An Interview with Dr. Dan Fischer from Ultradent

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Today we’re talking with Dr. Dan Fischer, the founder and president of Ultradent, on the early days of the company, their dental philosophy, and how Ultradent is shaping the future of dentistry. As a visionary and a forward thinker, Dr. Fischer has great insight on the industry. As a long time friend of Dr. Hornbrook, you can believe they had a lively conversation and got right down to business.

The Development of Ultradent

Ultradent began when Dr. Dan Fischer developed a piece of dental technology that could revolutionize the industry, but companies didn’t quite believe it. What began in his family’s basement soon moved to a 40 foot by 60 foot converted hay barn as dentists began recognizing the products’ value.

Dr. Fischer’s initial invention was Viscostat, the ferric sulfate coagulate hemostatic formula, first known as the strident liquid form in the dental infuser. This allows dentists to quickly stop bleeding, minimizing chair time. Their next product was Ultradent’s retraction cord, which they began producing on the same type of knitting needles used for pantyhose.

We’d be remiss if we didn’t mention Dr. Fischer’s commitment to his employees and their families. He knows every employee and engages with each team on a regular basis. He believes a great company is built by a great team, and while he won’t admit it, his leadership has be pivotal for Ultradent’s growth.

The Growth of Conservative Dentistry

“…Our greatest opportunity [as humans] is to share with our fellow humans,” says Dr. Fischer, who has long been a proponent of conservative dentistry. The more you cut tooth, the more the tooth will weaken. Instead of taking the restorative approach, conservative dentistry tries to save as much of the tooth, when possible.

The ultimate goal is to repair, rather than replace. Because it’s often minimally invasive, it costs less and leaves the non-problematic teeth intact. When you can bond materials to it, there’s no purpose to the added time and expense to remove it.

Henry Ford believed that true progress is not realized until technology is made available to the masses; the team at Ultradent believe this, too. Their goal is to make this high strength and high tech adhesive widely available, and that it will help propel the growth of conservative dentistry.

Embracing New Technology

If we don’t build upon technology, then we miss out. Dr. Fischer believes that the dental industry tends to succumb to over-cutting, which compromises the enamel. The patient should always “win” in these situations, but they often end up losing since the teeth don’t stay vital as long as they could.

Dr. Fischer believes that we should treat that responsibility as though every one of our patients are our spouse, brother, sister, or child. When the patient wins, we win.

The Ultradent Package

R&D and Their Vertical Integration

One of the many facets that sets Ultradent apart is that they have an in-house R&D team. They also manufacture 98% of their products in house, and 70% of that is sold outside the United States. This means they’re one of the most vertically integrated dental companies in the world, housing a machine shop, injection molding, and packaging, as well as their advertising.

This makes the movement of R&D to production much faster, and can move into areas that some may not be able to go into. Their satisfaction comes not from the increased sales, but from going somewhere and doing something that no one has done before. And that, friends, is the sign of a company with a solid foundation.

Ultradent’s Vision

Ultradent’s vision is that they are “passionately driven to improve oral health globally through science, creativity, and education.” The first piece of that is respecting the natural tissue, as mentioned above, and the second is progressive, trustworthy solutions for clinicians. The third piece is searching for cures for caries and gum disease.

They regularly work with clinics for low-income people internationally, as part of these efforts to fulfill their vision. Because of this, they work to make their product something not just top dentists will be able to use. Those will only moderate experience, like in less-developed countries, will still be able to benefit from Ultradent’s products.

Patients’ Wants and Needs

So, will this development lead to a decrease in the dental field? It’s a good thing to fix problems and help keep people healthy, but we’re also then putting ourselves out of business! Right? Dr. Fischer doesn’t think so.

Once caries and abscessed teeth and other preventable issues are cured and/or easily prevented, then we as dentists can focus on a patient’s wants, not just needs. Dr. Fischer goes one step further, and says that a dentist needs to view a patient’s want, regardless of how cosmetic it is, as a need.

A patient’s want means a better smile, and if we don’t need to worry about caries, then we’ll be able to then focus on cosmetic changes to help them love their smile. This is even more important in a society where good teeth are essentially a requirement for jobs, relationships, and overall quality of life.

So if we can develop these ways to proactively treat dental health, then we can also focus on the more cosmetic desires of our patients for a better overall dental experience.

While preventative dentistry may not be as exciting as restorative dentistry, it’s important to not lose sight of that element of your patients’ health. If we can do that, then their teeth will be in better overall health, which is the ultimate goal as a dentist.

If you’re interested in learning more about Ultradent, their website is a great resource for dentists and has information on all products. They also host summits to help further dentists’ education.

We hope you enjoyed this episode, if you’d like to hear more, we’re on iTunes, which has more resources for you and your practice.

Podcast Transcription:

Dr. Hornbrook: Hello, this is Doctor David Hornbrook, the clinical director of education technology here at Keating Dental Arts in Irvin California. We’re back today for one of our weekly podcasts at Dental Up. If you want to see podcasts that we’ve done in the past, you can go to iTunes and search podcastsdentalup all one word. We also have a website where we have some videos, technique videos as well as product reviews as well as some videos of our podcasts and you can go to Dental Up. We’re in for a real treat today because I get to talk to a very very good friend of mine. Someone that I have known for years and years and I have so much respect for, and I know that most of all our listeners do as well, and that’s Dan Fischer a dentist as well, as the president and founder of Ultradent. Welcome, Dan.

Dan Fischer: Hey, thank you so much Dave, and I feel like the lucky one. It has been a great journey with you over the last few decades actually Dave, and you always been a joy and your contributions and what you bring to dentists as large is so substantial so significant so keep up your good stuff.

Dr. Hornbrook: I appreciate you saying that although I think what I’m doing compared to what you and Ultradent are doing is dwarfed. Every time I meet with you and for those that don’t know where Ultradent is located it’s just south of Salt Lake City. It started basically as a garage industry. A mom and pop industry literally and has grown into just as unbelievable successful businessmen and Dan as an entrepreneurial and a giver back to dentistry. It has been awesome to watch you grow and watch your ability grow.

Dan Fischer: You know Dave, at the end of the day I can’t take all the credit for this, and it stands to reason that we should be accomplishing more than you. We’ve got 1700 employees.

Dr. Hornbrook: I was going to ask you how man employees you’ve got.

Dan Fischer: We’ve got this large R&D group in chemistry and in engineering and design, in clinical. What you accomplish yourself and with the small team around you is amazing. I just got a whole lot of great people here that help me looking good and that are also brilliant and sharp that I get to learn from be it chemists, engineers and the like. I just feel like a kid going to a toy shop at Ultradent.

Dr. Hornbrook: Every time I come to Ultradent I feel like I’m at a toys are us for a dentist and tacky nerves like me just to see what all the cool things you’re doing, but let’s start a little bit, so you went to dental school like I did and most of our listeners and you came out, and you were going to be a dentist, and you started practicing dentistry and all of a sudden as you mentioned you have 1000 plus employees. You’re doing things around the globe. What was your impetus to say you know what I can’t be just that dentist on the corner working 9:00 to 5:00 drilling and filling, where did this all start?

Dan Fischer: Yes, it actually started Dave when I first invented namely the ferric sulfate coagulate hemostatic first known as the strigident liquid form thereof and the dental infuser. It happened on the hills of me offering that technology those products to some of the larger dental companies and none of them really saw the value at least not enough to pay for. At that juncture, I came to realize either we’d have to do this as a family, or it wouldn’t be made available for dentists so at the end of the day we started on the kitchen table and literally and ultimately ended up in a converted hay barn 40 foot by 60 foot. I had to learn a lot about FDA real quick but passed FDA inspections several times in that facility, and we’ve continued to grow since then. It was all built on the backs of the family and initially but we have so many wonderful people that have contributed over the years, and they help respect and maintain that family feeling and that family culture. It’s been a wonderful journey from those very humble beginnings.

Dr. Hornbrook: Then your retraction cord I know soon followed, and I’ve been to that barn. I’ve met your family, and you know the story I was told was that you actually knitted the cord yourself in that barn, and you actually marketed it that way.

Dan Fischer: Yeah, we took little knitting needles size used to make ladies pantyhose and miniaturized and optimized everything needed to make the tiniest knitted cotton cord in the world for which even though some have attempted to copy we still have the tiniest knitted cotton cord. It took 9 months to make the first inch. Now, we actually started before the hay barn was ready. We started in our bedroom, and you can envision a wooden floor, and there were 3 smaller bedrooms below that bedroom and the master bath and kids trying to go to sleep and these knitting machines the needles they’re moving up and down with every little loop that’s created. You’re grabbing a threads the size of cobwebs, and you’re pulling loops through loops and that clunky clunky clunky finally the little red head my bride Leany says either that or I go. That put the impetus on getting that metal hay barn converted quickly, and the first project in it was that ultra-pack knitted cord and for the very reasons I just shared here.

Dr. Hornbrook: That’s a great story, and I met your family. I met your beautiful wife, and you’re a lucky man, and I would say she’s a lucky woman as well.

Dan Fischer: I’m a lucky man that’s for sure Dave. I’m a lucky guy.

Dr. Hornbrook: Yeah you are and I think you hit the nail on the head in that you’ve got these great people around you, but they’re around you because of who you are, and they’re following you because of your leadership, and I said this to many people that you’re the only the person who actually walks faster than I do. I walk like I’m on a mission and you do too and walking through Ultradent where you know everyone’s name, and I think the last time that we actually walked thought the place together you had about 700 employees, and you knew all their names, all their family names and you greeted them like you were their best friend which I just admire that so much so.

Dan Fischer: Yes, they are. They’re extended family Dave. They really are and humans our greatest opportunity is to share with our fellow humans. In fact, I often say that sharing is the finest form of caring and how you share with your education is just marvelous complete with the hands on. You sharing with these employees. We’re the most interesting living life form on planet earth and I know you’re a people person Dave, and I would go nuts if there weren’t a lot of unique, interesting quality personalities around me. They contribute, they add to my day immensely, so it’s definitely a 2-way street.

Dr. Hornbrook: Yeah, I agree with you on that. Let’s switch a little bit. We’re going to come back to what you’re doing at Ultradent many times throughout this conversation but you look at dentistry today, and I’ve heard you lecture. You and I have had personal conversation over dinner about the state of dentistry and adhesive dentistry and cosmetic dentistry and one thing that you said many years ago that kind of stuck with me that I have repeated and always give you credit for is where you said the advantage of adhesive or tooth colored dentistry is its repairable dentistry. Which means we’re not destroying just because we have a restoration that fails and ultimately everything will. We’re not destroying more tooth to get that thing out to repair it so talk to me a little bit if I was a skeptic. Dan, if I said listen the gold is still to about why do you want to do this direct composite or why do you want to do this tooth colored conservative dentistry? What would your answer be for me if I was a skeptic?
Dan Fischer: The first thing I would do is put your mind at ease to a certain degree that it doesn’t mean that gold has left our lives. For example, I had to have a root canal done ultimately on both my upper second molars and unrelated to any caries. They were caries free, but I was the victim of a dental school requirement in which a classmate one year ahead of me in order to graduate he had to do one more set of impacted wisdom teeth. This guy he wasn’t the sharpest knife in the drawer, and he took the buckle plate of bone away from my second molars when he took out the third molars behind them and ultimately it led to sinus infections which ultimately came from just the gangrenous tissue in these 2 molars.
The root canal is done, and they’re like well when you got a molar is just being pounded on like how I pound and how I grind and chew. I had my daughter wrap that second molar in a gold casting, and nobody sees it, and that’s one of the finest most permanent things I can do for hat part of my oral cavity. At least, at least for in most cases, first molars forward and second molar if they’ve not been mutilated or violated if that’s such a word for those. For those, for the 98% of the needs if you’re in operative dentistry to be able to conserve as much 2 structure as is reasonably possible. That’s a big deal. I’ve often said that the more you cut tooth, the more you weaken tooth and the more times you cut, and the more that you cut, the sooner you kill the tooth from it the tooth is [inaudible 00:10:11].
To be able to push back in time and not use what we were taught in dental school with the guidelines of 20 years or 22 years or whatever and then automatically go in and start crowning or [on lying 00:10:21] teeth because supposedly the pulp chamber is small enough at that point in time that the tooth is not going to die. Only the older those teeth can be before the more invasive crowns on-lays are prepared for and placed the better. In this whole scheme of things to be able to repair it. To be able to leave intact that part of a restoration which is not problematic especially if it’s a material you can bond to such as composite in some cases a ceramic to be able to keep that intact assuming it’s bonded well and simply replaced what has been lost with fracture or caries or whatever. That is a fabulous ethical contributor to the whole subject of minimal invasive dentistry.
It’s all contributing to keeping teeth vital and for longer periods of time and gorgeous side benefits you get from it is that it’s more affordable. I strongly believe what Henry Ford taught when he said true progress is not realized until technology is made available to masses and being able to use high tech high strength adhesives of which of the 100 plus brands there is only about 5 that are truly non-compromising that can truly born to the dentin it that two-thirds to three-fourths the intricate strength of denting. That’s an opportunity. That enables dentists to treat their patients in ways that past the daughter tests. It’s what they do on their daughter or on their son or their spouse. It’s a big big deal and in fact, I believe that adhesive dentistry was the single greatest contribution of the 20th century to modern operative dentistry and coming about in the most meaningful aspects in the last say 12 years thereof of the 20th century.
It’s something that I believe we really miss out of we don’t embrace and build upon. I believe of we succumb to this over cutting; this needless execution of dent and in the enamel and now via very active CAD/CAM type of dentistry. The patient loses in the process. At the end of the day when things go wrong. When teeth don’t stay vital as long as they could. When restorations don’t last as long as they could for a multiplicity of reasons be it at the bonding agent that wasn’t adequately, be it the curing like that wasn’t adequate. The patients pay the price. Most of the time they don’t even understand why. They just believe they have soft teeth, and I believe it’s critical that we as doctors as dentists that we be responsible to those we serve and treat them as though they are our spouse, our brother, or our sister.

Dr. Hornbrook: Those are all excellent points and I totally agree with you about adhesive dentistry it’s changed the way we’ve done dentistry. The stuff that you and I learned in dental school. In fact, the thing that most young men and women are learning in dental school today can really be set aside because of adhesive dentistry and dental bonding and predictability of the materials. I think a lot of although most of our listeners use some Ultradent product to some degree. I think a lot of them may not know that you’re doing the R&D there, you’re actually manufacturing a lot of the chemistry there. I’ve been in those laboratories and what a great group of smart individual you have. Let’s talk about-

Dan Fischer: We’re so fortunate Dave. We’ve got tremendous R&D that yes we manufacture 98% of what we sell and for that that we manufacture we sell 70% of it outside of US of A.

Dr. Hornbrook: I did not know that. I did not know that but-

Dan Fischer: Yeah, we’re a proud American manufacturer, and we’re probably the most vertically integrated dental company in the world with our machine shop, our own injection molding, our own packaging, our own advertising, our own social media department. We’re very vertically integrated, and it gives us the freedom to be able to do things quicker and to go places that many can’t go. In fact, I often say that at Ultradent we have no interests in yacht’s and fancy cars and jets. We get turned on to technology and with that’s even the reason why we have some technologies here that are only found west of the Mississippi and yeah to go places no one’s gone before that’s a hoot. That’s what excites us. I can totally relate with the Columbus’s and the others. Just going where somewhere and doing something that no one’s done before that’s a big deal. It just is so satisfying.

Dr. Hornbrook: You’re doing a lot of things. I know you know the topic I told you ahead of time what we’re going to do this is to go back and forth. You’re doing some very cool things with the less fortunate and in other countries and providing materials and in helping in clinics. Because you and I talked a little bit about this last summer. Can you talk a little bit about what you’re doing and I say you as a dentist but also you as a company to make things more affordable and accessible to dentistry throughout the world.

Dan Fischer: Sure we tackle it from a number of fronts and even as it’s critical to us living our vision and our core values. Our vision is that we’re passionately driven to improve oral health globally through science, creativity, and education and the first prong of it we’ve already spoken on Dave and that ties to respecting the natural tissues preserving as much as we reasonably can. The second prong is with progressive trustworthy solutions to the clinician, and the third is searching to find cures for caries and gum disease. This vision it’s global, and hence, we are continually in R&D putting an emphasis on our products being the types of products that can help even those with only moderate dental training to be able to succeed. This is major in my mind. We can’t be thinking only about the A grade dentist. Only about the B grade.
We got to be thinking about those less fortunate be there in our county or second, third world who just didn’t get all the training that ideally they should have had or didn’t have the hand skills or whatever to do something like what you can do Dave. You try to make up for that in the designs and the materials to the best of your ability and this is something that medicine has been exemplary in. You think of when we were in dental school, Dave, the open heart surgeon they were the king on top of the mountain but today we do maybe what 5% of the number of open heart surgeries as what was done then. Because of the technology and a medium trained physician able to thread a capacitor up through the femoral artery or vein and go into the heart and bring about the stint or the repair to the valve. This is what we’ve got to be keeping n mind for dentistry. It makes all the sense in the world.
When it comes to the direct activities relative to boots on the ground if you will we feel that it’s our opportunity, our honor to be able to help those dentists who give up their time with their staff and other fellow colleagues and help those less fortunate be it here in US of A or be it in other remote and impoverished areas. We have a program with about 4 people working full-time. We use returned product or product that’s near out of date, but very often we don’t have enough of that and the we pull it right off of our inventory before it’s sold or shipped and we send it no cost to these dentists clinics to use. The only thing we ask is that they send pictures so people here can see that they’re working for things beyond money and whereas here at Ultradent we have so many colleagues from all over the globe, South East Asians, Chinese, Middle Easterners, multiple religions from every continent.
It puts big smiles on their faces when thy can see that what they have created is helping their fellow previous countryman of where they originated from. We are so fortunate to with all of our problems we’ve got in this country and any of these goofy political ones right now we still are the richest country in the world. We still are the most fortunate humans, and it’s important we remind ourselves that it is our opportunity to help those less fortunate. It’s a big deal, and there’s got to be more to life that only money Dave.

Dr. Hornbrook: I would agree with you up to 100%, and yet I applaud what you’re doing and your dedication to others and make that happen. As a visionary and forward thinker which I know you. You are thinking about tomorrow as we’re talking now or about next year. Let’s talk a little bit about where dentistry is going so 20 years ago when if it was a direct restoration it would been a DO alagum if it was a full covered crown or indirect it would be a gold or a PFM. We take that from 20 years ago or 25 years ago and then today it may be CAD/CAM restoration. It may be a bonded composite or an all ceramics but a conservative in there. Where do you think 10 years from now if we’re going to have this conversation and we’re thinking about what we’re doing in the clinic in our oratory on a daily basis? What do you think is going to change from where we are right now?

Dan Fischer: Yes, what I would prefer to talk about is what I Dan Fischer and our colleagues here at Ultradent are going to be pushing and paddling like crazy to have occurred 10 years from now. We cannot buy into the overuse of CAD/CAM. We cannot buy into the 60 at best or 120-micron gaps between the restoration and the preparation. We are committed to minimally invasive dentistry, to preventive solutions and the like. The picture that I would like to paint would be one in which the patient comes in and potentially after great oral hygiene and instruction and the usuals of the hygiene program and potentially with even superior devices be it improved ultrasonic ones or some other new technology. That the stage is set for that patient to be able to maintain their oral health at an optimum level but then if the need arises for addressing caries or fractured tooth or whatever after after a risk assessment is mad, after some more predictable caries detective devices are used. Which really our biggest challenge with current ones is over faults positives.
After that’s done complete with a risk assessment potentially that patient has the opportunity to receive some high tech technology some of which we are working on as we speak and even working with FDA on. That could enable that patient to not grow those heinous big augured out holes. It’s virtually embarrassing to me that in this the 21st century we’re still scoping big old rotten, decayed lesions out of human autonomy and plug in the holes be it with CAD/CAM, direct bonded composite or amalgam. It’s barbaric, and it’s the most common infectious disease on planet earth, and it’s undoubtedly the number one source of severe pain to masses of the world who don’t have western dentists but who have converted to our western diets. The abscessed tooth is undoubtedly the number one source of severe pain globally.
10 years from now I’d like to see the picture where hey we stop having this discussion at least for younger people and for their lives going into 2040 and 2060. Do we extract this and put in a plant or do we do a root canal? Rather as hey are we going to need to do any restorations here or if we do are they ever going to need to go beyond say 2, 3 millimeters in outline? Then dentists might say but okay you’re going to destroy us. We may not have livelihoods. No, I believe the exact opposite. I believe if we could bring cures to caries today we’d still need more dentists and what you’re doing Davis is a classic example of it. From even 10 year ago, 20 years ago even today we get screwed up on this foolish notion or trying to decipher whether that’s a patients wants or their needs. At the end of the day, if any patient wants a better smile that’s a need.
We should stop this goofy debate. It’s a need and to get jobs nowadays, to find a boyfriend, a girlfriend, a reasonable employment how many job descriptions facilitate, how many quality jobs that pay good facilitate the opportunity for a potential employees to be hired if they’re missing essentials, if they got dark disfigured teeth, if their malaligned and alike. It’s a tribute to society when we have matured to such a level. We should embrace it, relish it because dentists are going to be so damn busy creating and maintaining pretty smiles, and additionally we need to remember that people are living longer, a lot longer. 10 years from now the life expectancy Dave could be 10 to 15 years further into the future for people. Teeth come twice in a lifetime and the first set that come and for such a damn short period of time for the permanent teeth when they come in that’s one chance of teeth.
Teeth are like tires. They’re good for so many miles, the threads wear out, the flexing, the bending the side walls give out. Okay, aging patients all of our medications. We could prevent the curious lesions but there is a high probability we’re still going to be challenged with root caries with these medication that dry up salivary glands and with all of the goofy acid drinks and the soda pops, with the Gatorade’s and the energy drinks that are so acidic and the acid candy and on and on which directly attack the mineral tissues unrelated to bacteria. We’re going to be so damn busy and with diagnostic opportunities better for cancer, better for caries more opportunities to work in proactive ways to prevent some of this goofy barbaric destruction that occurs.
Okay, the CAD/CAM guys are going to be saying you’re just going to see it keep growing. It’s going to be 3 times what it is 10 years from now. They might be right but I’m going to be tooting my horn and I’m going to be marching in the band that says let’s make it so you don’t need this big invasive restorations whether they are CAD/CAM designed, whether they are laboratory constructed and in the process let’s find the ways that we reach that one-third of our fellow Americans who can’t afford to go to the dentists except for emergency treatment and the two-thirds of the world that are in the same condition. That’s meeting the definition of true progress is outlined by Henry Ford, and that’s what turns me on, and that’s where I want to spend my energy, and I think we can make a substantial contribution going down that path Dave.

Dr. Hornbrook: Yeah and I agree with you. It’s so interesting I was listening to you, and I’m thinking about conversations I’ve had with their dentists and other friends and were talked about need and want at a conversation with a colleague of mine. It’s a little bit more conservative in deciding when to treat a patient, but we’re talking about a force infused metal crown on a [inaudible 00:27:58] right central incisor that was ugly. The metal was exposed. There was some gingival migration, and the dentist said that doesn’t need to be replaced, and I said does the patient like it? He said no, the patient doesn’t like it but doesn’t need to be replaced. My reply was if the patient wants it that’s a need, and I think people are looking away for more.

Dan Fischer: We should stop trying to separate in our minds what those 2 words are. In the patients mind, it’s a need. You’re totally right Dave.

Dr. Hornbrook: Something else that you brought I look at if we opened a dentistry today or inside dentistry we’re so restoratively driven. New CAD/CAM, new [inaudible 00:28:37] cements, new composites that we’ve kind of lost focus and maybe some people disagree with me on this, but we’ve lost focus on preventive. Preventative dentistry is not as exciting as is restoratively dentistry and I think that if we can find a means where our preventative care, whether it be diagnostic tools. Whether it be preventative to me is you mentioned caries detecting being able to detect caries early on so we can make small little incipio restorations and if we can make that sexy. If we can make that exciting, I think the fact hat’s it hard.

Dan Fischer: You know what makes it sexy Dave, and this isn’t true for all dentists, but it’s true for most humans unrelated to dentists or otherwise you get what you financially reward for. We have learned that a long time ago with our employees what you reward for that is what you get and sometimes unwittingly in your attempts to appropriately reward you screw up and you discover they’re going 40 degrees a different direction to what you intended because of your goofy design of compensation and you have to adjust it. I’m going to salute ADA. To my surprise, just this March they have approved for implementation this next March compensation for things like caries detection and other proactive preventive procedures and that’s starts to get it more sexy when insurance companies pick it up. What’s really neat about it is we get to start being compensated appropriately for doing what doctors should be doing and not just technicians.

Dr. Hornbrook: Right, I absolutely agree with you on that, and it is sad that we’ve got to say it’s going to be sexy now that it’s covered by insurance but when we have clinicians that are motivated by that-

Dan Fischer: We’ve got to feed our families.

Dr. Hornbrook: I totally agree with you on that.

Dan Fischer: You get to feed your families. Dentists can’t work for nothing.

Dr. Hornbrook: Yeah, it will be nice if we could right but we can’t.

Dan Fischer: Yeah, that would be fun yeah.

Dr. Hornbrook: Let’s get in because I know a lot of our listeners are okay lets about we’ve talked about tomorrow; we talked about yesterday. Let’s talk about today and as I mentioned before you’re doing your R&D there. I know who’s doing your debt and bond studies. I’ve been there done several debt and bond studies they’ve been so much fun. Where are we today? I’ve watched your adhesive [inaudible 00:31:16] grow from Permagen to PQ1, and now we’ve got Peak Universal, which is one of our universals. Without selling secrets here from what’s happening downstairs what are you excited about what’s happening now in adhesive dentistry?
Dan Fischer: I think the most exciting hat’s occurred recently it came when the ISO World Standard chose voted in our Ultradent testing jigs and testing apparatus for bond testing to bring a standard across the board for all companies, all universities, all third parties testing facilities. This now this type of testing is used by I don’t 40 to 60% of dental schools in America. High percentages is in Europe and elsewhere all of our competitors who have bonding agents that are serious and have you bond testing apparatus the Ultradent tester. This lets us start compare apples to apples, and it helps eliminate the games that were played in the era of the celluloid capsule composite buttons and all of the faults reading and results caused by that with straight blade breaking of the specimens.
That enables multiple manufacturers to start doing what our guys Neil who’s now Vice President of R&D to start doing what they were able to do many years ago namely when they developed bonding agents to be able to close the loop quickly for the chemists and to be able to show the chemist within one day and sometimes sooner whether the change they made on that chemistry is going in the right way or the wrong way. This raises the water for all boats and everybody wins in the process but most importantly the patient. Yeah, that I think was one of the most important advances of a reasonably recent times for adhesive dentistry. Certainly ease of applications will always be important, but we’ve also lived the goofiness of ease of application surpassing the importance of maximizing our adhesion. The more we can make any restoration a mono block with the tooth in a ceiling sense. In a structural sense the greater the long-term prognosis.
I see that continuing to get better for those companies who are driven to be ethical, who are driving to not manufacture products for the needs or marketing mentalities, who simply want to create something that’s sounds like it’s better when it’s really not. Just on adhesives that’s where we’re coming. You’re going to see some fabulous new developments coming out relative like curing that are stupendous. You’re going to see some fabulous things coming out relative to isolation and controlling saliva and increasing visibility. We dentists everything else being equal our dentistry is no better than our ability to see what we’re doing, and that’s a lot of what maturing as the dentists is just learning how to use that wrinkly little mirror and the rest and to be able to see and visualize and upside down and backwards and the rest. Doing this in this pool of gushing saliva that can be like a Niagara Falls at times and a thrusting thrashing hammering bullet of a tongue back and forth and of high speed going at a half million RPM and there it goes right into the diamond back.
This you’re going to see improve. There is opportunities, so we’re driven to improve oral health. Yes with preventive dentistry but also by making dentistry easier, more predictable for dentists and so they can work in control which is where we started with our first product the hemostatic as a blood can be the number one enemy to quality impression making be it digital or mechanical. Certainly to direct restorative certainly against bonding agents blood is a disaster. It follows what we’ve been about from the beginning to improve the quality of dentistry, to improve the oral health be it from the dentist and the materials in the operative or be it the preventive and the like.

Dr. Hornbrook: That’s awesome. I totally agree with you on that, and I appreciate those comments. It brings me back to a story you told me not to long ago even though I’ve known you 20 plus years is coming up with the syringes where you said you were practicing dentistry and on your schedule was Mrs. Jones but when Mrs. Jones showed up, she had her 8 kids there and Mr. Jones. They all thought they were going to have their appointments, and you had to develop the ergonomics of syringe delivery so that you could see Mrs. Jones, Mr. Jones and the 8 kids in the time that normally you’d only see one patient. I [cross talk 00:36:34] that story.

Dan Fischer: Yes, it definitely was a large family. It was definitely a large family Dave, but there is something I speak more openly on today is many of my earlier patients were large polygamous families, and so we would schedule one family for the entire day. A family with 25 to 35 kids and they were coming from about 350 miles to the south, coming in their large vans. My waiting room couldn’t contain them all, so we learned how to have fun with them skipping in and about the oparatories and the like, but that’s when I realized I had to rethink my dentistry. I had to find better ways to deliver quality dentistry. I had to mass produce quality dentistry as their expectation was that I would address the needs for each child in that one appointment for the entire year because it was 700-mile round trip.
That’s when syringes really came to light and boy that was a great help. A great breakthrough relative to just a strigident and the dental infuser. My lovely bride Leany, who was my assistant back in those early years, she shares how that trimmed 20 minutes off of a single crowd appointment. You predictably get that impression the first time and a whole lot quicker and easier and relative to operative dentistry just bringing predictability is a big deal and to obtain profound hemostasis status. The type that you can blast the tissue within in their water syringe and bump it with your syringe tip and bump it with you adhesive applicator that is important and with this massive amount root caries 360 we’re seeing where Rubber Dam can’t work.
You got to be able to seal off those capillaries below the cut tissue and to seal them with little mechanical coagulum plugs that’s a big deal. Because to do quality adhesive operative dentistry today we dentists have to be control freaks. We have to be control freaks, and Rubber Damn can answer it a good part of the time and every year that goes by it becomes more challenging for Rubber Dam to be the end all answer to all of these kinds of problems.

Dr. Hornbrook: I would agree to you on that. I hate to say that we’ve got to wrap up but as I told you as we starts it’s about 30 minutes and enough time for people to finish their treadmill workout while they listen to us. As we wrap up I would again like to thank you, Dan; you’re a busy man. You’ve got a great family, and you’ve got a couple of kids that are dentists as well and-

Dan Fischer: Grandkids that are heading for dentistry.

Dr. Hornbrook: That’s so much.

Dan Fischer: Isn’t that a hoot?

Dr. Hornbrook: They can obviously sense your passion and say I want to be like grandpa which is possible.

Dan Fischer: Dave, at the end of the day Dave I believe to my boot straps that dentistry is the most fabulous professional people profession any human could hope to be in. It’s a blast.

Dr. Hornbrook: I would agree with you on that. It’s been good to both of us, and I think a lot of our listeners can say the same thing. It’s been good to them. Is there anything you’d like to close with if they wanted to learn a little bit more about what you’re doing? They could go to ultradent.com?

Dan Fischer: Sure if you go to ultradent.com you can see what we’re about. You can see our catalogs, our products, and the rest. I think you’ve picked up on the fact that I don’t like to go over commercial. I like to stay professional on these kinds of scenarios. Certainly though we do a summit. We’ve got one coming up in August I think another one in October and even to enhance the education more we’re putting a fourth floor on our building as we speak. We’re going to have an auditorium over there that’s going to see 300 clinicians with benches in front of them Dave. We’re looking for a bright future with continued education.

Dr. Hornbrook: Again I’m looking forward to come back up there. I know I’d get to come up in the summer so.

Dan Fischer: Hey, you need to come and say come and contribute.

Dr. Hornbrook: It’s going fun, and I’d recommend, and I know that you personally and you as a company are so giving and if anyone is the Salt Lake City area call ahead, or email ahead and maybe do a tour. At least see what you’ve done because it is such a [cross talk 00:40:57].

Dan Fischer: Absolutely glad to see you off.

Dr. Hornbrook: Anyway I just wanted to say thank and I’m going to wrap up with for those who came on later if you want to go to see our other podcasts listen or view you can either go to Dental Up all one word, or you can go iTunesdentalup search podcasts, and you can listen to some of the cool things we’ve done in the past. Dan, I’ll see you this summer. Have a great day. Tell your family we said hi when you’re back in [cross talk 00:41:23] I expect a dinner.

Dan Fischer: I will, and I’m still enjoying that West Virginia coffee mug every morning.

Dr. Hornbrook: That’s good. That’s where my family is from.

Dan Fischer: There you go. Good stuff.

Dr. Hornbrook: All right my friend you take care of yourself.

Dan Fischer: You too.

Dr. Hornbrook: Thanks again. Bye Dan.

Dan Fischer: Be good. We’ll see you. Okay bye bye.

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