Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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1099 Cosmetic Dentistry and more with Alex Rubinov, DDS at MegeGen, Las Vegas: Dentistry Uncensored

1099 Cosmetic Dentistry and more with Alex Rubinov, DDS at MegeGen, Las Vegas: Dentistry Uncensored

10/15/2018 10:01:48 AM   |   Comments: 0   |   Views: 231
Dr. Alexander Rubinov graduated from Columbia University College of Dental Medicine with distinction, where he served as President of the American Student Dental Association and was the founder of the Aesthetics Group. He then completed a prestigious General Practice Residency at the James J. Peters VA Medical Center in New York City, an affiliate of Mount Sinai Hospital. During his residency, he received world-class training in treating complex cases, implant placement, and advanced dental and surgical techniques. He has engaged his skills beyond the dental clinic to provide community outreach, dental service in Cambodia, and continuing education. Dr. Rubinov follows in a storied tradition of dental excellence, building on the legacy of his grandfather, who founded the first dental clinic in St. Petersburg, Russia, his grandmother, as well as his father. Alex Rubinov is passionately committed to meeting all of your dental health needs.

AUDIO-DUwHF #1099 Alex Rubinov, DDS

VIDEO-DUwHF-1099 Alex Rubinov, DDS

Howard: It is just a huge honor for me today to be podcast interviewing Alexander Rubinov, he's speaking today at the Megagen conference, just a very huge conference there's 1200 dentists here it's just an honor that we were even invited to speak here today and I saw him speak and I said no no no you gotta come next door. So I kidnapped him and he'd probably rather be anywhere right now than here but I got him

Alex: That's not true.

Howard: I got him to come on the show, in a nutshell he was born in Russia and his third generation dentists. Fortunately unlike his father he did have to go back to dental school after practicing dentistry for 15 years, prior to dental school he completed his master's in biomedical science and worked at Johnson Johnson for a year in R&D oral care, he graduated Columbia University which is in Manhattan Columbia University of Dennis dental medicine in 2014. Upon graduating he completed a one-year GPR at the Bronx VA and split a six day workweek between his New Jersey practice with his father and working for Larry Rosenthal and Michael Appa which are probably the two most prestigious cosmetic dentists in the world they both been on the show. After two years he started the dr. Alex brand where he currently practices in Manhattan on Madison Avenue and is the preferred dentist for the society management the Ford model agency and Elite Model Management help stop celebrities, athletes models and influences achieve the perfect Smile. So thank you so much for coming on the show and what are you doing here talking about?

Alex: So I am here as it seems I have a lot of experience in cosmetic dentistry my mentors are all about porcelain veneers however I think dentistry has taken a change ever so slightly and that change is that education and knowledge is so easily accessible because that's the case I think dentists and general dentists have expanded their scope of practice more so now than ever and so having such a strong cosmetic background which I sort of expressed a lot of my social media and my outlets to everyone but my surgical part I don't really emphasize as much as I do and so Megagen, I'm a Minich night with Megagen. Which is a Megagen international research and clinical research member and that organization is really a compilation of Megagen users all around the world that have the opportunity to exchange knowledge and talk about what they're really good at. So my my field is being able to take a tooth and understand that smart the smile design aspect of it but really get into the surgical part of it as well and so I start talking about how your brain needs to think to capitalize on time and efficiency and beauty for your patients. So when I spoke today about bone grafting and implant placement simultaneously in the entire smile design for a smile makeover that's really it's the pattern of do an implant wait two years and then we'll get to your smile that's far in the past. Now it's everybody wants their smile to be done yesterday and so what I was able to speak about is how implants and surgery kind of fits into the overall scheme of rejuvenation.

Howard: You know it's interesting because I'm when Invisalign came out everybody was doing changing the clear aligners once a month for two years right now they're changing the aligners every two weeks and doing 24 trays in 12 months everybody wants faster-faster-faster. So when when you know when I got out of school 31 years ago the reason I didn't like the veneer guys is because it seemed like they were shaving down so much tooth structure and all that stuff because if you're only tool looks like a nail.

Alex: Yes

Howard: and then the next strategy was that you would have to add ortho skills and they would unwind a lot of this deal with some ortho whatever and I would always say and it looks so much better than it was so much conservative. Now it sounds like your generation the elite cosmetic dentists are at in implants, so I mean first it was just file everything down then it was let's unwind it with ortho and now you're adding implantology to cosmetic dentistry.

Alex: I think it's a very European model right in America it's typically if your specialist you focus on that if your general dentist you just kind of do crown and bridge you can probably tell me better than I don't you think there's a paradigm shift in how dentistry is being done today and more towards that dentists are able to have a larger scope of practice and implant dentistry plays a huge role in that because now whether you do the surgery where you're just knowledgeable on the surgeries the key is, is knowledge is power in the knowledge and knowledge is power and so if you want to be the quarterback you want to be the general dentist that can have an open communication with your surgeon and say listen this is what I really want to accomplish let's get here together not let me just send you a patient you tell me what to do. Now you're not in control because now that that surgeon does not want to refer back to you that person is like listen they you know whatever you seem and are able to take control of anything the other person on the other side is thinks about you as I want to work with this person more I want to see how now I have a patient that I want to refer to you because you're able to dictate to me what I need to do now let's do that again let's play that over again and the confidence that you have my patient will see that in you as well.

Howard: Yeah you make a good point. It's really embarrassing as a dentist when I go to some of these labs. The largest removable partial denture lab and they're all shipped to Nogales Arizona and then they're drives from Nogales to Mexico and they have a big partial framework acid makes a lot of frameworks for existing labs. They do a thousand a day.

Alex: Wow

Howard: and I go down there and 90% of the prescription just says lower partial

Alex: Yeah

Howard: I mean just says lower partial and say are you really a thousand you're gonna get a thousand dollars for this and all you could write is two words lower partial. So you're saying that taking control is contagious for both the patient, your referrals, your specialist?

Alex: I think so, so as a young dentist the ability in to grow myself has really just been in that consultation.

Howard: Now your third-generation dentists your dad's in Manhattan too?

Alex: He's not he is right over the bridge in New Jersey, he started actually my grandfather fortunately my career didn't start the way there's did my grandfather was on the German Russian front in Saint Petersburg then started the dental school in St. Petersburg.

Howard: Started  the dental school, that is one of the most beautiful cities. I took three of my four boys of St. Petersburg.

Alex: You know it's an honor but I still have friends and colleagues that are in Russia and they say the first day of dental school they have the history which is something that America doesn't have I went to Columbia you think that they would give us a history of what our ancestors from this University were like but they still do that in Russia and I still get a I still get people mentioning to me that there's a photo of my grandfather that's up there. So that's the way my dad started as a dentist and then after 15 years he had to come back to start it all over again two boys immigrating to this country

Howard: because they didn't respect his license.

Alex: He did a foreign dental program in the 90s.

Howard: Oh in the 1990s

Alex: 1989 is when he left I was 5 years old

for what city St. Petersburg?

Alex: St. Petersburg and then directly to New York, New Jersey.

Howard: So do you remember st. Petersburg at all?

Alex: I do I it's funny because when you're small everything looks big and so my first visit back when I was a teen I looked at things like my grandmother's apartment and her summer house and everything and there's vivid memories of things looking so large and grand and then when you're grown up you know what it is

Howard: You know why that is?

Alex: Why is that?

Howard: I watched a youtube video, so when you're little your eyes are closer so that the cross still so when your eyes are closer the fields everything's huge and then as your head gets bigger in the eyes get further apart everything comes down in size it's actually physics.

Alex: So it's all the optic nerve it's all the eyes.

Howard: It's all the interpupillary distance so as they get closer everything's huge and as you pull them apart they get smaller.

Alex: I would have thought it's because I was two feet tall.

Howard: Yeah you were two feet tall but it was the inter pupil distance yeah it is amazing. So I am always embarrassed I'm talking about right you said you're grandfather's on the Russian German line. I always get so sad about that because you watch all these American movies about World War two and it's always like the Americans are the heroes and they go in there and they win in World War two, dude the the Americans lost like three hundred eighty thousand or I think 360,000 the UK lost like three hundred eighty thousand the Soviets lost 20 million people in that line that the the whole Russian the whole German breakdown bogged down was at the expense of the Russians and then have the UK and the Americans come in the back door at the very end and to victory is just insulting do you agree or disagree?

Alex: I wouldn't say that it's necessarily insulting but it's just it's all about timing right. So clearly the Russians were there from the start and then from the backside is when they came in through the UK.

Howard: but 20 million casualties, I mean a lot of people they don't understand Russian why do they do that or whether they act like that, dude they lost 20 million people during World War two you don't survive I mean America lost 1 million during the Civil War a hundred years ago and that's still strong alive emotions today. I couldn't imagine losing 20 million just 60 years ago.

Alex: I mean consider I did a lot of volunteer work in Cambodia I was in debt school and talk about that kind of a country where you're losing 50% of the population that's educated that's influential that's political it's lawyers, doctors, teachers, and all you have is now the farmers because the regime wants to be able to capitalize on that and to now see these kids and see the kind of growth that the country has to go through see what's in sort of, you always you don't want to feel bad but you want to just look at it and say you know how does society how do people let things like this happen, how does that happen.

Howard: That happens from the inside out.

Alex: That happens from the inside out and the 70s in the 70s what were you doing in the mid 70s I know or do I not want to know?

Howard: I mean I was born in 62 but you know when I lectured in Cambodia I had three of my four boys with me and the first couple of days I just it was really weird because it'd be like third generation that's like I'm really hitting it off how old are you 34 I'm really hitting it off with a 24 to 34 and having all this fun and his dad's a dentist but he's just kind of like I can't tell how he's looking at me he's just kind of looking like daunt or no energy and finally this one kid I was really close I said does your dad, you know he just doesn't seem happier engaged or whatever he says Howard it's everybody your age they lived through the Khmer Rouge they all lost a mom a sister they all lost half of their family they're all dead inside and he goes my dad is a broken man and all the dentists that are your age they're all broken and dead and it's just so sad and then we went to the museum what was that called the Khmer Rouge?

Alex: The killing fields.

Howard: The killing field and it's like oh my gosh but anyway we I don't...

Alex: No it's okay to talk about it because we're at a conference right now that's 1200 people that are focused on dentistry and bettering the society in the world and we're in Las Vegas I mean how amazing is this country that we live in the opportunities are available to us the tragedies that we didn't have to go through but yet everybody in their minds constantly thinks about these different footsteps that we have to take to better ourselves and we struggle all right. Dentist I obviously dentistry is one of the most sought-after careers in the world right now however if you talk to every single person or half the people that are in the conference the first thing they're gonna talk to you about is a complaint, Oh I can't get a patient oh this surgery didn't go well oh I don't like to do cosmetics oh this is hard is it really all that hard. I mean you talk to people every single day that's what you do that's where that's why people look up to you is it all about the mindset it's all about the framing that you've put yourself into and we're and also how how knowledge and societal norms have developed us and with this fast-paced day-to-day like businesses are built in less than a year, 20 years ago take 10 it takes 10 years you just see a successful business growth. Now in New York City there are companies being bought after one year startups are being sold like that for 10x 20x DSOs. Right DSOs today they I mean you could tell us more than anybody else they tried to start them up back in the early to mid 90s they weren't as successful as they are today.

Howard: I think it's whenever I hear people complaining about the economy they say well you know it's only growing like on average two to nine percent for last 20 years, its like dude during a world war but like Germany when when World War 2 was over in 1945 they didn't declare the reconstruction over until 1980 so you're bitching about 2% growth you're in peacetime how would you like to have your economy dip 25 percent or 40 percent or and it's like...

Alex: How would you like to not have a currency that means that yeah where money doesn't mean anything the value of a dollar doesn't exist so it doesn't matter how hard you work because there's nothing to buy.

Howard: So how many years out have you been from dental school how many years out?

Alex: I have been it's four years now one year residency.

Howard: So answer question that people as old as your dad and me always wonder when when we were in dental school 30 years ago everybody wanted to get out and own their own practice a lot of people say that the Millennials are a different generation and that maybe as many as half of them don't even want to own their own practice they just want to 8 to 5 job they're just not like that is true or false?

Alex: I guess it really depends on the circle that you surround yourself right it's what kind of people are your friends and they're the ones that are the go-getters and the ones that have passion for their career their life their love life their friends and they always want to better themselves or they just complacent. So the people that I surround myself with are the ones that want to start a job that one that when I say am still at the office at 11:30 no problem in we can't do dinner today that's fine. Like I think that it really is person dependent and what you have right now is the opportunity to choose whereas maybe thirty years ago you didn't have that opportunity to choose because all you were gonna you were never gonna grow as an individual working the nine-to-five but now you can you can be part of a bigger organization that will let you. I didn't have to go to dental school I could have grown within Johnson Johnson but I wanted to have my own career I wanted to have the opportunity of and the freedom to choose my own schedule to if I wanted to give lectures I could lecture if I wanted to go do a mission I can if I wanted to just work in the office six days a week which I typically do I'm able to do that as well. I think more now than ever people want to consider themselves entrepreneurs but with this maybe idea that they come out with such debt and they need to go into a stable stable practice where they know they're getting a consistent salary maybe the comfort of that is what's guiding people into a nine-to-five.

Howard: but I always tell the people you know if these jobs are so great and if you're gonna gradually down this year in 2018 then you should go back to the graduating class five years go to 2013 and you should just find hundreds of people that are all happily working at a DSO Monday through Friday 8 to 5 making consistent income and life's good and I don't see that, I see their average job hop one to two years. I mean it's considered the best DSO if your average doctor can stay there two years and the average is more than a year and I think it's not a fault to the DSO because I see the same thing in the private practice. I think when you are finding people that have eight years of college and are dentists physicians lawyers it's like herding cats if you want to build a big organization like a military you need a bunch of young eighteen year olds if you want to be the largest employer of Walmart the majority there people are high schools but if you want to hire a hundred dentists they won't even agree that today is Friday you know they you I mean look at many different implant companies there are because dentists don't agree dentists lawyers look at look at Supreme Court they're lawyers every major decision is always five to four.

Alex: Right

Howard: It's like dude the Constitution that you're all looking at the same words but that mean so highly educated minds don't usually work well under my thumb. So I always tell them you know look the bottom line is you want to be happy you're gonna open up your own place but then they're gonna tell me they're gonna say okay but Howard yeah there's a you Alex and I really go to Manhattan I mean God you got NYU that graduated six and a half percent of all the dentist in America you got Columbia how many?

Alex: Stony Brook

Howard: Stony Brook

Alex: Rutgers that's about 45 minutes from the city

Howard: In New Jersey

Alex: In New Jersey and then Buffalo a little ways up.

Howard: and then a new one don't you?

Alex: We do, right.

Howard: So the question is I just went to I just went to NYU at $100,000 here I'm $400,000 in debt would it be insane for me to open up my own practice in Manhattan can i still be done or those days over?

Alex: It's a great question I think what needs to really happen is you need to have a realistic viewpoint on it what do you want to accomplish and what I've been talking to a lot of friends is they have started their own but at the same time they're also maybe doing two or three days somewhere else that's consistent it's an associateship yet maybe one or two days renting a chair and trying to grow their own practice I think it's still possible you have to be willing to work for you have to be willing to get out there and network and more importantly you need two things that I think are critical one is you need to make sure that you're technologically advanced that you're up-to-date that what dental school teaches you is just a framework just like a building. You just need it you need the dental schools responsibilities to give you something that you can build off of and now after that is your responsibility to grow. My mentors have really been able to change my life they're the ones that have grown whether that's from Florida Jay, lerner Larry, Rosenthal Michael Appa my residency director Dr. Ornstein who I did 100 implants with during residency. I've had the opportunity to dabble in a bunch of different things my father who does a lot of orthodontics and TMJ and so my view my mindset it sort of expanded because of that from a functional aesthetic and a surgical standpoint. So I think you need to have the knowledge in order to go out there leaving right out of dental school without mentorship or a lot of CE courses during. Dental XP I mean this is embarrassing to say but people used to say to me Alex like what TV show do you watch before you go to bed and while I was in dental school my TV show was Dentalxp I would open up I would watch an hour of Maurice talk or Doc's from overseas surgical cases and really that just gives you the opportunity so that next time you go see your patient in the clinical world you can start thinking about what you just learned yesterday it's the same thing as reading a book watching the news it just gives you more padding more and that starts from today. So really the thing is is can you start a practice today absolutely what do you have to offer what do you have to offer.

Howard: Maurice Amma love that guy and his older brother what's his name?

ALex: Henry

Howard: Henry

Alex: They're both here they're both speaking

Howard: Yeah I mean I he's I've been to his place in Atlanta Georgia.

Alex: Same

Howard: Just an amazing man. So again I you know 30 years ago your dad and I it was just file down veneers then they start adding ortho and invisalign and they're in early so now you're adding implants, it's tough for her to decide how does she go from cuz you gonna tell me I graduated Columbia $400,000 in debt guess how many implants she placed?

Alex: Zero

Howard: Zero, so there's all these systems there's all these cores Walker from I'm a de Colombia I want to be like you and I grew up and why did why did you pick Megagen out of all the implant and are you agnostic or are you are you into Megagen?

ALex: That's a great question so I don't think there's any one system that you have to use but there's a few criteria that I really liked from the implant systems and that was I was trained on straumann Nobel and Astra and there's things that I liked about all of them whether it was a deep conical connection whether it was aggressive threads like the nobel active or whether it was a greatcoat like the straumann and so Megagen hasn't been able to incorporate all of those factors has a deep conical connection has great pitch and great threads and an amazing X speed coat that allows oxidation and integration of the bone into the implant.

Howard: Okay the first thing you said is a deep conical connection, explain them to someone who doesn't know what that is.

 Alex: Right so when implants I was just gonna kind of show you the analogy of external hex is what implants started with and everybody just knew the flat top connection everything was flat and that's the screw was what was really holding the implant together and then it was normal to have one or two millimeters of bone loss you'd say you look at the other x-ray a few years after you'd say oh that's normal after three months you can see this after six months you can see that after two years you'd see this but nowadays nobody wants that and so the reason that deep conical connections which is if you were to put one cup into another cup they would fit in like a like a Morse taper really beautiful fit. So what that offers and whether that allows is not only the screw that's now holding the implant but now that friction fit inside is holding the implant to the abutment to the restoration and allowing for a platform switch which down...

Howard: There really two forms of abutment, the conical Morse taper plus a screw so you like the the two


the two connections then and that way in what mega gen was that the Megagen?

Alex: Megagen has adapted.

Howard: is that the but what is your

Alex: That's the Any Ridge

Howard: Megagen Anyridge, so is that your favorite implant? The Megagen Anyridge or...

Alex: That's a system that I typically use.

Howard: Well if you place a hundred implants what percent would be which ones?

Alex: Between Zimmer and Megagen, Megagen is now the implant that I primarily use.

Howard: So  Zimmer and Megagen.

Alex: Yeah I started placing a private practice Zimmer...

Howard: You know I want you to do me a favor, you're in Manhattan right so I want you to walk to all the way in where that Bowl is yes because all there's all these rumors well it's not really rumors I've seen it that Zimmer has put their dental implant division up for sell have you heard that?

Alex: They were acquired by they joined with 3i, 3i and Zimmer is now one.

Howard: Zimmer acquired 3i long time ago yes and but now that whole division they've told Wall Street they want to sell it.

Alex: Well dentistry in the world doesn't

Howard: You should buy it.

Alex: You and I together let's do it together.

Howard: We'll call it the any dentaltown.

Alex: [Laughter]but what I would say to the girl thats graduating right, what do I say to her... I say follow what your passion is, follow what you want whether it's a balanced life whether it's a career that you want to own three practices follow that and then find people that are in that realm that are in that world that want to get that want to help you because everybody that's just like you why do you share your knowledge why do you share with why do you have podcasts because you have so much to share and you just want to let people you want to help people. Same thing with mentors they've done it they love how they love being able to share with you how they got to where they are today and guide somebody to get there because paying it forward there's nothing better you can make all the money in the world but paying it forward there's nothing better. I love having mentors actually one of my mentees just got into Columbia and she text me every single day something that's new I just got my new typiton I just passed my exam I just every exam I did was above 90 I'm the best in the club I'm doing this chair on in philanthropy. I mean all of these different things and I love it, it makes me feel good I don't make a penny out of that it just there's things in life that are rewarding and so being passionate about what you do is probably the most rewarding thing making you happy in life always you have ups and downs but it's really being able to mellow out and find out how that consistent path going upwards is gonna get you there and so having that debt of 400,000 you knew you were getting in there before it's not like all of a sudden they said you're gonna come out with no debt and then and then you four years later you get a check but you get a bill and says by the way you've paid a payout, we all knew that so is our mindset needed to be framed in order to get there. So I think mentorship is absolutely key education is absolutely key whether you feel like you're the individual that's gonna go out and go to conferences and do a hundred hours a year of CE regardless of whether it's required or not or not if you're not that person that wants to learn about it like I was just taking a course with Gr. Gelb on sleep apnea which i think is huge or now and everybody needs to be at least knowledgeable on how sleep apnea affects individuals lives affects the ability to perform sleep is huge and one of my friends that I was in my master's program she's a dentist three days a week two to three days a week she practices dentistry the other days of the week she does what she really loves which is a stand-up comedy and that's great that she's able to acknowledge that she says...

Howard: She's a dentist in Manhattan?

Alex: in Manhattan

Howard: She's my new best friend.

Alex: I'm gonna link you up with her

Howard: You know I don't know if people know this but it's always been my hobby yeah so I've done every stand-up venue in Arizona just loved it.

Alex: So I knew that I always wanted cosmetic dentistry to be sort of the point of my career, so I wanted to be the doc that somebody turns to and says hey I needed veneers I need a smile makeover that's the guy you gotta go to and so from the I could have gone to my state school of Rutgers or I had the opportunity to go to Columbia I was debating between the two and I said to myself I'm gonna take advantage of this opportunity and I want to be in New York City and I'm gonna give it my best shot. Well I was there I started a lot of different organizations and I grew a lot of different things and I was very proactive one of the things that it was probably the most pivotal of my career was I started the esthetics organization invited five of the top doctors cosmetic dentists in New York City to come to Columbia University and speak. One of them was Michael Appa after a few attempts of getting out of him and saying hey would you come eventually he came up and he spoke and that was the beginning that was a relationship that started three years before I started working with him. So everything doesn't happen overnight it takes time and so that relationship while I was in residency we would start spending time in his office and getting along again to know each other and before I finished residency offered me a position and so I had the opportunity of working in with Larry and Mike side-by-side grinding day and night and seeing how these brilliantly incredibly talented driven passionate individuals function on a daily basis doing hundreds of cases every year and I said this is exactly what I love.

Howard: and they work hard and they hustle.

Alex: If anybody looks at them and says you know they this is luck he just got this you're completely you're just in denial because they're working day and night all the time hours and getting better the keys is they're constantly looking at their cases they're critiquing themselves and they say how could I do this better and that's what really make a professional, not one that's in denial I think that's what makes an individual become stronger is being able to accept right I'm sure you understand you've talked about this a ton EQ versus IQ emotional intelligence versus intellectual intelligence.

Howard: Larry taught me two profound things I went and I was lecturing at some New York meeting and I stayed a couple of days with him afterwards and I was very little I think I was like 28 29 and what was blew my mind the most is I thought veneers was something a young beautiful woman got and Larry was the one who taught me was a young beautiful woman already young and beautiful and they don't have any money and so it was lunchtime so Larry said you want to go grab lunch so we go down the elevator we jump in his black Porsche and what does he do during his lunch hour did he eat oh hell no he stopped at this one place where there's like 50, 60, 80 year-old women having lunch and he's just walking around Margaret used it up in here oh my god if you got veneers you'd look like you were today over 65 these 80 year old women are all excited all that and he's kissing them and hugging him and pressing the flesh then we went to another place and I mean during his during his lunch hour he probably planted 10 marketing seeds to really old women who could buy a $50,000 veneer in cash. So I mean the guy was hustling in the flesh pressing the flesh and he was like he's like every one of these 80 year old widows whose husbands now not alive and complaining about spending money and they want to all look younger and fancier and I mean so did was was that sellers practice when you were there recently?

Alex: Absolutely

Howard: Absolutely

Alex: Absolutely never stops

Howard: but I'm saying what what percent were young hot women getting veneers done versus a bunch of really wealthy older women?

Alex: I think it's a combination combination so social media has really changed the exposure of and the image. Kim Kardashian for what for whatever you want to take it has absolutely changed and been a tremendous paradigm shift and how beauty is perceived nowadays and what I saw is that you can never stop whether you want or you don't want to if you want to become a powerhouse in your field I was giving a lecture today but this is a text message that came through I can't lie the date is and the time is all written I want you to read what's going on over there.

Howard: Do read it or don't?

Alex: You can read absolutely.

Howard: Starting the first one?

Alex: First line.

Howard: "Hi guys Justin this is Alex he's amazing person friend dentist everything, wanted to connect you guys thank you so much just like you, minus dentist part lol"

Alex: That's Christina who wrote that and then what did I say?

Howard: "Glad I'm a person first and foremost Christina thank you I love you too just so nice to meet you happy to help" You said Kim Kardashian and you have more Instagram followers than anybody I know in dentistry your your Instagram page is drAlexNYC you have thirteen point seven thousand followers I would talk about are you the Kim Kardashian of dentistry?

Alex: I wouldn't say I'm Kim Kardashian.

Howard: What's the other guy Kanye West?

Alex: Kanye West but this girl Christina had she first come to me because of social media and now

Howard: When you say social media do you mean Instagram?

Alex: I mean Instagram.

Howard: More than all the others.

Alex: and now and what does she do she does spray tan she has something called sun kissed by a Kris and so she goes around to people that are image centric and she spray tans them and she can't and now has friends and colleagues and and customers that she just links me up with all the time I'd say they look at my smile and now they want to reach out to you and so most people used to say have them call my office...

Howard: They look at your smile?

Alex: No look at her smile and they and she's nice and I did her smile okay she found out Instagram I did her smile and most people would say oh well have this person called the office I say if you have anyone you want to refer have them call me or put us on a group message text let's talk because people want to be connected they want to hear her say Wow Dr. Alex is amazing not only as a friend he's a dentist but you should get in touch now Justine want's can't wait to see me and so everybody wants things now social media Kim Kardashian has changed it from oh call my office on Monday yesterday's Saturday and we're in Las Vegas and they're in New York but she wants to know that she can see me first thing Monday morning when I get back to New York City and I'm damn well going to make availability for her.

Howard: So when you look at social media I read things like that your generation is leaving Facebook and going to Instagram true or false?

Alex: Well the honest truth is it's all one in the same Facebook owns both Instagram and Facebook but what really is going on is there definitely is a generational change snapchat is utilized by a lot of the teens the younger age in the middle probably 20s to 30s to probably 40s is Instagram and then 40s and above is Facebook because Facebook people want to connect with each other they want to find old friends this college friends and that's really easy to kind of do Instagram is a little more immediate gratification. I want to see the best cars that are that LeBron James is driving I want to flip through and look at I want to be wowed right now our minds are being changed to immediate gratification instantaneously I want to be I want to be uplifted I want to be excited in photography and photos that's the way that it's being done right now for better for worse I definitely I believe from a business standpoint I think it's amazing. I like being on Instagram because I'm able to communicate with my followers I'm able to grow a network of Doc's like I'm friends with people from all over the world where there's a swath from Tunisia or me Mitsy is from Greece this is what's keeping us in touch this is what I comment on their work they're coming into my work they're seeing my patients they're like Victoria's Secret models can you bring them to me and I'm like come and come in and hang out in the office for a day and you'll see really the energy and the vibe is what was what has attracted. So that's just you can create whatever image you want on your website Instagram but the truth is is when they come to see you in person are you really that person that you want to be and so I'm authentic and I'm genuine with what I what I show I manager myself I work hard at at seeing what my followers like to like me to post and that's what's critical in today's day and age that's where business is going but it has to be coupled with that personal ability to hop into a restaurant and say hi to five people that you know this is all this is just it can't be limited to that I believe. I think it's just these additional things keep growing on top of one another.

Howard: So and this lecture that this symposium and the last Megagen symposium I was honored to lecture I was 3 years ago in NYC but almost every lecture here will tell you that you know that you know do that do the single molars do the maxillary second buys do not ever do an anterior implant on a good-looking girl and that's what you do. Well that's that's guts that's that's you have large stones when you have a beautiful woman who needs a single tooth in the front what advice would you give them on a single tooth implant?

Alex: So the advice that I would give is never get into something that you don't think that you can handle and so I have close relationships with surgeons absolutely do I have a periodontist that I work closely with do I have an oral surgeon that absolutely am I not the shoe maker that can do anything. I'm the guy who says I know that I can complete this I have the knowledge and I have the skill set to do these things but if for a moment I feel like I can't...

Howard: Well that's what I want to ask about.

Alex: My ego is not over the top.

Howard: because I think um I think dentist dentistry you know a lot of the same philosophies and religion and politics end up in dentistry for instance dentists will try to shame someone who files down a second bicuspid a second molar and it's a 3, bridge will say yeah why don't you file down those teeth well my friends and Phoenix that are ear nose and throat urologist why didn't you just file down two teeth why did you do that to the sinus and then they'd show me videos of sticking a camera up into the sinus of a failing leaking implant of the scientists where someone's thought they've had allergies for ten years and the inter notes of jokes like why do you damn dentists get into our sinuses you got two teeth to file down. So the the inter nose and throat thinks the sinus is sacred

Alex: Sure

Howard: The dentist he's an odontologist so he's he worships at the altar of enamel and dentin and when it gets to an anterior tooth I've had this so many times her you know when it's an old fat guy like me with a liver spot no one you know cares really I mean put a pfm there but when it's a really good-looking woman or she has really high aesthetic needs sometimes I think missing number eight that a three-unit bridge and a single crown would nail it more than all the risk involved with an implant and crown. Now when I say it to a bunch of dentist I'll immediately just throw me off the building and say did he just say no he didn't did he just say what I thought he said shoot Howard but do you think sometimes a three-unit bridge and a veneer is is more predictable and better-looking than a single unit implant on an incisor?

Alex: It's funny you say that because Larry and I would always talk about this working on different cases together our philosophy is a little bit my philosophy which is been engraved in my mind is create the best outcome possible and so rather than using an acrylic temporary we'll go if there's an implant involved we would still go through with the final three unit bridge made out of whether it's zirconia Emacs and it would we would temporarily cement it so it would be a final permanent some material with temporary cement and we'd look at these cases and where it's three unit bridges where we're gonna have a single unit implant and everything's gonna be single unit eventually we take it out after three four five six months after that implant is mature and we look at that papilla we say wow this three unit bridge in this papilla and the nature and how beautiful this looks is incredible and our goal is to now be able to mimic that with implants. So the answer is people now because that consumer says I don't want a three-unit bridge I want individual teeth they're now forcing us because of the knowledge because of social media because of Google they were like I don't if you're not the one that's gonna do it for me I'm gonna go somewhere else. So we want to be that one that can say yes I can do it for you and this is how I'm gonna do it for you I'm gonna stage in a certain way in a predictable way that's gonna get you the best possible outcome. I mean partial extraction therapy now is membrane therapy is now one of the hottest topics in dentistry keep the root place the implants you'll keep all the papilla you'll keep all the bone you're gonna see five tenure outcomes right now that coming out people are lecturing from Salama and from grease and Howie Gluckman I mean they're all talking about this being anterior posterior mandible upper this is really a paradigm shifting long term predictability of maintaining that papilla so that now we can say predictably I would go with a single unit because I'm not concerned that I'll lose that bone I'll lose that papilla and the final outcome is going to really be just as good as having a three unit bridge.

Howard: You mentioned Howard Gluckman have you noticed that all the greatest dentist are bald and named Edward we know it so far so? Howie Gluckman love that guy. Can we ever get a article in dental town magazine or online see coursers the man someday.

Alex: Absolutely

Howard: I would love to have your lecture.

Alex: What would you like me to talk about

Howard: What you're most passionate about.

Alex: Absolutely

Howard: and the Millennial see dentistry very different than people you're like your dad and me so I wouldn't want to pollute I wouldn't want to confine you. Big fan of yours thank you so much

Alex: Huge fan of yours.

Howard: Taking time out of this meeting to come talk my homies today, the honor was all mine.

Alex: The honor is actually all mine it's you've been a legend in the dental field for many years when I told my father he said THE Howard I said yeah yeah he said how'd you weaselly way there and I go it was really just a few minute conversation that we had he said he knows who I am and it's an absolute honor to have the opportunity to exchange my love my passion for dentistry for life and just for being happy. So thank you for continuing to share and letting people know what's available what's out there and keep doing what you're doing because people like me the younger population the older population everybody loves you.

Howard: All right well look for his online CE course coming up on Dentaltown and article in Dentaltown magazine thank you very much. 


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