Dentistry Uncensored with Howard Farran
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1137 Dr. Tara N. Hardin DDS, FAGD, FAACD of Hardin Advanced Dentistry in Mason, Ohio : Dentistry Uncensored with Howard Farran

1137 Dr. Tara N. Hardin DDS, FAGD, FAACD of Hardin Advanced Dentistry in Mason, Ohio : Dentistry Uncensored with Howard Farran

2/9/2019 10:30:33 AM   |   Comments: 0   |   Views: 169

Dr. Tara Hardin, DDS, is the award-winning owner of Hardin Advanced Dentistry in Mason, Ohio. She has been practicing with her father, Dr, Gary Hardin, for the past 15 years. Dr. Tara Hardin is 1 of only 359 dentists worldwide who are accredited members of the American Academy of Cosmetic Dentistry. In 2015 she was named one of the top 25 women in dentistry by Dental Products Reports. 


VIDEO - DUwHF #1137 - Tara Hardin

 

AUDIO - DUwHF #1137 - Tara Hardin



She is also a member of the Academy of General Dentistry, the American Dental Association, Ohio Dental Association, Cincinnati Dental Society, and several other sleep organizations. She devotes countless hours of continuing education on facial esthetics, cosmetic dentistry, TMJ therapy, and sleep apnea. She lectures on laser dentistry and is a key opinion leader for Philips Sonicare. Dr. Tara graduated from Furman University with a Bachelor of Science Degree in 1996 where she played college tennis for the Lady Paladins for four years. She then attended Ohio State University where she received her Doctorate of Dental Surgery in 2000. She continued her passion for advanced training at The Las Vegas Institute for Advanced Dental Studies, earning a fellowship with LVI. In addition to operating a flourishing full-time practice, Dr. Tara is the mother of three young children; Lillian, 9, Carson, 8, and Kayla, 5 years old. By balancing her professional and personal life, she remains active in such outreach initiatives as Pink Ribbon Girls, JDRF, The American Heart Association, and the Make-a-Wish Foundation. Hundreds of hours of continuing education each year keep Dr. Tara Hardin and her team among an elite class of dentists who provide exceptional esthetic and restorative dentistry. Dr. Tara Hardin and her staff at Hardin Advanced Dentistry will give you the smile you've always wanted. Specialties: Cosmetic & Family Dentistry, Dental Implants, Porcelain Veneers, Smile Makeovers, Same-Day Crowns, Sedation Dentistry, Dentures, Invisalign, Sleep Apnea, Teeth Whitening. Hardin Advanced Dentistry is Cincinnati's premiere dental practice offering patients the latest dental technology in a comfortable, spa-like atmosphere. I am a dentist that is very passionate about smile makeovers. Hardin Advanced Dentistry can create the smile of your dreams. Imagine yourself with a beautiful, new, white smile. Whether we create this for you with veneers, bondings, whitening, bridges, or implants, you, your family and friends will love the new you. Let us help you achieve your goal. Experience the Hardin Dental Difference!

Howard: It is just a huge honor for me today to be podcast interviewing Dr. Tara Hardin DDS, an award-winning owner of Hardin advanced dentistry in Mason, Ohio. She has been practicing with her father Dr.Gary Hardin for the past 15 years. She is one of only 359 dentists worldwide who are accredited members of the American Academy of cosmetic dentistry. In 2015 she was named one of the top 25 women in dentistry by Dental Products Reports, she is also a member of the Academy of General Dentistry the ATA Ohio Dental Association Cincinnati Dental Society and several others sleep organizations. She devotes countless hours of continued education on facial aesthetics cosmetic dentistry, TMJ therapy and sleep apnea. She lectures on laser dentistry and is a key opinion leader for Philips Sonicare. Dr. Tara graduated from Furman University with a Bachelor of Science degree in 96 when she played college tennis for the lady platen for four years, she then attended Ohio State University where she received her doctorate in dental surgery in 2000. She continued her passion for advanced training at the Las Vegas Institute for Advanced Dental Studies earning a fellowship with LVI, in addition to operating a flourishing full-time practice Dr. Tara is the mother of three young children Lily nine, carson eight, and carla five years old. By balancing her professional and personal life she remains active in such outreach initiatives as pink ribbon girls JDRF the American Heart Association and Make A Wish Foundation. Hundreds of hours of continued education each year keep Dr. Tara hardin and her team among an elite class of dentists to provide exceptional aesthetic and restorative dentistry. Dr. Tara Hardin and her staff at Hardin Advanced Dentistry will give you the smile you've always wanted. Her specialties are cosmetic & Family Dentistry, dental implants for some, veneers smile makeovers, same day crowns, sedation dentistry, dentures, Invisalign, sleep apnea, teeth whitening, Hardin Advanced Dentistry is Cincinnati's premiere dental practice offering patients the latest technology in comfortable spa like atmosphere. She's a dentist that is very passionate about smile makeovers. It is just an honor to have you on the show today thanks so much for accepting my invitation.

 Tara: Oh thank you for asking

Howard: Oh my gosh, so your dad's a dentist your mom's a hygienist does that mean your three daughters are biologically cursed to become a dentist?

Tara: Well I have a son. My son is Carson in the middle

Howard: Okay

Tara: You know I tell them all the time they say oh my gosh mom how do you do what you do, but yeah dentistry has been wonderful career. I knew I was going to the dental office with my dad at the age of nine before you had to wear gloves and suctioning for him on holidays Christmas Eve he never he couldn't say no ever.

Howard: Hey well you know that's a good segue for a question as you know when I was in dental school there were hardly any women dentists, now the dental schools are over half women and a lot of women dentists and dental school come to a fork in the road, they say okay I want to have three kids just like you did but what's easier to be I mean they want to be a supermom they want to be a super dentist if I want to be a supermom is it easier to work at like Heartland dental monday through friday 8 to 5... so I don't have to worry about any of the business or is it easier to be a supermom if I own my own business?

Tara: I have to say that I love owning my own business and being in control of my own destiny and making choices about my practice but I think being a part of a DSO is an easier road to take and you know worrying about the building and the facility I operate in and who's paying the bills and the parking lot didn't get de-iced this weekend . So we had issues there and you know buying my own supplies and having to control everything is you don't realize it's all the little things that add up when you're trying to be a mom and get out of the office at 3:30 and take them to tennis practice or soccer wherever they need to be, it's really tough so without help it's I would say it has challenges.

Howard: I was really lucky I had four boys and after school they would just walk down to the bar and start drinking and then after work I would just meet him at the bar so maybe it was so

Tara: Sounds like it, sounds different

Howard: So you started LVI really early I mean you were you were the first class with LVI with Ron Jackson when you were a second year dental student would you say that was your first major pivot was to own going to price of your dad and then start off with LVI to be a cosmetic dentist is that kind of your foundation cosmetic dentistry?

Tara: It really became my passion when I was when I had my first round of ortho and they took my braces off and I looked in the mirror and I thought oh my gosh I felt pretty for the first time in my life, with my smile. I had my teeth came in every which way but straight and I had a big gap between my front teeth, my canines came in you know way up top and everything just was the wrong way it was it was not good and the orthodontist took my brackets off and I looked in the mirror and I thought this is amazing. I had refused dentistry almost because my parents you know they were working Saturdays, one Saturday a month they were working Wednesdays every Wednesday late. I thought I never want to do that and after I got my braces off that's when I said I'm gonna do dentistry. So that's when it became my passion really and it's the aesthetic piece I just I love because it's you know not everything is a full mouth or even you know not everything is even veneers. I mean sometimes just whitening someone's teeth maybe even reshaping doing some enamel plasti on a few teeth you can't believe or doing a few bondings the difference you can make is someone smile so and it changes your personality in your life.

Howard: Well when I read that you're one of only 359 dentists worldwide accredited members of the American Academy of Cosmetic Dentistry really you're a fellow in the American is that a typo on my part is it what a 300?

Tara: Well you must've read yeah I just became a fellow beginning at December so I don't know the information wasn't updated. So I'm actually the 82 fellow.

Howard: You're the 82nd fellow and the 359th accredited members or one of the 359. So Wow you're one of the first 100 fellows of the American Academy of cosmetic dentistry how damn cool is that?

Tara: It's pretty cool, I was really excited it was a lot of work and you know working with the great labs in the country and just doing your best and taking great photography and it's definitely my greatest accomplishment thus far, well it's other than my family.

Howard: Other than your family yeah my family I always thought my kids were the biggest disaster I ever did but I don't have DNA testing so I might not even be responsible so I'm leaving that out for the jury. So what first I want to say one comment on the fellowship the Academy whenever I see someone who's a fellow of the Academy of cosmetic dentistry or has a really high cosmetic practice they're always hot. I mean I lectured the other night in Scottsdale and their are a couple of AACC guys there, Rod Gore I mean they're you know Dickerson Hornebrooke, you know all these guys. I've never seen a short fat bald guy crushing it in cosmetic dentistry tummy tucks, boob jobs, facelifts and NSF. So do you do you think do you think it's a prerequisite to go into Academy of Cosmetic Dentistry fellowship to at least be an 8 on a 1 to 10?

Tara: No I think what's important is to take care of yourself and to you know even if you just a trim and healthy and practice what you preach and have a good smile we're working on yourself because it's very difficult to encourage someone to engage in any sort of aesthetics when you yourself aren't taking care of yourself. Whether that's you know something simple like teeth whitening or doing something more advanced I do think it's important you have a great smile if you're a dentist that's gonna try to encourage people to get a great smile you can say this you can say this is what it did for me so let it do that for you so you're truly speaking from the heart versus trying to sell somebody something.

Howard: I remember the stupidest thing I ever said in a I was an 87 Jim Pride was lecturing in Phoenix I you know I went there I sat the front rows and he was telling me that anybody can sell cosmetic dentistry. So I innocently raised my hand I think I was 24 years old I said well if it's if anyone you know if it's so easy it's all cosmetic dentistry how come you haven't got cosmetic dentistry, I mean you have some of the worst teeth I've ever seen in my life they're all brown and raggedy and and then I went to that Oh what was that boot camp in Texas Haley's boot camp...

Tara: Walter Haley

Howard: Yeah and it was the same thing I mean I think him and Jim Pride are probably the two most cosmetic dentist people I've ever seen in my life and they were always telling everybody to sell it. So I always called Bologna on and said well it must not be really easy to sell if two of the most famous dentists on her Jim Pride and Walter Haley can't get it done. In fact when I was there at Walter Haley's boot camp Hornbrook was with me David Hornbrook and I remembered David Hornbrook telling me at dinner I said dude come to San Diego I'll fix your teeth for free and he wouldn't go to San Diego to fix them for free. So I thought okay there must be more. So tell us about what is the journey to become a fellow of the American Academy of Cosmetic Dentistry if some young dentists in dental school listening to you right now and says I want to be a I want to make the top 100 what  do they have to do to become a fellow in the AACD?

Tara: Well first of all you've got to join the Angus Ed to start and I've met so many amazing like-minded individuals that truly have pushed me to do better dentistry and you know when you're in it together at meetings or talking on the phone you say hey what lab are you using what techniques are you using and you're sharing ideas and thoughts. So surrounding yourself with a group of people that are like-minded and have the same goals I say I always say it's very important in any aspect of life but definitely if you want to do this AACD pathway. When you're at the meetings going there's a test you have to take online obviously to begin the process of submitting cases but finding out about the accreditation process you know it seems daunting and people always think oh that's impossible I don't ever want to have to submit 50 cases but why not you know why not try at least I mean who hasn't failed at something but then you just try again right. So I'm a firm believer in just keep working at it and you eventually if that's your goal and you put a target at it and set deadlines for yourself then it will you can make it happen you can make anything we can make anything happen. yeah it's just a myth it's a mindset it's you know I never wanted to say hey because now everybody calls themselves a cosmetic dentist and really there's nothing else besides the AACD and it's making you submit cases without your name on them without the submission they have no idea to sending in these cases and anonymously and there is a board of dentist that you know is judging your work, so I think you need to do that if you want to say I'm a cosmetic dentist.

Howard: Okay well that's better advice than than my advice, I was telling if they wanted to be a black belt in karate get their Eagle Scout or their fellowship in the AACD you can buy all those on eBay. In fact you might be able to buy them I got my black belt in one hour on eBay and so you know one of the things I noticed about the AACD people, you're really big into the photography but I always thought you know a lot of people you know a lot of people say well I don't want to do all that photography stuff but I kind of see the digital camera as more important in 2019 as a CBCT and a CAD/CAM and all that stuff because when I was a little only rich people or if you work for the government could fly an airplane or fortune 500 now with Southwest airline you got their cost so low that everyone has the freedom to fly. I meet dentists all the time and they document all their work on their website and said this is all my own work and they're in Kansas City and people are flying to them from Omaha and St. Louis and they're flying over hundreds of dental offices that could do the exact same work but you go to those dental looks like it's so fun to be sitting at dinner with a guy and all he's talking about how much he loves implants and all he does is implants and he's got all these diplomas and everything in implants and I go to his website right there and I'm like dude you don't have one case of an implant. So do you think the AACD forcing you on those series of photographs has helped you with case presentation and marketing?

Tara: The photos are so impactful and it's so wonderful to sit you know side by side with your patient and show them the photos and honestly it diagnoses so much dentistry. I love the occlusal shots because I tell people this is like looking at your mouth from Google Earth like we're gonna go way out and just look at the big picture here we're going to see the occlusal wear,  we're gonna see you know restorations breaking down you can zoom in on things. It's just I love taking the AACD series of photos it's time begin all my new patient exams looking at the portrait we take their profile shot you can see a lot from the profile you know, what if their mandible look like, what is their neck look like what's their head posture there's so many amazing pieces of information you can get from the photos. I mean the AACD photos the lateral shots not in AACD series, so I do take a few extra photos but going through those photos is invaluable.

Howard: Does any camera work or do you have a certain digital camera that you're in love with?

Tara: I just used the Canon I mean if you call any of these big outfits, Photomed has some great you know some great options Norman camera has some great options just call one of those guys and they'll set you up with all the settings and they'll even walk you through things. Norman camera is amazing if you ever need help outside of you know work hours there's always somebody available to help you.

Howard: and what was his name, Norman what?

Tara: No it's Norman Camera

Howard: Norman Camera

Tara: Yes and there they have a few locations but the Michigan is where their location is that I contact and I won't hold that against them being from Ohio but their great.

Howard: You know one of the greatest advances in LVI and the AACD is you know I got out of school in 87 you know my you know I got out when Fred Flintstone graduated the year behind me and all the cosmetic dentists at the time I used to cringe on it because they would always file down all the upper ten teeth for crowns and then orthodontics came along and people started realizing minimally invasive dentistry and that came to a halt and everybody started unraveling all these teeth. I remember so many of those cases you had to do a root canals on the lateral incisors just to correct the rotation but now it seems like no one is on top of their game in orthodontics if you're not combining bleaching, bonding, veneers with orthodontics do you agree?

Tara: I agree I you know I always take the easiest route the simplest path I don't nobody wants to cut someone's teeth down I truly treat their enamel as if it were mine so you know I can't tell you the number of times the labs like you're under reduced you know we need to think about how we want to change this but it's tough to reduce tooth structure but it's nice now with pre-planning these cases with digital smile design and trying on the trial smile over there over there enamel and then you could actually not have to prep the teeth or seet only certain areas where you can even just use the disk to remove tooth structure so overlaying the matrix on their existing dentition without touching a piece of tooth is the best way and then you can know where to reduce from there instead of arbitrarily using reduction guides. So I love all my cases I try to do a trial smile and try it on their teeth and and then we take pictures from there and see how the patient likes that.

Howard: Wow you really...

Tara: Christian Coachman has really done a great things in that area of Dentistry.

Howard: Yes he has and its genetic with him too. I just in fact the last podcast I just did was I with a dentist from Brazil but Brazil's really really into cosmic necessary we podcast interview Christian Coachman 186 he was a warm-up for Tara, he was the is the opening band for you today. So when you said digital smile design what software, does that merge with your iTero scanners? I know you use iTero  scanners, what would software you do digital smile design with?

Tara: So now their's an app for digital smile design, so you can use their app or you can honestly a lot of times you can draw these lines you can draw a lot of these lines in the old app that they used to have just dragging pictures in and putting you know lines on the face and following the curve of the arch and then you send those to a lab and there's a lot of great labs out there that are designing digitally with software such as 3Shape, that's a big software they're using. So 3Shape is most familiar with the iTero's people that have trio scanner that usually have some sort of 3Shape software but the labs have the 3Shape software. So we don't have that in our office but it's just again you scan the patient, you send them the photos good photos and they're going to draw most of the lines for you and do a digital smile workup for digital smile design workup. So then they send you back...

Howard: So you prefer using your iTero with the digital smile design.com?

Tara: It doesn't really matter what scanner you use they're all the same I mean you could use and you can use the care stream it doesn't matter you can as long as you send it to a lab that can take the D the STL file import it into the software and then they can design something for you and the cool thing is that you can end up getting these trial smiles back faster now with them sending us back an STL file and we can print it right in our office and then make a putty matrix and try it on the patient that day, that's how quick yeah that's how quick the process is becoming.

Howard: I'm gonna pin you down on the software in the scanner just a little more because I know that I'm I know that align technology owns Invisalign and iTero and they were having some legal issues with 3Shape and

Tara: Right

Howard: So how does that affect you I mean in your office are you doing more clear aligners with three shape oral scanner or you which is what I got a little more of an open system or you and more of a closed system with iTero and Invisalign?

Tara: So 3Shape is the software trios, iTero, Carestream those are scanners. So it doesn't matter what scanner you choose to go through but the issue with the trio scanner is that they will not Invisalign will not accept will not accept their scan, so that's the issue if you do a lot of Invisalign through Align Technology then you would have to think twice about getting the trio scanner because they're not going to accept their scans.

Howard: So

Tara: So that's why I got the iTero because a lot of the cases I realign the teeth again I'm not a fan of prepping in fact Denis Wells I don't know if you've ever met Dennis but he's an amazing cosmetic dentist in Nashville and I had the good fortune of taking his course about ten years ago and that's when I really got into no prep dentistry no prep veneers and it can be done really well and a lot of guys say oh no it can't be done but it truly can be done.

Howard: Wow that sounds like the Align Technology business model is working I mean it's causing people not to go to 3Shape if they're not accepting their scans.

Tara: I mean if you I mean but now with this now with the ability of being able to make your own aligners so you buy a printer and you use another software company that will actually design the teeth already you can just suck it down in your office with one of those really great suck down machines from Great Lakes. So you print the model this series and so you'll have a series of you know retainers that you'll give the patient just like you would if you were paying the fee from Align to make your own aligners. A lot of orthodontists are making their own aligners in-office now with the capabilities of printing and then having the machine to suck it down.

Howard: Is that a goal of yours that's something you plan on doing?

Tara: I don't really have the time to you know I have the CEREC technology in my office and you know I did one today but I I'm not a fan of having to spend that extra time and I feel like the restorations are not as aesthetic as what my lab can produce for me and you know if you're really doing aesthetic dentistry I just unless you take like James Clem's course or one of these courses and you're sitting there staining me can you imagine me sitting there staining and glazing in the middle of the day.

Howard: It's not a very scalable business model, I mean if you graduate from lawnmower school and you push a lawn mower from age 25 to 65 that's not nearly as much money as if you own a team of five people that one guys got a lawn mower, weed eater, a blower. I mean it's just not very scalable do it all yourself and I see these courses where people are saying oh yeah buy a CEREC machine and I do all my veneer cases with it I'm like really you do all your veneer cases with a CEREC machine. I don't know how you're the dentist or the dental assistant could be as amazing as a lab it just does it full-time. I know well let's switch the crown, so for posterior crowns are you scanning and sending them to a lab are you taking polyvinyl siloxane are you doing chairside milling with a CEREC machine what's a that when I look at insurance data there's 32 teeth and you look at all the claims it's just for big spikes on the first on the six-year molars. I mean what's the tooth most likely be crown'd root canal extracted implant so I just I would have pin you hold your feet down to just the for first-year molars when someone comes in and needs up first molar three fourteen nineteen thirty would how do you how are you doing a crown on that tooth, lab?

Tara: I'm doing an iTero scan a bottomless posterior scan the labs producing a bottomless restoration that comes back in a box no model at all. So I scan the tooth I pack cord always scan the tooth send them a great scan and then they send back a restoration in about two weeks Emacs bonded on the first molars.

Howard: and which lab are you using

Tara: I use Utah Valley actually I use David Moore Brooks lab they do a beautiful job they work, yeah David is a friend of mine.

Howard: Richard Wilers own owns it right

Tara: I speak to JD I know Kent is now the head lab guy over there who's really easy to work with.

Howard: Did you say JD or JT?

Tara: JD

Howard: JD oh yeah after Jeff Henderson Jeff JD Henderson

Tara: Yep

Howard: Okay and and

Tara: He's wonderful, he's wonderful Kent is so great he's new to the lab doing an awesome job they're really really wonderful people to work with.

Howard: and Hornbrook he's there dentist now for a long time?

Tara: You know I don't know how long he's been there and I don't know the exact relationship I know there's ownership but obviously I don't know is that their spokesman if you will I don't know I would say a couple years now.

Howard: I always wanted to own my own lab but I could never meet a single chick that owned a lab that was willing to marry me. I figured that was the best way to get into the lab business. So yeah labs I don't know, the market has spoken I mean cad/cam was out when I was in dental school I was in dental school 84 to 87 and the French were the ones that were spending all the heavy lifting dollars on cad/cam because it was socialized medicine and they thought the government could save all this money on lab bills by having all this so they were a long story short you know I've been a dentist for 31 years and I don't even think 15% of crowns are being chair side milled. I think what's gonna be a lot bigger is what you're doing which is scanning the tooth and sending the scan to a lab and what if some was what if some young dentist just got a dental school is asking well what's the difference really between an iTero scan and sending it to Utah dental lab versus just an Impregum impression, what would you tell her?

Tara: Well I mean you're getting with the iTero scan you're getting down to five microns of accuracy I don't know what Impergum I mean I hear it tastes bad and I've never used it in private practice so I know there's still prosthodontists using it but I'm yeah I don't use it. (Inaudible 26:19)

Howard: (Inaudible 26:19)

Tara: I'm sorry

Howard: It was made, it was a German company SP or 3M, 3M bought them.

Tara: I remember you had to squirt the two lines and mix it right on the mixing pad I don't know maybe they have it out of a gun now I don't know.

Howard: No I think you're saying it's a rubber base

Tara: Oh probably

Howard: I need to have a podcast one for senior citizen dentist and then one for all the Millennials they probably we probably don't make a lot of sense.

Tara: Oh my gosh I wish I wish I was a millennial.

Howard: Well if you if you graduate technically you are a millennial because the definition of Millennials that you were coming to age at the year 2000. 2000 you just walked out of dental school I mean no that was that was your you were coming to age in 2000 I would say.

Tara: Yeah I was coming, coming into my career.

Howard: Coming into your career, so you also got into airway and breathing, why and what motivated you to get an airway and breathing. Talk about your journey of how that got in your path.

Tara: Well I'm part of this mastermind group and it's just random dentists from around the country that kind of formed together several of us have been to LVI in different places and we do an annual meeting every year and everybody talks on you know what's their hot topic like you know my hot topic was doing layering composites and you know other people their hot topic was airway and breathing this is back years ago and so I started it I had a lot of interest in that too because I know the importance of breathing and you take any of these courses and you can't believe the amount of people with obstructive sleep apnea and what they're predicting the future to be hasn't become a more obese Society there's going to be more issues with it and so really making sure and and developing young people their airway at an early age you know kids that are thumb suckers, kids that besides sucking their thumb you know have tonsillar issues they have they need to be breathing through their nose, it's so critical and so when the research that you learn about you think my god are we are we dying an early death by not getting oxygen to our brain into our heart into all the areas of our body you say I need to make sure when I as a dentist that I'm screening them blood pressure screenings looking at their medications looking at their airway and saying what's going on here is the reason there's so much occlusal wear. Could it be related to the fact they have obstructive sleep apnea. So know sometimes you got to get to the root cause of the issue and not just treat the problem you know we see rapid carries, so what do we do we drill a hole and everybody's tooth we packed with filling material is that really gonna last if we don't talk about acidity sugar bacteria. It's not gonna work I got to dig in so what is the root cause of all of these issues.

Howard: You know one of the reasons you know in 2004 we started the online CE on Dentaltown, we got 450 courses they've been viewed almost a million times and the reason I started this podcast was because the one thing I've noticed in 31 years of being a dentists people like you all the people that thought the first thing that that differentiates them from everyone else's are addicted to CE. I mean you're in a mastermind group you got your fellowship the AGD,  your fellowship in the Academy of cosmetic dentistry what it is in my mind is you talk about you know that the joining at AACD and hanging out with all these like-minded people if you immerse yourself in a lot of CE, you immerse yourself and a lot of other successful dentists all this stuff is thrown against the wall something's gonna stick whether you fall in love with the AACD or implant dentistry or sleep apnea it doesn't matter, you'll just be motivated something will stick and then you'll get really good and really successful at something. I can't believe, it's embarrassing to be with a bunch of dentists at a table and listen to some guy complaining that to renew his license he has to go get 12 hours of continuing education oh and it's like dude you should get 12 hours of continuation on a weekend several times the year. So I want you to talk about that young kid she's 25 she just walked out of dental school she's $400,000 in debt and she's saying Tara I don't want to spend any money on CE, I don't want to go see koi so I don't want to go see Coachman, I don't know to LVI, I want to I want to you know eat ramen noodles and pay down my student loans.

Tara: Well my advice would be to you know the first thing they do is they get out and they think they should drive a Mercedes and spend money on a car and some fancy stuff and if you invest in yourself and your education the rewards will be much greater maybe not immediately but further down the road. So it's really important for these young dentists to get with an advisor and and I've got to be careful with that word when you say a plan or somebody that's going to look at their debt load and figure out how can we pay this back and which one should we pay back faster and but yet still spend money on my education and me and a lot of things can be done online, finding a great mentor in this arena in this field. I mean we want to help people I had a young dentist call me and I was honored you know she was just out of school and she said I'm gonna visit Dennis wells practice I'm going to visit your practice, I'm gonna go see Deborah gray King in Atlanta and I said of course comes in two days with my family, she stayed at my house and I thought what a smart kid you know what a go-getter to think about that you know because obviously I'm not no one's gonna charge her to have them come have her come and stay with us and visit our practices. So we just want to help I mean we want to grow I want to keep the sole proprietor dentist alive. It hurts me when I see these big dsos coming in and they've got buying power that we can't touch they can buy skin there's for half the price we can buy scanners they buy supplies half we can buy supplies and I'm waiting for someone like you Howard to ban us all together and say okay let's hire a really smart person that can negotiate these rates for us and keep the sole proprietor dentist a lives that's what needs to happen in our industry but young people we want to help I mean any person wants to call me and come to my practice for a day they're welcome to come and hang out.

Howard: That is beyond cool. So why do you think it's important for solo practitioners to be the delivering business model as opposed to everyone working at a Heartland or Aspen or a DSO our Pacific Dental something like that?

Tara: It it's so simple because when you own your own business you're have your own practice you care more than anybody else, you really do and you care about reviews and all of it hurts you know you want to do the best always and I feel like when you're just an employee somewhere it's not the same it's not the same.

Howard: Well every dental practice management consultant I've had on this show that goes in and does office does they always say the same thing the owner at a seminar there in the front row taking notes the associates on snapchat or Instagram when they go in the office you know the owner dentist is all motivated and the associates aren't and I also think it's almost like a natural selection. So all the people that all are they're all in you know they they they committed to the the debt they're all in they usually end up in private practice owning working for themselves which natural selection leaves over a lot less motivated people to become employees and all and I just don't see many people making money off associate dentist just because they're not motivated to take all the CE, going these mastermind grooves take you know get their fellowship and the AACD and the AGD. Everything you did was kind of what you see more of in an owner/operator model whereas when you get to an employee model it's more like they're watching the clock and you know trying you know so I think it's structurally gonna be really interesting to watch but since you're one of only 82 fellows in the American Academy of cosmetic dentistry I want to answer still more questions for the young kids and again I'm only talking about six year molars, because when you get out of school that's not when you do an anterior veneer case and all on four I mean it's like if you want to win the Super Bowl you're gonna have to do a block a tackle a pass a catch and all the dentistry is done on four six year molars and she's wondering you just said Emax on a first year molar does it matter me what about Bruxer,if I'm Bruxer I can just see menute if I do Emax

Tara: So Bruxer yeah of course you can go Bruxer right at first on a first molar but it's aesthetically I wouldn't want to brush around my first molar so and especially if it's a female and she has a large smile on an upper first molar you better believe she's gonna see it I mean how many smiles have you seen ruined by PFM's in the posterior on the first molar, so you know I just think the opacity of the Bruxer for you know first molar unless there's really severe occlusal issues would I do that. I mean when you when you're getting 500 megapascals the strain do you need 900 I mean how do you what on a little what if it's a female I mean do you need 900 megapascals of strength?

Howard: I do believe what you're saying is that if it's a man with the liver spot use zirconia and if it's a woman use Emax lithium disilicate.

Tara: No that's terrible that sounded so bad, I don't mean that

Howard: That's what you said

Tara: That is not was I said, a female on a first mobile upper I'm not going to do a Bruxier I can tell you that so.

Howard: and I want to tell you a really solid advice and I don't know if Tara will agree or not but in my in my career when I wanted to do a cosmetic case if she was if she was beautiful female high lip line or whatever I didn't want that case. I mean I got a some AACD people I should and when you're doing dentistry like I'm in Phoenix there's a lot of retirees in Phoenix I'm in Ahwatukee, it's a third retiree I mean man if they got a liver spot I don't even pull out a shade guide I just say you know A3/5 you know. I mean I don't I can't imagine anybody saying I this to doesn't match my liver spot but man when you start getting into some high intense beautiful women with high expectation, satisfaction equals perception of what just happened - what I expected. So to be a good dentist you have to lower their expectations and you know that's why I say you know whatever I pull a tooth they say you know this me so will this be sore afterwards, well you say no you'll be fine my god any soreness at all you blew their expectations. I always say you know when this thing wears off I hope you got a bottle of whiskey and a pistol because you're probably going to want to shoot yourself and you know and I prepare them for just death and then they always come back...

Tara: Lower the expectation

Howard: Like when a girl says to me she goes well can you make it match the other one I always say well God made that one and I don't know one so far has ever called me God so you know I'm a I'm a walking monkey I'll do it really really good you know I got my fellowship and my mastership but i'll try but so I always lower their expectations and then you can see in her face that she's like oh damn this is my front tooth I take five Instagram pictures a day so you really lower their expectation and then when you nail it and you hand them the mirror like oh my god alright and that's up.

Tara: I tell them five try on appointments, five try on appointments for a single tooth, central because if I nail it the second time or if I nail it the first time I'm a hero.

Howard: Wow yeah same thing with root canals, I know dentists that sit there and say oh yeah I never prescribe pain pills I'm you know you shouldn't have any discomfort after a root canal yeah and you'll need new patients the rest of life because all these people are getting a root canal saying my god he said it wouldn't hurt at all and it hurt like hell. So just lover their; and every time I pull a tooth I don't know do you like blood and guts you like extractions?

Tara: I do very infrequently but I do do it, I took a tooth out today.

Howard: I always hold the root in from their face no matter what the root looks like I hold it I say look at that curve on that thing this thing curved up behind your cheekbone damn near grew in your eye. I swear to God when this thing wears off hopefully you'll be able to shoot yourself because this is gonna horrible and they're just prepared for the worst and then I'm their hero because you lower their expectation so beware of the in fact they even got a show I watched an episode guys at my son's house something about some plastic surgeon guy redoing other people's work

Tara: It's called Botched

Howard: Yeah so treatment plan presentations a lot of stuff. So do you think I want to ask you another question cuz you're really in a your ear in the reddest state I mean I was born raised in Kansas went to Creighton and Nebraska dental school Missouri you're in Ohio which is pretty much ground zero for middle red-state America. Is Invisalign a brand where they come in and they say dr. Hardin I want Invisalign or can you switch them to clear aligner they these want whiter brighter sexier teeth or is it really brand sensitive ,like any time you order coke and they'll say well it's Pepsi okay I mean you have to say is Pepsi okay if they asked for Invisalign?

Tara: They never come and they don't know they don't necessarily ask for the brand in fact what's becoming the rage now I'm sure you're familiar is Candid CO and Smile Direct Club so you know people are I have physicians coming to me and saying here take a look at my video they sent me of what my smile could look like if I did this and the ironic part about this case that was presented to me is she was missing about 20% of the incisal edge of her tooth and they just extruded the tooth for the incisal edges to match up. So it was really funny for me to see a case are you not funny I said to her I tried to explain to her that part of her tooth was missing and that she would be actually self extracting if she went with their treatment plan but yeah I don't think that these companies should be doing I think a lot of bites are going to be not treated correctly, there's going to be a sand tmd that's going to result broken teeth down the road and they're going to be coming to the dentist and can you fix this for me so I'm not a huge fan of patients practicing dentistry you know in their own home I think it needs to be needs to be monitored.

Howard: but I think competition is great for any industry and some of the numbers you know if I'm wrong on my numbers if I say something I'm wrong email me Howard@dentaltown.com or put the notes in the comment under the YouTube video but you know what I keep hearing and a lot of my information you know there's a lot of publicly traded companies like Invisalign is publicly traded, Smile Direct Club is doing an IPO, Straumann sells the most implants in the world because they bought you know Neodent in Brazil, they bought MIS Make It Simple in Israel but what I'm reading in what Wall Street's reading is that ortho is basically sixty five hundred bucks and only five percent of Americans got it. So if someone comes on the scene like Smiles Direct Club get the cost down to say twenty five hundred that you would think easily that pricey last sixty if if sixty five hundred got five percent I would think twenty five hundred would get another ten to twenty percent and I think that's what Wall Street's gonna think and they'll probably walk out of there with a billion dollar valuation but the that competition is good for America it's good for the patient the dentist's because what it means is you can you squeeze cost down and when I look at ortho you know maybe you don't need to see the patient every month, maybe you can see them every other month maybe you can see them every third month I mean because what Smiles Direct Club is doing, they're just gonna give them all their trays at one time. That might be a little extreme and it's not supervised by a doctor dental surgery like I would want my children or my grandchildren to be supervised but I do think it's gonna make everyone think about how can I squeeze costs out of this orthodontic procedure so that I can do more of them do you agree with that or disagree?

Tara: I see ortho they're making orthodontics be a commodity and as you said early on in the conversation you know not all orthodontists are created equal and some of the ortho you see is not good and they're treating early the second molars aren't even in occlusion when they're finishing these cases some of them are partially erupted and then I see them five years later and their second molars are super erupted and their upper seconds aren't in so they're lower seconds are now super erupted their uppers aren't even in. So I think it's really important to knowmake dentistry of commodity because it's not and if the skill of the technician and when you're doing ortho you're doing a full mouth rehabilitation really every tooth needs to work with the opposing and you know creating discrepancies and the fight and and other issues I just I don't I don't see it as being good for any of us but I understand we your talking about with the business model but as far as the treatment and the end result for patients I don't think it's there

Howard: Now ortho has changed so much I mean when I got us go there there were orthodontists in town but almost over 3/4 of their patients had four bicuspid extraction and now those guys are down to about 1/4 and notice...

Tara: Their should be, it should be zero it should be zero if given the choice I would say on my kids you know my kids are the ages were wrong they're 12, 11, and 9 but my kids ages the youngest one is very crowded she's got big teeth that have come in and the orthodontist said gosh Tara for as against bicuspid extractions you are she might be one and I said I will leave her teeth crooked before I would do a for bicuspid extraction because she's going to be a big kid my husband is six six and I'm never gonna narrow her airway never gonna narrow her airway and that is the problem is when you take those teeth out and narrow the dental arches the tongue has nowhere to go but back, so I shouldn't say narrow the airway but narrow her dental arches that then narrow the tongue spacing that's a problem you can't narrow the space for the tongue, you can only go back

Howard: Your husband is 6'6, is his name Leif Erikson was he a Viking

Tara: No, no he's 100% Irish

Howard: He's Irish 6'6 I think a Viking must have landed in Ireland a thousand years ago that is a huge man but yeah that is interesting and the other thing about when I was little a lot of four bicuspid extraction you know I got five sisters and due to HIPAA I'm not allowed to say my own sister G Marie had that but the other thing I've noticed is that when we were little you just got the family could just afford ortho like one time and you just did it for that right kid at one time but now it seems like they're getting ortho they're getting a preventive interceptive or tow by a PDS

Tara: Phase one

Howard: Phase one they're getting ortho at the orthodontist but man they're back in your chair 35,55. Do you also see a lot of post-divorce cleanup it seems like when they when that when they they ditch their their Viking man and they're back on the market they're back into bleaching bonding ortho again do you see that a lot as a fellow the AACD?

Tara: I do have to say there is a trend of people trying to look more youthful that's what I'm gonna say people are trying to look more youthful.

Howard: I don't know why they do that why don't they just uh you know why don't they just cut and paste some fancy movie stars picture on their Tinder what is it Tinder swipe left swipe right okay can they just bring in a photo to you and you can Photoshop it and upload it straight to plenty of fish and match.com so I don't have to go through all that but yeah so I think that's another thing that the thing I'm saying about it worked out this is I'm sorry more succinctly if you're young and you're coming out of school $400,000 in debt there's gonna be a lot of upward demand for ortho clear aligners and implants. No matter where I I've lectured in 50 countries I don't if you go to Cambodia, Malaysia, Brazil in South Africa, Tunisia. Anywhere I've lectured that the people the seven and a half billion Earthlings are wanting more implants then when you read some of these publicly traded statements from like oh say Struman they're the the largest supplier of dental implants, they have a list on their website of all the countries of how many implants they place for a hundred thousand and the United States does you make the top twenty. So Wall Street looks at that and say got if the American dentist places many implants per 10,000 people as they do in Korea and Germany and a whole bunch of other countries that markets gonna double or explode. So my succinctly I would ask you that if they're coming out of school you're a master of cosmetic dentistry so sell why she should go that way instead of placing implants or do you don't place implants do you?

Tara: I you know it's what your passion is and you have to be passionate about whatever area of Dentistry that really intrigues you because you're going to get really good at it and my firm belief in dentistry is that there's a book called the one thing and I love that book and it just says focus on something and just get really good at it and be the best in your trade of it and so I think just finding what area of genis if it's implantology they get you know learn to do guided surgeries, you're gonna need a CBCT machine. Make sure you're doing placing those implants if you're going to be a general dentist place those implants better than the oral surgeon that says I don't need a guide or better than the periodontist that says I don't need a guide. So if you're gonna be a general dentist get really really good at placing implants if that's what you love if you love cosmetics then train in cosmetics and get really great at that but whatever area you choose just become your best at it and you will succeed well.

Howard: I agree because oh my god what a perfect segue to my next question I can't believe you said the one thing is I see these dentists me and you know 1900 there were no specialties and by 2000 the physicians at 15 the dentist had nine and I meet these young kids in school they're like well I want to get really good at molar endo and Invisalign and veneers and placing implants and bone grafting and sinus lifts and I'm like dude we're not going back to the 1900 you can't.

Tara: Right

Howard: I mean I know endodontist in my backyard that it's everything they've got just a master every single thing about endodontics and then the pediatric dentist got silver diamine Fluoride okay,  so talk about this one thing that made you the one thing the surprisingly simple truth behind extraordinary results by Gary Keller that sounds like that was a big impact on you?

Tara: It was a big impact I mean I again that's the whole we talked about choosing which pathway and why I wanted to become a cosmetic dentist but getting making sure it's your passion and then getting really good at it and being warranted to be called a cosmetic dentist if you want to call yourself an implantologist well then do everything to show that you are you should be called an implantologist so I really enjoyed it nice everybody should have a focus and maybe you do two things really really well but I think when you do ten things you're the jack of all trade and the master of nothing right?

Howard: Right and I think what you're also say it's so true that you know I always get that question about you know should I should I specialize and I'm like you know should I be a pediatric dentist so say that looks like it's a hot growth, I said well if I was if I had a choice between being a pediatric dentist and being the Taco Bell night manager I would be the Taco Bell night manager I mean I would rather probably go to hell than do that. So I think they should specialize in something they're passionate about I always asked them it's your life you only live one time and everybody is, retires in the same size grave so why don't you do what what you like.

Tara: Exactly, no that's exactly the way I feel

Howard: and so any other takeaways from the book the one thing

Tara: I mean my new book is morning miracle have you heard of that?

Howard: No Morning Miracle and whats...

Tara: and I can't remember his last name but his first name is Hal, but I've been listening to that every morning and it's really been I put it on audible on my phone because I've listened to it on my way to work but you know put on your bedside or whatever but it it's really an inspiring story and it's you know I'm not even halfway through but it's really getting me motivated to get my focus and spending time in the morning working out exercising you know we got to take better care of ourselves today and you know as dentists we work really hard we need to take better care of ourselves physically as well as with our food intake and just a lot of areas that we need to we just need to be working on improvement, self-improvement and all the rest follows you know it's it's amazing when you work on yourself what the results are.

Howard: The miracle morning by Hal Elrod, Hal Elrod and he's got a review I recommended by Robert Kiyosaki best-selling author Rich Dad Poor Dad who lives up the street I'm here. So yeah so so follow your passions get addicted to us continue education by the way in a lot of these countries I've been in...

Tara: Take good care of yourself, take good care of yourself eat well yes eat right don't do drugs I never one of my other policies I never drink ever during the workweek never because I want to have a really clear focused mind. So I just think that patients deserve 110% from us and that we need to give it to them and deliver getting good rest sleeping right all those things are super important

 Howard: but then when it comes to weekend then what do you drink?

Tara: No even weekends, but everything in moderation and I say just taking good care of yourself I think is is really important today.

Howard: Okay so I'm gonna guess

Tara: If you don't because if you don't have your health you don't have anything

Howard: Right health is wealth and and that is an interesting thing like it was the mail you know I'm out here in Phoenix Arizona which has a Mayo Clinic and they're a Rochester but they put one in our Florida and Phoenix it was the Mayo brothers who first really realized in health care that when people are going down they will pay for the best and it didn't make sense because it'd be like an 85 year old grandma who had been on a wheat farmer whole life and the Mayo brothers were shocked that the family was willing to sell her entire farm life work they they'd sell it all to save grandma but you know you look at grandma 85 years old with some terminal disease you would think well the best thing to do is just take her to the vet and put her down but that's not how people work they're like no save grandma even if it's a million dollars and and if I love that book health versus wealth I mean once you lose your health you have nothing. So that's why when you see this amazing wealth in fact I just published this day everybody's doing the ten year challenge you've been hearing the ten year challenge, whether you know they're showing a picture of themselves ten years ago and today. I like

Tara: Yeah

Howard: I like the world's ten year challenge in 2008 extreme poverty was 21%now it's only 8%, child mortality in 2008 was 6% now it's 4%, youth illiteracy was 11% now it's 8% and life expectancy has gone from 69 to 72. So as these countries get rich you got 20 countries with almost all the money and as those countries get rich what do they do, they bit up the price for health care, clean water, clean air. I mean could you imagine in World War two when America was trying to knock off you know Imperial Japan and Nazi Germany if you would have been out there saying that you wanted to save all the butterflies in Ohio, I mean no one cared about the lakes and rivers in Ohio when you got Nazi Germany that just rolled over Poland but now that we've had peace for so long and we're so wealthy it's so refreshing to see all these young people that really are concerned about global warming and trash in the oceans and all these things what they don't realize is those are only luxury items that really rich people can want because once you lose all of the economy and all that kind of stuff it's just war and then it's not about a matter of are you growing your economy two and a half percent. Like a lot of people complain that America from 1980 to 2020 basically has a 30 a 40 year trend rate I've only grown their GDP two and a half percent a year. Well how would like to be Germany during World War one and World War two, when their economy was going down 50 percent. I mean when you go in there and wipe out an entire country so these are these are really good luxury problems to have take care of yourself, surround yourself with good people, audit. I always say I'm gonna say the reverse of what she said she said join the AACD to surround yourself with good people that's so true but you also the same time audit out your dentist friends who hate dentistry think that is very bad case you don't need that evil sick stuff in your mind when people are telling it

Tara: I have to correct you, you said good people I said like-minded people. All people are good people in our profession. It's just like-minded people not just good people, because I don't want anyone to come say oh Tara said everybody from the a AACD is good people. They are great people but we're all great people.

Howard: Yeah

Tara: Just because you're not part of it but you need to be part of it I think you know it keep going but it's true it's finding people that are like you getting rid of your friends that say dentistry this is the worst profession ever or just negative people in general because you need people that bring you up and lift you up.

Howard: Yeah and it also includes family some people some dentists I know the most toxic person in their life is in their immediate family and it's like dude I don't care that you and your brother shared the same condo the first nine months of life you know you don't you need to be sharing his condo anymore. I mean just may have a nickname last but not least like I can't believe we went over an hour could I have one overtime question?

Tara: Sure

Howard: She's 25 she just graduated dental school whether it was A.T. Still in Mesa or Midwestern and Glendale she's $400,000 in debt she's working at a DSO Aspen, Heartland, whatever and she keeps thinking one day I'm gonna grow up and be like Tara and own my own office. What would you say to her I mean she's kind of in a comfort zone she's making 150 grand a year, she sees you she obviously would rather be you in your state than where she is right now. What advice would you give her to to cross the chasm I mean it's kind of like crossing the Grand Canyon. She's got to go all the way down cross the Colorado River and climb all the way back out to be where you are what advice would you give her?

Tara: You have to find somebody find a great mentor find someone that's willing to take you under their wing and help you grow as a person and grow your business and so I think if this individual found the right person that said you know I really don't want to sell to a DSO, I want someone to come into my practice and then and teach them because let's face the facts you can't practice forever. So some people think they can but you know I do things at a high level of detail and I'm not going to continue to do dentistry well into my late 60s when my eyesight's not as good and I feel my level of detail has has you know fallen. You know going out on top so I think there are dentists out there that want to complete their career and then they want to pass with the time and dentistry has been such a gift to me that I want to give that gift to someone else and so finding just the right person that and they could be you might have to move somewhere you might not be able to say in the state of Colorado which you love so much or wherever it is you might have to travel to find this office a unique situation but finding someone that wants to support you and help you and and grow yourself because you are in a debt situation and that's going to be tough to get out of without some support and I think you need a great mentor or group of mentors even to help you help you get there.

Howard: Well that's Dr. Tara Hardin DDS, FAGD, FAACD, one of only 82 fellows of the American Academy of Cosmetic Dentistry it was an honor to podcast you today thank you so much for coming on the show

Tara: Thank you the honor was mine, thank you.

Howard: Oh would you ever consider writing an article for Dentaltown magazine or an online city course?

Tara: Of course I'd be happy to

Howard: Those the Millennials they we put up four hundred and fifty one hour courses on Dentaltown, they've been viewed almost a million times they love just curling up on their iPad and put in their earphones or whatever the hell they do and they love that hours segment thing and they love a podcast where they're commuting to work. I'm sorry if you've been on the Stairmaster this whole time I hope you've already got off and you're at the finishing this podcast at the bar eating some fried cheese balls and a beer but yeah if you if you made a an online CE course that would be so amazing and it raised the you know the value of Dentaltown online CE. I mean it'd be a real honor to have a course on the online CE from you.

Tara: Okay well let me know what content what you'd like to hear about more about I'd be happy to take care of that.

Howard: No I'm gonna answer that with your own question, I want you do a course on what you're most passionate about.

Tara: Well my course on what bonding, aesthetic dentistry, bleaching, which portion?

Howard: We'll take them all

Tara: Which topic which topic you want oh you want me to continue

 Howard: oh hell yeah

Tara: Howard you missed you missed the part of the twelve eleven and eight-year-old and running a full-time practice with eleven ops and ten employees.

 Howard: and on that note guess why I'm so excited guess what I get a do after work today, my four boys are 21, 23, 25, 28 and we're all for going to dinner tonight in Phoenix oh I'm so excited I know you think when they're that age that it's the most fun age but it just gets better every single year I'm actually when my four boys were your kids age I always thought it's gonna be over soon and I'd get sad things about to be over hell it's more fun in their 20s it was in their teens. So

Tara: That's really great, that's great to hear that's really fun that's that's awesome

Howard: and I'm such a role model for them because I know they always the more time I spend with them they know exactly what not to do. So I'm right now I'm there don't be like dad and then though they'll be successful. So have fun with your kids and I tell your husband I said hello and thank you so much for coming on the show.

Tara: Thank you 

 
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