Howard: It's just a huge honor for me today to be podcast interviewing Dr. Neil Park DMD, FAGD, DICOI, diplomatic and Congress oral implantology. He's Glidewell dentals vice president of clinical of affairs. After receiving his DMD from Temple University School of Dentistry Dr. Park practiced dentistry for 12 years before beginning his career in the dental implant industry. For the past two decades Dr. Park has held top leadership positions at companies such as Nobel Biocare Henry Schein. He is recognized for his work in the creation of management of innovative programs designed to bring technology to private practitioners. He is responsible for the development implementation of key changes and the pre-doctoral implant curriculum of universities throughout North America. He joined Glidewell three years ago in 2016 where he now oversees clinical research development as well as training and education programs an implant restorative and aesthetic dentistry in addition he serves as an executive editor of chair sight magazine. I mean my gosh your background Zimmer Dental, Henry Schein and their implant cam Logue, clear choice, vice president professor at Nobel Biocare man it is an honor to have you on the show today.
Neil: Well thanks Howard it's an honor to be here with you you're certainly a pioneer and in your way of communicating to so many dentists and it's a it's a great opportunity to be able to reach so many people.
Howard: You know we've seen so many changes and in your background and implants I mean Nobel Biocare, I remember when they start Nobel Biocare care he would only lecture to oral surgeons and it took you had to pull teeth to get him to add periodontist and now general dentists have taken over implants around the world and then you went to clear choice which is the largest provider all on fours and then Henry Schein with cam log and then Zimmer Dental. I want to ask you about Zimmer Dental because I read on the internet that Zimmer Dental put there told Wall Street they're willing to sell that division off was that mark.
Neil: That's totally true yeah that was that was a public announcement so what happened was Zoomer acquired Biomed so and and these were orthopedic deals right, these were two huge orthopedic companies two leaders in the industry and each of them just happened to have a dental division. So as they merge the orthopedic divisions they merge these two dental divisions together and what probably is happening is that the executives of Zimmer Biomet said you know the trajectory of a dental business is a little bit different than the pathway of a orthopedic business so we're gonna be best off spinning this off. So I would imagine at some point there'll be some some deep pockets are gonna come by and purchase that great company and super Biomet and they'll be off serving us in dentistry some more.
Howard: Do you think it'll be Straumann because Straumann sells more implants than anyone through mergers and acquisitions they they bought Neodent in Brazil, Mis and Israel. they seem to be the most M&A; intuitive do you think that'll be a natural for them?
Neil: If there was something in particular that this Zimmer Biomet had that they didn't have you know. So as you mentioned Straumann's done a great job they have their premium implant line globally and then they have some value implant lines that they've purchased. So they've got that part of the market covered it may be for example Zimmer Biomet has that very nice line of regenerative products so all the nice Zimmer reagin products. So they may decide to purchase it for those products if the numbers work out for them but you are you're absolutely right strohman done a great job with mergers and acquisitions and they certainly know their way around this space.
Howard: and I really love Marco Gadola he's the CEO of Straumann and he came on the show episode 839 and it was amazing was a new format I did. I did a podcast live at a seminar I was lecturing in, in Canada and he took questions from the field and you never know what some dentist is and what crazy thing adenosine to say man he was just he held his ground he was an amazing man and I want to tell you that growing up Catholic in Kansas with seven brothers and sisters and my grandparents in Parsons and all these small towns your boss your owner Jim Glidewell has always been a personal hero of mine. Just like the CEO of Southwest Airlines when I started flying back in the 80s only rich people could fly only people were getting paid for by a fortune 500 company or the government and Herb Kelleher said you know keep one eye on the customer and one eye on your costs until you can drive down the price of what you sell until the middle class has the freedom to afford to fly and if anybody has been more dedicated to driving down the cost of dental laboratories so that the average American can have the freedom to save their teeth it has been Jim Gladwell. If dentistry I mean I mean he's a hall-of-famer I mean he really is he's absolutely a role model I love the fact and plus he's Irish that might be a bias there but the fact that the fact that he just on Dentaltown for 31 for 30 years and people sit there and try to talk trash about Glidewell or something I just say yeah and you're using like maybe people would you go to these courses they'd recommend these labs that church 300 dollars a unit I said how is that gonna help anybody in my family. I mean that might help someone in Key Biscayne or Beverly Hills or Manhattan but that ain't gonna help the Farran family out I mean you know I still pay for a lot of Dentistry for family members just because they can't afford actually it's cheaper to pay a dentist to do it back in Wichita than to fly him out here and do it myself but yeah I just love Jim Glidewell I love his approach he's the Southwest Airlines of Dentistry, do you agree with that?
Neil: Absolutely and you know he's an inspirational leader and he's absolutely focused in making quality dentistry available to more patients that's what drives him all day long for for the 49 years that he's had this laboratory. You know and something like the Bruxzir crown which you know he was the inspiration behind that, he put together the R&D; team that created this material that created the procedures to make this and now it's something where any dentist can purchase this crown for $99 provided to his patients at a really reasonable fee and it's a tooth-colored high quality high strength high aesthetic restoration and if we just didn't have anything like that before. You know I you've been around not quite as long as I have but but in dentistry where to get a beautiful strong aesthetic crown was always a challenge and the the monolithic zirconia really really was a new solution to that problem.
Howard: Well I'm very sad that today is January 29th because it was on January 15th 1970 the Jim Glidewell open the doors his first laboratory serving five local dentists in Dustin California. My gosh what a true pioneer and I've got, we spoke on the same what's that before Chicago midwinter the dental laboratories have a meeting is it the Chicago?
Neil: LMT lab day something like that...
Howard: Yeah something like that and I think Jim and I are the only two people who have spoken on that program four times everyone else spoken less than that and I every time you listen to Jim you just say my god because he's sitting on so much data I mean doesn't he do like 5% of all the crowns in America?
Neil: Well it looks like we have about 7% of the of the US dental laboratory market which which doesn't sound like a lot for a company this size but it's a very fragmented industry as you know most most labs employ fewer than a hundred people.
Howard: Well not when you and I were little when you and I were little and got out of school there were 15,000 dental laboratories and now it's it's been cut in half right so what is what does right now about 7,500?
Neil: Yeah and it's hard you know it's harder to be a mom-and-pop dental lab
Howard: How many dental labs do you think their are?
Neil: I honestly couldn't tell you, if you say it's about 7,500 sounds about right to me.
Howard: Yeah I love it when people email me and say do you got a quote for that statistic I always said I bet yeah Howard Farran. I've had a magnet I've had a monthly column since 1994 done 1200 podcast interviews I think I should be considered a source but so with the mom-and-pop they just can't compete because there's too much technology equipment they have to acquire?
Neil: That's right that's right you know it isn't like the old days when you needed some wax of spatula and a Bunsen burner and you were in the lab business and so it's different now the just the software licenses that you have to purchase work or in our case we develop our own software. So we actually have a software development company you know the scanners the the mills all the design software that you have to have and then of course we since since we're in a new area especially with the with the Bruxzir crowns we had to develop our own methods for for staining finishing and even for bonding so some of the materials that we make. So it's it's kind of an end to end situation and Jim prides himself on having that vertical integration and doing everything from creating the material all the way to helping the dentist learn how to use it successfully.
Howard: Well I think the reason I envisioned that Dentaltown and it'll be 20 years to Saint Patrick's Day in 1999 is because dentists are all alone and they they they really want to see what everyone else is doing and you do 7% of the the dental laboratory business in the United States should give us some give us any macro stat you get like like what percent of crowns come in one at a time?
Neil: The bulk of crowns are single units, yeah the bulk of it.
Howard: Do you know what percent that would be?
Neil: No I couldn't tell you off hand I can I can look that up and maybe we could do a little supplement for your readers. I don't want to give false statistics here but but the great bulk of work is single-unit crowns and and look we know why that is right if a patient comes in with a broken tooth or a broken alloy restoration you don't have to be zig ziglar to get that patient to accept the crown.
Howard: That's a good line can I steal that line from you at my seminar?
Neil: Absolutely absolutely and that was when the Romans Zig Ziglar was having his implants placed oh so that's what that's what how it's meaningful.
Howard: Is that right?
Neil: Yeah that's right
Howard: Is he still alive?
Neil: No he's not he's no longer alive.
Howard: Oh my gosh I'll never forget when I listened to, remember when Tony Robbins came out with a 30 day the 30 day personal power and that's idea I stole for the 30 day dental MBA and but but I was upside loved it because I had four boys and we were working on the garage every day listened to these tapes but he said he copied so many Zig Ziglar lines. I mean here your altitude your attitude determines your altitude your aptitude which determines your altitude I mean he was a Zig Ziglar fan you could maybe he didn't know he's doing it on purpose but my gosh so much Zig Ziglar comes out of Tony Robbins. I mean he was really a pioneer.
Neil: I mean their's nothing left to say after Zig I mean he said it all and what he was selling pots and pans in rural Alabama and and developed his technique so you got to be good to do that.
Howard: So when you and I came out of school in the 80s that it was the 30s.
Neil: I'm from the 70's but go ahead.
Howard: What year did you get out?
Howard: Okay, Oh temple 79 and I was 87 and the three unit bridge was the King. I mean again when you look at insurance statistics the for first-year molars get all the dental work. I mean what's he's most likely MOD crown root canal extracted it's a so back when we got out of school when they were missing a first molar it was a three unit bridge. Has a three unit bridge died, like Bruxier killed the pfm I mean if you want to say what killed the pfm which was a new thing when I was in school going from gold crowns of these new pfm's and Bruxier are killed the pfm. Did implants kill the three unit bridge or do you still do a lot of three unit bridges?
Neil: Their's still a fair number of three unit bridges but certainly the the bulk of implants being done are there single tooth implants and the and the most popular one is the is the lower first molar that's that's where a lot of us got our start do it doing those and hey it's a better it's a better service for the patient that's what it's all about. You know what they say if you get a single tooth implant it's a one tooth problem and you solve it as a one tooth problem, if you do a three unit bridge you took your one tooth problem and you just turn it into a three tooth and in the long run the patient could be worse off as that bridge needs to be remade and the next time there's some endo involved and then maybe the time after that it becomes a four-unit bridge or a five-unit bridge. So it's it's a great service it's a it's a very conservative way of doing dentistry not not involving other teeth and and certainly you know listen Howard as much as all of us have dentists work to learn new skills and to advance our practices it's to a great extent it's the patients that drag the dentist's kicking and screaming into implant dentistry because they're not going to accept that three-unit bridge. You know they want something better they're not going to accept that partial denture or that or that lower denture that flops around and a large number of dentists have been forced into this technology by the demands of their patients.
Howard: So you're also I mean you're the VP of the only place that is both a manufacturer of dental implants and an implant dental laboratory. Glidewell has your subsidiary what is it prismatic judgment Prismatik Dentalcraft, Inc. fabricates both the inclusive dental implant and the Hahn dental implant. That's another guy Hahns from Ohio.
Neil: (Inaudible 14:44)
Howard: He's what?
Neil: Dr. Hahn, have you had him as your guest?
Howard: No I know, I my gosh I lecture to him I I went to his lectures in Ohio and I still had hair, that guy has been yeah tell him to come on the show I would kill to have him come on the show.
Neil: He was the keynote speaker at our Glidewell symposium that we had an October in DC and he absolutely killed it, he just killed it. You know he he can still get up there and teach great destroy show beautiful cases but he's just so incredibly entertaining he has such a great way of relating to the audience.
Howard: Did you film it?
Neil: Yeah yeah we've got our video we'll put little clips out there.
Howard: My god if you film the lecture send it to me and I'll put it on Dentaltown online continued education.
Neil: Well there you go.
Howard: We'll make a CE course out it because...
Neil: I think we can do that absolutely.
Howard: because a lot of those guys that lecturer and do clinical and all that stuff they just don't want to they just don't want to do that they the graphic they doesn't want to mess with it a lot of our online CE these dentists say oh yeah you can do it if we send a camera guy out there and film it and and we do a lot of that. Howard Goldstein flies all around the country because these dentists say yeah I'd love to do it but I just around the time or the technique.
Neil: We got some nice programs up there we just put a program with Tim Kaczynski up on your educational site a great job and there's some there's some programs we helped out with for Chuck Schlesinger put some on and that's a really nice program where Chuck takes people through kind of step-by-step to get started with implants but yeah we I look forward to working with you. You've got a great platform you've got some some devoted dentists that really want to advance their their skills and we're happy to support that.
Howard: Yeah Charles Schlesinger he used to be in Albuquerque what was the implant, what implant company was that?
Neil: It was company called OCO
Neil: OCO and before that you know when I was general manager of a Camelot in the US and Chuck was one of our national instructors for that as well so he's been teaching for quite a while.
Howard: and the other guy I'm you mentioned Tim is...
Neil: Yeah Tim Kaczynski (inaudible 16:58)
Howard: That guy Tim Kaczynski he's been in the implant business as long as you have.
Neil: I believe so in fact I met him in the early days he was one of the few GP's that broke through very early on and he still has an incredible practice going up in Bingham Farms Michigan does beautiful work and very very busy practitioner.
Howard: So I know that a lot of people listen here and say he's biased because he works for Glidewell so he's gonna be all pro Huhn implants or whatever but are inclusive but I mean is an implant an implant an implant or here's this the same question. The greatest dental meeting in the world was every other year it's coming up in Cologne Germany I've been to it a half dozen times and about a hundred thousand dentist show up to the IDS meeting in Cologne Germany you gotta go it's so damn cool. If you walk at the normal pace that you walk when you go for a walk around the block you couldn't walk by every booth in the five days that it's there, every dentist talk to us from a different country it's so damn cool and romantic but dude there do you want to know how many dental implant companies are got a booth scheduled to be there this year?
Neil: Do you know the number because I don't, I know last time I went it was over 200 I don't know what it'll be this year.
Howard: Italy alone has 400 dental implant companies just a country of Italy. So my homies listening right now they don't want to go learn 25 different systems and they know all the old dogs like me already have five or six systems. If someone was gonna get into implants they were just gonna buy one system what would you recommend?
Neil: Well you're right I am biased, unapologetically I pick the Hahn system and the reason for that is there are certain characteristics of a dental implant that the market has decided are the right way to go okay it's got to be a tapered implant right so it's got to have a conical connection and it's got to have a platform shift and it's got to have a fairly aggressive thread to give you good immediate stability right. So now if you look for all of those characteristics you've probably gotten rid of you know 50 or 60 percent of the implants...
Howard: Okay I want to stop you right there, you said take say the three, just three things tape say it again...tapered
Neil: Yeah you want to you want a tapered implant body, you want a conical connection that allows you a platform shift, alright and you want a moderately aggressive thread to give you good immediate stability okay to me those are the key things you have to have.
Howard: Well unfortunately people our age read books and newspapers and the people who listen to podcasts 25% send me an email Howard@dentaltown.com or leave a comment in the youtube channels www.youtube.com/dentaltownmagazine but 25% of them are still in school the rest are all under 30. So take each one of those three one by one and explain it like you were talking at dental kindergarten.
Neil: Sure sure so as far as a tapered implant you know the the shape of your implant it's either a parallel walled implant which which the original brand mark was and there's still a lot of a lot of tape of a parallel walled implants on the market. The problem with that is that it's harder to get immediate stability and and that shape also doesn't mimic the shape of the tooth root and its replacing right. If you have a tapered implant then you have a better opportunity to get good primary stability which of course you're not going to get secondary stability if you don't have primary stability right so so that taper gives you the opportunity to get go back. So we're good on the on the tapered shape?
Neil: Okay the connection right there the first Branemark Implant was a hex top implant and it was a flat on a flat, okay and that meant that if it got forces from the side torquing forces that connection was going to open up and if the connection opens up enough to get a loose screw. So then the internal connection was developed and it was refined over the years so now it's a the the state-of-the-art connection is a conical connection with a hex so we're somewhere inside that internal connection and then it's also been shown that a platform shift where the abutment is is slightly less diameter than the implant platform that gives you a little more opportunity to create a favorable situation for the soft tissue okay. So that's called a platform ship so so that's the second part is the stable internal connection with the platform shift and the third part is the threads. Is the thread design has to be such that you've got good primary stability so Howard an implant goes in and it it doesn't fall out originally because of the primary stability right that's mechanical right it's like like putting a screw into wood it's that initial primary stability and secondary stability is the key to to long-term success. So those are the those are the three things that I think are important. I learned this from Jack Hahn right. So Jack was originally a Stereos user back when I was with Nobel Biocare and then he developed the replace system and then right before I joined here at Glidewell he worked with with the folks here and designed the Hahn system and you know in addition to having those basic characteristics that I believe are key to success we've got a really good support system here at Glidewell and i'll tell you about one of the best things about the Hahn system is if you submit a Hahn case to the lab you get 20% discount on your lab bill and our implant lab is if not the largest in the country it's pretty darn close I don't know if one that's that's even close in size. So you send the case on on a Hahn implant you got 20% off when your lab bill that's kind of a good thing wouldn't you say?
Howard: Yeah but you own two dental implant companies you have the Inclusive Dental Solution and you have the Hahn. So do you like one of those more than the other?
Neil: I do, so the Inclusive is basically a clone of the old Zimmer TSP the tapered screw bin it's it's pretty much that implant. You know that implant was very early to come off of patents and so it's been frequently copied and that's why we chose that design because it's it's kind of ubiquitous in dentistry it's everybody's been copying it for many many years it's 20 year old design. I like the Hahn implant more because it it takes into account so much that we've learned over the last 20 years about implant design and believe me Jack Hahn was here in fact he was here a couple of weeks ago but he comes here he sits with our engineers he works with our trainers to share with them the benefits of his many many years of expertise and experience.
Howard: Well next time he's at Glidewell take him into the studio and have him Skype me and...
Howard: that would be and if you got an now that his killer luxury yet I would love to put that up on downtown that that guy is a legend and the other thing I like about him, the same reason like Jim he's not from the rich hoity-toity part of town. I mean he did this in nowhere Ohio.
Neil: That's right well since Cincinnati and he tells you know of course Jack tells a lot of great stories but basically he went and took a course it was big he took the course in an upstairs above a dry cleaning place in Brooklyn came back home did the first one for free because he was learning and the second one he charged for because now he was an expert and he's going from there.
Howard: and also back then I got to remind you young kids you know don't don't throw these pioneers under bridge because when I was in dental school from 84 to 87 the lectures would openly talk trash about the one oral surgeon who was placing implants, he was called there they called him butchers I remember some of the greatest implant pioneers in the small redneck flyover States and the first time they'd have a case go bad the local board would take their license away and I knew one of these a couple of these guys they just went into depression alcoholism and ended up in a trailer and these guys are pioneers. So the those guys did all the I mean members subperiosteal and blades you know and these were miracle solutions but come on how many subperiosteal might go bad might get infected might look ugly.
Neil: You know you know this is really instructive Howard, if you take a look at some of these patients that had ramus frames and subperiosteally and when those cases fail as most of them do at some point when those cases fail they immediately want to know when you can put another one in when you can retreat them because as much as they suffered with the failure of that of that prosthesis in that support mechanism it was so much better than having a floating lower denture and you know these these pioneers did a lot for people and you know we do we our profession sits on the on the shoulders of giants.
Howard: I remember the first time I was with a guy taking an impression of a subperiosteal and I was so frightened that the impression would lock around them into the mental foramen and I mean and what these guys did and how some of them were treated and what happened to their careers was just inexcusable, tribalism, thinking in fear and scarcity gosh darn it's come so far, so don't...
Neil: When I was in dental school I only learned two things about implants, one is that they don't work and the other is that ethical doctors don't mess with them and that was it that was the totally learning.
Howard: and I had to sign to finish my operative dentistry class the chairman of operative made us all sign an ethical statement that we would never place these new composites because they were plastic they were garbage they were crap and an amalgam was try and amalgams do last longer than compostits, I get all that but what my operative instructor didn't get is that if you told every woman in Phoenix when I opened up 87 that the black silver filling would last twice as long as a tooth colored what did a hundred percent of them pick?
Neil: They want tooth colored.
Howard: The tooth colored I mean you know I don't have hair but I'm sure when girls go to the salon and bleach your hair I'm sure it's not good for it but that they want to colored you have to you had to listen to the market and the other thing I liked about tooth colored fillings and ortho and all that is I always noticed with Americans that if they don't like their teeth they don't take care of they don't brush you don't floss they don't go to the dentist but as they start to like their teeth I mean I noticed that was bleaching remember when it was Omni bleaching came out of Arkansas nowheres nine hundred dollars for six bottles. I said no one's gonna pay for this Oh everybody did and but what I noticed with the bleaching is that once you started to bleach your teeth and it was like well what about this felling and what about this missing tooth and in it with humans you know you either Bowl on a bowling league and own your own ball or you haven't been bowling in ten years you either own a boat and go to the lake every week or you haven't been a lake in ten years and that's the way dentistry is the people that don't take care of their teeth they don't like their teeth they that they're ashamed of their teeth they think they have bad teeth and if you can just get this patient to say no you got good teeth and not talking down to your page there's so many dentists or condescending and they're like you know that they make them feel bad well people who feel bad aren't gonna come back and give you money. You got to be that coach and in fact I still think most boys the reason they excel at the sport they are is because at the earliest juncture a coach in that sport was making them feel good and that's why they ended up in hockey or lacrosse or wrestling as opposed to some of the more famous one and you're not gonna be a great coach making everybody feel bad you know so.
Neil: Sure and so many so many patients whose teeth are in terrible shape one seeking dental care they've had some kind of bad experience or an experience that they interpret as being a bad experience that validates what they're doing and that was something I learned that clear choice because most of the patients that seek care and clear choice haven't been to a dentist of any kind in ten years and it's the situation you're talking about they hate their teeth they don't want to invest any money they don't want to put any care into it and then they hear that there's a way to get this taken care of and and the organization supports them and gives them a good buying experience right they give them a pathway you're going to do this this and this and you're going to get this done in this period of time and that's that's what people want they they want a clear buying pathway to get the things that they want and I'm saying want not need right because we're driven by wants not so much by needs.
Howard: and back to fear and scarcity thinking versus hope growth and abundance. I remember when clear choice I came to Phoenix Arizona all the oral surgeons and periodontist were all getting up in arms and starting to get tribal and protective well what did they do they went on TV they did a gazillion commercials and that lifted all the dental implant boats you had patients coming in saying I saw this commercial on TV about this and that and they didn't and for everyone that went to clear choice probably nine went to their back to their same dentist and start asking the right question so it's not about fear and scarcity it's about hope growth in abundance.
Neil: that's been proven over and over and over and (inaudible 31:02) people moving because they don't know that there's a solution and if someone comes on TV and tells them there's a solution well great if they've got a relationship with a local dentist they'll go see that dentist if they don't they'll go see the the person that's doing the advertisement.
Howard: and if you want to throw clear choice under a bus clear choice does about 20,000 units a year for $25,000 an arch and 95% of the dentist when they retired they never did one $25,000 treatment plan in their life unlike the American patient who buys 13 no 13 cars between the ages of 16 and 70 new cars for a median price at thirty three thousand five hundred and five percent of the dentist block off Fridays for their big case and they do a big case like that every Friday their whole career and the other ninety five percent and dentists will never do it one time in their life because they just think that nobody has any money and nobody buys a new car nobody gets all their teeth done and you should be learning from these legends not being afraid of them.
Neil: Great point great point and clear choice is a great organization actually my old boss Kevin Mosier the former CEO of Nobel biocare is the CEO of clear choice and and he's a great leader and their and they're always moving forward and trying to do to serve more people in better way so I have absolutely no issues with clear choice.
Howard: Did Nobel Biocare turned into no was that noble pharma or those two separate companies or?
Neil: Well yeah it's a little complicated but the company that was Nobel Pharma changed its named a Nobel Biocare due to a change in ownership in back in the Swedish days right and so so that I think that probably happened about maybe I'm gonna guess and say around 95 that that happened and then that company was a free-standing publicly traded company and then it it purchased Stereos which was a tremendously advanced and rapidly growing us-based company and that combination of Nobel which was the Branemark system and Stereos which was a real up-and-coming company that created the Nobel Biocare that we know today which of course that company has since been acquired by Danaher.
Howard: Well then what's Noble Pharma then right now out of Japan
Neil: Their is no Novel Pharma, there hasn't been a pneumo Pharma since the 90s
Howard: No really so they're they're gone huh
Neil: They're gone
Howard: Man there's so much so many changes going on. So you've been in this field long time are you more focused at Glidewell, are you more focused on dental implants or crown and bridge or restorative adhesives?
Neil: So I am focused on helping doctors be successful with new technologies. So a lot of that is creating content so I spend a lot of my time with our chairside Magazine trying to make that magazine better and more useful to doctors all the time. I spend a lot of time with our educational programs we started a fellowship. I began the our global symposium which in 2019 is going to be our third Glidewell symposium which is you know has become a very big event. so that's
Howard: Where's that gonna be next year?
Neil: What's that?
Howard: Where's that gonna be next year?
Neil: We're going to be in Orlando in November 2000 19 at the Shingle Creek it's the you know that's the hotel that's got that Hilton on one side and the Waldorf Astoria on the other so depending on how wealthy you feel when you check in you can get a fancy room or...
Howard: Does Jim speak at those meetings?
Neil: He does he does he opens up the meeting absolutely.
Howard: Nice I'm gonna have to hit that that's a that sounds
Neil: We'd love to have you.
Howard: Yeah so but when you talk about technology let's keep it real these kids are coming out as dental school four hundred thousand dollars in debt and they say they ask me they email me Howard@dentaltown.com they say dude I'm 250 to 350 to 400 thousand in debt if they get married in dental school and have kids they're over 400 and LDS and they they'll say if I buy Dentsply Sirona CAD CAM and a CBCT and a Lanap laser I just double my student loan debt. So when you talk about incorporating new technologies to be successful I know what my homies are thinking they're like Bing does DDS stand for doctor of debt service. I mean how much debt do I have to go into to be successful so talk to my talk to my doctor a debt service dentists with student loans and tell me what technologies do you think have a return on investment and I'm gonna hold your feet to the fire with my first question do they need to buy a Dentsply Sirona CAD CAM for 140?
Neil: I would strongly recommend that they not do that okay. So Howard this whole this whole cad/cam thing it didn't roll out the way it should have rolled out. What happened was the CEREC's and E4D's of the world came out and said you need to buy this six-figure system so that you can scan and you can design and you can mill all at one time and besides being incredibly expensive that's very disruptive to a practice right. The way this should have rolled out and if it would have rolled out this way Howard every dentist in the world would be a digital dentist right now. It should all rolled out with the intraoral scanner okay. I thought as an intraoral scanner cannot imagine how we lived without one okay you get an intraoral scanner. Now our partner is iTero, so we're really like...
Howard: Really Jim Glidewells partners with iTaro owned by Align Technology.
Neil: So we built a mill and we created the materials to be used in that mill and we created the software to be used in designing the crown to be milled and then we picked iTero because it's it's a great scanner it's got great support and it's got a terrific network. So you know of course right now iTero users have been buying our Gladwell dotIO mill and crazy and then a lot of people have been joining up joining in and
Howard: Say that again Glidewell...
Neil: Glidewell DotIO so that's our mill the fast mill and it's a you know it's much less expensive than the other mills that you mentioned and it works and that you know it's really great Howard it will mill a fully sintered BruxZir block right so it doesn't want to do these things where you're gonna you're going to get a pre sintered block mill it and then put in the oven forever you know you're going to get a fully sintered BruxZir it's called BruxZir Now, you put it in the mill and fifty fifty five minutes you've got a finished BruxZir crown to insert into your patient. So that's that's quite an advantage and as you know BruxZir is is quite a bit stronger than the you know the lithium die silicates that are typically used in a CEREC scanner.
Howard: So it's Glidewell dot IO so I that's like .com what does io stand for?
Neil: In office
Howard: Yeah but for a domain name it probably had they come from a country...
Neil: No it's not it's not a domain name it's just our product name so if you want to information about it just come to the Glidewell website we've got information there
Howard: dot io i'll let me find out oh it's that i well you're okay so your site is your site is Glidewell.io but what i'm saying is to use that dot io when it was set up that's for the British Indian Ocean Territory so any dollar dot io because there's some really neat ones but yeah when you go look at that the list of countries that can be your instead of using .com .org or .edu for education but yeah .IO that's cool cuz that's the name your system so you guys use the British Indian Ocean Territory tell your marketing team whoever did that I'm thoroughly impressed but because I oh it's not the British Indian territories it's a Glidewell.io for in office solution which is a versatile suite of technologies that empowers clinicians providing an immediate portal to Glidewell dental and the ability to create restorations right in place for same appointment crowns design a mill with ease, but do you think it's a better business decision to take that Itero scanner scan it and send it to the lab are to actually really do that in office chair side and.
Neil: So it's different for different strategies for different people right, so ideally you want to have the choice right so you want to be able to scan the patient decide the crown and then decide is this a person where I've got to get the shape just right and I've got to have all the contours just right then I'm going to go ahead and and check this box and send that to Glidewell laboratories to be fabricated or this is an airline pilot that needs to be out of town tomorrow so I need to sit down here and pull out my BruxZir now block and mill it right now so it's ideal to have that flexibility but when you talk about ROI for the young dentist who's got a heavy debt burden they get the scanner start with that get involved in digital dentistry.
Howard: You recommend or get a tarot scanner?
Neil: Get the itero scanner, absolutely absolutely and then you know later on decide we can always add the mill later on.
Howard: So you guys wrote the software for iTero two for the scanning to go to a milling out the crown?
Neil: So there's three steps right there scanning there's designing and they're milling right so so the iTero is a free-standing scanner we didn't write the software that controls that but we wrote the software that designs the crown and it's and it's a very intuitive software even I can design a crown on the software you know the art design software and then you just send it to the mill or you can send it to be milled by the by the lab.
Howard: So here's my take on that yeah if somebody needs the crown today you can do that but to making it to milling it out in your office whole time how long do you think it takes for someone to numb up a first molar prep it scan it design it mill it see minute insert what do you think the average time would be chair assignment. How long would that patient be in the operatory?
Neil: Probably talking two and a half to three hours
Howard: Right so what I what I don't like about that is a lot of times the dentist doesn't like the crown but he doesn't have the guts to say I'm sorry but Neil do you care if I redo this and you sit in the chair another three hours. Now to put that in perspective my sister went to have her hair colored and she went in there at three and then get out till nine so she's at there six hours for her hair so it's nothing in the end world but I don't know I I just like I just think the doctors who scan it and then send it to the lab they have less remakes right I've heard that people are sitting in impressions have 5% remakes and people sending in scans have 1% you confirm that or you know why?
Neil: I mean you've seen the scan you can take a look at it if you miss the margin it's on your screen you know it happened right and the same token when you go to design the crown if the crowns not going to be right you're going to know it right then and there and Howard, you know as far as your question about whether whether this is what doctors want to do I would just say you know here is the largest dental lab in the country whose job it is to fabricate crowns for doctors right and we got into in office milling why did we do that and the point is that you cannot fight the trend the technology has developed it's going to be a certain percentage of crowns are going to be fabricated in office and we've got some tools and talents that will help people get there we do not expect 75% of crowns ever to be fabricated in office but there will be a certain percentage and we want to with a great offering to help them do that.
Howard: and how much is a starter set by the way this isn't a commercial did did did you pay me to come on the show no I did not and did I not beg you to come on the show for almost 1,200 days I've been asking you and Jim and Jack and you kept saying no your show but so this is not a commercial people. So how much would it cost her to get into the Hahn implant system how much how much money would it cost her out-of-pocket to get into this?
Neil: So you can get into the hon implant system for 20 about $2,500 okay so you're gonna buy ten implants and get a kit. You know if you want to I mean the great thing about the Hawn system is that the implants are 160 dollars and they're absolutely made of the best materials in the world the best engineers the best machinists the best equipment you can get. You know if you know Jim Glidewell we don't we don't skimp that's the that's the advice that he always gives me in any project that I do don't skimp make it right and you know we've got a factory I don't know if you can see behind me so I'm in Newport Beach California our implants are made in that building right over there they don't come from from Asia or Europe or anywhere they come from Newport Beach California by some of the most experienced and high-quality machinists in the world and you know we're just able to do that you know you can certainly spend three times as much money on on another implant if that makes you feel better or that rep is in your office and provide some service that you value that's great go ahead and do that but if you're looking for a high quality implant that you can use to offer your patient a great service at a fair price I don't really see how you could do any better. We had a great experience with with Carl Misch we we we had some opportunity to work with the mission stitute which i consider to be the really preeminent group as far as a free-standing training institute for dental implants and and Carl when he was a lot he took a good look at the implant and and said this is great this is this is better than implants that cost much more and so you know and now with that Dr. Randy Resnick running the mission state and doing most of the teaching that's actually become a great source of new customers for us is our relationship with the mission city because the faculty there the students in the laboratories they have such a great experience using using this very well designed product.
Howard: Carl Misch's podcasters me hat is the most viewed of all time it was twelve thousand on YouTube is gazillion on Facebook and all this stuff and I got my fellowship in the missions too before I got my diplomat International Congress of implantology but I loved that guy so much because when I walked out of school they told me that you know these butchers placing implants these butchers doing sinus lifts you know they're all butchers and so here's here's how stupid me lucked into Carl I went to get my FAGD because whenever I went to the continued education courses the dentist said there FAGD and there MAGD there were elite doneness at elite practice so I said okay I need to be like them I want to get my MAGD well I got my FAGD which is 500 hours of lecture but then the MAGD was 600 hours and 400 had to be hands-on and so I didn't want to place implants and so I called the guy and said I don't want to go take a bunch of stupid implant courses cuz I'm not gonna place them and I don't believe them and I think you know they're butchers and all this stuff like that and he goes well sorry we're not changing the curriculum for you but if you go take Carl's course he can fill all your hands on so I had my hands crossed I had a bad attitude I flew to Pittsburgh three days a week and my gosh I wasn't in there for an hour and I met Carl and I was scared he had an anesthesiologist had the patient center and he's doing full mouth you know incisions and flaps and he's placing like 20 implants and half the time he's look at me in the eyes talking to me like we're sitting at a bar eating a hamburger and I could even talk I mean it's kind of like you want to learn how to shoot a gun but you you sign up for war and you go to war for a year and then you come back and shooting your little 12-gauge looks like nothing. So I feel like I went to the Vietnam of dental implants and when you walk out of there then I went back to Phoenix to place that one little implant to replace a molar I felt embarrassed because I knew guys like Carl were placing you know what do you thinks the most number of implants he place in a day?
Neil: Oh gosh no but but I would say it would certainly hit 3 figures.
Howard: Yeah yeah so when you go back there and watch this guy and then come back you were fearless because you were dissecting out the mental foramen and doing all this stuff. I mean he was just he was so amazing.
Neil: You know what he did that'll last he he systematized and made it into a science look like so many like so many areas it starts as an art form right in my hands this works if I do in a certain way but Carl's idea was to systematize it. So we had the you know the bone densities and the bone volumes and he created a system for for the way the way you restore cases you know the the the different fixed designs the different removable designs I mean that's the beauty and that'll live on forever and that is you know his textbooks are the most purchased books in the history of Dentistry and they should be because no one has ever put it together that way.
Howard: You know the first time I heard something's wrong is he actually cancelled at our Townie meeting like a month before and I thought what and they said well he's sick and even when he got sick and they told him how long he had to live he even doubled that I mean he was such a warrior he he outlived twice as long as the doctor said he would live and but just a total total unbelievable man and he was a he was from Detroit originally wasn't he?
Howard: because he was again you know I always got turned off by the elitists I remember some of the early course I went to they'd say these are A patients these are B patients and then they describe each one and talked about how you need and when they describe each one I thought wow the entire Farran family reunion is a D patient and I'm listening the schmuck in Key Biscayne I mean I mean you know and and and Carl just kept it real. I want to switch to...
Neil: I had the hey the opportunity to work with Carl in his final couple of years and I am never seen anybody face what he faced with the heroic nature that he did. I mean I will always remember that he worked until the last possible moment that he could work because he was so motivated to get in front of students and to talk to them, so yeah he's a hero no question about it.
Howard: and no one no one's ever afraid of dying if they're married just remember that and so I want to switch gears completely from dental implants to composites. You guys are your camouflage nano hybrid composite is you guys are or in the composite business how's that going and what do you think of that?
Neil: You know we may affect our own composite and then part of that is we also manufacture our own composite blocks. So the composite crown has had its ups and downs in dentistry but at this point we've developed a camouflage composite crown that can be milled very quickly in the office and then we've developed a bonding protocol that makes it very very safe you know and that is you know if the the crown either has to provide the strength as in BruxZir or the bonding method has to provide the strength as in a camouflage crown. So you know you know it depends on the insurance plan and and how it's reimbursed whether whether it'll be useful to a doctor or not but it's certainly a great option to have in it and in Mills very quickly. We do we do have our brand of camouflage composite that we sell at an extremely reasonable price and it's a very high quality and it's a development of our R&D; department we have almost 80 people working in a building next door to me in R&D they're working on new formulations of BruxZir and new shading mechanisms you know new software there's just so many things that they're working on and camouflage was a development by that group.
Howard: Well you know when I was little my dad on vacation he wanted to always go to an amusement park I mean we got in out there where you are here we are in Wichita, Kansas we've gotten a station wagon and drove from Wichita Kansas to Disneyland and they're in Safeway and me and my five sisters were in the back playing Monopoly you know no seat belt a is blankets and pillows played Monopoly the whole way my mom and dad were in the front seat with a big case of a Pabst Blue Miller ribbon or something you know drinking the beers and throwing them out the windows and we drove all the way down there and see Disneyland or Six Flags be always stopped at manufacturing places. So I got to see all these things manufacturers beer but we I got to see our family station wagon made while we were being pulled by a golf cart you know he just loved me being in a factory. So I love that tradition so when the first time I ever went to Disneyland or Disney World and all the Disneyland I took my four boys I mean I'm taking my four boys through Glidewell probably I don't know five times and the first time I went in there I was nobody from nowhere I had these four kids and Jim gave us a tour I mean he spent an hour answering my Eric who's now 28 Eric was probably eight and asking him these you know dental questions because his dad was a dentist and Jim was answering that guy as if he was Carl Misch asking the question and he was so sweet and but you could tell and I told them to do this because I have learned I mean you can go up you can go take a tour of a company and you'll know more about their product line and what they do and also I'll tell you another thing some companies you go in there there's nobody with the PhD there's nobody in R$D but they have a 50-person call center and some cheerleader with the thermometer dialing for dollars and it's all about the money and then you go to other companies and it's all about the science it's all about the research and then you I also might want as I'm always pulling over anytime someone introduced themselves I always say how long you been here and some of these companies are all sales oriented companies no R&D; and nobody's nobody's worked there three or four years and that that's my first red flag in fact I wish Wall Street what I wish the SEC would mandate employee turnover employee longevity. I mean if I was gonna go into a sector of Airlines and there was nine Airlines and and I could just see the chart of how long the average employees been there I would just buy the one where the employees have been there the longest and that's another thing when you're talking about buying a dental practice why would you buy a dental practice where the oldest person that office has been there three years. I mean my new hygienist the one we just hired has been there nine years you know and you know so it's it's so Jim is a classic act. So this is Dentistry Uncensored, so let me throw you under a bridge, some endodontists wonder that back in the old day when it was gold crowns or in a pfm the porcelain would easily crack off the metal that when somebody bit something hard the weakest the weakest part was the porcelain to the metal but now some people are wondering since BruxZir an elephant can stand on it that's not gonna break if you bite down on something too hard then what would give would it be the root canal fracture and if that is so would you do you think we should go to softer stuff like camouflage blocks that can absorb some of the force, so do you think a crown like BruxZir can be too hard and do you think it should shift back to something softer to absorb force or do you know nothing that's an issue?
Neil: No I don't think it's an issue and I think there's you know it's a theoretical issue right seems like such a hard material and it hits this other hard material but the point is that this at this time Howard there are 16 million BruxZir crowns that are out there and then Dr. Gordon and Rella Christensen they just published an eight-year clinical study and what they found is that BruxZir where's the opposing dentition much less than any other material that they've ever tested. So a lot of the hypotheticals of gee material seems so hard so strong it must be it must be unkind to to to material sorts of the natural dentition it just hasn't it just hasn't proven out. So as you said there's there's always a weak link in any system at its I have a friend who's a prosthodontist at Clear Choice and he put in you know we do a full arch BruxZir implant bridge. So he had just done ten cases of BruxZir against BruxZir okay and of course people are saying oh my goodness that's rock against rock it's got to be killing the implants whatever. We follow these cases and there just isn't any issue it just there just isn't any issue. So even though you've got theoretical concerns the clinical data just doesn't bear that out and at this point it's III don't think there's more BruxZir Crown's than gold crowns but there's certainly more BruxZir crowns than any other kind of crown that's out there so it's a lot.
Howard: How come I'm all of my crowns and inlays and onlays why are they all gold and why I'm the gold dye or is it still is there what would percent over business is gold?
Neil: It's a great material it just got horrendously expensive and at certain times that that price will spike up right and that's what really made BruxZir that was the impetus to develop this product for Jim it was, you know it's actually Gordon Christensen and Rella Christensen today they had this list of things they wanted to develop for the perfect material and they wanted it to be tooth color they want it to be a reasonable price it's like the white version of gold okay and the problem is gold just got too expensive and BruxZir fulfills all these other requirements that they that they listed. So it's we're lucky we have this material or a lot of people would be priced out of the dental restorative market.
Howard: So let's go back to this iTero intraoral scanner which is owned by Align Technology which owns Invisalign. Do you all those patents it seems like have all starting to expire and we've seen a explosion of clear aligners companies pop up on the market, even Henry shines I'm starting their own clear aligner is that a business that your Glidewell wants to get into?
Neil: Not at this time, you know we're really a restorative based business and we really haven't done a lot with orthodontics at this time that's not to say that we wouldn't be involved in the future but at this time we're not. I think that clear aligners are a great part of the market but as you mentioned there's quite a bit of intellectual property that's closely protected by these companies and and we're not interested in treading on anybody's anybody's property.
Howard: Yeah so I want you to put your dad hat on um your ol not to have a child that just walked out of dental school she's your daughter she's 24 she just graduated from dental school she's let's say she's $300,000 in debt. You've been in this business for 31 years you've hung out with the greatest minds the greatest companies what advice would you give her?
Neil: I would say pedal-to-the-metal do it okay you know there's a lot of trends driving dentists in a certain direction and I'm on the the deans board of one of the dental schools and I've seen our graduates you know 40 percent of graduates every year go to work for DSO and if that's and if you're comfortable doing that you want to do that I think it's great. I mean there there are some tremendous dsos where you can have a great career but my hypothetical daughter I would say hey let's get the money let's go out there because dentistry is a fantastic business and if you go out there and treat it like a business and do your homework and do your research and commit to it and understand that you've got a you've got to know marketing finance operations HR all those other things you've got to do that and if you're willing to make that commitment and do it you can be fantastically successful and that ms the direction I would point people to and people have different personalities.
Howard: Talking about thinking in fear and scarcity versus and hope growth abundance. I'm interviewing the editorial director of Chairside Magazine which is one of the greatest dental magazines out there and people someone's thinking well why would he advertise a competing magazine to Dentaltown. It's because I think anybody who's doing anything to help my homies is my friend I don't think in fear and scarcity I've also never met a dentist who only reads one magazine. I mean you know I mean you know I don't know a dentist that even owns one implant system do you know any dentists that only own one implant system? Theirs Dentaltown, rock on.
Neil: You know I read them all because as you said first of all we can learn from everybody and secondly if I want to do a better job I want to see what what my competitors are doing as well because...
Howard: When someone declines my offer to come on the show say well I can't because I write for a competing magazines like well I'm not competing with anybody so how is there a magazine competing with me. I mean I mean back to the implant systems all my friends that are my age guess how many implant systems they own?
Neil: Three to five
Howard: Yeah and how many composites do they have how many composite kits how many bonding kits. I mean quit thank you yeah so talk about Chairside Magazine, how many issues have you done? Your on...
Neil: Oh so yeah you know I mean I've been here about about three years a little more than three years now so we do four issues a year. Before that we had two magazines we had inclusive magazine which was which was all about implants and then we had Chairside. We we merged the two together a couple of years ago because we felt that implant dentistry was no longer a separate discipline, that if you're practicing General Dentistry you're involved in implants and why have two different magazines. So what we try to do in each issue a Chairside, you know I'm just understanding up the the issue that will be mailed in about a week and we've got forensic dentistry. I got my props Howard, we've got...
Howard: You know I'm laughing?
Howard: because it's a big joke at our office because we say well you know if we want to be a better dental magazine we should be like Glidewell their magazine Chairside Magazine, because seriously if you go back like 20, 30 issues it looks like the Miss Universe contest. I mean I really I can hold up I can hold up your online versions where every single one of them is a beautiful. So is that is that really your secret sauce you first start with who's a gorgeous female dentist and then work backwards from there is that your strategy?
Neil: No it's not but you know all things well you know Dr. Mary shields who's on the cover a really a really sharp forensic dentist and that's an area that a lot of dentists don't know about and she does she photographs very well.
Howard: Well the next time you see Rella, I want you to tell her that I said on my podcast that of all the beautiful women that have been on the cover of your magazine Rella is still rocking it the hottest.
Neil: That's a very kind thing to say, very sweet.
Howard: I think of her as my dental mom you know it was her and Gordon who made me realize that if I studied everything known to dentistry I could never figure it out and that if I practice for 50 years I'll still die with more questions than I have answers because that's how complex and it was actually Gordon and Rella who really made me realize wow I went into something it's not like carpentry work you can actually figure out how to build a cabinet this isn't plumbing where you can actually fix a toilet. You're into something that's probably not gonna be all figured out for several thousand years. I remember Rella telling me one time you guys know the pyramids were five thousand years ago and we're probably only halfway to understand that joke on physics like this physicists know everything except 95% of the mass of the universe dark energy you know black holes. I mean you literally have a list of 20 things that physicists don't have a clue about but then when they talk about what they know about they act like they just really really know everything. It's like dude the list of what you don't know is infinitely longer than what you do know and that's what Rella gave to me. Rella Gordon gave that to me that I don't care how hard you try and how much you read and how much you study you're they're not gonna figure out dentistry for thousands of years.
Neil: and they have this insatiable curiosity you know it's funny Howard it's you've probably been involved in some research I have over the years and it's so hard to produce good clinical research. If you go through the dental journals there are really very few long-term random randomly controlled clinical trials and they that's what they do they do these long-term trials they took a look at materials they don't look at it for six months eight months you know hey you know everything works for three years it doesn't matter what it is but let's see how it does in five years six years seven years and that's and that's the big difference and that's you know for them to publish this this ruksar study the senior BruxZir study was amazing for us because there's nobody else they could do that.
Howard: Well I can't believe you stayed on I can't believe I got the the dental director of the largest dental laboratory in the world to come on my show for free and talk to my homies. We went way over the brands an hour and we're way over but Neil seriously I thank you for all that you've done for dentistry thank you so much for coming on the show if you can get Jim Glidewell or Jack Hahn to come on the show I'll name my next grandchild after you if I can get my boys to sign off on it but thanks for all you've done for dentistry and thanks so much man, honor and a privilege to podcast interview you.
Neil: An honor for me as well I really enjoyed it Howard and I well I will work on Jim and Jack for you.
Howard: Well tell Jim if, Jim's 100% Irish so he has to he has to come on the show or it'll be or I won't drink beer with him but thanks a lot for coming on the show buddy.