Dentistry Uncensored with Howard Farran
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400 Fearless Dentistry with Delia Tuttle : Dentistry Uncensored with Howard Farran

400 Fearless Dentistry with Delia Tuttle : Dentistry Uncensored with Howard Farran

5/21/2016 5:00:52 AM   |   Comments: 0   |   Views: 377

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VIDEO - DUwHF #400 - Delia Tuttle


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AUDIO - DUwHF #400 - Delia Tuttle


Dr. Tuttle’s unique background enables her to provide exceptional care for all her patients, she graduated from UCLA in 2009 with the prestigious Dean’s leadership award and Dr. Tuttle also graduated from Medical School in Romania in 2000 where she practiced as a physician before she became a dentist. This experience in the medical field helps compromised patients to receive the best dental care.

Since then Dr. Tuttle has enjoyed practicing all aspects of general dentistry including but not limited to wisdom teeth extractions, bone grafting, implants, gum surgery, root canals, dentures, partials, and cosmetic dentistry. When she is not creating beautiful smiles, she spends time with her husband CJ and her son Alexander. Dr. Tuttle believes that Zumba exercise is the best stress reliever after a full day of work. She would like to be on Dancing with the stars but she is not that famous, yet…

Dr. Tuttle is professional, ethical, gentle, and a good listener. She has the capability of easing patient’s anxiety about dental work so they feel relaxed and comfortable.

Dr. Tuttle believes that a great smile creates pride in a patient’s self-image and will open doors for them throughout their lives. As a bonus she also speaks English, Spanish, and Romanian.

www.CanyonLakeDentist.com 

Howard:

It is the most amazing, most hugest honor ever to have the biggest rock star in dentistry Dr. Delia Tuttle to be on my podcast interview at the Townie meeting 2016. This is her 14th annual Townie meeting.

 

 

I've got to tell you something, Delia. Is it Delia?

 

Delia:

Delia. Delia.

 

Howard:

Delia?

 

Delia:

Yes.

 

Howard:

The only D I ever got in my life was in Spanish. After one year of piano lessons my piano teacher actually fired me. She told my mother that I couldn't carry a tune in a lunch pail. When you get fired from your piano teacher, who's probably in it to make money, and get a D in Spanish I don't have a good ear for sound. Seriously, when I was in school it was the male professional and I got an 87 [inaudible 00:00:50]. Now when you go to schools it's half females. I don't know of a bigger ...

 

 

Now when you go to dental schools 45% of the class is women.

 

Delia:

It is. That's right.

 

Howard:

I can't think of a bigger, better, bolder woman role model than you. I'm dead serious.

 

Delia:

Thank you. Thank you so much. Thank you for inviting me. It's a pleasure to be here in Vegas.

 

Howard:

You were born and raised in Romania?

 

Delia:

Yes, Transylvania.

 

Howard:

You graduated from dental school. Transylvania?

 

Delia:

Transylvania. That's right.

 

Howard:

Did you ever see the Rocky Horror Picture Show?

 

Delia:

Not yet. Not yet.

 

Howard:

There was a song there. Born in Transylvania. One of my favorite movies. Then you came to the United States.

 

Delia:

Yes, about 10 years ago.

 

Howard:

Of course they wouldn't accept a license from another country without going through the [inaudible 00:01:32]

 

Delia:

Correct.

 

Howard:

You go to UCLA.

 

Delia:

I went to UCLA graduating in 2009.

 

Howard:

2009. This is only 2016. That was only ... You come out of school and in 7 years you're one of the biggest names in dentistry. You've got 15,000 people following on Facebook.

 

Delia:

Thank you.

 

Howard:

Your work ... Some of the greatest surgeons I know like Ziv ...

 

Delia:

Oh, yes, yes. Ziv Simon from Beverly Hills.

 

Howard:

So many of the greatest surgeons I know just say that ...

 

Delia:

He's awesome.

 

Howard:

No, no, you're different because you just have gifted hands.

 

Delia:

I'm just fearless.

 

Howard:

I see it like this. I see it like this. You can have two people go to singing school for 8 years and they both become a doctor in singing but one person can sing and the other person can't sing. I imagine two people go to painting school and one gets a doctorate in painting and the other one didn't go to school. The one that didn't go to school ... I mean, you, your hands, you do stuff that no one else can do.

 

Delia:

Thank you. Thank you. I'm trying. It's a lot of work and dedication. It's constantly learning. Constantly a hunger for education. I just wanted to succeed. I'm actually living the American dream. I do know lots of international dentists and it's quite a transition when you move from another country to be successful in the States. I did everything in my power to succeed. It was a long journey, beautiful journey, and I'm so happy to be here today and have this opportunity in front of the camera for sure.

 

Howard:

Did you come with your husband or did you meet him here?

 

Delia:

No, actually, I met him here.

 

Howard:

You came alone?

 

Delia:

Yes.

 

Howard:

Just by yourself?

 

Delia:

All my life I was trying to fight mediocrity. That was my goal. I came many times to the States to many dental conventions and I met my husband here in the States through one of my friends. Her name is Tanya.

 

 

Then I went back to Romania and I came back again after three years and we decided that we are soul mates and he proposed after 6 months. I said yes. I left everything behind. My parents were very mad. They were mad because I left after so many years of education in my country. I came to the States and I studied really, really hard. I was accepted at UCLA. I applied actually only for two schools because my husband had his job in the States and he didn't want to move. The chances were very, very limited to go. There were only like 12 seats available per school here in South California. I was very honored to go to school. It was a great experience. It was worth every penny I spent for my education. It's been good.

 

Howard:

You said something right out of the gate that I wanted to dwell on and that is the fact that the bottom line is you're fearless. Every dentist has a million reasons of why ... Well, I look at this because the specialists they want the case. They want to make the money.

 

Delia:

For sure.

 

Howard:

They're saying, "Oh, well, you should have referred that root canal to me because we've done so many more and you haven't done any." I always say, "Well, didn't you have to do your first root canal?" How many root canals did you do on your first day of dental school? I've done more root canals as of today at age 53 than any endodontist that ever got out of endo school. I've done a gazillion of them.

 

 

How do people get good at endo and they say, "That root's really curved. I'm going to send that to an endodontist." Well, you know, they always have 400 reasons why they need to not do it and you just always seem to do it. Is that something you're born with or are you fearless?

 

Delia:

Not really. After graduating dental school I had lots of loans and I wish to go for farther education since I do have a medical background from my country so I graduated from medical school in 2000. I graduated dental school in 2005 and then I moved to the States and unfortunately I couldn't go for farther education. I had in mind a career for oral surgery and then right after school my son was 2 years old. It was a very tough time. My husband really worked really, really hard for us to go through school and everything. Very supportive family. I am very, very blessed. I decided just to go for it.

 

 

I had a couple of choices. I went for a couple of interviews. I decided to take the hard road so I worked for a corporate for 3 years.

 

Howard:

Which one?

 

Delia:

Pacific Dental Services.

 

Howard:

Steve Thornton.

 

Delia:

Yes. Absolutely. I was driving probably two hours and a half a day to go to this beautiful location. I work towards the Palm Springs area. I developed great leadership skills there being a general dentist. I had to support the schedule for all the specialists. It was very, very hard because it was allowed for us to just do restorative procedures. No perio, no, oral surgery. I had no choice but make it work. You had to survive. It's one of those things.

 

 

I had a great, great relationship with the specialist and I wanted to make sure to have great schedule. In return they taught me some things. When I was ready I left the group and I jumped fully into a private practice.

 

Howard:

Did you start from scratch or did you buy one?

 

Delia:

This is what happened. I started ... Actually I bought a practice from two dentists with only two days of patients. It was a mixed practice, HMO and PPO, and in three weeks I was fully booked 6 days a week. Then from there everything opened the door for everything.

 

 

When I bought the practice ...

 

Howard:

Why do you think those two guys only had two days of patients and you bought it and you're booked out 6 weeks in advance?

 

Delia:

They had different practices. They were not able to actually concentrate and put the time in the practice. Where I am it's in Lake House. A very pretty area. Canyon Lake. It's next door.

 

Howard:

Outside of San Diego?

 

Delia:

It's actually one hour and 20 minutes from San Diego. Towards the winery where Temecula is and they didn't have the time to put in the practice. It's in a shopping center. Both of them have different practices. The area is a very new area. Lots of people are moving into the area from Orange County or maybe LA area. Before I jumped in I looked at so many things before I bought the practice. I look at the locations, I looked at the possibility of expanding if I will grow in a couple of years. I was very, very blessed to be there, put all my time for my patients, and in 3 years I was able to double the space.

 

 

I doubled my practice in 3 years basically after I bought it.

 

Howard:

You know what's amazing? I read like 89% of every student in America struggling to get a PHD was not born in America. Whenever I go around and see the most amazing dentists in the world it's the hungriest dentists from 220 other countries that come all the way here. Then when they get here it seems like the American people have some anti-immigration thing. Then you look at the IPO's it's like 4 out of 5 IPO's in the United States they're always by some Delia who came from Romania.

 

 

I mean, Google. Sergey Brin is from Russia. Intel, Andy Grove was from Hungaria. Whatever. It's like this country was built on immigrants. Whenever I meet just a world class dentist that just blows my mind they were never born in the United States. Have you noticed that?

 

Delia:

Yeah.

 

Howard:

It takes a special breed of cat to sit there and say, "I'm going to leave my country with the shirt on my back and come all the way to ..." I think is the greatest country ever. Good lord. Every time an immigrant comes to this country our government should be giving them $10,000 cash at the border and trying to find them a place or help them. It's just amazing what these immigrants do. We truly brain drain the rest of the planet.

 

Delia:

It was not easy for sure to leave everything behind. Studying a different language. Trying to break that barrier. Language barrier. Going to UCLA and it was very intense. I was very, very blessed with everything what I accomplished during UCLA. I knew that when I'm done with the training there I have to pay for all the continuing education courses and everything. Basically I lived inside the UCLA. I went for every single course you can imagine. I assist every resident I could. I took advantage. I was like a little sponge ready to jump.

 

 

If you are working really hard, you care what you do, and you do have a passion it's impossible not to succeed. That's my vision. Everyone can do it.

 

Howard:

What kind of practice do you have? How would you describe your practice? Is it a family practice? Is it a reconstruction practice?

 

Delia:

Yes, I'm a general dentist. I do a lot of specialty procedures. I rarely refer out. Mainly I refer out complicated root canals or maybe some TNJ cases. Basically I can treat anything that comes through the door from periodontal surgery to implants to dental [inaudible 00:11:32] hybrids, single implant cases, to any procedure you can imagine.

 

 

It's all about building to the pyramid. If you are really good and you are done with the school and you go to certain classes, you have a passion, I'm watching webinars, three webinars a week. I'm interested in some procedures ...

 

Howard:

Where are you watching these webinars?

 

Delia:

Because my email is everywhere it's kind of on social media. I'm getting those emails all the time from different companies like Academy of [inaudible 00:12:03] Integration, Doctor Ziv Simon, I went also on Dentaltown. I recently took a class on Dentaltown on removable bridge. You know, Aryan [inaudible 00:12:17], AD, German. I'm interested in doing those for periodontal compromised patients. Everywhere. Dental XP, YouTube, everything I can get my hands or eyes on.

 

 

Sometimes I do between patients. I'm very active on social media and that opens the door tremendously for me. Seeing cases everyday and then go ahead and practice and see a similarity with the cases you saw. You're going to conventions. You buy certain instruments. I don't have too much technology in my office at this time. I can do miracles with just the [inaudible 00:12:54] scalpel. I am excited to share it.

 

Howard:

You have a CAD cam?

 

Delia:

No, I don't.

 

Howard:

You don't have a [inaudible 00:13:02] machine?

 

Delia:

No, I don't.

 

Howard:

Do you have a $75,000 laser?

 

Delia:

No, I don't.

 

Howard:

Do you have a CBCT?

 

Delia:

No, I don't.

 

Howard:

You have the biggest practice known to man and you're the greatest surgeon and you're the greatest everything and you don't have any of those toys and these people think they have to buy all these fancy toys to be successful. If I had to pick one person to work on me it absolutely would be you.

 

Delia:

Oh, how sweet. You are welcome any time.

 

Howard:

I'm dead serious and you don't have any of that stuff. When dentists are making money they're standing on a rheostat with a drill in their hand or a scalpel and a suture and it's not technology dependent.

 

Delia:

Yes, exactly.

 

Howard:

You place implants?

 

Delia:

I do place implants.

 

Howard:

You use a surgical guides or non-surgical guides?

 

Delia:

I used to place free handed implants for about a year. After I bought my practice I had the freedom to go ahead and start doing implants. Then after a year I saw lots of cases coming in from the previous doctors or maybe outside the area and they were really ideal placement. I decided to take it to a different level. As a general dentist you want to make sure you do specialty work but you do it at the highest standard. If you ever go to court you are going to be judged the same as a specialist work. I decided to go and I took a class on guided surgery. It was amazing. I took it with Implant Direct. I was very, very excited because ...

 

Howard:

Who's the founder of Implant Direct? Jerry?

 

Delia:

It Niznick but he left.

 

Howard:

Niznick. Niznick. Yeah.

 

Delia:

He left right now the company. It's a small company. I'm very happy with it.

 

Howard:

Implants Direct?

 

Delia:

Implant Direct. Yes.

 

Howard:

That's a huge company.

 

Delia:

It's not from the first companies out there but I'm very happy with the product. It's made in USA in California. I took the surgical implant placement guided surgeries and I came back from the course and in a couple of weeks actually I went and I did the hybrid dangerous case and 7 implants. That was my first dangerous case which I'm going to present actually tomorrow for my lecture here at Dentaltown.

 

 

Then after that everything kind of fell in place. I wanted to be at the highest standard, everything what I do, I took for every single implant case I do a CBCT. I'm referring my patients out to a center. They have a very good i-CAT machine. I did everything in my power to convince my patient to get the CT scan because I wanted to make sure I place it right. I bought the software for Anatomage. I'm overlapping all of this information and my implants are turning just fabulous.

 

 

If you know about soft tissue management and that's why I opened the Facebook page which is international, follow the pink, you are going to be so successful as a long-term. That's pretty much the story with the implant.

 

Howard:

Another thing about you is not only did you come here for Romania and I'm sure they're crying every day that they lost you to America but not only are your implant surgical skills top 1/10th, 1% your marketing was genius. You had this whole campaign of Follow the Pink which everybody knows about. There's no dentist on Facebook that doesn't understand Follow the Pink. Where did that come about? Did you just think of that?

 

Delia:

I was just fascinated by the soft tissue. You know in the mouth everything heals in two weeks. It's about two weeks of healing but what's under is important. What we do with the bone, how we place the suture, everything is like that. I was just fascinated. To be able to graduate from UCLA we had to be able to do periodontal surgery so I was blessed to do that. We learned how to do frontalectomies, pocket reduction surgery, crown landings, and that was the start point for me.

 

 

I just feel that crown landing procedure can open the doors for so many areas. If you know how to lay a flap you are going to be able to lay a flap if you have to for an implant. If you know crown landing you know how to save teeth. If you save teeth you are a dentist. That's how we went to school for. If you know crown landing you know how to do periodontal plastic surgery. You can work on those beautiful gum smile cases which I have a passion for. It's just opening your doors for so many areas.

 

 

I really, really highly recommend if you have a fear for surgeries and take a really good course on crown landing and it's going to be amazing for your surgical skills. That's my advice for the people out there, especially for women which are a little bit have a little fear for the surgical aspect.

 

Howard:

You know, if I go ask a bunch of male dentists like, "Who's your role model? Who's your idol?" They're going to say Dawson or [inaudible 00:17:51] or Spear. All these guys. So many of those women I say, "Who's your idol?" They say you. They say Follow the Pink. I want to ask you this. Some of these women think that they graduated in an all-male profession. They go to the study club and they're the only girl. It's kind of they feel like they don't fit in. I feel like you just moved in.

 

Delia:

I'm just fearless.

 

Howard:

Yeah, so is this ... Do you feel like you're a woman in an all-male profession? Or do you not even see that?

 

Delia:

No, I do feel like it's this way.

 

Howard:

You do feel like you're a woman in a male profession?

 

Delia:

I do. For example, I had to go to have a lecture for the Implant Direct for my company and it was probably one woman in the room and the rest, the audience, was just male and they're looking at me. Everywhere I go, the majority of the audience, I looked, and they're all male. That I'm so happy to see a woman there. I'm going and I'm chatting with her and encourage her. I like to inspire people. Not only women. In general, everyone.

 

Howard:

Was it really a woman? I mean, you were in California. It's probably a transgender. Was it really a woman?

 

Delia:

It was really a woman. Yeah. I was in Vegas actually.

 

Howard:

What would you say to a young girl that that intimidates her? Did that intimidate you?

 

Delia:

In the beginning a little bit but you will learn how to overcome your fear. You learn to be confident. Every day you get better and better. Of course it's not easy to come out there, post something on social media. I started maybe two or three years ago and I was very shy to post anything just because of the negative criticism.

 

 

Salvador Dali said, "You have no fear for profession. You will never reach it." If you are out there and you are trying to come out and try more things just try to be fearless. Every day think positive, be confident, if you need help ask for help. That's what I did. I was transparent with my cases out there. I got criticism. I took it to my heart. Next day I was trying to go back.

 

 

In the same time I got connected with this amazing international dentist all over the world. Overnight I was so overwhelmed with so many positive feedback. Now we do have a group called Divas in Dentistry which is international as well. A lot of women from Russia, Portugal, Argentina, Mexico, we are all sharing cases and helping each other to succeed. It's pretty phenomenal.

 

Howard:

Have we been talking to you about doing a Divas in Dentistry convention?

 

Delia:

Not yet.

 

Howard:

Well, [inaudible 00:20:41], can you go find Lorie because I told her what I want to do is I want to put together a Townie meeting where just the theme is Divas in Dentistry. Yeah, yeah. Just have a complete ... You are the leader of the Divas in Dentistry.

 

Delia:

Correct.

 

Howard:

Every woman rock star dentist from here to Romania that I've ever heard of in my life is following you.

 

Delia:

Well, not all of them.

 

Howard:

All of them.

 

Delia:

I am here to help. That's for sure.

 

Howard:

Follow the Pink comes from pink gums?

 

Delia:

Yeah. From soft tissue management and it's addressed to dentists. Can be hygienists. They're a little shy to post, though. Also, lab technicians. Sometimes in aesthetics we are talking about pink aesthetics and you have no choice and you have to do a restoration like a severe, severe ridge resorption then you have no choice and you want the lab technician to be in the group so they will guide you what will be the best how to do this. Other lab technicians started to post as well in the group. I'm very happy with that.

 

 

Actually I went for a DTG symposium last weekend and I mingled with lots of lab technicians. I'm trying to learn more about the lab part.

 

Howard:

DTG?

 

Delia:

DTG.

 

Howard:

Was that in Utah?

 

Delia:

Yes, that's the one. Absolutely.

 

Howard:

I was out of the ... I wanted to go to that so bad and I was out of the country.

 

Delia:

Yes, you learn so much. They talk about their part. You know your part. They have all kind of demonstrations on the floor. You can mingle with them. If you have any questions you can ask. I got to meet a lot of important people. If I do have questions they always can answer. I got very blessed working with one of the best lab technicians which was Bill Marais. He's originally from Africa. I'm doing amazing cases with him which you see on social media.

 

Howard:

Where's he from in Africa? South Africa? Johannesburg? Or Cape Town?

 

Delia:

I'm not sure exactly. I think it's South Africa but he's in Oregon right now. He's just a one man show. He does everything by himself. He's putting that fingerprint on his restorations. It's absolutely amazing, amazing work he does.

 

Howard:

What would you say, being the role model that you are, what would you say to a young woman who just came out of school? She's $350,000 in debt. She doesn't know if she should just go get a safe job at corporate or if she should bite the bullet and buy a practice. What would you say to her?

 

Delia:

Yes, I will say, do not buy the practice. We are not fully trained after graduation to be able to manage a dental practice. There's so many things beside teeth. It's just overwhelming. You have to develop your leadership skills. You have to know how to manage stuff. You know how to manage financials. One day you are going to be able to ... Hello?

 

Howard:

This is my president. Another diva in dentistry, Lorie, and I think the biggest meeting ...

 

Delia:

Delia Tuttle.

 

Howard:

Have you ever met Delia?

 

Lorie:

No, we haven't met yet.

 

Howard:

This is my president Lori Xelowski.

 

Delia:

Oh, yes. We've been collaborating on the emails.

 

Howard:

She's the brains behind Dentaltown and I'm just the front man. She leads the Divas in Dentistry. Every woman rock star from here to Romania to Europe to anywhere. She's got 15,000 followers. We need to do a Dentaltown event. We need to do the Divas in Dentistry. It would be ...

 

Lorie:

We have the Dentaltown learning live events.

 

Howard:

I think we should come ... What city do you think it would be best in?

 

Delia:

Las Vegas is pretty good.

 

Howard:

I'm telling you she's got 15,000 followers. A rock star. When I go around and I talk to guys I say, "Well, who's your idol?" It's the same old men. It's Peter Dawson. It's [inaudible 00:24:31]. It's Spear. It's this or that. When I go to the women it's always Delia Tuttle. She's just ... I asked her, I said, "Well, if you weren't the number one diva dentist or female dentistry rock star in dentistry who would it be?" Neither of us could even think of who number two would be. She's that far ahead.

 

Delia:

You're too sweet.

 

Howard:

No, no, she's that far ahead of the pack.

 

Lorie:

Awesome.

 

Howard:

You should submit us the list of who should lecture there and we'll do it. It'll be huge.

 

Delia:

I was just blown away by the Divas in Dentistry cases. Actually I met with some of them. I had one of the divas, [inaudible 00:25:11], traveling from Venezuela a couple of weeks back. We were talking in the office, she showed me her presentations, and it's unbelievable cases. Then we have Raquel from Portugal. She's very, very good with the really heavy surgeries. Moving the IA nerve to place an implant. That's her favorite thing to do. Sinus, it's just fearless. Those girls are fearless. [inaudible 00:25:37] from Russia. We have even younger ones coming to the place from Mexico. Right now she's having a baby. Her name is Mirna.

 

 

Also I'm trying to engage also the hygienists in Divas in Dentistry through my friend and my hygienist Amy and trying to encourage them to come up to the plate. There's so many things to talk about in the hygiene department as well. Argentina, I have my very, very good friend. She's a lab technician and a dentist as well. She has Follow the White. She does everything. Her husband is a Orthogenetic surgeon and facial plastic. They transform lives of the patients.

 

 

The cases are just amazing. Cleopatra is working with biological factors in Greece and she's the one that does the facial aesthetics with the IP rough. It's just amazing. They will be here this summer in August for the ICO meeting.

 

Howard:

All of those people will be?

 

Delia:

I'm trying to get most of them. We are trying to get some pictures for marketing.

 

Howard:

What does the ICO mean?

 

Delia:

It's in August.

 

Howard:

We should do it in August while they're all here.

 

Delia:

It should be in August. We're all here.

 

Howard:

This is all women. All elite. Every one of them women, almost every male dentist that you've met in your life they couldn't even do their scraps.

 

Delia:

Yes, sometimes you get a lot of private messages, most cases, sometimes even on Dentaltown little shy to post out there and most of them watching the cases. Then they have the private groups as well. I notice there. Just the other day I posted a video, someone asked me about some suture technique.

 

Howard:

Well, you know what? Only 1% of the dentists post cases. 99% won't because of the fear of criticism.

 

Delia:

The fear. Yeah. The fear in a way it's good in the beginning. It's like a positive thing. You get back the positive criticism, the negative criticism. You have that ability to stand back, get the good and the bad, put it together and this is how I progressed. You take beautiful pictures, at the end of the day you look at the case how I would do it differently this procedure and then you get there. You have to break the barrier. Don't be shy anymore. Don't care what other people are saying. Just be fearless and be out there.

 

Howard:

That's true. This will be the biggest thing. These are the most amazing women in the world and every one of them is eating out of her hand and she's the leader of the pack and this would just be so damn fun.

 

Lorie:

We'll have to email and get together.

 

Delia:

Yes, absolutely.

 

Howard:

Do you have her email?

 

Lorie:

Yeah, I do.

 

Delia:

You're so good to responding. All the time. Thank you.

 

Lorie:

You're welcome. Of course.

 

Delia:

Yes, absolutely.

 

Lorie:

All right. Thank you. I'll let you get back to the podcast.

 

Howard:

I think one of the reasons ...

 

Delia:

Thank you. Thank you. Nice to meet you.

 

Howard:

99% of the people won't post because they're afraid of criticism.

 

Delia:

Afraid, yes, absolutely.

 

Howard:

A social animal, they just can't overcome it.

 

Delia:

It's a good thing. It's a good thing breaking that fear. I'm really sure, I'm positive that more women will post if they have encouragement and support. I got very good feedback from the men as well saying, "Good job on there. I'm so impressed." Even here at the convention they came to me and said, "I love your cases."

 

Howard:

I just always love the criticism the most because I always thought of myself ... So many of the 7 billion Earthlings they have beliefs in their mind that just aren't right. I always thought ... I started writing a monthly column in '94 and I used to love it because whenever you'd write something that was wrong immediately you get 100 letters and emails and all that I was wrong.

 

Delia:

Of course.

 

Howard:

I just think, "God, I'm so lucky because I have all these friends and homies pointing out ..." Even [inaudible 00:29:15]. I remember one time I made a comment that 5 star Patton, General Patton said this, "As long as you keep moving and keep taking risk" I got a hundred emails that said Patton was only a 4 star general. The point was that his military success plan was we don't dig in. We keep advancing. We don't dig in and we keep taking risks. You're going to win the war.

 

 

I had a hundred people point out that he wasn't a 5 star general. He was a 4 star general. I'll say stuff in orthodontics and Anne Marie Gorczyca will immediately say ... On any of these blogs if I say anything that's not orthodontically correct ... I got an orthodontist Anne Marie that sends me, "Oh, you said this and that's absolutely wrong." I'm just thinking to myself, "How lucky am I that I got friends correcting me and taking wrong information out and putting in right information?"

 

 

I don't think it's thick skin. I just think it's the fact that ... I don't know. It's just never bothered me. I don't know if I'm socially retarded.

 

Delia:

You are different, though.

 

Howard:

Yeah, maybe I am different.

 

Delia:

You are way different.

 

Howard:

I think also part of it might be is I look at humans as just a little bit different than a cat and a dog. When you come home from work you don't look at your cat and say, "You lazy cat, you've been laying here all day. You're a bum." And kick it. You just think, "Well, it's a cat."

 

Delia:

It's a cat.

 

Howard:

When you come home and your dog craps on the floor and eats your shoe you don't shoot him because you had no expectations for him. I think people hurt themselves the most because they have such irrational high expectations of other humans behaviors.

 

Delia:

Correct.

 

Howard:

When you lower your expectations for all 7 billion people to that of a cat or a dog or a monkey and realize they're just talking monkeys how do you get mad at a talking monkey?

 

Delia:

Instead of helping ... If I can give you one single tip or maybe something to help everyone out there it will be to invest in photography. Photography really changed my attitude in dentistry. It changed diagnosing, chip implanting, case acceptance, marketing. If you want to progress, buy a good camera, go to a course ...

 

Howard:

What kind of camera? What kind of course?

 

Delia:

You just had a course here at Dentaltown with one of the biggest doctors here recently. You can take a course. I took a course with Milos Miladinovic. You interview him before. He's from Romania. I went all the way to New York because it was not available here in California and I have two cameras I'm working with. One I have a flash Nikon ... You know, flash camera with Nikon and I'm using basically just for my surgeries. I have a different one with the R1C1 brackets which I'm using for cosmetics. I bought also an ELICOM system with the lights so I can really see the shade, so I can really see the texture of the gum. I can take beautiful pictures for my patients.

 

 

At the end of the day you go ahead, I have a server, I align all of them in my computer, case by case, and I go over the pictures and I see what I can do better. From those pictures I have tremendous information. I can do a keynote presentation, any time on any topic. I can create something for the patient like a brochure, what's the difference between an onlay or a crown or a filling. I can show my surgery cases I can show what's the implant. Everything what you can imagine. You can place in the lobby.

 

 

That will make you a better dentist, better case acceptance, and you are going to progress a lot in your career. I have Nikon. Canon is good as well. Just find a very good course. That's my biggest tip I give to anyone who is watching right now the podcast. That helped me tremendously. Dr. Roberto Rossi actually gave me this tip. You interview him as well. I'm having a great collaboration with him from Italy. As a matter of fact, we work together for some projects. Back then I was just taking picture with my iPhone which is better than nothing. I didn't have time, working a corporate, to really put that time into it. One day he inboxed me and says, "Delia, you have great cases but your photography is really, really bad so please do buy a good camera."

 

 

Next convention I went out there, I bought a camera, then since then the social media just gave me so many opportunities. I'm invited all kind of events. I met interesting people. My career took a different approach. My practice grew. Case acceptance is high. Everything started from photography as well.

 

Howard:

Another thing I want to talk about, a lot of people I believe will never do the cases you do. Not only because they probably don't know how or can't do them but they could never even sell them. It seems like you'll see a person come in with 20 things going wrong and these little shy timid dentists say, "Let's do the filling here" or, "We'll just extract the one ..." How do you have the mojo, the karma, the energy just to ...

 

Delia:

Explain, yes.

 

Howard:

You're just presenting game changing treatment plans and they're saying yes because I see the photos of your work. Why do you think you're just saying, "Let's go for it and let's do this big case" whereas most dentists say, "Let's just fix the one that's bothering you the most."

 

Delia:

I see.

 

Howard:

It's not just a question they couldn't do the work you're doing. They wouldn't even have the balls to present.

 

Delia:

Yes, well, success is about passion. I do have a lot of passion for dentistry. Also success is based on personality and the sense of humanity. If you blend in all these three you're going to be successful.

 

 

Now when a patient comes in I'm not going to jump and say, "Oh my goodness, your veneers are looking really [inaudible 00:35:18] and your teeth are very square" and I'm going to jump into negative criticism as long as they step into my practice. I'm trying to get to know them. I'm asking them about their chief complaint. I always address the chief complaint first. Of course I'm addressing the periodontal statues as well. Then slowly as the conversation goes we take photos. I put them on the screen and then we talk about the smile. If they are going to say, "Oh, wow. It bothered me for so long. This gum smile." Or maybe that implant is placed in the wrong position right here in the front so what do you think about that?

 

 

Then I kind of create a little window to get into their world based on the photography what I'm telling you and then from there the discussion can be open. I'm not going to be negative. I'm practicing as a general dentist in California where people are more interested in cosmetic work as well. They had cosmetic work in the past maybe 20 years ago and now it's failing. They know it has to be replaced. Like any other plastic surgery it doesn't last forever. Only diamonds are forever. That's what I'm telling them. Only diamonds are forever.

 

 

Then I'm trying to approach them differently in a very sweet, nice way. Then I said, "Hey, I do have a similar case. Would you like me to share with you?" Then I'm having my keynote presentation right there. I have iPad in my office. I open and I'm going to show them step by step how it's done. They go home. I'm not pressuring them in any way. They go home, they think about it, and I have patients they return after 2 years thinking about what we talked 2 years ago. Then they go ahead and proceed with the chip implant.

 

 

It's all about if you are confident about your work and you are confident patient can sense it. Patients now are very educated. They are not coming from an area they don't understand about veneers or about the gum smile or lifting the gums, receding gums. They understand so much more. They have Google. They go on Google, they Google you, they see what you do. They come up and come to me and say, "I want that kind of restoration for you to do it. I heard about this technique." They're very educated. They have high expectations. In the same time you have to balance everything together. It can be a blessing in disguise or it can be a curse because they have high expectations and the case is very hard to do it. You have to talk to them from the beginning.

 

 

It's like a completely round approach. They can [inaudible 00:37:54] all the aspects plus the legal aspects as well. Taking those photographies before the X-Rays, having a very correct chip implant from the beginning, you know, informed consent, everything signed. That makes you to have a better way to approach those patients.

 

Howard:

Delia, you talked about when I said you're coming out of school should you buy a practice, should you go work corporate? You said you're not trained to take a practice. You need some more experience.

 

Delia:

Correct.

 

Howard:

I hear a lot of younger woman dentists believe that it's harder for a woman to lead five women in a dental office than a man. Is that true or false?

 

Delia:

You know, from my experience it's false because I am working with seven beautiful women and they all have one name. It's a Diva. If I need anything I just say, "Hey, I need a diva here." You can't go wrong with that.

 

 

That's amazing. You will believe that there will be so much drama in the office and so much negativity and everything. I feel for my husband because he's the manager of the office and he has to deal with all of us. For some reason ...

 

Howard:

I somehow feel like he loves the job.

 

Delia:

Yes, yes, yes. He's just going to twink an eye and then we know we're in trouble. I'm getting along with everyone. It's very important to have leadership skills. When they see your passion about your dentistry you involve them in the cases. Recently I just sent to one of my assistants to a photography class because it took me a long time to get all the photos and in that time I can do another procedure. Now she's in charge with that. She's so excited about the pictures.

 

 

If they want to grow there is room to grow. One of my assistants went actually for hygienist school. She's actually going to graduate this summer because she wants to progress. I'm not holding them back. I'm pushing them forward and I know all of them want to return. If they want to go for extension functions I'm going to make that dream coming true for them as well. Seeing me excited about dentistry, seeing the patient environment ... Patient as soon as they step in the office they sense the tension-free environment and that's so important. If you step in an office and the receptionist is mad because she had a bad day or the child ... When we are in the office we are really having fun. They're talking about cosmetics, where did you shop last time? I'm taking them shopping. I do reports every three months. I give raises. It's very important to make them happy as well.

 

 

I feel like I'm a good boss. I'm handling everything with diplomacy when it's a tension situation. I am the one working with them. It's just flowing. My husband is having a hard time wearing pink at the office. That was the hardest part for him. We converted him. Today I bought a tie with a little pink. He's wearing it tomorrow. A little light pink shirt. By the time he's really now realizing he's wearing really straight pink ... We converted him as well. It's all about the pink. We have pink glass, the pink mask, we have Follow the Pink logo on our shirts. We have different rooms as well like Follow the Pink room we have. Africa, I wanted to do one, as I told you. We have Paris room. We have New York room. Then how do you feel today? You feel a little Marilyn Monroe?

 

 

My patients are really treated so well. We are all happy working together and the patient can sense that environment which is so important.

 

Howard:

Your clinical skills are unmatched but your marketing skills are genius.

 

Delia:

I learn from social media and I know some of that is very well.

 

Howard:

No, your Follow the Pink campaign was ... I can't think of any dental office that did a marketing campaign that was more bulls eye marketing than that.

 

 

I want to counter. There's these big billion dollar companies control a lot of message. Big powerful social media people ... By the way, how do they follow you on Facebook? Facebook dot com ...

 

Delia:

It's Follow the Pink. Follow the Pink. I'm public as well on my Delia Tuttle as well.

 

Howard:

What's your Twitter? At Delia Tuttle?

 

Delia:

Yes.

 

Howard:

That's D-E-L-I-A T-U-T-T-L-E?

 

Delia:

T-U-T-T-L-E yes.

 

Howard:

At Delia Tuttle. What is it on LinkedIn?

 

Delia:

It's the same. I think I have the same. Yes. It's other Delia Tuttle or Tuttle Delia. It's either way. I have Divas in Dentistry and Follow the Pink as well.

 

Howard:

One of these billion dollar companies are telling everybody that you can just do the veneers chair side with a CAD/CAM. Do you think you can take a monolithic block and mail out and do veneers to the level you're doing ... Or anterior crowns and not use a human making this on a lab?

 

Delia:

Honestly, I don't think so. I do respect everyone's work. As a matter of fact, being a corporate before I got to try those veneers that you were talking about. It was a long day.

 

Howard:

Don't those kind of look like fake fingernails?

 

Delia:

It was a long day.

 

Howard:

Compared to ... Are you doing [inaudible 00:43:08] porcelain?

 

Delia:

I do [inaudible 00:43:10] as well. I do [inaudible 00:43:13] cut back and layered.

 

Howard:

Can a chair side monolithic CAD/CAM veneer or crown on a ... I get it. If you're working with a guy like me who's a 53 year old fat bald guy. He doesn't show his teeth. On me you could probably just pull the tooth and not even replace it. If it's a good looking girl and she's got a high lip line you can't do CAD/CAM on a monolithic block and have a bulls eye cosmetic work. Do you think so?

 

Delia:

No, I don't believe in that.

 

Howard:

Do you hear anybody saying that?

 

Delia:

I do. I do.

 

Howard:

Anybody with the balls to say that?

 

Delia:

I don't want to make anyone mad.

 

Howard:

Everyone's afraid of making them mad.

 

Delia:

You know me, I'm straightforward.

 

Howard:

This is Dentistry Uncensored.

 

Delia:

I'm raw. I used to raw more and I became a diplomatic over time. I did have a chance to work with Kelkin for 3 years for Pacific Dental Services and I got to experience from fractures to wrong shade to anything you can imagine taking after another dentist or being in a practice, being a huge practice, you can see those people coming back. The biggest problem I faced there was not having the right blocks for the right shade so even if you try to go ahead and try to glaze it and do different staining at the chair side it never looked the same.

 

 

I did one case, veneers, and I had to use actually my birth to make it looking more natural. We glazed it and we stained it. [inaudible 00:44:46] the gum line. Never look as good as they're coming from a human touch. I do not say that CAD/CAM it's not a good tool because it's a fantastic tool.

 

Howard:

You don't own it.

 

Delia:

I do not own it and I'm telling you why. I'm telling you why and I'm straightforward and I'm telling you why. Because I am so anal about my work that I will never let my assistant to create the casts or that inclusion that the machine gives or I'll modify it. Then it takes time for me to take it from the chair side, go do the design the way I want it, glaze it the way I want it, and stain it the way I want it. In a short time.

 

 

I do have a periodontal program very strongly in my practice. My patient's gums are great. It will be a great fit. I just do not trust ... My assistant needs to be at least a lab tech to understand the inclusion and everything. Even the CAD/CAM is very performative as well.

 

 

I'm very anal about my work and I care and then when they come back from the lab they fit so well. They're so shiny and glazed and they're perfect contacts the way I want it, the way I want it to be stained. It's just easy for me to deliver as well. That's the only reason I do not own a CAD/CAM because it's a lot of work. Then maintenance and then evolving the staff. Then I have to be worried tomorrow or like I have to deliver the same day. The pressure is on. Not that it's always going by the book that I have to deliver the restoration in the same day. Other things can change on your schedule. I do have a big practice ... I'm working right now on 8 chairs. So many things can do it. I have my patients being mad waiting for me. It happened for other companies. Sometimes they're there for 5 hours.

 

Howard:

I know. I know.

 

Delia:

Sometimes you have to do it with the temporary cement. I have them back to do the right way. I experience all these pitfalls before and then I decided not to have a CAD/CAM at this point. That was the story about the CAD/CAM.

 

Howard:

Well, it's like they went to school 8 years to be a doctor and then they go pay $150,000 to be demoted to a lab tech. It used to be they scheduled an hour and they would numb, prep, pack cord, and press temporize, an hour and they're gone. Two weeks later they come back for 30 minutes to cement. Now they're in there for 3 hours.

 

Delia:

Or 5.

 

Howard:

3 hours, 4 hours, 5 hours making a crown that they're not as good as their own lab tech. They're doing a crown and they've done maybe 20, 50, 100 and their lab man's done maybe that many a week for the last 10, 20 years.

 

Delia:

Yes, and managing the soft tissue is another issue for the office I was working for because it's not easy to do the bonding. When everything is bleeding you have to put your rubbers down. That takes time. You have to make sure you bonded, the cements are sometimes hard to clean. I like to take X-Rays before and after delivery and make sure I don't leave the cement there, make sure the margins are closed.

 

 

If you really want to be successful, you want your dentistry to last, you are going to check those things. If not, you just do in and out dentistry and that's the way you create your name. It takes a lot of work to create a good name. Especially when I'm planning to retire from this place and I'm not going to buy any other practices. This is it.

 

Howard:

Oh my God. You will never retire. She will do it when she's 103.

 

Delia:

No.

 

Howard:

You have more energy.

 

Delia:

I do. I do.

 

Howard:

You couldn't retire if you had to. I want to ask you, I've only got you for 10 more minutes, I'm just going through questions I know you're an expert in. A lot of people in diagnosing and transplanting it's a first molar. She has gum disease. They're young. These podcast listeners ... Podcast is a young behavior. They're almost all under 30. It seems like 20% of these people are probably junior, seniors in dental school. Probably another 6000 have been out of school the last 5 years. They don't know, should I pull this three rooted teeth that's got a 6 millimeter pocket and is that even worth the time? Should I treat the periodontal disease or should I just pull it and go to titanium? How does your brain analyze to save ... I have a feeling that you might be emotional like me where you kind of lean towards, "Well, if it was my tooth I'd want to save it." I don't know if it was my tooth if I'd be jumping to go to titanium. How do your wrestle that in your mind to save or to forceps?

 

Delia:

Absolutely. This is actually one of my topic that I'm going to talk about tomorrow and it's exactly the same situation you are talking about. I am having this young woman, she's about 34 years old, and she had some problems in her past. Psychological, emotional, medical compromised patient and she has all these huge cavities on the front actually pressing in on her mouth. The question is what am I going to do? I'm going to go ahead and pull her teeth when she's 34? Or I'm going to go ahead and fight for it with the gum surgery. I'm trying to counsel her and put her on a special perio program.

 

 

For me it's all about ... If I wanted to ... I'm not sure exactly how that tooth is going to do. I'm trying to fix the periodontal problem first. If they need endo, I treat endo. Then I do perio. I make sure the pocket is this ... If it needs periodontal infra bone defect or periodontic surgical procedure I will do that. I always start ... Let's say it's a very huge cavity. I always start with the [inaudible 00:50:30] and I see how far it goes and where we are getting to that point. Always I am trying, I am fighting for the teeth. Even if I place implants in my practice I always save teeth. My patients know. Word of the mouth. They come for sometimes second opinion from another dentist, "I heard she's saving the teeth. Go there. She will save it for you." I do crown landings. Whatever is necessary to be able to do it.

 

 

Of course, if the tooth has huge mobility and I feel like I'm not successful with this tooth for the future if the patient is young it's better to approach it that way. Sometimes you can go for extrusion, you gain more soft tissue and hard tissue so you do like a soft and hard tissue management. Then you go ahead and do your implant. All these calculations that you are planning it takes time. It's not like jumping into a situation. I go, I analyze, I try to trip, I try to make it happen for a patient. The last resort is extraction for me. It's a long journey until I make the decision. Sometimes it's just straightforward but sometimes I just go ahead and fight for that tooth for sure.

 

Howard:

Okay, here's another question. I want you to help my homies out. My motto is in 1998 when I saw the internet came out I said, "No dentist should ever have to practice solo again." I started Dentaltown in '98. Facebook wouldn't be until 2004. I beat Facebook by 6 years.

 

Delia:

I see.

 

Howard:

They're walking into these dental conventions and there's 175 different implant companies.

 

Delia:

I see. Yes. How do you know?

 

Howard:

Help her pick an implant company.

 

Delia:

Well, that's a tough one. You go through those courses and everyone says, "My implant is the best out there. It has this coating and it has this architecture and the neck is this way and it's friendly for the gum and for the bone to grow." It's kind of you have to do your homework. For me, it was I wanted to make sure my implant is fabricated in the United States. It's very important for my patients as well. I'm supporting United States economy as well.

 

Howard:

Do you do that for quality control? Is that emotional? Political? Dental? Science?

 

Delia:

When the patient is asking me, "Hey, I hope you're not going to send a crown to China". It's the same philosophy with the implants. Where are you getting your implants? Are those fabricated in China? For the patient mentality it's the same way for the crown. I say, "No, they're made in the United States. They're here in California." I have one implant in my mouth. I am relating to them. I am human. I am the same like you. I have issues. I had issues in the past.

 

 

It's a hard decision to make. You go to those conventions and you don't know what to look at. You look at the data. You look at the cases. You talk to people. You talk to important people like the titans out there. Try to make your own decision. Based on all these factors that I told you about it. Whatever you feel like.

 

Howard:

Which one did you end up going with? Implant Direct?

 

Delia:

Implant Direct. Yes.

 

Howard:

See, if I tell my patients, if I said, "Do you care if it's made in China?" They go, "China? Is that near Albuquerque?" That's why I love Phoenix. They couldn't find China on a map.

 

Delia:

They want to know exactly where the implants are fabricated, where is my lab, who is my lab technician. Actually, they go on Facebook and they follow my lab technician on his Facebook page.

 

Howard:

Who is your lab technician?

 

Delia:

Right now I'm working on all the cosmetic cases with Bill Marais. The one from Africa. I told you about him. He has his own lab.

 

Howard:

Is he in Africa or is he in California?

 

Delia:

He's in Oregon.

 

Howard:

He's in Oregon. How do you spell ...

 

Delia:

Bill Marais. He's on Facebook.

 

Howard:

Bill. How do you spell his last name?

 

Delia:

B-I-L-L M-A-R-A-I-S.

 

Howard:

A-I-S?

 

Delia:

Yes. A-I-S.

 

Howard:

A-I-S.

 

Delia:

Yes, you saw him so many times. He's fantastic.

 

Howard:

I've seen him so many times?

 

Delia:

Probably you saw my name associated with his name because he's ...

 

Howard:

M-A-R-A-I-S.

 

Delia:

Let me take a look.

 

Howard:

I'm on LinkedIn. Maybe he's William.

 

Delia:

No, don't go on LinkedIn. Go on Facebook. Better. It's easy to find on Facebook.

 

Howard:

Do you see him on LinkedIn?

 

Delia: