Dr. Monica Casadei graduated with honors at the University of Bologna in Medicine and Surgery in 1982. She works as a general dentist since 1983 in private practice in Ravenna with her partner and husband Dott. Massimo Testi.
In 1984 she obtained the Post-Graduate Edgewise with Prof. A. Horn in the Tweed technique.
She attended Prof. Langlade's courses for Ricketts technique.
She attended the Donau University from 1998 to 2004 obtaining the Master's degree with Prof. S. Sato in orthodontics: "Orthodontic treatment of functional patients and dysfunctional".
In the gnathological field she attended the courses of Prof. C. Avril, of Prof. Alain Landry, then followed the Postgraduate in gnathology at the University of Vienna with Prof. Slavicek in 1996. Core curriculum with Prof. Slavicek in 2006.
Ordinary member Sido (Italian Society Of Orthodontics). IBO member. Founding member A.I.G. (Italian Gnatology Association) in which she covered the adviser charge from 2008 to 2016. IAAID member (International Academy of Advanced Interdisciplinary Dentistry).
She translated the books of Prof. Sadao Sato: “Orthodontic treatment of malocclusions according to craniofacial dynamics” and "MEAW: orthodontic treatment with the multiloop arc”.
Since 2016 she have been part of the teaching staff of the basic core curriculum of the VIESID Fondation of Prof Rudolf Slavicek.
She teach for the VIESID Foundation a Postgraduate clinical course of orthodontics in Vienna in English 3 years under the patronage of the University of Vienna as a course director and having as guest lecturer Prof Sadao Sato.
She teach for the VIESID Foundation a Postgraduate clinical course of orthodontics in Poznan Poland.
She propose yearly basic and clinical courses of orthodontics with Dr. Dario D'Alessio throughout Italy applying the orthodontic and gnathological concepts of Prof Sadao Sato and Rudolf Slavicek.
https://www.casadeitesti.it/
VIDEO - DUwHF #1048 - Monica Casadei
AUDIO - DUwHF #1048 - Monica Casadei
Howard: It is just a huge honor for me today to be podcast interviewing Dr. Monica Casadei, who graduated with honors at the University of Bologna in medicine and surgery in 1982. She works as a general dentist since 1983 and in private practice in Ravenna, Italy with her partner and husband of thirty years. Dr.Massimo Testi.
In 1984, she obtained the postgraduate Edgewise with Professor A. Horn in the TWEED technique. She attended Professor Langlade’s course for RICKETTS technique. She attended the Denau University from 1990 to 2004 for obtaining the masters degree with Professor Sato in orthodontics, 'Orthodontic Treatment of Functional Patients and Dysfunctional'. In the gnathological field, she attended the course of Professor C. Avril, of Professor Alaine Landry then followed the postgraduate in gnathology at the University of Vienna with professor Slavicek. In 1996, ordinary member of the Italian Society of Orthodontics, IBO member founding member of AIG, Italian Gnathological Association, in which she covered the advisor charge from 2008 to 2016.
She’s a member of the International Academy of Advanced Interdisciplinary Dentistry. She translated the books of Professor Sadao Sato: “Orthodontic Treatment of Malocclusion According to Craniofacial Dynamics” and “MEAW: Orthodontic Treatment with the Multiloop Arc. MEAW is M-E-A-W. Since 2016, she has been part of the teaching staff of the basic core curriculum of VieSID Foundation of Professor Rudolf Slavicek. She teaches for the VieSID foundation, a postgraduate clinical course of orthodontics in Vienna in English three years under the patronage of the University of Vienna as a course director and having as guest lecture Professor Sadao Sato. She teaches for VieSID Foundation, a postgraduate clinical course of orthodontics in Poznan, Poland. She proposed yearly basic and clinical course orthodontics throughout Italy, applying orthodontical and gnathological concepts. It is just a huge honor for you to come on the show today.
Monica: Are you sure it is my curricula?
Howard: Yeah... I had to laugh when you said, you teach at the University of Vienna, because I remember the first time I lectured in Vienna…
Monica: Yes.
Howard: When you live in America, people are always having plumbers come to their house or something wrong with the toilet, there's always something wrong. And I checked into the hotel in Vienna with I think, were you there with me, Ryan?
Ryan: No, That was Eric in Vienna.
Howard: Eric, and anyone else?
Ryan: just Eric.
Howard: Just Eric!
I had never seen that complex plumbing in the bathroom and the shower. I felt like I was on the Star Wars ship. I mean, when I looked at the plumbing in Vienna, I thought, my gosh, I think they’re the number one in the world in plumbing. And then I talked to the guy and because it was a very old hotel and he said he thought that that plumbing would last another hundred years.
Monica: Do you remember the name of the hotel? because hotel Atlanta is a very old hotel close to the Vienna University, and when I went for the first time thirty years ago, I normally stay in this hotel, and now that I come back for teaching in the same university, University is completely renovated but the Italians are all the same the change is only the lift, you know. The smell is the same.
Howard: Gosh, there's so many things I want to..., I was asked by several orthodontists on Orthotown to try to get you on the program because of your MEAW, M-E-A-W orthodontic treatment with the multiloop arc. There’s so many things I want to talk about. What did you want to talk about for us? Do you want to share your experience with the Gnathological School? A professor Slavicek and the orthodontic teaching with Professor Sato?
Monica: Yes, I want to start just to call briefly my story, the beginning, because it is funny, it’s a little bit funny always, start everything, I started my Dentistry career as a general dentist but immediately, I followed that Professor Slavicek courses in Indiana about occlusion and function and you know, Rudolf Slavicek is the father of modern Gnathology and in Europe is the pope of the Dentistry. And follow his concept was while reasonable easy for me in prosthodontic dentistry but to apply these ideas in orthodontics was really hard. I can't say that I felt completely loved that with orthodontic when I first met Professor Sato in 1995 at least eleven years after my graduation. And it was funny because a professor Slavicek called me around the middle of August in the office and told me that I must must must must attend because of Professor Sato. If you know a little bit Italian, you can immediately understand that I wasn't really joyful of that year, because the 15th of August in Italy is almost a holiday, the summer holiday.
If you know, professor Slavicek, he’s a person to whom you cannot say 'No', 'No thanks' and 'No, I don't agree'. So I remember also that during the call he said, “Listen Monika, listen to me”, he treats severe class ii high hanger cases skeletal open bite without the premolar extraction, without surgery, without [unclear 00:06:43] hypotraction, extruding the upper molar. So, if you have such an affirmation for an orthodontist was madness. Now in the case of class ii high hanger is thinking through the upper molar, but I believe so much in my mentor because he always taught me very important things, very nice approach. So, I did the course, I believe so much and I believe I did the course and I can say that my professional life is totally changed because finally this orthodontic approach was very much in tune or with the gnathological concepts of that Slavicek taught. I never found a technique, or rather orthodontic diagnosis that fits so perfectly with gnathologic concept, that’s why.
When I arrived in Vienna, I immediately noticed that there are only a few participants attending the course, probably both for the date of course. And because at that time in 1995 professor Sato was not so well known outside of Japan. And he was at that time the director of the orthodontic department of the Kanagawa Dental College in Yokosuka; that is a big college close to Tokyo But in Europe and abroad, he wasn't very well known. You have also to think that in 1995, there were no digital device, no PowerPoint, no digital camera. So, professor drove from Japan so many kilometers a long distance, brought from Japan trunks of slides for supporting his lessons and for showing his cases.
He was the output of course of his loyal Japanese students, But the wonderful thing is that he began to enlight us with a history on the causes of malocclusion because till now we don't really have the causes of malocclusion, we speak about genetics, but we don't really treat (for me) the causes but the fact. So he spoke about history of the causes of malocclusion and speak about also the big influence of that the inclination for example, that the occlusal plane has on the development of class iii malocclusion or class ii malocclusion then I prepared just a little presentation to show the concept of that I think is more easier to explain. He started from evolution very far and described all the movement of the bone sphenoid [unclear 00:11:04] synchondrosis and the growth of the temporal bone that are bones that…
Of course, studied anatomy years before, but I have studied not in the functional way. For me, it’s just bone, full stop. He started to explain how everything especially the growth of the visceral cranium was strongly related to the function of the masticatory organ. he began to show his other clinical cases that were very ugly cases with this Gnathologic approach. And in particular he showed how he used the MEAW. The MEAW is only a tool, just a Multi-loop Edgewise Archwire that professor Kim before used in a different way. But with this Arch and with the use of elastics you can have so big change in the inclinational level planes or extruding the teeth for them in low angle cases.
The problem is always that we have to intrude 'for the big bite' the normally frontal teeth and then after some years, everything come back again like before, instead of using this kind of a wire and the elastic way, how they put an extrusion of the lateral side of the premolar and the molar. It is favorable in the time. And yes, the treatment time and other things is nice that is shorter in one year , one year and a half, we can finish all the very severe cases, mostly cases of surgical or border line . It is possible to treat or to give to the people who don’t want to change their face, just want to have a functional occlusion.
You can provide a functional occlusion without to force to go to surgery. Another thing sir is the impression at me showed follow-up of ten years. Normally, when you go to the courses, you see one year, one year and a half and that's all. When you see the follow-up of ten years, seven years, five years, I think that it is very, like I say, you can believe now you can believe in what you, what you are learning. As you're told, I attended several courses before it, TWEED, Lang Lade RICKETTS course, [unclear 00:14:51] wire and I am a person that when I come back home from a course, I immediately change everything. If I go to a course, it means they have something to learn to change in my practice.
I come home my office and I make a revolutionary. My assistant also didn’t agree, but I wanted to change it if it is something that doesn't work. Every time I was so frustrated because it is so difficult the learning curve, when you see that some cases are stable and some are not and you don't know why I'm not stable and so you cannot learn from the failure. For me, I was really frustrated. I wanted to stop to be an orthodontist and make only prosthodontic treatment and so on. But after the course of Professor Sato, I've really changed a lot.
I don't want to say that now everything is perfect and I have no mistake and my cases are so beautiful, but if I saw some relapse, saw something wrong. If I go back looking at what happened during the treatments, I found what I did wrong, and so you can accept and you can learn because you can fail but you can do again. What I want to say, for example, to the younger colleague it's that normally what is teached in the university is that we look at to the developmental and the treatment of the malocclusion especially focus on the sagittal way.
We want to treat the class iii and class ii, just looking to the moving subjects in the sagittal way of the teeth. There is space?? No? So we've to extract the teeth. Instead of, Professor Sato concept is more focused on the vertical treatment. For example for ours, the guiding dental arch is not the lower that will indeed force it to extract the teeth, but the upper ones. For example, you can by expanding and changing the occlusal plane and increasing the vertical dimension, so the lower arch can adapt. The big difference, for example in the treatment of class ii is that we move the mandible, normally is done in a functional treatment or during the grow. If you want to move the mandible, here it is important to have the morphologic concept and to have instruments to measure. You cannot move forward the mandible as you want.
We use for example, the condylography; the tracing of the sagittal condylar path of the eminence. It's like a bussola, I don't know in English as the name of the bussola "she means like a compass" with the North, the South, East and West, if you make an examination, you can know where you are and where you want to go and how much. And so you can measure. . In class ii, believe me; I normally do use the condylography or so in the children. In class ii you find always also if you don't have symptoms of spine, you'll find compression, of light compression or worse compression, but anyway, always compression in the TMJ. Moving and treating with the class ii and moving a little bit to the mandible forward.
Instead, to distalize or to remove the premolar is really asking for the patient because Howard, if you remove the four premolars, sometimes with very not big crowding, you provide a steepness frontal teeth. You'll reduce the transversal size of the arch. The tongue that is so important have a less space and also you have less posterior support of the teeth. I think that this is why I see normally not immediately fortunately for the dentist, but I saw some years after orthodontic treatment with the extraction of the premolar that they became, not all, but they became dysfunctional patient. And you know I think why? Because now respect some years ago, we, all the people, is become a clincher because of stress, because they are, the children are always on the digital device, they don't go to make sport.
The clincher, I think also in America, the bruxism increased a lot. If you have not good occlusion compared to some years ago, thirty forty years ago now just a little lack of support or just a little too close occlusion provides inconvenience. I don't know if you are agree with me. After learning... How can I say... good things so no? I followed the professor Sato for six years, of course it's not six years nearly because I go every three months for three four days in Vienna to follow the lecture and we can bring also to the patient so he's a supervision, we can treat the patient and from Italy it's [unclear 00:22:51] difficult.
I bring to the slide until our points come, and I have all the information; how to go on with the treatment. And so I started, I was so happy to learn that I felt the desire to teach the other colleague this new method, not this new method of making, not only from the clinical point of view, but especially from the method of making the diagnosis of Malocclusion. Professor Sato also supported me with his choice; he shared his material with me. I am at this time; I have three children too, so also my husband supported me because otherwise I cannot start to teach. I have my first course in Salerno in the south of Italy, near Amalfi, so an amazing place.
After the course, I received a call, one day, I received another call. Can you imagine? The story start with a call from Slavicek and then after ten years maybe I receive a call, I was on my motorcycle with helmet, so I was thinking... I have to answer or not? You know the women are too curious. So I stopped the motorcycle and I answered the call and it was my colleague that work in the ANDI. ANDI in Italy is Italian National Association of Dentistry and he was one who followed my course and he invited me to speak for one day in Giffoni. Giffoni is a very nice place in the south of Italy where take place children film festival every year.
He was a very amazing place. But, in that time, I unconsciously answered "Yes", but I've never spoken in public. And I was very shy, you can believe many times I regret having accepted so I spend all my summer time scanning a slide because I want to transfer to the audience all the best that I've learned, I never thanked enough my colleague that invite for this, for inviting me because at that time, I don't think really to teach. Now I teach in Italy a basic course. I work in my office, in the weekend, I teach, for example, a basic course. It is eight days divided in four times in Milano, Turin, Bologna, Rimini, Rome ,Bari and Catania, so all the parts and also abroad .Professor Sato, he was ten years older than me, So it's 72 and he passed me the duty to other clinical course in Vienna with the student and with the patient. And so on. Now we have a clinical course in Vienna as you said before.
In May, I will start in Bologna in unclear [00:29:12] and in [unclear 00:29:14] tool and I am really very happy because I didn't expect that I would like teaching so much. But now the problem is that this year is very intensive because I have to take care of the office I have to take care of the teaching time. I have no time for myself, no time for my health, no time for my friend, no time for my husband. It’s a little bit dangerous. I'm teaching now to [unclear 00:29:56] that is a young dentist. I like how He is very angry ''eager'' to understand and to learn what I know. I hope that next year to have much more time to concentrate on the teaching and just to have less days, maybe only two if it's possible, my husband agreed only two days in the office to much more time for my life because I am 62 and I spent really the last ten years too much concentrated in the work. Because I liked the work. But the life cycle done. Everything must be well distributed, the time for you, for the youth, for the friends. And now I am a little bit only in one way. So, that's all.
I think that to be an orthodontist and treat the patient in this way is really marvelous, because I feel that I'm a real doctor. I am not only an aligner of teeth and I am a real doctor.
To take out of my story, always answer the phone, because there could be an opportunity to be find. This is briefly all my story.
Howard: It's a beautiful story. What I'm very interested in is before the Internet, many, many countries practiced dentistry independently, and they didn't really share a lot of information, and now that you have the internet and now that it's very low cost to fly around the world, it's really interesting to point out discrepancy. How do great civilizations do dentistry differently? For instance, do you agree that the Americans do a lot more orthognathic surgery than say the Taiwanese, the Korean’s, people ....
Monica: Of course not, of course not.
Howard: You don’t agree?
Monica: No, I don’t agree. For me, the surgical treatment must be done if the patient wants to change a really the face or if you have a very, very severe malocclusion that you cannot provide to the patient a functional occlusion. You don't have to stay in the middle; you don't have to make only a camouflage and not a functional occlusion. But if you are able to provide a functional occlusion and the patient that came to me probably because they know, they come because they don't want to go to surgery. Sometimes they have a long face, but they accept it, but also if not, I think why you don't provide a functional occlusion without surgery. And then if you wanted to me to improve your profile, your face to make a light surgery for example, the chin surgery or something not so big like now. For me, now it's a little bit abused the surgery. For me, also is the same in Italy. In Italy, a lot of dentists look to the patient if he has some little crowding or some little chin a little bit big, so immediately go to surgery. But, not all the patient fortunately accept.
Howard: So you feel the orthognathic surgery rates are pretty much the same from the United States to Italy to Korea to Japan? The same percentage of cases as the same common, used about the same amount?
Monica: No, I think that in Asia are less.
Howard: Is it in Italy it's less?
Monica: No, in Asian country, I think, I don't know. I think they use less surgery. I don't know, it depends, because I follow Chris Chang, and the other guys very, very clever that they are able using other device, like the [unclear 00:36:13] they are able to jump to this surgery, to treat severe class iii [unclear 00:36:22] . I also use sometimes the MEAW. The thing that it's difficult to accept for the patient is that they have to wearing the elastics. And it is a condition that equal none if you don't wear the elastics, it doesn't work. It become worse the malocclusion. But in the future for next year when I have more time, I want to keep the concept, but I want slightly to change the mechanics. Because MEAW is important for something, for some steps, but some other step you can use the new device that we have like the [unclear :37:17], zygomatic arch, and why not? It's marvelous. I saw some cases, a lot of cases of Chris Chang and I download all the cases from the [unclear 00:37:35 Beethoven] from YouTube. But I have a lot of idea when I treat my patient from his case and I try to make them.
Howard: When I got out of school thirty years ago in 1987, it seems like about half the cases were treated with four bicuspid extraction. Now that I've been out thirty years, it's fallen in half to about a quarter of cases, that I see and my colleagues see. But you haven't done a four bicuspid extraction in twenty years. Why the discrepancy? I like to find discrepancies.
Monica: I can show you if you want after in my presentation, because if you remove the premolar, because you think that the causes is in front. You see the crowding in the front. So you remove the teeth in the front. But in reality, the crowding is because there is a mesialization of teeth. If you look at these, if you look at the photo of the patient you can see to the cast of the patient, you can see that all the teeth in the lateral side are mesialized. If you remove instead of the premolar, if you remove the wisdom teeth in early stage, you can also prevent some problem, not with [unclear 00:39:18] 'nerve alveolaris inferior'. So if you remove the wisdom teeth, you have a lot of space. But the problem is how to uprighting the teeth, and also faster. Now you can use the [unclear 00:39:41] or the MEAW. If you are uprighting the teeth for example, fifteen degrees of uprighting, you can have a four millimeters and half in each side. So for, with nine millimeter, you can really correct all the crowding. But the problem is sometimes when you are upright the teeth, unfortunately you have also an extrusion. And for example, in class ii high hanger it is not really a good thing to have this extrusion, but if you use the MEAW with the [unclear 00:40:22] band with elastic, you are able to upright the teeth and to maintain , not increase the extrusion, but to maintain the same level or also to increase. So this is the fantastic things that can do with this kind of arch and with elastic of course, and so it's not necessary. You say, "why wisdom teeth instead of premolar?" Because if the problem is in the posterior area, if you remove the premolar, first of all, the treatments and mechanics is also a little bit difficult because we have to move the canine and all the teeth very straight with a root, not only incline the crown like I said, but I was trying to, and the problem is not the after some years, I extracted before the premolar and after some years there is a relapse, sometimes I have crowding and I have space.
Howard: So when you lecture in Poland and Russia, what language do you lecture in when you're in Poland and Russia?
Monica: In English.
Howard: How many languages do you speak?
Monica: Italian and English.
Howard: And what percent of the dentists in Poland can understand that lecture in English? Same in Russia.
Monica: In Russia they have the translator.
Howard: Okay. Right.
Monica: In Poland, all the people they understand English.
Howard: So, in Russia you will lecture in Italian and then have a translator translate it to Russian?
Monica: No, I prefer to lecture in English because I hope to improve. If I speak in Italian, I never improve my English. So, I try to improve always my English. I want to be out of my comfort zone and I speak in English. I teach in English.
Howard: I've lectured in Italy several times and I can't speak a word of Italian. I'm so impressed when dentists can lecture in a separate language in their mother tongue, to me that is just unbelievable. One of the biggest things that's come out since I graduated, there was no such thing as invisalign or clear aligners and now it is a major company around the world. There is still an invisalign as much as they are in Asia, Europe, America. What are your thoughts on invisalign?
Monica: Howard, why are you asked me this question?
Howard: Because it’s dentistry uncensored and I don't want to talk about anything anyone agrees on. I think this show is successful…
Monica: Because I must be [inaudible 00:43:54], I must be bad a woman. You know my answer if I spoke about function, it’s impossible to treat patients functionally only with invisalign. I saw that are very huge colleague that treat several cases with a lot of crowding with invisalign, but you cannot have the control. Another thing so that we take into account when we in the finishing of the other cases, for example, is not to have just the class i looking from vestibular part, but the stability of the cases is when you have the Palatal cusp of the upper teeth in the fossa. It's very difficult if you cannot work with a torque, with extrusion tool to achieve these. Now I want to see.
I will be the development of the Suresmile. Suresmile is machine that you make a dental scan, for example, for the finishing. You can make a dental scan of the palatal part and you can send the file and you can ask to, to put all these little moment and they provide you a wire. I think in TMC, better Titanium and there is a robot bend the wire for you for the finishing and in two months you can [unclear 00:46:07] .I would like to try also next year a lot of things that have to do the next year because the finishing is important, for example, Professor Sato and me ,we don't use fixed retention, if we use fixed retention, sometimes are used in the lower arch but never in the upper arch because if you use this fixed retention , it means that the case is not stable, otherwise , you don't need to use.
He use removable appliance for nine months, three months day and night and six months only during the night. And then nothing, stay without anything because you have the palatal cusp, the big part of the cusp of the sixth, the premolar if you fix it very well in the fossa, it is impossible that the case isn't stable. I use invisalign, but for very little correction. For example, if I have a little rotation and the patient doesn't want, some patient are very crazy because I liked so much when the teeth are not so well aligned. In fact, when I worked removable, a prosthodontic, now I put to the teeth, not well aligned, but because the patient either one the people say " Oh, you have a removable prosthesis" and in orthodontic field, instead of, we have to align everything, but some patient wants everything that must be aligned. So, in such cases I use invisalign but not normally.
Howard: I want to ask about, differences in Italy as opposed like to United States. Like for instance, does Italy use water fluoridation? Do they adjust the fluoride? Does Italy adjust the fluoride concentration and its drinking water to reduce decay? Do they use water fluoridation?
Monica: Water fluor...?
Howard: water fluoridation. That's where you..
Monica: No, we haven't water fluoridation. Because in Italy, in some regions like the north of Italy there is a lot of fluoride, so sometimes the patient have the problem because they have too much fluoride so they have enamel problem and so on. So we don't use, I gave like a therapy, like a drunk to the children, but not in the water that you can have from the tap.
Howard: I want to ask, some people in the United States always say that some countries in Europe have banned amalgam because of a mercury toxicity. Are you aware of any countries in Europe that have banned the use of a silver filling?
Monica: Yes, Nobody use amalgam.
Howard: But has any governments made it illegal? Have any government anywhere in Italy or Scandinavia or Germany, Denmark, Sweden, Switzerland, Has any governments passed a law that said you cannot use it or our dentists just not using it because they don't want to, Or has there been an actual law that says [unclear 00:50:39] to use it?
Monica: To this question I really don't know if there is a law, but I think yes, because for example, when we have to remove the amalgam, we have to write in the book, everything ,and there is a special company to collect of these material, but I'm not really sure if it is really a law written.
Howard: I just want to say that a lot of Americans always say that it's illegal in some countries, advanced countries in Europe. And I've not been able to chase down a lead, I have lectured all over Europe. I've done podcasts all over Europe. A couple of countries have recommended that it not be used in pregnant women. But, I cannot find any dentist to confirm that there was a law passed to ban the use . So when you're at your local study club and someone tells you what they're doing in Europe, ask them if they've actually been there and if they can give you a name and an email of a dentist, I can verify that and then email it to me, Howard@dentaltown.com because I don't believe you. I'm in Italy. You have sixty million people and sixty thousand dentists. So you have a dentist for every one thousand people. Does that make dentistry? I mean that seems like a lot of dentists. The United States is about one dentist for every eighteen hundred and fifty people are almost one in two thousands. Do you think there's too many dentists in Italy or is it or is the industry still a good business even though there's one for every one thousand people?
Monica: No, it's not. Never a good business. We are lucky because now we are very specialized in this field. So I have patients from all over Poland, from Kraków , from Dublin, and a lot of colleagues send to me. Of course, I have only difficult cases, but in Italy, for example, started to grow this center of dentists, which work with a very low price, because we are also [unclear 00:53:37] he close to other that make a lot of work in marketing to try to keep our patients. So, I think that the future is not good for the dentist. In fact, I have three children now one is studying in Sydney, in physiotherapy and the other, the second one, the son work in business accountant, and the oldest one is close to me. Arianna, she is graduated in a economy and marketing. No one of my children, I push it to be a dentist because I don't believe in the future in Italy that the profession the dentist, I think that it will be worse.
Howard: Italy is part of the EU, the European Union. So that means you can practice in water. What is it? a 28 different member countries, so you could take your dental license and practice and Belgium, Bulgaria, Croatia, Czech Republic, Denmark, Germany, Estonia, Greece, Spain, France, Ireland, Italy, Cyprus, Latvia, Lithuania, Hungary, Malta, Netherlands, Austria, Poland…
Monica: How many?? I can put metastasis everywhere.
Howard: So is that true though? So could any dentist in any of those other countries? Like from a dentist, from any country on that list come to Italy and practice?
Monica: Yeah, there is some, but mostly Italians go abroad. For example, a lot of my colleagues in Spain, or in London, but we don't have dentist from the other country, from Romania. it is the easier that Italian goes abroad.
Howard: More people from Italy go to other countries. Other countries come there.
Monica: Yeah.
Howard: I don't ever want to talk politics and we talked for the whole hour, but I just want to ask one political question and I hope it's not offensive. I'm over here. We always hear about Brexit, the United Kingdom leaving the EU with Brexit. Is that the beginning? Is that going to be a trend or do you think the United Kingdom was just very unique? It's an island and it's just a one country deal or do you think ten years from now other countries will have left the EU?
Monica: No, I think that we you must be unit .Europe must be unit. I think that the Brexit is not a good choice for Great Britain. I don't follow too much political because in Italy, I don't know in America, but when you watch on television, they spoke about some events for minute. I went to Australia in Sydney there is two minutes political information and all the other news good news, and to see that the television, the political on the television in Italy is a very boring. But anyway, I think that Europe must be unit, must stay unit, and I don't think that the Brexit is a good choice that Great Britain have done.
Howard: Well, I have to think you and that my mom is very Catholic and her two oldest daughters are Catholic nuns and probably one of the greatest gifts I ever gave to my mother was I sent her on a church group to Rome. And I literally thought she wasn't going to come back. She thinks Rome and Jerusalem are the two greatest cities in the world and oh my god, I love Rome too…
Monica: Me too.
Howard: Yeah, I mean the history. I'm in Phoenix, Arizona. I'm in the middle of the desert. Basically before the air conditioner, there was no big cities out here and there's a lot of Indians, all the reservations but, this city exploded after the invention of the air conditioner, about 1940. In my city, the oldest building I can find is maybe eighty years old. Then you go to Rome and you see Colosseum that are two thousand years old and the Catacombs.
Monica: Incredible.
Howard: I'm telling people that It doesn't matter if you're Catholic or not, or Christian or not. Well. Rome was the first city that passed one million in population and it was, oh my God, what an empire. What a history. In fact, when you go to the IDS meeting in Cologne, Germany. Cologne was the furthest, a German outreach of the Roman Empire. So even Cologne still has a wall around it and I mean, it would take you a month to go to every museum you want to see in Rome.
Monica: Yeah ,and also in Florence Rome is special because now I don't know when you went in Roma because now it is a little bit changed because it is beautiful also the sound of the dialect of the Romans, but now in the center there is only Pakistan only if you go to the market. It is completely full of Asian people. Of course you have the monument and Fontana Di Trevi, and when I went, I loved so much (inaudible: 01.01.10) and I sit down in that restaurant that is a little expensive but doesn't matter because I appreciate to see this big square and I loved Roma too. When I go out from Roma termini, it's like if I take an antidepressive drugs, I feel full of energy, I don't know why, it's the same as Napoli. Napoli is a little bit dangerous, but also Napoli is big fashion.
Howard: And the other thing I thought of, last question, when you love food, like I do food - take Mexican food. Mexican food is so different in Mexico than it is the United States. And even the states that border Mexico, in Texas, they call it Tex Mex. I think the best Mexican food is in new Mexico. Arizonan Mexican food is very different than New Mexico food. And when you get into southern Mexico, all of the Mexican food items that Americans like, they don't even know what you're talking about, but I'll tell you what, it was in Venice of all places with me and Eric, there's a lot of Italians in the United States, especially in the east coast, like New York and New Jersey. I tell people there's no Italian food in America. You think there is, but there's not. Because when we went to Venice, I mean that lasagna, and that all the dishes, I mean it was at a different level of amazement.
Monica: It is normal, if you want Italian food, you’ll have to come to eat in Italy of course.
Howard: Well, I believed before I went to Italy that there are so many Italians and Italian heritage in New York City that in New York City you could find an authentic Italian restaurant. But I assure everyone listening, there is not one Italian restaurant in all the United States, you can't eat Italian food, like the second, third, fourth generation Italian. And the Italian food especially in Venice was at a different level.
Monica: Yeah, probably also because there is a second generation and also because the products is not really the same. Because the 'Parmigiano Reggiano' for example abroad you can find Parmesan. Parmesan is not the same, the taste is completely different, or the mozzarella you can eat, you have to eat in Italy. In America, you have to eat American food. I don't know which is American food.
Howard: Well, it was a huge honor for you, we went over an hour so they're probably sitting in the parking lot waiting and ready to go into work. But I just want to tell you that it's a nine o'clock in the morning on a Monday here. What time is it in Italy?
Monica: Now it’s six in the afternoon.
Howard: Six p.m. So you're nine hours ahead. Thank you so much for coming on the show today. I was so excited when you accepted my invitation, you’re so informative. Thank you so much for coming on today and talking to everybody and I hope you go out and have yourself a very nice Italian dinner tonight.
Monica: Yes, and Howard, remember that if you want to come in Italy, you can pass to Ravenna, you can visit me. Because also Ravenna was the capital of the Byzantine Empire Occident. And we have so beautiful mosaique; she is a very little city. You can go by bicycle and it's very like a jewel.
Howard: Didn't Mozart Play in Vienna?
Monica: Did?
Howard: Did Mozart, Wolfgang Amadeus Mozart, didn't he play in Vienna?
Monica: Yes of course. You can hear the music in all the street, but especially in Salzburg because he was born in Vienna, but he lived in Salzburg.
Howard: Thank you very much for coming on the show. I hope I get to have dinner with you and Italy someday.