The Pursuit of Dental Happiness!

Full Transcription:

Dr. David:

Hello, this is Dr. David Hombrook in our weekly podcast. Another great Tuesday and we’re looking forward to another incredible 30 minutes, so we’re in for a special treat today. I’m in Irvine, California at Keating Dental Lab, full service dental lab. As most of you know, I am the Director of Clinical Education and Technology here at Keating. Today’s going to be a really fun time, we’ve got Damien McDonough, the President of [Cursivron 00:00:25]. The dentist and clinicians that are listening, we’ve known about Kerr forever and initially you think, Herculite although it’s …

Damien M.:I’m glad you think Herculite.

Dr. David:

Absolutely we do. I mean, that’s been a kind of a mainstay, that was the goal and standard for so many years and now Herculite Ultra is back on top, but it’s much more than that. Kerr is much more than Herculite and [Melktubon 00:00:47], it’s a huge entity. To give you a little bit about his background, he’s from Sydney, Australia and he now lives in Orange County in San Juan Capistrano.

Damien M.:That’s right.

Dr. David:

That’s where you’re living now, yeah. For those that haven’t met him, the women in the audience are going to listen to his voice and say, “I want to meet him.” All the men are going to say, “How come I can’t sound like him?” You’ve got that charming, debonair voice and it’s so much fun. We’ve known each other about 3 years now?

Damien M.:That’s right.

Dr. David: I’ve had the pleasure of having a glass of wine and eating at your home and we’ve had dinner together and you’ve sat in my dental chair.

Damien M.:I’ve had many hours in your dental chair and very grateful for the chair.

Dr. David: Thank you, so it’s been a great patient. A lot of people don’t know that Kerr, the Kerr that a lot of us that have been in practice 20+ years when it was a small little composite company, it’s part of this huge umbrella, Danaher.

Damien M.:That’s right.

Dr. David: You came from that side, Danaher?

Damien M.:That’s right. Danaher made a very conscious decision to get into businesses where science and technology made a difference and about 04, 05 started getting in with the science of Gendex and KaVo and so, equipment. Then in 07 bought the [00:02:00] Cyberon family of companies and integrated the 2 sides of equipment and consumables. Really the journey for Danaher has been about trying to get deeper into the science of the patient care of dentistry, most recently with the acquisition of Nobel Biocare which is tremendously …

Dr. David:

That’s huge.

Damien M.:Yeah, tremendously exciting for us. The family of companies now, we think and we’ve got some pretty good data, we think that we’re in 99% of dental practitioners offices globally. There’s some part of our family of companies is in 99% of practitioners offices. That gives us tremendous insight and I think what people are going to see from us over the next 5 to 10 years, that insight is going to really pay off in terms of the things that we develop, the innovations we bring to the market because we can see the entire workflow. In fact, all the discussions we’re having now as a family of executives, is about the workflow. How is it that we make a difference whatever you’re doing, general practitioner, endodontist, a general practitioner and who’s doing endodontics, how is it that we help you with the workflow? Similarly with implants and there’s a lot of case studies and planning that you need to understand, how is that we can make that easier?

Dr. David:

Okay, which makes sense, I mean, typically it’s always been isolated. I don’t do endo, I don’t do ortho in my practice, so I

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never had any interaction with those companies at all. I don’t know the reps, I don’t even know the names of the companies and now you’ve got under that Danaher umbrella, you have your ortho company which would be …

Damien M.:Ormco.

Dr. David: … Ormco, which everyone’s heard of, but people like me have never worked with them. Then the endo side is …

Damien M.:There’s a group what’s called Cyberon Endo. Dr. David: Okay, that’s right.
Damien M.:Access which made all the burrs and …
Dr. David: Right.

Damien M.:I think this is the interesting thing, you’re talking about, this dynamic. What we’re seeing is the general practitioners are saying, “Well, hang on a second. If I’m really going to take care of the patient, how is it that I can be more [00:04:00] integrated into all their treatment?” What we’re seeing is, general practitioners are sort of making a decision about which pathway they’re going to choice to be more active with the patient. Is it, I’m going to be a general practitioner plus doing implants, going to be a general practitioner plus the endo, general practitioner plus the ortho, because you can’t really do all 3. It’s probably not fair to the patient, but it’s really not fair to you as a practitioner, to become a specialist to all 3. People I think are making this conscious choice about how is it that they can provide better care to their patients and which one of these 3 or 4 pathways are they going to step down which is tremendously exciting for us.

Dr. David:

Absolutely. You mentioned the pathways and we talked a little bit about this before we started and you mentioned those same 3 pathways. Is it companies and executives that is training your sales team and your training team and your educational team, how do you train? They came into my office and I sat down with

my rep and I said, “You know, I’m not as busy as I used to be, I don’t do endo, I don’t removable, I don’t do endo, I don’t do ortho and I’m thinking to add one of those into my demographics.” How do you train your employees to kind of help the doctors with that?

Damien M.:We’ve made a very conscious choice to say that being in one of these other spaces requires a specialists knowledge, so one model is that you could say to your rep, “You’re going to be the rep of everything.” and there are people who have made that choice. We believe that the better way to do this is to have the specialist within a geography, but and have our specialists connected more closely with CRM, patient management system, customer relationship management. We’ve made a very conscious decision that we’re going to keep … For you for example, we would have in your geography a person who’s very well trained in restoratives, one trained in hygiene and one trained in endodontics. Similarly, [00:06:00] the sister company, Implant Direct, has their implant specialists. We think our job is to connect you with the best specialist and so we’re using technology inside the company so our restoratives rep has a great relationship with you, they’re talking and you say, “Hey, I think I might get into endodontics.” we would bring in our endodontics specialist and then connect you into what we think is a growing and very competitive offering for education.

Dr. David:

Okay, I like that because obviously if I already trust my restorative rep versus opening dentistry today or insight dentistry and trying to find some course somewhere that I never heard about, I’ve got direct access to a specialty or specialist or an organization through my restorative rep.

Damien M.:I think this comes back to something that we’ve certainly found as important is this is all about trust. The products are nice and lots of products are probably interchangeable, but what we’re trying to really continue to invest in is this trust that exists between the specialist rep and the dentist. We think that if we do that well, people will find a pathway of our clinical education and our specialists, teachers like you and that ultimately is

Dr. David:

going to lead to better patient outcomes if people have the best training.

Yeah, that makes sense. Something that you said earlier too about combining these different technologies with materials, with science. One good example was I think a lot of people utilize but don’t know the details is SonicFill.

Damien M.:Right.

Dr. David:

SonicFill is, as you know I present on SonicFill, I’ve lectured all the country on that, well I guess the world now and Japan, or China. When I say a handpiece was made by KaVo, and the composite was made by Kerr and they say, “Well, how did that happen?” They don’t realize it’s under this big umbrella which everyone wins. I mean, KaVo’s the number one handpiece so they got the sonic handpiece from there and then Kerr being the number one composite, they were to marry those 2 in the science and technology [00:08:00] to deliver a good product for you guys.

Damien M.:I’d like to say it was simple and it was all seamless and honestly, we muscled through a lot of things because it was very new for us to collaborate like that, but I think the ultimate thing was, people saw that this was something that would made a substantial change, not only to the dentist but also to the patient. We muscled through and I think what we came up with was a really great piece of technology. We’ve now done more than 6,000,000 restorations with this.

Really?

Dr. David:
Damien M.:Yeah, which is extraordinary, right, in 4 years? Dr. David: Right.

Damien M.:What we are really excited about is only 15% of dentists in North America are still using SonicFill, we still have a lot of people to get this message out to. We’ve just brought out what we call SonicFill 2.0 which a lot of people said the first one was

nice, all sorts of things are amazing, but it would be great if there was better polish-ability and better wear-ability and so we’ve made some changes to the science and that’s what we brought out the new composite or composite.

Dr. David: Yeah.
Damien M.:I have to loop … Dr. David: That’s right. Damien M.:… between them … Dr. David: Now I know. Damien M.:… the 2 words.

Dr. David:

We have some Canadian listeners that’s composite for you all and composite for the rest of us. Yeah, I was involved in testing and it’s not something that … The nice thing that I do like about Kerr, a lot of companies, they come out with their second product or the next generation, they say, “Well give us a feedback.” Then when you give them the feedback, they say, “Well actually we’ve already gone to production. Maybe the third series …” I actually was intimately involved with Carlos Munoz and Ron Jackson in going through those multiple baby steps to get where at, SonicFill 2 now.

Damien M.:We’re lucky to have that, I mean, firstly the collaborations that we have with you and the key opinion leaders who I think have really great insight to what’s happening in a practice and the ability to see things earlier, really critical to us but, people who are inventive like Ron Jackson and there’s a number of people who have that sort of skill. We like to think that we’re good at trying to translate the [00:10:00] ideas into practice. Then we were tremendously lucky to have Carlos Munoz join us from Academic Practice, I mean he has seen everything.

Dr. David: Yes.

Damien M.:Our round table, we call it The Key Opinion Leader Round Table, that we have every year, we really do believe that that is the point at which we should show a group of you and that’s about 15 of you, the things that are early in our plans and have you really weigh in about the direction we’re taking at and help us with the clinical direction that we’re taking. There’s no point and like you said, there’s no point showing you something that’s already boxed …

Dr. David:

Already fixed, yeah.

Damien M.:… and we’re shipping it next week because there’s no way we’re going to get better and improve and so we love the dynamic of the round table. Hey, it’s controversial sometimes, I mean there’s been years I’ve been at the meeting with you guys and you’ve said, “That’s probably the dumbest thing we’ve ever seen in our life.”

Dr. David:

Yeah, like last year I think we said that about something.

Damien M.:Let me say, we took it to heart and but again, we could of kept going with that, spent another several million dollars developing it and people’s time and passion instead of creating something that really did make a difference, so it was tremendously helpful, controversial.

Dr. David:

Yeah, it is controversial for some of you saying, “I don’t really know what they’re talking about.” once a year we basically have a meeting of the minds where in this particular case Kerr invites about 15 to 20 of us and breaks up into small groups, presents ideas or maybe we present ideas or we evaluate a product that is almost there to try to take it to the next level. You know we’re all practicing clinicians as well as educators and so, I think we have kind of a unique insight to what drives dentists and what dentists need, some are academia, some are clinical practices like myself. Then we give feedback back to Kerr and sometimes help present an idea and I mean literally in the past, the last year was one where they’ll say, “We’re thinking about buying this or taking this technology.” [00:12:00] and sometimes it’s like, whoa, why didn’t I think of that? Other times it’s, thank God

I didn’t think of that because it’s a dumb idea and so I think it’s …

Damien M.:Which was last year.

Dr. David: Yeah, I think it’s admirable that you do what you do. When I originally invited you and your actually in my dental chair, as I said, “Hey, come do my podcast.” and your local which is always nice versus doing Skype …

Damien M.:I did like that technique by the way, you’re about to operate on me and say, “Would you like to be on my podcast?” you know?

Dr. David: Yeah, as the anesthetic … Damien M.:At that point …
Dr. David: … is dripping from … Damien M.:Exactly.

Dr. David: … the end of the needle, yes.

Damien M.:The only answer is yes, but of course you know I’m happy to be here. It’s a …

Dr. David:

Yeah, well I appreciate it. Again, it’s local and being able to be face-to-face is awesome. When I emailed you and talked to you, we talked a little bit about changing trends in dentistry and I think you’re in a unique position because you’re seeing the trend. You’re hearing it again from the endo guys and the ortho guys and the fix guys and the removal guys and the dental laboratories, you’re seeing all this. What’s interesting is something that you and I talked about a little bit before we actually went online that I would like for you to share briefly and that’s the difference between … Because you came from medical background.

Damien M.:That’s right.
Dr. David: Medical sales and technology.

Damien M.:Old Med Tech for 25 years.

Dr. David: You have a huge history and know you entered dentistry 4 years ago, right?

Damien M.:World’s biggest [cottage 00:13:13] industry, it’s extraordinary.

Dr. David: Talk to us a little bit about that because what you said to me earlier before we started fascinated me a little bit, so describe the differences as you were to describe dentistry versus medicine or pharmaceuticals.

Damien M.:I think the thing for me that strikes me about dentistry is, people in this industry … I’ll stay on the industry side, let’s stick there for a second. People in this industry have tended to be in this industry from their whole career and when they’ve moved, they’ve moved between dental companies. I mean, it’s pretty rare, I’m one of the few that came in from the outside and I’ve been 4 1/2 years now, but to come in at the level I was lucky enough to come in, is quite rare because nearly everyone is grown up in the industry and I think there’s a couple of things about that that are really key. Firstly,[00:14:00] people in this industry are desperately passionate about what they’re here to do and I find that quite fascinating because I think if you’re going to be in healthcare, you have to be almost mission oriented.

You need to be doing this because you think you’re going to make a difference to the planet. Even more specifically, in dentistry I think all of these people are here because they really do love and believe in what dentistry can do for patients, it’s self-esteem for their creating a smile, creating less pain. People love this industry, so that’s the first thing. I think secondly what you get is this incredible sort of institutional richness and people are developing products based on a really deep understanding of what goes on in the market and how clinicians interact with their patient and how clinicians interact with technology. In a lot of spaces people come and go and you sort of constantly reinventing things, I think that fact that people know each other, talk about things, really work and collaborate well together

Dr. David:

within the industry means that the invention, the way that we’re approaching innovation is a very customized entry. It’s quite remarkable.

Yeah, it is and as you were talking I was just visualizing like my local sales rep, then became 5 years later the regional manager, then West Coast rep and then Western Regional, now they’re the VP of Marketing and it’s someone that when they were 25 years old, sold me this little product and came in their briefcase and with their grip stock and …

Damien M.:Clearly that was successful supporting you.

Dr. David:

Yeah, let’s hope so. Obviously, they talked somebody into something. We talked about some of the trends earlier and I know and you just mentioned technology’s huge, the way digital and CAD/CAM, whether it’d be radiographs, whether it’d be Cone Beam, whether it’d be you walk through the Keating floor and you saw how we’re integrating [00:16:00] CAD/CAM technology so much in the dental lab, let’s expand on that.

Damien M.:Like I said earlier, there’s an interesting choice that dentists are having to make. Firstly, I’m a general dentist plus and most people are making that decision. Am I going to be implants, am I going to do endo, am I going to do ortho? Then after that, you’ve then got this massive decision to make is how do I invest in my practice? I think I said earlier that there’s still 50% of images are taken with film, but that’s rapidly declining. You’ve got this huge decision to make about what digital thing am I going to pick up and there’s obviously a range of choices you can make, but then how interconnected are you going to have that digital choice? To the lab and which lab?

Then how far are you going to go with this imagining, you going to do 2D imagining, you going to do 3D imaging, you going to have a combo? These are very large investment decisions because if you’re going to practice for another 5 years, that’s one choice. If you’re in this for another 10 or 15 or 20 years, that’s a very different choice and how you also going to absorb … Reading a Code Beam 3D image is a very tricky thing, it’s

Dr. David:

going to take a big investment of your own time. I think that right now is an exciting time espec- on the industry side, but I think if you’re a general practitioner, how you’re going to make this decision and how much you’re going to integrate into your practice …

They’re important decisions because it’s technology’s not cheap. It’s not like a SonicFill, it’s going to cost me 1,000 bucks …

Damien M.:Right exactly.

Dr. David: … then I decide if I don’t like it or do like it, I’m going to buy another one or not use it, I mean, you’re talking about 100,000 …

Damien M.:100,000 …

Dr. David: … easy.

Damien M.:10’s of thousands in the first instance and 100’s of thousands if you really get deep into it and these are major financial decisions and can make or break your practice and have a significant impact on the health of your practice [00:18:00] and what you can do next. Again, I think on the industry side this is tremendously exciting, but also has a tremendous burden for us because I think it really puts the onus back on us to help people make the right decision. I could tell you, buy an I-CAT FLX, phenomenal, 3D imaging …

Is that your product?

Dr. David:
Damien M.:That’s the sister companies … Dr. David: Yeah, okay.
Damien M.:… product.
Dr. David: That’s a …

Damien M.:KaVo’s product and it’s a tremendous product and it’s extraordinary. The field vision that it has and the ability to take such incredible images, but with low radiation, amazing, right? I should tell you, buy an I-CAT FLX. The fact of the matter is, there are other choices you probably need to consider and I think that’s where it comes back on us is, responsible partners, to have a discussion with you and say, “Really what are you trying to do with your practice? If that’s what you’re doing, maybe you just need a NOMAD, a handheld device that can give you tremendous image quality. Maybe you need a 2D/3D combo, the maxio unit.” I think that we have a really important role to play, but a tremendous responsibility to help steer people through this very, I think turbulent time, but exciting.

Dr. David:

It is very, very exciting. As a company asset aside, what technology you need to add to your [inaudible 19:24], because you don’t have an intraoral scanner, right, intraoral digital scanner for impressions right now?

Damien M.:We do but it’s still very … It’s orthodontic centric and so we’re working on building out software to make that applicable for …

Dr. David: For restore.

Damien M.:… for restorative …

Dr. David: Okay, well good. That’s, I mean, I know a lot of people are saying, “Wow, I never thought of that.” because I never thought of that either so, I just remember, everyone thinks like me, right?

Damien M.:Yes.

Dr. David: Like nice socks, okay. The one thing that Damien does, he always sits in my chair, kicks off his shoes and he’s got the most amazing socks and they’re what brand?

Damien M.:They’re all Paul Smith.

Dr. David: Okay, he tells me they’re Paul Smith, [00:20:00] the most comfortable socks in the world, what’s that? I think, I want socks like that, I try to, but …

Damien M.:You do, you …
Dr. David: … they’re not like that. I’m a Ted Baker fan. Damien M.:Right, I know, yes.

Dr. David:

I’ve got a few of his socks but, I need to, I’m saving up for my Cone Beam so I can’t buy $50.00 pairs of socks anymore. All right, the other thing that you’re very much aware of because you have to deal with the huge change in dentistry and that’s the DMO’s or the DMSO’s. There’s not one too far from me that they charge a third of the price that I do for a crown, they’re stealing all the young docs. A lot of them are technology heavy whether it be CEREC and lasers, they’re attracting these young dentists. How do you think that’s affecting … Well too, how is it affecting our industry and I’m going to through you as a manufacturer, how you look at that a little differently and how it’s going to affect me as a private fee for service practitioner that’s going to practice for another 10 years?

Damien M.:Yeah, I would say I think this is one of the biggest things facing the industry and this dynamic of the dental service organization and who they’re attracting, they’re getting most of the graduates come out of school now with massive debt and it’s an easy choice to join a DSO to help pay off that debt quickly and without taking on the burden of a practice or a partnership. I think for patients, making that choice of going to a DSO versus a private practitioner is also a very big choice and I’m not sure that people really think about that too much, they think they’re going to their dentist. I think there’s a difference in direction because for me for example, I have a very personal relationship with my dentist and that’s important. Whereas a DSO, you’re going to have a very different relationship. I think, thinking through that as a patient is one thing, thinking through that as a dentist is another and then from the industry point of view, how

we do we support both groups because it’s 20% of the market is now DSO’s.

Dr. David: What, you said 20%? [00:22:00]

Damien M.:20%. It’s a very fast growing segment, so for us the challenge is, how do we support it because the training and education requirements are different. The product offering is starting to vary, the DSO’s want to be able to put 100 units of something in very quickly across their offices or they, “Don’t send us things in packs of 10, we’d like it in 600.” I think there’s all sorts of …

Dr. David:

They want it cheaper.

Damien M.:That, and that other little issue.

Dr. David: Yeah.

Damien M.:I think this is a very important dynamic in the market and I said,

Dr. David:

the fact is that people come out of school with a lot of debt now.

I don’t think people realize … You met my wife [Engien 00:22:46] who just graduated from dental school, she’s from Turkey, she was a dentist in Turkey, had to start all over, just graduated last May, a year ago May and she owes about $400,000.00.

Damien M.:Right.

Dr. David: The average debt service is in between $450 and $490,000.00. I mean it’s absolutely incredible, these young dentists they come out, they’re not going to go buy a practice.

Damien M.:Exactly, and so I think, again, it’s tremendously attractive, if you’re a recent graduate to go join a DSO, but that then at some point, you start thinking, “Well, I wouldn’t mind my own practice or I could go and be a partner with Dr. David Hombrook and help him build his practice out.” so there’s a lot of really interesting decisions that young dentists are having to make right now. Again, if we do our job right, we can help

Dr. David:

people look at the alternatives in education programs and think about, where am I going to invest and how do I think about that.

Yeah, and the DMSO’s, the DMO’s, that’s corporate dentistry. A lot of you now I know are thinking, “Oh, yeah, that place right down the street.” There’s multiple names, multiple companies, a lot of them ran my venture capitalists so they’re very lean as far as overhead and the materials they buy, you know, they’re marketing the dental students.

Damien M.:Mm-hmm (affirmative).

Dr. David: You go to these dental schools and they’ll have this particular, I’m not going to name names but, this DMO [00:24:00] is doing pizza and beer night and they bring a salesman in and say, “You know, when you graduate, we’ll pay $125,000.00 a year, we’ll move you to Texas.”

Damien M.:They’re recruiting like very well structured corporate entities. One group whose name I won’t mention, they’re 60 schools, but this one group hires 10% of all graduates every year.

Dr. David: Wow.

Damien M.:Now one DSO group, so again, fascinating dynamic and something this industry hasn’t seen because there hasn’t been that sort of corporate approach.

Dr. David:

We never recruited, I mean, as a young dentist, I get the young dental student would go out and try to get as much information as they can from all the dentists. We’d walk the pavement and hit 20 or 30 dentists looking for a job. Now, you’re right, it’s about pay’s and you know, women in dentistry’s changing.

Damien M.:50% of the graduates now …

Dr. David: Yeah, which is …

Damien M.:… which has I think implications for firstly the corporates who are recruiting a lot of the graduates, but also for practitioners who are thinking about hiring a partner. I think it’s tremendous

Dr. David:

for the female population that are coming out of these school because the opportunities for them are extraordinary. Then as an industry, part of the things that we have to think about too is the industrial design of our products and how do we think about product design differently. Like even this one discussion that you and I had a few months back about the plunger on one of our syringes, and you said you don’t like our plunger because the way it bends when you put pressure on it. Well the pressure that you can put on it is very different to a …

Yeah, to a woman, yeah.

Damien M.:… then a woman can and so for us …

Dr. David: Is that what your R&D company said when you went back and

said, “He doesn’t like this plunger.” There’s a reason for that.

Damien M.:I said I had some very direct voice of customer. I know, but I think this is a really interesting impact on the industry, is how is it that handpiece design changes, how is that force and pressure changes and I think if you’re going to do the right [00:26:00] job as manufacturer, you have to think through these things.

Dr. David:

Us as clinicians, or even me as an innovator, you don’t think about those things and this is not being chauvinistic or sexual at all, but smaller hands. Smaller hands are going to be different curing lights, hand pieces have to be designed differently, CR syringes, I mean a lot of things that have always been the same forever are redesigned as …

Damien M.:That whole approach to industrial design is changing …

Dr. David: Then you say …

Damien M.:… in our company as a result of when we started first talking about this dynamic about 3 years ago, we really have to think about things very differently. Even our round table demographic has changed, now we have more female clinicians coming because it’s an important voice.

Dr. David:

Yeah, and mention Engien, she works at a Dell office in San Diego that pretty modern office, she’s only 5′ 1″ and the chairs that they put in, not Pelton and Crane which happens to be yours which is the ones I have, the chair will not go low enough so that she can work on someone big, like a big man, and so she literally has to pull her chair and now all her ergonomics with posture, she can’t touch the floor. I mean it’s things like that people don’t think about as they design equipment.

Damien M.:Again, tremendously important aspect of what’s happening in the market.

Dr. David: Interesting.

Damien M.:We like to think that we’re listening well, but I’m sure whatever we’re doing, we could be doing better.

Dr. David:

Interesting. What else would you like to talk about? We kind of talked about the changes a little bit. Where do you see … This is something you guys are not in to and it’s being [Dan Hur 00:27:39] or Kerr, and that’s laser and dentistry. I talked to Allen Miller last week who owns A&G Lasers, all he sells is lasers.

Damien M.:Yeah.

Dr. David: I know that a lot of companies have kind of dabbled, I have a car for one, have the Navigator and the Odyssey and 5 years later they say, “Oh, we’re not in the laser business anymore.” Have you looked into that or where are you in that arena?

Damien M.:Yeah, we have, and [00:28:00] there was years when we were like, “Let’s find a laser company, got to have a laser company in the family.” and then we learned a little bit from someone like Ivoclar and Bob Ganley and that team of super smart so if they can’t make it work, we sort of take a step back and say, “Oh boy, maybe we should leave it.” I think we are constantly looking for ways to improve the patient care and the workflow. We know that things are going to come and go. I worked in another medical space, plastic surgery, for a number of years and one of the great things that happened at one of their events

Dr. David:

was that every year one of the senior clinicians would always do a What’s Hot, What’s New lecture. He would talk about all the things that had come out in the past year, but also all the things that had been sort of shown to be voodoo or not work in that last year and I thought that was a tremendous service to not only clinicians, but also to the industry and that’s the same thing we struggle within dentistry, there’s all these things come out every year, this new chemistry, this new polymer and then a year later it’s like, not worth it.

Yeah.

Damien M.:I think that’s one of the single biggest challenges we face as a company is, how do we spot the new technology and again, in having conversations with people like you is really important in that. Then how do you validate that it really has a patient benefit or a clinical practice benefit? That’s the tricky thing. We’re constantly looking, we’ve got a very active group of people who are trying to find those things, but then it comes back to very simple stuff. Stand beside a clinician watching their workflow, watch … When is it that you through something across the room because you’re annoyed. Those moments of truth are the really important things to spot and then how do we invent into that or find something that can support that. We’re really focused on workflow.

Dr. David:

Yeah, and I think that’s important because technology and equipment and materials will kind of come and go, but that workflow, [00:30:00] you’re just going to be substituting or plotting in these little things into that workflow.

Damien M.:That’s why, that’s honestly, that’s SonicFill came about. We were standing beside some clinicians and you put the syringe in, take it out, cure. Put the syringe in, take it out, cure and we’re like 5 layers for a big restoration on it, there’s got to be a better way. Not only for the clinician, but for the patient because that’s not fun with those interchanges. That’s why SonicFill’s so incredible because you do it one placement, 2 seconds and then you cure. Those are the moments that when we find

something like that, that we think we’re really lucky but we’re constantly trying to search for that workflow improvement.

Dr. David: Yeah. That’s awesome, good. As we wrap up here, because I know we’re close to about 30 minutes or so and we like to keep what I call treadmill time.

Damien M.:Right.

Dr. David:

Right, I do 30 minutes on the treadmill, I close for the day, even and his friends. Without giving away any trade secrets or something you can’t talk about, envision what my operatory would look like in, let’s just do 2, 5 years and 10 years. You’ve been to my office now and you know I use a cable handpiece and Pelton and Crane chairs and that’s my technology now. What would you envision my office would like if I kept up?

Damien M.:Yeah.

Dr. David: Obviously I’m not going to, right, but imagine that I kept up with technology and I was using state of the art in all the things that would be available 5 years from now and 10 years from now.

Damien M.:Right. I think, back to this workflow, what you’re going to see is more inter-connectivity between things. You’re imaging and your practice software for looking at the patients software and the treatment planning is going to be more interconnected. I think the things that you have on the chair and attachments are going to be connected to the case much more seamlessly. I think your ability to look at the patient … Again, most people are going to be doing the general practitioner work plus so having [00:32:00] the practice be flexible enough to adapt to that, is it the endodontics, is it the implants, is it the orthodontics, so that for me I think is where it’s going to happen, the inter- connectivity.

Then a lot of people are going to chair side CAD/CAM. How is that going to evolve? At the moment still there’s only, let’s call it roughly 30% penetration of that. I think this is a very important nexus, is that going to happen in the office or with a lab

Dr. David:

partner? I think people are going to make a very distinct choice because not everyone wants to do all of that stuff in their office because that’s quite difficult and requires a lot of skill. Whereas you can have a lab partner who has really got a craft of the aesthetics and the fitting and the choice of materials and now they’re really important decisions people are going to have to make. Related to that they need connectivity between your office and your lab partner is going to become really critical.

Some of the manufactures, I won’t name names that have gone to that chair side CAD/CAM have kind of segregated, they’ve drawn a big chiasm between those 2 models so things are going to have to change in those as well.

Damien M.:I think again, you’ve got to be flexible. We’d like to think that we’re trying to design products in to a space where people can make that choice based on their practice rather than forcing them down a particular pathway. I think this inter-connectivity between the patient chair, the planning for the tri-, and the partner that you have is going to be really key. Again, we’re looking at varying models, some that revolve around chair side, some that involve around design at a third place and then a connectivity to lab or back to the office, so very exciting times.

Dr. David:

Yeah, it is exciting. As I look at technology and I’m involved in a lot of dental forums, so I always see [00:34:00] these questions come when they yell forum.

Damien M.:Right.

Dr. David:

“I’m thinking of using this x-ray, but I have this software and this intergal camera, will they connect?” and “Well, no, you got to get this bridge or those 2 won’t work.” It’s, you know, as a clinician working in equipment, I may like your I-CAT best but, if there isn’t that seamless connection with my practice management software, that’s a problem that you’re not going to sell a product or I’m going to have inferior product or something like that.

Damien M.:It’s a funny space for the industry because it’s been so hardware, product oriented and now, so much of the industry is having to get good at software which is a whole new skill set and again, something that lots of other industries have already cracked the code on and we’re really are just in the first generation, early generation of this. What’s going on in our industry is going to be a really great case study in about 10 years’ time.

Dr. David:

We’ll look back at it. We’ll have you back, before then though, we’ll have you back in. We’ll have a glass of wine and [Jamie 00:34:57] is a tremendous chef. We’ll meet at either my house or yours, we’ll have a glass of wine and we’ll rehash what we just talked about today.

Damien M.:We’ll play this podcast to say, what did we get right or not and …

Dr. David: 10 years from now both your daughters will be teenagers, so you’ll be constantly getting that cellphone or that built in earphone or whatever they have 10 years from now about the call about your teenage daughters.

Damien M.:Frightening thought.

Dr. David: Yeah. Anyway, I know you’re crazy and I really appreciate the fact that you took a time and we made you wait a little bit and this was certainly worthwhile to me …

Damien M.:Wonderful.

Dr. David: … I learned something and I know our listeners were excited to hear how changes are being made because we don’t …

Damien M.:Wonderful to be here and again, I think a part of our job is to try and give back to the community of the clinicians who support us and so, least I could do, not only for what I think is the broader mission but, the fact that you and I have such a great relationship and great to be here at Keating.

Dr. David: Yeah, it’s been fun.

Damien M.:Tremendous facility and …
Dr. David: It is.
Damien M.:… what these guys are doing is quite incredible.

Dr. David: We gave Damien the tour, our nickel tour that took a quarters [00:36:00] amount of time but, it’s interesting. The first time I saw it I was blown away because I like technology and instantly the way you think, because I know how you think, you were thinking workflow.

Damien M.:Yeah.

Dr. David:

I kind of went backwards, I showed him my operatory first which is where the final product is delivered and then we went basically literally backward and we ended up in shipping near the end. I know the way your mind was working because half way through it you said, “So, where do these cases come in again and then where do they go? Where’s the model run?”

Damien M.:Then when you play it back, the workflow is tremendous and the fact these guys are so sort of committed to the quality of the outcome and the way that they’re looking at that is important, but also the technology that they’ve invested in, the milling and the various sets of milling tools that they have and the conscious choice they’ve made about that to make a good quality product is really important sign about what Keating’s trying to do.

Dr. David:

Yeah, and Shawn Keating, the owner’s done a wonderful job. Just like in dentistryism, as a practitioner, there’s new technologies coming crazy on the lab side, new milling machine, milling models, something you can mill metal above and it’s like, do we invest this 50 or 60 or 150 grand on this? Is it going to change that much or is it going to change the workflow that much?

Damien M.:Back to that thing we’re talking about, what partner decision are you going to make as a clinical practitioner and what quality are you going to be getting?

Dr. David: Absolutely.
Damien M.:Important choice. Anyway, thanks for having me.

Dr. David:

Thanks so much. For those that … If this is the first time you’re listening with us, you can go to Dental Up and Dental Up, if you saw some of our campaign for that it’s we came up with that name like man-up or cowboy-up or step-up, it’s Dental Up, bring your dentistry to a better level, a new level. You can go to DentalUp.xyz or you can go to keatingdentallab.com, go to the media page. Where shooting a lot of video, a lot of whiteboard videos as well as podcasts of the past so, hopefully you’ll be able to stop by our lab sometime soon in Irvine or hopefully [00:38:00] I’ll see you again sometime.