Episode Transcript
00:00:00:04 - 00:00:19:40
Speaker 1
Keeps me on my toes. It keeps me on the cutting edge of everything I say. I owe my buddy like a lot. Like at least a nice Porsche. And I thought we were going to move to new Jersey. But apparently she had other ideas and she was going to move me to Long Island, and I got my photogrammetry unit.
00:00:19:45 - 00:00:31:02
Speaker 1
There were very few people who knew how to handle the data.
00:00:31:07 - 00:00:55:40
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 transforming the world of dentistry. I'm your host, Rob Norton, and today's guest came out of training about his certified and credentials as you could get Chief resident, three National Awards board certified. He built a practice in periodontal and implants over two decades.
00:00:55:40 - 00:01:12:40
Speaker 2
But then he did with a lot of other doctors, haven't done or don't know about and haven't reached and maybe never get to. He sold his practice. So today is not just going to be about credentials. Today is going to be about that experience, his experience, that kind of perspective and all that he brings to the world here in this conversation.
00:01:12:40 - 00:01:17:02
Speaker 2
We are pleased to have you. Doctor Adams, welcome to the show. How are you?
00:01:17:12 - 00:01:19:21
Speaker 3
Thank you. I'm great. Thanks for having me.
00:01:19:26 - 00:01:25:40
Speaker 2
Thanks for being here. So I'm going to ask. All right. Like, how did you get connected with evolution, dental science?
00:01:25:45 - 00:01:51:40
Speaker 1
When I started doing digital dentistry and I got my photogrammetry unit from Emeric. There were very few people who knew how to handle the data, and evolution was one of them. And so I got directed quickly to Josh Jackson. He guided me through it, and we've been doing that ever since. I mean, for over six years, I think.
00:01:51:40 - 00:01:59:02
Speaker 2
Now that's awesome. Yeah. There are a few people as skilled as Josh is in the digital dentistry world. Yeah, yeah.
00:01:59:04 - 00:02:12:31
Speaker 1
He actually taught me how to use the actual data, the I metric, the photogrammetry data in CAD, which is really cool. And so I've never, you know, I've never strayed from them.
00:02:12:36 - 00:02:16:50
Speaker 2
How did that. How did that change your daily workflow?
00:02:16:55 - 00:02:42:18
Speaker 1
Just an absolute game changer. I think that one of the reasons why I became a paradox and didn't say as a general dentist, was because I didn't want to take impressions, because I felt like that was very not precise and sort of difficult to know whether you got what you needed or didn't. So I like kind of straight away from that stuff.
00:02:42:19 - 00:03:07:24
Speaker 1
And then when digital dentistry came along and I was doing a little bit of restorative dentistry, a little bit of restorative implant dentistry, I should say, before that, you know, I used to use regular impression materials and whatnot, and it was okay. But once the digital came along its shape, it changed everything that I do. The way I do it, the ease, the accuracy, the predictability, success rates just night and day.
00:03:07:28 - 00:03:09:38
Speaker 1
So it's made everything so much more fun.
00:03:09:48 - 00:03:24:50
Speaker 2
Oh, it's definitely transform thing. So what what would you say drew you to dentistry in the first place? Like, not the elevator pitch, but like, what would you say? Like if you had the whole dinner party to discuss it? Like what? Where did that fascination start? Where did you begin that journey?
00:03:24:55 - 00:03:42:55
Speaker 1
I mean, to difficult question or an easy question about it, depending on how you want to look at it. My dad was a general dentist, but it's not as though I spent every day at his office watching him do things over his shoulder. He never pressured me. He said. Never said to me, okay, you need to be a dentist.
00:03:43:00 - 00:04:00:19
Speaker 1
And so I moved towards dentistry, and I guess I kind of knew what it was based on osmosis from living with a dentist, you know, and having a dad like that. And so that's how I got into it. But, you know, I wasn't like a kid who grew up, like saying, I'm going to be a dentist when I grow up.
00:04:00:19 - 00:04:02:40
Speaker 1
I it just kind of happened.
00:04:02:52 - 00:04:10:02
Speaker 2
It's a good fit. I mean, it sounds like you you threw yourself all the way into it coming out. You said your chief resident. I was not remembering that correctly.
00:04:10:02 - 00:04:20:04
Speaker 1
So I went to dental school, and then I went to a residency, and then I. Yeah, I was chief resident in my period program my final year.
00:04:20:09 - 00:04:29:14
Speaker 2
You immediately go into a practice, you start one of your own. You practice with your dad. What did that the transformation look like for you?
00:04:29:19 - 00:04:43:45
Speaker 1
So actually I'm going to give a shout out to my wife. I thought we were going to move to new Jersey, but apparently she had other ideas and she was going to move me to Long Island. And I said, I don't have contacts there. I don't like, you know, I don't know anyone. Don't worry. I'll get you a job.
00:04:43:45 - 00:05:09:09
Speaker 1
And she got me. She sent out resumes to, I think, every periodontist in Long Island. And and I got a couple jobs and one thing led to another and came out of my residency the first week of my residency, I finished on a Tuesday, and I started working here at Total Dental Care on a Thursday. And that was almost 20 years ago.
00:05:09:13 - 00:05:10:09
Speaker 1
Yeah. Wait, you.
00:05:10:19 - 00:05:22:07
Speaker 2
You finished on a Tuesday and then started it on a Thursday? I did. I don't think I've ever heard that one before. That's what was that like. Because like that's out of the fire pan and into the fire. Right.
00:05:22:09 - 00:05:25:50
Speaker 1
Like that was, you know, that was crazy.
00:05:25:52 - 00:05:28:48
Speaker 2
That was crazy. That was crazy. Yeah.
00:05:28:50 - 00:05:50:19
Speaker 1
Yeah, it was crazy, but it worked out. It was good. I never left here. You know, my dad was very old school dentist, and I guess I knew I kind of wanted to be, like, a little bit more cutting edge. I also was very interested always in the multi-specialty model. So that's what this is. That's what both of my practices are.
00:05:50:26 - 00:05:55:43
Speaker 1
So, you know, he had a little practice. It was great. Just wasn't for me.
00:05:55:57 - 00:06:09:28
Speaker 2
Just wasn't for you. You were. You said you're looking to get more cutting edge. Where along the way did you start adopting the cutting? And did you come in right out of the gate and go, we got to get into old scanners? Or was that something that came up like later on?
00:06:09:33 - 00:06:30:00
Speaker 1
Okay, so that's a great question. If I'm being honest. I had a I have a friend who was quite a great influence on me and told me, you know, you should get this, you should get that. And I got this and I got that. And he goes to the meetings and he travels the world, and he tells me about all the good stuff.
00:06:30:00 - 00:06:55:15
Speaker 1
And I say, I'm going to get that, I'm going to get that. And yeah, he keeps me on my toes. He keeps me on the cutting edge of everything. I mean, he's a great friend. And so we are friends anyway, so this is what we chat about and I'm interested in it. But he's always been very helpful with like telling me, okay, this is this is what's going on out there.
00:06:55:19 - 00:06:59:52
Speaker 2
That's awesome. And does he also practice in the same area or is he somewhere way across the country?
00:06:59:55 - 00:07:01:40
Speaker 1
He's in new Jersey okay.
00:07:01:43 - 00:07:13:26
Speaker 2
Yeah yeah yeah yeah. Do you let. So here's here's here's a question about it. Yeah. Do you let him stub his toe on new tech first or do you jump in feet first with him?
00:07:13:31 - 00:07:19:31
Speaker 1
He's not a stub his toe kind of guy. He's a he's he's doctor perfect. I mean, he's.
00:07:19:33 - 00:07:19:45
Speaker 2
Just.
00:07:19:48 - 00:07:25:24
Speaker 1
After perfect. He's he's he's he's an ace. He doesn't he's. No.
00:07:25:36 - 00:07:28:55
Speaker 2
So you know, if he's he's brought it in, he's vetted it.
00:07:29:02 - 00:07:54:19
Speaker 1
I mean actually that is a good question because sometimes he is the guy who vets the product. Right. And he won't tell me to get something unless he's done quite a bunch of research on it. But sometimes as a a key opinion leader and the guy who, you know, is testing the the product or the device or whatever.
00:07:54:21 - 00:08:11:06
Speaker 1
Yeah, he does have some insight. And, I guess you could say he stubs his toe for the companies, you know, so that I don't have to. But in reality, he doesn't, you know, he he, he knows his stuff inside and out, like there's no missteps.
00:08:11:10 - 00:08:22:55
Speaker 2
And so that's a tremendous resource for you. And, you know, it's awesome that he that he goes out and seeks out that kind of. So what have been some of the bigger, what have been some of the bigger technologies you've adopted from that over the years?
00:08:22:55 - 00:08:49:52
Speaker 1
So I was just thinking that that was going to be the next question. And the answer is going to be kind of boring, because there's really only two pieces of equipment that I use technologically, or three, you know, a CT scan and an internal scanner and photogrammetry. And with those three tools pretty much do what I do. I have not gotten into facial scanners just yet.
00:08:49:52 - 00:08:58:00
Speaker 1
I want to besides that, I think I'm using pretty much the right stuff.
00:08:58:04 - 00:09:15:43
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.
00:09:15:45 - 00:09:42:04
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. How was that shift from going to the analog way before to using this technology now? Like how has that changed what you can deliver to the patients? And frankly, how's that changed your personal life? Like, I mean, does that mean you spend more time at the clinic or less?
00:09:42:09 - 00:10:10:43
Speaker 1
It doesn't change the amount of time that I spend here. It increases my productivity so that I can do more things in less time. Because everything is much, much, much more efficient. Patients benefit from it tremendously because the outcomes are just night and day. The amount of try ins, the amount of reduce and remakes is just cut to very, very little.
00:10:10:48 - 00:10:38:38
Speaker 1
The confidence with which I can do things is skyrocketed. The stress with which I do things is so much less than it was. It's just it's incredible. It's night and day from how we did it before. It's. Yeah, I say I owe my buddy, like, a lot. Like at least a nice Porsche. Like a nice Porsche 911 or something.
00:10:38:45 - 00:10:52:00
Speaker 1
And, and and I know in my heart, like I owe him. I owe him tremendously for introducing me to his technology. And I will make good on it. You know, just someday.
00:10:52:04 - 00:10:58:40
Speaker 2
Somebody needs to share the episode with him. Hey, man, like I'm looking for a Targa.
00:10:58:45 - 00:11:02:48
Speaker 2
I want to read and.
00:11:02:52 - 00:11:06:57
Speaker 1
That's great. I know, I know, I know what he likes, so I'll be fine.
00:11:07:09 - 00:11:07:57
Speaker 2
That's perfect.
00:11:08:09 - 00:11:33:35
Speaker 2
And correct me if you think otherwise, but one of the things I think is probably underrated there that maybe kind of buried just just slightly under the surface that you brought out, talking about your friend there is just the power. Putting aside the technology, putting aside specific to practice management and certain cases like the relationships you build with other doctors and colleagues in the industry like you, just you can put a dollar figure on it.
00:11:33:35 - 00:11:38:35
Speaker 2
But I mean, you you called it a new nine over 11. So, you know, we can put a dollar figure on that.
00:11:38:35 - 00:11:41:52
Speaker 1
And that's that's an understatement a tremendous.
00:11:41:52 - 00:11:57:18
Speaker 2
Yeah. And just like so like that debt of gratitude but like that kind of advantage to if you didn't have this friend, you know, if you didn't have the network of people that you already have, you know, where would you be? Just out here in the market kind of shopping and bumping around stubborn your toe, as we were discussing earlier?
00:11:57:23 - 00:12:12:59
Speaker 1
Yeah, I think that's one of the things I love about evolution is I feel like I'm working with and rubbing elbows with these guys who are just on the cutting edge. We're traveling the country and every show and know every little new thing that's I like that.
00:12:13:09 - 00:12:23:52
Speaker 2
That sounds like you found a really good system. You outsource it to the people who really, really love the tech like we do, like your friend does. And then let us, let us dive into all that, and then you can reap the benefits on the other end, because I.
00:12:23:52 - 00:12:33:40
Speaker 1
Do like how it source. I've always been into outsourcing because I know, I know what I'm good at it. And I can like, you know, let other people do what they're good at.
00:12:33:45 - 00:12:44:35
Speaker 2
That seems like it might be a pretty good segue to. So I mentioned at the beginning of the at the intro, like, so you sold your practice, right. And so your responsibilities have changed there.
00:12:44:45 - 00:12:46:21
Speaker 1
So I have two practices.
00:12:46:23 - 00:12:47:09
Speaker 2
Two practices.
00:12:47:09 - 00:12:56:42
Speaker 1
I sold one, the one that I'm at today, the one that I use most of the technology and I, I sold in 2023.
00:12:56:47 - 00:13:01:33
Speaker 2
And what brought you to that decision and what's that experience been like for you?
00:13:01:37 - 00:13:04:35
Speaker 1
So.
00:13:04:40 - 00:13:29:30
Speaker 1
Back to, you know, where I started. So I came out of school, I started at this office, that week I finished my residency, and a couple years later, the owner was going to sell the practice. And I was thinking to myself, well, I don't really want to look for a new job. I was working there a couple days a week, so maybe I'll just buy it now.
00:13:29:30 - 00:13:48:23
Speaker 1
The thing was, this was I was in a little bit over my head. It is a 17 chair practice with multiple general dentists, and an oral surgeon was on staff, you know, bunch of high genius.
00:13:48:28 - 00:13:50:57
Speaker 2
Yeah, that's not a practice. That's an operation.
00:13:50:59 - 00:14:21:28
Speaker 1
Right. So. So I stepped up and I said, okay, I want to buy it. You know, and long story short, and I ended up buying it and I owned it for 13 years. And it was great. And it was amazing. I went through Covid, which was difficult. That was a tough, tough time. I had like 50 employees or so, and it was a challenging time going down and getting back up and again.
00:14:21:30 - 00:14:43:30
Speaker 1
I always had good people around me. I had a great team surrounding me, so I was fine. But 13 years later, the whole thing became tiring. It's difficult to manage at a manage multiple managers who managed multiple people. And you know, and I was working full time. It wasn't like I was coming here and doing administrative stuff.
00:14:43:30 - 00:15:10:16
Speaker 1
I was never doing administrative stuff. I was always doing dentistry. And then, you know, managing the management. And that was not so easy. And then managing a payroll of half $1 million a month was a little nerve wracking and got to me after a while. So when one of these dsos came knocking and they were interested in one of these large monster practices.
00:15:10:21 - 00:15:30:42
Speaker 1
I it was the timing was right, and I went for it. And I anticipated working for them, which I do. And so my existence hasn't changed much. I still do all my clinical stuff. I just don't have to worry about all the management of the of the practice. And it's been great. Been really great.
00:15:30:47 - 00:15:40:21
Speaker 2
Yeah. So so what does a typical day in the office look like for you? With an office with a practice? It has, you said 17 chairs in like 100 doctors basically.
00:15:40:25 - 00:16:04:47
Speaker 1
Yeah. So a few, a few general dentists, a periodontist, a bunch of hygienists was a typical day look like. I mean, it's great because you see a lot of stuff as a specialist. I get called down here and there to get an opinion on this or that. There's lots of exams to be done. So there's lots of interesting things to see.
00:16:04:52 - 00:16:26:47
Speaker 1
And then, you know, I have my own my own schedule on top of that, seeing all my new patients and my procedures and whatnot. But because of all the, you know, all the patient flow and all the doctors treating patients, a lot of things come up. And so, you know, I'm called in for consultations a lot, and that's a lot of fun.
00:16:26:52 - 00:16:37:52
Speaker 1
It's fun being now, as a more senior dentist, I can render an opinion and help out younger practitioners and teach them some things. So it's a really nice environment.
00:16:37:57 - 00:16:49:04
Speaker 2
Sounds like you've had a lot of the more stressful aspects of running the practice lifted off your shoulders, but the things that you enjoy are still in your hands. Yeah, yeah.
00:16:49:09 - 00:17:09:06
Speaker 1
And and it's still feels like my practice. And I still get the respect as if it's my practice. I just don't have to make the decisions that I don't want to make. And honestly, I always was like that, even when I did own it. Any kind of difficult situations, I'd kind of scoot around as much as I could to avoid them because I never liked that.
00:17:09:06 - 00:17:11:18
Speaker 1
So now you know.
00:17:11:23 - 00:17:15:11
Speaker 2
Now that's their problem and not yours, and you get to do what you love. Yeah.
00:17:15:11 - 00:17:17:06
Speaker 1
It's a good place to be.
00:17:17:11 - 00:17:22:16
Speaker 2
How was the how was that conversation? So did they. You said they approached you.
00:17:22:21 - 00:17:32:30
Speaker 1
They I guess they send letters to practices. And so one day I got a nice letter from.
00:17:32:35 - 00:17:48:54
Speaker 1
One of the representatives from the DSO and said, okay, you know, do you want to meet up for dinner? I said, sure, and we met up for dinner and had nice conversation. And I said to them, look, you know, I'm more than interested in selling the practice, but it has to make sense financially for me and my family.
00:17:48:54 - 00:17:53:40
Speaker 1
And and it did. And it was simple and easy.
00:17:53:45 - 00:17:55:59
Speaker 2
How did that feel?
00:17:56:04 - 00:17:58:40
Speaker 1
Oh. Felt great. Felt like winning.
00:17:58:45 - 00:18:04:11
Speaker 2
Felt like winning. See, it felt like winning. And not like you were losing the thing that you built.
00:18:04:16 - 00:18:30:13
Speaker 1
No. Because. Because in reality, I didn't build it, I bought it. That's fair. Bought it, so I didn't I didn't create it I my only goal was to not destroy it during my tenure there, you know. Okay. And while we were, while we did own it, we grew and we did fine. But no, it was no, it wasn't like, oh, I, I, I mean, and plus I'm still here.
00:18:30:13 - 00:18:34:21
Speaker 1
I don't miss anything. I don't, you know, I don't miss any. No.
00:18:34:25 - 00:18:36:49
Speaker 2
He didn't hand it off and. Okay. Goodbye. Have fun.
00:18:36:52 - 00:18:38:54
Speaker 1
No no no.
00:18:39:04 - 00:18:58:09
Speaker 2
So so you you look at yourself. Correct me if this is wrong, but it sounds like you look at yourself more like a steward of this practice. Like it was in a place where they weren't sure where they were going. And then you stepped up and bought the practice and took it along and said, 13 years. Yeah, 13 years, a long time.
00:18:58:09 - 00:19:08:52
Speaker 2
And then when you had somebody come that you felt like was a good fit, then you handed it off to them and you're still still here taking care of things, but concentrated more on the things that you really like doing.
00:19:09:01 - 00:19:22:11
Speaker 1
That is true. Yeah. Yeah. And and I still am a steward of the practice and they are as well. And you know, everything is going just fine.
00:19:22:13 - 00:19:26:01
Speaker 2
That's excellent. Let me say you have two practices you work with.
00:19:26:06 - 00:19:46:13
Speaker 1
So I have another practice in also in Long Island in New Hyde Park where it is me and a partner. And I do periodontics and he does general dentistry, and that's where I spend my other half of the week. I spend half my week here and half my week there. Gotcha. It's a much smaller, smaller operation.
00:19:46:17 - 00:19:56:04
Speaker 2
Much smaller operation. What is it about that one that you like. Like what drew you to either starting that or getting involved with that second practice.
00:19:56:09 - 00:20:21:25
Speaker 1
So this came first. But it was only, you know, a two and a half day schedule because it's hard to have that much volume as a periodontist, you know, as a specialist. And so the other practice, I had the opportunity to buy also because I really do like to be, you know, I do like to own as much as I can for as long as I can.
00:20:21:30 - 00:20:43:04
Speaker 1
But, this practice was going to fill my other days, and it was a good opportunity. And I have a good partner. I was a good, you know, partnership that we developed and a good practice that we purchased and then developed. It just kind of happened that way. It wasn't like this organized plan.
00:20:43:06 - 00:20:44:35
Speaker 2
Kind of came together.
00:20:44:40 - 00:20:47:37
Speaker 1
I needed to fill my time, you know.
00:20:47:42 - 00:20:53:30
Speaker 2
Was the was the partner you work with or somebody you knew beforehand as a long term friend or somebody you found through the grapevine?
00:20:53:33 - 00:21:15:40
Speaker 1
Know somebody somebody at a study club, an oral surgeon? My, my now partner was friends with him, and he put us together sort of like little matchmaking type of thing. He's a general dentist. There was a paradox, and he knew that he was looking for a partner, and we hit it off and we built that.
00:21:15:45 - 00:21:21:45
Speaker 2
That's awesome. Yeah, yeah. Sounds like it just kind of came together. Good people working together, and it feels the rest of the time for the week.
00:21:21:52 - 00:21:26:42
Speaker 1
And that's been going strong for almost 20 years now too.
00:21:26:47 - 00:21:32:28
Speaker 2
Fantastic. And I understand you do a lot. You do a lot of over dentures. Is that right?
00:21:32:33 - 00:21:37:01
Speaker 1
Not as much as I would like, but still tremendously.
00:21:37:06 - 00:21:38:35
Speaker 2
Not as much as you would like.
00:21:38:37 - 00:22:14:58
Speaker 1
Well well, I, I would, I wish and I've spoken to people and experts, I wish that I didn't have to do direct chair side pick up as the last stage of the over denture process. So when I do my photogrammetry, everything fits perfectly and screws down. I wish that with my over your workflow at the very end, I didn't have to chair side attach, you know, housings and loot them in place in the patient's mouth right there.
00:22:14:59 - 00:22:30:23
Speaker 1
I wish it would come from the laboratory with them already in place, but I know that there's still some limitation with the digital data where it's just not as perfect if you do it indirect in comparison to doing the last step in in the chair with the patient there.
00:22:30:28 - 00:22:31:40
Speaker 2
Gotcha.
00:22:31:45 - 00:22:39:57
Speaker 1
What else is great? Everything else is, you know, everything else is really good. And, you know, digital scanning and all that stuff is great.
00:22:40:01 - 00:22:54:13
Speaker 2
What do you think the gap is there if you can speak to it? Because personally I've done thousands and thousands of crowns. I've done like for over dentures with the help of some colleagues. So like this is an area that I'm not particularly well versed in.
00:22:54:13 - 00:23:00:24
Speaker 1
I'm trying to speak to everyone about a workflow for that so we can avoid the chair side pick up,
00:23:00:29 - 00:23:24:41
Speaker 1
you can attach locator housings to multi-unit abutments. And the only thing you can do with photogrammetry with right now is multi-unit abutments. So if you could put multi abutments and then put locator housings on them, or if you could put multi-unit abutments and all that data to the lab and actually create an accurate model.
00:23:24:46 - 00:23:46:48
Speaker 1
And then in the lab they build an accurate model. They put the locator housings on there, they build the prosthesis on top, and they send you all that. You put the locators in on top of those multis that were already there. And then the prosthesis should snap on and off. But that's a lot of steps. Maybe a little bit of waste, maybe a little bit of overkill.
00:23:46:53 - 00:24:05:46
Speaker 1
Maybe not something that the industry would really appreciate or really want to do. Maybe not be worth it. But in my world, that could be. That could be the workflow multi Units Photogrammetry Laboratory does most of the prep work based on that I think it could be done.
00:24:05:51 - 00:24:22:08
Speaker 2
As you say, just in your world. But I'm certain you're not the only one and all is super popular right now. But it's not always the answer. Like how do you choose? How do you recommend for a patient? What's your path of choosing like go for an all on X, go for a denture, go for an over denture.
00:24:22:12 - 00:24:25:39
Speaker 2
Where does your thoughts land on that?
00:24:25:44 - 00:24:49:58
Speaker 1
At this point, I think that anybody who can have a fixed implant restoration should and it's better. I think it's a lot less maintenance. I think it's a lot better for the implants, healthier for the tissue. I think that the in the, you know, the in and out of the over denture puts a lot of stress on those those implants.
00:24:49:58 - 00:25:10:00
Speaker 1
I think they do better when it's just fix and splintered together. So in most cases we're steering in the direction of fixed if they can. But it really comes down to finances. We offer, you know, the highest plan and middle level and lower levels. But patients generally make our decisions based on finances.
00:25:10:05 - 00:25:15:39
Speaker 2
It makes a lot of sense. What do you see more of these days?
00:25:15:44 - 00:25:19:28
Speaker 1
It's a great question. I'd say it's 5050 now.
00:25:19:39 - 00:25:21:27
Speaker 2
5050.
00:25:21:32 - 00:25:40:00
Speaker 1
And again, just due to the financial decision, you know some people want the implants, you know, and it's the lowest level plan of just dentures is really not attractive anymore. So people will opt for the over denture rather than nothing.
00:25:40:10 - 00:25:44:48
Speaker 2
Just kind of a half step in between there. Yeah. What's your.
00:25:44:48 - 00:25:46:12
Speaker 1
Workflow look like.
00:25:46:17 - 00:25:57:17
Speaker 2
What's your workflow look like with say, the over dentures versus say on all on X. Patient comes in the door and says, hey, I need teeth. Where does it go from there within your practice.
00:25:57:22 - 00:26:05:29
Speaker 1
So let's talk about the over denture first. So if they come and they're.
00:26:05:34 - 00:26:30:00
Speaker 1
They have failing dentition. If they're dentists they already have a set of dentures. Then we simply place the implants, let them heal and then do internal scanning. Place locators, use locator scan bodies, do try ins until we get a perfect prototype. And then the last time is the final restoration and we do the chairs I pick up.
00:26:30:05 - 00:26:58:08
Speaker 1
If they have an existing dentition, and we try to fabricate immediate dentures and do the surgical aspect, get the extractions and the implants, place what those heal and then make the implant over dentures after that for the on x if they come and their dental, then we scan them where they are and we plan the case. And then we do the surgical visit.
00:26:58:08 - 00:27:25:00
Speaker 1
And that same day we usually use fiduciary markers and scan again and place our implants and scan again and do our photogrammetry. And then we send all the data to you guys. And actually I have to check because I just sent some data over. I need to make sure my local lab will mil a PMMa restoration and then I deliver it next day.
00:27:25:00 - 00:27:39:27
Speaker 1
I do not do same day. I can't, I can't do it. Just too stressful on everyone a patient and me. And so we do next day deliveries of fixed prosthesis.
00:27:39:32 - 00:27:48:29
Speaker 2
Next day deliveries. Yeah. The same days is become incredibly popular in a lot of ways. How do you feel about the same day? I mean, obviously you said it causes stress on you and the staff.
00:27:48:29 - 00:27:53:29
Speaker 1
So we,
00:27:53:34 - 00:28:24:20
Speaker 1
Well, at the beginning of the workflow, we used to take a denture and drill holes and loot cylinders and send them home, and it was just not good. Then we moved on to we got a 3D printer and we would try to do the surgery, manufacture the prosthesis all in the same day. It was just not not ideal.
00:28:24:24 - 00:28:53:22
Speaker 1
And so now we move to next day. It just makes things a hell of a lot easier. And honestly, I think the patients are happier doing that because it's a long day. It's a long day without having to do the final prosthesis. And I also prefer milled PMMa restorations as temps over my 3D printed restorations, which we can do in a jam, but I prefer the PMMa.
00:28:53:27 - 00:28:56:29
Speaker 2
What is it you prefer about the PMMa?
00:28:56:34 - 00:29:09:51
Speaker 1
Holds up better. Definitely stronger because every once in a while you will have a fracture of a provisional prosthesis and that's no fun. So I'd rather take that out of the equation.
00:29:09:56 - 00:29:17:15
Speaker 2
Yeah, having a male PMMa in a space gap of a day definitely sounds like it gives you that kind of the that kind of ability.
00:29:17:20 - 00:29:23:20
Speaker 1
Yeah. It also, you know, it's just it's a it's a nice product. It's a good product.
00:29:23:24 - 00:29:47:12
Speaker 2
Yeah. They've had been around now at least good 25 years. Like they've really they you can buy PMMa that the discs rival the cost of zirconia but also the esthetics rival the cost of zircon. It's still plastic. It's still I mean once it's that poly methylene mono acrylic or something like that. But it such a beautiful product by comparison to some others.
00:29:47:15 - 00:29:54:48
Speaker 2
The 3D printers have come a long way, but they can't do the multi layering stuff just yet. Like you can get into the pavement.
00:29:54:53 - 00:30:02:44
Speaker 1
Yeah, I do like my 3D printer but.
00:30:02:48 - 00:30:06:34
Speaker 1
Just I'd rather outsource that. At this.
00:30:06:34 - 00:30:11:34
Speaker 2
Point it's more of a stopgap and less part of your just regular workflow. It sounds like.
00:30:11:41 - 00:30:18:15
Speaker 1
Yeah, yeah, it's fun, it's it's fun and all, but it's. Yeah.
00:30:18:20 - 00:30:34:39
Speaker 2
I mean, I'd be lying if I said that the fun of 3D printing and digital manufacturing wasn't a huge part of what pulled me into dentistry in the first place. So, yeah, I can relate to that for certain. So speaking of fun, what do you what do you like to do? Outside of the outside of the office, especially since you have a little bit more bandwidth in the headspace?
00:30:34:48 - 00:30:39:44
Speaker 2
What do you have any hobbies or things you'd like to get into outside of dentistry?
00:30:39:48 - 00:31:08:00
Speaker 1
So my main hobby is hanging out with my family, especially my three boys. I have 14, 14, there are twins and a 16 year old boy, and so my life revolves around them and any other activities, and it doesn't leave a tremendous amount of space for me and my stuff. My passion since I was a little kid was cars, and I love cars.
00:31:08:05 - 00:31:32:46
Speaker 1
I actually pursued getting a wholesale car dealers license so I can buy and sell and trade cars and be on the inside of all of that. So that's how into cars I am. And then aside from that, whatever these guys are into, whatever my boys are into tennis, we play tennis together. I have one boy who plays pickleball, so I play pickleball with him.
00:31:32:53 - 00:31:41:34
Speaker 1
I like boating, like to be out on the water. I.
00:31:41:39 - 00:32:07:46
Speaker 1
Do a little bit of, like, DIY stuff at home. I like to, you know, get my hands dirty on all kinds of projects and landscaping and building stuff. I think that's like a lot of fun. And that about fills my life because, you know, I try to be healthy, you know, go to sleep early. I spend all the time I get with my kids and my wife, and that's pretty much it.
00:32:07:48 - 00:32:15:29
Speaker 2
It sounds like a pretty full life. And hey, man, 14, 14 and 16, they're going to be if they're not already into cars, they're going to be in the car soon.
00:32:15:41 - 00:32:39:29
Speaker 1
I think that I am so into cars that they are not into cars, if you know what I mean. Like sometimes they so and I think that's a good thing because now I have a kid who's 16 who's going to get a driver's license in October, and he does not care what kind of car he gets. So he's not like, I need a so it's another car for me to like pick out for him.
00:32:39:29 - 00:32:40:58
Speaker 1
And that's.
00:32:40:58 - 00:32:45:22
Speaker 2
What I mean. I'm a big car guy myself. What kind of cars are you into, man?
00:32:45:27 - 00:33:21:56
Speaker 1
Me personally, Porsche's Porsches. Yeah. Yeah, I actually keep a an album on my phone and I call it History of Cars. And I have had many a nine over 11, including nine, six fours. And the thing that some people don't take into consideration with the investment is yes, it can appreciate in value, but it also when you consider all the expenses to to own maintenance and especially some very costly maintenance on those kind of cars, on those air cool cars and the insurance and the this and that.
00:33:22:05 - 00:33:42:20
Speaker 1
Yes. From what you bought it for, to what you sell it for will increase. But the maintenance, you're not getting that much. I mean, unless you're real lucky, you know, if you've ever rebuilt an engine, you know, it's expensive and painful on a nine over 11. It's a big ordeal.
00:33:42:20 - 00:33:46:10
Speaker 2
And you can't just take that to, you know, Jiffy Lube.
00:33:46:15 - 00:33:54:27
Speaker 1
No, you just you just wouldn't. You have to. You got to take it to the specialist. It's like photogrammetry, you know? Not everybody knows how to handle it. It's just gotta take it to the source.
00:33:54:27 - 00:34:16:51
Speaker 2
So yeah, absolutely goes back to the relationship thing we were talking about cultivating before too. Because like if you know the right people then you can maintain these cars. I mean I've had the the German car affliction since I was like 16. And if it weren't for knowing the right people over the years, there's no way I could have had any of these ridiculous cars I've had.
00:34:16:53 - 00:34:35:12
Speaker 2
And even then, like, I probably would have a house a lot earlier in my life than I do now. But, you know, having gone through this process, is there anything you'd do differently, or what advice would you give to other doctors that are considering selling? Because lots of doctors talk about selling and then they sell about the same time they hear the dirt hitting the top of the lid on the coffin.
00:34:35:17 - 00:34:41:48
Speaker 2
So what? What would you say to anyone who's thinking about it or planning ahead for the future?
00:34:41:53 - 00:35:11:51
Speaker 1
I mean, it has to be right for each individual provider and each individual situation. Like, I have a perfect situation because I have my own practice, you know, where we're independently operating. And then I work for a DSO, so I don't have all my eggs in one basket. And I think that's an important thing. If it's not right for you and you find out that it is, and that's your only existence, that can be a big problem.
00:35:11:51 - 00:35:34:27
Speaker 1
So I don't necessarily give advice. I don't tell people to, you know, do what I have done. It just works. It just worked for me. And I'm pretty easy going guy. I'm the kind of guy that makes something work. I'll make it work for me, but I wouldn't suggest it for everyone and anyone. And there's not enough research you can do to find out whether it's going to work for you until you get completely into it.
00:35:34:27 - 00:35:36:27
Speaker 1
I think.
00:35:36:31 - 00:35:49:32
Speaker 2
That sounds pretty fair. Is there anything that you think you would do differently if you had, if you could do it over again?
00:35:49:36 - 00:35:52:41
Speaker 1
Honestly. Not really.
00:35:52:46 - 00:36:00:00
Speaker 2
That's beautiful. Like absolutely beautiful. Like. No was a great answer. No. Oh, man.
00:36:00:15 - 00:36:32:36
Speaker 1
The DSO that I worked with was great. You know, it was not a lot of back and forth with the contracts. Everything was pretty fair. And now I am approaching three and a half years with them, and everything's been completely on the up and up for me. Everything that was promised has. I can't say anything negative about the experience for me in my situation.
00:36:32:39 - 00:36:39:51
Speaker 1
I know a lot of people that have, you know, terrible things to say about these different dsos, but my, my experience has been great.
00:36:40:05 - 00:36:59:20
Speaker 2
Sure. I mean, everybody has different experiences. All we're all just people at the end of the day and we're all different people. And so not everybody's friends with everybody. So that makes perfect sense. But it's it's incredibly reassuring to hear somebody say, no, actually this went out and I wouldn't change anything in three years. You're outside that honeymoon phase.
00:36:59:20 - 00:37:01:24
Speaker 2
So it's clearly working.
00:37:01:29 - 00:37:22:24
Speaker 1
Yeah, I mean, I, I come to work, I treat the organization if it's my as if it's my own and treat my patients the same way that I would treat them anywhere or at any time. So, you know, it's easy like that. For me.
00:37:22:29 - 00:37:27:44
Speaker 2
It's incredible. Man. Thank you so much for being a part of this. I appreciate you taking the time to speak with us today.
00:37:27:48 - 00:37:49:34
Speaker 1
No, I mean, I have a tremendous amount of respect for evolution. What you guys have done and are doing, it's it's been a great ride with you guys. So that's why I'm happy to do this. This is out of my comfort zone and out of my wheelhouse completely. But for you guys, I will do it.
00:37:49:39 - 00:38:07:03
Speaker 2
Well thank you. And it's working with people like you. It's working with the partners that we work with that really make all this come together. We wouldn't be here without you and vice versa. So thank you again man. I appreciate you joining us. Is there if people want to look up total dental care or you is there a place online that they can do it.
00:38:07:08 - 00:38:26:12
Speaker 1
So total dental care is now a smile list. So you can look up the smiles. Com and you can look for me. I don't have a tremendous internet presence, but you can certainly Google my name. I'm the only Adams cough in the world. So pretty easy to find me and figure out everything that I do and where I am.
00:38:26:17 - 00:38:29:03
Speaker 2
That's awesome. Thank you again for being a part of this.
00:38:29:03 - 00:38:30:08
Speaker 1
Thanks for having me.
00:38:30:22 - 00:38:45:29
Speaker 2
And thank you everyone for tuning into this episode of the Evolution of Dental Podcast. Please remember to look for us on all the social media platforms like subscribe, share the show with your friends and helps out more than you know. And please never stop evolving.
