Dr. Mike Dostal completed his undergraduate studies at the University of Kansas, and continued his dental degree at the University of Missouri – Kansas City. Since then, he is recognized as an expert in comprehensive restorative treatment using implants, full arch implants, full mouth reconstruction, and orthodontics. Dr. Mike has a Midwest heart thru and thru, but that doesn’t keep him in one spot. He has invested hundreds of hours in implant and full mouth reconstruction training. This routinely takes him across the continental US to assimilate the latest research and techniques. Dr. Mike’s commitment to education is demonstrated by his membership to the American Dental Association, the Kansas Dental Association, International Association for Orthodontics, American Academy of Implant Dentistry, and International Congress of Oral Implantologists where he has achieved Fellowship status. His latest endeavor, extending his passion for dentistry, includes mentoring other doctors with a focus on practice growth and implants.
https://www.KCimplantinstitue.com
VIDEO - DUwHF #1352 - Mike Dostal
AUDIO - DUwHF #1352 - Mike Dostal
Howard: it's just a huge honor for me today to be podcast interviewing Dr. Michael Dostal DDS the founder of the Kansas City implant Institute he completed his undergraduate studies at the University of Kansas City like all the best dentists do and continued his dental degree at the University of Missouri Kansas City since then he is recognized as an expert in comprehensive restorative treatment using implants full-arch implants full mouth reconstruction and orthodontics Dr. Mike has a midwest heart through and through but that doesn't keep him in one spot he has invested hundreds of hours in implant and full mouth reconstruction and training this routinely takes him across the continental US to assimilate the latest research and techniques his commitment to education is demonstrated by his membership to the American Dental Association the Kansas Dental Association International Association for orthodontics American Academy implant dentistry International Congress of Worrell implantology where is achieved fellowship status his latest endeavors extending his passion for dentistry include mentoring other doctors with a focus on practice growth and implants he has been incorporating implants in his practice for over a decade from the single tooth restoration and placement all the way up to life-changing guided full mouth rehab surgeries using all on five or six techniques he enjoys every facet of implants my gosh I could um look oh I could keep going on and on but I have to stop and say how was the Chiefs game yesterday and just you know it's so much better when you're when you're down like that and then you come back and and it's I think I saw on ESPN today was a ninety six percent chance that the Niners were gonna look we're gonna win that game with seven minutes to go and cheese flying up winning so it was great it was great I'm sure you know your cheese fan Cardinals fan man I went over to UMKC don't know just like your buddy I mean my gosh and my mom I mean when when it was they were down 10 to 20 I had that sinking pit on my god no and then they won that was just the greatest game greatest game I mean I can't remember a Super Bowl that great that was just an amazing dinner um I'm so excited for you to come on the show because as I've been saying on the show for a long time that from Pier for shard to GV black to 20/20 cleanings exams root canals the dental industry is an old industry I mean it's two centuries old and it grows like the US economy I mean from night I graduate high school 1980 to 2008 for four years the economy for the United States what is it one and a half three and a half percent that's dentistry except for two areas that are in double-digit growth implants and clear aligners and so these kids are coming out of UMKC dental school just like you and me and they've got some student loan debt and they need to do something what what's great about implants and clear liners the most is that all the government and employment insurance schemes are setting the prices for cleanings exams x-rays and fillings and they're not setting the prices for implants and clear aligners and the smartest guy closest to you is Warren Buffett about three hours drive to Omaha and he says never go into an industry where someone else sets your prices and we didn't take his advice we knew something that Warren didn't know and we went into dentistry we're Delta Dental and employers and all these people set their prices but people are setting the prices and implants and clear aligners and a lot of dental offices it's their only profit margin especially when you get to really government socialized medicine schemes like the NHS and I'm England or Malaysia went from one dental school to eleven you know a lot of these countries were the government has drownded them in price-fixing and in fact what's amazing as America didn't even start dental insurance until the federal government you'd wait freezes and then so the Union said well we can't ask for more money so we're not gonna ask him to buy our house or our truck so how about dental and in I so we wouldn't even have got in into bed with government and employer dental insurance if it wasn't for the stupid government doing on price regulations so now that implants and clear liners the price isn't set Warren Buffett would give you the blessing to go forward into this deal how did you get into it did you get into it because it wasn't a government regulated price-fixing scheme or tell us about your journey how do you just walk out of dental school and decide you're gonna be a blood and guts implant placer
Dr. Michael Dostal: yeah you know it's a journey for everybody for myself you know I got out of school and I did a young I did a Association went out to Denver Colorado and my wife and I went out there and just enjoyed the mountains and played and did that and then we came back and started to practice and you know after a couple years of practice when she started up practice yeah break away but you know to a couple years of the practice and kind of figuring out finally how to do that I started looking at different ways to you know increase the revenues of the practice but then more importantly I started you know once you start restoring the implants that that you're not placing and you're thinking yourself oh gosh I wonder if this could have been place a little differently a little better or you know it kind of starts getting it can get confusing when it comes to even the restoration part of it with you know if you refer to a few different people and there's different parts and you can get kind of confusing so that was kind of a kick for me to at least put my foot in the door with it as I wanted to I'm kind of a control freak I like a lot of dentists are but I wanted to be able to control the placement of it that way I could control the restoration of it and then all the parts in between and then you know the patients don't have to jump from office to office they don't want to do that so that started it with me I started with the weekend course and then you know I had a I had five patients lined up on that on that Monday after the course and and I'm kind of one of those type I just I'll just jump right in and there were some yes some friends of mine and I did him for a severely discounted rate for him just to kind of get my hands wet with it and and you know picked and choose easy ones and kind of reviewed them you know what's instructor and they turned out turned out great and it was fun and easy and then you know just like you said when a patient comes in anymore you almost kind of I kind of pray that they don't have dental and I'm in playing coverage on their plan that way you don't have to mess with all those hoops you know or that they even don't have insurance at all but dental insurance plans cover implants no not really I'm not seeing any increase in my year
Howard: did you get out of UMKC 2009 2009 and was your wife in your same class 2009 year in KC it was yeah her father is a dentist in st. Louis who who recently retired just I'm just in November so it's a genetic disease and your kids are they had they been tested for this she wants to do it
Dr. Michael Dostal: she orthodontic appliance you know functional appliance right now and now she's you know she's loving it she like loves wearing this thing at five years old so she's already thinking she's gonna do it too but yeah oh man that is awesome so
Howard: you just had a class this weekend so that was a January 31st what would day was that 31st and February first was up Friday the Friday Saturday just here yeah just here yeah and when is your next course we're having the other one in April in the paper I think it's 24 25 I believe so April 24 25 September 25 26 this isn't a commercial he didn't pay me to come on the show but I'm I'm trying you know when you're a leader you got it you're trying to I know what they want to do but sometimes it's better to learn clear liners and implants where you have a breathing profit margin Delta just lowered all of our fee schedules fight percentage beginning a year so January 1st we woke up - Thank You Delta we they lowered our fees 5% and it just is what it is and so I want you to give your best spiel why should she learn blood and guts implants April 24th and 25th at year place and set a soft and pretty Invisalign bleaching bonding veneers where you don't even have to put in a stitch
Dr. Michael Dostal: yeah the biggest thing there's so much need for it out there and then you know it also it's what it can do for the patient's you know if you have it starts with the little onesie twosie zi you know that's just kind of getting your feet wet but then once you advanced and start doing you know the over dentures and the all on things those are the things that really I have found to become fun you know those are the things I look forward to because when you can take a little nine-year-old you know 90-pound little lady who hasn't been able to eat for years or go out in public for four years because she hates her lower denture and she can't wear it and then you can put in a couple implants and snap or denture onto it with some locators it yeah it changes her life and you know you get hugs and you know you get gift certificates to places from patients and you know it's it's just way more fun than than just the bread and butter dentistry so that many my advice the clear liners are great too I mean you know we do those as well but I think you got to kind of explore both options I know what you like incorporate them both you know if you really want your practice to grow and provide everything you can for the patients now do you know how many kids you have I'm 217
Howard: so is your wife still full-time and you guys work together or is she raising kids
Dr. Michael Dostal: no she's still full-time she that's her choice she wants to she she's very proud to be a dentist you know and she's very proud so so when that's the case I don't know I've never been married to a dentist before and but
Howard: um do you say okay let's not learn the same thing that's kind of overlap let's not work the same hours I mean why would you both work the same hours and do the same things do you say I'm gonna work Monday Tuesday Wednesday into implants and you do Thursday Friday Saturday nuclear liners or is that how it works are not really
Dr. Michael Dostal: no that's exactly how we how we structured it at first she she doesn't she used to work in public health and she would do the blood and guts extraction since up all day long but she's really tapered away from that and she'll um she just kind of likes to stick to the easy stuff and she's focused on the sleep apnea side of the practice and then and then I do the implants and in the larger cases a static cases in it started when we had our first you know we had our only practice we were we have staggered hours where she would come into the morning and work afternoon we'd overlap a little after noon and I'd come in and work till the evening she'd be able to get home and get the kids and do dinner and things like that and then I'd finish out the day but since we just about a year or two ago we bought another practice and now she's over there she's over there more to buy another practice to get your wife out of the office in Howard: Missouri and Shawnee Kansas right I'm from Wichita Kansas would you say it's obvious that the Kansas people are just a little finer than the Missouri people have you noticed that so how far apart are is Shawnee Kansas to Lee Summit that's both in the Kansas City metro yeah it's clear east-west
Dr. Michael Dostal: yeah pretty much 20 30 miles as the crow flies apart yeah and and what made you buy another office what were you thinking about buying white
Howard: why did you want to buy another office it was something
Dr. Michael Dostal: I always wanted to do and try out as always them back in my mind and and you know I did my first office as a startup and I knew how that worked and and I also wanted to try to go in and buy a practice where a guy was ready to retire and I saw a practice where I could add some value to it you know by adding him plans and having procedures that we do and we found one and we jumped on it and it worked out great for everybody involved we didn't use a broker we we found a we found the doc and kind of worked worked the contracts together and and you know within the first year so we probably doubled the you know double the revenues of the practice just and I go there one day a week to do the implants and do that so the lease summit was your first office that was a de novo from scratch and then the other way around
Howard: okay so Johnny Kansas was a de novo that you started from scratch and now you said you got out of school in 2009 hmm and then what year did you do the de novo 2011 so you wanted to Colorado 9/10 for two years and then you came back and did a de novo in a Shawnee Kansas and and then you did a an M&A activity a mergers and acquisition what year did you buy that practice
Dr. Michael Dostal: just last year so 2019
Howard: so that's genius I mean my gosh mergers and acquisition are just huge in Wall Street and every time I meet a dentist that's at the 3 to 5 million mark taking home 750 or more you know it was like it's always the same source like you know we went to a town of 10,000 those small towns have a dentist for every thousand because there's a dentist for every 2,000 and the rural draw is twice of the the city so a city of 10,000 as a draw of another 10,000 so a dentist every 2,000 be one out of a thousand in the city of 10,000 but every five years when the old man retired this smart old guy would just buy his practice roll them into his own practice whoever selling the practice they almost always change your mind income want to come back work a day or two but over the years that 10 doctors in a town of 10,000 turned in nine and then it turned into eight and then it turned into seven and then here you come and he's my AG 60 and it's a town of 10,000 with five dentists and this massive deal and what you're just said is that the price is not the price if the price is a dollar and all he does is fillings and your and he refers out all of his root canals and his pediatric children and doesn't place implants man you can see a practice for sell for a dollar doing a dollar a year in revenue and come in and make it do two dollars it sounds like that's what you did
Dr. Michael Dostal: yeah it's been ooh wait wait easier than I thought it was gonna be to tell you the truth you know we got very fortunate and in the staff they all stayed you know the employees um everybody stayed we had one lady retire with the doctor the hygienist who you know she was just retirement age as well but what was that
Howard: what was that retirement age oh she was in her sixties a lot of people always say a lot of people are afraid of that when you buy a practice and the some of the older staff retired did you get a lot of pushback like Oh where's where's uh where's that hygienist that was here forever
Dr. Michael Dostal: a little bit you know you're gonna get that but you know we did we had him sitting on a nice letter you know and and you know we kind of helped draft and you know he we got to know him pretty well before you know we signed on the dotted line and he trusted us and felt like we're you know a good group and it's been it's been great you know you know
Howard: you know what I like most about what you're doing and what I'm really in love with it a lot of times a dentists say you can't see once learning how to place implants so they get in an airplane and they fly three four five six hours away sometimes other countries like Dominican Republic or whatever and then a year later they have a problem and it's like and I always said well who taught you this and it's some guy in another state like well why would you have to leave Kansas City to go learn how to place an implant and then when you go in your backyard you have a friend you have a buddy and you know you need your friend when something goes wrong and then guy in another country or another eight so or is this mostly as most of your students local to Kansas and Missouri
Dr. Michael Dostal: yeah some from Arkansas some from Iowa and
Howard: you're calling Arkansas its Arkansas River goes all the way through Arkansas
Dr. Michael Dostal: yeah because they can you know they can get up in the morning and just drive to the course you know state you can stay one night or go home if you're you know close enough do they do that of course the next day and then go home you know it's way more cost-effective and even the guy from Arkansas he he drove up that morning you know was like a five-hour drive or something he just got up and drove in that morning you don't want to say to hotel
Howard: I used to leave Wichita six hours to where Walmart was what was that what was this city that Bentonville Arkansas because that was where I forgot that it was either the brown river the white river fed into the Arkansas River and whenever you have two rivers are two different temperatures the fish are just they're all there and that's where we always go trout fishing so I liked what you said on what you said in the beginning was so profound because I said why do you like him Blanche you say you know make a patient happy and overdenture ball you go to these courses like um like last week was the the Yankee in Boston and whenever you go to these meetings you know when they teach him plants it's always the all on for the 25,000 and arch the the rich dentistry for the richest people and it's like that's not America America is its grandma she's got a denture and the bottom ones loose and in Australia they just placed one down the middle and put a ball not write down the symphysis and then the Americans like to make a they'd like to and but you know when you go to a lecture as a state meeting on all on for when for every Oh four done in America how many all on nuns would you say we're done it's not it's not one it's not one-to-one it's not one to ten it's not one to hundred in its it's probably between one and a hundred and one in a thousand and then you say well are you having any courses on the all on none no what are you doing after this course oh we're gonna go get lawyers to sue smiles drug Club for trying to make ortho cheaper okay are you guys a trade union or a guild and so I love the fact that when so one of the things I want you kids understand is that don't decide that you want to go start learning veneers where did that come from you you're a dentist in a town what needs are you seeing on your plate what's landing on your door and when you're saying oh it's a toothache and they need a root canal I don't do that I'm gonna send them out well how would you like to go to a hospital with a broken leg and they say you know we don't do legs we do arms but not legs you know so learn what's at your doorstep and implants really in a big country like America it starts with dental cripples they got they got dentures they got partials and then next it's probably cosmetic emergencies like I'm sure if your wife lost a first bicuspid she would walk around with her hand over mouth until it was fixed so you know be cosmetic nightmare and I like what like this morning on the way here I rolled down my window and my wig flew off and I I didn't even I didn't even hit the brakes and try to find it so do you do you think starting off where do you recommend starting is that a loose denture and we're gonna do one or two balls and o-rings is it a single missing tooth I mean you obviously don't start on all on four or five or six
Dr. Michael Dostal: yeah just start with a single two you know an easy posterior upper or lower you know either one would start with that uncomfortable placing I'm just with the protocol and then won't take long after you do you know ten or twenty or thirty of those then then you can start doing the over dentures and you know and once you get comfortable with the over dentures - then you can decide and you know you're comfortable with them and you know the process is you know you can decrease your fee as much as you want for it you know to help the patient out as much as you know as much as you want and the rewards are way greater than then you know they need to expect for these patients it's a lot of fun
Howard: where do you like to start for what we're wordy where do you think they should start where do you think they should get in to implants what you think it's single tooth where do you think the entry point
Dr. Michael Dostal: yeah definitely single tooth yeah just single tooth single single to single crown just to you know find an easy spot and do it and you know find some patients that are willing to you know either for a friend or you know friend of a friend or someone that you know would could use a discount on an implant and you know get in there and just just just go for it you know get get some good training get some good basics learn the basis of the flap you know learn the basics of extractions as well and grafting but but you know just just get in there and do it and and then once you started doing those singles then you can you know then you can advance and move on to do the over dentures and then after that then you can advance to move on to the to the all but that was kind of my journey
Howard: so it's been good so what are the problems that the kids are become aware of very quick is that continuing education in America I mean America I mean I they just need to change the constitution to money's the answer what's the question I mean let's just get focused and when you look at it plant education it's tied by manufacturers so if it's so tied to a manufacturer that the kids are imeem they're smart and they come out they say I feel like I need to pick which implant I'm going to use because you know if you this whole courses by bio horizons which is owned by shine or I notice this one's noble bio care and implants direct which is owned by Invista which just went off from Danaher or you know or the straumann I mean they own neo dead Mende teak clear you know clear correct dental wings I mean they own clear crack dental wings and they just bought another one what was that one they just bought the other day they just bought oh my gosh I know the name of this but anyway so um the question is are you implant agnostic and how do you how do you tell this little girl who's twenty five that straumann courses covering straumann neo Dettman DK clear correct dental wings it's obviously different than Daniels curses that don't double bio care they also know cave oak or Armco ikat you know so so how do you separate I just want to learn implants versus there's a lot of big power dogs out there controlling a lot of that food chain you know and so
Dr. Michael Dostal: I think it's good if you can get with a good group of people and you know or even a company that offers the main types of implants you know I mean there's the internal hacks there's a conical connections there's the Morse taper connections and one that can offer all of those and then you can kind of learn about all three of those different types of connections and decide which one you like and you know you really might have to learn how to place you know a couple different types of them I'm gonna be comfortable with it and then you know this company that that were working with H biomedical they're there a doctor own company which I like IH IH biomedical biomedical dr. own company that I like and it's it's a it's a nice compatible system that's that's got a good you know good prices for everything which I like to in and make it they make it easy to place and easy to restore and and it's pretty nice
Howard: so let's see what comes up under IH biomedical ih biomedical is that one word or is that two words or biomedical dental implants yeah are you huh what's the what's the website to that ih biomedical comm I have found it there you okay so so so tell me about I H I I H biomedical comm tell me about that
Dr. Michael Dostal: yeah it's just it's a ot company all american-made implants that that they got just about a year or two ago a friend of mine introduced me to them and it's a try them out see how you like I mean and I tried him out and I liked him a lot I like the packaging that come in I like the like the you know the ease of placement they've been working you know really great for me and so yeah they kind of disaster if I wanted to kind of help share the word about their implants and go from there and
Howard: so you started to say something about um when these kids get in implants they got a certain learning three different connections you said internal hacks what was the other two connection and then like a Morse taper type connection conical connection and then Morse Morse taper yeah okay well considering that if fourth of our viewers are still in dental kindergarten will you go over those three just elementary and and by the way if your listen to send me an email Howard at dental town comm tell me how old you are what country you're from or leave comments in the YouTube but so so you're saying because my question is um are you agnostic to implants that the implant companies are tight very much to the continued education so what implant would you recommend for a starter course I mean there's 400 implant companies that were at the last cologne meeting the last internet and I what is it the internet dental form or Internet the big cologne meeting every other year in Germany they had they had 275 implant companies with a booth out of their list of 400 so she's got time for that I mean she's 25 you've been doing this for a long time would implant company would you start and go over those three connections
Dr. Michael Dostal: yeah you know there's easy but the connection types there's one that's called the internal hacks that's kind of a pretty popular one there's it's very similar like Zimmer's and implant directs legacy type but it's basically it's an internal hex design you know the abutments for it are gonna kind of lay right on right on top of that implant and then what I really like are the ones that are like a Morse taper type of a connection where the above and actually fits on me it's a platform switch so that means that it's the abutments more narrow than the implant platform and then they can snug in there and keep it nice and tight and keeps out all the bacteria and actually actually can help tissue growth and you know soft tissue and bone growth around the neck of that implant those are the ones I really like now and the nice thing about that type of connection that platform switch internal connection is when you take off that healing cap and if there's any tissue that was grown over anything it's usually okay because the abutment is gonna fit on the inside of the of the implant instead of trying to fit on top of it like a like a typical I'm you know in relax implants so I think you need to know I think you really kind of need to know a couple different types because there's gonna be different different situations for each one you know like if you're going to you know place an implant say near the zionists if you're gonna do like a little sinus pump or something like that you're going to need like a round it in and rounded round ended up implant you know whereas if you're going somewhere else the softer bone on the mandibular you may need a more aggressive you know threaded tapered implant to get some good um you know primary stability on that so I am liking this company right now I did I think you know an implant is an implant you know I don't think the brand name really matters all that much I think a lot of it has to do with just the person placing the implant and then the patient that is receiving the implant too so that's why I kind of like this system that you know I'm using now ha that is
Howard: so you talk about the internal hacks conical connection Morse taper you know I'm a big fan of your dental town on posts I mean you're I mean really that that's why I called you to be on this show not just because you're part of the UMKC mafia ah but I you know you're just always um I'm gonna go over some of your poet implants and excess inner arch space best way to go some of the kids are very confused because the periodontist talks about all this conserving bone and then they're watchin all on for case where they just go you know just trim off all this bone so it's kind of like so implants and inner arch space why what to talk about that if you're doing case like that then then you really need to just make enough room for the prosthetic
Dr. Michael Dostal: yeah I tend to when I play same planes think of the tooth position first and then work back from there which is another reason why you know I like to place the implants myself versus a specialist who might just be thinking I'm gonna put the implant where the bone and you know we'll figure it out but you have to think about the tooth position first but yeah you know if you don't have enough space you know it's almost every time I do an all along case you're doing some significant bone reduction in those cases you know it's hard to grasp with the first time first couple times you're doing it because you're thinking just like he said as a dual student cannot you're like I have to conserve as much bone as possible to make this work and then you're going in there and you're you know hacking off huge chunks of bone but it works it gives the prosthesis enough enough length to be strong and stability and have good stability
Howard: now are you um oh one last question on that IH that IH biomedical is that a type of implant or is that an implant store that sells multiple kinds
Dr. Michael Dostal: it's a store that sells four different types for different time for different brand names may have four brand names in their store and what what are the four brand names okay what's first one I hex it's the internal X I I hex is the name of the implant mm-hmm okay what's the IX to which is another internal hex but it's a self-tapping implant okay as a very simple way to put it in okay and then the other one is a more store implant and that's the one that has wide aggressive threads with the rounded end and has that more paper connection okay and the for and then and then the fourth one is IH active which is a internal connection as well clinical connection it's very similar to like the Nobel I'm active
Howard: and are you um you know when I get out of school all the legends in implantology that had placed 10 20 30 thousand implants had done them all on a panel and nowadays you hear Millennials talk about a pan oh you don't saying someone was it was some evil villain that you know that was doing something incredibly evil but that used to be I mean that used to be the greatest thing in all of us tree in fact I still think the greatest achievement ever achieved in radiology was not the CBC team but whoever figured out how to put that are on one side in the L on the other I thought that was the greatest thing in oral radiology but um are you doing this all on CBC T are you agnostic to that or is there some software machine combination that you think's more intuitive or we're yet on all that oh I think you know
Dr. Michael Dostal: I think you don't have to have a CBT to get started you know there's some techniques you can learn with the pano and and bone sounding but you can start placing the easy implants and you know if you have a mentor or someone you can call and run some cases by then you know they can kind of walk you through it too but you know a cone beam makes a huge difference and everything you can't also you know it can also be a little dangerous I think because it can kind of have the confidence a little too high and if people are you know using surgical guides and you know if that's I kind of feel like you need to learn how to place implants without a guide first and then you can go to the guided cases you know because there's gonna be times where the guide may not work it may not fit or you can't get your instruments in there or something like that or I had a case where my I had a on six case and we go to reach the guide it was a case we're doing guided and the one of my assistants had sterilized he'd sterilized the guide in it in a melted right you know it melted so it distorted it and you know we want to come and do the case freehand but it was but with tow beams you know it makes a huge difference they're fantastic in the price is gone down on them
Howard: so much you know they're getting your phone what do you have an iPhone or droid I'm an iPhone and how and how old is it I think I'm not a 7 iPhone 7 but what what year this is 2020 what you're probably two years two three that's that's the thing that I have I get a confused about because when I go to the MDS and they have 15 specialties nobody expects the imager to be there you go there and they say hey here's roofer and in where I'm at in Phoenix it's in the same building you just go down to the other end and there's a lady there and she's got four or five different machines and you after two years when I read your iPhone where sometimes they buy this hundred thousand dollar CB CT and they're like my god after I you know it's a sick there's a five year lease and as soon as that lease payments off that's so great because I'll never have a lease payment again till I retire and it's like dude you're on a you're on a Motorola Nokia flip phone and so how do you balance the fact that the consumer patient doesn't expect you to image the fact that all the dentists upgrade their iPhone every two to three years and so versus setting amounts imaging so how would you wrap your amazing mind between refer to an image you have someone else do all that and read it or do it in-house
Dr. Michael Dostal: oh yeah definitely I mean you can find you can find a used combi like I actually used a company called renew digital for my first cone beam that I purchased it was a Sirona it was used a few years old and I think if you know you can find them on there for forty thousand you know fifty sometimes even less get a really nice and there and you know not a plug for this company inhibitive and fantastic we actually had our server go down a couple weeks ago and and they've had to reinstall all the software and they've been they've spent weeks trying to get this going on my cone beam going again and you know for really no no charge because they were because I bought the machine from you know years ago but yeah I think you can get into a pretty affordably and you know lots of times they pay for themselves you know I charge the patient for it you know um you know one hundred and forty seven bucks and you know tell them it's just kind of part of the process if you're interested in implants or if youknow or in for endo I mean it's huge for endo makes endo so much easier combien endo to go in there and measure the canals I see how many canals there are and it takes a lot of guesswork out of it well
Howard: you just said something out very profound and that is you just actually mentioned the best feature of having imaging in a house and and this has been going on a long time in dentistry and that is for the sales presentation that the clothes the whole nine yards people I mean like I don't even know I'm going to McDonalds until I see it coming up on the road and I think now I'm gonna change lanes and go I mean you know two blocks away I didn't think about and we saw this in orthodontics a long time ago where dolphin imaging came out and it was a huge success because people would come to their work and say do I do I need ortho and the orthodontist is sitting there like I can't see anything I mean I haven't seen this a for a panel I mean I can kind of tell you this and that but it's all contingent on I need a so dolphin came and said Luke when they come to ask that were that honest for if they want ortho they want to know the answer now so dolphin came out with a deal where the patient was in there and they put some it was all designed to take a pano staff and trace it instantly so the to the orthodontist could tell you I'm sure if Laura walked in were there two kids with ortho said does my baby need ortho she doesn't want to hear it's like when you're watching a movie and there's no clothes stay tuned for next week for part two it's like part two yeah I wish I wouldn't watch the whole thing next week I don't want a part two so for the clothes when people come in they say you know you're gonna pull that tooth can I have an implant or whatever it is nice to be able to image it on the spot and tell them your doctor thoughts so this definitely increases the presentation the cells the clothes all that kind of stuff like that um so go over the so your next course here's where the commercial starts brought to you by me not you um so your next course is April 24 to 25th that'll be perfect because you'll just got done paying your taxes to the Mafia and now you'll need to go out and try to sell plasma or something to get back in the game what is your curriculum for that course so if she came to you the 24th and 25th is that in your office in Kansas City
Dr. Michael Dostal: yeah the lease on that office mm-hmm and and how much is that and that comes with 14 hours I'm see and it comes with so it's 2,000 bucks in at least some Missouri which is Kansas City and 2 grand April 24th and 25th right you know and where's the information on that course that is that um KC implant Institute yeah CC implant Institute and
Howard: my god and so the Chiefs will be the Kansas City Chiefs won't be playing on that date but the Kansas City chefs are actually even better I still miss West Court the buttes in the plaza my god that's some of the best seating in town but um so anyway so it's a two-day course what what are they gonna learn what's the curriculum like yes
Dr. Michael Dostal: so the first day we go over all the basics of implants you know the flap design some some tips and tricks just kind of all the basics so that everyone is on the same page and then we do some live surgeries in there I really encourage the participants to you know if they have some cases they want to bring you know bring five cases or so and we'll kind of customize them and go over them with you and pick out the implants form and kind of talk about how you'll do the case will you actually do the case will I do their case yeah well no I mean I'll have my own I'll have some patients lined up I'll have some patients lined up that they can you know that they can watch me do some procedures on now you know in the future I am hoping that we can do have had the participants bring their own patient especially if they're licensed in Kansas or Missouri yeah that'd be pretty easy to bring your own patient in and and do it there but sir
Howard: so are most dentists in Kansas legally can they do dentistry Missouri license yeah that's Arizona do you see how Arizona became the first state to honor any dental license in any state yeah it's so cool because it's so it's just mean when you know in the thirty years I've been here to be like some 50 year old Dentist born and raised eyes his kids are all out of home they're all out of school and then he gets like some disease and he's being a hot dry area if it's long or MS or whatever and then they come down here and they're trying to you know get them to take these boards and all this stuff but yeah Arizona is so cool but I'll tell you a workaround that you can do that I'm Chris Volchek dad down here and that is you go to the board if you were patient is a homeless guy or a vet or someone someone in need and you say okay I'm teaching a course and dentists are gonna coming at licensed dentists from around the United States or Kansas or Nebraska or they're gonna come to the course and we want them to buy a course license for a hundred bucks um you you just cannot be that government worker that has to answer to channel 10 news that says no you can't come to my state and work on a homeless vet I mean I'll never forget the faces when you picture it's like the Supreme Court that Supreme Court you know there's a million cases each year they cherry picked that case to where it's the perfect test case you know I mean and once you go up there and say yes or no can a homeless vet in my office be worked on by another dentist license in America well if you say no to that you should just quit your job today and file for unemployment because this is not gonna go down pretty on social media and that's what they're doing they're doing it in Phoenix now they're doing it in New Jersey they're just going to in fact it's really really cool because some of these homeless shelters people are going to by Oh raisins which is owned by Stan Bergman and Henry Schein and they're saying though they'll find some homeless shelter and shine I'll put in a operatory or a clinic or whatever then some local dentists will start having hands-on courses for root canals or implants where everybody's winning I mean I mean Stan Bergman wants to do a lot of charity all rich people at that age start wanting to do a lot of charity you have you notice that just right before I'm just here but no I mean twice twice in the middle of nowhere in a jungle and Africa I've all of a sudden walked into like the nicest dental office I ever seen and sure enough it's built by Stan Bertrand and Henry Schein and it's all charity and all this up but it's really really cool so if that license things an issue start working that angle you know I also notice the difference between boys and girls a lot of boys don't care about going down to Mexico or the Caribbean to learn implants but a lot of women don't don't feel safe about doing that you know it's it's one thing if you and me want to go to the Caribbean and drink beer while we're placing implants but there's a lot of girls who just don't think that's a good idea and so having them do a hands-on course so my deal is my god don't learn how to place implants unless that guy is real close to you and can help you when the hits the fan cuz on their first 100 implants how many in all reality are gonna fail ladies and gentlemen that might have been the most honest statement ever told by a dentist on any podcast in the world he just said 20 to 30 percent of your first implants are gonna film let me give you some sourcing for that right so it used to be these DSO and I don't like to term dia so I like the term a group practice because dentistry like medicine is moving to group practices for a lot of reasons one is the same reason why I got an associate when I got right out of school I was bored I mean hell you just left a hundred and twenty drinking partying crazy Dennis um Casey and now you're by yourself well that wasn't fun and show you how dumb I was my first associate was just as young and dumb as I was I mean I should have got like an old wise guy but I was looking for fun so group practice dentists are having more fun when you do buy that CBC tea now you can share it among three or four people that's why medicine has rapidly consolidated when you buy an MRI machine or dialysis machine you sure as hell can't have one for every MD in town and so it's just a lot more fun environment but then also when something goes wrong someone's there but these DSOs as they as a group practice one location turns into a group practice more than one location I would say the average what people call a DSO they always talk about Heartland and Aspen at Bob Fontana or Stephen Thorne's Pacific Dental that all three of those have like a thousand locations whether those are three huge outliers most DSOs the sweet spot is between five and thirty locations that that's all the DSOs and all those DSOs they used to take young kids and send them to courses like you and having to teach implants and all that so but now they're bringing in Perry Don us to place the implants why because when these kids come out of school and they work for you for two years they place 30 implants well over the next five years you have to pay a periodontist to redo like you just said a quarter to a third of them and it's not cheap number two is the insurance company if I do the molar root-canal Delta will give me say say 700 but if you're an ended honest they'll give you 1,200 so if I have a general dentist do it and I pay them 25 percent I actually net more money having an endodontist do it even though the ended on wants half the fee 50% of the higher fee is cheap is more money than 25% of the lower fee after you work into the fact that when endodontists do 100 molar endows in five years 60 months five percent are extracted whereas when general dentists do it ten percent are extracted fails and when you place your first implants that isn't the same success rate as someone who places implants 500 through 600 or 5,000 through 50 100 or ten thousand to ten thousand 100 so um so I recommend don't fly around the world drive to someone in your backyard so that when these wanting for fail you can actually go talk to somebody
Dr. Michael Dostal: yeah I mean and you know I always give my phone number and email out to everybody that comes and they can call me and text me and they do you know we talk through cases and you know the cool thing about the course is that we've had there they're so relaxed you know they're kind of like a study club I think you know everybody kind of chips in things and you always wanted to learn and something when you do these courses to from somebody somebody shares one of their tricks or you know you kind of share your frustrations with practice and what's working for you and what's not and you know it's kind of nice getting back to that small study club type mentality so it's it's been a lot of fun it's been a really good group of people we've had and and everybody's gone away you know
Howard: so who's the founder and CEO of IH biomedical I know it's I know it's um Dentist owned
Dr. Michael Dostal: I'm not quite sure who all of it is to tell you the truth but I know I know it's Dennis town I know I know they're all American made parts and everything's you know America made on in the Midwest and in the wet on the west coast but yeah okay um very very interesting so we go ahead oh I do know too that they said that with the course and in the sea and everything that you can get some everybody should be able to pick out about five implants or so and they can take them home with them or have them ordered as part of that as part of the registration fee for the course as well
Howard: so when I got out of school implants on my gosh in 87 the goal of an implant was the longest implant possible I mean I mean I remember I would start place the implant you know slide you know yet a pano but you know you'd have that 14 millimeter 16 18 sometimes a 20 22 you have like five laying out I hope when you could get that I mean what you wanted to do is get the implant to go out the back of their head around the moon three times and back in and so sinus lifts all the time but now implants are getting shorter faster there's sinus bumps um well how does a sinus lift look today in 2020 then versus 2000
Dr. Michael Dostal: you know I think pretty rare far in between I wouldn't be you know I was starting my journey and implants I I wouldn't be too worried about it you know learning that procedure right now you can you can learn with this short life like you said they're shorter implants and the bump she can do and the things you can do with bursts of burst you know the crest ellipse you can do it that was it's you know rarely do you have to do lifts like that I don't do lifts like that I only had to send out I think one or two in my entire career where there was absolutely nothing to work with and that was even before I started you know doing these bumps in these out these sinus bumps and can do that perseveres but I just don't think you I wouldn't worry about it very much they're certain to be pretty rare in my opinion and even with these all along cases that you do you know we're putting those implants isn't in the back and the way I'm doing it but in the way I've been taught to do it but you know you're putting them in the front where there's lots of and then yeah I just want to worry about too much I think like you kind of mentioned too it's good to learn you know immediate implants because like you said it's gonna be a lot more trauma type things you know long term it's gonna be less of the the cavities or the things like that that we're fixing a belong you know down the road it's gonna be people who are who fallen you know where they've had a root canal been post you know number ten that breaks off when they bite into a piece of crunchy bread and you know they come in and they want to fix right it right away so you know we touch on a meeting implants and also touch on how to put a um you know media screw taint provisional on those implants - after the sir after a tooth extraction and placement and you know the type of implant to use for those so what kind of touch on all those things
Howard: so when you so are you I'd not back to the CB CT do you are you agnostic to the Machine is there one you think that's better
Dr. Michael Dostal: no I think it's actually more about the software you have to play around the software and know which software you like and for me it's quick you know it's how quick you can be with it how easy you can use it you know so which software so which CB
Howard: so you're saying that the CB c t to you the value the CB c t is not how they throw an energy wave it's the software which software do you like the most well I've you
Dr. Michael Dostal: I use the Sirona with the conch Alexis that's the cerebrum it's just the small small field of view I think it's like a by eight that was the first one I bought that was used and you know I think you can even the same model I have you can even get it cheaper now you'll break thirty forty thousand dollars with a small field of view but the software is pretty pretty slick on you know I'm sure people are biased based on whichever one they've learned you know but but if I can get it take the cone beam in with it and said you gotta use
Howard: so you bought the Sirona go axis so Sirona is that it so when i got at school serranos Siemens which is kind of Johnson Johnson and Gillette and then there some CEO thought they were over waiting out here so he spun it off but the building didn't move in Austria still sat there the people just loved it they loved it they were freed from that and then it decided to get married to DENTSPLY out of York Pennsylvania so the Cerrone is now the dense fly but where dan you said you bought it you said you bought it used where did you find it used
Dr. Michael Dostal: Oh renew digital I believe that down there there's someone talking about on dental town an awesome company right and so how long
Howard: so you like the Sirona go axis CB CT because you think the diagnosis think that the software the trim planning software is more intuitive and easy just quick and quick and easy yeah that's what I like because I don't want to spend a lot of time trying to get the right slice and moving it around and everything what did you pay for that cerana glasses from Renu
Dr. Michael Dostal: you know at the time I think it was a 2012 model and I bought it and probably 14 or 15 at the time it was 60 mm find this
Howard: so were you born in Kansas or Missouri cuz you selling you're born in Kansas but which side were you born in you know I know Missouri boy so you know you you buy a new car you drive it off to car lot and it loses 20% of its value and a lot of dentists will sit there and they want to build a dental office it's like you want to build it oh so you got to buy land and then you got to get legal fees and you got to go pay architectural fees and you're gonna design a building I mean when you the smart people you know when you build something in America it's about a hundred year cycle between a brand-new house for a rich guy versus one century later now it's a crack house and a bulldozers about to it's about a hundred year cycle and you find guys like Ricker sir he owns three hundred dental offices and he didn't build one of them he goes and he drives around till he finds like an old 2000 square-foot state farm building or chiropractic building I was in Tennessee one of the coolest dentists in the world saw a bankrupt gas station it was one of those ones with the dinosaur on it what was that what was it Sinclair yes and clear HIPPA he bought an old Sinclair gas station and tight in the dinosaur to the decor it was so damn cool thing is I mean he picked that up for you know 20% of replacement guys so here's a 60 to $100,000 CBC T and you picked it up for 14,000 right though you said well I'd know I bought it in 2014 I think so it's probably $100,000 CB CT that
Dr. Michael Dostal: I bought used for about 60 okay you say 40,000 yeah and now you can even buy the same one same model even for like you know thirty or forty thousand dollars you know and
Howard: dental town ads the dental town classifieds average is about 5,000 ads they're all they all follow go away after 120 days so they're all current and I mean like someone will want to get into CAD cam they'll say yeah the I talked to Patterson and shine and they wanted 144 this I picked one up on dental town use for half the price I mean just be smart in fact I got my dental degree on eBay ten bucks and it was a part of the black belt Eagle Scout oral maxillofacial surgeon all-in-one so just just be smart any money so you like the so the key point he said there is buy used and it's about the software the treatment planning designing software is the the the most important part around that right
Dr. Michael Dostal: yeah
Howard: you know you save some money and and you know find something that works for you find something that's easy you can I want you to tread carefully on because when you come out of school on the young are very easily manipulated by old patients where they're the dog and they're gonna wag the dentist tail and they say yeah I want that implant I want it immediately and I and they just I ain't it happen to me they they talk you into things where when it goes wrong you're just they can well how how was i talked into this well you're 25 this guy was 60 and you know blah blah blah but how do you manage patient expectations how do you as a dentist the dog wagging the patient tell and how do these kids avoid getting into trouble when because sometimes you ask them like well what tailed you there for that that's what he wanted me to do I know I know I told him it was a bad idea but he told me to do it anyway and so so how do you do it because I still I still see a lot of stuff that shouldn't have been immediate I mean what what's wrong with I mean if my doctor told me okay Howard you need a quadruple bypass but you know but your insurance only let me do one valve a month so you'll you know how do you how do you maintain control being the doctor when someone says yeah I want those implants I wanted me immediately loaded and I'm going to a wedding the next night and I want it to look perfect how do you manage expectations
Dr. Michael Dostal: well yeah you know you have to educate them first you know tell them tell them the reason why you know that it's not going to work like that but I always try to keep the expectations low anyway and I feel like you know as GPS we kind of have a little bit of more of an advantage and specialist when it comes to things like immediate like immediate implants because like I was talking to a periodontist friend of mine you know he's saying I can't do a lot of medias like that because if the implant doesn't take then I've just lost that referral source you know and as a GP we can you know bill to have a good relationship with the patient a good trusting relationship right where and you know if I usually tell them like look you know we might try and mediate here it may not be a great case if it doesn't take it so it's okay well I'm you know all we lost was time it's not gonna cost you any more money or anything if it doesn't take and we have to replace it and we've just lost a little bit of time but you know you have to know which cases you can do that into which ones you can you have to have good bone you have to have you know a nice easy clean extraction can't be a big surgical mess in there you know big big nasty surgical extraction it's kind of you can choose your battles but I'm not afraid to stand up to a patient and you know stick with things with them I might and I encourage everybody to do the same thing it's not comfortable for even then don't do it you know and
Howard: I've called the police on a patient every decade for three decades we're talking and all sudden go south and next thing you're dropping f-bombs and calling my assistants names and all that I don't I don't have to explain to you what's wrong with that you're in a public building and the laws in health care and the first time I did I tell this story I was I was so mad but when they but anyway when they he was going for the judge I thought I'm gonna go down there just in case he starts saying it was something else never even called me you know why when he went in front of the judge guess what the first thing the judge said to him hmm she looks over and she says what did I tell you the last time you were in my courtroom what did I tell you I'm so glad I did that because she just just about us she probably would have come down there and just beat the crap out of him if she legally could have but anyway I'm yeah you just just you're the doctor and the thing about implants here's the dark side of implants no one's gonna tell you if you do five implant cases and one of them fails you're gonna fix it for free from the profit dollars of two other of those five cases so you should have just done two cases for money and by the way if you ever do find someone that's poor and can't afford to have it done right well then do it shitty because then when it fails they're gonna go to someone else and that person's gonna call an attorney and you're gonna pay for the best implantology in the world to redo it a Mercedes Benz so you know if you can't do it right do it wrong and you'll pay to have someone else do it right and implant cases on for every five you do if one fails two of the other five profit dollars will go to do that so diagnosing and treating plan is everything and I know we passed the hour but two more could I hold you to two more questions on the on the guides I mean I know when you're an alcoholic in Phoenix the old dinosaur say my place 5000 implants oh I never had a guide use the pain of the whole time then the kids trying to justify wines a you know CB CT and once everything guided surgery so obviously the old people pretty much I would say every single person alive today that's placed thirty thousand implants did at least their first ten with no surgical guides because it didn't exist so surgical guide are you is it like a rubber dam on a root canal a hundred percent every time or is it sometimes yes sometimes no how do you wrap your mind around a surgical guide
Dr. Michael Dostal: well I think you have to learn how to play some without first of all just make sure you know how to place in my doubt but I only use them for the cases where it's gonna be really tight in there you know if it's super tight or if it's something that you know in angulation case where you know if you're doing like an upper all on case and angulation has to be just perfect they don't have a lot of bone to work with then that's what I do guided on those but for you know 95% of the onesie twosie zai do and in the lower upper dentures and things like that and I don't I don't do those guided just kind of have a nice flat where you can see everything we can see the bone and you don't know where you're going and with the comb beam you know you kind of know you're with and and you know what to stay away from so I'm I'm not a big fan of guides and it also just kind of adds a little length to the to the time to do it unless you're preening your guides I'm in office which which I'm not doing I know some guys are but you know then you have to wait for turnaround for that too but there are some cool things you can do it then I'll do I do some immediate on the upper that you know like I said like a number seven that's broke off at the bone level and you gotta take it out you can do it guided and the provisional maid you know already you know so you place the implant in and the Provisionals already made and just screw it right on and you know works works pretty good and but on that same token if your provisional if your guides not right or the implant angle gets off or something somehow gets off that Provisionals not going to go on so then you either have to have a backup you know flipper may or you have to be able to know how to make a provisional you know chair side to point with what you got
Howard: so um I found all those happen to me before so we're talking about CBC T's we're talking about surgical guides now there's some new technology with image navigations where they're tying into your CB CT and your high-speed drill do you think that's is it there is a bleeding edge the leading edge is something where you're thinking I wish I had some image navigation
Dr. Michael Dostal: not at all for me I'm not you know I'm pretty hands-on guy I would feel pretty nervous about that I have to see a lot of it a lot of it done a lot of it done successfully too to go that far but I mean you know do we have to do that you know I feel like if you have good basic fundamentals you know you know a good surgeon can can get it done
Howard: so and last question I mean I'm confused because she could go to your website KC implant Institute and for 2,000 bucks which is about what your first implant I mean an implant a single tooth implants can be $2,000 gonna be an implant in the crown 2,000 bucks and you're having that course April 24th and 25th in your Shawnee in your lee summit missouri right so why should she do that when the Chinese already have a robot that place an implant and I could be sitting in my Jacuzzi drinking a beer while my robot is at the office placing an implant
Dr. Michael Dostal: I can't imagine how expensive that robot is probably way more you know used comb beam or something but I you know in place just there good practice builder a good revenue generator and you know if your hands on like like I am and then plus you know you're gonna be restoring them so you know with the system that I'm using from is biomechanical that you know we can get the you know even the restoration of everything the cost down to I think it's about you know 200 to 250 or so by the time you do the implant in the in the crown and everything just for a single posterior I mean that could be pretty you know cost friendly when sometimes you're paying $800 or so you know if you're using some of the some other other brands like the office that we bought recently I've been having to restore some of the implants that were referred out previously to specialists that are coming in and you know when I looked at my liability other day for one of them and it was like four or five hundred bucks you know by the time you do that the abutment in the crown and I mean I stuff adds up so you know start doing it if you want to do more of them decrease your fee for it you know because you got a little more margin there and you know and if you want to really change some people's lives you can do more of them I'm that's part of you know another goal of mine with this institute is to try to not only help the local Doc's that help the local community to and I want to try to do some some pre cases like you said a veteran or or something like that I want to try to do some free
Howard: you know all on cases in the future for people and just kind of make it good for everybody and if you were if you did buy a chinese robot and you were a home in your Jacuzzi drinking beer would you drink a corona beer with the corona virus breaking out on your chinese robot or would you switch from your corona beer and drink ebola beer while your chinese robot was placing him back hey thank you so much for coming on the show today it was just amazing and this is uh this is implants and clear liners is the only double-digit growth in dentistry i'm went to UMKC everybody I know back in UMKC has been you gotta get this kid on your show he's just amazing so Michael Dostal go to his website KC implant Institute and his next course is is April 24th and 25th or September 25th and 26 and it's kinda like ortho like Richland I do ortho and his four three day weekend course is like five grand well what would is your first ortho case cost five grand this is a two thousand dollar course how much is your first implant case a thousand-dollar implant a thousand-dollar crown by the way are you lab agnostic or to you you or do you usually only use one Cronenberg implant lab
Dr. Michael Dostal: no I unfortunately use about four or five different labs you know as confusing as it can be for our technicians our assistants but yeah
Howard: I mean I like for certain things okay well I'm congratulations on all your luck and congratulations on doing the smartest thing any dental student can ever do which is marry one of his classmates and I was just sweet whose dad is a dentist too I mean talk about that's the I mean really so uh thank you for all that you've done thank you so much for coming on the show and go chiefs
Dr. Michael Dostal: I really appreciate you've done I can't believe it you know because that's
Howard: uh ten twenty years old and it's still the same it's like well geometry calculus algebra business it's it's not gonna change and you know and until we evolve into some species I haven't seen yet its businesses business it's people time and money yeah I have a rockin hot day good luck with those two kids.