, we’d get down there for training with Indian health service and found out I really liked Albuquerque. When I wanted to open my own practice and as you know particularly now it’s hard to find places where you can just hang a shingle. Albuquerque I knew I could hang a shingle, open a practice and be busy so that’s why I moved to Albuquerque.
|
|
Howard:
|
Did you do demographic research?
|
|
Charles:
|
Yes.
|
|
Howard:
|
This when you’re became an endodontist? After endo school you did Indian public health?
|
|
Charles:
|
No, right before.
|
|
Howard:
|
Right before endo school?
|
|
Charles:
|
yeah right before endo school I did public health. That’s how I got to learn about Albuquerque.
|
|
Howard:
|
then you went to Connecticut?
|
|
Charles:
|
Yup.
|
|
Howard:
|
Then you realized supply and demand mattered and you decided Albuquerque?
|
|
Charles:
|
Love the west. You start looking at Denver, Phoenix, Albuquerque, Dallas, Austin. You just starting looking out west and you start going you even like Missoula, Montana. You just finding there’s already endodontist there. There’s a lot.
|
|
Howard:
|
It’s so sad because I’m in a dozen dental schools a year and all those kids say the same thing. “I want to build a dental office that looks out over the ocean Huffington Beach or whatever. It’s going to be …” It’s like, “Yeah you got …” I saw Rick [Hirsch 00:19:38] tweeted yesterday he goes, “My new year’s resolution is I’m going to quit arguing with dental students.” It’s like, “Dude if you want to go set up where there’s a dentist for over 300 people good luck or you’ll be selling Amway at night.”
|
|
Charles:
|
You have to find. Albuquerque while I love Albuquerque endodontist mostly moved … I think what happened is the endodontist would come down to Albuquerque. Their spouse would come with them then they’d go fly to Denver, fly to Phoenix, go fly to Dallas and you’re going to go “No I’m going to go to Dallas, Denver or Phoenix.” Albuquerque it’s a small town. You got to love Albuquerque. No sports team. It’s just small.
|
|
Howard:
|
Mile high.
|
|
Charles:
|
it’s a mile high up and I think that’s what kept a lot of people out. I go, “well I’ll go to Albuquerque. I don’t have a Problem with that. I love the west and Albuquerque is a great town and Santa fe is close.” That’s why I moved there.
|
|
Howard:
|
You know [Chris Ber 00:20:34]?
|
|
Charles:
|
Yes.
|
|
Howard:
|
[Christ Ber 00:20:36] is my class me and Steichen too.
|
|
Charles:
|
Up in Colorado?
|
|
Howard:
|
Yeah. He’s up in Santa Fe.
|
|
Charles:
|
No, in dental school …
|
|
Howard:
|
We went to UMKC.
|
|
Charles:
|
Yeah.
|
|
Howard:
|
University of Missouri Kansas City and …
|
|
Charles:
|
[Chris Ber 00:20:49] is a great guy. Great dentist.
|
|
Howard:
|
One time we left dental school …
|
|
Charles:
|
Just a healthy attitude about life.
|
|
Howard:
|
He had 2 BMW 1600s and we got out of dental school like 5:00 on a Friday and we had wild hair up our ass. We’re at the bar. We said “Let’s go home.” we jumped on 2 BMW 1600s and rode about 150 miles an hour cutting across Kansas on these 2 lane roads that are flat. You could see forever. You can just open these bikes up. We rode from Kansas City to his mom’s house in Santa Fe before sun up. When we got to her driveway it was all the stars. That was the most beautiful motorcycle ride I had ever done. That was I think in 86. No helmets, nothing. I mean it just crazy.
|
|
Charles:
|
I know New Mexico that you don’t need helmets.
|
|
Howard:
|
It’s so beautiful
|
|
Charles:
|
It’s just amazing out there. Seeing the sunrise in Santa Fe beautiful.
|
|
Howard:
|
You get out of school in …
|
|
Charles:
|
Go to Albuquerque.
|
|
Howard:
|
In ‘96 go to Albuquerque. When did you start playing with file?
|
|
Charles:
|
I start thinking that boy I think I can do this better. I think I can do this better.
|
|
Howard:
|
From your paper in grad school?
|
|
Charles:
|
From writing that and just now that I’m working I’m going, “They should do it this way. They should it that way. They should do it this way.” Finally I said, “let’s I need that …”
|
|
Howard:
|
Go to a set of points. Some could say well did you do it because you had a passion of the file or you just thought it was a good business opportunity or …?
|
|
Charles:
|
No, it was more just as I’m using I’m going “Why aren’t they doing it this way?”
|
|
Howard:
|
Explain that. Go over that thinking.
|
|
Charles:
|
When I’m feeling going into the canal I’m going, “There’s got to be a way to make this cut better, be more flexible and just prepare the canal better.” I start looking at different flute designs, how the pitch should be opened. You just start experimenting and finally I go “I need to make some prototypes.” Then back and I’m thinking about 2002 that’s when I finally …
|
|
Howard:
|
How the hell do you make a nickel NiTi prototype endo file? Did you go to Denver? Did you have quality dental make it?
|
|
Charles:
|
Quality Dental again they’re in Johnson City. By then Tulsa Dental which was owned by DENTSPLY. By then you had pretty much just Tulsa Dental and Sybron making files.
|
|
Howard:
|
Sybron which is Kerr. Owned by Danaher.
|
|
Charles:
|
Yeah. My advice to them would be I love the Kerr name but you changed it to Sybron and all the kids for the last 20 years are used to Sybron rotary files. Now you switch it back to Kerr I think you know from branding yourself they should it keep it Sybron even though Kerr is 100 year old name the last 20 years nobody knows who Kerr is. They know what Sybron is.
|
|
Howard:
|
I remember 3Am change Vitremer to RelyX just out of the blue. Just went from Viteremer to RelyX and every dentist on dental town whenever they talked about RelyX would could it Vitremer for about a decade.
|
|
Charles:
|
Now Kerr they were pretty much the 2 players and contacting them they weren’t too much interest. They had their own visions where they want …
|
|
Howard:
|
There was a lot of big patents on all this stuff. I remember back in the day when Ben Johnson was out and he used to … I heard him say, “I own all the patents on endo files.” Was that true or did they just eventually expired or …?
|
|
Charles:
|
No. After my brother-in-law worked for a large patent firm and he connected with someone in their office.
|
|
Howard:
|
In Detroit?
|
|
Charles:
|
No, out in New York. My wife is from New York and her sister married a patent attorney. It got me really into trying to understand patents. I spent a couple of years just digesting all the patents out there and …
|
|
Howard:
|
On endo files?
|
|
Charles:
|
On endo files and …
|
|
Howard:
|
Who held most of those patents?
|
|
Charles:
|
A lot were by Derek Heath. John McSpadden held a lot. Ben Johnson held a lot. After just looking at them it seemed pretty clear to me that you could make a NiTi rotary file.
|
|
Howard:
|
That could get around their patent.
|
|
Charles:
|
That didn’t infringe on their patent.
|
|
Howard:
|
About when where all those endo file patents placed because I keep hearing that most all of them are expiring like even this year will be some of the last …
|
|
Charles:
|
Those are all over about 20 years ago.
|
|
Howard:
|
All those NiTi patents were placed 20 years ago or expired 20 years?
|
|
Charles:
|
They all were granted in the early 90s.
|
|
Howard:
|
How long is the patent?
|
|
Charles:
|
Usually it’s about 20 years.
|
|
Howard:
|
Usually about 20 years unless you’re the recording industry in America and went to congress and got there [inaudible 00:26:15].
|
|
Charles:
|
Yeah you got a little longer. Most of those have been expired. When I launched my first file with Guidance back in the mid 2000 like 2004 or 2005 so that was my first endodontic company was with Guidance Endo and we had …
|
|
Howard:
|
That was all your company?
|
|
Charles:
|
That was all my company yes.
|
|
Howard:
|
Why did you change the name?
|
|
Charles:
|
Then supplying myself. We got into … because again they felt they had certain patents which I disagree that we were in any way infringing we went back and forth.
|
|
Howard:
|
For years.
|
|
Charles:
|
For years and years.
|
|
Howard:
|
How many years and years?
|
|
Charles:
|
I think about 3 or 4.
|
|
Howard:
|
Then you won that, right?
|
|
Charles:
|
There was a mutual understanding.
|
|
Howard:
|
A mutual understanding where the money went from DENTSPLY to you?
|
|
Charles:
|
Just a mutual understanding.
|
|
Howard:
|
You can’t say anything, right?
|
|
Charles:
|
Just a mutual understanding.
|
|
Howard:
|
Can I just say all the rumors are that they had to give you a chunk of change?
|
|
Charles:
|
Those may be the rumors but there was just a mutual understanding.
|
|
Howard:
|
Then when that was over, you changed the name to Guidance?
|
|
Charles:
|
Then when that was done because it was such a long process, I wanted to step back and just regroup. After about 6 months …
|
|
Howard:
|
That was as long as you would take a vacation 6 months and then the crazy dentist engineer yeah I’m going to retire 6 months later. What’s next? I tried retirement. What’s next?
|
|
Charles:
|
I still had my endo practice because I enjoy doing endo. What I love to be a centerfield for the Detroit Tigers? Yes. Would I love to play quarterback for the Detroit Lions? Yes. It just didn’t quite work out that way. I found …
|
|
Howard:
|
Would I like to have hair? Yes.
|
|
Charles:
|
I can do a pretty good root canal and I enjoy doing it. As you know just like you’re still practicing dentistry you don’t have to practice dentistry but we just do it because it’s what we do.
|
|
Howard:
|
On new year’s eve we were all supposed to leave at noon an at 10 afternoon some 61 year old man that I’ve known forever walked in and he’s just holding his face and my youngest son Zac was assisting me and I said, “Hell yeah we’ll see him.” There was my youngest baby and we do a root canal for an hour and a half then I told the guy I said, “This is my son.” I said, “Do you care if I really explain what I’m doing to my son?” He’s like, “Oh I think it’s so cool that he’s with you.” I sit there and lectured endo to my baby and I was doing this root canal. I was getting him out of pain. I was fixing his tooth. He was going to have a miserable new year’s eve. I got more satisfaction that day from noon to 1:30 than anything I did on New Year’s Eve.
|
|
Charles:
|
You were helping someone.
|
|
Howard:
|
Yeah. Who the hell … if that doesn’t turn you on, you should get out of healthcare, get out of teaching. You know what I mean?
|
|
Charles:
|
The number 1 thing is helping your patients. That’s got to be what jazzes you up. That’s got to be your passion.
|
|
Howard:
|
Then we filled it with Sargenti which you taught me and I push it down with the McSpadden condenser like John McSpadden. I got a nice bolus of paraformaldehyde into the inferior alveolar canal and I don’t think he feels anything. You remember teaching me all that?
|
|
Charles:
|
[inaudible 00:30:15]
|
|
Howard:
|
Can you believe last year I saw another $1 million lawsuit paid with the use of Sargenti. It was in Kansas where a bolus went out the end, pickled the whole inferior [alba 00:30:29]. It’s amazing how you still see that stuff. Then I was an endodontist in Albuquerque, is it gone or do you still … is there anyone still placing it?
|
|
Charles:
|
From what I understand there is a few dentist that will place it. Some use it a sealer. Some use it as a permanent filling. It’s not too many but it’s out there. I don’t think the risk reward is …
|
|
Howard:
|
I want to ask you good. Angelo Sargenti who’s life do you think it was a great thing because it saved millions of teeth or do you think his whole life and what he did at Italy do you think he saved millions of teeth around the world or do you think the whole deal was a step backwards? Do you think Angelo Sargenti was 1 step forward, 2 steps back? How would you describe his …?
|
|
Charles:
|
Being an endodontist first thing when you get into endo school you read his book, his N2 book. You read it. You digest it and then we all …
|
|
Howard:
|
What year is that written?
|
|
Charles:
|
What year I can’t remember if it was in the 50s or 60s.
|
|
Howard:
|
What did they teach [inaudible 00:31:39]?
|
|
Charles:
|
I can’t remember now. Come on I’m 50.
|
|
Howard:
|
It’s something weird.
|
|
Charles:
|
Yeah I remember.
|
|
Howard:
|
In endo school you read N2.
|
|
Charles:
|
We read it and then we burn it figuratively. The point is I’m probably not the best person to ask because I come from a very … as an endodontist we’re going to come from a very jaded way of looking at it.
|
|
Howard:
|
Do you remember the endodontist rock star out of Dana Point, California [inaudible 00:32:07]?
|
|
Charles:
|
Yeah.
|
|
Howard:
|
You know he actually the only reason he went to endo school is to teach those son of a bitches how Sargenti is better. They reschooled him and it took him. He said it took about a month before he realized that he was wrong. That’s why he went to endo school. He was going to take Sargenti to the endo program.
|
|
Charles:
|
There’s again some interesting properties about it. It’s just again the risk reward, the risk I think just a little too high.
|
|
Howard:
|
I think to sum up Sargenti deal is god bless him if he saved a bunch of teeth or whatever but when people tell you I did Sargenti for 20 years and it worked great that’s because they were cleaning and shaping the canal really well because it’s not with their obturator with. You see them on track. Now you close guidance and now you opened … is it [Luke 00:32:59] Edge Endo but your website, is it Edge Endo or root canal rock star?
|
|
Charles:
|
We also have on there because people like a forum, showcases and talk. That’s why we just came up with root canal rock star because if you want to showcase …
|
|
Howard:
|
Is it mostly general dentist or endodontist?
|
|
Charles:
|
For Edge Endo we have over 1000 endodontist and 10,000 general dentist are our customers right now.
|
|
Howard:
|
Edge Endo you have 1000 endodontist out of how many …
|
|
Charles:
|
5000.
|
|
Howard:
|
Out of 5000 in the US, how many in the world?
|
|
Charles:
|
The world, we’re only selling in US and Canada. We do some distribution. You have to know endodontist there’s 5000 endodontist in the US, in Canada but in the world there’s really not that many endodontist.
|
|
Howard:
|
The United States is very much the only one that really into the specialty thing. When you go to most other countries they don’t really have that.
|
|
Charles:
|
Correct.
|
|
Howard:
|
I own Ortho Town so there’s like 10,500 endodontist in the United States but the whole world is only like 70,000. You can’t even double the US specialist. Whatever the US is originally 5% of the world’s population, double that number and that’s over them.
|
|
Charles:
|
The US has probably 5000 and probably the rest of the world, probably only has 2500.
|
|
Howard:
|
Rootcanalrockstart.com that’s more a message board community?
|
|
Charles:
|
Yes.
|
|
Howard:
|
How many dentist you had on that?
|
|
Charles:
|
I think a couple of thousand.
|
|
Howard:
|
I always see those … and they’re posting cases and sharing cases and all that stuff. When did Edge Endo open?
|
|
Charles:
|
Edge Endo was 3 years ago.
|
|
Howard:
|
What is your file system?
|
|
Charles:
|
The file system we have the edge file which is an 0406 system. In that we also have a reverse fluted one that we call the X1. That would …
|
|
Howard:
|
Reverse flute.
|
|
Charles:
|
If you’re a wave 1 user, you could use our Edge file X1 and it’s again half the cost, even less than half the cost.
|
|
Howard:
|
You’ve always been at half the cost, right?
|
|
Charles:
|
Yes.
|
|
Howard:
|
the only thing Herb Kelleher of southwestern alliance said, “The only secret to lower price, lower cost.” Southwest airlines they took out the meals. They only fly 1 plane. How can you make … would you say your average endo file is how much cheaper than the ones that everyone is buying?
|
|
Charles:
|
Typically average endo file might be $11. Ours is under 4.
|
|
Howard:
|
The only secret to lower price is lower cost. How do you make it for 4?
|
|
Charles:
|
I would say everybody is making it for a similar …
|
|
Howard:
|
What do you think everybody is making it for a cost on the file?
|
|
Charles:
|
I think it’s probably somewhere between a dollar to $2.
|
|
Howard:
|
A buck to 2.
|
|
Charles:
|
When you have …
|
|
Howard:
|
Do you sell direct or do you go …?
|
|
Charles:
|
We sell direct.
|
|
Howard:
|
That’s a big crazy thing because what does Patterson, Shine, Benco, Burkhardt, what is the average dealer mark everything up when they buy?
|
|
Charles:
|
From what I understand they usually want 30% to 40% maybe even 50% increase.
|
|
Howard:
|
Probably in that 30%, 40%, 50% so just selling direct you can almost get from 10 to 5.
|
|
Charles:
|
The main …
|
|
Howard:
|
Interesting DENTSPLY when they bought Tulsa Dental product they told Patterson, “No, that’s a direct company. We’re leaving that baby direct. We’re not going to …”
|
|
Charles:
|
Really the major players in endo, also direct.
|
|
Howard:
|
Who are they?
|
|
Charles:
|
Tulsa Dental.
|
|
Howard:
|
Tulsa Dental direct.
|
|
Charles:
|
Brasseler and Kerr Sybron. Kerr Sybron they sell through distribution but pretty much most of their sales from what I understand are direct.
|
|
Howard:
|
You can buy all the subdirect from Sybron Kerr. Is it Sybron Kerr or Kerr Sybron?
|
|
Charles:
|
That’s what I’m saying. I’m struggling with. I think they should just call themselves …
|
|
Howard:
|
Then what’s the other?
|
|
Charles:
|
Then there’s us.
|
|
Howard:
|
There’s us which his Edge Endo.
|
|
Charles:
|
Pretty much I expect by the end of 2016 we should pass Kerr Sybron we’ll be the third largest seller in the US.
|
|
Howard:
|
Number 1 would be Tulsa. Number 2 would be ...
|
|
Charles:
|
Brasseler
|
|
Howard:
|
Really? Did you ever meet Peter Brasseler?
|
|
Charles:
|
No.
|
|
Howard:
|
God he is an amazing man.
|
|
Charles:
|
No I didn’t.
|
|
Howard:
|
That was a loss when he passed away. You’re 4 down. You think you’re about to be third.
|
|
Charles:
|
We’ll be third. I feel very confident [inaudible 00:37:52] will be third.
|
|
Howard:
|
I would think if you’re … would you say your average half the price?
|
|
Charles:
|
Yes. I think the most important thing is not only half the price, I think the big kicker is I know like from cyclic fatigue which is a direct link to fracture 8s longevity in the file ours last twice as long as anyone else than any other file on the market and its more flexible.
|
|
Howard:
|
Is breakage still an issue with dentist? Let’s not talk about general dentist because they don’t know what they don’t know. Let’s talk about you got 1000 endodontist customers. I think the fact that you have 1000 endodontist buy in is that what you said?
|
|
Charles:
|
Correct.
|
|
Howard:
|
You got 1000 endodontist buying through you. That’s probably your number 1 accolade going right now. Do those 1000 endodontist do they still tell you that between Tulsa, Brasseler, Kerr and edge endo is file breakage still an issue?
|
|
Charles:
|
Even as an endodontist if you may only break 1 or … again you have to look they’re doing 2000 cases a year so …
|
|
Howard:
|
Damn! The average American 40 hours a week, 50 weeks a year is 2000 hours so they’re doing a molar 8 hours a day, 5 days a week. The average endodontist doing 2000 …
|
|
Charles:
|
By about 2000 root canals a year. They’ll say they’re going to get a few breakages a year.
|
|
Howard:
|
What a few?
|
|
Charles:
|
One to three.
|
|
Howard:
|
They’re getting 1 to 3.
|
|
Charles:
|
About 1 out of 1000. Ours would be “Why don’t you by having twice the cyclic fatigue of anything out there …
|
|
Howard:
|
Does it have tricyclic fatigue?
|
|
Charles:
|
It has. By far twice as cyclic fatigue as ...
|
|
Howard:
|
You spray Windex into the canal so I’m thinking maybe I didn’t know that was that joke was going to run by [inaudible 00:39:42] Now I feel horrible. Only know the cat’s not Greek. As a function of the metal composition of the nickel titanium?
|
|
Charles:
|
Ours is heat treated.
|
|
Howard:
|
Explain that. What does that mean? When you’re done you …
|
|
Charles:
|
After the file is grounded, made, produced, put the flutes in it, then you heat treat it at a higher temperature.
|
|
Howard:
|
Let’s back up for now. Culture has it that NiTi was invented by NASA. When we were little if you’ve been a copper pipe state bend, if you’ve been a iron pipe state bend but NASA figured out if you added nickel to the copper pipe and bent it, it would come back.
|
|
Charles:
|
It was actually the naval ordinance. Dr. Fred Wang who is a good friend of mine actually now I’m going to sound like Al Gore but the …
|
|
Howard:
|
Fred Wang invented it? Is he still alive?
|
|
Charles:
|
He’s still alive.
|
|
Howard:
|
Holy moly! I want to podcast that dude.
|
|
Charles:
|
Fred right now he finally sold his company. He’s been working in Taiwan as a consultant. He’s about 80. We became pretty good friends and he liked me because I was about to say I’d [inaudible 00:40:55].
|
|
Howard:
|
Was it NASA? It was the navy?
|
|
Charles:
|
It was the naval ordinance.
|
|
Howard:
|
What did they need it for?
|
|
Charles:
|
They didn’t need it really for anything. They were just messing around. They’re all just 20 year old kids with PhDs.
|
|
Howard:
|
They did invent internet. They truly did. The internet was first invented … it was a military solution. Washington was afraid that if the Russians attacked first and blew the phone lines from DC to NORAD they couldn’t even call on a strike back. They invented a way where they could take a message, chop it up into 100 pieces, send it out over any available telephone wire that was still out there and then reassemble it at the back end.
|
|
Charles:
|
It wasn’t Al Gore.
|
|
Howard:
|
It was the military. When all these people think the government is so useless I say “Why do you think government is useless?” They invented the internet. Sounds like they invented NiTi. A lot of R&D stuff comes out of government R&D.
|
|
Charles:
|
There’s an amazing amount of things that come out of government.
|
|
Howard:
|
They were just playing around research lab. Explain what NiTi does and ho is your metal different. Is it the different percentages of nickel versus titanium?
|
|
Charles:
|
Anyone pretty much gets their nickel titanium from the same source.
|
|
Howard:
|
You’re buying a block like a blank wire?
|
|
Charles:
|
Yeah.
|
|
Howard:
|
Everybody is getting that from the same source. What is the metal composition? What percentage is that nickel titanium?
|
|
Charles:
|
About 55 to 45 between nickel and titanium.
|
|
Howard:
|
55 nickel and 45 titanium?
|
|
Charles:
|
It’s the other way around.
|
|
Howard:
|
45 nickel and 55 titanium?
|
|
Charles:
|
Correct.
|
|
Howard:
|
Then you take those blanks and you mill them?
|
|
Charles:
|
Yeah you mill them.
|
|
Howard:
|
Are you milling them yourself in Albuquerque?
|
|
Charles:
|
no. I have a company in Johnson City, Tennessee. Everybody has got a company in Johnson City. It’s like Detroit.
|
|
Howard:
|
You see that and most of them are. In fact all the movies are in Hollywood. All the cars in Detroit. It sounds like all the endo files are at Johnson City, Tennessee.
|
|
Charles:
|
Kerr makes theirs in Mexico somewhere in Yucatan peninsula. I can’t remember. Then after they’re made, then they are heat treated so then we heat treat it.
|
|
Howard:
|
You’re the only one that heat treats afterwards?
|
|
Charles:
|
The DNS heat treats. Tulsa dental heat treats. We heat treat … those are the ones that I’m aware of that sell heat treated NiTi files. I think Coltene/Whaledent may heat treat a file. I can’t recall the name.
|
|
Howard:
|
Why do you think yours has less cyclic fatigue?
|
|
Charles:
|
The cyclic fatigue all the studies have shown you put it in a block or you’re putting it so it has a bend in it and then you’re just running it. Ours will go almost 700 seconds whereas the next highest which would be either ProTaper Gold or Vortex Blue will do about little over 300.
|
|
Howard:
|
These are independent dental schools or faculties?
|
|
Charles:
|
Ours was done in-house and then the ones that have been done independently like I know the University of Florida, Baylor has done studies and they’ve confirmed the same results.
|
|
Howard:
|
You have less cyclic fatigue. You’re half the cyclic fatigue and you’re half the price.
|
|
Charles:
|
Yeah.
|
|
Howard:
|
Is that why you had 1000 endodontists buying from you?
|
|
Charles:
|
It’s more flexible. I know it’s a better file. I know by having the cyclic fatigue rate where it’s less likely to break and more flexible.
|
|
Howard:
|
My job is that … try to guess whether these thousands of homies are out there thinking. I’m going to ask you the most controversial question. Single use throwaway or can you autoclave them and reuse them if you don’t want to have a file break?
|
|
Charles:
|
You can autoclave and reuse them. I may now again do like most file companies do we advocate single use files? Yes. Will I use … I’ll use file in 3 maybe 4 molars.
|
|
Howard:
|
Really?
|
|
Charles:
|
[crosstalk 00:45:15] cyclic fatigue.
|
|
Howard:
|
I won’t do that because I don’t want to file the break.
|
|
Charles:
|
There’s nothing wrong with throwing away right away and that’s why we just tell everybody go ahead. I just find that’s a great …
|
|
Howard:
|
You personally …
|
|
Charles:
|
Me personally with the edge files?
|
|
Howard:
|
Do you autoclave it?
|
|
Charles:
|
With the edge files with their high cyclic fatigue rate they’ll go on and on and on and on.
|
|
Howard:
|
Next question. Which file is most likely to break? Is it the 6 10 15 or the big dogs 35 40?
|
|
Charles:
|
The reason why the big dogs will break more is just when they’re going around a curve I don’t know how well this is showing up on video but when its going around a curve …
|
|
Howard:
|
90% of all of our listeners are sound only. They’re not [inaudible 00:45:57]
|
|
Charles:
|
When it’s going around a curve because it’s just so fat, the outer part of the metal is getting stretched more as its going around a curve whereas if you take like a 15 02 it goes around a curve. That hour to surface isn’t getting stretched very much whereas you take let’s say a 4008 because it’s just fatter on the outside, you bend it the outer surface gets stretched more. That’s where breakage occurs.
|
|
Howard:
|
What is the most commonly broke file?
|
|
Charles:
|
I would say again you have to look at what’s the most commonly used file too like 2506s I would say our … I don’t know if there’s been a study but I just find in my own practice when people are sending me cases where a field broke it seems to be like 2506s just because that’s a very common file to use.
|
|
Howard:
|
A 25?
|
|
Charles:
|
Yeah a 25 and then a 06. Where it usually is breaking is in merging canals. If people would look at it, it’s usually the break … they take the file down the mesial buccal of the lower molar then down the mesiolingual. They merge and when they merge it takes a sharp hook when it merges into that other canal. If you want to reduce file breakage to I think almost zero 1, sorry I’m going to prop up my file, use our file because it works so much better than everybody else.
|
|
Howard:
|
It last 700 seconds?
|
|
Charles:
|
700 seconds compared to the next one which is about 330 whereas you look at like vortex non heat treated Brasseler that only goes like about 70, 80 seconds. You also don’t take the files into merging canals. In other words, when you’re taking your glide path, you can tell out of the mesial buccal or mesiolingual which is the most patent, which goes down easier. Whichever goes down easier, take that file to length. The other one is taking a sharp curve where it’s merging. Only take your rotary files down to that merging point. That will knock your fraction rate down to zero.
|
|
Howard:
|
Which teeth are most common where there’s this scenario emerging?
|
|
Charles:
|
It’s the lower molars.
|
|
Howard:
|
[crosstalk 00:48:13]
|
|
Charles:
|
The lower molars is where I’ve seen it the most. Then upper molars between MB1, MB2. It’s usually these merging canals. If people would just not take these rotaries into merging canals. Again, find which is the most patent which is the easiest to go down and then the other one only take it down to that merger point. I think it’d be a huge benefit. The files just aren’t built to be able to hit that merge then it bounces off the side of the other canal and then it goes straight. That’s pretty rough. You’re talking about maybe there’s only 2 mm at the apex where its doing that.
|
|
Howard:
|
What file length would you say this is? Only in Howard’s fix you could look at the ass of a cat in your face.
|
|
Charles:
|
Isn’t that like Dumb and Dumber 2. I was going to say when you call your cat
|
|
Howard:
|
These endodontist, what percent I think the most interesting thing … I don’t know if you know this but endodontist only work on people not born in the united states because all the general dentist tell me they’ve never had a root canal fill knock on wood. Then I see 5000 endodontist. What percent of these 5000 American endodontist what percent of the practice is retreats?
|
|
Charles:
|
It’s probably from what I remember the last study it’s in the high 20% maybe almost 30% [inaudible 00:49:39].
|
|
Howard:
|
None of the 150,000 dentist have a failure and 5000 dentist spend 20% on retreats that means these are all immigrants. They came here from other countries. What is the most common country for these immigrants to come to you from since Americans have never had a filled endo. My question is, when you see failed endo, what’s the low hanging fruit you can tell my homies? What’s the low hanging fruit of why these root canals fail? [inaudible 00:50:04]
|
|
Charles:
|
Number 1 reason is a missed canal. It’s really a missed canal. It’s difficult to know on upper molars and lower molars. Sometimes there’s 2 canals. Then on lower molars … upper, lower premolars there’s 2 canals. Then on molars, I’m finding people are missing the second distal canal a lot.
|
|
Howard:
|
On mandibular second molars?
|
|
Charles:
|
Mandibular first and second molars. They’re just missing that second canal. Upper molars are missing MB2.
|
|
Howard:
|
Would you say on the lower molars that on the distal canal, do you think the distal canal is 1 canal sometimes 2 or 2 canals sometimes 1?
|
|
Charles:
|
I think we should be focused that its 2 canals that go into 1.
|
|
Howard:
|
Two canals sometimes 1?
|
|
Charles:
|
That might be merging into 1. If everyone was thinking there’s 2 canals because even when its just 1 true canal, there’s usually a large fin that people aren’t picking up and it’s got a lot of crud in it that we have to take care of. You should always be thinking 2 canals and you want to just flare it out buccal and lingually because we’re missing these fins that are very common. I would say missed canals in the lower molars in the distal and if it’s not 2 canals then its 1 canal that has a fin that’s almost like a second canal that we need to pick up. Maxillary molars get MB2s a lot. We retreat. It’s missed canals.
|
|
Howard:
|
What person at a time do you think a maxillary molar has a MB2 that goes all the way to apex?
|
|
Charles:
|
If we could use an electronic microscope and dissect it, do I think its 100%? Yes I think its 100%. Do I know even on a good month am I getting 70 maybe 75%? Yes. Am I getting 100%? No.
|
|
Howard:
|
do the molar endo some people arguing that standard of care is take a CBCT then you can 3 dimensionally see where all the anatomy is. What do you think of that statement? What percent of the molars of these thousand endodontist buying from your …or 5000 endodontist in the united states, what percent in time are they getting a 3 dimensional x-ray before they treat it to look at this anatomy?
|
|
Charles:
|
I don’t think it is standard of care where every single tooth is getting a 3 dimensional x-ray. I would talk to endodontists. There are some that are doing 100% but I don’t even think 50% are doing 100%. Usually if it’s a straightforward case, we’re just using a traditional [crosstalk 00:52:55].
|
|
Howard:
|
There are some endodontist doing 100%?
|
|
Charles:
|
Some are doing 100%. I was going to go back to even if you see it on a 3 dimensional x-ray it can be incredibly hard to find even if you see it on the 3 dimensional x-ray. We all know there’s MB2s and there’s MB3s even and sometimes MB4s. We even know the location. We have high powered microscope. We’re using ultrasonic to find it. It’s when you’re going down the canal how far you’re going to go because usually it’ll be calcified to where you’re like “I might perf.” or “I’m weakening the root.”
|
|
|
Again that risk cause risk ratio whereas if you’re hogging out too much of that mesial root to go find an MB2 or 3 that just can’t … like I said that 25% where I don’t find them. I don’t want to overhog out that root because then it can lead to failure due to fracture or a weakened root. These are always going through my mind. I don’t think there’s any endodontist getting 100% of [crosstalk 00:54:04]
|
|
Howard:
|
I was born and raised in Kansas and I’ve only heard the hog out in Kansas. Is your mom or dad from Kansas? Where did you learn that term hog out to? Is that a mechanical engineering term?
|
|
Charles:
|
I believe it is.
|
|
Howard:
|
Same question with the microscope. Some people are saying, “Standard care microscope. You go to St. Louis, you get a $15,000 global microscope.”
|
|
Charles:
|
I do love global.
|
|
Howard:
|
Why do you love global more than German size? Is it just because it’s lower cost?
|
|
Charles:
|
One, the lower cost. Two, the ZEISS again amazing microscope. It’s just boy it seems like something right out of hunt from red October where it is like … it’s a serious scope. I love those little globes.
|
|
Howard:
|
I don’t know why any endodontist would want a Porsche if they could buy a ZEISS microscope. That’s got to be ... [inaudible 00:54:59]
|
|
Charles:
|
It is beautiful.
|
|
Howard:
|
How much is the ZEISS and how much is the global?
|
|
Charles:
|
Global now I think you can even get down in the low teens. The ZEISS is going to be well up in the high teens and the 20s and sometimes …
|
|
Howard:
|
It’s not that big of a difference then.
|
|
Charles:
|
It’s not that big. It might be a $10,000 difference but still …
|
|
Howard:
|
You said …
|
|
Charles:
|
It could be in the low teens to the difference are the high teens and then if you want a real tricked out ZEISS
|
|
Howard:
|
You do.
|
|
Charles:
|
If you want the whale’s tail on the back
|
|
Howard:
|
Dude that’s a cool site. Who needs a girlfriend if you can get a tricked out ZEISS microscope. Same question. What percent … these 5000 endodontist, what percent of the molars are they busting out of microscope?
|
|
Charles:
|
There’s not a case that I don’t use the microscope now because I think it’s that important. I would say when I’m talking to other dentist I would think on a molar case I think probably 80% are busting out there scope. It’s just part of what they do.
|
|
Howard:
|
Can a general dentist do quality endo if they’re not going to have access to a CBCT in their office if they need it or pull out a microscope if they need it?
|
|
Charles:
|
I think you can still do a high quality root canals without 3 dimensional x-rays, without a scope. I think at least if you had 6 times loops I think it’s important. I think it’s a little rough with your bare eye particularly if you’re in your 50s like us to be able to find a second distal. I think it’s rough but that’s just my opinion. I know some dentist that do amazing work, don’t use a microscope but I just think if you can have a scope …
|
|
Howard:
|
Does Steichen do more endo?
|
|
Charles:
|
I think he does.
|
|
Howard:
|
Does he?
|
|
Charles:
|
Yeah.
|
|
Howard:
|
The only thing he ever talks about is his CEREC machine. I think some days he’s just going to marry it. I literally think he’s going to go down the aisle with his CEREC machine and just marry that. He only has one subject and that’s CEREC. What percent of the bacteria, virus, fungus infection is removed by mechanical engineering files?
|
|
Charles:
|
Probably half.
|
|
Howard:
|
These homies when they think they got it all cleaned out that’s just access to get the disinfectant now?
|
|
Charles:
|
I know Dr. Buchanan used to talk a lot about and he probably still does about root canals, file shape, irrigants clean and I know some endodontist disagree with that.
|
|
Howard:
|
He would say what?
|
|
Charles:
|
Rotary files shape, disinfectants clean.
|
|
Howard:
|
That’s fact, ain’t it?
|
|
Charles:
|
I think it is. Some endodontist I don’t know why we’re messing with semantics. Yes a rotary file will clean half of the bugs out but you need irrigant …
|
|
Howard:
|
What you say rotary files …
|
|
Charles:
|
File shape, irrigants clean.
|
|
Howard:
|
That’s a fact.
|
|
Charles:
|
I think that is.
|
|
Howard:
|
If you have a problem with those 4 words you’re not right in the head.
|
|
Charles:
|
There are endodontist who go I think you’re simplifying it a little but I think we’re just playing with words, playing with semantics is that you need to irrigate. Again, irrigation is you’ve heard it over and over that’s really the next frontier. That’s something I’m thinking about a lot on how we can get the irrigation even better.
|
|
Howard:
|
If the gold standard is still just the dollar gallon of bleach that you buy at the grocery store.
|
|
Charles:
|
I’d say one you use the liquid EDTA 17% liquid EDTA to get rid of the smear layer first. After you’ve completely shaped. I like to shape completely with 17% liquid EDTA because it has a more lubricating effect which makes the files easier to go down, easier to shape, less likely to ledge, less likely for fractures. When I’m making my glide path with hand files or I’m using rotary glide paths or I’m using my rotary files, all I do is 17% liquid EDTA.
|
|
Howard:
|
Why would you use that instead of 100% KY Jelly? I stunned him. I stumped him.
|
|
Charles:
|
I don’t have any experience at least in root canals with the KY Jelly.
|
|
Howard:
|
What you like about the EDTA is the lubricant …
|
|
Charles:
|
Much better.
|
|
Howard:
|
Does that help you so you don’t have file breakage?
|
|
Charles:
|
It helps reduce the stress on the file. It also allows it to go down easier. It’s just a much …
|
|
Howard:
|
Explain for the homies that many thousands of dentist someone who doesn’t know what EDTA is. Explain what EDTA is.
|
|
Charles:
|
What it does is it has more lubricating effect.
|
|
Howard:
|
What is EDTA?
|
|
Charles:
|
Now you’re busting my chops because I’m about to say, “What is this for?” I can’t remember.
|
|
Howard:
|
I mean generically is it a disinfectant? Is this a lubricant?
|
|
Charles:
|
All it is, is a lubricant.
|
|
Howard:
|
What was that other lubricant back in the day that we’d always use? It was a little …
|
|
Charles:
|
RC-Prep.
|
|
Howard:
|
RC-Prep.
|
|
Charles:
|
RC-Prep is a gel.
|
|
Howard:
|
Was that EDTA?
|
|
Charles:
|
It’s a 17% gel EDTA.
|
|
Howard:
|
RC-Prep?
|
|
Charles:
|
Yeah.
|
|
Howard:
|
Do they still sell RC-Prep?
|
|
Charles:
|
Yes. What I’d like to use is at least some form of RC-Prep. I put it on the file that’s like your KY Jelly then what I’ll do is I’ll put the liquid inside of the canal.
|
|
Howard:
|
Who owns RC-Prep?
|
|
Charles:
|
I can’t remember.
|
|
Howard:
|
Man that’s going by.
|
|
Charles:
|
There’s the …
|
|
Howard:
|
Do you sell EDTA?
|
|
Charles:
|
We sell liquid EDTA and we also sell the gel EDTA.
|
|
Howard:
|
Which would be like an RC-Prep?
|
|
Charles:
|
Would be like an RC-Prep.
|
|
Howard:
|
Then you’ve got your mechanic engineer. You prepared the canal which is basically in my opinion all that does is get you a shape so that you can get the disinfectant in there. Is that what you think?
|
|
Charles:
|
Right on.
|
|
Howard:
|
Let’s switch to really the only … dentist they always want to talk about when you’re in a bar with a bunch of dentist they always want to talk about what you obturate the canal. Well it’s like “Dude it’s not what you put in, it’s what you take out.”
|
|
Charles:
|
I agree.
|
|
Howard:
|
You got your canal shaped and now you’re ready to do the whole root canal which is to disinfect it. How do you disinfect it?
|
|
Charles:
|
100% disinfectant. What I’ll do is I’ll do 1 more rinse of 17% EDTA because it gets rid of the final smear layer. The smear layer is just when we’re cleaning the canals out we’re just putting this swath of dentin just coating the side of the canal. I want to get that out of there to open up the dentinal tubules. Studies have shown if you can get rid of the smear layer first before you use your sodium hypochloride, you’ll get rid of more bugs. That’s basically it. I’m going to rinse for about 1 minute with 17% EDTA.
|
|
Howard:
|
Rinse for 1 minute.
|
|
Charles:
|
In between the each of the canals. I’m just rinsing. Boom, I might go if it’s a 4 canal molar I’ll rinse for maybe 15 seconds in each canal but it’s usually like 5 seconds, 5 seconds, 5 seconds keep going on.
|
|
Howard:
|
When you’re rinsing though that the cannula that needle, what percent of the way down the prepared canal are you getting?
|
|
Charles:
|
I’m still keeping it about 3 mm short. I’ll keep about 3 mm short. Then what I’ll do is either I’ll take ultrasonics. There’s also different brushes like I think like the EndoActivator that Dr. Ruddle has come up with. I think that works well.
|
|
Howard:
|
Cliff Ruddle and his wife Phyllis who’s adorable.
|
|
Charles:
|
They’re wonderful people. Then you have this [Vista Dental 01:02:59]. They also have like an EndoActivator. There’s also different ways to get the liquid down the canal. There’s different [crosstalk 01:03:10]
|
|
Howard:
|
Are you still talking about EDTA?
|
|
Charles:
|
Still EDTA because all of them I’m going to use either ultrasonics something like an EndoActivator, some sort of brush or mechanism to now go all the way down the canal to get the fluid down the canal because I’m keeping it about 3 mm short of the apex. I’m going to use some sort of mechanical device.
|
|
Howard:
|
With EDTA?
|
|
Charles:
|
With EDTA in there to get it down the rest of the way. After I’ve rinsed it then I’ll use a device in there to get it down there. That all takes about a minute. Then I’m going to rinse that out with sodium hypochloride and I’ll do the same thing with sodium hypochloride. Usually the sodium hypochloride now the times very differently. I usually like it in there about 5 to 10 minutes.
|
|
Howard:
|
5 to 10 minutes?
|
|
Charles:
|
Yeah Dr. Buchanan will …
|
|
Howard:
|
Says 1 hour.
|
|
Charles:
|
He’ll talk about an hour.
|
|
Howard:
|
Since that’s the only way you’re treating the other 50%, do you think that’s the most important stuff of the root canal?
|
|
Charles:
|
I guess it’s the most important stuff of the root canal. Then I like to go ahead …
|
|
Howard:
|
I’m just going to tell you what they’re saying on the message boards. A lot of times they don’t say [inaudible 01:04:21] but they’ll tell it to me.
|
|
Charles:
|
It’s like Mark Twain who said “It’s not what they say, its what they think.” We all say the right stories but then what we really think is completely different.
|
|
Howard:
|
When you’re on a fishing boat with him out in the middle of New Orleans out there. They’ll say things like, “Dude after you do a root canal and you file that out and you pack that shit its cut from nutrients anything in there would just be like throwing a live person in a casket and burying him. It’s all going to die anyway.” I wouldn’t say that.
|
|
Charles:
|
I wouldn’t agree with that.
|
|
Howard:
|
You would or wouldn’t?
|
|
Charles:
|
I would not. We need to be very active with trying to get as much of the bugs out of there as we can. I think when you’re using EDTA then you’re rinsing with sodium hypochloride then I like to use a chlorhexidine rinse at the very end and that chlorhexidine rinse will stay in the canal even once it’s rinsed out, it’s in the dentinal tubules and its killing bacteria for weeks. That’s how I like to finish my rinsing with it.
|
|
Howard:
|
Then obturating, I want to get right to the [inaudible 01:05:43] stuff. I never see people arguing about whether you should use hot gutta-percha, single cone lateral …
|
|
Charles:
|
Endodontist do.
|
|
Howard:
|
It seems like …
|
|
Charles:
|
It’s a huge deal.
|
|
Howard:
|
Where my general dentist homies are always arguing about is whether or not you can use a single cone carrier with gutta-percha. Some people say the endodontist hate that stuff. Ben Johnson [inaudible 01:06:07]. Other endodontist tell me that , “Dude if you can’t get a carrier base gutta-percha then you’re not even an endodontist.” Some dentist just say, “God it is so easy to take those single carrier gutta-percha.” Is that okay or is it not okay?
|
|
Charles:
|
We even sell our edge fill we sell a plastic core and we also sell a gutta-percha core gutta-percha thermal carrier.
|
|
Howard:
|
You heat those up on oven?
|
|
Charles:
|
You heat them up in an oven just like you do with the Thermafil.
|
|
Howard:
|
Someone honestly say that actually works better in really curved canals.
|
|
Charles:
|
I like thermal carrier obturation.
|
|
Howard:
|
That’s what you use?
|
|
Charles:
|
I use thermal care but I also because …
|
|
Howard:
|
Thermal carrier is the generic term for gutta-percha or any carrier on a stick.
|
|
Charles:
|
Correct.
|
|
Howard:
|
Corn dog on a stick. The word corndog is already taken so you [inaudible 01:07:05]
|
|
Charles:
|
I will say …
|
|
Howard:
|
Who says that a hotdog just a thermal carrier for a cornbread.
|
|
Charles:
|
It is. I don’t think it taste as good. I would say I’ll use that on half the cases because we sell it and the other half I use warm down pack.
|
|
Howard:
|
Then I got to ask you just knocking off the controversies. It seems like they’re all split on or they’re an apical barbarian where if you don’t get a puff of sealer out the apex you didn’t get it all out and then there’s the pulp levers who always are real anal about saying half millimeter short and they really want to prepare a short deal. Are you an apical barbarian where you’re just like to get patency and make sure when you’re done there sealer out the end or are you a pulp lover and like to say a millimeter short of the apex and preserve all that pulp?
|
|
Charles:
|
I don’t think long term it matters. I’ve seen so many endodontist, so many general dentist do it either way. I don’t see the cases being different. Myself I’ve always gotten the puff and I’ve been a pulp lover and kept a little bit. I don’t see a difference. I think we’re talking about less than a millimeter difference. It’s like the NFL and football. A guy will run ball, gets tackled. They pretend they know where he went down so they spot it.
|
|
|
Then a ref underhand throws it 20 yards to another ref to the hash and then he tries to spot it. Then you’ve got the chain gang they’re trying to figure out where it should be and then at the very end they come up and they try to measure whether you got a first down or not. You know all of that was just … there’s probably half maybe a foot back and forth.
|
|
Howard:
|
So many thing went wrong before they got to that chains.
|
|
Charles:
|
I just think when you’re talking about a millimeter, if you’re doing everything else right, whether you’re getting a puff or you’re half a millimeter back, I don’t think it matters. I know there’s a lot of endodontist who will disagree and say, “Nope it’s got to be this way, this way.” If you’ve done all those other steps right whether you’re a millimeter short or a millimeter long, whether you’re using single cone, whether you’re using Thermafil, whether you’re using warm gutta-percha and this is where a lot of endodontist will disagree with me but I say, “I don’t think it matters.” I care about everything up to what you just said is that I shaped it. I found all the canals which I think is the number 1 reason for failure because you’re not finding all the canals.
|
|
Howard:
|
Misanatomy you say is the number 1 by far?
|
|
Charles:
|
By far number 1 cause.
|
|
Howard:
|
What would be number 2?
|
|
Charles:
|
I would say number 2 its just if you’re like 4 mm short or this is where Thermafil gets a bad rap is you could open almost distal canal of the lower molar and you could throw down a thermal carrier and not even clean it at all. I would say underprepared canals but it’s not so much unprepared it’s almost non prepared canals.
|
|
Howard:
|
They think the obturation is so important.
|
|
Charles:
|
It’s not. It’s the least important step.
|
|
Howard:
|
It’s the shaping so that you can clean with irrigants and the obturation is the least significant part.
|
|
Charles:
|
If a root canal was properly shaped and properly … if you want to say you want to take everything let’s say another specific controversy. I don’t think it matters whether you want a small apex with a large taper meaning keeping things at let’s say a 20 or a 25 08 or 06 or you want to take everything with a large apex let’s say a 35 or a 40 with a small taper let’s say an 04 to me it doesn’t matter whether how you’re shaping it if you get at least let’s say a 2008 or 2506 in most canals or if you’re using an 04 is if you’re getting at least to a 30 to a 35 then you’ve done proper irrigation all these other controversy I just think it’s just noise.
|
|
|
It just goes on and on and on. It’s like look let’s just get the canal shaped properly. Let’s use the irrigants properly. Do I think
|
|
|
a 2004 and a distal root of a lower molar is going to do it? No, I don’t. You’re probably going to have to take that up to a 2008 or 2010.
|
|
Howard:
|
Let’s go back to the file. Some people are wondering if an 06 is to much tooth removal weakling the tooth so it’s setting up down the road for a fracture and you see some people thinking, “Maybe I shouldn’t use an 04.” Do you think that rotary NiTi in the last 10, 20 years have augured too much tooth and 06 is just too much and we couldn’t do this. Is that part of some of the endodontic failure rates as over filing out the canals?
|
|
Charles:
|
I think if you’re using a 06 and you’re keeping it a 30 or less again depending on most of the anatomy, most of the anatomy you’re going to fine with a 3006. Now if you’re talking about a lower anterior 3006 might be a little too much. If you’re talking about a mesial buccal root of a lower molar where you see the root is very thin where its let’s say a 25 mm long root, you’re probably not going to want to take a 3006.
|
|
Howard:
|
Let me rephrase my question. When you see endodontic failures, you were saying the number 1 cause of failure was a missed canal. If you saw 100 …
|
|
Charles:
|
Or just unprepared.
|
|
Howard:
|
If you 100 endodontic failures, what percent of them do you think were caused by too much of the canal being augured out?
|
|
Charles:
|
Where I see the failure would it be augured out is where the post base is too large. Not from using a 3006. It’s pretty small. I’m not saying that there isn’t strip perfs what I just described where you’re talking a real [inaudible 01:13:38]
|
|
Howard:
|
Tell me if I’m right or wrong.
|
|
Charles:
|
Go ahead.
|
|
Howard:
|
I personally believe the majority of post that I see in root canals should have never been in place.
|
|
Charles:
|
I agree.
|
|
Howard:
|
I think it’s the most overused … if you have a 3 mm ferrule all the way around and then if you’re going to do a post, don’t make the canal any bigger if you really have to put a post there would you say just fit one in the size of your gutta-percha or …
|
|
Charles:
|
Yes.
|
|
Howard:
|
You’re not a big post fan either?
|
|
Charles:
|
I think that’s where the majority of the problems are. Now I know again other endodontist they’re going to say no. you should never use a 06. I just call it noise. I’m not saying that a 06 would never strip perf. It’s so small of a percentage where the problems are from the post that’s where we’re getting [also 01:14:41].
|
|
Howard:
|
I want to tell you my pet peeve with endo files and going to the gym a lifetime fitness. When you’re doing dumbbells or you’re doing weights, they go from 5 to 10. That’s a double. Then its 10 to 15 that’s up 50%. That’s 15 to 20 that’s only up a quarter. How come the dumbbells each dumbbell doesn’t have a percentage increase in weight? On the files it’s the same thing. You start with a 10 file and then the next one is 15. It’s like, “Damn that’s a huge jump.” Then the next one is 20 and then by the time you get to 35 well the next bigger file is hardly any bigger. It could just use a 35 and moved it around a little bit. Why are files not increase in size on a percentage? Is it just culture and custom like going to the gym and it’ll always be that way?
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Charles:
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Your point is absolutely true. That’s where Dr. Herb Schilder when he came up with the series 29 that meant ever file was increasing 29%. I don’t know how he …
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Howard:
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When did he do that?
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Charles:
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That was one of the first files that came out. The series 29 was probably out in the early ‘90s, mid ‘90s for sure. That was his logic was just increasing about 29%.
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Howard:
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By volume?
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Charles:
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By diameter. Now that’s where I started to think and I haven’t really pursued it too much is we really shouldn’t be looking at diameter. We should be looking at volume removed, stress on the file. It should be not increasing a percentage of the diameter, it should be a percentage of the volume removed and I played with that a little bit. Now that we’ve talked about it you know on the way home I’m going to be thinking “Pi r squared, the area of …”
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Howard:
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What are you doing in Phoenix? How do I get the good fortune to see you?
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Charles:
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Just with family.
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Howard:
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You’re down here vacationing?
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Charles:
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Yeah just with family.
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Howard:
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Where are you vacationing at? The resort?
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Charles:
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We’re up just north of Scottsdale there’s a … even though I don’t golf it’s mostly because we can bring the dogs. There’s a place called the Boulders. It’s [inaudible 01:17:00] it’s nice up there.
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Howard:
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I love the Boulders.
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Charles:
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You can bring the dogs and …
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Howard:
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My sister Shelly lives up in Cave Creek north of Scottsdale.
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Charles:
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yeah.
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Howard:
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Her husband is one of the golf manager up there at the golf course for 15 years. He text me some pictures of mama mountain lion with 2 babies.
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Charles:
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That’s amazing.
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Howard:
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That thing I swear to God was so big it absolutely would have killed you and me. It looked like a lion. I mean not a lion, a tiger.
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Charles:
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A lot of zoos have this but like the Albuquerque zoo they have a bridge that the mountain lions can cross from 1 pen to another so it goes over you. Now you got be careful because they’ll pee on you just to tick you off. Because it’s a caged bridge obviously enclosed and when you see them walking across, they look like a tiger. They are huge. You wouldn’t have a … that’s why people go “Why do you run with your dog without a leash?” The dogs are the first ones to tell you if there’s a mountain lion around. They’ll at least chase the mountain lion away.
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Howard:
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I just think it’s funny that here on New Year’s break and you’re such a maniac that you drove to my house to do a podcast with me in my dining room on a Saturday. This is supposed to be an hour long. We’re at hour and 20. The reason I want to interview you so much is because so many dentist think you’re a legend. So many dentist love your files. Craig Steichen says you have the best reputation in the world and he’s my best friend in your backyard. I put up 350 online CE courses on dental town and they’ve been viewed over half a million times and
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I’m still a big speaker out there and for 15 years ever since we launched online CE dental town in 98 all those meeting planner show me excel spreadsheets where their attendance has just been drifting down and they can’t understand it. I think it’s all moving to the University of Phoenix online. I don’t think dentist want to close down their office for $4000 production and then drive and then have to check in. all of a sudden they like this online CE and then the research is showing that he human mind can only absorb info for an hour and then all these neurotransmitters …
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Charles:
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That’s why you want to keep editing.
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Howard:
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They’re all flush. They need to stand up and go walk, fart, eat, something, go to the bathroom.
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Charles:
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Like this is nice as they can stop. Like right now you said we’re coming on an hour and 20 but hopefully they stop the few times.
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Howard:
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All this is I’m begging you if you put up an online CE course on Dental Town explaining all this you’d be teaching dentist from here to Katmandu.
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Charles:
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That’s what I want to do. We’re going to get it done.
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Howard:
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the thing that makes me almost cry I mean it really does. It has made me cry. I walked in the dental schools in Asia and Katmandu where they had 20 Chinese books that were 20 years old and 15 or 20 French books that are 20 years old. They’re telling me in Katmandu that they all speak Nepalese. They can only look at the pictures. Then they found Dental Town and this 1 dental school the dean’s husband went and fetched a wire and it goes out like the third story window clear down this … you know they have all these millions of wires and he wired that thing like 10 blocks to tap into the internet and Dental Town is the whole curriculum. I’ve seen it in Africa. I’ve seen it in Asia.
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Charles:
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What you’ve done is amazing Howard.
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Howard:
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Know what Al Gore has done with the internet.
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Charles:
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You’re second though.
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Howard:
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I was in Tanzania and I listen to this woman Islamic dentist with the veil and sari. She’s on Dental Town. She was doing United States of America top endo and she said I learned it all on Dental Town. She thought her family sent her to the best dental school in the world and it was in Darussalam. I forgot the country. Ethiopia or whatever and she said, “No.” She goes, “It was dental town.” She goes, “Dental Town was far better than my dental school and Dental Town was free.”
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When I talk to dentist I think their biggest thing that they have problems with, they hate is more endo. In fact half of my friends in Phoenix as soon as they start making money, the first thing they give up is [inaudible 01:21:34]. One of my buddy [inaudible 01:21:37] he’d rather be beaten than do more endo. I feel the same way about pediatric dentistry. I don’t know why you become a pediatric dentist. I’m sure substance abuse has something to do with it.
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Charles:
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As you know pediatric dentist they have the formula down and it’s just boom, booom, boom. It’s just like an endodontist when someone says, “How can you do molar endo all day?” It is bang, bang, bang.
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Howard:
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You’ll put some endo curriculum up there?
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Charles:
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100%.
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Howard:
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I would really appreciate that and I think there’s 2 million dentist around the world and I think too many Americans like us we always think of the US Canadian market and I don’t. The whole North and South America has a billion people. There’s a billion just in Africa. There’s a billion 2 in India and a billion 3 in China. What turns me on is stealing the greatest information from the top lead Americans like you and then transferring it on a free iPhone to Africa, Asia, South America.
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I think what the internet and the smart phone are going to do is an arbitrage play where every year we’re going to lower the extreme difference of [things 01:22:46]. I saw it when I opened up here in ‘87 you get a root canal in Phoenix, drive 100 miles down south, cross an invisible line into Mexico and the root canal is like “Are you kidding me?” You know what I mean? I think the smart phone is going to get rid of that merits.
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Charles:
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I would agree with you 100%.
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Howard:
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Did I have any other questions? Last but not least, did you ever remember my friend [Joe Dobkin 01:23:10]
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Charles:
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Wonderful person.
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Howard:
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He was my roommate in Creighton University in Swanson Hall.
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Charles:
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Great endodontist. Great person.
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Howard:
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He personally tutored half the 9th floor to get through school. The guy can answer any question Physics, math, chemistry. Not take anything away from you, I never met an endodontist who ate, lived and breathe endo 24 hours a day 7 days a week. He died last year.
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Charles:
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Great loss. He’s an amazing person, amazing dentist.
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Howard:
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Joe D. We’ll dedicate this podcast to him?
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Charles:
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Yes.
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Howard:
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Thank you so much for coming by on your vacation. Has your wife and children mad at you for …?
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Charles:
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No they’re probably …
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Howard:
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They’re still in bed?
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Charles:
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Yeah they’re probably still sleeping.
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Howard:
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Just wife and dogs?
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Charles:
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No, I have triplets.
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Howard:
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You have triplets?
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Charles:
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Two boys and a girl.
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Howard:
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How old are they?
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Charles:
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They’re 12.
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Howard:
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No kidding! This is a man who gets it done. When he decide to have a family, he just popped it out one time. Three kids at one time?
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Charles:
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Correct, yeah.
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Howard:
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What was that like?
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Charles:
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Very interesting the first couple of years.
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Howard:
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How long did it take from when 3 babies were born before you slept your first all-night 8 hours?
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Charles:
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I still not.
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Howard:
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They’re 12. Seriously, thank you so much on your vacation driving all the way to [inaudible 01:24:30] to my house and doing a podcast. I think you’re a rock star. You named your website … by the way his website is rootcanalrockstar if you want to hang out on message boards, communities iwht a thousand endodontist, 5000 dentist and if you want to buy root canal files at half the price, its edgeendo.com E-D-G-E endo.com. Charles Goodis you’re the man.
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Charles:
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Thank you.
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