An Insiders Perspective into the Legal Process in the Dental Industry with Dr. David W. Eggleston, DDS

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 a real world dentist bringing you in-depth interviews, motivating stories, current events and sports. Here’s 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 the USC School of Dentistry with the unique distinction of receiving the Daniel Cabe memorial award and the Lewis E. Ford memorial award for achievements in prosthodontics.

Shaun Keating: He practiced prosthodontics at Bolling Air Force Base in Washington, D.C., achieving the rank of major. He has published numerous articles and has been part of several publications worldwide. He’s a very active member and supporter of his community, and offers continuous support to charities such as Smile Train, Wounded Warriors, The USO, and Angelito’s D’Oro. Practicing from Newport Beach California, please welcome Dr. David W. Eggleston DDS. How’s it going Dr. Eggleston?

Dr. Eggleston: Going great.

Shaun Keating: Thank you so much for coming on by. It’s a neat thing, you’re local and you’re here in the lab with me and most of my guys I’m doing them out of state and so I don’t see them so it’s kind of neat to have the doctor right in front of me so, thank you so much man, I really appreciate it. I always start off a little bit talking about sports and I know you’re a big USC guy and we’re gonna get into that, but you’re a USC Trojan fan are you?

Dr. Eggleston: Absolutely.

Shaun Keating: Yep, the fight on, what do you like, football?

Dr. Eggleston: Yeah, it’s a little harder this year than most years, but we’re backing them all the way.

Shaun Keating: Yeah, I tell you man I got a lot of footballs and stuff from the guys on different football teams, but USC, my brother went to dental school there too. He was class of ’81, but he was president of his class and man I go through your bio here dude. I’ve had a lot of bios I’ve talked to in the last three years of doing these things, and this is the biggest most informative bio and you’re probably the smartest dude I’ve ever come across and I know I see your dentistry and you practice some of the best dentistry. I mean top, top-notch, top 1% for sure, but thank you so much man. I say we go ahead and let you dental up. I always like to start off asking the doctor, okay, why did you get into dentistry and at what point did you think I wanna be a dentist?

Dr. Eggleston: Very early, I wanted to be a dentist in the fourth grade.

Shaun Keating: Oh you’re kidding.

Dr. Eggleston: No, I did my vocation report in the seventh grade on dentistry, and my dad had some friends that were dentists, and I shadowed them when I was in grade school. I just thought this was the coolest thing ever. So that was it, I decided to be a dentist and here I am.

Shaun Keating: That is so cool, fourth grade man, that’s so neat. I was eighth grade and my brother’s going to dental school. He’s the oldest one in our family, so he’d make me my mouth guards and stuff. He always said Shaun you’re gonna be a dental tech, and I’ll be a dentist. So I kind of knew from then on, eighth grade on, and sure enough, I went into dental technology school and then when I graduated, he goes, Shaun guess what, I’m specializing in endodontics and I don’t need your services. I was on my own, I was like what the heck.

Shaun Keating: So it kind of worked out because if I would’ve been work for him, I would’ve been a one practice dentist, and I went on to work for a big lab that turned into a big lab and learned a lot and worked there for a long time and then started my own lab in 2002, but it’s so neat to have you here. I just can’t thank you enough. So tell me a little bit about where you went to dental school and tell me a little bit about that if you could.

Dr. Eggleston: Well I went to USC dental school, graduated way back in 1970. Then stayed for the pros training and finished that in 1972, then two years in the air force. It was during the Vietnam War, and I had the distinct privilege of treating six of our POWs that were there.

Shaun Keating: Oh, you’re kidding, that’s-

Dr. Eggleston: At that time, I was so impressed with them. I thought all of dental school, all of my grad pros, if I did nothing else but treat these guys, it’d be worth it.

Shaun Keating: No kidding.

Dr. Eggleston: Yeah, they were amazing, they were in captivity from four to eight years.

Shaun Keating: Oh you’re kidding.

Dr. Eggleston: A lot of trauma to the teeth, a lot of reconstruction. So they were amazing, absolutely amazing.

Shaun Keating: Good for you, that is so neat.

Dr. Eggleston: That is the highlight of my career.

Shaun Keating: That’s awesome, I love to hear that story, that’s really neat. So when you got through with dental school and stuff, now did you go out and start your own practice, did you work as an associate, tell me a little bit about that if you could.

Dr. Eggleston: Well I had the distinct honor and privilege of going in as an associate with Daniel Gordon, he’s still a marvel. He was president of a number of major organizations and CDA, the American College of Prosthodontics, there’s still an annual award in his name, and he passed away in 1984. So he is one of our all time leaders.

Dr. Eggleston: So it was a big deal for me to go in as an associate with him, and first day I was here, he came in with a broken arm from playing tennis. So I had to treat his patients until he healed and that gave me a good start. We became best of friends and I worked with him as his associate until 1978, then he decided to retire. I told him there was a building opening up in Fashion Island in Newport Beach and I would set up an office there, and instead of retiring, he could come in just whenever he wanted just to practice part-time because I was gonna buy his practice. As everyone knows, when you buy good will, it’s not tax deductible.

Dr. Eggleston: So I was gonna have to come up with a lot of cash, after tax dollars, and I had this truly genius idea that he would come in and be my associate and I would pay him an extra 10% of whatever he produced, and that would pay off the purchase of his practice. So he ended up generating the money that I used to buy his practice. So at the time I had a formula where I paid the dentist associates 40%, I paid the staff 40%, and I used 20% to pay the overhead.

Shaun Keating: Unbelievable.

Dr. Eggleston: So I paid him 50%, and his fees were higher. So when he did a crown, I actually did better than when the other dentists in the office did a crown. So after five years, the agreement was for five years, I just kept it. I said you’re still on 50%, then he developed pancreatic cancer and passed away. Just like he had a backache and three months later he was dead.

Shaun Keating: Can you believe that.

Dr. Eggleston: So, count your blessings. But he was truly great pioneer in dentistry. He was on the faculty at USC and that’s where I first met him. He was my mentor, and he was the guy.

Shaun Keating: Wow, what a great thing.

Dr. Eggleston: So he passed away in 1984, which left a big void, then I had great bit of luck in Bruce Coy was looking for a spot. So he came in and he took over that space in the office and stayed with me until three months ago. He retired at age 73, he finally retired. So that was kind of the way I turned into a owner of a practice from being an associate with Dan Gordon.

Dr. Eggleston: Now we’ve expanded. Our initial office was about 3,000 square feet. Now we’re at 4,500, and we’ve got two labs and 11 operatories and we have six dentists.

Shaun Keating: Don’t you have like four ceramists too or something?

Dr. Eggleston: Yeah, we’ve got seven lab techs in the office.

Shaun Keating: A couple of them are like wizards man, I hear things. It’s so neat ’cause I’ve just known about you in the industry about a dentist, and we have a bunch of dentists out of Newport that I’ve worked with, but Eggleston’s always been the [inaudible 00:09:02], and I’m like man I was just so proud when I heard that you were sending us digital cases, and it was just like, gosh we better do good for this guy. We get everything is so sweet from you and it’s just … I’m so thankful for that.

Shaun Keating: Then you do these models, we get a model and you do a lot of study models and we make like eight different models and I’m telling my guys like really. He goes yeah, he always does it, so tell me a little bit about why I’m doing so many study models on cases.

Dr. Eggleston: Well I picked up the scanner, a three shaped scanner.

Shaun Keating: Best one babe.

Dr. Eggleston: Yeah it is.

Shaun Keating: I love that thing.

Dr. Eggleston: So we have it now, four or five months and using it more and more. But I do a number of legal cases, and when we examine do an independent dental review of a patient, instead of making stone casts that can get chipped or cracked and all this, we scan it and have it printed in acrylic and there’s no bubbles, there’re no streaks, it just looks gorgeous.

Shaun Keating: Oh, they’re beautiful models.

Dr. Eggleston: So we have that and I need a printed model for all of the attorneys involved, and the patient typically wants one as well and then we keep one. So yeah, I’ll have four or five sets printed off, and why not, the fifth one is just as accurate and perfect as the first one.

Shaun Keating: They’re so amazing.

Dr. Eggleston: So I’ve been using that for legal cases.

Shaun Keating: You’re really big into that. I mean tell me a little bit about that, I mean you’re doing … I’ll get into the story here in a little bit. But helped us out in the situation, but you do a lot of that with just you’re like the authority when it comes to legal cases and this and that, tell me a little bit about that. How’d you get started with that?

Dr. Eggleston: Well it started a number of years ago. It’s always been a relatively small percentage of my practice as I spend a lot more time treating patients than doing legal work. But it started out with some attorneys in the area, and it’s because I’ve gone through some dental organizations and have credentials.

Dr. Eggleston: ‘Cause jury, they don’t know what we’re talking about. We go into court and both sides are battling it out and the jury. The jury’s gonna look, this guy was president of this and president of that and this other guy doesn’t have those credentials. So I’m going with the first guy.

Shaun Keating: Exactly.

Dr. Eggleston: So that’s what attracts attorneys, they wanna find someone with the most credentials. So I’ve been president of my specialty board and president of a number of dental organizations and that just seems to be very good for legal cases. I only take cases that I think … on the right side. I won’t take a case if I think we’re on the wrong side.

Dr. Eggleston: So I do both defense and plaintiff, and I won’t take a plaintiff case if I think it’s a frivolous lawsuit, and I won’t take a defense case if I think the dentist really screwed up, and they’ve gotta really screw up for me to take it. I mean really screw up. So I’m talking fraud and spallation records and gross negligence beyond anything you can imagine.

Shaun Keating: I bet.

Dr. Eggleston: The Dental Board will review any case that settles for more than $10,000, any kind of a verdict from a jury, a judgment from a judge or decision from an arbitrator. Anything over $10,000, the dental board will review. Then they review it and they will typically ask the plaintiffs, if it’s against the dentist, the plaintiffs expert for all of his or her notes, records, everything that dealt with the case.

Dr. Eggleston: So the Dental Board calls in, me in this particular case, and gets all of my material that I used for the lawsuit and the court. So they have that, and then they decide with another expert reviewing it, whether they should file an accusation, whether there was violation of the dental practice act.

Dr. Eggleston: That can be gross negligence, multiple acts of negligence, incompetence, unprofessional conduct, fraud, spallation of dental records. So even one of those will cause an accusation against the dentist.

Shaun Keating: Oh I bet.

Dr. Eggleston: So they take three years to put that together. The only reason they take three years is because the statute of limitations is three years.

Shaun Keating: Oh you’re kidding.

Dr. Eggleston: If the statute of limitations is a week, they could do it in a week because they have all the material to do it. So they take three years, and on the last day of three years, they file a lawsuit against the dentist and as an accusation, and it goes into administrative law.

Dr. Eggleston: So then it goes to the Attorney General’s office, and then it takes two years to get on the docket for an administrative hearing in front of an administrative law judge. When that occurs, then the administrative law judge decides whether the dentist should have discipline on the license. So probation, revocation, or nothing done. So it takes a total of one year in civil court and five years and administrative law before the dental license is determined to be revoked or suspended or on probation or no discipline at all.

Shaun Keating: In the meantime, the dentist is still practicing and doing everything?

Dr. Eggleston: Yes, the dentist continues to practice, but then additional complaints to the Dental Board are added to the accusation. So there’s only one accusation, but it could have five, six, seven, eight patients on it. So each patient that comes forward with a complaint is then investigated, and then added to the accusation if it’s determined there was anything in those categories.

Dr. Eggleston: The main categories are the gross negligence, negligence and incompetence. Those are the ones that the Dental Board gets excited about.

Shaun Keating: Oh I bet.

Dr. Eggleston: It gets to the point where it goes through an administrative judge. The Attorney General’s office doesn’t have any dentists. They handle these accusations against dentists, physicians, attorneys, beauticians, anyone that’s licensed by the Department of Consumer Affairs.

Shaun Keating: Unbelievable.

Dr. Eggleston: So whenever they have one, they request a member of that profession to be the consultant for the case and it’s a volunteer position. So for a period of five years, it’s strictly volunteer work and we need to do it. We’re the ones handing out diplomas and when we make a mistake we need to-

Shaun Keating: Man up to it.

Dr. Eggleston: Yeah, we need to protect the public. Then there are cases where the dentist didn’t do anything wrong. I was expert for the defense in a case in Hawaii that went on for 14 years.

Shaun Keating: Unbelievable.

Dr. Eggleston: In Hawaii, they don’t settle these things up in a matter of couple of years like they do in California. For 14 years this dentist had to go through all of the depositions, the interrogatories and briefs and mandatory settlement conferences, and all of these procedures. Then he was clear, because he never did anything wrong in the first place.

Shaun Keating: Exactly, and it just gets drawn out so much. That’s amazing. What kind of advice can you give to some of our GPs and our practitioners out there, dos and don’ts, keep yourself out of something you know. The golden rule, just try to do the right thing, I mean it’s common sense basically isn’t it in a way?

Dr. Eggleston: It is, we’re all required to take a two hour course in California law every two years. So every dentist is exposed to a lecture in that particular topic on maintaining proper records and informed consent and practicing within the Dental Practice Act, and never, ever change any records.

Shaun Keating: Yeah, you gotta get it together and be good. Do the right thing.

Dr. Eggleston: They need to be aware that the ink can be dated.

Shaun Keating: Oh really.

Dr. Eggleston: Okay, so there’re forensic experts that can look at the written dental records and when they say date the ink, I thought there was some chemical in the ink that they would like carbon date or something like that. It’s not it at all, when you write on a sheet of paper, it leaves an imprint of what you’ve written on the sheet below it. So these forensic experts, they gather the original dental records and they go through and they look for imprints on the sheets of paper that were made from writing on the sheet above it.

Dr. Eggleston: When you write on a sheet and you date it in March, it shouldn’t leave an imprint on a sheet that was dated the same year in August, because then they know that it was rewritten after August and dated in March.

Shaun Keating: Then there’s also like key strokes, like computers and they check keystrokes and all that stuff they can do can’t they?

Dr. Eggleston: Well if you have paperless charts and you make an entry, and sometime in the future you change the entry, the computer notes that. So you can’t get around it. So dentists that are using paperless charts, and even written charts, if you wanna make a change in the chart, go ahead and write it and just date it. It’s perfectly legal to remember something that you didn’t remember to write in at the time that was contemporaneous.

Dr. Eggleston: So if you think of something later and you wanna change the record, you can do that, you can add to it, just date it when you make that addition, and that’s very legal, that’s perfectly fine.

Shaun Keating: That’s amazing, so you’ve been doing peer reviews for a long time, Peer Review Board for a while?

Dr. Eggleston: I was for the American College of Prosthodontics. We had a period of time in California when peer review was first started, and it was started by Dan Gordon incidentally. So I was in on it being his associate, as he was working on it I would be talking to him. So initially, all of the specialty organizations handled peer review in the state of California for their specialty, which is what peer review, the definition, is. If I have a complaint against me as a prosthodontist, it’s nice to be reviewed by other prosthodontist.

Dr. Eggleston: So that’s the way it was for a number of years and for nine years I served on the peer review committee for the American College of Prosthodontist for the state of California.

Shaun Keating: You’re like the president of that, you’ve been a part of that association from 19 I mean forever. It’s pretty amazing, all your different fellowships and presidencies and dang, man you’re like Albert Einstein.

Dr. Eggleston: No, no, no, it means I’ve been around a long time and I started treating patients in dental school in 1968, so I’ve been treating patients now 50 years. So I’m just getting started, I just signed a 10 year lease.

Shaun Keating: You look in better shape than I am, you look young as heck, you’re full of life. I mean I can see you going to keep going for a long time.

Dr. Eggleston: Well I do some extreme exercise. This Saturday, I’m doing the Cactus to Clouds hike. The hike is from Palm Springs at elevation 400 feet, you start at the Palm Springs Art Museum. There’s a trail that goes up to the top of San Jacinto mountain.

Shaun Keating: You’re kidding.

Dr. Eggleston: The hike is 21 miles long and you go up 10,400 feet in elevation gain.

Shaun Keating: That is so crazy.

Dr. Eggleston: So this’ll be my third time and I really enjoy it. Backpacking magazine rates it as the most difficult day hike in the entire world. There’s no other place where we have a desert floor right next to a mountain that’s 10,800 feet high.

Shaun Keating: Is that where the tram goes up?

Dr. Eggleston: Yeah, the trail goes up to the top of the tram and then you go another five miles to the top of, five and a half to the top of San Jacinto. So unfortunately this is not live or I could invite anyone that wants to join me.

Dr. Eggleston: We’re starting at the art museum at three o’clock in the morning Saturday, and then we’ll finish, get back down to the museum probably by seven or eight that evening.

Shaun Keating: That’s good for you, I get tired on that tram just going to the top, just sitting on the tram. That’s terrible.

Dr. Eggleston: It’s a lot of fun.

Shaun Keating: That’s so cool.

Dr. Eggleston: But I think hiking exercise is what we’re designed to do. So I’ve been doing this now 20 years, and I’ve got my resting pulse down to 37 and my triglycerides down to 30 and it’s all from eight 10, 20 mile hikes doing every week.

Shaun Keating: I got baby steps, I started, I’m doing one mile a day, 1.1 every day and it’s a start and I’m tired at the end of it every time. But hey you gotta start somewhere and god made your body to move, I’m sedentary so much at work, I come ten, 12 hour days sitting and then I go home and sit and I’ll play the drums.

Shaun Keating: But I gotta exercise as I get older, then I’m eating you know fatty stuff and drinking beer and it’s like dude I ain’t gonna make 60 if I keep doing it. So I gotta see my grandkids, so I’m changing it up. But it’s baby steps, hats off to you man.

Dr. Eggleston: Well dentistry is a sedentary type of profession, and in that regard, eight years ago we started an annual event for dental students at SCU. I challenged them to hike up Black Star Canyon up by Irvine Lake. We just had it just a few weeks ago was our eighth annual and we had 125 students show up, and we have a 8k, it’s a five mile course up the canyon with a 10% grade, and then we have a hiking group as well and it’s a race, hiking.

Dr. Eggleston: So we pass out scholarships for the winners, and we have a picnic afterwards, and it’s a great event. So the students have kind of taken it over. One of my associates, Andrew Vo, recent grade from SC. He and I started it eight years ago and it’s been going ever since.

Shaun Keating: Well let me know if I can help out with the sponsoring or anything.

Dr. Eggleston: That’d be great. We have Patterson is our main sponsor, and we pass out typically about 18, 19,000 dollars in scholarships.

Shaun Keating: No kidding, I’d love to help sponsor some of those new young dentists. You never know, they might try my laboratory down the line.

Dr. Eggleston: Well I’ll tell you, the students have Patterson ringing in their ears because they sponsor us, and that’s a great thing for Patterson and for the students, they love it, they get out in fresh air and about half of them out there are females, so it’s a big social thing, and the guys like to show off in front of the gals.

Shaun Keating: Oh Black Star up there, don’t they have like waterfalls up there or something?

Dr. Eggleston: There is a waterfall whenever there’s some rain, but the waterfall is a side trail off. We don’t go by the waterfall. We stay on the main trail, and it’s a beautiful hike, lot of oak trees down low and-

Shaun Keating: We lived in Irvine for 25 years and we’d go up there all the time, and it’s beautiful and there is some little sneaky areas you can go to and my older son … my sons are adults now, but I think I got calls a few times, they’re up in this area here in Blackstone. I was like, they’re not supposed to be, well come and get them. Back there in North Woods high school is where they went, and that’s right up towards the far end up there [inaudible 00:25:58]

Shaun Keating: But that’s so neat man, that’s good for you. I said man, look at this guy, he looks like a spring chicken. You got all your hair.

Dr. Eggleston: Well I don’t have as much hair as you do.

Shaun Keating: Mines’ long, I’m saying on top there you are thick dude.

Dr. Eggleston: But we’re having a good time. At practice most of my staff has been with me anywhere from 35 to 42 years, and in fact some of them were with me with Dan Gordon in Santa Anna and they stayed with him. Yeah, so I have some people that have been with me since 1976, and-

Shaun Keating: That’s so important, I’m mean we got staff too, been with me the whole time. It’s like a Super Bowl team, it’s like the NFL when you have that core together. Like every day we’re all on the same page and it’s just so neat. You take care of your employees and you treat them like family and they stay with you and you’re just on your A game every day. It’s such a neat thing.

Dr. Eggleston: No, there’s actually nothing better than having staff with you that’s been with you for decades, may decades. There are many dentists that try to do a turnover because of vesting in a retirement plan, or whatever, and it’s counter-productive. You’re so much better off keeping [inaudible 00:27:14] and trying to find new ones and train them, and the patients recognize it too.

Dr. Eggleston: We have people that move out of the area and then 20 years later they move back in and they come in, it’s the same people. So they really=

Shaun Keating: Or they’ll come and fly you in for dentistry ’cause there are ceratin doctors that have people flying that had left and they still stick with them. They come on in for a weekend, now that’s it, you treat your people good, you treat your patients good and you’ll never have to worry about growing a practice because things’ll just happen. Do the right thing and do good dentistry and it’s so neat when I hear this and see this. So that’s awesome.

Shaun Keating: So tell me a little bit about something in your favorite procedures, what’s your go to thing that you really lie, you liked the full rehab, what makes your eye twinkle a little bit.

Dr. Eggleston: Well I limit my practice to prosthodontics, so I refer out all the perio and oral survey. As a prosthodontist from I can place implants, but I worked with an oral surgeon in the building that I have a good relationship with and I prefer to have him do it.

Shaun Keating: That’s perfect so are pros, they’re kind of like that? They just do the prosthodontics and kind of service all the endo, everything else in this. It would be unethical for me to announce that I limit myself to prosthodontics, and then start doing root canals.

Dr. Eggleston: So the last root canal I did was in 1970 when I graduated. So it’s lucky for the patients I have done recently. It’s an ethical time when you announce a limitation of practice you should limit it to what you announce.

Shaun Keating: What about like I got all oral surgeons that send me through all sorts of crown and bridge, should they not be doing that?

Dr. Eggleston: Well there is an ethical issue there, if they announce themselves as an oral and they’re doing prosthodontist procedures, but they’re coming will be well pros on us of we’re now putting in implants.

Dr. Eggleston: But the prosthodontics specialty has been rewritten over the last few years to include surgical placement dental implants and the three are prosthodontics programs across the country, include service placement of an implant in the three year program.

Shaun Keating: Is that what a residency of prosthodontics usually is like a three year thing?

Dr. Eggleston: Yes, when I did it in 1970, it was two years, but we didn’t have computers, we didn’t have implants, we didn’t have anything. We were making dentures and doing bridges and doing porcelain faced crowns and we had harmonyponics-

Shaun Keating: Thin ledges.

Dr. Eggleston: Thin ledges, yeah I was doing three quarter pin ledges on anterior teeth.

Shaun Keating: Didn’t believe that.

Dr. Eggleston: And gold foils.

Shaun Keating: Gold foils, I was gonna say.

Dr. Eggleston: So those were, my god I’m dating myself, but those were the days, and now that all the programs for any of the specialties are three years, where before they were two.

Shaun Keating: Yeah, no that’s good, I think it’s great. I think they should have more lab work like the old-timers. New dental schools they don’t even touch on any of that or any of the business part of it. I just think younger dentists are good, but I just think some of these old school guys that really did a great job and they do a lot of gold work and they do it to last and what works and now everything’s kind of fancy smancy with this all ceramics and stuff.

Shaun Keating: But they’re getting stronger, it’s a neat thing, but it was less education it seemed like at these dental schools when they’re coming out nowadays.

Dr. Eggleston: Well the curriculum’s crowded. I’ve been on the board of counselors now 26 years, and we meet with the dean four times a year and a three day weekend mixed in there and we go over the curriculum, and it’s crowded. You’ve got just four years, so they don’t do a full dissection on a cadaver like we used to do, they don’t wax teeth, they don’t set denture teeth, they don’t do a lot of things. They don’t do their own lab work because there just isn’t time for it. So they’re using digital equipment, they’re scanning, they’re doing CAT CAM-

Shaun Keating: Yeah, they’re really switching it up, 21st century, but I don’t know if it’s anything better than it was, but it’s like four or five hundred grand for the darn course.

Dr. Eggleston: Well the average debt for a student graduating from USC school of dentistry is $500,000.

Shaun Keating: 500 grand.

Dr. Eggleston: That’s the average, and there was a kid that graduated rather recently. He went to undergrad at SC, the dental school and then to orthodontics for three years, and he has one million dollar debt for student debt, one million bucks.

Shaun Keating: Unbelievable.

Dr. Eggleston: Okay, the good news is that the maximum you’re required to pay each year is 10% of your income. So if you start off slow and you don’t have much income, you pay 10% of it to your school loan, and if you do 10% of your income for 25 years or whatever it is, might be 20, or 25 something like that. Then the balance is waived. So this guy that owes a million bucks, if he pays 10 percent of his income for the next 20, 25 years. Whatever’s left of that million, gets finger cross.

Dr. Eggleston: You can always go into underserved areas and get a remission of some of your student debt if you practice in areas that are undeserved. So there’s a number of items to help out with that, but still it’s a lot of debt. My concern is that these kids coming out of dental school, that much debt, they end up working for corporate dentistry.

Shaun Keating: Cutting and everything that comes in that chair probably ’cause they have to get that nut.

Dr. Eggleston: Yeah, it’s really a problem, I don’t know if I’m gonna get sued for comments on corporate dentistry, but the owners of the dental office are into return on investment, and more so than ethical dentistry. Yeah I know, they can’t even touch my lab because they want stuff at $69 and it’s all about the money and the dollar what they can bet in and get out.

Dr. Eggleston: It’s a tough deal and I feel sorry for the dentist because they go in there and they’re an employee and not running their practice. They’re told what to do, what patients to see and what treatment to provide. They don’t get a voice in that in many instances. So it’s a difficult situation.

Shaun Keating: That’s crazy, back to when you’re checking into dentists and peer review and all that, what do you see is most prominent. Are they cutting out teeth when they shouldn’t or what is it the teeth need endo and they’re restoring them open margins, what do you see most of when the neglect that they were doing. Is it across the board-

Dr. Eggleston: Well, what the Dental Board is most interested in is fraud and gross negligence, things like that. The Dental Board doesn’t have the time to get into-

Shaun Keating: If that tooth was alive, all this and all that.

Dr. Eggleston: Well they don’t get into fits of crowns, things like that. There’s a limited number of investigators they have. So they are going after the fraud, so there are cases where one relatively famous case was UPS got a dental program for all of their employees’ that paid 100%. So this dentist, which will remain unnamed, gathered up UPS people and said, actually paid them to come in so that he could bill 100%.

Shaun Keating: Max I tout.

Dr. Eggleston: And he would pay them to bring in their friends that work for UPS and ended up scamming, billing for procedures that were never even done, to the tune of $700,000. So it’s that kind of fraud that the dental board is upset with. The case that I mentioned before, we have records showing that the dentist was taking perfect healthy teeth, with no decay and drilling right into the pulp to create the need for root canals.

Shaun Keating: Yeah that’s nuts.

Dr. Eggleston: So on extracting beautiful molars just to get dental implants. So that’s what the dental board is most interested in.

Shaun Keating: Yeah, the knucklehead criminal type.

Dr. Eggleston: It is [inaudible 00:36:02] outright, and in some cases, the written into the accusation was battery. In other words, it was not only gross negligence, incompetence and multiple and also sports a battery.

Dr. Eggleston: Battery is when you treat a tooth that doesn’t need treating, and you don’t have an informed consent to treat it. So the dentist put in, first molar to first molar, restorations, full coverage restorations and the inclusion was off.

Dr. Eggleston: So instead of adjusting the restorations, the dentists ground down the opposing teeth, the lower of which were pristine that needed no treatment at all. Because the pain persisted, dentist kept adjusting the bit further and further to where when the patient was examined by an investigator or a consultant for the Dental Board. The only teeth in inclusion were the second molars. And all the lower teeth that were abused, needed restorations.

Shaun Keating: Oh, yeah.

Dr. Eggleston: If the patient ends up with a few crowns that need redoing because they didn’t fit quite right, that’s not gonna generate an accusation from the dental boar because it costs them about 100 grand to follow through a five year process of a going all the way with a particular dentist.

Shaun Keating: That’s amazing, I had a thing years back probably five, six years ago. I was in a trademark thing with another lab, it was over a name, and I had this company for trademark like the top company called Kenobe Martin, so I didn’t even know this until recently, but it was neat that you were the expert thing and it was just on a name, a generic name and it was kind of neat.

Shaun Keating: At the end of it all through a few years, two and a half years, they came back and we had won the case. So thank you for your professionalism-

Dr. Eggleston: Well you’re most welcome, and it was one of the few cases that I’ve been involved with as an expert witness that did not involve direct patient treatment of a particular patient. So I’ve always been an expert for the plaintiff for the defense, and it’s over a particular case that was treated.

Dr. Eggleston: Your situation it was over a trademark and there were no patient names, there were no dentists per se, and it was a whole new experience.

Shaun Keating: But it was, you broke it down and Judge Carter, he’s a ninth district top judge, and he’s a really smart guy, Marine, and he’s a bulldog and I just learned so much in that whole experience. But he listened to you and it was like, bam, summary judgment, Keating Dental Lab. I was like, thank you lord.

Dr. Eggleston: So anyway it was a good experience and I-

Shaun Keating: Thank you for that, it was a learning experience for me. It was just a great thing, but to have you was part of it and I heard about you and learned a lot about you then. I’d always heard about you. Didn’t you do some stuff for like Chase and Piquette back in the day or no? I thought you had like a certain group of doctors, maybe it was a study club you had or something.

Shaun Keating: But there’s a certain group of dentists out there in Newport, you guys are just well known throughout the nation, it’s kind of a neat thing.

Dr. Eggleston: Well Dan Gordon had a study group, and Drs. Chase and Piquette each have a study group that’s separate from that. Then there was the Newport Harbor Academy, which a lot of people in Newport there were involved with. That has just recently disbanded, been around for decades. Carl Reader was the one that ran that and has since been retired.

Shaun Keating: Do you remember Dr. Schwartz, Ken Schwartz?

Dr. Eggleston: Sure.

Shaun Keating: Yeah, he’s a great guy, I did his work for 30 years and he retired recently, but what a great guy. I see him walking over by that little hut, the palms, dates and shake track over on PCH and he’s just a great guy and his wife, it’s a small world, just really neat.

Dr. Eggleston: Well Newport’s a great place to practice ’cause there’s just a lot of dentists and a lot of personalities and lot of really great people and we have fun. We cover for each other, we help each other. People would think that we’re competitive, but it’s not.

Dr. Eggleston: So there are dentists in our Newport area, when I’m on vacation, they’ll … well I have enough dentists in the office to cover, but they keep track and if it’s a solo practice, I’ll cover them for when they’re on vacation. So we learn something new, we can’t wait to meet with the other dentists in our area and tell the about it. So it’s that kind of relationship.

Shaun Keating: I think you could do a really neat thing out there. I mean you’re just so knowledgeable in this area. Most dentists are like hey, we’re doing this and that, prep them this way and this and that, but with what you bring, you bring a whole vast knowledge of aspects of dentistry. But to really practice proper dentistry, this and that, I think dentists need to hear it more.

Shaun Keating: Like what you should be doing and not be doing and you can have consequences that’ll be very detrimental if you go this route. I don’t know I just think some knowledge like this will be well-received, guys will listen. They’ll be like lets listen to this guy, what you should and shouldn’t do you know.

Dr. Eggleston: Yeah, there’s some great study groups out and then the schools put on great CE programs and the California Dental Association and so forth. There’s a lot of continuing education that dentists can avail themselves of and the study groups are fun. One of the dentists in my office, Dr. Laura Wittenaur has a study group that meets on a regular basis, and it’s just great. It’s an exchange of ideas and it’s not like one person is just lecturing. The whole group brings information in.

Shaun Keating: That’s awesome, you’re so humble. Okay, well let me find out this, what has been your marketing strategy. Do you do any mailers, do you do any social media, is it word of mouth, just referrals from existence. Through the years, how do you drive so much people to your practice?

Dr. Eggleston: Well word of mouth is the main thing, and that’s the biggest one. Because it’s so much more emphatic than what someone might see in a mailer. But I have an August brochure that lists … that has pictures of the all the staff and each of the dentists. Just before and after dental treatments, has a bio of everyone on her staff, I think patients bond to the staff as much or more than the dentist.

Dr. Eggleston: So when they pick up an office brochure, when they see each and every one of the dental assistants and the lab techs and the hygienists, the front office people are all biographed in that document, or in that brochure, and it’s a 38 page brochure. They really like that, they find out the background of each of the staff, where they trained, how many years they’ve been doing it. What their social activities are as far as hobbies and so forth and their charity work and-

Shaun Keating: Yeah, you got a smoking hot website and we gotta put that on this podcast so that the people can just click on it and just to see that you’re set up and even to your bio. I swear it’s eight pages long, it’s so neat.

Dr. Eggleston: Well the only thing I do is this office brochure and our web page and that’s it. I know a lot of dentists do newsletters and have open houses and all kinds of social media on Facebook. But maybe I’m kind of a dinosaur in that respect because I’m not into the social media. I probably should be, just not.

Shaun Keating: No, well you’ve done so much, I think you should put it out there just so people can see what you’re all about and you’re done a lot for dentistry in the last 50 years, really have. I think people should see that, especially in the dental world. I think it’s a lot of other podcasters that are gonna hear this and they’re gonna say hey, let’s get Dr. Eggleston in the middle of this.

Dr. Eggleston: I have the website and then along with it I have a blog.

Shaun Keating: Oh okay, why don’t we put your blog up too, sure.

Dr. Eggleston: The blog is kind of fun because I’ve had a few adventures here and there. So on the blog I’ve put those on. I’ve gone up Kilimanjaro twice and I’ve been in a hurricane in a 45 foot boat, and I’ve been a number of things that have created some interest.

Dr. Eggleston: The hurricane I was in, I wrote a story on that and it got published in Western Outdoor News.

Shaun Keating: Oh, you’re kidding.

Dr. Eggleston: Got a lot of feedback on that. We’re lucky to be here, we were in a category four at 140 mile an hour winds in a 45 foot boat.

Shaun Keating: Dude, I got a 54 foot boat and I get a little rough over the back side by Catalina. I’m ready to call the Coast Guard, come get me.

Dr. Eggleston: We were in the storm.

Shaun Keating: Ten foot waves man, that’s nuts.

Dr. Eggleston: We were in a storm that sank over 100 boats, and killed a bunch of people, it was 2003, Hurricane Marty in Baja California, Sea of Cortes and we were saying goodbye to each other.

Shaun Keating: Unbelievable. What kind of boat was it?

Dr. Eggleston: Well unfortunately it was 45 foot bayliner and they have a very rounded bottom, there’re no kinds of … if you’re aware of that what is on a boat. So they roll like crazy, so we were in … it started out as a true gale, and we had a long way to get back to the marina, but we couldn’t go directly because we would have rolled over, so we had to tack into it and tack out of it, and it was at night, so it was just, the boat was going airborne over these waves.

Shaun Keating: Can you believe that?

Dr. Eggleston: It was very exciting and-

Shaun Keating: I would’ve been yakking ’cause I get a boat, I get stupid sea sick. But 45 footer in that bad of a hurricane, I just can’t believe you made it through that.

Dr. Eggleston: Well the full force of the hurricane hit when we made it into the marina. Then there were three marinas at that time in Le Pas, and it wiped out two of them. The boats just blew away from the moorings and the slips and they all piled up and sank. So we were in the one marina that managed to survive for the most part, and so-

Shaun Keating: That was the good lord looking down upon you. I see a little halo over there in that silver hair of yours.

Dr. Eggleston: No, I think when it comes to hurricanes, nature has a lot of indifference. So anyway right after that, my wife says, just like the movie Jaws, we need a bigger boat. So now we have a 57 footer that’s twice the weight and three times the power. So power-

Shaun Keating: What kind is that one?

Dr. Eggleston: Well I got it, it’s a Meridian, it a 57 foot.

Shaun Keating: Oh, that’s beautiful, I got a Bertran man, it’s about all I need.

Dr. Eggleston: Oh, well that’s the best, yeah.

Shaun Keating: It’s a [inaudible 00:48:17] I even put a Sea Keeper in it to try to keep it from the roll. You gotta try those [inaudible 00:48:21]

Dr. Eggleston: No, I put one in.

Shaun Keating: Oh did you?

Dr. Eggleston: Yeah, I put one in a year ago.

Shaun Keating: Oh I love it.

Dr. Eggleston: It’s unbelievable.

Shaun Keating: What a difference, you can go out into the kelp and fish and not get the roll and just so nice.

Dr. Eggleston: People listening probably don’t know what we’re talking about, but the Sea Keeper is a gyro, and the one I have weighs one ton and it spins on 10,000 RPMs. It spins in a vacuum to help maintain its momentum, and it has hydraulics.

Dr. Eggleston: So when it senses the boats’ gonna roll to the right, then the hydraulics push the gyro to the left and the boat stays steady. When you’re in the trough or swells, the boat just goes up and down, it doesn’t roll. That doesn’t help pitching much, but it helps the roll and that’s where people-

Shaun Keating: That’s where they get the sick, and I told so many people about it, I didn’t even know all that. So I know it cost 100 grand.

Dr. Eggleston: Yeah, I bet, it was that or a second Tesla. So anyway, my wife was all for it ’cause she gets sea sick and now we can invite anyone out on the boat. It just absolutely unbelievable.

Shaun Keating: Unbelievable, do you do it up with the parade in the harbor and stuff?

Dr. Eggleston: Yeah I do, but I kept the boat in Le Pas for 18 years and I just brought it back two years ago. So back in the ’90s when I had a boat here, I did the boat parade and the Hoag Hospital fishing tournaments and all that. So it’s fun to get back into some of that in this area, but-

Shaun Keating: I’ve done Dana Point but we do … it’s a much smaller marina, but we did the boat parade a couple years ago. We took it down to Newport and it was neat. We got best new entry and my captain took two weeks to do the boat up and did it with outriggers and I had marlins on each side. These 12 foot stickered marlins on my boat, the big marlins [inaudible 00:50:26]

Shaun Keating: So we did the lights around it, it’s pretty neat, we love it and I’m the big fish at Dana Point, you go down to Newport and I’m just a little fish.

Dr. Eggleston: Oh no, you got a nice size boat. It’s just a lot of fun, so I think its important, we get so wrapped up in dentistry we need to have other activities. Boating is certainly one of them.

Shaun Keating: Oh it’s beautiful, we just love going out looking at the whales and the dolphins. My wife is just right out front, even if we go sit out back and just look out. Where we’re at it’s the boat launch area, so we see all the guys launching their boats and that’s a character to watch these guys, they’re bringing the whole car into the water, they’re not getting out and the wives and the husbands are yelling, and we just sit there with a beer and watch it. It’s entertaining, it’s like the best spot in the whole marina.

Dr. Eggleston: It’s where they forget the plug that’s-

Shaun Keating: I did that once. I had a ski boat, we were at Lake Paris, I had a bayliner, a little 21 foot Capri open bow, and our boys were probably six and four and my wife and I’m out there and Paris and I’m just loving it and all of a sudden, the whole boat is like back in the water and Sharon goes, we’re sinking. I go, oh no, the plug, so I had to go under the water, underneath the water and put it in and screw it and come back up, get air, go back down and screw it some more.

Shaun Keating: So many dumb things and I remember one time I was driving by my neighborhood, and I see my buddies in their cul-de-sac and I’m like hey, and then I stopped and then I just backed it up, ’cause I wanted to go back down the cul-de-sac. I just like didn’t look back and just backed up and the dang thing jackknifed and I put a big dent in the back.

Shaun Keating: So many dumb things, I remember pulling in this gas station, I pulled around the back and there was no exit out the back, so I tried to get back out and I’m dumb or dyslexic or whatever go right turn to left, left to go right and I couldn’t’ get the thing out and we actually had to unhook it from the hitch and push the boat. I’m not a real good boat guy, that’s why I got a captain ’cause I’m just not real good at it.

Dr. Eggleston: Having a captain’s cool.

Shaun Keating: It’s a must, you get a DUI on a boat just like a car. You can’t be drinking beer and you get pulled over, they’ll make you blow, just like in a car. So plus the responsibility, my boats’ like 70 tons, you don’t wanna be rolling into the rocks or into the … it’s just nuts, but a lot of fun.

Shaun Keating: Well guy man, it’s such a neat thing. We should do the Dental Up podcast education with Dr. Eggleston on different subjects and stuff. I’d love to have you on here.

Dr. Eggleston: Oh happy to do it.

Shaun Keating: Yeah, I’d love to even talk about a day in the practice. I mean what do you … your full rehabs, do you ever do them in like three or four days or just long process.

Dr. Eggleston: There are times with the VIP patient, they’re in for a few days and then they’re out.

Shaun Keating: Yeah, prep on Tuesday, see them on Thursday, I do a lot of those. Even here we have an operatory and all that. But if it’s all done properly and we got pre-models and wax ups and even custom tabs. It’s kind of a neat thing, really is. But there is a lot time planning cases and stuff. Is that mostly what you do, a lot of bigger stuff?

Dr. Eggleston: Yeah as a prosthodontist, there’re a lot of full mouth rehabs. Lot of redos, some are minor, some are my redos. But then we do a lot of single tooth dentistry as well. But under pressure, probably the one that would be the most fun, I treated a head of state in the Middle East, and had to fly here, arrive on a Tuesday evening and it had to be done by Friday, a crown on every tooth.

Shaun Keating: You’ve gotta be kidding. Have you used their lab?

Dr. Eggleston: No, I bought 18 pieces of luggage with lab supplies, and I bought my lab tech with me and we went 24/7 around the clock and got it done in time.

Shaun Keating: Do you hand [inaudible 00:54:45] or something or-

Dr. Eggleston: Well it was in the 1980s, so it was all PFMs, and so the first night I arrived we prepped all the upper teeth and spent the night waxing it up and the next day putting on the porcelain, and in 24 hours they put the upper teeth in and prep the lowers and then we had actually a couple of days to do the lower. But it was a deadline that was-

Shaun Keating: That’s awesome, we should do an over the shoulder here, you come in mine, we’ll pack the house. I’ve had Coys here and [inaudible 00:55:20] used to do a bunch for me and I’ve had a lot of dentists come through the doors here and we just do it. It’s usually a Thursday-Friday or Friday-Saturday, doctors come in and we’ll prep it up and have it ready to temporize and show them how to temp it then I go off to the lab, we work on it that night and boom next day we see them and everyone comes in. It’s kind of a neat thing, but-

Dr. Eggleston: Now are you doing those with scanning?

Shaun Keating: We’ve done them with scanning recently, but mostly it’s just conventional impressions, and we go in … it’s mostly like a lot of Emacs where you’re usually doing veneers and full-coverage. But now we just have our techs, they’ll work through the night. Instead of working in the daytime, we’ll have our senior techs will come in and it’s all set up. But they’ve all worked out and sometimes we’ll do two sets just to make sure, but we never used the second set ever, but it’s kind of neat and just the dentist where we have a limit of 15 dentists, but they’re chair side and they can see it and they can get in next to the chair next to them, and it’s just a real neat thing on how to do 12 or 14 teeth. It’s usually 10 or 12 up top, 10 or 12 on the bottom.

Shaun Keating: But pre-screen patients and all that and we love it ’cause a lot of my techs and employees here, they’ve got a lot of new fresh grills where we need a patient. So it’s like lab works’ free too. It’s kind of neat, but we’d love to have you and it’s just such a joy to talk to someone so smart in the dental world and so humble too. You’re a real humble guy and just you’re the man and I can’t think you enough for coming on my podcast.

Dr. Eggleston: Well thank you I enjoyed it.

Shaun Keating: All right, we’ll talk to you. Well thank you everyone for listening and we’ll see you next week.

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 dig what you heard, please leave a review on iTunes and we’ll be back next week.