Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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989 Life as a Recent Grad with Kent Tuttle, DMD : Dentistry Uncensored with Howard Farran

989 Life as a Recent Grad with Kent Tuttle, DMD : Dentistry Uncensored with Howard Farran

4/13/2018 6:09:24 AM   |   Comments: 0   |   Views: 359

989 Life as a Recent Grad with Kent Tuttle, DMD : Dentistry Uncensored with Howard Farran

Dr. Kent Tuttle DMD is in his 3rd year out of dental school from Midwestern University in Glendale., Arizona. He works for Risas Dental and Braces in downtown Phoenix by GCU, a group practice privately owned in Colorado and Arizona. Kent is the son of Dr. Gregory Tuttle DDS, founder of TuttleNumbNow, the revolutionary intraosseous single tooth anesthesia technique. Dr Tuttle served a two year LDS mission to Ecuador where he learned Spanish and went on to major in Latin American Studies at BYU in provo, Utah. Kent went on to play D1 college volleyball for BYU and semi professional basketball before becoming a dentist. While in school in Arizona he met the love of his life, Jessica and they were married the same week he graduated. Kent and Jessica have two young children. Kent is passionate about serving the underserved and loves that he can use his Spanish every day and bring dentistry to those who otherwise could not afford it. Kent is passionate about all things dental related. When he is not at the office you can find him playing golf or swimming laps.

VIDEO - DUwHF #989 - Kent Tuttle

AUDIO - DUwHF #989 - Kent Tuttle

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989 Life as a Recent Grad with Kent Tuttle, DMD : Dentistry Uncensored with Howard Farran

Howard: It's just a huge honour for me today to be podcast interviewing Kent Tuttle right here in my home. Thank you so much. He practices up the street for me. Are you in Phoenix too? 

Kent: Yeah.

Howard: Technically we're both in Phoenix.

Kent: West Phoenix. 

Howard: He’s in West Phoenix. I'm in South Phoenix. Kent Tuttle is in his third year out of Dental School for Midwestern University in Glendale, Arizona. He works for Risas Dental and Braces in downtown Phoenix by GCU, which is Grand Canyon University. That's a Christian school?

Kent: It is, yeah.

Howard: A Christian school. A group practice, privately owned in Colorado and Arizona. Kent is the son of Doctor Gregory Tuttle, who we've had on the show. The founder of TuttleNumbNow, the revolutionary intraosseous single tooth anaesthesia technique. Doctor Tuttle served a two year LDS mission to Ecuador, which means equator in Spanish, right…

Kent: That’s right.

Howard: …where he learned Spanish and went on to major in Latin American studies at BYU in Provo, Utah, where the god of dentistry lives, Gordon Christian, right 

Kent: (01.09 inaudible)

Howard: What's that?

Kent: (01.11 inaudible), that’s Spanish 

Howard: Kent went on to play D-one college volleyball for BYU and semi-professional basketball. He's six foot five, before becoming a dentist. While in school in Arizona, he met the love of his life, Jessica and they were married the same week he graduated. Kent and Jessica now I have two young children. Kent is passionate about serving the underserved and loves that. He can use the Spanish every day and bring dentistry to those who otherwise could not afford it. Kent is passionate about all things dental related. When he's not at the office, you can find them playing golf or swimming laps. Well, I know what you like to swim. 

Kent: Why is that?

Howard: Well, I read a whole deal on it, you know. A short fat guy like me is like a barge, and you're pushing all that water…

Kent: Right, right, right, I see where you’re going.

Howard: …but if you look at all the submarine designs and you have a shape. And I read this deal that if you're ever going to get an Olympic medal in swimming... 

Kent: Okay.

Howard: you’ve got to have your height. How tall is Phelps? 

Kent: I think he's up there six-four or probably six-five.

Howard: Can you google how tall is Phelps, the Olympic medallist. 

Kent: Yeah he’s up there. He’s got the torso though. They say that that's good. He’s got shorter legs and a long torso. I’ve got kind of longer heavier legs, so I sink a little bit. 

Howard: Well, it's all…six-four

Kent: I mean, yeah.

Howard: and you are six-five? 

Kent: Yeah.

Howard: In swimming fast is all about reducing your resistance. 

Kent: That’s right.

Howard: And, if you look at those guys, like when they doing their stroke, half their body is out of water…

Kent: Right.

Howard: …half the time. They're just…

Kent: Oh yeah it’s phenomenal.

Howard: It's funny, because when I did three Iron Man’s. I did Arizona Ironman three years in a row and you know, the bike, you just got to learn how to pedal and not get hit by a car. 

Kent: Right.

Howard: The run, you just have to pretend there’s four lions behind you and you're going to die if you don’t get moving. But the swim was so technical.

Kent: Yeah.

Howard: And it was Mike Detoll who told me, “dude, don't learn how to swim without a coach.” You don't learn how to play golf or swim without a coach. 

Kent: Okay. All right.

Howard: Because he said, you can't afford a bad habit…

Kent: Why do you need to get a coach though? I don’t know what I’m doing.

Howard: Oh my god. I met this girl Angie. Swimming is like more technical than gymnastics.

Kent: Well you know why I started swimming, all the wear and tear on my joints from playing college volleyball and then semi-professional basketball. My joints are so bad. Even at thirty-two, where I just resorted to swimming. I did CrossFit for a little while, my joints just took a pounding. So swimming is you know, it’s a great exercise.

Howard: Well, your eyes still work, because hold up your iPhone.

Kent: Yeah.

Howard: You know you have an eye problem when you have the six X iphone, and you have to wear (inaudible 00:03:47), and you still…

Kent: This is outdated. This is the SE. But I love it because of how small it is. It fits right in my pocket. That's like an iPad. 

Howard: Yeah, and It's funny. Yesterday… you know what I did? I was so dumb yesterday, I posted an article and it was from 2010, because on this big screen and my readers, I thought it was 2018.

Kent: Yeah, yeah,

Howard: And then the first comment is like, “dude, that was from 2010”. And I’m like, I wanted to say, “hey, screw you. I'm fifty-five with readers on. And the biggest damn iPhone I can buy…”

Kent: You’ve seen those guys that go counterculture. I heard an article of Karl Malone. Karl Malone, the NBA player for the Jazz. He went back to a BlackBerry. Like just to have a little flip phone, you know, BlackBerry. I don't know why some guys do that, but…

Howard: And Eddie Murphy has never had a cell phone. 

Kent: Really? Wow. Interesting. 

Howard: He said he’s never had the Internet, the social media, the phone…

Kent: They’re addictive little devices. 

Howard: That’s what he said. He was on TV. He says, all you people (inaudible 00:04:42)

Kent: Before I go to bed. Yeah, it’s bad.

Howard: So tell us about your journey. So, when you graduated dental school, did you have any student loans? 

Kent: Midwestern, I went to Midwestern private, you know, private school here in Arizona, in Glendale. And it was pricey. A great education. Love the school, love my instructors. Great experience. But yeah, it was pricey. So up over, I took the maximum out, even though I was single, I probably went on a little too many vacations during school, you know what I mean? Just stress, but yeah, up over five hundred grand in debt. 

Howard: So, I love this tab, because the cost of raising a child in the United States from birth to seventeen is $233,000. So you basically graduated, already bought two kids in middle school. 

Kent: Right.

Howard: And now you had two more. 

Kent: Oh my god. Up over a million

Howard: So now you’re really…I have four kids. You have four kids, just two of them are named student loan…

Kent: Student loan A and B.

Howard: Student loan point A and student loan point B.

Kent: That’s funny.

Howard: So now did you, you said you met your wife in dental school? 

Kent: So yeah, I was in dental school. I was living over in Glendale, but you know, I moved a little bit further East in the Scottsdale area because I felt like there were more girls out there. Where I was at, it was like five to one guy to girl, you know, because you got all the, the Midwestern students. So I moved out east and yeah, there she was. She was just sitting there in church and yeah, the rest is history. We were friends for a while and then yeah, it was crazy. We moved. I graduated from, no, I turned thirty, graduated dental school, got married and moved all in one week. 

Howard: Damn.

Kent: It was crazy. 

Howard: Is she a dentist too? Or…

Kent: No, she not a dentist. She graduated from ASU. She's got her bachelor's, but she's a stay at home mom right now.

Howard: Stay at home mom right now. And how many kids do you guys want?

Kent: You know, I'm the oldest of five kids, so probably three to four to maybe five. 

Howard: You know, I grew up with five sisters and a brother. 

Kent: Okay, I like big families.

Howard: So that’s seven. So for me four, I have a very small family. And it’s all relative.

Kent: Four is small to you. 

Howard: Four is very small.

Kent: It's funny. 

Howard: And I wish I would’ve had six or eight. 

Kent: Oh my gosh.

Howard: So where are you at in your journey now? So you decided to work for a DSO. 

Kent: Yeah.

Howard: I mean, would you call Risa Dental, a dental services organization? I mean they have…

Kent: Yeah, kind of like a group.

Howard: …twenty, thirty locations 

Kent: Privately owned, but I'd call it more of a group practice setting versus corporate, you know, I've got a couple of partners, but they are expanding rapidly. I mean it's growing big time. So Yeah, but I'm in there. I mean, my main thing out of school was, you know, my dad's a dentist, he gave me the advice to keep your hand piece humming and I kind of liked that phrase. Just keep your hand piece humming. And you know, in school I probably did what, five endo’s, you know, and they limited to molar endo’s. Those were all done by a specialist with a microscope and you know. So I get out of school you know, yeah, I know how to do fillings. 

Howard: And how many…

Kent: But endo’s you know, and extractions… 

Howard: And how many board certified endodontist work at Midwestern full time? 

Kent: That's a good question. I do not know the answer.

Howard: I mean can you name any?

Kent: I would say just there's one.

Howard: One?

Kent: I know Doctor John.

Howard Farra: That’s what me and Brad Gettleman were talking about because we both were graduating UMKC. There were six full times…

Kent: Really?

Howard: We were there and a lot of these private schools, it's like the tuition is twice as much and they have like one guy. 

Kent: Yeah, I know.

Howard: Like how does one guy teach? 

Kent: Right.

Howard: What was your graduating class, what is it? A hundred a year?

Kent: Into the two hundred range. Midwestern had a bigger class size. About two hundred.

Howard: So you guys were about to two hundred in your graduating class?

Kent: I was a little over two hundred. 

Howard: So one endodontist can't teach two hundred people endo. 

Kent: I know.

Howard: It just can’t happen. So, but that's the best thing to do is get out of school. Go work in a high volume dental office. 

Kent: Exactly. High volume. I don't know what the average dentist sees. Maybe like ten, fifteen patients a day. I know I see up over thirty. I do all my own cleanings and so I’m very busy.

Howard: So do they not have hygienists there?

Kent: No, no hygienist. I do my own cleanings. I do, you know, lots and lots of endo. I think since I've been there, the stat was kind of crazy when I looked at it. In just two years I've done over three hundred and fifty root canal procedures. So I think that's kind of a lot. 

Howard: So, it's an interesting concept. So explain why you think there are no hygienists there. 

Kent: You know, it's keeping everything, I guess, you know, when you have a hygienist, when you pay for a hygienist and I guess, we're pretty efficient in what we do. The SRP’s and I think we just take care of people right then and there. 

Howard: Well, you know, I'll take it a step further.

Kent: Go for it.

Howard: This is dentistry uncensored, so we only talk about what everybody doesn't agree on. I don't want to talk about anything that everybody agrees on, but the bottom line is there's only three publicly traded dental offices on earth.

Kent: Right.

Howard: And two are in Australia, one 1300Dentist, Pacific Smiles and one in Singapore, Q&M, and none of them have hygienists. Due to insurance, I can't pay a hygienist $40 an hour to do a $55 cleaning, in a dental office with a sixty-five overhead. It's simple math.

Kent: Right. 

Howard: So whenever you look, you guys are expanding rapidly, correct? You have no hygienists. 

Kent: No hygienist.

Howard: So look at that versus the all the other DSO’s, none of which can go public. Imagine going on Shark Tank and telling the smartest one is Mr. Wonderful, because he’s bald.

Kent: Yeah, yeah.

Howard: You’re probably Marc Cuban because he's a basketball player…

Kent: There’s a wisdom in there right.

Howard: You’re trying to get a job from Mark Cuban. 

Kent: Right.

Speaker 2: What would you if Mark Cuban called you and offered you a job? Would you leave your dental office and run to the mavericks or… In a heartbeat.

Kent:, I probably would, yeah.

Howard: So, imagine going to Mark Cuban or Marc saying, “well, what do you want to do?” You say, “Well, I want a million dollars and I’m going to buy a million dollar dental office.”

Kent: Right.

Howard: That's all these DSS are, the roll-ups. So then you come back and say, man, we went from zero to a million, but Wall street’s saying, but we’re your balance sheet, you've got a million of debt, so now what do you want to do?  I want to get a ten more million, buy ten more offices, so I can come back … 

Kent: So it keeps expanding, yeah.

Howard: So there debt sheet keeps going… They’re buying sells. It’s just a roll-up. There's nothing unique about it, whereas the three publicly traded dental offices…

Kent: Okay.

Howard: …they went and got a million dollars…

Kent: Okay.

Howard: …and then every year they're paying their debt down, while their sales are going up and up and up and up and up. And they all have a few things in common. Number one, none of them have hygienists…

Kent: That’s very interesting 

Howard: …because they say, you know, if I was going to have a hygienist, I need the insurance to give me twice as much money for a cleaning exam. 

Kent: No.

Howard: They're not going to budge. So there went the hygienists and so in your dental offices, the dentist do their own cleanings…

Kent: Yeah I mean…

Howard: …and trying to beat this dead horse again. But guys, I'm telling you that you're still sucking this happy day, seventy Brady bunch model where you sent Delta Dental your fees and they just paid a 100% of your cleanings, x-rays, whatever fees you submitted… 

Kent: Yeah.

Howard: …and that's gone. They're paying PBO’s. So what's happened? You go to a place like Singapore, you know, back in the seventies they'll have four or five ops. I had a dentist checking two hygiene, doing the American thing. As the fees come down and you go back to Singapore and there's no hygienist. They’ve got ten hygienists in the country. I don't know what you call it, a country? It’s a city country.

Kent: City Country, yeah right. Singapore.

Howard: It's a country, but there's no hygienist there. And if you look at the dental offices in America today that have 50% overhead…

Kent: Right.

Howard: …the one thing they all have in common is no hygienist. 

Kent: Really? Wow. What about assisted hygiene? 

Howard: Well…

Kent: That’s technically what we're doing. We're doing assistant hygiene, we’re able to do quickly, you know the cleaning… 

Howard: With assistant hygiens here's the deal. So, when you look at hygienists getting $40 an hour to do a $55 cleaning, you know, so much of the time spent is not hygienist. I'm sitting there in the room, I'm going to get the patients, seating the patient, taking x-rays. Well the dental assistant can do all that? And then when you do the scaling you need someone to record the numbers…

Kent: Right.

Howard: … and then the dentist has to come and do an exam so you have assisted hygiene. I still need a five or seven minute block for the dentist to come and do the exam. 

Kent: That’s it…

Howard: But when you just come in and do the peril probing and then the scaling and that's your exam. You're bonding with the patient. How's the wife? How's the kid? How’s your cars. 

Kent: Right.

Howard: And then when you leave the assistant comes back and does the polishing, the flossing, the flouride treatment, checks out the patient, cleans up the room. And so with assisted hygiene, I still got to have a hygienist in there and a dentist exam check. And then who gets the fee? The dentist would get twenty five, what percent do they pay you?

Kent: So it varies month to month based on collections, So…

Howard: But is it just a straight percent of collection? 

Kent: No.

Howard: Oh it’s more complicated than that…

Kent: No, it varies month to month. That's more complicated and I can't really talk about it. 

Howard: And that's totally cool. We don't want to get you in trouble…

Kent: Yeah, of course.

Howard: …with your management team.

Kent: They're good to us though.

Howard: Good. But they don't have hygiene and so they're massively profitable as pointed out by their massively expanding. 

Kent: Yeah.

Howard: So then you go to these dental offices, you say labour should be 25%, and you see twenty-five to 35% all day long. 

Kent: Yeah.

Howard: And they say, well it's 25% of production. It's like, dude, you don't get paid on production. You get paid on adjusted production. 

Kent: Exactly.

Howard: You tell everyone, if I call a dental office (inaudible: 14.12). How much you charge for a crown? Thousand dollars?

Kent: Okay.

Howard: And I say buddy, 90% of all the crowns you did were with Delta and all these PPO’s. 90% of the crowns you did were for seven hundred. Tell everybody on the phone, it's a thousand and then they hang up and call someone else. 

Kent: Yeah.

Howard: Why do you tell everybody your prices that you never get. I mean you get…

Kent: You get whatever the contracted fee is. 

Howard: And a lot destists say they’re not… Ryan, google Delta Dental. What percent of American dentists participate in Delta Dental, I mean, I think last time I saw on their website, it's like 95%.

Kent: Is it really, wow…

Howard: So 95% are all getting the fees set. You know, when I graduated thirty years ago I got a thousand for a crown and a thousand for a molar root canal. 

Kent: Okay, yeah.

Howard: Now thirty years later, that’s like seven hundred and seven hundred. So the fees have gone down nationally 42%. 

Kent: Interesting. 

Howard: So the hygienists are the first casualty of war and they're still opening up hygiene schools and you go to hygiene schools. What's the problem? You know, what do you think of hygiene schools? Well, it's hard to find jobs…

Kent: Yeah.

Howard: … and it’s like okay. We've been in an economic expansion for six or seven years and they're having a hard time finding jobs. 

Kent: Right.

Howard: What do you think it's going to be like an economic contraction… 

Ryan: I can’t get the exact percent you wanted, but it says approximately 30% of Americans with Delta Dental benefits are covered by the number of companies have the Delta Dental Clients Association. 

Howard: So 30% of Americans have Delta?

Ryan: Yeah, it doesn't say what percent of dentists accept it, but does say 30% of Americans have it. 

Howard: 30% of Americans? Is it 30% of Americans or 30% of Americans employed? There are three hundred twenty-five million people. About a hundred and fifty million have a job. 

Ryan: It’s says 30% of Americans with dental benefits. 

Howard: 30% with dental benefits. 

Kent: Okay, that makes sense. 

Ryan: I’ll try and find…

Howard: No that’s okay. I think it's about 95%. So, you’ve been with Risas for three years? 

Kent: Yeah, coming up on three years. In November it'll be three years. 

Howard: So, what is your plan? I mean, do you think you'll stay with these guys for a long time?

Kent: My plan is to ride this wave, you know, as far as it takes me. Pay off debt and then, you know, we’ll see at that point. Someday, you know, I do have those dreams of being, you know, my own private practitioner, have my own practice. But with all that, with the astronomical student debt and with the situation we get put in when we graduate dental school, to go into debt for a practice right now, it doesn't make a ton of sense. But you never know. You never know. I'm just kind of taking it one day at a time right now. 

Howard: Well, I mean one day at a time, three years is a long time. 

Kent: It's a long time. 

Howard: Are you familiar with any other a corporate dental office chains in our backyard of Phoenix that do not have hygienists either. 

Kent: In our backyard?

Howard: In our backyard.

Kent: I do not know. I do not know.

Howard: Is Risas the largest corporate dental ...

Kent: In Arizona?

Howard: In Arizona. 

Kent: I don't think so. There's Bright Now, what are some of the other ones? There's Comfort Dental, that's more Colorado.

Howard: Right. 

Kent: There's a few. There's a few. I'm not sure. I'm not sure the names off the top of my head. 

Howard: So none of their officers have hygienists.

Kent: Pacific Dental Services is…

Howard: Oh no, I’m talking just local, not national ones.

Kent: No, I don't know about the hygienists specific. I haven’t researched. 

Howard: But how many other locations have you worked in? 

Kent: The Risas Dental locations? Just in this one. I started the office from the ground up. So the building was, you know, we built the building, we had zero patients and then I started the office. 

Howard: Interesting.

Kent: Yeah. 

Howard: Yeah, I hate saying that message because it really crushes hygienists’ hearts when I say that.

Kent: And this is kind of daunting, right?

Howard: Well here's what I say to them. I say that, you know, your patients aren't willing to pay you a fee out of their cash.

Kent: Right.

Howard: I mean, if you drop the dental insurance subsidies and the hygienist says, well, I'm just going to cleanings, exams, and x-rays at your dental office and I’m going to charge two-fifty. We'll be profitable. Well your patient is not going to pay it. So how many dentists do I know that said, you know, and I hate this insurance. They dropped all of their insurance, usually some cosmetic guru tells them how to do this, who doesn't have a dental office, you know, and you're paying $4,000 a week and to go hear this blowhard. So then you go back, you drop all your dental insurance and guess what happens? 

Kent: Yeah.

Howard: Now they go south. And some of these kids, I remember talking to one dentist, I was in a small mining town…

Kent: Okay.

Howard: …once all the student’s parents are saying, oh yeah, he's too good for us. He doesn't take the minor's insurance. His kids started getting beat up at school. 

Kent: No way. That’s brutal, it’s a dog eat dog world right?

Howard: He had to send a letter saying…now, I mean everybody needs a dentist. If you're in a mining town of five thousand, Utah, Nevada, they got lots of towns where…

Kent: They do yeah.

Howard: So, you're the local dentist there, you're sitting with them at church on Sunday, but you won't take their minor’s insurance. I mean that's the way to get the shit beat out of you. 

Kent: Wow, for sure.

Howard: So if these dental offices drop all the insurances, well the patient isn't going to pay for the overhead structure. That was what I thought was so funny when the hygenists said, well, we went independent practice and all the dentists are like, no, you can’t let him to do that. It's like, no, let them go. 

Kent: Let them do that.

Howard: Let them go. Because by the time they get the rent, mortgage (inaudible: 19.51) by the time they get in there, they're going to realize that they would…

Kent: That doesn’t make sense 

Howard: That they would go bankrupt. 

Kent: If it doesn’t make dollars, it doesn't make sense. 

Howard: Yeah. So, you've been there three years. That's a long time.

Kent: It's a long time. And I’ve gotten plenty of experience.

Howard: You're a millennial. 

Kent: Yeah I guess so, barely.

Howard: So millennials it’s not just in dentistry, but when you go the greatest companies to work for. The highest multiples of twenty-nine times earnings on their price earnings. Facebook, Amazon…

Kent: Right.

Howard: …Apple, Reflex, Microsoft, Google. The average millennial only works one to two years.

Kent: Really?

Howard: So when you go into the large national DSO’s, I say, well, that's your number one problem? They go, their employee, dentist turnover.

Kent: Retention.

Howard: These big companies that have several hundred dental offices, they had vacant dental offices in small towns…

Kent: Yeah.

Howard: … all around America where they're looking for a dentist. I mean they have full time recruiters and by the way, when I asked every one of them, where’s the best way to recruit dentist associates or sell a dental office, they'll say, Howard, it's on your free classified ads on Dentaltown. 

Kent: Wow, really? 

Howard: Yeah, we have sixty-five hundred ads. They're all free…

Kent: Wow, great.

Howard: …and over a thousand unique dentists a day visit the classifieds. If you're looking for and associate and plus we made it so if you're looking for a job, you can upload your resume and picture. We stole every idea that all the major job boards have, like monster job and all that stuff. 

Kent: Great, great.

Howard: And it's a great place to a buy and sell a practice. And a lot of people, a lot of brokers are selling offices, like say in Arizona they advertise to all the people in Arizona.

Kent: Yeah.

Howard: Well, hell the guy that might be buying the practice in Arizona, maybe he's in the navy and right now he's in Hawaii or Florida or he just got married…

Kent: Yeah.

Howard: …and he is in Michigan, but his wife says I want to live in Phoenix.

Kent: I want to live in Arizona.

Howard: So the international of the Internet, so the classifieds are flipping amazing. But so you've been there three years.

Kent: I have.

Howard: I mean, that's…

Kent: a significant amount of time.

Howard: …a long time for a dentist associate. That's a really long time. 

Kent: Yeah, I would say so. I mean, I think the difference though, with Risas, they treat us really, really well. The culture is second to none I think, as far as those DSO’s and stuff like that go, they take really, really good care of us. So, the retention of these average places is pretty high, or pretty bad. And the, you know, lots of dentists leaving. Risas is very, very good. 

Howard: So is common to have the associates stay?

Kent: I mean, I can count probably on two hands how many people have left.

Howard: Yeah, so who do you credit that to? The CEO is Jeff Adams. 

Kent: Yeah.

Howard: The mafia said the fish rots from the head down, so it’s the top dog that creates a culture of a company. 

Kent: Yeah, the CEO, Jeff Adams, he's a phenomenal guy. Phenomenal guy. You just got to get to know him. 

Howard: Well tell him if he doesn't want to come on the show and give away trade secrets stuff. I still want to have lunch with him.

Kent: OK, sounds good. I'll pass along the message. 

Howard: Tell him I'd love to meet him. I love talking dentistry, especially if you're eating a big old greasy cheesburger.

Kent: I went golfing with him just the other day, went to Paradise Valley country club and it's the first time walking with a caddy. It's pretty cool. Pretty cool. Golfing with the caddy was pretty cool. 

Howard: So is Tiger Woods your golf idol. 

Kent: No. I think his life’s kind of outside of golf.

Howard: So, the $500,000 in student loans and now you're getting married. Now you’re going to have a couple of kids. Did you refinance that? Do you have… 

Kent: Not yet. I'm headed towards that, to refinance. That's kind of the next step. 

Howard: And what are your thoughts about that? 

Kent: I think it's a good idea to get a lower interest rate. I mean, part of it, you know, getting away from the government, right? Because then you go to the privately owned and then, I don't know if there's ever loan forgiveness thing, that kind of worries me. That we'd be with a private company instead of having the government loans that could possibly be forgiven, but I think with our incomes we’re never going to be forgiven of the debt. So that's why I'm okay with refinancing and then just going into the lower interest rate, so… 

Howard: Well, the brutal reality is that the rich get richer and the poor get poorer. So every time they, the government of any country is going to do anything, it's going to benefit the very richest people.

Kent: Yeah.

Howard: So they could give billionaires and millionaires ..., like I just got this huge tax cut. Well, don’t you think that should have been a student loan forgiveness program? 

Kent: Right.

Howard: Are people losing their home? 

Kent: I feel they pumped a lot of money into the economy if they’ve forgiven that.

Howard: I know. I know. It's just, it's the way tribal…All people are in tribes and all tribes have their leaders and all the leaders grease each other…

Kent: Yeah.

Howard: …and no one has ever cared about the poor man since the beginning. 

Kent: (inaudible 00:24:35). So my dad's a dentist and you know, I know there's some dads who probably help their kids out with the student loan debt. I've heard of that, you know…

Howard: Oh yeah.

Kent: …or my dad's paying for, they got family money. Oh my dad's paying for my loans. My dad told me, he's like, no, I want you to feel every dollar that student loan, that weight on your back so that you are motivated to be successful, so that you work hard at your craft, so that you're sweating every day, you know, to do. Because you guys all had student loans?

Howard: My dad told me the same thing.

Kent: Maybe the number wasn't as high but…

Howard: He paid for my sisters go to go to college, because they were girls. But I was a boy, and says, Howie, I pay for your college, you're going to go up there and drink beer and chase women. No way.

Kent: Right. No, you’ve got to pave your way…

Howard: You have to be self-made man, it’s all on you. He didn’t give me a dime.

Kent: Which I appreciate. That’s good.

Howard: And it was really a weird feeling to be up at Creighton University, having to take out student loans and buy pot with it. It just didn’t feel right.

Kent: Yeah, that doesn’t feel right.

Howard: It'll be a cold day in hell before the government paid off all the students loans. 

Kent: It’s not going to happen.

Howard: It’s not going to happen. Because if they had a choice between paying off a trillion dollars of of student loans…

Kent: Right.

Howard: …or one trillion dollars of the people's credit cards, or one trillion dollars of tax cuts for the fortune five-hundred. Guess who…

Kent: It’s going to be the latter.

Howard: Because the only way you get a bill passed in America is with a wad of bills. And, it's just amazing how when he talked to those…

Kent: Corporate America, right. 

Howard: They always talk about all these other countries where they take bribes. In America, it's the same thing. But if you asked the congressmen, well, doesn't that money affect you? No, he's just buying in to what I believe. I respect the fact that he's buying into my campaign with $100,000 notion because he believes in my vision. 

Kent: Yeah, no. Same level of corruption.

Howard: It’s corruption if they give you….I thought the biggest deal that I thought was amazing, was when Walmart, you know, they were selling these prescription pills for ten bucks a pill in the United States, but selling them for fifty cents a pill in Asia. So Walmart said, no problem, we'll start buying him in Hong Kong and shipping them back to America. 

Kent: Yeah.

Howard: And the pharmaceuticals raised just six million bucks for George W. Bush's campaign. And the first thing he did was ban that practice.

 Kent: Really.

Howard: So it’s like all these poor grandma's. I like to go to help them. 

Kent: They can’t do anything. Right.

Howard: And at the end of the day the Chinese lady gets it for fifty cents and I paid ten bucks because I live in America and I voted. 

Kent: It’s a just a rip-off. A complete rip-off.

Howard: And that's why a lot of people they see me, they go, god, you spend so much time on Dentaltown and dentistry and Dentaltown. I feel good when I'm working in dentistry. When I watch the news I get nauseous.

Kent: Depressing.

Howard: I don't want to hear about because they're just gross. 

Kent: It’s funny you say that because with any free time I had my kind of stress relief was either sports or it was going into the news and current events. You know, Dredds report, Nine-sixty, the patriot, you know, I was on all these websites, Alex Jones even, you know, the conspiracy theory guy. So I'm into all of this and I stopped completely recently and I've switched only over to Dentaltown, you know, because I got my CE credits coming up a little short. So, you know, I'm diving into now the craft and I want to learn all I can. I'm passionate about dentistry because that other stuff, it gets even the sports, it's just mindless distraction. 

Howard: So who is the most favourite character on Sesame Street? There is a couple. One was big bird. And was it Oscar the grouch was it the same guy?

Kent: My son loves Cookie monster. I mean he has got to be it, right.

Howard: What's the new one? Not Cookie..

Ryan: Elmo.

Howard: Elmo!

Kent: Elmo.

Howard: So one guy did Big Bird and Oscar and then a hundred guys did all the other characters.

Kent: Yeah, Big bird and Oscar. Interesting.

Howard: And he was retired because a new puppet, Elmo, the kids dumped over, but when they talked to them about Oscar the Grouch. You know why all the kids love Oscar the grouch? 

Kent: Why?

Howard: This is what’s sad. Who do you think Oscar is? 

Kent: I have no idea.

Howard: Their grandpa…

Kent: Are you serious?

Howard: …he's sitting in the chair, Wha, wha, wha...

Kent: Yeah, cynical, angry at the world.

Howard: Remember when we were little, the Peanuts cartoon. Whenever the adult would talk, whah, whah whah whah, you didn't even know what they're saying , they’re talking over their head. And I have seen so many times when my grandchildren in the room and their fathers are screaming at the news…

Kent: At the television.

Howard: …I see the face on these little kids. And I’ll just be in the room, and I’d say, guys, you're scaring my granddaughter. 

Kent: Yeah.

Howard: And then they're like (inaudible 00:29:13), I just think it’s all toxic. 

Kent: Yeah, just cut it out of your life.

Howard: Well, so you cut is all out of your life?

Kent: Well, I'm cutting, I'm scaling back. Definitely, where I used to grab my phone and go on the news. Now I'm grabbing my phone, going on Dentaltown or going on, you know YouTube videos…

Howard: It’s why I stopped golf, because my golfing friends…

Kent: They’re obsessed or what…

Howard: Well I mean they miss a pod in their throwing clubs, yelling profanity. And I'm just like… 

Kent: It's not a great culture either, the drinking, the cigars, the know.. 

Howard: No, that’s awesome. I’m just saying this. If you go do something…

Kent: Right.

Howard: …and it reduces dope and it secretes dopamine, Serotonin, oxytocin, I'm all in. 

Kent: Yeah.

Howard: But if you say, hey, Howard, you want to go do something where I'm going to get really upset and cuss and yell and throw my clubs and like … not really.

Kent: Probably not. That’s anger management though.

Howard: My friends are in politics and golf.,I don't even like them. But when they are at the bar, eating cheeseburgers, watching the Cardinals, they're my best buds. 

Kent: Okay, I see what you mean. 

Howard: Marilyn Monroe said, you know, if you can't handle me at my worst, you don't deserve me at my best. 

Kent: Yeah.

Howard: Well, I am not married to my friends. If you're going to go out and be miserable…

Kent: It's interesting what you're saying though because I think there is a streak of that in new graduates. It's really easy to get down with the situation that we’re placed in. Because look at my dad, he graduated in 1990, from University Nebraska with fifty grand of student loans. That's it, fifty grand. Only, you know how many years later, twenty five years later, I graduated in 2015, add a zero on the end, exponentially increased by a factor of, are you kidding me? Like that's not inflation right there. That's just, I feel like it's control, you know, I feel like they want to control the medical profession. So they got control and now they want to control dentists, and the way they're doing it through our pocket books. I mean it's hard to get ahead and it's hard to earn. You know, I can't complain with the money coming in. It's great. You know, we live a great life, but you have to be careful about your attitude and how you respond to the situation we're in. For sure. We chose it…

Howard: Well I just want to say a couple of things about that. So if you look at the history of time, there's always indentured servants where they give you a ride from here to America…

Kent TuttIe: That’s what I feel like sometimes, an indentured servant.

Howard: …and you have to work at the farm for seven years, you might say that was a really bad deal. Well it was a whole lot better deal than the African slaves.

Kent: Yeah. 

Howard: That was a really human rights atrocity. But the thing I look at that is, okay, so you graduated $500,000 in debt and the average dentists make $75,000…

Kent: And that's higher than average, I think, right? The average is maybe two fifty or so. I don’t know what it is now a days.

Speaker 2: Yeah. In the public schools it's a lot higher. So I just want to try to get my calculator out since my brain no longer does math…

Kent: No problem.

Howard: …problems. So $500,000 divided by $175,000 a year on your on average job for general dentists, is two point eight five seven, so three years. The question is, would you pay $3 to get a job that pays a dollar a year when the average salary of the United States. People who have a job and have a salary, the average salary is $60,000 a year. So one seventy five, divided by sixty thousand, is three times greater. So would you pay $3 to get a job that pays a dollar here? And the average American who has a job and is on salary, that average is sixty thousand. In fact, I'll tell you the exact numbers. I just post that. And so in a time when artificial intelligence is destroying jobs, like for instance, Uber, 65% of the taxis hails in New York City. Look what happened to Uber. So here’s taxi drivers, and then here is Uber. 

Kent: Wow.

Howard: And then we look at the salaries. The average salary, the highest is Luxenberg is sixty-two thousand. Number two is United States, sixty thousand, Netherlands, fifty-two thousand.

Kent: So it’s based on the salary.

Howard: Yeah. If you're on salary in these countries and by the time you're down to Mexico to fifteen thousand. So a lot of dentists will throw a pity party. I sit there, but what they're predicting now is like Tesla has to drive this little semi cars…

Kent: I saw that yesterday actually. 

Howard: So why would you want to pay the truck driver, who every eight hours has to pull over and go to sleep.

Kent: Right.

Howard: He needs labour, medical and dental, and he can only drive eight hours without sleep, well now I can buy a driverless car. And I just set it up. Plus when they wreck it's human error. I mean forty thousand Americans die in a car every year. So, the truck driver, what is he trying to do? Go a little faster or…

Kent: And the liability that comes with that.

Howard: So the driverless car will go exactly fifty-five point zero, zero, zero, zero, zero for twenty- four hours a day. So they're all going to lose their jobs. Pilots just look at pilot versus the cruise missiles. It's like the cruise missiles can fly ten million miles without a single accident.

Kent: Right.

Howard: Well, talking monkeys can't do that. And right now they're already using cruise control technology for everything but taking off and landing. 

Kent: Right.

Howard: But the reality is that's when they screw everything up the most take off landing. So anybody that owns an airplane would love to fire all the pilots. The question is, when is America going to be ready to go get on Southwest Airlines and know it's been flown by Obi-wan Kenobi three P O…

Kent: Yeah, not quite yet.

Howard: And R2D2. You still hear, you know, Phoenix as the tests deal for Google's driverless - Waymo’s. Have you seen those around?

Kent: Yeah, my brother, his commute every morning he follows one of those cars is every single morning, same exact road, same exact path. And they're testing them. 

Speaker 2: Yeah. And then here's the human who doesn't trust that and they're driving down the street like this on their cell phone…

Kent: Right.

Howard: So, you’re texting on Facebook going down the road, forty-five miles an hour. And you're worried about the driverless car? 

Kent: That’s the thing, our addictions can kill us like our phone addictions. If we're doing that, it can kill us. It’s scary.

Howard: So, talk about your update…

Kent: Yeah.

Howard: …the podcast before you was Stanley F. Malamed. And you have some news. So talk. So review your dad's TuttleNumbNow. Do you use it? Septodont’s. It’s in the news with Septodont. It’s in the news with a Malamed. Tell us about that.

Kent: Yeah. So, to start from the beginning, in school they taught us not to bend the needle. And my dad was bending needles, getting into bone interosseous with his technique So I'm caught in the middle here, right? Between traditional dentistry, you know, the academia world, you know, this is what you do. My dad's in the trenches every day. Hey, this is what I am doing, this works. And so I didn't have the right needles. I had these short, short needles and I said, “heck, I'm just going to start trying.” And I actually got in the bone a couple of times with a short, short needles, but it was, it was really tough, but part of me was kind of sceptical of my dad. I'm his biggest critic. I'm just kind of like, “you got lots of passion, you know, but is this really legit?” And so I get out of school and I'm like, “all right, this is my time, I'm going to learn it.” I had trouble in the beginning. I had trouble. And then it wasn't until I got with him, I watched him do a few and then he sent me the videos, these instructional videos on how to do it, twenty steps to do it. And then there was a little learning curve and then I got it. The hardest part in the beginning, was knowing if I was in bone or not. So then once I did the steps, once I, you know, practiced the technique, I was able to get in bone consistently. And I was like, “wow, this actually works.” And I was stoked about it because right out of school I was able to get people instantly numb. I'm a fast, you know, I'm in this office with two other dentists that are my partners, and a guy right out of school, they have a little more experience. 

Kent: And your numbers are right about the same. So, you know, I kind of credit that to TotalNumbNow and being able to sit down the syringe, pick up the drill, start working. So the updates, there's a couple of updates. One is that officially TuttleNumbNow has signed a contract with Septodont, a company from France who makes septocaine. They're going to manufacture a needle guide, a needle bending guide. It's right here. I got the update here from my dad today with the three D version is right there. I was sitting with my dad in his private office, and we came up with this together. Me and him. Pretty cool. 

Howard: That is so cool.

Kent: Now they're going to manufacture it and he's, you know, he's getting a cut of the deal, a pretty good deal for him. But to safely bend a needle…

Howard: I can’t believe your phone is this small.

Kent: Yeah, you probably make loups right?

Howard: I would just have to give up my phone if I had to look at this, right? 

Kent: Yeah. Yeah. So, so we've got the needle bending guide that's now official. This is going to be on the market soon. And using those Evolution needles, those are the best. I've tried both needle types, I’ve tried just like standard needles, but the Evolution needle has the double bevel tip, and so it sharper and it can get into bone easier. So, it's great.

Howard: So, what is the advantages? Why would you want to go through all this as opposed to doing… This is only for mandibular (inaudible: 38.34)? 

Kent: For eyes and stuff like that.

Howard: For just mandible?

Kent: No, I use it on upper as well. 

Howard: Why would you do that as opposed to just putting a (inaudible: 38.43) of the maxillary tooth?

Kent: You know, Great question. Even when I put a (inaudible:38.47) to the buccal, the local does really well on the on the upper, but I don't like giving the pallet, palatal injections. 

Howard: Right. 

Kent: So I come in from the buccal with the NumbNow, I'm able to get into bone and blanches the entire palette pretty much. And so then I…

Howard: So you think it's a less painful shot?

Kent: Yeah, more comfortable because I'm not doing the pallet. Once I go into I might give a little extra on the pallet, but after I've done NumbNow, and they feel nothing. 

Howard: And now they got that St. Renatus, it’s a nasal spray. Have you tried that?

Kent: I haven't tried it yet. That's really interesting. Yeah. 

Howard: So there's a nasal spray now that will numb the whole maxilla. So I mean…

Kent: That’s just, I mean that's pretty cool. I mean those shots up on the anterior, they’re not fun. I think my dad did talk about in the podcast with you is there is a way you can do TuttleNumbNow. Not Having to go infiltrate on the upper. You can just go in right in between eight and nine and get into that bone that way. You know, safely, effectively, going slow. 

Howard: But on the mandibular, it would be a huge deal.

Kent: It’s a game changer, it's a game changer. I see so many patients that sometimes I want my patients to wait. We have multiple ops. You know, there's nine operatories in my office and I'm working by myself. I got all kinds of ops.

Howard: You're by yourself in nine ops?

Kent: No, no, normally there's two doctors there. There’s either the orthodontist or there's me and another general doc. So I have the chairs where people can wait, so I'll just numb, have them wait. 

Howard: Hi Lexi, hi Emma.

Kent: But I can't even tell you how valuable it is when I want someone to be numb, to be able to go through the protocol and not have to guess and not have to worry, you know, sometimes if I give an IA, I come back, they still feel it. Well I don't mess around with that. You know, I'll just give TuttleNumbNow every single time, every single tooth because of how numb they get. I tell people that come in and I'm like, I will get you super numb, you know, and they love that. I'll get you super numb. And so that's what I do. That's what I do, and patients love it. 

Howard: So what else do patients love? What are your hours in your dental office?

Kent: So I work twelve hour days. It is long days.

Howard: What is your hours? 

Kent: So we see patients from nine AM until eight PM. 

Howard: Nine AM to eight PM?

Kent: So my wife's usually call me, at eight o’clock, come home.

Howard: So how many days?

Kent: So, three days a week 

Howard: No, not the office, for the consumer?

Kent: The consumer, it's six days a week. It's open. So it's open Monday through Saturday.

Howard: Monday through Saturday nine AM to eight PM. 

Kent: Nine AM to eight PM. 

Howard: And so why not Sunday? Is that religious? Chick-fil-A doesn't open on Sunday, right? 

Kent: Right. It may be faith-based. Yeah, we just don't do work on Sundays. I'm not sure if it's faith-based or not.

Howard: Because that's the one thing that always concerns me that dentistry is in Arizona, 8% of (inaudible 00:41:48) odontogenic and origin. 

Kent: Interesting. And it's a high, high number. 

Howard: If you're child fell down and broke his leg on a Saturday or Sunday or on a Sunday or Christmas… 

Kent: Yeah, what will you do?

Howard: …fire department will show up, take you a hospital, fully staffed, open twenty four hours a day. So she broke her leg. She's good. If she broke her tooth. She's SOL. 

Kent: Isn’t that why they passed recently the emergency access. Have you heard much about that? 

Howard: I have not. Is that just for…

Kent: All Day. Every day, Arizona. So they're trying to get the patients out of the emergency rooms and into dental offices. So what they've done is they've given all the Arizona state plans a thousand dollars. So 50%, over 50% of people are on this access and they have a thousand dollars of emergency treatment to now using the dental offices.

Howard: So you guys take access?

Kent: Yeah, we take it all. So they come in, it's a dental emergency, we get a thousand dollars, we can do a root canal, you know, a root canal.. 

Howard: Which is amazing because the government was averaging $1500 to pay the emergency room…

Kent: Right.

Howard: …and they got no care. They just got…

Kent: Interesting.

Howard: …vicodin and…

Kent: Yeah, they give them medication and say, go see a dentist. 

Howard:: Yeah they put them on (inaudible 00:42:52) and Vicodin 

Kent: If its severe they might admit them and put them on a IV or whatever.

Howard: But if they gave you two thirds of that? A thousand, you’d actually do some definitive treatment.

Kent: Exactly. So, all of our new patients that we see everyday. I would say almost half of them all have emergency access. So that's, it's a big, big thing. 

Howard: So, you know, a lot of people will work for say Heartland or Pacific, or whatever and all they want to do is get out. Then when they get on there and I say, well, what business did you learn from a heartland? And so Rick Workman manages eight hundred. You don't, you don't think that Rick Workman might know a little more about managing a practice. 

Kent: About business right.

Howard: Then the dentist who manages one, look at Steven Dorn, he's not even a dentist, maybe just five hundred offices.

Kent: It's incredible.

Howard: So you're in a location that has what, thirty offices?

Kent: Yeah, a little less, but yeah.

Howard: I mean, that is sophisticated managing. I mean that's upper one tenth of 1% to be able to have the skills to run thirty officers. 

Kent: Yeah, right.

Howard: What are you learning a lot of? So what are you taking away… 

Kent: There’s no secret sauce. I think, the power of people and your team, and people you have around you. So I think Risas has been really smart to hire well. The doctors are all, you know, honest stand up guys that are energetic and passionate about their work and I think they've hired really well. And so they'll tell you themselves that the power of Risas is the doctor's, you know. So I, I think its good people.

Howard: And all the doctors are employees?

Kent: Yeah.

Howard: There's no owners?

Kent: No owner doctors. They have an equity plan for us. 

Howard: They do? 

Kent: Yeah.

Howard: So are they more likely to get new grads who just graduated out of Midwestern, or more likely to get the guy from Minnesota. His last kid went off to college and he says, I hate winters…

Kent: Right.

Howard: …and I'm going to come down to Arizona. 

Kent: Little bit of both. A little bit of both. Yeah. I think the Risas model is unique. It's tough for a new Grad to come in and handle the patient load. 

Howard: Right.

Kent: So I was able to do it, I think just because my dad had, had the experience. He taught me everything he knew and then with the NumbNow and then I'm just learning on the fly, which was fine, but I don't think everyone can do it, but they do a little bit of both. They hire out of school or they get guys that they just liked the idea of, you know, not having to deal with as much of the headaches of private practice and they're able to just clock, you know, go to work and take care of patients. 

Howard: I taught Ryan everything I know and it took almost thirty minutes. 

Kent: Yeah?

Howard: It was a long time. 

Kent: Thirty minutes, yeah.

Howard: I mean a lot of these kids are smarter. They look at the macro economics, the general dentist maxed out at $215,000 a year in two thousand and five. It's been falling, thirty-eight hundred…

Kent: That was the average?

Howard: …yeah it’s been falling. It was two hundred and seventeen thousand…

Kent: Okay.

Howard: And it has been falling thirty –eight hundred a year.

Kent: Unbelievable.

Howard: And It’s down to one seventy five, and there's no sign of letting up. 

Kent: Yeah.

Howard: So a lot of them come out and say, well, if this company, has a business model because it's open nine or six days a week, they take all the access…

Kent: Yes.

Howard: … to insurance, it's profitable. So they're expanding. Maybe that's a safer bet than opening up your own prototype

Kent: Right.

Howard: Because there's a couple of things, I mean there's only a few major strategies like pew research. That’s the data for every state of where the counties are under served, but they don't come out of Midwestern and wanting to go to, underserved. Like how many times have you driven to LA?

Kent: A lot. 

Howard: So what's the border town between Arizona and California? Blythe?

Kent: Okay, yeah. Blythe.

Howard: Blythe don’t have a dentist. 

Kent: No dentist really?

Howard: No. And I remember when some of my friends were coming out thirty years ago and they were like, I don't want to go to North Scottsdale. So I'm like, dude, go to Maricopa that doesn't have a dentist. They had nine thousand people and no dentistry. Florence had seven thousand before and no dentist. Like to this day, the dentist in Maricopa, they're just crushing it. 

Kent: Really?

Howard: And the dentists in True North Scottsdale are suffering. 

Kent: That's what I hear. 

Howard: That's the stupidest thing is so many of my friends live here in Phoenix, and they commute to North Scottsdale. It’s the same commute to Maricopa. They commuted an hour where there's a dentist for every five people instead of commuting at the same hour for every thirty five hundred people. and they don't understand demographics. And I say to understand demographics, what you should do, you should graduate from dental school, you should set up your dental office in Afghanistan, Somalia, Syria, and practice there until you realize maybe demographics matter.

Kent: Yeah, maybe.

Howard: Maybe if you, you know…

Kent: It was interesting the decision people made out of school.

Howard: …but you don't have to do your demographics because pew research has done them for every state because they're trying to get dental therapist passed.

Kent: You know, somebody said that the happiest dentist, these assistants who worked with multiple dentists. They said the happiest dentist they ever saw were Risas dentist. Which I felt like it was kind of interesting. I don’t know the reasons…

Howard: I’m the happiest dentist. 

Kent: I think part of it is a lifestyle.

Howard: And eating Risas peanut Butter Cups.

Kent: There you go. It’s part of the lifestyle, being able to right out of school work three days a week. I mean, I'm home four days a week, it's great. My wife loves it, you know, and then…

Howard: That's definitely some weird newlywed stuff. Spending four days week with your wife. Come back and tell me about twenty years now. So you work nine to eight, what? 

Kent: Yeah, nine to eight.

Howard: Three days?

Kent: So every week it's different. 

Howard: Okay, so you do three days and off four?

Kent: Yeah. 

Howard: So they're long days. What does it feel like at eight PM at the end of the third day?

Kent: Crushed.

Howard: I mean, you're saying that you're thirty-two. How old your dad? 

Kent: So my dad's fifty, mid-fifties, yeah.

Howard: Same as me. We’re both fifty-five.

Kent: Okay.

Howard: So do you think you can do that because you're thirty-two? Could your dad and me do that?

Kent: So the longevity part of it. Yeah, that's, that's definitely a question mark. You know, it's backbreaking work. Dentistry in general is backbreaking work I think. And then if you're seeing double the amount of patients, yeah, it's definitely backbreaking. But that's I think every individual's decision. If you have good ergonomics, I don't know. I really don't know. I mean, I've only been in practice a couple of years and my body feels great, but I could see how it could get tough. 

Howard: Well, you're a professional athlete, so you'll probably…

Kent: Well, as long as I keep that court stuff.

Howard: Have you ever been paid for sports? Because You're a professional athlete.

Kent: I got paid, yes. My one claim to fame. I did get paid.

Howard: Then you’re a professional athlete. I'm still shocked at the Arizona Cardinals. They never even interviewed me. 

Kent: Yeah, that one, $2,000 check was great. 

Howard: So when you go around the world, a lot of the names, a lot of people's names, Ashley Smith, it was a blacksmith. 

Kent: Yeah, yeah.

Howard: And when you go around the world, you know, if you're born in Somalia and your third generation goat farmer, that's the smartest visitor. I mean, yeah, when I was in Kansas is everybody that I knew that graduated in my school, that went into growing a weed, corn dairy. 

Kent: Yeah.

Howard: Those farms were in the family for hundreds of years. So kids following their parent's occupation is around the world. Any dental school had gone to. I say, raise your hand if someone else in your family is a dentist. 

Kent: Yeah.

Howard: It's a quarter to a third of the hands go up.

Kent: Wow.

Howard: Was your dad, the first dentist in your pedigree? 

Kent: Yeah he was. He was kind of the trailblazer.

Howard: So you’re number two? And how many kids did your dad have and how many went dentistry?

Kent: Yeah, so five of us and I'm the oldest and I'm the only one to go into dentistry. My brother does finance. He lives in the valley and then my littlest brother, he's on a two year church mission in Thailand right now. So he's going to get back. He wants to be an engineer though. He's kind of. He's the brains of the family. I think he wants to be a rocket engineer, or something like that. 

Howard: Yeah?

Kent: So yeah, we'll see what he does. 

Howard: So we're along your journey did you decide you wanted to follow dad? Did you think that he… Did he encourage you?

Kent: In the beginning I was like, encourage it. In the beginning I was like, no way I want to do what my dad does. I was petrified of needles. I don't know if it was the vaccines for school when I was little or something, I'd go and then I was already scared of my dad because he's kind of an authority figure, you know? And I don't know. Children used to live in fear of their parents right. I guess he's great. I love him. But yeah, I was a little scared of him, you know, I don't want to disobey. And then I come into the dental chair and it's like him with a needle. It was like the scariest thing in the world, right. So I would tell them, I'll be like, drill on my tooth. I do not want a needle. And I refused needle. I was the worst patient, worst patient. And so I would let them drill occlusal fillings with no with no needles and I just take it and, you know. 

Kent: But, so growing up I did not want to be a dentist, I had a little interest the older I got. He'd come home every day and just be like, dentistry is great, you know. Four out of five days and one out of the five days he'd be like, man, I don't know if you want to do this, you know, I had a tough day to day. But then it wasn't until I was on my two year mission trip in Ecuador, and I saw these dentists come over for humanitarian purposes, you know, the Red Cross and, you know, Smiles, what’s that company? Operation smiles. So they would come over there and they would do this service. But then they also get to see the foreign country travel. I was on the Galapagos islands on my mission trip, so I was in Ecuador, but then that's owned by the Ecuador and I was out there and these mission trip people came and I had a change of heart. I was like, you know what, I just want to be in a service oriented job as opposed to selling a product. I wanted to be serving people. And that's when it all clicked 

Howard: So it’s kind of a faith based decision? 

Kent: Yeah. When I got home I was like, I want to help people out. 

Howard: You know what I love the most are about the Mormon missionaries. 

Kent: What’s that?

Howard: Oh my god, so you're taking these young kids that just got out of high school, right? 

Kent: Yeah. Eighteen, nineteen , right?

Howard: Pre College. So that's about the most open minded you're ever going to be. You're not going to change a fifty year old from a Republican to a Democrat. Like my sister that's a non. Do you think I could turn her into a Lutheran or a Jew or a Muslim?

Kent: No chance.

Howard: So they're there at that juncture of the most young, impressionable, bright-eyed, bushy-tailed, still open minded. And I've lectured in fifty countries, and whenever we see them, you know, you always spot them. 

Kent: Yeah.

Howard: You know, two guys on a bicycle, white shirts, and I always stop. And it's the most amazing, because I say, okay, and I just ask one question, how long have you been here? They'll say, I don't know, six months, a year, whatever. 

Howard: And I'll say, why aren’t they're poor? Why do you think this is a third world country?

Kent: Yeah.

Howard: And this is an 18 year old minor who's living here for a year, who came from America and it's always the same. So you read this stuff when you're studying economics…

Kent: Okay.

Howard: … about what corruption does, what that poverty systemic to. I mean… 

Kent: The breakdown of the family and how that affects us.

Howard Tuttle: Yeah, all this stuff. And Yeah, it's so funny and I always thought of myself, the greatest book that needs to be written is, there's two hundred and twenty countries. Get two have those Mormon kids at the end of their missionary, sat everyone down in the room and say, why do you think, you know, Somalia was poor. 

Kent: Interesting.

Howard: Why do you think Ecuador is poor yet? And just have this index because there's more missionaries in Phoenix, Arizona.

Kent: Right. 

Howard: They have more missionaries from feelings that were born in Phoenix, right?

Kent: Yeah, totally. 

Howard: I mean, you could be born in Phoenix and your mission could be in Phoenix.

Kent: Could Happen.

Howard: And I want to write the book of…

Kent: Okay.

Howard: …and it needs to be written. I want to interview two hundred and twenty kids, you know, because I want to see pairs. Or is it a pairing thing when you're out on a mission?

Kent: It has to be, yeah.

Howard: Now I want to get the two hundred and twenty pairs from all two hundred and twenty countries and then see how the story changes from Luxembourg…

Kent: Okay.

Howard: …all the way down to Syria.

Kent: Interesting. So what do you ask the ones who practice or are that are here in Phoenix serving or whatever. 

Howard: I mean at the end of the day it's a function of lying, cheating, stealing. I remember I did a missionary trip in Africa one time. And I got there, here's four of us dentists, flying all this stuff, and we get there, the luggage comes down, and the luggage comes down. Everything comes down, but our big box of dental supplies. So I'll walk to some military guy at the end, and there it is. And I'm thinking that's too big for the commander, and he got it, he puts his foot on it. He says, that will be $500.

Kent: What?

Howard: I go, dude where volunteers, were down here for a foreign orphanage. And so, what does that say to everyone coming into your country to help the poor? 

Kent: Yeah. 

Howard: First thing I had to do is pay a bribe and then what is the chance that you could do that at Sky Harbour airport?

Kent: Zero.

Howard: And people don't realize that. They think our government's great, but it's all raising money and bribery…

Kent: Yeah.

Howard: … and if you got rid of all that decision making would be, well, what's the best decision? Whereas right now it's like well…

Kent: Who has the most bribe.

Howard: …where's the biggest bribe? And they don't see that in America because they see it so much worse in South America or Asia or Africa.

Kent: Makes sense.

Howard: The joke, I love my favourite international joke. Was an American businessman walks up and points. See that bridge over there? He says Yeah, he goes, government contract, I made 10%. He says cool. So they go to Asia and the guy goes, see I bridge over there. And he goes, yeah, it a government contract. I made 20%. That’s cool. Then they go to Africa and they see a bridge of there. No, I don't see the bridge, he goes, government contract, I took a 100%. And so it's just a level of, you can't have third world poverty…

Kent: Right.

Howard: … without being systemic in the business and the family. And another thing about that, was in these poor countries in central South America, Panama, I mean, if you have a twenty-seven year old man who had a child was six different ladies that systemic poverty…

Kent: Yeah.

Howard: … because you've got six ladies sharing a breadwinner. I mean, so the family unit is an asset builder or it's an asset destroy. So when you go to really poor countries and the government's all lying, cheating and stealing…

Kent: Yeah.

Howard: … and then men are having babies with four or five different women routinely…

Kent: Yeah.

Howard: … and then you're shocked that they're a third world country. 

Kent: Right.

Howard: So how do you fix the government from lying to you, stealing, and how do you teach this man to say, no, I'm only going to be married to you. So it's a…

Kent: It's tough.

Howard: ...and it's tough with only point 3% of mammals are, what do you call it? When you only have one spouse?

Kent: Yeah, monogamous.

Howard: I mean, it's not an animal. 

Kent: It’s like a rare species of birds, right? 

Howard: Yeah. Because, if you say there were ten boys and ten girls, and it doesn't matter if you're a penguins are monkeys and ten of them went away for the day and got nine of them got eaten by a shark and one came back. It just doesn't make sense. Have One guy say, oh no, I'm only with Amy.

Kent: Right.

Howard: And then you have nine females. 

Kent: Right, that makes sense. 

Howard: So the number one biological thing is, can we always keep everyone fertile and reproducing and having offspring? So monogamy is not natural.

Kent: No.

Howard: I mean there's nothing natural about monogamy and that's the only point 3%. So, I just love some of the greatest conversations I ever had were these young kids. How would you say the average one is? 

Kent: So the average is probably eighteen, nineteen. Yeah. I mean I served from nineteen to twenty-one. They lowered the age to eighteen. So you wouldn't have that awkward girl graduation. 

Howard: Yeah, and they added girls.

Kent: Girls who've been able to go for a long, long time…

Howard: All right.

Kent: … ever since the beginning, I'm pretty sure, but yeah, they lower the age.

Howard: So, no matter if you're ever on a European vacation, wherever, you see two Mormon kids say, hey, stop. I want to buy you lunch. 

Kent: Pick their brains a little bit.

Howard: just shut up and listen to the young whippersnapper minds, bright out of university.

Kent: That’s how my mind was changed. You know, that's where my heart changed. When I was out there and I saw these people coming over on the mission trips, I saw the level of poverty. I mean, you've got people living in cane shacks. They drill a hole in their floor and their sewage is right underneath their house. Like literally. I mean you have places too, that taxi drivers don't go, the cops don't go because it's just another level of just, it's like anarchy. And you have people machete fighting, cutting off each other’s arms, all kinds of crazy. 

Howard: You saw that in Ecuador?

Kent: Yeah, Yeah. It’s pretty nuts.


Howard: The most interesting thing I've ever had though, is I talked to this…you know you're an idiot when the local dentist won’t take you there. And I remember, none of my homies in Alaska, would drive be to Prudhoe Bay, because in Alaska, there's no public road to the Arctic Ocean…

Kent: Yeah.

Howard: … but there's Alaska pipeline has the service road, but there's all these big signs you can't drive, this is private property 

Kent: Okay.

Howard: But I mean, (inaudible 00:59:49).And I said to his guy, so what do you what will happen to me and that driving that road. He said, dude, I see a sheriff like once a year. He said, but, you won't have enough gas to get there. So you need five gallons of gas in the back. So you're driving a car, breathing gas fumes. All the local dentists wouldn't go with me. They're like, “you're out of your mind.” 

Kent: Right, right.

Howard: And about halfway through you realize, yeah, we are out of our mind. I mean the roads were washed out. I mean it was insane. But it was the most fun deal. When I was in Brazil, I told him I wanted to see a witch doctor…

Kent: Just for the experience?

Howard: … and it’s just about an hour in. And these guys said, no man, that's dangerous. So no one wanted to do it, but I found a taxi driver…

Kent: To take you there.

Howard: Hey man, it was so cool. I mean, I was in this hut, all the make-up, bowls and lotion on. It was bat shit crazy.

Kent: Wow.

Howard: But it was anthropology heaven. 

Kent: Yeah. You talking about other levels of experience, I mean that’s priceless.

Howard: And I’m street smart. So, a lot of times, I’ve been in some big towns in Africa where, you know, I wanted to see the garment district and the local people at the hotel were saying, “no, you can't leave the hotel property. We got this big fence. We've got razor wire. It's not safe. It's not safe. It's not safe. You can’t do that.” And all the dentists I’m with are like, “yeah, that, that's be a dumb idea.” But then I walk straight and I see the biggest man in the whole place. I mean, I'm just looking for someone who's twice as tall, you know, I'm looking for that three hundred pound Charles Barkley. And I walk up to him and I said, “I want to see the garment district but they say it’s not safe.” Then I show him a Benjamin and I said, “if I pay a Benjamin, can you walk me through the garment district.” He said sure, absolutely. 

Kent: Yeah. 

Howard: So I mean, you know, you just got to be smart about it…

Kent: Wow.

Howard: …but god, I love…So was the mission trip one of the biggest highlights of your life going to Ecuador away from home? Leaving mom and dad…

Kent: Short of my marriage and kids for sure.

Howard: I mean, that's a stunning…

Kent: It’s like number three. 

Howard: It's like, to take a kid out of his element and put them in a whole different element, a whole different language for two years. 

Kent: Yeah, it was brutal. But one of the biggest things was, I was at Risas in my office and I just felt so grateful and so blessed to be in an awesome opportunity right out of school. And I just had this overwhelming feeling come over me and you know, I believe it was, you know, inspired, divine and basically just said, you know, you were here and I'm taking care of you because you served a good mission. You know, because I took care of people, God was taking care of me and has me in a situation where I'm able to, you know, continue helping people. It was pretty cool…

Howard: It’s so cool.

Kent: … pretty overwhelming. So, I’m happy to be a dentist, it's, by far and away one of the best decisions I've ever made. Short of going on my mission trip, getting married, having kids, a great decision to be a dentist.

Howard: And you don’t know if your kids are going to turn out. How old are they? 

Kent: They're really young.

Howard: so let me tell you about kids…

Kent: One and zero, so…

Howard: So when your kids, before they get to her car keys, you'll think you're such a good father that he should write a book about how to raise kids…

Kent: Right.

Howard: One by one, you give them keys to a car…

Kent: Game over.

Howard: More trouble and mayhem. Come back and talk to me a when they’re sixteen to twenty-one.

Kent: Gotcha. Well see, that’s a scary thought.

Howard: How old are they now?

Kent: Zero and one. So we have a three month old and then we have one that's almost two. 

Howard: So that's good because the two year old doesn't have any jealousy because at that age they don't really realize that Tuesday I was the only child and Wednesday…

Kent: They’re clueless 

Howard: My boys were all eighteen months apart, and I love the fact that they never knew…

Kent: They never knew.

Howard: that yesterday they were the only child, today there’s two. 

Kent: They didn't have a long time to get all spoiled. So yeah. 

Howard: Yeah, but I also liked that they are so close because my friends that had one child, it takes twice as much effort to raise an only child…

Kent: Yeah.

Howard: … because they want you to be on the swing set. They want you. 

Kent: That makes sense. 

Howard: When my four boys were two, four, six, the whole time, I always thought, you know, I could probably leave, go to Kairos restaurant, have dinner, go see a movie, come back three hours later, they probably wouldn't even know I left.

Kent: They wouldn’t even know…

Howard: They were just a tornado running around the house and the backyard…

Kent: Now that you say tornado, my brother has two kids. And I asked them how it was. I was like, how's it going? And this was right around when the hurricanes were hitting. He all he did was sent me a picture of hurricane Irma, and he's like, this is how it has going from one to two, which is pretty true. I mean, kids eats up so much time. I don't have time for news anymore. I don't have time for sports. Like I focus on my career, you know, and Dentaltown getting better, learning the craft and then my kids and that's pretty much it. 

Howard: Well that’s awesome.

Kent: It’s all I have time for. 

Howard: And don't be that Oscar the grouch. Don't be…

Kent: There's no reason to be.

Howard: I mean if you're watching news and it's making you feel horrible and you're scaring your grandchildren or your children. Stop it. 

Kent: Yeah.

Howard: Watch something that makes them not see you as Oscar the grouch, and sees you as I don't know what would be a good one? 

Kent: If you throw up a YouTube video of an implant procedure or something. They might get a little sketched out…

Howard: You know what, my granddaughter, she's already telling me she wants to be a dentist, because we always do that. Do you know Jared Pope?

Kent: I don't, no.

Howard: Jared Pope is a buddy mine in America, but he learned how to place implants just by coming home every night after work…

Kent: Okay.

Howard: … has apple TV..

Kent: Yeah.

Howard: …would YouTube dental implant surgery, throw it up on the screen. 

Kent: Yeah.

Howard: And my god, my grandchildren are glued to that. They're like, what are they doing?

Kent: They're just fascinated by it.

Howard: Hell it’s fascinating.

Kent: It really is.

Howard: How the hell could that not be fascinating to a five year old? But hey, thank you so much…

Kent: Thanks Howard. 

Howard: …for making the time to come over and share your journey with my homies. They're all commuting to work and they love to…

Kent: Appreciate it.

Howard: … they know their story. It's just really cool to hear other people's stories. 

Kent: I love it, thanks Howard.

Howard: Thank you for sharing your journey and give those two babies a kiss from uncle Howie.

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