Dr. Steven Davidowitz is the owner and practicing dentist at Luxury Dentistry NYC located in the upper east side of Manhattan. He is also the Co-Founder and serves as the Director of Dental Services at MOD Mouth. Dr. Steven received his DDS degree from the New York University College of Dentistry and completed a general dentistry residency at the Brooklyn Hospital Medical Center. He did his fellowship training in Implant Surgery and Restorative Implant Dentistry at New York University and is a Fellow in the International Congress of Oral Implantologists. Dr. Steven practices general and cosmetic dentistry with a true love for smile makeover through clear aligner and porcelain veneer treatment.
VIDEO - DUwHF #1483 - Steven Davidowitz
AUDIO - DUwHF #1483 - Steven Davidowitz
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**Please excuse any typos as this was digitally transcribed.
It is just a huge honor for me today to be podcast interviewing Dr Stephen Davidowitz DDS aka dr d at luxury dentistry New York city he is the owner and practicing dentist at luxury dentistry in NYC located in the upper east side of Manhattan he's also the co-founder and serves the director of dental services at mod mouth dr steven received his DDS degree from the new York university college of dentistry where seven percent of all American dentists went and completed a general dentistry residency at Brooklyn hospital medical center he did his fellowship training in implant surgery and restorative implant dentistry at new York university and is a fellow in the international congress oral implantology dr steven practices general and cosmetic dentistry with a true love for smile makeover through clear aligner and porcelain veneer treatment he is also an active member in the American academy of clairliners in which he has published multiple articles on clear liner therapy and modalities as well as being a member of the American dental association the academy general dentistry and the American academy of facial aesthetics he was recently named a member of the real self medical review advisory board for cosmetic dentistry content on their website and platform at real self.com dr steven has been invited to collaborate with other professionals as a contributor to the upcoming smile book creating healthy and beautiful smiles with cosmetic dentistry it is currently scheduled for release in early 2020 the book will offer expert information on cosmetic and restorative dentistry procedures it is designed to be a book for dental patients that will allow them to access the latest information on how cosmetic dentistry can improve their lives he's an elite one percent Invisalign doctor currently one of only 25 nationally he's a board member of an exclusive Invisalign team of treating dentists known as rain gauge with over 100 hours of ce knowledge a year he trains mentors and teaches Invisalign dentists across north America upon graduating from the university at medicine industry in new York um he dedicated himself to providing the best dentistry he can but by the way I’m not even halfway through his resume but so I’m gonna I’m just gonna say this true or false every time i meet some guy like you who's crushing it in cosmetic dentistry they're always hot they're always good-looking they look you don't ever see somebody like me killing it in cosmetic dentistry tummy tucks facelifts boob jobs is that a fair assessment you're making me blush showered i I’m not even sure how to respond to that but it's true i mean you wouldn't go to an aerobics instructor class if it was Danny DeVito smoking a cigar up there would you so I’ll tell you what in new York city cutthroat right a cosmetic dentist you call yourself a cosmetic dentist in new York city you have to take care of yourself you got to be you got to be young to start and then you can start letting things go a little bit once you have that reputation so I’m getting to that point where i think in a few more years i could get my beer belly and start to let my beard grow and you know and not worry too much but at this point I’m still you know focused on the on the looks matching the name well i have to the guys in Scottsdale that are killing it in women's you know tummy tucks and face jobs and all that kind of stuff they're always hot and then the Elmer Fudd across the street who might have you know graduated first in his class in physics not doing too well and the same thing with physical trainers i mean you wouldn't want to get a physical trainer that was tough before we get started on all things cosmetic um i think it kind of is bizarre to me it's October 14th that's why I’m wearing orange this is my Halloween costume i uh is the greater new York dental meeting really going to be on i mean i mean they canceled hinman in march i they've already canceled the ada meeting in Florida and the greater new York still i I’ve even called them they're like we're still on and I’m like come on dude you're from downtown new York you know there's so much money involved with it that i think they're going to keep trying to make it happen as we are going through this together and the and the wave is going down in new York but now it's on its uptick i think it's going to coincide with our greater dental new York meeting i cannot imagine i mean i could see the ce aspect going on and having that done in the right way but to have those thousands and thousands of dentists and family or whatever it is walking around from booth to booth i can't see it at this point with the projection of what's going on yeah it just doesn't make any sense but i mean we're getting close because that's always it's the perfect meeting in the world because it's right after thanksgiving and the new York city i mean my god if you go there and you know like greater new York as it and i mean um the yankee has it in like February I’m like why don't you move the meeting to Antarctica um you know um Chicago midwinter Chicago in the spring in the fall it's perfect but they always have it in February where you know the wind's coming off the great lakes it's horrible but new York’s the only one the only meeting I’m aware of like even the big cologne meeting has it in march in Germany you know that's up by Poland and Russia 70 percent of Russia would be in Canada if it was on in our deal and new York’s the only one smart enough to say you know what the perfect weekend in new York is right after thanksgiving the weather's perfect i mean it's just the best meeting in the world simply because it's at the right time of the year i totally agree and you know obviously this year is an anomaly but if they had it down i have colleagues and friends from school traveling from across the country to come back to that meeting because it's a perfect time they're off from work they're able to bring their family they go to a nice hotel the city is bustling and it's gorgeous at that time of year uh and the weather is not so bad it's usually great uh but this is you know an unprecedented year for us and i cannot really imagine it going on or at least the way that i see it every year and i will probably not attend uh this year i can say that with almost full certainty so now you're in um you're right smack downtown were you born in Manhattan are you you're in Manhattan were you born in Manhattan right so the practice is actually uptown it's upper east side of Manhattan um i was born in Brooklyn i was born in Brooklyn and maimonides hospital where a lot of my family was born and that's where i grew up um and then i spent some years in Manhattan and i moved out like most uh to greener pastures and in new York we call that long island uh and that's where I’m living now with my beautiful family i have two children eli and lily and my amazing wife shawna why didn't you just buy stock in eli lilly instead of having two children and doing eli endless that's awesome um my gosh um by the way um i always think it's so funny about new York city because every time I’ve ever lectured in another country um anybody that's come to America they always run to me says I’ve visited your country i went to your country and I’m from kansas and I’m thinking okay where did you go and they always say the same thing the greater new York meeting I’m like well did you leave new York no we were there the whole time and I’m just sitting here thinking god the united states of America and they just have a vision of it that it's just new York city and I’m like okay that's uh not a very big sample size of America but i do love new York and it is confusing for the international people because new yorkers don't realize they do it but whenever you talk to a new yorker nobody actually lives in new York city like you look at denison as i say do you live in new York city no i live in Manhattan i ask you do you live in Manhattan no i live in northern Manhattan do you live in new York no i live in Brooklyn but anyway for around the world um it's just a tribal thing they all live in new York city but one-on-one no one lives in new York city it's kind of kind of weird that way isn't it you got that right howard that's the way it is i personally um uh you know i got um i just want to say this i don't like i shouldn't even be the guy to interview you because i um i don't like cosmetics i mean when a pretty girl comes in and wants veneers i mean i want a toothache i want somebody holding their face that didn't sleep last night i want to pull out a wisdom teeth i if i could just pull out teeth and do root canals i'd live happily ever after but when some girl comes in and to me this is how i see the market in my patient for 32 years if they're young and beautiful they don't need cosmetic dentistry and if they think they do they don't have any money and if they're older they just got divorced they're now going back to get fixed up to go on plenty of fish and tender and all that kind of stuff and they really want to give you a bunch of money and look 20 years younger and they're telling all this criteria and I’m and i just want to say ma'am d do you know you have a liver spot on your head uh i just i mean i run from those what attracted you to people who want to look 10 20 years later i i'd run from that case but i'd get a broken file out of an mb2 if it took me three hours so there's a bunch of answers to that firstly you know what is it about dentistry right why do we love it at least you should love it what is it about it that attracts the practitioner to want to get to that office every day some people say money but that shouldn't be the drive right it's not it's not the money it's to get somebody out of a discomfort and give them something that's going to make them feel better right so whether that's i love doing root canals because somebody comes in with this abscess and they just want to kiss you and all of a sudden you do that ind and the pressure is gone and now they feel so good they're they they're in love with you and you love that feeling because you're giving somebody back that feeling of normalcy cosmetic dentistry i feel gives somebody that feeling and it continues on and on and on and on hopefully with good prevention and regular recalls that feeling of just feeling of self-worth and whatever was bothering them that they're going crazy about in their head that they're feeling good about that that same aspect right whether it's an ind a root canal uh getting rid of excavating and aligning and putting a beautiful uh filling or an online there and getting them back function i see it the same way but with cosmetic dentistry you know um beauty is weird um you know I’m it's just it's all in the eyes the beholder i noticed when I’m um and in europe for the last 30 years they always say yeah those americans why do they whiten their teeth so much oh my god that and that wasn't half of it until the middle east got into cosmetic density because if you're wearing an all-black veil and the only thing you're showing is this area my god there's not a white enough shade in saudi i mean there's just not i mean middle east those girls they want it they want it whiter than white um how do you um how do you determine that if she's uh because i got to tell you my first uh my first veneer case was after i did lvi with dickerson back a hundred years ago fred flintstone was in the class barney rubble and i came back and he had convinced me to use this lab um by a guy named matt up in idaho and it was like 400 dollars a veneer whatever long story short i do this case and oh my god it was just perfect she looked at it and started crying because it was so ugly because there were mammalian grooves and there it was just the most naturally perfect aesthetic thing so what did i do i cut off these 400 veneers reimpressed sent it to glidewell for 89 and they gave me 10 piano keys i glued them on and now she's crying because they're the most the perfect thing and i don't even understand the word natural i mean how does it look natural that you have lipstick on i mean do you sit there and say my god your vermilion border has such excellent circulation it's like i can see the red blood cells coming out their plastic surgery their anti-gravity their face lifts look like they're you know i mean i just look at this and say you know i don't even know what to do all i do is i refer to the guy up the street from me that that once he's a glutton for this type of punishment i do i i'd rather take a pedo kid pediatric dentistry that you know needed for chrome still crowns then do a veneer case on so how do you um and then when they say i want it to look natural i mean natural like what um the coronavirus natural like hiv natural like a black hole sucking in the galaxy what i don't even know their language but how do you how you have your signature um you have the signature smile makeover approach to oral beauty um what is your signature smile makeover approach to oral beauty and how do you figure out who you're even dealing with when you're talking to that patient yeah so that's a multi-factorial question you said that's a rant that's just a rant you should just and you know what today just to you know go away from this a little bit but still in the topic um just finished up my whole staff just left we had at the end of the day i had to redo a veneer case of eight upper veneers and the reason was is that i missed something in that in the diagnostic aspect of what the patient wanted and it's very tough because people want natural but what they really are saying are chiclets and you gotta read between the lines and what made it so uh difficult is that ups was supposed to delivered it last night and it didn't come last night and my staff stayed over time we spoke to our driver at home because we have his number and he promised a beer in the morning so he knew it was on the truck and patient was scheduled three pm today 3 pm comes no case uh my office manager is running around the neighborhood trying to find the truck patients in the chair question is do we number up and start this up not these are things that that dentists you know whether it's cosmetic or anything this is just you know the extra stress that we don't need but the main thing is that i missed the cue right i missed something initially because i already did these veneers about a month ago and i tried to convince her that it was perfect i thought it was but i missed something but as far as what is natural versus you know what people actually want it's completely changed my father his name is gary Davidowitz so gary Davidowitz was at nyu at the time that they placed the first veneers it was 1982. so it's the first time they were bonding that the porcelain veneers and figuring out how it works they didn't know at that time over reduction less you know less enamel less adhesion but they were getting their bearings and at that point there were a lot of limitations in cosmetics but he moved on and he became the international aesthetics professor at nyu and he was teaching dentists from actually all over the world they would come and they have a separate program for these international dentists and he would show them these kind of tips to success that I’ve taken over as far as how do we uh how do we learn from people's interviews and how can we create something that people actually want and the main thing is obviously good verbal communication you got you got to take your time a lot of what's going on during corona now is how can we do everything remotely and not see patients right but there's a there's a there's a big need to actually see the patient and actually get to know them they have to like you have to like them they have to feel comfortable you get the right information you have to be able to ask the right questions depending where these people are from you may ask the questions in a different way but you really have to try to get a sense of what they're looking for two is we always do smile simulations there's all different ways of doing this these days with digital dentistry you could download a program and do it yourself you can have your laboratories do it we're always showing the patient what we are envisioning after our initial consultation and interview how is that going to look is the way that I’m seeing it whether it's the color shade the uh texture if it's going to have line angles length uh the whole deal and then i have a separate consultation after showing them that that image i don't just send them an email and say here you go i have them come back and we review that simulated smile so a lot of the visual and the understanding is there they they're knowing what they're getting that image then is waxed up always do a wax up when you're doing a full smile makeover i even do wax ups you know i used to be embarrassed to say it but not anymore for two veneers if I’m doing two lateral veneers i still do a wax up a lot of my colleagues see it's a waste of money so when you redo a case like that is that um is that warranty i mean do you eat the lab build you say look ma'am i know it's not perfect but I’m not going to let perfect be the enemy a damn good uh would are you either they going to have to pick up the lab bill or anything or time money materials anything right so i mean on our side we would say how could that be am right that our time is worth pretty darn a lot uh lab bills are high um but at the same time following the aesthetic tips to success of showing these simulations having transitionals that are made out of wax ups right so it's exactly what you plan on making with digital dentistry reading these wax ups and the actual transitional veneers in the mouth they should be used to everything to the point where which is most of my cases about 99.9 percent they're ecstatic at the end shading could always be something but the actual definition of the teeth using computer assisted design and then and then actually milling out these units these days it's basically what they had as a transitional veneer so they're almost always happy with that yes that small percentage i do it as a warranty it's all on me some people you can't make happy some people are crazy um a lot of people are crazy I’m crazy but yeah myself included yeah but something you just you know you cannot make happy and that's where you got to like draw the line and you know there are times where I’ll be like hey i dropped the ball because of x y and z and i need to redo this there are other times i will continuously just repeat myself that hey this is actually the best that i believe i could do for you and if i don't think i could do better I’m not going to cut these things off and potentially cause an irreversible reaction to your pulp and have other issues going on here and have less adhesion of the veneer so you gotta you have to use your judgment but definitely if i just did a case it's a large case and the patient's not happy and i think that hey okay now that i understand what's going on here i can make it better i will not charge them and that's the importance of charging the right amount initially and not keeping your fees super low and competitive right because you kind of need that the room for when those cases have to be redone and you're going to take some of that profit from somewhere and give it over to somebody else and so for your kids i want you to real think about something really quick let's just say for easy math the average overhead was um 80 it's actually 65 according to ada now when i got to school in 87 and when your dad got a gary what you're gary get out of dental school he was in 78 78 um anyway overhead used to be 50 now it's 65 but for easy man let's say it's 80 and let's say you do an implant case and you place five implant cases but one of them fails and you have an 80 overhead well to warranty redo this 80 overhead costs the profits of the other four cases and so the reason walmart has a no questions asked return policy is because only one percent of um the stuff gets returned i think the media makes everyone think that if you know go to the park you're gonna get a van is gonna drive by real slow and offer your grandkids candy and sale it's just so rare i mean um most people are good I’ll give you another example when um gaspar lazarus an orthodontist out of uh new orleans uh and a good game last night new orleans that was the saints uh weren't the ants last night that was an amazing game but when he did orthodontic centers of America he did the most genius thing him he offered um free financing so think this out uh let's say i go get my nails done and uh and i do i get my nails done and pedicure because i have my brother's gay and uh so when we get together i mean uh he doesn't want to eat and be fat like me and i don't want to go see all the movies he wants to see so often we go get her nails done let's say i went in there to get my nails done and they said okay howard it's a hundred dollars and you need them done once a month and I’m going to sell you a two-year contract so 100 a month 24 months it'd be 2 400 and I’ll need a third down and I’ll finance the other two thirds at 10 interest well you would think that's ridiculous and that's what orthodontists do all day long because the brackets are a hundred bucks uh why do you need a third when the orthodontist says i need a third down i would say well braces are two years a third down it would be eight months are you gonna prepay your staff for eight months are you gonna pre-pay your rent mortgage equipment build that computer insurance malpractice computer updates for fun hell no it's just ridiculous so gas for lazarus which is the only guy who started a dso that made it on the new York stock exchange with a billion dollar valuation before the orthodontist started getting weird about it um you know he financed all this stuff because there's nothing to finance i mean my gosh there's no financing in dentistry eighty percent of your costs are variable costs of lab labor and our people lab supplies only 20 is your fixed cost variable cost is on increases if you have more from one patient to 100 you have 100 times cost fixed costs i got to pay my rent mortgage bill that computer i got to pay my rent whether I’m open or closed so um but when you go back to these old guys like this here's where this rant was leading if you go back to guys as old as gary and gaspar lazarus and howard they still believe that only stacked porcelain is aesthetic and all this stuff you're milling out on the computer is not real so what do you how does a young guy like you um do cad cam milling when every dentist over probably over 50 thinks feldspathic stacked porcelain is the only beautiful stuff how do you change their mind about that that's it false pathway porcelain is beautiful and i still use it on cases where i know it's a young dentition they're not grinders there's no signs of wear and tear it's a beautiful material it really is the newer materials lithium dye silicate lithium silicates are gorgeous as well they really are when done properly they look great but their strength is there meaning less problems less chipping less issues down the line it also allows for the use of digital impressions and then overlaying your transitional veneers which you now put into the patient's mouth to design it in the exact same proportion because a milling machine is not human it's going to take exactly what you adjusted in the mouth right after we do our transitional veneers we realize oh this is this cusp is way too long this is going to be uh a dominant cusp it shouldn't be we got to reduce that and you do all that work and you take an image of that right digital image and now a laboratory that is well versed in this digital uh atmosphere is able to map that out and overlay it and literally mill that out and then they could add their beauty to it right there's always additional things that could be done afterwards you actually get a better result it's less human error and i love humans I’m human i think but if you allow the computer to do 99 and the human to do one percent i think we get closer to 100 perfection so um i know my homies i mean we we've had this show for years um whenever you say something like digital impressions you didn't say what kind so they're already thinking was it 3m uh true death was it um itero from uh align technology was it um you know so will you go through and the other thing is when you come out of school with 400 000 student loans if you said well you need a cad cam okay there's 100 grand you need a cbct there's 100 grand you need a millennium lately 100 grand so would you um go over um what technology is worth the return on investment for you what do you not need or you know what did you have to buy and think of that 25 year old baby that just got out of dental kindergarten school and she's just she doesn't want to go out and buy she doesn't want to double her student loan debt on three purchases of equipment especially if she doesn't need them but she wants to grow up to be like you she wants to be a new York city cosmetic dentist what technology would she have to buy and would you recommend and is worth the return on investment so I’ll say along with most dentists in this country i have my closet filled with toys that I’ll probably never ever use it's just it's things that the rep made seemed so cool and it seemed like it was going to save me money time effort it's gone right so what i learned over the decade plus uh extending close to 15 years now is you got to speak to people right you have to you have to talk to people that have used this technology before you go ahead and give your credit card or finance or things like that find out how it was in other people's hands doesn't mean it might be right for you but don't always trust that you know the lead statements of an advertisement and you know the um the ability to get forward as a cosmetic dentist or really just to be known in your area as the person on top you do have to invest and yes i still have my student debt I’ll probably have it until I’m 78 according to my last calculation but that's okay it's a part of the game so is investing in things it just adds to your investment why do people invest right why do we go into real estate why do we invest in the stock market it's to make money off of that investment so an investment should always have a return of investment but it doesn't always have to an example of that is i brought in uh into my practice something called the solea laser right by convergent a super extensive piece of technology uh i could probably do the same things at a fraction i can't even think of the fraction because it's so small the cost right a burr with the hand piece that i already have i could do the same thing with my conversion laser but it helped transform my practice in so many levels whether it's those who are crazy fearful of the drill whether it's uh with our sleep solea that I’m able to use now and then there's the fact that my dentistry is better I’m able to get these margins around my crowns like my diode laser can never do or any other laser can do I’m able to mill my crowns in the office with so much more certainty that I’m not gonna have trouble I’m gonna be able to make money on that one crown and i have to redo it I’m not gonna have it I’m not gonna have these long appointments so that crazy investment on the solea laser ends up not that it's a return of investment as far as oh i bought this piece of technology and now I’m able to do all these other procedures it just means that my procedures are actually going to have less issues less problems less sending back to the labs less you know time in the chair uh my main focus is on always excelling going further than what we're trained when you're in dental school we're not trained on anything you know whether you go to colombia or nyu we always have a little uh fun with that in new York city i still believe when you get out of dental school we don't know anything there's nothing we know how to do the basics and you should never feel uncomfortable about going past your comfort zone always learn take more ces talk to your colleagues your colleagues are not competitors they're really not even in new York in my four block radius i have like 10 dentists because we have a high population it's fine these are your colleagues learn from them and purchase things whether it's a hundred thousand dollars or three thousand dollars make the investment if you feel that it's going to take you to the next level don't be afraid take it take you to the next level if you're just going to be doing what your father did or what your dentist did as you were growing up you'll probably be left behind so um would you say that you're more a digital dentist and milling this out chair side or digital dentist sending it to a lab and they're milling out chair side or are you still um you know taking uh polyether and sending it to a lab and they're pouring up stone and models and would you say that you're more the lab or you're more have a lab man in in a lab that's not in your office uh so i have uh laboratories that are not in my office i never wanted to have a laboratory in my office i have some friends of mine who do they're it's great when you do especially in those moments where you have somebody in the chair and you have to change the shade and they could stain and things like that or dentures and they could pour it up right there uh i have great relationships with laboratories all across the country depending on the case um as far as what we use uh the uh digital dentistry that we used from the get-go from basically once i opened the practice was digital scanning right just to take an impression without having to take an analog impression and i have a gag reflex i hated impressions so when the technology was there not you know not just for sarah but to actually just take an impression that was that was viable and we could actually use i bought into it right away it was a fortune and they never used it stayed in my corner of my operator and i was still using polyether i was using pbs because it was a pill i had to spray uh this glitter all over the patient they look like they just went to a strip joint um and then they would have to go home to their uh to their spouse and explain what you know where they were and they're like oh i was about my dentist and it was it was tedious but as time evolved as time went on these impressions got easier to take more accurate to take quicker to take and it was worth the initial investment why because i was already in i was ready i already invested into it and that was a tremendous just to be able to take these digital impressions instead of taking these analog impressions sending them to the lab carrying back in the lab going back and forth and things like that you could see it when you're taking a digital impression you see your margins you if you can't see it the lab can't see it i remember with my first impressions i was like i see like about 340 degrees of the margin the lab is going to figure out the rest right they can because our lab they see like thousands of these I’m sure they can figure it out when i got into digital impressions it changed me it was like how the hell can they figure out where this margin is I’m seeing this in like high definition i can magnify it with my fingers i still can't see the margin there's no way that this restoration is going to fit properly this is only going to bite me in the ass i shouldn't be sending this in so digital impressions is really that first layer of the digital atmosphere just recently uh i got to the next so originally i was in an office that used a cerec i dabbled with it um it was tedious it was hard because you know what i didn't have the time i didn't and it was all me it still allowed me and i just didn't have the time to be that lab tech and also be the dentist um so i still worked with laboratories but i was working with digital dentistry i just recently with the whole kobit and everybody out in new York city wanting to get in and out right i come into your office i don't want to see you for six months because i have no idea what the world is going to be like i invested in glidewells uh fast mill the fastener io and i trusted i trusted the glidewell because glidewell has thousands of crowns coming in uh every week and they have such a this this artificial intelligence of picking out these crowns i didn't have to become a lab tech and it's worked out really well but we're talking in the past year so designing my own restorations just the past year prior to that always labs always working if it's cosmetic cases with these simulations wax ups uh digital scans of the transitional veneers or crowns and then copying that over to the final so using the digital atmosphere to create this predictable result therefore having less unhappy patients right to just a small percent and also having more accurate impressions because as i said if you can't see the margin don't send it in right have them come back there's no reason for it it's a waste of time so having this opportunity to see things so grandiose and seeing like these like the margin blown up to be like four times both of our faces put together is an amazing thing okay well I’m going to ask you I’m going to put you on the spot and uh so you said the fafsa bill so uh a townie posted today um i am thinking of getting this mill was wondering if anyone has any experience with it looked great at benco's showroom and we even had an eight-hour ce on it for single units with various materials i can see a benefit it mills post centered zirconia but also softer materials seemingly well any others out there the next guy says um i use this daily the one at benco is the ts-150e the one from glidewell is the fast mill io they have the same internal components and mechanisms a fast mill i o is a smaller footprint you will be able to make mill emacs soon if not already i love the mill for single units happy to talk if needed been using it for almost three years and then the last guy says what's the ballpark price on one of these bat boys do you think he meant to say ball boys or bat boys oh bat boys yeah so um so um how would you answer uh all that guy's thread yeah as of now the fastenal io since i introduced it was literally in march because that's when new York got crazy hit um and i started looking into it i brought it into the practice april i was seeing emergencies so that if i had to do this crown i could spit it out right away it's great for posterior right first second molar crowns uh they have their bruxer now i mean everything about it was perfect it's easy uh it integrates well i use the itero scanner uh right now uh it integrates beautifully with that their library of teeth that they're designing for you is almost there like you basically only have to modify these cad cam images i slightly basically the milling time is about 40 minutes so for quadrant dentistry what i do is I’ll prep the crown i will design i will start the milling get right back into the room finish the quadrant do my mods do's whatever else is going on there and by the time I’m done with that the crown is done relieve the sprue cement the crown um so it's been tremendously profitable all in one visit all while the patient is still numb from the ian block so it's been great as far as anteriors i have not yet because it's only been months i haven't used it for anterior cases yet and i probably wouldn't i have such a great relationship and love with my ceramists and laboratories that I’m using for my anterior cases any names you want to give on that or um uh so i love uh brooks uh it's uh larry and john brooks from smile vision uh i think that they play a huge role in the same lecture that my father gave and i had to listen to growing up uh of his aesthetic steps to success as far as having a good wax up and going along the way smile vision which are the brooks they are doing that visualization of the of a smile simulation for you they're actually waxing up to the exact same proportions they do such a fine job of following the same technique i love those guys uh and their work is phenomenal well lawrence is a dentist so he's a dentist that owns a lab that's right yes and his son is a lab technician uh that is licensed uh and uh there but exactly you have that too i think it's great to have that dentist there as well because he went through it he went through the grind um and that's so important right lab technicians sometimes will hate on the dentist because they're like what am i supposed to do with this right or what does he want from me but to have somebody there that went through the grind of cosmetic dentistry or dentistry alone uh is great so you went with um so you said you started out with digital impressions which on dense white serrano remember dense fly x-ray they bought uh serona which used to be siemens and now it's all one that's cerak but now you say you're using the itero which align technology owns Invisalign and eye tarot um did you use um did you go with itero because obviously you're a cosmetic dentist and you do a ton of Invisalign because if you scan with like uh three shapes um or uh truedev i think 3m sold off truedef i mean because align technology's only going to take a scan from their own scanner correct that's yeah that was that happened that didn't so was that the was that the mafiosa hard tactic where a cosmetic dentist said well you gotta buy aitero because the line is obviously the company I’ve asked a lot of orthodontists to get upset with that because um i own orthotown too and the orthodontist on me they go yeah that really pissed me off and i said well are you going to quit using them and use another clear liner and they go well unfortunately i they had the best aligners so did was that a good strategy from joe hogan where he said well i know we got the best product so if i only take itero scanners you got to deal with me so is that why you probably went with itero because it was 3m i had the 3m that was the glitter with the strip club um 3m lava i believe it was called uh and then uh cadent was taken over by itaro right or but rather by a line and they termed it itero i was familiar with cadence i knew somebody who knew somebody that was in the company of caden but they transformed it align is amazing they really are Invisalign is an amazing company joe is a great person to be leading the company now for innovation i was a huge Invisalign provider so yeah that played a huge role as far as where I’m going to throw my money and my trust it went with what they were selling because i knew that it would integrate well with all my Invisalign patients i had at one point i had 67 67 of my patient base undergoing or finished with Invisalign in my practice which is crazy uh they ready went through it or they were undergoing it and to not go with a system for my restorative cases that is so compatible with a line didn't make sense well you know i love you for that because i remember when i got out of dental school in 87 um the cosmetic dentist would come through town and uh to me i was just mortified the whole room was clapping and i was like nauseous because it was always saying would be like some girl that's already beautiful it's always a girl who's already beautiful and doesn't need crap and then she has some crowding and this and this and then the next slide ate up her eight lower teeth are filed down to rice curdles you're like oh my god and they go and um i love the fact that now you know they used to have to do a bunch of endo so you know you do a cosmetic case and you have to do well we have to root canal these four teeth and i love the fact that i think a real cosmetic doctor um will unravel a lot of that stuff so you don't have to peel off uh all the banana peeling and nerves and root canals so i love the fact that you said you finish all these uh cosmetic case with Invisalign i love the fact that we can unroll these this crowding so we don't have to stick every tooth and a pencil especially lower in size my god when you prep a lower incisor for a crown it's a rice kernel and i only eat rice when i want to sit down and eat like 2 000 of the same thing just i just want to eat 2 000 same things and um yeah so that those were gross those were uh my favorite my favorite thing howard is when somebody loses their temporary veneer all right it happens it happens all the time uh somebody loses their temper of an area what are we thinking about we're obviously thinking about occlusion we're looking at excursions and why did this come off but that's on the side point my favorite part is somebody says i don't really have to come in because it doesn't look so bad it doesn't you know it's fine i can wait the extra four days if i didn't straighten those teeth prior expand the arch and they had this little peg that was sticking out there there's not a chance in hell that they would say it's okay because it would be an excruciating pain and they would be looking terrible so it's all about conservative dentistry and the way to do that is multi-factorial you have to think about everything and easiest way is using for adults is using clear aligners to get these teeth into a better position the beautiful thing about putting veneers on teeth is that teeth don't have to be perfect before you put veneers on them because if they were you wouldn't be putting the veneers on them so the alignment doesn't have to be perfect you just want it to be better right you want that you want the uh the clearance to be there you don't want overlapping uh you want to be able to minimally prepare these teeth so using you know a line Invisalign or whatever clear aligner system i even came up with my own aligner system that me and my partners are involved in to get teeth into a healthier location better looking and then do your restorative work whether it's an implant veneers crowns your work is going to last so much longer when somebody can floss normally between teeth when somebody has a bite that's not going to be in a cross fight or into a heavy occlusion uh so i think it should always play a role at least on that ideal treatment plan like hey let's uh let's straighten the teeth before we restore these teeth um so you were I’ve also read some but um you're excited about evoke what is evoke so evoke is pretty cool uh evoke allows me I’m a cosmetic dentist so what do i know about face loves lifts i know that joan rivers looked terrible before she was deceased i know that you can overdo face lifts but evoke is a technology that uses radio frequency to help tighten and tone and reduce the fat of areas that we work with around the smile so it's the lower third of the face which is in the zone of a dentist right so when we're smiling and we're showing our teeth or if we're not smiling what is framing our mouth we got the orbicularis aurus we got our masseter muscles right and some mental right will be the floor of the mouth so all those areas when we're dealing with cosmetic dentistry it plays a huge role so if somebody has sagging skin and you give them a smile of a 20 year old you're using the lvi of a 20 year old right all of a sudden they have this youthful smile so I’m going to pick a youthful smile but their skin is like this when they're smiling it's not going to really complement each other so what evoke has allowed me to do is with a hands-free technique it's uh it's fda a class ii medical device i we're able to apply a stimulator that helps tighten the skin right around the areas of the smile which is right on the jowls and right under the chin and you um how much does it cost to get into somebody or what what's the website for that so it's in mode i-n-m-o-d-e name of the product is evoke they sell products for all over the body there are many products there that might make you blush howard and they're things that if i try to push on a patient that would probably get arrested but evoke is the is the one that really fits in beautifully with anyone that's doing any cosmetic dentistry it's a non-invasive class 2 medical device meaning not only do you not have to be licensed to use it you can actually have an assistant do it on your own and it makes cosmetic dentistry so much better in those after pictures really that is uh that is interesting and um you're uh and it's a big company i mean uh my in mode is a leading global provider of innovative radio frequency minimally and non-invasive aesthetic technology uh my gosh uh that is a uh if you if you did a hundred of your signature uh smile makeovers um how many of them would use that so i would say probably about twenty percent believe it or not uh and it happens to be I’m a strange cosmetic dentist uh most of my colleagues that i talk to that are cosmetic dentists their age bracket of where they're doing most of their work are on 40 50 and 60 year olds which is so that's so 20 percent or one in five of your patients uh use this in their case evoke and then back to um sending it out to a lab versus glidewells mill what percent if you did 100ks what percent would go out to a lab and what percent would you chairside mill 100 of my cosmetic cases is going to go out to a lab 100 yeah uh second molars first molars maybe a bicuspid uh of a single units which for many dentists is their bread and butter right if i could do five single unit crowns a day I’m golden uh i think the mill is great for that so you're using the chairside milling uh for posteriors same-day dentistry exactly yes that's why i love the glidewell because that's what it's great yeah that's where that's where it's at if i was going to try to do anterior aesthetic cases i probably would not you know glide was great i would not i would not be trusting their library for my anterior cases so if um just for a specific to keep it constant first molar upper right tooth number three unless you're canadian i don't even i give up um too number three if you did a hundred sing a hundred patients for a hundred single unit crowns what percent would you same day dentistry uh chair side mill with the glide mill fast mill for uh first molar number three yeah so in all transparency howard again i just started this in in uh march april literally uh before that everything was going into the lab since starting back up full time after we were closed down in new York um first molar second molar i would say 95 are going through my mill that's nice yeah it really is nice by the way i went out to jim's uh 50th uh birthday uh it's a 50-year anniversary of gladwell right and i did yeah i didn't get invited but i got an email oh my god and uh that that guy is just uh he's just a lot to me he reminds me of herb kelleher who we lost in the beginning of this year and you know um with everything going on they never make you know i mean i mean hell um but anyway he passed away but uh i always thought he was the herb kell heard dennis german he came back from vietnam and um you know he um started that in his um apartment and you know he went to vietnam with his best friend and his best friend didn't come back and it was just his rock bottom and he just poured his whole existence into uh dentistry and what a legend what a man what a uh just i just i just love that guy so much i really do um so the other guy out there in california who had another lab um was bob ibsen bob ibsen was an op uh opt not an ophthalmologist but optician an eye doctor and he was out there in southern cal and he noticed the cosmetic revolution coming and um and so he started denmat which was dental materials and it was he actually wrote the first book in adhesive dentistry just wasn't called cosmetic dentistry and um he started a lab on this stuff he was the first advertiser for the um miss universe contest uh bob everson was sponsored by renbrandt and he asked me i remember him calling me and asked me what he what i thought of that i said i think it's a horrible idea because with the miss universe contest i mean obviously it's rigged because all the winners are from planet earth and i there's not one other winner from anyone even in our local cluster uh but uh so you know it's a rigged election but uh this beauty thing is just getting bigger and bigger but i want to ask you this um it's kind of inappropriate but I’ll just say it um when they started doing breast augmentation uh they took off in texas and they just couldn't be big enough and then they got too big and they started coming back down right and now um my friend uh lawrence uh shaw um i mean i mean they were you know they came out you know they started with 100 cc they went to 200 cc they went all the way up to 400 cc there were people and now they're coming way back down and now um they're you don't see like they used to be is that kind of happening in cosmetic dentistry did veneers start out in the 70s and 80s just going clorox bleach white crazy and are they coming back and um are you are you seeing a trend line like that that when it came off it went too extreme and now it's kind of coming back down to more normal it's funny i feel like cosmetic industry is behind um i feel like in plastic surgery and cosmetic dermatology uh i was actually trained by the aafe American academy of facial aesthetics uh dr mohammad uh and he has a he has this ce courses they do a great job training you for fillers botox and his whole thing is natural less is more uh it's everything that i was taught in cosmetic dentistry both by my dad uh and even in school right you want you want to have the mammalons you mentioned before you want to have translucency and that's what we're told people at this point what I’m saying at least here on the east coast they don't want to see that anymore they want to see this monochromatic white blinding tooth with a hollywood straight across inside the ledge so no longer we looking at the inverse of a smile line and things like that in order to get people their wants interestingly with injectables botox fillers with breast augmentation with any other plastic surgery there was a crazy period of time in the 90s where everything was hyper blown lips were like you know if i was sitting over here next to the computer i might hit you in the face howard with my lip because i got some lip filler right same thing with the with the breast augmentation and then it quieted down into more natural i feel like dentistry or cosmetic dentistry kind of did the reverse it started off with let's try to make things natural what's beautiful natural let's have a melons let's have a translucent layer and what I’m seeing for my patients is they don't want that anymore more often than not and that's the importance of that initial consultation showing them different examples doing a smile simulation they're like oh i don't want that at all i want it like straight across i want it to look like a chiclet I’m like really because you know and this is your body it's your teeth if that's what you want but it seems like teeth are kind of lagging behind if not even reverse of what happened in cosmetic dermatology and plastic surgery yeah um it's funny when i think in new York city i always think of lady gaga that's probably the first thing it comes my mind someone said new York city i think a lady gaga and what i like the most about lady gaga and madonna uh is uh the word vogue and even the magazine and i you know they have different looks i mean you know there's a there's some people that have the same look for 50 60 years i just am so impressed how lady gaga or mcdonald you never know who's gonna show up what they look like uh my mom sent me a video on lady gaga just today and she was uh what was she doing something with that what was that uh the sound of music these are the hills of the sound of music and anyway there it was a julie andrews deal and sure enough she shows up she looks just like you know the lady of the big old white dress i just think it's so cool how people are just uh so artsy like that like my kids watch every classic movie i grew up in because we're all stuck we were stuck at home for like two months uh my wife is a nurse practitioner in a local hospital by us so she was going into work and i got to really know my kids but i made them watch every movie i had to watch growing up and sound the music was one of them and they were walking around the house whistling that song uh i find that so funny but well actually sound of music is a sound of music and what's the one what's the other one where it's a uh um fiddler on the roof right those are those are my two favorite movies of all time i got it i gotta divulge it but i think they were too young because they had nightmares so i think that was the wrong move but they loved sound the music they loved uh back to the future that's what i grew up on uh these are yeah i think my 1980 you know on phil the roof just blame the soundtrack because you don't even need to see the move but uh oh my gosh but i grew up with five sisters so that's why I’ve always been against democracy because i'd be like uh money night football one vote five girls sound of music okay and now when someone says well they're not very democratic I’m always thinking either am i I’ve been burned by democracy on every monday night football game my entire childhood um so is there um what about even more specifics like um cosmetic dentistry um anterior teeth obviously we're talking about um do you have a favorite direct composite do you think one looks sexier cosmetic er you know than the others are you brand loyal and i mean and again this doesn't mean that this is the right it's all in the power of your hands and what you do with it i think we have a amazing dental companies and they're so innovative these days and what's coming out it's worth trying them all and seeing what in your hands comes out the best and then following it through i love following through with my patients when they come in for their recalls i am noting not in their charts but i have a little notebook in my office about what material i use at that point how the restoration looks radiographically and how it looks visually it's just so helpful because things sometimes look beautiful at the moment and they're easy to place but they just don't hold up so it's my own anecdotal clinical evidence in my office and I’ve changed many times because of that because retroactively it's not as great as it seemed initially right now I’m loving voco admirer fusion for my anterior composites it's a ceramic hybrid composite voco what v-o-c-o hierarchy ira adm adm ira ira fusion one word or two uh two two and whitey why do you like vocal uh enviro admirer the consistency is amazing i just feel like a build up anything uh both enter and i also use a poster early the polish ability is amazing i it just looks so natural and yes it comes it comes in all the shades that you would expect but somehow it has this chameleon feel to it where if I’m off a shade and i put it on there and i cure it and i polish it it just blends in beautifully you know um morals and values are bizarre like um dentist um someone will be missing a six year molar and they'll say well my god I’m not gonna file down two virgin teeth you're an animal you do that I’m gonna place an implant okay so then I’m at uh lifetime fitness and my ear nose and throat guy comes up to me and says good god i keep seeing these implants into sinuses and I’m up there in a scope and it's all a fungus infection what the hell are you guys doing in my sinus when you had two perfectly good teeth and I’m like perfectly good uh are you saying they were a virgin i don't even know what a virgin to this how do you get out of dental school and say a tooth is virgin i mean uh it didn't make sense but the ent say stay out of my sinus and they have schooled me uh one of them is a rhino rhinopathist or rhino guy or whatever i mean just some horror cases where some lady thought for 20 years that she moved to arizona and developed all these allergies and elba and he finally goes a guy sticks a dill and he goes no it's a failing root canal or a failing implant nine out of ten times it's a failing root canal i mean most dentists have never found an mb2 in their entire life and every tooth has one and so this lady's got an mb2 draining into her sinus and and all that stuff um so where do you um and then on the anterior it's the same thing i know I’m not a cosmetic dentistry I’m not you but if i had to do replace a missing tooth on a beautiful woman i could nail it with a three unit bridge i mean i can nail it but if i go in there and place an implant and the implant doesn't heal just right and and whatever next thing you know i got black triangles and spaces so isn't it i mean if you saw someone missing um an anterior tooth would you just say I’m a cosmetic dentist damn it in the biggest city in America you're going to get an implant and I’m going to nail it or would you ever be that that guy who files down virgin teeth and do a three unit bridge with maybe a veneer um you know because cosmetics more important i know that's a long question but I’m so dumb what i do is i i just throw out a rant and i hope something sticks and you get a question out of that and can answer it and sound uh informative yeah if my answer makes no sense to you means i totally didn't get it but um what i what i love is to treat every case differently so I’m not a slam dunk uh implant guy i mean anteriorly you gotta be crazy to me if you don't have if you don't have a immediate replacement implant and the gingiva gets blunted straight across and you have no papilla there you're you're screwed there's no way you can make that look good you can make it like a square right of porcelain if you try to like close everything up that's not gonna be a tank that you're not gonna be able to clean properly and it's not gonna look good or you could do a beautiful three-unit bridge so every case is dependent on what's going on what was the etiology and the disease process what what am i left with and what do i see as being the most cosmetic result not just cosmetic but long term cosmetic i mean three in a bridge we could do a slam dunk and make it look awesome but what if 10 years later all of a sudden that pontic is now like four millimeters past the ridge right from attrition so it goes both ways but i definitely don't lean towards that whole thought process of this implant is always the most ideal option it really depends on what's there what are we working with how is it going to look and how easy is this going to be to clean and maintain well that was my follow-up question is if you're because everybody around the world knows i mean new York city is the biggest beast in America i mean it's uh wha what's the metro that sound have you uh do you know what the metro population is of in new York city a lot i know i mean yes i know that the building right on top of me it's one of the tallest buildings here on the upper east side that if i had uh half of the of those apartments as patients right i would be set so that means in my building alone i could have my practice run for 30 40 50 years just out for this apartment but on my block i have about six of those right so it's tremendous it's a tremendous population per square foot oh i mean uh google uh says that the new York city metropolitan population is 18.8 million my favorite my favorite uh study i or uh graph i have was uh um at asu um if every of the eight billion humans if they all lived at the same density of Manhattan we could all live in new zealand and never even have to touch another con i mean it's just it's just unbelievable uh the density is about but being the cosmetic guru and the biggest city in America do you need all porcelain implants i mean are you telling implant companies i can't do titanium on front it's lady gaga i need all porcelain implants something like that or you know i do uh zirconia implants every enter case you do yeah i take the risk that's involved with it so that in six seven years I’m not seeing any titanium from any recession that's there so it's a zirconia interior as we get past the smile line we go titanium oh my god I’ve been looking for someone crazy enough to make me an online ce course for downtown we put up 400 one-hour courses they've been viewed over a million times and i can't get find anybody but anyway i i would just be honored if you made any course on there but that is a that is a um that was the first thing i was thinking when i was uh again a podcast usa i wonder if he ever did that because a lot of just people say um you can't if it breaks or something goes wrong it's just a nightmare you can't remove it you got to drill out the whole thing what would what brand are you using so for my zirconia abutments you're saying no certain implants yeah for the implants so i i actually don't place them however that's what makes it easy for me so i have my oral surgeons and i give them my preference and i say go zirconia because i want it to be what brand what brand is he using it it depends so i have four different oral surgeons here so it's across the board it's across the board ah because that is uh do you want to think too much about it because it's not it's i don't do I’m trained in placing implants but I’m doing the restorative aspect i wouldn't want to give pros or cons on the implants itself because i I’m not familiar with the actual placement to them but but do you think do you see the trend uh of all porcelain zirconium implants do you think the trend will go up or do you think it'll go down so i think that eventually it's going to go up once the success rates are shown that those horrible cases that we're seeing of a fractured implant and right at the junction of the platform and what do you do at that point is decreased people are going to feel a lot more confident everybody wants to have the more cosmetic option right pfms when i was being trained was the option right we had other materials but that was that was what was known but nobody wanted it it was just because that was you know what was working you have to prove that the newer materials are going to have the longevity and then everyone will quickly gravitate towards the more cosmetic option um a few more questions do you mind sure um i i like these hundred questions dennis i mean they're just like economists or physicists or mathematicians if you did a hundred cosmetic veneer cases a hundred individual people um what percent of them would get fillers and botox so the amazing thing is is that on our forms many of those that are getting their cosmetic work already has their dermatologist plastic surgeon doing their fillers and botox for them so it's not like they're doing everything at once or they're like oh i want to redo my teeth and then i also want to do my lips and i also want to do you know my wrinkles and i want to do invoke and things like that they're already doing work to themselves botox fillers are non-invasive veneers are more invasive right it's a much higher level they couple together beautifully though so if you're trained to do both we're all trained to do veneers right you have to just feel comfortable doing them but we're all trained to do big cases and you couple that with knowledge of botox which by the way is the easiest injection known to a dentist i mean what we're doing in the mouth and where we're injecting is crazy because we don't see what the hell we're doing we're just going off the anatomical landmarks and the and the average you're doing botox you're seeing you're palpating it's it's it's a tiny insulin needle it's crazy but anyways when you couple them together you get so much more amazing results at the same place they trust us already they're coming in every six months for their preventative they're part of our patient base they trust us enough if they're doing their veneers to spend thirty thousand dollars to do their smile they're gonna leave that dermatologist or plastic surgeon like that if you say it with confidence that you're also going to continue the framing of the mouth to resemble the smile that they just did so it's not so much to couple the treatment of the veneers together with the other modalities right of botox fillers and evoke but rather convert these patients that are already doing something to themselves so many people in major metropolitan areas already doing and have somebody and having that as a part of your recall and it increases your revenue it's easy i it it just makes sense to add that onto your services and a couple more hundred questions um 100 cases of a smile makeover what percent would be boys versus girls would it be 80 women so it's it's uh right now we're looking at about i would say 70 30 uh 70 women 30 men my meals are typically an older demographic compared to the females so females were looking at 20s 30s and 40s for most of my cases and the males I’m looking at about 50s and 60s and what percent of the males are gay uh i would say probably about 30 and I’ll tell you why a lot of the cases I’m doing on on the males uh just over the years what I’ve noticed a lot of it is is bruxism attrition it's they've ground down their teeth it's restorative in nature so those are married men the stressed out married men who right now those that are those that are gay are more you know their teeth are fine they look great they just want it to be even better yeah um yeah um amazing so um final last and final question um so she's in dental's kindergarten school she's listening to you she when she grows up she wants to be just like you what where does she learn to be a cosmic dentist she just got out of school she just got out this year what give her baby steps i mean you know it's 10 steps till you get to the second floor um where how should she start her journey to end up like you someday pretend that you know what you're doing when you get out of dental school that's all you can do and look in the mirror there used to be this snl character i forgot his name uh he would you're good enough you're drawing that guy yeah i forgot his character name i know it was um so uh you got to feel it you got to feel confident as i said earlier in our talks tonight and i still believe it i mean dental schools are great but they're terrible how much can you learn in a few years i think dental school should be 10 years because there's so much to learn and so much to to to appreciate and to to do comprehensive cases you're not going to get that in the three four or five years that you're in school and residency so when you get out feel confident that hey you got through it if you got through that at least in nyu you know they put you through hell if you got through that you're able to get through anything as long as you have confidence i have the confidence to move forward but be critical be very critical of yourself i think one of the worst things somebody could do is be passive is to pass work that you know is not adequate that you wouldn't want in your own mouth or in your mom's mouth right uh i think that's that's where that's the the point where somebody is going to be not just successful but have a really rewarding career and feel good about the profession because when you're doing good work i don't think that i did good work when i first came out of dental school i know i didn't but i learned from that when i when i didn't know what the heck i was doing i quickly looked up courses that i could take or i spoke to people or i spoke to reps and i tried and tried again but when in front forward facing of a patient i always had confidence i was like yeah we can do that let's do it but i knew that it could be better and you got to train yourself you got to invest in the right things you got to keep moving forward and then you'll do bigger and bigger cases faster and faster a lot of my friends and colleagues are shocked at how many cases that i do and I’ve only been practicing for 11 years but it i think it all came from what would i want in my mouth what would i want in my mom's mouth how could i get there what can of c course could i take i don't care if it costs eight thousand dollars I’m already hundred thousand hundreds of thousand dollars in debt from dental school i might as well do this the right way if you're gonna be in debt do it the right way so should we name this uh podcast uh dr stuart smalley says I’m good enough I’m smart enough and doug got it people like me people like me yeah i like you and i like what you're doing and I’m uh you know my my favorite people in dentistry are the pediatric dentists because i don't know what the hell they i mean what was their second best idea just to go to hell and work on lucifer i mean to think that they consciously want to be around crying screaming kids all day uh but that i tell you i would rather i'd rather do a sinus lift in fact I’ll tell you how brave i am do you know my first sinus lift for an implant was on my my mother-in-law wow now I’ll probably get sued my first implant uh out of the training right now out of nyu was on my grandma she was 19 years old she lost an incisor she started going through some dementia my mother is like just do it for her and i was like it was an immediate implant mis a little 3.3 i stuck in there 3.0 and uh yeah and you know what i that's how i would want to treat every single person that walks into my door can we always know but you always want you have to have that feeling because if you do you're going to get better and better and your confidence goes way up but if you're just like how could i get through this procedure as quickly as possible using the cheapest materials and you know hopefully they don't complain you're not you're not going to get there and it won't be rewarding howard i want to talk about one thing before we hang on um if you have the time yeah all right so i spoke about Invisalign i love Invisalign i i was an elite provider invisible i still do loads of it new York loves Invisalign as well uh everybody knows the name it's a great brand i use uh clear aligners for a lot of my cosmetic cases so um recently about three and a half years ago i started toying around with different plastics and different uh algorithms of different companies that were out there and you know them all I’m sure but i created a company called modmouth which is m-o-d-m-o-u-t-h and what that is is satellite offices of mine and my partner dentis and it's clear aligners that are made affordable to kind of compete with what happened with small direct club and those other guys out there to keep it within the dental world and give people a more cosmetic result in my own office and my partner's offices we use it as a an alternative to the higher priced clear aligners out there for those cases because if I’m doing 10 veneers and I’m like oh and by the way i gotta charge you another six thousand dollars to straighten your teeth first i might lose that case but if i could say you know for two thousand dollars I’ll straighten your teeth first because it'll be a lot more conservative that's a lot more valuable so worked and worked and worked on it along with my partners and we really found a a group of people and a team to make clear aligners for the general dentist right we're not dealing with uh with ap corrections or or crazy rotations of those molars past six degrees or big extrusion or intrusions of teeth but for the majority of cases that's not the case they already had orthodontics that relapse or whatever it may be and we created this uh mod m-o-u-t-h and the the purpose of it was for ourselves really to use it ourselves for our own practices but what we realized as we kind of shared it with our colleagues is that people loved it they were like oh this plastic is great it's so much more affordable it's made by dentists the dentists are behind it we decided along with other partners to extend it out there to the general dentist and we're calling it mod mouth pro so it's mod hyphen m-o-u-t-h dot com slash providers and you're not gonna get too much information there because we're keeping it kind of close to the chest right now because we're expecting to release uh all the information in 2021 uh but it's just an alternative it's it's something else out there love Invisalign i like clear correct i like everything that was out there I’ve used everything i i used essex aligners and i my first job was working in my dad's basement taking hillary pliers and heating it up and and and making these little indications of plastic so i love everything out there but this just it's an alternative for the general dentist to save on costs have an aligner company that's made by dentists for dentists we have so many cool ideas about ways of integrating this into practices helping get patients there for restorative work along with clear aligners it's it's something else out there and i think it's really cool so you know just sign up you're not signing up for anything except for information by putting your information in there so the mod doesn't stand for mesial occlusal distal stands for modernizing the clear aligner space that's exactly right so it's it's a it's a tongue-in-cheek uh in a way right so we'll we'll look at mod as dentists and that's the first one we think is a nice large filling that maybe we should spend only into um but uh mod is for the modern way of looking at the mouth is that hey i want to get this alignment better before i put that crown on i want to get this lining better before we put that implant in i want to i want to get this bite better so that I’m able to put these veneer cases in it might not be this comprehensive orthodontic case where we're loading up the mouth with attachments so we're trying to do crazy rotations extrusions intrusions or to translate these roots through bone and crazy waves i just want it in a better position so it's better cleansability it looks better it's more cosmetic and it's quick and that's the algorithms that we're using with mod mouth so it's kind of that focus in mind to get through it as quickly as possible less expensive and and help with the restoration well that is that is a amazing and and how is how do you think um this is going to be received to the marketplace so we're not looking to go huge we're actually looking to sign up uh you know the first crew of dentists that ask for information whoever wants to try out cases we're gonna give a nice discount so they could try it out we actually want to learn from their experiences to build this out super slowly not to compete with any of the large you know dogs out there who are great as i said i use them in my prior practice but it's to build something that's not just an aligner company but it's actually something that is more of this restorative uh understanding from a general dentist and and see what kind of help a company like monmouth could do aside from obviously a much less expensive aligner which everybody likes but what else could it help with perhaps it's people out there who need restorative work come to a site like ours because we're advertising that you know because they need an implant space and they don't have it and finding that restorative dentist in idaho that is a mod mouth provider to use our system get that space have that dentist place the implant have a great restoration that's that's like one of the idea that we have but it's really going to be this collaborative for dentist by dentist a fun aligner company you might not use it for everything you might go back to a line for those comprehensive cases or other companies out there but for i think the majority of relapse cases restorative cases um and for for uh for those that just you know six seven thousand dollars is too much and maybe you want to give them another option i think that's a great a great company out there that i helped co-found well here's like so um by the way quit sending me emails guys about signing an nda I’m not going to sign an nda it's a non-disclosure agreement i mean I’ve been in dentistry for 32 years how hell I’ve podcasted 1500 people you really think you're going to tell me something in dentistry I’ve never heard and furthermore i think um but here's what i want you you don't need an nda you do this hold up your hand it's got to be faster easier better cheaper and smaller and by the way a lot of dentists have sent me deals said that they don't like the word cheaper well you know if you decide to trigger yourself on the word cheaper i have nothing to do with it okay you're you're triggering yourself on your own you don't need me but it's got to be better faster easier cheaper smaller that's the nutshell and dennis always said me something that well it's slower more complicated and cost twice as much i know that's that's why the 87 car companies before henry ford you don't know the names of them because there's five guys making one really expensive car for a king or a queen or a noble landlord and if you just got to America four minutes ago this is about the middle class we don't give a [ __ ] about kings and queens and all that so is it better faster easier higher quality smaller you're gonna make money but here's the other thing you probably already know that from listen to my show but here's the other thing why i like his idea and that is dentistry is a really old technology i mean just in America gv black was a century ago um um in france beer uh fishard that was two centuries ago but dentistry is so old that you know it just grows with inflation if the economy grows three percent dentistry is three percent but if you micro break that down what's growing faster than the inflationary growth it's only two things clear aligners and implants so if you're a baby and you're still in dental school you got to decide i mean steven's uh been completely honest that he said i don't place the implants i restore them well placing the damn implant a hundred times easier than restoring it on lady gaga's front tooth if lady gaga told me to restore the first implant in her front tooth i would just move to like indonesia or china or i would never come back but the bottom line is here's what i like about it clear liners and implants are growing double digits i mean you're not talking twice the rate of growth in place i mean if the the economy in the 20 richest countries in the world has been growing one and a half to three percent uh since i got out of high school in 1980 implant clear aligners implants are growing double-digit growth rate and I’ll tell you another thing when i was little we were irish catholic in kansas i had five sisters and a brother and every family only the ugliest girl who would have to enter the nunnery uh got braces dad was like well we gotta fix up emily or she's gonna have to be a nun now with birth control with families going from five to two everybody gets ortho and it's not just once you get ortho first when you're uh maybe a pediatric dentist is gonna do a rapid pillow expander then an orthodontist does your ortho and then after your first divorce you come back and get it again and then when your husband dies they they take the the uh inheritance money and do it a fourth time but I’ll tell you what my boys i had their mind let me tell you how irrational beauty is because first of all if you're a girl you're not ugly and need cosmetic dentistry just by definition you're a girl okay and um but i mean we would be in we'd be lecturing cambodia vietnam asia hong kong and it'd be like the most beautiful little asian girl chinese girl whatever you ever seen and she had Invisalign on and I’m doing the numbers with i mean it was like one third of her income for two years is going Invisalign and we're looking at this perfectly beautiful girl saying well why did you do that and they in asia they would hold their finger to their nose to their chin and if their lip uh touched their chin they wanted their upper bicuspids pulled and everything pulled back and I’m sitting there thinking okay we're in china there's a billion 300 million people and there's not one boy in the entire country who cares that your lip touches your finger but she's willing to spend you know uh january February march april two years in a row to get two by casting football so beauty you know you want to look like a peacock fine that's great but my god ortho is still rock bottom i mean you're going from just one kid out of six gets it now all kids get it now all kids get it once twice three times the lady and my god even and I’ve like there's 58 countries in africa and I’ve taken at least two or three or four of the boys so i lectured in i don't know 10 or 20 of them i mean even in africa i mean we were talking this beautiful woman in tanzania and uh she's spending her whole income on braces and we're like okay you're already so so this so so here's what i want you to do in baby dental school um and i can tell by your root canals i can tell by your root cause now school if you do your first root canal and you get all the way the apex and a puff of sealer out there and you're an april barbarian and go blood and gut surgery but if you like are trying to stop a half millimeter from the apex and get tucked back and and and all that stuff go soft pretty go bleaching bonding and if and if you uh seriously want to finish all your root canals a millimeter from the apex you're not an endodontist be so you're either blood and guts apical barbarian or you're soft and pretty bleaching bonding botox I’m blood and guts stephen I’m so glad there's people like you dr d and pediatric dentist because i would run from every one of your patients thank you so much for coming on the show and if you ever want to put an online ce course or an article in dental town i would love to have it because it's the future implants cosmetic dentistry that's growing double digit don't forget that that would be my pleasure it was great hanging with you thank you for having me forget about the disaster that happened over the past four hours before this podcast that with my veneer case uh but it was a great night talking to you and i look forward to doing this again in the future yeah i can't wait that was Dr Steven Davidowitz DDS aka Dr D at Luxury Dentistry New York City thanks buddy