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Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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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1493 Dr. Francisco T. Barbosa, Founder of Periospot, on International Implant Dentistry : Dentistry Uncensored with Howard Farran

1493 Dr. Francisco T. Barbosa, Founder of Periospot, on International Implant Dentistry : Dentistry Uncensored with Howard Farran

11/4/2020 4:00:00 AM   |   Comments: 2   |   Views: 411
Francisco Teixeira Barbosa graduated from the University Alfonso X El Sabio in Madrid, Spain in 2004. He moved his practice to Barcelona where he continued his education at Escuela Superior de Implantologia and as a dentist at the Maxillofacial department of Hospital del Mar at Barcelona. At the same time, he started his private practice in Barcelona and also finished his degree in Advanced Oral Implantology at Loma Linda University in Los Angeles. He graduated with an MBA at ESADE Business School. He is the founder of Periospot, and is also the Global Customer Success Manager Clinical DSO at Straumann. Dr. Barbosa specializes in digital and implant dentistry.


VIDEO - DUwHF #1493 - Francisco Barbosa


AUDIO - DUwHF #1493 - Francisco Barbosa


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*Please excuse any typos as this was digitally transcribed.

It is just a huge honor for me today to be podcast interviewing Dr Francisco Barbosa DDS NBA all the way from Barcelona Spain he graduated from the university Alfonzo xl senile Madrid Spain in 2004 moved his practice to Barcelona where he continued his education ask you less superior dm plantagio in Barcelona I’m so sorry i know I’m butchering your name next time you see me you can just punch me right in the nose um at the same time he started his private practice in Barcelona and also finished his degree in advanced oral implantology at Loma Linda university which is like a six hour drive from here uh he graduated with an MBA from Assad business school and he's the founder or co-founder of peri spot which is specialized in digital implant dentistry uh my gosh um i am such a big fan of yours um you have so much your YouTube channel is so huge and um i mean you got thousands and thousands of subscribers uh thank you so much for coming on the show today cisco uh it's a real honor to have you on the show no thank you Howard for this opportunity and thank thank you for for having me and also for your kind presentation and introduction to myself so it it's really an honor to of being and participate on your uh internationally renowned podcast everybody listening wants to know how you really pronounce your name so i want you to say your name i said Francisco Teixeira Barbosa now now say it like your your mom would say it hello wow i could probably I’ll be the cow that jumps over the moon twice uh before I’ll ever be able to say that um first of all um let's get candid this is dentistry uncensored let's go right to the beef um the world's in the middle of a pandemic and we're on the other side of the world i mean you know the the western hemisphere with the Americas only has one billion people you're on the side that has seven out of eight people and we're hearing in the Americas um that Europe is uh having a second wave but Americans can't believe anything in their newspapers because it's uh you can always tell when a politician's lying because their lips are moving and whenever you read it you don't know if it's true or not what's it look like on the ground to you in Barcelona Spain do you see a second wave or is that hype yeah the thing is that you you you cannot feel it uh because i i don't work in a hospital and uh but the thing is that there is there are coming some more restrictions and you know we we have now you know this uh this uh start off that you cannot meet more than six people you you all the restaurants are being closed for the last week so they are going to be close i think that two weeks more and uh and we have some more restrictions so uh from 10 a.m from 10 p.m to 6 a.m we should not go outside and this i i don't know um until we will have these restrictions but now we are we are taking it more seriously because in the first wave i think that we didn't took it so seriously and you know what happened with it with all the the people that died here and and now the the the caesar people so i think that right now the politicians are taking it more seriously uh i i i see it very far away you know a complete lock down like in the first way but because you know that there were a lot of consequences economical consequences and i think that politicians could not take um could not overcome another another uh second lockdown complete luck then and uh but we are seeing some small restrictions every day uh and they are trying everything just to reduce you know the curve and trying to get down the cases everyday cases uh the daily case is down but um on the ground you cannot feel it uh the thing is that you just see that you cannot go out for dinner you just you you have to it's a a.m to go out for a run but everything the rest is more or less the same of course you know you you you you if you see a friend you have to you you have to celebrate with your elbows so we could we keep doing this kind of things and you know this this new way of uh this new reality that what they call you know that is at some point is i i i completely i i do not agree on this new reality i think that we we will overcome this and in the near future we will will come back to you know to the old reality that we're that we would like to be again yeah and uh yes i absolutely agree that what you see in the news it cannot be maybe it's not so true and you know sometimes they overreact and and yeah but on the ground you cannot feel it but in the hospitals people that work in hospitals they say that they are they are starting to see a lot of cases and they are stein start to starting to be collapsed and by the way if you if some of the kids listening want to know um what does that mean when Howard said you know you can't believe the news um if you're still young and you believe the news please go back and read the book manufacturing consent the political economy and the mass media by noam Chomsky that was the um you know when you when you look at economics for me Milton Friedman Nobel prize winner who wrote the book free to choose and got a Nobel prize and explaining that all in place from his monetary policy in media the Milton Friedman would be gnome Chomsky and if you're a kid and you're and you're listening to whatever news source there is on tv it doesn't matter what country where you're at read the book manufacturing consent the political economy of mass media because i actually own a media company and it's hard to keep my mouth shut because you journalism competes with just people buying the media i mean i mean there's articles in dental magazines that are basically the instruction from the bonding agent kit i mean so so read manufacturing consent uh by noam Chomsky but anyway uh but but you said um you didn't believe in it um what what is um what do you what do you I’m wondering this I’m 58 so I’m almost 60. you're a young kid you're only you're what 41 uh so I’m uh I’m old enough to be your dad especially since I’m catholic you only have to be 15 to be a father if you're catholic but um at 40 years old do you personally fear you catching the coronavirus out there are you scared of it or do you think it's hype and exaggerated where where do you because you're a smart smart surgeon yeah well thank you for you for your words kind of words but i i have to tell you my story uh I’m February i was really training hard i was i did one marathon and eight eight five marathons in February and in the first week marathons in one month eight in one month eight half marathons and one marathon in February i did it was i was training really hard and in march in the first week of march i started feeling a fever and i started feeling very very bad i went to bed and it was corona so i was sick for corona and i was i was in bed literally for three weeks you know almost two weeks of fever really high fever i could not recover i was really feeling very bad so i felt in first person what corona is and i can tell you is it's really serious disease you have to be really well prepared and your body has to be strong to overcome this disease because i was you know at that moment i was really prepared because i was physically i was you know with a lot of sports i was really really uh in good shape and this corona almost took me to into the hospital because i i i was really feeling bad i could not eat i could not almost walk uh i just going into the shower for me was like climbing the uh climbing the the kilimanjaro so it was a huge effort for me to do anything i i barely could write an email so for me it's really serious but the thing is that people you know around in my family i have five kids and uh five kids and oh yeah that's five kids yes are you catholic or catholic yeah yeah catholic traditionally traditional catholic all my family they are catholics and yeah and so yeah we are here we have uh yeah so we we are we have a big family we are like the kelly family here in the in the neighborhood and um and of course you know two of my kids they they have some symptoms of corona uh they went with fever but it was it was not as so bad as myself and also my wife she only had you know uh small symptoms of corona and also it depends on the person how corona can attack you and i really don't know why on my case i i was feeling so so bad so when someone tells me that corona is a is a disease that you have to take care i i really i strongly recommend you just to to stay away from it as much as possible and avoid it until we have the vaccine because you never know um if you are physically prepared to to you know to to get this kind of these buyers because we we we we we do not uh yet understand uh how wha what is behind this virus on how powerful it can be you know because it's really strange that it it attack your lungs but then suddenly you can have a troubles it's it's really really a very complex disease yeah i um i actually talked to a coronavirus that was leaving my body and he said that there was so much uh radiation mercury sodium hypochlorite tooth dust eugenol latex methyl molasterite and acetone that the the virus gave up in my body and just said it was too toxic for him to live there he said he was gonna go try to find some healthy person like you where he wanted to live but he wasn't gonna live in my body the last time we um talked was actually four years ago when you wrote that article immediate implants tips for improving the outcome in the aesthetic zone by Francisco texiera Barbosa and that was an amazing article um i've always so i my brand when when i think of you i always think of implants uh i just think of uh your YouTube channel has so much implants is is that really you i mean are you mostly an implantologist yeah yeah I’m very focused on on on implant industry but also on the digital dentistry also on the work digital workflows and how to implement digital workflows into the old ecosystem in implant dentistry so this is my this is my main field of work of course i i can do other things you know i can do period surgery i can do some you know Winston thief i do some uh oral surgery but you know my my inspiration and also where i when I’m focused when i and when i go to to study scientific articles i i I’m very focused on implant dentistry mainly um so his websites um he's got um i'd recommend go to periospot.com perio spa think of periodontal diseases spot period spot but on YouTube my god he's got an incredible YouTube channel and it's youtube.com and uh why don't you change Francisco texara Barbosa to just cisco or the cisco kid uh that that might be easier did you ever hear that song uh cisco kid no cisco kid no no oh my god that was one of my favorite all-time songs graham it's it's by the band war uh have you heard that Kyle cisco kid oh yeah it's called six cisco kid and uh every time seriously every time i see your name or I’m watching one of your YouTube channels the incident i see Francisco i think of the cisco kid uh I’ll hear oh ola I’ll email you the uh song so you can see it but it's truly uh one of the greatest songs but where does your where does that of all the things you could do in dentistry um why what was your infatuation with uh dental implants why why was that uh where you kind of uh uh landed on and stayed well i i have to say that my my inspiration for for implants i think that it was the first time i saw Maurice Solomon on stage you know oh yeah so it was such a huge impact and when i saw him and and then 10 years after i met him in person and and we could go for a dinner and i i felt he was so such such a close person you know but when i saw him the first time in on the stage lecturing about implant industry i said to myself oh my god i i i i want to be like this guy how he communicates how he delivers the message how he makes everything simple and and and how how with the passion you feel that he has passion for why are we what is he explaining what and what he's doing that i i i i saw myself you know on the stage also and and doing the same thing and i visualize myself and i foresee myself and in some years uh doing the same down marissa but of course you know in such a such a high level but on my on my on my my on my own uh you know events so so i finally made it man but it was my my my my my my strongest inspiration it was definitely Maurice Salama yeah love Maurice um he's um managing partner of uh Goldstein Garber and Salama uh they sold their practice to my very good friend rick workman CEO of heartland dentistry and I’m pretty sure the only dentist on earth who has a billion dollars and um he's also the um now the owner of dental up and he's also if you're listing Maurice you've said you're going to come on my show like three times he's always so busy he's always like oh yeah yeah I’ll do it next week and then next week falls five months later I’m like dude it's it's past a week now oh yeah yeah absolutely I’ll do it and in fact when I’m in Atlanta last time i was in Atlanta i didn't even call him make an appointment i thought okay this guy's way too busy um last time i saw him i just walked in his office unannounced i was on a layover in Atlanta and he said you got three hours the first thing i thought is oh my god i can get to the 600 galleria parkway sweet 800 Atlanta Georgia and back but yeah just a great guy love love guys like that um trying to make the profession um better um so um on implants um you said you pull wisdom teeth you said you do surgery I’m always finding kids who pull teeth do extractions actually say they love extractions but they're afraid of implants and i was wondering if you could kind of compare what kind of extraction skills would you need to be able to be an implantologist and when i say implantologist i know when you go to the big meetings the big sexy thing is the all-on-four and all that kind of stuff but I’m I’m in real world you know in my world for every one time you do an all on four you do a hundred all on none it's called a denture and um and most implants are placed one at a time to replace a six-year molar uh but but what type of if this kid can do extract this type of teeth what would what would be equivalent to him placing a single implant to replace a six-year molar or a bicuspid i think that you know the the most important thing that you have to know when you are getting into uh into implant dentistry is that you have to be very careful in choosing the right patient for the implant dentistry for your first implant so it has to be a very suitable case you know that you you know quite well the an anatomical limitations that you have the bone of availability the medical conditions of the patient and also the willingness of the patient to collaborate with you in this surgery in this first surgery so i think that you know doing an implant and between me and you is is is a very straightforward thing you know it's it's it's drilling something in the in a hole that is the bone he's drilling a hole in a bone and then placing an implant that you can compare to a screw at some moment of course but we have to respect biology and and of course you have to respect all what happens all the events that happen you know after you place an implant we are with all due respect but at the end you know the surgery uh of replacing one teeth one thing of tooth in the posterior region you you really should understand you know that the first thing is to choose the right case and have a correct uh risk assessment of the case you know there is there is this publication the the you know the sac classification the iti for me is my favorite assessment tool that you can go through and you can you can you can check you can do a sort of checklist before you go to a surgery to to check if your case is simple complex a straightforward or an advanced case so if you see that your case is a straightforward you you can go for it but of course you you need to know about you know uh anatomy you need to know the limitations and atomic uh structures that you cannot touch or you should not invade and this is i think that the most important things that you should know it should uh should understand and also have a good mentor have someone you know that is over your shoulder helping you at least during the first surgeries and I’m correcting you and if something goes wrong is is there for you i think that this is the most important thing uh uh for for for someone that wants to start an implant industry by the way you even have you even have 10 000 followers on uh twitter at cisco underscore research and i love your twitter handling how you have father of five kids you have five little smiley faces but i noticed you always say to maha DDS two maha two t-u-m-i-n-h-a underscored DDS what is toumen hot DDS oh this is you know to me to me yeah it's how we say in portuguese uh you you you spell it to menia it's how my family calls me you know they do not call me neither Francisco neither cisco they call me tumena and is that just you or is that what they call all dads no no no they call me to menia because my first words when i was born when i was a baby one year old or one year and a half i only could say to mania two i just could only say two mina two mina and everyone started calling me tuminia and my sister calling to me and to me at media and this is how my family calls me tuminia yes i wondered what that was i thought i had something i didn't understand uh that is so cute uh my god that's adorable uh and i was also curious um here um the big first holiday of the fall is halloween at the end of this month and i was wondering is that a using or do they have halloween in portugal yeah or Spain we we are we are sort of importing this these traditions and i really like and enjoy it to do you know to import this tradition for the us i think halloween all my kids they are really excited about halloween uh of course we would like we have a party on saturday but we have of course with the corona some restrictions on the number of people but of course i will go with my freddie mercury outfit so so yeah we we are we are start celebrating these things and and i really enjoy it i i hope that in the short term we are also important thanksgiving you know also because i think that is a beautiful a beautiful uh way to celebrate in family uh you know uh and you are you always see these these films where people celebrate thanksgiving and you see this is quite familiar and i feel jealous about these these traditions that you have in the us and we don't have and at some point we are start importing these ones and the first one is halloween because it's quite easy and for the kids it's such entertaining you know you go knocking on the doors and and you receive a lot of candies so for them it's just an amazing day and they are really society so uh this tradition is already implemented in the at least in Spain uh in the big cities so and and i hope that in the rest of Europe they they are going to start also as well to to to implement not not at a level in the u.s because in the u.s you are you know it's its top level but i think that we we are going to start importing this this this this this kind of traditions and thanksgiving it would be great as well you know we i love i love the turkey so you know and i tried to cook one turkey uh last christmas and it was not so successful that's why when i see that perfect turkey that you you cook during your thanksgiving i i feel a little bit jealous about you know the us and all the us food and traditions yeah at some point um when i look at um um you're a master uh consultant with uh strawman uh you're uh you're the co-founder of perry spa but you're a global customer success trainer and educational manager strawman and i and i wanted you to look around the world because it seems like um when you look at some of the data i mean some of the data is showing that like in countries like korea germany Spain brazil um one in ever three out of four dentists place an implant every month and then you go to the united states and it's like yeah that's true with all the specialists the periodontists and the oral surgeons but it's kind of the opposite it's almost like three out of four dentists did not place an implant net last month do you see that trend uh do you see that around the united states and the world or is that closing in or going away what does that look like to you i think that you know the implant growth and the implant implementation and also the yeah and also the implant trim treatment is going to be uh you know a a very very common treatment in the in the near future in the united states you know there there are of course countries like Spain or south korea where implants are so popular where the ratio for implant per per 1000 implants it's so huge and then you go to other countries or for example the uk or the us that there is there is so much room for improvement that uh you know that they will come to uh to uh they will come to some to an end that there will be a uh you know you you you you will finally catch up i i think that the us will final catch up definitely the the spanish and the south korean numbers and you see that you know the the the popularity of the implant saga are going to also to to be much more are going to increase in the next and the upcoming years you know because uh more and more clinicians are open we are now the dsos and you know people in the seos they they have also internal trainings to train people to enable need these gdps to start you know with implant distress maybe you start restoring then you start doing your first cases you know easy cases and then you finally you you finally become you know like an oral surgeon 10 years later and you are doing for archers so i think that you you you're definitely in the us in other countries you will definitely catch up and we will see that you know the implant is going to be a mainstream treatment in in the in the in just in the in the midterm in in any country and what do you think is the main driver of why we see these uh discrepancies in uh implants placed per thousand among different countries what what do you what do you think is driving that mostly i i think from uh what i could say it's uh it's one point one one one of the factors could be cultural really uh because you know here in Spain we are the dsco one of the biggest yes yo in Spain they are more than 20 years old they began more than two years a year ago and they like democrat reside the democratization the implant dentistry so they convert implants in a commodity in a sort of commodity you know it's not more anymore a luxury uh treatment is a commodity so it's something that anyone in Spain can access so anyone in Spain can have implants because there are you know a sort of conditions or a lot of clinics that do implants and also the prices that are as you have so many competitors the price of the implant is is lower than in the us and in the other markets so you you can really go for an implant treatment with a reasonable price compared for example in the u.s and i think that in the u.s when you know the competition starts really being more tightening i think that the prices are going to be a little bit lower and i think that is going the property will grow uh this is can be one of the factors culturally of course training education is is a key you are having a proper training education a proper training education offering to the to the to the dentist so they can start uh being educated on implant dentistry not not only after uh finishing the dental degree including inside during the dental degree when you have a student dental degree you should already have some knowledge about implant dentistry and after finishing you should have a huge offer of courses and also graduation or master's degrees so you can learn and start with implant dentistry and i think that training in education are that is definitely one of the drivers for this growth um yeah i when i um i did a podcast with uh uh marco de gola yeah of course yeah and um my gosh she um i uh let me try to uh read this a little more clearly uh dental implant penetration by country um and by the way to the kids out there you know if you buy one share of stock by law from the uh sec security exchange commissioner they have to mail you their 10q quarterly report and 10 qs are allowed to be optimistic or hopeful in the piece and then they're year in 10k and the 10k you can't exaggerate you can't be optimistic it's just the facts do not read the 10 qs there's too many companies and just read the 10ks but let me tell you something when you read the 10k of patterson and shine and dense fly sirona and strahman and i mean my god these are the biggest companies in dentistry telling telling wall street who's invested billions and billions of dollars and they're just priceless and it um but like but like straw men on when i was talking to marco last time um i mean my gosh um dental implant penetration by country per 10 000 population so the highest one is south korea and it's like like 400 and then it's Spain where you are by the way um in u.s history class Spain and portugal used to be one country then they broke up then they got married then they got divorced it's kind of in and out of one country or two is that right or wrong no it's a actually it was portugal is the most ancient country in Europe with the actual frontiers borders so Portugal was first before Spain because before Spain was splitted into different kingdoms and Portugal was already a former country before Spain get together these kingdoms get got together but but yes Portugal was you know a sort of a gift of a county to a french let's say a french [Music] knight we say a night yes a night you know like a french knight so um and he he convert that country into a country that is Portugal so so that was my that was my first trip outside of the united states because i went to catholic high school and they were always trying to get all the boys to be a priest and all the girls to be a nun so they would fly you at 16 they rented a 747 and they flew all the boys to Fatima Lisbon Portugal to Fatima and then we were at Fatima uh for 10 days and um and the whole deal was trying to get you to cancel your plane ticket home and my two sisters they did it it worked on them they canceled became nuns they're still catholic nuns um but i came home um mainly because i wanted to see this blonde girl named jane who lived next door to me but anyway enough that um so south Korea is number one at like it's like 400. then Spain is next and in my walnut brain Spain Portugal then Italy then Germany then Austria then by France you're at about 50. and my god by the time you get to i mean then you got Sweden Netherlands then you're at the us and i mean we're um the only person smaller than the us on this chart is Australia um Australia so i don't know what they're doing down under but it probably has something to do with a koala baron and kangaroo but i mean when i look at the us penetration of dental implants per ten thousand people i mean my gosh it's not even a fraction of Spain and south Korea why why why what explains that huge discrepancy yeah i think that mainly i think that yeah definitely i uh there is a lot of room for or for improv for growth in the us and i think that is you basically i think that the tne offering i think that there is a huge room for for improvement for not not not in the quality but in the quantity uh on enabling these uh these dentists young dentists into implant dentistry and also i don't know how is the regulation there on the implant density side and also i think that from the legal point of view in the u.s you know when you have a problem with the patients which is something that happens very often compared to Europe i think that maybe is an obstacle or a roadblock for for some uh for some dentists you know to go into a implant dentistry i think that you know it's not the same to have a problem with a dental feeling or to have a problem with an implant it's much more serious so i think that the dentist maybe they are not feeling encouraged and having a legal problem with a patient with an implant and they prefer to stick to you know to to more simple and conventional treatments instead of complicating themselves with with more complicated treatments but of course at the end you know you you you you have to choose you if you are if you want to progress in your professional career if you have to grow and you if you don't want to end up with 60 years old only doing feelings so you have to move on and you have to specialize yourself into orthodontics into endodontics or into implant dentistry so then you have to overcome these roadblocks but i think it's culturally but also the the tne offering i think it's it's it's key it's key well you know how some people want a vaccine for the coronavirus i just want a vaccine for lawyers uh could we uh could we cure the legal disease before the coronavirus i think i think most Americans would agree with that um so um it just um so back to the uh the uh the lawsuits um the way i see the the the um um the lawsuits it's really more the dentist's fault from psychologically like if you go get your knees or your hips done the doctors clears a bell tell grandma okay it's 50 000 to get a new hip um knees are uh 10 000 a piece and if you're lucky you might get five or seven years out of this here's a dentist i swear to god if i place an implant there you'll end up taking it to heaven someday it'll it'll last the rest of your life and then 10 12 years later it fails but she thought satisfaction equals perception minus expectation um when it comes to pain i mean i always lower expectations every time i pull a tooth i always hold it in front of the page and go cisco look at the hook on the end of that route i swear to god it was hooked back behind your eye when this thing wears off i hope you have a gun because you're going to want to shoot yourself and I’m sorry about that man and they're just like prepared for rock bottom and then they come back two weeks later ago Howard it didn't even hurt i mean i and when they say well after that root canal can i go back to work go back to work dude you're gonna wish you were dead after the root canal you're gonna wish you were never born okay you're probably oh my god go back to work so you lower their expectations and then when they jump over it you're good and i think the problem with implants i mean i mean match it cosmetics you know the a girl will break out frontier and say well can you match that one and i say okay look god made this one and a short fat bald guy made this one uh so far no one's ever accused me of being god but if you think i can do it as good as god you're you're the first woman on earth that ever said that so i i say well hell no i can't make it look just like that one because I’m not god and and then so their expectations are all low and then i do the best i can and then i and they're expecting a nightmare then they get to be like oh my god they're all happy so i think a lot of the dental lawsuits are dentists raising people and that's salesmen everybody hates salesmen because they over promise under deliver and you have to under promise and over deliver and that's why no one likes a used car salesman so how do you how um when someone replaces an implant how long should we say it's gonna last so we don't get them thinking they're gonna take it to heaven when they die someday you know i i absolutely agree that we should be better on managing expectations with patients i think that is also our fault when it comes to manage the expectation with patients and i have some tips on that like you have then you just share and for example when I’m placing an implant to a patient and for example during the surgery I’m already suturing but I’m telling the patient you know uh now we are going to start drilling the hole just to place the implant I’m explaining in but I’m already suturing and it thinks that i am starting to place the implant and I’m already suturing and then after you know 10 seconds and i say that's it you can go and you say oh my god but you just tell me that you are going to start you say i was you know just to just to just to make you uh feel a little conscious for one second and in 10 seconds you just say no it's finished you i you are that suitor you can go home and it's it's a sort of you know to manage uh in in in place with the patient and and to make them feel you know a relationship of trust with you because you and even when during an extraction when it gets complicated you can you you already remove the teeth and you you you can tell to your patient hey this is going to take longer than i thought I’m sorry for that and you and the truth is already out but you can tell that to the patient and the patient said okay it's fine but then you just you know 10 seconds later you can chat to the patient it was a joke the teeth is already here you can see it and go home and he is going to feel so happy and he's going to he's going to be your patient forever you know so in that part i absolutely agree with you that managing your expectations next potential is really really really important when it comes to what we can promise to the to the to the patients it's a look there is an important factor and and there is some articles that support that you know brand matters you know it it is all the brands the implant systems they are not the same and there is scientific data that proves that um also i think that we have enough data to say that the survival rate of the implant that I’m not talking about success and talk about survival rate after 10 years is go up to 98 depending on the brand that you are using but 98 of of the implants are going to have a survival rate so you can tell to the patient you know 10 years you know you should not have problems we have a we we we have a success rate of more or less 98 to 10 years after that of course there are no no now long-term studies and that number goes a little bit lower but this should be you know the um this should be the the ideal case scenario but of course it depends on the patient because in this in this research in these publications then you have the inclusion criteria and this is something that you have to read very carefully is it a smoker what is the medical condition of the patient it's not the same place and an implant in a smoker not in a non-smoker it's not the patient it's not the same place and placing an implant in a patient with aci or ac83 or a patient with some you know diabetic or other systemic disease so you have to consider this and talk to the patient in you know in a different every patient is one different situation so you cannot uh manage the expectations of a patient that is a diabetic with a high systemic disease and uh smoker than a patient with 24 years old and is healthy and you know with completely uh and you know andy is also with with good habits so it's it's completely uh depending on the pension so when the patient tells you it's going to last forever you you you have to say that no this is not going to last forever of course if your patient is 90 years old you can tell me and you can just no clapping in the shoulder and say this is this is going to last forever don't worry because you are 90 years old this is going freebore error but if you if your patient is going to ha is 20 years old or 24 you say maybe maybe we don't know you know sometimes you have to to you have to to look at other other medical specialities as you mentioned you know a hip okay or you I’m going to replace your hip I’m going to replace you a bubble in the in your in your heart and in ten years i i have to replace it because you know you need it so you you you are already managing the expectations of the patient so we have to be mindful when when it comes to to these uh expectations and how to manage this with with with the the the the the the patients that are uh that we want to to treat with implants um when you um when you're a strawman and you look around the world um i i think people like architecture and food and all that because i mean we're all humans we all gotta eat uh but everybody makes food differently um i love architecture i mean you just a simple thing like a bathroom is so different in every country um what you're seeing uh with strahman you're seeing dentistry from 30 000 feet around the world uh what what variance uh what variances do you see that we all should do i mean obviously um you're seeing some countries doing it faster better easier more profitable what lessons have you picked up from around the world that the individual person listening to you right now should should learn and adopt yeah i think that there are some cultural differences around the world you know for example when i go lecturing to the to the nordic sweden uh norway uh denmark uh they are much more conservative they are really into perio in to preserve the teeth in through you know uh stick to the to the conventional protocol loading protocols you know placing the implant wait uh three months and then replace and then load the the implant they're very really really careful conservative they will go really for you know how we can say really treatments that are you know already supported in the scientific literature they are not support they are supported by meta-analysis and with uh systematic reviews and these kind of publications and when you go to to the countries more military and in countries like for example Italy or Portugal or Spain you will see much more immediacy you know people they they they search the dentists like to offer to the patient you know you are going to go out of my office with your denture on your teeth and this uh this something this is happening also in the states in the states i think in the united states you culturally you are quite close to that of offering to the patient no immediacy you come to the office we remove your hopeless teeth and you go out to you you go back home with it with your new denture and this is uh some of the difference and uh of course for me there are other parts of the world that i do not know so much but but I’m learning uh about this market for example in china there's a complete different approach on an implant dentistry you know they are big hospitals where they cheat a lot of people but of course they are we're quite open to to all to implant industry and they are really interested in learning everything that comes out on new protocols and uh and and yeah that is my my my my point of view and and also in the countries you know for example uh i i i i i i lecture a lot in south america and also they they they feel a lot of respect to the implant you know there are some just some specialists that place implants not everyone plays implants it's uh it's a it's a treatment that is only performed by just a few people and is not yet so popular at it could be in uh oh you can say a Latino country like uh you know uh Colombia chile or uh Venezuela but this thing but i think that this switch and this this change will happen in the near term so uh this is the main cultural things that i feel uh when i go traveling around the world and when i talk to the different dentists you know that with social media we we can be close to anyone in the world and we can be connected and we have our network of dentists in our social media that we can you know see the difference between them even though even though you cannot travel right now but you you can you can really check with with them what are the difference and i mean and you see that really is it's something culturally no it's a it's it's a it's a mindset it's a mindset um strowman you you mentioned brazil um strawman um um has done a lot of amazing uh mergers and acquisition i i think um i think they've been from a business point of view just incredibly smart they bought neodent in brazil and um why um why did they buy neodent and how was neodent different than strawmen in switzerland and then how does it look now that it's merged into one company yeah i think that is a very good question and i think that knew that it was a really really nice move from stravan uh it was before i was in strong you know it was the in the i i believe that the requisition about 2014 i believe it or 2012 is starting 2012. and definitely 12 2014 or 5 15. but it was a really really smart move because they they really bought you know a really good good product that they want to uh at some point stroma wants to to have you know the value segment uh fulfill the value segment with the implant system and that is reliable that has a scientific background and uh and and also that as other value propositions you know also new then they have ill appear their own university where they can do training education to enable dentists into more you know complex cases and even into more you know more simple cases so i think that the overall package you know with neodent is is really was really a good movement and i think that this acquisition was i agree with with strumming 100 on this acquisition because the product is amazing i i've been placing now three years uh the neodent is a special implant you have to know how to place it because you know it's a and it's an implant that you have to place it super crassly you have to manage you know one abutment one time you know you just place the put money in the same day after surgery it's a it's a system that you have to learn how to manage it but you then you see the heck is race and then you see the how it might it the the bone is preserved around the implant and now you see how all the pairing plants soft tissue and how the pain plant bone is preserved and you say oh my god this system is really great and and you know i mean when you put a new balance you put in the hand you know the the outcome that you have with the with the new event and also uh the price that you can have you know the costs that you can have in the in the treatment we knew that so you you you you can open more you can offer these treatments to more patients with with an evidence and i think it's it's really a nice product uh and uh and for me it it it really helps me you know because i mean I’m in the dental business and for me that is really a a a tool and or a system or a solution there that i i think is really really really helpful for for the company and creates a lot of value um i want to tell you that when you came on the show today i have a hard time recognizing you because I’m I’m used to you on your YouTube channel where you have that white uh sweater on jacket that says a period spot on it and uh you know what jacket I’m talking about yeah and uh so um you're not wearing your uniform i thought you'd have periods but on but what is perio spot and why uh on all your um on all your videos you know you're the perio spot founder what is perispot okay so i i can tell you the story about perry spot because perispot was i i start when i start with implant industry i start documenting my cases and at some point i have you know a huge amount of clinical cases on my computer and i said you know these clinical cases they don't have any value here in my computer and you know all the things that i study all the the research that i read every day every single day all the publications they don't have any value if i do not share what i know with the rest of the world and then in 2008 you know all these social media appear you know Instagram we have twitter we have Facebook and we start with the dental communities with dental groups and i start with a website that it was Francisco purpose implantology.com where i was you know just uploading my case there and it was like a showcase and then during the MBA when i start the MBA you know during the MBA they ask you that you have to to build from scratch a project and you have to create a startup so my startup my idea was you know let's let's let's just you know clone dental xp and make it better that was my idea and i said I’m going to do something like dental xp but I’m going to to improve some some some things and i I’m going to attract a new public into into my new platform and you know you have to create this project and then you have to present to some business angels and if they like the idea they are giving you the money and then and then you you can further develop your idea and you can go for for this startup you know and build the startup the thing is that i present the project to these business angels and they like the idea but you know they said you know this is not an unicorn this is for a niche this is for a dentist only and we are we are searching for a unicorn we are searching for twitter we are searching for uh netflix we are searching for something like that so i didn't get the money but i didn't uh give up from the project because i already paid the platform i paid the web page i put the server i put you know the design everything and so and i said I’m going to start you know creating content and putting content there the the main problem that i that i have you know that now i have some some collaborators but daniel robles is collaborating with me but at some point you know i feel a little bit alone on this because paris but it's it's myself you know creating the content reading writing and now i am some guests posts from other pers other dentists around the world which i really thank you then for for for the but at the end you know you have to put this you have to I’ll do all these illustrations create the animations put it in the website and all these no during the weekend because during the week i have nine to five uh work during with strumming group and then in the weekend i switched to paris spot so you have to you know it's it's uh it's almost working you know uh eight hours per day during uh 24 7. 7 30 65 yeah but you could save a lot of money if you dropped your five kids off at the orphanage have you ever thought of that you know it's funny you know perry spot for me it's not it's it's not it is not giving me any you know the income that i get from perispot uh doesn't cover the the spend so i can tell you that i can tell you that that you know right now it's not profitable it's not profitable if if i put the hours that i put there you i can tell you that it's not profitable because you you we don't have nothing there potentially to sell we just have some affiliations you know when if someone buys an a book or something like that from prairie spot in amazon so we have affiliation links we recommend but that's it so that's the way we monetize perispot but at the end this is my passion because perispot keeps me you know is like and push me to to be updated every day and to read every day you know scientific publications to be updated and to create things that are available and that i can use for other purpose you know then i can use you know for lecturing i can use for training education and i think it's it's really something that keeps me alive well i can say is the children aren't profitable either so just remember that hey i want to i want to cut right to the chase and that is um um perry and plantains are a failure right we're talking about expectations and and on this program at least a quarter of our viewers are still in dental kindergarten school and it seems like almost all of them are under 30. send me an email Howard at dentaltown.com especially if you're over 30 or leave a comment in the section so i want you to summarize for them that they they want to know um in um if you placed um a hundred implants let's say you placed 100 implants what would be the top three reasons they fell i mean we hear so much about smoking we hear about peri-implantitis some people do things where they hook an implant to a you know a natural tooth some are failed because there's cantilevers on them but could you just kind of go through the low-hanging fruit of what you shouldn't do and where all your problems are going to end up on a failure yeah you know it's a multi-factorial and you just mentioned some of them i think that for example as many implants of you place the more likely root you have prayer implantations the less implants you place the less likelihood you have implants per implantitis also of course there is the brand some brands you know there are some uh there is some more likelihood of uh developing a periplantitis then there is the host you know the patient there is a smoker no smoker systemic disease and there is something that for me is really really important is if the patient has any ant incident of periodontitis if a patient just went to your office and he already has a periodontitis and if you do not properly address this problem before you go into implants you will have a problem because you have to control these patients that have periplantatus because they these uh these uh you know this uh uh you know how you can say that the the the the causes that for peridotites also will affect the the implants so the bacterias will remain if you do not address this problem and this is one of the main reasons and there is scientific evidence here when it comes to to you know when you have a patient with pain with with uh uh with peridotitis just treat the the periodontitis stabilize the the disease and then go for the implants and the other one and other reasons is that you know the prosthetic design how you design the processes how you should design uh you should design something that allows the patient to aginize at home the implant so they can have a proper hygiene of the implant so it's a it's a sort of a multi-factorial factors that can affect and can lead to to have a periplantitis uh and and these are for me the main reason and of course there are other reasons when you place the implants where you place the implants in which conditions this does the implants have is surrounded by bone the the position of the implants is is it position in the 3d ideal position is it not positioned in that 3d idea position so it's a it's a it's a multi-factorial ecosystem that can affect the outcome on the medium long term with a pairing plantitis and um would you um you know when you the young kids i mean this is so confusing to the young kids because you know someone like you who is a runner and watches their diet and does everything right they're never sitting in our chair needing implants the person sitting in our chair especially my I’m in phoenix arizona i mean the person in the chair uh my god he's I’m I’m just like I’m just thankful that he's not smoking in the chair you know what i mean they they throw it out on the way in and i got one patient oh my god i love him to death but he always throws the cigarette out as he walks in but his last exhale is in the waiting room um my god when i started out dental school i was referring all these people that i i thought they had a liver problem because i thought i was smelling ketones or acetone in their breath because i didn't even realize that 10 of america are 14 to alcoholic and uh so the people that need all these implants are smoking they're drinking let's just admit they're all irish uh and uh they're smoking they're drinking uh you know they they don't eat right they eat fast food um and she's like are they still patients and on the one hand you know it's their money they have a free i mean a smoker has the right to buy cigarettes and a dental implant but i mean um this health history it just seems kind of bizarre because the worse the health history is the more they need dental implants so what would how are you supposed to think about all that yeah yeah you know this is a this is a whole story and uh it's it's really you you have to be you you really have to inform your patient you know if he's a smoker you have to tell him you know you are a smoker you you if you do not quit smoking you are already you will probably you will have problems in the future with implants and it this reminds me also to my patients you know when when i do some sort of immediate loading and you tell the patient you know you should avoid any kind of you know you should go for soft diet for you know two months and then you just place the implants in place approaches in the same day and you you you come out of the office and you see your patient in the cafeteria eating a sandwich just after the surgery and they say oh my god i just tell them totally about the soft side soft diet about after the immediate loading and is eating a sandwich here in front of me so this is this is the thing that is the patient the factor patient is also is something that you cannot control also you you tell him you know this is the hygienic habits that you should implement i is it going to implement it is any way that you can monetize that yeah we are building tools for that and and at straumann we are now developing some ai tools that can track you know and you can do some kind of checking at home and check the patients from home so that we tell the dentistry and check if they are plaque and if they have you know if they are gingivitis if they are mucus so this sort of tools that can help in uh right now has tracking much more the patient and control the patient but the thing is that the patient also asks has to be asked to commit to a treatment you know when you place an implant to a patient you are marrying him or her and and you are creating a bond and this patient is going to be for you with you forever and when he has a problem or when he doesn't have a problem but we he will be with you forever so you should take place in an implant as a marriage and and of course is a marriage is a two-way around thing is not just one way i commit myself to do my job properly you know to place an implant in the proper position to deliver a prosthetic that is nice and it's good and it's going to deliver the function and but you have to also job to commit you know to get into the hygienic habits if you are a smoker you should quit smoking it's not only good for the implant it's going to go good for your overall overall health and and the other things you know you should control your diabetes you should control your diet you should you know it is like creating new habits and you can you can recommend him even even to the patients start reading james clear book you know atomic habits and let's maybe it will help you to to change your habits so it's it's a sort of you know this factor the patience is something that we cannot control but at some point we have to manage you know what uh is the favorite cigarette among the irish what yours sorry though though their their favorite cigarette is yours yours yeah i get it they bum one from you they don't buy their own they just take yours my grandfather uh the the doctor told me you cannot buy uh any cigarettes anymore it totally you cannot buy cigarettes it was a mistake and he said the doctor and then we told him the doctor said that you have to quit smoking and he said no no he told me that i could not buy cigarettes so i borrowed for you so he was and foreign my grandfather now is 96 years old and he keeps smoking so it's something that you know it depends on the genetics uh yeah yeah my doctor told me the only good pair of jeans i had was a pair of levi's and uh it's all the all the rest were uh were crazy um when you um you know we're in a recession because you know there's 12 months in the year and in arizona we had to close down for two months so when you take revenue for 12 months and two of those months are a zero i mean you're already uh well what is uh uh i should know this top of my head what is a one divided by six i mean that that's already a 16 point you know that that's 17 percent down for the year um so um so money is always important and i always tell people they got an idea hold up your hand is it better faster easier cheaper smaller and if it's not better faster easier cheaper smaller um why isn't it and so when they have failing implants um with with uh peri-implantitis there's companies that advertise a hundred and thirty five thousand dollar millennium laser uh to to help with peri-implantitis and my broke homies are like dude that's a lot of money you can buy a house for a hundred and thirty-five thousand dollars do you think a hundred and thirty five thousand dollar laser is justified and a good investment to treat peri-implantitis or are there cheaper faster are there faster better easier cheaper smaller ways to treat it than with a big laser well in my i I’m going to give you my opinion on my limited knowledge about you know laser treatment for periplantitis i think there is a lack of research when it comes to meta-analysis on the systematic reviews on this topic so the last time i checked there is sort of good results with laser but the thing is that you have to now to ask yourself [Music] is it going to be a predictable treatment in your hands or is something that is going to work in someone that is really experiencing in using laser you know so for me it's uh it's an option and maybe it's going to be a solution for pairing plantations but it has to be something that is easy to implement and easy to learn and is replicable and also reliable so the thing is that if it comes an article that you say that i have a success of imperium planetite is treating with laser off you know i don't know eighty-five percent ninety percent but you you you you you know you you you cannot you you cannot you cannot know if if in your hands it is going to be it is going to be a reliable and feasible as well so for me my opinion uh perimplantitis for me it's a it's a really really hard thing to treat and uh in my opinion and when i when it comes to periplantitis if the parent mentality is that effect is not too big and if it is something that we at the you know what the early stage i try to treat it i try to you know regeneration and i try to you know start over but the thing is that when i see that thing is is is is is uh is not predictable with the defector is a little bit bigger i just go and i i i start all over again i remove the implant i regenerate i wait i place a new implant um another i I’m i call it dentistry uncensored because i don't want to talk about anything that everybody agrees with I’m trying to find the stuff uh that gets you in trouble and gets controversy and debating all this stuff a lot a lot of the old guys uh an old person is just anybody one day older than me um a lot of the old guys um were we we were surgeons we laid flaps we dissected out the mental frame and so we didn't hit it we we did surgery and then we see and we did everything with a two-dimensional x-ray it was a pano and we never had a cbct or an mri in fact we thought i thought the greatest thing that ever happened in radiology was when they figured out how to put a r on one side and an l on the other on the pano so you could see which side it was i mean i i i still think that was the greatest invention in in all of radiology is that left and right thing um but we would lay a flap and we would place the implant and if there's a problem we'd lay a flank now we see these kids with these hundred and fifty thousand dollars cbct machines they're sending a dicom file to the lab they're getting a guided splanned hell they're trying to buy a robot to actually place the implant i mean gosh i mean it just sounds like they don't even want to be a surgeon i mean I’m worried that if you're doing all of that if you have a complication they're not even going to know how to lay a flap and fix it um so my question is succinctly how come everyone that i personally know that's placed over 25 000 implants did the first 20 000 with a pano never had a cbct and they never had a guided splint and now we're being told by everyone who's 40 and under that you have to have a cbt you have to have a guided splint and if you don't you're just a really bad guy and a bad surgeon and when you die you'll probably go to hell so where where where's the middle ground here yeah well here the thing what is science is telling about that and we have an article in 2019 that was really the conclusion is i i cannot recall the name of the how author but it was the conclusion was you know placing implants with hand or with guided surgery you know the accuracy with guided surgery is going to be superior than with you know hand free hand placement okay so the the position of the implant is going to be more accurate when we go for guided surgery but the thing is that message putting the message out there that guided surgery is for beginners it can be a dangerous thing because i can tell you i do a lot of guided surgery and i love guided surgery but i have to tell you that sometimes i suffer and i think I’m an experienced surgeon and i suffer with guidance surgery because you know when you go for guided surgery and you have to place implants in the posterior you have to you the patient has to open very wide the mouth and you have to be you know very mindful about you you know the dreams and so on and if everything is is placed in the in where it should and it's something that we should think about that before you move into guided surgery you really should be training in other things in raising flaps in treating complications in removing a lot of winds on teeth you'll you learn a lot on removing winds on teeth um you know on treating and treating on doing guided bone regeneration learned these things before because you you you can in you know during a guided surgery anything can happen it can go bad and you know the implant can be placed you know in a position that was not planted and you have to you have to solve the situation in the same surgeries so you have to open a flap and you have to know how to do a guided bone regeneration and to place an implant with a free hand and you have to be prepared to do a lot of things that otherwise if you are a beginner and if someone tells you that you can solve everything with guided surgery maybe you are doomed to to to to failure so before moving into guided surgery my recommendation is learn about raising a flap learn about period surgery learn about oral surgery learn about guided bone regeneration learn about prayer implantations learn about how to how to remove an implant learn about how to you know uh fix things in in in the same moment that you have a problem in the surgery because with guidance surgery of course it's going to be well a lot of the the most of the times 99 98 but the two percent of the cases that you mess up you have to be prepared during the surgery to fix that and doing that in a fashion way that your patient doesn't even notice it so this is my message okay guided surgery it's okay you should plan everything you know in a comprehensive way and using the all the digital tools that you have right now available but just be mindful that you have to know all the rest you have to know a lot of surgery and now a lot of other techniques before you move due to due to guided surgery ah that was the beautiful answer so um what i tell the kid but by the way um we've gone over an hour and i know you're um it's 3 30 here what time you're what eight hours ahead of me what time is it there 9 30 you say yes it's uh 11 35 it's 11 35 at night yeah oh my god I’m so sorry because i know the bars close at midnight are you gonna miss the last call for alcohol at the bar um you know um when they when they come out of school um even though they paid a hundred thousand dollars a year for four years they they didn't place a single implant they they owe 400 000 in student loans i met a young lady uh the other day graduating dental school did not do a root canal on a human she only did 12 root canals on extracted teeth in a lab yet it has 400 000 student loans um I’m not talking about how do you get her to place an all on four but how what advice would you give her i mean you know you got to go up the stairway what would be the first steps when you come out of school your 400 000 student loans you've never placed one implant and then here's Francisco on the top of the empire state building how does she just get to where she can place a single implant and in america when you look at the insurance data we number the teeth one to 32 so the six-year molars are the four sixer molars when you look at the insurance spikes just four big spikes on the you know what's the tooth most likely to be crowned the first molar root canal mod extracted implant i mean in america almost more than half of all the dentistry is done on four teeth the four six year molars what talker what would she have to do to be able to place one implant on a six-year molar what what what what path would you give her i would give you uh my advice would be that she she should start with uh with um with simple surgeries you know extractions extraction you could you can start with extractions extractions of period teeth then extraction of some you know windsor teeth then extraction of you know phrenectomy uh you know period surgery you can start with peri surgery regenerative period surgery a small you know these small surgeries uh get used you know to uh to to use the surgical knife and to get used to the surgery and after that you know after you understand how to raise a flap and you feel comfortable raising a flag and also after you you understand what should be the ideal patient to place the implant and you really know how to plan an implant you you can you can you can start with that but also there is one thing that i think is important is after after in the dental school after you finish and and if you want just just find a mentor just find someone that is your godfather that you gonna that is going to be there for you you know you can email him or you can send him a message and you can he can help you in any case in any doubt you you should have a godfather you know uh someone that really is there for you in case you need help and to guide you through the pathway you know to to your to your to your you know where you see yourself in in 10 years and that can help you so for me it's it's it's really that this is really important this part you know this is more the human part of the philosophical part and then the more the technical part that is you know start with simple extractions when the wisdom wins on truth and small surgeries period surgeries but do a lot of that and then you go far for a you know you start placing your your first implant in a molar where you have you know like 10 millimeters of bone with eight and uh 40 millimeters of bone off weight uh of white so i would start with simple cases and and from there you you start complicate yourself and then when you see it when you see in in some years you will see yourself doing full arches but don't don't don't rush the thing is that you should not rush you know if you if you if you have any doubt about any case just refer you out you have to search not your happiness and not your fulfillment on your professional career you have to search for your patient happiness that is to your first goal that should be your first goal so at at any moment that you feel that you are not comfortable what what what what you want to do just refer it to someone that you think that is an expert and it's going to solve and and it's going to fulfill patient expectations um there's so many different implant companies and strawman actually has purchased a lot of them like um like neodym that's the largest implant company in brazil um they um um etcon uh my gosh um so many uh companies uh neoded medentica botus keep naming them what would all did you guys buy mis make it simple implant no no mis mis was acquired by dead supply oh okay this way but i knew it got acquired i had the acquisition right um and then you bought um um clearcorrect right did you bike yeah so do you own uh the whole company clearcorrect yes clear correct yes and uh that is uh that's the big famous all all-on-four company uh right that's that that's what you're talking about no no secrets no no clearcorrect is ortho but yeah but clear choice no no no clear choice is that the seo in the u.s they are customers drama customers but they they only they only place your implants all right you have an exclusive yeah yeah exactly yes so clear choice the largest all-on-four company dsl in america by the way what's the largest dso in uh Europe in Europe the largest usc right now i could say that this colosseum dental group colosseum dental group they are in the nordics and england you know you know the ceo or do you know anybody there yeah his name is uh nielson uh i cannot recall the surname but i know him personally he's a really nice guy in new zealand but yeah um yeah but uh can can you uh can you introduce us via email send me an email Howard dentaltown.com and cc him yeah sure sure i can i can i can i can i can reach you yeah i can connect you okay so so the the thing i was making about um um your acquisitions do what's the short list of uh implant companies that you've acquired neodent strawmen neodent what are they uh this is the these are the main companies that we that we manage right now and so um brazil is uh i mean my gosh it's one of the uh neatest countries in the world have you been down to brazil have you been there no never never oh my god it is just so uh it is just so beautiful it's so cool it's amazing uh but i have to imagine that um strawmen in Europe versus neodet in brazil uh you both made implants for your local people uh did you learn any the the strawmen parent company did they learn anything from nia dent about um what did neodet learn in a country of 200 million brazilians versus strawmen um did you learn anything huge from that yeah i think it was quite interesting because now right now when when you are at stroma hq you know in in in switzerland uh in basel you see that there are um a lot of brazilian people that use it to work in new dent and now they work on stramit hq and this is a great thing uh because you you know there is some culturally exchange there and uh and at some point you know the brazilians they have a mindset that is more a latino mindset that brought to strawman maybe a little bit more you know like this um i could say this mindset of uh being a a little bit more daring uh learning more i i say easter but uh so there is a lot of character that the brazilians uh right now brought into strumming group and the other way around you know with strumming group strawman uh also exported to neo then you know like uh the swiss way of doing things you know that is searching always for perfection yeah and in in all in all the situations for operational point of view product part-time few and uh presentations point of view and you know the management point of view so it's it was a like an exchange a cultural uh exchange but we can say that there was a an exchange in in a lot of layers you know not only culturally and not only management and and on on and other fields so yeah of course i think that everyone learned with with this fusion you know the brazilians learned and also the the swiss learner from from from from the brazilians it was really a nice a nice match well all i want to say is uh uh this podcast is not over homies because you can go to um YouTube user uh that's his child name tomina t-u-m-i-n-h-a-21 and uh my gosh uh i've i've watched all of his videos um he's just uh he's just a great teacher he's a great guy to listen to and uh so switch now to his um by the way Francisco um not that you need any marketing hell you got 10 000 followers on twitter and your YouTube channel but when you post on dentaltown uh when you make a post there's a button there uh with the link with the says YouTube button and on YouTube when you have a video um you can uh click share which gives you the little YouTube code but the next button over is um embed uh on share you you click uh embed and then you drop that button in the dental town post and it's your YouTube video and everyone that does that it explodes their YouTube channel i mean your YouTube channel's already exploded but if you drop in some of your YouTube videos into the message board thread uh i know my homies on dental town not only will they watch the video they'll subscribe to your your your video so uh i just want to thank you for uh going over an hour i feel so bad that i kept you up so late the bars are closed and you're gonna have to go to bed sober for the first time in your entire life I’m so sorry five kids and the poor man has to go to bed sober but thank you so much for coming on the show it was just a huge honor and the pandemic's over i hope to see you in Spain again i hope to see you in person also Howard and i really thank you for having me and I’ll see you also for you know to to to to support me on my span english uh uh podcasting i think it's not the only ones spanning english podcasting but uh i think your audience is prepared to to listen to me you know and understand me perfectly but i really appreciate your your invitation for me it was a great honor and don't worry about the hours you know because i i i will get sleep anyway so no problem for me all right well sleep tight have a good night you too okay
Category: Implant Dentistry
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