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1356 Brexit and Irish Orthodontics with Dr. Stephen Murray : Dentistry Uncensored with Howard Farran

1356 Brexit and Irish Orthodontics with Dr. Stephen Murray : Dentistry Uncensored with Howard Farran

2/17/2020 3:00:00 AM   |   Comments: 0   |   Views: 52

Stephen recently stood down as president of the Orthodontic Society of Ireland and is one of Listly’s 30 Dentists on Twitter. He’s originally from Northern Ireland, but he now works in Dublin in the Republic of Ireland. He graduated in Dentistry in a previous century. He managed this on the first attempt, which was more than could be said for his driving test. Dr. Murray has carried out dental research, lectured in dental topics in Ireland and the UK, published articles in dental scientific journals, and helped the editors of other journals review articles. He also teaches other dentists, having lectured and delivered popular workshops in dental photography.

VIDEO - DUwHF #1356 - Stephen Murray


AUDIO - DUwHF #1356 - Stephen Murray



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Howard: it's just a huge honor for me today to be podcast interviewing orthodontist Dr. Stephen Murray: BSC that's Bachelor of Science BDS Bachelor dental surgery FDS fellow dental surgery fellows dental surgery RSC engineer that's Royal College of surgical England Royal College of Surgeons of England MSC's master's science ortho a morph is masters in ortho and then the last one is Royal College Service England in Brook what is it Edinburgh and but you know what gang I I'm glad I did this exercise with you because I'm we're all dentist and he's Irish and I something like 1520 I think after the Irish diaspora for a time Irish were the largest minority group in the United States and but anyway and we don't know what half these initials mean so remember when you do your advertising you put a hard Frank DD SFA g BM AGD diplomat and you know that people don't know this we just know he's Stephen Murray and he's an orthodontist as swords orthodontics he's the principal orthodontists at Swords orthodontics originally graduating in dentistry BDS from Queen's University Belfast Stephen enjoyed oral surgery and he became a fellow of the dental surgery faculty at the Royal College of Surgeons of England in 1995 in 99 he was awarded a master's degree MSS ms small c in orthodontics from the University of Newcastle upon time and became a member of the Royal College of Surgeons of Edinburgh in 2000 he also is a first class honors degree in biochemistry he is registered with the Dental Council of Ireland both as a dentist and on there specialist register as an orthodontist dr. Murray has carried out dental research lectured and dental topics in Ireland in the UK published articles and dental scientific journals and helped the editors of other journals review articles he also teaches other dentists having lectured and deliver popular workshops and dental photography in a non dental capacity he has given lectures on public speaking and represented Ireland in public speaking and debating obviously he did not was not able to help Conor McGregor who I still can't understand after a fight he likes to combine his interests and abilities in dentistry and communication to reassure nervous patients dr. Murray is passionate about what he does and he's committed to continuing education about it I could go on and on and on but for me personally what Steven means to me is he's the smartest funniest guy on Twitter if you follow if you're on Twitter and by the way when Dentist tell me they're not on Twitter I have to remind you you know that the only reason the president states is the presidents from Twitter right you know that right I mean there's 1 million on CNN every night there's 3 million on Fox and this guy had 25 million Twitter followers and he got out the White House but um yeah all the power brokers and dentistry are on Twitter and LinkedIn so if you're all into Facebook it just means you're probably into Instagram and snapchat too but all the older people and all the power brokers the owners of all the dental companies all the deans of all the dental schools the smartest we're gonna find dentistry there on Twitter and LinkedIn it goes without saying but your tweets on at t4 so what is it TF orthodontist so what is the for the mainly orthodontist so that was meant 

Dr. Stephen Murray: to be the friendly orthodontist and then I realized that abbreviation could mean something else but it was a bit too late to change it what else could it have meant the friendly orthodontist couldn't possibly imagine the friendly okay read the wise read the friendly manual RTFM when something gets broken you go RTFM read the friendly manual 

Howard: oh is that what it is okay that's interesting but I but seriously man I've been loving every one of your tweets on Twitter it's either profound or funny well your were you I would say are the best fan on Twitter by a longshot your Twitter tweeting is of a very high caliber ha well you're too you're only saying that because we're both we're both Irishmen by the way is you two the greatest musician rock group that ever existed in the entire universe are just the Milky Way Dr. Stephen Murray: probably qualified I do actually like the Beatles but I would say we do two are probably the best of their generation member tanja friend of mine he said Steve this gonna upset a lot of Americans I'm really sorry about this but he says Steve could you imagine back in the mid 80s somebody might seriously been having a conversation of which was the better band u2 or Bon Jovi and the idea that anybody nowadays would have that bunch of what we probably do more concerts and sell more records and stuff but I would just say in terms of creative impact over whatever it is 40 years YouTube I don't see anybody having had the same cultural Klaus and I don't think it will because music gets more and more dispersed like they'll never be a singer as big a deal as Elvis again you know I tell you know why you know why there's media as I presume is dispersed you don't have the same narrowness the funneling of media you don't have just three TV channels on the US right

Howard:  exactly the long the long tail you used to have them too you used to have a radio station and it was half commercials so the other half was 6 3 minute song so it'd be like the police the Beatles whatever  and those guys also fifty million albums but once Steve Jobs plug the internet into the phone no one hit 50 million again and it fell to 40 to 30 to 20 to 10 and now the only people who can sell 10 million records is if their base is too poor to own a smartphone so when you look at those numbers of album sells what it tells you more is where all the poverty is around the earth because they can't afford a smartphone or anything like that butyou know what and but the other less than if we just talk about is a very profound computer rolled me back to high school the heir apparent to the Beatles and the Rolling Stones was gonna be the police how are you 

Dr. Stephen Murray: you graduated about the late eighties

Howard:  I graduated high school in 1980 okay and the police was I mean when they came out with Roxanne it was banned from the Church of in Kansas the Catholic Church the bishop told us not only to not listen to the police out there singing about prostitutes but to not listen to the radio station t95 because it was evil so every one of my friends said we didn't know what it was or like what what is he talking about so he drove straight to the record store and bought the police and then we turned around and drove out to Mays Kansas and 21st to see this new radio station t95 and put 95 singers so it shows you that just because they made it illegal was the only reason me and all my friends checked it out but the police was gonna be amazing but they couldn't keep the band together and u2 has kept the band together and when I go into dental offices why did you leave that last dental office it's always you know every time I go in there two different hygienists every time they clean my teeth it's a different girl that's why these big DSOs are they can't they can't create trust because every time the patient goes back it's a different dentist industry is

Dr. Stephen Murray:  not it should really be commodity commoditizing because it is such an intimate and personal thing for the patient they need to have a certain degree of trust and a lot of the time you're only gonna build that up by the familiarity with the person yeah 

Howard: and the police couldn't keep the band together despite all the money offered them to stay together that guy was they were just too damn crazy

Dr. Stephen Murray:  to stay together so was you three very talented individuals and this is very important for the industry as a as a life lesson I think in dentistry it is interpersonal skills have way more effect than people give them credit for dental school so you go to dental school and you are learning fillings and you know to service amalgams and Crowne margins and stuff and anybody attempts to talk to you about soft skills communication skills the first thing you're gonna say is is this on the do I need to know this and the answer is no but when you get out into the actual real world you certainly do need to know this and the interpersonal skills in between the police I'd say most of being dreadful like you've Stewart Copeland he's one of my top five drummers I've seen the police I probably being 20 feet away from Stewart Copeland and it is like being at an altar in a temple I mean he is just it's phenomenal to watch what he does but the idea that him and sting could be living in the same bus for I don't know five six years even if they had their own bosses it would still be too close to each other for guys of that caliber to to interact for any great length of time you know so they got back together in 2007 or something did a world tour sold every ticket and went their separate ways for good you know so your interpersonal skills is a big deal if you want to keep the bond together

Howrad:  and my only as a foreign the only claim I have the music is my first cousin Bobby McFerrin saying don't worry be happy it's white he made a good job of it I love that song don't worry be happy Bobby McFerrin so is that a very common name over there 

Dr. Stephen Murray: McFerrin McFerrin with an airport in Cary called foreign for now I have to look into the ideology of thousand four but I'm sure one of your ancestors had a hand in it Farr is is the Irish word for man really 

Howard: so I in Manly from that far means man yeah now we would spell it fe AR AR but you know you it would get I'm a size 2 Farr ha I never understood my name because I you know ran far I told my doctor what is diabetes run in my family he says because nobody runs in your family and I said well my name is far rat and he said they're running far away from you it has nothing to do with your diabetes so anyway and so anyway so one thing that surprised me about you and your tweets cuz like I feel like you're a brother I mean I I've been following on Twitter for so long you loved surgery I mean why didn't you go to oral you would into ortho that that's the opposite of oral surgery I mean you look at your you're raising and your  dental surgery and your accolades and surgery how did you end up an ortho

Dr. Stephen Murray:  well when I started I certainly was something I enjoyed and this other se was particularly good at it but the other thing was that if you wanted a career in surgery at the time there wasn't an established specialty in surgery and there wasn't really established training so most of it was you pick it up on the job and I prefer like a structured approach to learning so orthodontics was probably the only sort of organized teaching at that stage you know you could probably go on a course and do endo somewhere but I don't think there was as much opportunity to learn surgery then as there was now but the other thing was if you wanted to do surgery you were probably going into max faqs maxillofacial surgery rather than dead to alveolar surgery and if you were gonna do that you're going back to to medicine and you're gonna be called two o'clock in the morning cuz somebody the broken cheekbone and I've done the broken cheekbone thing but I didn't know whether I wanted to be doing that long term now the orthodontics just looked like a fun thing I do love orthodontics because the transformational aspect of but you know somebody is awful looking teeth and you can turn that around into something that looks good 

Howard: you know I really was looking so forward to having you on today because I wanted to ask you a political question in the US and since you're not in the u.s. since you're across the pond regarding smiles direct Club where you know when I got out of Dennis okay when I was born in 62 there were two billion people when I graduated from dental school in 87 there were three no it was three billion people when I was born I got a dental school we were up to five billion now I am a grandpa and we're almost an 8 billion so from 60 to the ROSAT but anyway went from 3 to 5 billion but when I got out of dental school you know a big-screen TV was five thousand dollars and it took four people to lift it and now it was the big screen how big was a big screen then would you say probably am a square meter and now that big screen TV is this thick and you can hang it on the wall and it's $500 so orthodontics has been $6,500 since I got out of school and so typically technology comes at disintermediate the middleman it makes everything faster easier higher quality lower cost so they said let's use this oral skinning we'll have a I replace the orthodontist will go from 6,500 to 2500 and the orthodontists are declared war on it and over here you can't talk about it maybe like going to a Catholic Church and talking about the Queen of England so you know so how does it look Catholic Church I wouldn't try the Church of England though that was what I meant to say so so being across the pond you can't create any enemies in America from Ireland how do you see the smiles Direct Club versus old-school orthodontist from 9,000 miles away 

Dr. Stephen Murray: well I can create enough enemies in Ireland so I've got to be careful about what I say those kind of guys of lawyers that that reach along a long way smile direct club is in Ireland incidentally they came into Ireland last year and we also have another direct-to-consumer orthodontist called your smile direct or something along those lines so we've a couple and we will have a couple of operations in Ireland that we're providing the service to other European countries because a lot of this is done cross border as well it's not just on within a country so I suppose the first thing is if you're gonna and I've been approached probably in about four occasions by an indirect orthodontic company to provide the orthodontic services for them which I declined I will be very just as a provider unhappy to be providing orthodontics for a patient that I don't actually personally see and now I would be keen on doing tele-dentistry and having the the respond ability of making a prescription for a patient that I haven't examined now I appreciate that goes against technology I mean you're sitting there in Arizona I'm sitting here in Dublin we're having this conversation it's probably a couple of seconds of a time lag but you know it would have been unimaginable this level of technology when you qualified when I qualified I mean you know let's America put a man on the moon 50 years ago but we couldn't have done this so technology has moved on but I probably wouldn't be keen on doing orthodontics over the internet as a provider what do I think of it as an orthodontist my main concern would be the patient safety aspect if you haven't properly examined a patient it's pretty difficult to prescribed for a patient so yeah the kind of the kind of director consumer to mail-order orthodontics it's proposed I wouldn't be keen on it why if they declared war on it in the US I suppose there's two levels of concern amongst the specialty is there is the idea of dentists in orthodontics which I wouldn't really I can see why they're unhappy with it but I don't think you from serious argument against it if somebody is competent and it's within their field but the idea of the consumer directly accessing dentistry that is I don't know it's these guys who do it they would be getting a lot of applause because of scene is a disrupter you know they're disrupting a monopolized provision of service and you know they're cutting out the middleman and so forth but I don't think that the service that they give when you say it's dentistry two-and-a-half thousand dollars instead of six and a half thousand dollars it's not exactly the same it's not even the same as an orthodontists providing Invisalign you know you're not going to be putting the attachments on the teeth you're going to be doing I would imagine some sort of it would be a treatment probably like a predecessor of Invisalign you don't you one of those aligners is not going to have the same kind of force transmission to two teeth no I'm not speaking from experience I haven't tried smile direct aligners I'd already want to bring down their wrath upon me but I you know a liner technology is getting progressively more and more sophisticated but it's not getting significantly cheaper to the consumer at least when it's provided by provided by dentists but

Howard:  by the way when I was telling everybody I was on today that I was so excited to podcast you the orthodontist from Ireland I'm sorry to say this all my friends were asking now is that Northern Ireland or I told me you were in Dublin and they said they asked if that's Northern Ireland or Ireland so I'm gonna have to throw that one at you I mean I know

Dr. Stephen Murray:  but these friends these friends who don't know where Dublin is our family even the there are there their official alcoholic friends and they don't even know what okay no does this thing look the right way up to you because sometimes I've put stuff up on skype and it's like a mirror image how's that look right to you can you can you read those words are they the right way around that's where Dublin is so I don't know does that say Dublin they're the right way around it does it look like you're looking in a mirror it's right it's right way it's right way so Dublin is here that's the capital of the Republic of Ireland whoops there you go that pen doesn't work what you got the gist of it so that's Dublin Galway is where I used to work and I still have my house there so is there the weekend I'm registered to vote we just had an election in Ireland returned about politics so we had our election there on Saturday so we're going to choose a new government and they're still counting the votes and that's where I vote is Galway so I was driving across country there that's about two hours of a drive just to put that in perspective so I'm sure all of this country would fit inside our rizzo probably are close to it my time driving around Arizona you could drive for five hours and it wouldn't get from one end to the other right big State now Northern Ireland is these the this corner up here so Ireland is divided up into counties like you've got your country divided into States not they're not run the same way like there wouldn't be you know it's autonomous is yours but so there's six counties up here and that's Northern Ireland so down ARMA Tyrone Londonderry Antrim Londonderry sometimes called Terry as well so these and and form a note down here so these six counties are Northern Ireland Belfast where I did my degree is here it's halfway it's Belfast part of its and down part of its in Antrim so that's where I'm from originally County down and that's where they fill in Game of Thrones so if you ever seen Game of Thrones it's made in Belfast Maine and Belfast and that's part of the UK so they don't use the euro they use the pound sterling and they're about to leave the EU later this year or last month depending on what way you look at it but that's Northern Ireland and then that's the Republic of Ireland which is yeah different country really 

Howard: one less thing on the map so you had an election and they just passed the brexit so is are you guys having Northern Ireland up to the north are you glad of the new brexit direction or

Dr. Stephen Murray:  is just a nightmare that won't stop it's going to be a bit of a nightmare that won't stop my suspect Briggs it is the UK so Northern Ireland's part of the UK they're going to leave with the braixen but I think we talked originally about me coming on your show I was going to talk about brexit and dentistry and that was a couple of years ago and every month brexit took a different turn briggs it was getting more and more complicated and now it's sort of slowed down and it's not in the news it's not as big a deal anymore but i guess the big thing for Ireland north and south is when regs have happened we have an island and there's two different administrative systems on it one as part of the UK one is this separate country it's the Republic of Ireland and we have a border but those the two countries the UK and the Republic of Ireland went into the EU at the same time 1973 and over there whatever it was intervening 45 years or something like that that border became less and less obvious you know when I was a kid when we went down to visit my granny and we would go across the border and you'd have to stop at a customs post you probably have a customs supposed to go into Utah but by and large I'm sure if you drive into California it's not such a big deal but certainly you know if you drive into Canada or Mexico that border crossing is a big deal so over the over my lifetime that border became less and less significant and now suddenly it becomes highly significant because one of these countries is no longer in the EU but you know when we were both in the EU as time went on the borders between various EU countries got less and less significant and that was what applied to our the border on our island but that will probably have to be reappraised so when you talk about nightmares that never end I don't know that we have a really concrete idea even in the next 12 months how that border is going to be operating so it's a bit of an unknown thing our election well ads for the Republic of Ireland we have let's say it's two o'clock in the afternoon in Arizona so yeah you just be people who take an interest in Irish Affairs I don't know if there's many of them but yeah they'll just be getting the last results I would imagine by dinner time in the US and we're going to have a fairly extreme change of government I would say because we've had an election result that would be highly unusual here probably in the history of the States so I've taught of really going on going into a whole political analysis but we've had our government the sitting government has lost a significant number of seats and probably won't be returned as in government the main opposition party has got a few seats but probably not as many as they thought and then one of the smaller parties an absolute landslide at the election they won the biggest share of first preference votes oh yeah I need to explain Irish voting system very different to yours but I can come back to that but they have a massive number of seats probably well certainly the biggest number of seats that they've ever had and it might be their first shot at going into government and that's a party called Shin fain who will be strongly identified with the cause of reuniting Ireland and returning this six counties of Northern Ireland into the Republic of Ireland growing the IRA right sorry contain a connection to it yeah yeah 

Howard: so were you does brexit give a higher chance at north and south ireland will be reunited what kind of a timescale but

Dr. Stephen Murray:  it certainly makes the relationship between Northern Ireland and the Republic of Ireland a lot more difficult and it probably is going to create a lot more turmoil and soul-searching within Northern Ireland and within the UK so you will get some commentators will say the pregs it will destabilize the UK Scotland had a referendum to leave the UK in 2014 they voted with a small majority to remain in the UK now once brags had happened they want to have that referendum again brexit was presented to the starts in 20 the brig's a referendum was 2016 the government of the day that was David Cameron was the prime minister in the UK he was in favor of remaining in the EU and he told Scotland when the Scotland's having his referendum in 2014 the government of the day said the starts you know the only way you can be sure of staying the EU is to vote to remain in the UK if Scotland became an independent country they couldn't be sure that they the EU would have them in the EU so if they wanted to stay in the European Union they had to stay in the UK that was presented them in 2014 2016 the UK leaves the European Union anyway and the Scots weren't happy about it the starts with one of the Scotland's one of the areas in the UK that as a geographical entity voted to remain in the EU so what obviously there's more people live in England and you know that that's what carried the vote UK wise UK wide that the UK wanted to leave the European Union Scotland wanted to remain in the European Union Northern Ireland wanted to remain in the European Union whether they want to do it that badly that they want to join the Republic of Ireland that must remain to be seen but I think that's a fair while down in the cards but it's certainly gonna be back on the table it's gonna be back on the agenda with the shake-up of the government that we had in the Republic of Ireland that kind of question it's not going on the back shelf that will be I would say revisited again and again at least in terms of political rhetoric for the next few years quite frequently 

Howard: and how will all that political stuff affect the dental business of Ireland or even the UK will affect the UK 

Dr. Stephen Murray: probably the most because the Republic of Ireland still remains in the EU and whatever goes on in the EU were still part of that a lot of like my suppliers my the people that supply me with materials and stuff will have their own offices in Ireland and whether the stuff was manufactured in the US or in China or Europe you know as long as we have our supply lines the stuff will get there the problem will be if the stuff had to come in from the UK and against stock in a lorry that has to spend time at a customs post will it affect the UK it probably will because I don't know how much stuff is actually manufactured in the UK so it'll have to have its own trade arrangements with wherever its importing its stuff from [Music] but these things can be sorted I was just a question of how long it'll take them to sort it out the bigger thing then after materials is people and the free movement of people was one of the big deals of the European Union unions based on four principles free movement of goods services capital and people so I was tweet yesterday from somebody that a Greek dentist and great dentist is now this is in somewhere in England and agreed to has gone back to Greece but previously anybody in EU citizen can live and work anywhere else in the EU so there's a fair bit of movement around the place but that may show up so you were talking at the start of the podcast about dental services corporations and so forth and a lot of them would work with dentists who've graduated outside the UK and they come to work in the UK for a few years but the movement of people from around different European countries is going to stop considerably I would say in the UK until they sort out their long term arrangement with the European Union now in Ireland is not going to make a huge difference you're a French dentist want to work in Ireland you can still do that you're an Irish dentist want to work in Germany you can still do that but you UK dentist wants to work in Germany that's going to be subject to negotiations and vice versa and 

Howard: Here I am 50 qualified in Kansas but you work in Arizona do you have to do any new exams or do you just say there's my qualification from Kansas I can tell you're Irish because that was the question that was the answer I was saying right I mean you just read my mind that where are you drinking Jameson right now - I'm drinking tea berries - very classic blends yeah that's Irish for hell yeah you know there's Jameson's in that tea but but basically Arizona it's been on a bucket list forever but Arizona just passed a law that if you're a licensed dentist anywhere in the United States are license anything nurse architect engineer anything you come to Arizona work so it is causing so much obvious I'm you know I'm a Milton Freedman freak I mean I don't when people disagree is built-in Friedman it's like they're usually their disagreements there's so much wrong with it you don't even know where to start I mean it's just like you know the whole house fell down but um you know the the new the the weirdest thing about America is if you ask anybody what was the what made America great they say well man it was 500 years of people just moving here voting on their feet wanting to escape something that was worse and coming here 500 years of unfettered immigration plus some abuses I mean obviously the annihilation of the the natives the slavery all that obviously horrible but for the economic out but it was 500 years immigration so you're like and then since I got out of high school to now we anemic Leaguer like one and a half to nine percent so you say okay so you want to make America great again so you're gonna open back up Ellis Island and let people move here and vote on their feet income no no and it's like okay so the whole planet wants to shoot themselves in the foot over territorial tribalism control limiting people for movement what they don't realize that that's what the pent up demand of movement of people that's why you have border clashes Wars stagnant economy and so III assume if I live to be a hundred nothing's gonna change on the major economic issues that's why I really don't even care I mean I I think people are gonna have to learn everything they learned in 1776 they're gonna have to learn it again and again and again and someday you will have all the ingredients of almost no government free movement of people and just leave every you know if nobody's bothering you leave them alone I mean every time they vote on something you know they they make alcohol illegal on the 18th amendment they bring it back on the 21st I mean they're they're always wishy-washy back and forth and but the joke is that you know they always go back to the government the government's the one that causes a problem it's like the government will come up to you break your knee with a baseball bat steal your money and then offer to help you buy a wheelchair and it's just every time they have a problem they go back and if you look at the data around the world is about a 10% approval rating of your government and still everybody thinks that the next government will be better they just don't know that the government is the problem it's never the solution but anyway enough of that politics what's

Dr. Stephen Murray:  the alternative because you know like church that said the democracies that the worst except for all of the other alternatives

Howard:  right because I think that there's I still can't believe what nobody's talking about and that is you know when you said America went to the moon I when I hear that I always try not to laugh I'm pretty sure no one spoke English on the Apollo program those were all Nazi German soldiers stolen from Berlin who makes the Mercedes they weren't Americans that make the Chrysler it's like when Boston won the Stanley Cup no one on the team was even born in America they're all you know Canadians and Russians and you know and and Neil Armstrong when he did land on the moon he had a computer but it wasn't as strong as the one in my hand and I think when Steve Jobs plug the internet into the smartphone in 2007 that was when the individual for the first time landed on earth and he was empowered to me so everybody is connected so everybody you know so all the government laws rules and traditions were written when 90% of the people in 1880 90% of earth was illiterate and couldn't read or write and that's where all the institutions were built and they don't realize it now all those institutions have been delegitimized because this anybody with an opposing thumb as a smartphone and has access to all information and knowledge so having this old-school parochial deal where I can't get antibiotics unless I go to the doctor and get a permission slip well that's just corruption that's just a lawyer getting again pay bribing a government to pass a law so that the physicians have income inequality and I got to go through the Tollbooth and pay off the lawyer and the pharmacist and the doctors they can all make their money so I can get my antibiotics but then I can walk onto a farm and go by pounds of penicillin for cows sheep goats I mean it's so stupid ridiculous they always tell you about the opioid crisis well everyone dying of opioid overdoses because they can't legally buy it at Walgreens so they go buy it from some guy who made it in his bathtub and it's cut with fentanyl and ten other things so when they talk about fifty thousand people dying that they'll never say well the government murdered fifty thousand people by not letting them get vicodin at Walgreens or from their pharmacist they never they never want to take responsibility you lose these bulges they talk about the affordable housing crisis and so what they do is they tell you how their plan gonna pay for it but you're not planning to pay for it you're planning to go mob-style mafia shakedown people for their money and if they don't pay you the taxes you're gonna kidnap them and put them in a cage and the only reason there's a housing crisis is because of all the regulation so the government makes all the problems and then and then the people think the government is going to solve all the problems that they make it's just so asked that they're so stupid but I don't want to talk about imagine if you were a Neanderthal and you on you on were disgusted when it getting interested in geometry and you wanted to those apes are jumping around and there's a big pyramid thing if you were if you were the first Neanderthal that appreciated art it's best just to shut up and die because you're surrounded by Neanderthals and right now the people are just I mean when they're still running to the to the people that cause all the problems the government they're still running it but I'm optimistic as hell because I know this smartphone is gonna liberate him and destroy him you see that right now on China so China has been threatening everybody in the around in the press has been saying that the Chinese government's gonna shut off the Internet to Hong Kong so I was actually contacting my friends that are dentists I've lectured at their only dental school I've been the keynote speaker and Cheng Jan I was telling my friends goodbye and I hope you're okay and long live what the individual and they were laughing they're like dude they shut it down who do you think runs their internet he thinks the programmers they still haven't done anything and it's because of the smartphone so I think 2007 was the Neil Armstrong landed on the moon in 1969 and I was seven years old and I was born in 62 I remember watching it and on a black-and-white TV and the humans landed on earth in 2007 with a smartphone I was the Apollo mission by a scale and I think 2007 2 107 is going to be America the Homo sapiens finest century I mean it's it's just it's just getting better and better and better and it's all connected to the power of the individual on that smartphone interconnected so I'm totally bullets I don't think the government knows that that the smartphone cut their legs out from underneath them 2007 but I think they're starting to wise up too and Brooks is just an otherwise I mean so you're telling me I'm in England and there's this city and another that's on the continent of Europe and Brussels none of them face an election I don't know who they are and they're telling me how many fish I can get out of the sea and what I can do and one who the hell thought and now they want to build an army and you think that's a good idea I mean you're perfectly going the wrong way all the way back to Ginga's Khan and the Roman Empire I mean it's going the wrong way the individual doesn't need a queen the individual doesn't need Brussels when I want to make a decision I don't need the phone Washington DC 2,000 miles away I don't need to call you 5,000 miles away I got my supercomputer I'm the one in the environment I have the most data at hand I got all the skin in the game and I have more faith in the individual than I do Brussels or DC and when I can't understand these Millennials is I tell them all time how come I have more faith in you the individual than I do your government or Brussels or DC I mean it's just there hopefully they'll get a self-esteem pill someday and realize that they can just make a damn decision and when Moscow used to make all the aggregate cultural decisions and America didn't we exported wheat and they had to import it and they had for three times as much land the guy on the farm should decide what to plant and if your best idea is that that should be decided in Brussels or DC it's probably because you're really  dumb and not very smart and you know you could never make the decision but I can tell you the guy living on the farm he knows if he should switch from chickens to pigs to cows wheat soybean or corn and everybody's saying oh no no there should be a Department of Agriculture to make all those decisions okay just cuz you're really dumb doesn't mean the farmers dumb and the only reason you're dumb is because you think you're dumb I think you're ten times smarter than you do if they would just have faith in themselves and put their opposing thumb on their smart phone they got their eyes with their natural intelligence and they got their opposing thumb on their artificial intelligence augmented intelligence and between this natural intelligence and that augmented intelligence and that eye and that opposing thumb oh my god nothing will stop the individual and it's certainly not going to be the Roman Empire Genghis Khan or Napoleon or the modern day you know the modern day crazies so that's my rant I know but I have a note on my deal I've never supposed to talk about religion sex politics and violence have we have we violated any of those four and we missing we forgot sex did I did you two have a sexcapade so um so yeah so bringing it back to dentistry my deal would be I mean look at regulation I mean look at me look a regulation here's some they talk about the poor people not getting health care so you live in it I live on Mexico and when people talk about Mexico they always forget the fact that you went to war and stole 40% of Mexican America stoled Texas it wasn't originally intake hose New Mexico six they stole 40% of Mexico and then they then then they want to call them illegally so you go steal their Lincoln you if I came over I once told your house and then told you you were an illegal alien living in my house that I just sold like the British you know their only invention was a flag they would just land there to put up a flag and they'd say well look that's our flag this must be our country and a very very cunning invention but the bottom line is when the when some dentists from Mexico comes up here to Guadalupe which is an area of all Mexicans right across street from my dental office no American dentists license lives their practices there nothing and he sets up a dental office treating the poorest of the poor just like Jesus would have done what do they do they send in the police they arrest him which is kidnapping and take him down there and put him in a cage and then export and I mean so let me get this right you know and why well he didn't have his American paperwork in order you know what the Fuhrer says you have to have your paperwork and it has to be stamped and signed and it's just all corruption and and I think the individual should be able to decide do I want to go get a filling made for $20 by a guy that got his dental degree in Mexico in Guadalupe or do I want to go to dr. Faye ran fair ran far meeting man I should just start calling myself man man man man Fred and pay $200 I mean I have faith at the individual and because that poor person that can't afford 200 he can't afford it and now he gets nothing and they'll never tell you about they'll say well he wasn't legal well he you know he wasn't it wouldn't be quality dentistry well how do you define the quality of the dentistry that was never done so when poor people don't get dentistry that's all fine but if a poor person might get dentistry from someone trained in another country well we we better kidnap them and arrest them because everybody knows when you grew up your mother and father taught you at an early age how good it was to kidnap other people and put them in cages I mean that was just didn't you used to play that game where you'd kidnapped the neighbor and put him in a cage in the basement you just put up a tweet where you had your grand show in a cage oh my god that's so funny that you said that you connect that but but yeah so I mean I'm just I'm just anti-government and I but I don't want to get into it because I think it's gonna be a thousand years before these individuals have any faith in themselves I mean it's like the Department of Education there even says in the Constitution we do you know that's a state level but they still made a department of federal education and then when you have these kids in your state and you're trying to pick the schoolbooks for first graders at 8-6 the first thing they do is want to know what washington DC recommends dude you mean you mean we're talking about a book for a six-year-old that can barely find his butt cheek with with both hands and you need to ask someone 2,000 miles away what book he should read how about how about how about that that kid should be your parent and when you're that dumb you should just tell your six-year-old hey Frey your sex I'm three here's my car keys here's my debit card I basically can't think let you know as if you got a question ask the dog or the cat I mean I just cannot believe how pathetic people are that they think the only way society will operate is if some of the biggest fools you can find and that that's basically what I am in dentistry I'm just the  dentistry a court jester i'm the the motley fool where i'm saying it in comedy in disguise but for some reason the king won't cut my head off I mean the whole thirty years I've lectured when I get done lecturing people always say it's much the other lectures ago my god if I would have said half of what you said they wouldn't even have paint my honor I am how do you get away with saying this I said I get away with saying it because I'm gonna say it no matter what and I don't care what anybody does me I mean it living in fear is not an option and when people say that that they'll never have me back I consider that a success because everyone in your circle is telling you what you want to hear and I'm telling you what I truly believe and I in my school if I truly love and respect you and I do I really do big fan of yours well then I expect that you expect me to tell you what I honestly believe not what I'm trying to what I think you want to hear there's no point in telling me stuff like that

Dr. Stephen Murray:  I want to know a different opinion I want to be exposed to new ideas I want to be hearing stuff that I don't already hear you know there's no point in is you're talking about Steve Jobs and he's a fan of this it's like I want to employ people who tell me stuff I don't know

Howard:  yeah and even the Catholic Church remember my two older sisters are Catholic nuns and they had that my first trip out of the United States was to Fatima in Lisbon Portugal because they had this program where they would run a 747 and they'd fly 450 boys to the Seminary in Fatima and then two weeks and they'd all this religious stuff because they could get about 15 or 20 to cancel their flight home and that tripped worked on my two oldest sister they went to Fatima they signed they cancelled a return flight they've been you know nuns for 30 years and I went over there and it was one of the best trips I ever known because they didn't have Portuguese girls walking around in Wichita Kansas and they were so so fine and but anyway so the conversion trip didn't work on me but um I was where was I going with that thought oh the Catholic Church and they had the devil's advocate and the devil's advocate was kind of like the motley fool the quartet someone has to ask the opposite question and in the Catholic Church it was a formal deal so they would say we're gonna canonized Stephen Murray and everybody would tell me why he was such a saint but the Catholic Church knew well we're gonna have one guy formally be the devil's advocate and he's gonna tell me absolutely why Stephen Murray should not be canonized a saint and it would always and it was and it would always draw up a great argument so like on on smiles direct Club everybody will say to me well you know off the record I think and then they'll say what they think and I'll say well why is off the record once you post out on dental town oh my god I wouldn't want to piss off my orthodontist I mean he's in my town and he's my friend everybody's over it just like every dental lecture I go to you know you're you can't stay awake you're falling asleep then after the seminar y'all go to the bar and after two beers he's just all lit up and he's illuminated and someone will say well hey what do you think about thermal Phil and he's like man I wouldn't use that stuff on my dog I'm like why didn't you say that during your lecture just like that but in the lecture now they're a suit and a tie and they're reading a slide and they're you know they're being all weird and that's what I call mind dentistry and sounds like if you if I offend you I'm doing my job and if you can't handle it that's all you buddy it's not me I mean I'm I'm the devil's advocate I'm the I'm the motley fool I'm the court jester I'm just telling you there's two sides to every being and what Dentist never want to talk about is why it cost sixty five hundred dollars to straighten some teeth and what is that gonna be a fixed-rate tariff to what the end of time I mean we landed the moon at 69 what what about when we discover life on another planet then can we lower to 6,000 I mean what do we have to do we have to land on the Sun the moon the blue I mean I mean what just tell me I mean is it gonna be $6,500 till the end of time and if anybody tries to lower should they be shot or just be kidnapped and go to jail

Dr. Stephen Murray:  is it always that price or do you mean did the buying power of

Howard:  I mean what was it and whatever when you graduated or 6502 and and the CPI index I you it's a joke Americans believe in it but it's a joke so they told you there's been no inflation since Paul Volcker broke inflation in 1980 he was a New York Fed Chairman and we haven't had any inflation sense there's only like one or two percent okay $6,500 probably bought a Mustang or a Corvette or something in 1980 well there you go so when I was in high school in 1980 $10,000 would a bunch of the the the the going rate fine car today it's thirty thousand but in that same period from 1980 to 2020 there's been no inflation so you look at the numbers and you talk to PhDs in economics I got my MBA to ASU and they say well look at look at the house you know the houses weren't getting better bigger and the inflation was going out but they notice that the roofs the ceilings from 8 foot to 9 foot to 10 foot now they have vaulted ceilings so they went from being square foot to volume feet human foot cubic foot so that would keep the inflation down and you look at how they've changed all the measurements you know they just the reason there hasn't been a name for it same thing with crime it's the thing with crime they read the reason crime rates are falling down so much is because they change all the ways they record the crime do you get this in 

Dr. Stephen Murray: confectionery now you call them candy bars we have chocolate bars but the bar is the same price but the amount of chocolate in it has got less over the years so you used to get a 100 gram chocolate bar a 50 gram chocolate bar and now it's 35 grams instead of 50 grams but it still costs a pound or a year or whatever so the money stayed the same but the quantity that you got for that money was this

Howard:  yeah right now when I go to the store what I always do and I'm filling up my car with gas I always go in and buy one bottled water and while I'm filling my car with gas I did the calculation of 20 gallons of gas to the bottled water and you know the bottled water cost more than the gas I mean you know it's just uh it's just people but anyway I I uh I mean the end this was just saying that I I have faith in the individual I think it's gonna be great but I think it's gonna take them a hundred years to have any self esteem than the self and it's got to be it's got to be internally motivated I'll give you a management advice management all management is part of this collectivism socialism you know it's the whole mindset where if Stephen Murray shows up late to work every day he comes to work he's half hour late and he's got a bottle of Jameson in his hand and he's drunk well that's all my fault and I gotta motivate you and I got to do all these things you know you know why I'm a good manager cuz I don't manage people I find great people get out of their way if I find you give you money and then every time you have a problem you come to me and and you don't have any new ideas and I to give you new ideas so now I'm paying you and doing your job hey I got an idea I'm gonna fire your ass and I'm gonna go find someone that does their own job and that's the individual I look for internally driven self-motivated people that have a smartphone that every time they fall down they can solve their problem and the people all voting for Brussels and DC and socialized medicine are like I'm just I just want to sit on the couch and I want everything handed to me free and I have no faith in my decision-making and I really don't want to work and that that's where the battle is coming down to it's coming down to the battle of the individual and right now in America less than half the people work and the other half are like well we don't want to work and we want to shake you down and  that just makes everything more expensive more clumsy more deal so I think in the future and in fact a lot of my advice to these dentists they'll sit there and say you know they say to me things like well I wanted to put a sign on my building but I looked it up and  I'd have to get a zoning permit and I have to get a zoning bill and it's like okay well you deserve not to have a sign because you're an idiot you know what if you were to put up the sign the chance that your incompetent government would have figured I was about 5% and if they did figure it out then the chance act for 1/10 of fee a lawyer would write up a letter and I'm gonna confess to a crime I did write on the air like shouldn't do it when I was building my dental office they told me I couldn't remove this tree and when I came back to the  deal I told the guy said why the hell did you put the sign right in front of a tree I said that's the dumbest thing ever city said oh that's where it's planned but the City of Phoenix won't let you cut down that tree and I just all I'm gonna say is that tree is not there today it just it just doesn't exist and no I you know I  they fortunately they didn't have to kidnap me or throw me in a cage or give me the death penalty but the bottom line is I'm just do it it's what what did my dad I would say he'd say I'd cried to him I'd say Oh mom said I couldn't he said well you know you could have just done it and you would have got in trouble for one minute but now you ask permission she said no so now you're gonna suffer all day so that's good that's usually

Dr. Stephen Murray:  easier to get forgiveness than permission 

Howard: yes you know that that's what you get you ask permission you were denied remember that because it's gonna keep reappearing your whole life and one day you'll stop asking for information from everybody or approval or any of that stuff but I want to ask and do you think you're very on top of American social media and European UK Ireland is there really any difference between orthodontic's say in US Canada versus UK 

Dr. Stephen Murray: I mean it depends our technical you want to go to I would think if the fixed orthodontics works with wires and slot sizes and the the variety of slot size in the US will be bigger than us I think that you know there's in Europe we use a no to slope I don't know if you really want to get this technical but the OT to stop will be much more popular in Europe for the ornate wood I think something like thirty percent of us orthodontist still use the o18 slop whereas I don't think we'll be nearly as popular in Europe because a metric to imperial mouth or well here's one of the great mysteries and I've asked a lot of American orthodontists when did America go metric for ortho we do talk about Oh - Oh 1925 wires but any orthodontist you go to the US they talk about moving teeth by millimeters and they talk about grams of force you know very rarely will you hear American tone but only move that tooth by quarter inch when I moved it by thirty two second of an inch so there's a fair amount of metric but I'm sure when Edward angle was coming up with his plans back in nineteen hundred and five or something like that he wasn't thinking in terms of millimeters and grams 

Howard: well America is totally metric now really yeah I mean with drugs you know we buy by the gram we buy cocaine by the kilo and our guns we only use a nine-millimeter and it's all metric so I think I think it's funny that first we converted to metric with drugs and then the 9-millimeter gun and now at ortho so it's drugs gun an ortho that should be your next post or your next idea drugs got an ortho how my kilo of cocaine bought with my 9-millimeter move that tooth 1.8 millimeters

Dr. Stephen Murray:  very very fast 

Howard: so um isn't is Invisalign most American orthodontist that all the ones have been on my show tell me it's 80/20 eighty percent fixed wire twenty percent in design would you say that's the Ireland reality by the way if they tell you if they tell you they don't do any fix wire anymore hello hello he's a NASCAR driver for Invisalign I've always said that all the instructors should have to wear a suit with a badge of all the people that give them money and the only people I know that don't use hard wire or throw in brackets anymore they think they're on the lecture circuit for a clear aligner company and  why you can't see that just means they're young but anyway it's so it's 80/20 if it's a real-world orthodontist who actually works for a living it's 80% hardwired 20% of his line in Arizona the guy that did or

Dr. Stephen Murray:  Invisalign certification boom I won't give his name but he will be reasonably well known on the Invisalign circuit and he certified me and a lot of my Irish orthodontic buddies back in 2008 or thereabouts but my memory of him talking was that he his Invisalign was about 15% of his practice now I don't know if that's changed since Invisalign have sent him around the world to talk to us about and this but it's still only one in seven patients I don't know what would be in the practice as a whole but in terms of adult patients I'm sure it's the majority of my adult patients are Invisalign but you know teen patients certainly minority so you know 

Howard: what percent of your practice is clear liner and when you say and when I what percent of Ireland orthodontist not general dentists but orthodontist what percent of Ireland ortho is an is Claire liner

Dr. Stephen Murray:  I wish I knew I honestly I'd love to be able to tell you I'm not trying to keep it a secret I just wouldn't know what that statistic is you know I guess some of my colleagues are doing more Invisalign than me and some of them don't do it at all I don't do any lingual orthodontics that's trying to make it come back lingual orthodontics I mean the problem with lingual orthodontics when I first started getting into it as they would play with it till their their tongue but you can't control your tongue to quit playing with it and it would just come in to where the end of the tongue would just turn into a hamburger thing puts me off it is the kind of person who wants lingual orthodontics is because they are saying I have a job where I'm dealing with the public I couldn't possibly have metal things on the front of my teeth and I have to say - are you dealing with the public - are you a mime artist are you actually speaking them because if you're doing your job we have to speak to the public it may not be such a good idea to have things stuck to the back of your teeth Invisalign probably suits them better but lingual orthodontics probably does deliver better torque and the of the clear aligner market what percent is aligned technologies Invisalign or are you starting to see some newcomers come to play that are making a Invisalign run no our line is still a big boy on the block absolutely it certainly in terms of stuff that dentist used I'm not talking about the director patient model but you know I don't even know of anybody is at the races what's you know you're talking about VHS versus Betamax back in 1985 or you're talking about nokia phones where they are now compared to where they used to be you know there would be very few other aligner systems making any kind of progress in your EU one day

Howard:  what about um what about social judgemental what what does the Ireland orthodontist think when the general dentist starts to north 

Dr. Stephen Murray: Oh probably so them don't care let it be honest there's a lot of orthodontists here aren't will be indifferent to Invisalign and they just said it's a gimmick and it'll never replace the horse and there would be few orthodontists think I wish I'd got into that earlier looks like a growth market and there would be a few people would say that their bigger problem is the director consumer stuff because the darkness what do worth it on us think of the general family practicing dentists doing orthodontics Oh what do they think of that will be there would be a variation I think some people are okay with it because they still will X someday that general dentist is going to come across stuff that he's not that happy to do and you'll need to refer it out and they don't want to upset a guy who's potentially gonna refer a patient to them if the dentist knows his limitations or knows her limitations they will know what it is that they're gonna do and what they're gonna refer out and my made the two practices let's say two of the three practices that would refer patients to me most will do a certain amount of their own orthodontics there's a stock-picking question

Howard: I'm gonna set you up where you have to tell me if you had to buy put all your money in smiles direct Club or aligned technology smiles direct club they last year they plunged 48 percent after their IPO whereas align technology shares went up 61 percent but going forward align technology year-over-year revenue growth is about 22 percent we're smiles drug Club growth your ears 51 percent so smiles direct so align technology expanding with the orthodontist smiles direct Club expanding with the consumer has a bigger upside potential would go if we just started the race today 2020 and you had to put all your money in smiles direct or align technology for five years and to sell your house all your money would it be smiles direct or a line 

Dr. Stephen Murray: I don't know enough about tell us which of them is the bigger market capital company who has the bigot mark bigger market cap hmm that's that's a good question I don't know there is a financial connection between the two companies isn't there and one of those companies does have a certain amount of us a share or an interest in the other now sooner or later one of those companies started to look bigger or look like it was doing well it's not impossible that the other company would want to buy more of them or buy the mouse or own them ha okay because the business model is going to the business model could be variable for either of them smile direct will at some stage want to talk to dentists to be able to provide their stuff or their provided through is it Walmart they provide it through some company that provided some sort of retail environment in the u.s. though they 

Howard:yeah so I just found out so smiles direct Club has a market cap of 6 billion and align technology as a market cap of 20 billion 

Dr. Stephen Murray: so if I was a lion tech and I thought the smiles direct was doing well at what stage do I say I'd like to buy your company 

Howard: so you think so the first thing comes your mind is M&A activity mergers and acquisition so you're thinking that the first thing that you're thinking of is that align technology is going to be knocking on the door of smiles to our club would but I know that that could be an option for them where its smile direct what how do they grow they a market to the individual and then they try and break into the dental market or not whereas says Invisalign has already got their relationship with the dental market they could Rob Lowe from that

Howard:  I'm gonna take this a different question we talked about orthodontists in ortho we talked about clear liners is there six month braces thing going on and over in York a like 

Dr. Stephen Murray: I it is over here do you have the six month braces six month cases where general dentists just try to do that something about Mary and the guy was talking about five minute abs and then he wants to four minute abs yeah so we do have six month smiles we also have quick straight teeth Rylan like well right quick straight teeth and then there was fast smiles or something like that I don't have to go and get the leaflet or something chuckle II fit through my door three or four of those though you're asking me earlier on about how big a deal Invisalign is compared to other aligners Invisalign is far ahead the biggest provider of clear aligners but in terms of limited's go alignment orthodontics it's probably three or four difference franchisee companies doing there's another one oh wire direct or something or crazy wires or something there's there's a few different companies where you can go and do day of training and their technicians will be the wrong word but their mentors would help supervise cases we think in Inman aligner system I don't know if you have that and the US there's different removable aligners and they've moved into clear aligners but I don't know how big a market share they have so there'll be a few different ones but there'll be certainly a bigger variety of people offering fixed brace quick fix braces rather than rather than aligners but you know we do have them and 

Howard: are you going to do you think you will start cutting a line technology out of the mix and printing your own clear aligner trays you see how the printing technology is rapidly developing this does that look like that's in your horizon

Dr. Stephen Murray:  so forth for probably a couple of years and I still think I never get around to it you know it's a if you're not doing a lot of it at what point does it become worthwhile invest in the capital in the equipment and at the moment I probably wouldn't do enough of it to be good enough added to be better than Invisalign I might be able to make a whole load of aligners cheaper but maybe not 50 liners or 20 liners it might be simple for if it's the one or two two or three aligners to reposition a tooth but at the moment I mean somebody said one of my associates said like Steve would you not do all about digitally and I said it still isn't for me wouldn't be cheaper to do it digitally than to do it in plaster so I'll give you I'll give you another reason why this Brussels things thrown in my face I mean 

Howard: I just open up your web site swords ortho first thing I have to do is accept the cookies click a box and go to continue well who brought me that bullshit Russell the number one roadblock on the entire freakin Internet is I have to go accept cookies on every God dang website because somebody with an IQ of 3 it's like when I get on an airplane time they say this is a non-smoking flight I raise my hand if she said I'm like you can't smoke and she doesn't know you mean vape you can't baby there I'm gonna have a baby I'm talking about smoking are you saying we can't smoke and everything around me is laughing and it's just like and then she teaches me how to put a seatbelt on I mean this is government you know III think that if you're if you want to know how to put on your seatbelt you should pull out your smart phone and go to youtube and say is there a YouTube video that can show me how to put on a seatbelt because I have a head injury or a tumor the size of a grapefruit inside my head and it just yeah so it just I just went to your website and had to be interrupted interrupted by the greater insanity Society so but they couldn't made me lose my train of thought not just me oh yeah it's every website it's like it's like I mean if the government touches something you know you know free enterprise came up with Chanel number five the government only has one odor and it's Chanel number two but um so but I want to tell her I'm gonna tell the kids I'm gonna make that joke work somewhere calm I'm just gonna keep throwing it out there until someone laughs at it but I'm but my um but my am deal with ortho

Dr. Stephen Murray:  I went vintage aftershave some perfumes and stuff like that chanel Coco had an affair with Russian cavalry officer and there's a very rare Chanel fragrance called queer de roots which is Russian leather and fundamental smell a lot of people pick up from it is horse manure they say it's really smells like somebody's cleaned out a stable very controversial smell auditor has a sort of fecal kind of a vibe to it and they only made it for a few years in the Idaho 1920s 1930s then I made a comeback but people say that they're the current incarnation of queer the ruse is not a patch on the one they had in the 30s so 

Howard:  but I would say one thing to the kids about ortho I'll tell you this 32 years of watching it I love it when dentists you know when every tool is a hammer everything looks like a nail when I look at the greatest implantology that I ever met it was Carl Mesh and he started out as making removable dentures and the only reason he got accepted to implants is because in school they would show you these implants that were snapped and everybody blamed it on the implants but he was looking at the snap-on denture on the ramus frame and the bars and the subperiosteal saying someone here doesn't even know how to take a bite and I think learning ortho for me changed all my views on TMJ you notice that all the views on TMJ there's one set of views by a whole gallery of people eating peanuts who have never done one orthodontic case in their life and then then the orthodontists you know wouldn't you do one orthodontic case you're gonna you're gonna lose your religion with half of what you learned in TMJ because you just saw it all you know it all just changed so I love cross training and the AGD makes you do that I mean when I want to get my fa GD you had to take 500 hours but they were spread over eight areas and I didn't want to learn implants north though and I tried to get out of it they wouldn't let me but once I learned these things I understood the wisdom of my elders and so I love cross training but I can tell you that diagnosis and treatment plan is everything I'd rather you get an A+ on the diagnosis and dream plan and a C on the work because what you're gonna do one day you're gonna get an A on your work and you're gonna get an F on the die I mean you're gonna start someone that has an open bite a long face you're you know so everything is a diagnosing this is an answer to short-termer though and six-month orthos I would go if you're gonna do this I will get trained by a board-certified orthodontics who teaches orthodontists and that is the only one in America that does that is Richard Lit and and the other guy in my backyard who Harry green those are the only two orthodontists that teach it and learn how to diagnose and Dreamland and then even if you don't ever do or though now you can sit there and do diagnosis you can answer mom's questions who wants to know how our baby and our child's developing and all that stuff but a man if you go into if you go into ortho and you don't understand diagnosing true plane you can get over your head real quick and if you are gonna learn ortho I still say go ask the orthodontist across the street because let him help you learn Invisalign and do some day because he wants you to be your buddy anyway he's trying to meet you he's trying to court ya and he'd rather have 80% of something than a hundred percent of nothing and go go learn cuz you can get over your head really fast in Oregon in fact that's where I want to leave this we went over our our but a quarter my viewers are still in dental kindergarten school and the rest are all under 30 give give them a little glimpse of how a simple little can you straight my teeth and I start doing ortho and it goes terribly wrong terribly fast give them a scenario

Dr. Stephen Murray:  not looking at the whole thing the skeletal pattern of the patient is there some sort of displacement that you're missing that they're the reason they have their bite the way it is is because they're compensating for the positions of the teeth and then when you move the teeth and don't allow for the other bits and pieces they end up with a problem that was worse than when you when you began seen that happen

Howard:  have you ever had were the only way you could move the job back was have Conor McGregor just punch him right in the jaw oh yeah is Conor a hometown hero

Dr. Stephen Murray:  I think a lot of people are very proud of his his success and then he might do something it's a bit city and you know he's on the the negative coverage of things but the people will love Conor McGregor I mean it surprised me the last time I was in the u.s. 2017 when I was in the last time I was in but it was last time everything around about the time he was fighting but you see all these people walking around with McGregor t-shirts and I had no idea he was as famous abroad you know

Howard:  so you know why is so big here and during the Irish diaspora I mean it was when by the time I was in high school the african-americans Irish Americans and Latinos were all pretty much even now the Latinos took it away I think they went over 15% but 13% of this country is african-american and 13% is Irish American but man that last fight I could not believe that I was 57 years old watching my boys and I'm third-generation wrestling him so our garage was a wrestling mat the whole time we never parked a car in the garage and none of us had ever seen someone hook up with a guy and then break punch him with his shoulder and he busted his nose and then the second punch was the shoulder to the eye I mean talk about genius innovation none of me or my four boys would not we'd never seen it we'd never heard about it never thought about it we just never end Cal boy he didn't know any he had no idea he got he got punched twice in the nose and the face when he wasn't even ready for it because how would you have punched him and it was he used his shoulder that guy is a freak genius fighter and the other thing about Conor is no wild punches every single time he moves his hand it's a surgical placement of his hand crazy just crazy and then when people tell me all the crazy stuff I do I always look at him and say you know he's Irish right but I'm trying to think anything else I miss my gosh I'm just one last thing I want to ask about you know how a big red flag that someone's not thinking straight is extremism I mean you know when they just when they think completely extreme there's a lot of American dentist you think there is no indication for bicuspid extraction ever and if you do it you're just one of them you know you're you're you're not right in the head and I've just seen cases where the dad was six foot four and played football for the Phoenix Cardinals was african-american and his little wife was you know five foot tall blonde little teeth and the daughter had to have nine teeth extracted to even do this case and there's still dentist that just there's no extraction if you extract teeth you're gonna ditch the face they're gonna look all ugly blah blah blah what do you what do you say to the one out of four listeners to you that are from America saying that no you can't extract bicuspid you're gonna ditch the face ruin the smile what are you not right in the head what would you say to those people 

Dr. Stephen Murray: what's your what's your plan for the perio what where are you putting those teeth where do you think this bone is going to come from the this idea has been a big deal in American orthodontics since American orthodontics ticked off Edward angle with the great man oh no you got thirty-two teeth you should have room for thirty-two teeth in your head and legend has it that Edward angle had this skull on his desk called Old Glory and you know all thirty-two teeth were erupted and relatively well aligned now the thing was no I don't want to get in trouble with the angle society I don't know what the anthropological ethnic origin of this skull was but it probably was not racially the same as the clients that Edward was treating back in the day and a lot of the classic ideas of facial Beauty were probably at that stage based on Michelangelo's David and these sort of Greek statues and so forth but there's such variety in human anatomy and there's such variety in genetics and how people's jaws develop you know if somebody's got really bad crowding where are you going to fit though was teeth if you think you can straighten the most without you know you're not particularly in an adult you know you're not going to make the job significantly bigger white or longer etc are you gonna dish the face in you've got individuals that already have thin lips and they have poor lip support you're certainly not going to make that any better by taking the teeth out and you need to bear that in mind but on the other hand if somebody's got really bad crying I don't think you've got a straight in the teeth out so there will be cases where you can get away with straightening out the teeth and there will be cases where you will not by taking the teeth out 

Howard: noticed when you're in countries where everybody's saying like when you're in Korea everyone's Korean when you're in Japan everyone Japan even Poland's like 99% polish but when you're in the UK or Canada United States you just can't talk about racial stuff everybody's so freaked out but but there's a lot of racial - orthodontist me aren't doesn't Japan have the highest amount of class stories 

Dr. Stephen Murray: well you certainly get more times three cases in the Far East like we occasionally get a Korean lecturer over and a lot of it is pitched around treatment of class threes well when I went to when mini-implants became popular that's Korea is a big place for many implants and they were showing their implant cases and a lot of them are more class you're going to show more class three cases than we would ever be seeing where is Ireland it's a big deal a lot of us are class two because we was just small mandibles and that's the way the sort of regular facial pattern here cleft palate stats are very different from for deaf different ethnic groups don't ask me to quote them I know it's one in bi 1 in 700 occasions of a cleft palate but it's very different for other racial groups so you you know we are physically different that's when you know we will look different and certain emotive that's going to be represented in our jaws and in our teeth there are different careful metric norms the incisor inclinations are different for Caucasians two afro-americans two Asians you know that you know we'd alert him for an exam there's not that big of variety of people walk in my door but you have to be prepared for us 

Howard: well it's funny I mean when the founder of mega gen Dr. Park was in Scottsdale and someone said why did you start making gen he just said he was so honest he's so cute adorably says well the Korean people are very different they have very different teeth and jaws and when we kept telling noble Biocare that these implants were working Koreans they need to be whiter and fatter because we have more force and they kept telling us that that's impossible that all humans are the same and that that was there was no evidence for that and dr. Park said so I didn't know what to do you know Nobel Biocare they they were Caucasian and we were Korean and they didn't want to hear anything that Koreans were different than then Swedes so he started making because of that I mean he was trying to get them to change mmm only because they wouldn't do what he that they were asking that he actually started his own magazine was started in his dental office I mean he started they denied themselves a market by not taking on that kind of because  you're just so just told that there could be no difference between a Korean and a Sweden if you had think there is a difference you must be some kind of racist or something we want to do for our the orthodontic Society meets twice a year in Ireland and

Dr. Stephen Murray:  we were talking about that will be a good topic for 2021 is racial variations because we're talking earlier around there in the podcast about people moving across borders or moving around the world so you know the kind of mixture of people that an orthodontist in 2020 treats it's going to be very different to the orthodontist in 2000 and the orthodontist in 1980 you know you're gonna be geared up for different kinds of racial variation in facial profile in teeth and physiology probably as well there's different diseases affect different people 

Howard: we are at a time and my gosh thank you so much for coming on the show you can follow Stephen at TAF orthodontist by the way you never told us is that the friendly orthodontist all right Frankie with the best friendly orthodontist that friendly orthodontist which is TF orthodontist Stephen thank you so much for your gazillion and-a-half tweets and I've been a fan of all of them and thank you so much for coming on the show today thanks very much it's been a pleasure all right have a good day.

Category: Orthodontics
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