Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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1224 Las Vegas Esthetics Dental Laboratory with Ray Foster, Yin Garcia, James Dodge and Dr. Shahin Safarian : Dentistry Uncensored with Howard Farran

1224 Las Vegas Esthetics Dental Laboratory with Ray Foster, Yin Garcia, James Dodge and Dr. Shahin Safarian : Dentistry Uncensored with Howard Farran

7/29/2019 5:48:34 PM   |   Comments: 0   |   Views: 66

Las Vegas Esthetics was founded in 1997. The lab sponsored LVI for 12 years and supported all of the live patient courses including Dr. Ron Jackson’s posterior course and all of the esthetic/smile and neuromuscular courses taught at LVI. The lab had the pleasure of working with some of the best dentists in the US and Canada.

VIDEO - DUwHF #1224 - Las Vegas Esthetics

AUDIO - DUwHF #1224 - Las Vegas Esthetics

Their focus at the lab is on implant cases, smile enhancement, full mouth rehabilitation, quadrant dentistry and TMJ appliances. At the lab they work with many different doctors with different disciplines as they have found it important not to be limited in their knowledge. Currently Las Vegas Esthetics sponsors courses for Myotronics and Occlusal Connections.

Howard: it is just a huge honor for me today to be podcast interviewing four legends of dentistry Jin Garcia is on the far left James Dodge ray Foster and Shaheen Safari and who we just podcasted earlier and gave me the lead Thank You Shahan for this lead it's a Las Vegas Esthetics Dental Lab: it was founded in 1997 by Ray foster dental labs are becoming more important in dental practices as our profession continues to grow and new technologies are introduced they love what they do and want to make things easier for dentists and form a strong team they know they can produce high-quality lab work with the latest technologies at disposals in their lab the best way to provide this care to the patient is to make sure that the dentist communicates with them to make sure they are meeting patient expectations their goal is to make dentists better with their services they are very excited to be joining dr. Shaheen Safari on and his national program called love bites not the Japanese all-girl heavy metal band which is what I recommend that you review first then go to love bites odd dental they know they can save dentists money on their lab costs with this campaign of up to 50% for some dentists and with the live training and marketing of this program offers a dentist will be a win-win for the dentist and the patient and the lab providing predictable dentistry at the highest quality with financial savings for the dentist and the consumer makes total sense to them why don't you guys introduce yourself why don't we start on the left with Jim Garcia but Jim has actually spelled why I n so

Las Vegas Esthetics Dental Lab:  yes and you know what's up I was a Korean signal they gave me a C and again that's that's my name but in Spanish I'm not from Mexico really but his messages is pronounced Jim so gene yang Wow and 

Howard: you know where Wai ghin was created no they actually thought Jin our Tanqueray as I call it was actually repelled mosquitoes for malaria so they actually would show all the Navy people their beverage of choice was gin because they thought that would help them against malaria but I don't know if you're having any malaria outbreaks in Las Vegas a true story absolutely and so so Jim Garcia so why don't you introduce yourself and then we'll go left to right we have

Las Vegas Esthetics Dental Lab:  my name is Jesse I'm the brother manager here in Las Vegas a steady said being the human part of the team for about 50 years and basically I love my job everything I do here so yeah I'm a teacher I take care of following the cases when they come through they'll have you know from a key to each one of the departments model room waxing you know all the way to the start a mechanic you see part of it so that's kind of what I do here in the lab okay not to interrupt but 

Howard: um are you do you prefer receiving oral scans as opposed to vinyl poly siloxane impressions I mean because you're the receiving end of these impressions and oral scan so

Las Vegas Esthetics Dental Lab:  I'm going to start right there what's your thoughts on that well there's some pros and cons for both of them I personally right now I like the digital end just quicker also you know there's no need for us to clean any of the impressions so you know digital format is it's pretty efficient so any day it's 

Howard: it's a piece of technology with a lot of brandings I mean if you do a lot of Invisalign I could see why you'd want to go with that I Tarot because I Tarot and in designer owned by me lion align technology 3m has a true def scanner here in the states Copenhagen Denmark has the three shape there's all kinds of oral scanners do if someone was listening to you right now and wanted to be a cosmetic dentist is there a scan that you significantly prefer more the others you know

Las Vegas Esthetics Dental Lab:  I mean we here at the lab we have two systems we have the CEREC system and we also have the depreciates system so we're very versatile both of them but personally I'd like the Surrey a community necessary scanner the price continues Kennedy came out as beautifully so what's it my name is Alice Eric the breading the what this place Roman no no but I mean which new scanner you said new scanner which model prime scam

Howard:  okay so you prefer the digital scans and you work primarily with prime scan by dense why Sirona which is a CEREC scanner and the three shape what's the three shape one called trios so those are your two faves yes all right so James Dodge it's you yes it's me so 

Las Vegas Esthetics Dental Lab: my name is James I've actually been in the dental industry since I was 16 so going on almost 30 years now I've been here with Las Vegas aesthetics for 17 years Jim and I both started at the same time back in 2002 I started out in the dental industry doing deliveries for a local dental laboratory and that's actually how I met ray I have no red for the past 30 years now and my role here is as laboratory manager I've kind of worked my way up when I was 16 I was doing deliveries and I just kind of learned over the shoulder as I've been going along learned how to do waxy metal finishing model work worked my way up to porcelain on my own lab for a couple years and then I decided to partner up with Ray and my role now is laboratory manager so I kind of oversee everything that goes on at the lab all different aspects nice all right ray a cue baby I think I'm gonna date myself a little bit because I I first got into dentistry in 1978 when I joined the Air Force Wow so I I've seen everything probably about ten years on the clinical in chairside so I've been a surgical assistant at the hygiene worked in all the different specialties but then trance I kind of translated over into the lab and there were more opportunities for guys you know getting into lab work and as dental assistants

Howard:  which has really changed now that United States has lost 50 million manufacturing jobs from 1980 to 2020 it's amazing how many men are flooding into the healthcare sector which is the fastest growing part of the economy 

Las Vegas Esthetics Dental Lab: well I do notice a lot more guys in the offices when I go in to meet doctors yeah I'm saying yeah I've had a guy at the front desk

Howard: I've had a guy at the assist yeah they love it I mean they're they're making they're making a lot better money plus I'm out here in Arizona who'd want to be out there hammering shingles when it's a hundred and eight degrees right now and the high 115 another true story you know my dad's brother Mike Fran was the first male nurse in Kansas know and guess why he graduated high school in Parsons Kansas and he never got a date with the love of his life my Aunt Shirley and he was so depressed and he found out that she applied to nursing school so he wouldn't apply to nursing school they're like you're a boy they're like I don't care and so then he came a nurse and it took till junior year before he married my Aunt Shirley so he was the first male nurse for all the wrong reasons and but uh so ahem so what is your involvement with this lab why what you did a podcast with us earlier and what made you get interested in the lab side of cosmetic dentistry 

Las Vegas Esthetics Dental Lab: yeah so my name is dr. Janine Safari and as Howard mentioned I'm a practicing dentist in San Diego California for the past 18 years and the reason I got involved I mean it back to really your one-two-three and my involvement with continuing education but just a fast-forward 2014 I started getting involved with trying to find ways that that I can help the dentist and have impact in the profession and one thing led to another and here we are started talking to Ray over a year ago and towards the end of last year and our conversation just kind of progressed into talking about how can we as a lab and as a licensed dentist create a program where we can really help doctors around the country and not you know local relationship so that's how they all kind of started we came out here in January then a bunch of recordings video recordings we'll talk about that a little bit more but really my goal is to create an opportunity I know you know the private sector even the any dentist practicing there's much more of a squeeze today as far as you know trying to get a bottom line and so that's really the essence of what we're trying to accomplish with this and also really give the opportunity for the doctors to really get proper cosmetic training with cosmetic cosmetic instructors and also have the lab make sure that they're fully involved as well I mean ultimately it's a complete team process and you know they're really happy with these guys these guys is just so you know how're they sponsored Las Vegas Institute for Advanced Dental Studies LBI for over ten years and they're currently involved with Clayton chains occlusal connections program and also are involved with my atronics so you see three humble guys here but they are very well diversify and very high quality cases are coming out of this laboratory from straightforward cases to full mouth rehabilitation with physiologic bike component attached to it it's pretty cool stuff they can do these guys at their lab here so I wanted to be affiliated with him and and thank goodness that they said yes all right now

Howard:  now that what you just said was a completely different story than what ray told me about you he said that I when the Chargers left town you moved to Vegas to become a Raiders fan actually we came here yesterday drove by the stadium and they said got some work to do on that Stadium you know why everyone in Arizona is mad at the that stadium boy can't hire a welder in Arizona they have sucked all the welders out of Southern Cal and Arizona and the average income of a welder in Arizona is going through the roof and my patients at our welders say they used to go from job to job and now they had to get a calendar because they're booked up three months in advance because everybody who knows how to weld is now in Las Vegas so I want to start with some very specific courses because podcasters tend to a quarter of my homeys are still in dental school and the rest are all under 30 old people like us read books and newspapers and magazines and they don't so their first question because they're very confused I saw I just want to go I started with the scan which I'm a big fan of scans just because with humans if you go to lubes anything to increase magnification loops you see more the greatest send adonis i'm check about 8x before the obturator look down at those canals and see if they missed any it got all cleaned out whenever i oral scan a prep i want to just burn my dental license because you see your prep 40 times larger and you think there's something wrong with me i mean i should be able to show one of my scans to a neurologist and he says we'll find that tumor buddy there's obviously something in your brain not working so I think magnification is huge and I think a lot of labs are reporting less remakes with scans but the next question they're going to ask you on these big cases articulate errs or not and it's confusing because they they graduate from school and they want to be a dentist just like their mom and they're in there with their mom and their mom doesn't even own an articulator and so so let's start with the controversy articulator to warm you up for the even greater controversy which is occlusion TMJ neuromuscular all that stuff so let's cook it so that so who wants to tackle that 

Las Vegas Esthetics Dental Lab: as far as we do articulator are not to articulator on the larger cases using an articulator let's just say let's just say you're doing a case that's two units and not two units for use in the anterior four units to say ten units putting it on an articulator having some type of a symmetry bite it's very helpful plus it gives you something to hold in the end you can you can still do these cases virtually you really can and on the digital way of doing it you've got grids so you can level things out but I'm gonna hold her and I'd like to hold something in my hand with Yin he can he can design a virtual case and then we can go ahead and take that to the mill and finish it so we kind of do a combination of both some of the cases we do a model is you know three unit bridges a single four units four units and even more you can do you could actually do models 

Howard: okay so um I gotta play devil's advocate for the kids um so they're doing an anterior veneer case or no let's say it's an anterior crown case four to ten units okay the four of you do you want that oral scan and be model us and all that or would you prefer an articulator would you as you say so hold something in your hand what 

Las Vegas Esthetics Dental Lab: I actually prefer to scan because with the scan we can do anything we want with it if we want to produce a model here we can send it to a 3d printer and we can print out a model but if you can if you can take advantage of scanning I absolutely love the idea is behind scanning the main thing I like about it is you can actually go in and check your press I noticed that the doctors that are taking scans they're actually prepping their cases better they can go and in conventional little space they have they can look and see if they if they if they could have divergent actual walls for trial and everything and if things don't work out you're going to see it on the scan and then you're gonna have to bring it out to me to go back and pants your crap 

Howard: and the other thing III think when I listen and I read people talking about scans I think they might not completely understand the digital transformation which is basically the intersection of four really big things elastic cloud computing big data Internet of Things in AI and what they have to realize is that big data when you send in one scan it says okay Howard this is scan but by the time I've said in ten scans I 10x the data for the AI to machine learn what the hell is Howard trying to do and then you you scale again to a hundred cases scaling into a thousand and maybe ten thousand right the more you do the more big data you give to AI the better decisions that make so it's one of those things and I need to if anybody's listen to this and know somebody in AI need to get somebody from then slice Sharona or as the technical computer side of it but people don't realize that machine learning is all about big data and with elastic cloud computing to where what used to be I mean we've seen the death of statistician z-- because it used to be well we can't analyze all the data so we're get a stats guy to draw a sample size and build a mark well nobody wants to do that anymore when you have available with cloud computing you want all the data all the time and keep machine learning it and so these oral scans are the quality is gonna grow a scale compared to the old Egyptian way of the lost-wax technique from thousands of years ago so yeah I think the the scan and by the way when you when you said you recommend to the C rack you know they were building that when I was in dental school and the guy is from France that we're building that we're saying that the biggest problem was they they couldn't do it right because the Intel processing chip was so slow and so small they had to make all these compromises but now with with cloud computing or a lasting cloud computing what I mean by elastic cloud computing is you know you have your own physical server but with cloud computing if you if you host it on any of the cloud computer like Amazon Web Services AWS half their income Microsoft Azure IBM Watson Google cloud if I just all the sudden send in the biggest problem in the world my cloud computing expands so so if they build me one hour a day for a thousand days that's the same cost as a thousand hours for one hour right now just to knock it out so with cloud computing I think this digital scanning is gonna be the only way it'll be just a matter of time when you'll say no we're not taking alginates and vinyl Poly's and polyethers and all that kind of stuff okay but if they were gonna send in an articulator again any any favorites 

Las Vegas Esthetics Dental Lab: I think articulate it would be distressed that's the one we're most well versed in that's one that we use the most is the Stratus articulate starting for this so that's yeah this one that we've been using for as long as I've been here Stratos by Ivan Flores the one that makes that and that articulator fills on our needs very well 

Howard: nice if they're gonna take an impression and sent it in on a Stratus articulator polyvinyl siloxane call ether what was that green gel we used to use 30 years ago right the other ones don't know about this but what was that green gel in the heated water bath yeah oh the Hydra Club you know that's when I cut my teeth on oh my gosh I can't believe it also be careful with that material because you had to have it at a working temperature so you had to be real careful on the temperature of that material because if you put it in the tray well if it's too hot you'd have a disaster when you when's the last time you got a hydrocolloid impression 

Las Vegas Esthetics Dental Lab: I don't even remember I think I don't know we've ever had one here I know I've worked with them probably 25 28 years ago so yeah I know a little bit about them too I know that when you're the delivery person and you bring it back if you don't pour it up right away you're gonna get in trouble the next day

Howard:  all I know is if you're out there using hydrocolloid impression we assume you have an email that's and that's that for an erectile dysfunction so what do you think are the biggest challenges for young kids again I want to focus on these young kids um how do they learn how to be a cosmetic dentist they just graduated from the school you know back in June it's only July and they see this big case they want to do it what would you tell these kids 

Las Vegas Esthetics Dental Lab: Wow you know we this is one of the things that we're really excited about starting 2020 we're going to get some of the best cosmetic dentists in the country to help us you know educate either the new ground or the seasoned Dentist you'd be surprised somebody sees in Venice can get a little bit of help on prep design as well on these cases depending on multiple factors but with that said that's what we're excited about this opportunity is very inexpensive and quite frankly it's a free program that we have for doctors if they become members of our program so conceptually one thing that was really important to me is I wanted a cosmetic dentist that did a lot of cosmetic work and also directly works with lvd Las Vegas aesthetics dental lab and we already now as we speak have a couple of doctors that are in the process of putting all of their work documenting all of their work in conjunction with all the work that Rey and his team are putting together and in in the anticipation then we're going to launch the live programs nationwide starting 2020 and you know the cosmetic training as you you've researched obviously interviewed many people it's not in that an expensive endeavor and what we've really done is create an opportunity quite frankly that that you actually save money by joining the joining the program and he did the free training and we can talk a little bit about that too but there's a lot of details to cosmetic training and the new grant graduating with $400,000 of school loans it's not going to be able to afford paying another you know whatever the number is four thousand three thousand dollars to get training for three four days on on how to do cosmetic dentistry

Howard:  okay my job is not to be an abrasive guy who's trying to be abrasive for the sake of abrasiveness but let me throw you off a cliff for the purposes of Dentistry uncensored are you ready so let's go so they come out of school and they all know that they didn't learn enough occlusion and my gosh speaking of occlusion we all have to say a word to Peter Dawson who passed away over the weekend just unbelievable Peter Dawson is no more they right it is with heavy hearts that we announce dr. Pete Dawson peacefully passed away this morning in the loving company of his friends and family our thoughts and prayers go out to him and his family he lived from 1930 to 2019 I was one of my most favorite podcasts that I did it was podcast number 500 and we purposely did an even round number like that like he was ready to go like for 70 I mean right so now it's making a number no one will forget and then he just came out with this book a better way the surprising path to a complete life by Peter Dawson on Amazon but basically the kids come out of school let's say their dad adored Peter Dawson like I did I mean just an amazing guy seems like yesterday I was having breakfast with him and he is known with that CR pinkie whatever lvi is no one nor a muscular and so the kids want to learn more occlusion but the first fork in the road they have to get their head around as do I go left with CR Dawson pinkie do I go right neuromuscular with my electronics you you mentioned Clayton Chan he's a big neuromuscular so so so explain to the kids sure they go right to lvie would their muscular or left with CR and how are they supposed to approach this 

Las Vegas Esthetics Dental Lab: yeah look to be honest our just this Co dentistry coming out of school right just do general dentistry do Co dentistry don't get confused into CR and neuromuscular physiologic like I think coming out of school what you really need to focus more on it's not necessarily occlusion and mastering occlusion I think you need to master just being in the real world feeling would just cut in crowns and you know building up your speed getting some positive results getting some positive feedback from your patients right out of school it's certainly something I would recommend getting into that rabbit hole but if you are a little bit crazy and you want to be that 1% that wants to get into that arena I would highly suggest being open-minded to all different events and you know go and see for yourself there's a lot of people that talk a lot right but you know there's nothing more powerful than yourself judging because you've gone through it yourself so I think that's the most powerful I will tell you that you know one of the things that we pay attention to clinically is every time a patient talks to me their lower jaw comes down and forward it doesn't go back so that in itself tells me naturally that either the maxilla is deficient or the patient's lower jaw just wants to naturally come down and forward so you know but that's again 15 16 years later that it's easy for me to make that statement through my training so I'm a little bit more down in forward dag and not backing up so but you know just for yourself I think that's really the key thing and I don't know if these guys I mean these guys will do any type of dentistry for you because you know they've practiced all the camps well basically at the end of the day all of the doctors records so whether he is a senior dog or a neuromuscular doc Berger his records and applied those philosophies in the case now we do have a lot of neuromuscular training year I've been doing neuromuscular for 20 years myself though I was trained by lvi I was trained by dr. Chang and dr. jangle son back in the day so I understand that philosophy go well but you've got doctors that have different philosophies they're going as far as a conclusion isn't sorry so for us is just we just adapt what they want to do and follow their instructions as far as the new doc I'm not a school I would suggest that they either go you can go coochi connections then take level 1 to get a real good taste of what neuromuscular is about and then you can go and you see up horse and then that that student or that doctor can decide which direction he wants to go but at least they're given both the chance here's the areas that it becomes problematic when you're trying to prep number 22 to 26 and the patient it's got a deep bite right you got it at least understand the concept of opening vertical because you're gonna be very over aggressive with that preparation designed to get that to fit into Co but generally speaking I mean you're looking at 95 to 98% of what I do on a daily basis it's in Co so you know focus on the CEO try to just get comfortable with coming out of school and then like Ray said in the first three years of your practice getting out of school go take a couple of courses through CR Pro like horses and and koi stirs you know four or five different programs out there that can educate you on the different schools of thought and then that will help you now with your practical training that will help be three four years in as far as you know what route you want to go 

Howard: well I definitely like your answer better Shaheen then raised because you were able to work in going down the rabbit hole with Alice's Adventures in Wonderland by Lewis Carroll that was Ray I'll give it a follow up you got a chance can you odd beat Alice in Wonderland in your answer you know

Las Vegas Esthetics Dental Lab:  there's so much to learn I mean if you if you if you go and take an intro course it's it's gonna expose you to a whole world out there of possibilities as far as the neuromuscular in is concerned I mean we do a lot of neural Buster cases but we do a lot of Steel cases also so okay but she she's driving to work and she might not be catching what's the difference in a CR case in a co case you've referred to Co cases three or four times explain that to someone who might have missed that so see no is just where your teeth come together round by your teeth together and that's where that's your normal bite it's that's pretty much that simple and then CR obviously there's you know we it's been defined in different lengths you know different ways but ultimately it's important condylar movement as far as pushing it back and more posterior-anterior and then neuromuscular is a little bit more you know down and forward as far as opening the vertical and bring the lower jaw forward and not being asked focused on the condyle but rather being more focused on muscle relaxation and alleviating muscle fatigue so it's a little bit more of a muscular treatment as opposed to joint treatment and it also depends on what the patient therefore some of the patients are there just because they want a pretty smile some of their because they have pain they have issues they're over close there's a lot of wear so you need to know how to address those but majority of people are going in they want to do an 8 to 10 of your case they want you know they want a whiter smile so just building them in there a bit you'll see oh you really can't go wrong there they're comfortable with that position you address their needs as far as aesthetics are concerned so down the road you don't have buying issues 

Howard: so you know you must know by now Ray since you're are you older than Yoda or less than Yoda well you must know Yoda by now that they'd rather swim with sharks then open the bite why is opening the bite so it's so scary I mean - I mean it just I mean you want you said open the bite they just drove off the road and hit a tree 

Las Vegas Esthetics Dental Lab: it's really not it's really not that scary we do these intro courses with  Plantronics we just did one in Baltimore and it was all the basics of how to tins how to determine what your anterior Shinbashi numbers should be and they're shooting a bite accordingly so those guys they come and they'll spend two days I don't think the bees on that course are very very much but they'll spend two days once they get their tens they're ready to start taking bites now as time goes on they get better at taking bites but they get enough information even in that one course to be able to go back and start addressing on those vertical change cases whenever there's a vertical change is always going to be an AP shift and recording that you really do need that tends to do that I mean you can just have the patient open and close and shooter by there but now you're  gambling and  when it comes to the normal school ER cases let's just say we're going to change the riverboat change the AP all of that has to be tested with an orthotic so you don't open the bite and then go straight towards prepping and finishing you open the bite you test it with an orthotic if the patient is comfortable then you can move on from there so there are a few things that you do before getting in there and  just starting to practice B and you know what how are you have to be ready for the information if you are clinically not knowledgeable enough and I hate to use that word coming out of school the information might not make as much sense and that's why I'm saying it's important to get some clinical training go out in the real world see some cases get some feedback from patients during your examinations as far as what their chief complaints are right you don't need to open the vertical if the patient is not complaining of pain for example but you also sometimes doctors open verticals like I said because they know that they can provide better quality care with the severe overbite and they're asking them to have their lower teeth prepped so there's a it's a it's a big discussion there's so many different dynamics involved but one of the things that it does is it opens your mind up with a combination of understanding orthodontics it really opens your mind up to understanding how to treat the oral cavity as a doctor as opposed to just to be honest just going in and doing some mechanical work on teeth and it's really what it comes down so you become a doctor of the oral cavity when you start understanding these different occlusal philosophies and this is kind of a deep rabbit hole because when you start opening when you start opening vertical and pap shift one of the things that we found to be true is a lot of these newer muscular cases actually for those slash restorative cases so now you're going into even more so you need to understand orthodontics to address by cuts the drop-off things like that so it starts to get really deep but an intro course on the different philosophies it is it by it's just it's really simple many of these cases it's more based on maxillary deficiency than amended their problem and that is the key is that we forget that the maxilla is involved in this game much more important than many times in the manual and so these are things where again you know it's just you know 18 years in this is something I had no clue about you know right out of school and I went to Tufts down which is one of the top schools in the country so you know it's a fun game when you get into it but maybe not right out of school 

Howard: are you saying that Tufts finally got accredited no they finally learned a little bit more about occlusion right I'm still I'm still upset with you that I've you know you just mentioned Alice in Wonderland again you didn't come up with your own I'm suggesting that you should have worked in the matrix when neo is approached by Morpheus who tells him everything he has ever seen her hurt is not real and an order friend to know the truth he has to swallow the red pill in his right hand or if he wishes to resume the illusion take the blue pill I don't think just copy Sheheen's Alice in Wonderland coach that's what you know

Las Vegas Esthetics Dental Lab:  I said I told these guys that in March when I came on I said we already talked about IDI a little bit so I said Howard is pretty cool if we sure would be guys so don't worry we need to get 

Howard: we need to get Morpheus to come on the show and talk about occlusion do you think how we can do that you know actually you mentioned Clayton Clayton I god that would be awesome you guys you think you can deliver Clayton Chan to the show to keep the I do that and you know what I will tell you something even more interesting which again this gets into the discussion of sleep apnea right I mean this is a huge topic just picture what you do when you're opening it for you when you deliver a sleep apnea appliances to your patients what are you doing and that's conceptually the same thing I mean obviously it's not in that drastic movement and you know it's that it's an discussion but there's a couple of instructors that I'm working with right now we actually one of the other programs that we're launching Howard is gonna be sleep apnea conceptually the same idea is what we're doing with Love Bites that's gonna launch at about three four months and there's some amazing smart smart doctors that are involved with that program some of the top guys I've had to spend four four thousand dollars to listen to three four different occasions every three day so what fifteen twenty thousand dollars to just listen to them they're coming along with us and joining our program so really excited about that I'll share that information with the hour and but certainly I mean these guys work closely with claim and I know Clayton well as well so we can do that 

Howard: well I'm the reason I keep asking and another reason about neuron neuromuscular and all that no I want to stay on it is you  said you were down at my atronics and so when you go into neuromuscular you might need to buy some equipments when you're talking to fraidy the CEO of my atronics who does he think are the maya tranny who which clinical dentist transferred the knowledge the best about my atronics and his opening like you when you guys went down there who was lecturing 

Las Vegas Esthetics Dental Lab: well you've got mike the Esaki sam karate you've got Jeffrey he had it so you got quite a few guys out there that are very very knowledgeable and really excited about sharing this information with their colleagues and Clayton as well yeah in Chan as well I mean he's  got an occlusal connection program here in Las Vegas and free for those of you guys that don't know Clayton just google his name and you know look up his contents and see what he's done over the last 25 years with occlusion yeah  it's occlusion  connections and I was gonna go to Las Vegas and go to that course but I actually went to the pond store to see my ball beauty but what a pong stars it's close to Pawn Stars I mean you're missing the are but but you know with that said I think what's going to happen is Clayton would be really happy to come and talk to you and look the bottom line is you know I've been in this game for 15 years as far as occlusal camps and really a lot of the battles where people just talking just going in a tent of course and judge for yourself and if you like it great if you don't like it great nobody's forcing you to they have all 

Howard: and all I want to weigh in as and when they asked me should I learn neuromuscular or CR I always tell them dude you got to learn both you got to learn a hundred hours of CE a year that's why I started this podcast she's lives in a small rural America most these speakers don't come to her town she might have a husband and kids and I'm delivering people like you right to her doing car stereo on the way to work and because in my 32 years at this every dentist I know 32 years ago that gun ball with a GD or the FA GD and set out on this journey taking a hundred hours of CEA year they'll earn their way out of any issue that came up and they all did well and then the dentist who got all upset because every three to five years he had to take 12 hours of CE to get his license renewed they just seemed to be unhappy and frustrated and life is just so much more fulfilling if you master your occupation and you  know you got family and yet business and there's just nothing more rewarding than being good at your occupation

Las Vegas Esthetics Dental Lab:  the main thing is to approach it first on both with an open mind that's approaching with an open mind yeah you went back how to talk about new grads and that was initially a question I would say master centric occlusion first and then you can get into the other camps sincere will also tell you centric occlusion is a struggle for many dentists 

Howard: so let's focus on the CEO before you go crazy on the other stuff right yeah and so much the occlusion is even stranger now the general dentists are starting to get into clear aligners because you don't hear a I'm well I'm I'm not even you throw myself on a bridge when I could throw all four of you under a bridge Oh a lot of it a lot of the big occlusion people are not impressed with the way orthodontist there's ten thousand eight hundred orthodontists in America and what do you think of the the way the orthodontist treated close I mean standard straight wire blows away the curve is be the curve Wilson I mean it does all these things in the name of beauty so these young kids are out there and they're saying well the orthodontist doesn't do that do you think the orthodontist confused the occlusion debate with general dentist look just because they're north of Adonis I would say the same thing go to these occlusal camps and judge for yourself simple they don't get Clayton Chan's neuromuscular philosophies in ortho school so go learn it it's something that we also then learn and down school there's nothing wrong with going and paying attention to what's out there you know just to hide behind the concept of honest specialists 

Las Vegas Esthetics Dental Lab: I know everything you know there's some limitations to that thought so like Ray said just be open-minded it doesn't hurt you to go and say hey you know what I want to learn something that I think can be very beneficial to my patients that's the bottom line so now you know as far as ortho and you know clear aligners and you know verticalization is a big component in opening verticals this is something we talk about there are wires that can accomplish that so it is in the orthodontic realm to open verticals there is neuromuscular orthodontic doctors out there treating cases and you know we've been those there's some orthodontists doing it as well Clayton has fourth of course it's Norma so called of course or so I think the key is just take that initial camp of you know what is the philosophy of occlusion under the physiologic fight neuromuscular realm what is it under CR and then just  for yourself it's really that simple if you skip those first you know first or second course and jump into just wanting to move wires and move teeth around you're going to miss the concept what you're really trying to do and I think that's where a lot of potential issues are is you just skip the basics and that's that doesn't allow you to have that mindset that this is really something

Howard: if you get too open-minded your brain will fall out so be careful um no go right back to economics I mean the five rules of economics are make it faster easier higher quality lower cost and smaller and you stated that you think that what you guys are doing is gonna save dentists money on their lab cost and with this campaign they might save up to 50% and so that perched my ears and I hope it perked young kids ears how do you plan on saving dentists money

Las Vegas Esthetics Dental Lab:  so you know the and sorry I'll step in here just a little bit to talk about that because that is a big topic you have a range I've talked to doctors hundreds of doctors last couple years and you know certain Quantium for $35 that a lab is doing for you all the way up to Emacs laird Emacs up to $1,000 but I think generally speaking you're looking at 350 to $400 range for high quality cosmetic work and these guys are going to do that high quality cosmetic work for you per unit for $200 so if you're spending 350 400 dollars that's where the 50% number comes in we have a doctor it's $197 a month so he is invested in three months $600 and he has saved over $13,000 on his lab bill because he was paying the 350 400 dollars and now he's reduced it down to $200 a year and so that makes total sense and to be honest these guys right away said well this is kind of crazy but I talked to rein I said Rick what is your five-year goal and raised like you know I want to be out there I want to educate doctors I want to be in front of many doctors I want to lecture I want to be I'm excited I love this profession I love what we're doing and we can do this to a higher volume base clientele or doctor this if we're able to reduce the number and get more exposure and it's really what we're trying to do with this whole model is if I can save your family and you the doctor in your business 10,000 15,000 80,000 $120,000 a year depending on what you're doing on your $2,500 return on investment it's just a no-brainer it's really just that simple and we've also added a couple other programs on top of that within this model that allows you to take advantage of Google ads and kind of become a little bit more of the provider directory so you'll get some SEO advantages we have a full marketing team that's going to run this campaign nationally so we have a full national SEO program involved with this if you're a provider and they're going to also be involved with making sure that the content is up-to-date there's just a whole list of other things that our marketing team is doing in support of this model with Las Vegas aesthetics 

Howard: so Shaheen you're saying with this program that you're launching Love Bites that they'll be able to pay their alimony help you okay I would I never switch gears completely everything we already talked about let's completely in that and go on to a whole new topic instead of cosmetics and TMJ and neuromuscular all that stuff let's talk about the two fastest-growing segments in dentistry our implants and clear liners so now let's talk all things implants and then I also want to wrap up into all things clear liners because when Ray and I got started in dentistry we kind of cringed when these cosmetic dentists to show these cases where they file down all the front twelve teeth to little kernels of corn and crowned everything and a lot of people left and think I wouldn't do that to my teeth and now the modern-day cosmetic dentist is unraveling all those cases with clear aligners so I don't think you can really be a cosmetic dentist today if you're not doing mild class one clear aligner unraveling instead of over prepping teeth but you can start there or you can go right to implants because implants and ortho are the two biggest gross and the reason so is because dental insurance schemes whether it be you know national government dental insurance in Japan England whatever they don't pay for ortho or implants so you're able to set your own fee whereas the fees that give you for cleaning exams and x-rays a lot of these dentists don't even break even so if they're not using their insurance patient base if they're not upgrading one of those patients a week to a clear aligner or an implant they're losing money but if they do upgrade one patient per week to one implant or one clear aligner they're making Bank and they're the richest dentists in Cambodia Indonesia Malaysia I've seen it all so so let's start with implants what would you say to a young kid is who's venturing out into implants and how is your lab position to help them through implants 

Las Vegas Esthetics Dental Lab: we really like to partner with all the different implant companies we do a lot of their plants through the lab here and we've been doing them for as long as I've been here so we've been doing for 17 plus years so that I don't even know how many implants we've done but I think someone coming out I think you know definitely find a lab that's done a lot of them and talk to them and make sure that you know they're well versed so I'm doing those implants we work with all the different major implant companies no bells straumann bio horizons you know all of them and I think it's really important to make sure that you're working with someone who's really understanding of of all the different components of the implants and what to do and someone that can help you help guide you through the decisions that you need to make us as you're placing those 

Howard: okay well you're not gonna get off that easy you didn't say anything for the first 50 minutes I thought you were just there for eye candy James they always complain to me he said something didn't mention a name brand or what you just said mentioned all the name brand she's driving to work she's probably about the same age as you've been dentistry you named all these major brands but if you had to pick one implant company do you have a thing for her and I'd be called and that's called kids that's called channel conflict so you got to understand the person talking to you channel conflict that doesn't want to piss off seven companies all right so I'd like do it anyway as she's driving of listening the car whatever to do as

Las Vegas Esthetics Dental Lab:  I would say give James a call at Las Vegas aesthetics and he will talk you through it and what is and what is that number one eight hundred seven one one six zero one one so if you're at the bathroom now Circle K right on the wall for a good time call one eight hundred seven one one zero six zero one one eight hundred seven one one six zero one one but they can you take away that he did say though that

Howard:  I'm gonna tell you is he said major implant companies and if you talk to anybody who does dental malpractice for a full-time job when the implant case goes south and the implant company doesn't exist the first thing they start doing is asking you for the literature to support this implant company and now you're you're you're settling the case and we haven't even got to the court so you know an major implant company as someone who's going to be around in ten years and you said straumann noble biocare implants direct you know right by other ways and by and 

Las Vegas Esthetics Dental Lab: as you say that also Howard I think it's important you make sure that your lab is using the genuine parts that go with your implant system I think one thing that the labs do quite often is they try to cut costs here and they try to cut cost there and with implants there's so many different companies and so many different knockoffs that you want to make sure that whoever you're working with if you're placing a novela implant in there and you send it off to the lab you wanna make sure you're getting back a nobel above something that came from the nobel come to me because if there is a problem down the road you want to make sure that you have the full force of know below behind you and not have to worry about oh well i don't know what my lab put in i don't know what they made and now I'm as the as the doctor I'm here all by myself and I've got no one to back me up so you want to make sure whoever you're working with is using genuine parts actually just to add a little bit to that one of the recommendations also that I would say is see who is your local representative in phone companies have sales people and also local resources or for for the doctors so you'll see that you'll be able to call to a couple of different even companies and see who their rep is and when you contact of red that rep is responsible to give you and provide you with information and also the support the US Adventists need you know one of the things that I like the most is that we partner with local implant representatives and together we do different study clubs now likewise there's been instances that we have a new doctor who is doing restoring their first in one case and we're able to then us as a lab go and meet with the doctor and also meet with the with the implant representatives now both the words are able to help the doctor King at the doctor through the process so they're able to understand well we need as a lab and also they're able to ask the questions to the red and get a support from them to look at the parts and pieces and also that procedure in general you know many times doctors don't have to do this by themselves you know they're their support for them it doesn't cost them anything you know there was an instance with a case recently that would restore and fertile a the doctor was not too knowledgeable of the parts and pieces and I was able to connect with the in representative and the implant representative was able to be there for the delivery of the restoration to be able to help out the doctor as well so I would say see who your level resources are so many phone companies don't have a local red in you area so therefore those people in companies you're going to have a little more difficulty to be able to get the parts and pieces or to be able to get the support you need or to have answers to their questions but like the Manor young companies they do have a local support that you're able to rely upon and also your local level  that was genius advice 

Howard: I've said so many times it's the rule of 52 if you're not doing one case a week you're never gonna reach critical mass and competency or profitability when you get into sleep apnea and you're doing one case every other month my gosh they're worried about it the night before they get to work early the they take way too much time to do the case you got to do one a week to get really good and fast and every single person I know that place is an implant a week has a relationship with a local rep and their and when I started getting into implants a long time ago it was just a matter of hey there's two or three of us meeting at this restaurant after work for drinks you want to come and  the rep was just was more a connector a networker and then when you got in over your head they knew who would fix it for you or who would help you or who to show it for or if the surgery you know so it's everything same things like people always ask me will die by my supplies through Cheyne Patterson Benko and I don't even want to tell you the answer because I've been with all three of them and why have I been with all three em I've been following the same girl as she goes from the company to the company the company it has a relationship with this person and if she changes jobs I don't care if she gets it from whoever but right now she's working for Ben Co so that just it just is what it is it's the relationship first and the relationships gonna make you do a better faster just make sure the company has been around ten years and we'll be there in ten years because the defense attorney is going to want to show that you were bouncing an implant where there was no research done on that implant and the members cost more because they spent a ton of money searching the implants they're selling you and if you don't have that research in the United States which is a very litigious society then it's gonna harm you 

Las Vegas Esthetics Dental Lab: on that note you talk about malpractice it's important also as much as you can you want to as a general then it's the first thing that happens if you get into that situation they're going to have the defense is going the  plaintiff side has been a half specialist coming after your case so what you want to do is you want to try your best to have predictable implant placement which means today if you can use 3d technology to take your initials you know use Surgical scans make sure you're actually using the proper steps instead of trying to freehand your implant cases I think that's where a lot of times gp's get into trouble and it's the early thirty times that you get started into trouble you just you know it's kind of like touching a hot stove if you stop doing it so if you want to get into the game get into it properly and make sure that you're protected so if you do get a situation you got all your documentation and they'll step away from you I mean sometimes implants fail I mean a specialist they fill in their hands too so it is it is part of the surgical you know risk that you take so I think that's important to keep in mind as well if you're early on in the game 

Howard: all right so clear aligners do do you see a lot of cases were there ortho cosmetic hybrid cases all wrapped into one what are your thoughts on ortho and cosmetics especially in the anterior you know the

Las Vegas Esthetics Dental Lab:  biggest thing is expand okay expand your cases expand your arches you put a patient into an expansion appliance for three months four months clear liners typically my knowledge is expansion is about two millimeters predictably and some of these cases need four or five six millimeters of expansion what you're trying to do is you're trying to you know fill in the buccal corridor with your natural teeth and you're also trying to alleviate being over-aggressive on your prep design because you're putting teeth in a more ideal position prior to the actual preparation so youth expansion appliances they haven't been fixed fashion you glue it on the molars with the bands and their gears you turn them a couple a couple of days a couple of times a week a quarter-turn pretty straightforward and that's something that I think a lot of dentists skip that step in order to get that quicker production on that day but what they're ending up doing is getting it and resolved it's not as as beautiful if I could use that word on the back end so expansion appliances are key as far as clear liners you know the patient is anti anything with expansion appliances then yeah expand with clear aligners there's nothing wrong with that again couple of millimeters of natural teeth is much better than cutting construction

Howard:  we went over an hour I can't believe we're already into overtime I want to start on the left with Jim then we'll go to James and raised and Shahan but I'm she just walked out of school she's two hundred eighty four thousand dollars in student loans there's a lot of people saying you might have made the wrong decision you got into too much debt there's too many dentists there's one on every corner ray I mean you've seen so much changes in dentistry I mean guy you started lab business back when I got out school in 87 there were 15,000 labs now half of them are gone so starting with a gen on the left what would you tell her did she spend too much money and was it a bad idea what advice would you give her

Las Vegas Esthetics Dental Lab:  no I want to say that education everybody knows it's going to be investing in yourself it's the best investment you could either ever make so don't worry about the money I just just need to make the smart moves and the thing is sometimes you're asking the questions not being afraid of saying I don't know this is it's it's where you encounter the most knowledge from from the simple homo questions you know not knowing had about the case no knowing what in my part to order no knowing how to manage by asking somebody that knows you know whether it be a mentor whether it be your local lab or whether it be or lat over there be a local evil and representative acknowledging your or your your shortcomings it's actually pretty strong knowing what you're not capable of doing so that way you could have someone help you along the way so I would say no invest as much money as you can in your education and yourself ultimately we all want to better ourselves and at the same time I would say know your strengths and your weaknesses and those weaknesses work upon them you know so that way be humble enough to say you know what I don't know this part I'll ask somebody that knows and I'll get a lot of results from that alright James you're up alright I'm up well Jim took all the good answers I think there's a few things that I would do I mean talks about finding a mentor someone or someone to help you along that's one of the things that I love about partnering with dr. Safari is I really believe in the program that he's putting together because here's someone who's been in the Prak practice scene for 17 18 19 years and is willing to put this program together to be able to help mentor dentists and share his experiences so I was I would say find someone to mentor you I would definitely say look for dr. Safari and I love the I would love looking for online help you know dental town comm obviously has a ton of threads going on all the time where you can you can partner with with dentists all over the place and put a put a question out there and get answers and get different points of view and different perspectives and then you know finding the good lab to work with definitely you want to find somebody you can partner with that you gel with that you work good with so that you can you can have a good team and and a good collaborative effort moving forward all right ragin baby so got it you got it you got it you gotta give this a dental practice a dental laboratory hot dog stand they're all businesses and they have to be run properly you need to know what your costs are with what you're having to put out on a day to day basis you have to have goals set financial goals set in business management I mean it's it's really all about business management in the practices that we work with one of the things I noticed at the really busy practices are they've got staff that are very people who are in the staff is really friendly the doctor has patients that you know they call a friend they get referrals from these people it's all about relationships what we do like you said you follow that sales rep from one company to the next to the next so that will do the same thing because we get we have a relationship with that person and it works out for us but it really falls down to business management and having a plan 

Howard: well what I think the best place to go for business management is Safari and that's saf a Rin and be a dot-com have you ever heard of that here's the simple truth you know 

Las Vegas Esthetics Dental Lab: we're not trained to be in the real world when I were talking to that new graduate okay we're not trained to be in the real world a lot of these grads new grads are you know 25 to 30 years old and they've been you know institutionalized and academic arena so now you're in the real world and what you really need to understand is you need to have the ability to work on yourself and you know it's interesting because I think what needs to be stressed here is how you can be calm in your head when there's chaos everywhere around you and if there is chaos around you it should copy your ability to become in your mind and in your in your approach that will allow you to persevere through the challenges of our profession that's so important to understand you can't become chaotic when there is chaos that only becomes you know it just becomes failure that's important to understand don't focus on the $300,000 loan but focus on how you can best implement yourself into the real world and make sure you realize that as much as you know how to cut teeth and place dental implants you're dealing with real people that are that you're exchanging money with that has nothing to do with the $300,000 you just invested on your class twos and occlusal camps you have to be able to deal with people in a positive manner where they respect you they trust you and they have value in what you're talking about these things are things we just don't learn in dental school and quite frankly in our undergrad programs either so I think that's really the key I would advise you as much as you're getting training on the clinical side of learning how to do clear liners how to place implants and the different occlusal cams you have to remember that you also have to work on yourself to make sure that you become a better individual and I think that's the best advice I can give and Howard: what a website should they go to Las Vegas esthetics com we are that's certainly the website that that

Las Vegas Esthetics Dental Lab:  Las Vegas aesthetics has we've collaborated with them as we've discussed love bikes that website is launching August 16th we're really excited about certainly share you know your information with us if you're interested how it give isn't for me give the phone number of the lab you can call you can talk to me direct with just a simple get  we can communicate we are launching a total of four national programs love bikes is one of them I mentioned sleep apnea the other one and then Safari and MBA is the third one and that's involved with practice management's and some of the things that I touched on here towards the end and then we're also putting together an online reputation social media program as well that I really believe is very important look the reality is if you want to build relationships with your community you got to be in front of your community and this is one of the things that doctors just need to fully understand you can't hide behind a photo anymore you gotta be in fun as a leader of your community and

Howard:  that's what that program is about so you're saving to eat your your website will be love bites smiles calm l.o.v.e bi tes SMI le s no s at the end so smile calm that's right okay Greg Lamia and then look

Las Vegas Esthetics Dental Lab:  let me let me add this to Howard you can go on seven-figure dental practice on Facebook that's our closed group just ask to join it's all dentists and a lot of information is there we have over ten partners golden goose scheduling voice legwork and obviously Las Vegas statics just to name a few that are involved with our program we're doing some amazing things for some really cool doctors and to be honest that makes me feel really good well 

Howard: once again I'm ending an amazing discussion always wondering why is the bald guy always the smartest one in the room Thank You Riley thank you for carrying this podcast with those three other guys is all that curly hair on their head you made the whole show thanks gentlemen so much for all you do thanks for coming on the show I still want to get I hope you can deliver a clay Clayton to come back on because I a lot of these questions are driven by emails they get about 300 emails a day at Howard at dental town comm you can ask comments on YouTube which is um on YouTube but thanks again for coming on the show and answering so many questions Miami's it's been a real honor to podcast you and the next time I go to Las Vegas I'd love to come by and see your place alright you guys have a great day thank you

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