Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
How to perform dentistry faster, easier, higher in quality and lower in cost.
Blog By:

1046 Epic Endo with Dr. Rico D. Short : Dentistry Uncensored with Howard Farran

1046 Epic Endo with Dr. Rico D. Short : Dentistry Uncensored with Howard Farran

6/4/2018 7:04:42 AM   |   Comments: 0   |   Views: 302

1046 Epic Endo with Dr. Rico D. Short : Dentistry Uncensored with Howard Farran

Dr. Rico D. Short

- Microsurgical Root Canal Specialist
- Diplomate of the American Board of Endodontics
- Clinical Assistant Professor The Dental College of Georgia 

Dr. Rico Short attended the Medical College of Georgia School of Dentistry (The Dental College of Georgia) to attain a Doctor of Dental Medicine Degree in 1999. In 2002 he earned his post doctorate degree in Endodontics from Nova Southeastern University. Dr. Short added the final notch to his belt and became a Diplomate of the American Board of Endodontics in 2009.  His private practice, Apex Endodontics P.C, was opened in 2004 and is located in Smyrna Georgia just outside Atlanta.  

Dr. Short has almost 20 years of experience in dentistry and over 15 years in endodontics. He is an expert consultant in endodontics to the Georgia Board of Dentistry and an assistant clinical professor at The Dental College of Georgia in Augusta.  He is a independent national lecturer and is endorsed by the American Association of Endodontists speaker’s bureau.  In addition, he has treated numerous celebrities from actors, producers, writers, comedians, television anchors, sport athletes, and music artists.  He is affectionately known as “The Root Canal Specialist To The Stars.”

Dr. Short has written articles and published in several journals including Dentistry Today (He made the exclusive cover April 2013), Inside Dentistry, UpScale Magazine, Rolling Out Magazine, and the Journal of Endodontics.  He has lectured at the American Dental Association and the National Dental Association annual meetings, in addition throughout the United States and the Caribbean.  Dr. Short’s work has been published in dental journals around the world with opportunities to speak in China and the Philippines. Furthermore, Dr. Short has a very robust online presence in dentistry.  He has over 3,000 followers in LinkedIn worldwide and over 10,000 followers on FaceBook explaining various dental procedures and current trends in dentistry.  

Dr. Short was named one of the Top 40 Dentist under 40 in America by Incisal Edge Magazine in 2013 and has been named in Dentistry Today consistently as one of the top leaders in continuing education.  He his a frequent contributor to online dental journals as well. In addition, he has made several guest appearances on local and national radio / television stations. In June 2012, he spoke on Trinity Broadcast Networks to over 80 million households worldwide dispelling myths about root canal therapy and optimizing oral health.

Dr. Short has received several prestigious awards and accolades throughout his career. He is very philanthropic in his community.  Dr. Short has established an annual scholarship  at The Dental College of Georgia in Augusta, formally known as The Medical College of Georgia School of Dentistry. He is an American Dental Association Success Speaker and a graduate of the Institute of Diversity and Leadership Program.  With this knowledge, Dr. Short travels around the country speaking to senior dental students about the future of dentistry. In addition, he volunteers at various non-profit organizations and charity dental clinics. In October 2012, Dr. Short was selected as a panelist for the Affordable Care Act.  He was invited to The White House to give his personal opinion about how The Affordable Care Act would affect both businesses and citizens of our country from a healthcare provider perspective.

Dr. Short is also a motivational speaker and author.  His new book entitled “Getting to the Root of Your Problem” 365 Days of Inspirational Thinking is considered one of the most thought provoking self published books to date.  He travels abroad teaching people to tap into their God given potential to make a positive difference in society.  Dr. Short is married to Angela Short who is a dental hygienist.  They have two children Jayla and Ava. 

Oldest Root Canal Video - Filmed in 1917 by M. L. Rhein, MD, DDS

VIDEO - DUwHF #1046 - Rico Short

AUDIO - DUwHF #1046 - Rico Short

Listen on iTunes

1046 Epic Endo with Dr. Rico D. Short : Dentistry Uncensored with Howard Farran

Howard: It is just a huge honor for me today to be podcast interviewing Dr Rico Dumond Short. I've been trying to get him on the show since day one. He attended the medical college of Georgia School of Dentistry to attain a Doctor of Dental Medicine degree in 99. In 2002 he earned his Post Doctorate Degree in Endodontics from Nova Southeastern University. He added the final notch to his belt and became a diplomat of the American Board of Endodontics in 2009. His private practice, Apex Endodontics was opened in 2004 and is located in Smyrna, Georgia just outside Atlanta. Dr Short has almost twenty years of experience in dentistry and over fifteen years in endodontics. He is an expert consultant in endodontics to the Georgia Board of Dentistry and an Assistant Clinical Professor at the Dental College of Georgia in Augusta. He is an independent national lecturer and is endorsed by the American Association of Endodontists Speaker's Bureau. In addition, he has treated numerous celebrities from actors, producers, writers, comedians, television anchors, sports athletes, and music artists.

Howard: He is affectionately known as the root canal specialist to the stars. Dr Short has written articles and published in several journals, including Dentistry of Today. He made the exclusive cover April 20, 2013 Inside Dentistry, Upscale Magazine, Rolling Out magazine, and the Journal of Endodontics. He has lectured at the American Dental Association and the National Dental Association annual meetings in addition throughout the United States and the Caribbean. Dr Short's work has been published in dental journals around the world with opportunities to speak in China and the Philippines. Furthermore, Dr Short has a very robust online presence in dentistry. He has over three thousand followers on LinkedIn worldwide and over ten thousand followers on Facebook explaining various dental procedures and current trends in dentistry. Dr Short was named one of the top forty dentists under forty in America by Incisal Edge magazine in 2013, and has been named in Dentistry Today consistently as one of the top leaders in continuing education.

Howard: He is a frequent contributor to online dental journals as well. In addition, he has made several guest appearances on local and national radio television stations. In June 2012, he spoke at Trinity Broadcast Networks to over eighty million households worldwide, dispelling myths about root canal therapy and optimizing oral health. Dr Short has received several prestigious awards and accolades throughout his career. He is very philanthropic in his community. Dr Short has established an annual scholarship at the Dental College of Georgia and Augusta, formally known as the Medical College of Georgia School of Dentistry. He is an American Dental Association success speaker and graduate of the Institute of Diversity and Leadership Program. With his knowledge, Dr Short travels around the country speaking to senior dental students about the future of dentistry. In addition, he volunteers at various non-profit organizations and charity events. In October 2012, Dr Short was selected as a panelist for the Affordable Care Act. He was invited to the White House to give his personal opinion about how the Affordable Care Act would affect both businesses and citizens of our country from a healthcare provider perspective.

Howard: Dr Short is also a motivational speaker and author. His new book entitled Getting to the Root of Your Problem: 365 Days of Inspirational Thinking is considered one of the most thought provoking self-published books today, and by the way, my oldest sister is a Catholic nun and she loves the book. He traveled abroad, teaching people to tap into their God-given potential to make a positive difference in society. Dr Short is married to Angela Short, who is a dental hygienist. They have two children, Jayla and Ava. Gosh darn, what a resume, man. Thank you so much for coming on the show. I'm such a big fan of yours. Those cases you post on LinkedIn, I almost wondered, does he ever get an initial root canal where it's just a simple molar root canal. They're always these heroic herodontics. They ought to call you Rico Herodontics Short. There are just some of the most amazing retreats I've ever seen.

Rico: Oh, thank you. Thank you. I tell everybody before I go in, I go into a phone booth like Clark Kent and I turn to Superman, I have a cape with an S on my back and then we go to work. So, I'm known as the guy to be able to save teeth that other people can't save. So at first it was very difficult and I'm like, "God, why are you doing this to me?" But I realized in the end that as you get the tough cases, you become an expert, you become a master at those. So when you get the easy cases,  it's kind of like this is a straightforward molar and you learn to appreciate those. But like anything else the more you do something, the better you're going to get good at it. And it's always work to be done. There's work to be improved on. So I enjoy doing it.

Howard: Well. What do you think of endodontists now starting to place implants? Do you think it's going to make them look at some of these very difficult retreats and say, "It takes me three hours to retreat this, but I could pull it and place an implant in an hour?"

Rico: Well actually that's a good point. We actually was in the dawn of that back in 2008 when the economy kind of crashed. I was actually in an endo meeting in Dallas and I pulled up and I saw a big sign that said Nobel Biocare, and I'm like, "What the hell is this? Where am I?" We were carrying bags with Nobel Biocare. Well, what they were saying at the time, since people aren't spending the money getting root canals, endodontists must get into implants or else your practice is doomed. I was going to practice management seminars and that's what some of the gurus were saying and say, "Dr Short, I know you're good at doing endo, but if you don't get into implants, you're not going to survive two to three years." And I was kind of bummed out about it. I'm like, I busted my butt learning what I learned and doing what I do and I just say what, I don't agree with it.

Rico: I think people are going to always want to save their teeth. We are in a recession now. I think we'll come back and there were a lot of endodontists that invested a lot of time, money, resource into the equipment. But guess what? Now the pendulum is swinging. We're seeing that periodontists and oral surgeons are saying, "Hey, you know what long term this implant is not what we thought. We want to save the natural tooth." So now the pendulum is swinging back and now there are endodontists that got piles and piles of implant stuff in their office. And guess what? They're not using it. So now the pendulum is swinging back into saving teeth. So it's glad that I've been around dentistry awhile. I know you have too. You probably remember when they had silver points and we thought that was the best thing since sliced bread and now guess what, we're going back to the gutta percha what we were using since 1922. So, I do think implants have a place in dentistry, but we're seeing the pendulum starting to swing back to keeping the natural tooth.

Howard: Ryan, you know what we have to do this weekend, it'll be a birthday, Christmas present, all wrapped up in one for Rico. You know at the end of the Brad Gettleman podcast with that video. So, Ben Johnson, the founder of Tulsa dental products and Tulsa, Oklahoma. He actually, somebody sold him the oldest video of a root canal being performed. It's like a hundred years old. And when you said silver points, it was so amazing because with the silver point, people would say, well, why do you got to clean all this stuff? I got this little silver point. It looks like a little silver one. It's because they cleaned out the canal. They cleaned out the infection. I remember my endodontic teacher, who I think is the smartest guy I ever met in my life, Bamiduro Oguntebi. He was from Lagos Nigeria. Do you know him?

Rico: Yeah, we had to learn about all those guys, Oguntebi, of course.

Howard: Oh my God. And he used to always say “Howard, if you find all the canals and you get them all cleaned out, you could fill them with bird shit as long as it was sterile” and so that's the deal. So this hundred year old root canal, they paid so attention to cleaning that it was amazing. Well, let's cut that out.

Ryan: I'm sending it over to Rico right now.

Howard: Ryan's sending it to you right now. It's the oldest root canal video ever. But that's my present to you. When's your birthday?

Rico: My birthday is June 29th coming up. I'll be 21 again.

Howard: Okay, well I was the first one that gave you a birthday present this year.

Rico: Alright, I appreciate it.

Howard: I beat everyone else?

Rico: That's right.

Howard: So I want to start, Rico, podcasters are millennial's, old dogs like me, I'm 55, I got grandchildren. When I get on an airplane, I pull out my book and when the guy next to me is reading a book, I don't have to ask him if he has grandchildren, it's a given, but these millennia... So you're talking to a younger audience and what scares me is they're coming out of school three, $400,000 in debt and the first thing they say is, I hate endo. I only did one in school. We had two kids that graduated from dental school, $400,000 in debt on a podcast. One had done zero root canals in school and he's already decided he hated them. And the other guy did one and he decided he hated them. And I said, “well, you've come this far. You're $400,000 in debt. I don't care if you hate dentistry or not. You're going to have to do dentistry because you came too far.” What would you say to a kid who walks out of dental school and says, “Rico, I hate endo. I just want to do bleaching, bonding, veneers.”

Rico: Right, so I would tell that kid and I actually get a, I have a very awesome platform through the ADA, called the ADA Success Speakers. So I actually get a chance to go and talk to the senior dentists before, I mean senior dental students before they graduate and talk to them about things like this and I tell them, look, dentistry is such a big field and there's so much things that you can do, find those things you love, find those things you're passionate about and be very good at it because if you're not passionate about it, you're not going to be efficient and you're not going to be good at it. So why would you frustrate yourself on doing a molar root canal when you can be doing other things that you enjoy and that you'd be more profitable. There's nothing more frustrating than spending three hours trying to do a molar root canal and the patient still says, “hey, you know what? This tooth is still hurting when you get done.” You can't put a crown on it. So then what are you going to do? Explain to the patient, hey, you know what? I don't know what's going on. The root canal looks good. Let's just send him to the specialist. Then the patient's going to get frustrated, they got to spend more money again, and then they've got to get it redone. So having said that, if you don't like doing root canals, that's okay. There are so many other things you can do in dentistry that can be more profitable, you can have fun and enjoy doing it. Now having said that, if you got three hours set your side and you have an anterior tooth, I'm not telling you to punt the endo. If you've got the time to do it, and it's something in your comfort zone, do it, and make sure you explain everything to the patients and do it well. So, it all depends on the individual,what do you like, and not only if you like it, get the right training. I teach at the dental school at Georgia. These kids can't do not one molar. They can't touch it, which I think is crazy. Now again, I'm a volunteer professor there, so I don't have any bark in the fight when it comes down to all the political stuff happening in the dental school. But I think it's crazy not to have a student to at least have an experience with the molar root canal. So to sum it up, I think that you need to do what you feel comfortable with, what you feel passionate about. If you like endo, make sure you invest and take CE courses, read articles that I put out. Look at some of my daily short posts of the day and it'll give you some insight, some information to help you be more comfortable and profitable. And if you don't love it, if you can like it and do it. If you hate endo, there are some dentists hate it. That's okay, that doesn't make you a terrible dentist, send it to your local endodontist and let them take care of it. And I think you'll do great.

Howard: I wish you'd start your dental... Dentaltown is a message board forum, so it's organized into fifty forums, root canals, fillings, crowns. I wish you'd start a forum under endodontics: Rico's post of the day. Because you're putting these on LinkedIn, which are amazing, but these millennial dental students aren't on LinkedIn as much as Dentaltown and your cases are so motivational and I love your quotes too, your motivational quotes. I don't know what I love more your endo cases or your motivational inspirational quotes. They're always a good picker upper, but I wish you'd start a thread on those because they are truly amazing. I'm going to go back to implants. A lot of these kids come out of school and they see a failed root canal or they see a tooth with peri, with a bunch of periodontal disease around it and then they tell you, well since implants have a 98% success rate, I think that instead of retreating the root canal or treating the perio, we should just extract the tooth and place an implant. What, do you think when you hear these kids say that implants have a 98% success rate?

Rico: I think it's just straining a net out of some milk.  I think that (inaudible 00:13:03) will extrapolate one little point that someone says and boy that all the other parameters that talk about that 98%, I mean there may be one study that was quoted that, but that might be over maybe a period of two years, four years and it all depends on the, it has to be the ideal environment. Was that patient a smoker? Were they on bisphosphonates? Are they on antidepressants? All those things play a factor in having an implant last five and ten years. So in my opinion it's a lot of misinformation out there and the thing is the public, they're getting more smart. The public, they're going online, they're looking up information, they're getting research and they're asking questions and if you're not prepared to answer their questions properly or if you do something that's not in the proper guidelines, guess what? The attorneys are going to have a field day on them and that's what happens. I did a podcast with an attorney here in Atlanta and that's what we talked about. We talked about malpractice in dentistry. We can talked about malpractice in endodontics and some of those things did encounter upon teeth that could have been saved, teeth that were extracted, that could have been retreated, the root canal could have been done, crown lengthening could have been done, but it was taken out, implant was placed and now the patient has issues with the implant. But guess what, you can't go back and put the natural tooth in once you get the implant in there. So the only other solution is another implant, and that could become a problem. So we want to make sure that we educate our new students and the new dentists that implants isn't the panacea, it is a great option if the tooth can't be saved, but implants will, you will be seeing a lot more complications in the future with the implants.

Howard: Most of the stuff I read from the periodontist is that at five years, 20% of implants have peri implantitis and at nine years the studies are all from 40 to 60% have peri implantitis.

Rico: Exactly. I read that study also by the NIH published that as well. With dentistry, and that's what they said and peri implantitis is so difficult to treat. Once you get that, it's kind of like the downhill spiral. You can try to manage it as best you can, but ultimately you end up having to take the implant out, clean the site out, do a graft and put another implant in there. And yeah, and that's an issue. And we know that the longer we live, people are living longer. We know the bone is changing, the bone is remodeling, you get no more medications. One of the studies came out, University of Buffalo a few years ago showing that antidepressants is one of the most prescribed drug in the United States now and now is linked to four times implant failure after ten years. So guess what, people on all those antidepressants, they're going to have some issues with those implants. So all these things that are coming out, we need to really look closely into them because we don't want the pendulum to shift. Well, it is going to shift just like it did when we talked about earlier, we talked about silver points, gutta percha, silver points and now we're back to gutta percha again. So it's just one of those things we just have to educate and I understand what you're saying. Going back to the original question, these dental students, man, they got a hill to climb. I mean, you talk about three, $400,000 in student loan debt. Mean my God, how are we going to serve it? But guess what, I tell him, I said Rome wasn't built in a day. You will get those things down once you establish a plan and you don't have to just go hard. I tried to do that. When I came out of Endo, my endo program, I owed about $300,000 from dental school and my endo program and I'm like, I'm trying to work six days a week. I got burnt out and I couldn't do it. And I just say, what? I'm just going to pace myself gradually, gradually, gradually. And I think it took me probably eight years and I was able to pay all that debt down and off so it takes time, but you'll look up and it'll be gone. So I tell him, don't stress out about it, just keep hammering out a little at a time and then you'll get that paid.

Howard: This is dentistry uncensored, so I don't want to talk about anything that everyone agrees on. When I got out of school thirty years ago, the media made us the bad guys because people were dying of cancer and not given morphine and opioids and people were having wisdom teeth taken out, not given dilaudid and all these things like that. And we dentists and physicians and MDs are just too conservative and people are suffering. Oh my God, did the pendulum swing. Now we're the bad guys again because we prescribe opioids and you do a molar root canal. We're just talking about root canals. You do a molar root canal and Frank's sixty years old and he's had three and he wants Vicodin and he calls it by name and now these dentists are feeling like they're dirty if they give someone an opioid, how do you just, and I know the punches are going to come back because. But anyway, what, what do you, if you did one hundred molar root canals, what percent of them would get an opioid?

Rico: Well, it all depends on the case. It all depends on what if they came in a lot of pain, if they're swollen, they've been abscessed, they've been up all night. So it all depends. It's a case by case basis. Now the majority of the patients that the, in my opinion, I would say 80% of them can be managed with over the counter pain medicine. There has been some great studies that show if a patient can take Ibuprofen and Tylenol, I typically give patients six hundred milligrams of Ibuprofen and one extra strength Tylenol, which is five hundred milligrams of Acetaminophen, take that in combination before the anesthetic wears off after treatment. Most of them don't need to take anything else after that. It really gets on top of it. Some of the studies show it's just as effective as a narcotic without the side effects. They can go to work, they can presume normal activities. You don't really have to worry about them getting addicted to that or even having their kids go in their medicine cabinet and grab their opioids and abuse them. So always use that as the first line of defense. So that's key. That's numero uno. And there are some occasions I still would prescribe opioids as well, but I'll tell them what the opioids, when it comes down to the kind of work we do, it doesn't manage your pain as effectively as you might think. It almost acts as a central nervous system depressant. And it kind of makes you forget about the pain versus the Tylenol and Ibuprofen combo that actually actively manage the pain because of the (inaudible 00:19:48) the anti-inflammatories that's triggered either before treatment or after treatment. And that really gives you the pain relief. So, I actually have a couple of articles on that and I post that with the big opiate challenge that we're dealing with. I've been posting it. I've been talking about that now almost ten years and people are starting to use it and it's like, wow, this works better than the Tramadol and the Vicodin and all that kind of stuff. So, that's what I would definitely recommend that.

Howard: What percent of your practice would you say is retreat versus initial treatment?

Rico: I would say probably at least 80% of my practice is retreatment. Why? Because most dentists are doing their own root canals. Why? Because go back to what we were talking about, most of them are trying to chop at that student loan debt, and I don't blame them. Hey, you know what, let's try, if it doesn't work out, send them to the endodontist. And statistically, 80% according to the AAE, in 2017, 80% of root canals are done by the general dentist.

Howard: What percent?

Rico: 80.

Howard: 80%?

Rico: Yeah of root canals are done by the general dentist, so as an endodontist we're only seeing about 20% of them (inaudible 00:21:15) that haven't been touched. So now if you're going to be a very good endodontist, you got to be very good at retreating or very good at doing surgery because that's what we're seeing most of the time now.

Howard: And when you see 80% of your practice, you see a failed root canal. Why do they fail? Is it missed canal? Do they not get to the apex? You think they're just making it cleaning and shaping as far so it looks good on an x-ray? Why do you think they're failing?

Rico: Most of the failures I see are just like you just mentioned, number one, missed canal, and number two, failed to get to the apex or failure to be able to clean out as Seltzer and Bender old school endodontist says, remove the critical mass of bacteria being able to clean, like you said before we talked about back in the day, why did these old root canals work that look like crap on the x-ray is because they spent two hours cleaning it out. They spent two hours letting bleach soak in there, they spent two hours hand filing and that's why, because they spent more time cleaning it out. And one of the big failures that we're seeing now is because there are some endodontist that's making it easy. They're coming out with easy file systems. Step one, step two, step three plug it. I can teach you to do a root canal, a molar root canal in thirty minutes. The problem is you're doing it too fast and you don't have enough time for the irrigants to work. The irrigants to clean it out. And so sometimes we'll see beautiful root canals that are failing. The main root canals that I see that are failing that look great are thermo fills, they look perfect on the x-ray patients are in pain, swollen, hurting. Why? It's because it's a failure of cleaning and shaping. Why? Because the thermo fill is a plastic carrier with gutta percha wrapped around it. You can jam that inside the canal, tissue can be everywhere and it looks great on the x-ray. But guess what? You can't do traditional gutta percha like that. Why? Because it's going to crinkle on top. Once it hit that tissue or the or any pulp (inaudible 00:23:20) then it's going to crinkle and you can't get it down, so you can't quote unquote cheat as well with traditional gutta percha than you can with these thermal fill, carrier based operators. So as endodontists, we'll all tell you, we retreat more thermal fills and carrier base operators than ever before. And it's not because the technique is terrible, it's usually involved and not spending enough time cleaning and shaping and finding the canals.

Howard: So do you, how long does it take you? When you're doing an initial treatment, a molar first time, carrier window, how long does it take you?

Rico: Well, again, it all depends on the case. I've been doing it long enough where I don't cookie cut cases. Every case is unique. Every patient is unique. So it all depends on the situation. Does it have a large lesion on it? If I open it up, is it very hyperemic if I open it up, is it draining pus everywhere? So it all depends on the case, but an average molar root canal for me, I feel comfortable with doing it probably about forty five minutes to an hour to make sure we find all the canals and make sure we got everything cleaned and shaped properly. And then we're ready to (inaudible 00:24:34) it. We can dry the canal. So on average I like to spend about forty five minutes to an hour for a molar. Cannot do it faster than that. I'm pretty sure I can. But is that going to be in the best interest of the patient? Long term? Probably not. So, and that's what we're after. We're after the best long term success, not how fast we can do it or how much money we can produce. So that's what I always preach or teach to my students and also to my online audience.

Howard: And a lot of people wonder what are you thinking when you decided to one step versus one appointment versus two appointment endo? When do you say we need to temporize this?

Rico: I think most endo can be done in one visit if you've a. found all the canals and b. cleaned and shaped properly and c. if you're able to dry the case. If you typically can do that, the studies show that there is no difference between one visit and two visits. There are some cases though, I have patients and they'd been up all night, they've been hurting and they've just been having a dog time with the tooth. A lot of those I don't like to do it in one visit. I like to do it in two visits, not because I don't think one visit can work. I like to bring the patient back. How are you doing, Ms Jones? How is the tooth feeling okay? I feel more comfortable in being able to complete it when they are feeling better and they've been comfortable with, but they've been up all night suffering a lot of swelling and then, those are the cases I like to do in two visits to bring them back just to make sure they're doing okay and make sure we got everything cleaned out and give them a better chance at long term success

Howard: When you're talking on the podcast, to the lawyer and lawsuits regarding endodontics, it seems like standard of care, a definition of standard of care is all over the place. I mean if you ask ten dentists what standard of care is, you're going to get ten different answers. What do you and the lawyers think is standard of care?

Rico: Well right now, there's only one universal standard of care and in endodontics and that's using the rubber dam on every case, on every endo case. That is the standard of care. That's what we have. That's what it is. Now, all these other things are kind of outliers and that's all dependent on the judge and the jury, what's the standard of care, it all depends on what falls in their hands. And, we used to have something called a locality rule. What that means is that you have to do endo just as good as the endodontists in your area if you're a general dentist. Now that's kind of wiped off the books, so to speak, because you have the internet, you have access to information, that you'd never really had before if you were practicing in some part of West Virginia and you're the only dentist in a two hundred mile radius, will guess what you are that person for everybody, and you wasn't at one point held to the same standard of care, but now you are. So, most of the time the standard of care lies in the hands of the lawyers and also the juror. Now having said that, there are some things that people would say is these standard of care that's really not number one. Some endodontists would say a microscope is the standard of care, which is not. We use a microscope, it definitely helps us, but it doesn't necessarily say somebody's using the loops aren't as good as somebody who used a microscope. There are some studies that have said that, but again, that's not a standard of care. Everything that kind of comes new to the pipeline and that's the Buzzword, kind of try to get wrapped with the label of standard of care cone beam CT. A lot of people are saying, oh, this is the new standard of care, but guess what? It's not as of yet. It might be in the future, but right now two dimensional x-rays are the standard of care on every case, specially you can't see in between teeth clinically. So, the standard of care thing, people drag it out, people will try to use it for their advantage to try to market things and all that. But really there's only one standard of care we have an endo and that's using the rubber dam. That's it.

Howard: When you see cases actually go to lawyers, what stands out about those guys? What do you think is the difference between a root canal, a failed root canal versus it went all the way to the lawyer?

Rico: Usually when I have to look at cases before it goes to a lawyer, usually it's incomplete documentation. The documentation is not complete. The documentation does not indicate that there was a rubber dam used, there is no x-ray that shows that a rubber dam was used. And it's a lot of things about documentation and the other thing is communication with the patient. No informed consent. If you don't inform the patient of what you're doing and have them sign off on it, that's a problem. So those are the main two things that I see is, incomplete documentation and no rubber dam. Now, however, there are some cases in which I'm dealing with right now, there is a case where a dentist, he likes to do root canals in Atlanta. He did a root canal and the case did not go well. The patient found out about me and I told him he needed to have it retreated and there was a missed NB2 incompletely filled mesiobuccal short field palatal lesions on both roots. We retreated, we took care of it. The dentist did not want to give the patient back his money, so the patient decided to sue him. So now there's a case in which we're going to see how far it's going to go and it's not considered the standard of care, but if this patient would not have got it retreated, they would have problems out the tooth and pain and suffering would have ensued. So we've got to see how this case goes. I always try to defend my dentists and try to make sure they don't have to go down that route to try to help him out. But of course, with anything else, there are some that just don't listen to the advice and they do it their way. So we're going to see how that one goes. So, we see that come through, but at the end of the day, no one wants to be sued. I don't like to see any of my fellow colleagues in a courtroom trying to defend themselves on why they did a root canal the way they did it.

Howard: I just can't understand not giving a refund. I mean, my gosh, I mean even if you think if you went to the board, they are going to have sleepless nights. They're going to have to cancel patients to go to the board. All this, all this crap. And then I look at Walmart. I mean I'm from Kansas, I wasn't born in Beverly Hills or Key Biscayne and in Kansas or Nordstrom's has a different name and the Nordstrom's in Kansas, they call them Walmart and Walmart's returns 7% of sales. You buy a toaster or anything at Walmart and you say you don't like it and you bring it back. Seven out of a hundred items are returned and Walmart never questions you. They have a no questions asked return policy because the next time you're in there shopping and they don't want you worrying about the return policy so they can return 7% and some dentists would, instead of refunding a denture or a root canal, decide no, I'm going to stand my ground. And now he's dealing with an attorney. How much will his attorney costs be? I mean, what, ten root canals? I mean, it's just crazy. And I think a lot of it, they get emotional about what's right and what's wrong. What do you mean what's right and what's wrong? People are crazy. You go to a friend family reunion, there should be the centers of disease control should be there doing DNA testing to see what went wrong with half the population. I mean people are just crazy. And I have let me... I've refunded money on a denture and he wouldn't even give me the denture bag. Grandpa wanted a refund on my horrible denture, but wouldn't give it back and I could see he was wearing it because I saw it, but I gave it back to him because the guys going to live a mile from my office until he dies. And I don't want him walking around Safeway's saying that guy is horrible. I mean, people are crazy, refund the money. If Walmart can do 7%, I bet the average dentist in America doesn't even refund 1%. So if Walmart's doing 7%, why can't a dentist? It's just ego and pride.

Rico: Yeah, and I agree in that there, there are some cases that, you can do the best you can, the patient's unhappy and I think that I agree with you, I think the best thing to do is to, even if you don't refund all the money, just refund something just to show that, hey, you know what, I understand your issue. We may not agree, but here's something that can try to help you out. That's just how it is. I mean, I've refunded patients back money on things like that even though I've done the best I could with the case, but most of the time it boils down to unclear communication and unexpected expectations not met. And that happens, but like you said before, why in the world would you want to spend your time, your money away from your practice on an attorney that's going to cost you so much more. Just give the patient back their money and just move on with it. I mean and because like you said, it's going to mess with your sleep, it's going to mess with your spouse, you're going to kick your dog, you're going to just be a grumpy old man, old woman, whoever you are, so it's not worth it. So just try to do the right thing and just move ahead, move on.

Howard: Yeah and the other thing, it takes your smile off your face. It makes them stressed. I mean, you have enough stress dealing with crazy patients. Crazy staff, crazy insurance companies. Last thing you need to do is be shooting yourself in the foot over a refund. But here's the consumer side. I want to talk about warranties because the average American between age sixteen and seventy six, in sixty years will actually buy thirteen new cars with the median average price of that new car, thirty three thousand five hundred. So when they buy a car, the reason GMAC finance will finance it because they don't have to worry about the car lasting five years. They know that's not the risk. The risk is what percent are going to default on the car. So, but then when they come in and get a root canal or they get any dentistry done, a lot of people just have that five year thing in their head. Well, this didn't even last five years, in thirty years I've listened to people; they throw that five around all the time because that's what they know from auto. And the biggest expense they'll have is their house. Second is their car. So when someone comes in and gets a molar root canal from Rico, do you warranty of five years? How does your mind wrap around warranties?

Rico: Well, I'll tell him like this. I said the only reason why they can give you a warranty is because those things are man made it and it's different than what we do. What we do, we're working on a human body. There's so many more factors that can go wrong that we can't fix because this is not man made. You did not come with an instruction manual. No one didn't put you on an assembly line and put you together. So therefore there are some things that is going to be out of our hands and we do the best job we can in order for your body to accept the treatment that we do. And I tell people all the time, I can't make you heal, but I could put your body in the best position for it to heal itself. So statistically, how long does a good root canal last if it's restored properly? It can last you indefinitely. 95%. That's what I tell patients. Average 95% if it's restored properly, you'll have this indefinitely. Now, depending on the case, the percentages can go down but we're going to do our best to try to help you keep this tooth as long as possible. When you're coming in for a root canal, you're not coming in for maintenance work. You're coming in as a last step in order to save your tooth. It's like you're coming in, you just had a heart attack. You're going into the cardiologist, the cardiothoracic surgeon. Hey buddy; this is your last round. We're going to do the best we can to get that heart going and to keep you alive. But guess what? When it doesn't work, it's not that cardiologists fault. It's not the fact that cardiologists or the cardiothoracic surgeon did something wrong. They did the best they could to get you more longevity out of your life. Guess what, the endodontist it's not my fault that you have a big hole in your tooth, that you didn't brush your tooth or you were in a trauma. We're coming in to try to buy you some more time. That's what we're trying to do. You're past the maintenance phase when you come and see us, you know what I mean? So that's what we do. And when we put it like that, patients understand - wait this is different. This is not something like Walmart that I need to get a warranty so to speak on it. This is something that's different because I don't know, not one patient that ever tried to sue their cardiologist or their cardiothoracic surgeon because they died because that surgeon was trying to help them. And I put it that way and they say, "Wow, I didn't think about that." And I'm like, "Yeah, it's different." So I try, me personally, my practice, I try to remove the stigma of trying to attach what we do to what a Walmart does and what a Nordstrom does. And so when I spend that time with the patient, they say, "Oh, okay, I get it. It is different." So that's what I try to do.

Howard: When I asked … the insurance companies don't like to share data, but I was speaking in Florida to a group of two hundred insurance people and they were showing me data, but they won't post on Dentaltown and they won't give it to me. They're, they're very, I was talking to the ADA about that, how they really, I wish they'd really try to get more data from Delta to release their numbers, but these big insurance were showing me that if a general... measuring root canal failure by just the tooth was extracted, crystal clear. No you're looking at it and saying there's periapical radiology or it's symptomatic, none of that just was the tooth pulled or not. That when endodontists do a root canal at five years, 5% of the teeth are extracted and when general dentists do the molar root canal, at five years, 10% are extracted. So as measured by extractions, endo does have a 95%, five year survival rate. General dentist is 90%. When you're talking about … back to standard of care, malpractice, warranties, is file separation partly the dentist's fault, the endodontists fault; is it the file company's fault? What are you thinking when you see file separation?

Rico: I think it's multi-factorial. Of course the dental companies don't want to say, hey, you know what, this file we had a glitch in this file, we had a micro nick in it, and we went around that curve, that's what caused the separate. There're not going to be any dental company's that's going to fess up to that. So there are some manufacturer errors, there are some operator errors, there are some cases in which you pick the wrong file for that case. And all that comes with experience and getting more education on which files to use on certain cases, but guess what? A separated instrument is not practicing below the standard of care, is not a breach of the standard of care. The key is that should be in your consent that endodontic instruments can separate inside the canal and the patient to understand that. And number two, if that happens to you, you have to document that in the chart and tell the patient. If you've done all three of those, you're fine. Even if the separated canal caught … let me backup the - file itself, as long as it's sterile, the file never causes the problem. I tell people, you're talking about a file that's three, four millimeters in length, maybe half a millimeter or two in diameter, and you got a freaking knee implant. That's titanium. That's like you've got ten pounds of titanium in your knee, as long as it's sterile it's okay. The problem is a lot of dentists go in there and they, the first thing they pick up is these rotary files and they go straight in there and they haven't cleaned the canal out well. So the bacteria beyond the file, that becomes a problem. It goes back to the bacteria, not cleaning it out, but you look at the x-ray, you would think, oh man, there's a file in there and there's a big (inaudible 00:41:45) infection. Man, the separated file must be the cause of it. It's not, and a separated file is going to happen to all of us. It still happens to me even done a hundred thousand of better cases, it still happens. But the key is if you've cleaned it out well with hand files and I'm still an advocate, I'm still old school with that, first, and then if you have a separate instrument use it, it doesn't even play a part in the success rate of the case. I tell the patient, "Hey, you know what; you just left with a parting gift. You left with something more expensive in your mouth than you had before", and they laugh and I'm like, "Okay, just make sure it doesn't go off when I'm going through the airport security system." I said, "No, it won't." So it's fine. In most cases it's fine. You just have to make sure that that's explained to the patient, make sure it's documented. If they do have an issue with it, send it to your local friendly endodontist and we can take care of it from there.

Howard: How far do you work it up before you switch from hand file to rotary file?

Rico: Well, in most cases, I like to have at least a ten or a size fifteen hand file to my working with at the apex. Once I've got that taken care of, I'm pretty secure in just about any file system that I choose to use on the case. A lot of times with all this marketing going on, you don't even have to use hand files just go straight to rotary. If you do that, and if you have a separated instrument, you're in trouble at that point. So when I teach, I always tell them, get you a good glidepath, at least a ten or fifteen hand file to the apex where it's safe and then you introduce your rotaries and if you do have a separated instrument, chances are you've already been down there, you've at least cleaned it out somewhat. Chances are the case will still be okay.

Howard: I hope you honor a Sunday with putting an online CE course on Dentaltown. We put up four hundred one hour courses all ADA approved and they're coming up on a million views in every single country on earth.

Rico: Wow, incredible.

Howard: Yeah, it is amazing. What is your go to file system?

Rico: Well, I still use a hybrid system. One of my favorite file systems is Edge System. The EdgeFile. Dr Goodis is a good friend of mine…

Howard: (Inaudible 00:44:16) Albuquerque.

Rico: Yeah, Albuquerque. I call him my brother from another mother and I salute him for challenging all the big endo guys and it's been a small guy, he started from scratch. He has phenomenal products. I've tried them all, but my favorite is the Edge X7. It's a really nice universal heat treated file that's cost effective, strong, resilient, it can go around curves, you can bend it. No shape memory, so it doesn't typically straighten out in a case. So it's my go to file on most cases. It's half the cost of most of the other files out there and I trust them. I mean Dr Goodis, he's an endodontist and also he's an engineer. I think you've had, I know you've had him on the show because I saw the podcast, which was great. And he does a good job with the files. And he's giving these other big endos hell. He's giving them hell. And they, I told them, I said I talked with Dentsply and I talked with breslin, I'll talk with all those guys and say, "Hey, you know what, if you're going to be competitive, you guys are going to have to get your prices down because if not, they're going to eat your lunch." I mean that's just how it is. I mean, I'm not saying you guys have bad files. I think everybody has a nice file, some people. What do you drive, Howard? What do you drive?

Howard: A 2004 Lexus 450 with a hundred and fifty thousand miles on it.

Rico: Okay. So (inaudible 00:45:44) there's difference than someone driving a Subaru because it gets you where you need to go. It doesn't matter. And I tell people it doesn't matter your file system, you just like it and you get good at it and you know it. I still have my 2004 BMW, I still, no it's 2005.

Howard: I won then, mine's a year older. I won.  How many miles you got on it?

Rico: Sixty thousand, only got sixty thousand miles on it.

Howard: Man, where do you live three blocks from work?

Rico: No, the freaking thing stays in the shop so much; I'm usually too scared to drive it. You crank it up (inaudible 00:46:21). So but guess what? I have a 2007 Lexus. It has a hundred and twenty five thousand miles on it, ES 350; it never is in the shop, man. It doesn't (inaudible 00:46:35). It's a Toyota for goodness sake. It's what it is. So I tell people, just find out what you got and you use it. Now there are some cases I'll pull my BMW out, a nice night, it isn't raining and I pull it out. But guess what? Most of the time I pull out my Lexus because it's a tried and true. And it's the same way with file systems. I mean you're spending $25 on a nice file system, X7 EdgeEndo. Why the heck wouldn't you use it? And it has all the studies and all that kind of stuff talks about it. You could spend money on all this other fancy smancy stuff. You know that you get big marketing and they're taking over with marketing, but guess what, at the end of the day, we're going to get to the same place. It depends on how you want to get there. So, that's just the bottom line on that.

Howard: Ryan's in the market for a new car and I said son, Japanese, Japanese. I mean, when I bought my Lexus, I knew I'd get two hundred and fifty thousand miles out of it. I just didn't know that fourteen years later I'd still have a hundred thousand to go. But I mean, the car hasn't blinked. I have no problem with it. And I don't even think people realize how damn old it is, it's just so tried and true. I'm going to switch the pains... all the studies I've seen for thirty years, you can cut the American market in half consistently for three decades. Half of the people are shopping on price or fear of cost and half are fear of pain. And whether it be psychological pain, it's going to look ugly, whatever, but the big deal is the pain, the shot, and it's very, very emotional because they're so scared yet they're sleeved with a tattoo all the way on their arm they had a million shots. They have paper clips to their eyebrow, a bar through their tongue, their belly buttons pierced. You are in the worst of it because the most feared procedure is a root canal. Do you put people to sleep? Do you use laughing gas? Do you use Halcion? Do you manage it with armchair psychology? How do you deal with, I mean, you have to know that at least half of your customers do not want to be having a root canal.

Rico: Absolutely. Well, more than half I would say. I would say nobody wants a root canal and no one ever signed up saying, "Hey, I'm here because I love getting root canals." Now they will say that for ortho, everybody wants to look pretty and nice and all that kind of stuff. But first I started with just some general chairside psychology, compassion, getting them to understand we're all on the same page. We're here to help you and we go through that. I would say 90% of the time I don't have to do any other oral sedations, any Halcion or Nitrous or any of that kind of stuff. Now, for the other 10%, we do have to do some type of sedation. Most of the time we use Nitrous and there are some situations that we have to use some Valium or things like that. But most of the time, it really boils down to that chair side manner. Chairside psychology, talking them through the whole procedure, letting them feel that they are in control over the procedure and that's very important. "Hey, I'm going to do this. If you have any discomfort, raise your left hand we'll stop immediately. We're going to take care of you." And once we get through that and the key is, and what I teach is make sure you have profound anesthesia before you get going. And there are some techniques to that. If you have that and they have no pain, they are going to think you are god as an endodontist because they're going to say, "Wow, my feeling hurt worse than getting that root canal" and that's a great testament to what we do and not only that, we'll get a good patient and this is what I encourage my other endo colleagues to do, and even my dentists. Get them, give them to give you a patient testimonial, video click testimony, put it on the website, put it on your podcast. Let people know that, hey, you know what, it doesn't have to hurt and they'll see these things and that will bring that fear down. In fact, we just came off Root Canal Awareness Week last week and there was a national campaign that we talked about root canals don't cause pain, they prevent pain or they get you out of pain. You know all those kinds of things. And now the fear of root canals amongst millennials are nil to none. Most of millennials aren't scared of a root canal it's the guys that's fifty, sixty and above they're, "Oh my god..." Because they had bad experiences growing up as a kid at a dentist. You take most of the patients that's under forty and under these guys aren't like, "Oh my god, I got to get a root canal." They're just "All right, you just got to do the root canal so I can do what I got to do" and they're done. So I think it's a lot to do with that age gap where dentistry, it was at one point hell, terrible. But now a lot of these forty and unders, millennials, it's not, they don't fear it like the other age does.

Howard: And are you using Septocaine or Lidocaine?

Rico: I use both. It all depends on the situation. I like to use Septocaine on a hot lower molar infiltration. I don't like to do a block. Some of the studies saying blocking with it can cause some paresthesia and that's still kind of up to debate. There are some studies that said yes it does and some studies say it doesn't make a difference, but I always like to err on the side of caution (inaudible 00:52:25) why do I want to give a block on something that could possibly cause that. Even if it was only one case out of a hundred thousand, I don't want to be that one case. So I still block with my traditional Zylocaine, and Lidocaine and, and I'll do infiltration with the Septocaine or Articaine if I need to.

Howard: A lot of times these kids are posting pictures on Dentaltown where they were going to go in to do a root canal, but after they took out the mod amalgam, they now see a black line down the bottom what it, what goes through your mind when you remove the MOD amalgam and there's a black line down there.

Rico: Usually then if there's a black line, obviously there's a crack. It doesn't mean the tooth needs to be extracted though. I mean you have to look at the whole case. It could just be just a crack that just stopped right at the pulpal floor and if you don't have any other issues like do you have a sinus tract present? Do you have significant probing? Do you have mobility, do you have depressability? And if the bone is solid around there, I would definitely not think extraction. You do the endo and if you like, for myself, I have a microscope and as long as I don't see the crack going into the root canal system, I think the tooth has a good chance at lasting a long time and I encourage the patient to try to keep the tooth, do the endo, restore it and we hope long term that it'll last. Now we do let them know that there's a crack there, we don't like the crack. The prognosis isn't as high as it normally would be if we didn't see it, but it definitely doesn't mean the tooth needs to come out and get an implant.

Howard: What microscope do you have? What brand did you go with?

Rico: I use Global Microscope.

Howard: Out of St. Louis?

Rico: Out of St. Louis, that's right. Yep, Global the old tried and true. So, I tell people all the time, again, it goes back to the whole car thing. It doesn't matter what kind of microscope you use, there's people who are iPhone junkies. There are people who are smart phone, it doesn't matter. Both of them still can make a phone call, both of them can still get on the internet. Both of them still can do what you want them to do. You have all these other company, Zeiss, Seiler, the list goes on and on. Some of them have better optics than others. Some of them, the clarity is better than others. Even if you don't have a microscope, I mean, if you have the loops, if you have some high power loops with good magnification and illumination, you still can find what you need to find and get a great result. So, I still have my Global and I've had it for almost twenty years. It has not broken down, not one time. I had to change a light source out because over a period of time it'll get dim and you just keep moving.

Howard: And how often do you have to use your microscope? If you did a hundred molars, what percent of the time, how many of those would you pull out your microscope?

Rico: 100% of them. I use them on every case, if it's a number nine. And the reason is because there's certain things that we'll be able to see in the microscope. It may just be something small, like a little piece of tissue tag that you wouldn't be able to see otherwise. So, I use a microscope on every single case 100% of the time.

Howard: Wow. So tell us about being an ADA spokesperson and you're an ADA success speaker. Tell us about your journey there. How did that come along? What was that like?

Rico: Well that came along and I'm just going to be frank with you, I've tried to get involved in organized dentistry in my area for years and I'm in the south, I'm from the south, so I know how sometimes things can work in the south when you are a minority. And you are in a certain area and I just got sick and tired of having to keep asking and no one giving me an opportunity. So I actually wrote the ADA and I said, "Hey, I've been doing this a long time. I think I contribute a lot to dentistry and I just can't get my foot in the door in my area in organized dentistry." And they said, "Okay, what have you ever heard of a program called the ADA Diversity in Leadership?" I said, "No." They said, "Apply for it." So I applied once, did not get in, applied twice, did not get in. The third time they said "apply again." I say, "No, this is the same bs that I deal with at in Georgia. I'm not going to apply again." They said, "Just try it one more time." So I applied and got in. So when I got into the program, it opened a lot of doors for me. The people got to know me that I normally wouldn't otherwise get a chance to rub shoulders with and they say, "Hey, you know what, this guy, he has something to offer, our profession as far from a leadership standpoint." And I started to do some projects with them and started volunteering at the ADA on a national level. They sent word to my local organization, say, "hey, you need to be giving this guy an opportunity." And they talked to somebody, they talked to somebody and all of a sudden I got opportunities to do a lot of different things.

Howard: Being able to be an ADA, I spoke at the ADA National Meeting in Denver a couple of years ago as a new speaker. I did it well. They said "where in the hell have you been?" I said, "hey, I can't go anywhere, no one gives me an opportunity and I don't want to sign with a company for them to put me up in lights for them to... they pay me to say certain things. I want to be independent." And I did well and I got invited to the ADA when it was here in Atlanta and I spoke here and since then, it just catapulted me for a lot of other opportunities through the ADA Diversity in Leadership program. And I'm a sounding board for the board of trustees and I tell them some of the issues that other minority dentists have and some of the frank... they're afraid.

Rico: I mean, if I walk into a room, I'm a young dentist and I see someone like you, Howard and everybody's like you. No one's talking to me. I mean, what the hell am I supposed to do? I'm not going to feel comfortable. So if I don't feel comfortable, I don't feel welcome. I'm not going to come back. So, and then they say, "Hey, where is the diversity?" Well, if you don't make people feel comfortable, there will not be diversity in leadership or in dentistry, so you have to be intentional. So, there were some people, James Crowley, the president of ADA and I spoke to him about it and he's like, "hey, we need you here to be a sounding board." So through that I've been had other opportunities to be an ADA spokesperson in endodontics and again, you have to apply for these positions, go through an interview process. And the spokesperson position is dealing with endo if there's a crisis or if they need an expert, the ADA need an expert to talk about root canals causing cancer or this root canal causing my liver to fail, I'm the person they call. If CNN needs to interview someone or National Radio, NPR, anybody needs somebody. So I'm the guy that they call in that particular area. So it's just given me a lot of opportunities to network and to make us stronger together, as diversity, diversified dentists all over, not only the United States but all over the world. So, and I was one of those guys, Howard, that I paid my dues since 1999 as an ADA member even though I didn't feel like at the time I really got anything in return, but I felt like that was just the right thing to do and I'm just now getting involved as of probably three or four years ago. And it's just been a very awesome journey and I'm able to pull other people through that have a desire to get involved in organized dentistry and leadership, but they're afraid, and they don't feel like they have things in common with other people. So, it's just been an awesome, awesome journey so far.

Howard: When I was in dental school in 1984, the head of the oral surgeries, Brett Ferguson, an African-American, who's now the president of the American Association of Oral Maxillofacial Surgery, AAOMS. And one day we were talking about prescriptions or something.

Rico: Howard, not Butch Ferguson?

Howard: Brett Ferguson.

Rico: Is he, where is he now?

Howard: Brett Ferguson?

Rico: Yes. Where does he practice?

Howard: Kansas City.

Rico: Kansas City, okay. Because I know a guy, he's an oral surgeon, he's in Augusta. He teaches in Augusta and his name is Butch Ferguson. So he's (inaudible 01:01:09) so I'm like, wait a minute, is this the same guy, but go ahead.

Howard: But yeah, it's Brett Ferguson and anyway, we were talking one day in oral surgery and I said, "Dr Ferguson." I said, "You are so damn smart." I said, "How do you keep all this in your head? I mean, you don't even look at the pharmaceutical." And he goes, "Are you kidding me, Howard?" He goes, "I'm an African American. I got into the, I am the chairman of the department. I couldn't make a B ever. I had to be straight A. I couldn't even get an A minus." He goes, year after, he says, "A white kid like you, you could have got in with a 3.2. But me, I had to be perfect to get in here." And then the other oral surgeons, African American and UMKC Charlie White say the same thing, in endo we talked about Bamiduro Oguntebi from Lagos, Nigeria, and the hurdles that they had to pass. And when I saw him become the president of the AAMOS I actually got verklempt. I mean, it made me cry. I couldn't believe the journey, it had to be a long, long road. We need to get you a course on Dentaltown and get your beautiful face on the cover of Dentaltown magazine. I would love that. I can't believe we already went over an hour, god, we've been babbling eight minutes past overtime. Our brands an hour and we already went eight minutes after I could talk to you forty days, forty nights. But I want you to; you can't go without talking about your book Getting to the Root of Your Problem on Amazon. Tell us about your journey. What made you write that book? Tell them about the book Getting to the Root of Your Problem. And it's actually not have anything to do with root canals and microscopes and getting to the apex. What is Getting to the Root of Your Problem: 365 Days Of Inspirational Thinking. All five star reviews on Amazon. Tell us about your journey. Why did you write that book?

Rico: Well, I wrote the book because I realize that in life we all have problems. We all deal with problems.

Howard: Are you talking about Ryan?

Rico: Yeah, just yeah, it was Ryan.

Howard: Yeah, that's my only problem, everything else is…

Rico: A lot of times, people don't know how to deal with certain problems and a lot of times, some people say if you go to churches, open your bible and read it, well the bible can be very confusing and it can be very overwhelming for someone just to open it up and read it. So I said, you know what, I'm going to take little bits and pieces of things from my life, from the bible, from other philosophers like Socrates and Plato, and put just the daily inspirational read, something that will encourage you the beginning of the day and gets you through today. And it was birthed out of me posting data inspiration on Facebook and someone said, "hey, you know what, you need to have a book because all these things that you're posting, we might not know all the root canal stuff, but the stuff about life, it is making a difference." And I'm like, eh, whatever, making a difference and I ended up getting a lady end up inboxing me and said "because of something you said today, I did not commit suicide. I had a gun to my head, but something you posted that encouraged me to let it go, live another day tomorrow will be better." And she lived because it was something that I posted. And when she said that it sent chills down my spine. I'm like, man, I'm a little (inaudible 01:04:38) kid from Columbus, Georgia and I had the ability to keep somebody from committing suicide. I must have some type of gift inside of me, that I need to share with the world. And that's when I started writing the book and I wanted to leave something for my kids, also. I have two kids, they're ten and twelve now so they can know how their dad thought and how they processed and it's not about all the accolades and the house you live in and the car you drive. It's about the difference that you're making in the lives of other people. Same thing about what you're doing, the difference that you're making in the lives of other people, Howard, when you sacrificing your time and your talent, you building this thing that some people probably told you that this is not want to work. You're wasting your time. This is going to cost you all these things and you're taking time and you're (inaudible 01:05:28) the lives of people all over the world. That's making a huge difference and when you're gone, your legacy is still going to be ringing out the hearts of people all over the world and people will be thanking you for what you've done, contribute to dentistry and also contributing to their personal lives as well. And so I said I want to make a small impact right now with that book and that book hopefully would catapult me to be even a bigger influence in other people's lives, and it has, it's opened the doors for me to do a lot of radio interviews and television. I got a chance to speak at TBN, over eighty million viewers all over the world, about my faith walk and how I got to where I am and just using dentistry as a platform. Howard, I'm going to tell you, I believe that dentistry for us is just the platform to touch the lives of people, to heal people, to make people have a better today and hopefully have a better tomorrow. And that's what God is about. God has given us the gift of healing, a gift to be able to use our hands, to touch people, to make them feel better. He's giving you a gift of communication. I always kid with you, I say you're Howard Farran, but you're the Howard Stern of dentistry because you're honest and you don't care about what other people think and what their opinions are and I think that's beautiful. So that's what I want to do and hopefully, you don't know this, but you're a mentor of mine. I watch you from afar and I appreciate everything that you're doing in dentistry and putting those podcasts out there.

Howard: Well thanks, man, we should start a mutual admiration club. We'll be the only two members. Final question, when the Falcons are playing the Patriots in the Super Bowl at the halftime at twenty eight to three. Would you have bet both of your cars you were going to win? Were you already celebrating? Did you already have the TV turned off? And then did that instantly go to one of the lowest points in your life?

Rico: I would have gave away all four of my cars, man. I thought we had it. I was like, man, we got it. We just got to hold on, we just got to hold on and then when I start seeing, we started sweating a little bit and I looked at Tom Brady's eyes and he saw some blood. I'm like, oh shit we are in trouble and when they start climbing back, it was about three minutes left in the game, I turned the TV off because I pretty much knew what was going to happen. I turned the TV off, I tried to sleep, I could not sleep. I went upstairs and closed the door, turned all the lights off, and I told my wife, "Please don't come in here and tell me even if we win, I don't want to know" because it should not have been that close. Three o'clock in the morning she broke the news and I was just hurt. I mean it felt like somebody had ripped my heart out and stomped it on the ground and I was just like his can't be happening. So having said that, I still end up buying a PSL. I still ended up going into the new stadium with my hope still alive, that this is going to be the year, the Super Bowl's in Atlanta. This is our redemption year. We're going to hoist that thing up in our own stadium at Mercedes-Benz dome and it's going to make everything a lot better. So that's where my faith is now. So we'll see.

Howard: Well, we share the same pain. I'll never forget me and my mom, it was in 2009. The Arizona Cardinals were beating the Steelers with one minute left and then that Ben Rothschild throws a hail Mary pass and that guy... our street was screaming, my mom, she lost her voice. I mean we won. We had one minute they were backed up. There's no way they could win. And if that son of a gun didn't throw a bomb, the guy caught it, ran right down the line. The whole street was just silent for probably about a week. That was tough. And so we lost at twenty seven, twenty three. So I felt your pain during that deal. But hey…

Rico: Remember with that Howard. Not only that, guess what, same thing happened with Georgia in the national championship with Alabama. It was the same story. We had it. So I don't know. Hey, the Braves are in first place now, so we'll see how long that's going to last. We just have to enjoy the moment  I guess because at the end of the day, the big game, who knows.

Howard: Well, I'm your biggest fan. Love your cases on LinkedIn.

Rico: Thank you.

Howard: My gosh. I hope someday you start your own Rico thread on endodontics on Dentaltown and repost from there. You're amazing, I'm your biggest fan. I was so excited today to know that I got to wake up and I had to podcast interview you. Thank you so much for coming on the show today and talking to my homies. I hope you have a rocking hot day.

Rico: Hey, thank you. My pleasure. Have a blessed day.


Category: endodontics
More Like This

Total Blog Activity

Total Bloggers
Total Blog Posts
Total Podcasts
Total Videos


Townie® Poll

Do you utilize treatment acceleration?

Site Help

Sally Gross, Member Services
Phone: +1-480-445-9710

Follow Orthotown

Mobile App



9633 S. 48th Street Suite 200 • Phoenix, AZ 85044 · Phone: +1-480-598-0001 · Fax: +1-480-598-3450
©1999-2019 Orthotown, L.L.C., a division of Farran Media, L.L.C. · All Rights Reserved