Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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940 Orthodontics and General Dentistry with Dr. Brock Rondeau : Dentistry Uncensored with Howard Farran

940 Orthodontics and General Dentistry with Dr. Brock Rondeau : Dentistry Uncensored with Howard Farran

2/6/2018 6:56:08 AM   |   Comments: 0   |   Views: 859

940 Orthodontics and General Dentistry with Dr. Brock Rondeau : Ahwatukee Uncensored with Howard Farran

Dr. Rondeau is one of North America’s most sought after clinician who lectures over 100 days per year. Over 23,000 dentists have attended his courses and study clubs in the United States, Canada, China, Australia, England, Turkey and Poland. He has an extremely busy practice, which is limited to the treatment of patients with orthodontic, orthopedic, TMD, and snoring and sleep apnea problems. Dr. Rondeau is a Diplomate of the International Board of Orthodontics, a Diplomate of the American Board of Dental Sleep Medicine, a Diplomate of the American Board of Craniofacial Pain. He has published over 30 articles in orthodontic and dental journals and has produced a series of videos on all phases of orthodontics as well as extensive internet courses in Orthodontics, TMD and Snoring and Sleep Apnea.

Approximately 1/3 of the dentists that have attended Dr. Rondeau’s courses are referred by dentists who have taken his courses and were very pleased with what they learned.

Unfortunately, 10 minutes of the interview was lost near the beginning of the podcast. We apologize for the lost content and you can learn more from Dr. Rondeau at WWW.RONDEAUSEMINARS.COM

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940 Orthodontics and General Dentistry with Dr. Brock Rondeau : Ahwatukee Uncensored with Howard Farran

VIDEO - DUwHF #940 - Brock Rondeau

AUDIO - DUwHF #940 - Brock Rondeau

HOWARD: It is just a huge honor for me today to be podcast interviewing my buddy of 30 years Dr. Brock Rondeau, all the way from London, Ontario, Canada. He is one of North America's most sought-after clinicians who lectures over 100 days per year. Over 23,000 dentists have attended his courses and study clubs in the United States, Canada, China, Australia, England, Turkey, and Poland. He has an extremely busy practice which is limited to the treatment of patients with orthodontic, orthopedic, TMD, snoring, sleep apnea. Dr. Brock Rondeau is a diplomate of the International Board of Orthodontics, a diplomate of the American Board of Dental Sleep Medicine, a diplomate at the American Board of Craniofacial Pain. He has published over 30 articles in orthodontic and dental journals and has produced a series of videos on all phases of orthodontics as well as extensive internet courses in orthodontics, TMD, and snoring and sleep apnea. 

Approximately 1/3 of the dentists that have attended Dr. Rondeau's courses are referred by dentists who have taken his courses and were very pleased with what they learned. I can't even remember the year. It was so far back that I mean all my local Phoenix homies all took your course.

What I love about you, Brock, is so many instructors, they get high, the fact that they can explain it so complicated that nobody knows. I remember in ASU and I was to get my MBA degree. I mean they couldn't even teach anything without adding algebra, calculus, you know all this shit, and what I love about you-- Einstein said you know if you can't teach it to a six-year-old you don't understand your subject. And you are the best teacher. I mean you can explain the complex so eloquently that the whole class gets it.

BROCK: Thank you Howard very much. I appreciate that, and I enjoy reacquainting myself with you again in Toronto at that midwinter convention. Now I've got something I want to show you. Here's a picture of the Farran Report in 1996.

HOWARD: Oh my gosh.

BROCK: You featured me on the cover.

HOWARD: I did.

BROCK: There I am in the cover in 1996 in one of the original journals.

HOWARD: You're right.

BROCK: Okay, it's all about ourselves.

HOWARD: So going back to the the young kids, so my debut in publishing started out as The Farran Report. It's a black and white-- How many pages was that newsletter? 30?

BROCK: Not even 30. Yeah pretty close, 27.

HOWARD: It was a little 27, 28-page newsletter, black and white. I had about 4000 dentists subscribed to it. No advertising. Was ten bucks an issue, a hundred and nineteen bucks a year and I did that 94, 95, 96, 97, 98 and then boom I've discovered the internet. And so when I got the internet, I realized it wasn't about Farran sending you information one way. It was this new interactive internet thing. And so I dropped the Farran, called it Dentaltown.

(lost audio, according to YouTube)

BROCK: The other reason general dentists have to be doing ortho is because in the rural areas there's no orthodontist. 

HOWARD: Correct.

BROCK: And so if the general dentist doesn't help the children, who's going to help them? So I mean it's a problem, most orthodontists go to the big centers, they go to cities, they don't go to the rural areas. And I was just thinking one other thing that your-- the girl that talked about Invisalign. Remember orthodontics is moving teeth. If you just want to move teeth, then take Invisalign. But if you want to move bone and really change patients’ faces and profiles, then you absolutely have to do orthopedics, you have to do functional appliances.

HOWARD: (inaudible 03:42) about your course (inaudible 03:43) 4000. That's the-- I mean your first ortho case is more than that.

BROCK: That’s right.

HOWARD: I mean what I don't understand about ortho, is you do one case and you got all your money back. I mean, I mean 4000 doll-- And the other thing is, I wonder if this is a bias too, some of the people you listen to in TMJ, you can tell they've never done one orthodontic case in their life. Do you really think you can understand TMJ, and TMD, and occlusion, all that, if you don't understand the principles of orthodontics?

BROCK: No, I agree. In fact, I-- Probably 30 percent of my TMJ practice is taking a patient that's got a temporomandibular joint problem and their disc is just displaced. I move them forward with a splint. I get the disc back in the right position. I get rid of all the symptoms and then they all-- They got a splint between their back teeth. Now what I have to do is I have to do orthodontics and replace that splint with their teeth. And so for sure you have to do orthodontics. And if you-- Ortho is a good way to start though. We teach some TMJ in our course, but I also have a two-day TMD course live and online, but I teach enough of the basics and the basic ortho course that they'll know what case to treat and what case to stay away from.

HOWARD: Well the thing that I love the most about getting my fellowship in AGD is when I signed up for that, you have to take all this course and 16 different subjects and I got-- I call up the head guy there is on AGD and I'd argue with them. I'd say, "Look! But I'm not going to do implants and I'm not going to do ortho. I don't want to learn that. I want to take more in restorative (inaudible 05:22 and kind of) bridge." And this old guy who's putting up with me and he's put his arm around me, he said, "Look, look! You need to cross-train. And even though you're never going to do ortho or never going to do implants. You need to learn that stuff and that will make you think differently about everything else." Oh my god was he so right. I mean cross-trainings— (inaudible 05:39 Even) Carl Misch said he think he became the greatest implantologist because he mastered dentures first.


HOWARD: And if-- See these cases where the implants would snap off and people were saying that the implant was malpractice and he's like, "No, the bite was you weren't even close." And Misch said that if you can't do, if you're not great at dentures, well you're never going to be good at implant retained dentures. And I thought orthodontics complemented the other spectrum that TMD and TMJ and occlusion and-- my gosh those kids. I tell-- I want them all to get their FAGD. Because it forces you out of your comfort zone and you're going to have to learn how to do something that you-- So cross training is everything.

So what brackets do you recommend?

BROCK: I use a Schein, Henry Schein ortho. The Maestro Brackets Rondeau prescription. I've got my own prescription. I've been doing this long enough and I have enough people buying the brackets that I recommend that I've got my own prescription.

HOWARD: Maestro, right. My god, Henry Schein ortho got huge.

BROCK: Oh yes. 

HOWARD: I mean they would--

BROCK: They're going to be number one soon. They've hired a lot of people from other companies to work for them. They've got a really great marketing budget and a lot of new products coming along. They've got something called the Carriere Motion Appliance which is unbelievable right.

HOWARD: Right, right. (inaudible 07:02) Yeah.

BROCK: Yeah it's really good. It's a fantastic appliance. I've got a patient with a Class II on one side and a Class I on the other. You can distalize the Class II back in about two months. It's fantastic. A lot of Invisalign dentists are jumping on the Carriere Motion system so they can correct the Class II molar relations first and then do Invisalign.

So it's just nice to know everything. It's nice to know about functional appliances. It's nice to know how to treat children. It's nice to know about braces. It's nice to know about TMJ. It's just nice, as you say, in education and everything. And I think the four things we didn't learn in dental school were: number one, ortho; number two, TMJ; number three, snoring and sleep apnea; and number four, practice management. So those are things that I-- You've been teaching practice management for many, many years. You've helped lots of us. And I remember reading your books, it was a very thick book. Your first book was really thick, and I think I found it the other day, maybe I should reread it. Maybe it's-- You think it's still relevant.

HOWARD: We got to do an audio on that book. We did an audio on my new book, Uncomplicate Business, you only (inaudible 08:11 memorize) things people, time, and money. And we did that audio version. The millennials don't read books. I came out with a book on Amazon and then we had the audio (inaudible 08:20 the audio book is where) the book but right and we need to sit down and read that original book. But-- So ortho, TMG, sleep apnea in orthodontics. When I went to school, we had a board-certified orthodontist and all he taught us was craniofacial development and embryos and fetuses and all this theory and all that stuff and not one applicable thing.

BROCK: It's crazy.

HOWARD: But sleep apnea, I plead the Fifth on that. 1987, I don't think anybody ever said those words together. I don't even think it existed. When did that come on the field? It seems like it just exploded like a volcano. And I ten-- What made it explode? Did you ever figure that out?

BROCK: I think what happened, for us, the the physicians have always controlled sleep apnea, OK, you have to go for a hospital sleep center.

HOWARD: But they didn't say-- But they were doing sleep apnea 30 years ago, are they?

BROCK: No, no. But they were probably 25 years ago. The first CPAP came out of Australia probably 25 years ago. And they were doing it and they-- The sleep physicians were the only ones who knew it. But about 19-- Oh I'm bad on dates. Probably 12 years ago, the American Academy of Dental Sleep Medicine said that for mild to moderate sleep apnea, the oral appliance was number one. And for severe sleep apnea, CPAP was number one. But prior to that, everybody got the CPAP. There were no oral appliances. But as you say, it's been an explosion. The last 12 years. And we get lots of dentists that are taking those courses again. The public have to be informed of this. Right. A lot of public don't know what sleep apnea even is, even though 20 percent have it. Now 50 percent of men over 50 snores and they know about it. But again, if they go to the physician and the physician says, "Well don't worry about it," only their wife worries about it, it affects their marriage. Higher divorce rate with snorers and so it's-- But my practice is growing like crazy because I'm getting a lot of referrals from medical doctors and sleep physicians. I got about five sleep physicians saying to me patients that can't wear the CPAP. Because if they can't wear the CPAP and they can't wear an oral appliance, their health is going to go downhill fast.

HOWARD: What what I was most amazed is here in Phoenix, Arizona were the Arizona Cardinals and how the NFL got (inaudible 10:50 religion) on this. Because I mean they all have 50 athletes, 50 humans. And they don't want to pay someone millions of dollars a year and then him not resting and having recovery and on-road games. But I was shocked. I mean they treat-- They are on top of sleep apnea more than any group of people on earth. Professional athletes.

BROCK: That's great.

HOWARD: It's amazing. I mean you can't find anyone in the NFL. In fact, I would say the average NFL player might know more about sleep apnea than the average dentist.

BROCK: Which is kind of scary, isn't it?

HOWARD: Yeah. Because I mean they got (inaudible 11:32 religion) on, what do they call it, recovery. They work out for hours, they need eight hours of deep sleep. I listened to Tom Brady on YouTube talking about it. I mean these guys take exercise, diet, and nutrition to a whole new level. And for sleep apnea, they're just, it's just amazing.

BROCK: But I think the dental profession may have played a part in that because I know there's some organizations that work with NFL football players to educate them on it. And I think dentistry in the last 12 years has really gotten involved in this because we think, we're now, we're part of the game. Before everybody was given a CPAP, nobody paid attention to oral appliance (inaudible 12:13 has been in) the last 12 years. Oral appliances are becoming very, very effective. I've got cases of severe sleep apnea. I fix their oral appliances. I don't guarantee it to a patient, but I have done cases like that and saved lives.

HOWARD: And what's also neat about the NFL is they just reached a settlement with their players' union for millions and millions of dollars for all current and ex-NFL players for dental insurance.

BROCK: Really?

HOWARD: Oh yeah. Yes huge, huge, huge, huge. Who's that guy that we podcast on that owns the orthodontic lab here in Phoenix? David Gergen. Yeah. David Gergen has told me about it.

BROCK: Oh, David. I know David.

HOWARD: David Gergen was part of the negotiating team on that and one of the reasons it got front and center is because dentistry is front and center because of sleep apnea.

BROCK: Right.

HOWARD: You know, and they want their professional athletes to be well-rested every day.

BROCK: How about us wanting commercial truck drivers to be well-rested every day? There's no testing for commercial truck drivers. And they can just go drive anywhere they want, they can fall asleep and kill as many people as they want. It's unbelievable. Professional pilots, professional truck drivers, more accidents on the highway from sleep apnea than from drunk driving. Huge numbers, huge numbers.

HOWARD: Yeah, I'm in Phoenix where Google's testing Waymo the driverless car. Every day when I drive around, I see these Waymo cars filming everything. So my area already has driverless cars and you know, the first thought is it's going to bankrupt all the truck drivers, Uber drivers, you know drivers, but you know who's most excited about it which I never thought about? What is Phoenix? Its 10 percent retired Canadian. Coming out of the snow and these 80-year-old grandmas and grandpas, they can't drive. They gave up their car keys and now they got a car again. And it's a driverless car and they're just, they just-- I mean it's just bringing them back to life. I mean can you imagine having to give up your car keys and now you've got a car again? Because it's driverless?

BROCK: It's fantastic. It's going to be great.

HOWARD: I'm going to get it just, so I can drink can drive

BROCK: That would be great.

HOWARD: Well I mean it hasn't been touched yet, but you know you go to a restaurant. I have a friend of mine, who lives up street, went to a Macayo's Mexican restaurant, had one margarita, was driving one and a half miles home, got pulled over and (inaudible 14:44 fell to the light) from one margarita. I mean I just won't drink at a restaurant. I mean you can't have one margarita and drive

BROCK: I'm imagining you driving in your car pretending you're drunk, singing, drinking as you as you drive, watching all the people want to drink and sing with their hands waving in the air as you're not touching the steering wheel. For people who don't know about that, they go crazy.

HOWARD: Well it is actually weird when you pull up to an intersection right here in Phoenix and you look over in the car next you. There's a guy sitting in the back seat and there's no one in the front seat.  I mean that is weird. That is very wary. Should they do your level one ortho case before course-- the eight two-day sessions whether online or class before you go into sleep apnea? Is ortho a prerequisite for sleep apnea or can you do sleep apnea without doing ortho?

BROCK: You could do sleep apnea without ortho but remember you're going to be taking bite registrations, you got to examine the TMJ if you're doing sleep apnea, you have to take impressions, you have to educate the patient. I would advise him to go ortho first. But certainly, if they have an ortho background we could certainly teach some TMJ because you know. In the online course, it's more cases. I think I get through more on the online course because I don't get off-topic as much and don't have to ask too many questions. It's amazing. We get lots of people taking level one online and then they take level two live, but you can do a whole course online. You have to (inaudible 16:24 trace 14 steps), you can send them to us, we'll check them off. You have to put brackets on teeth, you can take photos and we can check them off with the photos. You can bend wires, we can check them off by looking at the wires. It's amazing that some dentists can take the course online and actually started cases. It's amazing to me. But I think it's because they have to run a test every 20 minutes, so we know we got it, and we send a 300-page course manual with each session. So I think the course is probably under-priced, Howard. I should probably, Howard, raise the fees.

HOWARD: No if you want more money, you always lower your price. That is the most misunderstood concept that I learned in my MBA in Arizona State University. You sell something for ten thousand dollars, you sell one. So you have 10,000. You sell for a thousand, you sell 100, now you have 100,000. You have a course that's totally scalable. There's no, you know, if you are selling a grand piano for four thousand dollars, you have to make a grand piano for every one of those 4000. But for your online course, there's no, you know, the fixed costs in making the course, there's no variable costs of selling one-point unit. So when you're variable cost is zero and it's all fixed cost, I guarantee you I could do a price elasticity curve on this, and you can give me all the data of how many units you downloaded since you started per month. You should do that. You should get an Excel spreadsheet, and how many units were sold per month since the day you started, then lower the price from 4000 to 3000. I guarantee you, total dollars collected will be more and then that would give you the information to drop it to 2000 and then your total dollars, (inaudible 18:03) it would be even more. And by the time it got down to 500, everybody in India and China and Indonesia would be taking your course.

BROCK: I'm going to balance that out. You've got an MBA (inaudible 18:14 Scott), man he's got an MBA and I bet he'll agree with you. And I thank you for that comment on that.

HOWARD: Yeah, it's called-- You don't look at the price, you look at the total collection and if it's a fixed cost asset like if I wanted to build scale another nuclear power plant (inaudible 18:32 and then) another 10 billion in ten years to make the next plant. You can copy and paste your course, and for zero costs. But this is Dentistry Uncensored. I want to talk about more controversial stuff. Some people are saying-- Because remember we're talking to a girl who just graduated. She's 25, she's 250 thousand dollars in debt and somebody at the last dental convention told her that to do sleep apnea, she really needs a CBCT. And she went in practice with her dad, and her dad's got a 20 year old Pano/Ceph machine and now she's thinking, "Do I need to buy a hundred thousand dollars CBCT to (inaudible 19:10) sleep apnea?"

BROCK: No, you don't.

HOWARD:  That's what they're saying at the convention (inaudible 19:14).

BROCK: Well sure, they're trying to sell CBCT. No, you certainly don't need one of those for sleep apnea. Because you can-- Just by moving the jaw forward, you're opening the airway. You don't have to take an X-ray to prove it. It just opens automatically. And yes, we take a bite in a (inaudible 19:30) position and then slowly titrate forward in half-millimeter increments. As soon as-- And we also do sleep studies. Our-- Very important. What she does need if she's going to do sleep apnea is a home sleep study. Because a lot of patients don't want to go to the hospital for a sleep study, or a private sleep clinic. They want it done now. The home sleep study costs around four thousand dollars for the whole thing. And then about sixty-five dollars every time you use it.

HOWARD: And what is that called? Which one are you recommending?

BROCK: I like the Ares Home sleep study. A. R. E. S.

HOWARD: Can you find that, Ryan? A. R. E. S.

BROCK: And I get a sleep specialist to read the study for me. So I take the study, I send it by computer into the sleep specialist, he reviews it and sends me a report. When I get a report, if the patient's mild to moderate, the sleep specialist will say, "Make them the appliance." If the sleep study comes back, severe sleep apnea, the sleep specialist says, "I'm going to send them for a CPAP." And I agree with that. If they can't wear their CPAP, they're allowed to come back and see me. The big thing is the diagnosis has to be made by a sleep specialist. But you've bypassed the hospital sleep centers if you can get the ARES sleep study, and I can give you the name of sleep specialists who will read that thing for a hundred bucks. And that's what you need to do. Really that's what you need. You need that more than a CBT. And that's 4000 dollars and you're in business. But there are some fantastic appliances I got. Have you seen the Narval appliance? It's a fantastic two-piece made of nylon, won't break, easily adjustable, so small, so thin. N. A. R. V. A. L. It's fantastic. Yeah that's the appliance they want to use. They want to learn how to use that? At my courses, I have the rep come and demonstrate it that I can-- We show you how to make and show you how to use it. 

HOWARD: Well, I am-- So that take-home study, they're on Twitter at sleep mad inc, @sleepmadinc. So I just retweeted that because my homies right now, they're listening to you, they're driving to work. Probably 85 percent have an hour commute to work, so everybody's on a commute to work or they're on a treadmill or stairmaster or some. So they. So I just retweet that. So I retweeted you and then this @sleepmadinc. I want to ask you another Dentistry Uncensored controversial question. What do you think of Invisalign bypassing orthodontists and dentists and-- By buying into SmileDirectClub and just doing Invisalign straight from the company to the patient. What are your thoughts on that?

BROCK: Not impressed. Not impressed. That company was built on the backs of general dentists and orthodontists and now they're saying, "We want it. We want to run it on our own." They already have one in Toronto. There's an office in Toronto that's strictly run, owned by Invisalign and they're hiring orthodontists to run the clinic. So I don't agree with it all. That one is a little better, at least there's an orthodontist involved in that one but I don't agree at all with what they're doing. But you know, Howard, corporations are in the business of making money. It's not a matter of ethics with them. They just want to make money. In the profession, we're a little different. We want to be ethical. I like to make money. You like to make money. But we want to do it ethically and that's why I disagree with what the orthodontists are doing. With the Canadians (inaudible 23:12 those a rather nice ad.) That's not ethical.

HOWARD: Well the most ethical way to make money is to always remember that you can marry more money in a minute than you can earn in one.

BROCK: (Laughed.)

HOWARD: It's all about finding that 80-year-old lady on who's sitting on a hundred million dollars in treasuries and being her little boy toy. So I want to ask you another Dentistry Uncensored question. Why is TMJ and TMD so controversial? I mean I've podcasted 25 pediatric dentists. They don't argue about anything. Maybe a little bit about silver diamine fluoride. You get 100 endodon--. I podcast 25 endodontists, they don't argue with each other. I mean you talk to oral surg-- I mean nobody really argues much about anything until you go in a TMJ and then it's like a bunch of world religions. It's like trying to get the Hindus and the Buddhists and the Lutherans and the Mormons. Why is it so controversial? I mean isn't that kind of a red flag that it's so controversial? That something must be wrong?

BROCK: Oh, I think it's just the education...

HOWARD: First of all, do you agree that it's controversial?

BROCK: Oh yes, absolutely.

HOWARD: Do you agree that it is the most controversial subject in dentistry?

BROCK: I do. I do. And I think here's the big problem. People that have jaw problems get the flat plane night guard, and the flat plane night guard is made by every-- Is recommended by every dental school in North America, all over Europe, all over everywhere I've been. They recognize the flat plane night guard. That is bad news because if you're clicking and you got a flat plane anything, your jaw could go back, and you could lock. I've had probably 15 patients or more lock on night guards and that's what's being taught in all the dental schools. So if you're clicking, dentist, please don't put in a night guard. You need a repositioning splint. You need to move the jaw forward to a position where they don't click. Clifton Simmons says if you move them into position where they don't click, you'll get rid of 94 percent of the symptoms. TMJ is not a psychological disorder, it's a structural disorder. You're clenching your teeth at night and you've got to stop that. If you put in a flat plane night guard, you don't stop that. They wear it down. They make holes in it. It's a joke. You got to make an appliance similar to NTI. A little different, that I've designed, that only contacts the front teeth, and the back teeth don't touch. The back teeth don't touch, you can't clench, and you knock out the clenching and the grinding at night. And then you put the appliance in during the day to recapture the disc and get rid of all the symptoms and you're golden. It's not that tough. I do it. I mean that's what I do every day and I've got a high, high success rate. Nobody's 100 because there could be other things causing those headaches besides the TMJ. But boy I get a lot of success. And the dentists that take my courses, they're doing the same because they're writing me telling me that they're happy they're not using the night guards anymore. So you're right it's controversial. There's a lot of dentists who swear by night guards. And the night guard is good, Howard, if there's acute injury. Let's say you've got your disc in the right position, you have acute injury, it's knocked out of position. Put anything between the teeth and it's going to work. But then eventually when the disc stays in position you have to get rid of it. So I don't think TMJ is that difficult. But again, I've studied a lot on this. I've got a diplomate in TMJ and there's only six of us in Canada and so I've treated a lot of cases as you say. I've treated a lot of cases. I'd be pleased to come on again and do a TMJ when-- I think we should do a webinar on TMJ, so I can show you some cases.

HOWARD: The webinar's a bad idea because you got to get everybody there at the same time and America covers four time zones. There's 24 on the world. When you do an online CE course then while you're sleeping, they're listening to in Indonesia, China and India-- 

BROCK: OK will do that.

HOWARD: So yeah. So I. And you know, when's the last time you put up an online CE course on Dentaltown?

BROCK: It's been a long time, and I apologize

HOWARD: No, what I would do-- The best marketing in the world, Brock, would be-- You got these, your level, you got all these courses, right? Put the first hour on Dentaltown. So then it's mass marketed, and then at the end of the deal if you want to watch the rest of this, go to your website and give them four grand and get the whole thing. So you should put teaser, an hour or two, so that they can meet you, see you, fall in love with you, like your style, all that kind of stuff.

I want to ask you another question about (inaudible 27:59 we were talking about controversies). The father of American orthodontics is Dr. Edward H. Angle M.D., D.D.S. from 1855 to 1930. Is he kind of like your G.V. Black? What do you think when I say, when someone says Dr. Angle? What does that, what does he mean to you?

BROCK: Well I think he was very reputable at the time. And he-- It was interesting because Angle thought no extractions, and he was trying to develop all the arches with wires, and a lot of orthodontists had bad results with Angle. And then along came the next guy, and a can’t remember now, Tweed I think. And then Tweed started to do all the extractions. So I may be wrong but I think that's it. And but the thing is you can't develop arches with wires. You have to use appliances. Because when you use an appliance, you're moving the bone, when you're moving just wires, you're not-- You're moving teeth mainly. So I think today the concept is develop the arches with functional appliances, and straighten the teeth with the wires and the braces.

HOWARD: I want to ask you another controversial question. Do you agree or disagree with this statement that in the field of orthodontics, probably the most controversial man that ever lived was Witzig? Do you agree with that or disagree with that? And why was that so? Well first of all, do you agree with that, that he was the most controversial?

BROCK: I think so. I agree with that.

HOWARD? And why? What is your view on-- Now he passed away and all due respect. Why do you think that was? What did you think of his overall message?

BROCK: OK so you've got these orthodontists who go to school for two years, and three years to learn how to do orthodontics. And most of them were taught to extract like bicuspids. If there was an overjet in teenagers and adults. So along comes this professional wrestler. Witzig is a professional, ex-professional wrestler, goes to dental school, becomes a dentist, and then stands up there and says to six hundred people including orthodontists in the audience, "If you're extracting bicuspids, you should go to jail. You ought to be. You ought to have your license removed. What the hell is wrong with you. Here's the way you should do it." And he brought in functional appliances from Europe and showed how to treat (inaudible 30:25 lip plastic,) these malocclusions, without extracting any teeth. And he certainly turned their profession upside down, and certainly had a big of effect on me. Because I sat there, and I said I love the phases, I love the profiles that he's showing, and I don't like when I see a profile that an orthodontist extracted bicuspids on which is all collapsed. It looks like someone hit the (inaudible (30:48) page) with a baseball bat across the face. I don't like that look. I'm not saying everybody looks like that with extractions, but not a lot of patients don't look better following extractions. Plus TMJ problems later, plus snoring and sleep apnea problem maybe later. So yes, he was controversial. He had many, many orthodontists jump on board with him and used to lecture with him. And I kind of went to his courses but then I was competing with him.

I had courses in functional appliances, he has courses in functional appliances. So, in the beginning, we were friendly, good friends, but at the end not so friendly. He wanted to be the king and he didn't want anybody knocking him off his throne. And I wasn't trying to knock him off his throne. I have the respect of all lecturers. You lecture, you know what preparation you put in your lectures. You know the time that goes in your preparation, and when you make a presentation for an hour or two hours or a day, and the same thing with all the lecturers who are out there. I respect everybody out there trying to teach general dentists and orthodontists how to do (inaudible 31:52 it. This is the power) orthodontists taking my courses. And it's quite interesting because there's a money back guarantee and none of them have asked for their money back. I think they regard me as a colleague when they come to the course and they want to see my opinion on what I'm doing.

HOWARD: I want to ask you another controversial question. A lot of these young kids are 25 years old. They're listening to you right now, and you're talking about orthodontics, and they keep seeing a bunch of stuff about short term orthodontics. Lot of advertising, six-month braces, high-speed braces. Patients come in now and because of social media they'll say, "Do you offer high-speed braces, or do you offer short term ortho?" Rant on that. What are your thoughts on that?

BROCK: I've looked at some of those courses, and in my opinion, they don't teach records. They don't teach proper diagnosis. They just teach you to move teeth around. If one of my dentist takes my course, they want to know about short term braces or high-speed braces, we teach that too. You put on the brackets, you put on three wires, and the teeth are straight. I mean that's no mystery. The wires are phenomenal, and the brackets are phenomenal. So, they do a great job of straightening the teeth. But any bracket will work, and any wire will work. If you put it on correctly. So yeah, everybody's trying to make a buck. I mean I just have decided I want to teach a comprehensive course or nothing. I was approached by a group, a long time ago, to do the short-term stuff and I said, "No, I do long term stuff. I teach a complete course, or I'm not interested. Do it right or don't do it." I would urge those young dentists to not take those courses because they're very expensive too. They're 2000 dollars instead of a thousand dollars. I charge a thousand, they charge two. And there's no records and there's no backup. 

Howard, if you get in trouble with the dental board, the patient moves and transfers to another area, and somebody on the other end doesn't like what you've done to that patient and reports to the dental board, you better have good records. If you have good records, you sleep at night, you'll have no problem. Many times, if you have good records, one of my partners has excellent records and he had a complaint against him. He took his records to the malpractice lawyer, and the malpractice lawyer said, "These are your records." He said, "Yes you're going to win." He said, "Based on the size of these records and the completeness of your records, you will not lose this case." And it was settled. 

It wasn't even-- When they sent the records to the person that was complaining about them, the case was just thrown out. So, good records mean good diagnosis. Treat easy cases, don't treat difficult cases. We still need our orthodontic colleagues for the tough cases. They went to ortho school. What they have to realize though, that they went to ortho school to learn how to do difficult cases. Let the GPs do the simple cases. The smarter orthodontists that I know are saying, "Look, you're a GP. You want to do the simple cases, do them. But send me the tough cases." (inaudible 35:04 And the GP will send more cases to the orthodontist if he understands orthodontics.) So, the orthodontist will just relax and not criticize us for doing ortho when our licensing body says we can do it and we have special training in it. The (inaudible 35:17 IO) has been around for 60 years training general dentists how to do ortho and this is just not acceptable, for them to criticize. So far, the American orthodontists haven't done it. The American (inaudible 35:29 Ortho Association hasn't done,) just the Canadians. Maybe, I mean, I was very fort-- I'm very fortunate, Howard. I mean I had 77 dentists take my three courses a couple of weeks ago in Toronto, 77 dentists, and that's-- So obviously there's a lot of general dentists who want to learn to do ortho and want to learn to do it right. So, and I know you, hopefully you're doing it right. Are you still doing or doing your time?

HOWARD: I bought an artificial intelligent robot. Did you see that? That China had the first robot place a dental implant. Did you see that?

BROCK: No, I did not. I think that's amazing.

HOWARD: It's amazing. I'm sure there is a ton of prep work. I want to ask you some more questions. You know I (inaudible 36:17 was on) orthodontics was a lot like Boeing in the fact that no matter what airline they come out with 727, 37, 47, 57, 67, they still all only fly five hundred fifty miles an hour. You know they don't make them go any faster or it was always two years. But lately we've seen some companies making a lot of claims to accelerate ortho like Propel. There's a couple of technologies. Do you like any of these accelerating technologies? To make ortho go faster.

BROCK: It's interesting because Propel is coming to my office on Thursday, two days from now. Propel's going to my office and going to show me how to use the instrument. And I've got a dental assistant, that's got a space between her teeth and we're using Invisalign to close it. And we're going to use Propel to speed it up. So I just had my first lecture on Propel.

HOWARD: Explain what Propel is to homies that don't know what it is.

BROCK: It just speeds up the movement of the teeth by rearranging the osteoclast and osteoblast. And it's just a little hole in the bowl, you make it right through the gingiva, make a little hole in the bone, and the teeth move faster. And then they use, I'm trying to think what that accelerator or something, there's a device that the patient wears like a tray.

HOWARD: The vibration, the vibration.

BROCK: The vibration machine. Yeah it's accelerator or something, I just forget the name, and Invisalign now are recommending that if you want to move the teeth quickly, use that tray and use propel, and you can change the trays like in three days instead of two weeks. So this profession is changing quickly. I haven't got into Propel because I wanted to see if it will last. And it's been out for a couple of years now and I think it's successful and so now I want to try it. I don't always want to be first in case it doesn't work so I can't be telling people to do what I haven't done myself.

HOWARD: We've gone way over an hour. I still got two more questions. Are you good on time?

BROCK: I'm fine, I'm fine. It's (inaudible 38:23) seeing you again.

HOWARD: I want to ask another question. Again, I don't like talking about anything that everyone agrees on. I want to go right to the controversial stuff.

Myofunctional therapy. You have orthodontists who swear to god it is all voodoo and they don't believe zero-point one percent of it. And then on the other side you've got people that just-- it's their whole world. What does your amazing mind think when someone says myofunctional therapy?

BROCK: Well they have-- It's been around. There's been an appliance called, first of all, it's called-- It's called Myobrace now, used to call The Trainer. So it's like a silicone mouthpiece that retrains the muscles. OK. If the patients got a loose, that lower lip, it tightens the lower lip by impacting the mentalis, it controls the tongue thrust, it controls the tongue thrust, it controls swallowing. It's been around for 25 years. OK. There was a guy called Chris Farrell in Australia that started this 25 years ago. And again, Howard, like you--

HOWARD: Is he still alive?

BROCK: He's still alive. He’s going to speak in my Vegas meeting.

HOWARD: Introduce us. Can you find Chris Farrel?

BROCK: He's phenomenal.

HOWARD: How do you spell his name? 

BROCK: F. A. R. R. E. L. Maybe two L's in there. But know he's tremendous.

HOWARD: Can you email him and introduce him?

BROCK: I will. I mean just like you, you've been around for 25 years. He's been around for 25 years. Anybody's been around for 25 years. Must be good. And his appliance is fantastic. So he has this silicone appliance that the patient wears to prevent the tongue thrust. So my little granddaughter had a tongue thrust and I made her a Hyrax appliance, with a crib, a metal crib. And all she did was complain, she said, "Grandpa Brock, this is a very uncomfortable appliance." I wish that I'd use Chris Farrell's appliance called myobrace. It's called myobrace. M. Y. O. B. R. A. C. E. It's called myofunctional research. Look it up, it's phenomenal. And it's, you just put it in. You just wear it, and all that you have to do Howard is wear it for one hour a day and all night. That's it. And that controls the habit, prevents the tongue thrust, gets proper swallowing, gets proper nasal breathing. It's phenomenal. Then they put another appliance in, it expands the upper arch a little bit. And the last one straightens the teeth. It's unbelievable.

HOWARD: OK. His website is M. Y. O. research dot com. And you recommend him. Well why don't you tell him to come on.

BROCK: I will.

HOWARD: We'll have your MBA business guy and I'll follow him up with Chris Farrell.

Two more questions. There's a new thing that's really exploding in the United States where when you deliver your baby in the hospital, they breathe, they send in a lady who kind of teaches you, chairside, an hour or two, about breastfeeding. Because hospitals really want to encourage breastfeeding. And a lot of these girls that teach that, they say, "You know this baby's tongue tie and you need to go to a dentist and they got lasers and sear that off." So some people are thinking that the pendulum is swinging way over correcting big time and these little infants are getting-- So, are you aware of this? Have you heard this? And what are your thoughts on this?

BROCK: I'm aware of a tongue tie. But I wasn't aware that this was such a big thing in the hospitals now. You just informed me. That's good. For sure, if your tongue doesn't go to the roof of your mouth when you swallow, you can't develop the upper arch and you end up with a constricted upper arch, you end up with mouth-breathing problems, end up with crooked teeth, and all kinds of malocclusions. The main malocclusion is caused by a constricted upper arch. It's the cause of a Class II malocclusion. When the upper arch is constricted, the mandible goes (inaudible 42:18 Reginette and) doesn't (inaudible 42:19 comport) to its proper position. The patient, when you've got a constricted upper arch, the patient breathes through the mouth and not the nose, you get 20 percent more oxygen through your nose than in your mouth. It's the key to help, the proper sized maxillary arch. So for sure, if you're tongue tied and you can't put your tongue on the roof of your mouth when you swallow, you should get that fixed. It might affect your whole life afterwards. It's a huge--

HOWARD: OK. Last question. I know we're in triple overtime. I've already gotten 15 minutes over. Last question. Lingual braces. Is there even a place for-- Is there something you should learn? Do you ever use that? How many-- What are your thoughts on lingual brace? I mean it sounds so obvious because they want Invisalign because they don't want to see anybody with a brace on. So why don't you just put them on the lingual? What are your thoughts on lingual braces?

43.05 BROCK: I don't like them. I like-- I do not like them. I did subscribe to a system once and maybe I put them on two patients. But they're very-- They're sharp and they (inaudible 43:17 bite their) tongue. And they're hard to get at. They're really hard to see to move the teeth. You have to do the indirect technique where you have to put it in a tray and like (inaudible 43:25 light cure it) on there. I just didn't like it at all. I know there's some orthodontists doing it. I think Invisalign is a lot smarter way to go. Especially with the attachments they have in the teeth now. And definitely. But rotations, remember, you can't correct a severe rotation with Invisalign. I mean, so what I do with Invisalign cases, I'd say, "Look. Here's the deal. You want Invisalign. I’ve made a diagnosis you don't have a TMJ problem, you don't have an airway problem, and you just got crooked teeth. You don't have any orthopedic problem, no bone problem, no narrow jaws, whatever. I'll put Invisalign on there but if you're not happy with the result, I'll put braces on two, three months and finish you. So let's do. But you will be happy when you leave this office."

But remember make a complete diagnosis. Don't just put-- Don't move teeth around and make teeth look pretty. Make people healthy. That's the big thing. Not sure if I was teaching this when you took my course 20 years ago. I'm now thinking I'm more into the health of the patient than straight teeth. Everybody wants straight teeth, everybody gets straight teeth. But I want my patients to be healthier when they leave my office than when they arrived. And I'm worried about their long-term health.

HOWARD: Well you're a good man and what I want to say to my homies out there listening is his online course is four grand and your first ortho case will be at least four grand. I mean the average orthodontist in Phoenix is charging sixty-five hundred dollars. You can't practice from 25 to 75 without cross training in this field. You need to learn ortho and my last tip is this: you kids, that are in dental school, there's a lot of research done by Pew and they've just come out with-- they're different state by state. I just posted yesterday on Dentaltown, I put it out on Facebook and all that stuff. Kansas has seven different counties that don't even have a single dentist. And we're talking about not teaching ortho in dental school, you know, half of America lives in a 147-metros. The other half lives in 19000 little towns. And we're talking entire flipping counties in Kansas don't even have a single dentist. And you know who's the only one that will go there? It's the guy who wants to open up, takes no Medicaid, no Medicare, no insurance, charge a thousand bucks for a crown, a thousand bucks for a root canal, and they go in there and they work four 10-hour days Monday through Thursday, and then they get in their black Porsche or airplane and fly to the big metro for a Friday, Saturday and Sunday. I mean the reason you kids are broke is because every last one of you wants to practice across the street from your dental school because that's where the NFL is, and the hockey, and the basketball, and all the fancy restaurants, and business in three words is supply and demand. And your patients are coming in, they're demanding Invisalign, and even if you don't do ortho, when mom points to her seven-year-old daughter and says, "Is she going to need braces?" and you say, "I have no idea. Here, I'll just write your referral to an orthodontist." You don't look smart. You should be able to answer all those questions. But my god, if you're coming out of school 350000 dollars in debt. Especially if you're Mormon and you got a stay-at-home wife, and you already got a couple kids, that's your whole party. You don't need downtown Scottsdale, you already have the party in the home. Go to a county in Kansas with no dentist, make bank. I mean you could do a million dollars your first year, take home 350. You're all worried about your three hundred fifty thousand dollars in debt. Dude you can get it back in a year, but you're not hungry enough. And especially, the ones that are the craziest is when their parents came from 15000 miles from around the world to give their family a better opportunity and now they're a lazy millennial, won't even go an hour outside of town. Come on your mom came from Pakistan! And you won't go an hour out into the rural to be a better family? 

So, (inaudible 47:30 supplant,) Brock, thank you so much. Almost every orthodontist who ever tries to teach general dentists in America gets black balled by their orthodontist. Do you agree or disagree with that?

BROCK: I think so. Yeah, and it's too bad. It's too bad.

HOWARD: I'll tell you. Everyone will tell you. If an endodontist comes, starts teaching endo, all of them will say it's great. If an orthodontist teachers ortho, all of his colleagues don't like him anymore. And you were one brave son of a gun. And I know back in the day, you used to get flak from every side. I mean, because you were teaching the dark side, you were teaching us low life vermin general dentists orthodontics. And for that, I think you, you are truly a pioneer. You're a brave pioneer and I want you to-- You've already got a gazillion hours online CE course. Put our two teasers up on Dentaltown. That way it'll be mass marketed because I know, if my homies got to know you and took your online CE course, they'll be better dentists. And for that I thank you, Brock, thank you so much for coming on my show today.

BROCK: Thank you, Howard. It's always a pleasure. You're looking good and you're still fired up. Fired up 25 years ago. You're still fired. I love it. I love it. And you're such a brave guy. You do so much reading and you have such a great (inaudible 48:50 perspective) on the profession, so keep doing what you're doing. And I will definitely put some courses up online.

HOWARD: You and I should start a mutual admiration society and we'll be the only two members, and we'll just, every day we'll just admire each other.

BROCK: Well I do admire you very much. Thank you very much.

HOWARD: All right. Thanks a lot.

Category: Orthodontics
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