Commitment to Perfection

Shaun Keating CDT + Dr. Richard Carrara DMD

This week we have Dr. Richard Carrara DMD from Morristown NJ to discuss how he has been committed to excellent dental care for almost three decades! Learn how two friends from dental school became partners with the same vision and ideals in terms of quality and how to run a dental practice from a business standpoint.

Dr. Carrara will be discussing how technology has radically changed in the dental industry, and how he’s planning on implementing these changes to his practice.

Full Transcription:

Shaun: This week we have Dr. Richard Carrara, DMD from Morristown, New Jersey, to discuss how he is being committed to dental care for almost three decades. Today, we’ll be talking about how two friends from dental school became partners with the same vision and ideals in terms of quality and how to run a dental practice. Dr. Carrara will be discussing how technology has changed in the dental industry and how he’s planning on implementing these changes to his practice.

This guy I’ve known for a long time and Dr. Carrara, good to have you on board.

Dr. Carrara: Thank you Sean. It has been a long time. I was thinking this morning, when you asked me to do this … I think I’ve known you only about six years longer than I’ve known my wife.

Shaun: I know, man. It’s like 1990, or 91 we started working together and I just can’t thank you enough for all the work dude. You do so much good work and you’re one of my New Jersey doctors, man. And Morristown, I don’t know where Morristown is. Is that by Met Life Stadium at all or you guys by the Jersey shore? Where the heck you at in Morristown?

Dr. Carrara: We’re in central northern New Jersey. So we’re about … Probably about 40 minutes outside of New York City, but kind of in that center of that northern part of the state and kinda equal … In a good distance from just about everything that you want to get to.

Shaun: No kidding. How’s that work with … I always remember … big Sopranos fans and the way New Jersey there looked like it was in the hills and a bunch of trees and just real kind of beautiful. Is it by … is that a fake area, the Sopranos? Or was that real in New Jersey, actually?

Dr. Carrara: That’s actually real. I probably grew up only about two or three miles from that house actually that they filmed in. But yeah, it’s the misnomers that Northern New Jersey’s all just the turn pike you see in the beginning of the Sopranos and it’s not. Most of it’s just a beautiful state. A lot of park areas and trees. What you see on that … What people think is the typical New Jersey is really that eastern corridor. But really most of New Jersey is just a really beautiful state. You’d think you were in Pennsylvania.

Shaun: No kidding. Yeah, I remember too that strip club there, Bada Bing or something or …

Dr. Carrara: I wouldn’t know.

Shaun: Yeah, that’s the right thing to say. Cause our wives will probably listen to this later. I’ve never been to a strip … I’ve been married 33 years or whatever. It’s been 34 years I tell her, since the last time I’ve been to one of those. That’s funny.

Dr. Carrara: Yeah, but it’s a beautiful state, a nice state to live in and to practice in.

Shaun: No kidding. What a trip, dude. So what about sports there? I know you got the New Jersey Devils, they’re one of the best hockey teams out in the National Hockey League. And then you got the Giants and Jets and they’re actually in Jersey playing. What’s your sports? Who do you like?

Dr. Carrara: They are. Giants, I’m a football fan. Yeah it is a bit odd having two teams in the same stadium and it’s fun and it’s odd. You know? You got friends that are Jets fans, friends that are Giants fans. And everybody’s in the same area, but I’m a Giants fan.

Shaun: That’s so cool. We’re actually gonna … We haven’t had football in over 20 years here in our area. We got the Rams back, but we got the Chargers that are coming into LA now, too and it’s like, so we’re gonna have a two team stadium and Kroenke dude, Stan, whatever rich dude that owns the Rams. He’s building like this 30 billion dollar stadium in Inglewood, which is a lot closer than the Coliseum for us from Orange County. So that’s not coming up til like 2020, but I’m real excited about that. But every weekend in football season, you’ll have either the Chargers there one weekend or the Rams there and so it’ll be great for the economy, great for the football guys that have been jonesing for football.

So it’s kind of neat. It’s gonna be tough on how that works with a lot of the Rams fans. They don’t like the Chargers. Chargers don’t like the Rams. Used to have the Raiders way back in the day, but I’m excited, cause they’re gonna make this kind of like a tourist destination, making it an event for the weekend. It’s gonna be such a big hotel, casino type thing and entertaining of restaurants. So it’s not gonna be just go for a two hour game. You’re gonna make a day or a weekend of it. And I’m excited about that. At the end of the day, I don’t think we’re gonna be fielding some great teams anytime in the near future, but you never know. It just takes a few guys here and there to get a team going and look at New York Giants. Those guys were horrible for years. I remember back in Phil Simms days and you guys got going there for a while, but then you got the Manning kid, who came in and actually won two Super Bowls for you guys out there and that’s crazy, who would’ve thought. But I know those New York fans are tough fans.

Dr. Carrara: They’re tough. You know, we’ve got our rivalries. You got the Eagles south of us and you got the Pats north of us and I actually have a future daughter-in-law … The world works in mysterious ways … Who’s a Pats fan from Massachusetts. So I’ve gotta deal with that.

Shaun: Oh man, that’s it?

Dr. Carrara: It’s a rough …

Shaun: Oh, I bet. You gotta let that go. My dad is like Dorchester born and raised. In Dorchester a little Irish Catholic community area, so I’m kind of a little bit of a Boston guy, but I’ve lived here in California all my life. It’s like, I’ve seen a little too much of Brady and them. And those Boston fans, they just … They get in your ear at the Lakers game whenever the Celtics … They’re very cocky dudes out there and I kind of like that, but when it’s going against my team, it wears on me a little bit and I want to wring their necks, but you know.

Dr. Carrara: It’s rough. It’s rough. It’s always good though, the rivalries, the Cowboys. I mean, great game. The first game in that brand new billion dollar stadium and the Giants win. You gotta love that.

Shaun: Oh that was huge, man. And I remember that. That was great. I remember the punters were kicking the bottom of the television stand and they didn’t really think that, engineering wise, out too wisely with the guys were launching those punts and they’re just hitting the big jumbo-tron there before they had to adjust that and raise it up a little bit I think.

Dr. Carrara: Maybe they’ll build you guys a dome stadium too. All the dome stadiums in the nice weather areas. We needed that.

Shaun: Yeah, you guys do. I’ve been out in New York and New Jersey quite a bit through the years and it’s always in a … The New York meeting, which is like right around November, December or whatever and it’s colder than heck and snow, but it’s kind of like beautiful. We always fly into Newark, because it’s easier and going to New York in the winter time, with all the lighting and the snow and the whatever that tree is … Rockefeller Center and stuff.

Dr. Carrara: Rockefeller Center, yeah.

Shaun: It’s kinda cool, man. But those are some tough people in New York. Those guys don’t mess around there. We’re walking around, you better have sharp elbows and don’t mess around with those New Yorkers. That’s a tough people.

Dr. Carrara: It’s a fast pace out here. It’s a fast pace.

Shaun: And I love those little dirty dogs. The hot water hot dogs. My wife said ‘Take it easy, Sean, just got one.’ And I’m like, well, these are better than the Chicago dogs. I like the hot dirty dogs, I call them, just floating around in that hot water. It’s some good stuff. Gotta watch that lately. Can’t be eating those hot dogs like the old days.

Let’s dental up. So tell me, dude. Tell me a little bit about how you got started in dentistry. I’m not even sure I never asked you about that, but tell me about how you got into dentistry, Dr. Carrera.

Dr. Carrara: I had a family friend who was a dentist and actually in addition to that, good friend of mine from high school. His older brother was, I guess he was four or five years older than us, and he was going into dental school and that kind of peaked my interest. I started to give it more thought and I knew I wanted to do something in health care. And I decided after speaking to my buddy’s brother, as well as our family friend that it was a good profession and I looked into it a little bit more and I felt it was a good blend of my skills not only in health care but also you’re more of a surgeon in dentistry than you are just doing a general practitioner where you’re like a physician and you’re doing exams. You know it’s a little more hands on and that appealed to me. The artistic end of it appealed to me.

28 years later, here I am. But I really don’t regret going into the profession at all. Some people regret the professions that they’ve chosen. I love the profession I went into. I still enjoy it. The business end of it’s not so much fun but the dental end of it is fun. I still enjoy it every day. And I’m very, very pleased that I went into the profession.

Shaun: That’s awesome, dude. What about what college did you go to, to dental school?

Dr. Carrara: Went to University of Medicine and Dentistry of New Jersey. Went to Drew University, as an undergrad. Then I did a master’s at Montclair State University and then went to University of Medicine and Dentistry of New Jersey, which is down in Newark, part of Rutgers, so now I’m a Rutgers grad. Great, great clinical experience there. Excellent professors and excellent clinicians. And my partner and I both graduated from that school and another decision that I was very happy with, I had a choice of a number of schools. I chose that one and again, whether it’s luck or whatever, another good decision.

Shaun: That’s awesome. Yeah, Dr. Corsello is your partner, and I just remember is Carrara and Corsello and I remember way back in the day, Carrara, that’s kind of a unique name, and I was a big Porsche guy way back. My oldest brother, who’s a dentist and Adonis he was always into Porsches when he was older, buying a 911, when he could and I always wanted to follow in my brother’s foot steps, so I started getting Porsches. But I always used to call you turbo Carrera like, “Hey, Turbo Carrera, you got a turbo Carrera?” And you were like, “No, Sean. I don’t.” Then I think you might have got one and maybe I’m not sure.

Dr. Carrara: It was funny. I do remember that. When we first met and you coined that nickname. It was funny, because I used to call … I think there was some times I actually called the lab looking for you saying, “Just tell him it’s Turbo on the phone” and getting to speak to him.

Shaun: That’s great.

Dr. Carrara: You know, it’s been a long relationship and it’s been a good one. I do have a 911 at this point. But it’s not a turbo.

Shaun: No kidding. That’s so cool.

Dr. Carrara: It is funny. Even though my name is spelt without an e, it’s all a’s and r’s.

Shaun: Yeah, where’s that from? Are you from Italy? Parents? Where are you parents form and all that? Is that Italian or … What’s Carrara?

Dr. Carrara: Italian heritage. Yup, on both sides of my family. Not my parents, but my grandparents. Northern Italy, one of my grandfathers was from Sicily. But yeah, I’m 100% Italian.

Shaun: Well shit, why don’t you got yourself a Ferrari now? I’m about to …

Dr. Carrara: I should, I should.

Shaun: You know Ferrari’s are so neat, just the sound of them, man. I just love the sound of a Ferrari. Once you get one, you always kind of have one. So tell me a little bit on your practice, where you wanted to set it up? Is it your first practice, second practice? Have you been in the same place? Tell us how you started and maybe after getting out of dental school, I’m not sure how much debt you had. Tell us, starting off, how was it and if you’re … Tell us a little about that.

Dr. Carrara: When I got out of dental school … My partner was a very good friend of mine in dental school. And my partner did a general practice residency when we first graduated. I was getting married about two months after we graduated and my plans were a little different. I needed the money, so I went in … I skipped the general practice residency and went into private practice with another doctor, as an associate, which was a quality practice and it was a good decision for me, because he allowed me to do … You know, I think some young guys get into practices and they’re kind of hog tied to maybe the doctor that brings them in is reluctant to let them do and treat whatever they would like to do. And this particular doctor allowed me, kind of free reign and almost took me as a partner. That kind of feeling and it was a good experience. I was there for only about a year.

My partner and I then purchased a very small practice in Morristown. It was a young doctor who had just started growing a practice, his wife got transferred down south. We took over the practice. We were in a second floor walk up, small practice. Not many patients, but we just decided to go into it with both feet. We didn’t work a separate practice, we worked our practice five days a week. We felt we would grow the practice that way. Rather than, I know a lot of people start out working a practice maybe two or three days a week, because there’s just not as many patients. We felt let’s just hit this hard and grow the practice from there. And 28 years later, here we are. We always had the mindset that we were going to be quality oriented.

We started out, even back then, not joining many insurance programs. Certainly not getting into any DMOs, cause we just didn’t believe in the model. We didn’t believe in … It was almost a bit of an unethical model. And til this day, we still have avoided the DMO model. While we are in just a couple of insurance plans, we’re really trying to be quality oriented and stay away from … We want to do the dentistry that we feel is appropriate, what we were taught in school. We try not to deviate from that. And I think patients appreciate that.

Quality is really our main concern and that’s why we’re using your lab. Obviously there are a lot of labs out there. Everybody’s jumping ship for cheaper lab, using cheaper products. We try to use the best products. It costs us more, but I think in the long run, I’ve been doing this for 28 years and patients really appreciate it. And they see the difference. They may go to another practice and they realize, they see the difference in the practice.

Shaun: That’s awesome, dude. Thank you for saying it, but that is so true and how you guys are stuck to your vision and come together. You know, a partnership is like a marriage and for you guys to have almost three decades, almost 30 years of working together, how do your guys’ vision ideals, how do they match up? You have one more … Is Corsello more of the [inaudible 00:15:22]guy or business guy or how do you guys work together and how did that all come to be? I mean, the dos and the donts, cause a lot of guys are out there. My brother did the same thing. He got a partner like 30 years ago and they just, they really meshed and came together and there was not a whole lot of issues. There’s a lot to it and some guys it’s just like marriages, they just aren’t meant to be. But tell us how both of you had the same vision and ideals and how that came together and how that still works together, working with Dr. Corsello.

Dr. Carrara: Yeah, I mean it’s a good thing for us to discuss this. I think it may help. Maybe what I get into now will help some younger guys. My partner and I were friends in dental school and we’re still friends today. And obviously, it is like a marriage like you said and you know there are some times when it’s a little rougher, it’s a little easier. And they’re not long periods of rough spots. Yeah, you’re gonna disagree on things, but for the most part, we always had the same vision for the practice. We also … I think it makes it easier, when you both sort of have the same goals.

You know, you’re gonna get married, you’re gonna have a family. I think it’s more difficult if you have a guy that wants to start a family, get married and maybe have another guy who wants to be a lifetime bachelor. Because then your goals, your personal goals, may deviate. And that makes it a little bit more difficult. That can make it a little bit more difficult. But I think our goals, as far as our professional goals and our personal goals really aligned quite well. I think we were raised similarly, so we had same ethical standards and that’s a big part of it. A lot of what you see in dentistry today, doctors are getting pulled left and right with these different products and different …

Shaun: Flavors of the month type thing.

Dr. Carrara: Flavors, different gizmo. There was a doctor that once … One of our professors down in school had said this before we graduated. You know, you’re gonna be bombarded when you get out of here with just tons of technology and different products and just because a product has been created does not mean that you have to use it or that it’s actually gonna be beneficial to your practice.

Shaun: Absolutely.

Dr. Carrara: And so you really need to kind of analyze each product you bring into your practice. But, that being said, we really have the same parallel path and that’s made it much easier, I think. I mean granted, we’re only working in one office and a lot of doctors out there probably have multiple offices or maybe more than one partner. I think that would be difficult for me, but we decided what we do well and we stick to that as far as the business end. We have things that we’re responsible for in the practice. I think that it’s important to keep a handle on your … My partner does a lot of the ordering of our supplies, I do a lot of the paying of the bills and I know a lot of young guys out there might be delegating that to office staff and yes it’s easier to do it that way, but I think if I had to advise a younger guy coming up right now, a young doc coming up, even though it’s more work, that’s … You do want to keep a hand on that, because that ultimately is gonna help you run your practice more efficiently.

Shaun: And keep them from embezzling. I mean, even til this day for me, we’re 15 years of my own business and I still sign every check. And it’s hundreds of checks and I sign every check. And we have the masters going to the house to double check. I mean, our accountant said you need to do things like that. You can’t just pass it off to people. You like to keep your hands involved with it and stuff like that. But a lot of embezzling going from different people in different practices, when it’s not the dentist. Or maybe sometimes one dentist or not, but you gotta keep your hand on the till there like the old days, I think.

Dr. Carrara: It’s true. But what it really does is it really keeps you focused on where your practice is going. How much material are you using? Have there been changes in your ordering? Keeping an eye on your budget. When that gets away from you, when you’re not cognitive of those things, you don’t have as good a handle on your practice. And part of that practice is, you want to run it efficiently and the bills are the bills. They gotta be paid and it allows you to just be able to control your practice a little more accurately. I know in our practice, the staff will put down what they need to order and my partner always double checks it before he orders materials and that’s an important point. A lot of staff, as good as they are, they’re not paying the bills for those materials and so it’s always good to have a second eye on it, make sure you don’t have six months of stock sitting on the shelf.

Shaun: Oh, absolutely. I mean, that’s the biggest thing. We have to do inventory of what’s on stock, this and that, couple times a year for tax purposes and or other things for us for checks and balances. And we have certain technicians, while they’re going through 25 burrs a week where the average is 7.5. So what’s going on there are they pocketing some burrs, this and that. And just other products that if you really don’t see what’s going on and keep your hand on the post, you have your averages and it’s kind of like the water department. The water department where I live, they send me a thing in the mail saying Mr. Keating, you have a water bill that went up by 38% this month. What’s going on? And they just habit so automated and so perfect that yeah, we have a slab leak and they found out that instantly. And it’s just a lot of times … And it’s way deep underground and it just kind of goes into this … I live on this hill and it just kind of goes into the soil and you don’t really feel it or see it, but it’s going.

And you need to do that with your dental practice on the little things. The purchases and how much material you’re using and why it differentiates from this week to that week and when you know what’s going on, it runs much smoother and there’s less chance of having turmoil. It will happen at your practice, because of not knowing. Lack of preparation or I always used to say, when we worked with people, lack of preparation by management shouldn’t constitute an emergency for the people, because you know … And it’s the same in business. Well, this happened to me. Well, because you let it happen to you and you weren’t prepared for it and you weren’t doing the checks and balances that you need. Just the basic checks and balances too, will save you a lot of heartache and turmoil, when it comes to people abusing products and materials and when you’re paying for it …

It’s kind of like a parent always saying turn off the lights, the electricity. And I never was that kind of person, but when it comes to the company now, it’s like sometimes I think we have great people, but they’re not paying for it. And they don’t really look at it and when you look at all little things it’s like, we’re paying for this. Let’s try to be conscious of that. And the people, if they have a good heart and they’re good people, you should kind of pretend like we always say too, when you’re making these teeth, pretend like it’s going in your mouth or your mother’s or father’s mouth or your family for every case. And when you do that over and over, you just have that quality mentality of like, the quality that you receive is what you tolerate. And so if you tolerate people doing [00:23:33] contacts all the time or not polishing the best polish margins and this and that, you’re gonna receive that. But if you demand excellence and it happens over time, you’ll get and receive that.

Dr. Carrara: You’re right, you’re right.

Shaun: Kind of a little bit off there, but …

Dr. Carrara: Yeah but we do that as one thing and actually it’s on our website. That’s one thing that we do feel. When we’re treating patients, if we’re gonna prescribe something, it’s always in the back of our heads like would I do this for my brother, my sister, my mother, my father? You want to … I think that’s important. I think that sometimes that’s lost and you just need to go back and say you know, things snowball over time. Always reach back to the basics, back to the way things should be done. You know, is this appropriate? How do I want to treat this? It’s a good thing to practice.

Shaun: Yeah and the people pick up on that too. I think we heard this last week, one of our doctors are talking that the patient can pick up on your sincerity and your passion for what you do. If you’re running through and you’re just kind of going through the motions, people are pretty perceptive when it comes to that and they pick up on that quite quickly.

Dr. Carrara: Absolutely.

Shaun: And when you do what you do and you love what you do and you try to show it and have the passion, people pick up on that. And then they tell people and that’s why there’s a lot of successful practices out there, because of basically, the people care about what they do. And I don’t care if you’re a plumber, a painter, own a coffee shop, if you practice with passion and love, the people pick it up and you will grow and you will have a successful business even in the down times. It’s just kind of the golden rule again, you know? Treat people how you want to be treated and good things usually happen. Sure, things don’t go your way sometimes, but you just try to keep doing the good, staying faith and I think everything will happen on the upside for you.

Dr. Carrara: Yeah, absolutely.

Shaun: So tell me, dude, a little about … I noticed too on your thing you were voted one of the top New Jersey dentists in just last year here. Tell me a little about that and how’s that work?

Dr. Carrara: Good, good. You know, we’ve been voted a number of times as top dentists in state of New Jersey. And you know, these are one of these things that you don’t really strive for. If it happens, it happens. But I mean, we’re just always striving to do the best dentistry we can do, be honest with our patients. As you said, you know when I see a patient and I’m recommending treatment, I always like to basically back that up and show a patient either with a picture or x-ray or both exactly why something needs to be done, how we’re gonna complete that, what type of restoration we’re gonna do. And I think spending the time and explaining it to patients, explaining your treatment to patients, that extra time where some doctors may say I’m buzzing through, I’ve gotta do three patients this hour and my assistants are doing some of the treatment. I think that ends up hurting your practice. And I think if you spend the time, the patients really appreciate it. I think that time is well spent and I think it leads to case acceptance down the road with that patient in the future. Living that everyday, I think yeah it’s nice if you get the accolades, but if you live that every day, it’s fun to practice. And in the end, you’re recognized for it.

Shaun: That really is so on the money right there. And it’s neat that you say that. Now tell me a little bit about … I know you’re into for your anesthesia you use the wand. How long have you been using the wand and tell me how you got started with that?

Dr. Carrara: Yeah, I’ve used the wand for quite a while now. Gosh, it must be maybe 15 years. I always gave a pretty comfortable injection, but the wand was interesting. I think that’s probably one of the most … Most doctors will admit that’s probably one of the most stressful times for the patient, during the procedure. That impending injection coming. The patients are just getting all geared up for it and they get very nervous. And you get the wand there, it doesn’t really look like it … If you’ve ever seen it, it’s just a plastic tube with a syringe tip and it’s very innocuous looking. It almost looks like a straw. And I think it just calms patients down and then okay, I’m going to explain it to them that there’s a very small needle. It’s a very comfortable injection, as comfortable as we try to make them. You’re expressing the liquid into a tight space, an interstitial space and that expression of the liquid, as gently as you’d like to do it, can still cause a little bit of burning, a little bit of stinging.

The wand definitely takes that … We use a topical anesthetic for a few minutes and then go in with the wand for some of these more sensitive areas. And it makes for a more pleasant injection and I think once you’ve had it, once patients have had it, they look for it and it’s been good. It’s just another thing that we do to make patients more comfortable here. It’s not like we’re marketing it, but I think just … It’s every little thing you do in your daily routine for performing for procedures. And it just becomes routine after a while, but patients look for that.

Shaun: That’s awesome. I wish I could have had that growing up. Because I think like you said, a lot of people, that’s the worst part is that shot. And I’m a big boy, but I’m a sissy boy when it comes to shots. Even when I have to go give blood to check my cholesterol like every few months or whatever, I hate it. I can’t even look at this girl doing it to me, I gotta turn away. She goes, big guy like you all scared. I’m like, hey girl you don’t even know. Just shut your trap and finish this up and be gentle and some girls will get a little bruise job and some will slide it right in, but that’s the big thing. When you get in that chair and that shot and back in my day it was like, dude, with those old Navy dentists and they couldn’t get me numb, too. What’s going on? You gotta get it in the right pocket back there to block this thing out or whatever, but I think it’s come a long way. But that wand anesthesia, that’s the hot ticket for a lot of people and still a lot of guys don’t do it. They just, I don’t know, might be the old timers. I think the newer, younger guys are doing it, but I think that’s awesome.

Tell me a little bit about … I know you’ve been biting at the bit to get into more digital dentistry with the digital scanner. What are you looking at and what are you thinking about there, Dr. Carrara?

Dr. Carrara: Yeah, that’s a good question. We’re never first to jump on the bandwagon and I really don’t like to … That’s just us. We don’t like to treat our patients such, so to speak, as guinea pigs. So even on the digital x-rays, we were a little … I mean, we’ve been doing that for quite some time now, but we weren’t right out of the gate jumping on that. We didn’t feel the gray scale was accurate. As soon as they got to the second, third generation of sensors now, they’re more refined. We got a good gray scale, we decide we’ll go into that. And that was years ago. But we’re seeing the digital impressions now, the digital dentistry and I know a lot of guys have been in the CEREC and other systems and again this is just our take on it. We weren’t real big CEREC fans, still not, as far as the milling machine in the office. I just don’t think … I’ve looked at them, I just don’t think that the product is up to our standards. Don’t really like the aesthetics of them.

But the digital end of it, that was something my partner and I said probably years ago, when that CEREC first came out. Boy it’d be really great to use just the digital end, have the lab handle the fabrication end, just do the design end and have you guys handle the fabrication end. And that’s now come to fruition. That’s something that’s becoming more commonplace with Invisalign’s kind of pushed to the head a little bit. And so we’re really excited. We are looking at a sensor. In fact, we decided on the iTero sensor … We’re between the iTero and the Trios and we’ve vetted them both pretty heavily. We had each rep out twice, but we just felt for our needs that the iTero was a better product and we’re gonna be implementing that in the next month.

Shaun: Yeah, I’m excited, cause dude out of all my frickin’ dentists I got in the nation, you’re the only dude I have to send FedEx. Cause I’m a UPS guy and it’s just, I got a contract with them and it works for me and I still lose my butt on every case that I send, but you’re a FedEx guy. So we’re gonna clean up a lot of shipping one way at least.

Dr. Carrara: Yeah, well I’m excited. Not only for the patient comfort, I think it’s just … There are some things that they’re developing now with these systems that are really gonna … To me, it’s another door that’s opening for dentistry that’s gonna have a big future. You know that, coupled with these new ceramics that we keep. Every year we got new ceramics coming out, they’re getting better and better. It’s an exciting time. I’m really looking forward to it.

Shaun: It really is. You know how we got so much success with each other, but I still got these liquid powder ratios, pouring stone up. And it’s just some other little issues, but it’s not a perfect meeting. And what we do, even on your end, teeth like to move around, this and that, but this is taking a lot of the variables out. And it’s just so frickin’ accurate on these digital impressions, man. And it’s like a lot of these single, onesies, twosies, even the bridge work, we can do modelists. And it’s so neat and we can still do it out of any product we want. I mean, we’re just getting this and we can design it and I can print it and then I can still stack it all by hand. I can do all that, but it’s a neat thing. And it’s really come a long way and iTero’s a great system, Trios is a great system.

I mean there’s just a lot of neat opportunities out there for dentists that don’t still want to sit in a back room and watch a machine mill out a single unit for an hour or whatever it takes. And I think with the volume that you do, and we’ve done many, many, over a million dollars in the last several … in the last few decades with you and it’s just a beautiful thing that working smarter, not harder, is what’s coming upon you. When you do this, you wave it in the mouth, that wand, and in a minute, you got your dang impression and everything. And then it’s basically like a one day turn around for me, because I’m given in an instant and it’s like a day or so.

So I mean ideally, and I’m shooting stuff out, so your case box is from Keating is gonna be stacked up and if you ever get your system down really good where you got a patient cancel, we’ll call it Miss Smith, we got her crown back already and I’m sure she’s gonna want to get that rough little temporary out of her mouth and it’s a five minute seat. You come on in and in 20 minutes, you’re in and out, because your crown fits so nicely, but it’s pretty neat for me. I get excited with the accuracy, but moreso at the end of the day, our margins are so small, the shipping alone is saving me a charge that can help me out a little bit. You know, I’m the bottom man and it’s just so … The greedy person a little bit where the money’s important, but the accuracy is really the most important. But on the other hand, it’s a neat thing that I can save a little bit.

I mean I think we even drop it if we’re doing your ultras, I think we drop the 20 dollars and I’m still, because that’s just labor and then the shipping helps me there. But if you got a $119 crown, it’s now a $99 crown. Or a $99 crown is now a $79 crown. It passes on to you, it passes on to me. And it’s just a neat thing.

Dr. Carrara: It’s a great thing. The accuracy works great for … And the doctors out there that are using it know that. Single crowns are not a big deal. You know, you get three, four, five unit bridge. Larger spans, where you’re getting an impression and every doctor out there knows if they’ve done them, you’ve got this beautiful impression and then there it is on one particular area, maybe it’s a millimeter wide on one of the abutment teeth, where you just have an imperfection, whether it was air bubble or a little bit of bleeding that occurred. And now your impression’s basically ruined. You’ve gotta go back, repack some cord, redo this impression and with this new scanning device, it’s just fantastic. You’ve got an area there that didn’t scan well, maybe there’s a little blood, you can just go back, dry it, and just re-scan that one area and it’s just … It makes your day.

Shaun: We had this thing, it was really bitching. Bob Brandon, our general manager here, he goes, “Sean, check this out.” You know what’s really neat? We did like several units on a patient. It’s all digital, virtual reality. So it’s all done, we send it out to him and we missed a margin on the read of our guy that read it, we missed it by about a millimeter and a half on the mesial distal area of this prep, because it was kind of like a shoulder bevel-ish type … We read it wrong. We read it where it went supra, when it was sub in that area, so basically all we did was went to the file, brought the margin down to that area that oh that was the margin. Because it was kind of funky. Printed it, and just redid that single unit, in an hour, couple hours and we sent it out over night and we had the contacts, the dimensions, everything and he just goes, that’s just the craziest thing. He didn’t have to take an impression, he didn’t have to get the … He just put it in temporarily cement and he went back in and permanently cemented it with the perfect margin and it was just like that and it was like the patient didn’t even know.

The patient was home with the temp and we just saw it and we did it. The patient came back in the next day, the new crown was there, he re-cemented it and permanently on everything and it was like, oh my god. Because you keep the files and this and that and especially when we’re doing something like, if we’re doing the patient’s custom temps to start it off and we need to match out exactly. We can go to that file and boom, boom, boom. Or even if we’re doing a little Sil-Tech matrix, where you’re doing direct, chair side temps. We can snap a model of that, you can scan that, send it to me and it’s just … the options are just limitless.

Dr. Carrara: I think they’re moving towards being able to give you some shade matching, within that. So you’re gonna be getting almost a digital image of the area, so you can even do … It’s just gonna take a lot, as you stated, a lot of variables out of the whole fabrication process, which is you’re model pouring the shade and the application of the porcelain. I mean, it’s just gonna be … It’s a big, big move in dentistry and I think you’ll see … I was just at a course [00:39:19] I think only less than 20 percent of dentists have these. I just foresee in the near future that it’s just gonna become very popular, because I just think you will improve your practice with it.

Shaun: Not too many years ago, it was less than 2%. Now it’s already getting up there, so we’re excited, dude. And I can’t thank you enough on this. I know you’re at lunch, I know you took your time out, but I just want to find out of the last year, we’re doing good for you and everything else? Your crowd’s dropping in for us?

Dr. Carrara: They are. They are, we talked to Bob, almost on a daily basis. And you know, my partner and I are very happy with your lab and as you know, we’ve been with you for a good many years and I’m sure we’ll be with you for a good many more. So we really appreciate it.

Shaun: That’s awesome. No, we appreciate it.

Dr. Carrara: Your attention to detail has been great.

Shaun: That’s so cool, dude. Now tell me your boys, you’ve got like five, six boys? How many boys you got?

Dr. Carrara: Four.

Shaun: Four boys. No girls, four boys. I remember that because I got two boys and four boys, how old are they? They out at college and everything now? They gotta be all in …

Dr. Carrara: Yeah, young men now, right? Everybody’s in college or out. I got two out and two that are in. One’s getting married next year, so yeah. It’s a crazy life. Time rolls on.

Shaun: That’s so cool, dude. Yeah, four boys, man. They’re gonna be taking care of mom and pop, before you know. They’ll be wiping our bum bums, before we know it.

Dr. Carrara: That’s it.

Shaun: Well hey, Dr. Carrara, I want to thank you for this so much. I know you’re so busy and I just can’t thank you for all the work and the quality work. Can you make us better? You’ve always made us better. You’re very demanding, but it just makes us better through the years and it’s just a pleasure to work with you and your staff. You’ve got a great staff. Everyone there, they’re all upbeat, they’re all positive and they all got it down. And we love that, when the staff’s been with someone a long time and we’re just like those playoff teams in the playoffs. We’re just peaking, like every day here’s the playoffs for us. Because every day, every patient’s a new patient and you’re only as good as your last restoration and we try to keep up on top of it every day, stay motivated every day. And guys like you and with your staff and we just appreciate it, man, and we’re very lucky to have you with us so we thank you and we thank you for throwing all those little letters you get every day from all those other labs in the trash can, because you’ve been with us a long time and I want to work with you for a long time in the future, but I can’t thank you enough.

Dr. Carrara: I appreciate that, Sean. And I appreciate, like I said, the quality of your product. And it’s funny, because patients say, “Oh, where’s yours labs?” Occasionally, someone will ask me that. And I’ll say California. They look at me like, California?! And I say, “Hey, it’s the age of FedEx and UPS. They could be next door.” But no, I’ve been working with you for a long time and I really appreciate the quality of the product and I appreciate your staff, Bob Brandon, Jim, all the other staff there have been very responsive, they’ve always … Hey listen, practicing this long and practicing with you that long, there are gonna be some times when we get some tough cases and not things won’t always work out perfectly, but you know, at the end of the day, we get through it. We may send things back, but they all turn out very nicely.

Shaun: That’s so cool, dude. Well, you’re the man, Dr. Carrara. I want to thank you, have a great day. And we’ll be talking to you real soon.

Dr. Carrara: Thank you too, Sean. And I’ll look you up when I’m out there.

Shaun: Right on, dude.

Dr. Carrara: At some point.

Shaun: Anytime, you’re welcome.

Dr. Carrara: Thanks.

Shaun: Later man.

Dr. Carrara: Have a nice day.

Shaun: You too, bye.

Dr. Carrara: Bye.

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