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357 LaDenta Dental Clinic with Christian Andri : Dentistry Uncensored with Howard Farran

357 LaDenta Dental Clinic with Christian Andri : Dentistry Uncensored with Howard Farran

4/8/2016 4:29:34 PM   |   Comments: 0   |   Views: 249

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AUDIO - DUwHF #357 - Christian Andri



Drg. Christian Andri:

Founder and CEO of LaDenta Dental Clinic in Medan, Indonesia. Graduated From faculty Of Dentistry University of Sumatera Utara, Indonesia. He specializes in Dental Implants, Esthetic Dentistry, and Family Dentistry. He is also the Vice of Secretary of the Indonesian Dental Association branch in Medan.

 

www.ladenta.org 


Speaker 1:

Greetings, I am with my buddy Christian Andri, who was the man who brought me in to speak in Indonesia. We spoke yesterday. It was just an amazing meeting you put on. It was two-day meeting. I've never seen that much pageantry in Hollywood associated with a meeting before. Ryan, remember that one girl said that each morning when they started the meeting she had chills and I saw, it's the only dental meeting I've seen where people were verklempt, they were emotional. It was an amazing meeting and this is the couple days after the meeting and we're an hour and an half inland up into the mountains. We're an hour and a half inland from Indonesia up in the highlands, just some of the most gorgeous scenery I've ever seen in my life. Thank you for joining me on a podcast. You're very interesting because knowing you, you're very passionate, not about you and building your office sort of, you're very passionate about building dentistry in Indonesia. There's 240 million people.

 

 

There's 27,000 dentists and you've put on 40 meetings and you're just talking to you, knowing you, you're just passionate about. You want all 27,000 dentists to just be better and more high tech and faster, higher quality. Tell me where you got that passion? Okay, did you get that from your mom, your dad, your teacher. Where did you get that?

 

Speaker 2:

I got my patients involving as an organizing committee when I'm in dental schools. I met so many inspiring expert dentists since this manner, they teach me to have patience to do something in community. So I learn a lot of them. I inspire from them and so after graduate from Denver Schools, I develop myself and try to be a little bit giving, paying attention to dentists [inaudible 00:02:26] especially in Indonesia. Right now I'm also focused on [inaudible 00:02:31] in Southeast Asia.

 

Speaker 1:

Name the countries that you'd be interested in Southeast Asia.

 

Speaker 2:

Malaysia, Singapore, Thailand.

 

Speaker 1:

So Malaysia, Singapore is just an island south of Malaysia.

 

Speaker 2:

Malaysia.

 

Speaker 1:

Then Indonesia's just across the island. So it's Malaysia, Singapore's a little island at the bottom. You cross the water, there's Madon.

 

Speaker 2:

Madon.

 

Speaker 1:

What's the other country you're interested in?

 

Speaker 2:

Thailand.

 

Speaker 1:

Thailand. So why those four countries?

 

Speaker 2:

Right now we call this area the Golden Triangle.

 

Speaker 1:

In America we have the Bermuda Triangle.

 

Speaker 2:

Bermuda Triangle.

 

Speaker 1:

We won't go there.

 

Speaker 2:

The characteristic of the [inaudible 00:03:16], the nature and then also some of them makes local so, these four countries we have a similar characteristic. So actually, growing up together with all the dentists from these four countries.

 

Speaker 1:

You know one thing about being in Indonesia, it's 17,000 islands?

 

Speaker 2:

13,000 islands.

 

Speaker 1:

13,000 islands.

 

Speaker 2:

Yeah.

 

Speaker 1:

Half the dentists tell me it's 17,000 and the other half tell me it's 13,000, but the one that that's so neat about Indonesia is there's really not an Indonesian look. When you're in Indonesia, it's the fourth most popular country and the diversity of the people, I mean, just everywhere you go they all look like they're from a different country, but they're all Indonesia.

 

Speaker 2:

Correct.

 

Speaker 1:

Explain that.

 

Speaker 2:

Actually we are a [inaudible 00:04:13] country, so we have around thousands of ethnic, we speak different language, we have different skin, we have different hair color, so uniquely things in Indonesia.

 

Speaker 1:

Your hair is a little different than mine.

 

Speaker 2:

The difference is giving a diversity. How our founding fathers integrate all the different ethnic into one nations, so we have the spirit of Indonesia characters, so it's developed different. When you realize that we have some care and emotional living giving each other, so we try to develop very socialize, try to more socialize to have a social care and responsibility. So it's quite different in the western style and the eastern style. We try to combine the western and eastern side in here in Indonesia. So you know we have the biggest Muslim population in the world.

 

Speaker 1:

The biggest what?

 

Speaker 2:

Muslim population.

 

Speaker 1:

Oh, Muslim. It's 90% Muslim there.

 

Speaker 2:

Yeah.

 

Speaker 1:

Even with the Muslims, if you go to some Muslim countries, they seem to all dress the same. You come here and the mother may not be wearing a scarf, the daughter might be in all black. The other daughter might be in blue. The diversity even amongst the Muslims, I can't even tell half the Muslims are Muslims.

 

Speaker 2:

Yeah, correct. So we have them across the country. That's a characteristic. There's a uniquely. So, since the founding father giving a very good solid foundation about how there's a different region and we can integrate into one Asians so we can still, right now we have Indonesia as one of the, I think the hottest country in the world right now because-

 

Speaker 1:

Hot, you mean the women or the temperature?

 

Speaker 2:

Oh, everything. Woman and temperature. There's a future we. We have a lot of population. Also we have how we're giving a good example for another part of the world where Indonesia can living in world peace, living together. I think Indonesia can be a very good example for the world.

 

Speaker 1:

I have to give a shout out to some of the other Muslim countries that I feel are like that. I've lectured in Albania, Kosovo, [inaudible 00:07:03], they're very open and welcome diversity and nobody could care less that I was a Catholic from the United States.

 

Speaker 2:

That's the point. Since we know that one of the, right now Dubai, right now there are really open, especially they invite a lot of expert for teaching, for some provisional ... Indonesia, right now we try to think more globally, so that's why in dentistry, we try to develop that even Indonesia can treat the [inaudible 00:07:42]. For example, a lot of my patients are also foreigner. I treat foreigner, but last ten years ago, usually Indonesian the patients they always go to Singapore and Malaysia for dental treatment, even for scaling. Right now even foreigner marry a lot of expert. They trust us to giving us dental offices. That's the point. That makes us believe that there's a future in Indonesia and dentistry right now. So, we try to invite more speakers. We try to attract more awareness from the global, so we want to put Indonesia on the global map so some day we can sit in together and try to more compete in any professional fields.

 

Speaker 1:

So, in Indonesia what is the state of dental decay? Is it going up, is it flat, is it going down? How would you, in your lifetime, you're 32 years old?

 

Speaker 2:

Yeah.

 

Speaker 1:

So in third of a century on earth, do you think there's more cavities every day, do you think it's flattening off, or do you think it's going downward? What's the state of decay in this nation?

 

Speaker 2:

There's a point in the last five years, since last ten or five years ago that the [inaudible 00:09:06] of decay is around 70%.

 

Speaker 1:

70% of Indonesians would have an active cavity?

 

Speaker 2:

Active cavity.

 

Speaker 1:

Okay, and that's of all ages or just.

 

Speaker 2:

It's all of ages,

 

Speaker 1:

Okay, 7 out of 10 have a cavity.

 

Speaker 2:

Also the concentration is not only to relieve the pain. It's not to prevent the disease. So that's become our biggest problem.

 

Speaker 1:

You're saying most dentists, the patients are waiting until their in pain-

 

Speaker 2:

To relieve the pain.

 

Speaker 1:

And then they come in, and there's only a dentist for every 9,000 people, so there's not a lot of dentists at all. In the United States, there's a dentist for every less than 3,000.

 

Speaker 2:

Yes.

 

Speaker 1:

So you're saying most Indonesians wait till they have pain-

 

Speaker 2:

-Relieve the pain.

 

Speaker 1:

-and then they want to relieve the pain.

 

Speaker 2:

That's happened for last ten years ago.

 

Speaker 1:

Last ten years.

 

Speaker 2:

Last ten years ago. Right now [inaudible 00:10:00] telecommunications right now, the global communication. Let us, every one for example they have Facebook, they have social media, they have a smart phone. In Indonesia, they have at least one smart phone right now. Right now the number of the smart phones selling is twice, double, so if there's 250 million Indonesian population, maybe we have 300 million smart phone, 300 million or 315 [inaudible 00:10:38]. That makes it very easy to deliver the communications about the dental health to the patients. So, last five years, last three or five years, Indonesian people is concentrate about aesthetic. It's not only about the decay. It's not only about the preventive or relieve the pain, but the standard of their intelligence is going up right now because right now it's more focused about function, healthy, aesthetic for the quality of life. Right now we talk about more few the self esteem, more about confidence in the social works, in the education, maybe in the business, so right now dentists become primary needs right now. It's not only the basic needs.

 

Speaker 1:

Very interesting. How do you turn the corner to go from a country. Let's go back to the cavities. Do you think, when you see people coming in, is it one of those situations where they children are drinking more soda and pop and candy and sugar and carbohydrates and packaged foods and grandma and grandpa are eating more traditional older diets of fruits and vegetables. Do the elderly have less cavities than the young?

 

Speaker 2:

Okay, in my opinion, it's quite different with Indonesia in the population in the U.S. The soda, right now it's not so high any more. The consumption of soda is not so high, but the problem is about the there are [inaudible 00:12:27] in the suburban area in the rural area. The habit to take care, to maintain the oral hygiene. That's the only problem and then some case, some parents they know, they understand. They have less lack of knowledge for example the permanent teeth is already eruption since six years for children. They understand, oh, we bring the children when they are 13 years, 14 years old to dentist. They have a less information about the eruption tip.

 

Speaker 1:

Another thing that I've noticed about Indonesia reminds me of when you go around to countries, it seems like the countries where the people are waiting until they get in and go to pain, you go into all the dental offices and it's just dentists and when that country turns the corner and people are coming in to prevent pain, the dentist always has a hygienist, sometimes two. The United States, they kind of shoot for two hygienists for every dentist. That's their national ideal and there's almost 400,000 hygienists in the United States and only 150,000 dentist. I noticed when I asked the room yesterday, there were several hundred people, how many have a hygienist in the room. I think only two hands went up. What's the state of preventing with hygienists.

 

Speaker 2:

The funny thing is we still not at the hygienists in Indonesia. Right now the dentists only do the cleaning for the patients. In Singapore and Malaysia, they have the dental hygienist. I think the future, we must consider about the dental hygienist because since the dentist is focused on so many things and sometimes they not concerned about the oral hygiene, so for the last 40 years we still don't have the dental hygienist portion, so we don't have any dental hygienist, so even we not giving the chance for the nurse to touch the patients. Usually then this, giving the cleaning for the patients, but in my opinion, it's not optimally since you know that in comfort, the cleaning of hygienist is not good enough for them, so they not too concerned about the hygiene.

 

Speaker 1:

Exactly.

 

Speaker 2:

Exactly.

 

Speaker 1:

So someone would need to talk to the minister of health about getting some licensing and education to let these assistants start learning how to become hygienists to clean teeth.

 

Speaker 2:

Maybe some of them, or they propose this idea to the House of Representative because that's they way they can put in some law or regulation, right. It's still that sometimes our problem as Indonesians really sometimes some of them worry about if I'm giving this portion to dental hygienists, they will take one of my income, right, taking their income, so I think we must change the concept.

 

Speaker 1:

Well, it's an old concept of humans of thinking in fear and scarcity and thinking of hope, growth and abundancy and you have to start thinking with the end in mind. You're 32, let's say you die when you're 102, so how would you like the Indonesian dentistry to be when you're 102. Obviously there would be dentists and hygienists and prevention, so that's thinking with the end in mind, so now we go back to today and we think in abundancy and it's hard. Humans think zero some game. They think well, if I give you a a piece of pizza, I have less. When you think in abundancy, you think let's just make the pizza bigger.

 

Speaker 2:

Correct, let's make the pizza bigger.

 

Speaker 1:

Yeah, let's make the pizza bigger. So what's your next goal now. You're a man of many goals. You have six offices, five are what I would consider high end dentistry, higher cost. A Mercedes, a Porsche, an Audi. You have one of your six offices is more middle of the road family practice. I was wondering have you ever thought that you might ever try to do a low cost?

 

Speaker 2:

Yeah.

 

Speaker 1:

I noticed we were talking yesterday about your government, what two years ago past national dental insurance.

 

Speaker 2:

Dentist national insurance.

 

Speaker 1:

Is that for anyone or just children?

 

Speaker 2:

It's for anyone, from children to geriatrics.

 

Speaker 1:

That's two years into the making now. Have you eyed that market? Are you thinking about that market.

 

Speaker 2:

Yeah, I think that's a very good idea. That's a very solid foundation for us for dental insurance. Since we know that cover, it's a lot of people, to reach a lot of people. You need to upgrade the low class patients into the middle so since the last seven or ten years ago, the number of middle class population has become more high. The government, our government is trying to consider to giving the dental insurance. National dental insurance to help some people that cannot afford the dental services. It's good for us. It's good for dentistry. Yeah, there's limitations, I mean the product of the services in the National Dentistry Insurance is very limited. I mean they can do extraction, they can do filling, they do scaling, they do wisdom tooth surgery, but some of them is like some of the services like prosthetic dental whitening, orthodontic, maybe the advanced root canal, maybe the surgery, very advanced surgery is not provided by the National Dental Insurance, so I think we tried to increase more people that concerning dental health.

 

 

In the other part where the dentists was working for National Dental Insurance, they will do the best to giving the dental health services and then the other part where the doctor is working for the private dentist, the general practitioner, the specialties, the hospital, they try to find the more middle to up kind of the services, I mean to afford complicated treatment. So that's the way for the government to bring the industry of dentists to the next level of the dentistry.

 

Speaker 1:

So, it sounds like the National Government Insurance is going to cover basic dentistry, not high cost, cosmetic, elective dentistry. I noticed one of the things you covered in your basic dentistry was wisdom teeth. I notice that's a debate around the world. I know Americans seem to pull out the highest percentage of wisdom teeth and Germany has cut the percent of wisdom teeth they remove in half over the last decade or so. In Indonesia, what percent of the wisdom teeth do you think eventually need to be removed from a person?

 

Speaker 2:

I think around 45 to 50 percent.

 

Speaker 1:

Half of them need to come out?

 

Speaker 2:

Yeah.

 

Speaker 1:

I want to switch gears to a totally different subject. In 1950 in the United States, 50% of adults smoked and by 2015 it was under 20%. It's down to about 18%. I notice in Indonesia, 90% of adult males smoked and 30% of adult females smoked. Does that cause many dental issues. What are your thoughts on the smoking and dentistry. Do you think it's causing more oral cancer or gum disease? What are your thoughts on that?

 

Speaker 2:

You know, the manufacturer of the cigar is very quite developed here.

 

Speaker 1:

I'm not knocking anybody who likes a good cigar and a cup of coffee or a martini.

 

Speaker 2:

Our government try to restrict the commercial advertising about the cigar here.

 

Speaker 1:

When was that?

 

Speaker 2:

Since five years ago.

 

Speaker 1:

Okay, five years ago they started that? Okay, so five years, what did they stop?

 

Speaker 2:

Any entertainment concert, any sports, they don't allow the commercial about the advertising about the cigar.

 

Speaker 1:

Ryan, I don't think I've seen one cigarette advertising. This is 2016, so 2010 about 2010, they banned all advertising.

 

Speaker 2:

They banned all advertising.

 

Speaker 1:

Okay.

 

Speaker 2:

So you can advertise the cigar in TV commercial.

 

Speaker 1:

On TV?

 

Speaker 2:

After 10pm. Below 10pm, you cannot put an advertise about cigar. That's the way. That's the point, one point. Number two, but still the population of man who consumed the cigar is around 80%.

 

Speaker 1:

Oh, 80%, not 90.

 

Speaker 2:

Not 90, 80%, so it's still very high. The problem because of the smoking we know in dentistry, the correlation, the relationship with the cigar and the gum disease and yeah, and the stain and everything. Still I think very high correlation between the cigar and the dental disease.

 

Speaker 1:

My favorite joke, you know this is going back 25 years ago when you were lecturing around, I'd say like in the 1990s when restaurants in like say France had a smoking section. In American you'd have a smoking section and a non-smoking section.

 

Speaker 2:

Non-smoking section.

 

Speaker 1:

The joke in France was they had a smoking section and a chain smoking section.

 

Speaker 2:

Chain smoking section.

 

Speaker 1:

That's one of the biggest dental things I've seen change in my lifetime. I mean when I got out of school in 87, you could smoke anywhere and now 28 years later, I mean it's a taboo.

 

Speaker 2:

It's taboo.

 

Speaker 1:

You can't smoke pretty much anywhere.

 

Speaker 2:

There's a private room for smoking.

 

Speaker 1:

Yeah, yeah. That's interesting. So you're a man of so many missions. What is your next project?

 

Speaker 2:

In my personal [inaudible 00:23:56] I want to develop my practice. Since right now I have 30 associates, dentists-

 

Speaker 1:

30 associates?

 

Speaker 2:

Yeah, who is working for me, so I want to try to make [inaudible 00:24:10] cleaning as one of the, I mean try to be, okay, we have aesthetic, but we try to more close with the community, so there's a premium product, there's a mass product, so we try to combine the aesthetic, we try to follow the global needs, global trends, but we still consider about the community, so a couple of months we're doing the charity, we do dental services for the orphanage, for the people in suburban area. So, I consider try to make some events that very uniquely, try to do something out of box, so for example, for root canal, I mean for endodontic treatment, we try to make some event that focus on endodontic, but try to ... Since the endodontic right now is one of the most prestigious fields in dentistry in Indonesia, last ten years ago, no one touched root canal. No one's touched endodontic.

 

 

Endodontic become a taboo for the dentist, some dentists, but since the technology, the adequate information, adequate, let the high presentation of the [inaudible 00:25:38]. Many right now if you ask the [inaudible 00:25:43] maybe 40% out of 50% they want to enter the endodontic specialists, so it's quite interesting for us right now in the future that we want to meet all the fields in dentistry in Indonesia is more compete, can compete in the global competition, so you want try to make some of the figure a persona as a global player. Some of our dentists is very respectful dentist in Southeast Asia. Some of then invited as a speaker. Some of this invited as a lecturer. So, our idea you want the transfer of the knowledge and spirit from the global player, they come into Indonesia, they're inspiring, they giving a good example. They motivate, they giving a trigger, then in the next five years, ten years, some of us is going to be a global player as a respectful expert in development.

 

 

I love your passion and I want to give a shout out to the Dental Town team. We have several dentists that work for us, Ken Serota is an endodontist and Taronta works for Dental Town and Howard Goldstein's a dentist in Bethlehem, Pennsylvania that runs the online sea at Dental Town and they have put up on your smart phone, on your iPhone, on your Samsung, on your, two different endodontic curriculums, one's like 25 hours long, ones like 40 hours long that is taught by two different programs taught by two of the greatest legends in dentistry and oh, my God, they're just amazing. It's true. When you go around the world, the rock stars of dentistry are not cosmetic dentists doing fancy veneers on some woman. The rock stars in dentistry around the world are people getting you out of pain and that's an endodontist or an oral surgeon.

 

Speaker 1:

Yeah.

 

Speaker 2:

In Indonesia, what percent now that Indo has taken off, what percent is pain treated by oral surgery and exodontia and extraction versus we're going to save this tooth with a root canal. The population of the dentist.

 

Speaker 1:

Yeah.

 

Speaker 2:

I think the [inaudible 00:28:13] is less than 20%.

 

Speaker 1:

When the people come into your office, what percent choose the extraction, what percent are choosing the root canal?

 

Speaker 2:

If you're asking these questions to my senior dentist last ten years ago, maybe it becomes 60%, but right now I think it's below 30%.

 

Speaker 1:

Below what?

 

Speaker 2:

Below 30%.

 

Speaker 1:

Below 50 or 30.

 

Speaker 2:

30, 30%.

 

Speaker 1:

So it's gone from 60% two years ago to 30%. Nice.

 

Speaker 2:

They consider to try to maintain the original tip. They don't want to extract the tip right now.

 

Speaker 1:

They don't want to extract it. Who wouldn't? Okay, I think what we're going to do Ryan, I think we're going to do is we're going to end the podcast here and then we're going to drive an hour away to-

 

Speaker 2:

Hot Spring.

 

Speaker 1:

Hot Springs-

 

Speaker 2:

Mountain Hot Springs

 

Speaker 1:

See if we want to continue this lecture at a different location. Okay, thanks so much.

 

Speaker 2:

Okay, thank you so much. Thank you.

 

Speaker 3:

Did enough work in Indonesia. It's time to relax a little bit in these nice Hot Springs.

 

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