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"I'm still learning. I've been doing this for 45 years and I'm still devleoping new concepts and new ideas in order to make it even easier and better."
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AUDIO - HSP #135 - Bud Mopper
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VIDEO - HSP #135 - Bud Mopper
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. How to simplify bonding techniques and get consistent results every time
. How the young dentist can easily learn esthetic bonding techniques and make it professionally rewarding and at the same time profitable
. The importance of understanding the value of each bonding material and where they fit (these include microfill, nanofill, microhybrid, opaques and tints)
. Bud Mopper's intense believe that bonding is the most versatile material there is and the reasons why
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Dr. Bud Mopper is in private practice in Glenview, Illinois, where he has been doing minimally invasive dentistry with composite for almost forty years. Dr. Mopper is the recipient of two of the most prestigious awards given by the American Academy of Cosmetic Dentistry. One for “Lifelong Commitment to Providing Excellence in Continuing Education in Cosmetic Dentistry,” and second, an award for “Outstanding Contribution to Cosmetic Dentistry.” The AACD recently honored Dr. Mopper with an award for “Outstanding Innovation in Cosmetic Dentistry.” Dr. Mopper is Director of Education for the Center for Esthetic Excellence, in Chicago, IL, and is Co-Founder and Chairman of Cosmedent, Inc.
E-mail: moppers@ais.net
Phone number: 847-533-8844
Howard Farran: It is a great honor and a privilege to be interviewing today, a legend in dentistry, you got the lifetime achievement award for the American Academy of Cosmetic Dentistry, you've been doing this for 45 years. You've had an amazing journey. You started off as a pediatric dentist. How did you get from a pediatric dentist to where you are now, Buddy?
Bud Mopper: Well, I realized early on, that I didn't like to repair fractured anterior teeth with crowns, and when I got major fractures, and when I saw that with advent of [inaudible 00:00:40] that was the first time I really heard about it. A guy named Walter Dial has written about using acid etching with restorative materials, at that time we had [Servatron 00:00:52] and then when nanofill came along, it was a natural for me and I started using it but techniques I used, I got great results where everybody was not getting great results because of the policy techniques and things of that nature.
I made myself valuable bonding-wise early on and one thing lead to another. That's it. From pediatrics I expanded into a study dentistry for everybody with the use of composite, and that's really got me where I am now.
Howard Farran: Well, buddy, the AACD gave you the outstanding innovation in cosmetic dentistry, an extremely coveted award. What was it in your early days of bonding that made you finally realize, "you know what, I've got to start my own company and start making my own stuff" because the bottom line is a lot of these amazing cosmetic dentists are always name dropping Renamel. You hear that all the time from elite AACD. What was your innovations over the years and what made you decide, "I've gotta make this stuff myself"?
Bud Mopper: Well, early on we went to other people. We had ideas. You know Norman Birenbaum and he's passed away and that's who I originally started the concept with and at that time I as lecturing for Colzer. You know Colzer?
Howard Farran: Yeah.
Bud Mopper: I thought that when they came out with the microfill it was material, but I wanted to expand into more an aesthetic avenue, so we went to companies with ideas and they weren't willing to really listen to us the way we thought we should. We said, "Well, you know what, we'll just try to do it ourselves."
So, we started Cosmedent, and that's how one thing lead to another. We started ... because we built the company from the idea of the restorative dentists, the aesthetic dentists, we want to give them what they want. I knew what I wanted, so I had to develop what I needed in order to get the best of all the world. That's how it really happened and when microfill came out, I realized how fabulous it was. It still is.
When I think of the enamel surface, there's only one restorative that really restores the enamel surface, especially from an aesthetic standpoint and that's microfill. I stayed with it all these years and it does all the things I want it to do. What's so great about it is the fact that, it lets things happen from within because of its translucency, yet we've made it with opacity. We've made changes to make it more opaque so that it wasn't too translucent, and you can develop color from within and all these things.
I realized, as an aesthetic dentist, and I still keep learning, to tell you the truth. I've been doing this 45 years, and I am still developing new concepts and new ideas in order to make it even easier and better. That's the whole key. That's what it is for me. The thing I wanted to do is to simplify the techniques; to make it so it's understandable so that the every day dentist can do what I do. That's my whole thing and that's what I teach.
Howard Farran: You like to teach hands on classes in Chicago.
Bud Mopper: I do. We do and we teach at the center for Aesthetic Excellence. That's here in Chicago, and hands on is the way to really benefit and expedite the learning experience. You can go to a lecture, you can see what I do, and things of that nature but in a 2 day period I can change somebody's life and change their whole attitude towards the bonding experience. That's the whole key to a really good workshop.
Howard Farran: I know so many dentists that swear by their course with you, and when I was there I just thought it was an amazing facility. How often are you having those courses?
Bud Mopper: We have may courses here. We have other people who teach that are excellent. Jason Smith, who teaches here. Newton teaches here Dennis Hartleid teaches here. Bob Martin teaches here. We've had all kinds of people and we just had Brian Lesage come and teach here. I usually give a course maybe once or twice a year. I just finished a course this weekend which was one of the most rewarding experiences of my life because of how rapidly we took people who had never really had a concept of bonding and changed their whole attitude toward the bonding experience.
Howard Farran: Buddy, walk us through this this. 85% of the people listening to these podcasts are listening to sound only on an hour long commute to work or on a treadmill or whatever. What low-hanging fruit could you be telling these people that they're missing the boat on bonding? You've seen so many dentists double, triple their skill in being an aesthetic dentist, a cosmetic dentist, what do you think they're missing? The people devouring these podcasts the most are actually dental students and been out five years because they're totally into podcasts more than our generation. They're listening right now. Tell them what you think they're not understanding or what they're missing.
Bud Mopper: First of all, they're not understanding the versatility of composite bonding. It's really the most under-utilized and the most versatile material we have in dentistry. Think about it, there's nothing you can't do with it, if you want to. Even to the extent of doing full bonding crowns, but simple techniques; full bonding Diastema closure, class 4 repairs, class 2's, a repair of force. This is the only material that you can repair a force and restoration aesthetically in the mouth that you can't find. If you know how to do it, it's tremendous and it's a wonderful thing to have in your practice.
Then what they're really missing, and I think one of the problems is that, and I'm not trying to criticize or anything else, but I think people have make bonding too difficult. Bonding is, especially with the way we teach it and what we do, is really simple and the method by which we do it and the materials which we use can make it so simple every time, and the problem is that people can't get consistently reliable results and that's what we do. We teach them how to get consistently reliable results every time.
Howard Farran: Warren Buffet, he has so many famous quotes and quips, he says that 90% of CEOs spend all their time trying to figure out how they can make their business more complicated with higher overhead, and it just seems like dentists are the same breed of cat. It just seems like they so often make a mountain out of a molehill. Why do you think that is?
Bud Mopper: Because they don't have the faith ... I see it all the time. They go to a lecture and somebody tells them this is the magic material, and they're looking at this lecture and they're doing just as good as work as that person is and yet they'll change that material right away or this is the technique or things of that nature.
I think a lot of people don't have the confidence in themselves to realize when they've really become proficient. I think continuing education's a great thing. I think continuing education sometimes can be detrimental to a person's ability to realize their skills and what they can do and in the realm of composite dentistry, I know what's going on out there and there are people that are so talented and so terrific it's unbelievable. The thing is, can you go to their lecture or their workshop and then replicate what they do?
That's not what I'm all about. I don't care about how good I am, what I care about is how good I can make the people that come to my courses. That's the real key. If they become better than I am, so be it. I've been responsible for teaching better people who I think are more skillful than I am. That's the thing about being a great teacher. That's the one thing that I have that I think I excel in is the fact that I understand what's happening with each one of these materials, whether it's a microhybrid, or a nanofill, or a microfill, or a tint, or an opaque and what it brings to the bonding scenario.
I know how to explain it, I know where to tell them where it fits in the whole bonding technique and then I know how to ... We've got a system that simplifies everything for them because it's not a me-too system. It is a unique system to Cosmedent and the Renamel restorative system.
Howard Farran: Let's walk through your system. Simplify a very common question. There's so many generations of bonding agents that they give off. There's first generation, second, third, fourth. What are we up to now, eighth generation? Simplify that to some dentist who says, I can't even tell you the difference between 8 generations.
Bud Mopper: Howard, here's the thing. I believe in the total edge technique, and I believe the one bonding agent fits everything, whether it's ours which is complete, or whether it's somebody else's out there, which will bond to metal, which will bond to porcelain, which will bond to core paste, which will bond to porcelain, which will bond to acrylic, which will bond to a structure. You only need one really good bonding agent in your practice. You don't need ten. That's the way I feel. I know how our bonding agent works, we have literally no sensitivity, in fact I've never experienced sensitivity with my bonding agent, and it bonds to everything that I use. Why would I go looking for another bonding agent, when I know the bond strengths are adequate, because we don't loose much? Yes, we get some fractures and stuff like that, but I don't have stuff fall off, and things of that nature. The bond strengths are mostly bonding agents are excellent. But I'm going to use one that works for everything. I want to make sure that I bond to dentin, I want to make sure that I bond to enamel, and all the other thins I talked about.
Howard Farran: I don't like to talk about anything everyone agrees on. I like to talk about the things that are controversial, because that's what takes these dentist's mind out for a run. What do you think about, a lot of dentist say, okay some little girl wants veneers and she's eighteen years old, and they file down all of her teeth, and do indirect veneers. But they point out, that when it's the dentist daughter, he sends her to the orthodontist and gets braces, and bleaching, and does direct bonding if anything that lifts up. What do you think about the different between indirect and direct veneers on someone who's twenty-five and under? Do you think that's too aggressive? What are your thoughts.
Bud Mopper: It depends on the case. To tell you the truth, it all depends on whether the teeth are badly broken down. I think in that nature, where you might need porous. To me, you know, I'm almost 100% for bonded veneers in the anterior portion of the mouth. Number one, I'll tell you why; biologically for biologic compatibility, if you know how to do this stuff, you're going to get better biologic results, and tissue response with composite, than you'll get with any material, including gold, any material on the market. I can prove it. I've got it. You can come into my practice and see it. I've got long term results, it's incredible.
The other thing is, that they are driving this question of durability with these materials. Well these materials are very durable, and if they do break once in a while, they can be repaired. That's easy, it's a no brainer. For me, if I'm doing veneers in the anterior portion of the mouth, I'm always thinking composite. In almost every aspect.
I'll give you an example. My partner, Dennis Hartlieb, when he came to me, he hardly did any composite. Today 90% of the anterior work he does, is better than composite.
Howard Farran: I agree. Buddy, since you've been doing this forty-five years, tell these dentists listening, if you take ... I know that the true sentimental life, is not yes, no, right, left, up, down, it's fifty shades of grey. On average, the average veneer case, if someone came in with chipped teeth, not ideal, not pretty, and you did reduce a millimeter and a half off all their front teeth and place veneers, ten years later, what would those ten teeth look like? Would any of them have died?
Bud Mopper: You mean as far as porcelain is concerned, is that what you're talking about?
Howard Farran: No, I'm talking about the vitality of the tooth. What do these average veneer cases look like, a decade later?
Bud Mopper: You're talking about composite?
Howard Farran: No. Indirect veneers, where you reduce the tooth.
Bud Mopper: You know what? We do so little of them, I see other peoples work that comes in, I'm not as worried, Howard, about vitality of the tooth, and over prepping. Because let's face it, we do a lot of crowns where we prep even more than that, and the vitality of the tooth is still maintained. I'm worried about the condition of the jejunum tissue. I'm worried about the recessionary you see around porcelain. I'm worried about the look. I have people come in and say, I don't want that porcelain look. Because you know, Howard? Most of time porcelain looks very cold. With the new porcelain they're using, they're getting away from it, [inaudible 00:15:00]porcelain which is the most beautiful. That's probably because, I don't even want to go into that. You know what I'm talking about.
Howard Farran: CAD/CAM.
Bud Mopper: If Bud Mopper is doing porcelain veneers, he's doing [inaudible 00:15:13] only. For one reason, because the aesthetic properties are so beautiful compared to the rest of them, you can't compare it. Does that answer your question?
Howard Farran: Yes.
Bud Mopper: I will tell, the other thing is, I think the bio-compatibility of the material is really the big thing. The margination. The ability to marginate. Don't forget, when you do direct composite, it's direct that position of that material to the tooth's surface. When you're doing a porcelain veneer, you've got an intermediate between that and the tooth surface. It's hard to get margination.
Howard Farran: Buddy, a big part of this, is not so much ... A big part of it, you're saying is the bonding agent, and the efficient guy a low class guy, you say look, one bonding agent should do it, should bond everything. You don't need five different kits and all that stuff. I love that. I love simplicity. Keep it simple stupid. Do you like your nanofill?
Bud Mopper: My motto.
Howard Farran: What's that.
Bud Mopper: It's, "Keep it simple, Stupid." That's been my motto.
Howard Farran: Another huge part of this is the finishing and the polishing. Can you talk about the finishing and polishing? Because a lot of them are saying, should you use steel [carbines 00:16:37], 12 fluted, 20 fluted, should you use diamonds, fine diamonds, disc? There's rubber. There's more contraptions on finishing and polishing, than there are bonding agents.
Bud Mopper: But let me talk to you about polishing. The thing about most people when they polish, is they've never taken [teeth 00:16:55]. The most important thing in finish and polishing is shape. They forget about shape. They start to polish and finish too soon. The key to proper finishing and polishing, is to get the correct [00:17:10] the tooth surface in the first place. Is to get the shape and form beautiful. Then there are a series of instruments that I use. Yes, I will use [inaudible 00:17:21], but I love discs, also. When you use a disc system, and I love the disc system we have, because it leaves no scratches or anything else. We go through the grits.
Bonding involves many things. It involves art, it involves science. What kind of art? You've got to be a painter, you've got to be a sculptor, and it's a craft. Finish and polishing is a craft. It's a step by step procedure, in an order you get to what you're looking for. Number one, you've got to have the material that will finish and polish and retain the polish long term. There's only one material in composite dentistry that will do that. That is, microfill. You want it to maintain it's polish long term.
The second thing is to be able to do a step by step procedure in order after you get the shape the right way, is to visualize where you want the different curvatures of that tooth, in relationship of one tooth to one another. Then to be able to finish it, and polish it, and characterize it to where it looks realistic.
That's a skill. That's one of the a lot of things that we teach, and really emphasize in our workshops.
Howard Farran: Buddy, when I go into a lot of ... You said, you've got to be a painter and a sculptor. When I go into a lot of dental offices, the way they've got there chair and their cabinet, they're not even to physically able to swing the chair around, or get behind the patient, so they can drop their head in their lap, and look right down them at 12 o'clock. They physically can only see from the side. Do you think you could do the best work and not even having the capability of looking straight down on the patients head?
Bud Mopper: You have to be able to look straight down.
Howard Farran: What percent of dental offices, the way the chair and cabinet is, they physically can't even do that.
Bud Mopper: Because they get the chair too tight to the cabinet, so they can't move it back where they can get behind the patient. That's number one. Or their work station is behind, so they can't get behind their work station. That's why you can either work front delivery or side delivery. The other thing is, position of the patient is very important. One of the reasons people get fatigued is because they don't position the patient, so it's comfortable for you to work. That patient's going to be there for a little while.
For instance, let me give you an example. If I'm working on a canine, or a bicuspid, I'm going to position the patient on their side, so I look straight down, in flat opposition, on that surface, so I can see it. I also utilize a mirror, so I can see all my aspects of the inclination of that tooth, and as it relates to one another. When we're looking at a profile view, then we silhouette them, and we'll set them up, and we look side to side, or you'll turn the patients head, in flat back position and look side to side, when you silhouette one tooth to another. Positioning is an important thing. We talk about it all the time.
Howard Farran: I think it's funny because operatories and mirrors have two things in common. We're going to spend like a fourth of our life in an operatory, from age 25 to 65 or seventy. These guys always design a room that's eleven foot by eleven foot. It's like, why? You're house is 3,000 square feet. Why do you spend a third of your life in this crunched little deal? Some of the most gifted cosmetic dentists I've ever seen, while they're working on the patient, someone else could walk clear around the chair. Why don't you have more room? The same thing with mirrors. You go in these rooms, they can't swing the patient right behind them, yet their website says they're a cosmetic dentist. All their mirrors are three quarter inch. I love to be ... when I grab a mirror, it might be a three quarter inch, it might be an inch, it might be a two inch mirror.
Bud Mopper: It all depends on what you need in order to visualize. We have mirrors of all sizes that we look at. If I want to see a the whole arch, I'm going to have a very large mirror, to visualize the whole arch. You can't visualize the whole arch with a smaller mirror. It's impossible. The other thing about a mirror, is I see so many people use the scratched mirrors to visualize them. I don't use scratched mirrors, I get a scratch on my mirror I can't visualize. I throw the thing away, and I bring out a new one. That's what we do. Mirrors are really important. Some surface mirrors are great. that's what I'm looking for.
Because that's part of the clarity. It's just as important as having optics, good optics, so that you can visualize with magnification that's strong enough to see every aspect of what you want to do. I don't want to feel margins, I want to see margins.
Howard Farran: Buddy, walk them through the polishing technique. You've already done your bonding. You used your complete bonding agent, you used complete Renamel. Walk them through the bonding step. Are you diamonds guy? [crosstalk 00:22:26] flute, steels, disc? Walk them through how you do it. Because that's what they're thinking.
Bud Mopper: Well the next thing I want, is I got the shape of the tooth, exactly the way I want it. But we're slightly over contoured on the facial surface. The first thing I would do, would be to collectively design edge, and see the relationship between one incisor to another you're working with, with a disc. I would a porous disc, and bring that tooth back into alignment the way I see it. I can disc it all the way down, very nicely, to the gingival. Then I'll transfer. I like carbide burs. I love the ET system from [Brassur 00:23:06] it's a very good system. I've used it forever. I love carbide burs. The two I like, are the 12 and the 16 flute.
The thing about burs, here's a tip. Most people think stick that burs all the way into the hub. All the way up, into the [hand 00:23:28] piece. You can't. Because you don't have enough length. You have to extend that bur out as far as you can, so it gives you length, so you can work up and down the tooth, to file the contour of the tooth.
The other thing is, people tend to go too fast. Polishing is best when you take your time and you use a lot of low speed high torque with the discs and things of that nature. Even, I use electric hand piece today, which are [craft 00:23:55] casted. I never polish, never polish higher than 30,000RPMs at finish, and I'm usually somewhere between 20 and 15,000RPMS.
Howard Farran: What brand of electric hand piece are you using?
Bud Mopper: I'm using, here at the center we got the cable which is great, and in my office, I have the NXT.
Howard Farran: The cable factory is one of the most amazing factories. You go into factories around the world, and then you go into a German factory. They are the most organized people on the earth.
Bud Mopper: Our materials the [raw 00:24:37] material is made in Germany. I worked with our chemist for over thirty years and they're tremendous. We work so hard there to make our products excellent. They're the best as far that goes.
Howard Farran: You know what the cable factor and the space shuttle Columbia have in common in my mind?
Bud Mopper: No.
Howard Farran: First time they rolled out that space shuttle Columbia, there were these big letters on it that says, fuel here, with and arrow. I thought why the hell would NASA engineers need a sign to where the gas tank is? There's not one on my car. I'm a dentist, I know how to gas my car. Then you go to German factories and there's just notes and messages on everything. They just make everything fool proof. Because they're so into quality control. You don't even ask them where the bathroom is. You just point down to the blue line, and follow that blue line to go to the bathroom. The red one will take you to the front desk. They're the most organized people on earth. There's just nothing like it.
I also want to ask, but go through your polishing system.
Bud Mopper: The cosmetic polishing?
Howard Farran: Yes.
Bud Mopper: When we are polishing microfill, we'll use the FlexiDisc system which is cosmetic polishing system. It's an unbelievable disc system. It comes in either regular mandrel or a mini mandrel. The beautiful part about it, is the resilience of [paper 00:26:09]. Of the milar. Because it has tremendous snap back, it doesn't crimp. It's so that when you put it on a tooth surface, it holds the shape that you're producing, you can take it beneath the free margin. Without lacerating the digital margin because it has that hole. The coarse disc, it cuts beautifully but it leaves no scratches. It's [inaudible 00:26:33], but right to the disc system, you get a polish that you can't believe. That's part of the system.
The second part of the system are rubber impregnated instruments, which are rubber points, and rubber cups are also. These are all aluminum oxide now. That's what it is, in that part of the polishing system. That's a little [moshed 00:26:52] out polishing points for creating the anatomy, the characterization, the cups you can use it. They give you little circles to go beneath, between margin, and things of that nature. We have it all outlined, on how you should use these things, in our directions. We probably have the best directions in dentistry, on how to polish.
The discs are very important. This is aluminum oxide. We have aluminum oxide polishing base that's incredible. I use it on everything. You can use it on metal, you can use it on composite. You could use it on all types of, event eh enamel. For instance, after prophylaxis on a patient, if you want to bring up the luster, give them a different feel, if that enamel's there, you can use it to polish the enamel surface. It blows people away. With being abrasive. Without being abrasive. In the final two steps of the polishing the fine and the super fine. We also have aluminum oxide, of polishing strips that we used on the proximal surface.
In essence that's what we use to [pronounce 00:28:05] most of our composite restoration. With the exception, when you're on nanofill, or microfill, and you want to get a good polish, you need to use diamond. Not with this, but diamond points, diamond impregnated points, and wheels. That will give you, actually a higher polish. Then we usually use, either the enamilizer, to porous and polish the tooth. A [inaudible 00:28:33]polishing paste, to polish the microhybrid or the nano.
They're all color coded. To match the color coding of each system. They all match one another, in their color code. We also have diamond pregnated strips of it. You go and get it an approxal and take off plaque, they're terrific. They have form grit, they're ultra thin, and basically that's our polishing system for composite.
Howard Farran: I want to throw some more questions out. A lot of people just get confused. Simplify these three words. Explain these three words. Explain these to, we're averaging about 7,000 listeners per episode, so there's someone out there saying, buddy can you just explain the difference in a micro fill, a nanofill, and micro hybrid? What do they need to know about those three words?
Bud Mopper: Well, they're all different.
Howard Farran: I know.
Bud Mopper: A microfill has uniform particle size. Particle size is .04. Would you look at under it ... They can get this all on our website. All the stuff you're asking I've got on our website, in a six webinar series. I can give you the name of the website later on.
Howard Farran: No, give it now. What's the name of the website? Cosmadent.com? C-O-S-M-E-D-E-N-T.COM?
Bud Mopper: Right. Blended education it's called. You go to cosmedent.com, then you look for blended education. The philosophy of what I'm talking about, everything I do is on there. It's a six webinar series, and it's got every technique, basically every technique that I do. Except for some of the advanced techniques.
Howard Farran: Now, how much do those courses cost online?
Bud Mopper: Nothing.
Howard Farran: Well, if they're free Buddy, you should also put them up on dental town, just drive your brand. Because we just passed 200,000 members on dental town.
Bud Mopper: I'll take a look at it. Tell us what you want. Because they're absolutely fabulous, I'm telling you. Everybody loves them. we're even making our webpage better and it will be done, in about a moth, and it's going to be easier to navigate. It's a wonderful site, we'd be glad to put it up on dental town also.
Howard Farran: You were explaining microfill, they were all uniform size, under a certain size. A nanofill, just the sizes are smaller?
Bud Mopper: No, nanofill is this. If you look, and you'll see that on my website too. There's all kinds of nanofills, there's a pure nanofill. It's the only one Filtek Supreme as you well know. They say it's all small particles. If you take a look at it under a CM, yes there are a bunch of smaller particles, 00.25, they're even smaller than microfill, but microfill, lets face it, anything with less than one fifth of a micron is described as a nanofill particle. The first nanofill ever made was microfill. Are you with me Howard?
Howard Farran: Yes.
Bud Mopper: It's already a nanofill. But the beauty of microfill, is when you look under a SCM you don't see anything. When you look at all the, and you have to go on the website to see it, if you look at all these other ones, whether they're nano hybrids or the pure microfill, including ours, they're all going to be a little bit different. You're going to see big particles in them. Why are the big particles there? Because they have to have it, in order to give them good handling properties.
There's also big particles in the microfill, but for some reason they're conglomerated. When they come together, and they polish it up, it doesn't affect the overall polish, long term. Whereas in all these other materials, the bigger particles, which they need for handling properties and strength, okay? Whether it's ours, Filtek supreme, whatever it is it's for some reason, that's the ones that they've lucked out. That's why they don't hold their polish long term. That's the way I feel. All these companies say they polish over time better, they don't. The only one that holds it's polish is microfill, and I know it.
Howard Farran: You're talking about holding your polish. Another big question that we see all the time, is dentists asking, Buddy, to keep the luster going, are some toothpaste over the counter, Crest, Colgate, Rembrandt, do any of these toothpastes keep the luster going longer? Then, another controversy is when they talk about whitening, it's just so standard to people to say, well it only whitens teeth, it doesn't whiten crowns or bonding, or whatever. Does bleaching teeth, does it clean up older composite at all. Talk about keeping the luster going with tooth paste and or, home whitening, or office whitening.
Bud Mopper: There are two toothpastes that I use, that I know are terrific. I've said this forever, but Crest cavity control, that's what I have people use. Or if they want to pay more money they can use [Erwin 00:34:24] smile tooth paste, super smile. You've heard of that one. Those are the two toothpastes, that will keep the luster constantly. Everything else, I think is too abrasive. I'm not sure about Colgate, the Colgate material. But what they need is a toothpaste with the least abrasive that they can get. I know that Crest works, that what I have everybody get. You ask me a question, I'm going to tell you. I've told this to them. They don't market their material that way, but that's them. I market it for them. Because I know what it does for me, as a practitioner.
The other thing is, on the maintenance of [diamond 00:35:03] restorations, depending on the color you use and stuff like that, there are some people that may need to come in more often for what we call a bond polish. I have some people I see every year. Some people I see in six months. Some people I see at three months. I've got one person I see at two months. Because he's got super bright, Hollywood smile, and she drinks a lot of tea. Tea will stain it. But none of these things will stain, at least our composite, in terms of it.
I'll tell you something about our composite. Can I say this?
Howard Farran: You can say whatever you want.
Bud Mopper: It never changes color. Ever.
Howard Farran: Is that because the microfill doesn't incorporate stain? It's too smooth.
Bud Mopper: That's all our product. I think part of it is polishing with a microfill, but our color system is so true. We're the only ones really now, that really, truly match the[elitis 00:36:02] system. We built our whole thing, the match, the beauty classic [inaudible 00:36:07], and then we match some of the other shades from the 3D shade guy, that they wouldn't let us use their trade mark.
We built the whole thing. The reason I did it, and the reason, you talk about quality control? We are quality control. The thing about shade is, you can only take it so far with a computer. Then it takes the eye to get it where you want it. You've got to be on what side you want, the green side, the red side, so forth and so on. You add a little brown, you add a little more grey, and it takes time to get it the way you want it. We match the beauty shade guide, the middle of that beauty shade guide, and we're right on time. That's what's so beautiful. That's one the things that makes it so simple to use. Because it does match that shade guide.
You asked me about bleaching? I don't know. I don't think bleaching cleans up bonding, to tell you the truth. It's certainly not going to change the color about it. It may clean up other stains, and things of that nature. You know that it will do that. It's not going to change the color of bonding. I know what happens with over bleaching the teeth, I certainly changes the overall look of those teeth. They can be become very florescent, very blueish in color, and things of that nature. Which I don't like about over bleaching. I realize there's a place for bleaching, and we use it in our practice but we're not over bleachers in our practice.
Howard Farran: Buddy, Albert Einstein said, "If you can't explain your subject, you don't understand it well enough." I've always thought you were an Albert Einstein of cosmetic dentistry. You can explain anything to anyone, and I want you to go on three more words that offers some confusion. Explain what an opaquer is.
Bud Mopper: Opaquer is a material. The concept o opaquing is, "Hey, I want to black out this undercover, or black out this translucency." The problem was they didn't get the opaquer and they didn't take color blending into consideration at the same time. Let's say, I've got a fractured anterior, and I want to make sure that thing is invisible, opaquers are ... You need opaquers. Especially when I'm using microfill. Because if you just put a material on the tooth surface, and you've got the differentiation on the [cavets 00:38:33] between the, the material you place it's a tool. You'll see, let's say you did microhybridor, you put a nano on there and you place it, it looks real good. Patient comes back the next day, or next week or two weeks later, and you see a little dip. A transition, a differentiation between the material and the tooth surface.
What opaquers do, you could create invisibility. Because it will block out that transition if it color blends at the same time. If you just put a light opaquer on there, and it doesn't match the tooth shade, you're dead meat. You can't do that. You're tooth has made it too. Let me explain something also Howard, all of the materials are replacing dentin and enamel in the shade. I'm not doing that. I don't care what color the dentin is. I want to go to the surface color. When we relay our colors, they're all related in color. In other words, if I've got an A1 tooth, and I need to the nanofill or microhybrid respect, I'm going to use that. But when I go to block it out I'm going to use an A1 opaquer to block it out. When I want to match it, I'm not going to put an A1 dentin that's darker, I'm going to put an A1 dentin that matches the surface color. Then I'll use a A1 dentin to block out the shine through, that matches the A1 surface color. Then I'll use an A1 microfill to go over the top that matches the surface color.
In order to do that, the materials have to match in color perfectly. The only difference is, the opaquers the most opaque. The nano and microfill is the least opaque. Everybody wants a cookbook, this is the cookbook. It's simple. All the materials should match. Only their opacities are different. They match in color, their opacities are different you've got it made. Do you understand where I'm coming from?
Howard Farran: I do. I'll tell you what, I remember the first time I saw you lecture in '87. I said damn that guy is passionate. I just love it when you're explaining something, you had to lean clear forward in the chair to make your point. I just love your passion and enthusiasm.
Then, I want to keep this ball going. What is a tint? When do you use tints?
Bud Mopper: I use tints almost all the time. The reason I use them is because it will add hue and chroma to your restoration. The thing you want to use. Add some surgical crhoma and you can make it intense or not intense, depending on how the timer rises. You want to create the illusion of [inaudible 00:41:33] translucency. The beauty of it is that you're building, when you're using tints, we're building from within. When you build color from within, it's the most beautiful. Then I go back to ceramics.
If you look at [inaudible 00:41:45] course of Lan river, about that, the crown is built from within. The color's look good, go back to a Lithium Disilicate or Zirconium they got a tinted, they got a stained on top. It never looks the same. The concept is still the same with tints. Why does it work with microfill, but won't work with nanofill and microhybrid, because of the translucency of the microfill. We put the tints on the layer, where we're blocking out under color and everything. Which might be the microhybrid layer, or the nanofill layer. Then we will have taken what we needed. Then we will tint it where we want to, very artistically, scribbing up from the incisor and creating the illusion of man [lines 00:42:32]. Making the chroma digital, very subtle change from digital, to the body of the tooth. They're beautiful.
The thing about tints, is tints need to be transparent, they are colored for transparency. That lets the light shine through the tint and bring it into the microfill, and that's how tints are valuable.
Howard Farran: I hope I don't upset you with this question, because it's my job to guesstimate questions from 7,000 people, that could be a junior in dental school, to a fellowship in AA city, but I know someone out there is listening, and is confused. What is exactly the difference between opaquer and the tint? What of that confuses you?
Bud Mopper: The opaquer is something that blocks out light, blocks out under color. There's not much that light come through. It produces the opacity that a surface that will blend with the opacity of the restoration. That's what opaquer does. It's like, I'm trying to explain how you do it. Say you've got a wind shield, that you want to slightly crossover, but they want the light to come through. That's where opaquer does it.
A tint, they're not the same. A tint is color. Now, think about it this way; if you want to bring up value on something, you use opaquer, that raises value. If you want to decrease value, you use color, you use tints. Do you follow what I'm saying?
Howard Farran: I am.
Bud Mopper: What tints do, it will give you the color that you're looking for. For instance it might be a little dentin color down, with the digital shining through, so that you can see the chroma at the digital. Then it will create the illusion of transistency at the incisor. You can't do that with opaquer, opaquer is going to block everything out. It's a blocking agent essentially, but at the same time it's going to blend with the color you're working with. I don't know if that explains that to you or not.
Howard Farran: I think you're an excellent instructor. Buddy one of the things that you're perspective is so valuable, you've been in this industry 48 years. I've been in it 28 years. There's a lot of younger people 10 years out that are wondering. I what you to talk about two major trends we see. When I got out of school there were 15,000 small labs, and they all used [inaudible 00:45:18]. Now you're getting CAD/CAM, huge. What do you think of that.
Bud Mopper: CAD/CAM?
Howard Farran: Yeah, you have 15,000 small labs, so now about 7,500. We've lost like half our small labs. They're being replaced basically with CAD/CAM. What are your thoughts on CAD/CAM?
Bud Mopper: You're never going to replace a product technician with CAD/CAM. No way. Number one. One of my thoughts is they can't polish CAD/CAM, but [inaudible 00:45:51] very rapidly we got a system that can polish everything. Include file back and forth, pretty soon lasers aren't going to be needed. I got a polishing system that's incredible. It will be out in a couple of weeks. We could polish Zirconium we can polish Lithium Disilicate, in a matter of seconds. Polishing is going to be the future of these things, and not lasers.
How do I feel about CAD/CAM? I think it's a way for dentist to do dentistry, maybe on a one tooth basis, fairly rapidly. If he's artistic he can do it, but we're talking about exotic work that the patient needs to have done [forever 00:46:37]. Not daily rate. We need good lab technicians in this country. We need to train them to do the work that needs to be done. That's the way Bud Mopper feels, but I'm coming from, I'm an older generation, I'm an older guy, but I think I'm right on that.
Howard Farran: Buddy it seems like when you study history, it's always, what comes up must down. It's always cycles. It's always the stock market's going up or down. There's bubbles in real estates. Do you think that you will see a rebirth of these smaller labs? Or do you think they're just headed on a straight line projectory out the door?
Bud Mopper: I can't tell you that. Because my partner could say, that they're not going to there. I'll be very honest with you. I don't do a lot of lab work. You know that. In fact I don't do any. My practice does a lot, we're still doing implants, we don't have CAD/CAM in our office. We're not CAD/CAM people. That doesn't mean they're right and I'm wrong, or I'm wrong and they're right. I just don't want to do that. I want margins he way I want margins, I want color the way I want color. We're an aesthetic practice and we get better at aesthetics all the way around, and the best of everything. Usually top notch lab people, that's the way we feel.
Howard Farran: Maybe I should start doing the Johnny Carson thing where he holds a card up to his head and tries to guess the question. I know someone's asking right now, you're talking a lot about anterior. You said that you only need one etching system, your complete total etch. Is renamel for the anterior teeth and the posterior?
Bud Mopper: Yes. Renamel restorative assisted, can be used anywhere. Renamel is just not microfill. It's a system. Like I said, microhybrid, nanofills, microfill, opaquers, tints. They can be used anywhere in the mouth. The next question you're going to ask is, did I use microfill in the back of the mouth. Yes. We do restorations, where we will put even the microhybrid or the nanofill in the tooth and then we will surface it with the microfill. Because it will be a better overall polish posteriorly. It's probably better long term result.
Howard Farran: Originally I said explain microfill and nanofill, microhybrid and opaque or tint. You explained four of them real well. You didn't really talk about microhybrid. Why would you put a microhybrid on the floor, and a microfill on top. What is the difference between a microhybrid, and why did you choose to put down the bottom versus a microfill that you put on top.
Bud Mopper: Let's make it a difference between the nanofill and the microhybrid. Because those re the two I use underneath anterior. The microhybrid is more opaque, but ours has an interesting wettability to it. When I'm working on dark color shades and things like that nature, it's so easy. Because it blocks out ultra thin layers, and it sculpts so beautifully, you can almost bend the material. In fact they'll see that example. They'll go into veneering in my website. It shows how easy it is to apply. When I'm doing veneering cases, most of the time I'm using microhybrids to add the under layer. Before I do the tinting or the opaquing or whatever, before I apply the microfill.
The nanofill, it handles better, so with fractured incisors, I go to use the nanofill because it doesn't slump or anything else like that. You place it on, you can put it where you want it. The only this is, it's more translucent, that's another reason I like to use the opaquer when I'm going veneering, so it's more translucent. That means I'm going to have to use a little more opaquer, if I'm out on incisor edge like that.
In the posterior, I'm not going to microhybrid today, I'm going to use nanofill. Why? Because it has less shrinkage than any other materials. The one that shrinks the most is the microfill. If they go into our program it will show you, "Hi, I'm taking care of the shrinkage problem, at the interiorly of any microfill." At the digital margins, things of that nature. In [blocks areas 00:51:07] it will shrink the most. We don't use it in [blocks areas 00:51:10]. We use the microhybrid usually the nanofill. That has the least shrinkage.
There's advantages to each one of these materials. That's what the practitioner has to understand. Like I said, where do es each one fit the [monic 00:51:26] scenario? That's what we describe.
Howard Farran: How many courses do you have on your website? Did you say eight?
Bud Mopper: We have six. We have one on posteriors that my partner did, Dennis Hartlied, that's beautiful. Then I did five, 45 minute webinars. They're all about 45 minutes. There are six webinars. We did it in conjunction with the AACD, and I did it in conjunction with them, it's on our website now.
Howard Farran: Those are all at cosmedent.com. C-O-S-M-E-D-E-N-T. That is amazing. Another question I want to ask ...
Bud Mopper: Can I say one thing Howard?
Howard Farran: Yeah.
Bud Mopper: The education we have. That includes the other people that are associated with our company that lectures on our materials part time, things of that nature. We've got a myriad of what's called tips and things of that nature. Almost for nothing. We don't charge for it.
Howard Farran: One of the most successful podcasts we did, we just did one series. I was lecturing at the megagen implant symposium. I podcast interviewed one hour of each of the ten speakers they had there, and we released them in a row. That was amazing, a lot of people said, that was just amazing to listen to ten podcasts on implants in a row. You ought to get your whole crew to each do a podcast, and we just release them right in a row, so they just have a curriculum of everything you're talking about. If that interests you. I think the viewers would love that.
Bud Mopper: Well we talked to some of our people already, and some of them want to do it, and maybe we can get more involved.
Howard Farran: You're so international. You got people from London and Brazil, and America. That's three continents, am I missing one? Do you have any speakers from Antarctica?
Bud Mopper: Antarctica maybe.
Howard Farran: Antarctica? I'm trying to guesstimate these questions, somebody's probably wondering Buddy, you said you got a lot of hands on courses, how much are they, and what would be the best one to take first? Is it like a curriculum. Like level one, two, three, four, five? Or are they just anterior ...
Bud Mopper: Can I be biased?
Howard Farran: Yes.
Bud Mopper: Mines the best one to take first. Because I'm the one that explains the science of the material and combines the art and science and puts it all together, and I make it simple. I'm about simplicity. I'm about a person being able to go out the next day and make a buck. In order to do this stuff, you've got to do it, but you've got to do it with the idea that you've got to make some money. That's the key. That's my key. That's what I do. You know what? This is going all over the country, but I don't care. Look. I've been around a long time. I've got thousands of people that I've encountered over the years. I know what my seminar does. I bring everything together.
The other people we have our excellent. You know who they are. Courtney Willhite, [inaudible 00:54:45], Luke Duvall, Jason Smithson. Dennis hartleid. Occasionally we have Jeff Morley here. These guys are fabulous. They know what they're doing. They bring more art, maybe more of an artistic feel to it, they differently than I do it. That's okay. They get beautiful results. Dennis knows that basically, the way I do it, because I trained him how to do it.
Then we have people here, like my son Robert. You know Robert.
Howard Farran: Absolutely.
Bud Mopper: And Dennis, they are well trained, they get free courses, and inducted into this stuff, and how to do it. They are skillful. They teach all over the world. That's what we do. I'm in the product business, but I don't want people to pick up a product and not know how to use it. They have to know how to use it. That's what we're all about.
Howard Farran: I remember when implants come out, brand mark wouldn't even sell you the implant until you went through his course.
Bud Mopper: The whole thing. [inaudible 00:55:56] is the key for me.
Howard Farran: I want to ask you another thing, the view out of your office is worth the whole trip, I mean it's amazing. I want to ask you a question; number one, why is the Chicago mid winter, in the coldest time to ever visit Chicago, and what time of the world would you recommend Chicago at it's finest to see your beautiful city.
Bud Mopper: The time of the year is May. Either May or October, those two months.
Howard Farran: Why is Chicago mid-winter, wouldn't they have a lot more attendance if it was beautiful may and Chicago? Instead of just hiding ...
Bud Mopper: It is spectacular usually here. I don't know, to tell you the truth. October is, the fall is beautiful too. If it's September October. Those three months are really ...
Howard Farran: If you were going to bring your wife, what hotel would you recommend? What would be a nice place to stay, that would be in walking distance? Because if you guys haven't been there, you can see Wrigley mansion, or what is it called?
Bud Mopper: The Wrigley building. Right down the Chicago river it's absolutely magnificent.
Howard Farran: What hotel do you recommend staying on there?
Bud Mopper: What?
Howard Farran: What recommend would you recommend staying to go here?
Bud Mopper: You could stay at the Ritz, which is close. You could stay at the theater, that one, you just walk to. You can stay at the Four Seasons, you could stay at the peninsula, you can stay at the Omni, there's so many of them, and they're all clustered right in our area, and we're right on Michigan avenue, the wives could have the Michigan avenue. They can bring their kids, there's so much to see in Chicago, it's incredible. Really, you know the town is full of history. The museums are second to none in this city.
You've got the baseball, you've got the basket ball, whenever they want it come. We might be able to get you tickets to some of the game, things of that nature. We try anyway. Erica's the gal who runs our center. She's fantastic. She's the most accommodating person I've ever seen. She's very kind. She works very hard to help people, to get the accommodations and everything that they need.
Howard Farran: Another interesting thing about Chicago, a lot of people might not know unless you're from Poland. When you go to Poland, every single person in Poland has an aunt, and uncle, a niece, a nephew in Chicago. Have you noticed that?
Bud Mopper: That's true.
Howard Farran: I've lectured in Poland and Warsaw three times and every single person in the room has family in Chicago. I think it's the largest polish population, outside of Poland.
Bud Mopper: I think it is.
Howard Farran: Then, the last but not least, how much are these courses?
Bud Mopper: They range ... What are they? Around 3,500? I'm asking Antonio. I don't even know. What are they?
I'm the cheapest one here, I don't pay myself when I'm in [room 00:58:57]. Mine is 29.95 for the two days. The others are 39.95. Then there's the free courses, which are not free. They're not free anymore, because we found out that too many people cancelled when you're giving them away for nothing. That's the truth. It was Erica's idea, she says you can't do that anymore. We charge 49.95 for the three courses that they get [lunch 00:59:33]. After one day course. That's forty-nine dollars, and ninety-five cents.
Howard Farran: The thing I love most about seeing you interact with us, due to everything, you're a father figure, you're like a Vince Lombardi. I've seen you so pick up on what these young dentists, thirty-five and under, what they're missing. Whether it's self esteem or confidence or whatever. You are just a legend, you're a role model, you're a Vince Lombardi lifter, upper. Really Buddy, I'm not blowing smoke up your dress. I think you're just an amazing man. I want to end with one question, because we're out of time. It's one hour. But just one minute over time question; you've been in this field forty-five years, you and I saw, corporate dentistry rise to the top, where orthodontic centers of america was on the New York stock exchange, a dozen on NASDAQ when they all collapsed they disappeared for ten years, now they're all back. Do you think they're back and here to stay? And is this a good thing? A bad thing? Or just market segmentation is just differentiating, just here's 330 million people, and there's going to be a lot of business models providing dentistry? What are your thoughts on that?
Bud Mopper: I don't know, as far as I'm concerned I think corporate dentistry may be here to stay, but if it is here to stay, then they need to upgrade their skills just like everybody else does. To me, I still believe in group practices or small private practices. I believe just in the attitude that you see, it's a different type of attitude. First of all, I think, without being political, I think you're seeing things, like Edmund Byne Humana, insurance companies buying hospitals. You're going to see a huge change in what's going on in health care in this country. I don't want to see that huge change. I think our healthcare is terrific if delivered by the individual practitioner, if they're knowledgeable. I think a corporate practice can be a great thing, if their people are trained properly and their attitudes. I just don't know what to tell you on that, Howard.
Howard Farran: Let me ask you more specifically. Because specifically I'm talking about the 5,000 kids that just walked out of dental school, they got $230,000 in student loans, they're looking at you saying, "Buddy, was that a good move? Was becoming a dentist in 2015 with $230,000 in debt, was that a good move? Or am I kind of fool and I'm never going to pay these student loans off?"
Bud Mopper: I can't answer that. I got some kids that I just talked to, that they're $400,000 in debt. You know, when a school charges $85,000 for the tuition, where are we going here? They're not getting the type of education they need to get. I'm telling you right now. Then these kids need to come out, they have to upgrade their skills to the techniques that we've been talking about today. Our bread and butter here. I'm talking about the skills you need in everyday dentistry. The emphasis at schools today, is in the high tech, and you know that. I think we need regress the emphasis on the skillful dentist. That may change the attitude of the professional.
Howard Farran: That's why I never opened up a change of dentists, because I always thought in dentistry the product is the dentist. I think, if you want to be a rocking hot dentist, you need to focus on yourself, block out not only corporate dentistry, block out 220 other countries, just look in the mirror and man up, and make yourself the best damn dentist there is, and you're going to be successful.
Bud Mopper: Can I interrupt there? That's always been my attitude. We've never marketed our practice, the only thing that markets our practice, is our skill, and our caring, and our service. There's a thing on my wall, my dad opened up a grocery store, in a little town [inaudible 01:03:39] Iowa, in 1953. It had wide aisles, all kinds of things, conveyor belt, it had a restroom, a bakery. This is 1953, in a town of 1,000 people. My family taught me two things, that will make you survive in business. Especially as a small business. That's what dentistry is basically. For most of us, it's a small business. You give service and quality, and you're going to win. That's been my key in business. That's been my key in my practice, all my life. That's been my key, in our business in cosmetic. We're a small company, but we've stayed here, we're 35 years old, and we're growing, now I have my son in it. Mike O'Maley, who you know real well. He's [been 01:04:32] with our company, he's got his daughter in it. We've got the best people that have been with us for years. Working with us. We are family. That's what we're all about.
Howard Farran: On that note, we're an hour and four minutes I've got to go. But Buddy seriously, thank you so much, personally for everything you've done for my career, starting back in 1987, when I first saw you. Thank you to all your amazing raving fans, I run into all the time. You're a legend and it was just a complete honor that you spent an hour with me today.
Bud Mopper: Thank you for having me, I appreciate it. Thank you to all the people that you work with, I look forward to seeing them sometime.
Howard Farran: All right, Buddy, I'll see you around.
Bud Mopper: Take care.
Howard Farran: Take care.