Dentistry Uncensored with Howard Farran
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359 Implantology in Tokyo with Kiyotaka Umezu : Dentistry Uncensored with Howard Farran

359 Implantology in Tokyo with Kiyotaka Umezu : Dentistry Uncensored with Howard Farran

4/10/2016 7:27:35 AM   |   Comments: 0   |   Views: 354

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AUDIO - DUwHF #359 - Kiyotaka Umezu



Howard sat down with Dr. Kiyotaka Umezu DDS, MS, a graduate of Nippon Dental University in 1997.

 

Dr. Kiyotaka Umezu DDS, MS is a Clinical Assistant Professor Loma Linda University and is the only Diplomate of the American Board of Oral Implantology in Nippon (Japan).

 

Dental hygienist Atsuko Masutani joined the podcast towards the end.


Howard Farran:

It is just an extreme, extreme honor today to be in Tokyo Japan, podcast interviewing Dr. Kiyotaka Umezu?

 

Kiyotaka Umezu:

Yep.

 

Howard Farran:

Did I get that right?

 

Kiyotaka Umezu:

Yeah, you got that right almost.

 

Howard Farran:

You graduated from Nippon Dental School in 1997, but then you went to [Loma Linda 00:00:26] to do residency in oral implantology?

 

Kiyotaka Umezu:

Yes, oral implantology, yes.

 

Howard Farran:

Oral implantology in [Loma Linda 00:00:36], and that's where ... When I got out of school in dental school at the University of Missouri, Kansas City, to practice in Arizona, I had to go to Loma Linda to take my boards in 1997.

 

Kiyotaka Umezu:

Oh okay yes, to take the boards as well.

 

Howard Farran:

That's also where Dan Fisher, the founder of Ultradent ...

 

Kiyotaka Umezu:

Right.

 

Howard Farran:

He went to Loma Linda.

 

Kiyotaka Umezu:

He went to ... Yeah, undergrad he went to the Loma Linda.

 

Howard Farran:

What year did he get out of there? Do you remember?

 

Kiyotaka Umezu:

I don't know, I don't know, because ...

 

Howard Farran:

You probably weren't born yet.

 

Kiyotaka Umezu:

Maybe, that's ...

 

Howard Farran:

That is just amazing. I was so excited. We both have our Diplomat in the ...

 

Kiyotaka Umezu:

American Board of Oral Implantology.

 

Howard Farran:

American Board of Oral Implantology.

 

Kiyotaka Umezu:

Uh-huh (affirmative).

 

Howard Farran:

I can't even remember when I got mine. I think it was in the early 1990s. You're the only Diplomat of the American Board of Oral Implantology in all of Nippon.

 

Kiyotaka Umezu:

Mm-hmm (affirmative).

 

Howard Farran:

To Americans, Nippon means Japan, okay? Next time you go to Germany, remember you're in Deutschland.

 

Kiyotaka Umezu:

Deutschland.

 

Howard Farran:

It's interesting, in Japan ... They call it Nippon, but some of the people call it Nihon.

 

Kiyotaka Umezu:

Mm-hmm (affirmative), Nihon.

 

Howard Farran:

I assume ... I live in the United States, some call it America, some call it the USA.

 

Kiyotaka Umezu:

Right.

 

Howard Farran:

Some call it Nihon and some call it Nippon. What's the different use of Nippon and Nihon. Is it older? Is it more formal?

 

Kiyotaka Umezu:

I guess I'm not sure, because anyways in Japan itself is not ... We don't call ourselves Japan, so it's Nippon or Nihon. Nippon sounds like more just older style. Nihon is maybe current style. We don't know which one is [crosstalk 00:02:17]

 

Howard Farran:

Nippon is older? That's why I'm calling it Nippon, because I'm 53. You're calling it Nihon because you're still in your youthful age.

 

Kiyotaka Umezu:

[crosstalk 00:02:24] World War II, maybe [inaudible 00:02:26]. Yeah.

 

Howard Farran:

One of the things I like to do talking to dentists around the world is that,  I believe when a dentist is born, raised, reared, lives in one country, they think everything in finite. Albert Einstein said, "You can't solve today's problems with today's thinking because your thinking is causing the problems."

 

 

When you go to the United Kingdom ... When I got out of school in '87 all 19,000 dentists in England participated in the NHS. They paid very low fees.

 

Kiyotaka Umezu:

Right.

 

Howard Farran:

They kept just cutting the fees lower and lower and lower. Finally dentists in the UK realized, "They don't even have dental insurance in Singapore. They don't even have it in Brazil, maybe I don't even need to play this game". Now, I've been out of school 28 years, and now 5,000 dentists in the United Kingdom don't even participate in the NHS.

 

 

What I'd like to do is I'd like to talk to you because you're so amazing. You've practiced dentistry in California in the United States.

 

Kiyotaka Umezu:

Not exactly [inaudible 00:03:40] practicing because I didn't have that license because I'm not ... I'm the 4th generation of the dentistry so I know ...

 

Howard Farran:

You're 4th generation?

 

Kiyotaka Umezu:

Yes, yes. My grandfather [crosstalk 00:03:48]

 

Howard Farran:

Your Dad, grandfather ... Oh my God! Congratulations.

 

Kiyotaka Umezu:

I know. I wish I could have a dental license when I was born because I'm the first generation but I couldn't get it. That's why I have to go to dental school, and after that I went to that grad school in California. Anyways, I'm sure I was going to come back, so I didn't go through the board because I didn't want to get the license, or whatever. I didn't want to start over as whatever I studied in dental school in Japan, doing it over in the United States. That's why I went to that grad school.

 

 

Anyway, so practically, I didn't practice in California, but I was helping, and seeing, and watching, and talking to the practitioner in California. Pretty much I can discuss what situation they have in the United States, what's good about it without the insurance or something like that. The good things about having insurance in Japan, and then bad things about having insurance. It's very difficult to say one thing.

 

Howard Farran:

Right, yeah, the devil is always in the details.

 

Kiyotaka Umezu:

Yeah. Mm-hmm (affirmative).

 

Howard Farran:

Explain this, because talking to Japanese dentists, what I get a feeling for is they love orthodontics because the Japanese Dental Association, the Japanese insurance ... The National Japanese Dental Insurance Company doesn't set a fee for orthodontics or implants, but they do set fees for fillings, crowns, and root canals.

 

Kiyotaka Umezu:

Exactly. Mm-hmm (affirmative).

 

Howard Farran:

Some of them say that they want to do orthodontics, or place implants, because they have the freedom to raise their price. Specifically with root canals, that the fee is so low for root canals that it's virtually hard to be able to afford to take the time to do it.

 

Kiyotaka Umezu:

Mm-hmm (affirmative).

 

Howard Farran:

What is your thoughts on the fee for a root canal in the United States versus Japan?

 

Kiyotaka Umezu:

Yeah, also I was going to say, it's based on the National Health Care Insurance in Japan. The orthodontic treatment it's very, as you know, the fee is very low. That's why-

 

Howard Farran:

How low?

 

Kiyotaka Umezu:

It's maybe less than one-tenth.

 

Howard Farran:

Of the United States?

 

Kiyotaka Umezu:

Of the United States.

 

Howard Farran:

Yeah, so the United States is about a thousand bucks for a root canal, and here it's about a hundred dollars US.

 

Kiyotaka Umezu:

At the most. At the most.

 

Howard Farran:

At the most.

 

Kiyotaka Umezu:

Also what happened is in Japan, most people have a tendency, that is, in the past ... I'm not sure if it's current dentists or a younger generation does the same thing like this. In the past, what they do is instead they can not charge too much for the root canal, what they do is they ask the patient, "Okay spend 5 minutes one time, but we can just charge for just a re-examination". We can ask them to come back once a week, and just to see the patient for 5 minutes, and just clean it inside and put some chemicals, just 5 minutes. Then they can come, for example, 5, 10 times, then they can charge for the re-examination for 5, 10 times. That can be the main charge for the root canal if they do only the root canal.

 

 

That's why they say, "5 minutes, what you can do?" You say hi, if you are a talkative person, if you talk 5 minutes, that's all about it, right? That's why I don't think it's happening right now, but it seems like that the root canal treatment is ... That's why from the United States, if you do the microscope, and you spend the rubber dam, and they just spend 90 minutes, or 60 minutes, maybe your root-canal treatment, good root-canal treatment, can be done with maybe two, three appointments. They just do the very much straight forward, but that is different in the background.

 

 

That's why maybe in Japan, sometimes the root-canal treatment is very bad. That's why the 5, 10 years later maybe re-treatment is necessary. I don't think it's very bad rotation work, the circulation's starting to begin with.

 

Howard Farran:

Are they doing it with lateral condensation, or are they using more a sargenti ... [crosstalk 00:07:49] Formaldehyde paste.

 

Kiyotaka Umezu:

Before, for this ... To begin with, I work lateral condensation first. Lately there's a lot of people that are having a microscope, and a lot of people they're doing the rubber dams, and spending more time, like one hour or one hour 90 minutes, or just like you guys do in the United States, some people does that. But to do that, we can not charge as dental insurance. That's why most people they explain to the patient, "Okay, if you do the insurance, we can not charge a lot and we can not do the right way". That's why we explain to the patient we might have to charge more, of course, but the result, and also what we do is more accurate. That's how we explain. The important things is the patient has choice of which kind of the treatment they want to get. At least sometimes if you just go for the dentist who is seeing 70, 80 patients per day, they don't even have time to talk about, or explain the patient which kind of the direction they want to go. That's the difference.

 

 

The good thing about my environment is actually, right now I don't have access here right now but the last year, until 2 years ago, I had one of the US dentist working with me. He was doing dentistry. Maybe I did say, in the future, you can come back and maybe this time I'm going to introduce him. He retired. He is 70 years old, or something like that. He's been practicing in Japan for the past 30 years, in Japan. I know only one of the dentists who's license is from the United States and got a license in Japan, and he had a practice 30 years in Japan. Maybe he might give you some other good aspects of your answer to what [inaudible 00:09:46] question that you have right now.

 

Howard Farran:

Where was he born?

 

Kiyotaka Umezu:

West Virginia.

 

Howard Farran:

West Virginia?

 

Kiyotaka Umezu:

Yeah, and he went to Michigan University for the undergrad, and after that dental school. Which dental school was it? I forget where that was.

 

Atsuko Masutani:

[inaudible 00:10:02]

 

Kiyotaka Umezu:

No, no, no, it was after, in the United States.

 

Atsuko Masutani:

Hawaii.

 

Kiyotaka Umezu:

Hawaii? Really?

 

Howard Farran:

I don't think Hawaii has a dental school. Hawaii doesn't have a dental school.

 

Kiyotaka Umezu:

Anyways, yeah. Somewhere [crosstalk 00:10:18]

 

Howard Farran:

What made him come to Japan? It had to be love.

 

Kiyotaka Umezu:

Yeah.

 

Howard Farran:

Was it love?

 

Kiyotaka Umezu:

Yeah.

 

Atsuko Masutani:

[inaudible 00:10:24] he became a dentist?

 

Kiyotaka Umezu:

[foreign language 00:10:28]

 

Howard Farran:

Before he became a dentist he fell in love with a Japanese girl?

 

Atsuko Masutani:

Yes, she was a Japanese teacher.

 

Howard Farran:

Back home, in America?

 

Atsuko Masutani:

Here, in Japan.

 

Howard Farran:

He met her ... How did he meet her?

 

Atsuko Masutani:

She was his Japanese teacher.

 

Kiyotaka Umezu:

In the United States? In Japan? [crosstalk 00:10:50]

 

Howard Farran:

How did he get to Japan then? They say only one percent of the 7 billion earthlings live in a country they weren't born in. They only leave for three reasons. It's about a third, a third, a third. It's for a job, for love, or they're running from the law. If he's a dentist, we're just going to go with that he's Doc Holiday and he was running from the law and came over here and fell in love with a Japanese woman from Kobe. This is a much greater story.

 

Kiyotaka Umezu:

Yeah. I think if you you do it, it's a much, much longer interview from him.

 

Howard Farran:

Is he around here in Tokyo?

 

Kiyotaka Umezu:

He's living in Tokyo but right now he is very inspired for the volunteering for past several 10, 20 years. After he retired he goes to the ... Where?

 

Atsuko Masutani:

Myanmar.

 

Kiyotaka Umezu:

Myanmar, and gives the free treatment or something. Giving the [crosstalk 00:11:41]

 

Howard Farran:

Do you have his phone number?

 

Kiyotaka Umezu:

I do have his phone number.

 

Howard Farran:

Try and get ... See, Ryan, if you can get him on his phone number. You have his phone number?

 

Kiyotaka Umezu:

Yeah, he was working with me. I asked him to come over here.

 

Howard Farran:

Today?

 

Kiyotaka Umezu:

No, no, no, no, when I opened up my clinic three years ago. I asked him ... He was going to retire because he was 67 or something like that. He wanted to do a few more years for the wrapping up his dentistry history, or dentistry life. That's why I asked him to come over [inaudible 00:12:17] and to do it for a couple years.

 

 

Hi, Dr. [Ward 00:12:18] this is [Kiyotaka 00:12:19]. Hi, where are you right now? Okay. Okay Doctor, that's fine. Whenever you come back call me back okay?

 

 

He is in Africa right now.

 

Howard Farran:

Ah, he's in Africa. What do you call it, the Japanese Health Insurance, or Japanese ...

 

Kiyotaka Umezu:

National Health Care Insurance, or Japanese Health Care Insurance.

 

Howard Farran:

National Health Care Insurance?

 

Kiyotaka Umezu:

Mm-hmm (affirmative).

 

Howard Farran:

They don't set the fees for implants?

 

Kiyotaka Umezu:

They don't, but the funny thing is they set the fees for removing the implant.

 

Howard Farran:

If it fails?

 

Kiyotaka Umezu:

Yeah, if it fails, and it's to remove the implant, in a different office, I can claim it, but it's not good enough anyways, because if I do remove an implant sometimes we have to do the bone graft, and those kind of [sedative 00:13:07] procedures but it doesn't cover for that. Usually if I have to do that, the implant and recovery, the removal then I have to charge for different ... That's for a [inaudible 00:13:19] service, okay?

 

 

Also they started charging the covering for replacing the implant for the [inaudible 00:13:24] denture for two implants for the mandibula in specific facilities, which is like a university environment or something like that. That's not really great.

 

Howard Farran:

Do you predict that Japan may do what the United Kingdom did where, 20 years ago, all 19,000 dentists participated in the NHS, and now 25 years later 5,000 are just fee for service and do not participate in the NHS? Or do you see any Japanese dentists just quitting and saying, "You know what? I'm just [crosstalk 00:14:01]".

 

Kiyotaka Umezu:

Yeah, I understand, but I don't think Japanese [inaudible 00:14:08] Dental Society is going to quit using National Health Insurance because of that. They're still an easy way to get the money because they're so much got used to doing the same [kind 00:14:18]. They don't want it to change [inaudible 00:14:18], they just want to [inaudible 00:14:22] whatever they have been doing from the past. Maybe from a big town, like cities, like Tokyo, or Osaka, or Nagoya, or those kinds of big cities. There are several places, several dentists that claimed, especially in Tokyo, of course sometimes some dentists don't those kinds of insurance.

 

Howard Farran:

Do you think it's one percent, or two percent? Or less than one percent?

 

Kiyotaka Umezu:

Oh, I just don't know exactly, but maybe it's less than five percent.

 

Howard Farran:

Less than percent.

 

Kiyotaka Umezu:

Yeah, but they can just do a good enough amount of the patients to just get [inaudible 00:15:00] their money with only the private patient which doesn't take ... That just pay for the fee for service. Maybe then some people go for it. I don't think it's ... Not many people would go for it because the education itself is almost like, "Okay, whatever you come to patient like this, just treat like this, treat like this, treat like this". The way they teach how to treat the patient is dependent on how they charge for the national health care insurance.

 

 

[inaudible 00:15:30] "This kind of patient you have to charge like this way, and you have to use this material for this patient to get the payback from the government", but occasionally it's not like this, because for each patient, each [inaudible 00:15:41] you have to diagnose well, and what it's [inaudible 00:15:47] ... When I was in the United States, that's what I learned. Beside the fee, it doesn't matter for the money, but first thing that you have to think about is, "What is the best way for the patient?" Then you have to talk about the fee, the implant is expensive, or the endodontic treatment is expensive, or something like that.

 

 

In Japan, it's different. It's a fee. You have to think about the how to manage with the insurance first. That's how they do the ... What is that? For the insurance. That's why when I was graduating from my university, dental school, in '97, even the national examination, even the implant, the word "implant" wasn't even exist, even the whole examination. That much in Japan is so much, and behind of those educations, because normally right now they don't teach much about the removal partial denture because of the [inaudible 00:16:49] implant, so that's why they teach the basic thing is about the removal partial denture, but then not too much. Instead of ... Time is limited. Four years in dental school, so they have to balance it. [inaudible 00:17:03] maybe less time, but instead of squeezing the time, you have a little bit more time, then you spend more time to teaching in the dental [inaudible 00:17:11], right? The education itself, it seems like in the dental school it hasn't been changed for a while, so I don't know.

 

 

They're pretty much conservative.

 

Howard Farran:

Very much.

 

Kiyotaka Umezu:

Very much.

 

Howard Farran:

Do you ...? You can't advertise in Hong Kong or Singapore. Can you advertise your implant practice in Tokyo?

 

Kiyotaka Umezu:

No, actually for the dental association in Japan, so I don't think it's implant. There's some word that I could use for implant center, or some word, if the government catches you, maybe it's that you cannot use any specialty, the implant or something like that. I cannot say "implant" or something like that. Sometimes, some people in Tokyo, there's a lot a of people advertising implant center, implant clinic, or something like that. To be honest, I don't know. It's ... There are just some regulation, and you cannot really write down "implant" or something like that.

 

Howard Farran:

Do you ...? Is this mostly an implant practice, or is this a ...?

 

Kiyotaka Umezu:

Here in my clinic?

 

Howard Farran:

Here in your dental office is it-

 

Kiyotaka Umezu:

My dental clinic is basically the general.

 

Howard Farran:

General dentist.

 

Kiyotaka Umezu:

Basically. Yeah, because that [inaudible 00:18:21] like I said, is I'm the fourth generation of dentistry, so I just didn't want to stick in only one-

 

Howard Farran:

Fourth generation, so your dad, grandfather, and great grandfather.

 

Kiyotaka Umezu:

Mm-hmm (affirmative).

 

Howard Farran:

Are any of them alive?

 

Kiyotaka Umezu:

My father is alive.

 

Howard Farran:

Does he still practice?

 

Kiyotaka Umezu:

No, he had ... We had a practice in [inaudible 00:18:38] close to this place, but unfortunately my father had a motorcycle accident.

 

Howard Farran:

Wow.

 

Kiyotaka Umezu:

Yeah, he got paralyzed for two [inaudible 00:18:45] below the neck, so after that he's-

 

Howard Farran:

Is he still paralyzed?

 

Kiyotaka Umezu:

No, no, no. He is getting better, but still the half, the right hand, that side, is numb. It's very difficult to keep doing dentistry. That's at a time I decided to not do ... To take over his practice because at the time, I just came back from the United States, so I didn't even have a chance to think about it, what are we going to do for the dentistry in Japan, because as you know, as I explained, '97 I graduated, and didn't have have the practice, and I didn't have any kind of experience in Japan, then went to the United States. Then I got the education in the United States.

 

 

Once I came back, in the year 2003, I was okay and doing pretty much good at the implant practice, but not the "dental" practice in Japan. That is about the time that my father had the accident, so that's why I decided to not do any kind of the work in taking his practice over, so that's why we quit, closed our clinic, and I just went to work for somebody else to learn how to deal with it, because taking care of the Japanese patient and the people from the United States, different. Yeah. Very different.

 

Howard Farran:

How's it different?

 

Kiyotaka Umezu:

The Japanese people is more conservative, and the people don't like the surgical procedure. Of course, [inaudible 00:20:10] my patient [inaudible 00:20:10] in the United States normally there is more ... I was in the implant clinic, so that's why they say everybody is so educated because the patient themself is educated because they come over to your clinic, and if I talk about their dental implant, they pretty much know, and I got scared the first time with the first patient that they just had the print out, the one of the research from the [inaudible 00:20:30]. They are just talking about, "Doctor, would you do this kind of procedure? What kind of material they do? What kind of experience you have?" That is a patient that they have over there, but in Japan, maybe lately some of them, they wanted to know what kind of treatment we provide, but before that, the patient in Japan is like, "Oh, you're son of a big doctor, your father, so whatever you are good, you came from the United States", whatever, but they don't even ask what kind of procedure. If [inaudible 00:21:01] doctor, so, "Okay doctor, whatever you think is good, go ahead, please do it".

 

 

Sometimes they don't care what kind of treatment. That's why I say, even though I say ... If we ... Because that is based on maybe the treatment is under the national healthcare insurance, so that's why they know the price is not going to go that much high, so that's why they are thinking, "Oh, that's fine, that's fine. Please do it. Please do it". Right? Once, if we talk about the implant and the bone, and put the price is so expensive, they say, "What are you talking about? Why are you so expensive?"

 

 

The first time I came over to Japan, the first patient I wanted to do that agreement, and the sign-up-for sheet like in the United States, they put all the documentation, right? Agreement, sign it. They put what is the possibility of the surgical procedure: Bleeding, swelling, numbness, whatever, but you have to sign it before the implant treatment, right? If I do this, and everything is translated in Japanese and I ask the Japanese people to sign it before the treatment, they reject, "Okay, I am so scared. I don't want to do it". Okay, so it's a little bit different. I couldn't do exactly the same treatment.

 

Howard Farran:

Are lawyers a big issue in Japan like they are in the United States?

 

Kiyotaka Umezu:

Lately yes.

 

Howard Farran:

It is?

 

Kiyotaka Umezu:

I came back almost 13 years ago, but at the beginning, they were not ... We were not even thinking about the lawyers, what kind of issue they have, but lately, the patient is now, they wanted to know what kind of treatment we provide, why the implant is so high? Why since [inaudible 00:22:36] procedure, what kind of material we are using. Then sometimes, if it's a patient that we, our doctors [inaudible 00:22:44] some people don't explain well to the patient because the explanation, or the agreement, or those kinds of education wasn't provided in the past because everybody is based on the treatment on what's provided like healthcare insurance. All of a sudden some doctors started doing those kinds of expensive treatment, and without telling them, or without reaching to the agreement, so that's why they have the conflict, or some kind of a problem, then the lawyers started getting involved with the dental field.

 

 

That other issue is, they ... At some the [schools 00:23:19], they started by making it a law school. Before, we didn't have the law school, so there's a lot of more lawyers who really want to have a good job, or an issue, so they hear about, "Oh dentistry, maybe it's a good field to do [inaudible 00:23:36] law suit", or something like that. That's why that maybe the law suit is something much much more right now.

 

Howard Farran:

What implant system are you using?

 

Kiyotaka Umezu:

I'm using, it's right now, it's a global company, like a big company. I started from the [inaudible 00:23:52] because [inaudible 00:23:53] had a special treatment, the relationship with [inaudible 00:23:56], which is Yorba Linda. It sounds like Loma Linda, but Yorba Linda is only 30 minutes from Loma Linda, so that's why. Did you know the [inaudible 00:24:06] was merged, and they got in [inaudible 00:24:11] care. At the time as I was using [inaudible 00:24:14] care, and after I came back, I was using [inaudible 00:24:17] system. Anyways, any kind of system, I can provide for any kind of the country, pretty much, like Europe and the United States, or Brazil, or South America, because I have several patients [inaudible 00:24:32] some patients, I know, they just stay here in Japan at a certain time, but they go [inaudible 00:24:35] to their own country, but I just wanted to have the big company, because then they can get some parts ... If they have a problem with parts or something like that, they can provide it still. That's why I wanted to stick several companies and who is big and doesn't disappear.

 

Howard Farran:

Does Japan ... Does Nippon make an implant?

 

Kiyotaka Umezu:

Yes, the GC. You know GC right?

 

Howard Farran:

GC-

 

Kiyotaka Umezu:

Yeah, like the [inaudible 00:25:01] [resin 00:25:03].

 

Howard Farran:

Yeah. Yeah.

 

Kiyotaka Umezu:

You know [crosstalk 00:25:03] resin. As a dentist, you-

 

Howard Farran:

Glass ionomer, [crosstalk 00:25:07]

 

Kiyotaka Umezu:

Yes, yes. That company has a GC implant system in Japan, okay? They are providing [inaudible 00:25:13] they developed one of the systems, even in Europe as well, but they don't have this in the United States.

 

Howard Farran:

Did GC move their headquarters to Switzerland?

 

Kiyotaka Umezu:

Yes, they did, because [crosstalk 00:25:26] tax issue, or something like that.

 

Howard Farran:

It was for taxes?

 

Kiyotaka Umezu:

Or maybe those kinds of issues, because anyways, they're a big company, so that's why instead of having it in the headquarter in Tokyo, but maybe it's better to have the headquarter there. Maybe. Anyways. [crosstalk 00:25:40]

 

Howard Farran:

I wonder why they moved to Switzerland.

 

Kiyotaka Umezu:

Yeah, because they're a good company, and actually what happens is that, I've been helping in GC since I came over [inaudible 00:25:52] in Japan, because what happened is I wanted to [inaudible 00:25:54] for my Master's degree, for the Master's thesis, I wanted to do some of the research with implant from Japan, but there was no GC implant available at the time. I just came back to Japan, and I asked the GC guys, and [inaudible 00:26:12] I'm Japanese, and I wanted to do that on some kind of the health [inaudible 00:26:15] to improve the Japanese implant system. Since then, I've been just giving them some advice or something like that.

 

 

One of the implant they in Japan marketing and we're selling right now in Japan is one of the systems that I got involved for development.

 

Howard Farran:

Where is GC? Is it in Tokyo?

 

Kiyotaka Umezu:

It is Tokyo, yes.

 

Howard Farran:

Is it near here?

 

Kiyotaka Umezu:

Yeah, it's 20, 30 minutes from here.

 

Howard Farran:

Is the company mainly in Tokyo, they just have headquarters in Switzerland just for tax purposes?

 

Kiyotaka Umezu:

I guess. I don't know about the tax purposes, but anyways, right now there's a CEO. The CEO is living in Switzerland, and the younger generation, my generation, he is ... They are living in Tokyo.

 

Howard Farran:

Yeah. I noticed some of the German dental companies, they moved their headquarters to Austria for tax purposes.

 

Kiyotaka Umezu:

Oh okay, yeah.

 

Howard Farran:

Very interesting. Are you using the GC implant system now?

 

Kiyotaka Umezu:

Yes, I'm using the GC system as well, but I wanted to make sure GC is not the ... You cannot purchase in the United States, so I'm not going to be using it with any kind of US patients to [inaudible 00:27:31] the implant. Most of the time I make sure the patient's going to be stick around here in Japan, Tokyo.

 

Howard Farran:

No, come on in. Come on in.

 

Kiyotaka Umezu:

Come on in.

 

Howard Farran:

Is that a patient?

 

Kiyotaka Umezu:

Yeah, it's my patient, but it's [inaudible 00:27:43]. Sorry.

 

Howard Farran:

No, no, come on in, please

 

Kiyotaka Umezu:

Go ahead. I'm just having an interview, so I'm [crosstalk 00:27:48]

 

Howard Farran:

Oh no, no, no, no, no.

 

Speaker 4:

I should get out.

 

Howard Farran:

No, no. Is he an American?

 

Kiyotaka Umezu:

No, he is half Japanese, half Filipino.

 

Howard Farran:

Half ...?

 

Kiyotaka Umezu:

Maybe you can go ahead [crosstalk 00:27:57]

 

Howard Farran:

You can sit right here. You can sit right here.

 

Kiyotaka Umezu:

No.

 

Howard Farran:

No, no.

 

Kiyotaka Umezu:

If you're okay, we can just shut it off, okay?

 

Howard Farran:

You need to go with [him 00:28:08].

 

Kiyotaka Umezu:

What time is it?

 

Howard Farran:

It's-

 

Kiyotaka Umezu:

It's 20 ... He came a little earlier.

 

Howard Farran:

What time is his appointment?

 

Kiyotaka Umezu:

His appointment is at 2:30.

 

Howard Farran:

Anything to finish on? I wanted to capitalize on since you lived in both countries ...

 

Kiyotaka Umezu:

Mm-hmm (affirmative).

 

Howard Farran:

Are there any other difference between dentistry in Nippon versus dentistry in American that you were able to ...? I think it helps dentists think outside the box when they think ... When everybody in their country does it this way. If everybody in a country does it red, and then they see, "Oh, another country does it blue", it makes them think.

 

Kiyotaka Umezu:

Oh okay.

 

Howard Farran:

You think there's any think-outside-the-box lessons of what you've seen different from United States versus Japan, or Singapore, or Hong Kong, or Southeast Asia versus the United States to make [him 00:29:03] food for thought, things that are different?

 

Kiyotaka Umezu:

Actually, as a dentist, I think it's a ... For me, because I didn't have to open up a practice, or I didn't have my own practice in the United States, so that's why I cannot really compare what I have and the stuff that I had had over there, but I think it is being in Japan is ... In Tokyo at least, and I think it's a quality I can just keep ... Actually it's a goal for me, my practice, is here, I wanted to do dentistry like the United States, because the United States, the insurance system also that the patient [inaudible 00:29:32], we don't need to see a patient too many, but in Japan, to keep the insurance situation, we have to see a patient a lot, like every 15, 20 minutes, or something like that.

 

 

I just ... I wanted to talk-

 

Howard Farran:

How many patients, average dentists, Japanese dentists see a day since due to the insurance?

 

Kiyotaka Umezu:

Actually some people ... [foreign language 00:29:55] Maybe this ...

 

Howard Farran:

Come talk on the ... You have to get on the podcast for the last one minute. Come here, come here, come here. You got a chair here. You have to be on the show the last one minute. Come on, your next patient's here, you have to join us for the last minute. All right. Come sit down. You're a dental hygienist.

 

Atsuko Masutani:

Yes I am.

 

Howard Farran:

Tell me you name.

 

Atsuko Masutani:

Atsuko Masutani.

 

Howard Farran:

What?

 

Atsuko Masutani:

My name is Atsuko Masutani.

 

Howard Farran:

You're a dental hygienist?

 

Atsuko Masutani:

Yes.

 

Howard Farran:

Where did you ...? Did you go to ...? Does the dental school have a hygiene program, or is it ...?

 

Atsuko Masutani:

Yes, I went to the ... Hokkai ... Do you know Hokkaido? The north part of Japan.

 

Howard Farran:

Mm-hmm (affirmative).

 

Atsuko Masutani:

Hokkaido prefecture hygiene college, the part of the dental school.

 

Howard Farran:

Do you do the cleanings here?

 

Atsuko Masutani:

Yes.

 

Howard Farran:

Or you do more dental assistant?

 

Atsuko Masutani:

Usually I do teeth cleaning, but sometimes I do his assistant, always.

 

Howard Farran:

Very good. All you hygienists back in America need to be assisting your dentists too. They mostly just like to do cleanings, and you say, "Will you come help me?" They say, "No".

 

Atsuko Masutani:

Mm-hmm (affirmative). I like assistant too, so that's why I-

 

Kiyotaka Umezu:

I think it should be balanced, right?

 

Atsuko Masutani:

Mm-hmm (affirmative). Yes.

 

Kiyotaka Umezu:

Not too many ... Because for them, it's only the cleaning [inaudible 00:31:25] making inside their [inaudible 00:31:26] [crosstalk 00:31:29]

 

Howard Farran:

I want you guys to talk about one last thing. I noticed you have an [inaudible 00:31:32] camera right above your surgery. You can film with a digital camera, and it's right on the big screen. Why do you do that?

 

Kiyotaka Umezu:

Actually, during the recordings, I don't just do it on the big screen, but it's only the screen big when it's to show the patient, it's like a panoramic x-ray, and sometimes this is a dental x-ray to draw the pictures, what is bad and what is good about it. Basically, when we are taping the movie, or something like that, I don't use the big screen, but I want to make sure that I'm taping it to the right location. That's all about it.

 

Howard Farran:

My last ... You guys have a patient [inaudible 00:32:11]. My last and final question is, how come I've been in Japan for a week and I have seen no one driving my Lexus? I have a Lexus, and I have not seen my Lexus in Tokyo. Do they sell Americans the Lexuses that they won't sell in Japan?

 

Kiyotaka Umezu:

Lately it's some, but it's very few.

 

Howard Farran:

Why is that?

 

Kiyotaka Umezu:

I think it's that Toyota has ... Because the Lexus is pretty much they get sold ... They made it, the name itself is to sell in the United States.

 

Howard Farran:

Oh.

 

Kiyotaka Umezu:

So that's why. It's the same kind of engine, the framework, everything, but they have it the same, the Toyota name here.

 

Howard Farran:

Here, it's a Toyota?

 

Kiyotaka Umezu:

If you see the Lexus here in Tokyo, it's somebody who like the Lexus and buying from their US Lexus [inaudible 00:32:58] here.

 

Atsuko Masutani:

No, no, no, no. [inaudible 00:33:00] had a Lexus [inaudible 00:33:03], but Toyota's Lexus.

 

Kiyotaka Umezu:

Yeah. Toyota Lexus. Yeah.

 

Atsuko Masutani:

Yeah, I have a Lexus.

 

Howard Farran:

You have a Lexus?

 

Atsuko Masutani:

Yes. Mm-hmm (affirmative).

 

Kiyotaka Umezu:

That's why there's original ... Lately.

 

Atsuko Masutani:

More than 10 years I think.

 

Kiyotaka Umezu:

More than 10 years?

 

Atsuko Masutani:

Mm-hmm (affirmative).

 

Howard Farran:

When you do a cleaning, how long do you schedule a patient for a cleaning?

 

Atsuko Masutani:

Usually one hour.

 

Howard Farran:

One hour?

 

Atsuko Masutani:

If it's a very simple case, but if I have a heavy case, for example, my patient have some problem about periodontal issue or something, I need one and a half.

 

Howard Farran:

Why do you have so many friends in America? You said you have friends in Mississippi, Louisiana, Chicago. How do you make all these friends in America?

 

Atsuko Masutani:

I'm a very friendly person, that's why.

 

Kiyotaka Umezu:

That's right.

 

Howard Farran:

Did you meet them over the Internet or did you go back to America for-

 

Atsuko Masutani:

No, no, no, no, no. I have several friends here from US. Then everyone introduced me another friends, so [inaudible 00:34:02] several times, I went there, and then everyone introduced me some other friends. Friends of friends, and friends of friends from friends, or something like that.

 

Howard Farran:

Now, are you going to come to Phoenix and visit me and Ryan?

 

Atsuko Masutani:

Yeah.

 

Howard Farran:

We'll give you a cactus that you can take home. It's a token cactus.

 

Atsuko Masutani:

Oh, that's nice.

 

Howard Farran:

Anything else you want to share in the final minute? Anything else you want to say? Anything?

 

Kiyotaka Umezu:

No, just thank you for the time and coming over, and I hope that you guys are going to enjoy the time in Japan, and hopefully come back again, under some "schedule". Tell me in advance a little bit more. Anyways, I just like your idea in sharing all the information to improve all kind of the dental work, it doesn't matter the countries, because I just wanted to help, or improve whatever the service that we can provide for our patient. That's the whole idea, and that's why I decide to get interviewed [inaudible 00:35:04]. Hopefully it's all the patient it's all over the world can be evenly nice that can get the nice ... The treatment, right?

 

Howard Farran:

That is very sweet. I think it would be so romantic and so special if you, someday, created an online E-course.

 

Kiyotaka Umezu:

Mm-hmm (affirmative).

 

Howard Farran:

Every time we put up a course on Dental Town, somebody from every single country ... There was a ... The other day, I saw on Facebook a dentist named [Neal Ponté 00:35:34] from Kathmandu, Nepal; their dental study [club 00:35:42] was just watching an online [inaudible 00:35:43] course.

 

 

I hope someday you create us a course on Dental Town.

 

 

Okay, thank you very much.

 

Kiyotaka Umezu:

I just got interviewed, so [inaudible 00:35:53]

 

Howard Farran:

Okay.

 

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