Dentistry Uncensored with Howard Farran

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

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Howard Farran:

It is just a huge honor for me today to be podcast interviewing Melissa Herbinko who's the professional relations coordinator at GKG Orthodontics in Wexford, Pennsylvania, the part of Pennsylvania that almost touches Ohio. And I don't have nearly enough front office people personnel on my show, and I contacted you, you did not contact me, because I see your social media and your professional relations promotions as world class, unbelievable. And you've been doing it for 26 years, and you don't even look 26 years old. I think I should have not been the dentist, I should have been the professional relations coordinator and maybe I'd still look good.

Melissa Herbinko, AKA Mel, began her dental career working as a dental assistant, and joined Dr. John Grady's practice in 1992. She's been there 26 years, which just speaks volumes of the doctor who can keep someone like you. Anybody who can attract and retain a quality key person, nothing speaks more volumes about a person than that. You should think that when you're looking for an associate job. If that old man can keep someone like you for 26 years, that's a practice I would join. The practice has grown into a three doctor practice known as GKG Ortho. Mel works along with Dr. Dan Kastner and Dr. Matthew Gornick too. She was an orthodontic assistant, and in 2013, she took on the role of professional relations coordinator. Mel is outgoing, energetic, enthusiastic personality and commitment to the practice success makes her the ideal person for this position.

She is highly involved in creating and building strong relationships with our referring dentists and their staff. Mel creates the fun contests that are held in their office and makes visits to local schools, helping to educate the students on the importance of excellent oral health. She participates in community sponsored events, answering neighbors questions about orthodontic care and promoting the benefits of orthodontic treatment. She also runs the referral marketing program in the practice and coordinates our Make-A-Wish Foundation events. My gosh, you are just the queen of ... it is.

So do you focus on trying to get B-to-B dentists to refer to your orthodontic practice? Or B-to-C business to consumer, trying to get consumers just to come directly to you? What's the better return on investment, B-to-B or B-to-C?

Melissa H.:

Well Howard, it's as little bit of both. Kinda hard now because some general dentists are doing some of their own ortho. So going into their practices you've got to explain to them why we're a specialist and why we should … why they should send their patients to us. And then on the other end being in the marketing, going into the community events, working with the schools, I probably have a better return. I'm a people person and when you can walk up to somebody and start a conversation with them and befriend them, then they like you, and they want to send their kids to you or themselves to do their treatment.

Howard Farran:

Yeah, and they never know all the alphabet soup stuff behind your name. They don't know what a DDS, MS, just like when some realtor has got a billboard and they've got all these initials behind their name. They never remember who did the crown on their tooth. They only remember how you make them feel, and the best marketers make you secrete dopamine, serotonin, oxytocin, and they want a relationship with you. It's all the people stuff.

Melissa H.:

It is. I mean, it really is. I also treatment coordinate. I fill in for our treatment coordinator when she vacations, and it's a good sales background too. You really have to have a little bit of a sales background because-

Howard Farran:

I can't believe you cussed on my show. Sales is the dirtiest four letter word. Dentists cringe when they hear sales. They don't ever want to hear the word customer. It's a patient and you're supposed to be patient with their horrible practice. You're not selling, you're talking down to them and saying, "You shall get a root canal."

Melissa H.:

The ortho is a little bit different. They come to us-

Howard Farran:

I agree.

Melissa H.:

… because they want to get their teeth straightened. Do you know what I mean? So we have to explain to them why they should come to our office, why we will make them feel like they are the only patient that we have for our practice. We do see … we have three doctors, so we do see a good amount of patients a day. But every patient that leaves here, if you go on our website and read our reviews, they feel like they're the only patient. Our customer service is above and beyond. I think that's why-

Howard Farran:

I looked up all those reviews and two of them were your sisters and three of them were your aunts. Your grandma posted, your mom, I think they were all your family members posting. They were too good to be true.

Melissa H.:

No. They're not. I do have a lot of family that do come here, but no. No there weren't.

Howard Farran:

How much do you pay your family members to write you online reviews?

Melissa H.:

I wish. They don't get paid anything. They do not get paid anything.

Howard Farran:

One of the first words out of your mouth was that when you're not doing this, you're treatment planning coordinator, and we have Orthotown Magazine and website, the magazine goes to all 10,000 orthodontists, we have the Dentaltown Magazine and website, and one of the biggest differences between orthodontists and general dentists is that within two years almost every orthodontist has a treatment plan presenter. And then when you go into general dentistry, it's about 20/80, and the 20% who the dentist refers as to someone who can say sells and customer and present the treatment and the finance, they do about a million and a half a year, and then the 80% that says, "No, no, no. I'm the doctor, I'll explain it. You have irreversible pulpitis and will need endodontic therapy and then a post build-up and a full cast coverage restoration. Do you have any questions? Okay, when you go out front, tell Agnes you need a RCT endodontic build-up PFM, thank you." And then they wonder why two out of three people just walk out the front door.

Why do you think orthodontists all get it, and have a treatment plan presenter, and the average dentist is taking home about a buck 75 a year, and the average orthodontist is north of 300? I mean it just, they're just so much better in business. Why do you think orthodontists are twice as good in business as general dentists?

Melissa H.:

That's a great question, so, I would-

Howard Farran:

Actually, all my questions are great. I've never had one not great yet. Right Ryan?

Melissa H.:

So when I started here I was nineteen, and I was gonna go on to hygiene school and I decided to stay here with doctor Grady, and the first thing he ever told me was in order for us to get patients, it's customer service. It's how you treat your patients, it's how you make them feel when they come in the door, it's how they leave. So when I do a treatment day, I see maybe 10 to 12 new patients a day. Out of that, I have almost all of them that will schedule treatment and I feel it's because I'm one-on-one with that patient. I get down to their level. I'll sit down with the kids. I just feel like Mom feels like I have a connection. So I think it's all about people, how you act towards those people, how you present everything. I think that's very important.

Howard Farran:

I think Wexford, Pennsylvania, you should just move to Phoenix, Arizona. I'll have a U-Haul at your front door tomorrow at 8:00? Just pack everything up and move to my practice, Today's Dental. I mean, Phoenix and Pennsylvania, they both start with P, but Phoenix, I mean, come on. Are you ready to move across the country and come work for me?

Melissa H.:

I don't know if Dr. Grady would let me do that. So we have a tie to retire together so I don't know.

Howard Farran:

This is what I want to … podcasters are young so probably almost 90% of everybody listening to me could probably be my own child by age, but the new patient experience is what you just talked about and that's soft stuff, and they come out with algebra, calculus, and the periodic table and they think it's doing the dental work. Doing the dental work high quality, that's your own personal satisfaction. The patient has no idea if it's good or bad, and whether the treatment's good or bad usually has no effect on the success of the patient. I mean, there's million dollar practices that do the worst dentistry in town and there's some of the best dentists in town don't do $500,000 a year. I mean, the soft stuff is what matters. The treatment plan presentation, the new patient experience. What do you think your average close rate is? For every 100 at-bats what do you think your close is?

Melissa H.:

I would say we're a good 95 to 97%.

Howard Farran:

Oh my, so I'm so good. You gotta be number one.

Melissa H.:

We are.

Howard Farran:

There's no one that does that.

Melissa H.:

We are. We have a three-doctor practice so sometimes Sarah and I will, in the summer, she's our other treatment coordinator, we'll back-to-back just because summertime is when you get these parents in because kids are on vacation, they don't have to take them out of school, and summers book up. So we'll have a mom call and there's nowhere to put them. So I'll be out in referring offices and they'll call me and they'll be like, "Hey, Mel. We got a mom on the phone. If we can't get her in tomorrow, then she's going somewhere else." So I'll call that mom and I'll say, "Hey, I'll meet you at the office at 5:30, after work hours, and I'll do a consult. One of the doctors will stay with me." So what does that speak, right? Volumes. I'm coming in. I'm not here in the office. I'm coming in and we're coming in after hours.

So what's that mom gonna do? When she's at the bus stop, "Hey, GKG Orthodontics, they did this for me," and that word of mouth just spreads, and spreads, and spreads. I go above and beyond. The docs will tell you I stay late, come in early, just so those moms can talk. That's very important. The school events I do, same thing. They'll be like, "Oh my gosh, did you go see Mel?" I just think that's out there and I think that's very important.

Howard Farran:

You're my Jan. My Jan's been with me 30 years too, and girls like you and Jan are priceless. Is there any way you'd ever write up an article for Orthotown Magazine? I mean, you've got to be the number one orthodontic treatment plan closer in the world.

Melissa H.:

So, Howard, you're a little bit late on that, because I did, actually. I wrote it up in April. I was in an April's issue and I wrote-

Howard Farran:

Oh, that's where I found you.

Melissa H.:

Yes, yes.

Howard Farran:

That's where I found you.

Melissa H.:

Yes, I wrote that article was talking about the summer splash and all my plans for summer and what I had planned going on for my staff and for-

Howard Farran:

See, the problem with Orthotown is you have to be an orthodontist to go on there. So even though I own the site, I'm not allowed to go on there and I can't post. So I saw the PDF approval email, but I'm not allowed to go on the website because you have to be either a Jesus, Yahweh, Allah, or an orthodontist, and I'm just a mere mortal human. But yeah, those boys on Orthotown, it's a orthodontist-only club. It's their club. They want it. I gave it to them. They love it. I think half the orthodontists in the United States are on that site regularly. So yeah, so I never got to see that article and refer it out. I wonder if I should … well, you know what? Are you a member? Well, you're not a member of Orthotown. Is any of your three dentists a member of Orthotown?

Melissa H.:

Yes, they are. Yup.

Howard Farran:

Well, okay, when you read the article, people can … online, you know how people can comment or share?

Melissa H.:

Yes.

Howard Farran:

You can also click and forward that to their Facebook, their Twitter. Just one click and it'll go out to your Facebook, or your Twitter, or your email, or whatever. You should log on as one of those doctors and refer that out so that all the orthodontists that are following them on Facebook, Twitter, LinkedIn, Pinterest, Google+ can do that because that is just amazing. And trying to get these dentists who went to school eight years because they wanted to do surgery all day with their hands and fix people …

The most exciting thing I loved about dentistry the most is the emergency room. If I was at a hospital I only want to be … I want the person walking through there holding their face in pain. I feel so good. I feel like a fireman. I can fix that. You get the X-ray, and you pull the tooth or do the root canal, whatever it is. They love that. But then I gotta sit there and say, "Okay, but if you don't know your numbers, and if you can't sell the case, you don't get to do the treatment." If you want to do toothaches all day long, you gotta know the business of dentistry.

Melissa H.:

Right.

Howard Farran:

And you gotta be able to sell that. I have to tell you that in both of our careers, when we both entered dentistry, the biggest brands were already Crest, and Colgate, and Listerine. The biggest brand in dentistry that was made in our lifetimes was Invisalign.

Melissa H.:

Yes.

Howard Farran:

Most orthodontists tell me that it's about 20% of their practice. What percent of the practice is it with you?

Melissa H.:

We're a little bit more. We're actually a top 1% provider, or now they call it VIP provider. So if you go on the doc locator we'll come up, like the top VIP provider in the Wexford area. So I would say we're about maybe, I would say almost 60% Invisalign. We do have a lot of teen cases too. We are the top percent for teen in the Wexford area, so that's huge for us too.

Howard Farran:

You know, I get the whole Invisalign thing with adults. I get it. They gotta go to work. They're in sales. I totally get that. But it seems to me the young girls in our practice when they talk about orthodontics, they love to pick different color rubber bands, for Halloween they want orange and black, and Christmas they want red and green. Do high school girls who are all about their looks, do they … I thought they liked to show off their braces with colorful rubber bands, but now you're saying they like to hide it with Invisalign?

Melissa H.:

They do, yes. So if someone would come in, if I was treatment coordinating and they would come in, and I looked in there and seen like bad oral hygiene, I would definitely push Invisalign for them because you don't want them to have stains on their teeth with their braces on. So when you see bad oral hygiene, you have to think to yourself, "Okay, do I want to tell them Invisalign's better for them or braces?" So there's so many factors you have to factor in. You have to look at their bites. You have to look how crowded they are. Of course brace cases are gonna be a little bit faster. You have the ability to tweak those, where Invisalign we would have to refer that back to Costa Rica where they make all the little adjustments. So it really depends on the case and who it is. I'll look at the kid. If they're very outgoing, then I may suggest the Invisalign. It all depends on that person when they're in my room. I get that gut feeling what I should do for them to make what's their best choice.

Howard Farran:

As a father of four boys and two grandchildren, it just seems like a very sexist thing to say is that girls are into their appearance and would always wear the Invisalign as told. I mean, boys who wear the same shirt three days in a row and have a booger hanging outside their nose, I would just think that they're compliance would not be so well with Invisalign. It seems like I'd rather fix it to his teeth. Is that just true or totally-

Melissa H.:

So some of the questions we'll ask the mom about how compliant they are. If they're really good about doing their homework and going to bed on time, things like that, then they're a compliant child. But if Mom says, "There's no way he's gonna wear that," then we'll definitely say, "Okay, well let's go down the brace." We also have, we offer the incognito braces, which are the ones the go behind your teeth. So we do have that option. They're a little more expensive than braces, so we really don't push that as much, but that is an option for kids that aren't going to want to see them, but also have the brace end of it.

Howard Farran:

So why do you think all four of my boys were noncompliant?

Melissa H.:

I don't know.

Howard Farran:

Do you think maybe it's me. Do you think it's me, Ryan? Ryan never went to bed on time his entire life.

Melissa H.:

What?

Howard Farran:

Ryan? He says not true. I'm just kidding.

So Invisalign, gosh, do you even remember the year that came out? Ryan, look up when Invisalign-

Melissa H.:

Yeah, I'm not sure when Invisalign came out. That's a good question. When it first came out-

Howard Farran:

That's the second time you said it was a good question. I'm doing good today.

Melissa H.:

You are.

Howard Farran:

I've had two good questions so far.

Melissa H.:

When Invisalign first came out, our docs were a little skeptical on it.

Howard Farran:

What, Ryan? 1997, so that was 10 years after I got out of dental school. I got out in 19 … so 1997 that came out.

Melissa H.:

Okay, 1997, so that's how long we've been here. So yeah, so we got into it right away. The docs took the training on it, but there were so many techniques that Invisalign had to work out so we weren't 100%, you know what I mean, on board with it. We did have some cases, but we didn't push it 100%. As Invisalign made changes and got better, I would say in the last four years we really started to like the product and we had a lot of patients asking us for it so we wanted to be trained 100% in it so we could offer our patients everything that Invisalign had to offer. We also offer accelerated treatment with it, and that kind of really helps because instead of changing your liners — which Invisalign just changed — you were changing them every two weeks, now it's every week, but now we offer the accelerated treatment. Have you heard about that with like [crosstalk 00:17:59]?

Howard Farran:

Yeah, but I'd say the first five or 10 years there was one tray a month.

Melissa H.:

Was it one a month? I can't-

Howard Farran:

Yeah, when it started it was one a month and then they dropped down and then you did two a month, and now you're doing one a week.

Melissa H.:

Now we're doing one a week and with the AcceleDent, now we have patients change them every five days.

Howard Farran:

Okay, and explain what the AcceleDent is to my homies that don't know.

Melissa H.:

So AcceleDent is a little unit that you put in your mouth. It has a little tray like a mouth guard and it vibrates. And what that does is it helps speed up treatment. So it goes back to that osteoblast and osteoclast, and so those two together just help movement a little bit faster. We do offer it with our brace cases too, and we are seeing that movement is a little bit faster. They're saying with Invisalign it's about 30% and with braces we're seeing about 50%.

Howard Farran:

So do they take the device home?

Melissa H.:

Yes. Yup, it's a little, just a little square device with like a mouth guard. Almost looks like a mouthpiece that you're gonna put in for football. And there's a little button on it and it vibrates just the littlest amount. They'll wear that for 20 minutes a day.

Howard Farran:

So you were either born in the south or your mom or dad was born in the south because you're not speaking Pennsylvanian.

Melissa H.:

I have Pittsburghese bad.

Howard Farran:

Really? It's Pittsburgh. That's Pittsburghese?

Melissa H.:

Bad. It's Pittsburghese. I got Pittsburghese.

Howard Farran:

I would say it's sounding more like Tennessee.

Melissa H.:

No, I'd like to be from Tennessee.

Howard Farran:

But you are the only 10 I see. I thought you were from Tennessee.

Melissa H.:

No, you're awesome. I'm from Pittsburgh, Pennsylvania.

Howard Farran:

So do you think the vibration is … how much of it do you think is just by the vibration really seating the aligner really, really well versus how much of it do you think is causing some kind of inflammation in the gum and bone to kind of speed up softening up so osteoblast and osteoclast can do their thing?

Melissa H.:

So what I did was back in January I had some movement on my lower and I decided to go through Invisalign treatment to test this out and track it, and I did a whole Facebook blog on our Facebook page. So I went ahead and got the scan for Invisalign and I got some aligners, and I did wear the AcceleDent. I actually changed my aligners every three days and as soon as I would put a new aligner in, I would wear the AcceleDent and my aligner would seat 100% within 10 minutes of doing the AcceleDent. So I really feel that compliant patients could change their aligners every three days, but we don't promote that. We go every five days.

Howard Farran:

So it's the vibration is just really seating the-

Melissa H.:

Not only that, Howard, it's comfort. For your braces and your Invisalign, it is like a massage for your teeth. It is the most comforting feeling, especially when you're getting a tightening with your braces or you're first putting those aligners in and they're really tight. It's a total like massage for your mouth.

Howard Farran:

And when you started out in ortho 26 years ago, it was all, you were doing this all by alginate impressions-

Melissa H.:

We were.

Howard Farran:

… and then they got into the digital Invisalign bought … what would they buy iTero?

Melissa H.:

We bought an iTero Element scanner, so we have the newest edition right now.

Howard Farran:

And what do you think of iTero digital scanning versus … were you taking usually alginates or vinyl polysiloxane, polyethers?

Melissa H.:

So when we would do just retainers we were using just impression material, just the alginate, and then when we had to do the Invisalign there was a little bit more of that textured material we had to use, and now we use the scanner. So it's so much better. We're scanning in about a minute 27 a patient. So what we've now incorporated is every new patient that comes in that has their adult teeth, whether it be a teen or an adult, we're doing a scan on them and we're able to show them simulation before and after right away whether they do Invisalign or braces, and that also helps with getting them to close the case.

Howard Farran:

So do you think the scanning is higher quality?

Melissa H.:

I absolutely do. Yes. We actually, Invisalign just came out with an update, and depending where you are in the queue, we just got ours last week. Like I said, we're scanning in a minute 27. There's no going back. There's no redoing. It's just continuous, which is awesome. Before, you'd have to click the pedal, stop, go back, adjust the red areas. We don't have to do that anymore. It's a continuous scan so it's going faster for the patient.

Howard Farran:

Tomorrow is my 20,000th day birthday on earth. I'm not making this up. So June 1st I will have been on earth 20,000 days and I celebrated my 10,000th day and my 20,000th day. I know I won't live long enough to be my 30,000 day. Oh, Ryan, will you figure that out? Just type in 10,000 day birthday. But anyway, you know what I want from you on my 20,000 day birthday?

Melissa H.:

What?

Howard Farran:

That probably only you can do. I mean, the president and CEO of Invisalign is Joseph M. Hogan. I wouldn't even know how to get ahold of him. But if you're a one percenter VIP, you probably have … I mean, I'm not even an orthodontist. But I want him on this show so bad. I'm so proud of that company. I've lectured in six continents, dozens of countries. I don't care if you're eating at a restaurant in Cambodia, Soweto, South Africa, Malaysia, Indonesia, once the waitress or bartender knows you're a dentist, they start asking about Invisalign. It's the biggest brand. It's the biggest new kid on the block in dentistry since Crest, and Colgate, and Listerine.

Melissa H.:

Well, Howard, I'll tell you what. Hogan just left our office a couple weeks ago. He stopped in here to see us.

Howard Farran:

Joseph Hogan did?

Melissa H.:

Yeah, he was here.

Howard Farran:

Oh my god, did you get his name, number, email?

Melissa H.:

Yes, he actually took an article, my Orthotown article with him. He was very impressed with it. I will reach out to him tomorrow and see what I can do for you.

Howard Farran:

Oh my god. If you do that, I'll be so happy, I'll give you all four of my children and just keep the grandchildren.

Melissa H.:

I just want to come visit in Phoenix, that's all.

Howard Farran:

Hey, anytime you ever want to come visit in Phoenix, it's my treat.

Did metal braces go extinct? Because now you got clear braces, you got Invisalign, you got lingual braces. Is metal braces … so you said 40% was Invisalign, right?

Melissa H.:

Yeah, we do about a good 40%, mm-hmm (affirmative).

Howard Farran:

Okay, so what's next? Would it be clear braces and then the smallest metal or would it just be-

Melissa H.:

So it really depends on the age. The littler kids like the metal braces. So when we do our fee structure and we give them our fees, metal braces are always included in their fee. So if they would like to do ceramic braces, which are the clear cosmetic ones, there's an upcharge for those. A few months back, maybe it was last year, they were trying to do the clear braces with color ties on them. Some of the reps were trying to get us to do that and they were saying it's the new clear, putting colors on them, but here in Wexford not many people were going for that. So we really didn't push that. Everyone would get the metal braces and pick their colors and then we have the ceramic. So I would say majority do metal. A lot of our adults and higher teens, 14-16, will do ceramic.

Howard Farran:

So you know what the newest, newest, newest thing is? I just post that on … I wish you'd have your doctors come visit the little people on Dentaltown. I just posted … actually there's a ton of orthodontists on Dentaltown. When they're on Orthotown they only want to talk to their other specialists, but when they're on Dentaltown, I think they post because they get a lot of referrals. I have a lot of specialists says, "The reason I post on Dentaltown is because then all of a sudden some dentist from five miles from here says, 'Oh my god, you're a Townie. I'm a Townie.'" It's almost like they're in a fraternity.

But I just posted, have you heard of orthodontic … have you heard of … oh what's his name? It's called orthodontic jaw wiring, OJW for weight control by doctor … by orthodontist Dr. Teddy Rothstein, DDS PhD?

Melissa H.:

No, I have not heard of that.

Howard Farran:

I'm telling you this is awesome. You know how people do extreme surgeries like they've got rubber bands around their stomach, they get gastric bypass surgery? I mean people go to great, great lengths to lose weight. I mean, they get their stomach stapled. I mean, even the governor of New Jersey did it. I mean, people go get $60-80,000 surgeries and this dentist … do you see this?

Melissa H.:

Yes, I do.

Howard Farran:

This dentist, I just posted on Dentaltown, I wish your docs would go on there and look at it and comment … you come in and he wires, he brackets up the canines and two bicuspids on each side and then he wires it so they can't open their mouth and they can only drink through a straw. And he says that people are eating for compulsive behavior, they know they shouldn't be eating a bag of Oreos and ice cream, but it's really taking off as a weight loss. Plus, when you get your gastric bypass or your stomach stapled, none of that's reversible.

Melissa H.:

Right, exactly. Wow.

Howard Farran:

But if you decide after a month or two that you've lost enough weight, he'll come in and he'll take your wires off.

Melissa H.:

Wow, we're gonna have to look at that. That's pretty neat. Yeah, that's extreme. I've never seen that before.

Howard Farran:

And Ryan wants me to get it done, but then I won't be able to podcast. I can't podcast with my mouth wired shut so I'm staying fat just to help dentists learn more to build their practice. I'm fat for you guys. How committed-

Melissa H.:

You're not fat.

Howard Farran:

… how committed of a podcaster I am that I'm staying obese just for my homies? But I really think that's going to take off because they're doing … and people say, "Well, that's kind of extreme." Well, hell, they're doing 10 times more extreme behaviors to lose weight with gastric bypass, and stomach stapling, and all that stuff. I really wanted to know if you thought that might be a next big deal. I mean, like in your area of Wexford, Pennsylvania, is there a lot of obese people in your neighborhood or is it a more healthy area?

Melissa H.:

We're a little bit in a more healthier area. We have a Whole Foods right across the street from us. So a lot of moms will drop their kids off … and we actually set something up with Whole Foods. If a patient's coming in for a long appointment, we went to Whole Foods and we bought coffee coupons from them so we'll give a mom a coffee coupon and send her over to Whole Foods and she'll do her shopping while her child's being taken care of here. So we kind of set up a marketing thing with them so it works out real nice.

Howard Farran:

Yeah, well, you know, log onto Dentaltown. I posted. So there's 50 categories, there's root canals, fillings, crowns. I posted under orthodontics. So if you go under orthodontics, it's the first post there, but I was wondering what you thought about that.

So lingual braces, back in the day when I was in school they said lingual braces will never take off because it'll just tear up the tongue, it'll chew up the tongue, people's tongues keep playing with it. What percent of your practice is lingual braces?

Melissa H.:

Very, very, very little. I mean, we probably have about, oh maybe 5%. It's very costly to do them because we have to, again, take digital impressions, a scan, and we send it off, and they have to robotically make those braces and wires. So it's a lot of work for lab fees for us and it's a lot of time for our patient manager, that's what we call our assistants, to work on the patients because you're almost upside down. It's almost backwards because you have to put the wires in according to the way the papers come back. It's a lot of work. We actually did it with one of our own assistants. She did have, like you said, a lot of tongue rubbing, a lot of irritation. So she was kind of our guinea pig just so we could see how it worked with her.

Howard Farran:

Yeah, well if she's really a guinea pig, she's really fat, you might just wire her teeth shut.

Melissa H.:

She's not fat by any means.

Howard Farran:

I thought you just called her a guinea pig?

Melissa H.:

Well, not an actual guinea pig, yeah. We tortured her to see how things were going to work out. She did well. So this way when we had our cases come in, we knew how to treat them. We do, we actually have a girl that goes to school in North Carolina and she has the lingual braces because she's a college student, and we can let her go out eight or 12 weeks with these wires in so they can unravel the teeth, un-rotate them, and then she comes back up on weekends. When she's here, one of us comes in with one of the docs and work on her.

Howard Farran:

What about lasers?

Melissa H.:

We do have lasers. So we do. Our docs are awesome. Our docs always go above and beyond for their patients and I think that's another reason why we're loved in the community. But what happens is if we have a child that had upper tooth two braces on, say they're eight or nine, they weren't the best brushers and they have like their tissue just grows over those braces. So we'll take the braces off at debond. We'll let the tissue heal up as much as we can. Then sometimes the docs can go in and do a little bit of gingival recontouring with the laser. Sometimes we'll take frenectomies off. If there's a big space between those front teeth and we can't get that space to close, the docs will go ahead and do a frenectomy and the laser, it literally takes five minutes. There you go, you're done. It's awesome. So they don't have to have-

Howard Farran:

Which laser do you use?

Melissa H.:

We have the Zappa laser. We have a little bit of an older laser. We've had it for about five years now, but we love it. It works awesome. So it's called Zappa.

Howard Farran:

Was it invented by Frank Zappa?

Melissa H.:

Not sure on that one, Howard.

Howard Farran:

Are you old enough to remember who Frank Zappa was?

Melissa H.:

I don't.

Howard Farran:

Oh my god, he was one of the craziest rock and roll artists back in the '60s. Frank Zappa.

Melissa H.:

Okay, I'll have to Google him.

Howard Farran:

Oh my gosh, I'm giving away my age but that is an amazing artist.

Back to the metal braces, do you know what … what do you think causes that when the tissue … you said a laser for cutting back hyper gingival growth where the tissue starts coming down and growing over the brackets?

Melissa H.:

It's one of two things. The kids might not be the best brushers. Sometimes when they're at that age if Mom can't get in there and help them brush, then that's when they get that gingival puffiness that we have to take down. Some people just have really thick gum tissue up there. So when you take that away, you get crown lengthening on those teeth and they're just beautiful. So the docs actually created a laser book, so we have a bunch of before and afters-

Howard Farran:

I have a completely different theory on that.

Melissa H.:

Okay.

Howard Farran:

Now, obviously with 7.5 billion humans and they each have 3.6 billion [inaudible 00:33:16], obviously it's not one thing, it's not binomial this, that, up, down, left, right. It could be many variables but the way I see it is this. If it was from not brushing properly, then almost all the kids who aren't good brushers would have this problem. But what I've seen it in is this. I think it's a hypersensitivity to base metal because some people, and they're mostly fair-skinned northern European, Irish, English, Scottish, Denmark, Norway, it's all the people that look like you and me.

If you put a cheap ring on the finger, the acidic skin that's slightly more acidic will start bleaching the base metal out and you'll get a tattooing around your deal. When you go to dark skinned people, South America, Africa, or Asia, they don't have that. They have a different skin reaction with base metal. And then if you go to those people who get cheap costume jewelry tattooing, they have to wear noble metals that don't react with carbon, hydrogen, oxygen, or nitrogen at one atmospheric room temperature, and they have to wear gold and silver. I only see that in people that are northern European. I never see that in my Latinos, my Africans, my Asians, my Filipinos. I only see it in people that would get a tattoo from costume jewelry. I think that the skin is different in those people and when it smells, and who knows how it's interacting with that metal whether its electromagnetic radiation whether it's acidity, something attracts it and the tissue starts reacting with it. Agree or disagree?

Melissa H.:

I'm not sure. I'd have to consult my Dr. Grady on that. He's my one that's very-

Howard Farran:

Do this. Do this. Do this. Next time you see it, for no charge, take off all the base metal, and switch them to Invisalign, and see if it goes away. Because even if you put porcelain brackets on, you still got that [inaudible 00:35:21] and nickel and titanium are both, they're not noble metals. They're both highly reactive and I guarantee, after 30 years of riding this rodeo, I think it's the same phenomena as wearing costume jewelry and getting a tattoo around your finger.

Melissa H.:

I'm definitely going to run that by my docs and get their opinion on that one. I definitely-

Howard Farran:

And if he doesn't agree, just slap him upside the head a couple times. Say, "Let this soak in," or put that vibration device thing you have and put it on his head, start vibrating his head so that [inaudible 00:35:56].

Okay, let's switch to marketing.

Melissa H.:

Okay, I like that.

Howard Farran:

Because you're world class in marketing.

Melissa H.:

Well, thank you.

Howard Farran:

Do you want to start with B-to-B, general dentist orthodontist, or do you want to start with B-to-C?

Melissa H.:

We can do B-to-B, it's fine.

Howard Farran:

Okay, let's do B-to-B.

Melissa H.:

Okay. So I'm gonna tell you, I've been with Dr. Grady, like I said, 26 years. I was a patient manager. I worked on the patients a lot. What had happened is we had had one of our treatment coordinators leave, and Dr. Grady had asked me to treatment coordinate, and I still had a little one at home and I couldn't commit to that full time. I was part-time at the time. And so he said, "Okay," he said, "I need someone to go out there and work one-on-one with the dentists," and so that's what I was doing because I could do that on a part-time basis. I fell in love with it, and I'm a people person, so I'm a people pleaser. So when I go into an office, I make them feel like they're number one, and they're appreciated, and what I can do for them. So that's why feel like I have such an advantage at getting general dentists, hygienists to refer their patients to our office.

Howard Farran:

So if everyone listening is driving, about 85% are on an hour-long commute to work, the other 15% are the poor bastards on a treadmill working out when they could be at a bar drinking bear, so to find you, I always retweet my guests. I'm @howardfarran, you're @gkgortho, so I just retweeted. You want me to … "We were very happy with the prompt and highly efficient service," with a little smile. Our celebrity smile contest. I'm gonna retweet that.

Melissa H.:

There you go. That just started today. So we're doing a smile contest. I created a patient rewards program for our patients and for our team members so what happens … and I also did one for our referring offices, so our general dentists, and our hygienists. So what happens is everyone gets kind of their own credit card, a GKG Ortho credit card, and what our referring offices do with it is, for any time we have a mutual patient that they do cleaning on, they send us over a certificate. That patient gets points on their card and also the hygienist and dentist get points. And those points build up and they can go to an online store and purchase gift cards. So the staff can go out to lunch, the doctor can take them for drinks, whatever they want to do.

So, that's a big part of my referring marketing with the dentists is I have these rewards cards. They get points for their birthdays, they get points for the office anniversary, they get points for playing contests we have. So I really feel that that really helps with me working one-one-one with them to reward them for their patients.

Howard Farran:

That is amazing, amazing, amazing. Let's go to B-to-C. What is your target audience? What percent are you going for that kid and that sweet spot versus the adult braces market? What is the sweet spot time for kids needing braces?

Melissa H.:

Well, really we would like to see them by the age of seven, or when their two front teeth are starting to come in because so many people don't realize there's two phases of treatment. The phase one is almost, it's a skeletal phase. So if you have a child that has a crossbite, and overbite, and underbite, and open bite, those are bites that you want to correct when they're around seven or eight. Because when you get around 13 or 14, you can't expand them to correct a crossbite because their pallet's already started to fuse. And at that age, then it becomes a skeletal or a surgical type of surgery because you can't correct it with an expander when you're 13 or 14 because that bone is fused in your pallet.

Howard Farran:

But what percent of your practice is that kid from seven to 14 versus adults?

Melissa H.:

Oh, we have a lot of adult patients too. I would say we're about, let's see, I would say we're probably about 65 child and then maybe the rest adult. We have a lot-

Howard Farran:

So 2/3 child and 1/3 adult. If that child comes in at seven and he's got that big lower Class III and he's gonna grow up to look like Jay Leno, do you just take him straight to the vet and put him down or do you try to help him?

Melissa H.:

No, we'll definitely, yeah, we'll give them a type … we have expanders here so we will definitely expand them. If they have the Class III, we have a face mask so we can pull that upper jaw out. Expanders are only six months. Our phase one treatments are about six months long. So many people don't realize that. They think that they're gonna be in braces for four or five years. Our phase ones are about six months long treatment and then usually our phase two, which is someone that would need full braces, can go from anywhere from eight to 18 months, depending on if they had a phase one prior to needing the second phase of treatment.

Howard Farran:

Okay, but if you're doing your B-to-C marketing, and 2/3 of your practice would be the kids seven to 14, 1/3 would be the adults, do you go after them differently? I mean, do you would the kids be direct mail and the adults, moms are on Facebook? What do you do mostly? Social media, direct mail, events?

Melissa H.:

[inaudible 00:41:29], work. I just feel direct mail does not work whatsoever so we don't do any direct mail. Everything is me being in the community. So I hit all of our school events, I hit all of our community events in the summer, health fairs at the schools, and it depends. So when a mom comes up to my booth, sometimes I'll have a balloon artist there, a paint artist, somebody doing something which draws the kids over, which in turn brings the parents over. And so then you start talking and you say, "Well, you know, who's your dentist? Have you seen an orthodontist yet?" It's all in how you approach them and then it goes from, "Well, hey, can you look at his bite?" and I can't tell you how many consults I've done at the scenes of community events and scheduled them to come in and start treatment. So it just depends on where you're at and how you approach that parent or that child.

Howard Farran:

You know, you're just the epitome of hungry, humble. You're just the American dream. I'm out here in Phoenix, but if you live in Phoenix there's this big park that's 100 blocks long, so 90% of people live north of South Mountain Park and they all say they live in Phoenix, but south of the park where I am, it's only 10% of Phoenix and no one here calls it Phoenix, they all say they live in Ahwatukee. It is Phoenix, but if you say to someone in Ahwatukee, "Do you live in Phoenix?" They say, "No, I live in Ahwatukee," but it is Phoenix, but they always have like an Easter parade every year

So I get my whole team to be in the Easter parade and then we'd have a little booth at the end. We go down to the Arizona Office of Dental Health and get all the free brochures they wanted, and then we'd all be there wearing t-shirts. Some of those Easter parades, we'd schedule 100 appointments, people walking around the parade, the carnival. Gosh, sending your hygienist or dentist or assistants into the third grade February dental health month and give each kid a fun kit with something to color, a toothbrush, sugarless gum, whatever the heck. That is the … you're a hustler, that's what … I mean, you're out there hustling and like you're running for mayor.

My dad told me when I opened my office, I said, "Dad, how do you think I should get new patients?" He said, "Howie, get out there and run for mayor. You're the mayor of your dental office. Get out there and knock on doors, go to events, go to nursing homes. Just get out there, shake hands, press the flesh, act like you're running for mayor. That's what they want. They want a human that they can relate to. They don't know your alphabet soup." I was self conscious that I was straight out of school and didn't know anything. Dad's like, "There's not a grandpa in the world that thinks like that. They just want to know if they like you or not. They assume you're a dentist." You're just a hustler, man, that is so damn cool.

Melissa H.:

It is. So my newest thing is we have a lot of corporations around here, and so have some big hospitals. So I was just working with a big hospital and got approved to create a flyer. So I'm gonna go on the union's list. So if anybody in the union would like to have orthodontic treatment with us, we offer them a discount. So all they have to do is bring in the flyer and then they'll go ahead and get a discount from our office. So I just got approved for that through one of our big hospitals here. And that's amazing because that's … just think about that. That's no marketing dollars. You know what I mean? That's just me creating a flyer and putting it on their website, and how many patients are we gonna get from that? I mean, they have, I think over 5000 patients in the hospital, or employees, that could be potential patients for us.

Howard Farran:

I know, I know. That is amazing. I want to switch to, you're old enough to remember Orthodontic Centers of America.

Melissa H.:

Yes.

Howard Farran:

What's your memory of Orthodontic Centers of America?

Melissa H.:

It was kind of like … I've got to think about that. I was little. I think I actually went to one, now that I remember. I think my mom took me to one, but my mom and dad were divorced so my dad said no that we're going here, but I remember that there wasn't the same orthodontist. It was like a rotating orthodontist, people weren't as friendly from what I remember. But that was a long time ago. I think I was only like seven.

Howard Farran:

Okay, so I'm 10 years older than you. Really? Ryan, Google what year did Orthodontic Centers of America go public. But the point I'm trying to make is that today everybody's like, "Oh, corporate dentistry is taking over the world." Dude, I've seen this rodeo twice. Orthodontic Centers of America tried it, made it all the way to the New York Stock Exchange and imploded. Here, you work in a practice … What year was it? 1994? 1994.

Melissa H.:

Oh wow.

Howard Farran:

So I was … I got out of school in 1987, so that was, let's see, simple algebra, so 19 … so that was seven years after I got out of school. You've been working in the same practice for 26 years. You're not the doctor, you're on the team. When you ask 100 dentists, "What stresses you out the most?" they always say, "It's my staff."

Melissa H.:

It is.

Howard Farran:

"The assistants fighting with the hygienists. The receptionist just flipped off the other one." What is your advice sitting here 26 years? I mean, you stayed in one place 26 years and Dr. Grady was able to attract Dr. Kastner, Dr. Gornick. What's your advice on how you make all the kids play nice in the sandbox? It seems like that's the difficult part.

Melissa H.:

It is difficult and we do have a big staff. It's keeping everybody happy. It's really listening to their complaints and fixing their problems, rewarding them when they're well. Our docs take care of us. I cannot tell you how many rewards we get. It's not always the negative, it's more of the positive from them. They'll always tell you what a good job you do and I really think that helps keep the morale up in the office. So I really feel like that's a big morale builder for us. And then the docs allow me to do a lot for our team, events, taking them out for happy hours. Next week is orthodontics staff appreciation week, so next Wednesday I have a big party planned for them. There's just so many reward points that they give them on their cards so they can cash them in. And then, I mean, we do have little tiffs that go on, but we work them out, we talk them out and that really works. You just can't let things blow up. You have to figure them out. You have to talk them through. I feel like that's what our docs do. They don't let the big blow ups happen. I feel that that's why a lot-

Howard Farran:

I do it totally differently. I do it just like United. I just beat them until their attitude improves.

Melissa H.:

Nice.

Howard Farran:

And they don't work, I just drag them clear out of the office and shove them out into the parking lot just like United does.

Melissa H.:

Well, I don't know about that.

Howard Farran:

I'm just kidding. So tell me this, how much of it, of that team morale, do you think comes from, do you guys have an office manager?

Melissa H.:

We have a couple different managers. We have a front office manager, we have the treatment coordinator, then we have myself that does the professional relations coordinator, and then we have human resources/office manager-type person too.

Howard Farran:

But I mean, is it more like a hierarchy like in the Catholic church you have the pope, the cardinals, the bishops, the [inaudible 00:49:14], the priest. Is there like one of those non-dentists like the pope or is it more of a flat organization where this lady's in charge of the front, this one's in treatment, marketing? Is it more flat or is it more hierarchal?

Melissa H.:

It is more, yeah, so we do. The front and back are kind of separate but they work as a team. So we have our front office, we have our admin team and we have a clinical team. So we're kind of divided into two teams like that.

Howard Farran:

So you have an admin team and a front office team? Is that what you called the front-

Melissa H.:

A clinical team. So we have an admin team, which is kind of like our dry hands people who kind of do the scheduling, the dry hands stuff, computer work, and then we have our clinical team who actually work in the patient's mouths.

Howard Farran:

Wow, I have never heard that described … I've never heard of dry hands, what'd you call them? Dry hands?

Melissa H.:

Dry hands. Dry hands, so that's our financial coordinator, our treatment coordinator, our appointment schedulers and myself. And then we have the clinical team that actually works in the patient's mouths, which we call our patient managers, so they're our clinical team.

Howard Farran:

So you don't call them wet hands because they're wearing gloves.

Melissa H.:

We do. So we have dry hands and we have wet hands.

Howard Farran:

But they're wearing gloves. Maybe you should just call them gloves and no gloves.

Melissa H.:

Yeah. So years ago we brought on a consultant and she used that analogy and it stayed with me ever since. Now she has passed, but she was remarkable and she's instilled so many good things in our office that we still use them to this day.

Howard Farran:

I just don't like when people call them the front desk. I don't think your career should be named after a piece of furniture.

Melissa H.:

Yeah, you're right. So yeah, they're the dry hands. We have an admin-

Howard Farran:

I like that.

Melissa H.:

… dry hands and then we have clinical, which is wet hands.

Howard Farran:

See, I don't know if I could call them gloves and no gloves because if I said to Jan, if I called her gloves, she'd say, "Okay, I'm gonna take my gloves off right now and punch you out." She would.

But the point I was making is this, do you think … the mafia in Italy said that the fish rotted from the head down, which means the heart and soul of your organization comes from the top dog. Some offices will say that that top dog for morale is more likely to come from the office manager, the dry hands, than it is to come from the doctors because there's a weird, natural selection about becoming a dentist, a physician, or a lawyer, and that is you gotta go to undergrad. And while every normal person's out drinking, and has a girlfriend, and joined the frat, and going to parties, you're that weird, nerd, geek who sat in the library and memorized calculus. So that natural selection of people who grew up in libraries aren't really the ones that make a team fun and be able to attract and retain people like you and keep them 26 years. And it's a lot more easier to find those types of personalities at the dry hands up front because you don't have that natural selection of you can't get into this house until you prove that you haven't had a life for eight years and became a dentist.

Melissa H.:

Right. So you gotta remember, I was a wet hands when I started. So I had that clinical experience and I just knew in my heart that you needed that team building morale to make things … it felt good. So when I knew Dr. Grady, Dr. Kastner, Dr. Gornick whoever would do something fun, reward the team, I knew I had to continue that. So when my role changed, I asked the doctors, you know, "What are my limits? What can I do for the staff?" and they're like, "Mel, whatever keeps the staff happy, run it by us, we'll say yes or no." So, I mean, I'm constantly doing things for the staff to make sure that they're happy, making sure lunch is brought in, rewarding them with extra reward points for staying late, coming in early. That's all on me. I just took them all, I bought them a box at the Pirates game two Fridays ago and we went to see our Pittsburgh Pirates for kickoff the summer party because summers are busy for us. So I'm always trying to make sure the team is happy.

Howard Farran:

Wow. How far away was it to drive to Pittsburgh?

Melissa H.:

Oh, it's only 20 minutes.

Howard Farran:

You're only 20 minutes from Pittsburgh?

Melissa H.:

We're 20 minutes out of Pittsburgh and about 45 minutes from the Ohio border.

Howard Farran:

Wow. I still think it never gets old when you fly into the Pittsburgh airport, and you're out in the middle of nowhere, and you get in the cab and you're driving in, and all of a sudden you come around like one corner and bam, three rivers, it's all in your face. Every time it happens, you're always breathless. You're always like, "Wow, that is just so beautiful."

Melissa H.:

Come through our tubes and you see the Point and the City, it is, it's beautiful. You come through our tunnels and it's beautiful, yeah. So we're very fortunate to have that right there.

Howard Farran:

I can still remember growing up as a kid, I never believed in democracy because I grew up with five sisters, and all I ever wanted to watch was Terry Bradshaw and the Pittsburgh Steelers. And then we'd have a vote and my five sisters would vote for the Oklahoma or the Brady Bunch or whatever, and I used to always say, "I hate this democracy thing. It's not good for minorities." But Pittsburgh, Terry Bradshaw, is he the greatest guy that ever came out of Pittsburgh?

Melissa H.:

Yeah, Terry Bradshaw's pretty awesome. Yup. He's pretty awesome. We have our Pittsburgh Penguins right now so we're in the Stanley Cup finals. So we won our first game Monday night. Now they play again tonight. So one of our doctors got to go. I get season tickets for the Pittsburgh Penguins, so I give them out to my top referring docs who refer to me. So they've been pretty excited because a lot of them have got to go to the playoff games so it's been pretty exciting.

Howard Farran:

Yeah, but you could only do that with football because football you wear a mouth guard and they all keep their teeth. Hockey they all get their teeth knocked out. Have you ever seen them pan the bench?

Melissa H.:

Yes.

Howard Farran:

I mean, when they pan the bench, everyone, I'd say what, 80% of those players are missing incisors.

Melissa H.:

Yes, centrals. How about how many centrals and laterals are missing? There's a ton.

Howard Farran:

Oh my god, those guys are just crazy.

Melissa H.:

I would love to hand my card out to them.

Howard Farran:

Yeah, I don't think any sport loses more teeth than hockey.

Melissa H.:

I know. [inaudible 00:55:27].

Howard Farran:

That is a lot. So are you guys getting into the new, big deal, the sleep apnea and all that stuff?

Melissa H.:

Yes. Dr. Grady's into it a lot. We actually have two studies going. We're actually trying to publish in the Dental Sleep Journal right now. We worked with two resident orthodontists that were here and now have gone back to Saudi Arabia, but we did a study with them with our patients. So Dr. Grady's in the process of trying to get that published in the Dental Sleep Journal. We also have another study going with a university in the area. One of their resident orthodontists is taking a lot of our data. So we compiled a sheet, we're taking data on all of our patients that parents consent to and they're working on a study also. So Dr. Grady's very big into that.

Howard Farran:

Well, I would love to have Dr. Grady come on and do a podcast and talk about that and everything. Think he'd ever be up for that?

Melissa H.:

Oh yeah, his airway is huge. So he does lunch and learns, which I set them all up for him, and we go into all the general dentist area, the ENTs, and we educate them on maxillary expansion and mouth breathing. So you gotta think about it, when these kids are little and they have very narrow pallets, what do they do? They breathe through their nose and they breathe through their mouth. So the floor of your mouth, or the roof of your mouth is the floor of your nose. So if you expand that, it opens your airway. So Dr. Grady has actually created CT scans of their airways on 3-D models. It's awesome. It's really cool. He actually wrote an article in Orthotown last year on them, so it was really neat.

Howard Farran:

Gosh, I wonder if I should go back to ortho school so I can join my own website.

Melissa H.:

Awe.

Howard Farran:

Some of these third-world countries, they have complete dental degree programs in six months. Maybe I could go live in Brazil for six months and come back and be a board-certified orthodontist.

Here's my last question, I can't believe we went over an hour, my last question is, you know millennials want to prevent disease. Like the generation before us, they wanted them to cure lung cancer. The millennials said, "Why don't you just quit smoking?" The millennials are far more into prevention than drill, fill, and bill, and I think the million dollar question in orthodontics is how come when you talk to all the anthropologists that when they look at human skeletons from 300 years ago to two million years ago, there's no malocclusions? And then something changed and now everyone has a malocclusion.

If I was an orthodontist, I think to attract all those moms, I'd start having seminars in my office how to prevent orthodontics because basically it's real simple. For years, those kids would nurse two or three years and when they were nursing and the tenacity, those forces were spreading the pallet, and then when they went to eat, mom was giving them some mastodon bone and this kid's chewing meat and cartilage off the bone. And now, the minute that kid has one difficulty nursing and cries one time and then farts, Mom switches to a baby bottle and a sippy cup where you need no forces, no sucking, nothing for guzzling milk, and then she feeds you applesauce out of jar, and then you show up with this narrow arch and a long face and all these malocclusions because that maxilla and mandible never had stress equals force divided by area. It was never worked out. I mean, obviously if you go to the gym and start doing pushups, and sit ups, and squats every day, your body is different.

The bottom line is it's so bizarre that due to getting off nursing and going to a soft, refined diet, and then the bottle and the sippy cup just completely just, now it's hopeless. Now every kid on earth has to go through orthodontic treatment because no one ever stimulated his muscle or his maxilla or his mandible and all those muscles one time and when you see … and then what's also the saddest thing about American culture is if I have a movie on with Sylvester Stallone or Arnold Schwarzenegger, and I have manmade M-16 machine guns and kill down 100 people, it's a family picture. But if some woman starts breastfeeding at the mall, people think the police should come and arrest her for nudity, and violence, and indecent exposure. It's like why are mammals afraid of mammary glands? Why are women feel ashamed when they nurse on the bus or the subway and the consequence of that is that every kid in America gets a malocclusion and has to go see an orthodontist because we …

And someone should invent a baby bottle … here's what I think. Ryan, you should invent this. Someone should invent a baby bottle where that baby has to use her feet and hands, and fight and bite, and can barely get the milk out. I mean, it should be a thing where they have to bury their face in this rubber flat thing and she has to cry and takes her an hour and a half to get the milk out, and then they should throw away all that soft baby food crap and after you get done eating your Kentucky Fried Chicken, you should just throw your kid the bones.

Melissa H.:

I know. I can't explain why. I don't know. That's a good one. I don't know how to explain that one, Howard.

Howard Farran:

Yeah, well it's a big cultural change because until we address this issue, every generation of every rich country's gonna send all their kids to an orthodontic factory because they didn't prevent the ortho. And again, the anthropologists are talking about this on social media. I've posted a lot of them on Dentaltown. You can find them. Just go to Dentaltown under orthodontics. There's tons of them and these anthropologists aren't even talking to orthodontists. They're just talking amongst themselves. You see them saying, "Why are they all normal 300 years ago to almost 1.7 million years back and now they have all these malocclusions?"

And the first orthodontist that even started thinking about this, I forgot his name, he was down in Australia. He was looking at the Aborigines and he was saying, "Why do the Aborigines all have perfect teeth and all the Europeans in Sydney and Melbourne have malocclusions?" That was his first deal and then he started going to [inaudible 01:02:10] and Indonesia, and he's like, "Man, the richer you are, the more malocclusion you have." He went to the invisible Indians of the Amazon rainforest, he didn't find it there either.

So that's what I'd start doing. I'd start having big meetings in your office to get all those pregnant moms in there and say, "Hey, are you pregnant? Come in, listen to this speech." If you talk them into nursing for a couple years, what would be the bad side of that?

Melissa H.:

That's true. That would be our Dr. Grady.

Howard Farran:

All right, well, hey, you think you can get him to come on my show?

Melissa H.:

Dr. Grady, I'm sure I could, yes.

Howard Farran:

All right, well tell him I want to talk to the man who was so damn cool that he could attract, and retain, and keep you for 26 years, and I think you are a dynamo. And thank you so much for coming on this show and talking to my homies today for an hour.

Melissa H.:

Well thank you for having me. I really appreciate it. I will definitely try to get Joe Hogan for you.

Howard Farran:

And I tell you what, you get tired of those snows, you got a full-time job with even more benefits. I'll meet and beat anything Dr. Grady can give you if you come work for me in Phoenix. If I had you and Jan, that'd be Batman and Robin.

Melissa H.:

See, that's awesome. Well, thank you.

Howard Farran:

And it is the highest compliment in the world to say you just remind me of my Jan. I just love her to death.

Melissa H.:

Well, thank you. I really appreciate that. That means a lot.

Howard Farran:

All right, well have a rocking hot day.