Accessible Mobile Dental Treatment for Senior Patients with Dr. Rich Bailey, DMD
August 29, 2019
Our guest this week Dr. Rich Bailey, DMD sits down with Shaun Keating and discuss Dr. Bailey’s creation of a Mobile Geriatric Treatment Program that directly brings Dental Care to Senior Patients at their long-term care facilities. We talk about his previous business called “Billy Bob Teeth” and what he learned from that successful venture. Dr. Bailey also talks about the advantages and challenges one faces when going into mobile dentistry. You will hear all this and more on this week’s episode of the Dental Up Podcast!
On this episode you will hear about: -Advantages and Disadvantages of Mobile Dentistry.
-Understanding how to Communicate with Nursing Home Staff and Older Patients.
-Creating an efficient workflow in a mobile setting.
-CE and Mentorship
-Dr. Bailey’s early side venture “Billy Bob Teeth” and his experience.
Host: Ladies and gentlemen, this is The Dental Up Podcast, brought to you by Keating Dental Lab, a full-service, award-winning dental laboratory. Each week, you’ll learn tips and techniques from real-world dentists, bringing you in-depth interviews, motivating stories, current events, and sports. Here is your host, Shaun Keating. Shaun Keating: Hey, everyone. Shaun here. Welcome to another episode of The Dental Up Podcast. Our guest this week graduated from Southern Illinois School of Dental Medicine in 1996. While attending dental school, he co-created a successful novelty product called Billy Bob Teeth, which has brought joy and laughter to customers worldwide for over 20 years. He is now the Director of Onsite Dental Services, bringing high quality dental services to senior citizens and long-term care facilities. Currently practicing from Sloatsburg, New York, please welcome Dr. Rich Bailey, DMD. How’s it going, Dr. Bailey? Dr. Rich Bailey: Hey, Shaun. How are you doing? Good to hear you. Shaun Keating: Oh, dude, thank you so much for coming on, man. Dang, when I seen that you’re the dude that’s coming on the podcast today, I’m like, “I know that guy.” I remember way back and I swear, the old lab I worked at, we just marveled at those Billy Bob Teeth and we made our own and they [crosstalk 00:01:32]- Dr. Rich Bailey: Awesome. Shaun Keating: They were big sellers there for a while, but they’re quite a bit more expensive. I think yours were going for about $20 a set or so in the stores back in the day? Or… I think it was around 20 [crosstalk 00:01:44]- Dr. Rich Bailey: Yeah, that was probably our main price point. We, of course, offered fries with the shake, so if you wanted your tooth chipped or you wanted an abscess or a cavity, we charged a little more for that, but yeah, that was kind of the regular retail price, $20. Shaun Keating: Unbelievable, and they had like the pus ones. They had some funky looking ones and I think the hillbilly ones were like the best. Right about that time, too, we had just did the Goldmember dude, Austin Powers, we did his teeth [crosstalk 00:02:19]- Dr. Rich Bailey: Austin Powers- Shaun Keating: For the movie and had to do like 20 sets, but very similar to your Billy Bob Teeth. They’re a European-type, London brown teeth with stains and it was kind of a neat thing back then, but I remember doing them, too, around Halloween. It was always really… Dentists were always saying, “Shaun, can you do me some vampire teeth?” We always did the vampire teeth and right here, I got some that I did with… I put all these diamonds on. They’re just like porcelain teeth but we did them kind of like my temporaries that I make, and so we kind of [crosstalk 00:02:57] did the little tight fit in approximal spaces and all that. It’s kind of like a Flexite partial thing, but it’s a facial fitting res face, but I got these ones with like big old karat diamonds in them and I got six or 11. I put them on all the time. They fit like a glove and I haven’t made any of these [crosstalk 00:03:17]- Dr. Rich Bailey: Lower the property value wherever you go. Shaun Keating: Exactly. Oh man, because you could do that, dude. You put in a bad set of teeth like these and you’d look at somebody and… It really does make a difference with teeth, man, because they would think… You got a good grill and all that, it’s one thing, but if you come in with those teeth and it’s just like, I got a picture of you on your site and stuff and it kind of shows you with the Billy Bob Teeth. You got the perfect picture of you above with your suit on. You look like a Hollywood movie star, and then you got your thing down below with your picture, and it’s like, “Well, where did Billy Bob come from?” Oh, dude, that’s pretty [crosstalk 00:04:02]- Dr. Rich Bailey: You figure out pretty quick who loves you when you’re wearing the teeth. Shaun Keating: Exactly. You find out who your real friends are, man. That’s why you can always say, you cam be fat, you can have big ogre whatever it’s called on your face, or it really doesn’t matter, but with a lot of people, that’s the way people are, but when you really have a bad set of teeth, it’s just so… People always put their hand over their mouth or they just don’t have the self-confidence. Or you can just have confidence in the way you look, for sure, but when your teeth are all missing or crooked and this and that, I think it’s really hard for people to have true confidence and stuff. That’s why I just love that we can change a person for sure with… Teeth make a difference. Dr. Rich Bailey: Teeth make a difference. Shaun Keating: Like, man, I’m kind of a fat slob, but I got a great set of teeth, so people look at me like, “Hey, Shaun”… No, I’m just kidding. We better cut that out there. No. Shaun Keating: Well, dude, I always start off a little bit talking about sports. Now, are you into any of those Yankees out there? You’re out in… How far is Sloatsburg [crosstalk 00:05:15] out of New York City? Is it pretty far? Or [crosstalk 00:05:17]- Dr. Rich Bailey: No, we’re about an hour outside the city. Actually, the team that I love is the team that everybody hates. I’m kind of a fan of Bill Belichick and the Patriots. Shaun Keating: Yeah, that awesome, dude. That’s hard. I’ve never heard many New Yorkers that are big Boston guys, but Belichick is a fricking legend and what they’ve done is unheard of. Even, too, Tom Brady, that dude is 42 years old, man. He’s out there and he’s [crosstalk 00:05:44] slinging it. Dr. Rich Bailey: Pretty amazing. Shaun Keating: Then, you got Andrew Luck, he just retired over the weekend. 29 years old and only been in the league like seven years and had a few good years. He made Pro Bowl like four years and he just had a rash of injuries the last two or three years and he just all of a sudden just said, “You know what? I’m out, man.” The owner, Isray or whatever his name is that owns the Colts, he was saying that he probably left close to $500 million on the plate. He could have got a couple three or four more year contracts and these contracts are coming out for a quarter of a million dollars for a lot of these quarterbacks, the elite quarterbacks. They’re getting paid so high, kind of like these baseball players and all that. They got these 3, $400 million contracts. Shaun Keating: I don’t know how they got it with a game like baseball. It’s so boring to watch lately. It’s like I couldn’t believe it, but it goes to show you, man, they’re just humans like all of us. At the end of the day, you want to be able to pick your kid up in the morning and you want to be able to walk and like your knees and everything else, I mean, football really does ravage your body. I played eight years of football and that was four years of youth and four years in high school and I’m feeling it. I just had a birthday last week, man, the big 5-7 and I feel like a 77-year-old. It’s like that’ll beat you up. I was a running back and I went head on and I probably had 30 or 40 concussions, man, through all of my years and seeing stars. That’s what we were taught. “Go head on and as fricking hard as you can hit those guys, try to flat back them. It’s [crosstalk 00:07:30]- Dr. Rich Bailey: Dane brammage. Shaun Keating: Exactly. That’s the only sport where kids can go play and their parents are clapping after little Johnny just went and knocked the other kid on his block, on his back, and took him out of the game and all the parents are clapping. It’s kind of crazy that this day… I guess they do that in hockey kind of, but football, it’s a different beast, but a lot of stuff is coming out now with all the CTE and all this stuff in the head, brain, and the whole thing. Antonio Brown with his helmet with the Raiders. He wants to play with his helmet that he’s had for 10 years and it’s like, “No, those aren’t certified anymore”, and the technology now is they’re able to protect the noggin quite a bit more with the newer helmets out, so with the newer technology. I’m all for that. It’s like… it’s a really ruthless sport and you really don’t realize it till you get older and you see [crosstalk 00:08:24]- Dr. Rich Bailey: It’s pretty rough. Shaun Keating: It’s pretty rough, man, and if I had little kids now… As soon as my kids were old enough, I have two boys, as soon as they’re old enough to play football, I was coaching them and had them in there and they’re both kind of banged up with knees and shoulder issues and they’re in their early 30s and it’s just like, “Yeah”… I’d probably rethink that if I was a parent coming in and maybe not let them do youth football, maybe high school, but even at that, at the end of the day, man, you look at the pros and cons and I just think there’s too much to lose with it with all the different things that they’re finding later. I don’t know, it’s just you think of all that glory [crosstalk 00:09:02]- Dr. Rich Bailey: I think dentistry is a better way to earn a living. Shaun Keating: Absolutely. No, I hear you there, man. Well, dude, let’s go ahead and Dental Up. Tell me, Dr. Bailey, now, why did you get into dentistry? At what point did you think, “I want to be a dentist”? Dr. Rich Bailey: I probably started thinking about it in high school. I think the thing that appealed to me was it’s… The way I viewed it at the time was it’s a combination of hand skills and people skills and both things kind of appealed to me. I can’t deny that there was a money motivator, too. My dentist had this sweet car, and I thought, “Well, that could be me”, and so there was that part of it, too, but I don’t think I really knew exactly… well, most of us don’t know what we’re getting into until we’re into it, but I thought everybody was going to love me. I didn’t understand that we’re not the most popular people in the world, but luckily there’s enough things about the job that do appeal to me that I feel like it is a good fit. Those two things really probably motivated me as much as anything. Shaun Keating: No kidding? I like that, he had a hot car. A lot of dentists got some nice cars, and some of them don’t, but I always heard that from a lot of guys. Like, “Well, the dentist drove a nice car and he only worked a couple of days a week.” I thought that was a nice kind of job to have and it’s so true, but then you got doctors that work six days a week. You got your worker bees and non-worker bees in all fields I think, but I think there is a lot of successful dentists that do a shorter, three, four-day week and are very successful and it’s pretty amazing. Not many industries you can do that. Dr. Rich Bailey: We’re really fortunate and I think as you age, your motivators change, what drives you, what’s important to you, so that’s what I was thinking about at the age of 16, but how many 16-year-olds have any real deep kind of quality thoughts? What motivated me then is not really what motivates me now. Shaun Keating: No, I hear that. Wait until you turn… you’re not 50 yet and it’ll come someday, but once I got over 50, really you start thinking about things a little differently and about life in general, man. It’s like, “Dang, I made it to 50. Am I going to make it 56 or 60?” It’s a trip how you look at life a little different as you get older and wiser, man. I think you become more thankful, too, as you see your kids grow and all of that. It’s just a blessing what we’re going through and every day is a gift, that’s for sure. Shaun Keating: Dude, tell me a little bit about where you attended dental school. Tell me a little bit about that. Tell me some of the things you liked [crosstalk 00:11:49] some of the things you didn’t like. Dr. Rich Bailey: It was Southern Illinois School of Dental Medicine. I think in retrospect, it was really a good program. One thing I appreciated about it now that I probably didn’t appreciate then is at the time I went through, it didn’t have any specialty programs. I think a lot of dental schools out there, if a tougher case comes along, those tougher cases get skirted to the specialty programs and the regular dental students don’t get to treat them where at my school at the time, there were no specialty schools. It was boot camp and I can’t say that it was always fun, but I feel like we were pretty… as prepared as you can be for that stage of your career. It’s like anything. You grow and I think there’s a pretty high attrition rate at my school. The standards are pretty high and you had to be self-motivated to make it happen. In retrospect, I think it was a good education, though. Shaun Keating: I love Chicago, man. How close was that to like downtown Chicago? Pretty far or close? Dr. Rich Bailey: Pretty far, actually. We’re on the other… Southern Illinois is in Alton, Illinois, so we were a suburb more or less of St. Louis, Missouri- Shaun Keating: Oh, okay. Dr. Rich Bailey: So we were a little farther away from Chicago. Probably a four- or five-hour drive. Shaun Keating: Okay, cool. Tell me a little bit… now, did you start out as an associate right out of school? Or did you buy a practice? Tell me a little bit about your startup as a dentist when you got out of college. Dr. Rich Bailey: Well, the first year and a half approximately out of dental school, I didn’t practice any dentistry. You mentioned the story of the Billy Bob Teeth, so I had this little invention and it was fun and I had a buddy of mine, his name is Jonah White that was helping me get started. We just had a blast selling teeth. In the beginning, I knew that an opportunity like that wouldn’t come around twice, and I wanted to take advantage of it so we started off at little things like county fairs and state fairs and gun shows and car shows. From there, we went to NASCAR and state fairs and coon dog conventions. I mean, you name it. NASCAR, Super Bowl, I’ve been to all 50 states and I’ve met all kinds of weird, interesting people and I got to sell crooked, ugly teeth. Dr. Rich Bailey: I don’t regret it, but after a while, I could see that it was not what I wanted to do with the rest of my life and I wanted to… that old saying, if you don’t use it, you lose it, so I was concerned about learning what I’d learned in dental school, so I decided to get back into it and had some family that lived in Idaho. As I had said, I’d done a lot of traveling and so that neck of the woods, Western Montana and Northern Idaho, Eastern Washington, to me it’s some of the best part of our country, and so I just decided I was going to job hunt up there. I didn’t have anything really tying me down at the time, so I looked for job opportunities there. I ended up buying a practice that nobody had been in and the equipment was still there and it was this little blue collar town in North Idaho. Shaun Keating: Oh good. Dr. Rich Bailey: Potlatch was the name of the town and I practiced there for 10 years and it was a great experience in a lot of ways. It’s a 45-minute drive, maybe 50-minute drive in any direction to get to the next closest dentist, so [crosstalk 00:15:30]- Shaun Keating: Oh, dang. Dr. Rich Bailey: I was a one-man band I guess for a while and I enjoyed it, but after a while I felt like it was time to make a change. I think a lot of us don’t understand what day-to-day dentistry is going to be like. Even dental school, you don’t get the perspective, and although there is parts of it that I really did enjoy, as I said the people skills part, the hand skills part, that part I enjoyed, but what was wearing me down was I didn’t understand going through school that dentistry… running a practice is really multitasking. You can call it a lot of things, but you’re working on one person, you got the hygienist giving you the dirty look because you need to do the exam. You got somebody else coming in 15 minutes. There might be a little drama going on with your staff that day. Dr. Rich Bailey: There’s just three or four things going on in your head all of the time and at the end of the day, that pace, it’s a money-making machine, there’s no doubt about it, but that pace did not fit me. It did not suit me well, and I think most men, most of us are not good at multitasking. Women are, but after a while, it started bugging me and I didn’t know what to do or how to change it or what my options were, but I knew that to some extent I felt like I was Bill Murray in Groundhog’s Day. I was just living the same day over and over and over and having the same conversations with the same people. It kind of lost its luster. I knew I had to make a change of some kind. Shaun Keating: No kidding. You got out of Idaho and then what? Dr. Rich Bailey: Well, I stayed there for a while and took some time off and did a little soul searching and I didn’t want to give up dentistry, but I didn’t want to keep practicing the way that I had been, and so I started filling in at different dental offices. There’s always a need for fill-in dentists and I just wanted to see what else was out there. I probably filled in at seven or eight facilities and I enjoyed to some extent, but finally I found a place that was going to be okay. I was just working for a friend of mine and as an independent contractor. I did that for like seven years, just three days a week, and I was able to just go in, do the work, leave, not have to worry about any of the business side of it, the practice management side of it. That part of it was good, but still to some extent, I’m multitasking and I just didn’t know how to re-engineer dentistry to make it work better for my personality. Dr. Rich Bailey: I started recognizing the problem that seniors go through. These senior citizens would come into the practice and most of them had taken really good care of their teeth their whole lives, and then all of a sudden they come in for one checkup and there’s a dozen cavities and they’re at the CEJ and they’re deep and, how did this happen? I saw the need that I think a lot of us do in private practice and I called the administrators and asked them, “Could you help them with their daily oral hygiene?” It always seemed like that plea fell on deaf ears. Dr. Rich Bailey: I started thinking about mobile dentistry and I started taking a couple of classes on it. I could quickly see why there aren’t many dentists that go into it. One problem was the equipment was really clumsy. I’d seen what was out there and a lot of guys are doing dentistry in RVs, and I can’t think of a better way to upset a frail old lady in February than pulling them out in a parking lot. That part I could see was not well thought out or designed, and then some guys were doing dentistry literally while the patient is sitting in a wheelchair at ground level. You’re hunched over like a shrimp. How long can you do that before it destroys your spine. Dr. Rich Bailey: That part of it I could see was a problem, and also the workflow. Nobody had devised a way to earn a living doing this. The need was there but those two things were a problem, and so I just started trying things and brainstorming. I’ve always believed that you can learn something from anybody, so I was always was bouncing ideas off different people, sometimes dentists, sometimes people that were not in the dental industry, just trying to brainstorm how to make it more efficient, how to make it work better. Dr. Rich Bailey: After a period of a few years of butting my head against a brick wall, I finally figured out the equipment that would make it efficient and easy and I figured out the workflow, how to design the day so that you’re not wasting time, that you’re earning a good living at it. Then, the best thing about it to me was that the idea that I could tear up the schedule because senior citizens in nursing homes, they’re not going anywhere. They’re there, so the whole place is kind of like your waiting room, and why have a schedule? When you tell a senior citizen of that generation you have an appointment tomorrow at 9 AM, they just stress out and they show up too early and they pace. Or if you just show up on short notice and say, “Hey, I talked to your daughter Debbie and she was real excited about us getting your teeth checked out today, so we’re just going to have you hop in the chair.” Dr. Rich Bailey: That worked way better and the person that’s in my chair has my undivided attention. There’s nobody else waiting on me. It takes what it takes, so that pace of dentistry just suits me so well and I do not feel exhausted at the end of the day. I earn a really good living doing it. Old people are quirky. They’re funny, they’re weird, and I dig that. You get to have the time to interact with them, to get to know them, and that part of it really appeals to me, so [crosstalk 00:22:12]- Shaun Keating: That’s just awesome [crosstalk 00:22:13]- Dr. Rich Bailey: I don’t feel like I’m a dog chasing me tail anymore. Shaun Keating: No, that’s very unique and I was reading about you on this Dentaltown a few months back, and you’re on the front cover and it’s just a really great thing, your story, and now it’s geriatric dentistry and it’s mobile dentistry and you’re just talking about how it’s tough on some of these patients. The plaque buildup, not being able to go see the dentist, and what you’re doing is like a hero. I think it’s neat. There’s not a lot of dentists that are raving and wanting to go work in older patients, in the old folks home or wherever it’s at. That’s just awesome [crosstalk 00:22:57] dude. Hats off to you, man. No, that’s really neat that you’re doing that and- Dr. Rich Bailey: It’s not sexy, cool dentistry for sure. If a person’s goal is to expand their skill set and to try every high-end thing that’s out there, this is probably not the job for them, but if they want to help people where there’s really a need and they’re willing to do what I call blue collar dentistry, drilling and filling, that kind of thing, then there’s an incredible need for it. They call this group Baby Boomers that are coming into the senior citizen stage now. They call it The Silver Tsunami. There’s [crosstalk 00:23:38]- Shaun Keating: Oh yeah. Dr. Rich Bailey: So many people [crosstalk 00:23:39]- Shaun Keating: They’re coming in [crosstalk 00:23:40] I’m like the [crosstalk 00:23:42]- Dr. Rich Bailey: They’re coming in. Shaun Keating: I’m the last of the Boomers, the youngest. Me and wife are like ’64… she was born in ’64, I’m ’62. I think it goes to 1960… or no, I think ’65 is the last and then before or whatever, but we’re all [crosstalk 00:23:59]- Dr. Rich Bailey: Something like that [crosstalk 00:23:59]- Shaun Keating: Someone is going to have to be wiping my bum in a very few years and I’m saving all my money so I can have it all picked out, the person that’s going to be there because when you have two boys… When you have daughters, you know your daughters will always take care of you, but if you have sons, they ain’t going to take care of you. They’re going to pass it off onto someone. That’s why we got our marbles in our head. We better take care of that now, but no. What you’re doing is just fricking awesome, dude. I just think… How is it? When you go in, do you have a portable chair? Do you have a portable handpiece? Tell me how you’re doing it and tell me a little bit about… What are you doing? Are you doing like extractions? Are you doing any fixed work? Or is it mostly drilling and filling? Tell me a little bit about [crosstalk 00:24:48]- Dr. Rich Bailey: Well- Shaun Keating: Your setup and how you did it and what kind of procedures you’re doing mostly. Dr. Rich Bailey: Well, before I tell you about the procedures, I kind of have to share my philosophy a little bit because with seniors, maybe the only blessing that comes with aging is teeth lose a lot of their vitality, so you can do restorative work on senior citizen’s teeth quite often without getting them numb. That’s a real advantage, so that [crosstalk 00:25:17]- Shaun Keating: Oh, really? Dr. Rich Bailey: That lowers drama a lot. Shaun Keating: That is really awesome. Dr. Rich Bailey: Also, when you look at some of the mouths, because a lot of the mouths are… I call them train wrecks. They’re at the train wreck stage. Things don’t look very good. The average person who is not in dentistry think this person really should be in pain, but they’re not. They not in pain, there’s not a lot of vitality, so you don’t actually get a lot of raging acute cellulitis infections. What you have is a lot of teeth that are not restorable, but on the other hand, I try to remember this, that at the end of the day, your goal… my overall goal with trying to help these seniors is to make them happy- Shaun Keating: Absolutely- Dr. Rich Bailey: And if they were in their 30s or 40s, then of course we’d be extracting teeth and placing implants and making fixed bridges or dentures or whatever they want, but at this stage, when you get that creative with your treatment planning, all you’re going to do is upset them. Shaun Keating: Exactly. Dr. Rich Bailey: Although their circumstances are far from perfect, human beings have this amazing ability to adapt to the circumstances the way that they are, and even though a lot of their teeth are broken down, they know how to get their food down. I over time slowly developed a philosophy where I told them, “Look, on one hand you would be healthier without these teeth. Your immune system would not be in battle mode, but on the other hand, these extractions, they’re not going to be that fun. You’re 90-something years old and even if the tooth comes out nice and easy, you may look like you were in a bar fight the next day- Shaun Keating: Exactly. Dr. Rich Bailey: “There’s going to be bruising and swelling and you got to be mentally prepared for that. If you want me to take them out, I’m at your service, but on the other hand, if you don’t want to do it, another option would be to have me smooth off all rough edges. I could excavate some of the tooth decay, I can paint in a product that’s designed to slow down tooth decay. Even though these teeth are kind of broken down, you are actually functioning on them.” Dr. Rich Bailey: At the end of the day, that ends up what happens a lot with the non-restorable teeth is smooth off rough edges and we paint in the silver diamine fluoride, slow down the decay, and then on the teeth that we can restore, I call it drilling and filling and billing. We excavate tooth decay. Usually we’re able to do it without anesthetic. We’re packing in the filling material that you like, the bonding system that you prefer, whatever, and we don’t try to fully restore the teeth. Most seniors cannot tolerate a crown preparation. It’s just too [crosstalk 00:28:07]- Shaun Keating: Oh, I bet. Dr. Rich Bailey: Much time in their mouth, but you provide a very valuable service in helping them keep what they currently have. With seniors, it’s kind of like working on kids. Their attention span isn’t very long and if you can keep them comfortable and distracted, you got a chance of getting something done. We play their favorite music. As far as the equipment goes, one thing that really helped is when I upgraded to… I actually use an electric wheelchair as the dental chair and the chair [crosstalk 00:28:42]- Shaun Keating: Awesome. Dr. Rich Bailey: The chair also serves as a taxi because they might be down playing bingo or whatever, and so I drive it down the hall and we get them put in the chair and then we use a couple of extra pillows to make the chair super comfy. I ask them, “What kind of music do you like?” We’re playing Lawrence Welk, Glenn Miller, whatever they want to listen to, and then we bring them down to the dental operatory where we’re at. I have invented this light stand which holds the dental light at the right height because one of the challenges with seniors is when you tip them back in the chair too far, they have swallowing problems. Shaun Keating: Oh, okay. Dr. Rich Bailey: We do stand-up dentistry, so that means that we don’t tip them back as far, which means we got to have lighting at the right height. I tried all the headlights that are out there and just found that I wanted a standard dental light, which provides the best lighting, and so I invented this light stand which holds the standard dental light at the right height. Then, I have a delivery unit. The company that I use is ASI and they’re in Colorado and they make an awesome product. Dr. Rich Bailey: There’s some other good companies out there, too, but I just think that the machine they make is the best. When it’s something that you’re using every day, you want it to be reliable. You want it to be able to handle the pounding that moving in and out of buildings delivers and the thing is pretty darn quiet for a mobile unit and you can use conventional handpieces on it. Anyhow, that’s some of the equipment that I use to deliver the service. Shaun Keating: Unbelievable. That’s neat, man. That is just such a neat thing, dude, just seeing that and going where no one else really went and there’s going to be so many Baby Boomers in the next 20 years, 10, 15, that are just going to be [crosstalk 00:30:43]- Dr. Rich Bailey: There’s a lot of them. Shaun Keating: A lot of them, man, and it’s a trip, but good for you and just even, too, with… I’m just so impressed with you creating those Billy Bob… over 15 million sets of those teeth have been sold. You made a little money on that, huh? Dr. Rich Bailey: Yeah, for the time that I spent in it, we made a pretty good chunk of change. It was not the lifestyle for me. To run that kind of business, you got to be willing to stay in hotel rooms a lot, and [crosstalk 00:31:10] that didn’t appeal to me that much. I kind of like to be at home at night, but there aren’t many things in life that you can say you got a lot out of it that you didn’t have to put a lot into, so it was one of those that was a lot of fun. I don’t regret doing it, it’s just not what I want to do the rest of my life. Shaun Keating: No, I hear you, and even, too, just doing regular dentistry, I got a lot of dentists that are in small little towns in Alaska and different parts of the United States that there’s no one around for a hundred miles and you have to do a lot of your stuff and thank God they have a post office that’ll come and get them and I’m able to do their work. What you’re doing is just a unique niche, and maybe more dentists are doing it that I just don’t realize, but you’re kind of giving back [crosstalk 00:31:57]- Dr. Rich Bailey: There aren’t that many [crosstalk 00:31:57]- Shaun Keating: I think. You really are giving back in doing that and the people got to just love it because you’re a funny dude. I was talking to you for a while there, and you got that sense of humor, and even, too, at such a young age to something with the teeth like you did and then to do regular dentistry like everyone does, but just to say in your heart you felt… just really not feeling it and then to find this, that’s a path, dude. That’s just something… just your whole setup, the way that light looks and what you developed there and your little taxi wheelchair and how it works. It’s very, very unique and, man, I could see that replicated across many states, but you’re going to need the right dentist that is going to have the heart and the patience to do that kind of… It’s not all about the money, it’s about the people and helping them. Dr. Rich Bailey: I think you’re right. Since I wrote that article, I’ve gotten a lot of phone calls from dentists and it’s kind of interesting. I think those of us in the dental field, a lot of us tend to be introverts. I’m not, I’m more extroverted, but I think everybody who has been in the dental field for very long feels the strain of multitasking, and part of them wants to do it a different way, but it’s kind of an all or nothing thing. If you’re going to serve this group of people, you got to be willing to get the right stuff. You got to get trained on how to use it, you got to know how to set up the accounts. There’s no rocket science to it, but you got to be all-in if it’s going to work well, and I think sometimes dentists toy with these ideas. “Oh, I’d love to have more freedom. I’d love to have more flexibility. I’d like to enjoy what I’m doing more.” Dr. Rich Bailey: I think a lot of people in our field have trouble pulling the trigger, you know? Shaun Keating: Oh yeah, absolutely. Dr. Rich Bailey: I just kind of feel like life is pretty short and if you’re not happy, you better get happy because you don’t get second chances at the time that we have. Time is our most valuable commodity that we have, so we better use it to the best of our ability. Shaun Keating: Absolutely. You can’t buy time, man. You can’t buy it no matter how much money you got. Look at that Koch dude that just died. He was only 69 I think or 70… I think he was 69. $40 billion [crosstalk 00:34:31]- Dr. Rich Bailey: David Koch, the billionaire? Shaun Keating: Yeah, 40 billion in the bank. What can you do with it? Nothing. Same thing with like Jobs. You just think of all of these people and God, you know? I always have a saying that yesterday is history and tomorrow is a mystery. Man, we got today and no one can dispute that. There’s no one out there because it’s just… I won’t go there. We’ll just kind of keep rolling here. Tell me a little bit about with… Are you doing any more CE that you have to keep up? What do you have to keep up on, it’s somewhat, but what are you doing for CE? Mostly online stuff? Are you going to any of the shows? Chicago Midwinter maybe? Dr. Rich Bailey: Yeah. Shaun Keating: Or… tell me a little bit about that if you’re going [crosstalk 00:35:15]- Dr. Rich Bailey: There’s two shows I’ve gone to recently. I went to the New York Greater Dental Meeting last fall, and then this spring I went to the… there’s a group called The Special Care Dentistry Association, so anybody who is involved in geriatric dentistry or special needs dentistry, that’s kind of the group, and so that’s where you get a lot of classes that deal with how to help seniors, how to do mobile dentistry, that kind of thing. There’s [crosstalk 00:35:50]- Shaun Keating: Beautiful. We’ll put that [crosstalk 00:35:51] on our show notes for sure because I’m sure [crosstalk 00:35:55]- Dr. Rich Bailey: It’s a good group [crosstalk 00:35:55]- Shaun Keating: There’s some guys out there thinking, listening to this podcast going, “That’s an avenue I could do and kind of make me feel good about myself. about not worrying about some vain rich lady in getting a four to 12 or four to 13 done and she is not happy with the color.” Where you can take care of people and feel appreciated, and sometimes not feel appreciated because they can’t let you know how they really feel. Shaun Keating: What about with the special needs? Are you working with those, too? Or is it mostly geriatric patients? Or… Special needs patients, I mean [crosstalk 00:36:30]- Dr. Rich Bailey: I think I mostly [crosstalk 00:36:30]- Shaun Keating: That would be tough [crosstalk 00:36:31]- Dr. Rich Bailey: Focus on geriatric, but you could… Mobile equipment is mobile equipment You could use it in any environment. There’s… Sky is the limit as far as where you use it or how you use it. Yes, you could serve that group. I work on friends and family at my house once in a while- Shaun Keating: Good, good [crosstalk 00:36:52]- Dr. Rich Bailey: So and so needs a bridge, whatever, so I don’t want those skills to get rusty, but it’s not what I do full time, but I think you can use this equipment any way that you want to once you know how to use it. The way that I provide care with this specific approach, this equipment that I use, it’s not the only wan to do it. If you take the continuing ed, you’re going to see how other dentists do it. I feel that my way is the simplest way and the easiest way and the most efficient from a logistics and from an economic standpoint. My overhead from my practice is probably 15%, which is way low. Shaun Keating: That’s so awesome. Average GP is like 70, 80. Dr. Rich Bailey: Oh, it eats them alive, and another big advantage to this kind of practice is the flexibility because seniors, they kind of forget you exist five minutes after you leave the room, so- Shaun Keating: Exactly. That’s so true [crosstalk 00:38:02]- Dr. Rich Bailey: And so… My staff is all part time. It depends on how much I want to work, so I have literally disappeared for six or eight weeks taking trips with my family- Shaun Keating: Beautiful. Dr. Rich Bailey: And when I got home, nobody was mad at me, you know? Shaun Keating: Yeah, you go to love that. Dr. Rich Bailey: You can’t do that with most businesses. Shaun Keating: No, you can’t. Do you still have a brick and mortar practice? Or are you just kind of [crosstalk 00:38:27]- Dr. Rich Bailey: No [crosstalk 00:38:28]- Shaun Keating: Just kind of sets you straight out of the house, huh? Dr. Rich Bailey: Yeah, my equipment is always in one facility or another, so I don’t really need it, and plus, there’s plenty of dentists already serving that group of people. That’s the main focus of dentistry, so- Shaun Keating: Exactly. Dr. Rich Bailey: I just feel like I don’t need to compete with them. I’ve got my own little niche and I love what I’m doing and I don’t really want to serve the general public. Shaun Keating: That’s awesome. Dr. Rich Bailey: I want [crosstalk 00:38:59]- Shaun Keating: You can do what you want and, hey, you’re the one who went to school for all of those years and you’re the man. That is so neat. What kind of perimeter are you working out of? A couple of hundred miles you go? A hundred miles? What do you think [crosstalk 00:39:11]- Dr. Rich Bailey: Not near that far. I’m in Rockland County, New York, now, and that’s another story in and of itself, but anyhow, where I’m at, the county that I’m in probably has 3 or 400,000 people, so- Shaun Keating: Oh, you’re kidding? Dr. Rich Bailey: There’s plenty of people. 20, 25 minutes is as far as I have to drive. Shaun Keating: Oh, beautiful, man. How hard is it, then, to get into these facilities? Do they… Are they all… You got to get past the sergeant of arms? Or to the front desk? Or [crosstalk 00:39:42]- Dr. Rich Bailey: It’s not tough. Shaun Keating: It’s not that tough? Dr. Rich Bailey: No. No, and like any business, once you learn what to say, what not to say, how to say it, you just repeat the process once you figure it out. For example, when I walk into a facility that I’ve never been into before, if I want to get another facility that I’m going to serve, I do a little research out in the parking lot, figure out who the administrator is that I need to talk to. I walk into the building and there’s usually some nice lady behind the desk whose job is to prevent me from talking to the administrator- Shaun Keating: Exactly Dr. Rich Bailey: And I usually walk right up to them and say something like, “Hi, I’m hoping you can help me. I have a mobile dental practice. My name is Rich Bailey and I was hoping to talk to your administrator Diane about the possibility of helping some of your residents who have mobility challenges.” That’s usually all it takes for me to get a meeting- Shaun Keating: Beautiful. Dr. Rich Bailey: And then once I have a meeting with the administrator, and usually they make themselves available once they find out what I’m offering, it’s just basically show and tell. I’ve got some good color photographs that show the equipment and show how much space we need and just explain what kind of care, and I tell them we’re not here trying to do major dentistry. We’re trying to keep people happy, and that means short-term solutions. That means checkups up and cleanings, and denture adjustments, things like that. That totally fits in line with what they’re trying to do. They can’t fix every problem, but they’re trying to keep them happy. Shaun Keating: What about… Is it kind of a Medicaid-type thing for them on payment? Or is it fee for service? How does that work? Dr. Rich Bailey: Both. In order to serve this group of people, you really need to be a Medicaid provider because some of the people that you’re going to care for are on Medicaid- Shaun Keating: Exactly. Dr. Rich Bailey: And some dentists would think, “Well, that’s a deal-breaker”, but you got to remember, when you don’t have to get people numb, you can excavate a lot of carries and pack in a lot of fillings really quick. It almost doesn’t matter what the pay rate is because you can do fillings so fast [crosstalk 00:41:58] after a while. Dr. Rich Bailey: Anyhow, the Medicaid is part of it, and then the other one, they’re private pay. Everybody is kind of at a different stage as far as what they can tolerate and what they want, and although mostly it’s classified fillings and denture adjustments, just like week I cemented a couple of three into bridges, so it does [crosstalk 00:42:22]- Shaun Keating: Recent [crosstalk 00:42:23]- Dr. Rich Bailey: Occasionally- Shaun Keating: Like recent onto what the had? Dr. Rich Bailey: Yeah. Shaun Keating: Have you got a little [crosstalk 00:42:27] sandblaster [crosstalk 00:42:28]- Dr. Rich Bailey: No [crosstalk 00:42:28]- Shaun Keating: At all? Like a little a Danville on the side? A little- Dr. Rich Bailey: No, no. We fabricated two, three into bridges [crosstalk 00:42:36]- Shaun Keating: Perfect. Dr. Rich Bailey: Two different ladies. You still end up once in a while doing conventional crown and bridge, but it just comes down to the stage that they’re at and what they can tolerate. I kind of use the cleaning appointment to judge what they’re going to tolerate from a restorative standpoint because sometimes you can get away with it and sometimes you can’t. Shaun Keating: How do you do it when you’re cleaning? Are you just using your instruments? Or you got like a Cavitron-type vibrating situation- Dr. Rich Bailey: Yeah. Shaun Keating: With older people? Dr. Rich Bailey: Yeah, we got- Shaun Keating: Tell me about that. Dr. Rich Bailey: Yeah, we got a Cavitron. Shaun Keating: Perfect. Dr. Rich Bailey: I found that if you get as aggressive as most dental hygienists do, you’re probably going to ruin your chances of getting any of your restorative dentistry done, and that’s [crosstalk 00:43:22]- Shaun Keating: Exactly. Dr. Rich Bailey: That’s what destroying their teeth is declassified carries. I do as good a job with what they will tolerate and I use a Cavitron primarily and I have the assistant running the suction that we can knock it off pretty fast and we do some periodontal screening record and we check pocket depths just generally, but we’re not trying to keep track of every pocket because that’s not what’s plaguing them. Shaun Keating: Exactly. Dr. Rich Bailey: What’s plaguing them is classified carries, so we knock off the tartar. Once I can see well enough to know what is going on and make a phone call to the family, this is the second phone call they have received from me, tell them what’s going on and get the green light to take care of the restorative stuff from the family- Shaun Keating: Perfect. Dr. Rich Bailey: And we’re… We try to do everything in one visit if possible because there’s only so much you can ask of a senior. Shaun Keating: Yeah, and you know what, dude? That’s just amazing. When you think about it, think about the whole business model of it that you’re in one little town, man. There’s like 3, 400,000 people There’s probably 50,000 older geriatric-type patients, but that’s probably the way it is across every state in the United States. There’s probably such a huge market. Have you ever thought of maybe kind of like RB Dental Services where it’s kind of like a Smile Brite or one of these bigger DSO-type things? Have you ever thought of replicating it [crosstalk 00:44:57]- Dr. Rich Bailey: Thought about it. Shaun Keating: And maybe franchising it [crosstalk 00:44:58]- Dr. Rich Bailey: Yeah. Shaun Keating: You’re such an entrepreneur [crosstalk 00:45:00]- Dr. Rich Bailey: I thought about- Shaun Keating: You know? Dr. Rich Bailey: And I checked into it, but really at the end of the day, I think all that would accomplish… the main thing it would accomplish is complicating my life. Right now, my life is so good [crosstalk 00:45:12]- Shaun Keating: Exactly. Dr. Rich Bailey: And simple. I call that white man’s disease, you got things going great and then you just got to chase one more goal, and [crosstalk 00:45:22]- Shaun Keating: No, no, no. Dr. Rich Bailey: So what I’ve done instead for the dentists that want my help because it is challenging to know what to buy and how to use the equipment and how to get the written agreement set up. There’s a lot of little things that you have to do in order to make this kind of business well. What I’ve done is that I’ve told other dentists, “Look, it’s not my primary goal, but if you want my help, if you want me to mentor you, I charge a flat fee of 10 grand and basically that’s going to allow me to help you [crosstalk 00:45:58]- Shaun Keating: To go into a town [crosstalk 00:45:59]- Dr. Rich Bailey: Go from where you’re at [crosstalk 00:46:00]- Shaun Keating: Of all these old people and to hook them up, babe. I think that’s a great thing. I think if I was a dentist and I want to change up, I’d pay that in a heartbeat, dude. That’s nothing and I just see it all over here. Dr. Rich Bailey: That’s not much. Shaun Keating: We got Leisure World and all this stuff around me here, and I don’t think there’s many mobile dentists doing it and if you got a good game plan like you do, I just think that’s awesome. We’ll put that out, your info for sure that there are some guys out there that I’m sure would like to look into that. I just think it’s win-win for sure and… Dr. Rich Bailey: It’s also a very low overhead business to start as well. If you don’t own any dental equipment and you’re starting from scratch, you could put this together probably somewhere between 50 and $55,000 as far as the equipment goes. That’s digital X-rays, the trailer, everything you would need. Shaun Keating: That’s so neat. That is just so cool. I love that. Now, one last thing with… back to your teeth, dude. You got out of that, so are you able to start up… like say if you wanted to start another tooth thing, are you… Have a noncompete? It’s been years, man. Could you ever get back into it like [crosstalk 00:47:09] that? Or no? Dr. Rich Bailey: You mean the Billy Bob stuff? Shaun Keating: Yeah. No, but call it something different, and we come up with like six new designs so it’s not so much the hillbilly down there, it’s more the rap star. You got Drake’s grill and we could do the gold grills, but we’ll do them out of nonprecious and gold plate them. We could do the starts [crosstalk 00:47:31] with the… What do you think, baby? Come on, I’d go on there with you. Dr. Rich Bailey: I think that’s your game, brother. I think that I’ve been there. I kind of view life as like a buffet table and once you’ve had potato salad, how many times are you going to eat potato salad? There’s other things on the buffet table that I want to try and that itch has been scratched from my standpoint, but if you want to do it, knock yourself out, brother. Shaun Keating: Yeah, but see, I don’t have all that impressment… the way you guys did it to where you don’t have to do a boil and bite. It was kind of forgot how you did it. I think you bit into it and we cured it or… I’m not sure how it was, but it was pretty genius that… It was fricking pretty awesome, but I know a lot of copycats came around, but you never know, man. Dr. Rich Bailey: You’ll get a kick out of this part of the story. The way we did it for a long time was with a polyvinyl impression material, and I was a freshman in dental school when I was first trying to figure this out and I was having trouble figuring out how to make the impression material stick to the shell that had the crooked ugly teeth to it. When you’re a freshman in dental school, you don’t know anything. You know less than nothing, and I had never actually seen an impression tray, you know with the holes in it? Shaun Keating: Yeah, exactly. Dr. Rich Bailey: I’m asking all my professors, “How can you make these two things stick together and it not be a liability? Someone wants to sue me.” They were talking about adhesives that you paint on, and I can see some kid swallowing that stuff, and they talked about different products that you can heat up and that sounded like a bunch of trouble. I had uncles, my Uncle Stan who is a farmer, he’s a hog farmer in the Midwest and I was explaining the problem to him. He just looked at it and he got these big sausage fingers and he said, “Dang, you’re an idiot. Just put three holes back here and then the putty will float through there [crosstalk 00:49:33]- Shaun Keating: Go through it all [crosstalk 00:49:33]- Dr. Rich Bailey: And then it’ll lock on there- Shaun Keating: Hold it with retention [crosstalk 00:49:35]- Dr. Rich Bailey: And I was [crosstalk 00:49:36]- Shaun Keating: That was it. That’s how you did it. I forgot. Dr. Rich Bailey: It was a eureka moment, and so anyhow, that’s a little story of how he [crosstalk 00:49:44]- Shaun Keating: Stan The Man [crosstalk 00:49:45] with the sausage fingers. Uncle Stan, that’s awesome, dude. Dr. Rich Bailey: Told you [crosstalk 00:49:50]- Shaun Keating: Gosh, that’s just a great thing, but kind of fads come and go, but I think that was a great thing. You never know, man. Another six different grills out there at a good price point because I remember [crosstalk 00:50:02]- Dr. Rich Bailey: Sky is the limit if you want to dive into it. Shaun Keating: I got to sell it somebody where I just make like 3% off of each sale or something. No, I remember where we always got them with us was in the malls where the things we used to all go to back in the day. There was a store called Spencer’s and Spencer’s was [crosstalk 00:50:21]- Dr. Rich Bailey: Oh yeah, we sold them there [crosstalk 00:50:21]- Shaun Keating: Across the United States, so we got them in there and we’d get all the different ones. We’d try to reverse engineer those things and make them our own, but I think we got to do it because now they got the snap-on teeth and I got people their teeth are all going every which way and we can kind of do an over… DenMat did them and they’re kind of ugly, kind of monolithic looking, but what a difference to click them on in there and you got them for pictures and stuff like that. It really helped but it’s just something… I think we charged like… I’d do a lot of those for friends and stuff [crosstalk 00:51:01]- Dr. Rich Bailey: It’s fun stuff. Shaun Keating: For sure, but we charged like 39 a tooth and it’ll cost you a couple of hundred bucks for sure and not 20 bucks, so price point is where you guys really hit it. Dr. Bailey, great talking to you, man. Just what a great story and really, God bless you and your family for what you’re doing on this for the people out there, the older people, and for doing what your heart tells you to do. It’s just something a lot of guys get burnt out in dentistry and they just get completely out of it, and some will just beat them down and you didn’t. I think the success you had in other avenues allowed you to do what you’re doing, where some guys can’t do that, but what you’re doing, too, is not a real big startup and every town has got these people and it’s like, “Come on [crosstalk 00:51:52]- Dr. Rich Bailey: Every town [crosstalk 00:51:52]- Shaun Keating: You can really [crosstalk 00:51:53]- Dr. Rich Bailey: Has got them. I think for a dentist who wants to do it, although the flexibility and the money part is excellent, you still at the end of the day got to love hanging out with seniors. You got to love [crosstalk 00:52:08]- Shaun Keating: Exactly. Dr. Rich Bailey: You got to love the quirky weirdness of it and you have to… if you’re not enjoying that part of it, then any job is going to be a drag if you don’t enjoy [crosstalk 00:52:20] the actual interaction part of it. Shaun Keating: I hear you, man, I hear you for sure. There’s some dentists, they don’t like seeing their regular patients in the daytime. They’re not going to like go seeing the older ones, but I think the older ones, like you said, they’re quirky, a little different. Some will have wisdom, some won’t. Some won’t remember you when you leave the room and come back, but I just think it’s got to be something that just really makes you feel good. Shaun Keating: At the end of the day, you’re helping these people and a lot of these people, the vanity has left and all that. It’s not about that anymore at all. It’s just about living your best life and having it to where you can keep the grill and things in order and, like you said, too, like dogs, they adapt. I have a dog that’s almost blind and deaf, and they adapt, man, like nothing is wrong. It pulls on your heartstrings and you worry about it. They’re not worried. They’re adapting and they’re living a full life for sure and the same thing with the humans. As we get older, we’re all getting older and some of us sooner than others, but I think what you’re doing is a great thing, Dr. Bailey. Again, man, thanks [crosstalk 00:53:30]- Dr. Rich Bailey: Thanks, Shaun. Shaun Keating: Thanks for telling us about this story of yours and thanks for coming on The Dental Up Podcast and dude, if there’s anything I can ever do, you need any of those bridges, I’ll donate some stuff for sure for you if you ever need some stuff. Man, I’d love to help you. It would be an honor and a pleasure for me to do that, but again, Dr. Bailey, thanks for coming on The Dental Up Podcast and we’ll talk to you real soon. Dr. Rich Bailey: Okay, thanks, Shaun. Shaun Keating: All right [crosstalk 00:53:51]- Dr. Rich Bailey: Take care [crosstalk 00:53:52]- Shaun Keating: Buddy. Thanks again. Host: Thanks for joining us on The Dental Up Podcast Show this week. Make sure to follow us on Facebook, Instagram, and Twitter, or search The Dental Up Podcast on iTunes for our weekly feed. Don’t forget to visit keatingdentallab.com/promo for exclusive offers. Keating Dental Lab is a full-service dental laboratory and we’re nationwide. We’d love for you to send us a case so we can show you the Keating difference. If you did what you heard, please leave a review on iTunes and we’ll be back next week.