Digital Implant Dentistry: The Rise of the Implant Outlaw | Dr. James A. Carter | EODP #26

00:00:00:26 - 00:00:32:52 Speaker 1 Place my first 50 implants in a year with no CVT. Quick draw, but you probably shouldn't be doing this stuff if you don't have the stones to go freehand. The most unexpected thing that I ended up liking and do a lot of now is impacted. Wisdom teeth now crushing some whizzes and people don't buy treatment or products they buy you. 00:00:32:57 - 00:00:55:24 Speaker 2 Welcome back to the Evolution of Dental Podcast, brought to you by Evolution Dental Science, where we share the stories of the people and the technology shaping the world of dentistry. Somewhere along the way, dentistry decided that there was a dress code and a personality to match. Either today's guy didn't get the memo or he decided to use it for target practice, guided implant surgery, full mouth rehab, smile. 00:00:55:24 - 00:01:07:28 Speaker 2 Design the whole arsenal. He shoots a bow and he places precision implants. Doctor Jimmy Carter or should I call you the implant outlaw? Howdy. Welcome to the show. 00:01:07:33 - 00:01:23:14 Speaker 1 Oh, I love it, I love it. Yeah, I, I, I go by many names. It's funny, I like to go by Jimmy now because it's it's. I rarely hear my own name anymore. It's Doctor Carter, but I wear many hats. 00:01:23:19 - 00:01:25:45 Speaker 2 And what a fine hat that is. 00:01:25:50 - 00:01:31:57 Speaker 1 Thank you, thank you. It's a. Yeah, a funny, funny story actually has to do with evil. 00:01:32:02 - 00:01:37:21 Speaker 2 Does it? Okay, now I really want to hear. I mean, it's not that I didn't want to hear it before, but, like. Yeah. Where does that come from? 00:01:37:28 - 00:02:01:57 Speaker 1 Oh, man. So, so right out of school, my first job towards the end of the year that I started working was with a dental corporation that they, you know, they go to this, this big conference that they put on every year and the evolve and their, you know, corporate branch, Olivia, believe it was their first time having a booth and coming to the to that conference. 00:02:01:57 - 00:02:23:14 Speaker 1 And I was just, you know, walking around didn't really know what to expect, didn't know where I fit in. I was like, are these people my boss? Like, I don't know. And, you know, I was walking through and I saw Andy Jackson and Alex Jackson and I just actually gotten a cowboy hat for it was like an early Christmas gift. 00:02:23:14 - 00:02:44:43 Speaker 1 And you ever get, like, a Christmas gift that you, you love so much that you like, you sleep in the bed with it for like a week. That was my hat and it was a Stetson. So in my mind, I'm like this, this is professional. And I had to dress up. At least I thought I did. You know, I saw a three piece suit and I had my Stetson on, and Andy Jackson was just like, hey, man, you know, love the hat. 00:02:44:43 - 00:02:50:24 Speaker 1 And, you know, we just we started talking and, you know, the rest is history, honestly. 00:02:50:28 - 00:03:01:19 Speaker 2 So so most people who get the name outlaw, they don't choose it for themselves. Like, where did that come from? How did that come to be? And the whole Tom Selleck cowboy mustache to match. 00:03:01:24 - 00:03:25:07 Speaker 1 It's it's funny, I've talked to a few different, you know, dentists now that back, you know, when we were students, I guess depending on what school you're at and what program, you know, if you had like, specialties at that school, they would, you know, pretty much like, I guess, hog all the specialty work. You know, we never got to touch in and plant or even see one when at my program. 00:03:25:07 - 00:03:43:04 Speaker 1 Whereas I've talked to, you know, other dentists and their school, they didn't have specialties. So, you know, they, they placed some not even in a GR just in their, in their program. So, you know, and coming through a school like that, they really scare you. You know, I was like, oh, you know I'm not supposed to do that as a general dentist. 00:03:43:12 - 00:04:04:26 Speaker 1 You know, you're going to all kinds of these horror stories, right? So, you know, like numbness, numb lip lawsuits. And it's something that it always interested me. You know, I grew up on a little 40 acre farm down in South Carolina working with my hands. So, you know, I'm good with that. So. And, you know, surgeries always, you know, interested me. 00:04:04:28 - 00:04:32:55 Speaker 1 So, you know, fresh out of school, I ramped up pretty well. And I was talking these people, I was like, hey, you know, I won't try. I want to play some plants. So, you know, I, I guess I talked to the right person, impress the right people. And they sent me to their implant continuum. And, you know, I learned, you know, I guess all the, you know, the basics went literally the first day back, I placed an implant before my mentor was supposed to come help me. 00:04:32:55 - 00:04:55:45 Speaker 1 So I guess, you know, I, I guess it stems from being a general dentist and at least from my school, not really supposed to be doing that. And then also, you know, doing it without a CBC. Placed my first 50 implants in a year with no CBC. Just, you know, quick draw. 00:04:55:50 - 00:05:13:33 Speaker 2 Oh, I didn't see you there. Hey, y'all, it's Robert with the Evolution of Dental podcast. If you love these stories and you want to see more guests, more content and help the show, please remember to share it. Like it? Subscribe to our channel and hit that little notification bell if you're watching on YouTube so you can get notified of our new episodes. 00:05:13:36 - 00:05:30:07 Speaker 2 New episodes drop every Friday. Follow us on all the socials. You'll see all the latest content. Looking forward to seeing you there. What do you think gave you the confidence to to place those without a CBC and and take that kind of approach? 00:05:30:12 - 00:06:00:16 Speaker 1 Well, I mean, just looking at it simply, you know, there's like the slob rule and, you know, 3D object on a 2D image and, you know, things can be foreshortened. You know, we know that, but they can't be and gated, right. So, you know, you know, particularly with all these landmarks that we're afraid of hitting, like, no matter what angle, it's that it's not going to be any, you know, further away than, you know, the perfect perpendicular angle. 00:06:00:19 - 00:06:24:28 Speaker 1 So on a par, if I've got 12 or 13mm from a certain site, you know, it's not going to be shorter than that. So or if it is a foreshortening that looks like ten, I'm just going to stay a little shorter than that. And obviously I had to visualize everything. So you know reflecting flats and looking at the thickness, you know, in person. 00:06:24:33 - 00:06:31:19 Speaker 2 From placing them all by hand without a CVT into your digital workflow that you that you live now. 00:06:31:24 - 00:07:06:28 Speaker 1 So I feel like it was good practice. And honestly, I've talked to some surgeons and general dentists who have transitioned to mostly full arch and they like and I, you know, these guided surgeries, it makes things quick. But you know, there's also complications and if for lack of a better term, it's funny, I remember this one guy saying he's like, you know, what you know, guy did is great, but you probably shouldn't be doing this stuff if you don't have the stones to go freehand. 00:07:06:31 - 00:07:14:19 Speaker 1 If you if you know something goes wrong because it does, you know, that's why they call it practicing dentistry, right? 00:07:14:24 - 00:07:31:48 Speaker 2 Yeah. I mean, that's one of my favorite jokes, but. So where, what are some things that you feel like best benefited from that hand off? And what are some things that you still feel are better done by hand or the old fashioned way, as you might say? 00:07:31:52 - 00:07:55:45 Speaker 1 Well, you know, I just recently did a full arch surgery that I had, you know, collaborated with Olivia with or, you know, evolve. And, you know, everything looks great on the screen and, you know, digitally with our angles and but, you know, you get in there and you know, you have a spinner, you don't have talk, you know, you want to send this patient home with teeth. 00:07:55:45 - 00:08:12:57 Speaker 1 And, you know, you just have to you have to pivot. So, you know, we had the osteotomy kind of guy goes over to the side and you know, we're adjusting angles, changing you know, diameters just, you know. 00:08:13:02 - 00:08:19:21 Speaker 2 So something you feel like gets lost in the digital technology versus like doing things freehand. 00:08:19:26 - 00:08:45:02 Speaker 1 Yeah, I feel like some people I guess the worry is that you never develop the feel, you know, just going through guides and, you know, hopefully everything goes right and you put it down to depth. And whereas I guess I really got a good deal of that, you know, going freehand of, you know, just the different types of bone and the torque and the way they can press. 00:08:45:07 - 00:09:02:33 Speaker 2 I've, I've worked on probably thousands of implant cases at this point, but I've never placed an implant. So for somebody like me or a doctor who is just curious, we'll call it implant. Curious about getting into this. Like, what do you mean by the feel? How does that translate, do you think? 00:09:02:38 - 00:09:25:00 Speaker 1 You know, that's one thing I love is analogies, especially with patients and with anything, I guess. But so, you know, growing up on a little farm, there's no shortage of things to do with your hands. I guess the best way I can put it is, you know, if you ever put in a wood screw with a drill or even by hand, and, you know, it's pretty hard depending on the type of what I suppose. 00:09:25:02 - 00:09:46:38 Speaker 1 But you can drill like a pilot hole and then it's a little bit easier. Or, you know, with implants, something I've done is like, you know, drill down to depth with, you know, undersized one and then go down halfway with the size that you're going to end up at. So, you know, it's kind of a. Oh, I love dentistry just because it's it's so creative. 00:09:46:43 - 00:10:06:50 Speaker 2 Now that makes a lot of sense that actually that puts a pretty good, pretty good visual in my own mind. I was actually just having a conversation with my brother like last night about that. He was he was trying to secure some trim to a door. And he was he used some choice words because the trim, which is, you know, that wide split in half and trying to drive a big screw through it, I'm like, man, you got to drill a pilot hole first. 00:10:06:55 - 00:10:12:06 Speaker 2 Like, what are you talking about? A pilot hole? It's like, well, these things. Yeah. 00:10:12:10 - 00:10:17:16 Speaker 1 You're putting it in a hard rock. Naval pine or balsa wood, you know, it's it's going to be different. 00:10:17:21 - 00:10:40:14 Speaker 2 Makes the difference. Yeah. And I have heard from a number of doctors before saying that, especially ones that are deeply involved with the digital but having big background in doing it freehand. Sometimes you can plan to the degree and when you get the actual day of surgery, turns out things in the bone are not as they looked on the CBC. 00:10:40:28 - 00:10:43:16 Speaker 2 Is that something like what you're describing here? 00:10:43:24 - 00:10:56:12 Speaker 1 That is exactly what I mean. Yeah. What is that? The Mike Tyson says everybody has a plan til they get punched in the face. Yeah, so that's exactly right. 00:10:56:16 - 00:11:04:40 Speaker 2 And so you, you went from you worked at a few practices before you started your own practice here. Right. Is that I remember you saying that correctly. 00:11:04:40 - 00:11:06:19 Speaker 1 That is correct. Yeah. 00:11:06:31 - 00:11:16:24 Speaker 2 What what surprised you most about your own practice? Ownership? Like, what were some of the challenges there? What? What are some of the things that you found that were more rewarding? 00:11:16:28 - 00:11:33:50 Speaker 1 So straight out of school, you know, I went into a practice with a, with a coder. So, you know, kind of supposed to be a 5050 thing, I suppose. But he's very by the book, you know, presents himself to the community like most. 00:11:33:55 - 00:11:35:24 Speaker 2 Where one of these chair sides. 00:11:35:33 - 00:12:05:50 Speaker 1 No, no. Yeah. It's funny, I love the guy outside of work, but, you know, he's, you know, straight edge. You know, and he the way he describes me as in a nice way, I suppose, is a little more cavalier. So, yeah. And that's the thing I actually one of the best CS I went to a bit of a C junkie actually was more actually on lifestyle and and work life balance. 00:12:05:50 - 00:12:35:16 Speaker 1 And it's like, you know, you can what do you want to do every day? How do you want to live? I guess is a better question. Yeah, I guess it's a bit of a soft filter, you know, right out of the bat, starting up a practice and putting me in my hat on the mailer. You know, it's interesting on social media, there's a couple people that dragged me and, you know, it's actually people are funny, but but, you know, if people have a problem with that, then those aren't really the people I want to work on anyways. 00:12:35:19 - 00:12:40:38 Speaker 1 You know, you spend more time at work than with your family, and I want to have a good time. 00:12:40:43 - 00:12:44:55 Speaker 2 I love that approach because not everyone is for everyone, you know. 00:12:44:57 - 00:12:48:43 Speaker 1 Right. I don't need every patience. We want the right patient. 00:12:48:45 - 00:13:10:19 Speaker 2 You know, the right patience. And so how I see the bow in the background there. Which which do you think informed wish do you think your. Because with archery I mean you either hit the mark or you don't. So what do you think? Did did did implant placement inform your archery or did archery inform your implant placement? 00:13:10:31 - 00:13:34:19 Speaker 1 Oh, man. Well, I've been shooting a stick and string traditional bow since I was maybe before five years old. Yeah, custom little bow about that big. Yeah. And, yeah, I love traditional archery. You know, there's there's no site on that thing. So people like, you know, how you, how are you hitting stuff? But just like throwing a baseball or football, you know, your brain kind of learns the line. 00:13:34:24 - 00:13:40:50 Speaker 1 But yes, I suppose maybe that's why my implants are all straight as an arrow. 00:13:40:55 - 00:13:43:45 Speaker 2 Straight as an arrow. Is that on your mailer? 00:13:43:50 - 00:13:48:19 Speaker 1 That should be. I'll put it on. 00:13:48:24 - 00:13:55:45 Speaker 2 That's pretty. That's really cool. And speaking of lifestyle stuff, you're also into some other handiwork, too. Leather work, is that right? 00:13:55:55 - 00:14:10:21 Speaker 1 Yeah, I hand tool leather. I've got a quiver hanging up in front of the pan where that I fabricated a hand tooled. So yeah, all kinds of all kinds of fun stuff. There's no shortage of thing just to do on the farm. 00:14:10:26 - 00:14:16:55 Speaker 2 Sounds like you've been into this for a while. In fact, you were, I think, before we started recording. You were showing us a picture. 00:14:17:00 - 00:14:37:36 Speaker 1 Yeah. And that's another thing I wish I could pick up this little camera, walk you around the office, because, you know, there's not many, many dental offices that I can really relate it to. Probably my my orthodontist, actually, who inspired me to go into dentistry. It was this almost a centric, crazy Einstein hair doctor Pinsk in Monroe, North Carolina. 00:14:37:38 - 00:14:55:24 Speaker 1 And you go inside and it's it's a pirate ship and there's a mast and wood all over the walls. So I guess I've drawn inspiration from him. So, you know, I've got my, my surfboard, my dirt bike helmet, my, my bows and quivers and all kinds of stuff throughout the office just sprinkled around. 00:14:55:28 - 00:14:56:43 Speaker 2 That's awesome. Though. 00:14:56:57 - 00:15:16:21 Speaker 1 I heard someone say that your practice should be a reflection of you. So, you know, we we've all walked into the room and kind of, you know, just gone out to the patient and it's like, you know, they're not too talkative. It's like, yeah. So how was your weekend? My goal is by the time I get into the chair, for them to be like, oh, you know, you surf you. 00:15:16:31 - 00:15:27:14 Speaker 1 I dare bikes, you like traditional archery, so it helps me connect. But yeah, here's a here's a picture of the young implant outlaw. 00:15:27:19 - 00:15:38:21 Speaker 1 As you can see, my aim has been deadly since since they first put out the Naia, my wanted reward. 00:15:38:26 - 00:15:42:26 Speaker 2 And see it in his eyes. 00:15:42:31 - 00:16:13:02 Speaker 2 So if if a new grad, if a new grad or somebody in residency were to say one, ask you one thing about what they should be most looking at right now, what would you what would you direct them to say or see like? Because one of the things I think is interesting, you've pointed out is both not just dentistry itself, but pulling your own personality into the practice, into your interactions, giving the patient something to react to and conversation pieces to start with. 00:16:13:04 - 00:16:25:40 Speaker 2 The size. Well, how was your morning? And aren't my walls and floors clean? You know, so what? What are some things you'd impart to them as they start this journey into their own world of seeking private practice later? 00:16:25:45 - 00:16:51:26 Speaker 1 Okay, well, I feel like it's much easier to do starting your own practice, implementing everything you want from the start rather than trying to kind of go into an existing practice. And they're like, oh, this is how we've always done things. But I mean, I guess the same thing just, you know, ask yourself, you know, what are you what are you willing to tolerate and what is your long term goal? 00:16:51:28 - 00:17:00:12 Speaker 1 So just, you know, be yourself. And if you know, some people won't be okay with that. But that's all right. 00:17:00:16 - 00:17:01:50 Speaker 2 You find your people. 00:17:01:55 - 00:17:26:45 Speaker 1 Yeah. But yeah, addressing things early because that's another thing. I have a buddy who, you know, went out on his own and started his own and we've, you know, bounced a lot of stuff off each other. So, you know, right out of the gate setting expectations and sticking to them. You know, if you've got a hygienist who's cut, cone, cut x rays for 30 years and you let that go and that's fine, and then all of a sudden you switch it up there, you know, that's hard. 00:17:26:45 - 00:17:30:04 Speaker 1 But if you set it right out of the gate, it's, you know, this is how we got to do it. 00:17:30:07 - 00:17:51:43 Speaker 2 So yeah. And speaking of like so we, we kind of touched earlier on transitioning from the freehand to the guided surgery stuff. What are some other new tools that you pulled into the practice over the years that you. What are some things that you've touched on that you're like, actually, maybe I should have just left that in the bin versus things that you just use every day now and you can't live without. 00:17:51:48 - 00:18:14:31 Speaker 1 So luckily I went to a school that was, you know, a little more advanced than some others. And you know we had all scanner training from you know year one. So that's something that I definitely, you know could not live without. I could take a PBS impression if I had to, I suppose I could go to the law, find some, hopefully borrow some from another practice. 00:18:14:31 - 00:18:39:36 Speaker 1 Maybe. But I would say I would say a camera. To stay on a professional camera is probably the most important thing. Just because, you know, you could set up all this stuff, you know, whether it be fixed, restorative veneers, crowns, implants, whatever. But you got to start from soft tissue. Landmarks is where we measure it off from. Right. 00:18:39:38 - 00:18:50:09 Speaker 1 So you could have this great prosthesis. But if they smile and the transition line is below the smile, then you know that's a failure. 00:18:50:14 - 00:19:04:28 Speaker 2 Heard a lot of talk about cameras lately on the podcast, and I really love hearing that. As a lab guy, I really love hearing that because, you know, otherwise we're just working on these patients in a vacuum. And I mean, because I'm a tooth nerd, I've been doing this for 15 years. I can look at you and go, oh, okay, that's her mouth. 00:19:04:28 - 00:19:10:55 Speaker 2 And that's his mouth without seeing a, you know, that's seeing a picture, but it's still just a guess. Well, seeing good photography, like. 00:19:10:57 - 00:19:29:16 Speaker 1 How I feel like that's a very good I heard somebody put it as especially, like Dennis that aren't placing their own implants, but you still have to restore them, right? So with your lab technician, your surgeon, and you as the general dentist, I've heard it said that you should be the quarterback. But everyone is equally important in this. 00:19:29:21 - 00:19:41:00 Speaker 1 You know, in putting this case together, you know, how are you as the technician going to know how to show one millimeter of incisal display at rest if you don't know where the lip hangs? Right. 00:19:41:04 - 00:19:51:16 Speaker 2 That's a really good analogy. And you are good with these analogies. I love it like the wood screw the quarterback. You know, the archery. What are some other favorite analogies of yours? What are some things that you use to communicate to patients? 00:19:51:21 - 00:19:54:26 Speaker 1 Oh, I have this. 00:19:54:31 - 00:19:56:38 Speaker 2 Put you on the spot, but to put you on the spot. 00:19:56:43 - 00:20:23:38 Speaker 1 It's funny because these these corporations that I've worked for, they track everything. And it's kind of cool, actually. But I was told that I had a a high crown acceptance rate, like in like the top 10%. Something like that. Can't remember, but I actually have this printed off picture of, you know, just like your typical you know, what you see amalgam on a molar with a fracture line extending down, it's stained. 00:20:23:38 - 00:20:43:19 Speaker 1 And then on the other side I have a laminated. I have, you know, what we always see after you? No broken off pulp exposure, broken tooth, vertical fracture. I'll just show them. I'm just like, hey, you know, this is very typical. Most broken teeth we see in this office look like this. And they never hurt, you know, until they do. 00:20:43:24 - 00:21:04:31 Speaker 1 And it's like, you know, you're biting down on this large amalgam. It's almost like a wedge. And it's not just one hard bite. It's just the repeated, you know, so one day, you know, enjoying a Jordan Almond and, you know. You're not doing breaks on a Saturday and I'm I'm in Hawaii. No. Not yet. Hopefully soon. 00:21:04:36 - 00:21:06:04 Speaker 2 On the farm shooting arrows. 00:21:06:07 - 00:21:09:48 Speaker 1 Not realistically. 00:21:09:52 - 00:21:27:24 Speaker 2 Yeah. I mean, as an aside, I hope you definitely send a picture of that to captain, because I think that would be really cool thing to feature right along the conversation to. Sure, I'd be really cool. So one of the things I wanted to kind of circle back to is obviously the cowboy hat social media profile. What's that been like? 00:21:27:24 - 00:21:42:02 Speaker 2 Has what's that been growing that process, embracing that personality and sharing that with, with with the dental world as well as the patients. How has that changed your practice and what was that journey like? 00:21:42:02 - 00:22:03:24 Speaker 1 So it's interesting because, you know, working with corporations, they you know, they have these legal teams then do everything by which, you know, smart and should, but you're limited as to what they put online. You know, there's a picture of me in a suit like every other dentist, you know, out there. But I was like, you don't want to portray more than that. 00:22:03:24 - 00:22:19:24 Speaker 1 I want to show these patients that I'm human and have a personality as well. So I, you know, branched out and created my own social media where I can, you know, post what I want. And it's interesting going back with a marketing team, I'm like, hey, you know, I want to do this. And they're like, well, we don't think we should. 00:22:19:26 - 00:22:30:14 Speaker 1 So I do on mine. And like, you know, it's like I have ten, 100 times more followers than our than their page. So we'll. 00:22:30:19 - 00:22:34:19 Speaker 2 It's almost like people like to see a personality other than just clear cut, you know. 00:22:34:21 - 00:22:47:57 Speaker 1 Yeah. Because, you know, they're coming in. It's, it's it's scary enough. Right. Being a patient, come to this cold office and you're gonna, you know, have surgery performed on you. You know, it's like something to lighten up the mood, right? 00:22:48:02 - 00:23:10:00 Speaker 2 Yeah. Something to keep it from being less scary. Right? Right. Speaking of, like, is there a case type that used to, like, genuinely make you nervous going in, like, you think about it the night before, it's now more like just Tuesday or what are some things that you've learned along the way with that sort of with those sort of cases. 00:23:10:04 - 00:23:37:24 Speaker 1 I would say root cause and Weitz so that's another thing, you know, like going, you know, in school they taught us like what? Cold lateral condensation, like master cone accessory cones. And, you know, just doing a single canal would take me, I don't know, three hours of school. I think everything took me three hours back in school. But yeah, especially like a single canal. 00:23:37:28 - 00:23:55:28 Speaker 1 Root canal. That's that's like an occlusal filling. That's like 30 minutes for me. That's like, come on, I'll do it all day. And then obviously, you know, like implants. Now, now it's more like, you know, getting into full arch. Yeah. Place a single implant the other day. And I remember, you know, blocking off three hours on my schedule. 00:23:55:29 - 00:24:08:21 Speaker 1 No side book. So working that out in the morning, huddles like, hey, look, I don't want a new patient here where I have to spend 15 minutes getting to know them next to this. And it's, you know, it took me, I don't know, they were in and out 30 minutes like. 00:24:08:26 - 00:24:14:14 Speaker 2 Now 30 minutes. And would you say that's more to experience or technology or some combination of the two. 00:24:14:28 - 00:24:36:43 Speaker 1 Definitely because so that was interestingly enough, most of my implants still are free handed because they come from like limited exams. They come in a hey, I broke a tooth, I'm going to lose this tooth. See to this or a root canal or we can't, you know, sound restored. So at least I have a seat where it makes me a little more comfortable. 00:24:36:43 - 00:24:51:19 Speaker 1 But, you know, get them done, take the seat. I'm like, okay, this is what we're working with. It's really osteotomy. I've got to put it in with the healing abutment. And yeah, they're out in 30, 45 minutes for a single. 00:24:51:24 - 00:25:06:04 Speaker 2 30, 45 minutes. That's I know, plenty of doctors. They wouldn't prep a tooth in that amount of time. That's that's that's it. To be honest, would you say you do a lot more full mouth these days, or singles or some kind of combination in between? 00:25:06:07 - 00:25:28:31 Speaker 1 There's definitely the patient need for it where I was especially and here. But it's a patient finance issue, right. So I would love to do it all day every day. But you know, hopefully we'll get to that point. But yeah, I mean I do a few cases a year, but they're they're like the most rewarding. Honestly I love it. 00:25:28:31 - 00:25:45:28 Speaker 1 Just the whole process, having someone that is ashamed of smile, they don't go out and do the things they used to. And but my favorite part is sending them home, you know, with the with the temporary teeth that day, just seeing their look, you know, their face in the mirror. 00:25:45:33 - 00:25:49:09 Speaker 2 And it's like, this is even the final form. It's going to get better from here. 00:25:49:12 - 00:26:10:00 Speaker 1 Yeah. And what's like I was talking about planning these cases from the soft tissue that I've heard you. That's like I said, I'm a C junkie and I go and I always learn like at least one nugget. And sometimes it's not even related to the subject of the C that I'm going to see. But one thing that was great was, you know, planning around soft tissue landmarks. 00:26:10:00 - 00:26:26:04 Speaker 1 And another thing at a recent one is you can plan around this, but you got to be even, you know, build a little wiggle room in there, right? Because, you know, you'll take a high smile picture. And these like I said, these patients all smile. And just like any other muscle, they're going to start smiling when they get these teeth. 00:26:26:04 - 00:26:32:04 Speaker 1 Right. So they're there. Hi. Smile. Line rises in six months. 00:26:32:09 - 00:26:42:45 Speaker 2 That's a pretty good observation. What are what's another thing that maybe surprised you about a C event that you that you took away from, whether it was part of the C or not? 00:26:42:50 - 00:27:03:52 Speaker 1 Like like I said, my favorite one was that lifestyle work life balance. Some other ones that I could think of is, you know, I went to a sinus lift, you know, see, that's another thing I got into relatively quickly. We'll sign this list at least, you know, vertical approach. They we learned how to soft tissue graph. 00:27:03:55 - 00:27:17:02 Speaker 3 Makes me think of an episode that we did recently with Doctor Tracy Wynn, which if you haven't seen that, absolutely worth checking out. But how what were some of your takeaways there. What what sticks what sticks in your mind? 00:27:17:07 - 00:27:36:07 Speaker 1 Well, I started doing some vertical sinus taps, you know, prior to that course, but it was an interesting course and it was put on by a periodontist. So, you know, we we got into connective tissue grafting and all sorts of stuff. So it was a great experience. 00:27:36:12 - 00:27:49:40 Speaker 3 So does that changed how you approach different cases, different patients. Have you involved any of the practices you learned from that course in cases that you've encountered since then? How has that shifted your perspective. 00:27:49:40 - 00:27:49:52 Speaker 2 Or. 00:27:49:52 - 00:27:51:02 Speaker 3 Placing implants? 00:27:51:07 - 00:28:05:16 Speaker 1 You know, I don't really like to place anything shorter than an eight. So if I can, you know, predictably get another 2 to 3mm with the vertical sinus tab, you know, why not? I will. 00:28:05:21 - 00:28:16:43 Speaker 3 If you'd known anything about what you learned in that course before, would that have changed some of the ways that you had placed implants in the past versus now? 00:28:16:48 - 00:28:37:52 Speaker 1 Yeah, yeah, I believe, you know you know, I've placed them shorter before, earlier in my career and, you know, worked around anatomical situations, refer it out a lot more. So, you know, I guess, you know, the biggest thing I would do is keep more of my implants in-house. And that's why I tried to I try to keep everything in-house. 00:28:37:57 - 00:28:46:24 Speaker 3 So are there cases that you keep in-house now that you would have referred out immediately before? Like, I don't want to touch that, but now you're like, bring it on. 00:28:46:26 - 00:28:55:38 Speaker 1 For sure. I guess the, the most unexpected thing that I ended up liking and do a lot of now is impacted wisdom teeth. 00:28:55:43 - 00:28:56:13 Speaker 2 Okay. 00:28:56:16 - 00:28:57:36 Speaker 3 So yeah. 00:28:57:40 - 00:29:17:02 Speaker 1 Yeah. So I was at my practice in Lancaster, South Carolina, and I was, you know, it had slowed down a little. So I was like, you know, I was a Tuesday through Friday doctor. And I was like, you know, I'll don't mind temping around at some other offices. So we talked to some other offices that had a seat. 00:29:17:09 - 00:29:35:19 Speaker 1 Their doctors weren't placing implants. So I was like, hey, you know, I'll come to consults, play some implants for you. And they're like, well, do you want to take out wisdom teeth, you know, on your downtime? And I was like, yeah, sure. You know, I've dabbled in it a little bit before. And, you know, the more times I practice, the more comfortable I got with it. 00:29:35:19 - 00:29:59:14 Speaker 1 And, to touch on unexpected delights at sea courses again, I went up to one in Canada. This surgical wisdom tooth. See his doctor, Nikki Jamal, up in Canada. Big name up there. So, you know, I stalking him, took his online course. And now crushing some whizzes. 00:29:59:19 - 00:30:01:02 Speaker 3 Crushing some whizzes. 00:30:01:04 - 00:30:05:12 Speaker 1 So yeah, I mean for impacted wisdom teeth. Come in the door I love it. 00:30:05:14 - 00:30:25:14 Speaker 3 Speaking of that kind of thing, is there something that you wish you'd learned and you would have incorporated into your practice sooner had you known? So what are some things like that that you would encourage some up and coming doctors or even season doctors to look into that you now have incorporated into your your daily workflow? 00:30:25:16 - 00:30:43:40 Speaker 1 I would say root canals, molar root canals and doing the crown prep at the same time. It's so much production, so much production that you're referring out. So and, you know, your patients are so much grateful for that, so much more grateful for that. You know, they're like, oh, they come in like, do you have to send me somewhere for that? 00:30:43:43 - 00:30:52:26 Speaker 1 Do you do that? I have patients asked me if I do extractions, like there's a lot of dentists out there that just, you know, if it gives them the slightest headache, they're not doing it. 00:30:52:28 - 00:31:15:28 Speaker 3 That reminds me of Marvin Berlin's Say Yes philosophy. What are some of the things that you're using that really changed, or you feel like or even underrated in your daily practice? Obviously you've mentioned your camera, which we love, the Integral Scanner, you're doing full mouth reconstructions, you're doing smile design and full mouth rehabs. So what's what's a tool? 00:31:15:28 - 00:31:25:45 Speaker 3 What's one of your favorite toys that you find you're using on a daily basis? It's really changed what you can say yes to or transformed how you approach these cases and these and these patients in general. 00:31:26:00 - 00:31:46:48 Speaker 1 The soft tissue laser is something that I got certified with and learn how to use. And now we have one of this practice. So, you know, sometimes cauterized an area that just, you know won't stop bleeding. Soft tissue laser is amazing actually. You know, you can treat at the sole serves sensitivity and teeth all kinds of stuff. Love it. 00:31:46:50 - 00:31:52:45 Speaker 3 Soft tissue laser. That's a good one. That's a that's one we don't talk about a lot, but it's an underrated very versatile tool. 00:31:52:48 - 00:32:00:31 Speaker 1 Yeah, I just did a fanatic to me on a patient. We can't close the diocese on eight and nine. So finishing up Invisalign with that. 00:32:00:36 - 00:32:03:33 Speaker 3 Do you do a lot of Invisalign and Ortho work? 00:32:03:33 - 00:32:24:24 Speaker 1 Not as much as I'd like to. Interestingly enough, I. I never wanted to be a dentist. I wanted to be an orthodontist. Like I was talking about Doctor Pinsk earlier. He was my inspiration and seeing, you know, the transformations he was able to do for patients. That's really where I drew my inspiration from. And seeing, you know, the transformations he was able to do for patients and change the lives essentially. 00:32:24:28 - 00:32:32:38 Speaker 3 So at what point did you decide to change tracks from orthodontics is where I want to be to know, actually, general dentistry is where I want to be. 00:32:32:43 - 00:32:54:40 Speaker 1 Well, it was, you know, I would go in and assist and observe a lot in the orthodontic clinic. And it was always so, you know, slow laid back, which is something I enjoyed and something I, I wanted to that's one of the reasons I wanted to go into ortho because he was always like, I don't know, like in his office shopping for classic cars on online or something. 00:32:54:40 - 00:32:58:50 Speaker 1 I don't know what he was doing back there. He would come in like, okay, everything looks good. See you in a month. 00:32:58:52 - 00:33:02:04 Speaker 3 As a car guy, I have to ask, are you in the classic cars yourself? 00:33:02:04 - 00:33:13:33 Speaker 1 I am, yeah. So my father and my and doctor hit it off pretty good. And, you know, obviously I like to work on motorcycles and cars as well. So yeah, we all. 00:33:13:36 - 00:33:15:12 Speaker 3 What kind of cars are you into lately? 00:33:15:14 - 00:33:20:31 Speaker 1 I got finally got a my dream truck here. I got a four Raptor. So. 00:33:20:36 - 00:33:22:28 Speaker 3 Oh okay. That's a nice truck. 00:33:22:33 - 00:33:33:50 Speaker 1 Upgrading and working on cars is a lot more expensive than than my dirt bike on the farm. Haven't really done too much to it, so. But yeah, I would, you know, grew up riding a dirt bike. 00:33:34:00 - 00:33:56:07 Speaker 3 It really sounds like your whole personality is on full display throughout your practice, which it sounds like that's also given your patients a lot of ways to build trust and connect with you before you even sit down and see them by the chair like that. That seems like a wonderful way to build rapport. Have mutual conversation between the you and the patient, and really build a solid connection. 00:33:56:12 - 00:34:12:13 Speaker 3 What are what are some ideas that you could advise or some things that you'd say to other doctors that are looking to break away from, like the white wall, traditional press collar dentistry, to also exercise their own personality and connect to the patients and build that kind of trust. 00:34:12:18 - 00:34:44:45 Speaker 1 I yeah, I would encourage people to, you know, to start leaning that way at least. You know, obviously it can be a fine line. So but yeah, it just it makes patients more comfortable coming in. They know a little bit about you and it helps you to establish rapport. Right. Because people I mean with, with as bad as it sounds, but it's mutually beneficial I guess we're in sales to an extent and but, you know, trying to help them do what they should. 00:34:44:48 - 00:35:12:02 Speaker 1 And people don't buy treatment or products. They buy you, you know, so establishing that rapport and getting, you know, a patient's trust, you know, that's that's huge before they let you work on them at all. If you can get out into the community, you know, wax lawyers, a smaller community, I try to show face a lot. And the hat and mustache combo, I go out where in my house without being recognized. 00:35:12:04 - 00:35:14:26 Speaker 3 Do you often run into your patients in the wild? 00:35:14:31 - 00:35:38:19 Speaker 1 Definitely. Well, I'm going out in Waxhaw even. You know, I'll leave the hat at home to try to be a little more incognito now. But they see the mustache and they're like, yeah, you're the guy. Yeah, yeah. That's me. I've got a social media ads in the mailers and, you know, talking to another one of my buddies, you know, before I went, leaned in so much to this, I was because he kind of practice in a small town as well and shows face a lot. 00:35:38:21 - 00:35:56:45 Speaker 1 I was like, well, what do you think about, you know, being out like, you know, at the bar or something like that? And I'm like, you know, how do you feel about that? What patients think about that? And he's like, honestly, man, he's like, patients love it. He's like, you know, as long as you're responsible, he's like, if she even shows more so that, you know, you're human. 00:35:57:00 - 00:36:00:02 Speaker 3 Yeah. Makes you a real person, somebody they can relate to. 00:36:00:07 - 00:36:17:07 Speaker 1 Trivia at the bar on a Tuesday night. And we've gotten patients like they've come in even, you know, some of my staff have like, oh, yeah, like we saw them and they wanted to come see you. You know, I have patients come in like, hey, where's the guy in the hat? You know, we saw the Miller. We just purely on the hat. 00:36:17:09 - 00:36:18:48 Speaker 1 They're like, well, I came in. This is why. 00:36:18:50 - 00:36:46:36 Speaker 3 There seems to be a lot of up and coming technology, a lot of a lot of promising stuff. But what what have you seen? Like, I've certainly seen over the years plenty of things that more than delivered on what the promises were, but also some things that definitely fell short. What are some things that you've either seen that are up and coming, that you're really excited about, or what are some other pieces of tech that you've adopted or witnessed that didn't quite deliver as you expected them to? 00:36:46:40 - 00:37:05:48 Speaker 1 Okay, so I've one of the things I love that I've gotten big into lately is, you know, networking, especially all these CS, and I don't personally own one, but I've talked to some doctors that do is the have you heard of the robot that places the the implants you all talking about? 00:37:05:50 - 00:37:07:45 Speaker 4 I think you're talking about the yummy. 00:37:07:48 - 00:37:12:48 Speaker 1 Yeah. That's it, that's it. Yeah. I don't have too much experience with it, but they're like, yeah, we got it. 00:37:12:50 - 00:37:15:48 Speaker 3 Is that something you've seen in person or just just on. 00:37:15:48 - 00:37:16:07 Speaker 2 Like. 00:37:16:09 - 00:37:37:55 Speaker 1 You know, online and hearing people talk about it. But, one thing that I do really like is the, the dental AI on the radiographs, like I've told you, you know, analogies and stuff for patient education, I love it because, you know, it has this patient view and it highlights, you know, I went to school to learn how to read things in grayscale. 00:37:37:57 - 00:37:45:12 Speaker 1 You know, my patients like you see this and they're like, I see toe jellyfish or whatever. They think the tooth looks like. 00:37:45:14 - 00:37:47:24 Speaker 3 It's a Rorschach image, not an X-ray. 00:37:47:26 - 00:37:48:31 Speaker 2 Right. I see. 00:37:48:33 - 00:37:59:02 Speaker 1 So, you know, and I click the button and it highlights it in red. I'm like, you know, this is you know, this is okay. And pictures and it's like, oh, wait, that's my mouth. Yep. Makes it really. 00:37:59:04 - 00:37:59:48 Speaker 2 That's powerful. 00:37:59:50 - 00:38:00:40 Speaker 1 Yeah. 00:38:00:45 - 00:38:04:36 Speaker 3 Making it real is half the battle there. 00:38:04:40 - 00:38:36:19 Speaker 1 Yeah. So yeah like like I mentioned preventative dentistry I feel like it's not talked about enough even even Dennis that I've been to new patients exams. They're like oh, you know, just brush floss, you know, come in and see us every six months. But they don't really I don't feel like explain enough the ideology of how a cavity is formed because I have patients come in all the time that I try to educate, you know, just and they're like, oh, I gave up sugar, I gave up soda. 00:38:36:26 - 00:38:53:28 Speaker 1 I'm trying to be good and still getting cavities, but, you know, it's a frequency issue. I'm like, I tell them, hey, I love sugar. And so, like, I had a pint of Haagen-Dazs for lunch. I don't tell people that. But, you know, and I try to everything. It's just like, as long as you're not, you know, snacking on that all day. 00:38:53:33 - 00:39:01:00 Speaker 3 Yeah. And not everyone's dentition put together the same way. I mean, there's also genetic factors as well. 00:39:01:04 - 00:39:03:50 Speaker 1 Yeah. Yeah. There it always is. Sliding sliding. 00:39:03:50 - 00:39:07:31 Speaker 2 Scale scales. 00:39:07:36 - 00:39:29:24 Speaker 3 The yummy robot though. That's that's a really interesting thing. I haven't heard anybody else actually talk about it or look or research into it. Like I said, I wasn't even sure if it was AI personally. What are what are some what would it take for you to consider adopting something like that and bringing it into your practice? Or what are some other things that you're kind of on the peripheral of thinking about incorporating into your practice? 00:39:29:26 - 00:39:30:45 Speaker 2 Okay. 00:39:30:50 - 00:39:50:28 Speaker 1 Honestly, I love, you know, developing personal connections. So, you know, if a sales representative came out, we talked. You know, explain to me about it took a, you know, to the course, you know, saw it working in person. You know, I would have more trust in it. Like I said, I just uneducated essentially. We know how I feel about that. 00:39:50:28 - 00:40:16:55 Speaker 1 But so things that I have seen that I would like to implement the. Have you seen the like what do they call it, it meta scan. By shining or it's like a 3D facial scanner. There may be some other brands out there, but you know, just, you know, the more diagnostic information I can give to the lab technician, the better the outcome will be. 00:40:16:57 - 00:40:18:07 Speaker 1 I feel. 00:40:18:12 - 00:40:42:14 Speaker 3 I do feel like they're a little bit more on the up and coming side. There's absolutely a spectrum of quality. And of course that correlates usually not with price. From what I've seen, I think that the ray face option is probably at the top right now. But that said, your traditional your traditional DSLR with 105 millimeter lens and good lighting is actually going to give you a better because of the definition of that. 00:40:42:14 - 00:41:03:00 Speaker 3 It's going to give you a better alignment with your oral scan. When you're doing your your your smile design with something like X and true smile or and Invisalign. That said, there's definitely a place for those in this industry, and it's helpful. It's certainly helpful to give the lab more information, and this has been a lot of fun. 00:41:03:00 - 00:41:30:02 Speaker 3 Thank you so much for being a part of this, and thank you for taking the time to share about all your your unique approach to dentistry, all your interesting hobbies, and the way you've brought some a richness and a fun attitude to the entire profession. If if there was one piece of advice that you could impart either to young up and coming dentists or even Dennis out there looking to shift how they look at things, what would that one piece, what would that one thing be? 00:41:30:07 - 00:42:09:01 Speaker 1 Just asking the question, you know, not what do I want to do, but how do you want to live? Because every, like I mentioned, touched on earlier, like even job whatever has a lifestyle attached to it. So you could, you know, go crazy and stay 12 hours a day at your practice, right. Taking every insurance and, you know, scheduling things yourself or, you know, you could outsource a bit, scale back and you no charge more for a better product and, you know, scale back, you know, lower overhead and kind of be more relaxed, slow paced. 00:42:09:02 - 00:42:30:16 Speaker 1 So that's kind of the direction I'm hoping to go, because I like that one on one time with patients, and I feel like I can deliver a better quality of care when I spend more time with a patient, rather than just bouncing around room to room, you know? And I feel like the patients pick up on that, you know, they they don't like to feel like a number. 00:42:30:21 - 00:42:34:31 Speaker 3 No, of course not. Where can people find the implant outlaw online. 00:42:34:31 - 00:42:43:19 Speaker 1 You can find us Woodside View Dental Care and you can find me the implant Outlaw on Instagram at outlaw. 00:42:43:24 - 00:43:06:36 Speaker 3 Love it. Thank you so much for being a part of this. And thank you, everyone for being a part of this episode of the Evolution of Dental Podcast. Please remember to share the show with your friends. We launch new episodes every Friday, look for us on all the major podcast platforms. Remember to like, subscribe, share the show with your friends and remember, never stop evolving.