Dr. Emil Verban taught himself to place implants without taking a $20,000 continuum. Learn how he did it and how to offer affordable implant options to your patients.
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Audio Howard Speaks Podcast #29 with Emil Verban
Links and References From the Show:
Video Howard Speaks Podcast 029 with Emil Verban
Dr. Verban's Drill-Stops: Verban Drill-Stops
International Team for Implantology (ITI): iti.org
Simple, Advanced, Complex (SAC) Classification/Assessment tool: link
Planmeca ProMax 3D CBCT: link
Dr. August De Oliveira CE on Dentaltown: link
Dr. Arun Garg: implantseminars.com
Implant Direct: implantdirect.com
Blue Sky Bio: blueskybio.com
Osstell meter for measuring implant stability (Dr. Verban likes a reading of 70+): osstell.com
enCore allograft: link
Grafton DBM: link
Dr. Emil Verban's Bio:
Dr. Emil M. Verban received his Doctor of Dental Surgery Degree from Loyola University School of Dental Science in 1976. He has been in full-time practice of General Dentistry, in Bloomington, Illinois with a special interest in cosmetic and implant dentistry. Dr. Verban is a nationally recognized leader, lecturer and educator in implant and restorative dentistry. He has developed and patented surgical products which greatly increase safety and precision for implant surgery. He has advanced training and is certified in intravenous sedation. He has published numerous articles on implant dentistry and is on the Editorial Board for the Journal of Implant and Advanced Clinical Dentistry. He has been President of the Mclean County Dental Society and Chairman of the Peer Review Board of Mclean County. Dr. Verban is a member of the American Dental Association, American Academy of General Dentistry, American Academy of Perio, American Academy of Osseointegration and International Team of Implantology of which he is a certified speaker.
Transcript (Download here)
Howard Farran: Even though today I’m interviewing the man, Dr. Barry Glassman, who needs no introduction, I’m going to go through his introduction. You have a private practice in Allentown, Pennsylvania, which is limited to chronic pain management, head and facial pain, TMJ, but sleep medicine is now where you’ve just gone to another planet. He's a diplomat of the American Academy of Craniofacial Pain, fellow with International College of Craniomandibular Orthopedics…
Barry Glassman: Howard, Howard, nobody care about all of that. Nobody cares.
Howard Farran: But you’re, I mean, but you are an amazing man, and you’ve reinvented yourself ten times. I mean, you’ve always been at the forefront of dentistry, you got out of dental school as a restorative dentist and you just keep taking it to the next level. I just had the luxury to hear you lecture in Las Vegas at the sleep convention
Barry Glassman: And I’m gonna correct…I want to say, Howard, that I’ve taken it to different levels. I’m not going to…you know, one of the things that when people do sleep and pain, and I think it’s critical because today we’re going to talk about the general dentist, and as a result of talking about the general dentist, many people will say to me, Oh, come on, Barry, who the hell are you to talk about general dentistry when you’re not one? And the irony is, yes, I am one, and we are all one, and that’s who we are, and when people say, Well, look what you’ve done with your career, look what you’ve done with pain, look what you’ve done with sleep, and I, when I say to them, to be honest with you, that’s not taking it to the next level, that’s taking it to another level. That’s just another… I just do something else with the information I’ve been given and blessed with meeting great people that led me in right directions after a whole bunch of people led me in the wrong direction. And having said that, therefore, this other level allows me to look at the general dentist, the one we’re going to talk about today, Howard, allows me to look at this general dentist and understand him and empathize with him enough…and understand that the amount of respect I have for general dentistry is massive. People say to me, God, Barry, look what you’ve done. Look what’s you’ve done…look… forget that. Look what dentistry’s done. Look what these guys do every day when they see 15, 20 patients and they put an implant and they do a lift and they do these things that I…scare the living crap out of me. And they do this on a regular basis, every day. The amount of respect I have for general dentistry is massive. So, right away, when we start talking, Howard, we’re talking about general dentistry, we’re talking about, it’s not Glassman another level, it’s a different level that’s frankly allowed me to look at the same people you look at and deal with on a regular basis in a very, very special way.
Howard Farran: Well, let’s start it like this. How many years have you been since dental school? How many years you been out practicing?
Barry Glassman: Do I have to tell you that?
Howard Farran: Yeah.
Barry Glassman: (Laughs) I graduated dental school in 1973.
Howard Farran: So, how many years is that? That’s uh…
Barry Glassman: Thirty-five maybe. More.
Howard Farran: So, 1973…so where I want to start this, Barry, is in fact, it’s funny because you refer to dentists as “he” and when I was a freshman in dental school, the senior class had one woman…
Barry Glassman: We had none.
Howard Farran: You had none, and my class had one, and last year’s graduating class is 45%. So, I want to start it out with this, Barry…you’ve been around the block, five thousand dentists just graduated in May, they’re going to start their forty-year journey of dentistry, and there’s another, you know, gazillion dentists out there who ever since this last recession, they’ve been sitting there in their town, their town’s going nowhere, it’s not going up, it’s not going down, they just say, you know, it’s just flat. There’s just nothing going on. So, you were going to talk about the dentists today, start with the perspective – what would you tell the five thousand graduating dentists to think about as they approach their forty-year-long clinical dentistry, and number two, what would you say to all the dentists out there, in not just America, but around the world, that are practicing…I mean, you and I have to admit, we have both practiced through a lot of recessions, but this one was totally different. Most of the recessions were kind of like dropping a bouncing basketball, they plummeted and bounced right back up, and this one, it’s kind of like the ball was flat. It just like plummeted, and it’s just lying there, nothing’s happening. So, what’s your words of wisdom?
Barry Glassman: What I would tell people is that looking at success and happiness is, as you know, Howard, better than anybody, more than looking at a balance sheet, and if your goal is only looking at a balance sheet, you will fail. And if your goal is to look at your town and be, and go down because you think that the, your town’s economics are going to control your level of success, you have no understanding about success and failure. And that, when I went to the Dental Town meeting - several years ago you were kind enough to invite me to speak on sleep, and I sat with 40 dentists, young dentists, I listened to them, and they said…and they’re all talking about ways of getting new patients and ways of new income and return on investment and technology, and they looked at the old guy sitting on the corner and they said, what are you saying? Glassman, you’re not saying anything. They asked me the same question that Howard Forran just asked me. What are your words of wisdom? And my words of wisdom are the following: One, get good at what you do first. Do whatever you have to do to get good at what you do. Two, understand that you’re treating patients, but you’re not really treating patients. Eliminate the word patients from your mindset. Remember that you’re treating people. People want to be heard. They’re tired of going to doctor after doctor and not being heard. It’s their number one complaint. If you understand that when a patient says yes to a treatment plan, they’re not saying yes to the DO, implant, lift, and prosthesis. They’re saying yes to you. If you give them a moment of time and you hear them, I don’t care – you can be in the poorest town, your town can be going downhill, there’ll be a reason that they’ll drive past five offices to get to you. So, get good at what you do and never forget that you’re treating people, and don’t forget make your goal the bottom line, make your goal good treatment, understanding that there are times that that treatment can’t be as ideal as you want it to be to provide it for the…what maybe that patient needs, and care about people, you will succeed and you will go to bed at night and be happy.
Howard Farran: I just read an interesting…somewhere about, you know, dentists and physicians, their number one complaint is not being heard – he didn’t listen to a word I said, they go home and they say they only spent three minutes per room, and the dentist actually took massively detailed notes and passes very high scores and heard everything, and this paper said that, you need to reiterate something back. If you said, you know, my…this lower tooth hurts and that…you can’t just say, okay, and then go to the next question. You have…you can’t say okay, you have to regurgitate something back, and when you do that technique, the patient thinks that you’re actually listening.
Barry Glassman: That’s a great technique. There’s lots of things. The first thing I would say to a new dentist is think about that first visit. Think about that first visit. The patient’s decided to come to you, alright? Now, you…I know you, Howard. I know what you teach. I know that you explain that that entire experience is essential, that how they feel when they walk…the worst thing a staff can do is hand out a piece of paper and say to them, Fill this out, the doctor will see you in a minute. What the…the doctor will…really? You know, fill this out, really? And then it asks for the medications and the first thing the doctor walks in, he says, Well, you taking any medications? The patient wants to say screw you, did you read the God damn thing? So, what we do is we make sure that…the first question I want to ask you is, I ask new dentists this, at the end of the first visit, first visit, how do you know whether your first visit was successful? And they’re answer will be, Well, did I get all the information, can I do my treatment plan, did the x-rays…did they pay for their visit…No. No, here’s the answer. If you could be a fly on the wall in the dining room, when she goes home that night and she sits down to dinner, and her husband walks in and says, Hey, honey, you went to see that new dentist today. How did it go? If I could hear the answer to that question, I’ll tell you whether my first visit was successful.
Howard Farran: I think, what you just said was, extremely amazing, Barry, because I’ve had the opportunity to be in hundreds and hundreds, probably thousands of dental offices and all the great ones like you and Omar Reed and, you know, just all the greats that, at a different level, when you see them walk into the room, it’s a passionate exchange between two passionate people, and the energy in the room just lights up. And then when you go see, walk in the operatory of all the dentists who are struggling, they walk in the room, it’s kind of like a librarian, they sit down, they start looking at the chart, they start pointing to an x-ray and it’s like, Oh my God, they just…I mean, they just m…the just miss the whole relationship, and…
Barry Glassman: Can you imagine how boring it is for them, what kind of life it is for them? If you’re tre….no offense, teeth, white little, what are the white things that stick out of the gums, those…that becomes your life? A tooth? Really? That…you want to talk about a lack of perspective? We got ISIS, we got the world collapsing, we got Obamacare, and we’re going to talk about a tooth being the center of our world. I’m here at the ADA convention in Sa….I couldn’t wait to come to this interview. I couldn’t wait to get out of all those 7,000 people who are fighting technology and fighting each other and competing to sell the right chair and the right laser and the right…Oh my God, oh my God I can't listen to one more second of this. Second to this, I thought thank God, I got Howard. You know, I got a breath of fresh air, of reality, of…and to be locked into this, to lock into 15 patients a day, 20, patients a day, and you and I both know that these dentists aren’t dentists who are seeing 15 or 16 patients a day, and every procedure, they are supposed to be perfect. That’s what we were taught in dental school. It’s perfection. And you and I both know that, out of 15 procedures, not all of them are perfect. And if you saw 14 patients and all 14 of them, amazingly, were perfect, and that 15th patient was a crown that didn’t go in for the third time, when you get into your car and you’re driving home and you’re banging your head against the windshield because of the 15th patient totally negating the 14 pat…why? Do you think a neurologist will see 14 patients perfectly? And then, on the 15th patient, have the migraine that patient…doesn’t go away, and bang his head against a windshield because the Topamax didn’t take away the patient’s migraine? Really? Dentistry. What dentistry has done to us and to those people that you’re talking about, it’s horrible. We give lip service. We are treating people, there are people tied to those teeth. Yeah, we say that and then the next thing we know is, get in the chair, open your mouth as fast as you can, because you don’t really…I don’t really need much from you except to open and pay your bill. And be open, open six…you know, what’s an ideal patient to most dentists? One who is loyal, pays their bill, is on time, open 60 mm, doesn’t’ have a tongue or cheek. You know, that’s an ideal patient…and stop salivating while you’re working. Yeah, that’s one…that’s perfect.
Howard Farran: Yeah, and another thing about the, the craziness of the imperfect…of the perfect mentality is not only do they beat themselves insane and send crowns back to the lab four or five times. First of all, the tooth got a cavity before it had a filling or a crown or a margin, and they treat dentistry like it’s a mechanical engine of moving parts, when really it’s a behavioral disease from diet and lack of home care, and you see it in coaching all the time. I mean, who are these great athletes? the kid’s mother took them to baseball and softball and ten different sports, but one coach touched that little kid and gave him positive feedback, and you’re got to do the same thing. You’ve got to find that coach in your life to turn this kid onto brush and floss. There’s nothing that makes me more high as a kite than when some 14-year-old punk kid from high school comes in with jeans hanging half way down his butt, and he smiles real big and he says, You know, I floss every day since I’ve seen you last time, and you think, Oh my God, I connected with this kid and I’m his role model for his oral health and, and if I missed all of that and then sit down and did ten MOD composites in there, they’re all gonna fail from not flossing and drinking Dr. Pepper in a year anyway.
Barry Glassman: So, you touch on a very important point, and that is, is that we…we are more than mechanics, and we’ve been saying that, but we give it lip service, then we go and become mechanics. Howard, I’m in the process of writing a book. I’m not pushing the book. Everyone will tell you I’m really good at a lot of those things, but my marketing sucks about everything, so I…but, the book the called Dentistry’s Victim, and what it refers to is us. How, I don’t know whether dental school screens and only gets people who are potential paranoid, insecure people, or whether the dental experience makes us that way. But, by teaching us that we’re supposed to be perfect, and that every procedure’s supposed to be perfect, and then when we’re not perfect, it’s our fault. And this goes on further when you talk about equilibrations and, you know, you can’t equilibrate as well as Dr. Dawson, so that’s why your patient doesn’t get…if it was Dr. Dawson, he’d make the head neck pain and testicular cancer all go away because he equilibrated her perfectly. Well, you know, and I don’t mean to pick on Pete – I love Pete, but it’d go on and on and on with everybody. And the reality is, this isn’t a perfect world and the things we do aren’t perfect, and it doesn’t have to be perfect, and it’s okay. We don’t…we aren’t taught about it in that capacity. We were taught to look at mechanical things and supposed to make them perfect, and if that makes them perfect, it’s fine. I deal every day with patients who had perfect procedures done, who now have referred odontalgia. And they want to blame the dentist who did the crown, when the crown was done perfectly. And that’s not what caused the afferent nociception that led to the central sensitization, and therefore pain. But, what I’m saying is that we’re taught to be perfect, and we think we’re supposed to be, and it’s drilled into us, and then when we get out and we know that we’re not, the only person, Howard, that knows that we’re not, every procedure that we do, is us. We’re the ones who see it. Not our assistant, not our patients, we see the lack of perfection every day. Now, the question is how do we deal with that? Every one of us deals with it differently. Because we’re not taught to look for it or understand it, most of us deal with it by hiding it. It eats at us. We don’t know about it. There’s a reason dentists…I know dentistry’s the greatest profession in the world, isn’t it Howard? Everybody says, I love it! I never went to a meeting where I didn’t hear, Oh, don’t you love our profession? Isn’t it great? Don’t you just…isn’t it fabulous? Oh, I love it. I have control of my life… And then I go out to dinner with the guys and by the second drink, what the !%*? !%#? patients and they're…so, what happened to the love? It only took two drinks to get rid of the love. I said, What are you talking about? It’s built-in frustration. It’s an amazing job, how we have to please ourselves, please our staff, please out…and create an income, create an income for other people, do procedures that people don’t want done, and create a value to that. It’s, it’s an almost impossible task. Many of us, many of our professions…when you ask me about young people, it scares me. Many of our young people will fail.
Howard Farran: And a lot of this goes to, back to the dental school deans. My favorite dental school dean by far is Jack Dillenberg who happens to be right here in the State of Arizona, and he says, you know, All the dental schools, they only attract you if you get 4.0s in calculus and geometry and physics and chemistry and biology, but if you’re a well-rounded kid and were on a volleyball team and maybe in a fraternity and had a girlfriend, heaven forbid, and had a 3.3 and just were a great guy, you’d never even have a chance at med school or dental school.
Barry Glassman: Okay, what have you got.,,
Howard Farran: It’s natural selection of…
Barry Glassman: I said that’s my question… I’ve often wondered about that. But, here’s my question. What was your major?
Howard Farran: Mine was psychology.
Barry Glassman: Yeah, mine, too. So, what does that tell you? Seriously, what does that…see, isn’t that interesting. And you know what, and I’ve always said, you know, look at the guys that got As in academia and they’re helping nobody. Look at the guys that got Bs and Cs, and it’s amazing what some of us have accomplished. In fact…
Howard Farran: I…I…When I went to college, there was only one thing I wanted to learn about and that was the human mind. How did these talking monkeys make it to the moon? I didn’t care about mitochondrial DNA and RNA and, you know, having permutations for a thousand, I mean, I just thought who cares, I want to know why that crazy person does what they do.
Barry Glassman: So, you’ve experienced exactly what I experienced. I get a whole bunch of people that were in my dental class and they, they pick up their phone and they call me, says, You know, there’s this guy, Glassman, Barry Glassman, lecturing around the country on pain and sleep. That’s amazing. He looks a lot like you. Because it can’t possibly be correct. It’s not my fault…(Laughs) So, I think that the point, if I could make any point, and when we listed, Howard, for those that are listening, Howard and I talked about the things to talk about and obviously we’re going to do this again and we’re going to do one on sleep, and if I would love to do one, Howard, on occlusion, and etc. because I think that that’s one of the things that drives dentists crazy for no good reason, that we’re asked as dentists to go through a bunch of hoops to make occlusions that don’t matter. for the most part. And when it does matter and when, oh, that’s very exciting and reality, but not to the level that we are taught. Having said that, if I wanted to accomplish anything in this hour, I wanted to get the word to those of you who are looking introspectively as yourselves with any degree of honesty, and tell you that it’s okay, that there are things about our profession that are difficult, and it’s better to face them in reality than to hide them. That when you…that my most popular course that I teach is with my clinical psychologist named Micah Sadigh, who teaches a course on burnout. The number of dentists that deal with burnout at a young age is massive. The number of marriages that fail because of their profession is massive. The number of people who don’t deal with their children well because they’re not who they should be, because of our profession is massive. The dental school experience is problematic. The thought that we’re supposed to be more than what we’re supposed to be is problematic. The thought that we’re entrenched to be perfect, that we can go to a lecture and look and start to pick on a margin, I want to take these people and scream at them and say to them don’t do that. Yes, I would ask all of you to consider picking up a book. Now, I hate reading. I’m not a good reader. My wife, who’s an English teacher, cringes when I say that. But, I’m not. I read journals incessantly, and I haven’t read a book for pleasure in years because I’m not good enough to appreciate, to enjoy it. And my wife forced me to read this book, it’s called The Four Agreements, from Miguel Ruiz. Howard, I will send you this book. It’s in big print so you’ll read it. And Miguel Ruiz was a surgeon. And he had a near-death experience. And you know there’s no one who has, or more likely to have less patient skills than a surgeon. Our oral surgeons are proof of that. And…did I just say that? And what I’ve learned, what he learned was, when he came out of the near-death experience, that there was more to life than cutting and dicing. And he developed what he called Toltec Wisdom – he’s from Mexico, and he developed these four agreements that he made with his world. And briefly, the first agreement was be impeccable with your word. Be honest. Now, in order to be honest with your world, there’s a prerequisite. You have to be honest with yourself. That’s what I’m getting at about the dental thing.
Howard Farran: Did you say Impeccable with your word or with the world?
Barry Glassman: Word. W-O-R-D.
Howard Farran: Okay.
Barry Glassman: Be impeccable with your word. To your word.
Howard Farran: Okay.
Barry Glassman: Being honest, being honest with your…to your fellow…so, when I’m at a lecture, Howard, and you’ve heard this, someone asks me a question and…I don’t know the answer, what’s my answer?
Howard Farran: I don’t know.
Barry Glassman: I don’t know. I don’t know. As opposed to you and all…you and I have all seeing lectures who have to have all the right answers. You know that. So, be impeccable with your word. Two, is don’t take anything personally. Now, for a dentist, that’s next to impossible. You know…you, this filling you did, look what you caused me, etc., etc. Now, that’s…don’t take anything personally. Um it’s…separate yourself from the outcome. Patient comes in and he says, Look what you did for me, and I say, No. It’s not that I did this for you. Or, I won’t take the credit for the great things we do or will I take the blame for the “less than great thing”, err, results. And finally, the last one is do your best. So, you still have to do your best. You still have to attempt to do the best dentistry you can do. No question about that. Four agreements, if you live by those four agreements, it will change your life.
Howard Farran: I want to tell you something about the, the book and the marketing, Barry, is a lot of the explosive part of the book market is actually in the audio books, so you say, we’ll talk about marketing your book, the people who are releasing a book but who will go in, and do a sound file on it, I mean, read it, and what you should do for your book is you should, you should read the book on Skype so someone can watch the man himself deliver the words, or if it’s an e-book, a lot of people just like to read it on their iPhone or iPad or whatever, but a lot of the fast-growing is audio multitasking, which is why we’re doing this podcast, because I’m just getting, um…we’ve done 25 of these and I’ve got a ton of people who listen to four every Saturday morning while they do all their laundry and cleaning and vacuuming and making their, you know, doing all their stuff, so multitasking during a book, especially the younger generation who grew up on video games, they’re so used to overstimulation that a black and white reading book is something they thing their grandparents do. They, they’re used to multimedia and fancy games and they, so they love to listen to, your book while they’re on a treadmill or lifting weights or doing something else.
Barry Glassman: So, that raises an interesting question I’ll ask you, even though you’re interviewing me, and that is our younger generation…one of the things that concerns me, obviously the thing that’s on everyone’s lips about our younger generation, is if, in fact, their happiness involves social skills, communication skills, the ability to listen. My fear is these are not…these skills will require more effort on their part than our generation because they don’t have those basic skills because of the technology boom. Is that a concern of yours?
Howard Farran: If they…you know, technology is very interesting. I love the joke about Anthony Weiner where he, you know, he lost his career on a technology that wasn’t even a year old. I mean, you know, if he just would have, if they would have, delayed technology, he’d still be in office. So, technology, like, I notice with, children that you, you call them, they don’t answer, and they immediately text back What up, and they, they don’t want that on the witness stand, they want to have a minute or two to process. I also find it extremely interesting how their birth rates are plummeting. Now, our generation, the baby boomers, we come out of World War II, we just worked, I mean, gosh we worked, and all around the countries of the world, they see, they saw that generation work and the young kids like, I don’t want to do that. So, I mean, so there…so after World War II in America, our birth rate was over five kids per family, 5.1, and the just to maintain a new one for everyone that dies, you need a 2.4, and Japan is now under 1, they’re a 0.9. America, if you backed out immigration, legal and illegal, we’re plummeting; Germany, if you just backed out, immigration from Turkey, they’re plummeting, so the advanced children are, you know, instead of having a kid at 16, they’re pushing it out a decade, over a decade, to 27…
Barry Glassman: Right, right.
Howard Farran: …and they’re saying, Man, that kid was a lot of work, and I see…and that’s one of the things that’s feeding these, chain dental clinics like Heartland Dental Care and Pacific Dental, they’re like, You know, I want a job three or four days a week, maybe…not five and I certainly don’t want to stay after five and do all the business and paperwork and go to the ADA convention and decide what dental chair I’m gonna get or what x-ray machine, so I think the, I think they saw us and how hard we worked and just said, Oh my God, I am not going to do that. So, that, you know, that’s uh…
Barry Glassman: I, I’m blown away, now that I’ve moved into sleep, at the level we are, and I really look forward to talking about that, but I’m blown away by the number of groups, small groups, large groups, the number…the acquiring of practices left and right…I mean, I just talked to a guy who just acquired ten pract…I mean, left and right, and all the dentists that are going in now as employees. I…
Howard Farran: Barry, I used to…back to your sleep and what we were talking about, I know. I actually thought, you know…the fact that I spent my entire life going to bed at 1:00 and waking up at 4:30 or 5:00, and I just, I just saw people who went to bed at, you know, 10:00 and slept in until 6, I just thought they were lazy. I mean, I…for 50 years of my life, I just considered it, you’re lazy. Kind of like I had that attitude where if you’re unemployed…if you can’t find a job in America and you’re on welfare, you’re on food stamps, I, you’re just lazy. I literally believed that for half a century. And then I…and then it was your lecture, and it was, two years ago, with Michael Glass, and started looking into this sleep thing that I started realizing, man, this is important for my longevity. So, I had that post-World War II, baby boomer work ethic, and now I actually – it’s kind of funny, but ever since I took your class two years ago, I don’t even sleep in my bedroom. My bedroom was decked out with big screens, Bose surround sound, all these electronic devices…I now sleep in the guest bedroom that doesn’t have a clock, it doesn’t have a TV, it has nothing, and I go in there and, and going back two years ago, I mean, I would literally lay down in bed at like 10:00 and stare at the ceiling ‘til when I usually went to bed at 1…it’s taken me…it took me a year to get from 4-1/2 to 6-1/2, and it took me another year to get to 7-1/2.
Barry Glassman: And you wouldn’t be running the way you’re running, and you wouldn’t be exercising as successfully as you are, and you wouldn’t be as healthy as you are without it.
Howard Farran: Yeah, and so, so yeah, it’s a lifestyle change, and these big chains, these Heartland Dental Cares and these Pacific Dentals, you know, it’s market segmentation. There’s not one car for every person – that was Henry Ford’s mistake, that everybody, he said, you can have any color you want so long as it is black. I mean, there are people that want trucks and 2-doors and vans and all kinds of things, and there’s going to be a large segment of our population that wants to go work for another dentist, whether that clinic corporate dentistry owns one office or five offices or 500 offices, just because they want a lower stress lifestyle. And there’s…so many of those young kids tell me, I want to do it like four six-hour shifts and that’s enough, and they want to live more simpler, they don’t want the big trophy house and the big trophy car and the big trophy vacation to post on Facebook. They just want to live simple lives.
Barry Glassman: I don’t…and I don’t…I’m not judgmental about that. And I think that, in a way, our generation needs to look at that and say, you know, at least you’ve given that thought. None of us thought about it. We didn’t go to work and decided we want to work, it’s what we did. We didn’t get married at, in college or shortly thereafter because it was the right woman, it was because it was the woman we were dating when we were supposed to get married. Some of…for some of us, it worked; for some of us, it didn’t. The additional thought is not negative. I don’t have a problem with that. The…working for someone else is an option as long as you don’t give up your morals. As long as you don’t give up your character. If working for someone else means that that means that you’ve got to see 20 patients a day and they don’t care about the quality, that doesn’t work. You won’t…you won’t be happy. You think that’s…you can go and show…walk away. If you’re that kind of person, then do a favor – get the hell out of dentistry, because you’re not doing us or yours…we have…we as dentists have to look at something…one thing differently. We had the option to work for a company that sold Fords. We could have done that. And if you’re working as a sales person, then you can judge your success at the end of the day by how many cars you sold, or how much money you extracted from somebody else’s wallet. That’s…did I just say that? That, that, that’s how you judge success. We went into a profession for a reason, that that wasn’t enough. That if that’s how…that’s all we have and that’s what upset me about the 40 people at that table. Don’t you understand the position you’re in? Do you understand how wonderful it is that God or whoever you want to go with put you in this position that allowed you, at the end of the day, to say, My goal in life is to make someone else’s life, someone else who’s experiencing this, this, whatever this is, this existence, this time we’re on the earth, to make the quality of somebody else’s life better. How unbelievable is that, at whatever level? We can do that. And that, that…so, we should be appreciative of that. And that’s got to…but, if…that’s why it’s so much better…we as professionals make poor business decisions every day. That’s what we’re paid to do. That’s what…so when somebody comes to us and all they need is a bonding on a lingual, on a nonbearing, weight bearing cusp, yes, you could sell the crown, but would you do that to your brother, if you liked him? You know, that, that’s the point. We…we make poor business decisions every day. If I’m working for someone who doesn’t understand that, then we both shouldn’t be in this profession. So, I have no problem with being in that profession, of being an employee as long as there is some agreement to the level of professionalism in my decision-making. Does that make sense?
Howard Farran: Absolutely. And I think It’s funny – and I don’t like the term corporate dentistry because half the dentists in America are incorporated and most of the people working for a corporate dentist are actually an associate, where they’re the only associate for a single dentist, do you know what I mean? They employ more…like I have two employee dentists, so they’re part of corporate dentistry. but I’m not a chain. I don’t have, you know, multiple locations. but the human side that people like you and the great ones like Omar Reed, you know, that you continue to talk about is back to that perfection of the dentistry, they also believe in some crazy, perfected treatment plan that they don’t understand, when this person has no money and they’re living in an apartment, and they’re cosmetically horrified by their teeth…I just had a lady, send me an email yesterday about how her upper denture was the single greatest decision she ever made and everybody talked her out of it and no dentist would go along with it and she couldn’t smile, she couldn’t talk, and it was just ruining her life. She didn’t have the money for all the root canals and the crowns and the implants and all that stuff. Finally, she found a dentist to pull her upper teeth and give her a beautiful denture and she is the happiest person in the world. And for, and dentists continually look at seven billion people on earth and shove them into one treatment plan, and then…
Barry Glassman: And there’s, there’s that…and I love them, don’t get me wrong. Dick Barnes and Pete and, uh…but they teach, you know, telling dentists don’t do onsies and twosies dentistry and to be a complete dentist, do the…you know, and then put occlusion in that so that you have to idealize the occlusion and this, and the jaw position, as though anybody knows what jaw position anybody’s in anytime, anyway, I mean, it’s the most ridiculous thing. I’m sorry to offend…but, it’s making dentists feel guilty about hoops that they don’t have to jump through. And makes no sense anyway. But, actually make you feel better and create these, these…and I don’t mean…I’m not referring to the names I just talked about, but there are those people that create these cults, there’s…they, they…and dentistry becomes a religion. And it’s about them. And their patients become then, forced into their religious beliefs because it’s right, when in fact, the science tells us it’s not. And so I couldn’t agree more that we need to listen…now, there are…and listen to me, please, carefully, those that are listening, we’re not saying therefore do whatever the patient wants and accept that and you just live with that because you’re doing…no, of course not. We all have our standards and what we know is in the best interest…and I wouldn’t do something that a patient wants when I know it isn’t the right thing to do. So, when a patient comes to me and their in pain in their upper bicuspid and they’re pointing to that tooth, they say, That hurts, do that root canal. I’ve got lots of people who would say, Well, go ahead and do that root canal, when in fact, every day I see patients who have had root canals and extractions and still have pain in that area because somebody did what the patient wanted without following the science. No, I’m not saying don’t follow the science and don’t guide people into the right treatment, but don’t be judgmental. Don’t…and listen to them and understand that people have a…prioritize their goals differently and that’s okay. If you can guide them into some improved life function, life, uh…structure and happiness about who they are, then you’ve done a service, even if you haven’t done what someone…you can put on a screen in a meeting with 500 dentists and brag. I think what Howard talked about, that guy with the, with the, what he did with the kid who’s flossing his teeth, is amazing. Three days ago, there was a 40-year-old with Down Syndrome, patient came to my office and he’s got this weird-looking of teeth, obviously, a constricted arch, and he’s obese and he’s in tears because his father just died, and he can’t stay awake because he’s got sleep apnea and they can’t put him in an appliance, in a CPAP. They told me there’s no way, no way that this kid would ever wear an oral appliance. We came and we did a forty-minute interview with him, he broke down in tears when he talked about his father, I broke down with him, we walked into the room and I, and I gave him a challenge, I said we’re going to have to take impressions. The caregiver looked at me like, really, you’re gonna take an impression on Dan, like that’s possible? I left for San Antonio Wednesday night; Wednesday morning we put him…a week ago Wednesday, we put an appliance in Dan, and Wednesday, a week, he came back to let me know that he’s worn the appliance every night and that he feels like he’s sleeping better. Now, I broke. I mean, how can you not break? How can you not… Is that a perfect appliance…does he still have screw-up occlusion, does he still have a constricted arch, does he still…yes. My God, you’re gonna criticize me for not fixing his bite? Really? There are patients all the time that no one…I swear, I am totally convinced, Howard, that no one in this world is more responsible for screwing up more people’s bites than me. I take…I’m number one. Between the NTIs and altered occlusal schemes and then oral appliances which create…so I create not only anterior bites, but amalgams I create posterior bites. I just, I do…I do everything I can to keep teeth from touching because, for me, the only time teeth get in trouble is when they touch each other. That’s the only time there’s…when there’s a…the increased force is the guts to our problems. No one screwed up more bites than me. And I’m pleased, I’m thrilled to tell you that I don’t think that I could, my life could be more fulfilled with helping more people. I would have never, ever imagined I have the chance, the opportunity that I’ve had. And yet there are…my profession that would look at me and say, Oh my God, what horrible things you’ve done, Glassman. Look at your bites.
Howard Farran: I want to touch on something you talked about, for these younger dentists to realize, you know, a lot of dentists are trained in biology that, you know, all animals are basically they want to eat, drink, reproduce, have offspring, but the social animals – cats, dogs, monkeys, humans, they’re hard-wired at birth to be tribal. you see it in a football game where, you know, you want your team to crush the other team for no apparent reason other than the different colored jersey. So, so, the only way these, these humans would have lasted, just like gorillas, chimpanzees, orangutans, monobos, is that they’re hard-wired at birth to obey the 400-pound gorilla, because you can’t have 50 different monkeys running in 50 different directions, they’ve all got to move and work together. So, you’re hard-wired to follow a leader, those leaders always have these cultures and customs and beliefs, and you’re hard-wired to accept that, and I see that in dentistry. There’s…you call them cults, and they are cults, and my joke is that you go to a study club and you sit down and a dentist will stand up and say, I’d like to make a toast, just I want everyone to know that I trim my own dyes, and then…and in their culture and custom, you know, the weaker monkeys start, Oh my God, oh my God, you know, they bow down, and then not to be all Dundee, the other gorilla stands up and says, I want you to know that I quarry my own stone, then pour out my own dyes, and then I trim them. And then the third dentist is like, Oh no, no, no, no, I have my own bee hive, I grow my own wax, I quarry my own stone, I trim my own dyes, and in dentis…these cults, the longest distance between two points for the highest price course is what all these young monkeys are hard-wired to go follow and give them all their money and make a mountain out of a mull hill, and you have to take that little frontal cortex and use critical thinking to out-think…just like, just like sometimes when, your body’s telling you you’re hungry or thirsty and you’ve got to critically think and say, No, I got 2,000 calories today, I couldn’t possibly be hungry, and so you’re hard-wired to follow these cults, and I, I look at, you know, like I’m crazy, I love the Arizona Cardinals, I know it’s fun, I know it’s silly, I know it’s stupid, but I love them, but tribalism can turn into world wars, tribalism can turn into you flying down every three months and giving some, some institute $5,000 because you want to be certified by their 400-pound gorilla and tell everybody that you’re a diplomat of the 400-pound gorilla organization, and in dentistry, whenever you just sit there and say, Hey, I found a really simple, easy, faster, lower cost, cheaper way to do this, a lot of them look at you like, Oh my God, that’s not even right. How could you even think of doing something faster, easier, and cheaper in the sacred cult of dental religion? So, I want these young dentists to be aware of their hard-wiring, and street-smart dentists can go take a course on Dental Town for $18 or listen to guys like you on our YouTube channel for free or on Dental Town videos for free. You don’t need to spend $4,000 on a weekend because you feel accepted and you want part of the customs and cultures and traditions and…
Barry Glassman: There’s another piece, and I know we’re getting to where we’re going to end this, Howard, but there’s another piece to this that I…you don’t know what it does – how heartwarming it is for me to hear you say that. I've often…you know, we’re…I was on Dental Town for a long time, Howard, before we actually ever communicated, and I’ve always wondered, I, I’m confident that you’re aware that I was out there, but I always wondered how you felt about my approach that wasn’t in…that tended to be more controversial, unfortunately, away from the cult and the, the traditional thinking, and today’s the first day that I recognize that you probably weren’t upset with that, but I, there’s, there’s more…there’s something here. The cultism isn’t just in the advanced continuing education high-level programs. The cultism starts where we start it, in dental school. The cultism starts without a series of “facts upon which our profession is based,” that are not facts, but are empirical evidence that turned out to be not true, but continued to be taught on a regular basis. the occlusions, the number one issue. dentists expect, think teeth belong together. If I give two dentists an upper and a lower model, the first thing they’re going to do is put them together and see how the inner cuspate or whether the max…whether the master and temporalis go into permanent construc…err, contraction, even though they never do that in function. maximum inner cuspations pathology, it should never happen. What we test every day, is pathology, though it should be tested. the teeth should never come together ever for any length of time. the…and making patients aware of their bite by asking them how they feel creates the sickest people in society with what we call occlusal dysesthesia, or positive occlusal awareness, or, you know, what we would call occlusal fanatics or neurotics. there’s a series of things, the assumptions about interferences and about…so, so, now we’ve got…now we build on…we take that poor information and then we build upon that, and that’s how some of these tabernacles get built, and building on that already poor information, and then making us jump through hoops and giving us belief systems. So, many times people often as me, Well, what do you believe in, and I believe in the reality of truth. And that’s all I believe in. I believe in what the science tells me, and I believe in what I know. What I believe is that we have to stop saying what do you believe in. It’s not a matter of belief. That it’s a matter of looking at what is reality, and the understanding that there are patients with really screwed up occlusions and that feel wonderful and patients with perfect occlusions that feel lousy. And there are patients in perfect joint position that feel lousy and patients with lousy joint positions that feel wonderful. And that should open our eyes to understanding that some of the hoops that these religious religions are carrying us through may not be as necessary, and there may be…I’ve often said, you know, not to…and I don’t talk about my two-day course, in occlusion, makes it very clear that you don’t need to…don’t take it again. I never understood what anyone learned in Occlusion 3. It never made any sense, what do we learn…what are we doing? And it’s…but, some are intimidated by this because it’s taking the foundation from underneath them. What we know is true. You tell somebody that what you know is true isn’t true, the thought is that therefore, all I’ve done up to this point is wrong. That’s not true. What you’ve done is right. But, it might be right for another reason. And once, if you had a better understanding of that mechanism of that mechanism of that reason, then you’d be right more often, and more readily.
Howard Farran: I want to do…I want you to do an entire podcast on occlusion, and I want you to do another podcast entire podcast on sleep. Would you be up for that?
Barry Glassman: Love it. Howard, you’re my man. I’ll appreciate it. I, I, I…frankly, if I had my choice of doing that now or going back to the ADA convention, I’d choose that, but we’ll do it another time.
Howard Farran: Okay. and, and what…and the question I started with, I want you to end with. Two things. I’ve only got you for 10 more minutes, so on this last 10 minutes, I want you to, what would you tell the dentists out there who are kind of, struggling because, you know, nothing’s going on, what would you tell them, over your years, what’s picked you up and motivated you and internally, got you to run to another area? You know, I said, I said when I signed up for the, I decided I was going to be, get my fellowship in the Academy of General Dentistry when I graduated from dental school, and then I found out the curriculum I had to take, these 500 hours in 16 different deals, and I literally called them up and argued, because I told them…
Barry Glassman: Why does that not surprise me? (Laughs)
Howard Farran: I said, Listen, this is dumb. I’m a general dentist. I do fillings and crowns and root canals and I’m not doing implants, and I don’t want to take any of the implant deals and that’s dumb, I’d rather spend those hours in fillings and crowns and root canals, and this older guy just was so nice and sweet and he was telling me about how, Carl Misch said that, you know, one of the great implantologists that, first, he was a prosthodontist making dentures, and then he got into implants to help his dentures. Then, he realized that people who didn’t know anything about dentures and were placing implants were having all these implants snap at the gum line, and had nothing to do with placing the implant and the bone and the density of the bone, they didn’t understand the functionality of what this implant was going to be linked to, so he was telling me about crosstraining, so I said, Alright, so I sat there and I…and he goes, You should take Carl’s because you could do all your requirements if you just went through Carl’s Institute, so I said, Well, that’s, that’s a no-brainer, I’ll just sign up for Carl, knock out my FAGD requirement for implants, and I’m never going to do one my whole life. And then, after the first hour, I thought, Oh my God, I just like discovered another continent, like Australia, and it’s called implantology. What would you tell these young dentists – you’ve been around the block, I’ve been out there 27 years, if you’re flat, you’re not going anywhere economically or professionally or personally and you’re starting to get a little burnout, what, what would you tell them they could think about to reignite their fire and get another, a second breath?
Barry Glassman: Okay, you know, if I, Howard…you just told your story. If I were tell mine, I, I joined a practice, with a partner who was six or seven years older who was rather, probably had the best hands that I’d ever seen on a dentist. His dentistry was miraculous. And I fought for years to match that. And I fought for years to become what he was. And one day, I woke up and realized that it was mechanics and I wasn’t a mechanic. I was a psychology major. I was a human. And there had to be more than the mechanics. And I think that people who are stuck don’t realize that. And we had a, a team come to our office to evaluate how we could improve, how we could make more money, how we could improve efficiency in the office. And they were the…one of these teams back in the ‘70s or early ‘80s, that they just, they hovered around your office for four days. They were flies on the wall, but they were the biggest f______ flies I’ve ever seen in my life. They…like you didn’t know they were there, right? And then, at the end of the four days, they sit you down and they’ve got these shit-eatin’ grins on their face and what, what what’s up. He says, Oh, this office is easy. You – points to me – you’re easy. I can double your income. I said, Cool. He said, you’ve got to stop talking to people. Your patients are spitting out a Cadillac, and then it’s spittooned every week. I kicked them out of that office faster than you can possibly imagine. If that’s what I had to do, I was going to lose. I don’t think…I think their lack of social skills hurts our kid’s chance of being happy. I think if all you are is mechanically reaching for perfection and you don’t, you don’t know that that person that you’re treating is going to their child’s wedding that night, you’re missing out. I wouldn’t want to be in that…I wouldn’t want to be fixing teeth all my life. So, I didn’t know that. I was so working hard and I really couldn’t compete, so I had to find something. I wound up taking a Niles Beauche course and that led to a Harold Gill course and that led to Jim Nicholson and then Dora ______, and if I told you my torturous path, I would never want anybody to take it. It was painful, it was painful, it was full of crap and lies and more lies in TMD than there was in dentistry. and finally, I met…along the way, I met many mentors, and people whom I love, but people who were misguided. I met John Remmers who from sleep, he’s living in Arizona and anyway, he…John forced me to look at science rather than look at the empirical evidence that we were…and, and I met some people along the way that I was fortunate enough, to learn from, but I think the most important thing I did along the way, Howard, was I started taking acting classes, and I was very active and I’ve had lots of opportunities and I’ve won some local awards and done some professional theater. And when you take these acting classes, what you learn is that when you’re acting, you’re not just saying words, but you’re responding, you’re forced to be in the moment – if you’re any good, you’re forced to forget that you’re Barry Glassman who has a dental practice, but you are Morrie, from Tuesdays with Morrie, or you are, McMurphy in…and this year, in case you want to see the sideburns, you’re Scrooge in Christmas Carol. And, well, my staff will tell you that that’s not…that was typecasting, but, but you’re forced to become, to be human, to listen to people and to respond to people and be someone else and put yourself…it’s not about you. Put yourself in their shoes. Think about what the…when a patient’s telling you, think, listen to what they’re saying. You hear what you’re hearing from your aspect. Think about it from the…once you start doing that, then you’ve become less frustrated with them. You understand them more. you don’t expect your own perfection, and your days when you separate yourself from the outcome, you’re not going from the highs of a perfect crown or making a patient cry because you’re putting great veneers, to the pain of screwing up the root canal and knowing the patient lost a tooth, and it’s your fault. You can’t live with that rollercoaster. The object isn’t to not care, but the object is to separate yourself from the outcome and make that path a smooth path. It’s not up and it’s not down, and you’re dealing not with teeth, but with people. If our profess…if we could…if our guys could…if you could do that…I don’t care if you’re…the business angle doesn’t matter. Who pays you, who they pay, who you work for, none of that matters. The only, what matters is where the rubber meets the road every day; you, as a human being, with your hands, that responsibility, in somebody else’s mouth, and understanding that that mouth really belongs to a person, and that you’re not perfect and you will make mistakes, and that person isn’t perfect when they leave your office, and they go and do their job and they will make mistakes. But, if you all do your best, and you care, that’s all you can ask, and at the end of the day, when you put your head on a pillow, you’ll fall asleep like you do now, as opposed to the way you didn’t before.
Howard Farran: Well, that’s the perfect note to end on, Barry. That was, one of the fastest hours I’ve ever had on a podcast.
Barry Glassman: I had a good time.
Howard Farran: You’re an amazing man and you’ve already promised our viewers that you’ll come back and do another one on occlusion and another one on sleep medicine.
Barry Glassman: It’s a lot of pressure, but I can handle it.
Howard Farran: I’m going to hold you to it.
Barry Glassman: You got it, Howard.
Howard Farran: Thank you for all that you do for dentistry, Barry.
Barry Glassman: Thanks for all you do, Howard. I mean that. You know that.
Howard Farran: Alright buddy, bye-bye.
Barry Glassman: Bye-bye.