Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
How to perform dentistry faster, easier, higher in quality and lower in cost.
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848 Professional Teeth Whitening with Paulette Smith : Dentistry Uncensored with Howard Farran

848 Professional Teeth Whitening with Paulette Smith : Dentistry Uncensored with Howard Farran

9/22/2017 9:11:52 AM   |   Comments: 0   |   Views: 221

848 Professional Teeth Whitening with Paulette Smith : Dentistry Uncensored with Howard Farran

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848 Professional Teeth Whitening with Paulette Smith : Dentistry Uncensored with Howard Farran

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Howard sat down with Paulette Smith, Managing Director of Professional Teeth Whitening and Dental Hygiene, to discuss teeth whitening, dental hygiene in Australia and more.


Howard: It’s just a huge honor to be sitting here in Sydney with a good friend of mine, Paulette Smith? How are you doing?

Paulette: I am well Howard. Thanks for being here, thank you.

Howard: Thank you so much for coming upstairs and letting me and Ryan bring you on the show. Paulette graduated as a dental hygienist in 1988. Part of this, she worked as a dental assistant. Shout out to South Yard Dental Group for the inspiration and guidance given to her at that time, that helped develop her passion for dentistry. She completed a Graduate Diploma in Adult Education and Training in 1990. Worked in general and specials practice and public and private service provision. When Paulette graduated in 1988, hygienists were not legally allowed to practice in Victoria, so she wrote a petition to Victoria Parliament to get legislation in place. Was one of the first three to practice as a hygienist in Victoria. Now is Victoria where Melbourne is?

Paulette: Yes.

Howard: Basically, Australia has two major towns, Melbourne and Sydney.  Both four and a half million people. Those two cities is about half the population of the whole country, isn’t it?

Paulette: Approximately. Yes. Yeah.

Howard: Paulette had a great career with many opportunities. A turning point was when she was offered a position at Dentsply International, as a Product Manager. At the time, she felt she was turning to the dark side but it was the best decision she ever made. The opportunity to look at the business of dentistry from a manufacturing and investor perspective was eye-opening and so relevant for the enhancement and development of her clinical skills. After Dentsply, she was involved in teaching dental assistants, dental prosthetists and dental hygienists and oral health therapists. This was challenging and very rewarding, teaching and mentoring the students was an invaluable experience where she discovered her passion for teaching. Paulette was a programme coordinator for the inaugural year of the Advanced Diploma of Oral Health initiated at RMIT.  Man, you’ve been doing this a long time.  

Paulette: A long time. Yes.

Howard: You guys graduated in 1988.

Paulette: Yes.

Howard: So you’re coming up on thirty years in the dental biz.

Paulette: In Victoria. Yes.

Howard: In fact, you work for Dentsply, now it is Dentsply Sirona.  

Paulette: Yes, it is.

Howard: One of the biggest American manufacturing companies, Dentsply.

Paulette: Great company.

Howard: Created this x-ray.

Paulette: Yeah.

Howard: Merged with the biggest one in Germany.

Paulette: Sirona. Yeah.

Howard: Sirona used to be part of Siemens. Did you know that?

Paulette: I didn’t know that.

Howard: Yeah. I think Siemens is the largest company in the whole of Europe.  It was their division of Siemens and they spun that off because of CEOs always reallocating their portfolio so much, medical, dental, whatever.

Paulette: All of it.

Howard: So what are you most passionate about now, coming up to your thirtieth year of doing this. What are you most passionate about now?

Paulette: I am lucky to have had the opportunity to do lots of different things.  In the last few years one of my plans was to start my own practice. So in the last few years I have actually opened a Teeth Whitening and Dental Hygiene Studio, which is a bit way out there because hygienists normally practice with a dentist.  So to meet the legal requirements around that I’ve created a structured, professional relationship with some local dentists and it works really well.

So I do a couple of days a week in my studio as a hygienist, so that’s keeping up to date with my clinical skills, and I work a couple of days a week with Doctor Geoff Naj at Professional Dentist Supplies in Melbourne as their Business Development Manager. So I love the industry side of it. Learning about the materials, industry and business side of dentistry has made a really big difference to the way I have been able to conduct my clinical side of dentistry.  Lots of great opportunities have got me to where I am now.

Howard: Yes, I remember it was in the beginning of Geoff Knight’s podcast.

Paulette: Yes.

Howard: You just gave us a cameo for about thirty seconds.

Paulette: Yeah.

Howard: So now what is

Paulette: whitesprofessional. Well that was my website. When I first started, I kind of went ‘well, people need to find out who I am and what I am doing’, so I put together my own website. Looking at it now I think it is time that I modernised it and made it a bit more user friendly. But it just represented the new model of dentistry that I was setting up.  Interestingly enough, recently on one of the Facebook posts, there is a dentist in the US that’s just started a chain of businesses called Floss Bars.

Howard: Floss what?

Paulette: Floss Bar.  

Howard: (inaudible 04:53) Floss Bar.

Paulette: You can go to the Floss Bar at lunchtime and have your teeth flossed and polished, or get a scan and clean or have your teeth whitened before work, after work, during lunch.  

Howard: Was this started by dentists?

Paulette: Dentist.

Howard: Or hygienist?

Paulette: A Dentist.

Howard: In what city?

Paulette: Oh God, now you are testing me. Don’t know. Don’t know. On one of the American Facebook pages that I’m on, there was a huge outcry ‘what’s this dentist thing she’s doing, starting this Floss Bar thing, it’s crazy’. But it is really successful. People are actually happy to go and get their teeth flossed and polished. If they have got a night out or they might want a bit of cosmetic whitening to freshen up before they’re out on a date. It’s been super fantastic. So it reminds me of the model that I started with my studio. In that I just wanted to do teeth whitening and dental hygiene, and anything else I am referring back to the dental practice. I think it is a great model. It gives people the opportunity to get stuff done. People are still scared to go the dentist.

Howard: It’s in New York City.

Paulette: Is it?

Howard: I should have known. New York City.

Paulette: Yeah.

Howard: Amazing.

Paulette: So good.

Howard: I had to come all the way to Sydney.

Paulette: To find out.

Howard: To find out about New York City. If you ask any dentist or hygienist, ‘is it about you or the patient?’ They always say ‘oh, it’s about the patient’. I’m like really? So your hours are Monday through Friday, eight to five. The Federal Reserve says a third of Americans cannot leave work Monday through Friday, eight to five. The patient goes to lunch at twelve to one, that’s when they all turn their phones over to answering machine.

Paulette: Yeah.

Howard: I always thought that it was insulting that when I go on a cruise, or you go on to a resort, the women can get their hair done, their nails, their this or that. I would be on the cruise ship and I think, I don’t want a facial, I don’t want to get my hair done, I’d like to get my teeth cleaned.

Paulette: Yes.

Howard: But it’s the dentist, going to the State Board, with their bible in their hand.

Paulette: Yes.

Howard: It’s all about the patient.

Paulette: Yeah.

Howard: It’s all about them, they say ‘well can the hygienist have access to care and go setup in Malls and resorts and clean teeth?’ No. No, because I believe that no care is better than sub-Doctor care.

Paulette: Absolutely.

Howard: It’s like, really?

Paulette: Totally ridiculous.

Howard: So nothing is better than something?  Humans can justify anything. Dentists are crazy. What was that joke by (inaudible 07:44) he gave dentists? A hundred guns they’d form a circle. Yeah, if you went into a dental commission and gave a hundred dentists a gun, they would form a circle and start shooting each other.

Paulette: Too much competition.

Howard: When people say can dentists give a flu shot? It’s actually the Dental Board just saying no.

Paulette: No.

Howard: Are you out of your mind? When they give them independent licenses, I’ve only seen with my own eyes about seven of them, they are all in Colorado.  They were all in a town of less than a thousand. They couldn’t afford to have their own office and building.

Paulette: Yes.

Howard: So they had their house and they got rid of their dining room table.

Paulette: Yes.

Howard: Their china closet and put in an operatory and the local people would come and have their cleaning. If she saw something wrong, she would give referral to the dentist up the street. When I go talk to the dentist up the street, he says ‘she’s the greatest thing in the world’.

Paulette: Yes.

Howard: ‘She refers me people with broken teeth and cavities’.

Paulette: That’s fantastic.

Howard: All the dentists don’t see that, they only see what’s in it for them.  

Paulette: Well funny you should say that because I have actually set up a complete dental surgery in the front room of my house.

Howard: That’s how you doing it?

Paulette: Yeah. So I didn’t have shop front.

Howard: So you didn’t go rent space?

Paulette: No, I didn’t go and rent a space. I don’t have a shop front. I actually live in the village on the Mornington Peninsula and our population is less than a thousand people, unless it is summertime and we get an influx of holidaymakers. But I have a pool of clients that come in from about a fifty kilometre radius.

Howard: I’m an American, I don’t know what a kilometre is.  

Paulette: I don’t even know how many miles that is, maybe thirty-five miles.

Howard: We still measure horses by hands. Can you believe that?

Paulette: We do too. Our horse is about fourteen hands. Yeah.

Howard: Oh my God. Yeah.

Paulette: So we still do use that. So that model is great, I am the only hygienist that I know of that’s currently practicing, and I am not practicing independently because we are not allowed to. So we can’t have a provider number which means that people can claim their treatment with their health insurance. So our hygiene association is looking at their petitioning, and writing things so that the government can look at that as a potential future opportunity where a hygienist can have a provider number, provide a service and the customer can claim it on their health benefits. Whereas, currently now, people who come to me can’t claim, but because I don’t have significant overheads I can keep my pricing reasonable which is what they pay…

Howard: So you’re using all cash?

Paulette: No, they can do card payment. They just don’t get a rebate from their health benefits.

Howard: There’s no insurance.

Paulette: No.

Howard: So it’s credit cards or cash.

Paulette: Yes. Yeah. That’s where the dentist still has the, I suppose it’s not really control but it’s…

Howard: No, it’s control. Adam Smith was a Scot.  He was thirty-two in 1776.  He wrote ‘The Wealth of Nation’ which is very bizarre, because another thirty-two year old Scot wrote the ‘Declaration of Independence’.

Paulette: Yeah.

Howard: Thomas Jefferson. So two thirty-two year old Scots published in the same year. One was about free markets, Adam Smith, one was about free people. In America, it basically was the first time free markets collided with free people, and that was the American explosion experiment. But Adam Smith said in his book, in 1776, that whenever you see two men meeting, they are colluding against the masses. They’re restricting trade.

Paulette: Yeah.

Howard: When you ask, why are poor countries poor, it’s always corruption.

Paulette: Yes.

Howard: It’s not that America and Sydney aren’t corrupt, they’re just less corrupt than…

Paulette: Other areas.

Howard: Other areas. But they’re terribly corrupt. The American Dental Association, they don’t represent the patient. They represent the dentist.

Paulette: Yes.

Howard: But you were a pioneer, you were the first one that got legislation to be a hygienist in Victoria.

Paulette: Yes.

Howard: Congratulations.

Paulette: Thanks.

Howard: That’s pretty impressive.  

Paulette: That was actually in the beginning of my career.

Howard: So now you are ready for another one?

Paulette: At the end of my career.

Howard: End of your career? Oh my God.

Paulette: Bring it on.

Howard: You are one, you will live to be a hundred and three.

Paulette:  Oh well, my grandmother did.

Howard: Yeah.

Paulette: So we have good genes. Yeah.

Howard: In the United States women live five years longer than men.

Paulette: Yeah.

Howard: If you go into a nursing home, there is a hundred women and one man named Lucky. That’s why men should try and be healthy.  (12:28 inaudible).

Paulette: Yes.

Howard: If you make it to the nursing home.

Paulette: Imagine how lucky they would be.

Howard: They’re all yours.

Paulette: Yes.

Howard: So right now, in Australia, how many dentists do you think are in Australia?

Paulette: I think there is about fourteen thousand registered.

Howard: Yeah. I hear everything from twelve to twenty.

Paulette: Okay.

Howard: But what percent of the dentists have a hygienist?

Paulette: It’s getting more now, but probably one in five, maybe one in seven practices would have a hygienist.

Howard: Yes, so…

Paulette: So it’s not significant.

Howard: In the United States eighty percent would have a hygienist.

Paulette: Yeah.

Howard: At least more hygienists in the United States would have two or three, as opposed to how many in Australia? Why is that?

Paulette: I hate to say it, but I think often dentists feel threatened by having a hygienist in their practice. You’re taking the workload away from them. There is a glut in Australia of new graduate dentists, because we have opened a significant number of dental schools and for a period of time, new graduate dentists have been paid less than new graduate hygienists. So they see that putting on a new graduate dentist can provide more services than a hygienist, and it’s costing them less money, they’re generating more income. They are often choosing a new grad, and the new grad often just ends up doing hygiene work until they can build their own portfolio of clients. So there’s a bit of an imbalance at the moment.  

Howard: Every dentist I talk to here says, if I run an ad for a hygienist I will get four dentists applying for every one hygienist.  

Paulette: Yes, absolutely. Yes.

Howard: Yeah.

Paulette: Yeah.

Howard: So who gives the better cleaning?

Paulette: Oh hygienists, of course.  

Howard: Explain why. A lot of dentists might think, ‘oh, you’re a cynic because you are a hygienist’.

Paulette: Well.

Howard: It’s a tribal answer, but what do you think the real answer is?

Paulette: It’s a long story but I will keep it short. When I graduated as a hygienist we had a little box at the end of the row of our dental bays. They said, that thing there, that’s a Cavitron. Brand name, ultrasonic unit and you only use that for people who have got significant amounts of supragingival deposits on their teeth. That’s like the jack hammer for cleaning patient’s teeth. Where we focussed was using hand instruments. We were using them quite refined, they were very delicate, and their application approach of instrumentation was the thing that we practiced consistently.

So when I went out into private practice I didn’t pick up an ultrasonic because it was a bit scary. Then, actually a guy from the US called Tony Adams came to Australia and he developed a really nice long, slim ultrasonic insert and all the Australian dentists went ‘he is a crazy man, what planet is he from?  You can’t instrument subgingivally with an ultrasonic’. So I went and did his course and I thought he was amazing and used ultrasonics ever since. Then when I started with Dentsply I went to the US, to their manufacturing plant where they make the ultrasonic inserts.

Howard: Was that in Pennsylvania?

Paulette: In Pennsylvania. Fantastic. That was just the best trip I had. They showed us how to refine our techniques with the ultrasonic. So we really learnt to use the instrument appropriately. Prior to that, it was turn it on full blast and bang it against the teeth, shadow the calculus off and the patient goes through the roof. It’s extremely painful and the screech of the ultrasonic, people just didn’t like it at all.

Since then, I think, with the training in the schools and the hygienists have used the instruments, we’re more refined with our skills. We’re using the instrumentation appropriately, and patients it’s more gentle. We take our time, we’ve got more time to do a clean. I am lucky because I work for myself but I wouldn’t see a patient under an hour. It would take me an hour to do an ultrasonic, a little bit of hand scaling and a profeel oral hygiene instructional, whatever I need to tailor for that particular person. The feedback I get constantly is ‘wow, I have never had my teeth cleaned like that before’.  

Howard: Do you still here that now, thirty years later?

Paulette: Yes, yesterday. Patient yesterday ‘I don’t want to get my teeth cleaned, I’m freaking out, haven’t been to the dentist for three years just because I’m terrified of getting my teeth cleaned’. So she came in, she had earplugs, music, she had taken a couple of tablets before she came in, so she could really relax. She just went ‘that was unbelievable. Book me in for six months, I am back here’. Didn’t blink an eyelid the whole way through the procedure. I think that’s the thing, we just take our time, we’re using our instrumentation effectively and appropriately. There is always going to be the hygienist that probably might be a little rough and heavy handed, but generally I think that’s our skill that’s what we good at, and that’s what the patients come to us for.

Howard: How many dentists do you think you’ve worked for in thirty years?

Paulette: Maybe ten.  

Howard: Ten?

Paulette: But that includes working at the dental hospital in the periodontics department where there is a couple of specialists that I was working with.

Howard: One thing with dentists is they always have to reinvent the wheel. It’s so easy to learn a lesson in a book, as opposed to sticking your tongue in a light socket and have to learn the hard way. So many hygienists and dental assistants work in so many offices. What would you say was things that dentists did in the more successful offices, that they didn’t do in the least successful offices? You say you’ve seen ten, obviously some were better than the others. Working in ten different dental offices, what do you think the smarter dentist did?

Paulette: I think their staff communication and appreciation that was significant. Where you worked in a practice and they were pushing the patients through, and you didn’t see enough patients, you didn’t charge that one for the toothbrush, you’ve had a break for fifteen minutes when you could have been doing something. The attitude of not trusting, you’re giving someone a job so let them do their job and let them do it well. Mentor them if you are not happy with what they’re doing and give them some positive feedback. Those practices, where the communication was really good and the dentists were really supportive and they work well as a team, fantastic.

Howard: It’s always the soft stuff.

Paulette: Yeah.

Howard: It’s never the equipment, it’s never the diplomas.

Paulette: No.

Howard: It’s never the degrees.

Paulette: No.

Howard: It’s never…

Paulette: Yeah.

Howard: Did you go to the best dental school and graduate on top of your class, or the worst dental school and the bottom.

Paulette: Yeah.

Howard: It’s never any of that, is it?

Paulette: No.

Howard: It’s always the people skills.

Paulette: Yes. Absolutely. A couple of people have called me this week wanting to come to your presentation in Australia, and they’ve said ‘Paulette, we’ve heard you speak and whatever, and I want you to speak to my staff and tell them about this presentation on Sunday, because I really want to get them pumped and excited’. Just empowering his staff, he is not just saying to them you need to go on Sunday, in your own time, on a Sunday, go to this course. He was really, I want them to be pumped, enthusiastic and excited. I’m flying the up there and I want them to be part of the programme. Take them under your wing when they get there and look after them. Like, I want to work for that dentist. He loves his staff, and he is showing them that he loves them. Really empowering them to be confident and work effectively and help build his business for him. Of course they are going to if he treats them like that.

Howard: I want to tell you, when you go to any course, be it root canals, crowns, ortho, practice management.

Paulette: Yeah.

Howard: The dentists are bringing their whole team. Those guys take home twice as much money.

Paulette: Absolutely.

Howard: As the guy comes by himself to save the money.

Paulette: Yeah.

Howard: They just don’t get that.

Paulette: No.

Howard: When someone calls the office, the dentist isn’t answering the phone. The front desk is answering all the questions on orthodontics, implants, everything.

Paulette: Yeah.

Howard: This was unique for me because you had me lecture on a Sunday.

Paulette: Yes.

Howard: I hardly ever do that because the Christians, the Sabbath is a Sunday, the Jewish people, the Sabbath is a Saturday.

Paulette: Yeah.

Howard: The Muslim’s Sabbath is on a Friday.

Paulett: Okay.

Howard: So what was the thinking on a Sunday?

Paulette: Well to think back, I’ve run a couple of short courses previously, and it’s been of an evening trying not to encroach too much on people’s…

Howard: Clinical time.

Paulette: Personal and family time.

Howard: Oh, family.

Paulette: The feedback has always been Sundays would be good. There is no kids sport. We don’t have Saturday morning practice. If I know about it well enough in advance I can plan for it. People like the idea of a Sunday, so okay let’s do Sunday.

Howard: Well you are an original.

Paulette: Yeah.

Howard: I think in thirty years this is the only time I have ever lectured on a Sunday.  

Paulette: Really?

Howard: Was for you. Yeah.

Paulette: Wow.

Howard: Yeah, and it’s funny those religious day’s the Sabbath because way back thirty years ago, Manhattan is predominantly Jewish.

Paulette: Okay.

Howard: In New York City.  One of my friends, Barry Musikant…

Paulette: Yes.

Howard: Barry Musikant said ‘we open up seven days a week’. Everybody said ‘you can’t do that, this is Manhattan, it’s all Jewish, no one will come on Saturday and no one will work for you on Saturday’. He said ‘no, we’re seven to seven, seven days a week. It’s Manhattan’.

Paulette: Unbelievable.

Howard: ‘There’s people that need a root canal seven days a week’.

Paulette: Yes.

Howard: Guess you has the largest endodontic practice?  

Paulette: He does

Howard: In all of Manhattan.

Paulette: Yeah.

Howard: The only guy who said ‘no, you can open on the Sabbath in Manhattan because people have toothaches on the Sabbath’.

Paulette: Yes, and they will come. There is an endodontist near us on the Peninsula. She is the only endodontist for miles. She books you in at eleven o’clock at night if that’s when you need to come. She has got a family, so she does family stuff during the day and she runs her clinic whatever hours are necessary to fit the people in.  I must admit, I do that too if someone wants to come on a Sunday.

Howard: What I did when I opened up my practice, I put up all my kids for adoption and gave them all away.

Paulette: Yeah.

Howard: They came back after college.

Paulette: Okay.

Howard: So I didn’t have to…

Paulette: Worry about… Yeah.

Howard: Raise them, didn’t have to pay for college.

Paulette: You could just go and work hard?

Howard: Yes. I’ve only known Ryan for just a couple of years now.

Paulette: Five minutes.

Howard: If you ask every consultant in America who’s been doing dental office consulting for ten, twenty, thirty years, say. What is the number one problem in every office? When you go to an office, what is the biggest problem? They always say it’s staff, and they always say that there is at least one, possibly two, sometimes three completely toxic, cancerous employees that have to go. Everybody says that. Then I ask you, you’ve worked in ten offices what was the most important thing, and you said ‘how they deal with staff’. Why do you think a consultant can go into a dental office and find out that Mary-Lou is completely toxic cancer, and the dentist doesn’t know. He has been working with her for five years. Why is that such a problem with dentists?

Paulette: I just don’t think they like confronting situations. I have been in a situation where we all know there is an issue, how do you deal with it? Perhaps now I’d deal with it better than I would have previously, and I can see dentists might say ‘well she works with me and I am fine and I am happy with that, if she doesn’t want to scrub her instruments, and someone else has to do them, and everyone else is upset about that, but I am okay’. We have an expression in Australia called ‘pull the ladder up jack, I am up’.

Howard: Pull the ladder up jack, I’m up.

Paulette: Pull the ladder up jack, I’m up.

Howard: What does that mean?

Paulette: For example, if you climbed up onto the roof, and three more people needed to climb up onto the roof. Well I’m already up there so I am going to pull the ladder up, and you find your own way up onto the roof.

Howard: So pull the ladder up jack, I am through?

Paulette: Yeah. I’m good.

Howard: I’m good.

Paulette: I am all good.

Howard: I am good?

Paulette: I am good, I don’t care what happens to the rest of you.

Howard: So pull the ladder up, I am good.

Paulette: Yes.

Howard: To hell with the rest of you.

Paulette: Yeah.  

Howard: Yeah. What percent of the time is the toxic person, doctor’s favourite? How many times have you seen that? Or, you’ll see this massive turnover.

Paulette: Yes.

Howard: Nobody stays around in two years, except doctor and the toxic lady who’s been there twenty years.

Paulette: Well you do wonder.

Howard: The only person that has been here, doing all that turnover.

Paulette: Yeah.

Howard: Is the one that everyone knows is toxic one minute into the office.  

Paulette: Well I’ll tell you a story. Working in the teaching environment, there was some people that had been there for twenty years, and staff had come and gone around them because they couldn’t work with that particular person. The University just went ‘we can’t even deal with that, we don’t even know where to start dealing with that, we don’t know how to deal with it. We can only suggest that they might do this or that or the other’. But all the really great staff and team members and even the students, students were leaving in droves because they ‘we don’t want to have that teacher’. Staff were leaving because ‘we can’t work with that person’, and that person still stayed.  

Howard: It is so sad.

Paulette: Yeah.

Howard: Americans they talk about both sides. They demand customer service.

Paulette: Yes.

Howard: But then they always vote in these government unions for teachers and government workers, and in American schools they get tenured so they can’t even be fired after a certain time.

Paulette: No.

Howard: The government employees from labour unions it’s like ‘okay, so you want customer service’, but then everybody bitches about the horrible customer service at the government.

Paulette: Yes.

Howard: At the Department of Motor Vehicles, but then you always vote for people who are pro unions.

Paulette: You wonder why things don’t change.

Howard: Yeah. Yeah. You can’t have your cake and eat it too.

Paulette: No.  

Howard: So dentists just don’t want to confront?

Paulette: Or they don’t know how to. We joke about how dentists learn how to be not very nice people at University. It’s like ‘be a bad dentist 101’. The DA’s in Australia, that’s what they do. My dentist learnt how to be, I probably can’t say the word.

Howard: You can say the word

Paulette: My boss is just a price. He is a prick.

Howard: He is a prick.

Paulette: Yeah, and he learnt to be a prick at Uni. That’s what they say. He went to that class 101 because they just don’t have good people skills. They are not good at talking to people. Sometimes you find even in their communication with their clients, and I have seen it because when I am out assessing students in the workplace. I observe how the dentist communicates with the client, and they’ll say ‘well, I’ve just examined your mouth, you need four fillings, a root canal and three crowns, just go out the front and make an appointment with the girl at the desk. I’ll see you then when you are booked in to do that’.

There is no communication. How do you feel about that? Were you aware you had a problem? Financially, these are some options we could look at. This is urgent, this can wait. How does that fit in with you? There is no communication. It’s just yes, you need to have stuff done so go out there and make the appointment.  Then wonder why the patient just pays the account, walks away and doesn’t come back.  

Howard: Yeah. The dentists don’t even want to accept that. Where you have data, we are just on cavities.

Paulette: Yeah.

Howard: Not veneers and implants.

Paulette: Yeah.

Howard: They only drill, fill and bill thirty-eight percent of the diagnosed cavities. They can only get one out of three people with a cavity.

Paulette: Yeah.

Howard: To get a filling.

Paulette: The ones that do well have got the lovely dental assistant sitting with them and they’re giving her the love, and the warmth, and we really care about you, and I am going to nurture this relationship. The patient if they do come back, is coming back because the dental assistant is the one who is showing them love, and they’re trusting that person. They don’t feel threatened by a dental assistant, where the dentist is on a pedestal up here. They want to ask questions, they don’t question the treatment plan, they just go ‘okay, that’s what the dentist said’. The dentists will leave the room, and they will say ‘so really, what’s the story with that, can you tell me more about that?’ The dentist walks back in the room and everyone is like this again, the dentist is back, we can’t talk. It’s a shame because if the dentist could establish that rapport and build that relationship, and show them the love they would have patients queuing up at the front door.  

Howard: Yeah. I was telling you, when I grew up my mom made us go to Catholic Mass every single day from birth until you left home. So for seventeen years, every single day, and I never once saw anybody raise their hand and ask the priest a question. They don’t ask doctors and priests. Everyone that ever bitches about the president, and I’ll say ‘well did you send him a letter?’ ‘No, I just bitch’.

Paulette: Yes.

Howard: I have sent the president so many well-intentioned letters. I always wondered if my phones are bugged. I wasn’t going to sit there and bitch about Reagan, Bush forty-one, and Clinton, and Obama, I was just going to tell them.  

Paulette: Yeah.

Howard: This is obvious.

Paulette: Yeah.

Howard: I sent my senator several letters. When you ask a patient do you have any questions? They say ‘no’. Then you turn on your phone recorder and you leave it there and you leave, and then they turn their hygienist or their assistant and they got six, seven, eight questions.

Paulette: Absolutely.

Howard: Then those doctors aren’t taking those two to the continued education course on root canals, fillings and crowns. Then the receptionist is actually answering the most questions.

Paulette: Yes.

Howard: They don’t even believe. You go to a dentist and say, what percentage of your diagnosed treatment actually gets done?

Paulette: Yes. Yeah.

Howard: He will say, I don’t know, ninety, ninety five percent, you’re just like, wow, you’re on a different planet.

Paulette: La La Land.

Howard: You’re in La La Land. For one nobody on earth has ever had a ninety percent success rate since Adam and Eve.

Paulette: Yeah.

Howard: There is a dentist here in Parsons, Kansas he is the guy.

Paulette: Yeah.

Howard: His average status stays with him three years and he’s got a ninety five percent, yeah. They don’t know what they don’t know.  

Paulette: No. That’s it, unfortunately. That’s why I think my local dentists, if they were clever, they would show me a bit of love, I think, because the patients are coming to me saying ‘I haven’t been to the dentist for ten years, or five years, or even three years, or in the last twelve months. But I don’t want to go back there because they said this, this and this, and I wasn’t happy with that. I’m looking for a new dentist, who should I go and see?’

I’ve got a group that I refer to and I know that this dentist does that well and this dentist does that well. I can say, I think you might be a good match with such and such because of this reason, and it works out really well. I have sent the dentist a letter to say ‘please accept Mrs such and such as a new patient, this is what we have discussed, this is what she is looking for’, because we’ve already had that connection and the referral, there is a little network happening. The patient walks in on a different foot. They are treated slightly differently.

Howard: They come in with trust.  

Paulette: They come in with absolute trust. I’ve got trust in Paulette, she sent me to you and now I’m trusting you. Whereas, if they went in just off the street that would be a completely different scenario.  

Howard: Your website is pearlywhiteprofessional?

Paulette: Yes.

Howard: Do you sell a bleaching product? Or is this Geoff Knights?

Paulette: Well this is Jeff Knight’s. I don’t have my own bleaching product but, funnily enough, when I started out in my practice I had been using a system in private practice in lots of sensitivity and the results were a bit up and down. I thought, if I am actually going to run a teeth whitening and hygiene studio I need to be more consistent, and really confident in the services that I am offering. So Mr Google, my favourite, actually identified a product from the US.  A dentist in the US had invented, for one of the better words, done the research and the development and this product had been around and was made in the US.  It was in Europe.

Howard: What is this called?

Paulette: It’s called Beyond. Beyond This, Beyond Max, Beyond Polis, Beyond White.  

Howard: Have you got that Ryan?

Paulette: And they…

Howard: What is it?

Paulette: Beyond. B-E-Y-O-N-D.

Howard: It’s Beyond Max.

Paulette: Yes, the brand name is Beyond.

Howard: It’s bleaching?

Paulette: Yeah.

Howard: So it is a bleaching product.

Paulette: Yeah. The crazy thing, they won best dental whitening system with dental advisor, fifteen, sixteen, seventeen and now 2018, and we don’t have any in Australia. We have good products in Australia, like we have got SDI, an Australian whitening, go to company.

Howard: SDI?

Paulette: SDI, Southern Dental Industries.

Howard: Oh, Southern Dental Industries.

Paulette: Yes, they do great.

Howard: Out of Melbourne.

Paulette: Yeah.

Howard: They’re the largest amalgam manufacturer in the world.

Paulette: I believe so. Yes.

Howard: They’re rapidly diversifying to composites.

Paulette: Yes. Yes, and they’re developing. They’re doing a lot of research and development in a few different areas.

Howard: Yeah.

Paulette: That is a good product as well. But I really liked my Beyond stuff from the US, so I just bring it in from the US now. It is registered in Australia, so I can use it. I don’t know, I love it. I get really good results. I also base my system on another US guy who has a protocol that he uses with his own brand of products and I’ve implemented my own …

Howard: And what was that?

Paulette: Kor Whitening.

Howard: With Rod Kurthy?

Paulette: With Rod Kurthy.

Howard: I think he has thirty thousand posts on DentalTown.

Paulette: Well there you go.

Howard: Yeah.

Paulette: His system for whitening is great and that’s why I love using it. This is a Jeff Knight innovation, these medical grade silicone trays. Now if I am doing an in-office whitening, I will get them to do a pre-whiten with the trays. I will do the in-office whitening, and then I will stabilise and lock it in with the post-whiten. It’s a really good system, and I am getting more predictable results with that.

Howard: So the website is beyonddent. Is that the people making the bleach in your kit?

Paulette: This is Jeff Knight. I mix it up and do my own thing using different products from different companies. So the best of a couple of different companies and I’ve put my own protocol together. This is an Australian product from Professional Dentist Supplies.  

Howard: So Jeff makes that? Jeff Knight?

Paulette: Yeah.  

Howard: What is that, carbamide peroxide?

Paulette: This is carbamide peroxide.

Howard: What percent?

Paulette: We’ve got a ten and a sixteen. We use that because the clinical studies all show that carbamide peroxide is the most effective whitening agent, over a longer period of time. It’s annoying for the clients because they want quick fix whiten, but from a predictability perspective, no sensitivity and long-term results, the carbamide is the best. I use a combination.

Howard: You do the pre-bleaching with the trays?

Paulette: Yeah, two days.

Howard: For two days.

Paulette: Yes.

Howard: Then you do the in-office bleaching.

Paulette: Yes.

Howard: For one hour?

Paulette: One hour.

Howard: Then post off.

Paulette: With my Beyond.

Howard: With Beyond.

Paulette: Yes.

Howard: Then post?

Paulette: I get them to do two or three days of carbamide. It stabilises it and locks it in so they get really good, nicely hydrated enamel and really good, predictable whitening results, with little or no sensitivity. Then they’ve got these trays, so they can top up their whitening down the track with the gel.

Howard: One of the nice things about these pre-made trays is now you don’t have to have aldomets, portstone.

Paulette: I was making my own trays.

Howard: Suckdown trays. That’s crazy.

Paulette: So the time and expense involved.  

Howard: How much do those trays cost?

Paulette: The dentist would buy these for about $90 for the whole kit.

Howard: What I learnt about that is, good Lord, to have the assistants go set up the aldomets, take the aldomets, then go back there and pour the models, then set up for an hour, then trim the models.

Paulette: Yeah.

Howard: Do the suckdown. That’s an hour.

Paulette: The dentist needs to run through, if you’re doing take home whitening with the patients, that’s dentist or hygienist chairside time, plus the lab time, plus the components and the trays that they are paying for, so the average take home whitening in Australia is around $275 to $450, for the trays and the gel. You can sell this at the front counter. You could have this sitting on the counter. The patients can ask about it, purchase it, take it home for under $150.

Howard: What is your suggested retail price?

Paulette: Around $150. Australian.

Howard:  So it costs $90 Australian.

Paulette: Yes.

Howard: You sell it for $150.

Paulette: Yes.  

Howard: At the counter.

Paulette: Yes.  

Howard: Nice.

Paulette: Yeah. There is no costs involved. We have a legal requirement that you can’t sell anything more than six percent hydrogen peroxide to a client. If you buy whitening products in a pharmacy, in a supermarket or at the beauty salon, it has to be less than six percent. Only a dental professional can prescribe more than six percent or provide a treatment with more than six percent, because it’s carbamide, it’s under the six percent limit, you can have it at the counter at the DA’s.

Howard: Did you hear that went all the way to the United States Supreme Court.

Paulette: No.

Howard: Yes. Last year, I think it was North Carolina or Tennessee, one of those. There were people selling bleaching at the mall. The Dental Board filed suites, you can’t do that anymore.

Paulette: Yeah.

Howard: They filed back and said ‘we’re not under your jurisdiction, you’re dental’, and they said ‘well that’s our space and you can’t do it, only dentists can’. It went all the way to the Supreme Court, and the Supreme Court said that Dental Boards usually act as a good old boy club for their people they’re regulating, and that’s a restraint of free and fair trade.

Paulette: Yeah.

Howard: There was another landmark decision in Texas, where some guy declared himself a specialist in implantology, and the American Dental Association said ‘no, we only have nine specialties and implantology is not one of them, so you can’t say that’.  

Paulette: Wow.

Howard: They sued him, and it went all the way to the Texas Supreme Court, and the Texas Supreme Court said ‘who is the American Dental Association? You’re not government agency, you are not regulatory agency’.  

Paulette: You can’t make those decisions.

Howard: So you can kick him out of your club. In fact this guy is a specialist in implantology, that’s all he does.  

Paulette: Wow. So he’s restricted his practice to implantology.

Howard: Yeah. So the American Dental Association…

Paulette: Yes.

Howard: Is starting to realise they are a club, they’re just a membership club. The State Boards are realising that you just can’t pass laws so that the dentists get more business.

Paulette: True. Wow.

Howard: You have to create more competition.  

Paulette: We had a case in Australia where a beauty therapist did teeth whitening and burnt all the gingiva of the client. The client obviously complained about that, and that was the point where they went ‘right that’s it, this is the restriction’. Lots of dental companies were already selling much stronger whitening products. A lot of companies went out of business at that point, because they could no longer sell their products to the general population.

Howard: Ultradent makes Opalescence.

Paulette: Yes.

Howard: Dan Fischer spent well north of a million dollars in legal fees trying to get it approved in the United Kingdom.  

Paulette: Wow.

Howard: The United Kingdom they just…

Paulette: Wouldn’t.

Howard: There was just one guy who said ‘no, dentists should not bleach teeth’.  

Paulette: That was it.

Howard: Again that is a dentist…

Paulette: Yes.

Howard: Shooting their own profession in the foot.

Paulette: Yes.

Howard: You say ‘well who kept dentists from bleaching in the United Kingdom?’ It’s a damn dentist.  

Paulette: Yeah. A couple of my clients are beauty pageant people, they have won Miss Australia, one went over to the US last year for the Miss Universe.  

Howard: Did she meet Donald Trump?

Paulette: Not that I know of. They bring in Crest Strips from the US because Crest stopped selling their teeth whitening strips in Australia, and they are slightly stronger than the ones that are available currently in Australia from a different company. So there is a guy in Regional Victoria that brings in a shipment of it once every few months, and all the beauty people buy direct from him to get their teeth whitening strips, he’s quite well known in the industry. There is always ways around things highly illegal. But people are buying it and he keeps bringing it in.

Howard: If drugs can make it into Australia, I am sure that teeth whitening strips…

Paulette: Teeth whitening strips.

Howard:  Can make it through.

Paulette: Absolutely.

Howard: I think it is so funny how dentist always talk about laws like ‘well it’s illegal for hygienist to diagnose’. I’m like ‘Dude, there is a thousand pounds of heroin and cocaine…

Paulette: Yes. Yeah.

Howard: In Phoenix, Arizona and you’re worried about your hygienist reading an x-ray. Well your husband’s a police officer so…

Paulette: Yes. So we know…

Howard: So if they banned all guns, who would be the only people with guns?  

Paulette: Well, the police officers and everyone else who wanted them.  

Howard: Who would be the criminals?  

Paulette:  Yeah.

Howard: Right?

Paulette: Well, that’s it. They would just get them…

Howard: Right.

Paulette: From wherever.

Howard: Yeah.

Paulette: As many as they want to.  

Howard: The interesting thing about these beauty pageants, I have seen this in thirty years, I’ve seen it about a half dozen times in thirty years. Where girls are eighteen, nineteen, twenty, twenty one and they are trying to be a model, and they pull their lower molars to accent their zygomatic arch. They want their mandible to sink in.

Paulette: Sink in.

Howard: So their cheek bones get bigger.

Paulette: Wow.

Howard: I know one girl who, when she pulled her wisdom tooth, pulled all three molars on the bottom of each side, and then got cheek implants on her zygomatic arch because she wanted this very accented deal.

Paulette: Wow.

Howard: I just want to say for the record, when you look at my face it is all natural. There’s no botox here. I am not even wearing a wig.  

Paulette: There you go.

Howard: This is all natural. That’s commitment to modelling…

Paulette: Yeah.

Howard: To pull all your molars.  

Paulette: That is incredible, I haven’t heard of that one.

Howard: So they could order all of those?

Paulette: Oh yes, so these are available only through the dentist. We are not selling them through a pharmacy or anything like that.  

Howard: What website would they buy on?

Paulette: Professional Dentist Supplies is a wholesale manufacturer, we don’t sell direct to the public.  

Howard: But do you sell direct to dentists?

Paulette: We sell to people like Henry Schein in Australia.

Howard: So you only sell to the distributors.

Paulette: We sell to the distributors.

Howard: Yeah.

Paulette: Amalgadent, Adam Dental, Medident, the big…

Howard: In America about seventy-five percent sell through distributors, like Henry Schein, and twenty-five percent sell direct. What made you want to go through distributors instead of selling direct?

Paulette: I think it’s just got much bigger reach. PDS has been established for thirty years, and so we’ve got a good distribution network with the big companies in Australia, and the little companies, for that matter. I can do training with staff at the companies, and train five or ten people and they’re going to go out and each talk to another twenty or thirty people. Whereas, if I was out on the road trying to sell direct to dentists, I am not going to have the reach that I have got going by these main distributors.

Howard: What do they use to mark it up? If you sold them for $1, what would they sell it for?

Paulette: Ten.

Howard: $10? The mark it up tenfold?

Paulette: Sometimes, if there is enough margin in it. Some of the things might go one or two dollars. Their markup is often around seventy to eighty percent.   

Howard: Wow, that is amazing. It’s a mixed business because I see, like you used to work for Dentsply.  

Paulette: Yes.

Howard: Dentsply have some divisions, like Pulse Dental Product, which is their endodontic division, they sell direct. Then there are other divisions like Kok, who only sells through distributors.

Paulette: Yeah.

Howard: Then I think the bizarrest strategy is, Henry Schein won’t let any of their companies list their products on Amazon. If you list on Amazon they won’t carry you.

Paulette: Okay.

Howard: But Henry Schein.

Paulette: Lists them on.

Howard: Sells all their Henry Schein…

Paulette: Products.

Howard: Sundries on Amazon.

Paulette: On Amazon.

Howard: It’s like, what?

Paulette: Yeah.

Howard: So you can buy all the Henry Schein generics on Amazon. But if 3M or Dentsply, or Ivoclar, they listed their stuff on there, Schein will throw a hissy fit.

Paulette: Incredible.

Howard: So we’re living in strange times.

Paulette: We are. Yeah.

Howard: The first thing I thought is, I’d have it on Amazon in an hour.  

Paulette: Maybe down the track we will develop a consumer version that we do sell direct to the public. We might just move it around a little bit, do something a bit different. We’ve set it up, for example we’ve got these QR codes now on our products, so that someone can scan that code and it takes them directly to a YouTube video about the product. People are going to be seeing these things on social media, on Facebook, on Instagram. There is a company in Australia that do the ‘I just used my pearly white product and look at my teeth’. They do the groovy blue light thing and everyone loves it.  Maybe we will add a blue light to it and sell it to the public and do the same social media marketing.  

Howard: Since the light has zero research. All the research on light has no effect.  

Paulette: Right, but people love it.

Howard: Yeah.

Paulette: That’s all that matters.

Howard: You should show the first bleaching that works with your smartphone flashlight.  

Paulette: No, there already is one. There is one already.

Howard: That uses… Yeah.

Paulette: Yes. Actually, you plug a connector into the end, into the microphone jack and it’s a little mouth piece like that.  It shines on your teeth…

Howard: Nice.

Paulette: After you have put the gel on. Perfect.

Howard: Nice.  Since it doesn’t do anything anyway, might as well just keep (inaudible 50:34).

Paulette: Yeah, people love it. You’re using your smartphone.

Howard: Yeah.

Paulette: It’s amazing.  

Howard: What else are you and Jeff Knight doing? Is it mostly the bleaching, the now?

Paulette: We’ve got a chlorhexidine product, we call it chlorofluid gel. It’s a chlorhexidine fluoride gel. It’s been around in Australia for about thirty years and it’s a go to product for patients who have gingivitis, and who have had periodontal treatment or mouth ulcers. We’ve all got those patients, when you look in their mouth they have got generalised bleeding, and they say ‘but I brush and floss, I do that every day’. They’re the ones that you go ‘well, if you just use this gel, it’s going to make all the difference, and you can still brush and floss every day, but brush and floss with the gel’. The chlorofluid gel helps to eliminate the nasty bacteria that is causing the gingival bleeding and irritation.  They get great results with that.  

Howard: Well one of the things that always had me excited. When you talk about carbamide peroxide between ten percent and sixteen percent. What I noticed the first five years out of school, is that if you didn’t floss every day and you had a mild gingivitis, bleach would burn like hell and you would say that it is very sensitive.

Paulette: Yes.

Howard: But the people who had no bleeding points, and you brush and floss every morning, and floss every night, they were fine. I always plant the seeds in my patients. I say ‘this bleaching, on me and my staff, there is no sensitivity. But everyone who is not a hard-core flosser that bleach is going to get in there’.

Paulette: Yes.

Howard: It’s going to sting.

Paulette: Yes.

Howard: It’s going to be sensitive. But I notice it was therapeutic. When you would bleach someone’s teeth, you would also really…

Paulette: See improvement.

Howard: See improvement…

Paulette: Yeah.

Howard: On their gingivitis…

Paulette: Yeah.

Howard: And bleeding.

Paulette: Yeah.

Howard: So what I like about the bleaching tray, do you use the same tray on the chlorhexidine fluoride? The gel?

Paulette: We haven’t recommended that you do. The ones we use for the chlorofluid gel are custom trays just so that it is not leaching out into the mouth and you are not swallowing it.  

Howard: But is it the same tray as the bleaching?

Paulette: We don’t have a tray. The chlorofluid gel we sell it individually. But because chlorhexidine is known to cause surface stain on the enamel, we sell it in a kit with a carbamide peroxide gel. You can either just brush it on, so you brush and spit, or the dentist can make a custom tray to put the gels into. That’s different to this tray. But it’s a good idea.  

Howard: Chlorhexidine does not stain teeth. It stains plaque. What I read about Paradex, is they’re coming out saying ‘this is stinging my teeth’. I would say ‘really? So I set them up in the chair, I’d raise the chair, I’d give them the mirror and I’d just take a toothpick. Then it would be ‘this is brown, especially in between the teeth’.

Paulette: Yeah.

Howard: I take a toothpick and I just wipe it off. I say ‘look, this stain’s plaque’.

Paulette: Yes.

Howard: ‘That’s why you have gum disease. You’re not removing your plaque’.

Paulette: Yeah.

Howard: That was another thing that I learned out of the gate, would you rather cut a two by four in half with a hand saw or a power saw? Some of those people, the only way they can make chlorhexidine not stain their teeth, is with an electric toothbrush. Especially if they were sixty, seventy, eighty years old, rheumatoid arthritis.

Paulette: Their manual dexterity’s difficult. Yeah.

Howard: Not quite right in the head, slow, old, elderly. They have puffy fingers and they are going like that. They can’t remove plaque.

Paulette: No.

Howard: Then you watch some kid in college, like I watch my boys brush their teeth, I am surprised sometimes their teeth don’t fly out of their head. Oh my God, you’d think somebody was going to die when he is brushing his teeth. But that can’t happen when you are sixty five.

Paulette: No.

Howard: Seventy five, eighty five, rheumatism, arthritis. So I really enjoyed the Paradex stain as a teaching moment.

Paulette: Yes.

Howard: That says ‘you have gum disease and that’s because you are not removing this plaque’.

Paulette: Yes.

Howard: Are you a fan of the electric toothbrush or do you just like manual? What do you like?

Paulette: My favourite toothbrush in the whole world is the Curaprox brush.  

Howard: The what?

Paulette: Curaprox

Howard: Can you send that? Curaprox?

Paulette: It’s called the Curaprox 5460, and it has five thousand four hundred and sixty bristles. So super tightly packed, small head, really soft.  

Howard: Who make is it?

Paulette: Curaden Switzerland, I think make them.

Howard: Switzerland?

Paulette: Yeah.

Howard: The Rolex?

Paulette: Rolex of toothbrushes, love them. They come in really funky colours.  I just buy those in bulk and give them to all my patients.

Howard: Did you find it, Ryan?

Paulette: I like the electric toothbrush.

Howard: So the Curaprox is a manual brush?

Paulette: It’s a manual brush.

Howard: Okay.

Paulette: Yeah, and it is really tightly packed with the super soft bristles.  Bucket loads of them. More than any of the brushes on the market. Yeah. So I’m a convert to the Curaprox brushes, I love them. They are my favourite.  

Howard: Curaprox ultrasoft toothbrush.

Paulette: Yeah.

Howard: At What’s

Paulette: They also make other products.

Howard: Is that a distributor? Is, is that a distributor?

Paulette:, I am imagining is a distributor in Australia. They’re in South Australia, and they distribute to all the major companies who then on-sell to…

Howard: What were you saying about the electric thing?

Paulette: Yes, the electrics are okay. I don’t love them.  

Howard: You’re not a big fan, are you?

Paulette: Yeah, I have got one. But I prefer the manual brush.  

Howard: And why is that?

Paulette: Good question. I have been using a manual brush for quite a few years, I think I just like the control and the tactile sensitivity. It’s the same as if you are instrumenting in a person’s mouth. Hygienists have got really good tactile sense so I can floss down the side of the tooth and feel a tiny little spicule of calculus. So when I am brushing, you can get the bristles right into round the areas that you need to get to, with control. As opposed to the toothbrush, often because of the vibration you are not getting that same sensation, so I like the sensation of the manual brushing.

Howard: Are you a fan of tongue brushing?

Paulette: Always.

Howard: Tongue scraper.

Paulette: Scraper. Always. Love them. My mouth doesn’t feel clean unless I have used a tongue scraper.

Howard: I am Irish and if I don’t swish with Jameson whisky straight out of the bottle, for sixty seconds swish and swallow.

Paulette: Yeah.

Howard: What tongue scraper do you like?

Paulette: Well there’s a company called, well I think it was called Therabreath. T-H-E-R-A. Therabreath. They went out of business. They had a mouth rinse called Chlorazol or Chorsol.

Howard: Chlorosis?

Paulite: Closys.

Howard: Closys, out of Phoenix. Was it out of Phoenix?

Paulette: I think it came in a kit with that Closys mouth rinse. I don’t think it is available in Australia any more. They came with these really flexible tongue scrapers, because I bought lots of them at a time I have still got a bunch of them. But I haven’t got enough that I can give them to my patients, and they would love them. So if you’ve got a contact, I would love to know.

Howard: So Closys was, back in the day, was Parry Radcliffe and Omar Reid.

Paulette: Okay.

Howard: Then Parry passed away and his son runs that company.  

Paulette: Okay.

Howard: But, yeah, we can…

Paulette: Their tongue scrapers, they’re a really nice, flexible plastic.  

Howard: Why do you think tongue scraping never took off to the degree of brushing, flossing took off?

Paulette: I just don’t think people are aware of it. What dentist tells you to scrape your tongue?

Howard: Only the people that try and manage bad breath.   

Paulette: Well that’s not very many then, is it?

Howard: Right. Same question, mouthwash. Are you a fan of mouth wash?

Paulette: Not really.

Howard: Why is that?

Paulette: If it’s a therapeutic mouthwash, I am a fan of it. Just a mouth wash for the sake of roll over and swish with Listerine when you wake up in the morning.  Just go and brush your teeth. Clean your teeth properly.

Howard: To be quite honest, if you were really a big fan of the research, the research says that toothpaste doesn’t even matter, it’s dry brushing.

Paulette: It’s the actual physical action of the brush.

Howard: Do you believe in dry brushing?  

Paulette: I believe in it but I don’t recommend…

Howard: Dry brushing removes all the plaque, but the patient wants whiter, brighter, sexier teeth.

Paulette: And fresh breath.

Howard: You don’t want to have morning breath. Yeah.

Paulette: Minty breath.

Howard: Yeah.

Paulette: My mom’s from an Island in the Indian Ocean.

Howard: (inaudible 60:21).

Paulette: From Reunion Island.

Howard: Your mom’s from Reunion Island?

Paulette: From Reunion. Yeah.

Howard: That’s French?

Paulette: Yes.

Howard: So you speak French?

Paulette: Yes.

Howard: Wow.

Paulette: So her toothbrush, when she was grown up, was a stick. They used to chew on the end of it. There is a name for them. They are called something like Sago Wackies, or Sag something.

Howard: Yeah. Big in Africa.  

Paulette: Yes, same. There was a lot of African in Reunion because it is off the coast of Africa.

Howard: Yeah.

Paulette: She is eighty and got all her teeth.

Howard: Yeah.

Paulette: Perfect.

Howard: In fact I have a YouTube video of when I was in Tanzania, I followed this guy and said ‘how do you brush your teeth?’ I followed him, he’s in his tribal (inaudible 61:05), I follow him into a tree.

Paulette: Oh yes.

Howard: He goes up in a tree, he whacks off a stick and he’s brushing. It is a very effective means. But the other thing about those guys is that they had a very paleo diet.

Paulette: Oh yes.

Howard: They ate meat, vegetables, roots. Basically they’re forced.

Paulette: Yes.

Howard: Then you go into the big cities.

Paulette: Yeah.

Howard: It’s coke.

Paulette: Flour, sugar.

Howard: Pepsi, flour.

Paulette: Yeah.

Howard: Processed foods.  

Paulette: There is a big difference.

Howard: Yeah.

Paulette: Yes.

Howard: Also really depending on where you are in Africa, because there’s a lot of areas where the lake water and river water is four, five or six part per million. So everybody has intense fluorosis around Tanzania. So you’ve a lot of spotted teeth.

Paulette: Yeah.

Howard: They don’t have any cavities. I will never forget because we went to work in an orphanage one time in Tanzania, and there is like three hundred kids. The home care was almost nothing and there was almost no work to be done because the all had fluorosis.

Paulette: Okay.

Howard: They had, I would say, moderate fluorosis, they had no decay.

Paulette: Incredible.

Howard: Yeah.

Paulette: Well that’s the thing with the dry brushing. I always say to my clients, toothpaste doesn’t clean your teeth. It’s the brushing action that makes all the difference use it, because it makes your mouth feel fresh. But you only need a tiny bit to get the freshness, the rest of it is a really good brushing action that makes all the difference, and some floss. Floss on a stick is good, anything to get in between your teeth and around so that you get rid of the bacteria, that’s all better than nothing at all.  

Howard: I am so honored to have you come on the show. To think you were the one who wrote legislation thirty years ago to get hygienists in Victoria. Here you are thirty years later trying to get independent practicing.

Paulette: Yes.

Howard: Hygienists. You’ve been a pioneer and a mover and a shaker for thirty years. It’s an honor to know you.

Paulette: Thank you, Howard, thank you.

Howard: Thank you so much for coming on the show.

Paulette: Can I just say? I saw you in Melbourne last week, and it was honestly the most entertaining, and business relevant dental presentation I have seen in thirty years. It was the way you present, and the interaction with the audience, and the stories that get the message across in such an entertaining way. But serious messages was really powerful, I don’t think I have stopped talking about it all week. I really enjoyed it. So I’m so looking forward to your presentation tomorrow.  

Howard: Alright.

Paulette: Fantastic, thank you.  

Howard: I want to just say one thing about a presentation. I have seen a lot of dental presentations.

Paulette: Yes.

Howard: The PowerPoint slide is a crutch. If I told you to give me a one-hour… How many children do you have?

Paulette: Three.

Howard:  If I told you to give me a one-hour presentation on your children, how many PowerPoint slides would you need?  

Paulette: Three.

Howard: Would you stand behind a podium?

Paulette: No.

Howard: Would you have handouts?

Paulette: No.

Howard: If you are speaking about a subject you love.

Paulette: Yes.

Howard: That’s why I think the greatest art form is stand-up comedy, because there is no props. There is just you and a microphone.

Paulette: Yes.

Howard: Its eye to eye contact and it’s in your face. It’s describing things so you can see it.

Paulette: Yes.

Howard: Without seeing a PowerPoint.

Paulette: Or reading stuff…

Howard: Yeah.

Paulette: On a screen, so blah blah.

Howard: You go to some of these presentations and they have three big screens.

Paulette: Yeah.

Howard: Three projectors, it’s like, okay, at that point.

Paulette: Enough.

Howard: You just need to go home.

Paulette: True.

Howard: If you are talking about a subject you love, a subject you are passionate about and you get rid of all the props. Now I learnt this earlier in my career, because back in the day when I started lecturing, Airlines were a mess and a lot of the times they lost your luggage. You had these big carousels of slides.

Paulette: Yes.

Howard: I would be travelling in sweats and a t-shirt and have that checked on in my luggage. Did they lose luggage? The first time it ever happened to me, I show up at the seminar and I’m in sweats and tennis shoes, I didn’t have any of my PowerPoint presentations and I’m like ‘oh my God, this is going to be horrible’. But the show must go on. I went out there and at the end of the day and I go ‘that was the best seminar I ever gave’.

Paulette: Yeah.

Howard: But then I went right back to all the PowerPoint bullshit, and all that stuff. Then about a year or two later they lost all my luggage again, and I went in there with sweats and tennis shoes and crushed it. It is sad because these people that put on the seminars will say ‘well, how was the PowerPoint presentation?’

Paulette: Yes.

Howard: ‘How was the handouts?’

Paulette: Yeah.

Howard: Everything they’re asking you to critique on.

Paulette: Yeah.

Howard: Is like, was he on the right drug? Was he drunk enough?

Paulette: That’s true.

Howard: Everything they are asking you about you shouldn’t even have.

Paulette: No.

Howard: It’s kind of like when they’re teaching you how to read food labels, if there is a label on the food, you shouldn’t be eating it.

Paulette: No.

Howard: There is no label on bananas and apples.

Paulette: No.

Howard: Steak and fish and chicken.

Paulette: Yeah.

Howard: It’s only on processed shit.  

Paulette: Absolutely.

Howard: So the story of reading labels, if it has a label don’t eat it.

Paulette: Yeah.

Howard: That’s what I tell people if they want to get into presentations. In a big city like Sydney or Melbourne they have comedy club lessons. These comedy deals have lessons where you will do it three nights a week for a month, and they have improv, because a lot of the people are afraid of the questions, because they don’t know what the questions will be.

Paulette: Yeah.

Howard: So go take an improv class. If you go learn the science of stand-up comedy and the science of improv, like I did as a student.

Paulette: Yes.

Howard: I went and learned it. I think it helps when presenting treatment because when you walk into the room with a new patient, just like when you walk out on stage on stand-up, or an improv, you’ve got about thirty seconds to establish likeability and trust.

Paulette: Yes.

Howard: They’re not going to say three or four minutes later ‘who is this fellow?’

Paulette: Yeah.

Howard: They just instantly decide do I like you, trust you, do I want to engage you?

Paulette: Yeah.

Howard: Or am I at the wrong place?

Paulette: Yeah.

Howard: Yeah.

Paulette: I’m switched off.

Howard: Yeah.

Paulette: Yeah.

Howard: Take it back to your dating days. How many times were you on a date and five seconds into the date you are like, this is a really bad idea.  

Paulette: I need to get home.

Howard: Especially for me, because my first five dates were all five of my sisters, and I sat there the whole time hoping to God my dad finds out. But thanks so much for having me.

Paulette: Thanks.

Howard: Can’t wait to see you tomorrow.

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