Dentistry Uncensored with Howard Farran

How to perform dentistry faster, easier, higher in quality and lower in cost. Subscribe to the podcast: https://podcasts.apple.com/us/podcast/dentistry-uncensored-with-howard-farran/id916907356

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Before founding McCall Dentures, Dr Ryan McCall was a typical Midwestern boy from Effingham, IL – a small town with a population of 12,000. Growing up in close proximity to a farm, he was sure about two things: he didn’t want to live in close proximity to a farm forever and he wanted to own a red Subaru Outback! After graduating from dental school, Dr. McCall opened his first office in the super dank city of Fort Collins, CO.  His initial marketing tactic was a $15 hand-painted sign in the front yard. Fifteen months later, he opened another office and then foolishly spent a full year flying from Indianapolis, IN to Denver, CO running both offices. He knew there had to be a better way for himself and future dentists. 2 years later, McCall Dentures was born and the persona of 2 Chairz took flight. Today, Dr. McCall continues to be involved with the company as Executive Chairman. He is always finding ways to encourage and support others - from making charitable donations to offering leadership advice. Beyond spending time with his wife Meredith and their four children, his two favorite past times are playing video games and posting excessively on Instagram (yes, he eventually did get that red Outback!).

https://www.mccalldentures.com/

Howard: It's just a huge honor for me to be sitting with Ryan McCall, DDS, who is my own personal idol, role model, mentor. I kid you not. The guy has forty-two thousand posts. In fact, I don't know if you know this, but my son, Ryan, was named after you.

Ryan: No. Really?

Howard: I don't know.

Ryan: And we look alike?

Howard: And you look alike. Hell, you might even be his father. Ryan, he might be your dad. We could do DNA testing.

Ryan: How old is he?

Howard: He is twenty-four years old.

Ryan: I'm not your dad.

Howard: How old are you?

Ryan: I'm only thirty-five.

Howard: Thirty-five. Let's see. Thirty-five minus twenty-four will be eleven. Well, are you Catholic?

Ryan: Yeah, I was raised Catholic.

Howard: Then you could be his father. You could be his father. I have a Catholic patient who had a baby at twelve so yeah.

Ryan: Wow that's a record.

Howard: That is not so much for Phoenix, but anyway. His bio: Before founding McCall Dentures, Dr. Ryan McCall,was a typical Midwestern boy from Effingham, Illinois, which is the hometown of Heartland Dental and Eaglesoft, two of the biggest dental companies from a town of ten thousand.

Ryan: Isn't that crazy?

Howard: A small town with a population of twelve thousand. Is the tallest thing in the city still a crucifix?

Ryan: It is and it is the second largest crucifix in the US. Do you know where the first is? Guess.

Howard: The largest.

Ryan: Texas.

Howard: Well, everything's bigger in Texas. I should have just guessed Texas. Growing up in close proximity to a farm, he was sure about two things. He didn't want to live in close proximity to a farm forever, and he wanted to own a red Subaru Outback. After graduating from medical school, Dr. McCall opened his first office in the Super Dang city of Fort Collins, Colorado. His initial marketing tactic was a $15 hand-painted sign in the front yard. Fifteen months, later he opened another office and then foolishly spent a full year of flying from Indianapolis, Indiana to Denver, Colorado running both offices. He knew there had to be a better way for himself and future dentists. Two years later, McCall Dentures was born, and the persona of two chairs took flight.

Today Dr. McCall continues to be involved with the company as executive chairman. He is always finding ways to encourage and support others for making charitable donations to offering leadership advice. Beyond spending time with his wife, Meredith, and their four children, his two favorite pastimes are playing video games and posting excessively on Instagram. Yes, he eventually did get that red Outback. We both have four children. How old are your children?

Ryan: They're eight, six, three, and one.

Howard: Wow and you're thirty-five. I know exactly where you're at, and you're playing video games. I actually do not play video games because I had four boys. When Nintendo 64 here on Mario, I actually got addicted to it. I came home every night, and we would play Mario Brothers, all four boys, for like three hours every day. It took us half a year to get all two hundred and four stars. When I got the last star, I said, "You know what, dude. I think you should just walk away from this game." I just lost a half a year three hours a day. We had fun though, remember?

Ryan: I'm jealous.

Howard: We did have fun. We would all sit there in the front room screaming and yelling. Do you remember that game Mario 64?

Ryan: Yeah absolutely. I grew up with that.

Howard: Walking on lava and jumping through the window pane.

Ryan: It was fantastic.

Howard: Bowser.

Ryan: Bowser. What about Mario Kart? Mario Kart was a killer.

Howard: Mario that was a weird dude. He was an Italian made from Japan. He was a weird character.

Ryan: That's awesome. I actually only play at the office. My wife made me take all the systems to work because our kids are pretty young, and she doesn't want them to get addicted.

Howard: Oh my gosh.

Ryan: We've gotten so busy that I can't play video games anymore. It's sad. It breaks my heart. I stole a lot of the bio from another guy from Effingham. He wanted a red Corvette.

Howard: Red Corvette?

Ryan: Yeah.

Howard: His neighbor was a Corvette guy.

Ryan: I think so, yes.

Howard: Do you know him?

Ryan: I've met him once, yes. I changed the Corvette to Subaru Outback. I thought that was pretty funny, but they're a great company.

Howard: Another interesting thing, Nintendo, I believe it's the oldest running company in Japan. I mean they were starting like 1890.

Ryan: Wow. Really?

Howard: Yeah. I read it on I think it was The Economist that they're sitting on so much cash that they wouldn't have to have any revenue for like twenty years.

Ryan: That's awesome.

Howard: I mean that's Japanese style. They're extremely long-term company. You know what I mean?

Ryan: Wow. Yeah, no doubt.

Howard: Sitting on just a ton of cash. I think I think that was the ultimate video game. I think it’s the gold standard.

Ryan: Do you think?

Howard: I think Nintendo 64 was the gold standard.

Ryan: You might be right, man. I'm a hockey guy. I play a lot of hockey games, football, sports games mostly. I tried the shooters at work but it scared patients, so I had to stop that so call of duty. I can't play that at all. That's a bummer. That's awesome. You guys played together. Have you been to Japan?

Howard: Oh yeah I've taken my boys there. It's one of the more interesting countries. You learn much about a country going there. Interestingly about Japan, not only was it the third richest economy today, US and China neck to neck and then Japan. Japan it's an island way north of Korea and halfway to Alaska. Their big city, Tokyo, faces the Pacific, which is half the planet of just water. It's a very isolated economy. It's the least English of any country I've ever been to in the world. You can go to any country in the world and if you go to a bus stop ask an English question, 25% at least can help you. Everyone's a tour guide in every country except Japan. They just don't know any English.

What's really cool about being a homie is that when I go to a foreign country, I'm not at the Hilton with a tour guide. I mean I have dentist friends like you. Some of the Japanese dentists that are totally English literate sat at the bar that's still three in the morning just explaining the whole history of Japan and totally agrees. They just really want to be left alone on an island. Nobody immigrates to Japan. Every year they have less people than the day before because you need two point three kids per family to maintain the herd. They don't even have point nine. Every year, there's less people than the day before. Every year, there's less workers paying taxes to support the senior citizens. That's why they're huge into robotics.

Ryan: Yeah no doubt.

Howard: A lot of people will say, "Well, why is Japan's cars made by so many robots than Americans?" Well, number one, we have a ton of low-cost labor. They don't have labor. It's very interesting. The biggest unintended consequence of when I gave my first lecture, a little boy from Kansas had no idea that five continents would feel like-I mean five continents feel to me today what Kansas felt to me when I graduated from dental school. I knew Kansas and I can say I know the world. It's really cool.

Ryan: That's awesome. That's what Ryan was saying too. He said it changes life.

Howard: When you grow up like everyone who says to me America is the greatest country in the world, they probably don't even have a passport. They've never even left America. If they did, maybe they went to a border town in Tijuana. I mean you can't travel the world figure out that, yeah, America is number one in military, medicine, banking, insurance, finance, movies, music. That's about it.

Ryan: That's it. Yeah.

Howard: They're not number one in cars. That's Japan and Germany. They're not number one in longevity. They're not number one. They're thirty-eight. Every year they slip an education. What's really cool is all humans are the same and they all approach. I've fallen in love with architecture because to me architecture is the easiest to see. It's easier to see than like the dentistry. Okay. We all need a window, a door, and a toilet.

But every country this is a little slightly different variation in how their simple toilet works or their door or lifting a window. All these humans have the same needs wants and the variation they do it. It gets really complex when you start talking about economics and politics. I don't think you could understand anything if you didn't see the ten different control groups. You know what I mean?

Ryan: That's cool.

Howard: It really is. It's really cool. I tell everybody that I'm international. If you're a dentist and you want your kids to get educated, don’t send them to the state school up the street. Get on Dentaltown and see if some homie dentist in Ireland or England or Sweden or Japan will take your kid for a year. I mean he takes your kid for a year and he doesn't even go to college. He just lives there for a year.

Ryan: I think it's free in Germany, right? College is free.

Howard: Is it?

Ryan: Yeah. Our neighbor is German. They're going to send their kids back when they're college age.

Howard: Yeah so there's a [inaudible 0:10:07] like in Scandinavia. When you give everybody free college, you don't spend any money on prison.

Ryan: It makes sense.

Howard: When college costs a ton of money, America, you have three million people in prison. Some states like California that cost you on average $36,000 a year per inmate, but you didn't want to give them free college for $5,000. You start to see the tradeoffs. You're going to spend this money. Are you going to spend them on keeping them in a cage or are you going to give them free college?

Now when you say free college, you start screaming, "Socialist, socialist, you're an evil socialist,' which is kind of bizarre for me because when you go to a socialist country like Denmark, Sweden, Finland, Helsinki, Finland where Planmeca is from, Copenhagen, Denmark where 3Shape is from. When you go to all these evil socialist countries, they're a shitload nicer than America. I mean they just are. It's bizarre when I go home to Kansas. I hear all these rednecks [inaudible 0:11:19] saying, "Well that's socialized. That’s socialized medicine." Dude, go live in Denmark, Sweden, Norway, Iceland, just for a month. Then when you come back, I'll never have to hear that stupid shit come out of your mouth again.

I think America is number one in optimist. They're number one in self-esteem. They can do their shit and it doesn't stink. Most Americans when they shit, they think they should wrap it up and sell it as a candy bar to a socialist country. But it's the same in dentistry. There's a lot of huge variances in dentistry.

Ryan: Do you think so?

Howard: Yeah. But enough about that. Tell them your story. You have the most amazing.

Ryan: I love your story though.

Howard: I want to start with your story because it's something we need to revisit. You joined Dentaltown when you were in undergrad.

Ryan: Yeah freshman year at Indiana.

Howard: Our policy now is that to become member of Dentaltown, you have to be accepted to dental school.

Ryan: I think so, yes.

Howard: You've got on Dentaltown four years before you went to dental school?

Ryan: Yeah. This would have been 1999 and maybe 2000. I snuck on. Howard Goldstein let me on.

Howard: Howard Goldstein is the guy that doesn't let you on today unless you are accepted to dental school.

Ryan: Yeah.

Howard: Can you text Hogo?

Ryan: I don’t know anything about any of this.

Howard: Text Hogo.

Ryan: I have no comment.

Howard: Well, no, but I mean you're one of the most amazing townie.

Ryan: Thank you.

Howard: How many offices you have?

Ryan: We're on our fourth and we're building our fifth.

Howard: You have four to five offices.

Ryan: Yes.

Howard: You have forty-two thousand posts.

Ryan: Yes.

Howard: I'm a huge fan of yours, and you got on four years before dental school.

Ryan: Yeah almost twenty years ago.

Howard: You should be the poster child of why we should let anybody from undergrad on Dentaltown because, otherwise, they have to go to that other. What's that other message board community?

Ryan: Facebook or something.

Howard: Facebook group.

Ryan: Oh the Dental Student Work, yes, I was a moderator on there. I was into it big time. I think maybe that's how I found him.

Howard: How many of those people on Dental Student Network do you think would be better served on Dentaltown?

Ryan: That's a good question. I would have asked Howard about that.

Howard: We need to revisit that. If you have an opinion on that email. Do you give out your email?

Ryan: Yeah for sure. It's just ryanmccall@gmail.com.

Howard: Ryan McCall.

Ryan: Yeah.

Howard: You're mixed. You're Irish?

Ryan: Yeah, I think so. That's in southern Illinois, right?

Howard: All the mixed are Irish.

Ryan: Yeah for sure.

Howard: I'm howard@Dentaltown.com. The guy who makes the decision is Howard Goldstein. He was the second Howard. He's Hogo for Howard Goldstein, H-O-G-O, @dentaltown.com, if you want to make an online CE course or if you have a question about [inaudible 0:14:08]. Let us know if you think of undergraduate students who are pre-dent should be allowed on Dentaltown because right now they have to go to Student Dental Network or they have to go to a Facebook group. After that, was hearing dentists talk, did that affect your thinking and decision-making as an undergrad?

Ryan: Actually, I got into a couple of medical schools. Once I got onto Dentaltown, I kind of realized it was for me. It changed the course of my life. It might be worth looking into. There are a lot of people that are interested and younger guys especially.

Howard: You got accepted in medical school and dental school.

Ryan: Yes and decided to go to dental school. I was going to be a pediatrician so like my whole life I wanted to be a pediatrician. I spent a full summer with my pediatrician in Effingham, and she told me to go to dental school because she was tired of working eighty hours a week and she was tired of not making a ton of money. She said, "If you're going to do pediatrics, go to dental school." I thought I was actually going to do pedo after dental school. I ended up moving to Colorado after that.

Howard: You just wanted to get out of Effingham.

Ryan: Went to IU.

Howard: A town of twelve thousand.

Ryan: Yeah and went to Indiana. Rode bikes. Are you familiar with it?

Howard: Undergrad was IU Indiana.

Ryan: IU in Bloomington.

Howard: In Bloomington. How come you didn’t follow Dave Letterman and go to Ball State? Is it Ball State?

Ryan: It’s in Muncie, yeah, that's why. I'm surprised you know that.

Howard: I mean how come you didn’t follow Dave letterman?

Ryan: Yeah he went to Broad Ripple High School so he's a legend. I'm not that funny. IU is great. We rode Little 500, the bike race. Have you seen Breaking Away, the movie?

Howard: Yeah.

Ryan: Dennis Quaid's first movie. That’s how I met my wife. So we both rode in the Little 500. Then I went to UIC for dental school. I got back to Illinois after that.

Howard: UIC.

Ryan: In Chicago. University of Illinois, Chicago.

Howard: Now, is that still open?

Ryan: Yeah, it’s still open.

Howard: University of Illinois, Chicago. UIC. University of Illinois, Chicago is still open.

Ryan: Yes.

Howard: But Northwestern closed.

Ryan: It closed a lot of their faculty.

Howard: They had four.

Ryan: Yeah, I think so. Now, they have Midwestern University. There's just two I think now.

Howard: The other Midwestern is at Glendale, Arizona. That's two Midwestern and then University of Illinois, Chicago. They just have two dental schools now?

Ryan: Two, I think, yes. It was a great experience because it was on the south side of Chicago. Looking back and comparing it to Indiana University, I got so much experience and I learned a lot.

Howard: What was it like living in Chicago for four years?

Ryan: Awesome. In my early twenties, like, oh my word, it was so fun.

Howard: Oh my god, going from a town of twelve thousand to Chicago.

Ryan: That was like a different world.

Howard: It must have been like the bar scene in Star Wars.

Ryan: Yes, absolutely. My wife, she's from St Louis. It wasn't such a big transition for her, but it was fun and we had a great time.

Howard: Did you marry Meredith before dental school?

Ryan: No. Actually like our senior year, we got engaged and then my mother-in-law-

Howard: When did you start dating her though?

Ryan: We've been dating for like freshman year in undergrad.

Howard: You dated her all through dental school?

Ryan: Yeah. We broke up for a little bit during sophomore year when it gets really hard. You take like thirty credit hours, and I was really grumpy all the time. She worked for HSBC, Hong Kong, the bank. She did commercial real estate in Chicago.

Howard: HS.

Ryan: BC. Hong Kong and Singapore Bank of China.

Howard: That's right.

Ryan: Then she did commercial real estate in Chicago, which is cutthroat, man. I think she was the only woman in the office. She did really well, but having that experience has helped us grow tremendously. She's a great businessperson and just an awesome support network. She really is. She's a blessing. We got married in Colorado. Then we had our first two kids Fort Collins. I moved to Durango after dental school.

Howard: Now, Fort Collins, isn't that where the nuclear weapons?

Ryan: That's in Wyoming, I think.

Howard: No, it's in Colorado, the underground bunker where they conduct the nuclear warfare.

Ryan: Oh really? I didn’t know about that. Oh really?

Howard: Yeah.

Ryan: Dang. No, I didn’t know.

Howard: Ryan, where is the Air Force nuclear war headquarters.

Ryan: I'm pretty sure it's Cheyenne, Wyoming, which is like half an hour away.

Howard: It's in an underground bunker underneath a mountain in Colorado.

Ryan: That sounds scary, man.

Howard: Yeah.

Ryan: We were in Durango for a while. Have you ever been there?

Howard: Yeah. You know Larry Suazo?

Ryan: I never met him.

Howard: He was a pediatric dentist, my classmate.

Ryan: Is he in Durango?

Howard: Yeah.

Ryan: He went to UMKC?

Howard: Then there's the famous endodontist on Dentaltown.

Ryan: Ragnar?

Howard: Ragnar.

Ryan: Okay. I used to ride bicycles with him. We used to do mountain biking together. He would let me come over to his office and watch endo when I was still doing endo at the time. What happened to Ragnar, man? Is he still alive?

Howard: Oh he's mad at me. I said something or someone on Dentaltown. It's either me or Dentaltown or something that pissed him off.

Ryan: Oh he's so talented though.

Howard: Yeah, he is.

Ryan: That's when I knew that I had to stop doing endo when I went to his office and watched and with the microscope.

Howard: In Durango?

Ryan: Yeah. I was like I'm done with endo.

Howard: What city?

Ryan: Colorado Springs?

Howard: It used to be on tour before 9/11. You could actually get there, but anyway. It's an underground hill with several years of water. It's on Springs. They have the command center and everything exciting there. The reason I want to tell you that is because that was why the internet was invented because Washington DC was afraid when they're talking on the telephone wire that if the Soviets launched first, those bombs coming over the North Pole if they blow up a telephone wire in Nebraska, the Washington DC couldn't talk to the command center.

So they asked their scientists the late 1970s, "How can we communicate if a wire is broken?" So they said, "Well, there might be some wire open. Let's make the message so that we can send it out over any available wire, but the HTTP will be reassembled at the other side." It might even go from Washington DC to New York to London to Moscow to your own enemy and come all the way around the other side.

To build that system, the first thing they built was the computerized bulletin board system, which is the message board, the message board format that we're on, the same as the Student Dental Network, very different than the early social media, which was email groups like dentists at CompuServe where you open up your email will be this endless newsfeed. Then all the social media apps, all they did is get that unorganized crazy shit out of your email. It was like Friendster and MySpace to Twitter to Facebook. It's just this endless newsfeed. The scientists who built [inaudible 0:21:32] which was the internet used the system that Dentaltown is on, which was the computer bulletin board system.

I like Twitter. I like Facebook. I like all that stuff. But I can't follow a Ragnar and learn how to do endo. It's not searchable like Dentaltown. I mean sometimes I go to Dentaltown and I have a problem with endo. I want to go right to endo.

Ryan: Search.

Howard: Search a broken MB2 and things like that. I like that format better. You had your first two babies in Fort Collins.

Ryan: We did, yes.

Howard: You had a dental office there.

Ryan: We did. We bought a practice in Fort Collins. I ended up selling.

Howard: Why Fort Collins?

Ryan: I looked all over the Front Range. We want to live in Boulder and Fort Collins that kind of area. I think I looked at like forty practices before we finally bought one. I found a seventy-two-year-old guy who was only replacing dentures like no surgery, no restorative, just replacement dentures. We bought that office, and I started doing some restorative.

Howard: Was this how you got into mastering dentures?

Ryan: Yeah.

Howard: Did you just fall into this?

Ryan: I did.

Howard: It sounds like your love was pediatric.

Ryan: It was at first, but then I realized that my passion was dentures. In Durango I worked for a guy that was doing same day dentures and I enjoyed it, but I knew there had to be a better way to kind of go about it. I found this practice in Fort Collins. He was an older gentleman, and he had a system everything. I worked with him for quite a while. He had a lab. I tried to switch it to restorative. I was good at restorative and I enjoyed it, but I realized like about six months in that my passion was dentures. It's so weird. I've never thought it'd be my future. I was the guy in the back of the class during removable lecture and I was like, "No one wears plastic teeth. That's dumb. It's a waste of time." Now it's my passion. It's what I do and it's what I do all day.

Howard: Now when you're in Fort Collins, did you also have an office back in Effingham?

Ryan: No.

Howard: Fort Collins was your first office.

Ryan: First Collins is the office.

Howard: You bought a seventy-two-year-old guy who just replaced dentures.

Ryan: That was it. I added surgery, and I tried to switch it over to general family dentistry. The area is really competitive. I had to find a niche and dentures it was because there's only one prosthodontist in town. I dove in and I taught myself everything. I went back to like Dr. Pound and like Dr. Turbyfil and just totally taught myself. We did a lot of remakes. I mean I'm not going to lie. We had a ton of remakes when I first started, but Earl Pound, genius.

Howard: Is he still around?

Ryan: These guys are old. He is. I think he still teaches. This is kind of where I got my start and I tried everything.

Howard: Ryan, what's Turbyfil?

Ryan: It's hard to pronounce, but I believe it's Turbyfil.

Howard: Turbyfil?

Ryan: Yeah. I think he still lectures some, but he's amazing.

Howard: Ryan, can you find these two dentists, Dr. Earl Pound and Dr. Turbyfil?

Ryan: During my lecture tomorrow.

Howard: They're going to be at the lecture?

Ryan: No, they're just my inspiration.

Howard: do you contact them?

Ryan: I took one of the lectures, but Dr. Pound passed away quite a while ago.

Howard: Oh Earl Pound passed away.

Ryan: Yeah. He's like the denture guy, neutral zone, and all that stuff. That's him. I just taught myself everything.

Howard: There's another one in Oklahoma. Everybody calls him Uncle Joe.

Ryan: Oh Dr. Massad?

Howard: Yeah.

Ryan: I've tried all his stuff.

Howard: Uncle Joe.

Ryan: His stuff is amazing also. Aquasil is a great material. I tried all the trays. I've done it all, man. It was all by myself just on the fly and kind of figuring it out. We're in Fort Collins. Someone posted on Dentaltown actually about a practice in Indy, and it had been on the market for three years and no one was interested in. The guy was doing two days a week. He'd see two patients a day. He would do one full mouth surgery in the morning one in the afternoon.

Howard: For immediate denture?

Ryan: For immediate dentures. He would see two patients a day. He was doing like 300,000 a year and no one was interested. Actually, Doug Sakura or Dr. Stogie called me and he was like, "You need to check this practice out. I flew to Indiana on a Thursday and we bought the office on a Friday. Then I ran both offices for a whole year.

Howard: Was there a non-stop flight from Fort Collins to Indianapolis?

Ryan: No, it's from Denver.

Howard: You had to fly to Denver or drive to Denver.

Ryan: I drive Denver and fly to Indy. Then I'd work Indy Thursday Friday, and then I would fly back on Sunday. Then I would work Monday, Tuesday, and Wednesday in Fort Collins for a full year. My wife was pregnant with our third at the time. I thought I could do it and manage both, and I had an associate. It was just too much, so we ended up selling that to a prosthodontist who kept the whole staff and it worked out really well.

Howard: Which one did you sell?

Ryan: Fort Collins.

Howard: You sold Fort Collins.

Ryan: We did.

Howard: You want to go back to Indiana because it was closer to family and wife in St. Louis.

Ryan: Family, yes, and there was that need for dentures, man. It just blew my mind when I got there, the need for dentures the lack of education in removable prosthodontics. When we got to Indy, it just exploded. It's unreal. I can't even like put it in words.

Howard: What year did you move back to Indy?

Ryan: This would have been probably like 2015 probably.

Howard: Just three years ago.

Ryan: Yeah like three or four years ago.

Howard: Three years ago, this is 2018. I took Algebra and Trig.

Ryan: I'm not good at math.

Howard: I'm thinking three years.

Ryan: I took [inaudible 0:27:14] to get there.

Howard: Three years ago, you had one office in Indianapolis, Indiana.

Ryan: Now we have three.

Howard: Now you have three.

Ryan: Three. We're on our fourth. They're all within an hour in Indy.

Howard: By the way, Indianapolis is the largest city in America. Did you know that?

Ryan: Indy is? Have you been to New York?

Howard: No, in geography.

Ryan: Oh geography. I thought you meant the population.

Howard: There's no suburbs in Indianapolis.

Ryan: Yeah for sure. It’s spread out.

Howard: Like Phoenix the actual city limits, it doesn't even have a million people, but the metro has three point eight million. When they made Indianapolis, they made the city so big it's the biggest city. I heard that.

Ryan: I'm going to steal that.

Howard: Well, I double check them on Wikipedia. It might have changed. You know what I mean? Name a suburb in Indianapolis.

Ryan: Name one? Carmel. Zionsville. Somewhere like that.

Howard: Any other big ones?

Ryan: Those are the big two right now. Fishers is growing a lot. I actually looked at a bunch of URLs like Fishers town and Carmel Town.

Howard: Were all three of your offices in Indianapolis right now?

Ryan: No. One's one in Indy and then one is in Lebanon which is about forty-five minutes or so northwest. I actually found that office. Another dentist tried to replicate what we were doing. It didn't take off quite as well, so he contacted me. I took it over and then it's rolling. Then we just opened Kokomo a few weeks ago. Kokomo.

Howard: Spell that.

Ryan: K-O-K-O-M-O

Howard: Somebody said Japanese dragon.

Ryan: It’s in the middle of Indiana cornfields, man.

Howard: Lebanon. I wonder if that's founded by Lebanese.

Ryan: Definitely not.

Howard: Definitely not?

Ryan: Nope. It's a farm town. It's a bit more rural. There's just such a need for what we do, so we're growing pretty quick.

Howard: The guy in Lebanon started it. It didn't work well. You took it over.

Ryan: I took it over.

Howard: What were the lessons learned? What do you think he didn't figure out?

Ryan: Marketing. He only saw sixty patients in six months. It's a good location, but we've been really blessed with social media to find a lot of new patients.

Howard: Let's go there for a minute. When you say social media, I know you're huge on Instagram.

Ryan: Instagram is big and Facebook.

Howard: What's your biggest? Facebook?

Ryan: Yeah, for patients for sure, Facebook is our biggest.

Howard: Facebook is biggest. What's next?

Ryan: Instagram is probably number two. Twitter is probably a waste of time, I'd say. Unless we're hiding IP, then Twitter is awesome.

Howard: Unless you're hiding what?

Ryan: Unless we're hiding intellectual property, then Twitter is fantastic.

Howard: What does that mean?

Ryan: Intellectual property like Tukeetown. I want to hear about it.

Howard: Twitter is a waste of time for B2C.

Ryan: Yeah that's what I'm saying.

Howard: But you're saying it’s good for B2B?

Ryan: No, I don’t think it’s good for anything.

Howard: You don’t think it's good for anything.

Ryan: Yeah.

Howard: Any others?

Ryan: LinkedIn is getting better. They've changed quite a bit on LinkedIn.

Howard: LinkedIn has a lot of people that need full mouth dentures?

Ryan: No, more for business to business. Twitter just changed their platform like last week, which is interesting because Facebook was in Washington, at the same time and Twitter stock took off. I've been working with it a little bit more. As far as patient attraction, Facebook is still the best.

Howard: Well, let me tell you my investment strategy on these stocks. I'm always giving money to Facebook to boost the post. Instagram is owned by Facebook, so I consider that the same company. That's the same company. I always give money to Facebook and Instagram, I've never given a dollar to Twitter or LinkedIn or Pinterest or Google Plus.

Ryan: That's a good thing.

Howard: Here's my belief on what they did. They knew there was a ton of fake accounts. They knew there were a lot of [inaudible 0:31:20]. But they wanted to have those big numbers. In doing that, they didn't have a very extensive registration process. I mean they don't even know I'm a dentist. I can't send a tweet to all the dentists. I would if I could post a podcast and pay a hundred bucks. I got twenty-five thousand followers on Twitter. If they said we have two hundred thousand dentists around the world that you can forward these tweets, I'd pay the money. But since they don't have any mechanism and since I don't get money, why would I buy the stock?

Ryan: Their new platform is better. I think if you put a lot of blog posts on there, that's a good way to get some traction. But that's the only thing I would use Twitter for. Facebook has been our best.

Howard: Do you brand each of the three offices?

Ryan: We have one main page just for our brand.

Howard: What is the main and what is that called?

Ryan: It’s mccall_dentures.

Howard: mccall_dentures.

Ryan: Actually that's the Instagram page. Instagram, we have thirty-six thousand followers now.

Howard: Oh my God.

Ryan: I know.

Howard: Now, these are B2C patients?

Ryan: Yeah, we're getting a lot of industry people on there too.

Howard: A lot of industry people.

Ryan: Yeah. I'm up there.

Howard: I'm sure I follow you. mccall_dentures. Yeah, I'm already following you.

Ryan: I tag you all the time.

Howard: Oh There's Ryan on there. You Ryans are sticking together.

Ryan: That's what I said, man.

Howard: You Ryans are sticking together.

Ryan: Doing a podcast with my guy.

Howard: Which is better, Instagram or Facebook?

Ryan: As far as attracting patients or for like your business?

Howard: Yeah, patients, patients.

Ryan: Probably Facebook. I actually went to an Instagram conference in LA last year. I got invited. They only invited a hundred entrepreneurs from all over the US. Vans was there, the shoe company, Williams Sonoma, Roy Choi, the guy who invented the food truck movement in LA and a couple of other like big-name people. The CEO of Instagram was there. I showed up with all these denture pictures. They were like, "What the hell?" It's like gross, right? But I learned so much. It was amazing. It was the coolest opportunity I've ever had.

Howard: What did you learn?

Ryan: I just learned how to brand myself and create our brand and how to find my passion and tell our story. They had small table group discussions. Have you heard of Drybar? It's this hair blowout place.

Howard: Oh come on, come on.

Ryan: I know, right? Sorry. That's a bad joke.

Howard: I use mousse.

Ryan: Her name is Alli and she was there. She has like, I don't know, sixty Drybars all over the US now.

Howard: Drybar.

Ryan: Drybar. D-R-Y-B-A-R.

Howard: What is a Drybar?

Ryan: It's fancy blow out your hair kind of thing for bridal parties and things like that. It's really genius. I met all these people and it was amazing like it just blew my mind.

Howard: It made me think of that girl in Dentaltown who's starting the Floss Bar.

Ryan: Yeah. Yeah, I mean that's a cool idea too.

Howard: Do you think that will take off?

Ryan: I'm not sure. I don't know enough about it. I really don't. Do you think it will?

Howard: I don't know. Too early to tell.

Ryan: Yeah for sure.

Howard: I like that they'll [inaudible 0:34:37]. I don't like the people who always think of a hundred reasons why to fail. I like the guys frigging try it and if it does fail. I mean they always forget for the average millionaire did a formal BK, bankruptcy, three times. These dentists say always they spend ten years talking about an idea. Do it, go bankrupt, and go onto the next thing.

Ryan: That's what I did, but we didn't go bankrupt thankfully. I went to this conference, and they couldn't believe that we've had much success on Instagram with our full mouth extraction cases. Because if you go through that, I mean there's some pretty graphic stuff on there. I met the COO, Marne Levine, I believe her name is. She's like number three or Facebook. She was blown away. She's like, "What are you doing here?" I was like, "This is what I do. This is my passion. I'm taking it everywhere. I'm going to teach dentures." It's been a tool to help us grow.

Howard: What I like about you is not just that you're another Irish Mick. I say it sincerely because when I got out of school, my mouth was soured because it was always about dentistry on lifestyles of the rich and famous. I mean I remember going to the Pankey Institute and hearing about the A patient, the B patient, the C patient, the D patient, how you only want the A patients. You only want to hang with the A patients. Having see patients in your waiting room [inaudible 0:36:09] and I'm like, "Dude, I'm from Kansas. My entire pedigree is C, D, and F patients."

Ryan: My patients are already A patients, man. I don't approach it like that.

Howard: Because you’re Southwest Airlines.

Ryan: Yeah. Well, I don't even care about that.

Howard: I mean every seat is first class [inaudible 0:36:28]. It's not my passion to help kings and queens and Kardashians of slightly finer shit. I like to roll in there with my Kansas homies where if you're in a family reunion, almost all of them uncles have dentures. Half the men didn't even wear them because they didn't fit. They had no problem eating with no teeth. I remember being a senior in dental school being at church with one of my uncles and I stood up. He was like six-three and I'm five-seven. I stood up with him because he's wearing overalls and he's eating almonds in the church and I said to him. I said, "Can I look at your lip while you eat the almond? I mean I think I was a senior in dental school. He had these callused ridges and they were dusting these almonds. The adaptability of human is intense.

I also always said this. Whenever you think of a cosmetic dentist, you think of some fellow in the AACD doing all these veneers and that is such a misinformation fake news. The majority of full mouth cosmetic makeovers are full dentures.

Ryan: Absolutely. It's a foundation, man.

Howard: I'm not talking about in Asia, Africa, and Latin America. When ten girls got a smile makeover, nine of them got a denture and only one or less than one or half of one got upper ten Empress veneers. Nobody wants to talk about the nine girls that lost their teeth, gum disease, meth addiction, poverty, un-education growing up where mama was handing Mountain Dew and animal crackers when she was two. Her self-esteem was blown. Now, she loves her smile.

Ryan: It changes life.

Howard: It changes lives.

Ryan: It does. I've listened to all your podcasts every single one of them, I swear.

Howard: I'm sorry.

Ryan: No, it's good. I love it. I still love it. One of my favorites and I think like which one is you're most downloaded? Do you know?

Howard: I think it's Carl Misch.

Ryan: Is it? Okay. Ryan said it was Kristine.

Howard: Oh it was Kristine, oh my god.

Ryan: Okay. I did my research.

Howard: Yeah, you're right. That was the most downloaded. She wasn’t even a dentist.

Ryan: Her story was amazing. No, not at all, man. I went to Buffalo like probably about three or four months ago and presented to them and talk about all our stuff and what we're doing. I'm hoping like maybe next year I can lecture with her maybe at Midwinter or something like that.

Howard: She's lecturing at dental conventions now?

Ryan: Yeah, I think she speaks to them and stuff because I mean like her story is what I see every day, man. It blew me away. That ad campaign is awesome. That's what I want to try and replicate with McCall Dentures because it changes lives and it makes a difference. There aren't a lot of dentists that are interested in it right now. I don't know why. Why do you think that is?

Howard: Because this industry tries to- you're summing up all dental continuing education. You go to a dental convention and the first guy says, "I just want you to know I'm the best dentist here because I trim my own dies." The next one says, "Oh no, no, no. I quarry my own stone, pour up my own dies, and trim myself. I'm the best." And the next goes, "No, no, no. I query my own stone, pour up my own impression, trim my own dies. I have my own beehive. I raise my own wax. It takes me forty days and forty nights to do a crown." They're like, "Oh my god."

Ryan: Oh you're the best dentist.

Howard: The longest, most complicated, most arcane bullshit, I mean, go back to the Pankey Institute. They were talking about these wax bites. You're like, "Well, how stable?" I mean it's an art and a science, but don't tell me this is rocket science when we're using soft wax and all. But what's crazed is it's a religion like valedictorian principles. If it's fun, it can't be good. You have to suffer and be miserable and be complicated. The harder you work and the less joy and satisfaction, the more puritan you are. Then I come in there and say, "Well, how about we just prep the tooth, take an Impregum on [inaudible 0:40:57] Premier Triple Tray. Send it to the lab guy for 90 bucks from Rockstar." Oh you whore. You're horrible making dentistry affordable to the masses and the poor.

Ryan: You still get flack for that?

Howard: Oh yeah. It was Herb Kelleher who gave Americans the freedom to afford to fly. When I started lecturing in 1990, Braniff, Eastern, TWA, only rich businessmen could afford that plane ticket. Then here comes this drunk alcoholic Texan, Herb Kelleher, smokes four packs a day, can't fly a plane because he's drinking Wild Turkey ice, figures out the cause that we're not doing hub-and-spoke. We’re only flying direct. No food. No meals. Only one plane. We only have one part. We only have one training. He gave Americans the freedom to afford to fly. Now, they can go and see their granddaughter's baptism or bar mitzvah because he made it affordable. I have more respect for Wal-Mart, Ikea, Southwest, Costco. Those are the people who give my people the freedom to afford to buy stuff.

When you come in and telling me about how this would be best for a movie star in Beverly Hills or the richest old widow in Key Biscayne, Florida, I don't give a shit. That doesn’t motivate me. Europe had eighty-six car companies before Henry Ford started Ford. By the way, his first Ford company went bankrupt and then he started a second. But see in Europe, eighty-six car companies will be like five guys making one car for a king or royalty or a cardinal or a pope. Our country was, "No, let's, let's figure out assembly line and throw out ten million of these babies for the middle class. His first one was six hundred and sixty-eight. Every year, they got faster, easier, higher quality, cheaper, and ten millionth one was two hundred twenty eight.

What did dentists do? Every time the earth goes around the sun raise all over their prices 5%, which is exactly the opposite. That's only healthcare and government. Raise taxes. Raise regulation. Raise costs. But the rest of the free enterprises no. We have three hundred sixty-five days. We got a lot of smart people. How can we give them a denture next year that's better, less appointments, and for a lower price?

Ryan: That is my MO like equality. I have two chairs, right? We have two chairs in the office. I do my own hygiene. We have a small staff.

Howard: You do your own cleanings?

Ryan: I do my own cleanings. We don't do a lot of cleanings, but it's mostly full mouth extractions, implants, and dentures. We have our own laboratory and my technicians are amazing. They've been doing it for combined like almost sixty years.

Howard: Is it more hand art lab or is it all digital?

Ryan: We're starting to switch towards digital though and that's why I'm so interested in it. Do you want to talk about that?

Howard: Your formula is two chairs.

Ryan: Two chairs, yes. Actually, we have three and I feel kind of like a fraud when I say we have three because my nickname is 2 Chairz, right?

Howard: On Dentaltown.

Ryan: Yeah. Don’t tell them we have three.

Howard: What is your name on Dentaltown?

Ryan: 2 Chairz but a Z like a rapper.

Howard: So the numeral 2.

Ryan: 2 Chairz with a Z. I don’t get that one.

Howard: Yeah. You have forty-two thousand posts.

Ryan: Yes.

Howard: Your three centers are all two operatory.

Ryan: Correct.

Howard: They're really three operatory?

Ryan: Yeah. Well, a couple of them.

Howard: A couple of them, okay.

Ryan: Don’t tell anybody.

Howard: Let's start with logistics.

Ryan: My model is different like totally different, central lab, small local.

Howard: Each office as a lab?

Ryan: Not right now. We're just doing one central lab.

Howard: Are you the only dentist for these three locations?

Ryan: I have associates? There are a lot of guys that need work.

Howard: Is associates working out for you?

Ryan: It is.

Howard: Because usually the average associate only stays one to two years.

Ryan: I know, right? We're looking for guys that want to stay long-term and help us grow. Would you take on a partner? Would you ever recommend that?

Howard: That's hell no because I don't want to say the F word. No, you married Meredith, right?

Ryan: Oh yeah.

Howard: You make passionate love and have four children. Four souls are hoping that you and Meredith stay together.

Ryan: Yes and they're all going to be lab techs.

Howard: That fails half the time, right? Now, now you want to marry a damn dentist?"

Ryan: I know.

Howard: I say the only time you partner with a dentist if they're awesome in bed and you want to have sex with them every day and they're rich.

Ryan: They're rich.

Howard: It doesn't even work on the org chart. Look at religion. What would have happened if you had multiple gods? There's a god of thunder and lightning. Who farted?

Ryan: That’s a hard one, man.

Howard: All the major religions have the best story to tell because they're monotheistic. This is God. This is you. There's an org chart.

Ryan: Oh sure. It's just crazy.

Howard: If you do have a partner, I'd say this, fifty-one to forty-nine. You're sixty and you're forty. I mean I would advise [inaudible 0:46:36]. Again, the noise of dentistry, all the lawyers and consultants that sell partnerships, they're making money off of it. They're telling you how great it is. They never tell you about divorce. Your wife is from St Louis.

Ryan: Yes.

Howard: You know one of my earliest lectures was in St Louis. I'm giving my lecture. I just started. It’s an eight to five deal. Two policemen come and I'm just still lecturing.

Ryan: East side?

Howard: I don’t know where it was.

Ryan: It's pretty bad.

Howard: It was like 1990. There's his whole office there with the dentist. The policeman goes in the room and he goes, "Come here." He comes out there, and he handcuffs him and walks him out.

Ryan: Really?

Howard: We all learned later that day. Check this out. He has a partnership, right? The other partner never came home that night. So finally, the wife got worried, finally drove to the dental office, he's laying in the office with a gunshot wound to the head. The partner shot up and then just went home, had dinner, went to bed, and woke up. Talk about disconnect.

Ryan: That was your first lecture.

Howard: I think it was the first lecture in St. Louis.

Ryan: You still lecture?

Howard: Yeah. See, they don't tell you about the partner who blew his other partner's head. They don't tell you of the hundreds of dentists that I've met that said their divorce was ten times easier. Because when you divorce your lover like when I got divorced, my wife handed me a divorce settlement, I did not read it and I just went like this.

Ryan: She took half?

Howard: Yeah and it's like I'm not going to fight with the mother of my four children. She was my best friend from age fourteen to twenty-four. Then we were married. Thirty years with this woman with four kids, do you think I'm going to fight with her?

Ryan: That's cool.

Howard: Hell, no. I'll just suck it up buttercup. That's relationship when you're married with kids. Now you're going to divorce a dentist who's got eight years of college who's fucking crazy, who's anal. I can give you the name of a hundred dentists who said their breakup with their partner was a hundred times worse than their divorce. Have I answered your question?

Ryan: I believe so. That is a definitive yes.

Howard: Here's another thing that you'll find out when you get older. A lot of the happiness in life is being in control of your own destination. Either there'd be a 100% control of three offices and living as a peaceful dictator than deal with the partners and the board and part of a hundred offices.

Ryan: We're doing associates and I need long-term.

Howard: That's why also I've never understood even Mark Zuckerberg. You're a big Facebook fan.

Ryan: I've given him a lot of money.

Howard: I've given him a lot of money. I love his father.

Ryan: Did you watch his testimony?

Howard: Yes.

Ryan: He crushed it, man. He answered everything.

Howard: He got interrupted every time. I don't know what his answers would have been because he never finished a sentence without getting interrupted.

Ryan: He referred to all of them as senator too every time [inaudible 0:49:46]. I enjoyed his dad's lecture a lot than you guys did .Genius.

Howard: What I don't understand about Mark is he already had a company making billions of dollars a year. Why would you even go public? Why would he even want to deal with Wall Street?

Ryan: They're too big.

Howard: A lot of those companies are really, really big and never go public. I would never go public. I would never deal with a partnership. Every year, someone tries to buy Dentaltown. Every single year. It's like what do I need money for? I'm not wearing a watch or underwear right now.

Ryan: Me neither. Putting some knuckles on that.

Howard: Nothing in my life would change if you gave me a bunch of pieces of paper. The first thing I always think about when someone tries to buy me out, I always say, first of all, I always ask my staff, "Would you rather work for me or this guy?" They always scream, "Neither. Neither. We hate both of you."

Ryan: I'm going to steal that too, okay. I'm going to write those jokes down.

Howard: My team is happy if they're left alone and they're autonomous, I don't want to screw up their world by having some publicly traded companies saying, "Laurie, you need to make your profit numbers. Cut costs. Increase sales. Shove more ads down their throat. We need to make them now.

Ryan: They all love you. That's what I've noticed this weekend, man. It's like everyone I've met that works for you loves you and like they would take a bullet for Howard. No one had said a bad thing about you at all.

Howard: Were they all drinking?

Ryan: I think they were pretty drunk but like that's when you're honest though.

Howard: Ask them again in the morning, but thank you. That's something.

Ryan: No, it's so cool and that's what I really connect with about Dentaltown because that's how we operate too like I'm gone this week. I left on Wednesday. I don't lecture until Saturday because I wanted to experience all of this. I've never been to Townie. They invited me to lecture at the very first one and that's when I was still in Colorado.

Howard: That's because we couldn't find anybody.

Ryan: Well, I suck too.

Howard: We had this empty space. We're like okay. Reach down deep who posts a lot.

Ryan: Okay. That totally resonates with me because I'm not there right now and I know all of our offices are doing well. I know all the doctors are going to take care of our patients. I got to recruit more doctors that are good at surgery and that enjoy doing dentures. I want to find them. I want to lecture and I want to speak about dentures because that's my passion. I don't want to cry but like that's what I want to do.

Howard: So you're the Herb Kelleher of dentistry. You're bringing affordable cosmetic makeovers to the masses.

Ryan: I wouldn't say that. My passion is dentures, and I want to teach dentures because it's a lost art form and it might die eventually.

Howard: Don't narrow the field because don't look for someone good at extraction who want to do dentures. Look for someone you just brought in Wichita because a guy like you could teach them extractions within a year.

Ryan: I'm getting tired and my back hurts. I mean I've extracted like three thousand teeth in the last four months, and it's getting exhausting. I'm going to bring in some surgeons, and I found a surgical prosthodontist I'll probably bring on eventually. We're going to grow one to two offices every year for the next ten years, and then we'll see where we're at.

Howard: Are they all going to be in Indiana?

Ryan: We're starting to branch out, man. I've got an interest in Ohio. We've looked in Illinois, but Illinois is not in good shape.

Howard: Well, let me give you a little advice. When you look at franchisees which is 13% of the country.

Ryan: We've already done our research, yeah.

Howard: But no, this was with franchises, not the franchiser, not the company McDonald's selling a franchisee, but the franchisor. It's 13% of the economy. A guy that will just here's your headquarters and will just branch out physically, so he ends up having twenty locations within ten miles of the first one. The management team can stay on top of it. Everybody can stay on top of it. Once you sit there and say, "Well, let's go one state over." Just the logistics of flying back and forth, driving back forth. There's a ton of researches saying the guy that owns sixteen subways but they're all in the Phoenix Valley compared to this guy who has sixteen subways but four in Utah and four in New Mexico and four in Colorado. The scales of efficiency, the scales of economy are exactly trashed by the distance. How many people live in Indiana?

Ryan: I don't know. Five.

Howard: Five million.

Ryan: Maybe.

Howard: That's at least a twenty-location state. I would not leave Indiana until you were done with Indiana.

Ryan: I won't. We want to do the whole state. We draw from all over.

Howard: Do the whole damn state.

Ryan: I've seen patients from New Orleans. We had a guy flying from New York a couple of weeks ago. We're getting people from Chicago. You're right. We've researched franchises.

Howard: Because you already did the Fort Collins to Indianapolis.

Ryan: Yeah and it didn’t work.

Howard: Just because you cut that distance in half doesn't help anything.

Ryan: You're so right.

Howard: Why grow the franchises? My Dad had nine Sonic drive-ins. I've been a student of franchises my whole life.

Ryan: Okay. Oh that makes sense.

Howard: What started the first franchise was the government infrastructure of the Interstate System. Before the Interstate System, Americans, they were raised, reared, and died and never went ninety miles away from home. Then on the Interstate, people sit there and say, "Shit. I can go [inaudible 0:55:22] Disneyland on the ocean.

Ryan: 1966.

Howard: That's what we did, yeah, 1966. I remember when we were little, dad got a station wagon. Him and mom were in the front seat, and me and my five sisters put down on the back, played monopoly all the way from Wichita to Disneyland.

Ryan: No seat belts.

Howard: My mom and dad said there were the case of Old Milwaukee, and we're throwing the cans out the window as they drank. They just drank and drive all the way to Disneyland with me and my five. That's the trailer. I don’t go on a trailer track. I was born in the barn and heck we were. We all lived. We're all fine.

Ryan: When we showed up on Wednesday and I saw you wearing jean shorts and like bright orange shoes, I was like, "I'm at home." I was like I trust this dude now.

Howard: Dad would have been eighty yesterday, and my mom turns eighty in June.

Ryan: Okay. Do they still live in Kansas?

Howard: Wichita, Kansas.

Ryan: Really?

Howard: Well, dad died. My mom's alive. I want to put down these two chairs. Right now your lab man so is it alginate? How many appointments is your denture?

Ryan: We still do traditional alginates. We don't usually do a custom tray. We'll usually take like a wash or the PVS at the wax try in.

Howard: Sort of explain. First alginate.

Ryan: First alginate.

Howard: Then pour the model.

Ryan: Yeah we still model.

Howard: You go ahead into your lab man. You're going to take the alginate and then your lab man is going to pour the model. The patient is going to stay in the chair?

Ryan: No, we just have them come back.

Howard: Okay. The first appointment was just alginates.

Ryan: Yeah. It's a relaxed environment. It's laid back. I mean we don't have production quotas. I don't like poured over everything. We actually have two full-time lab techs. They do the majority of the work. I owe them so much because they've been doing it for a long time, and they've seen a lot of dentures. We've been blessed to have some really good lab techs. We do alginates and then we'll do a wax rim still.

Howard: The second appointment is wax rims.

Ryan: Wax rims, yes, sir. I just use a facebow in every case.

Howard: You do?

Ryan: I use two. We go CAD/CAM in a few years. I'll probably start doing it again because I don't think you can do CAD/CAM dentures without a facebow. I really don’t. What do you think?

Ryan: What CAD/CAM company do you like? There's one in Scottsdale, Arizona.

Ryan: Well, I've tried that system.

Howard: What's that company?

Ryan: That's AvaDent. Is that right?

Howard: AvaDent.

Ryan: They're cool because it's monolithic and it’s closed source, all right. You can't buy your own mill. Is that correct?

Howard: I'm not sure.

Ryan: I think it is. I want to purchase a mill. I've tried the 3D printing. We checked it out. We looked into it and tested it, all that fun stuff. It's just for our volume it doesn't make sense at all.

Howard: This is so brutal to say because this is what pisses so many dentists off it. I'll give you an example. I take a $17 Impregum. On the side is Premier Triple Tray. Send it to my local lab man basically $100 BruxZir crown or a PFM and then submit it. It's perfect. What does the dentist say? Well, we want to buy a $150,000 CEREC machine and have my assistant who's never made a crown a chairside mill. This appointment which was an hour numb, prep, impress, temporize, release, come back in two weeks. Well, I want the same day crown. Now, she's in the operatory for two hours if you're lucky, sometimes three. I've been in dental offices with the assistants helping. Dude, he puts them in there at eight o'clock. They don't even leave until noon. Warren Buffett is my idol.

Ryan: He is?

Howard: I went to Creighton in Omaha, Nebraska. He lectured a business class.

Ryan: Oh cool.

Howard: He still says to this day, "95% of all the "CEOs go to work every day to try to figure out how they can do everything slower and more expensive." He says only 5% can sit there with a five by seven index card and a number two pencil. If you can explain to me your business on a five by seven index card with a freaking pencil, what is your Business? How do you make money? What is your story? If you can explain that on a five by seven index card, you already know what you're doing. Here's a denture facility. There's nothing wrong.

Ryan: Just write dentures online. That's what I'm saying.

Howard: It should be faster, easier, higher quality, lower cost dentures.

Ryan: Yes absolutely. That's what we're doing.

Howard: That’s what you do. Then they'll spend all their time going to course saying, "Well, how can we do this digital?' Why took an impression with alginate? How can I replace? How much do you think an alginate impression cost?

Ryan: Oh I don't know. Not much.

Howard: I mean an impregum impress I think it’s about $17 as impression for impregum. Polyvinyl or polyether, I don’t know. I'm thinking probably 5 bucks.

Ryan: If that yeah.

Howard: How could an oral scanner and a digital format? I mean look at 3M again. Laurie told me. We'll switch from impregum to the True Def Scanner. Hell, just the software agreement on the True Def Scanner is $200 a month. What's 200 times 12?

Ryan: Plus the upgrades.

Howard: $2400. Then I got to buy an equipment that's got to have freaking antiviral software and malware and updated. I mean it's like every time a dentist has an idea, their overhead goes up. I tell dentists they need to get a big white board in the break room. When they're driving to work and they're running twenty red lights, they got this big old exciting idea. They need to run in and write it down. Then blow a whistle. Get their team there and say, "Hey, hey, this is my idea and I'm really, really excited. Please, if you love me, stop me from doing this because every idea I have makes everything more expensive and messed up and slower. Can we just stick with the alginate and the impregum?"

When you look at same-day dentistry, I've been in this for thirty years. We only have two questions. Freaking scared. Are you going to hurt me? Can you knock me out? Can you let me sleep? You got that laughing gas stuff?

Ryan: That's what I'm saying.

Howard: Number two, I'm afraid of the cost. How much is it going to be? They only are saying two things. I'm afraid you're going to hurt me, and I'm afraid of the bill. What's your idea? We'll switch to a True Definition Scanner. My god, instead of having $7000 lab, now they're only $200. I'll have the only impression with a $200 a month software agreement. I mean sometimes I think, oh my god. I love your passion. I love your excitement. I love you. I love anybody who went to college eight years to help your fellow man with your hands doing surgery. But god damn when it comes to business, healthcare and government are so insane.

Ryan: Oh especially dentistry, man, it's just backwards, right? For us, it hasn't made any sense at all to approach that. I'm old school right now. I've seen some of the CAD/CAM stuff and some of the mills that I'm interested. Right now, it's a square peg for a round hole. Does that make sense? It doesn't improve our efficiency. It doesn't make us any more money. It doesn't make a better product anything that I've tried yet. Hopefully, something will come out eventually but if it doesn’t.

Howard: The next time you want to do a CAD/CAM convention, just go get some Disney film for your two-year-old kid painfully sent through. What's that Disney princess movie that everybody talks about?

Ryan: Tinker Bell. Speaking of which, I love her. Gigi is like my best friend.

Howard: Say hi to Gigi.

Ryan: Gigi, we love you. I talk to her like every day, man and we talk about this all the time. She is my go-to on dentures because I mean she's a genius.

Howard: Look how genius.

Ryan: No staff.

Howard: No employees. No stuff.

Ryan: Makes her own dentures.

Howard: This is her appointment system and a phone system. She does all of her own lab work. When she does $1 in dentistry, she takes home about $1.50. She's awesome. I talked to her a lot, man. She has been my mentor a lot of things, so I really appreciate her. I met her in Boston actually. Hogo sent us there, and Gigi just grilled them. She asked many questions. It was awesome. I love her to death. She's fantastic. But, yeah, I mean our business model is different. Low overhead. High quality.

Howard: So Gigi is extreme in overhead.

Ryan: I'm like less extreme.

Howard: Do you know what he said? He does his own cleanings. I'll go into offices and I'll say, "What is your problem?" "Well, my overhead, it's high. I'm not making any money." He's sitting back there in the office talking to me for an hour while his hygienist is cleaning the teeth. Then she comes in and says, "I need a hygiene exam." Then he sits there and talks to me for five more minutes. Then he goes and does an exam. I'm like why were you paying her $40 an hour while you sat here on your ass the whole time?

I look at what the hygienist does, and 50% of the time you don't even have to be a hygienist. She sets up the room. An assistant can do that. She goes and gets the patient and sits them. Then when she probes, she needs someone to come in that says the assistant is in there. Then when she's scaling and then when she's done, anybody could polish, floss, fluoride treatment, write up the chart, dismiss them, clean up the room, Then you get these dentists who say, "My overhead is high." I'm getting rid of the hygiene department. You don't have a hygienist?

Ryan: Nope.

Howard: No hygienist. Rick Kushner has 350 Comfort Dental with no hygienist. There's only three publicly traded dental offices on earth that are so profitable they can be publicly traded. Heartland couldn't go publicly trade. They're not profitable enough. There's not one DSO in America that could do an IPO on freaking Nasdaq.

Ryan: Really?

Howard: There's only two, 1300SMILES and Pacific smiles in Australia and Q & M Singapore. None of them have hygienists.

Ryan: Interesting.

Howard: They say, "Look, I can have an assistant set up the room and see the patient. The dentist comes in and probes and the assistant [inaudible 1:06:01]. Then when they scale, they're scaling each tooth while they're doing the exam while they're bonding to the patient. This is the only unique selling proposition of dentistry. I'm all done. The exam is done. We've all talked about everything. The assistant comes in, polishes, flosses, fluoride treatment, dismiss you, cleans up the room, the whole nine yards. I can't pay a hygienist $40 to do a cleaning where Delta gives me fifty-five. Insurance companies killed hygiene.

What you have in dentistry, let's call what is it? It's lazy. The doctor is back there sitting on his ass while the hygienist... Then they'll say, "Well, the hygienist does the cleaning, so I could do higher value procedures like molar, endo and implant. Dude, you did one molar implant today. You did one molar root canal today. Why didn't you do all your cleanings? Gigi takes a step further. No employees. No lab. Does it all. Takes the impression. Pours it up. Trims the die. Does it all.

Ryan: Trust no one.

Howard: Who would you want to do your denture if you could pick one townie to build with your denture?

Ryan: Gigi all day like no question.

Howard: Gigi or you.

Ryan: Or myself yeah. Well not to like brag or anything, but she is amazing and I really value her opinion on everything. I wanted her to lecture with me on Saturday, but she hates dentists. I think she might beat everyone. You know what I'm saying?

Howard: Talk about that. You say she hates' dentists. Let's talk about that.

Ryan: I don't want to say hates dentists, but I think she just hates everybody maybe or distrusts everyone. She's just like that kind of person, but I'll talk her into next year. I want her to lecture with me. I want to come back next year. I want to lecture on dentures again dammit. I want Gigi to come with me.

Howard: I love Gigi. I love Gigi.

Ryan: I'll talk her into it maybe, but she's my mentor.

Howard: Have you ever talked to her about her journey through life?

Ryan: Oh yeah. She's awesome.

Howard: Where she started?

Ryan: Oh man, her story is awesome.

Howard: That's a wild story.

Ryan: I enjoyed her podcass a lot.

Howard: There needs to be a first a book and then the movie.

Ryan: Yeah absolutely and my wife loves her too because she told me.

Howard: When she wrote the book, me and Ryan will raise the money in Hollywood to fund the Tinker Bell.

Ryan: I think they already did that movie though, Tinker Bell or something.

Howard: Okay. Wax rims.

Ryan: Wax rims. We go back to dentures. Wax rims.

Howard: Wax rims and then third.

Ryan: Then third, I do a try on in every case. We do a tiered system just like every other big denture company, but we try in everything, man. I don't do the same day much bites.

Howard: Now, is it, Chevy, Pontiac, Olds, Buick, Cadillac? You have low cost thing.

Ryan: I can do the low-cost thing.

Howard: Expensive Ivoclar teeth.

Ryan: I can do the mid-level. I can do the premium Phonares.

Howard: Tell me what are the low costs, mid-range, and premium teeth?

Ryan: We use a lot of materials whoever gives it to me for free. That's what I like. I like the Ivoclar materials. I do. We use a lot of their Ivostars for the economy teeth.

Howard: Ivostars.

Ryan: Yeah that's their economy tooth. Then the BlueLine that's been our go-to for long time. That's also Ivoclar. I use it a ton of their products.

Howard: BlueLine for the mid-level.

Ryan: Yeah. Then the premiums are Phonares.

Howard: Spell Phonares.

Ryan: P-H-O-N-A-R-E-S. That was Christie. Those were her teeth.

Howard: P-H-O-N-A-R-E-S.

Ryan: Yeah and they're on second generation.

Howard: That was Christie's teeth?

Ryan: Yeah. Remember her?

Ryan: Oh yeah.

Ryan: That's her. That's her whole thing.

Howard: That's the most expensive Ivoclar teeth?

Ryan: Yeah.

Howard: Does that affect the price of the denture?

Ryan: Yes, we'll charge a different price for it. I'm all fee for service.

Howard: What are your charges for low-cost, mid, and premium?

Ryan: I can match whatever Affordable does, man. I know exactly what Affordable charges and I know exactly what Aspen charges and we'll match it, so it depends.

Howard: So if they come in with Affordable price, you match that?

Ryan: Usually, we can below them.

Howard: What do you mean? Do you have your set fees?

Ryan: Yeah, we do.

Howard: Can you share your set fees?

Ryan: Yeah. I'll do a $399 denture for economy. Mid-level is going to be more like a $1400, $1500, $1600 denture and then $2000.

Howard: Wait. $399, was it arch or full denture?

Ryan: Full arch, yeah.

Howard: Okay. What was full arch for midline?

Ryan: Midline, I mean, it's going to be like $1400, $1500, $1600, or something like that.

Howard: $1500 an arch.

Ryan: Yeah.

Howard: $3000 for a denture.

Ryan: Yeah.

Howard: The other one was $399 an arch.

Ryan: It’s like $798 per set.

Howard: $798 per set. So eight hundred

Ryan: Then for the premium dentures which we're doing many more premium dentures just because people are finding us that we're getting close to like $4000 on that. That's going to be the higher end on the denture level.

Howard: Okay. You have $4000 for premium, $3000 for midline, and $789. You know why you're saying $399 instead of 400?

Ryan: Why?

Howard: Because a lot of people, it's confusing to the marketplace. A lot of people think that $399 sounds cheaper than $400. How that started was actuarial. It was for controlling peculation. In a cash register if I charged 99 cents for everything, I break a roll of pennies fifty. Every time someone gave a dollar, I'd have to give a penny.

As the owner of the accountant looking for stealing, I come in. If we only have twenty pennies, I know you did thirty transactions. That was just to get a transaction count. It was all for embezzlement and getting actuarial accounting. Then you sit there say, "Okay. Well, you did thirty transactions. How come you didn't pull the register thirty times? There's one thing missing." It never was that $399 sound cheaper than $400.

Ryan: Okay. I see. In Colorado though, I was only doing premium.

Howard: You're only doing $4000.

Ryan: That was it.

Howard: You have $4,000, $3000, and then the bottom, the premium. Just the cost, you would want to know what the other cheapest costs were.

Ryan: Yeah but I didn’t know what the other ones. I only did the premium ones in Colorado. I moved Indy and like it turned a lot of people off.

Howard: What did?

Ryan: The $4000 because they didn't have other options. It's not that it's a bad denture and it's not of lower quality because we still use great products and we take our time with it.

Howard: What's your market share percent of the $800 versus the mid-level $3000?

Ryan: Honestly, most people go for the mid-level. They really do. It’s an awesome denture. Anywhere else you go that's going to be the premium denture.

Howard: What percent of your sale is that? Eighty?

Ryan: Oh man, at least, yeah.

Howard: 80. That's a phenomenon that anywhere you go like [inaudible 1:12:47] that the basic, the premium, and the deluxe, everybody buys premium. Whenever you give them three choice, they're always thinking, "I don't want the cheapest, but I'm not made of money." So they always pick the middle. Whenever you have someone that just sells one thing, if you just add two more price points, they'll overall sell more just because of the psychological factor.

Ryan: I've noticed that too, but we're starting to get more premiums because we polarize the gum. We characterize them. It’s a nice process.

Howard: When I think of gum colorization or characterization, I'm thinking of non-white. I'm thinking Hispanic, American Indian, African American.

Ryan: I'm talking more like pink and like something you might do for a fixed hybrid or something like that like some detailed There's some composites that you can use as well. It's a little bit longer process, but I'll do anything. A lot of the economy dentists are like eighteen to twenty-three-year-old kids that I have to pull twenty-eight teeth on.

Howard: Is that for meth?

Ryan: Sometimes. A lot of heroin, a lot of heroin in Indiana, Mountain Dew, cigarettes, things like that. That's all they can afford, but we still make them a nice denture. It still changes their life and I'm happy to do that.

Howard: What percent of your business is immediate versus remake?

Ryan: Mostly immediate in Indiana. I'd say probably seventy-five over twenty-five remake because the remake, I mean, those are the hard cases.

Howard: So we got the alginate, then a wax rim, then a try-in, and then a delivery?

Ryan: Yeah.

Howard: So it’s four-appointment.

Ryan: Yeah.

Howard: Four-appointment.

Ryan: I mean it's old school but it works. It's tried and true. I've done tracers. I've done all that.

Howard: How long is the average from alginate to delivery?

Ryan: I could do it all in the same day with our lab, but usually we'll schedule a week in between.

Howard: But you can do a same day.

Ryan: Oh yeah, we can do same day.

Howard: What percent choose same day?

Ryan: We don't offer it really because we're just so busy. Typically, it will take a week and a half, maybe two weeks tops, to get the denture made. Now that we're getting so busy, I can't even schedule surgeries right now.

Howard: Let's go back to busy. It's your Facebook page.

Ryan: I had to stop advertising, Howard.

Howard: Your Facebook page, it's McCall Dentures.

Ryan: Yes.

Howard: That's your Facebook page.

Ryan: Correct.

Howard: Are you just like making a post and then boosting it or do you make a post?

Ryan: I tried it all, man, and that will be part of my lecture tomorrow.

Howard: What works best?

Ryan: It depends. It's changed a lot too. It's gotten a lot more expensive recently. When I first started in Indy, I would put up a post and we would get six hundred organic likes for free, right? Six hundred people would see that post and they would like it in Indy. Now, I'll put a post up and six people would like it because Facebook got smart.

Howard: No, no. Facebook knows what you're making money off of. Then they kill that until you boost the post.

Ryan: They're smart Americans.

Howard: Yeah. What do you have to spend to boost the post to go back to your six hundred likes?

Ryan: I mean like the industry standard is going to be over a dollar at least.

Howard: A dollar per like?

Ryan: No. Probably yeah. Well, it depends like cost per click, right? The industry standard would be closer to a $1 or $1.25 for all industries. I can do it for 10 or 15 cents.

Howard: For a click.

Ryan: Yeah.

Howard: You're making a post and then you just boost it?

Howard: Usually. Yeah. I mean that's typically the way to go.

Howard: Are you boosting up for the state of Indiana?

Ryan: We’re just blanketing the whole state now.

Howard: Okay. You make a post. You blanket the state of Indiana. You make one post a day on Facebook?

Ryan: No, I am not even posting on Facebook.

Howard: I mean in your heyday when you started. Was it one post a day?

Ryan: Yeah, I mean we found that ads work the best. Then I would just kind of run those ads and stick with the ones that work the best and got the best return in response and stuff and less click-through rate. It depends on how nerdy you want to get on all that.

Howard: Then get nerdy.

Ryan: Okay, yeah. Click-through rate is a big one. Impressions are a big one. Engagement is a huge like I monitor engagement like a hawk.

Howard: I'm wondering. Would you make one post a day? Would you make two posts a day?

Ryan: It depends after you've started.

Howard: What were you doing?

Ryan: I think less is more now to be honest with that, yeah, absolutely. I think if you're posting three or four times a day not like for you like all of your stuff, I see what you do.

Howard: Yeah, I'm B2B. I'm just posting for dentists.

Ryan: Do you use like BoostSuite or something like that to do all your posting or you make Ryan do it?

Howard: No. I do all my own posts.

Ryan: But you're posting like four times like four in the morning.

Howard: Well a couple things, number one, four o'clock in the morning, I'm up for the day.

Ryan: I was too today.

Howard: Number two, I get all my stuff sent to me. They're sending it to be on Facebook, on Twitter, or whatever. I don't know how to say this without legally throwing myself under the bus, but many dentists thank me all the time because I'm sharing stuff that they want to put on their page. I mean I can't tell you how many dentists have told me. I was on Dentaltown on Patient Education. Most dentists say, "Every day, I want to post something on my Facebook page. I just go to Dentaltown. I follow Howard on Patient Education." They'll throw out five or sixty things. Other dentists were throwing me things on that. Oh yeah, that's the one I want to put on my page.

Ryan: That's cool.

Howard: I'm just main guy.

Ryan: Yeah, it's awesome.

Howard: If anybody made any meme that's quasi-cool about dentistry.

Ryan: Oh you want to see some good ones?

Howard: I'm going to post it just to help my homeys fertilize their pages.

Ryan: You have to talk to Hogo then. He's seen some good ones.

Howard: I have that thread Dentally Incorrect. If they're over the top, if it was funny, post them on Dentally Incorrect.

Ryan: All right. I'll tell my friends.

Howard: If they're for a dentist website or Facebook page, post them on Patient Education because the dentist had to wear so many hats. They're trying to learn endo, and they're trying to place implants. They have so much time. I want to make it so if they're trying to do their Facebook thing if I got sent six cool things, it takes me no time to post them. I post 100% of anything at Howard Farran, so facebook.com Howard Farran, Twitter @HowardFarran. If it's Howard Farran, it’s me. Now if it’s Dentaltown, Orthotown, Hygienetown, Townie Meeting, then it's my marketing team. It's Julian. It's Chris.

Ryan: Oh cool. That makes sense.

Howard: It’s Ryan.

Ryan: Oh nice. Ryan is awesome, man. He's cool. That was a good kid.

Howard: I got four. I'll tell you. When you're my age, the thing you'll be most proud of is those four kids. There's nothing I've ever done in dentistry that would come close to Eric, Greg, Ryan's act.

Ryan: That's cool. That's awesome, man.

Howard: What I love the most about my professional career is I worked ten to twenty for my dad in the Sonics. I've only worked for my dad and me, but I can swear to God to this day I've never worked a day in my life. Because when my dad said, "Will you come to work with me today?" I mean I get to go with my dad and eat hamburgers and onion rings, and those carhops are gorgeous. What's the alternative? Stay home with my five sisters and pray the rosary and do a novena and the station of the cross?

I mean no. I begged my dad I always say. In fact when I was little, I used to screw with his head because I'd be like ten or eleven and it'd be like a summer or a Saturday. I say, "Can I go to work with you?" He goes, "No. Stay home today." And I'd cry. Then he'd say, "Oh Howie is crying." Then he'd think, "Well, he doesn't have a brother. He's got five girls." So I would shame, guilty, dirty him into taking me to work with him.

Then when I became a dentist, I mean, god, someone come in with a toothache. I mean I loved every minute of making hamburgers with dad, and I've loved every minute and then I love like the podcast. These are all free. There's no money in a podcast. I'd rather talk to you.

Ryan: You're doing it to help people.

Howard: I’d pay you $20 for this opportunity.

Ryan: That's I'm saying now. I'm the same way like you'd find something that you can play, right?

Howard: Yeah.

Ryan: Then it's not a job and that's when you win. That's the end of my lecture tomorrow. I got a quote in there. I forget which British philosopher it was. It was like find something to do where you play every day and you've won the game. You know what I'm saying?

Howard: Yeah.

Ryan: I agree with you 100% on that.

Howard: No one gets off this rock alive. I mean what was it? Thirteen people stood on the moon, but they all came back and died here. I mean no one gets off the rock alive. We all retire to the same grave under the ground. You might as well just freaking have fun.

Ryan: I never thought like dentures would be in my future like I would want to teach dentures, but like that's my passion now and that's what I'm going to do.

Howard: Then they're doing the old fashioned way. They're pressing it and baking it.

Ryan: No, we use the IvoBase system.

Howard: Talk about that, the Ivoclar IvoBase system.

Ryan: Yeah, it's a great system. It’s high-impact acrylic. I mean we make really quality dentures, and I can compete with the big chains and we care about our patients.

Howard: Are you ever going to make an online CE course on that?

Ryan: I'm going to. Yeah, I am.

Howard: I got eight operatories.

Ryan: I know and I've talked to Howard.

Howard: Do you want to put two operatory franchise in my Today's Dental?

Ryan: You said not to do franchises, but now you want to buy McCall Dentures? I would sell you a McCall Dentures.

Howard: I would do [inaudible 1:22:44].

Ryan: We would crush it.

Howard: Phoenix is a retirement area. It's 10% Canadian, North and South Dakota. If you're west of the Mississippi, you go to Phoenix. If you're east of Mississippi, you go to Florida. It's all these good old Midwestern people and they come down here. Because of your marketing because if you're a horrible website, they always think they're going to find better dentistry in the big city. They put off their dental work all summer because they're in a town of five thousand. They go to podunk website. It's just like an address. There's no photos of any work. There's no nothing. So they assume that they'll get it done better here.

Then they'll tell me their town they're from is like, dude, that guy has a diplomat in the International Congress of Oral Implantologists. He could've done all of this. But his website, they don't know it. I would love to have-

Ryan: You would be the only one I'd sell franchise to.

Howard: I would do it because the market for dentures in Phoenix, Arizona is monstrous.

Ryan: We should talk, man. I would love that. I don't think we're quite there yet.

Howard: I'd just give you the open door.

Ryan: But I hear what you're saying.

Howard: I got the area for the lab. I got a lab.

Ryan: Man, I would love to. Education like doing a continuum, I want to do that like no question. I've talked to Howard about it already. I would do it with a big company if they were interested.

Howard: Have you talked to the CEO of Ivoclar?

Ryan: No, I haven't talked to them about anything like that. If it gets it out there and it teaches other kids that aren't interested in dentures or never would be like I was.

Howard: Ryan, what episode was the CEO of Ivoclar. Bob Ganley or they might call them Robert Ganley. You've never met Robert Ganley?

Ryan: I didn't meet him when I was there. I spent a lot of time with Ted Smudde, I think it is. He's the director of Removable.

Howard: Ninety-four?

Ryan: They were amazing. I would love to do that or Howard. I want to teach this because I think it's a dying art form and it concerns me. It really does. I'm passionate about it, man, because I love removable.

Howard: You send me an email and then I'll reply to you and Robert Ganley and tell him.

Ryan: No, no, you don't have to do that. No, no, no.

Howard: You should be the pitch man for his denture line.

Ryan: Oh no, lord, no like don't even sweat that.

Howard: Why?

Ryan: Those guys are awesome. They've done so much for us.

Howard: Yeah but they don't have forty-two thousand posts. You have forty-two thousands post on Dentaltown. You're a social media maverick. Every great company needs to have a great flare for marketing.

Ryan: I would be honored to work with them. And their in-house guys are amazing but more towards the scientist side, not towards the marketing and social media side. Bob Ganley more than anyone, he led that cosmetic revolution because he was able to spot the Dickerson's, the Rosenthal's, the Hornbrook's, the Dorfman's. I mean he used to bring the biggest names in dentistry to here at Orlando to here at Ivoclar to professional baseball games because he wanted to know what we were all seeing in the field, what were the dentists talking about, what was their passionate. Bob Ganley, I mean come on, he runs a company that's a billion dollars a year and it's private. You don’t have to deal with Wall Street.

Ryan: I presented there like two months ago. They told me your story here. They're like he showed up in flip-flops and jean shorts. I was like that's my guy. I don’t like suit and tie and stuff. I actually like cried during my presentation. I hate to say that but like that's how much I care about like dentures and education and like making an impact while I'm here.

Howard: Where does that come from?

Ryan: I don't know like my upbringing maybe. Blue collar. Single mom [inaudible 1:27:00].

Howard: Single mom. Where is dad?

Ryan: I don’t know.

Howard: Do you know your dad?

Ryan: No, we don’t talk anymore. It's one of those things but like my background shaped me for where I'm at now because I understand denture patients. That's a large part of my lecture tomorrow is patient management and like had to grow with your denture patients and how to make them happy. I don't want this next generation of dentists to like come out and not want to do dentures or be interested in it because I need help.

I can't do three thousand extractions a month because my back hurts. I'm getting tired. Our marketing has been a tool to help me grow that. My true passion, man, is helping people. It really is. If it's with a company or if it's with you guys or whoever, I'm going to get that out there. I'm going to travel, and I'm going to take my kids to Europe or in Asia. I'm going to do that. I'm just going to follow your model. You know what I'm saying?

Howard: I've known I've loved it for a decade on Dentaltown.

Ryan: No lie. I'm just being honest. That's just how I feel and that's going to be my lecture tomorrow.

Howard: Remember, if you're a doctor for the lifestyles of the rich and famous, you're not a doctor. Everybody needs a doctor. You know what? Don't be judgmental. I mean some patients you make them feel bad because they smoke because they got addicted to the meth because they were on heroin because they were poor. You don't know their freaking story, and everyone needs a doctor. They don't need your judgmental bullshit.

I remember when I was in UMKC, the two oral surgeons that were my mentors were Brett Ferguson who's now the president of the Oral Surgery Association and the other one was Charlie White. One time we were at Truman Medical Center. It's emergency. It's a trauma case and I'm asking this patient, "Well, what happened?"

Brett grabbed me by the collar and pulled me back. He literally like pulled me in the hallway. He goes, "Howard, look, they need a doctor. They don't need a detective. They don’t need to find out if they should stay with their spouse. You're not a marriage counselor. They need a doctor. Total respect. Don't ask questions. Let's fix them up. Let's get them out of pain. Right now, they need a great oral surgeon and you to help. They don't need Tracy. They don't need a reverend. They don't need to fire and brimstone. They don’t need advice. They need a doctor."

When your patients come in and they need a freaking doctor, they don't need Judge Judy. They don't need Dr. Phil. They don't need you rolling your eyes and condescending. You know what I mean?

Ryan: Absolutely. That's part of my lecture tomorrow, man, is like how I management that. That's how we've grown so quickly. It's like we don't judge people. We manage expectations and I don't squash it. Like a lot of guys, they'll approach a denture especially like a lower denture. They're like, "It's going to suck. You're going to hate it. You're not going to wear it."

I don't do that like we're different. I'm going to teach you how to use your prosthetic arm, okay. We're going to work with you until you can wear these damn dentures and you're going to eat with them and you're going to look good. If you can't do that, you're going to bring them back and we're going to fix it because that's how I operate.

Howard: Then how many of these do you upgrade to implants?

Ryan: A lot.

Howard: What percent?

Ryan: I do so many. We do mostly Locators. I've done a lot All on 4. What brand of the Locators?

Ryan: Zest. They're great. All the Preat stuff is awesome and they were super nice. I really enjoyed meeting with them.

Howard: Preat.

Ryan: Right there. That dude is so smart.

Howard: Where was it?

Ryan: Straight ahead. Roberto, I think, is his name or something. He's very smart.

Howard: What's the difference between Preat and Zest?

Ryan: I think they maybe carry Zest. I don’t know.

Howard: What's that?

Ryan: I think they might carry their products. I'm not sure how that works. But like Zest has been the best far and I've tried all the ball attachments and everything. We do mostly locators. All on 4s are awesome.

Howard: You're doing four.

Ryan: If we can and if the patient can afford it.

Howard: Are you doing a pano or a CBCT?

Ryan: I do both if we need it.

Howard: Do you have a CBCT in the office?

Ryan: Not in all offices.

Howard: Do you have a pano?

Ryan: Digital panos yeah.

Howard: If you're just doing All on 4 in front of the mental foramens, do you need a CBCT or is a pano adequate?

Ryan: I think we probably do nowadays, yeah, probably unless you're really good surgically. I've done a lot All on 4s, but it's a lot of work.

Howard: Are you talking about All on 4s like Dr. Paulo Malo does who invented it in Lisbon, Portugal where it’s in the zygoma.

Ryan: Oh nothing like that.

Howard: Are you just talking about four implants with locators?

Ryan: Yeah four implants. No I'm talking about fixed hybrids so fixed attachable. I've done all that stuff, man, and it's a lot of work. I mean it's a lot of steps. How many people can afford $30,000 or none in their mouth, right? That's what a lot of the new graduates want to do. I want to make dentures cool again like I want to bring dentures back and make that hopping.

Howard: You're upgrading an all or none to an All on 4 locators?

Ryan: If we can yeah.

Howard: What does an All on 4locators cost per arch?

Ryan: It depends. I'm trying to keep implants affordable also because I think people are pricing themselves out. A lot of our patients will go see an oral surgeon and their fee is going to be $3000 for one implant, right?

Howard: Okay. The All on 4 at ClearChoice is $25,000 an arch. What is your All on 4locators?

Ryan: Oh I mean a fraction of that.

Howard: But what is it?

Ryan: I don't know. I'd have to look at it. Probably about a thousand per implant and maybe two thousand for the dentures. I'm going to get that price down.

Howard: It was two thousand for the denture and then a thousand so six thousand.

Ryan: Yeah. That's a business.

Howard: That's what's so amazing. All on none, he's got three price points. Basically you got a thousand, three thousand and four thousand. Then when he upgrades that to an All on 4 locators, he's at six thousand. Then ClearChoice is All on 4 at twenty five thousand.

Ryan: I can do that too.

Howard: You know who's really crushing the All on 4 market?

Howard: Who's that?

Ryan: There are these guys that practice in the same town as the ClearChoice where ClearChoice is doing all this marketing and raising the tide about All on 4. Then they start calling around and find out that, "Well, this guy does an All on 4 for thirteen thousand"

Ryan: I'm going to do it for ten.

Howard: That's half the price of the All on 4 at Clear Choice. I know implantologists in many of the cities where there's a ClearChoice that say, “I love ClearChoice.” They built this whole product segment category. Everybody's talking about All on 4. But they clearly charge twenty five thousand an arch, and I clearly say we do it for half the price, $12,500. I'm getting twenty-five grand. When someone hands you twenty-five grand, if you can't make money on that, something's incredibly wrong.

Ryan: It's crazy. I'm going to do it for ten.

Howard: Will it be All on 4 locators or All on 4 like Paulo Malo?

Howard: Fixed. I'm going to get that price point down.

Howard: All on 4 fixed like Paulo Malo.

Ryan: I'm going to do that, yes, absolutely.

Howard: Did you watch his podcast?

Ryan: It's very good, so I’ve watched them all, man. I really have.

Howard: You might be the only one who's watched... I'm the only one who's watched them all. I'm the only one. That's my claim to fame. I'm the only one who watched every single Dentistry Uncensored.

Ryan: No. Me and Howard are the only two that have watched all of his podcasts.

Howard: Hogo was never even seen one of my podcast shows?

Ryan: He was on your podcast.

Howard: That was the only one he watched.

Ryan: Oh that's the only one-oh savage.

Howard: Hogo, when is he going to put up an online CE course?

Ryan: We're figuring that out. 3

Male Speaker: Well, we're taping him tomorrow.

Ryan: Yeah tomorrow for sure. 

Male Speaker: We'll take that up. As soon as he do that, pay me to fly to Indiana. I would tape whole day of him.

Howard: Whenever you want.

Ryan: He wants a franchise.

Howard: If you ever do a franchise deal.

Ryan: Arizona is my first spot, man.

Howard: You got operatory seven and eight at Today's Dental. Our lab area I believe is a thousand square foot.

Ryan: Oh we can do it. Can you handle two hundred new patients a month, three days a week?

Howard: Yes. Yup.

Ryan: Okay, let's do it. I'll bring them.

Howard: I want to do it. Because it's a totally underserved area in Phoenix.

Ryan: It is. It’s everywhere.

Howard: There's four hundred thousand snowbirds and we are a hundred miles from the Mexican border. Who's coming over the Mexican border isn't just Mexicans. They're from Bulgaria, Romania, El Salvador, Honduras. A lot of them are edentulous people or need to put on dentures.

Ryan: I'm going to take the whole state of Indiana and then I'm doing one franchise only and it will be in Arizona.

Howard: All right. I'm your man. I'm your man.

Ryan: Give me a hug again. You'd better be in this shit because it will be long.

Howard: We'll do the whole damn thing on a handshake. We don’t need a lawyer.

Ryan: That's what I'm saying. What's a lawyer? Howard laughs.

Howard: All right. Thank you guys.

Ryan: Thank you, man, for everything.

Howard: Thank you so much for all that you do for dentistry.

Ryan: No, thank you.

Howard: Thanks for being the Herb Kelleher of dentistry.