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Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
How to perform dentistry faster, easier, higher in quality and lower in cost. Subscribe to the podcast: https://podcasts.apple.com/us/podcast/dentistry-uncensored-with-howard-farran/id916907356
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1511 Dr. Dr. Friedrich Widu on Hybrid Orthodontic Systems : Dentistry Uncensored with Howard Farran

1511 Dr. Dr. Friedrich Widu on Hybrid Orthodontic Systems : Dentistry Uncensored with Howard Farran

12/1/2020 4:00:00 AM   |   Comments: 0   |   Views: 214
Dr. Friedrich Widu is an orthodontic specialist, inventor and entrepreneur who has spent more than twenty years in clinical practice. He opened his first practice in 2001 and currently operates a chain of 6 clinics, including two MVZ Smilike practices in Berlin and Hamburg which exclusively focus on adult treatment with aligners. Dr. Widu is an early adopter of Invisalign and one of their largest customers in Europe, regularly treating 400 patients per year. A sought after speaker, Dr. Dr. Widu regularly lectures at industry events and teaches courses on the topics of aligner therapy, lingual orthodontics and the 2Clear System.


VIDEO - DUwHF #1511 - Friedrich Widu


AUDIO - DUwHF #1511 - Friedrich Widu


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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 Friedrich Widu DDS I’m not going to say orthodontist in German I’ll try keifer orthopaede that was pretty close that was pretty close let's hear you say it oh my gosh i won't even try that he's an orthodontist at smile for you 2c med tech smilelike.me in berlin Germany developed the two clear system that combines the advantages of bracket wire technology and aligner therapy he started with Invisalign in 2001 and has treated almost 4 000 cases deficiencies in the aligner therapy was the driver to invent the hybrid technique since not all cases could be treated with aligners hybrid technique solves this problem it is a replacement for the traditional fixed appliance as well with tremendous advantages over the traditional method treatment with the liners require a high level of experience and ongoing training we have been awarded diamond status for our commitment and the quality of treatment and the therapy with Invisalign in Germany we are one of the top three Invisalign users he has already given more than ten thousand patients a new smile smilelike.me stands for a particular comfortable orthodontic concept that makes the treatment of misaligned teeth easier than ever before he specializes in giving you the smile you always wanted within a few months with the help of invisible liners how does he do it he's pioneers in the application and further development of the so-called aligner therapy and my gosh ever since those patents expired about a year or two ago it seems like a lot of innovation is coming out in the clear aligners would you agree yeah i think it's to to uh drive us to the market uh yes uh patents that run are this uh one and it um it gives a lot of opportunities to direct to consumer brands now uh as as a doctor obviously i have my own opinion about direct to consumer brands but on the other hand it gives the opportunity to companies that try to compete with the line who is definitely benchmark and aligner technology and that is of course you know now a very dynamic market uh it goes also along with digitalization or it's clear that we move towards a dental worlds where scanning will replace uh impressions where on-site production of crowns and inlays will be something that also the patients demand and obviously in orthodontics is still a huge way to go from the traditional wire bracket method but uh it is something that the patient is demanding and this is the way we go so um when you say that you know some cases can't be just treated with clear aligners i mean obviously there's some people out there that disagree there there are some orthodontists who say that they can do a hundred percent of everything with Invisalign well how would you answer that well obviously clear aligners have come they've come a long way and now it's definitely a more powerful tool than it was in the beginning and that is the end of the 90s when the lion technology came up but obviously you know you have cases that are surgery you have cases with ectopic canines you have cases that beat heavy rotation and angulation correction and i hope I’m not getting too uh too deep into the you know expression mode of a dentist but i i think that most of your listeners are probably familiar with dentistry and probably also with some orthodontic terms so probably probably everyone's a dentist and this goes on orthotown too so probably everyone's a dentist or an orthodontist most likely then it's okay to continue like that so yes you can you can definitely do a lot more cases with the liners but if you if you're honest the surgery cases they still are surgery cases and if you need a mandibular advancement you would use a tool for that and you need palliative expansion there are tools for this and uh yeah i mean it's like with everything else in in the medical world you you have to use the right medicine or the right tool and if somebody says i can treat everything with one tool i think that's a little bit uh of a marketing phrase it's like in former times orthodontist said i treat everything with extraction i treat the i never extract and that's that's an extreme position i would say yeah when when when general dentist um it's tough for orthodontist what advice would you give to an orthodontist when say there's uh ten dentists in his town that refer to him but one of them is an extremist and doesn't believe there's ever a case for four bicuspid extraction and um how would you deal with that person i mean it's an extreme position and i i don't know of any orthodontist who would say that they've never seen a case that didn't need four bicuspid extraction would you agree with that yes of course you know it's like if you want to sit i don't know if you know this car fiat panda or 500 and cinco gento it's a very small italian car if you try to sit five fat people in the back row they will not fit and this is the same with big teeth on a small jaw so if somebody comes up with uh yeah we shouldn't extract there the question is whether you want to put the teeth you mean outside of the bone of course it's possible to level um in a in a manner that you have a very broad arch and very protruded teeth and even if you do slicing you know you cannot uh exaggerate on that either so it will just not fit and it will look strange and most of all you will have recession so if a dentist doesn't understand that because he has a strong belief that by cuss beats should never be extracted and probably i would try to not work with him i don't know sometimes you don't you just don't get a solution so um do you have an english website the smile uh the smi like uh a play on the word smile and like so it's smile s-i-m-s-m-i-l um i-k-e uh emmy that's in German and smile for use in German for english listeners do you have a website on the on this for in english uh for my German offices I’m afraid we don't so um so so talk about this journey um is it intimidating to sit there and have a new concept and go against a big monster company like Invisalign i mean is that a pretty intimidating to go after or how did you see that i think that whenever you come up with a new idea you have to convince people uh from it can be different kind of people know maybe investors maybe your colleagues uh maybe patients customers and that's that's difficult and after all you maybe need a long time till you convince uh you know a group of people so i for me it's not very intimidating that other players are on the market because we don't compete directly uh with a clear liner product or or a bracket product it's a it's a hybrid technology and it has some advantages that is you know proprietary to that technique so might be considered a niche market but i think it has a tremendous potential and it's actually pretty much self-explaining so um hybrid technique means that we use a bracket but then we switch to aligners because this bracket is uh so thin and has such a low dimension that we can you know work with it underneath the aligner so we do the leveling and the aligning which can be done very good with the wire and very fast and then we do the finishing with with the liners so this is something that an orthodontist actually understands because after leveling the lining after the end of the the fixed appliance phase they were using and still use positioners so actually it's a concept that is easy to understand and why don't you explain your concept of the hybrid therapy um i mean we both know there's obviously cases i mean um um take an example where a root canal has failed and you're trying to move the second molar into the position of the first mole i mean there's just a lot of complicated cases uh that you're saying um just the liner therapy is not going to work but explain your hybrid therapy technique um at the orthodontist level to the orthodontist listening to you right now well um usually it's like that but i started back in the days in 2001 with elana therapy and it was by then only Invisalign i also thought about other options how i can treat a patient invisible because i had a lot of adult patients and that was lingual back then lingual was a very small niche market and then the technology had started to have a peak between 2005 and 2010 11 12 something in europe and this was because a new system came up it was incognito and it was very efficient and also user friendly and it was more precise than any other lingual technique before by then the aligner approach was not so efficient uh in many ways it became better after Invisalign introduced for example smart track materials smart tech material and also optimized attachments but let's say 10 years ago i was searching for something that is not as difficult as lingual and more effective than aligners alone and i came up with this idea of the hybrid technique back in 2013 2014 i went for a patent in europe and then in the u.s and developed in parallel the prototypes which means also of course producing them but getting it in a legal way into the patient's mouth and i worked with the university of bonn to measure that and we have seen that it is great to use the advantages of the wire technique and of brackets and then not to have to debond to continue with the liners for the finishing the idea is to be very quick with the wire and to have a very small thin appliance that is easy to to clean for the patient and doesn't irritate the mucosa and all these things uh i think the the appliance after they accomplished this and obviously since the market changed the patterns fell there are so many companies now going into the uh aligner market that i think we have actually a good opportunity to develop further yeah it has been amazing uh how many companies have come on board how many companies do you think are right now in the clear aligner business i have no idea my feeling is that every week is a new one coming up especially in china um but i think that every bracket company now has a clear liner division and i've even heard i think it was gac who closed the bracket business completely to to switch over to aligners sometimes it is even overstretching the envelope i think that also brackets traditional brackets will stay valid for orthodontists in the next two or three decades and they have their advantages but right now it's a total run and i would say we have maybe 40 companies on the aligner market all together yeah yeah 40. uh that's uh that is a lot of competition a lot of innovation um it always makes me go back to uh the greatest ceos in the high-tech space mainly andy grove of intel the founder of intel and uh oh my gosh who was the manager of cisco chambers for years and they always asked him how do you know how do you pick the winning technology at the beginning of the game and they both said that they both have the same strategies they said we watch sales every quarter across all the competitors and the minute one of them has a 10x breakout that is it's the winner and so you'll just watch these 40 clear aligner companies and say they all sell one unit a month each month it's one unit then all of a sudden one company sells 10. for some reason the market is spoken and that's how they always pick their winning technology which is amazing so I’m going to start with some early benchmarks what percent of the orthodontic cases in Germany done by orthodontist or done clear aligner versus brackets as of 2020. oh that is a good question because there's not necessarily a totally official statistic on that but if you believe the companies it's going to be maybe 10 but you have to know that in Germany we have a pretty conservative system which means that the insurance space for children and adolescent treatment up to 18. uh so a liner treatment doesn't participate in that so sometimes families have to decide if they get a paid treatment by insurance which of course if you have one two three four children it's it is something that you think about and i would say that below 18 the percentage of a liner treatment might be less than 10 and if you're talking about adult treatment it might be something like 25 30 so you're saying the German dental insurance companies do not pay for clear aligner orthodontic treatment on children under 18. yes because they would go for the most cost effective medical solution and that is understandable if it's if it's an insurance company you know so what how would you um how do you wrap your mind around that a big debate is that orthodontics is just cosmetics i mean it just makes you look prettier pretty as a peacock it's just you know all primates want to find a mate and reproduce and have offspring and then others say oh no it's a um it's a health issue um in a German um state-sponsored insurance company um why would they even pay for orthodontic treatment on children under 18 do they think there's a medical reason is it sleep apnea what what would be the reason a German child would have to need orthodontic treatment it's also a very good question like 45 years ago there was a trial at the very high level courts and the question was does a patient have the right to charge for the treatment the state insurance because we have kind of like a state insurance and by then the court was not able to decide that 100 of the cases do not need treatment so obviously there is a percentage of cases that need orthodontic treatment because it's it's a health issue this might be for example a cross bite where you have a mandibular shift which is for growing patients sometimes something that can concern the temporomandibular joints and obviously a massive crowding can lead to teeth that do not erupt might lead to issues that you know difficult cleaning uh can need to divide this or even periodontal destruction pre-major contacts are are an issue or maybe preparation for prosthodontic treatment because the space you have is just not is sufficient for an implant so there are medical issues but obviously it's not 100 of the cases that are that have that you know medical issue a lot of patients come because they need or want aesthetic improvement so by then because of this core decision the law was that everybody can benefit but there is an age gap by an age condition under 18 and if you do not go for an orthodontic treatment within that age barrier uh then you have to pay for it so that's the launch i mean so my gosh there's so many things um another thing that um people um talk about is um you know this is my second virus rodeo i've lived through i mean when i came out of school in 87 hiv was the big virus which changed all of her protocols the gloves and masks and what have you and that was a very serious epidemic that went on to kill 36 plus million people um but a lot of the things we changed um are still in effect today which made us more robust for this um sars outbreak um some people think teledentistry is a permanent game changer in dentistry and others think it's uh just something we'll just do during the pandemic how did teledentistry first of all give us a um i know our all the americans and canadians uh around the world would love to get an update on covet 19 in Germany um how is uh the cove give us a covet update um what's it look like now and then the follow-up question that is has tele dentistry helped you during the pandemic and do you think it'll be a long-term permanent change where 10 years ago whatever you're doing with tele-dentistry you'll still be doing uh you know i think you have to make a difference between um the part of uh treatment where you have to actively do something for the patient which means for example you have to take a scan or you have to you know bond attachment bond a bracket change a wire it will never be possible to do this or at least not with the technology of today with the patient it does not come into your office what you can transfer to tele medical support is everything that is you know for example communication obviously you can send him an aligner to his home and obviously even without corona it is maybe a great service also from the medical side if you have somebody in africa who needs advice or a diagnosis that you can do via cell phone might save lives it might be a lot cheaper and if the next hospital is 100 miles away that's the way to go and probably we will go this way but i don't see how i should i can treat my patients from a to that just via zoom or any other device that transfer video information or sound so i think we will we will have for pretty long time patients that come to our office if you want to know what i have changed here in corona obviously we have sent devices to our patients home and obviously we did more video calls but to be honest right now I’m doing exactly the same thing that i was doing one year ago and how does the coronavirus look to you right now we're in november 18th some people think um we're having a fall surge and that it um it's gonna be get bad again what do you see on the ground in Germany and what do you hear about uh europe in general oh we are facing now a light lockdown and probably will face even a harder lockdown because our statistics say that we are going the wrong direction so i believe that they are working very intensively on a vaccine that we will get within the next month and hopefully we'll get we will get out of this pandemic situation uh pretty soon so it's uh yeah we have kind of a lockdown and it's a it's just a huge country i mean there's 83 million people in Germany um is that um you've you already had a lockdown um earlier right you had a lockdown in april that is correct but then we had a lockdown where we could not even [Music] to cut our hair you know to a hairdresser it was impossible and now we have a lockdown where you are allowed to work but you cannot go to a you know gym or we don't have any open restaurants and of course no no bars no pubs and so on no public meetings you cannot go to a football game as a spectator that is affecting us pretty much i don't know exactly how it is in in america because i know how it will be now after the election but in Germany it's it's pretty much like like that and there is no not clear if we will you know end this lockdown within the next weeks maybe before christmas because obviously hotels are also closed so no vacation so um do you think the upcoming lockdown will close orthodontic offices or is it mostly bars and gyms and soccer games and things you don't need or it would orthodontic practice be considered an essential service and be able to stay open as usual or will it curtail your practice well i think if they start to differentiate between what is essential and what what is not essential that is a very difficult discussion so at the end of the day we are medical personnel and obviously we have patients with active appliances out there and i think it's it's not fair to leave them without assistance so what so what do you think they'll do i don't think that they should and i don't think that they can close us for uh four months yeah i you know i understand you know things you don't need to do like you don't need to go to a bar i mean and I’m saying that and I’m even irish i mean when's the last time you heard an irishman say you don't need to go to a bar but actually you don't you can drink at home uh alone in the room in the dark um but i gosh i i think that dental offices i mean they've been dealing with hiv for three decades and i mean i just think that they can um and then when you go into hospitals there's definitely parts of the hospitals that i don't think are as successful as dental offices i mean that this they're doctors of dentistry and uh uh but these are very strange um interesting times um the aligner therapy to me um was kind of the next generation of lingual therapy i mean i remember back in the 80s i mean everybody was didn't want to show their braces so it seemed like braces went to first they went to clear brackets so there'd only be one wire some dentists were doing lingual so you couldn't see it on the other side and this aligner is just another iteration of this um this process did you ever um did you ever do lingual and was that a solution of having clear clear aligner therapy by having lingual braces or did you see that as a no go oh i think you know here we have a lot of issues obviously lingual is great it's it's a fantastic technique and i find it very demanding to learn but i like demanding things um on the other hand obviously it gets eased in Germany more and more difficult to get highly qualified stuff and you need this highly qualified stuff for linguals that is one reason why maybe less lingual cases are done on the other hand there is a strong marketing activity of the aligner companies so a lot of patients come to the office and this is what they are demanding they're excluding lingual from the beginning because they're afraid that it might be painful or the speech might be altered so they come and they are already prepared to go for a liner treatment with adolescents that are still growing where we have a teeth that still erupts that's a different issue obviously there are products a liner products also for for these patients but there we like to um to use our hybrid technique because it has a lot of advantages so as a matter of fact i don't do lingual today anymore so um do you have is uh is smiles direct club um in Germany or they i know they're all over united states canada hong kong are they in Germany or is there a similar type business model to um a smiles direct club going on now yeah we have the small direct club they just opened lately or they were a little bit slowed down by the corona pandemic we have also other direct to consumer brands but to be honest to you i don't understand exactly what the value on top is for the customer if it's a very reduced treatment this is something that any customer can get in in an orthodontic office or dental office probably for the same investment of money but he gets a highly qualified team um if if we talk about direct to consumer business and you sell an aligner you don't provide a treatment i think that is a little bit difficult i i don't i don't not truly understand the concept to be honest well to me what's bizarre is in many countries it's still illegal for a dentist or a physician a doctor of any healthcare to advertise i mean in er i live in uh arizona which was actually the state where a couple lawyers in 1973 took it all the way the supreme court because they said that not being able to advertise was a violation of freedom to speech and i just think it's bizarre that do-it-yourself orthodontic companies are are starting to operate in countries that don't even allow doctors to advertise i've been to Germany every two years forever because i uh i think the best meeting in the world is the idf meeting in cologne and i mean my gosh i am in love with cologne i could uh what is it the id idf or ids it's uh internationally intelligence the ids every two years yeah that's a great meeting that's that's true yes it's the ids right yeah it's the biggest fare for dental in the world yeah and there's usually um there's usually over a hundred thousand dentists there and what's so interesting is you at any time you're at a booth and you just ask the doc next to you where where are you from i mean it could be from morocco to brazil i mean it's just the whole dental world is there and cologne was the farthest outreach of the roman empire so you have the old italian roman empire walls and you can have the best italian food and the best German food and the best i mean i just absolutely love it um is that um when is that when is their next meeting that is a very good question again you're just asking fantastic good questions i don't know because obviously all meetings have been postponed and nobody knows exactly when we will get going again so i think it was supposed to be in march uh even next year yeah but i don't think it's going to happen yeah it's scheduled um it's scheduled for march 10 to the 13th um 2021 and i don't even think as an american i don't even think i could fly there i mean a lot of countries are not letting uh americans fly in because we're a big hot spot so my gosh they've got to decide pretty quick i mean march 10th will be here in no time but you're guessing uh they're probably not going to have it this year I’m guessing they're they're not going to have it yes that's correct wow and I’m and i also um back to the do-it-yourself companies like smiles direct club um i think of Germany as like you say a very conservative country um especially in dentistry i mean i only deal with it in dentistry whether it's um iva claire and liechtenstein or sirona and um you know austria um i just have a hard time believing that the German dentist would allow a do-it-yourself uh company and advertising on television and all stuff do you think that's something that um they'll liberalize and do or do you think the conservative um dental industry in Germany will put up a lot of roadblocks whether it be with laws or what have you well we are indeed a conservative markets one on the other hand in the the internet is working everywhere and to get back to this topic um direct consumer you generate the patients in the internet on with adwords instagram or facebook you tell them a story how great this treatment is and they believe you and obviously it's difficult to um you know go and say this is the law in Germany and it's forbidden because you know everybody can can order something via the internet and you cannot really you know make this illegal yeah um another you know I’m always trying to um decide if something's new and fancy and a fad or if it's really going to impact dentistry and sometimes it takes forever to find out like like take take serona i mean that that started in france and i moved to la when i was in dental school i think in 85 or 86 one of my teachers said that before i even graduated from dental school dental laboratories would be out of business and would be replaced by this chairside milling but it never really got more than 15 percent of the us dental market general dentist chair side milling like crowns um and you know compare that to digital radiography which hit 80 percent so I’m still um not convinced if chairside milling is a fad for high-tech dental geeks who just love that you know they always want to be a glorified lab technician it's obviously not mainstream and now I’m wondering the same thing about clear aligners do you think in 10 20 years that clear liners will be mostly milled and made chair-side in the dental office or do you think you'll be using digital scanning and sending it to a lab and having the aligners delivered straight to you or the or the patient oh we will have both um if you look at 3d printing we are already now able to you know scan and print within uh two hours the model uh maybe even faster and it becomes every month faster and then you can you know make a setup digital setup and the you can deliver the first aligner the same day now obviously uh i don't know if this in ortho is such a tremendous advantage because if you want to start straightening teeth you can bond brackets and you start also the same day you know with an active wire um so obviously orthodontic treatment sometimes years so i don't see such a big difference if you deliver the liner at the same day but uh i think it can be exploded marketing wise in the future i strongly believe that shareside milling will become more precise and and cost effective and it will be growing but also companies that produce you know larger quantities can have very streamlined processes and be priced competitive and comply with all rules by fda and other organizations and fairly good from a to b if you have hot spots might be also very very fast and look at amazon what they are doing is amazing when i deliver and so on and i think this is going to be valid also in the future so yes you will have probably both products and do you have any favorites of um 3d printing uh companies i mean uh is it sprint ray is it um any of them that are you using any of them in your office yes of course you have great 3d printers in america for example race what i like about fusion filament method is that it doesn't need so much chemistry you know you get a filament and it's you can produce models that are biodegradable and it's very precise when i started to use that nobody believed me that it's precise enough like tenth of a millimeter you would use something else than millimeters to count but for me that is easier so which capabilities are talking about which company are you talking about uh the the company the printer is called race uh and has a number i don't even know which one but the company uh race is is an american company okay r-a-i-s-e yeah there's the race 3d pro at 2 and you can buy them in europe for like 4 000 euros oh okay i i know okay 3d raise3d.com okay i got it race3d.com dual extruder 3d printer i have great results with that printing models sometimes that print mod is just given away as a present for the for the patients after a scan so obviously you don't get models for example from from a line so you have to have another option and i was doing my own aligners on my hybrid technique in my offices and now since we we generated this company that is now an american company i order my hybrid technique aligners with to see medtech and I’m very satisfied so you are are very satisfied so um so um do you um what is your digital workflow i mean are you i take it you're doing all um impressions have been replaced from polyvinyl siloxanes to oral scanners i mean explain your digital workflow oh well i have an office chain you know it's six offices in Germany and uh two of them are fully digitalized which means we do not have any impression material we use exclusively scanners and 3d printers and you know not not the classical things that that we do and four offices are i would say conservative and that is because we we have uh some rules we have to comply with so if it's like i said before uh insurance driven treatment or paid then you need to produce a classical model and you need to do impressions i know that sounds very strange like in ancient times but this is how the rules are in Germany so they are only to some extent digitalized and we we also use the traditional methods so what would um i know the dentist you know when they're listening to someone that they respect their opinion they always want to know your brand and this is an advertisement for any company uh in fact um it seems like if orthodontist uh like align technology owns Invisalign and itero so it seems like a lot of the orthodontist go to itero it seems like if they're not doing any clear aligners and they just want a scanner uh they like uh three shape from denmark so i just assume you you went with the itero scanner yeah i went with the itera scanner uh obviously it makes your life when you work with Invisalign easier but it also allows you to export the stl files and use it for other systems now you can export it and print the model so yeah also for my clear alignment for my hybrid itera scanners that was never a problem she made me flexible so i don't have any experience with three shape but i think it's a very good scanner as well so you have six orthodontic offices in Germany yes i mean that that that that's a kingpin i i assure you that 99 of all the orthodontists listening right now or in america uh do not own six dental offices um talk about that um i mean were you a natural-born leader where you just have a risk aversion i mean it's very most dentists and orthodontists have a very hard time managing their own small staff their own receptionist assistants uh it's very challenging um what was going on in your journey where all of a sudden an orthodontist can go lead a team large enough to open up six offices in Germany that or you must drink a lot of beer one of the two yeah it's uh um you're right it's pretty demanding with uh you know the communication and getting your stuff to do the right things but i would say it was more historically you know it grew not by a concept like i want to have six or ten offices it just was that i you know got a colleague that was very close to my first office and said don't you want to buy my office because I’m going to retire and i thought maybe it's a good idea this is how it was growing while our digital offices we created them on purpose in the biggest cities in Germany hamburg and berlin because we believed in 2016 and 17 when we opened them that it is a good idea to generate patients via the internet and it's good to be focusing on a special portfolio and small portfolio which is aligner so we did not go for the whole spectrum that you can find in ortho we did exclusively either aligners or our hybrid technique and you probably can imagine that if you have a a smaller spectrum of medical solutions that you offer and if you digitalize every patient and you have a treatment plan that you can see from wherever you are in the world it makes your um mix your life easier and it makes things more controllable and it makes your processes scalable and as a matter of fact we are one of the largest orthodontic offices regarding a liner treatment in Germany with several hundred starts a year and it's actually sometimes also a lot of fun to to go this way it's i learn everything something every day something new and what is the name of the brand that you um work under i mean because you own um smile4u dot d-e-d-e for Germany for deutschland and you also have smile like uh dot emmy um what is the commercial brand that you use um or are they all the same name no it's it's indeed two brands for two different approaches smile like is the aligner and hybrid technique digital approach and style for you is the classical ortho approach so two different names and too clear is our american company that sells the hybrid technique products so are they are they all the same name no all different names they're all they're all different names so what is your strategy we see that in the united states where um the biggest dso heartland um they if they buy if they bought your office it'd be dr vidu um they and then there's other ones like aspen where every one of them is branded as aspen dental and I’m not saying either is right or wrong everything's a trade-off but what was the what were you thinking when you decided to have six different names for orthodontic offices as opposed to branding them all like smile for you or something like that ah so sorry i was not clear so the the classical offices they have all one name and smile for you and the digital offices that they are called smilik and the idea was to have only one uh home page where you can advertise or one instagram channel or you know not you don't have to make all your marketing products totally different you know every letter you've write that has to look different oh it looks all the same makes it a little bit more streamlined and i thought and and marketing i mean you have to have a flare for marketing if you're going to be successful in any business and i really thought um i i don't speak German but on the smile like dot me uh you smile like me you use the uh domain name for the country of montenegro me so with the domain name uh smile like me that that was pretty cool was that your idea to be honest it was not my idea it was the idea of a good friend of bolihan who is a great marketer and he thought let's do something different so it stays in the memory of the customer yeah smile like me i mean i never thought about the domain name for montenegro until i landed on your site and i thought that you know that was just gosh darn good marketing i was gonna congratulate you on that um back to leadership skills um what advice would you give to the orthodontist listening to you that um you know for since 1999 um we're able to do surveys on dentaltown and orthotown and we'll say you know what what are the what stresses you out the most and it's always people whether it be patients or employees i mean it's never um i don't know how to diagnose this case or i don't know how to bond this bracket it's always people what advice would you have um to dentists in trying to deal with people when obviously for you to be leading six offices you must have learned a lot i think three things are really demanding number one is where do i generate the next patient if competition gets tough second is where do i get my stuff it has to have the right motivation the right mindset and so on and they have to do functionally and obviously it's not only to find the right person but it's also how how do i lead these people and third is how do i streamline and optimize my procedures and what is really demanding is if you're all day-long treating patients and you're in this operative business do you have time to optimize these three topics i think that is sometimes really tough and just to the um americans listening are are confused about why it's dr dr Friedrich vedu it's because he was explaining to me that if you have a doctorate from another country um you know it'd be one doctor if you're a doctor all trained in one country but if you're um have a doctorate from two different countries it's a doctor doctor and did your journey begin in um was it romania is that where you started out i started I’m actually born in romania yes i started back in the days when it was still a communist country it was very interesting to go there after i finished school in Germany so i was raised in Germany went back to romania went then to hungary went back to Germany finalized Germany my author degree and then i did a lingual master in paris a few years later so i had a very colorful dental journey regarding my education and and what it was um how would you describe it to people who haven't lived in Germany or romania um what what was that like living in romania nowadays it's actually a lot less of a difference now you get everywhere your mcdonald's burger if you want and also a diet coke but 30 years ago probably most people nowadays have no idea how it was in the eastern communist countries you could not buy a bmw or a color tv it was just not the developed market no it was like a let's say like you would imagine china 30 years ago like some african countries are nowadays it's just not the same infrastructure and do you ever worry that it could uh return that way someday i mean um you know they always say history always repeats itself and the uh um political things have been very bizarre lately to say the least do you ever worry that um that type of management can return be honest i don't really understand what's the perspective of of europe and Germany and special in the next 10 or 15 years when i look at uh how fast the technological development in asia is and how innovative they are and how much commitment they bring in then uh sometimes i have some some questions about our economic development in europe in general i think we will face very hard times i think america is is a lot better off and obviously asia is just rocking it um yeah i think um china really uh got into the passing lane during this pandemic i mean they they clamped down on it the uh fastest the hardest and they're they're like they take luxuries um i was reading on bloomberg this morning that luxury sale items like you were talking about at bmw um are up 45 in uh this year up 45 whereas in europe the united states that you know they've it's contracted you know a quarter um so that's really um this has been very advantageous uh for teledentistry social media sites um any type of um amazon.com where you don't have to go to a store and risk getting exposed to a virus um online retail store sales as a percentage of sales have already doubled in uh in this year i mean 2020 saw the doubling of online retail so uh but china has been a major benefactor of this uh do you think the vaccine um will be rolled out pretty quickly in Germany or do you think the will the German are the German mindset of the people more trusting and we'll try this new virus um vaccine or do you think they're more skeptical and will want to wait and see uh how the first millions of people do or if you can trust the statistics whilst majority is going to use it and i think you know it's it's a procedure i mean maybe in the next month we will have different uh producing companies but the the one that i have heard of is a joint venture of a man american and a German company they use a technique that has not been uh it's done the first time and what it really changes in your body over out of time maybe it's not so clear let's put it this way if you're 70 it might make a lot more sense to use it than if you're 30 you know first of all you have uh the chances that it changes something within your body that you might you know have the chance to live it is smaller and obviously you're more in a risk group so yeah i don't know if you ask me if i will get a vaccine i i did not decide today but i think a lot of people in Germany will be eager to to get the vaccine and when you talked about um the vaccine you were just talking about which one of the vaccines were you talking about that it was a different virus i mean different mechanism um which one were you talking about you know it is the method that they they extract the genetic information from the virus and put it uh and processes in a way that that can be injected into the human body it's uh it's a process that has not been uh used before i cannot give you more details obviously some details that were published now is that the bio in tech and pfizer are you talking about the bio intact and pfizer that one yeah yes exactly so um i think in the united states they're going to first only give it to uh mother-in-laws and see how that goes and then if it works [Laughter] i have also a list of people oh my gosh wouldn't that be nice if everybody could just submit the names of the people they think should uh be on the trial fought but but but dennis want to know i mean you're a really really smart guy i mean you're a double doctor you were the first one in romania uh to offer uh clear aligners and then move to Germany you're an amazing guy but so it's interesting to see uh there's a big threat on dental town will will you take the vaccine and they're probably wanting to know how you would wrap your mind around this vaccine i mean would you want to see it roll out for a month uh three months half a year what what would it take to make you uh try this new bio intact pfizer vaccine the thing is that if 95 of the population gets the vaccine then also the 5 who do not take it are a lot safer than before so that's a little bit the strategy in my head but you know if you use a new drug you never have long-term uh evaluation no because you need to to work on the statistics and with a lot of patients over over years to and that is why this process of getting an improvement by the fda is so long you want to be sure that also in the next five or ten years nothing bad happens if you think back uh uh in the 60s there had this anti-baby pill contagon and you had a lot of you know handicapped uh newborns and that was of course a catastrophe so there there's a very strong and secure regulation for new medications that get an approval and now we're doing it very fast because we're under pressure so obviously i think it's uh it's okay to have some you know at least questions about this project um so you were the first dentist offering clear aligners i mean the first orthodontist alpha and clear liners in romania um was that a second iteration of aligners i mean did you used to do inman aligners or i mean there's other types of aligners did you ever try the inman aligner and and uh what were your thoughts of to that honest i never tried him i tried another product it was by then called clearcorrect i think it's still called clearcorrect but it's now owned by straumann so it was bought by a swiss company that produces implants they bought an american company it produces aligners i have to admit it was a few years ago so maybe the product is better today but then i was not so satisfied because it did not have the advantages that i was used to work with within the system of Invisalign and for the other cases that were demanding and the other lessons reminding an aesthetic treatment i used our hybrid technique so no i have no experience with um i mean i have experience that i tried them but i was not very satisfied with other products so why did why did you specifically not like the clearcorrect which was um acquired by uh the strahman group which owns an implant company i thought that was very interesting when it happened and then they um they also who did they um who did they just buy the other day um they also acquired um i think sandura dr smiley yeah they acquired dr smiley and i think they also uh acquired bay materials um yeah but dr smile is a direct to consumer brand yes in Germany um why i was not satisfied because the software tools that they offered by then were more limited than what what i was used to work with and the material to me was um too stiff so i used to notice that when um orthodontists would um get upset with um line technology like like when they started putting offices in malls and sometimes you know you'd run into an orthodontist and he'd really be venting hard and upset and i'd say well does that mean you are going to quit using a line technology Invisalign in your office and you say oh no no i uh the material is better it works better so it obviously sounds like um they're the mercedes-benz of um um they they have that brand in uh dennis mind do you agree with that uh it it has a strong position in the market because they were doing it first and they gathered a lot of a lot of experience over the years so i don't know if they would start with direct to consumer production and marketing if this would lead to orthodontics of not using the product anymore they're still buying straumann implants even if uh man is investing in the product to consumer business that is called dr smile so it's going to be very interesting how these things develop within the next let's say five to ten years but what's amazing is um you know they bought dr smile which is a practice chain specialized and aesthetic dental treatments headquartered in berlin and they have six offices then um hell you you have six offices so it's uh it's a um interesting uh direct-to-consumer company but it's really not that big though i they have a lot of partner offices on the other hand so i think it's more the idea that was bought and what what is really you know uh as a hardware there because obviously dr smile does not offer any technical improvement or something you know like innovation-wise it's more uh you know the the marketing idea let's say something directly to the patient and let's sell it at least give them the idea it's cheaper because i don't i don't really think you save so much money on that you know the united states is a really big country i mean it's uh you know it goes from one ocean the ocean so there's a a lot of different countries in america i always view america as the same as i do Europe i mean i would never compare Germany to Greece or Portugal to Denmark i mean they're very very different countries but in some states of the united states um general dentists get the feeling from orthodontist that they're not um happy if the general dentist does the uh does orthodontics like Invisalign and yet here now you have companies that are like uh dr smile and smiles drug club where hell there's not even a doctor in the deal how do the German before Invisalign uh started taking off really big what what was the attitude of orthodontist in Germany and romania about general dennis doing ortho and if a general dentist was doing an ortho case um would they feel comfortable going to you asking questions or help or is it just considered um something that they don't like and would prefer they didn't do it uh yes well obviously it's a big difference between for example romania and Germany in romania the the law structures the markets into ortho and dental and if you do not have an orthodontist as a partner in your office you cannot you're not allowed to do orthodontic treatment by the way only two countries in europe with that regulation i personally find this regulation a bit strange because uh a dentist has an uh during his education in school also the topic ortho and obviously he can learn a lot of things as practical work so why shouldn't he do that i mean there are easy cases not so easy cases very difficult cases it's going to structure already by that if he transferred to an orthodontist or not i think it's it's something that makes no sense to regulate um by law it regulates by itself so i have my problem with that i know it's late at night um Germany is eight hours ahead we've gone over an hour i swear I’ll try to speed up my questions and shut up as quick as i can um a few last questions um there's a lot of companies that advertise accelerated orthodontics different techniques different products do any of them convince you that they're worth the money that if you buy uh use this product um your braces will go faster your treatment will go faster or do you think it's more uh marketing that is also a very good question you see there are only some situations uh in that where self-ligating brackets really are indeed maybe faster than the traditional brackets they're still sold very good um and i think it's the same with these products so accident in Germany didn't make it to very good sales and there's a second product um that works with uh with light so accident was with vibrations i think also soft pulse technology yeah orthopaedics so if you sell such an appliance for uh seven eight hundred euros and the whole treatment is maybe only five thousand then i think it has to have a tremendous advantage regarding um speed of treatment and i i before i integrate it into my treatment i need more valid data so you're not a fan then of um of um ortho pulse or um acceledent let's put it that way i don't have enough experience to judge but they didn't convince me until this day to uh buy and in my gosh um um is there any other things that you thought we would be uh talking about today uh that we that we didn't um talk about oh is there anything you're passionate about that uh that you wish we should uh we should talk about um no i think we we discussed actually everything I’m the thing that i really would love to see in ortho is that we stick to what we can really measure and what we you know get as a feedback from universities as a valid information and less to what is you know promised by marketing of companies smaller or bigger ones so when we developed our brackets we were always working with a university lab to measure for example friction and to see what is the actual value that that you have within that product so it's not just you know an idea that you have and sometimes i think there's confusion about what is indeed measured and what is a valid result by independent university studies for example or other organization and what is you know just marketing blah blah um one other controversy i mean i like to call dentistry uncensored because i don't want to talk about anything everyone agrees on i always want to ask good journalism questions and thank you you've for saying great questions so many times another big argument that i see on dental town is between the orthodontist and the pediatric dentist some pediatric dentists um do a lot of rapid palatal expander and then that uses up a dental insurance benefit and then when the patient comes back to get ortho and when they're in high school and you know older um a lot of the orthodontist didn't see the value of the pediatric dentist intervention how do you see the way pediatric dentists um evaluate the bite and and where this is going to develop versus the orthodontist you guys in Germany and romania you see eye to eye or is there a little um um disconnect there also yeah it i think that in Germany at least there's these are two different fields of work so the pediatric pediatric dentist has a group of patients that are in within an age of five four six seven eight and that's not necessarily the um biggest group of patients and orthodontic treats there is a gap in between you know like you go to the pediatric dentist because you need a treatment maybe it's not the most the easiest patient and then a few years later indeed he comes to the orthodontist so they don't communicate too intensively and i can totally understand what you say but in Germany we don't have that issue to that extent because the pediatric dentists do not um they don't do too much ortho they don't do very much no they don't and um and final question um a line also bought um orthocad back in the day um do you think that was a good purchase and is orthocad something that you use i was indeed one of the very few German autocad users that is like more than 10 years ago i think we were four in total in Germany so you're talking about this bracket positioning um that was transferred an optimized bracket position that was transferred via um uh and yeah like an aligner you know like a positioning template uh but they bought autocad not because of that system but because of the scanner i think that from that point they developed the itero so i think it was a very good acquisition indeed very smart so i just want to know when um they're going to buy a robot there's yomi the robot that that's placing uh dental implants when will you be able to stay home and uh drink a beer in your jacuzzi while a robot does all your orthodontic treatment well i don't know what i know is that we have a very smart people that predict that within 40 years we will not have any jobs anymore because everybody can be done by artificial intelligence or robots i think it will just be a different way to work you know maybe it will be in a way that we emphasize more on human values and what one can do for the other and not only in the in the frame of uh you know being a doctor being a lawyer being something maybe it will be a totally different world where still some people will decide something and others less i cannot answer that but one day within the next decades we will be there well I’m very excited about artificial intelligence because i have not been impressed by natural intelligence that's a good one and i can't let you go without um a shout out to leanne ella ellermeyer um tell um the townies what your relationship is with leanne ellenmeyer she's the ceo at 2c med tech and 2c dental ag you do a lot of business with her tell him your relationship with with leah well that's a longer story but i will make it short uh she's the wife of wood garupath who is a German and an engineer for ortho that is just absolutely outstanding and i got to to know uh rudka and with him i also met lee and she is just one of the smartest uh woman i have ever met in in my life it's a very interesting couple where he's um you know he he developed this ortho robot that was spending the wires the wire vending machine and from there he went with with incognito or lingual uh lingual care and he did so many great things technical develop developments in ortho you should do an interview with him as well and lee is just a great ceo and a fantastic person for that could work for for any company and would do a tremendous job and I’m just very feel very honored to work with both of them and um i think if we will have um in the future success with our uh to clear product and it's uh because of them so her husband is um is a christian schultz no christian schulz is another orthodontist that is uh also a very unique person he's a you know venture capital guy that just has a very very good uh outstanding talent to raise money you know and that that is very important nowadays so without christian we would not be able to have a company you know it's a startup no we so from the product that i developed uh that was not a company by then because you need some some funding you need to raise the money if you don't want to be only with your own money in the high risk area and that is at my age maybe not the smartest idea so her husband's in uh rudger rubert yeah the husband is with ka robot yes wow interesting um i just want so how late is it there now what time is it 10 p.m it's almost 10 p.m yeah well hey uh I’m so thankful that after a long day how many patients did you see today oh howard it was only around 50. oh my gosh so here you are on the other side of the world after a long day of seeing 50 patients uh before you go to bed you had to stay up and talk to me and my homies for an hour and a half i hope it doesn't give you nightmares tonight while you're sleeping um thank you so much and and if um you uh talking to um rudger rubert if he wants to come on the show um i would love to hear about the the journey of replicate tooth and all the things he's done i mean i just love hearing uh these entrepreneur stories and it's a good pickup story especially in this down time where a lot of people um are very stressed uh from this pandemic i mean it's just literally killing my mom my mom's 82 and uh just the fact that her bowling league was canceled i thought was almost gonna kill her um you know um so uh thank you so much for all that you've done for dentistry for orthodontics and for staying up uh tonight to talk to me and my homies um night night and i hope you sleep well thank you very much howard it's indeed it was a pleasure and lee already said that you are a great guy in front to talk to and she's 100 right so anytime you want to talk again you you're very welcome all right I’ll see you at the next fdi meeting
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