Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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795 Chase Your Dreams with Dr. Arthur (Tony) Tomaro : Dentistry Uncensored with Howard Farran

795 Chase Your Dreams with Dr. Arthur (Tony) Tomaro : Dentistry Uncensored with Howard Farran

8/3/2017 8:34:10 PM   |   Comments: 0   |   Views: 176

795 Chase Your Dreams with Dr. Arthur (Tony) Tomaro : Dentistry Uncensored with Howard Farran

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795 Chase Your Dreams with Dr. Arthur (Tony) Tomaro : Dentistry Uncensored with Howard Farran

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VIDEO - DUwHF #795 - Arthur Tomaro


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AUDIO - DUwHF #795 - Arthur Tomaro


Dr. Arthur (Tony) Tomaro, a graduate of The University of Michigan, School of Dentistry, where he also completed his Master’s of Science, and Bachelor of Science.  Prior to his relocation to Las Vegas, Nevada, Dr. Tomaro enjoyed 26 years of private practice in Grand Rapids, Michigan. Dr. Tomaro is previous Director of Clinics at Las Vegas Institute for Advance Dental Studies. He maintains a private practice, Arthur Tomaro Exceptional Dentistry, in Las Vegas, Nevada. As a member of Catapult Education, Dr. Tomaro teaches hands on courses, as well as peer lectures to dentists nationally and internationally. His teaching focuses on techniques related to General Dentistry (Tooth Colored Fillings & Crowns), Full Mouth Reconstruction, Diagnosis, Business of Dentistry, Cosmetic Dentistry, The Art of Smile Design, Treatment of Headaches, and Occlusal  Procedures that are used in daily patient care. 

Dr. Tony Tomaro is a published author and a consultant for dental laboratories and manufacturers, and a current contributing author to national dental publications and dental laboratory publications on several topics.  He is affiliated with the following prestigious organizations: ADA - American Dental Association, MDA - Michigan Dental Association, NDA - Nevada Dental Association. He can be reached at 702-533-3336 or via email at atomaro@ameritech.net

www.DrTomaro.com 


 

Howard: It is just a huge honour for me today to be podcast interviewing Arthur (Tony) Tomaro. He’s a graduate of the University of Michigan’s School of Dentistry, where he also completed his Master’s of Science and Bachelor of Science. Prior to his relocation to Las Vegas, Nevada, Doctor Tomaro enjoyed twenty-six years of private practice in Grand Rapids, Michigan. Which was the birthplace of water fluoridation, January 25th 1940, first city on Earth to adjust the fluoride in the water. 

He maintains a private practice, Arthur Tomaro Exceptional Dentistry in Las Vegas, Nevada. As a member of Catapult Education, Doctor Tomaro teaches hands-on courses as well as peer lectures to dentists, nationally and internationally. His teaching focuses on techniques related to General Dentistry (Tooth Colored Fillings and Crowns), Full Mouth Reconstruction, Diagnosis, Business of Dentistry, Cosmetic Dentistry, The Art of Smile Design, Treatment of Headaches and Occlusal Procedures that are used in daily patient care. 

Doctor Tony Tomaro’s a published author and a consultant for dental laboratories and manufacturers and a current contributor author to national dental publications and dental national publications on several topics. He is affiliated with the following prestigious organisations; the ADA, the Michigan Dental Association, Nevada Dental Association and you can call him, can I give your number and email?

Tony: Sure.

Howard: You can call him at 702-533-3336, my God that’s a lot of three’s. That’s two, four, five three’s. So it’s 702-5 then five three’s, then a six. That’s pretty cool. Or via email at atomaro@ameritech.net. How are you doing today, Tony?

Tony: I’m doing great, Howard. Thanks for having me on.

Howard: So with the last name, Tomaro. Is that Italian, Italian, Italian or Italian?

Tony: It’s Italian.

Howard: Is it linked to Italians.. I always think of Italian food. They probably use more tomatoes than any other... it’s kind of very close to the word tomato.

Tony: Well, it is. In fact my father and mother owned the largest, if not one of the largest Italian restaurants in the Detroit area for thirty-five years.

Howard: So Tomaro is related to the word tomato?

Tony: No.

Howard: Oh, it’s not.

Tony: It really was pronounced Tomaro and my grandfather said, ‘hey, the English, they don’t understand so just say Tomaro.’

Howard: Right on. Right on. So, my gosh, you’ve been doing this for so long and we just had six thousand kids graduate from dental school, and those are the ones that are devouring podcasts. Guys like you and me are going to conventions and reading text books and it’s the kids, it’s the millennials that are devouring these podcasts. What would you tell the graduating class of 2017, who all walk out of school and complain and say, ‘Tony, we didn’t learn anything about occlusion, TMJ, we didn’t place an implant, we didn’t do an invisalign, we didn’t do veneers.’ They basically got their basics down, they got the block, the tackle, the reception, the pass, and now they’re starting their journey. You and I are… have been doing it for three decades. What advice would you give to the new kids walking straight out of school?

Tony: The first advice I’d give is pursue your dream. In being at the different dental conventions, and booths, and lecturing. There’s a lot of young dentists that come up and say, ‘I’m doing this, and this, and this to pay off my debt.’ But I always encourage them to pursue their dream, if their dream is to have a private solo practice, or to be in private practice, then pursue it. Our profession allows you to do that. I mean, you may have a hurdle here or there, but always pursue that dream whatever that dream may be. We all get to that location where we want to be if we pursue it. The hardest thing obviously, is when we were in school the amount of debt that you and I may have accumulated, isn’t even close to what these young dentists are having nowadays. The cost of education is incredible. And a lot of times that detours them and discourages them, and I would tell them, ‘hey, don’t think of it like that, get business taken care of.’ 

The other thing is, become a business person as well as start mastering your clinical skills. I was fortunate to be raised by a very strict Italian father, where cash was king. And when I got out of dental school I understood business, because my parents owned a family business. But I can’t emphasize enough that learn your business skills, get a great accountant, get a great attorney, and master those business skills. When you get to continue an education just don’t take the clinical portion, but also take business skills. There’s a lot of great… and it doesn’t have to be related to dentistry, for instance, there’s a great person out there read… that if you take the time to read his books, John Maxwell, on mastering personal relationships, and becoming a leader, and that’s the key. It’s to develop leadership. 

Dental schools have a hard task, within three or four years to teach these young people clinical skills. When you and I were in dental school, we didn’t understand occlusion. But shortly after we got into private practice we realized how important occlusion was. It is what keeps our fillings, or crowns, or bridges around for some longevity. So, you go from... becoming a dentist, you graduate from a dental school, you pass your licence exam. Then all of a sudden, not only are you a dentist but you’re a CEO of a company. That’s where I see a lot of failures in the young dentists, they don’t have the business skills that they need.

Howard: I want to ask you a question. You just said occlusion, and you worked with Bill Dickerson. You were an instructor, clinical director for a decade and I just want to ask you a very bizarre question. If you asked a hundred paediatric dentists ‘what do you guys argue about?’ They don’t argue about anything. The endodontists, they don’t argue about anything.

Tony: Yeah.

Howard: My God, the occlusion camps. It’s like the top ten world religions, I mean they just…

Tony: Yeah.

Howard: Why… So why is occlusion… because it’s basically… would you say we basically treat three diseases, gum disease, caries diseases, and occlusal diseases. And I don’t think caries disease and… perio’s a little controversial with the laser, I know that (inaudible 06:47), alot of people talk about that..

Tony: Sure

Howard: But, gosh, would you agree that occlusal disease is the most controversial in dentistry?

Tony: I would agree with you to some extent, Howard, and that is I also went through PHACE and coming from the University of Michigan I was taught by Ash, Major Ash and the quite famous periodontists there. But, it’s funny, I was having this conversation just last night with my lab technician. And it’s... in a way we’re in a profession where… and in all professions, I would say, to some extent there’s always going to be politics. There’s always going to be, one person thinks one way, one person thinks another. My goal when I teach occlusion, is to teach the dentist to at least recognize it is a disease. 

Unfortunately, when I have a new patient come in, I’ll say to a patient after doing a comprehensive examination, ‘has anyone ever shared with you how your clenching,  grinding that you wear facets.’ And inevitably the patient will say, ‘hey, I don’t do that.’ And I go, ‘well, these teeth didn’t get this way just by chewing regular food.’ But back to the question, I said to my lab technician, last night I said, ‘what percent of the cases you see in your lab are CO dentistry? And without hesitation,  he said, ‘probably nine….’ and he does a lot of occlusal cases, probably ninety-eight percent of the cases. So, I’ve never done a survey, but let’s say that there’s ninety percent. So that ten percent are occlusal cases whether or not they’re changing the bite, or whatever they’re doing. So we have this big separation, let’s call it, amongst occlusal camps. And I respect all the camps, I really do. We have this big controversy for ten percent of all the dentistries that’s being done, and for me that’s a little foolish. Saying that, my key is to teach dentists, and also in my own practice, to recognize… people come in with occlusal diseases, not only that but occlusion can affect the rest…

Howard: Okay, I’ve got to stop you. I’m afraid you’re talking over their head when you said ninety percent was CO cases and ten percent weren’t. They might have missed that.

Tony: Okay, so if all the dentistry that goes to the dentist laboratory, I would say… let’s say that ninety percent is centric occlusion, in other words they restore the crown, or the bridge, or whatever it is to the original bite. So ten percent is either done in centric relation, or neuromuscular, or whatever occlusal belief you have. The key is we want to address the disease, and that’s what the purpose of education is. Now if you’re more comfortable doing neuromuscular, then by all means do a neuromuscular if you’re getting a success. If you’re more comfortable doing centric relation, then do centric relation. The question that comes up is the success of the case. Early on when neuromuscular started getting popular, there were a lot of centric relation leaders, centric relation teachers that was up in arms because of the way the cases were built and it was a learning process. So I’ve never chosen my friends, I’ve never got into the political scheme of things, I’ve never taken it to that extreme where a lot of people do. But my key is let’s recognize that occlusion is a disease, it’s a pathology. And when you go to treat a patient, try to do everything you can, not to contribute more of that pathology. There’s a saying that if you’re not measuring something it’s an opinion. So if you’re treating a full mouth reconstruction case, a lot of people… if you ask majority of the dentists, and I have done this, majority of them believe, ‘oh, I’m going to open the bite.’ But what they’re not educated about is that, and orthodontists understand this extremely well, is there’s an anterior, posterior factor in the mandible. There’s not only vertical, but there’s also pitch, roll and yaw. So to just jump in and to prep someone’s teeth, and put temporaries on and adjust them over a period of time like is done quite often. And say, ‘are you comfortable there’, then record that bite and have the lab fabricate it there. You’re asking for trouble, because you have nothing… you’ve already prepped the teeth. So if you take a very conservative and you either use some kind of splint, or some type of orthotic and you see where that bite is going to end up, then do the reconstruction. You’re treating them conservatively plus you’re going to dial in that bite without whaling on any teeth so to speak.

Howard: So, a couple of questions on that. First of all the neuromuscular dentistry was started by Doctor Bernard Jankelson, did you ever meet him?

Tony: I did not. I’m pretty good friends with his son, Bob.

Howard: And he… he… what’s the… Techskin?

Tony: No, he… the k-seven. The Myotronics

Howard: But. But isn’t that company called Techskin or…

Tony: No, it’s Myotronics.

Howard: Myotronics.

Tony: Myotronics. T-scan is something different if that’s what you’re referring to. It’s Myotronics out of Seattle.

Howard: Out of Seattle. So a lot of the kids listening might not even know. What’s the difference between centric relation and neuromuscular?

Tony: Okay so,  neuromuscular dentists, a true neuromuscular dentist believes that there’s, say a relationship between the central nervous system, the muscles and the teeth. Okay. A centric relation occlusion doctor, to sum it up, believes like respectfully, Doctor Dawson who’s probably most recognized in this area, believes that there’s a bone-to-bone adjoint relationship between the condyle and the positioning of that condyle. There’s been many, many definitions over the years, but it’s a position where they try to… that… they respectfully reconstruct if they’re going to do any reconstruction, or they position the patient as their home for their occlusion so to speak to make it as simple as I can.

Howard: Between Pete Dawson, Tony (you), and Howard (me), do you notice we’re all bald dentists. Have you ever noticed that all the greatest dentists are all bald? Peter Dawson, you and me.

Tony: It’s…

Howard: I mean is it just so obvious? I notice that everyday. Ross Nash, I mean, come on.

Tony: I’ve been mistaken. I have been mistaken at the Chicago Dental Show two years ago for Ross Nash, and I know Ross he’s a great guy.

Howard: Ross Nash is an amazing guy.

Tony: He is.

Howard: I know…

Tony: He is. And I said to Ryan, yesterday, I said, ‘hey, if you ever need me to step in for your dad let me know.’

Howard: Oh my God. There was an endodontist in town here, same shape size everything. And he just laughs his head off, he says that sometimes ..he’s at the Arizona Convention, someone will come up behind him and arm lock him and kiss him on the back of the head. And as he turns around he says, ‘I’m not Howard.’

Tony: They always  say that grass doesn’t grow on a busy highway. Right?

Howard: That’s… there you go. There you go. So, there’s so many things that these kids are… they’re being bombarded… they come out of school and they’re being told ‘you need to learn TMJ, TMD, occlusion, you need to learn invisalign, you need to learn how to play simplant, you need to be a cosmetic dentist and they’re bombarded with all these messages and it’s kind of that stair step. You’ve got to take one step at a time, they can’t take a thousand hours of continued education the first year out of school. Where do you think they should start? Walk them up to the second floor where you and I are sitting.

Tony: Yeah. Let’s say we’re just getting out of school today. One of the first places you need to start is in my lectures ,the most important for me, not only the business skills, but learning to develop your people skills. I was fortunate, my parents owned a restaurant since I was like seven years old, we started with the Carrion. I learned how to develop relationships. My love for teaching. I would say that for developing people skills, it helps you in every aspect of life. And developing relationships… when I do a course on a new patient called Help Where Do I Go From Here?, it’s all about people skills. One of the things I tease the dentists about, is if you ever have an opportunity to take a two or three day weekend and work as a waiter or waitress. Because if you think about it, a waiter or waitress has about forty-five seconds to develop how much tip they are going to get on that job. Are they efficient? Are they that…? But those people skills… I mean if you think of the great restaurants that all of us have been in, a lot of the times it is the people. If you think about the relationship between, let’s say a lady and her OB. It’s her comfortability being with that person. It’s all about people skills. 

And then the next thing is, depending where you’re at at that time in your career, is the business side. Dental school gives you… teaches you the basics, and there’s some great dental schools, most of our dental schools here are fantastic, and the Deans are great. And I was fortunate enough to go to the University of Michigan and we had great instructors. 

One of the things that does concern me today is the expectation from the students of the dental schools. It seems like… perhaps you and I were there during what we call... everything was done in gold we did wax ups, we did this. I always go over the new technology… earlier I mentioned you and I, we used to take our impressions with rubber base. If you look at the technology today and what is available, it’s incredible where I think it makes dentistry much easier. And it’s fantastic. It’s great. If you look at our material, if you look at our composites. This is a guy here who said many years ago, ‘we will never take those amalgams out of there and put this white goop in there.’ Eat my words once again, so I’ve learned to say never. But if you look at the technology, look at the scans. You can take and scan a crown prep, be at your lab in ten minutes have a 3D model printed and have that crown back, and the fits are unbelievable. 

So my point is, as a new dentist, make sure you have good, good people skills. If you don’t, learn them. People skills can be learned, leadership can be learned. And that’s the key, I think, to becoming a great dentist. Not only just the clinical side but also the business side. And  not just… when I say business I mean developing… learn how to develop that people skills. When a patient comes in… I have a saying that says, and I think I learned this from Omar. Omar Reid for you… for many of you who don’t know Omar is just an incredible person. But Omar said one time, and I’ll never forget this, ‘people don’t care how much you know until they know how much you care.’ And that’s a fact. Everything… I always tell dentists in lectures, everything we do is optional unless infection is involved. And the reason why it’s optional is people can live without teeth. So when you take a look at it that way, and you don’t tell people because people don’t need anything, it’s to be able to create that desire to want something and to develop that relationship. And it takes time, it takes a long time to do that and to master that.

Howard: You know it’s funny when you said rubber base, I instantly thought of the Star Wars movie when Ben Kenobi said Obi-Wan Kenobi now there’s a name I haven’t heard in a long, long time. Oh my gosh. I don’t think I’ve even… I don’t think my brain has even gone to the word rubber base in a decade. Also, when I graduated in ‘87, our operative instructor Doctor Moore made us sign an ethical pledge that we would not do any of that new white crap bondodontist. And a bondodontist was a slang… when someone called you a bondodontist it didn’t get much lower than that. I mean that was a bad word and these young millennials still don’t believe it but… and when I was in dental school from ‘84 to ‘87, the entire faculty openly badmouthed the oral surgeon that was placing implants and ramus frames, or subperiosteals, as the butcher…

Tony: Right.

Howard: The quacks. When I opened up in ‘87 there was this one dentist that was placing  ramus bars, and subperiosteals, and people openly said that he should have his licence taken away and all this stuff. And now it’s all mainstream, so I always like to remind… that was three decades ago for me, that was thirty years ago. Thirty years ago this May 11, I graduated from school. And I tell millennials that, keep an open mind you don’t know it all, all your colleagues are doctors, they all have eight, ten, twelve years of college. I have nine years of college, what may seem heretical, and crazy, and insane today, could be mainstream tomorrow and physicians, dentists and lawyers have an intense way of shooting whoever climbs the highest up the telephone pole.

Tony: Right.

Howard: And…

Tony: A lot of… I think it’s…

Howard: Omar Reid, and Ryan..we’ve got to get Omar on the show. Omar Reid, I mean… I think he was probably misquoted more than…

Tony: Yeah.

Howard: Anybody I know. I mean he used to say in his lectures that I heard in ‘87 that dentists they… when they’re doing a crown prep, they drill, rinse, dry, drill, rinse, dry, look, drill, rinse, dry, look, drill… and he says dammit the burrs only touched there for ninety seconds.

Tony: Exactly.

Howard: If you know what you’re doing cut the damn burr in ninety seconds. Instantly translated to, he’s the worst dentist in the world he only spends ninety seconds on a crown prep, it’s like… and when I started lecturing Omar told me, he said, ‘I just want you to know that ninety-nine percent of all the quotes that will ever be associated with you, you never even said.’ That’s the way… remember how they did that in kindergarten, where you’d sit in a circle and the teacher would whisper something in one ear and by the time it got to the end…

Tony: Right.

Howard: Everybody would start laughing because it wasn’t even close.

Tony: Yeah.

Howard: So tell us, if someone wants to get into… well first of all what’s your faves on tooth colored fillings and crowns? What do… I know what my homies want, they’re always emailing me, ‘you should’ve asked him what he uses.’ This is no commercial…

Tony: Right.

Howard: You’re doing this free. This is my free silly, insane hobby that I love. This is my favourite hobby. But I know they want to know, ‘well come on dude’, you’ve been doing this for thirty-seven years. What do you use for a composite? What is your white crown?

Tony: Well, again it relates back to a long study… career study in occlusion. It really is dictated by occlusion. I have an incredible lab technician, I mean I consider him one of the top in the world.

Howard: Who is it?

Tony: It’s Bob Clark at Williams Dental Lab out of Gilroy, California. It’s Williams Dental Lab. And Bobby… it’s a lab of about forty people… Bobby touches every piece of ceramic. So let’s talk a minute. I just wrote an article for Boko on Ormocer, it’s organic modified ceramic. And this material is incredible, it’s the first material without a monomer in it. It’s not a composite. 

My favourite composite… nowadays we’re blessed with… by the way, I wanted to mention. I graduated in 1980. In 1980, and this comes out in the article that’s going to be published in October.  In 1980, Howard… the gentleman in charge of our histology lab, and that’s the department I taught in and did research in, was Charlie Cox, who became a pulp biologist. But when I was in dental school you could only etch the enamel, we had concise and adapting they were the only two composites, and we used them in class three restorations. And that was it. So we never put etch on dentin. And when I’m lecturing I say, ‘now we put it on by the gallons’ it’s because we know it’s okay. As far as composites, there’s a lot of great composites out there. We’re now in an age where the tech… the scientist and the R and D that’s being done, we can now use a material that is bulk fill, like in the posterior. So before we used to layer one to two millimeters and cure, now we can go four, five millimeters and it’s unbelievable, and it doesn’t cause the stress in the restoration. There’s a lot of great composites, I like 3M’s products…

Howard: 3M made Concise, didn’t they?

Tony: Yes. Yeah.

Howard: And who made it Adaptic?

Tony: I think J and J.

Howard: Johnson and Johnson…

Tony: Yeah.

Howard: Made Adaptic.

Tony: Yeah.

Howard: And Concise was 3M.

Tony: Yeah. Yeah. So…

Howard: And where did you buy your rubber base from?

Tony: Didn’t it come…

Howard: Health Co?…

Tony: Back in those days we had so many multiple different dental suppliers and that’s the other thing, when you see some companies like Danaher and them that have just bought all of these conglomerates.

Howard: Yeah, and the biggest distributor back then was Health Co.

Tony: Health Co. was… when I took my Florida.

Howard: Out of Dallas.

Tony: Yeah. When I took my Florida licence, I was licenced in ‘83, ‘84 in Florida. They flunked about sixty percent of the applicants and it was a five day test, but Health Co. called me and they helped me actually get a perio patient down in Gainesville and I took it. Living in Michigan I thought, ‘well, I’ll spend the winters...I’ll be a snowbird in Florida.’ So Health Co. called me to let me know I’d passed but then we had so… And here is… a lot of young dentists may not recognize, we used to save up for like the big… For us in the Mid-West we’d go to the Chicago Dental Show, because that’s when the sales were going to take place. So we’d buy all these burrs, all these impression materials in huge quantity with huge savings at these meetings. Nowadays you don’t even have to keep anything in stock pretty much, you just call and it’s there the next day.

Howard: Why did Health Co. go bankrupt? I wonder.

Tony: I have not… Well the competition usually, but we had S and S White, you had Health Co., Patterson’s still here, Schein at the time was… the combination of Schein was… what was it? I forget. Henry Schein, but… but anyway… but my favourite composites are so many. GC makes a good composite. The one thing I do know is that when you decide to use a material, do a little checking on how much R and D was done. One of the things about 3M is that they have their own R and D and they put out good products. They really do. And there’s a lot of great companies.

Howard: You talked about that your lab is williamsdentallab.com

Tony: Yes.

Howard: williamsdentallab.com. A lot of the young kids are saying, ‘should I be using a williamsdentallab.com? Or should I buy a chairside milling machine?’

Tony: Well I have said… and by the way, for instance, my lab technician is all for that. It doesn’t bother him that someone has a milling machine. If I were just coming out of school or I reached a point, after a couple of years, I could afford it. You have to obviously... again, what’s the return on investment. Right? And I most likely would buy a milling machine nowadays, however, here’s the problem. I’m in Las Vegas and I’ve been blessed with some great patients, I get to do some of the performers, smile makeovers whatever. And it has to do with what are the patient’s expectations? When I do a smile makeover, whether it be eight, ten veneers, upper and lower, full mouth reconstruction, their expectations are incredible. The anterior crowns, when Bobby does a smile makeover, they’ll have anywhere from five, six, seven, eight different colors, the translucency, the texture (so you don’t look like chicklets). When you put this in, you… I want it to be able to… people to say, ‘is that real? Or is that fake?’

Howard: Well let me ask another difficult question. One of the biggest problems that twenty-five year olds have..

Tony: Right.

Howard: That fifty-five year olds don’t have, is the patient talking them into doing something they don’t want to do.

Tony: Right.

Howard: They say, ‘we need to paint this red’, they patient you to do it blue and then when it fails.

Tony: Right.

Howard: Then it’s like, ‘God, I didn’t even want to do that.’ And it’s tough to stand your ground when you’re twenty-five when you’ve been burned five or six times. But what do you do about this specifically?

Tony: Yeah.

Howard: When the patient wants something that looks like a bunch of chicklets on a straight line, bleach white, big. And she just wants some… she just wants some gosh darn chicklets, and the dentist is sitting there thinking, ‘no, you don’t.’ How do you handle that psychologically?

Tony: Well, for me, who’s buying the product? Okay. If it’s not going to violate any occlusal issues and the patient comes in, and I have had that happen. Now, there’s certain things that you and I could probably write a book for all the number of years we’ve been in practice. Where you’re halfway through something, ‘you go, oh my God, why am I in the middle of this?’ And that’s just time, you learn that professionally at the time where you realize… when you and I got out of school we thought, ‘okay, these are golden hands there’s no better hands. I have to let that patient know how much I know, not how much I care.’ We learned that’s the wrong thing. And then you think, ‘I have to treat every patient that walks through that door.’ No, you don’t. Sometimes, and that’s… when a new patient comes in our office, and I have a great team, I spend the first hour, probably the first half hour easily, interviewing that patient because I want to find out if it’s a good fit. Now you can’t always tell that, and we’ve all been there. But if I get into a cosmetic case where the patient says, ‘I want the absolute whitest teeth I can get,’ I don’t have a problem with that. As long as they realize, and I go over this with them and I have them sign a release, these will probably look fake. But, I have a patient right now that I did ten on top, ten on the bottom. And she’s a top hairdresser here in town, and she wants the mesials of the anterior teeth seven through ten, to be square. We know that’s not feminine as rounded, but she says, ‘no, I want them square.’ Now the key is here, in this situation, I can always round those. But if the patient is asking you to do something and you know, not that it’s a preference for you, but you know it’s going to somehow end in the failure of the case. I won’t do it. If it’s a preference that they want on color, shade, shape, whatever. They have to live with it. It has my name on it, but that’s their choice. They’re paying your bill.

Howard: I don’t want to be crude, or crass, or rude, or anything, but there was a great movie about this looking fake… knew these were going to look fake. Do you remember the documentary… the docu-drama movie Breast Men, that had David Schwimmer and Chris Cooper, an all star cast. Do you remember that? It was…

Tony: I don’t remember it.

Howard: It’s one of the… That’s the guy from Friends, right?

Tony: Yeah. Yeah. Yeah. Yeah.

Howard: Yeah. Yeah. And it was an amazing movie because back then in the day, I mean that movie would’ve started a… the invention in the 1960’s and down in Texas all the women wanted them just crazy big. And now that’s kind of gone. And now...

Tony: Except in Vegas. Except in Vegas.

Howard: Except in Vegas. But it was a really great movie because these doctors, their peers in the hospitals would say, ‘that is way too big,’ and they would say, ‘that’s what they want.’ In fact, that lady, I had to take her old ones out and put new ones in and that was crazy times. And Al Corning got sued. It was a neat movie.

Tony: Right.

Howard: Kind of like for HIV my favourite was, And The Band Played On, I mean those really were good docu-drama…

Tony: True.

Howard: Of the times we lived through. But yeah, but now it  does seem like the market is getting to more natural… I want it to look really good in natural. But in the ‘80’s the word natural wasn’t even a concept it was like fake was great. Even with money people would always say just fake it until you make it. I mean if you had…

Tony: Right. A perfect example is this, is sometime you’d have a patient come in for a smile makeover, they want veneers, and in most situations the smile corridor is usually to the first bicuspid, sometimes the second, but a lot of times the first bicuspid. And so they ask you, ‘how many teeth should I do?’ And so what I do is just hand them a big mirror and say, ‘smile.’ And you’ve learned that over the years and I say, ‘how many do you think you should do?’ And if they ask me I say, ‘usually, in most situations, eight will get you by with your smile. Eight on the top, on the bottom, whatever.’ And they’ll say, ‘well I only want to do six.’ So you’re in a dilemma saying, and there’s a very famous… (which I won’t say his name because the dentist… I met the dentist in  Florida) actor out there, that was on  Friends, that when they smiled you had cuspid to cuspid and the first bicuspids are as dark as can be, and that’s what you focussed on. But you’re in a dilemma, should I… okay am I going to do it? Yeah, you’re going to do it. Patient wants six, give them six. You gave the patient what they want.

Howard: We were joking about rubber base and saying that was a blast from the past. So going from rubber base, now we’re all the way to digital scanning.

Tony: Yeah.

Howard: When you’re working with your lab, Williams Dental Lab…

Tony: Yes.

Howard: Do you still find when you’re doing a big case, an arch, ten veneers, whatever, are you still using PVS, or Impregum, or have you switched to digital scanning?

Tony: I use both. Most of the time if it’s a big case I’ll still use impression material. And that usually has to do with convenience and also time. Okay. Now, I’m doing a study right now, and so far I have about twenty single crowns, where I’m taking postoperative xrays. And our impressions, I’m very proud, are  just beautiful. They really are when we do a single prep. But still you have the human factor of taking that impression material, pouring, trimming the dye. So you’re dependent not only on the chemistry of the impression material. Right? Coming down the cylinder, mixing. But you’re also depending on proper stone mixture, and the trimming of the dye. There’s a human factor there. Whereas with scanning it’s like a video and it’s 3D printed. There is… it sees exactly what’s there. And of course we can get into the discussion garbage in, garbage out. But the bits on these scan restorations are unbelievable. I cannot believe what I’m seeing. Because as you look down on a prep sometimes your enamel, if you’re doing a shoulder, a modified shoulder, chamfer, is a little bit thicker in an area and there will be… well when the lab technician, I have found, sometimes trims that away and you go to seat the crown it’s perfectly seated, it’s a perfect crown but there’ll be a little bleep of enamel you’ll see on the x-ray. So, the fit’s unbelievable. It’s incredible.

Howard: So, are you using scanning for single units and then impression material for large?

Tony: I’ve used scanning for anterior, smile makeovers. For full arch, because of the transfer, the occlusion and everything I’m still using the impression material. However, saying that…

Howard: Which impression material?

Tony: I use a combination of Imprint 4 from 3M and I also use Splash from Den-Mat. Because I like… the deal is I like an extra light body. If I’m doing a full arch, or a multiple tooth arch I want to have enough working time. And the extra light impression material from Den-Mat, the Splash is excellent and also the impression material Imprint from 3M is incredible also.

Howard: That’s going to be my new nickname, I’m going to start going by Splash since I’m an extra light body.

Tony: I think you’ve got to get in line for that one.

Howard: I’m going to go from Howard to Splash. And Imprint, that’s so far the only thing we’ve disagreed on. So you still like the vinyl polysiloxane, I’ve been on ether Impregum for…

Tony: Yeah

Howard: Thirty years.

Tony: We do.

Howard: What do you think of Impregum and Polyether?

Tony: I’ve used it. I have multiple impressions that I show in courses. I like it, the problem, and it’s gotten better, is I don’t like getting that stuff locked on man.

Howard: Well, it goes to show you I never will forget, I had dinner with John Miles one time who had the biggest boat in the Chesapeake Bay. He was the CEO of (inaudible 38:13) Fly forever.

Tony: Right. Right. Yeah.

Howard: He said that dentists were the most brand loyal customers there are in the industry and every industry he studied…

Tony: Right.

Howard: We were the most brand loyal because we had so many products, and we had so many things we had to learn and so many problems, that dentists will never fix anything that’s not broken. So there you go I’ve been on… I use Impregum, that wasn’t a problem.

Tony: It’s working, don’t break it. Right.

Howard: Yeah, because every dentist has so many things that’s not working, they’re always taking courses where the problems are. And so go back to scanner, which scanner did you like?

Tony: I have…

Howard: Or which one did you go with?

Tony: I have the 3M True Definition scanner. And I do some teaching for 3M, some instructing, and they’ve been very good to me as a company. In fact, it’s funny you mentioned that. I just talked to R and D the other day because the key is, it is a scanner that requires powder, and the key is to go powder free. However, saying that, the reason why everything isn’t powder free is because of the contrast. If you’re doing, let’s say, let’s use a single crown prep, you need that contrast for detail. And I’ve always said if powder free, and we know where this company, Sirona has gone from. If powder free is the absolute best, you have to believe Cerec would have it so fast it’s unbelievable. And they do have it a little bit powder free, however, in saying that it’s still, at this time the  engineers are working on getting that detail and that contrast powder free. It’s still a little… go ahead.

Howard: Well it’s kind of a weird market because like we’re doing a root canal…

Tony: Yeah.

Howard: For six hundred to twelve hundred dollars and the dentists want to go like, well I want to go a one file system. It’s like come on dude. I remember bonding agents, I mean forever the bond was etch primer resin, and those were the gold standards. So they’re like I just want a single bond I want to (inaudible 40:17).

Tony: Yeah.

Howard: I don’t want that other… sometimes maybe if another step is the best thing to do, I would hope the guy doing my bypass, or removing my colon cancer is not sitting there, with me flayed open saying, ‘well there was this really great technique, but I’m going to save a step.’ Do you know what I mean? I mean some of the stuff almost gets crazy where…

Tony: Well, and that brings up another issue. We have a morning huddle every morning, and in my lectures I talk about what is called showtime. And this is what showtime is, and this is my advice to the young dentists and to all dentists. Everyday, every patient deserves your very best, and we have a thing called showtime in the morning. We meet twenty, twenty-five minutes before our patients, we go over the schedule and we all have outside lives. We have lives outside the dental office, there may be a… you may have a young child that’s having a difficult… you may have something at home that’s going on. Guess what? Your patients don’t want to hear about it. And it’s just like you mentioned and I use this example, if I ever have to have bypass surgery you better believe that I want that cardio surgeon to have the best day of their lives. If they need a steak dinner the night before, if they need to go to a five star restaurant, whatever they need I’ll take care of that. But I want that doctor to have the best day of their life and quite honestly, that’s what every patient deserves every time they come in the office with us. They deserve the very best.

Howard: I actually want prostate cancer. You know why?

Tony: Why?

Howard: Because my doctor says that if you’re a man and you live long and like if you live to be…

Tony: Yeah. Yeah.

Howard: A hundred years old…

Tony: Yeah.

Howard: You’re going to get it.

Tony: Yeah.

Howard: So the only people who don’t get prostate cancer, in fact I tell my boys the only thing I want to be remembered for is, is everybody saying, ‘damn, he lived a long time.’

Tony: Yeah.

Howard: And your goal should be, I live so damn long I drop dead of prostate cancer at a hundred and fourteen.

Tony: Yeah.

Howard: But they say if you live long enough you will absolutely get it.

Tony: Yeah.

Howard: I want to give you a… I contacted you, you didn’t contact me. I’m a big fan of yours and spoke to you on the Catapult Speaking list, you guys are amazing. But your website is the best. Every time a dentist sends me an email, I hit reply and take off their name at and put a www in front of their deal… to see their website. And I would say that ninety-five percent of all the websites looked like they were bought at a convention…

Tony: Sure.

Howard: Five or ten years ago and the consumers come onto your website and the first thing they see from you… I mean it’s so personal and human…

Tony: Yeah.

Howard: Because if I was going to… if I was going to… say I had a… say I had to go get a bypass and… or whatever, I’d want to meet the doctor.

Tony: Yeah.

Howard: Is this someone I can relate to? Is this someone I have chemistry with? And then you go through and you introduce other team members.

Tony: Sure.

Howard: You talk about your exceptional staff, I mean you get a… I have to tell you, you have the best website I’ve ever seen. Everybody should go to drtomaroexceptionaldentistry.com and then go back and look at your website. And if you were Mrs Johnson and you were Googling veneers, or dentist, or whatever, look at your cut and paste website. And most dentists don’t even… they don’t even… most of us don’t even have a picture of ourselves on the website, and if they do it looks like a mugshot from their last DUI.

Tony: Right.

Howard: And here you have a video, a video. And you just seem so confident. I mean I watch that video and it’s like this guy knows what he’s talking about, and I would trust him to do whatever he says he’s going to do. You just… because we’re buying the invisible.

Tony: Yeah.

Howard: I don’t know if you… if you had three doctors to pick from, on doing your bypass, I mean I would want a referral, I would want to talk to physicians that know all three of these cardiovascular surgeons. And go into your website but kudo’s to you buddy.

Tony: Thank you.

Howard: Who… did you build that website yourself?

Tony: Yeah.

Howard: Did you use a company?

Tony: Yeah, a lot of it we build ourselves. In fact what I’m getting ready is to, you’re not going to believe this, redo it.

Howard: It’s never good enough. It’s never good enough for you perfectionists.

Tony: I know. I know, but there’s a certain part of the market… I’ve been blessed in that,  I’ve restored a lot of dentists mouth, which if… the young dentists if you want to see people try to put pressure on you. One of the first things I do when I restore a dentist's mouth is let them know, ‘hey, I’ll listen to you. You have a say in it, but you’re the patient, I’m the doctor.’ So, and I’ve been blessed with, like I said, out of town patients and things like that. One of the things that I really want to get across to young dentists, is we’re in a tough profession. We have a number of heart attacks and things like that, but just like for those that don’t know. Howard, his son Ryan, runs pretty much this podcast. I can’t tell dentists that are married or has a family, take the time to enjoy your family. Dentistry’s always going to be there. We have, my wife and I of thirty-seven years, and I’ve been blessed. She’s unbelievable. We have three boys and a daughter, I have three boys that play extensive hockey. But we always… I always… and they think I’m crazy and everything else, but I can’t tell you enough, to take the time to enjoy your family. And just make sure you have a set vacation, make sure that that family time is there. Like I said, Howard and I both can tell you. Dentistry is there forever, but those kids, they come and they go. Unfortunately we have four that are not married. So when I give a lecture, after the first break I say, ‘how many people here have children that still live at home and not married?’ And about eighty percent, I have the… I can tell you the trick, treat them like crap so they move out. But that’s really something that we need to also promote to younger dentists, enjoy your wife, your spouse or whatever the relationship and enjoy your family time.

Howard: So we disagreed, I use polyether, you use polyvinyl siloxane. You’re pro family, I always wish every morning I was an orphan. 

Tony: It’s like that.

Howard: If I ever did get married again she would definitely be an orphan. She would have no trace of any family. She’s just..born and raised..No I’m just kidding.

Tony: Yeah.

Howard: Yeah, family is everything. And today is so damn cool because this is a Saturday morning and when I’m done with you, I have all four of my baby boys are here.

Tony: That’s it. Right on, brother.

Howard: Twenty-two, twenty-four, twenty-six, twenty-eight. I want to talk about something else you talked about. Go back on it. You said your mom and dad own an Italian restaurant in Detroit.

Tony: In the Detroit area, actually Monroe, Michigan, it’s about twenty miles, twenty-five miles from downtown Detroit.

Howard: These… I’ve been seeing it for thirty years, where the mom and dad owned a restaurant…

Tony: True.

Howard: Where the mom and dad owned their own farm, owned their own business. Those kids, they had no idea how much business they had learned. They all thought their parents were stupid.

Tony: Right.

Howard: But they didn’t realize how much they learned. But it’s the dentists that come out of school…

Tony: Right.

Howard: Where mum and dad were employees and they don’t understand or get free enterprise at all. My gosh, I tell Deans all the time. They try to expand the class size so that it will get more kids out to the rural areas, and there’s no evidence of that. The only evidence the Deans now have, and realized that, the only way you can get a kid to go to a town of five thousand out in the middle of Kansas…

Tony: Right.

Howard: Is to accept the kids from rural.

Tony: Right.

Howard: So what the Deans need to do is only accept kids, I mean some of these Midwestern states, eleven percent of those towns don’t even have one dentist. And the dentist that goes there crushes it. The dentists coming out of school they go two hours from an airport to a town of two thousand with no dentist, they’ll do a million dollars their first year.

Tony : Sure.

Howard: And… but I also tell them if you could have everything, get that kid from a town of no bigger than five grand, and that should be your whole entrance class.

Tony: Sure.

Howard: And take the kid whose mum and dad own the farm, own the store, own the business, own the dry cleaner, own the restaurant. So my question to you is, what would you say to a graduate who just walked out at twenty-five years old and she had a stay home mum and her dad was an employee in a manufacturing shop? How does she learn free enterprise? How does she… How do you crash course the business of dentistry?

Tony: Well one of the things, and Ryan and the rest of the boys, the older I get the smarter my father gets. So if this young dentist was raised in that situation…  my wife, we met a number of years ago. We met in Yuba City, California. She was a volunteer working on migrant workers. We had an agreement when we had children that we wanted, and it’s our lifestyle, it’s our decision, a stay at home mum. Kind of the model back in the days when you and I were growing up, but that’s our decision. But also, respectfully, if I had… let’s say my advice to a young dentist was, again, learn your business skills, learn what makes people tick. Build those relationships, learn those relationships. Never burn bridges. And that’s what I’ve tried to do all my life, I may not agree with someone. And just because you disagree doesn’t mean that you’re going to burn that bridge. But establish those people skills, and learn that business side so that if the day comes where you, let’s say you want to have an established family. And I don’t know what the percent is that the ladies graduating from dental school, if they end up with a family. The beauty of dentistry is that you can have a family and still practise, if you’re the mum or the father. If they decide whoever’s going to raise the children… be more of a part of the children’s life. You can still… the beauty of dentistry is you can still do dentistry on your level.

Howard: You know, the birth rate is plummeting.

Tony: Yeah.

Howard: I mean at the end of World War Two, just 1945 there was five and a half kids a family. 

Tony: Yeah.

Howard: For our generation… the baby boomers one in four had no children.

Tony: Yeah.

Howard: They say the millennials it’s going to be one in three, and a herd of humans needs about two point three kids for a family, just to maintain the herd. And if you took the twenty richest countries in the world and backed out immigration, they all have contracting populations. Japan is plummeting the worst. I mean you already hear several countries telling young girls if they have a baby, they will get an economic subsidy every month.

Tony: Yeah.

Howard: So I’m guessing probably a third of the woman dentists will probably never have a child.

Tony: Right. It’s a personal decision and we should never question that. And I have some incredible friends that are incredible mums and dentists, I mean they’re unbelievable. And I will tell you I have so much respect for that, because I don’t know if you and I could do that. Go home to… I’ve said this it’s hard, at least our four children., if you had a choice when they’re young coming to me or their mum, I lost. But it doesn’t mean it’s like that everywhere.

Howard: But I think that the key is everybody wants you to live your life for them.

Tony: Yeah. Yeah.

Howard: But the minute you start doing something…

Tony: Right.

Howard: That someone else doesn’t want you to do. Now you’re selfish.

Tony: Yeah.

Howard: Whereas a scientist would say, ‘no, you’re following your own self interest.’

Tony: Right.

Howard: ‘You are not born for your mum, you are not born for your dad, you are not born for the church, they baptize you and you follow your own self interest.’ And you said this earlier straight out of the gate. When kids ask me, ‘do you think I should specialize in paediatric dentistry?’ Dude, I think you should specialize in what you’re passionate about.

Tony: Exactly.

Howard: I mean I don’t want you to become an endodontist when you hate root canals, you’ll be on Xanax and Vodka within a year. Just follow your passion. Follow your dreams and realize that, if your passion is to live and practice right on Long Beach and have an office looking over at the ocean. Just remember that you’re going be bagging groceries and driving an Uber car on evenings and weekends. Whereas if you are an hour inland and work Monday through Friday, four ten hour days, then you can get in your hundred thousand dollar Mercedes and drive to your beach home for Friday, and Saturday, and Sunday. So follow your passion but make sure it makes sense.

I want to ask you a very specific question again, a lot of them think I have to learn… think of a restaurant, I have to learn how to make all these dishes because I’ve got a three hundred and fifty thousand dollar student loan. So a lot of them think they’re going to go out and learn how to play Simplants, do invisalign, do sleep apnoea, be a cosmetic dentist, do all their endo, treat children and there’s a big belief system that they’re going to go out and have to be a super dentist, which I think is frightening because I think… all my endodontist friends say, ‘God it’s hard just to keep up on endo.’ Every periodontist and oral surgeon I know that places implants he says, ‘God, I can barely keep up just on bone grafting, let alone on dental implants.’ Sleep apnoea, are you kidding me, that’s like an entire science. TMJ, occlusion, migraines, that’s… I mean, gosh darn, do you think she can be a super dentist? Do you think she can be all things to all her patients?

Tony: I don’t think any of us are… I often say you have to have a PHD in dental materials nowadays just to keep up. But it’s a situation where getting out of school, just master the everyday general dentistry. Just get that down, you want to take some CE. But I think you’ve said it earlier. What are you passionate about? When you first get out of school… if someone were to tell me I was going to be passionate about occlusion and cosmetics, I would’ve said, ‘are you nuts? I’m happy just doing gold work and amalgams.’ And then I really got an interest in endodontics, actually I had a choice between Boston Dental School or coming to Las Vegas and so, it’s what you’re passionate about, that’s… and again this is the beauty of our profession. You can decide… if you want to see patients from two in the morning to six in the morning on your schedule, that’s the beauty of dentistry. You can do that within the law. But if you decide that you want to just do crown and bridge, or you just want to do composites, or general... You know what? Don’t let anyone talk… it’s… and you hit it earlier. Passionate people make great leaders, and when I look back on my career. I mean we have all tried… I was… I went through Hilt Tatum, who was an early implantologist, every year we had the Alabama Study Group of Implantologists, these are people that were placing implants back in the ‘50’s. And so like you said earlier, these people they could’ve been arrested. So when you look at where dentistry has gone, I realize when you have a three hundred thousand dollar loan sitting over your head, that’s a lot of stress and a lot of pressure. But you know how to eat an elephant as we all know, is one bite at a time. Find out what you’re passionate about, try different things and establish your niche. And don’t let anyone, and this is good advice, don’t let anyone pressure you into doing something you don’t like to do. When I raised my children I said, ‘listen, you’ve got to love what you do.’ My kids know there’s days I’d rather be duck hunting, pheasant hunting, or fishing. But my kids know I love to go to the office every day that I can go there. And I’ve been blessed, but you have to love what you do. If you don’t love what you do, don’t do it. You have that choice.

Howard: Yeah. And the other thing, they have that three hundred and fifty thousand student loans, and another thing they do a huge error is, they take on every case. And taking on every case is fun for growth and opportunity, especially if you have a lot of friends in your zip code that you can run cases by.

Tony: Sure.

Howard: For friends that you’re going to lunch with and all that, but where you’re always going to screw up is when you don’t have chemistry with that patient, and you sense, ‘okay, this is… this is a weird person, this is a bizarro, and this is a crazy person.’ And I’m not saying that it’s almost always a woman, but it is. And she’s got her crazy eye, she’s got her crazy expectations, she’s telling you everything she hated about the last three or four dentists. And you’re like,’yeah, this doing your upper ten veneer case sounds really cool,’ and you realize…

Tony: Yeah.

Howard: This is someone you’re not going to please. This is a crazy lady.

Tony: Right.

Howard: And even though that ten thousand dollars sounds real fun and cool.

Tony: Right.

Howard: It’s going to be the biggest nightmare you’ve ever had.

Tony: The biggest mistake that I see dentists do when they’re doing full mouth reconstruction, is they see the payday at the prep time and they hurry the occlusion, where the occlusion could be. Not only that, but as young dentists, establish those relationships with specialists, whether it is a good periodontist, a good endodontist, a good oral surgeon. Also, like in our town, we have Seattle Study Groups. There’s groups that when a case comes along you can go to these groups, or these people and say, ‘hey, can you help me out on this? What do you see in this?’ And there’s mentors that you can always find, I mean you think about the mentors that we’ve had over the years. And how many great people have promoted dentistry, and what great people have done for dentists. But also it works both ways. One of the things is I love getting a referral, which we do from our oral surgeon, our endodontist, and our periodontist. Because once you establish that confidence, and it’s a learning procedure, you’ll get patients back too. So it works multiple ways.

Howard: You said Seattle Study Club.

Tony: Yes.

Howard: So who started Seattle Study Club?

Tony: Oh, I know and I can’t…

Howard: Michael Cohen.

Tony: Yes.

Howard: And his son, I podcasted him, he was David Cohen. He’s a practice broker in Dallas. And we did a podcast of him buying and selling a dental practice. The whole time I just thought that is so damn adorable that his father, a periodontist, started the Seattle Study Club. And there’s his boy wonder selling dental practices. I just love to watch the circle of life. And that is another very interesting thing about dentistry, once you go into dentistry… like when you go to dental conventions, okay so you’ve known this lady for ten years and she’s at the 3M booth.

Tony: Yeah.

Howard: And then when she quits or moves over, she’s always on the booth across the aisle. Nobody in those conventions… nobody who ever works for the dental industry leaves the industry. It’s a cottage industry, it’s a family, if they worked for one dental lab and in ten years something went wrong or they moved to another and another one. It seems like it’s kind of like the hotel California, once you check in you’re never going to leave. It’s a great industry, I mean you’re helping patients, you’re doing surgery all day, you’re getting them out of pain. Follow your passion, I mean if I… if I had the… I had a very moral, ethical dilemma when I started my practice because I wanted to open emergency dental because the only thing I enjoyed the most… what I enjoyed the most was the emergency patients.

Tony: Sure.

Howard: When they come in holding their face, I’m just like… to get them relaxed, and get it numb, and their fear, and to remove the tooth, one in four times here in Phoenix, or root canal, fill a crown three or four times. I just wanted to do that, I didn’t want the hygiene and all that stuff. But then I thought… I had this dilemma like I had four boys…

Tony: Right.

Howard: It’s like well do I want to build a dental office that doesn’t concentrate on… for my four boys I wanted it to be all prevention, and hygiene, and sealants, and teaching them how to brush and floss. So see, Ryan, you ruined, you ruined your father’s dreams. If it wasn’t for you if I would have had a vasectomy in dental school, I would’ve learned emergency dental. And… but anyway… but yeah, so I think the best advice for these guys is don’t worry about the student loans money, there will be a day… if you’re hungry, humble, have an intense work ethic, work like no man has. There will be a year when you will make your entire student loan debt in one year.

Tony: Yeah.

Howard: You might be forty, or fifty. But there will be a year when in one year you’ll pay that whole damn thing off. In the meanwhile just have fun on the journey. Follow your dreams.

Tony: That’s…

Howard: Follow your passion. Do what turns you on. And don’t go into something for the money, go into where… follow your heart.

Tony: Right. And there’s something that I need to say here before we sign off, and that is, I always tell dentists that, do what you love to do and the money will come. But also I just want to pay kudo’s to you and what you’ve done with Dentaltown and everything else. And making, not only the dentists aware, … it’s like some dentists get upset when they see these whitening booths at the mall. And I always tell them, don’t get upset they’re making people aware of cosmetic dentistry. But I want to say to you, thank you for what you’ve done for dentists, you and your family. And what you do and making people aware of what’s available to young dentists, to existing dentists, to old dentists. But to organize a forum where you can go and ask questions, and get multiple answers. You’re just making dentists think. And I want to thank you for doing that.

Howard: Well thanks buddy, because I can honestly say I have never worked a day in my life. I grew up working with my dad and he had nine… sorry from ten to twenty I worked with my dad and everyone at school said, ‘is that right that after school you go work with your dad until twelve o’clock, it’s a school night shouldn’t you go to bed?’ It’s like the most fun part of the day was running from the school to the Sonic drive in..

Tony: Yeah.

Howard: To see my dad and that was so damn fun. Who the hell would want to go home when you could be at a the Sonic drive in with your dad eating onion rings and cheese burgers, being with your dad. All those good looking carhops on roller skates, I mean I was sad, I was sad when I had to go to school. And then with dentistry it was the same thing. I just always, always… I don’t think I ever worked a day in my life. So if you’re… one of the best advice I ever gave to any dentist in the world, is one of my buddies right up the street from me, he said, ‘dude, I’d rather be taken in the back yard and beat with a stick than do a root canal.’ I said, ‘Bob, they’re called endodontists.’ You can’t afford to do something you hate. 

Tony: I know.

Howard: He’s like, ‘but it’s a thousand dollars and insurance pays eighty percent.’ I said, ‘dude, if it takes the smile on your face, you’re not going to make a thousand dollars…

Tony: Oh, yeah.

Howard: You’re going to lose millions of dollars, your health, your stress.’ You can’t go in and hate dentistry. And I have the same rule with staff, you never ever give someone a paycheck on the first and the fifteenth that you can’t stand.

Tony: Right.

Howard: I mean if you can’t stand this person, you don’t pay them to stay in your room.

Tony: Right.

Howard: And no one's right or wrong, it’s just chemistry.

Tony: Yeah.

Howard: I mean, everyone’s different and just don’t ever do a procedure you hate, don’t ever keep existing staff that you can’t stand. Just have fun man. Just make it like a sandbox and have fun all day. I can’t believe on a Saturday morning, you decided to spend an hour talking to your bald buddy, but I’m telling you thank you so much for your Saturday morning… what’s that?

Tony: One last thing. One last thing and that is, listen I’m right here in Vegas. My offer to you. No, I don’t want a penny, is to give a lecture at the Dentaltown meeting here in Vegas. It’s about a fifteen minute drive and I’d be glad to spend hours with any young dentists, we can talk about new patients, art, smile design, whatever. But I want to thank you and what you do. And that’s my offer to you is to do that, I’d be honoured to do that for you anytime at Dentaltown meeting here.

Howard: Alright and now that this is taped and filmed, I’m going to hold you to record that the biggest event in Las Vegas history…

Tony: You’ve got it.

Howard: Since Muhammad Ali is Floyd Mayweather and Conor McGregor…

Tony: Here you go.

Howard: April 26, on a Saturday night. Three days before my birthday we’ll probably going Ryan.. Oh no, it’s not going to be… is it going to be in Vegas or is it going to be…

Tony: It’s in Vegas. I think it’s in Vegas isn’t it? It is.

Howard: I thought it was MGM Grand.

Tony: I am pretty sure. It’s either that or Team Mobile, our new arena with the hockey team coming. Team Mobile is incredible. I don’t know where it is.

Howard: And who’s going to win? The forty year old…

Tony: You ready for this? You ready for this?

Howard: The forty year old undefeated Mayweather, or the twenty-six year old (inaudible 66:30).

Tony: I learned Golden Gloves in Monroe, Michigan. I was the Golden Glove Dentist for twelve years in Grand Rapids, Michigan. You know who the top two and three fighters were for the Golden Gloves in Grand Rapids? Floyd Senior and his brother and Floyd Junior would be would be running around the gym. Their house was about two miles from my office. So, who do I think is going to win? I think Floyd is smoking.

Howard: Floyd is smoking..

Tony: Yeah.

Howard: But the question I have though is, he’s forty though. I mean this isn’t Floyd when he’s twenty-eight or thirty. I mean forty years old in boxing that’s… because remember when the greatest Muhammad Ali.

Tony: Right.

Howard: Everybody kept saying, ‘dude, retire. Retire. Retire.’ And he came back three times and you just like covering your a face like, you’re embarrassing everyone and yourself. Do you think forty is going to be a big factor?

Tony: He is so skilled, I mean we’ve seen him. A lot of his boxing matches have been frustrating, but he is so skilled about… he’s fast, he’s built like a brick. But he’s so skilled at staying away, and I think that’s going to be the key. If he gets caught with McGregor, I think he’ll go down. But I think Floyd will take him.

Howard: It’s going to be an interesting fight.

Tony: I would go one round for that kind of money, would you?

Howard: You know what’s sad though? What’s sad is the fastest growing sport in the last ten years has been this MMA, this UFC. But if any of those guys want to make any money, they have to leave that sport and go back to boxing. And McGregor will make a hundred million dollars… they’re each going to make a hundred million dollars and all the UFC fighters for that entire year, all their winnings combined, wouldn’t be a fraction of that kind of money.

Tony: No, and what’s frustrating is, and this is on my behalf, because growing up where… coming from The Bomber, Joe Lewis and seeing that growing up and everything. Is, in my own opinion, we’ve just lost the art of boxing. I mean, Muhammad Ali and Joe Frazier and those guys were incredible. I saw their first fight, I went to… I was going to school in Ohio and I went Columbus to watch it at a theatre and I think about… it was fighting, it was boxing. Nowadays, they run around the ring, they might throw twenty punches or whatever. And I miss the good old days when it was a slugfest.

Howard: And Muhammad Ali, my God what a promoter. A self promoter. I remember his fight with my favourite Muhammad Ali fight was with Earnie Shavers.

Tony: Yeah.

Howard: And he had the whole world calling him ‘Acorn’, remember that? ‘Acorn’.

Tony: Yeah.

Howard: And he was the most successful shameless promoter known to man. I mean, my God…

Tony: Thriller and Manilla all ropeadope, the whole thing…

Howard: And my dad, he was good at marketing. When I opened up my dental office, his parting words for me was, son, he goes… I opened it all up, it took four months to open. I graduated May 11, got open September 21st. First day, I was finally there, I was all ready. I had a receptionist, an assistant, a hygienist and the phone didn’t ring. And he said son, he said ‘you need to get out there and act like you’re running for mayor. You need to go to the schools, the churches, you’re running for mayor.’ He says the election is, I opened on September 11, ‘pretend that the election is November 15th. What would you do if you were going to run for mayor?’ And I went there and I got a map of my zip code 85044.

Tony: Right.

Howard: And on Saturdays and Sundays I walked down the street and knocked on every single door. And pressed the flash, gave them a  (inaudible 70:24) with my name and number. It took me six months to knock on every single door in Ahwatukee, and one out of three of those doors I knocked on became a patient.

Tony: Yeah. There’s a real quick story. So Muhammad Ali and Billy, the guy that gave the eulogy, Billy, real famous actor…

Howard: Oh yeah, Billy…

Tony: Yeah.

Howard: There used to be a Billy Squires, the guy in… not Billy Joel… Billy…

Tony: You know who I’m talking about.

Howard: Yeah, the comedian…

Tony: Muhammad Ali’s funeral he gave… he called him the Champ and everything… so they’re at Howard Cosell’s funeral and…

Howard: Billy Crystal.

Tony: Billy Crystal. Billy leans over to Muhammad Ali and says, ‘so Champ, do you think God knows that he wore a toupee?’ And Muhammad Ali said, ‘that’s the least of his worries.’ But anyway…

Howard: And the Muhammad Ali fundraiser in Phoenix every year is..

Tony: Yeah, he’s… love the guy, he just coming from Louisville, Cassius Clay, Muhammad Ali, he just took the sport to a different level. And he just… it was so much fun, it was just so exciting when there was a fight and George Foreman and all kinds of people just… I think people realize now that, not only was he the great boxer but, like you said, the promoter. But what he did for other people in the sport, it’s unbelievable.

Howard: Oh, yeah. He is the greatest. 

Tony: Alright my friend.

Howard: Thank you so much for spending your Saturday morning with me, Tony.

Tony: Thank you.

Howard: Have a rocking hot Father’s Day.

Tony: You also and Ryan thank you and don’t forget, when you’re in Vegas you call me. 


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