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1462 Endodontist Ben Johnson, DDS, Founder of Tulsa Dental Products & Pioneer in Modern Endodontics : Dentistry Uncensored with Howard Farran

9/17/2020 3:00:00 AM | Comments: 0 | Views: 1809

William Ben Johnson is an endodontist, inventor, entrepreneur, educator and philanthropist. He developed Thermafil and then established Tulsa Dental Products, beginning with the modernization of endodontic treatment. He has received several awards such as the 2004 President’s Award from the American Association of Endodontists and the 2000 Louis I Grossman Award from the French Endodontic Society. He is member of the Oklahoma Dental Association, American Association of Endodontists, and the International College of Dentists, among others. Most recently, Johnson has directed his efforts toward designing instruments for improved cleaning and shaping of the root canal system. He received his DDS degree and endodontic certificate from Baylor University Dental School.

VIDEO - DUwHF #1462 - Ben Johnson

AUDIO - DUwHF #1462 - Ben Johnson

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It is just a huge honor for me today to be podcast interviewing the legend of endodontics in my lifetime Dr William Ben Johnson DDS he's the founder of Dentsply sir it was actually called Tulsa dental products in the beginning now it's called Dentsply Sirona Tulsa endodontic products he's an inventor an entrepreneur an educator a philanthropist and one hell of a businessman he developed thermophile and then established occidental products beginning with the modernization of endodontic treatment he has received several awards such as the 2004 president's award from the American association of endodontists and the 2000 Lewis Grossman award from the French endodontic society he is a member of the Oklahoma dental association American association endodontist and the international college of dentists among others most recently Johnson has directed his efforts towards designing instruments for improved cleaning and shaping of the root canal system he received his DDS degree and endodontic certificate from Baylor university of dental school and even in your bio that's the first thing I like to historically clear up because I was under the impression when I got out of school in 87 that and still until they started the endodontic specialty general dentist who just wanted to be ended and only do root canals just said practice limited endodontics and that was all it takes then later they started now we need to do a program and start out a year long then it turned into a two year long and a three year long and I thought that was um your situation I didn't even know until Cliff Ruddell told me that um you actually went to endo program um I don't think John McFadden did he no john max madden didn't he's uh as you said a general practitioner who limited his practice to endodontics and actually that criteria with graduate programs started was back in the probably early 60s maybe late 50s there's some dispute as to which school was the first one to have a graduate program whether that was Ohio state or Illinois but they actually started graduate programs that long ago and after the age became a well after endodontics became a recognized specialty by the ad and i think that was in 64. the fellows who had their practices limited to endodontist if they wanted to become an endodontist had until 1969 to take the American board examination and be recognized as an endodontist after that to call yourself an endodontist you had to attend a graduate program and those vary from one and a half years to basically three years depending upon what school you go to and a few states Oklahoma being one of them actually had what they called a specialty law once you wanted to practice endodontics you had to you had to take their state examination for that I think there were only about five or six states that that had that kind of law but all you could do was endo and actually when I started practicing in Tulsa in 1973 uh because I wasn't ending honest they wouldn't let me do the permanent restoration or they wouldn't even let me put a post in a room canal they said that was the purview of a journal practitioner so when the general dentist referred a patient to me it was basically for the root canal I put cavett back in it and sent it back to them but a couple of years ago Oklahoma got rid of the specialty law and I don't know about the other side states I haven't kept up with them but it was it was interesting it was a good thing because from the standpoint of the patient if they were referred to an endodontist or oral surgeon or whatever they knew that they truly had the training and it was a good thing for the general practitioner because he knew he'd be getting the patient back for the restoration so it worked well you know um you're never supposed to talk about religion sex politics or violence so let's start with all form at the same time um you know um just because you don't agree with something doesn't mean you can't intellectually think about it and discover it and um there's a lot of um economists like Milton Who said the these uh these state boards is what made America and governments and the 20 richest countries so um healthcare so expensive so that eventually the people couldn't afford it and needed the government to help them buy it and Milton Friedman said um you know like in in America if there was you know about 1900 they set up all the state medical boards across the country so each one of these government state boards became the judge the jury the executioner and they shut down 90 of the medical and dental schools in that time period and they licensed who could be a school when you got out they licensed who could be a dentist they said all these rules and that that is what made it so expensive so the government made it so expensive not now that people are going back to the government saying will you help us and you know do some type of government socialized health care and like I see in Arizona I mean if it the poor people in Guadalupe there's like 25 000 um Guadalupe Indians and people born in Mexico that don't have a citizenship if they allowed Mexican dentists to come up and practice in Guadalupe they would all have low-cost dentistry but the reason they can't afford dentistry is because the state government made it illegal and so then they go and they need help with Medicaid and Medicare all this stuff like that how do you rationalize or how should the next generation of people and I know your wife uh and a fantastic endodontist from Russia so she's you guys have been around the world you and I have lectured all around the world how is the next generation of replacements the dentist just graduating how are they supposed to wrap around their mind that the only reason they make 175 000 is because the government has strangled the competition I mean business is supply and demand and the government has so regulated the supply that sure the dentist will make a lot of money but that's why health care is so expensive and I think the next generation is going to go to the government and say you pay the bill it's too expensive for me and I’m sitting there saying gosh they're the ones that broke it in the first place I mean it's hard for me to grab my mind that the government is the solution because all I’ve seen is the government is always the problem so how I know that's a lot to throw at you this early in the morning and I’m kind of scared to ask you because you got eight gut rifles behind you I’m afraid you might just pull one off the wall and shoot me right between the eyes well we're socially distanced so I don't think my shadows would carry that far but boy you opened up a can of worms there you basically gave a dissertation so I’m going to give a dissertation uh maybe a little bit different perspective since I lived through it but when I went through Baylor we uh let's see I graduated in 69 it was a private university and was extremely expensive I mean we're talking like 40 000 a semester so Baylor was one of the more expensive dental schools and when I graduated I had a pretty significant debt I had to pay back over I don't know 10 or 15 years so I was facing that and then in the when I became an endodontist and I was practicing here in Tulsa in 73 I think is when I started practice the dental schools all of the dental schools in the us if memory serves me correctly accepted government subsidies to increase their enrollment and all the schools uh accepted that money except for Oregon was the only one who didn't do that they did not increase their enrollment and some of the schools went so far as to increasing their enrollment and decreasing the time in school like uh Baylor went from four years to three years went from they were I think 92 students in my class in 69 and they went up to a 150 or 175 students and decreased the amount of time they were in school so and they were doing this because quote unquote there was going to be a population boom well I am the population boom so that was already receiving they were they were basing their criteria on antiquated uh statistics you know I mean they were already 30 years behind the curve and then they started producing so many students in the late 70s and early 80s that's when the crunch for dentists really happened I mean when I came to Tulsa in 73 I was the first graduate ended honest uh graduate training the dynasty in Tulsa and the banks when I went down to talk to a bank you tell us what you need we'll give you 110 loan your first payments not in six months and I mean student now going in with a degree to get a loan you better have 50 of the money just to talk to them so it's a totally different thing now and it's because we turned out in my mind too many dentists now your dissertation you were talking from the standpoint of the patients do I like having to get a pay a licensing fee for my x-ray machine no I don't like that do they ever come in and adjust my x-ray machine no they never did so I think that's a bunch of baloney as far as I’m concerned uh I think having to hire a registered and trained dental assistant is which that actually occurred in Oklahoma during the 90s late 90s before that my well I mean what they trained dental assistants to do to help a general dentist doesn't help me at all because all I did was endodontics and they got very little training in that my best dental assistants through the years were waitresses that knew how to take care of the of the customer who came in were prompt were courteous I mean that's I’d go out and I’d eat out a lot and like I said some of my best assistants came from came from that background of course they got grandfathered in you had to give them a radiology course so they could take x-rays and things like that but uh I i don't I don't I don't like some of the some of the license that goes on but on the other hand some of it is pretty good we went through in the 90s uh case where uh denture laboratory all of a sudden started advertising dentures for you know 150 dollars this is a laboratory guy who's had no dental training other than just making dentures and the state board stepped in and tried to stop him from doing that and he filed a federal lawsuit that making dentures was his occupation and all he got from the gym from the dentist anyway was a set of impressions and he could do that and he won that federal case uh which I thought was pretty bad uh I really I really think do you remember that you remember that case can do you have anything on that case that I could google um what would you google denture dentures it was denturist and it was in Oklahoma and if memory serves me correct that was in the mid to late 90s could have been the early 90s but he won in federal court and [Music] there were other similar cases either in Texas or Oklahoma [Music] where the state board removed the license of a dentist for doing inappropriate or inadequate care of a patient and they went to federal court and got their licenses back so it's a it's a mixed bag of uh bureaucracy uh yeah I already found it that is an amazing uh history but I just want to my job on these podcasts is I think the only value of knowledge or the most weighted value of knowledge is what we leave behind to the people who replace us I mean you know we're a million-year-old species a hundred billion have come and gone and um you know I i just like to capture all these succinct points so that the kids that just walked out of dental kindergarten school um can see the future but I just want to say that and one last thing and we'll get off that but um when people talk about Karl Marx and communism I just wanted to remind you that Karl Marx was an economist and his theory was never ever attempted or tried and Stalin took it over and it was just a uh is what it is and the same for the opposite of um Russia or communism is the united states capitalism we have never had capitalism in the united states it has been a completely managed between the richest people and the biggest powers of government have been managing this I mean why do you think um at least three us presidents have done huge atrocities um with Indonesia is because that was the fourth largest country was china India us and Indonesia and your government here in America was afraid that Indonesia would have a demonstration that scared the hell out of him and you're just like what where these guys come from I want to personally thank you ben you um you bought the oldest root canal video filmed in 1970 by Merlyn md DDS and you gave it to my buddy brad Gettleman who I went to dental school with and all four years he was g gentleman Ephraim and just the greatest endodontist I’ve ever personally Sammy he's just so intense and loves you to death and you gave him that video and he gave it to me to post on Dentaltown and I post on YouTube hell it has 6 000 views on just YouTube and what's amazing for this is it's it into the principles of endo hadn't even changed I mean this whole video is finding all the canals and getting them all cleaned right and a hundred years later everybody um wants to uh think about everything except that I remember when you came out with thermophile the um the biggest pushback I saw on that was so many people were afraid that the dentists weren't going to take the time to clean and shape all the canals because with thermophile man you could just you could file it out to only that 25 and you could get a gutta percha cone thermophile all the way to the apex but it kind of looks like when you watch that video ben that nothing's really changed in the principles of endo in over a century well a principle really shouldn't change techniques to fulfill those principles do change somewhat although you are correct up until well let's talk about that video that was actually a film that jake Friedland who practiced in north Carolina he's passed away a couple of decades ago but jake Friedland got that film from uh Edwin van valley and Edwin van valley was actually president of the and in the late 50s or early 60s I believe his father practiced with ml Ryan and ml Ryan if you're from new York they say that he's the one that coined the term endodontics if you're from the southeast they say harry Johnston in Atlanta coined the term endodontics but one of those two guys uh is responsible for uh coining the term endodontics but if you look in there the number three rubber dam clamp hasn't changed it was there and and it was 1917 not I think you said 1970 or else my hearing aids are playing a 1917 1917 yes and you notice the contra angle hadn't changed at all in that time frame and he was using a rubber dam and uh well he did spend three or four visits doing the root canal but keep in mind antibiotics didn't come out until world war ii so uh they irrigated with a bleach solution although it in the video it had a chemical name versus calling it bleach or whatnot and they used that on wounds during world war one instead of suturing up a really bad wound they would tie off the bleeders and leave it open when it can come by twice a day and pour bleach across it sort of micro chloride to dissolve away the necrotic tissue because they knew if they sutured it out that patient would get gangrene and I know this because an old patient I had early in the 70s when he came in and I was doing a root canal on him he said my god that sodium hypochlorite I looked at him and I said how do you know what that is he said I was a surgeon and he said during world war one this is what we used they said I can't stand the smell of that but uh he's because he had he used it so often but it's kind of interesting but like you say I mean he spent a great deal of time cleaning the root canal systems if you noticed in the film the canals were not enlarged dramatically because actually endodontic files the patent for the k file and by the way k stands for Kerr they're the ones who got the patent on the first files that was in 1919 so that was two years after that video was made they used broaches and what they called apical picks and things like that and Ryan actually had some uh kind of oval shaped instruments that he used for cleaning a root canal that he designed himself so there wasn't a lot of enlargement there was a lot of cleaning and I think that's there has been a change over the last uh 10 to 12 years with more emphasis on debridement we didn't have the emphasis on debridement prior to that because quite honestly we just were not doing a good job and we didn't know how to do it better there were a few articles published that gave you the road map that we're now traveling on so but having said that I’ll go back to an article published in 1965 in October it was a month after I entered dental school by seltzer and bender where they said debridement is a prerequisite for wound repair anywhere in the human body exclamation point pretty much and without proper debridement this this is what leads to failure and uh of course thermophile you mentioned thermophile well that was that was my first invention or introduction into the business side of the endodontics and uh that came about because in the 80s the mantra would seal the portals of exit and will heal because so much emphasis was on three-dimensional observation you know Allah her children his disciples but if you have debris in there and you have debris at the apex you have debris and lateral canals [Music] that was a false assumption but we're all kind of we're all kind of carrying around the baggage of what we were taught and what we believe unfortunately some of us don't have enough open mind to see when significant changes are about to occur but the principles are the same you are correct the principle and that's another bizarre thing about humans is when they have a problem um especially um every country you've read about in history when they have a problem they spend all their money on police and trying to you know um revenge and arrest and kidnap them and put them in a cage and just started taking that same time and money and just trying to study the problem it's amazing how um in every problem they just want to um instead of just working the problem so um you know the rubber dam I i don't know why dentists don't work under rubber dam it's so easy I mean I just take a rubber dam and I just uh tacked it into the ceiling above my head and I practice underneath that rubber dam for 32 years that's a joke not a very good one but I tried um but um so um but going so now um the first five years of my career before you um I you know these hand files and I did not know the k file was named after Kerr thank you that uh I that's just I that's get missed my mind um but I had a little blister on the tip of my finger and my thumb because for five years I was just doing you know this this um pee-wee Herman shuffle and uh my gosh when they came out with rotary at first it was stainless steel it would go um left and right and come back and um that was just amazing and then it was the um who um the um oh I’m not going to forget his name um what is uh um who's the guy who invented um nighttime oh um the guy who invented it was something like butler or buckler or something like that with us naval laboratory but the first article with using nickel titanium and endodontics was published I think in 87 out of Ohio state university 1957 1957 to 2018 uh known for his invention of uh night I in root canal therapy who was born in Miramar and that's confusing for a lot of us because he was actually born in Yangon formerly known as Rangoon and Miramar formerly known as Burma uh received his grief from um Manitoba college in India and then went on to Marquette but um yeah he is um he got the ralph f summer award in 2005. um but my gosh uh before that it was just it was so hard to file and all those files and then when it became engine driven first for stainless steel then night I mean it just made it so much faster and efficient and now some of these files it's just amazing if you're old where you'll um clean out or shape a canal and you're just like my god 30 years ago I couldn't have done that in half an hour and so now it's so fast and it's so good and it's so efficient now the complaints have gone clear to the other side that gosh ben you made your files so fast and so efficient that now they're removing too much to structure kind of reminds me of um I really like that um in 1896 the Italian economist uh Wilfred pared showed that 80 percent of the land in Italy was owned by 20 of the people and today that's called the pareto principle um a lot of most people call it the 80 20 rule but I would say that um my feel on dental town um is that probably 20 of the dentists and endodontists especially the ones on dental town following uh Kadima he's uh he's made so many thousands of posts that um it's taking out too much to structure that it's uh it's weakening the tooth and I would say at least 20 percent of one in five people doing root canals around the world especially ones listening to kadam are saying um they're too aggressive you did your job great but you did it too great um what do you what do you say to that do you do you think people are removing too much to structure and uh the building the root and the crown will be weaker because we made it you know we cleaned out too much dentin in the middle well you put me on the spot there because I have friends in both camps right and you're a ma and you're a master of that because the dentist they're oh there's just so many things you can't talk about without pushing buttons and I’ve seen you at dinner before I don't mind navigating endodontics with big you know there's a lot of ways to skin a cat no doubt about it and you mentioned with thermophili you could fill it with a 25 well we actually made a 20. so you could use a 20 size file and if you look at histology even in the older more calcified individual as far as teeth goes the apical diameter is a 20 in one dimension and a 27 or 28 another is actually elliptical in shape so that's what mother nature gave you uh our shaping our shaping really nothing more than convenience form uh if you go back to go black you know all those forms that he had extension for prevention convenience form and things of that nature but the shaping of root canals convenience form use the term cleaning and debridement I don't know that the file does that that much you're enlarging the canal and there is a camp that say you make it bigger it's cleaner but that really hasn't been proven uh to be a true fact uh there are some articles I mean endodontic literature is kind of like the bible you can find something to support everything uh but I do believe uh I i was never well that's not true my last my last two molars I did in graduate school I did using herb shielded shaping technique and obturation technique and that was back in 70 72 70 about 1972 so to me that's what I call a hog down looking root canal uh but if you listen to Buchanan uh after the mid 90s or so his shapes were becoming more conservative other guys not so more not conservative at all so there is the camp that believe that this deep shaping and these large preparations make it cleaner and better I think there's no I’m convinced there's no true evidence to show that but debridement is very important and you have to have the canal large enough to allow the fluids to get down in there with ultrasonics and whatnot to activate the fluids to really change if you're still irrigating with just a syringe needle sodium hypochlorite well you're not you're not actually cleaning the apical third so it needs activation in some sort some form or another and unfortunately some of those products that sell the most actually do the worst job but that's another issue uh I don't I don't know where you led me on this but I am into the conserving I’m not a nut about it but uh I mean there's some guys make a little pinpoint occlusal opening I’m not that that category but I don't believe that you should open the canal any more than is necessary and if I’m going to put a number on it I’d say the orifice is on a typical uh mesial root of a lower molar or buccal roots of an upper molar I would say the orifice should be about no bigger than 0.6 millimeters 0.65 something like that and a lot of those particularly on younger patients are already bigger than that but if you're talking about a difficult case and as an endodontist I generally only got the difficult cases I didn't I didn't enlarge them any more than that as a company did I make orifice openers yes and did I make them larger than that yes because as you as a manufacturer you've got to manufacture products to well for everybody and uh there's a there's a wide range of that but personally no I don't believe in opening the room canal to large size and to me I rarely took a 30 to the apex and when I say apex I’m talking about to my working length which was not a millimeter short I tried to go to the terminus through the terminus a little bit but not enlarge the terminus um some have suggested like um your buddy uh eric her Branson that you know so many people listen to that um he always says he wishes you came out with uh instead of prosper and wave one he calls it the prosper thin files or the wave one mini uh do you um and I know that you've um in the past you've had uh finances like true shape and true anatomy I love the truth anatomy where the uh that that's a great branding name true anatomy um have you is that a um do you think those will there'll be more of those in the future do you see more of those coming or do you um what are your thoughts on true save true anatomy and eric Hebert son’s protaper thin files wave one minis well erica Branson and I have been friends for decades and uh he rarely says anything that I disagree with the um in fact I got to shout out my oldest son eric his birthday today so something good can happen on 9 11 where we're doing this on a 9 11 on a Friday and um my gosh um that's why i named americ i named my son eric after eric oh did you really no but just that's for the show that's for the end of the program okay well uh like i said i very rarely disagree with anything that eric says uh and they're always the interesting thing about eric even when he's up against somebody who's uh very opposed to what he's saying he's a gentleman about it i mean he remains a gentleman about it and just reiterates his point and challenges their position uh so i like him very much and what he was doing with his conservation of two structure stuff was basically what i was doing anyway uh but going back to protaper the first two or three shaper one shape or two those are conservative of tooth structure which gets you up to about a size 20. now finisher one which is a 25 08 i've used one in my practice ever now the 3009 taper to me howard is like a 10-penny nail i mean i see no i see no place in that in endodontics and somebody will say well there's large anterior teeth well why are you going to grind it out and make it bigger i mean that makes no sense just clean what's in there and use the natural anatomy that's given to you uh i've never used a 30 uh pro taper in my life and i know that cliff ruttle and a lot of the shielder advocates they use those they like the shape they like the resistance form they think it makes the canal cleaner but that's the thought process that's not borne out as i've said before by literature so i i do believe that going to smaller preparations will be the wave of the future but that's because we are now encountering ways that we can better debrief the root canal and take the debris out before we obturate those go hand in hand and when you say when you say what's coming along the lines true anatomy i like that it's an eccentric file that way you can touch more to structure with a smaller instrument there's one that brassler has out i can't remember the name of it now the commercial name because just came out in the last few years that's not a particularly bad file but that was actually invented back in 2010 2012. it's taken that long to get into the um into the market uh i've actually been working on a two-fluted file uh and it's too fluted because that leaves more debris carrying capacity yet adequate torque to cleanse the root canal with minor shaping and i was actually thinking about it about calling it the cd cd2 file cd for complete debridement and conservation of dental that's what i refer to it myself it's not commercially available i've had prototypes made but i've had a lot of people over the last four or five years ask me why don't i start another dental company i'm 76 years old i fought those battles and when you talk about how many lectures you gave per year i did that also and i did it for from 1990 to 2000 i still have several memories of just you like um once i was kansas city i was leaving the lecture and you were getting out of the cab coming in and another time in las vegas i mean we uh yeah i mean that's why i love podcasting i mean we can sit here right now without shoes on and talk to dennis and kathmandu i want to ask you another question about when you go to these uh yes and eric is a gentleman he's a gentleman and a class act and one thing i want to point out to the kids um also is that um you know meeting for 32 years of meeting the biggest names in dentistry um it doesn't surprise me that eric j her branson bs dds ms he graduated with the bs and physics in 1964. in my own backyard um you know i i lived on the same dorm floor as joe dubkin uh the endodontist and um that guy could do almost all of freshman physics in his head i mean here he was trying to help everybody in the class you know all these other i mean so you know if you don't understand the you know the language of science is math like ben and i are talking the language of scientists which is english which before war two was german i'm so glad the only the best thing that came out of world war ii is that i didn't have to learn german and my gosh um so we're talking english between scientists math is a language of science and um and then you know the applied math is physics and then applied physics chemistry then biology and everything human is in biology but my gosh um if you um the people who understand the base of the pyramid the most they comprehend the most math they comprehend then they know the most physics i remember when i first met you talk about what a class act you are i was in phoenix arizona i was a punk kid i was 87 i called you up in your office and i was asking you these uh questions and you said god just be so much easier if i could if you just come down here and i'm like well dude southwest airlines i'll jump on a plane uh this weekend and you said great and you were so nice you let me spend the whole day with you but when i asked about um there a file and we're talking about um a round hollow you know drilling around it to grab it or something like that you did all the math just verbally you were talking about the strength of the if it was solid it'd be easy to snap but if it was hollow you know the forces are going around and uh so i mean know your physics i mean that that's all i'm saying is go back to your physics i want to ask one more thing about um you were talking about how eric was a gentleman and if someone disagrees he just repeats itself and he's a physics major you're not going to sit there raise your hand and say something to change the laws of physics um you know it's like but they a lot of dentists and physicians and people complain that a lot of the lecturers were nothing more than sales adonis and they pat and they passed the sunshine act um that was uh when was that in uh um august 1st 2013. so that was seven years ago um and it was supposed to clean up so that the um dentists weren't our physicians mainly was prescription pills is what they were going after it was the pharmaceuticals had all these physicians going around lecturing to take my pill for this do you think the sunshine act worked and there are less cellsodontist in the conventions today and whenever you lecture you have to declare if you have any financial interest or anything like that do you think that helped or do you think that was uh um a waste of time well i think the act itself was basically a waste of time i think uh well this last year was the first year that i could actually say that i have no commercial interest in anything which that was kind of relieving factor for me there was no disclaimer because it seems like whenever anybody has a disclaimer after his name people look at him kind of askew like he has he has something like he said he's trying to sell something i i like to think that i never did that i i would paint both sides of the picture my side i think was a little rosier but that was because i was talking about better products what i don't like is when a clinician gets up and speaks at a large meeting now you're not supposed to name a product well how could i talk how could i speak generically about thermophil there was not another product like that how could i speak generically about rotary nickel titanium there wasn't another product uh quite honestly i was glad when mcfadden came out with a couple of his uh i think quantec was the first one came out with quantic because now i could say rotary nickel titanium instead of just profile because there were at least two of them out there but when you when you're coming out with something innovative and something new or what i call a disruptor in their profession you have to refer to it and uh stepping across the border to being a general practitioner listening to a specialist speak they want to know what medication are you using are you doing it at two visits or one visit what instruments are you using they don't want to hear stainless steel they don't want to hear knock nickel titanium they want to hear what you are using and stepping back into my shoes as a lecturer i know that a skilled clinician could do a root canal with different sized fish hooks if he wanted to if he had to he could do that so is there really a big difference between one nickel titanium instrument than another each one has its attributes it also has its minuses so as a clinician you should know what those attributes are and what the minuses are so whenever i lectured on the rotary nickel titanium i generally showed three or four different instruments and i showed the true what they actually did in in plastic blocks as far as transportation goes and things of that nature unwinding separation i talked about what causes separation and which ones were the most resistance but i based it on literature not on sales material i mean one of the things that offended me most in a lecture i guess nobody can sue me at this point in time or if they can sue me i guess but i'll say it anyway because it is true but this lecture started talking about uh the cybron product uh now having a senior moment i can't think of it was a real strong one anyway they were talking about well the center core is parallel so the grooves are deeper coming up the shaft making it more flexible it was not more flexible i mean that's obvious to anybody who touched it and what he was quoting was right off of one of our patents that we had that was the profile that was made that way and i talked to him afterwards i said hey listen you're wrong about that well that's what it says in this article and i looked in the article and that's what it said and then i looked at the reference for that quote and it goes back to another article and i read that article and it references that quote going to the advertising brochure for cybron and uh advertising brochures should never be quoted in a scientific article much less a scientific presentation so some of them some of the presentations go overboard and that bothers me and at the same time it bothers me i kind of have to take responsibility somewhat for that because we instituted a uh what we called a local opinion leader program back in the early 90s offering slides and things like that anybody who wanted to give a program and that sort of thing but since then now you have companies who will pay people to give programs and things of that nature we didn't do that when i owned tulsa dental products we would pay their expenses but we didn't pay them to lecture so uh i i think it's good from the standpoint of a disclaimer at it you know this is sponsored by somebody or somebody you know some company or whatnot so that the attending people know that know that and then whatever he says if it's presented in a scientific manner well that's fine you can give them a few pluses if it's comes across as a sales pitch well maybe the company paid him a little more and he's making it more like a sales pitch so as the attendee i think it's i think it's probably good for them do i think the sunshine act has made any difference i really don't think it has it kind of irritates me because i used to go to graduate programs pretty frequently and talk to the graduate students as a practicing endodontist as a person who started a company and you know i think i'm a wealth of knowledge and as a consequence that when it became lunchtime would take them out for lunch now you can't do that you know you just can't do that so yeah but they all they all become a congressman or a senator and they're worth about a million dollars and then 20 years later they retire and they're worth a hundred million dollars yeah but both sides i know they do that and the reason i don't talk politics is i'm a registered libertarian and i see the uh the politics in america is you know 85 percent of all the stars are binary stars and we have a two-party binary star they're the both they're picking between one of those two parties like deciding if you want to die of cancer or heart disease or get your left molar pulled or your right molar but enough of that but hey my uh my buddy and your buddy uh mark olison the endodontist um in uh british columbia we both agree that the greatest thing you ever did was uh the 1994.04 taper which uh i still use to this day i mean i have a lot of my endodontist friend brad gettleman thinks it's a great file i mean was that your magnum opus i mean i know you've done so many things from thermophile on but would you say that the um the .04 taper profile is uh you should take down all those shotguns behind you and just replace them with 0.04 files did you think that was your magnum opus well i will tell you quite honestly howard of anything that's on the marketplace now that was the best file that was the best design file ever introduced having said that i did a 0.04 strictly off the top of my head i called the manufacturer and i said derrick i want you to make uh and that was actually that came off of the center core for the patent for thermophile because i had to design a carrier that was not a file because i had a previous uh published article on coding files with gutter purchase so the core had to be different than a file so i made it this u-flute design so it had no sharp edges i cut the flutes deeper so it was more flexible and i called derek and i said make this out of nickel titanium and double the taper what do you want to do that for i said i want to try something and sure enough in a rotation manner it cut great it would not cut in a push-pull motion at all and the grooves were cut deep if you over stressed an instrument it would start unwinding and when i say start unwinding howard those original files were cut with 19 spirals from the tip to the shank and i had one in a plastic block where i stressed it that it came out of a plastic block unwound 21 spirals in the opposite direction that is huge resistance to uh torque and deformation when densely bought the company in 1996 i believe is when it was sold first thing they did was decrease the depth of the flutes so it had more torque strength and so what you buy now in the way of a profile is not a bad file but it's not as good as the original ones were that's a long answer to your question uh but quite honestly i don't think if any one thing is as being a major point in my life uh i um i've actually spent the last oh 10 or 15 years working on debridement as opposed to instrumentation uh and i'm going to say this maybe i shouldn't say it but i'm going to say it enough what i should do and shouldn't do is never stop me from doing it so if i feel that's right a generally plugged right along but you have almost all the companies are now owned by major corporations i mean uh dense fly owns myford they bought tulsa dental products so you have you have engineers and accountants dictating what you're going to buy because they base it on you know how much does it cost to make how much are we going to be able to sell it for how much profit we make etc and you've got shine that purchased wrassler eight ten years ago so they owned brassler uh they also bought uh bought into agendo which is the low price guy in the market right now and we'll finish up that acquisition over the next five to six years or so and they'll completely own that along with that the manufacturer for the instruments for brassler is fkg in europe which is a family-owned company but shine has exclusive for marketing in the u.s so everything is controlled by major corporations uh there are some independent manufacturers [Music] in other foreign countries chinese made products eight to ten years ago were not very good they're getting better you've got ssy this white is a privately owned company and i think that's one of the ones that uh erica branson speaks on uh i can't remember what they're minimally shaped instruments are called but they are made by ss white but not particularly fond of the design uh from the standpoint of ship space or debris space that it allows you to maximize but it's a pretty good instrument true and well there's several there's several good instruments on the market and probably what the world needs the least is a new instrument manufacturer in the world but what the world does need are instruments designed for different skill sets and endodontics unfortunately endodontists as a group don't have a set of instruments that i would classify as low torque instruments for use in highly skilled hands uh they're given something that uh dental students can use and that's not exactly what they what endodontists need and not operatory we don't have we talked about it when i was still with gunslide about designated certain instruments as high torque high cyclic fatigue resistance you know having a little visual code on it so you as a clinician you're the best judge of what you could do and what you can't do you could pick the instruments to fit into your category i think that's a really good idea and i think i think companies should look at that and think about doing that because there are some minimally different design things that could help clinicians quite a bit but having said that i will tell you major corporations aren't going to do it because you just replaced the sale of this instrument with another instrument so you have no net new income so there is no impetus for them to do that i think probably the biggest mistake i made in my corporate life was selling the company i wish i hadn't done that but my investors they wanted the money so and i can't say that i didn't enjoy the money myself but i i was proud of tulsa dental products i thought we did some really unique things and something that maybe general practitioners don't use so much as mta metal trioxide aggregate great for repairing perforations great for in filling materials and i'll tell you it's great for pulp caps and pulpotomies i mean this is amazing stuff and that came about it was just a conversation with uh mahmoud torbino at nigh i said i said mahmoud what we really need is something like this and just listed the things that it could do and he was twisting my arm for a contribution for the research and education foundation and i said well you come up with uh something like this and i'll give you 500 000 and bless his heart within two years time he had it and what did he do with it he took it to densely a dense light turned it down because that was competing with one of their uh calcium hydroxide things that was used for pulp cap and then he came to me and he said well densely turned it down and i said well why didn't you bring it to tulsa dental and they said well dense lies bigger and i said well we'll do it so we did mta and then densely ended up acquiring us but that was never a big money making product but it's a great product and it's led to other things like bio ceramics and bc sealer and things like that you know so it was a disruptive product for that you know when you talked about um edge endo um by um with shine i mean what is the name what is the deal with goodis and endodontists i mean think i mean i mean chuck goodis founder of uh agendo harold goodis department bindo i mean um my gosh um do you think when you're when you're born with the last name goodis that there's some uh hidden dna that maybe they'll find on 23andme uh that will uh do that i mean have you ever thought about that i mean chocolate are they even related do you think they're related well chuck is not related to harold i don't believe but his uncle george goodis up in michigan he is they are related uh i think uncle and nephew uh harold goodis uh he was out in san francisco right so is related to george um george goodis george goodish yeah huh i did not know that yeah i mean well i know that they're related i don't think harold is related to them uh but uh chuck goodis was actually one of our opinion leaders and uh back during the 90s and then he started a company that got into a lawsuit with dennis fly and uh chuck won a bunch of money from dense fly and uh then he used that to start edging though he doesn't like denzel very much i don't like denzel very much either but it's not a personal thing not a personal thing i've been in lawsuits with them also so it's uh i like chuck i like what he's doing yeah he's a great guy but you're saying um you're saying um agendo sold to brasler and then shine on browser is that how it worked or he or she well peter brassler was the one who owned brassler and uh it's separate from the european country uh european company and uh over there were instruments that known as comet but uh peter brass or so well it might have been an intermediary purchaser but he sold to shine i'd say eight to ten years ago uh using cowboy math uh and shine took three or four years to finish up that acquisition but it that's complete now shine what year what the year did he sell what year did chuck goodis um ended on his founder owner agendo sell to henry shine yeah it'd be about two years ago there was a public announcement they own a significant amount of stock whether that's 49 or 51 i don't know but over the next uh six or seven years they finish up the acquisition and they'll completely own it so i'd say there's about five year four or five years left in that time frame and then that will be completely on my shine yeah january 2018. well let's uh um are you good on time i mean i'm sitting here with the legend of endo and we just passed one hour and i'm like no i gotta keep going i can't i can't let you go one hour well i got uh i've got another 20 minutes i've got a haircut appointment at two o'clock well a bald guy isn't gonna shut up to let some man watch his hair and go get a haircut i gotta get rid of this halo up here so well um back to um well let's see if i only got 20 minutes we're uh well um okay let's go back to uh mark um oleson i mean he was just at a seminar and he um just couldn't believe how gorgeous the cases um your wife's on dr eugenia johnson her cases were with the gentlewave technology and we started this show talking about this hundred year old video showing how important cleaning is um you and your wife both know about this um but the only the only um and the reason i say the .04 table was so great is because remember i'm a dentist with an mba you're a dentist with an endodontic degree and i um if you want more people to buy it you lower your price the number one winner in every category southwest airlines 27 percent of c miles sears sole price i mean what sam walton and sole price did the distribution is amazing but when you when you keep one eye on your patient and one eye on cost you give eight billion humans the freedom to afford to keep their teeth and um so this gentle wave is coming out there's no doubt that this thing is like a mercedes-benz for cleaning and shaping but come on dude it that's a lot of money and i um but you know they spent a hundred thousand on a cbct some spend a hundred thousand on cad cam um so my succinct questions to you to these kids coming out of school with four hundred thousand dollars of student loans do i need to buy a hundred thousand dollars cbct to do endo like ben and a microscope and now this new general wave technology for 75 grand i mean how much money do you know what's the return on investment at to some kid he just walked out of the midwestern dental school 400 000 in debt loves endo and wants to do the best endo does he need a cbct for every molar does he need gentle wave for 75 grand does he well is that enough is that enough questions at one time now ben said no i was supposed to leave 20 minutes ago not in 20 minutes well okay maybe i can give you an extra 10. she gave me a lot of questions here first of all i want to talk about sam walton and walmart because when i was in undergraduate school one of my uh one of my papers that i had to write i guess this was for english class i can't even remember what class it was but it was a you had to do research and whatnot and there was another discount store that started here in tulsa as a matter of fact it was called lube oils so it was lube oils and then there was uh walmart i think it just started and my paper was on how the interstate highway system which was done in the 50s keep in mind i was in undergraduate from 62 to 65 so not much later than that now the interstate highway system and the discount houses would be the death knell of rural america that was my premise and i got a c on it but everything i said has turned out to be true because uh here in oklahoma you wouldn't be familiar with the names but you get out western oklahoma out west of oklahoma city there's a town of clinton oklahoma that has a walmart at shamrock oklahoma and all these other little towns around there you drive through them there's nothing there but even though the highway of the interstate highway goes through shamrock they put the walmart in clinton so everybody drives 30 35 miles to get the better prices and mom and pop stores went to hell in the hand basket i also started another company called terminator spinnerbaits which was a fishing lure made out of nickel titanium which was which was bigger than your endo yeah well it lowered my cost on nickel titanium because i bought so much nickel titanium i could make more profit out of the files by selling the spinnerbaits and walmart was one of the big customers for fishing lures walmart every year wanted more sizes more colors more everything at a lower price i mean this the beat on you and beat on your beat on you every year they bought quarter ounce and three quarter ounce they bought white they bought chartreuse and they bought chartreuse and white no matter how many different sizes and colors i gave them that's all they have so if you're a fisherman and you want a one ounce size or something like that you can't get it at walmart and consequently none of the other stores well bass pro followed them and basically the same thing so yes low price is important in the marketplace it is very important but that also means you as a consumer have fewer choices and selections uh from right that's the other result of the fact about now having talked about that you go to the economic side i just want to remind you that i was born in wichita kansas and my mom had three brothers and um what is it uh chick mark pat and mark had a grocery store chain in edmond oklahoma and um and then i went to creighton and north in nebraska and right in eastern missouri for dental school so i know that whole area in fact i don't want to switch to politics again but my god everybody in kansas talking about that the supreme court just ruled that half of oklahoma is now a native american indian reservation i'm in arizona where a quarter of the whole state is an indian reservation um and you're talking about walmart going out west and i was sitting there thinking wow what's gonna happen out there i mean i know this edna dale but just real quick what do you think of the supreme court saying half of oklahoma is an indian reservation well actually this is the first time i've heard it i knew that it was coming up there because oh i'm 1 16 cherokee so i don't get any money i don't get anything but uh i mean historically you look at it we treated the indians very badly very badly i got no problem with them coming back and making money on the casinos and things like that i've got no problem with that america was built on two mortal sins they came here and exterminated the american indian and then they brought uh slavery but uh we everybody knows that that's what we're talking about but uh i do think i'm my boy's grandma i love 23andme because they're wondering why she was so much darker than the rest and turned out that her and my boy eric who's uh 31 today they got that same thing about a percent indian or something from the days in kansas from their grandma yeah but i wanted to go i wanted to talk a little bit about the economics of it uh a nickel titanium file from the manufacturing standpoint and you have to know i don't have any current information but back when i started this to make a nickel titanium file basically depending on the volumes cost you about 90 cents to a dollar 25 to make so you're talking about a six pack it's going to be 750 manufacturing cost how does the corporation justify selling that for 90. a six-pack i mean this is where the economics come from standpoint of a consumer buying uh dentist buying and whatnot so personally it tickled me pink when chuck came out with agendo where the price is down to where it was when we first introduced nickel titanium back in the mid-90s which was a decent profit margin it was about 50 percent or so but major corporations they want they want to have a 90 profit margin and of course they have a lot of bureaucracy that they have to support with salaries and stuff but unfortunately a lot of that money doesn't get plowed back into research and development most of the major corporations now in dentistry do it by acquisition somebody goes out and spends the money to prove that these products work well like tulsa's inner products i mean everybody turned thermophil down which is why i started tulsa dental products and the money i made from thermofilm i used to go with nickel titanium and you mentioned wallia walia's co-author on that article was brantley at ohio state and that was published in 87 why did no dental company make nickel titanium files before we did because they would be trading it would cost them more than stainless steel and they'd be training they'd be trading stainless steel sales for nickel titanium sales so there was no incremental sales to it just to me every time i lectured somebody said well how are you what files do you use and it quickly became apparent to me if we had a file system we could sell files so that's how i switched to nickel titanium the unfortunate thing for walia is he never patented that concept and it made a whole lot more money if he had uh but that got us to there again now you wanted to talk about signing sign in well not no i didn't want to start with sonnendo um i'm gonna back up this on endo um what is what high cost toys are necessary i mean is a cbct necessary that that's 135. that's twice you could buy tucson endos for that and then a microscope hanging on your ceiling from you know uh st louis's gc microscopes or the um expensive ones out of germany do they need a cbct a microscope and then a general wave or a son endo or same thing well from the standpoint of an endodontist i would say yes you do from the standpoint of a general practitioner no you don't but if you're thinking of uh measurable roots of lower molars as having two canals and mesial buccal roots of upper molars having two canals i can tell you got the wrong you got the wrong idea these are complexes in between those two canals and just by taking a file in and doing it you can't do it now with a cbct you at least have this indication beforehand and know how to do it you either got to have a lot of knowledge you've got to have the technology to know what you're facing so i'll leave that to the individual clinician if he thinks he can do without it fine now back in 1990 there was a big discussion do we really need microscopes i know of only one endodontist who doesn't have a microscope so that took 30 years for that technology to penetrate the profession cbcts now there are some cbt cts out there i saw one about six months ago that was in the 55 000 category and was pretty darn good got the business card somewhere i can't remember where it was i personally i like the jay marital one i think it's uh i think the images are better i think the quality of the image is better i made my wife buy one because she said the same thing you did i don't think i need it i don't think i need it well after she got it and started using it on her surgery cases so that she knew exactly what she was facing and then some of the more difficult things she was doing every patient she sees now that's what she wants to do and if a patient doesn't want to pay the extra price and it's a difficult case she'll do it at no charge just so that she knows what she's facing so yes i think those are those are necessary is it necessary to invest 75 000 in general wave well there's some other technologies out there that i have personal knowledge come close i haven't seen anything yet that's better but they've come close then i will tell you from the standpoint if you go back and look at an article i don't remember the author's name but it was out of ohio state uh and i think it was in 87 or 88 where they used number one passive ultrasonics as an oxymoron ultrasonics is an energy source and it's not passive but if you've prepared your canal to a size 25 or a 3004 shape or whatever you can take this little 15 probe pre-curve it and go to the terminus and activate it and what we typically did in the 80s was activated for a minute per canal irrigate and go ahead and fill they found that if you activated it three minutes per canal which now on a three canal mower that's getting you up to nine minutes four canal mower again for 12 minutes but the cleaning of that canal was more than doubled you went from 40 clean to 80 some odd percent clean and the and i'm including the isthmuses also which uh with just one minute businesses weren't clean at all businesses lateral canal but with three minutes very good cleaning so without any additional cost by using passive ultrasonics for three minutes per canal use it for a minute irrigate another minute irrigate another minute irrigated for three minutes per canal you can get into the debridement of the root canal system up into the high 80s where otherwise if you're just using needle ultrasonic needle irrigation syringe irrigation or ultrasonics for one minute you're talking 40 45 percent debridement so you've still got 55 of the crap left in there and if you're going you can do that and feel justified you're doing a good job without the additional expense but what Virginia is doing and what your friend talked to you about i've encouraged her just to instrument the upper half to two-thirds of the canal with 1506 maybe a 20 04 or 2006 and leave the rest of it instrumented and use the gentlewave which will ultrasonically cleanse ultrasonically and chemically remove all the debris this way she doesn't have to face instrument separation because instrument separation almost always occurs in the apical third you don't have that problem all the tissue is removed and then you can then you can obturate of course this changes your obturation because you haven't pre you haven't shaped this apical portion so now you have to use gutta-percha points to kind of fill what size is going to do but howard principally this is a sealer fill and single cone go to purchase what you end up with but you're filling all kinds of anatomy that we i never saw in my practice career uh and it it's made her wonderful ended honest and well that that begs the question because we started out you know i said that i think your magnum opus was the .04 taper because holy moly if you ever practice for five years with a blister on your finger and thumb you're blown away and that just made i mean even today in 2020 half a general dentist hate molar endo and don't want to do it and this made it so much easier and so much faster easier higher quality lower cost smaller that far more uh providers access to care you're talking about the rural areas now interstate hurt the rural and all these things like that i mean i it's hard for me growing up Irish catholic in wichita kansas where my parents had seven kids in three days um to worry about rich people getting treated by endodontists in rich cities from you know Paris to London to Tokyo i'm always worried about the other you know seven billion of the eight billion people do they have excess care but we also um but the negative on the .04 was it was not minimally invasive so my question is obviously does general wave which is made by sannendo which is uh also bought uh Gary car’s uh to uh do the uh doers do they does gentlewave solve the minimally invasive so you can clean that whole thing out without um making a large shape which we started to show that probably 20 percent of the endodontist following yeah i don't know how many uh general wave systems are out there five six hundred something like that almost all of those clinicians are doing less and less enlarging of the root canal but i will tell you howard it's impossible it's impossible to tell an endodontist not to use a file it's impossible to tell them you don't need files uh they're going to pick it up no matter what the heck you say to them so but do you need to shape that apical portion no you don't because the general wave system does remove that debris now if you were going to use ultrasonics as i mentioned before you are going to have to shape it to some degree before you can use the ultrasonics that way but there there's choices out there that that can be done but when you're talking about uh bringing the costs down and making it accessible uh so general practice practitioners can do Mueller endo let's see i think as cliff riddle says good is the uh good as the enemy of excellence uh you got to be you got to know what you are facing and you've got to know what is the norm and the norm for a lower molar mesial root of a lower molar is not two canals that is not the norm that is maybe ten percent uh of what you're facing so uh you gotta have this knowledge you've got to know what you have to do in order to get good debridement shape it minimally or maximally whichever way you want to do but the shaping is really for your observation convenience form and again i i since i have an mba from ASU i can see markets they always segment um you know if you're trying to target um say you're doing dental marketing and you want to do a bunch of implants so why are you on Instagram to a bunch of teenagers i mean i think the implant market a bunch of old people and that's direct mail and um you know um but market segment on price i mean look at look at houses you can have everything from a mansion a three bedroom a one bedroom an apartment you can live in a van down by the river same with cars um there's market segmentation but um but you personally ben you're uh you're a wealthy man um if you were gonna get a molar root canal um i'll hold your feet to file if you were to get a molar root canal would you want it done with a minimal shaping minimally invasive and gentle weight procedure or would you go back with to your magnum opus the .04 taper wave one shaping and routine irrigation what would big ben does anybody ever call you big ben after the London clock are you the big ben of endo the uh i've been i've been called almost everything some of them not so nice i want to correct one thing you said you said the 0.04 taper was not minimally invasive i will disagree with that uh because number one that instrument came down to size 15 1504 the natural progression of taper in a root canal system is about 03 to o5 so 04 just by picking off the top of my head is right in there yeah yes some of them is enlarging a little bit but an instrumented mesial root of a lower molar will look to you like a 2504 taper once it's obturated with paste filled and single cone because that's what mother nature gave you so that really was minimally invasive now if you used a 35 and a 40 and stuff up well now you're getting out of that program but ben johnson if ben johnson needs a root canal anytime in the near future it's going to be done with the best that we have to offer at this point in time and that's going to be shaped about halfway to two-thirds of the way down the canal minimally i would say 2006 maximum 1506 is okay with me and then it's going to be cleaned at this point in time it'll be cleaned with general wave now i they have a couple of different protocols now they have a reduced time protocol i would not do that i would use the full eight minute uh system i want to make sure everything's out of there before it's obturated that's what ben johnson would do right now okay so you're saying um so you answer the gentlewave um question um i mean obviously it there's no question that's an amazing cleaner in fact when i was lecturing in Israel um i saw another uh guy demo something uh very similar with um kind of look like the old micro air abrasion units we had but it was under high pressure water and when he gave me the demo i mean the hair on my arms stood up i mean just i mean um okay you answer that but what about the cbct um what um what percent of molars um with that endodontist i mean is that a is that a standard you want a three-dimensional film on every molar done or every tooth done is it um is it just for failed endo well for me that's every yeah that's every treatment every surgery i would do a cbct so that i know what i'm facing before i go into it not preoperatively on just a regular referral like every re-treatment and the reason i'm asking i mean i obviously know the difference between talking to ben and Stevie wonder i mean i totally understand that vision is but when you talk to a lot of oral radiologists they do not like all these cbct especially on kids getting screened for ortho they're like are you out of your mind uh some of these kids have already had you know two or three cbcts before they get out of high school and the oral radiologists uh they are not liking that but uh um my gosh um uh shoot you uh gotta go i could talk to you for 40 days for tonight ben do you think there's anything um that um i should have asked you when i had the man on i mean i got the big ben of endo on and i'm just hoping i didn't uh forget any uh big obvious questions um no yeah i don't think there's anything that you haven't asked me uh i i would say one thing particularly to general practitioners viewers it's always been my philosophy is do the best for the patient so if it looks like it's too long too curvy too calcified to whatever call your local endodontist you know don't right don't get into it and screw it up because kids when you come out of school i love your bright-eyed and bushy-tailed ambition and you want to learn undone Invisalign and period you want to learn it all but by god you can't there's only so many years the goal of dental schools is to turn out graduates who are competent that's stated in their goals they are competent to do this this or this did not say proficient so you only gain proficiency once you get out of dental school go to ce courses hands-on courses visit i mean like you say i i'll offer come out see me you know come out and spend the day watch but i got i got two i got two final questions i want to hurry up on because i don't want to miss out on these questions number one um these kids i mean they're in the middle of the pandemic they the class of covid 20 uh 2020. i mean we just graduated 6 500 dentists in the middle of the pandemic and a lot of them are thinking um to put in perspective on the classified ads on dental town we've always had about 1 000 practices for sale and about 5 000 jobs posted for job now there's 2 000 practices for sale and only 1 000 jobs a lot of the guys over 60 you know if they if they'd never lost their money in the stock market or divorce whether they're like i'm done um so um jobs are tough and a lot of are sitting there thinking maybe this is a good time to go to specialty school and there were eight when i got out of school now there are nine now there's uh 12 there's um but endo is the number one demand i mean oral surgery endo are the top two specialties that all the dsos are bringing in that's the highest demand and then to a much lesser extent period pediatric dentistry ortho proctological external anesthesia oral facial pain oral medicine oral path oral radiology and dental public health my question is what would you say to a dental student who's thinking about wanting to be an endodontist um do you still think 2020 if she's 25 years old at 2020 to being endorsed you think what does the future for her look like in your opinion actually i think it's i think it's i think it's very good uh i think very good for several reasons there's always been if you just take endodontist as a group you know why are general practitioners allowed to do endodontics it's so complicated that i mean that's a group thought process well number one if you take the number of root canals done every year and divide by 6 000 which is about how many clinicians we actually have in the u.s there's no way endodontists could handle the demand so that's a ridiculous thing now there's some concern that things like uh well rotary nickel titanium and or let's say uh general wave this is this is going to make endodontics so easy everybody will be doing it that's never happened it's never happened it increases our body of knowledge so i think i think the diagnosis the implementation the treatment i think endodontics this is the best time in the world in history to have a root canal and uh so i think the need is going to be there uh so if they're thinking about going to graduate school let's be top of my list but having said that howard i got to tell you i've lectured to graduate students for a long time now and the students that i see now when i go in to talk maybe it's just because they think i'm full of manure or whatnot but i don't see the attentiveness there that i saw in the early 90s in the early 90s it was like there were sponges wanting to soak up information now it's like they're bodies who just want to get out of class i don't see the ones i don't see the desire to be excellent 20 25 maybe the other 80 percent just want to do their time and get out and that bothers me man along with your graduating classes uh i talked to uh just this morning to a professor at one of the dental schools he said their graduating class is graduating having done endo only in plastic blocks i know and i think that's and the price double when brad Gelman and i were at umkc um in the 80s we had six full-time endodontists for our deal and now the tuition is five times more and they have one endodontist for the whole damn school and they're charging him a hundred thousand dollars a year so of course he wants everybody to do it on a plastic block i mean how did they triple the pro quadruple the price and cut the number of endodontists and say but i want to add but i want to go back to uh leave uh your um endo to uh business um you know when i when i look at the dental data of cells around the world it um it seems like dentistry grows with the growth of the economy i mean and economies have been growing one and a half to two and a half percent a year because governments are just completely incompetent but even within that the only double-digit growth i see is in clear aligners and uh and implants and um when you look at um dense fly i mean like 40 of their sales comes from the two channels they sell direct the tulsa dental end endo and the astrotech dental implants um what does that say for the middleman dental manufacturer we're talking about sam walton sam walton disintermediated the middleman and to tell you how brutal was when um when these big paper towels and toilet companies and toilet paper companies they wouldn't sell direct he said well this is the united states america there's more than one company that can sell toilet paper and paper towels in fact when those guys wanted to get back in this grace no when you drive down to Bentonville you will see large headquarters of these big fortune 500 companies who went there and built it because they didn't have a contract but they figured we missed out on the biggest distributor and maybe if all of our employees live in Bentonville Arkansas going to church in school whatever maybe sam will eventually forgive us i mean um but what does that say to the middleman of shine and Patterson and Benko and Burkhardt when dense fly is selling direct on their tulsa dental endo and their astrotech dental implants i mean um and none of these big companies like they don't sell direct on amazon but when you go to those dental schools every girl in that class has got the amazon app on her phone and uh so what does that say about the future of middleman distributors are they here to stay or do you think they're going to get disintermediated in the future or are a balance in between where is this going well they're going to they're going to be diminished uh that's a definite um number one i started selling direct because nobody would take the product and when i became successful everybody wanted to take the product but uh i tried with a couple of little distributors down in Georgia but uh the dental dealers are order takers and that's all they are they're order takers you can't expect a salesman to be proficient in 5 000 products it's not going to happen so uh we started selling direct you know you order by three o'clock you get it by ten o'clock the next morning paid by credit card we got our money everything is fine uh now just no longer calls it's just internet so it gets shipped out quickly and you mentioned shine in there well china's got brassler that's a direct sales also you've got uh agendo that's direct so most of their endodontic stuff are going that way existing products gotta purchase paper points uh you know anybody's got those and dental dealers have their have their use because if you're out oh my god let's call Patterson and get it delivered right away so they're there but they're not going to be the major source of distribution and howard i got to go oh okay hey um if i i know you go to um arizona lot with uh dr mcclammy but um my gosh after listening to you i would love to uh talk to um uh bhajan Bergheim of uh CEO of sanendo and your endodontist buddy right here in arizona tom mcclammy because you guys have so many great stars but uh hey thank you so much for all that you've done for me personally and for dentistry from let me come visit you and i had hair and helping me and everyone you've done so much um you're just i mean you are you're the maestro of endodontics and uh thank you for being the maestro of endodontics well i appreciate it thank you for having me

Category: Endodontics

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How to perform dentistry faster, easier, higher in quality and lower in cost. Subscribe to the podcast: https://podcasts.apple.com/us/podcast/dentistry-uncensored-with-howard-farran/id916907356
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