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Howard Farran:
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It is a huge honor for me today to have my buddy Cory Glenn back on the show. This is the second time you've been on, right?
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Cory Glenn:
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Second time, yeah.
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Howard Farran:
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You are everyone's legend, you are everyone's idol. I think Armond said the sweetest thing ever about any dentist ever was that the thing he loved about you the most is that you are so passionate to learn everything about quality dentistry just for patient care, just for the right reasons, and the he says you never even factor in if this is going to grow your business, make you more successful, you just are so hungry and passionate for all the knowledge for all the right reasons. You're just everyone's favorite dentist, you really are. Everyone is so concerned about you because you had a health scare a while back. Did you want to talk about that, or did you not want to mention that?
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Cory Glenn:
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Sure, no, absolutely. I tell you, that all came about not too long ago after our last podcast. I started having just a lot of tiredness and a lot of back pain, just some weird symptoms. Bruising and things like that. Right before Christmas I actually went to the doctor because I was actually in an extraction and my hand cramped up so much that I just couldn't undo it. The blood work came back really messed up and it turned out I had leukemia.
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I got the call that I had leukemia the day after Christmas. Acute promile acidic leukemia. We immediately had to go to Nashville and be admitted, and stayed in the hospital under kind of where I couldn't see anybody, I couldn't go outside of my hospital floor just because my immune system was so down for little over a month, and so we've since been gone into remission. Now I'm doing another 28 weeks or seven months of consolidation therapy with chemo to try and hopefully keep it gone. It's been a while ride the last few months.
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Howard Farran:
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That all started the day after Christmas, and tomorrow's Valentine's Day.
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Cory Glenn:
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Yeah.
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Howard Farran:
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Cory, will you be my valentine?
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Cory Glenn:
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Sure, I'd be happy to.
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Howard Farran:
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Or are you already spoken for?
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Cory Glenn:
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Yeah, my wife may take issue with it.
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Howard Farran:
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How's the wife and three kids doing through all of this?
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Cory Glenn:
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They're doing great. My wife has been incredible and she has stood by my side. She is mamma bear and she will not let me out of her sight. She's been at every doctors' appointment, stayed at the hospital the whole time. She's been really amazing. If you ever want to help a marriage, getting cancer is a great way to do that, because I'll tell you, it really puts perspective on what's important.
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The kids are doing good. We're starting to be able now to come home on the weekends, and usually maybe a day during the week for treatment. We're seeing them more and that's helping a whole lot. They're doing well.
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Howard Farran:
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How old are you and how old are the children?
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Cory Glenn:
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I'm 34, and my oldest is seven, and then I got a four and a two-year-old.
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Howard Farran:
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At seven, four and two do they know what's going on?
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Cory Glenn:
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The seven year old does. The four year old, she just knows she wants it back to normal and wants mom and dad at home. The two year old kind of the same way. She just wants it back to normal, but they don't really comprehend as much the seriousness of what all's been going on.
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Howard Farran:
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You have one wife and three daughters?
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Cory Glenn:
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Yes.
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Howard Farran:
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Wow.
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Cory Glenn:
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And six female office staff, so I'm outnumbered everywhere I go.
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Howard Farran:
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You have 10 women in your life?
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Cory Glenn:
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Yes.
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Howard Farran:
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You have six women at the office and a wife and three daughters?
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Cory Glenn:
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Yep.
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Howard Farran:
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You're probably the most cared for man on earth.
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Cory Glenn:
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I'd says that's a pretty fair statement.
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Howard Farran:
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I think any man would be a lucky genius if he had 10 women looking after him.
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Cory Glenn:
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Yeah.
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Howard Farran:
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How's your energy level now?
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Cory Glenn:
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It's not where it used to be. That last couple of months before Christmas I was really, really tired. I would go to the office and hit it hard all day, and by the time I got home my back was hurting so bad and I was so tired that I would lay down and that was pretty much it. It's a lot better than it was, but I'm still probably only at maybe 50% energy level, so I do tire out easy, but depending on what I'm doing, just talking, things like this, doesn't really bother me too much.
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Howard Farran:
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The lower back pain and your hand spasming, this causes muscle spasms, is that what it all is?
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Cory Glenn:
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I guess so. The muscles spasms have since gone away, the back pain hasn't. I know part of that can be the drugs that I'm taking. They can cause a lot of muscle soreness and achiness, and some other side effects, but I won't really know until I go off of those whether that's something that was prior to me developing this or if it's just part of the medicine.
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Howard Farran:
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Having the rug pulled out from underneath you at 34, what were the personal, spiritual reflection takeaways?
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Cory Glenn:
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Gosh. I'll tell you when I first got diagnosed, when I went that day and got the blood work done and they called me back and said that I had pancidopenia, meaning basically all my blood cells were nothing. I knew immediately something was seriously wrong, and so from that second on all I could think about was my kids. What am I going to do if I can't be with them? Everything else took a back seat. The practice, my teaching, patients, all of that took a back seat to my family and being there for them.
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It also put in perspective a lot of the things we chase that are just not that important: the money, the prestige with the lecturing, all of that stuff just didn't matter to me whatsoever anymore. That's been a big eye opener, and for that I'm really thankful because it's kind of given me the opportunity to push reset on life and hopefully get going back again but with the priorities on the right things.
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It definitely makes you appreciate your health. You take for granted the ability the just go do anything you want to, to be healthy, to know that your body's going to be there for you and be able to respond, because for the first time in my life I couldn't control this. I couldn't work out hard enough or just work at anything hard enough overcome it. It was just totally out of my control. Definitely a lot of thankfulness for my health, for my abilities, for my mind, all of that. We really take that for granted. That was a huge eye-opener as well.
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Howard Farran:
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What are the stages? What did they used to say back in the day? They were denial, shock, anger, acceptance? Is that what it is? Is that the order, denial?
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Cory Glenn:
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I think it was. I think I jumped straight to acceptance because I'm telling you the moment I got the call from the doctor, I absolutely knew it was something wrong and there just wasn't any question in my mind. When you get told you have cancer, you don't hear it as "You have cancer," you hear it as, "You're about to die." That's exactly what I thought, so I was so thankful. We were initially told that I had AML leukemia, and so if you look up the statistics on that it's about a 30% survival rate. I was pretty down about that. That's not great odds.
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When we got admitted to the hospital the doctor actually told us that we had APL, which is a sub-type of it. It's actually the most curable type of leukemia, so that was a huge burden lifted off our shoulders and gave us a lot of encouragement to try and fight this the best we could. They fully expect a full recovery, and this is the most curable. Most people that have this actually are totally cured and don't have to fool with it anymore at all.
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Howard Farran:
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When I first saw you on the screen I thought you were in mourning because you're in beautiful Tennessee and you're wearing an Arkansas shirt. I didn't know.
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Cory Glenn:
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I'm a native Ar-Kansan.
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Howard Farran:
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You what? You're a native?
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Cory Glenn:
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Native Ar-Kansan, so we have a split household here.
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Howard Farran:
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It's funny how some people call that Arkansas, and when I was in Kansas it was pronounced Arkansan, and it was the Ar-Kansas river. Then you cross the line into Arkansas and it became the Arkansas river.
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Cory Glenn:
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It's definitely the Arkansas.
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Howard Farran:
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It's the Arkansas river? It's not the Ar-Kansas river?
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Cory Glenn:
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No question, it's Arkansas.
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Howard Farran:
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I feel like I grew up in that river. Went to Arkansas. You were born and raised where, in Little Rock?
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Cory Glenn:
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No, in Jonesboro, which is Northeast corner fairly close to Memphis. We were about an hour from Memphis and that's where I ended up doing dental school as well.
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Howard Farran:
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Sam Walton was from Bentonville, Arkansas.
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Cory Glenn:
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Bentonville. That's the Northwest corner of the State.
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Howard Farran:
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You were in the Northeast corner of the State?
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Cory Glenn:
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Yep.
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Howard Farran:
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I think that's the most overlooked state. There's a couple states that are the most beautiful that no one ever talks about. It's the Carolina's, it's Arkansas, it's Idaho, Montana, Wyoming. Those three areas should be where all the resorts. In Arkansas, is it the brown river or the white river?
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Cory Glenn:
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White River, yeah.
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Howard Farran:
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It's the White river? We used to go trout fishing there in the White river, and that was the coolest thing in the entire world.
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Cory Glenn:
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Yeah, I've spent a lot of time on the White river.
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Howard Farran:
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There's a junction where we'd always go, where another river poured into it, and one river was like 10 degrees colder than the other river and for some reason that's where all the trout were. Do you know what that is?
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Cory Glenn:
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That's the Norefork river. We had a place on Lake Norefork up there, and where those two rivers meet, is really amazing trout area, but there's been several world record brown trout come from those two streams.
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Howard Farran:
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Yeah, that's where we'd go. Me and dad and we'd just sit. You could just catch them all day long.
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Cory Glenn:
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Yeah, it's amazing. It's a beautiful area. I was originally planning to go back to practice before marrying my wife. I married Tennessean, so she got me over here. We love it here too, but that's originally where I was going to go to.
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Howard Farran:
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I tell you what, I'm so glad you're doing well. I'm so glad you look great. You are one guy that dentistry needs. When you get back on your feet 100% how will this change your perspective, your lifestyle, you lecturing, your practice? Will it change how many hours you work? How many lectures you give? What priorities do you think changed?
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Cory Glenn:
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It may. My priority all along has been to continue growing the lecturing side of things. I really enjoy that. I really like teaching other dentists hanging out with them and doing that kind of thing. I fully want to get back to clinical practice, too. I have no intentions of leaving that behind. We did hire an associate, and so we're going to see how that goes, but he's holding down the fort while I'm away, and we'll see if that's something that we continue beyond the time when I get back. I would love to turn it into a two-doctor practice if we could, and so that's something that's on the radar. Definitely more teaching.
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I've actually gotten a job doing customer service and customer support for Blue Sky Bio while I'm undergoing all of this, so that's been really fun.
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Howard Farran:
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With Sheldon?
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Cory Glenn:
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Yeah, Sheldon and Albert. They pretty much took most of the customer service calls and emails themselves, and so I've had a great relationship with them. When this happened, they were very gracious to offer to me a job to do that. I think it helped them get some of that off of their plate, and it gave me something to do while I was cooped up in the hospital and really not able to do anything. That's great. I take calls and emails throughout the day and get to speak with dentists from all over the country, so that's kind of scratched the dentistry itch for me while I've been out of commission.
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Howard Farran:
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As far as running the practice, I want to share a story with you when I got out of school, because I'm 20 years older than you. When I got out of school in '87, probably the most successful dentist out in Phoenix was about an 85-88 year old Jewish woman from Germany. The World War II was starting to ramp up and she knew she had to get out of there. She was Jewish in Germany in the '40s. She came to America and they say, "We don't honor your dental degree even though Germany makes the greatest cars in the world." She goes and gets a lawyer and the lawyer said, "You can't practice dentistry, but you're lucky. You can own a dental office." By having lost her right to do dentistry, which made her cry for a very long time and just hurt, now she had to work on the business instead of in the business.
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By the time I got out of school, this woman had an office in North, South, East, West. Every one of them was doing two to three million a year, and I'm looking at this lady in a big ole Mercedes having to drive around, and I realize, that's what kept her going all the way to the year she was. She's running four offices, and I think that this is a challenge now that you brought in your first associate. You're not allowed to work. The richest dentist in the world, Rick Workman, he owns 1,500 dental offices. He hasn't seen a patient in 20 years. Rick Kurshner hasn't seen ... Most of these guys have not seen a patient in 20 years.
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Now that you can't see patients right now, you should just hold you feet to that fire and say, "I'm not going to see a patient for two years, and if this associate isn't working out or making money or profitable," now the problem's on your plate to figure out why. This may force you to solve all those problems and because of this, maybe when you're my age, you might own 20 offices in Tennessee, and it all started because someone took away your right to practice dentistry for a while. All these dentists they work too much time doing the dentistry, and then they say Friday afternoons they're going to work on their business and they're too tired, so they just go home and take a nap or go play golf. This is just making you 100%, I got to work on the biz in my dental office, and there's a hell of a lot more. Rick Workman's a billionaire. There's no billionaires from lecturing. There's a hell of a lot more money in providing dental services than there are on selling the gauze or the CE or whatever.
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The reality of dentistry is when a human walks up to a doctor and says I'll pay you a buck if you fix my tooth. That's the real industry. That's 80% of the whole thing. I'd keep your eye on that.
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Cory Glenn:
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I'm definitely going to have to focus more on the business side, especially if we continue on with two doctors. It's really not where my passion's at. I love the clinical. There's a lot of times I would just do that for free if I could.
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Howard Farran:
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We all do it for free.
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Cory Glenn:
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To be honest I do sometimes. Sometimes I see a cool case that I just want to do, and I won't make a dime off of it. That's what I really love and presenting that and showing it to other doctors, I can't ever see myself leaving that alone, just managing stuff, I'm not great at it. I hope this makes me better at it, but that's just really not where my passion is. Hopefully I can find a happy medium in there somewhere.
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Howard Farran:
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I'm sure you will, because your the smartest dentists I know. You really are. You're just smart from A to Z. What did smarten up and educate everybody about today on your podcast?
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Cory Glenn:
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I tell you one thing, I just listened to another one of your podcasts here recently, and it was a disability insurance guy. I'll tell you, that is something that I really would stress to all the younger dentists out there, and older for that matter, is if you don't have some disability insurance you've got to get some yesterday. I'm just looking at the bills coming in, and how much money it takes to keep a dental practice alive, and then your life and your house payment, you cars, pay for kids' school and all this stuff. If you don't have some disability insurance in place, you can very, very easily find yourself underwater and bankrupt in absolutely no time.
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I would really stress that. That's one thing I've done well all along this process, is every time that we were making more money, I increased my disability insurance and I always kept that maxed out, and I'm sure thankful for it now, because one this pre-nup elimination period runs out, we're going to not have to worry about money because the disability should kick in, until I can get back to work at my normal pace.
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Howard Farran:
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Can you give any specifics how much? What was the name of the company? What was the premium? How much will you get? How much were you able to max?
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Cory Glenn:
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The company I'm using is Guardian.
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Howard Farran:
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Okay, that's a big dog.
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Cory Glenn:
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I went with that, but I think they're one of the higher premium companies, but they have very good policies. For example, lets say my back never gets better and I can't go back to clinical dentistry but I can go do teaching or work at a school or do anything else in the field of dentistry, they'll still pay me my full benefit. I don't know the exact term for that, I think it's true on occupation. There's some of these policies that you can't ever do anything else in the dental field if you hope to get your benefit. That's not very good for dentist, because we're not trained to do much else other than stuff in the dental field.
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That was a big selling point for it. It's just a very good policy from what I've read. As far as the benefit, I think I have no idea the premium, like I said, I think it's high, but I knew it would be and that's something that I've always tried to make sure we did well. The benefit, we've paid for it with after-tax dollars, which is another important thing. If you pay for it with after-tax dollars, if you ever have to draw on your disability then it will be paid to you and it won't be taxable. I think when this kicks in, our benefit's going to be just under $17,000 a month non-taxable, which is enormous. Again, as a dentist with practice, you've got a lot to pay for. That was a big selling point.
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Howard Farran:
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Very good. Any other takeaways on that?
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Cory Glenn:
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Business overhead expense is something else that you should look at, although I did not have that. I've gone over this a bunch of times in my mind, and my thought with business overhead was if I get disabled, there's a month elimination period. If my practice sits there for a month with no one working it, there's probably not going to be much of a practice left if I'm out for any amount of time. My thought was surly within a month, if it's going to be longer than that, I can get someone in there to work it.
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That's exactly how it has worked out. We've got the associate there and that's keeping things afloat, but I do think it would be wise to have some business overhead expense insurance, because if we hadn't found an associate, once again, we would've had 20 something thousand dollars a month of expenses rolling in and it would just be coming out of savings, or it would be coming out of that disability once that kicks in. Those are big nuts to crack. I think you need some kind of coverage on that as well.
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Howard Farran:
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How did you find the associate?
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Cory Glenn:
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This is one of those crazy stories, that I would say this was divine providence. I was sitting probably the third or fourth day in the hospital, and I had just gotten off the phone with my oral surgeon buddy. He was asking me, "How are you going to keep your practice going?" I really didn't know. I hung up and was talking to my sister about the same thing and she was saying, "Can't you just find an associate?" I was like, "I'm in a small town. There's not a ton of doctors looking for a job right now, and I'm pretty picky as far as who I would let work on my patients."
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Literally as we're talking about that this nurse walks in and says, "Aren't you the Doctor Glenn that posts work on dental down?" I couldn't believe it, I said, "Yeah, that's me." She said, "I know this is totally stalker, but my boyfriend is a dentist and he goes on Dentaltown a lot. He actually saw your post and said, 'Isn't that the floor that you work on at the hospital?'" She came to check on me. It turns out that he was in an associate-ship and wasn't quite as busy as he wanted to be. He's a great doctor. Does IV sedation, does wisdom teeth and implants, and just a really nice guy.
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I got to meet up with him and talk with him, and it's worked out to where now he's working the practice three days a week, and so it's just kind of a crazy Dentaltown connection. His girlfriend is actually a nurse on the floor that I was on for a month.
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Howard Farran:
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How many days a work is he working for you now?
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Cory Glenn:
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He's working three days a week and he's still working his other job in Nashville a couple of days a week as well.
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Howard Farran:
|
That is just awesome. Now you're working for Blue Sky Bio, you're working for Sheldon Learner?
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Cory Glenn:
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I am. I'm doing some customer service for them, and hopefully pretty soon I'll be able to start doing some of the lecturing again. We're actually going to do a course, our guided surgery course in Nashville in April.
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Howard Farran:
|
I know. Armond's so sweet. He's doing that just so you didn't have to travel to Hawaii, right?
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Cory Glenn:
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Yeah. Armond's been a great resource through all of this.
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Howard Farran:
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Armond is the coolest guy in the world.
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Cory Glenn:
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He is. He's been a great partner through all of this.
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Howard Farran:
|
I have to tell you, it was a huge letdown when I met him.
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Cory Glenn:
|
You expected to get into an online fight, didn't you?
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Howard Farran:
|
Because on Dentaltown I was picturing this guy who was just hilarious, like the best stand up comedian on the world who's all sarcastic and all this stuff like that. Then you met him, he was just quite and shy.
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Cory Glenn:
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Yep.
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Howard Farran:
|
I'm like, "I was not expecting quite and shy from the Armond dude on Dentaltown."
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Cory Glenn:
|
Yeah. That's how we met. We had online arguments on Dentaltown about guided surgery and cone beam. I used to be in the camp that you didn't really need it, and so he made a wager with me that I would find a perforation after I finally got a cone beam. Sure enough I did, and he messaged me one night and was like, "How's it coming with the perforations?" I had found one my then. He made an entire Dentaltown thread devoted to Cory Glenn being wrong or something to that effect.
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Howard Farran:
|
Yep, I remember it well.
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Cory Glenn:
|
That was how we met, and then following that he said, "Do you do any speaking on guided surgery topics and that kind of thing?"
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Howard Farran:
|
We should start there. You should educate everyone on what you're doing for Sheldon Leaner on Blue Sky Bio, and what you're doing with Armond and Cadray. What Blue Sky Bio? Blueskybio.com?
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Cory Glenn:
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.com.
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Howard Farran:
|
What's Cadray?
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Cory Glenn:
|
I think it's just cad-ray.com.
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Howard Farran:
|
Just cad-ray.com?
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Cory Glenn:
|
Mm-hmm (affirmative).
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Howard Farran:
|
Do you want to explain that or did you want to talk about something else? What did you want to talk about, buddy?
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Cory Glenn:
|
No, that's fine. Right now if someone calls with a question or emails a question to Blue Sky Bio that's clinically related, that's probably going to get forwarded through to me, and so I'll be the first line there. Of course there's a few things that I may not know that I'll pass on up the line to Sheldon or Albert, but for the most part I'm fielding most of the clinical support type questions. Someone wondering about this implant or that, or if this is compatible with another implant, or any given clinical situation with their implant line, I'll be the first one to help the.
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Howard Farran:
|
With the Blue Sky Bio implant line?
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Cory Glenn:
|
Right, yes.
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Howard Farran:
|
What is their implant called, just Blue Sky Bio?
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Cory Glenn:
|
They've got a number of compatible implants. They've got implants that are tissue level that are similar to the strauman tissue levels. They've got ones with an internal hex connection, so if your people are familiar with Zimmer implants, they've got implants compatible to that. The one I personally place is the bio max implant, which is compatible to the Nobel Active Marrow platform. I think it's a great implant. They've got a number, I think five or six different compatible implants, and they're really great implants.
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Of course, they keep their prices low by not having huge buildings and sales forces out there and representatives. They're just an entirely internet-based company, so it allows them to keep prices really low.
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Howard Farran:
|
What did you think? Did you seen Tauren Argeral's last blog where he was saying that he thought you should use an expensive implant because if anything ever happened you want to be using the same system as the oral surgeon or the periodontist up the street? Did you buy into that or not really?
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Cory Glenn:
|
I don't. It's one thing if you've got a company that comes along and they've been in business for a year, and they've got a proprietary connection that you have no idea if it's going to be around in another year, or if this implant has to have an abutment changed in 20 years. Is anyone going to stock the parts for that? Companies like Blue Sky Bio or Implant Direct or there's a ton of companies that have compatible connections. That's just not the case at all in my opinion.
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|
We all know that titanium integrates. Some just integrate a whole lot cheaper. That's my feelings with these. There's no secret to how Blue Sky keeps their prices low. They're all American made so they're not cutting corners there. The engineering is amazing behind these. There's a lot of instances where they've actually improved on their counterparts that they're compatible with, but they just don't spin their money on sales forces and reps and things like that, which really drives up the cost of the implants. To me it's just smart business.
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I think they're just doing it right and they're hardly a new company. They've been around forever now, I want to say it's 15 years or something. I have to double the number on that.
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Howard Farran:
|
I don't think Sheldon Learner wants to hear that he's been around forever.
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Cory Glenn:
|
Sheldon knows he's been around for a while.
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Howard Farran:
|
People will get out their calculators and start figuring out his age.
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|
Cory Glenn:
|
Yeah. Those guys are brilliant. They're both engineers and Albert's an oral surgeon. Sheldon's a periodontist, and they both places more implants in a year than most of us will place in a lifetime. I think said at the end of his career, they were doing about 1,000 a year. You build up some experience and some knowledge about implants at that point. They've just made an incredibly good implant line.
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|
Howard Farran:
|
The founder of Clear Connect, no, Clear Choice Implant Centers.
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|
Cory Glenn:
|
Yeah.
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|
Howard Farran:
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They're a huge purchaser or implants. He was over at the house yesterday and he was telling me that the data that he's seen is that on now general dentists in America are placing 60% of the implants. They're buying 60% of the implants, so the oral surgeons and periodontists went under half and now they're under 40%.
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Cory Glenn:
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Yeah, I believe it, and it'll continue to go more that way. I don't want to act like implant dentistry is getting dumbed down at all. There's still a lot of skill and a lot of knowledge that has to go into it, but it's becoming now where you can jump that learning curve a whole lot quicker. Things like guided surgery that are going to help you get the implant in the right place more often. In the old days, you would have to spend five, 10 years of getting the tactile sensation down and working on your angulation. Now we can kind of jump some of that learning curve because of some of the things we've got available to us.
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That's one of the reasons I love guided surgery is because it does make it so much more accessible and it's going to really minimize a lot of the risks that many newer surgeons have, whether that's specialists or general dentists. When you're starting out, there's just so many things going on. You've got your patient management, their health history, their awake and looking at you and you're trying to do this surgery on them. You've got your surgical flap, and now you're doing this new procedure where you're putting a titanium screw into their head. It sure is nice to be able to do something that will help you get that into the right position and take one of those factors off the table for you. I'm a huge advocate of it.
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Howard Farran:
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Do you want to edumacate them on that, how to go to Blue Sky Bio and download the software? Did you want to talk about that?
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Cory Glenn:
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Yeah.
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Howard Farran:
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Because what I really love the most about you and people like Josh Ren Mississippi, he's a pediatric dentist where it seems like the guys in small town rural America. They've got one eye on the customer and one eye on cost, and they use their God-given three and a half pound brain talent to drive down cost and make it simple so that their patients have the freedom to afford what you do. Josh Ren does class-act pediatric dentistry at the lowest, high quality lowest cost, and that's what I was thinking about you.
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You could've used any system. Nobody owns Cory Glenn, why did you hook up with Blue Sky Bio, why did you hook up with Armond? I know why you hooked up Armond, just because you're a glutton for punishment and you wanted a really challenging friend. I'm just kidding. Why did you hook up with those two boys, who both have a passion for making everything fast, easier, higher quality and simple?
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Cory Glenn:
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With Blue Sky, the biggest thing for me is their guided surgery software. There's a lot of guided surgery software's that are out there. You might have to spend $5,000 to buy the software, and then you get the pleasure of spending $300-$400 per use every time you want to use it. Blue Sky went an entirely different direction with that. They've made this software which is amazing, and in my personal opinion is more powerful than really any of the others that are on the market, but they just made it free. You or anyone else can go on the website and download this software.
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It's a planning software. You can do anything with the software that you would do with any other planning software. Where it's different is that you can actually design your surgical guides. You can plan you implant position, and by the way, it doesn't have to be their implants. You can use anyone's implants on the market, but you plan your position, you can design the guide, and then export it and there's just a nominal charge when you export it. I think it's about $18 or so. Then just have that 3D printed by any number of places. Now you have your guide for $18 export and usually it's about $35 to 3D print it. Or like myself personally, I have a 3D printer, so I can print a guide for $1.
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Now for $20 I have a guide that I can use to put the implant exactly where it needs to go. It's makes my surgeries shorter. It's going to make the patient not have to be flapped open and have all that inflammation happening. It's just a very predictable way to do implants. They're continually improving that. There's always new developments going on. I use it for full arches. I've got several online cases where I've shown doing all on four techniques or just full-arch implants. It's just so predictable and easy compared to doing it free-hand. I don't want to minimize this to make it sound like it's doing an occlusal filling, although some single-tooth implants it's that easy.
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The full-arch cases, that's a big deal, and there's a lot that goes into them. Compared to free-handing it, it's just made it so much more affordable and predictable for me.
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Howard Farran:
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What was the tie in with Armond and Cadray?
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Cory Glenn:
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When Armond, when we did that thread and he was asking me about the perforations, he ended up asking me if I did any lecturing, because that's about when he was starting to do some courses through Cardray. I told him I was doing some lecturing, and we decided to start a Blue Sky Bio exclusive course, where we would teach doctors to actually do all the software themselves. Cadray's kind of a multi-faceted company. You can send them stone models and a dicom and they'll do everything for you. They'll plan it with dentists, design the guides, send it to you, and you don't really lift a finger.
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We also are an educational company. We teach courses in cerec-guided implantology, we do this Blue Sky Bio course which will teach someone to take that software and do everything themselves just like I do, have the stint 3D printed and do the guides for their surgeries. That's primarily what my connection is. I teach that course. As we're doing this right now, they're actually doing it in Hawaii right now. I obviously couldn't make that one.
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Howard Farran:
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We're, Dentaltown, is filming it right now in Hawaii.
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Cory Glenn:
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Are they?
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Howard Farran:
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Yeah, we sent a film crew, so all those courses are going to be filmed and put on Dentaltown. Which, by the way, are you on Android or iPhone?
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Cory Glenn:
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Android.
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Howard Farran:
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Okay, Android, so you've been able to get the online CE courses on Android on the Dentaltown app for a long time.
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Cory Glenn:
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Yeah, I usually do them on laptop. I've never actually tried them on the phone.
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Howard Farran:
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Now it's available on the iPhone. See that little deal there, it says, "Forms, messages, magazines, CE"? Now you can get those 350 online CE courses on your iPhone. You can get them on your Android. All those courses that Armond's at now in Hawaii will be on your iPhone here in no time at all.
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Cory Glenn:
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Great. I was really sad to miss that trip. I had never been to Hawaii. Didn't get to make that one because of the leukemia, but I guess there will always be a next time.
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Howard Farran:
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I'm so sorry you missed that, but you look great and everybody I know that knows that, we all said to ourselves, we all chuckled, we said, "If anybody could beat anything, it'd be Cory."
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Cory Glenn:
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Well, thank you. I'm really fortunate to have what I did. It's like hitting the cancer lottery to have APL. That used to be the most deadly form on leukemia. Now with the drugs that they've come out with, it's actually the most treatable, so I'm really fortunate in that respect.
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Howard Farran:
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Armond's website, cad-ray.com, has a hyphen between cad and ray, so it's CAD-RAY, right?
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Cory Glenn:
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Right, yeah.
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Howard Farran:
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You're teaching the cerec-guided implantology, too?
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Cory Glenn:
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No, Armond and Brian Turanni teach that. I'm teaching the Blue Sky Bio courses. Again, they're pretty multi-faceted company, but they offer both. The one that I teach is just on the Blue Sky Bio software, and it's teaching docs to do it all themselves.
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Howard Farran:
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What's the difference really between Blue Sky Bio versus a cerec-guided?
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Cory Glenn:
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Cerec's got a lot of guided options, too. If you have both a cerec and one of the Sirona cone beams, then they ...
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Howard Farran:
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The Galileo's?
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Cory Glenn:
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The Gelileo's, the XG-3D, you can actually do a number of different guided techniques with those. They've got the cerec guide two is the most recent one. You can actually mill out your own surgical guides in-office on your MCXL milling machine. They've got some great options, too. Obviously the issues with that is you've got to have the whole Sirona product line.
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Howard Farran:
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Do you?
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Cory Glenn:
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I do. I actually use the Blue Sky system though. I don't have an omni cam. I'm still using a blue cam, and so for me the process is not quite as streamlined, so I prefer to use the Blue Sky method. For someone who has the whole Sirona line, by all means, it's great, it works well. Armond could tell you a lot more about that just because he's more experienced with it, but the Blue Sky stuff, you can similar workflows, and at the end it's not quite as streamlined. You do need to get an optical scan from a lab done since you don't have a cerec that's integrating directly in, but you can still end up with a guide that's going to fit on the teeth and that's going to place the implants into the position they need to be in.
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Howard Farran:
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You also had the AOS comprehensive orthodontic curriculum. Was Orth still a big deal in your practice, or did it just kind of take a back seat to implants?
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Cory Glenn:
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Yeah, I never really implemented a lot with that, and the reason is, you know, I don't love working on kids. If I had it to do over again, that was a great course and I learned a lot, but it's orthodontics geared more towards kids and adolescents, which I don't have as many of in my practice. If I were to do it again, I would probably focus more on adult ortho and something like the Powerprox braces or six-month smiles, because that would fit better with my patient base. Really I just never made it happen. I got busy with the implant stuff and with guided surgery, and it was just adding one more thing to the practice to increase the complexity, and I just wasn't able to do it.
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I've been trained in it but I really don't do much of that. I'm probably going to be implementing some clear liner therapy because that's one of the things that Blue Sky is going to be working on in the future, is doing clear aligner therapy with their software, and so that's going to open it wide open to the general public to be able to do their own clear aligner cases.
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Howard Farran:
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The general public or the general dentists?
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Cory Glenn:
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The general dentists, yeah.
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Howard Farran:
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That's because basically all those invisiline patents are all expiring, all the nickel, titanium endo-files, that's stuff all past the expiration. All these patents are all expiring, so it's really going to open up a whole new dimension of endo-files and invisiline. Now clear choice or clear connect or whatever. Clear choice is implants, clear connect is the ortho.
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Cory Glenn:
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Yeah, I don't know a lot about the patents. I just know that Blue Sky is working on orthodontic software. It's not available yet, but that's in the pipeline. Eventually that's going to be something really nice where you can do similar workflow to the implants. You'll be able to print out your successive models and then do your clear aligners over those, and you're be able to very affordably do clear aligner ortho.
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Howard Farran:
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Cory, we just started a new section on Dentaltown called "Dentaltown Mentors." Have you seen that new section on Dentaltown?
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Cory Glenn:
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Yeah, I've heard about it when you first released it. I think that's a wonderful idea.
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Howard Farran:
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We've got 10 dental students signing up for every old guy like me, saying, they'll be a mentor. I want to change directions on this interview here, because you're the youngest dentist I know who's gone the farthest. I mean, you're only 34. How old were you when you got out of school?
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Cory Glenn:
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26 I think.
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Howard Farran:
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Okay, 26.
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Cory Glenn:
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26-7, something like that.
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Howard Farran:
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From 26 to 34, you went from like a baby to Batman. I've never seen anybody do this. Really, and I've had the same comment given to me by tons of doctors in their 50s and 60s, "How did this kid, Cory, go from 26 to 34?" It's just like you became Beat-oven overnight. Most fans of this show are young kids that are under 30. You're talking to thousands of kids, I got three emails by these kids in the back seat of a dental school class, they're sitting in dental school, they just sit in the back on their iPhone and listen to podcasts, online CE courses. But anyway, give them a stair step. They've never placed an implant. How do you go from never placing an implant ever to making all these stair step decisions? Do they need to buy, they just download the Blue Sky Bio, do they need to buy a CDCT or just have access to one? Help mentor this kid who's listening to you right now, who's like, "Shit, I've never done one. How do I go from zero to one?" Just focus on zero to one.
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Cory Glenn:
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First things first, if your school offers any kind of elective classes on doing that, by all means take it. I think I got to place three while I was at UT just in undergrad. That's obviously a huge confidence booster when you can actually do it under supervision with someone. I also went on to do an AEGD residency where I got to do another 20 or so, so that was a big confidence booster. From there, it's just been a continuous learning process.
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Once you get the first few down, from there it's just a matter of taking sequential courses to up your confidence level. For example, initially you don't need to do anything with bone grafting. Bone grafting, at least in my hands, is one of the least predictable things I do, so if you're looking at placing this 4mm implant into a 5mm ridge, that ain't the case to start on. You need to start with the ridge that's 10mm wide for a first molar.
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Howard Farran:
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Upper or lower?
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Cory Glenn:
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Doesn't matter. Do you dominant side, because I think it's significantly harder to work on your non-dominant side. If you're right handed, do number three or number 30. I think that will really make life a lot easier for you just because of the direct vision.
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Howard Farran:
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Really? I've never even thought of that? That's profound.
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Cory Glenn:
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I can look back at the screw-ups I've had over my career with implants, and almost invariably they're all on the left side, and so when I finally thought about that I noticed that when I'm trying to do this I'm struggling to see and it's harder to get the angulation right. It's just tougher on your non-dominant side. Look for an easy implant.
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Howard Farran:
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My failures were different. They were never on my immediate family, they were always on the in-laws. No, I'm just kidding. Bad joke, just kidding.
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Cory Glenn:
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My dad was my first ridge split. He was one of my first implants in private practice. In fact, this was a funny story. My dad need an implant on number 30, and so I was cheap, it was early on, and I wasn't going to pay a staff member to come up there on the weekend to do this on my dad, so I made my wife, who's a hygienist, go up there an assist me. We get up there and I make the first, initial incision and my wife was going, "Oh gosh. Oh gosh." Starts losing and about to pass out. I ended up doing an implant on my dad by myself with just an isolate mouthpiece, because my wife punked out on me.
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Anyway, back to the doc that wants to place their first implant. You've got to get some education, that's obvious. There's a number of these manufacturer weekend courses that you can do that are just going to give you the basics of implantology. You want to try to keep a couple of millimeters of bone on the buckle, that just explain the mechanics of the implant kits and the drills and knowing what you've got to work with. Once you've done that, you should be prepared to do one of these super-easy implants. I would suggest doing cone beam, I would suggest doing guided. Again, when you're starting out, do everything you possibly can to stack the deck in your favor. You don't want to be experimenting on people. You want to do something that's going to be predictable, it's going to work.
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I would say for your first case, maybe take impressions and a cone beam and send it to Armond at Cad-ray and let them design you a stint and develop the plant and go over with you the placement, and get all that nailed down. At the same time, you can be doing that in parallel with them and playing with it on the Blue Sky software so that you can be seeing what they're doing, thinking through the case and planning it yourself, so that once you've done a few that way with your hand being held you can start planning them on your own and get your own guides made.
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Do that. With the rest of it it's purely matter of education. If you want to start doing block grafts and ridge splits and sinus slips, you've just got to go do the courses where that's taught. Obviously with those, live-patient courses are going to be better. There's a lot of these that go on in the Dominican Republic. There's even a number of good ones here in the States. They're going to be more expensive, obviously. Just gradually take steps, start easy, and then build your confidence from there.
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Howard Farran:
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Any of these weekend courses in America, any names that you recommend?
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Cory Glenn:
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It's been so long since I looked into them. There's a lot out there and most of the implant companies have their own. That's something that I hope to actually start offering myself in the fairly near future once we get back up and running. It's just a weekend course where you can come, we'll do guided surgeries on models, hopefully do some live surgeries where at least you get to watch. There's some licensing issues with actually doing it hands-on, depending on the state. Again, there's just a lot of them out there.
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For your very most basic course of learning where to place the implant, how the kit works, I think there's a number of them that could work out well. I don't really know a specific name of one.
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Howard Farran:
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Also, it seems like the data shows that 94-96% of labs, all their crown and bridge comes in one unit at a time. Then if you got to a lecture, 99% of all the cases are full-mouth reconstruction. Same thing with implants. Implants are the same thing, 95-96% of them are placed onsies, and all the courses are complex stuff. I want to just go back to that onesie. Are you implant agnostic? Would you recommend the Blue Sky? The top questions are would you screw or cement? You already said bone graft is overkill for a first molar. Are you implant agnostic, or you like the Blue Sky?
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Cory Glenn:
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Like I said, everybody's implants are integrating. We figured that out. I would go with just companies that have great customer service. Again, I'm hardly impartial. I work for Blue Sky. I'm sold out for them as much as anybody on earth. I think its a great company to start with. If you have questions, I'm gonna be the guy answering them. I think that's a great place to start.
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Howard Farran:
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Would you cement or screw them?
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Cory Glenn:
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Here's the issue, screw [inaudible 00:47:55] are gonna have a lot more difficulty in delivering. Contacts have to be perfectly parallel. It takes forever to adjust them and you need to get them fitting passively, but still where you've got good snap contacts. I do think screw [inaudible 00:48:10] is ideal, tougher to do. I think cement retained is still very viable, but you need to get the margin of the abutment up towards the tissue. If you're trying to cement a restoration with a three millimeter subjingable margin, that's just asking how to cement sepsis. I would say try to stay away from it if you're gonna be using just a stock abutment that has a really low margin. Use a custom abutment that's anatomically shaped that gets up out of the tissue, and you're gonna have far less likelihood of getting cement trapped underneath there that could cause peri-implantitis.
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Howard Farran:
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Is this analogy I'm gonna give true or false, regards to buying a CBCT. Obviously, someone my age, your cell phone, every three years, you want the next greater. Do you think a cell phone and a CBCT is the same thing? You don't want to buy a $100,000 cell phone, only three years later to see your friend having the better version. Do you think CBCTs are gonna have a product shelf life of a cell phone and you just want access to one and don't want to own one?
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Cory Glenn:
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I really don't think so because for right now, I can do everything I need to do with it. I know there's some new developments coming along with some of the things with the airway and TMJ, and you might could make the case to go with a larger field of view based on those because a small field of view, you're not gonna be doing anything with the airway or TMJ. For implant placement, I really think if you've got a good, crisp image, it doesn't really matter which one you get. I think it should work for you for many, many years after that.
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Howard Farran:
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Okay. Any other words of wisdom you want to share today? I don't want to keep you very long. I don't want you to get tired. I won't want to wear you out. How you feeling?
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Cory Glenn:
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Pretty good. Like I said, I get tired more easily, but in general, I'm fine. I'm getting off way easier than people who have to have traditional chemo. I'm not losing my hair and I'm not feeling sick all the time. I'm fortunate there. I'm just kind of achy and a little more tired. I'm doing pretty good overall.
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Howard Farran:
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How's your spirits?
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Cory Glenn:
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Oh, great. Things could be so much worse for me and when this all went down, this gave me the chance to really put life in perspective. I know I'm not gonna make much money this year. I don't care. It's not about that. It's not a big deal to me. That's just not something that's a big deal. I've got my family. I'm getting my health back. I really don't think you need much else than that.
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Howard Farran:
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That disability is really something I remember one of my best friends from dental school, I don't want to say his name because if it ever got back to Craig Stike then he'd probably shoot me, but his whole life was just perfect. He was on a ski hill and hit a rock and he had to be in bed, in traction for a calendar year.
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Cory Glenn:
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Oh my gosh.
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Howard Farran:
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One day you're getting off a ski left and the next year you cannot see a patient. Due to HIPAA, I cannot say his name or who that is in Albuquerque, New Mexico. It'll get back to him. Any other words of wisdom? Like I said, I don't think we do these podcasts so that Carl Michgan learns something for his next implants. I like to focus on the bread and butter, the real world of crown and bridges one unit at a time, the real world of implants is one unit at a time, the most likely tooth missing is a first molar. It's the most likely tooth to be root canaled, it's the most likely tooth to be implant. Any more words of wisdom on this kid who's gonna do his first molar implant because Cory Glenn talked him into it?
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Cory Glenn:
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Maybe not specifically on that, but back to what you were just saying, everything you see in a magazine looks like that all dentists do all day is full mouth rehabs and veneers or full arch implants. I got the chance to speak at the practice on fire seminar last year, and these were the gunners of the gunners. These were people who were just doing the best they could on all fronts, just amazing business people, amazing clinicians. When I got up to speak, I asked everyone to raise their hand who had done a full mouth rehab in the last six months. We've got 100 of the biggest gunners in the country sitting in there, and about three of them raised their hand. For the doc that's coming out of school and they feel like everything they need to do is to go take all these continuum's to learn full mouth rehabs, reality is you're going to do one or two of those a year, if that, so you're wasting your money to a degree if that's what you're focusing on.
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There's gonna come a time and place for it, but make sure you're doing the bread and butter stuff. 90% of what I do is single tooth implants. The full arch stuff is cool and as I've grown over the years, I've figured that out. If I went to courses straight out of school on full arch implants, I would just be pissed because I would go back to my practice and no one would take me up on doing it. I would have all these pieces and parts sitting around for cases that I'm never gonna do. Learn the basics and master the basics and you're gonna find that most of those skills are gonna transfer over to the bigger things as well. Don't get down on yourself because you think everyone else is doing it. They're full of crap. They're not doing that stuff.
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Howard Farran:
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I want to ask you another philosophical question. The human condition is just black and white and extremism. There's no 50 shades of grey. There's no moderation. These people will get a Syriac machine, and then they'll just use only their Syriac machine, [inaudible 00:54:04] even when it doesn't make business sense and their office are running behind, it just makes so much sense to take an impression and temp [inaudible 00:54:11]. Same thing with implants. They start place the implants, they just said, I'll never do a three unit tooth again, and it's because they're a dentist, so they don't want to shave down two teeth, but they have no problem shaving down jawbone. Here's my specific question, you've got a beautiful woman in your office. She's 30 years old, when she smiles, she shows her liver. Number eight gets knocked out. Gosh, a three unit bridge there, you could nail the aesthetic, you could nail the [inaudible 00:54:41], blah, blah, blah. You go in there and say well, I'm not filing down two of Jason and sizers, and I'm gonna place a single unit implant right up on number eight on a gorgeous woman on her front teeth so when she smiles, she shows the gum line. Good idea, bad idea? Would you do the bridge? Would you tackle that? Would you refer it? Talk to me.
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Cory Glenn:
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If you're the guy starting out, I wouldn't touch it with a ten foot pole. I would probably refer the bridge on that person. There is so much that goes into that. How much they show of their smile line, how much bone they've got available. If she has a mountain of bone, good, soft tissue, my starting place would be the implant. Then if you start taking away some of those factors that are going to make it predictable, then I would start tipping the balance towards the bridge. A posterior tooth on a 95 year old guy, there's no question, I'm gonna do a bridge on them. Unless they're just adamant about wanting an implant, I don't think there's anything wrong with a three unit bridge. I think there's places where they're gonna work out better. There's patients that may not heal well, that may have diabetes or just any number of factors, but a bridge just makes more sense to them. The longer I've practiced, the less I care about which a patient chooses. If they want a bridge after I've told them the pros and cons of both scenarios, it's up to them at that point. I'm not gonna be emotionally attached to which one they choose. I think there's a good saying, don't care more about your patient's teeth than they do.
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Howard Farran:
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That's a great saying.
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Cory Glenn:
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Let them choose what they want to do, educate them. You can have your feelings about what you want to do. Unless you feel like it's malpractice and truly the wrong decision for them to make. Don't care more about it than they do. Let them do what they want. You're there to provide the care.
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Howard Farran:
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The [inaudible 00:56:43] advice on that. You're in a office, and the dentist does a filling or he does a crown, and the contact is not perfect and they're running late and now he wants to redo the whole damn thing on a person who hasn't been in the office for a cleaning for two and a half years, has six other cavities in their mouth, and you're trying to do A dentist, and now we're losing money, running late, stressing out the whole world, and you're right, the patient doesn't even care. That's a great way of saying don't lose money and have a heart attack doing A dentistry on a C-.
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Cory Glenn:
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Do your best, but good grief, you'll never do anything in your whole career that's perfect, so do your best. Be competent and do a good job and patients will appreciate you for it.
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Howard Farran:
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Have you ran into this with any of your ENT or [inaudible 00:57:38] friends? You know how dentists, they're tunnel vision, they want to save the enamel, and the enamel is a sacred god and all this stuff and they'll do a sinus lift. But you know what, Cory, I cannot find an ENT guy in my back yard or a rhinologist that likes this whole sinus lift thing. I mean, you go to the gym and you lift weights with an ENT or a rhinologist and he is barking at you, and his view is just, all you had to do was shave down the adjacent teeth and do a damn three and a bridge and now you're sticking cow bone and blah, blah. They're saying that they see yeast infections in there, and they're going up there with scopes and this stuff, and they're like, and this is all because some dumb dentist didn't want to shave down two teeth for a bridge. There's a different perspective from every which way, you know what I mean?
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Cory Glenn:
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Yeah. I think if you're going to do it, you need to have an ENT that understands the procedure that's in your corner and that you consult with on those cases. You're right. If you're standing out there on an island, and you add ten millimeters of bone on the sinus and you get an infection that you cannot control, the last thing you want is to send them to the only ENT within an hour and he just rips you a new one in front of the patient. We need to practice smart dentistry and smart medicine with our colleagues. Because for example, with the cone beams, you can generate a lot of referrals between an ENT and yourself because so much of what they deal with with [inaudible 00:59:12] that cannot be resolved, it's tooth related and they're not going to do a root canal. You can be their resource for treating a lot of the things that plague them. By the same token, when we have those cases that we need the sinus lift on and we need them to resolve [inaudible 00:59:27] before we do it, or we have the case that goes wrong, you need that person in your corner. It goes both ways, and I think there's nothing that can be better than having that person in your corner.
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Howard Farran:
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Yeah. I think that's turning out to be the greatest gift of a cone beam. I don't really even know if it's implantology. I actually think it's endodontistry, because so many of these endodontists are finding that these asymptomatic root canals that look great on PAs have been draining in the sinus for years. Then they go in there and retreat them and sometimes they just have to go to an extraction. Then this patient, he says, well I thought I've had allergies for ten years and ever since you pulled that tooth and did an implant, my nasal cleared up. In some of these cases they get cleared up, they're going to ENTs and they've got all kinds of infection and they cannot even be managed antibiotics, they've got to be scraped out, and there's yeast infection.
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Cory Glenn:
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[crosstalk 01:00:25] because there wasn't any pressure building. It's all releasing in the sinus. There's definitely a place for cone beam in the diagnosis of that, and I've been amazed at how often I see stuff, especially on max layer molars, that you just cannot appreciate from two dimensional X-rays. No question, a lot of sinus issues are related to the teeth.
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Howard Farran:
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It's one hour and I'm not gonna go into any overtime with you. I want you to get your rest and all that stuff. I just want to say, seriously, you're my friend, you're my idol, you're my role model, you're a legend in dentistry. I've never seen anybody go from 26 to 34 that fast. You're everyone's hero. Everyone's praying for you. Everyone is sending their love and their wish your way. I wish you and your 10 women in your world, your wife, three daughters, and six women staff, wish you the best of luck. If there's anything you ever need from anybody, I'm sure you'll let us know.
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Cory Glenn:
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Thanks man. I really appreciate it. Yourself and the whole dental health community has been amazing. I just want to publicly say I really, really appreciate them. You'd be amazed at the number of emails and calls that I've gotten from them. Gosh, I had townies that don't know me offer them to get bone marrow biopsies if I needed a transplant. An amazing group, and I really appreciate all of them.
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Howard Farran:
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Whenever I've been in a CE course and they talk about it, there's not a dry eye in the room.
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Cory Glenn:
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I appreciate it, man.
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Howard Farran:
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Love you, buddy.
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