Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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1477 Dr. Bob & Kim Stewart on Creating a Vision & Starting with Why : Dentistry Uncensored with Howard Farran

1477 Dr. Bob & Kim Stewart on Creating a Vision & Starting with Why : Dentistry Uncensored with Howard Farran

10/8/2020 3:00:00 AM   |   Comments: 0   |   Views: 272
Dr. Bob Stewart, known to his patients, team, and friends as Dr. Bob, has been practicing dentistry for 32 years, and loves it more today than ever. He graduated from dental school (San Antonio) in 1988 and worked as an associate dentist for a large group practice in the Houston area for three and a half years. From 1994 to 2014, Dr. Bob traveled coast to coast as an “expert” speaker for Lightspeed technologies, one of the pioneers in the endodontic rotary instrument explosion. In 1992, he purchased a small “cottage” practice in Pasadena, Texas, which has since moved location twice as it has grown over the years. In 2008, he purchased a second location, where the selling dentist decided to stay and working together, they have grown this location to over 3 times it’s original size.  Today, Dr. Bob loves both practicing clinical dentistry and leading a team of 5 dentists and 12 team members at 2 locations.

VIDEO - DUwHF #1477 - Bob & Kim Stewart

AUDIO - DUwHF #1477 - Bob & Kim Stewart

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**Please excuse any typos as this was digitally transcribed.

It is just a huge honor for me today to be podcast interviewing Dr Bob Kim stewart DDS fagd sitting next to his lovely wife Kim stewart who you know on dental town as molar wife uh known to bob is known to his patients and friends as dr bob he's been practicing dentistry for 32 years right up the street from my four of my six grandchildren Beeville Texas what is that about two hours away from you this is Friday yeah well if i ever if they ever start driving me to drinking I’ll be on your front porch before you know it I’ll just be driving over there begging for a beer he's been practicing dentistry for 32 years and loves it more today than ever he graduated from dental school san Antonio in 88 and worked as an associate dentist for a large group practice in the Houston area for three and a half years from 94 to 2014 dr bob traveled coast to coast as an expert speaker for lightspeed technologies one of the pioneers in the endodontic rotary instrument explosion in 92 he purchased a small cottage practice in Pasadena Texas which has since moved location twice as it has grown over the years in 2008 he purchased a second location where the selling dentist decided to stay and working together they have grown this location over three times its original size today dr bob loves both practicing clinical dentistry and leading a team of five dentists and 12 team members at two locations having said all that bob's true love is his beautiful wife Kim of almost 30 years his three incredible children Christy coco and bobby and his awesome granddaughter lacey grace I’m tell i tell my boys all the time that I’m so glad i never killed any of my four boys because they made six amazing grandchildren so never kill your children because they're going to make you something even better down the road how are you guys doing awesome good to be here thanks for having us so am i um tell me the god-awful truth am i over paranoid grandpa because i keep reading that Houston is a center for Kawasaki disease for coronavirus for children and then I’m thinking okay i got four grandchildren you know a couple hours up the street um so and everybody listened to the podcast they all wanted coronavirus update so can we just start there are my grandchildren um who are so excited because their daddy my oldest son Eric built them a chicken coop and now they're up to about nine to twelve eggs a day and um it's so funny because um they love the eggs more because they raised them but Eric did something really strange he found a breed of chickens that lay blue eggs and of course you know you can only get blue eggs if you raise them yourself you can't get those at the store even though Eric says that there's no nutritional difference or value or anything in fact um it's actually a lower productivity like some of your hens will miss a day laying a blue egg whereas if you get the most hearty species of chicken you know they'll always lay an egg every day but do you do you think my um what's the coronavirus look out there is it you know at one dental town a lot of the dentists think this is uh insane it was a virus like the flu a one percent mortality rate and we had to shut down the whole economy and then the other half are running for the hills and you know they you know blah blah blah where do you guys sit but most importantly this selfish man wants to know do you think my grandchildren are in risk of a Kawasaki disease in Beeville Texas well i would love to speak to that but I’m no Kawasaki disease expert but i will tell you that we feel safe we do um i I’ve had people call and ask you know how are you guys Houston’s the you know the new epic center like new york used to be and if you watch tv i i kind of got nervous myself i wondered what on earth was happening uh in my own home and then you know we go out to the store we go to the restaurant we wear our mask uh we we do what we feel is safe and follow all the recommendations and when we hit the street it doesn't feel that much different Howard it seems okay so were you so in Arizona we had to close down from st patrick's day to cinco de mayo so we we had two months two donuts you know where you kept all your team two donuts um or did you guys have to close down the same length of time was it about two months that's that's exactly it yeah we were we were closed for two months you know we were here just for the you know terrible emergencies and uh we're back now and we're feeling good are you um the ada says their data shows from coast to coast that we're back to about 71 of pre-pandemic level um that's about where our office is we're you know we say the 80 20 rule we're we still are short 20 percent um are you guys how close are you back to pre pandemic yeah i think your numbers spot on we're 75 to 80 yeah well i was exaggerating um at least 10 percent um i think i think i think we're about the 88 about 70 71 and it's um there's really two americas because i got four boys they're 31 you know they're basically uh 31 29 27 25 whatever and um they um they they they think this is a joke i mean they don't they haven't changed a single behavior and then i got my 82 year old mother who's um you know really really catholic she's so catholic she makes the pope look like a liberal and she don't believe in any of it either she thinks you know that when her time is done that was decided you know a million years ago and she hasn't changed her behavior anything and um but in our practice it seems like just like that the the 40 and under come in they don't care nothing's changed but it's the 60 and over um and those are the ones that need all the root canals crowns implants all the big case people um are still staying home even though we're offering them that if you pay for your appointment in advance we will block off the entire office and when you come it's just going to be you the doctor the assistant and that that helps some but it's um but it's still the older people need all the work and they're still um scared is that what you're seeing that that of the missing 30 percent is it mostly grandmas and grandpas you know that's a great question a big part of our practice is seniors and i haven't really seen that although i love your idea i mean the number one thing is we want to keep our patients safe so you know you do what you got to do and if that's required to keep them safe that's what we'll do and we hope we can get them in here and taking care of them man I’ll tell you what it's a um it's a great thing especially if you have any of those email contact systems where you can just send an email to everyone say i'd say 55 and over and say due to the pandemic you know the our regular hours are saying Monday through Thursday to Friday but we'll open up Friday and Saturday just you know we'll run it to you but you have to pay for your treatment in advance and if you don't show up um you lose that and i learned that from um the um the cosmetic surgeons out here the ones doing facelifts and tummy tucks and all that stuff like that that that's what they're doing they're saying okay I’ll block off the whole morning to do your face but you know you got to pay the ten thousand dollar fee for the appointment and if you don't show you forfeit the money um but that it's working for them well that's why we're counties uh Howard we learn these great things from you and i love it thanks for that tip and your and your wife is a townie too but now you're not Kim tell us about you you're um you're a mueller wife um you're uh are you the office manager are you as an assistant hygienist what do you do yes all of that um i i do whatever they all tell me to do i am a kindergarten teacher by trade who happened to marry a dentist 30 years ago this December and he said as we were raising babies do you want to come in and work uh assistant didn't show up or whatever and i would come in and help them now that the kids are grown and they're we're empty nesters I’m here full-time uh well except when i go visit the grand baby because she's a priority but i do whatever it is they need me to do i work up front i assist um so anything and you'll even see me on a ladder changing a light bulb or ceiling tile whatever i need to do i do yeah them Texas girls they could they could probably build the barn i mean there's uh i mean it whatever visions you have of ladies um you'll have your mind I’ll never forget i was in a Texas one time and this girl was walking out oh it's a grocery name Howard it's got a Howard in it h g grocery store h and so what's the big grocery store chain in Texas oh atv heb yeah and that that h is Howard um i learned that from my grandson um uh that's why god made google uh but my god i saw a Texas woman walk out of there and she had like a stroller four bags of groceries a kid on her neck a kid in her arm and she wasn't even blinking i mean she was just like this is what we do when we walk out to our car um so um my gosh um you know we both graduated those guys out in 87 you were 88 um you know we've this is our second rodeo i mean remember hiv you know it came they started talking about it in 79 80 it was a real thing it just kept growing and growing it went on to kill 36 million people the first person that died in my dental graduation class of 1987 umkc died of hiv and um my gosh it was a tragedy but we had to make all these changes and i remember back then being in Kansas when they were telling those dentists they had to start wearing gloves i mean they were they were like grabbing their shotgun saying oh yeah make me you know I’m not wearing a mask or a glove and now 30 years later it's not a glove it's a mask and they didn't like our custadores they didn't like the water line from the street we had to get the little bottles so we made a bunch of changes and got a lot better in fact when asia had their um 2012 sars epidemic we we had ours too but when sars hit america in 2012 it killed 38 million souls but they were all pigs so you know we didn't do anything but over in asia kill people and so like the airplanes you know they they figured out you can't recirculate there so the planes made after 2013 they don't recirculate there so we we made a bunch of incremental improvements and now we're it's the second rodeo virus that I’ve lived through and we're making changes again and I’m just wondering what changes did you make what changes do you think are just like caught up in the moment that we won't be doing 10 years from now but what changes do you think you've made for this sars pandemic that you'll still be doing 10 years from now when the pandemic's gone good question good question we spaced out our patients you know we put an extra time between every appointment trying to allow for the patients not to have to intermingle in the waiting room we locked off half of our chairs in the waiting room we have patients who wait in their cars if they like we don't force that we you know we tell them we'll text you if you would like if you try and treat to their comfort zone uh we put up plastic shields you know you see those everywhere these days uh we changed the filtration um basically i just changed the filters in our hvac system uh i i did a little research on that and I’m not an expert apparently a hospital is a merv 17 rating whatever that means so we went out and we wanted to top that we put merv 19 in our filters and I’m probably ruining the ac system with that but you know it's there so that's m-e-r-v-e merv 19 filtration i think it's m-e-r-v and i don't even know what that stands for Howard i forgot i i looked it up and that seemed to be the thing to do you know everybody was kind of running around chasing our tails and uh so we made some some changes trying to be safe yeah you know i am i i cut religion on this um 30 years ago when um you know you you um it was a different world before 9 11 and the internet and all that stuff but there was a time when you could actually go um be a tourist at the intel plant and i had a ton of patience from intel and i always told this guy one of the patients i always wanted to see that thing so he took me down there one time and i couldn't believe it because the employees show up they go into a room they take up all their clothes they shower they dress in this astronaut suit and they go into this room and it's like the air is filtered to like less than one part per billion in the air because one little skin follicle on a chip would ruin it and then you leave that and you go across the street to chandler hospital you know the biggest hospital in chandler category one helicopters and you can pull up there with the surgeon get out of his car walk in there go up the elevator walk into the surgery room and they might wash their hands for 15 minutes but they got the same tennis shoes on we walked across the parking lot with you know bird manure ant manure scorpion manure you know and i thought to myself wow the people who make chips are a thousand times cleaner and then the people that are filleting open human beings exposing them to all this stuff and then then you start talking to cdc people and they say well it's really hard to get the numbers but we think 200 to 300 000 americans die each year in the hospital from something they didn't go into the hospital which was another big reason i didn't like don't like government sponsored um health care i mean government you know pay like medicare for my mom that's totally different because the government's doing the insurance but for enterprises delivering it and i don't think the government can manage anything but my gosh i mean when they start talking about health care for all it's like i don't know if i want to ramp up a system that's already eating 300 000 americans a year i i think maybe they should fix that first before they start telling everybody and same thing with prescriptions i mean we know by the time you're on five prescriptions you have polyphagia and then they start having all these reactions and falling apart so when people start screaming that prescription should be free I’m like are you are you sure about that i i don't want my grandkids growing up in a world where everybody's handing them free pills and encouraging to go to the hospital for free i mean that's that's like two real high risky behaviors but um what do you what do you think um do you think all these things that you're doing now you'll be doing 10 years from now what do you think smart man he turns to his wife some of them i i certainly hope they do i mean some of the changes that i think they're good i think it's great we're um but i don't know that's a good question yeah what what changes did you like that you think are good was it the plastic shield was it what would it would have what have you changed where you thought yeah this makes a lot of sense well i mean i personally like the masks um you know i haven't had a cold since last year and I’m sure a lot of it's because people are walking around wearing masks when we're talking we're not spewing and so we're not in in you know breathing that in I’m good with the masks all of our team wears masks up front you know i mean just all the time and you know that was that was one of the most interesting because i grew up in a very catholic family my two older sisters went straight into the nunnery right out of high school my oldest sister's uh 61 i mean i think she's been a nun since she was like 18. and um the the western world judeo-christian islamic it's one type of thinking but the eastern world you know buddhism hinduism different world and i can remember the first times i started lecturing around asia you know shenzhen and hong kong and all those places right there and i would see people wearing a mask and i would i would say you know like why thinking are they immunocompromised or whatever and they were always wearing a mask because you know i i don't i didn't feel good today and i i don't want to be breathing a virus on someone they were always wearing the mask to protect you had nothing to do with them they're just like i feel like i might have something and so I’m just going to wear a mask until i feel great again i thought wow that is a totally different culture i mean uh saying and um and now of course when I’ve been there recently they wear it a lot more for pollution for themselves but before the the skies were gray from all the um industrial pollution they were actually wearing the mask because they were concerned about infecting you and it'll be really interesting to see if all this mass stuff makes us have a lot less influenza this year i wonder that too so you know that attitude Howard there's a country song i love and it's been on the radio a lot lately as a matter of fact it kind of epitomizes the um kind of my value and mission statement here and the song says in a world full of hate and i kind of change that to darkness hate or darkness be a light and so you know if um even if I’m not buying into this whole mass thing if I’m considerate of those around me enough to wear one for their sake that's being a light and that that's kind of what we try and do here in this office whether it's wearing our mask or doing the highest quality dentistry we can do that keith urban reba mcintyre be a light it is yeah i think you're right reba does a scene in it there's several that are involved in that that tune it's a wonderful wonderful oh I’m now that is the one beef i have at Texas my son grew up you know we uh our garage was always just a wrestling mat we never parked in the garage we're like third generation wrestling family from my uncle uh check to me to my four boys and we'd always um work out in that garage and we'd play those songs and um you know he grew up on bruce springsteen the boss and then he met some girl from Texas moved out to beville and now it's just country music and I’m like what happened to all the rock and roll that your daddy played for you and he says dad that was a warm-up for country and that is probably the only thing we disagree on I’m like well do you want to hear a little bit of bruce springsteen and then he and then he'll uh text me a youtube video some country song but uh yeah so it says be a light in a time full of war be peace and a time full of doubt just believe yeah there ain't that much difference between you and me in a time full of war be peace and a world full of hate be light when you do somebody wrong make it right don't hide in the dark you were born to shine in a world full of hate be light in a place that needs change make a difference and a time full of noise just listen because life is but a breeze better live it and a place that needs a change make a difference and a world full of hate be a light when you do somebody wrong make it right what those are great lyrics man kind of reminds me of that poem um i always loved everybody thinks that mother teresa calcutta wrote it but um she didn't write it um she just had it hanging on her wall it was that song anyway and that is that that is the only poem where i have to i actually have to read it at least a couple of times a month because um it just works for me and that is um people are illogical unreasonable and self-centered love them anyway if you do good people will accuse you of selfish alternative motives do good anyway if you're successful you win false friends and true enemies succeed anyway the good you do today will be forgotten tomorrow do good anyway honesty and frankness make you vulnerable be honest and frank anyway the biggest men and women with the biggest ideas can be shot down by the smallest men and women with the smallest minds think big anyway people favor underdogs but only follow top dogs uh fight for a few underdogs anyway what you spend years building may be destroyed overnight build anyway people really need help but may attack you if you do help them help them anyway and give the world the best you have and you'll get kicked in the teeth there's the dentist part of it that's why i love it i had teeth give the world the best you have anyway and it's just i just always tell my boys you know people are complicated and that's them but it's your job to be good anyway just just be good and uh and my oldest sister actually read all the major original religions in there um um in their um unique language i mean she she uh she's a translator for rome and uh she she knows all that stuff and she um sent me the most powerful thing i wonder if i have it um let me see if i still kept that anywhere um my gosh anyway it was um it was anyway in the uh top religions um the you can't find the name of a person place or town and all the major religions the only thing you can find that's in hinduism buddhism confucism christianity islam is the golden rule treat other people like you want to be treated and it's so it's so exactly written that if um if we all wrote it differently today at uh Texas a m they they call plagiarism and she and that's um where they that's where why she thinks they're all praying to the same god because she says they're either all praying to the same god or they're all plagiarizing you know because they're all stealing each other's work and then she goes back to the history of they probably couldn't uh uh get around and do that i thought i had that somewhere um i don't uh but um yeah it's amazing you know i wanted to um there's so many things i can talk to you about but but but you you um basically the main changes are air filters plexiglas shields mass more time in between the patients uh any anything else ring about no not that i can come to mind I’m sure there's some other things but right now off the top of my head well at least you got hair on the top of your head keeping your thoughts in there mine are just flying out there's nothing up there remember 1988 and 1990 when you started i don't think you had any more hair then did you no i was losing it in a high school and uh my gosh um so um did um did the hygienists have to give up any aerosol do they have to give up the cavitron the piezo reamers and go hand scaling any um what about you on endo any ultrasonic any any clinical stuff have to change yeah I’m glad you brought that up i didn't think about it we did we had to give up uh ultrasonic cleaners the hygienist did for a couple of months they're back as just maybe a week or two ago uh we still use some prudence you know we we don't let her use the ultrasonic you know routinely but uh for a period patient she can now use it but we can when she's worked alone now we give her an assistant yeah we were very careful not to leave you know we have a pretty busy practice and you know i might prep a crown and then go check hygiene while the assistants make an attempt and then come back and take the impression we had to stop that uh you know you sit down with one patient you stay with that patient until you're done and then you clean up re regard and go to the next patient and so we did some things like that so that made me wonder clear back in the day when this thing started coming if this was going to be the rebirth of the cad cam chairside milling because you don't you know once you suit up to go do a moonwalk you know with your you know neil armstrong suit on um you know you can't you know i can't go do a hygiene check go cement a crown go prep plus someone you know i can't run four or five chairs you suit up you go in there and i was sitting there thinking so okay so she came in for a toothache i always do the root canal first because you know when you prepare for your final restoration it shortens the tooth it flattens it out the links are the same the access is everything and then sometimes when you try to prepare the final restoration you find out the tooth is not even restorable and then it would have been a waste time but um when you get done with the root canal on the build up um gosh it'd be nice just to chair side scan mill it out all be done did you ever did you have the cerak machine or the or the e4d and um did you ever have that is that or does that look different to you now post pandemic yeah it does it's very attractive i do not have a side milling machine we do scan and email in our impressions and that that was nice that helped with workflow a lot because no longer do i return to take an impression you know i pretty much uh leave the prep and let the assistants do everything from that point on they take the scan i just give it a look and a blessing and we're good so that's that's been a huge time saver and helped with flow do you use holy water on the blessing or do you just uh you just like sign the cross but i i use Houston tap buddy it works great um do you oh that was a funny i want to get a picture uh uh i just i wouldn't get a picture last time my um two-year-old uh grandson jasper um he loves his bottled water and i sit there and i was drinking out of the hose and ryan took the picture and goes there's a difference between someone born in 1960 versus 2018 one's drinking bottled water and grandpa is still drinking out of the hose i still think there's no better tasting water than out of the hose there's something about hose water that it's the best water but when um were you an emperor gum boy and then what did what did you start scanning with did you go eye tarot did you do true death what um we have the trios and we love it the trios from three shape correct now i noticed that everyone that like you that gets the trio's three shape it seems like the implantologists love it the crown and bridge boys love it the all the crowd and bridge restorative implantologists love it but it seems like if you're doing clear aligners um you went with the itero scanner because that's owned by a line technology which owns invisalign so my when you said that you went with trios 3 say the first thing i thought is probably not doing clear aligners and you said earlier you got a lot of older patients uh do you do clear aligners we do we do and we use invisalign and actually i was surprised to find out that um you know the trials was not compatible with invisalign we're very blessed it was compatible until the big boys on wall street decided they they don't want to feed the competition and then they made it non-compatible and then um and then it went to a lawsuit i i don't know where it went with lawsuit but can you take a three shape right now and send that file into align invisalign uh invisalign will not take it there are other clear aligner companies out there that will uh so does that make you want to switch clear aligner companies and go to can we can we talk about this on the air or we can absolutely this is dentistry on cesar I’m just just the poem i said what did i say i said what did uh um the guy that wrote that poem it was called um his name was dr kent m keith and it was called the paradoxical commandments of leadership and mother teresa hanging on her wall and she all she did is change the last line where it says um give the world the best you have you'll get kicked in the teeth give the world the best you have anyway and then mother teresa just added because at the end of the day it was never between you and them it was between you and god so do the right thing so um but it was his deal but he says um he says um what did he say um honesty and frankness make you vulnerable be honest and frank anyway i mean I’ve always called my podcast dentistry uncensored i called my lecture i used to say you know i used to call my lecture dental mania i said look I’m a dental maniac and if i offend you just know that I’m talking to you as if i how i want you to talk to me i want you to tell me the truth i don't want you to sugarcoat it and i think that's why so many people are confused like um they'll say well why do all these americans care what these celebrities think well when when uh who's that um who's that um dope willie nelson when he's on the tonight show and he's telling you he smokes body he's telling you he didn't pay his taxes he's telling me he's going to jail why would he lie but when some guy walks out there with a suit and tie and he's a politician you know if his lips are moving he's lying and i i just told people i said you know i might offend you but I’m absolutely telling you what the hell i think I’m I’m not sugar coating it and I’m not lying to you so hell yeah uh be be honest um i always wondered back um because we were in orto town too right and um the orthodontist when on artstown when they started really getting matted invisalign they were setting up their own stores they were doing things with smiles direct club whatever i would say to them i say well so then are you going to quit using invisalign and they'd say well unfortunately i really like the product so it's kind of like it's kind of like microsoft it's like bill gates i mean everything he's ever sold me on microsoft has been a used chrysler with a thousand viruses so when i hear him out there talking about how we can do everything better I’m like why don't you shut up and go back to microsoft and just fix all the crap you've been telling me i mean for for 30 years i would give bill gates a thousand dollars for software and then i'd have to pay an i.t guy another thousand dollars to come work all the bugs and kinks and i remember getting yelled at by it people saying don't ever buy anything new for microsoft because they just sell crap they know it's all loaded with bugs and because it's just money money money and more money and money money and more money and he had to be the richest guy in the world and so when whenever i hear him uh I’m talking on tv or i have to change the channel just so that i don't have a stroke uh or throw something at my tv and then that'll even cost me more money um but yeah what what's your thoughts you you have the uh three shape um out of uh copenhagen denmark um the the trios um are you thinking about using another aligner company in the spirit of all honesty our uh our scanner uh i cannot say that we researched them all and chose it we chose it because it was free your trio's three-shaped scanner was free yeah it was free well how did how the hell did that happen to you you can't stop there i found if i squeeze the budget i can afford free [Laughter] ignore the bad jokes well their granddad jokes now they're even worse even worse so i got an email uh from a lab called dandy are you familiar with dandy um not off the top of my head okay is that out of Texas uh you know i don't know where their central office is honestly what i found is that that's an umbrella and they kind of sub out to some different labs i believe um so the first email i got from emmy you know if you're like me Howard you get 10 000 emails every day and everybody wants to give me something free and you know i just don't have time to sort through them all so the first year i got it kind of discarded and finally one day they caught me on a good day i don't know i was in a good humor and i clicked on it and read it and said okay send me your agreement because I’m thinking you know this is going to be a long commitment it's going to be there's some kind of catch their agreement was about as simple as it comes and basically the deal is if i will use them for my crowning bridge lab they sent me a free trios 3 all of the maintenance all of the updates and training for the team so i did it and i couldn't be happier it's been fantastic the crowns are literally you know for 32 years I’ve heard labs claim that their crowns drop in these crowns are dropping in um I’m I’m a happy camper and so that's why we got to trial three so to come back to your question what do i think about invisalign I’m really sad they won't take the trios 3 i wish that they would you know grow you know kind of figure all of that stuff out uh and and work together however invisalign is a good product and I’ve tried other clear aligners and i like invisalign better so we're pretty blessed here in Houston area there's a place called wilson radiograph radiographic labs and i basically send my patients there they get a chef they get a scan and and everything's uploaded to invisalign into my office so when someone wants clear aligners you send them to um oral radiology place is that what it is and they they and they do uh what do they do us um what do they do on a cbct panosuff what do they do you want them to if we if we have a we have a periodontist who comes in and he orders cbct's through wilson we order basically records if you like it's a turnkey they'll take your photographs they'll take yourself they'll do this again i usually use them for the scan since uh invisalign will not take our trios 3 and for a cef which i don't have in the office and and to the young kids um you know they come out of school and they're uh it is tough and i feel sorry for them and i really appreciate um you guys I’m not calling you older but you do have grandkids um to come on and talk real world dentistry and the the the kids um everyone listening right now a quarter of them are still in dental school and the rest are all under 30. almost no one sends me an email to Howard at and is and has reached uh 40. you know it just doesn't happen and you know i look at the kids and they upgrade their iphone you know every two or three years and then i say okay well if you buy a cbct for a hundred grand you're going to use it for 20 years would you like to go back to your motorola flip phone or your nikea phone or all that they don't even know what that is um but um and and then they they they're complaining because they got 400 000 student loans and i tell them okay well the average divorce in dentistry is about you know a million so you know you you know you you know just don't get divorced and you save your student loans two and a half times and then the other thing is um you know if they come out and they buy a hundred thousand dollar laser a hundred thousand dollar cbct and a hundred thousand dollar cad cam they just double their student loan debt and um and all the doctors i go to um if they needed something like a an x-ray a cat scan mri or whatever for 58 years they they just tell me you need to go here and i don't ever sit there and say well you should have a cat scan right here you know and um so it's just um the the you know if and if a cbct i hear that i heard this the other day well well you know those cpts were they were 132 000 but now they're on sale for a hundred thousand so I’ll save 32 000. you're not saving 32 000 if you spend 100 000 when you spend a hundred thousand dollars you spent a hundred thousand dollars you didn't save 32 000 so you don't even need so you're not even buying a cbct I’m not you know the other the other distinction i want to make with the periodontist is the other big trend that we're seeing and i learned this the hard way you know you get these kids young out of school and they go take courses on implants and they place some implants with you for two or three years and then they go on and then some of those implants when they fail here's what it is when the average dentist has two-thirds overhead 65 according to the ada and you do five implant cases and one of them fails and you have to send it to the periodontist to redo the whole case for free that cost the profit of the four implant companies that worked so now the dsos have all reached the same conclusion that we're not making any money by teaching young kids how to place implants when you got a period on us that's already placed a thousand or two thousand or three thousand and we'd rather send in the specialists and do it because and the other thing is the lawyers if a general dentist doesn't have fails the lawyers think oh well he should have referred it I’ll take him to the board but if it's a specialist they don't do that because they know it's going to be a dead end and then the insurance companies adding fuel to fire if i do a molar root canal they'll give me like 700 but if I’m an endodontist in the same building they'll give me like 1200. so if i pay the endodontist 40 of production i make more money than if i pay a general dentist 25 in production and on molar endos if a general dentist does it in five years ten percent will be extracted but if an endodontist does it in five years five percent extracted so you got one in 20 less teeth failing and when the endodontist fails this is like hey did everything he could general dennis fails now you got the the game theory well should it have been referred so i i see the dsos moving to periodontist and i also see them moving to um radiographic centers i mean why buy a cbct for 1000 locations when you can have regional x-ray centers so um so you you use a periodontist how often does he come in so he comes into each location just once a month and we line up our implants and our perio surgeries and he works till he's done and it's been great here's the best thing about that when you have to tell somebody they need to go to another office what do they say first thing out of their mouth can't you do it here doc and when we say yes we can do it here i bet we have about i I’m going to make up a number but i better accept a trade is 50 to 80 percent higher you know they just they come back and when we send them away we may or may not see them back before that we'll assume again in six months you know but they just don't like to go to a new place so it's a wonderful service for the patient and it's what we've all learned from watching 300 years of retail i mean 300 years ago his little shop house about size your garage you live upstairs and then the next generation of kids were saying well I’m going to combine the bread and the produce and have a bigger store and then bankrupt the other ones and the next i came along so I’m going to add a butcher so i have produce bread and meat and the stores just kept getting bigger until you have your modern day walmart ikea price club walmart sam's club where it's retail it's it's it's convenience and i and now I’m seeing that you know if a hundred soccer moms take their kid to a pediatric dentist a hundred of them are going to ask the pediatric dentist do you think little billy will need braces someday so here's a slip go down the street now you see young pediatric dentists with a young orthodontist so now you have one plus one equals three and a pediatric dentist starting with an orthodontist they grow twice as fast as an individual pediatric dentist individual because of convenience and who could miss out on clear choice where they took the periodontal surgeon the prosthodontist and the lab tech they put all three under one roof and i mean that thing's a couple hundred locations and been bought and sold four or five it's it's a cash cow for 25 000 an arch all on four just because it's all right under one roof and it's convenient and they offer the financing which i gotta remind you um you know my family's my mom claims we're a hundred percent irish i don't agree with that I’m sure there's a goat or a duck in there somewhere or a horse or a cow but it was um you know they all use singer sewing machines because during the irish diaspora in 1850 which is like 40 years before the um the statue of liberty when all the irish washed up on the shore all the jobs were in textiles and you couldn't get a textile job unless you had a sewing machine that was 50 bucks and everybody wanted their 50 bucks and singer was about the 20th sewing machine company to come along and it was not uh um known for anything other than the fact that old man singer said I’ll give you the sewing machine and you get paid three dollars every Friday and you're going to bring old man singer back one of them dollars for 50 weeks in a year and that was installment credit and then the same thing with henry ford i mean he made 10 million cars and everybody thinks he invented the car he was like the 85th car company but everybody else was making one car a year for the richest king and henry was going to make a car for the working man and he sold 10 million and it's like okay we'll finish the story and they they never finished the story right it was a french man dupont who went to a gm and he said well you know old man ford you can have any any car you want as long as it's a model t and it's black and you got to give them all 668 but we're going to have a chevy go against the pontiac and then for a hundred more we're going to have that luxury of um being able to take the wheels off and then for a hundred more we're going to have that new spark plug delco out of indiana for a hundred dollars more we're going to have a roof over the car and that's a buick and for a hundred dollars more than that we're going to have a cadillac which is going to have this new thing from motorola do you know what that was what rock and roll it was going to have a radio so he's going to have removable wheels a spark plug a roof and music but he said how we're going to sell this is installment credit ford wants all 668 right now and we're going to start gm ac financing and from day one until yesterday gmac financing has made three dollars a profit financing the one dollar car and henry had to close down the model t because everybody got installment credit so when people start so right now there's a lot of people ranting on dental town that you know what this pandemic it's the last draw for insurance I’m dropping insurance i want all my cash up front blah blah blah blah and um i i just don't know if you have 300 years of retail experience and financing experience i i i mean usually if you want more or something you subsidize it from the employer the government and if you want less of something you tax it raise the price or regulate regulated are you guys flirting with uh i mean do you guys have fantasy flirtations with dropping all insurance and going cash only uh and did the pandemic accelerate that thinking or squash it or change it well i have fantasies all the time Howard but they don't have to do with financing dentistry doesn't have to do with fishing [Laughter] but you've seen those threads on dental sound like like the other day there's a a big thread and i got the letter two from aetna where edna is um sending letters to endodontists saying we'll give you a big chunk of change if you agree to a lower fee schedule and um and a lot of dentists are thinking well when they didn't cover the ppe fee they're thinking I’m just going to drop insurance um do you do you take medicaid medicare hmo capitation ppo what is your insurance business model and has the pandemic changed any of it no we don't take any hmos no dmos we're we're probably mostly ppo we have an in-house uh insurance plan for people who don't have insurance um and um and we do have i think about three maybe five percent is uh uh medica kids uh is that medicaid medicaid yeah i would love to do uh no insurance but i do not see that in our future at all not not here i just can't even imagine yeah and the other thing that you know um it really helps first of all like when i when i um my first lecture august 4th 1990 i had no idea that 30 years later i'd lecture in 50 countries and the first thing you see right out of the gate is if the gov if the employers don't offer a dental subsidy it's not dental insurance to the kids what i mean by that is you know if 100 people drive a car we all have car insurance but only one guy wrecks the car and if we all have fire insurance on our house 100 people have it but only one person is smoking in bed and burns her house down so everybody pays a little for one guy to make a claim but health insurance if he had dental insurance for 100 people well how many of them would need a cleaning exam and x-ray how many would it be to recall how many wooden floss how many of them would drink coca-cola i mean there's no way to spread the risk around so all medical insurance has turned into medical subsidies so if the employer is subsidizing dentistry or the government in the state medicaid is subsidizing dentistry or whatever the dental industries in those countries are enormously bigger and then when you go to a country where the employers and the government doesn't subsidize it china is a great example and they do it out of their out of their philosophy their religion they say to me they go well if you drink coca-cola and eat chocolate all day and eat ten cavities why should your employer or your government pay for that and they call that a moral hazard they say well you know what maybe you having to pay a couple hundred dollars on ten fillings will make you quit eating chocolate and drinking dr pepper so that so i i don't even i don't know how they could get dental insurance going in china for at least another generation because that's what they believe but my gosh when the gov when employers in government subsidize something you see a lot more of it and so i i think the dental industry would would contract a lot if all the dental insurance and medicaids that they all went away i guarantee you as as those dollars went out the industry would would contract i mean do you agree or do you disagree well i do but you know i want to go back to what you said earlier and i think you were talking about um well I’m i don't want to get lost here but in talking about uh financing treatment where we were just a minute or two ago uh there is one of the clear aligner companies that is offering kind of an automatic approved finance and they're almost i think it's ortho clear but we may need to check that we may just need to fact check uh where if it's 20 aligners or less they finance it no questions asked and they pay the dentist a flat rate fee it's kind of an interesting concept but it's kind of coming back to what you were saying where you know they're almost making the dentist the employee are you familiar with that Howard yeah yeah and and what threw me off at dandy is on dandy it was uh formerly orthaly so that that that's patrick lee so that's what threw me for a loop on that um so so it's um they're financing um those guys are financing the clear aligners they are they are now it has to be a case under 20 aligners and um it's it's an auto approval from what i understand i haven't used any of those you know i haven't done this yet but it's some literature that's being sent out right now kind of in canvas huh interesting and um the one thing that um you know i always you always learn from other people's failures and um um orthodontic centers of america um gaspar lazarus you remember orthodontics centers of america you know he uh basically it was liquidity strategy you had a bunch of old orthodontists and it's kind of like a house if you have a three bedroom two bath house you can go to the market and sell it in a day or a week or a month but if you've got a 10 bedroom 10 million square foot mansion you let your money get really far from cash and it's going to be really hard to turn that back into cash and that's one of the reasons the nba and the nfl players do so more financially is because when you build a 10-bedroom home with an 11-car garage um the only other person who has the money to buy that wants to build their own dream house it's not it's just it's just they let their money get too far from cash I’ll say a word to the young dentists you say that are listening yeah can i do that yeah please well first of all congratulations dentistry is fantastic I’ve been doing it 32 years and you guys have made a good choice it's been awesome um don't don't let the um the the times i know this coveted world is a tough world but uh it's you know the sun will come out tomorrow and dentistry for me has been phenomenal and what other um business you know at the end of the day besides making a nice living for your family can you truly look back and go you know there was meaning to what i did today i improved someone else's life uh with what we did and um the other thing i will say so it's you've chosen a great career and and congratulations on that uh secondly i would say and you alluded to this earlier Howard when you said you were talking about you know a younger dentist want to get trained to do this and that my advice would be learn to do what you know learn those basics first a lot of times i do see young dentists and they're they're so caught up in excitement and wanting to take so many new things but they haven't really mastered uh the first things first and so you know master well uh the the few principles that you were taught in school and then start branching out you'll find your way it may you know for me I’m a gp but i kind of found my way into endodontics i i really liked that and taught it for a few years and yours may be surgery or it may be ortho uh but you've you've uh you've chosen a great career and keep your chins up and have a blast and uh make people better uh that is beautiful and um i want to talk to uh about that endo because um you were um going around the country and you were um with the um light speed uh technologies and when i was in um and now you have um so now there's a whole new movement going on and that is um and it started with um uh john on dentaltown uh um when he ended us john uh from um colorado what is that um where is he at not not um durango and john katami is that how you say his name but anyway he was saying he's been saying for a decade that you know that um when we went to 300 rpm nighttime when i got out of school it was all files and for the first five years i had a blister on my finger my thumb because you were just you're just working the files and then they came out with that 300 rpm nighttime it was ben johnson tulsa dental products and and i mean it was my god you could i mean you could just blow out those canals in one tenth of time and it was just crazy how efficient it was but a lot of people started screaming like well that's a 0.04 taper and that's weakening a lot of too structured and you're taking out too much and it shouldn't be over a 30 in size because all that is is a glide path to get the arrogance down there to irrigate and clean and shape and now sawnindo's come out where they say well you know just get it up to a 30 and then hook this thing up to a washing machine and it's going to irrigate and clean all that out and there's a lot of guy when i was at israel it was amazing you remember those danville micro etchers that had that um um what was the diamond's the hardest thing and then what it was it aluminum oxide which was the second hardest thing to diamonds and this israeli guy showed me where um oh my gosh he'd only file out to a 20 and then he hooked it up to this um water air aluminum oxide and he hooked that up to the molar and in like 30 seconds i mean every lateral canal on that block was just cleaned out and I’m hearing a lot of business models talk about that um what was what got you excited about lightspeed technologies um what what tell us your journey about that and how long ago that started and why um you were excited enough to go out and spread the word and and how do you think um that looks now 20 years later and what do you think the next generation of endo um do you think it'll be like these sannendo irrigators or so go back to your journey um how did you get into molar indo and i want the kids to listen because this is what you need to know a real doctor can get you out of pain with a root canal or an extraction and you don't go to the hospital with a broken leg and never hear the hospital say I’m sorry we we don't do broken legs um we just do broken fingers uh if you have a broken leg you need to go somewhere else like dude helicopters land here you're a hospital the buck stops here and you know one of the 12 specialties is dental public health and when someone comes in and they got a toothache and you say i can't do endo and i can't extract a tooth well why don't you give your license to someone who can because we all need to be public health dentists and here's another thing you graduate four hundred thousand dollars in student loans you're going to be a great salesman to sell bleaching bonding veneers you don't have to be a salesman at all when someone comes in holding their face saying i hurt like hell can you help me and same thing with a shark so and when the insurance will pay you almost a thousand bucks to do a root canal and you're four hundred thousand dollars in debt looks like to me you only got to do 400 molar root canals and we we fix your student loan situation so it boggles my mind that half the dentist in america won't do a molar root canal and that's why you have 4 000 endodontist um who used to do eight to nine molars a day they were used to be really productive but then they got microscopes and they slowed down to like four or five molars a day i mean they've really lowered their productivity and their income they used to make about what oral surgeons did and now oral surgeons are a couple hundred grand ahead of them because we've slowed down with these microscopes but um tell us your journey did you always love muller indo did you hate it did lightspeed change it tell us your lightspeed journey sure sure so a couple of things uh number one you're right for the young dogs uh indo can be an incredible tool so for me my favorite thing to do you know we all said what'd you say when you went to dental school and you went to your interview and they asked you why do you want to be a dentist you say because i like to work with my hands okay okay because i want to help people right okay so why is it that we would want to be in a position that the patient comes in in pain like you said earlier and i can't help them i want to be able to help them that is the the biggest kick i get out of practicing it's not a set of veneers that's fun and we all like doing that but really the biggest help i can do for my patients is to relieve their pain and when i do that and i go home at the end of the day i feel like a step and that's what i want to do and so being able to do endo allows me to do that for so many more patients not only that but as a practice builder so and it's convenient for the patient they don't have to go somewhere else as a practice builder when we send them out for the end now we gotta wait you know it's a waiting game now so when will they actually get in and how long will it take to get it done when will they get back when do i actually get to do my crown you know so if i can do endo for a myriad of reasons it's great uh going back to my journey on indo really I’m nobody special Howard I’m just a dentist and you know a blind hog will find an acre and every once in a while you know uh so i was into a blind hog will find an acorn every once in a while is that what you said that's that's what i said yeah i love it well I’ve never heard that one that is awesome a blind pig will find a and it reminds me of the even a broken clock is is gives the right time twice a day that's right that's right so um i just happened to be in the right place at the right time in uh san Antonio the head of the indo department was an incredible doctor named stephen cenia or steve cenia and he was the head of the residency program while i was doing undergraduate unbeknownst to me he and a dentist who now practices are an endodontist now in dallas bill wildly we're working on some research using nickel titanium files and uh back then there really wasn't much around this was from 80 to 88 and so um you know i i just kind of clocked on through you know unawares um and graduated and then just a few years later i see this thing out called lightspeed and it's my professor dr cenia who has his name on it and i knew him and i knew him to be a um a man of incredible integrity he was very passionate about endodontics you know he was that professor that you know walked around i think you know so some you know christians like to hold the bible he likes to hold into files you know uh and and that was his deal so i really put it it put a an extra validity on the technique so i tried it and uh it was kind of crazy the first one i did it was like angels were singing with this new technique you know it's kind of like you described earlier it just made the hand filing um well a thing of the past so i loved it and uh i actually called over to talk to him and uh apparently you know he was just getting started there weren't very many people doing this i got to train with him talk with him and before i knew it i was one of four so-called experts in the world on this technique now the the joke is in order to be an expert all you have to be is 50 miles away from your practice because then nobody really knows what you do so with that definition i was an expert because i was traveling around lecturing and i was very passionate about it because what that technique allowed it was a a non-tapered instrument and the cutting edge was only at the tip of the instrument on the smallest a tin it was about 0.25 millimeters in length that's all the cut otherwise you had a smooth shaft on the largest instrument which i believe is about 130 and it's been a few years it was 1.75 millimeters in length so the concern you mentioned earlier about blowing out your coronal third of your prep was really a new point because we weren't even prepping there uh we were prepping only at the tip of the instrument and then we looked back at a lot of research that kind of showed that the apical third of the canal was really a lot larger than maybe what we were prepping to the problem was we couldn't get to that size to clean the wall in a 360 degree circle without blowing out the coronal portion because we were using tapered instruments even our our k files are a 0.02 taper so that means if you take a 10 which is 0.1 millimeter at the tip it's 16 millimeters in length of the cutting fluid so now when you get up to the top of those cutting loops you're at a 42 in width so that that taper does have an effect uh so I’ve taught this for about 20 years was very passionate believed in it you know with all of my soul and heart and did a ton of window and loved it however as much as things remain the change they remain the same however that saying goes things do change you know and so in today's world we don't have to use that instrument because we do have some sonics we do have some other techniques to clean the canal more thoroughly and we can do it faster so for me at the end of my little lecture career on indo that's really all i knew i was kind of a one-trick pony ended simply because the technology was no longer the best there is i think there are other things out there that can do as good a job in as quick a time and uh that's what I’m using today so they um steve uh senior he ended up selling that to a discus dental in uh 2006. and then uh discus dental um got sold again i mean some of these companies have been sold so many times um is uh is steve still uh practicing or did he uh uh retire off that or what what what did he end up doing yeah so dr steve is the endodontist he retired a number of years ago and his son stephen was uh kind of made the transfer and worked for discus dental for a number of years he's a great guy he's now retired as well he lives in san Antonio i think he does maybe a little bit of um oh helps help somebody a little bit with his office maybe some consulting he was ceo of the or I’m going to get these titles wrong but stephen dr cynia's son uh was the head of the endodontic department they called it smart endo for discus dental for a number of years before they were sold wow it's a it's a small world and uh and I’m just curious what's closer to the selfish question what's closer to Beeville Texas is it san Antonio or Houston oh yeah san antonio's just you know a hop skip and a jump south of san Antonio i mean Beeville is just barely south of san Antonio and that's that's what i grew up where i went to middle school huh that is uh that is amazing so um what do you think of um sonnet oh so what are you using now when you quit using light speed what did you switch to so I’m using i believe believe it was cliff rebels research I’m using the um I’m going to tell you wrong endo activator so um I’m using the endo edge files which are the the system that i use is endo edge platinum it's a knock off of dentsply's protaper which was acquired from tulsa uh and then I’m using the endo activator to clean uh one side of my crap yeah so um endo edge that um that got bought by henry shine right that was um um chuck uh um they ended up out of albuquerque uh let me see uh chuck goodis yeah so um he was on uh he was on podcast 309 everything into edge with charles goodis who's uh in albuquerque which is really an interesting last name because some of the biggest legends in the history of endodontics all had the last name goodis and i asked him if he was related to the other ones and uh he said no but he smiled i think he uh i think he enjoyed having the last name though but didn't he um yeah so he got in a big lawsuit with uh um dentsply who bought tulsa dental products from um ben um ben um oh uh ben johnson thanks again skyle I’m getting old and see how by the way ben called me this morning he's he's just such a nice guy he's just so smart but what i love about ben is he sold tulsa dental products to dentsply they made a gazillion dollars and guess what he does now even though he has a gazillion dollars and he's still in tulsa oklahoma he just thinks about root canals he just he just keeps thinking about root canals but yeah so that into wedge um sold to uh henry shine i believe and uh so now that's their file to compete against dentsply um which i don't understand because well densely sells direct and you know patterson and shine and benko and burko they they don't like that they they want you to go through them um but distributors take about 40 you know percent off the top uh but tulsa when he sold that to um um dense fly he kept it as selling direct so they have direct uh divisions um i so do you guys buy mostly through a dealer or do you buy mostly direct I’m going to let you talk to my ordering specialist here we are in for mendo edge right we do our indo files but most of our stuff comes through darby oh yeah most of it comes to darby so you're you're you you could you could buy from anyone why darby they're so much cheaper i used to compare or crack price them to uh shine uh and i don't even do that anymore because it's just um and then when i call the rep and say well how much is this because i looked at it over there and he'll say you need to stop talking to shine it's just so much cheaper i i yeah yeah that is i um and then what's more confusing is you have these big companies like um a shine or whatever but then they have these different little buying clubs or groups or whatever and dennis tell me they go well you know i buy all my supplies from this company and now I’m hearing that that i would get it cheaper if i joined some club do you guys need to go we went over an hour or you got you got patience you need to I’m doing great how are you Howard I’m doing great man I’m I’m I’m talking dentistry so i lose track of time um but uh and and then um but but there is another business um thing that you talk about in mba school when i got my mba at asu and that is the um um it starts off with um it's all a cottage industry uh look like I’m catalyst today like not one company makes more than one percent of all the cows um you know the same thing with wheat and corn um they're caught as industries i mean everybody's an independent like even in dentistry there's a hundred and fifty thousand general dentists well shot well uh heartland only owns one thousand offices they'd have to own fifteen hundred offices to own one percent in fact that's why I’m so excited kyle um kyle when are we coming up on a 1500 uh podcast because the last one we put out today was 1471. do you realize well next month when i hit 1500 that will be one percent of the general dentist that means we interviewed one out of every hundred uh general dentists and uh so it's a very very cottage industry and um but anyway so then what happens is the cottage industry will consolidate to like three to five players will have like eighty percent of the market and as soon as about three players get eighty percent of the market or more then the industry deconsolidates so look at how my life's been since I’m just drinking beer starting in high school right there was a thousand little beer companies and then it consolidated all the way to just budweiser and coors owned 80 of everything and now it's deconsolidated back with all these microbreweries so now we have the same number of breweries when i started drinking an 80 so when i had my last beer last night 40 years later I’ve gone through the whole deconsult cottage consolidate deacons same thing with dental supplies when i started on dentistry there was every single city had like phoenix dental supplies you know ever and then a guy's like um pete fourchette a patterson stan bergman of henry schein they got a big line of credit they went and then consolidated all all the the suppliers and it got to where it was just like patterson sold a quarter shine sold a quarter benco and burke are sold a quarter then about 15 small people sold the rest and now it's deconsolidating again there i i i hear about a different dental buyers club you know routinely i think I’ve had six or seven on the show so um and then as soon as it gets all deconsolidated someone will have the great idea well man if someone just consolidated all these into one think of how much so that consolidating deconsolidate and the same with presidential elections i i don't i always think the uh the president i don't want to get into politics I’ve always been a libertarian but you know and it'll be uh it'll swing over here and be republican for a couple presidents and a swing it'll be democrat a couple presidents and it's just back and forth like two two presidents of reagan then two a clinton and two you know it's just back and forth and that that's why i actually predict trump will win because um the incumbent has the huge advantage and usually they get about two terms before everybody's sick of them then they'll switch to the other side and it just goes back and forth and to me it's like some hypnosis thing to just keep giving them all your tax dollars uh but um um but what do you think of these new well first of all i want to ask you if you buy into the theory that once you start filing out a molar more than 30 that you're going to weaken the tooth and by the time you weaken the tooth and if you put a post in i mean the only thing a post does is fracture a root i mean i don't i don't think it has any other uh function i think we should just call it a post fracture pull you know to get that extra leverage there but do you are you personally concerned about um the o4 taper taking out too much to structure weaken the tooth and will that make you look at sawn endo or some irrigating cleaning device to clean all that up so you just need a glide path to a 30. um I’ve heard companies talking about how um they'll start with maybe the file will be just a .03 um you know and maybe the an 05 instead of you know all the the does that bring a accord with you or is that not really what you're seeing in your practice in your hands oh it does so it's been a few years since i was on the lecture circuit as they say and so I’m not as involved in that research as i used to be so some of my information may be out of date my concern was never the size uh if you look at studies going all the way back you know trump's standing cares carry keys i believe I’m not saying that wrong i did a study in like 73 and found that the apical with a suction teeth one millimeter from the apex and then they looked at them under an electron microscope and took a measurement and the sizes that they found the width of the canals at that location was amazingly larger than what we would think you know the average width of a palatal canal of an upper first molar was like 0.8 okay which would would be a size 80 on an iso hand file so the problem was never the size it was the taper so yeah i i have to say I’m still a little worried about taper you know at one point i remember there was a 0.08 they called it the greater taper you know all of that was necessary because we couldn't get our arrogance down into a third you know if you've got a 0.8 in the apical third but it's a 0.5 in the coronal third how are you going to get anything down there to really clean that out and so yes i think some of some of our sonic and again I’m not up to the latest uh but i think anything that will help us get that canal cleaned out better I’m interested in our view um have you interested enough in son endo to demo orders because some people say well the price is a big chunk of chain and it's not just like the 75 grand it's the fact that you know the things you need for each molar the disposables for each tooth are going to be another 75 to 100 bucks um does that um are you tempted to demo that look into that or are not really at this time no good question um so I’m one of those you know old dogs uh you know i get in my habit i get in my routine and I’m very comfortable doing what I’m doing so i haven't been looking around that's why i say i may be out of date on some of my my uh what's available i would love to demo it be interested in that i think 75 grand to help me do a better endo is is a pretty big uh bite to swallow but uh yeah if it's going to help me do a better job i would be interested huh and and and um yeah it will be interesting to see how uh those come um i want to um you know a lot of books are written on the why you know that um and I’ve seen that with my boys i mean my my i couldn't believe how my boys went from the uh um ultimate kid bachelor hunting fishing fun and the minute they dropped one baby you know they had their why now they're just a totally different animal their their dad first you know the family first business that you know what what would you um where where how would you help a kid in dental school find his why like why he's a dentist we started at the beginning like why did you tell your interviewer you wanted to be a dentist because you want to work with your hands where did you create your vision where did you find your why and what would you tell some kid that just graduated in the middle of a damn pandemic and can't find a job how does he find his why so he just stays internally motivated for his entire dental career as opposed to burnout disease depression i think that's an incredible question uh you know if we go to work every day and we don't know why how long are we going to be able to keep that up but but if we know why we're doing what we do uh then that helps and now why does it need to be the same for every person i mean it shouldn't be it can't be you're why and my why are going to be completely from within um you know i mentioned to you earlier that probably what makes my day more than anything is taking somebody out of pain you know the patient comes into the office and they look terrible we had a patient like that this morning and uh you know swollen and you know almost crying and up all night and in five minutes and this is this is another little tip I’ll give the young dentist don't be afraid to numb somebody up i mean how can you let your financial person talk to them when they're sitting there you know get your diagnosis of course uh get them numb they're going to you're already their hero and then they can think straight to talk about their treatment and about the finances so how do you find your why well first of all ask yourself why you know maybe ask your team why uh in in our office are you familiar with do you know what we call our office hour did we talk about that at all blessed dental yeah yeah blessing um and as and is that where where did that make him and did that name have something to do with your why it does for sure it's and it's blessed bill you know I’ve taken a little criticism for that actually that you know maybe some people wouldn't be comfortable with that and you know when you come into the office we don't grab you and drag you into the closet and and try to convert you to anything you know what we do is we try to bless you just like you were one of our family members we try and treat you with compassion with kindness and with gentleness that's our tagline okay maybe someone else's why is that you know anything else um i i think our mission statement here and I’ve been working on this and this kind of comes from the the song that you uh read the lyrics to earlier you said um you know it's in a world full of hate be the light well i think in a world full of pain we can be the light and that's our wine i want to be the light to a hurting world i i want to make them feel better i want to improve their lives that's i think that okay and you you've practiced 30 years right i have and and that and so that's your why blessed dental treat other patients like you'd like to be treated how does your view look at the current state of dentistry from when you got out in the 80s to now in the 2020 is dentistry the sovereign profession dentistry moving more towards blessed dental or is it moving back the other way or what how would you how does it look to you so dentistry's in transition right now we all know that you know we know that some of the private practices are struggling we know that there's uh consolidation of dental offices and you know that's okay uh maybe you're a dentist that doesn't just love some of the administrative stuff maybe you want to focus on your why and and maybe it's growing and running offices maybe it's not maybe it's just focusing on the patient there's there's a place for all of our dentists uh within this world of dentistry uh even though we are transitioning so i think it'll be different in the future you know that the medical doctors have undergone that change before us so did any of your boys go into dentistry um they all worked for dad for a couple years as an assistant and i think um i think that they just did not want to commit to the calculus and the chemistry and all that but they loved the um packing cord and making temporaries and and um you know they loved everything with their hands and uh but basically their love i started them when wrestling way too early i started him at five full-time year-round and by time they were freshman high school you know they hadn't lost matches in years but they were done they were burned out and then they went into rock climbing and ev and then when they started going and rock climbing there'd always be these recruiters saying um they they can't get anybody to climb a thousand feet up a cell phone tower and switch out a verizon box i mean most people get about 30 feet up and they start offering my two oldest boys like okay dude we're we have an emergency I’ll give you a thousand dollars cash if i can drive you to this pole and they're like rock climbers they're like I’ll climb it for free they were telling me i said Eric when some guy offers you a thousand bucks take the cash and so now they they make more than dentists um climbing up a thousand foot deal and and ever and they tried to scale it you know they thought oh we're going to have a bunch of these every single employee quits on the first day at about 30 to 40 feet and then Eric he's always texting me pictures of him i kid you not you know hanging upside down by his knees taking a picture of his truck which looks like a little matchbox cars but talk about an essential service i mean you can't go without a cell phone tower and during this whole pandemic the government did said the the cell towers gotta get they they gotta stay up uh but where I’m concerned about is I’m not worried about my four boys they've all flown the nest um you know my um my dad died 21 years ago yesterday and i know that you know I’m grandpa i die next and I’m looking at my grandkids and when i saw cvs prescription pharmacy by aetna i mean like they're like as i say delta bought heartland and they consolidated the whole industry well where does my little taylor marie go if she needs to go to a dentist if the dentist works for the insurance company and wall street i mean i i want her to go to a dentist not a wall street broker and an insurance agent i mean so I’m uh I’m worried about the sovereign profession of dentistry i just want someone like you to look into taylor's mouth and treat her like you'd want to be treated not as a financial incentive like oh well taylor's got 28 teeth how many crown opportunities do we have do we i mean she's got seven mod amalgams let's show her a crack around that and file it down for a crown you know i I’m i just want the dentist to be in charge of dentistry i don't want wall street and insurance companies any more than i want um you know a wheat farmer in charge of it i mean i want dentists to be in charge of dentistry does that mean I’m old school and behind the times and dumb or just worried about my grandkids i think it means you know what your why is and i think if the dentist regardless of his environment understands his why you're not going to have a problem you're going to have that dentist available for your grandkids and that's a litmus test you know when google started you know sergey brin larry page said you know this could this could go horribly wrong and their whole motto was do no evil you know just like the hippocratic o said first do no harm and that's what i got to tell you kids that you know that it's a slow degrading and where you got to do you got to draw a line if you go work for anybody i don't care if it's private practice i don't care if it's a big box dsl whatever um you got to treat that patient like you want to be treated and once some office manager is up there telling you that no you know you need to do this or you need to do that you got to be able to say well you're not a dentist and that's not what i would do on myself or my kid or my mom and I’m not doing this if all the dentists just stick to that um but um one more question i gotta ask you for the the kids um they get out of school they're like 25 and they go working they get a job at a dental office and um their biggest stress you know they got a's in calculus geometry and trig they still know the difference between a cosine and a tangent and the biggest problems they have is with people it's either the patient or the staff and they keep being told they need to be a leader so final question how does a 25 year old baby that just got out of dental kindergarten school how does she become a leader and make it fast make it how does she become a leader from zero to 60 in one year how would you coach her to be a leader so before i go to leadership let me let me talk real quick uh just a short story on this one okay and on this people you're talking about story yesterday sweet little lady came in had her teeth cleaned um i did her exam everything went great she looks at me she seems very concerned she says um i need to talk to you in private I’m like oh my goodness she's angry what did my team do what's going on so brought her into our little console room that's what we're seeing right here what's up she says well i just wanted to give you an apology let's give you an apology what what's up well i lied really yeah i told your hygienist that I’ve been brushing my teeth and i haven't and she was really bothered by this well i just reached across and put my hand on her hand and i said it's okay i understand and she here's the short of the story her son passed away a few months ago she hadn't been motivated to do anything much less pressure t and so sometimes forget the tooth there's a person attached and so really the best thing i did yesterday had absolutely nothing to do with dentistry it had to do with putting the hand on a senior lady who had lost her 52 year old son and just letting her know that someone cared she told me she said that's that's the first human touch I’ve had since code that started and uh so when it comes to your why it may not always be about teeth then when it comes to leadership you ask about that let's talk about leadership uh i grew up in a very authoritarian or authoritative you know it was it was dad was right and patriarchal and my way or the highway and you know almost militaristic and i responded to that really great you know i snapped into place and that worked until i was you know i don't know how many years old and i realized that that's not the way of the world uh there's a book I’m reading right now by simon simon called leaders eat last you familiar with that book no fantastic book you know the opening chapter talks about um a marine well actually the opening chapter talks about uh someone who is providing cover for his troops on the ground and the risk he took to help them in time of war uh next scene they're they're in a in a mess hall and the officers are not at the front of the line they're at the back of the room and they don't eat until every one of those enlisted men is eaten and then the officers who really had the ring to step up front and take the food first only then did they eat and so how do you be a leader well it's it's not any great secret really it's simply make your team make your patients make anyone that your children whoever it is you're trying to lead make them realize that you would take a bullet for them make them realize that you're going to put their best interest ahead of your own it's back what the way you said Howard treat them the way you would want to be treated you know what you're going to develop the strongest most dedicated followers you'll ever have not because you're smart not because you're great or good looking but because they realize you know i heard you Howard sometime one time say i love my assistant i would take a hand grenade and throw it in my operatory before i would get rid of her you cared about her yeah that's what i think it takes to be a leader um i gotta you you're so good at 30 000 feet macro and i i gotta i gotta keep you over time for one more question um we know in 1900 there were no specialists right and and healthcare was only one percent of the gdp at the end of the century dentistry had eight specialists physicians had 58 and we were 14 of gdp now it's 2020 we're at 17 percent of gdp dentistry's gone from nine specialties to 12 and you have these kids coming out of school and they want to do everything they want to be a super dentist they want to be an endodontist periodontist they say i want to do invisalign like an orthodontist implants like an oral surgeon crown and bridge like a prostate and I’m like okay well i i know we can't go back in time because my friend who's an ophthalmologist he doesn't even do glaucoma or glasses he he only does the retina part of it i mean it's so specialized how do you what do you think of these kids who want to be a super dentist and do it all and and and i love the ambition i you know i i don't want to be the jerk that says well if you're going to learn invisalign and do it like an orthodontist you got to give something up you can't keep being an endodontist a pediatric dentist a perry not i mean what do you say to the super dentist who wants to master everything well i think that first of all I’m going to I’m going to say i praise you on your spunk you know what i mean we all wanna do everything that's great and maybe some of us can but maybe some of us can i would say if you're young you're right out of school again focus on the basics learn to do restorative learn to do filling so the patients don't come back with sensitive teeth first okay learn to do crown and bridge so that the crowns aren't falling off don't get distracted by all the peripheral ce yet it's incredibly important i love ce i get 2 300 hours a year probably and see it's absolutely fantastic but learn to do the basics first and then learn more if you can we talked earlier about I’m going to talk out of both sides of my mouth here because I’m saying learn the basics first but then you know if you get the spec out of your own eye you can see clearly to move forward so once you have those things mastered then find out what you like and that's great be a super dentist because it's going to allow you to provide that service for your patient again like we said earlier it's kind of nice for your patient not to have to go to five different offices to get their little work done if you can do it but make sure you're doing it well make sure that if if you were the patient you would want yourself if if I’m going to do a root canal i want to know what i want bob stewart doing my root canal and if i can say yes to that then that's great go for it okay final question Kim you have to answer um they're they're they're scared man they're 25 they got 400 000 student loans um dental town started in 1999 and it's always had about 1 000 dentists selling their practice and about 5 000 jobs now it's 2 000 dentists selling their practice because they don't want to deal with all this ppe and all that they're done and the 5000 jobs have gone down to 1 000 jobs so now there's two people selling and saying I’m done with dentistry I’m cashing out and I’m running and only 1 000 saying uh we're we're still going and growing and they can't find jobs they text me they put their resumes everywhere um they're scared they're broke and they're in the middle of a damn pandemic an election um they the the the the wall street cycle i mean I’ve been a big fan of warren buffett you know i mean um you know 10 years ago was layman's days 10 years ago was y2k 10 years ago was black Monday i mean the the economy so the economy was already headed uh in trouble a year before the pandemic what advice would you give them him what would you tell him just to start would you tell him just to switch from beer to whiskey just step it up a notch or what what advice would you tell him you know it's bad when Kim just says pass pass we'll see if bob's dumb enough to take this question very rarely is she short of words but you know and you mentioned whiskey in Texas our governor's decided the restaurants can sell it to go so we're we're all in for the pandemic we're okay but what what would you tell that kid she she's i mean i I’m getting three four emails and texts a day just in Arizona i mean we got a 3.8 million metro and they're just saying dude i graduated from a great school i can't find a job I’m in a pandemic what the hell should they do you know first of all i'd say I’m really sorry that you graduated at this time you know you and i Howard we graduated life was good you know but what what did we hear back then you know i heard the old guys going well the golden age of dentistry was the 70s well it's 88 and i just worked hard to get here you know so keep your chin up uh life dentistry's been great to me i said that earlier uh be real careful about debt you've been uh one of those persons who can go to post gratification you know you p your friends graduated high school and you know some of my buddies got new cars and jobs and i went to college and then i graduated college and some of my buddies got nicer cars and better jobs and then i went to dental school and so you've been doing that for years as a recent graduate and you're ready to live but you know you may have to put it off just a little bit more don't don't go crazy uh yet that your time is coming it's I’m telling you so people have teeth and they need us and and it's going to be wonderful just give yourself a chance to to spread your wings and fly I’m sorry i was just going to say we just hired a guy who just graduated i literally assisted him on his first very first occlusal filling and the patient looked at him and said so how old are you how long have you been doing this and he said well I’ve been doing it for four years but you're my first one so we kind of light-heartedly went through and realizing that that was his very first feeling he did outside of professors overlooking what he was doing and honestly i i think what he's doing he's young i think he's 27 he's getting married in December he's i think he's smart to me he's practicing under some i think a brilliant dentist right here he's he's a great teacher he's he's really good at a lot of things endo we didn't talk about how his amazing technique at getting people numb i think that's a skill that dentists need to know how do you get someone numb that how do you that's how you build a practice by not hurting people and he's kind of learning under him while making a living so limp along doing that get good at dentistry and then you're home free i mean it's what he did 33 years ago and and it's what dr lopez is doing now and i think he's going to be a great dentist for it somehow Kim you didn't finish the story did the patient live he's alive he lives oh my god it's a happy story yay yay the patient live hey guys thank you so much it was a blessed opportunity for all of our listeners to have you come on the show and keeping it real and the next time I’m in uh Beeville don't uh don't give me your address or I’ll bring you a blue egg you know what i would love to have any time hey i have to tell you real quick I’ve been in your office and you didn't even know i was a stealth visitor oh wow what year was that it was fantastic well it was when i was doing those lectures i was on my way to an event in l.a and i had a layover in phoenix it was back before the 911 time and so i just grabbed a rental car called your office and said I’m in town i want to see it they were wonderful i snuck in i hid in the corner and launched i learned a ton and you had a an associate dog dr savage yeah bob savage i love that guy it was awesome he gave me a tour around the office and i was totally impressed this has been an honor for me i got to do a podcast with my dentist hero Howard ferrin thank you thank you so much last story for me i have to say we um i i remember sitting in on one of your lectures and your wife was pregnant and you were really hoping it was going to be a girl and um i guess it was not uh but um anyway um he um i lost my train of thought see i do it too well by four my i had four boys and they've uh they've made six and two of them are girls and i actually i actually feel sorry for them I’m I’m kind of confused because all we do is take them hunting fish and motorcycle shotgun and it's like i keep telling my boys should we be doing something girly i mean is there's anything girly and they just say shh i don't think she knows she's a girl yet so Texas we need to go hunting together this girl this girl this girl shot a pig before she had a barbie doll i mean it's uh all right well what he did was 33 years ago he was not who he is today he was the dentist who said why do i have to tell my staff uh thank you i give them a paycheck and whereas today he's not that's not him as a leader he tells people thank you for being here you're amazing i heard you in a lecture one time say my stat my assistant is so important to me i really would take a hand grenade throw it into op 2 and blow it up before i would get rid of her throughout the 33 years of him practicing I’ve constantly remember what Howard says remember what Howard says and he literally has become that today he's much more see together you two have learned me better thank you all right on all right i hope to see you in Texas someday i love it all right have a great day.
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