Key Opinion Leaders (KOL) Talk Digital Dentistry


The Dental School Catapult with Dr. Marc Geissberger

Dr. Marc Geissberger, (University of the Pacific) provides an educational experience in this weeks episode of Dental Up.  Get the most out of digital dentistry in your practice and through higher learning with Digital Scans even if your right out of Dental School.

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Full Transcription:

Dr. Hornbrook: Hello, I’m Dr. David Hornbrook, the clinical director of education technology at Keating Dental Lab in Irvine, California. We’re here for another one of our weekly podcasts on Dental Up. You know we’ve had some great guests in the past, all different facets of dentistry, but nothing quite like Dr. Mark Geissberger. Welcome, Mark. I appreciate you being here.

Dr. Geissberger: Nice to be here, David. Thanks for having me.

Dr. Hornbrook: I say that, because you’re in a little different role than anyone I’ve had the opportunity to spend some time with, because of your role in academia, but you also private practice.

Dr. Geissberger: Yeah.

Dr. Hornbrook: You know, I asked him earlier, “What’s his title?” He said, “University of the Pacific in San Francisco.” They’ve got a brand new campus and I want to hear about that.

Dr. Geissberger: Beautiful.

Dr. Hornbrook: I thought he was Head of Restorative and I said, “What do you do?” What is it exactly that your title is?

Dr. Geissberger: Yeah, so it’s the Department of Integrative Reconstructive Dental Sciences, which is a fancy way of saying, Fixed pros., operative dentistry, rem pros., and implants. Kind of the motive of dental education now is to integrate everything. You and I were taught, Today is fixed pros., tomorrow is operative … Friday is removable. Whatever it was, you learned these segments separately and then you had to somehow merge them in practice. That’s just not how we think about it anymore. We try and integrate from the very beginning. Our new department recognizes that and it’s quite interesting and really, quite fun. You know, when I was in the clinic floor, if you were doing an onlay, you’d work with the operative instructors. Then, if it turned into a crown, you had to go find a new group of people, right, while they were all general dentists. It made no sense, but that’s how we were divided.

Dr. Hornbrook: It separated this, not so specialties, but facets, you know. Operative, we actually. When I went to UCLA, we had operative was only directs. You couldn’t do composites, so it’s was direct amalgam. If that turned into an onlay, we would have to temporize or reschedule, because there wouldn’t have been a chair available in the …

Dr. Geissberger: Onlay crowd, yeah. Crazy.

Dr. Hornbrook: Then, if we had to do a denture on a crown for a partial, I mean that was a freaking disaster. That wasn’t even on the same floor. You know, the separation and I want to hear more about how that idea evolved and initiated. You know, when I speak on smile design, and this is obviously the separation of how we compartmentalize from dental school. I do my lectures on smile design, I’ll ask the audience, “How many of you had a great smile design course in dental school?” They all laugh, “Yeah, right. We didn’t.” I say, “Really? Are you kidding?” And they say, “No, we didn’t have it.” I said, “How about a denture? Didn’t you make a wax rim? You went through all the smile design process, you picked teeth, you mounted them, you moved them around.” Then, it’s like, “Oh, yeah, we did.”

Dr. Geissberger: Same principles.

Dr. Hornbrook: As soon as I said, “Smile design,” their mind went to fixed dentistry. Crown-breaking. They separated it, as soon as you … Talk a little bit about how that evolved, because it hasn’t always been that way.

Dr. Geissberger: No, and it’s really interesting. It’s first of all, people don’t like change, generally speaking.

Dr. Hornbrook: Especially dental school [crosstalk 00:02:56]instructors that have been there 80 years.

Dr. Geissberger: Especially in dental, especially instructors. When you’ve kind of been tasked with doing that, it’s a slow transition. It happened for us about nine years ago.

Dr. Geissberger: Art Dugoni, the dean, came to me and said, “Listen, will you be chair of operative dentistry?” Well, the interesting thing is, I was in fixed pros, and I said, “Actually, that’s not of much interest to me. It’s not …”

Dr. Hornbrook: It’s not a raise.

Dr. Geissberger: Yeah, exactly. I’m like, “That’s not of much interest, so, no.” He said, “We really want you to do this.” I said, “Well you know what? I think it’s time we tear down that border,” operative, fixed, what’s the difference, really? Same skills. Same drill. We actually engaged in a conversation about maybe merging the two together. I got to tell you, up front, that was tough. The fixed guys saw the operative guys, really, as second-class citizens. That was the biggest challenge. They’re like, “No, I don’t want to work in there, don’t tell anyone, okay?”

Dr. Hornbrook: Pack amalgam, really?

Dr. Geissberger: Everyone said this was a terrible idea, “It’s not good. We shouldn’t do that. This is my expertise, that’s theirs. Let’s keep that autonomous.” The first year was a struggle. After about a year and half, we had some serious end roads and people started to see that, actually, it was the right thing. It’s how we thought in-practice. That’s what you do in-practice. One of our tenants was, “Listen, we want dental school to mirror private practice.” What we were doing currently didn’t mirror private practice.

We started that merger process. After about two years, when we asked people, “Hey, was this the right thing?” Everybody said, “Yeah. It was the right thing.” Then, things progressed a little further and we had our own department of rem pros, and our own department of implants. Art Dugoni, as he was transitioning out of dean, says, “I think the merger of you with rem pros and implants is going to be next.” Sure enough, with our new dean, Pat Ferrilo, we brought that forward and merged another department. That was a little easier, because I’d been through that type of transition. Yet, the rem pros guys only did rem pros. They didn’t do fixed. They didn’t do operative. Bonding agents weren’t comfortable for them. They had to learn a whole new area of teaching, not that they didn’t do it in-practice, but what we taught. That was another transition, but the right thing.

Dr. Hornbrook: Did you have to re-educate these doc … I think of, you know, it’s been a while since I went to dental school, but I’m thinking, the guy who taught me dentures, there’s no way I’d want him to show me how to prep an onlay. Or carve an amalgam with tertiary anatomy. Did you have to re-train?

Dr. Geissberger: Yeah. We went through, gosh, exhaustive calibration sessions. I mean, literally, it was every week, every day at lunch, one of us was running some course to the faculty on what we do with something. We’ve done that pretty consecutively for three years. Yeah. Just bringing it in … The nice thing is they’ve got CE. They go to an hour of CE and I’m like, “Hey, you’re going to learn about this,” but it was a lot of work.

Dr. Hornbrook: I bet. Did you lose some faculty, like, “Hey listen, I do dentures and that’s what I teach. I’m not going to get involved in this special new thing that I don’t know about?”

Dr. Geissberger: We really didn’t. We lost them for other reasons, you know, they retired or whatever. Nobody said, “No, this is not what I want to do,” and left for those reasons. We really didn’t. It actually has become a big recruiting tool for us, because we can tell a general practice, “You want to come and teach? Hey, you’re going to teach fixed, operative, removable, and implants.”

Dr. Hornbrook: Restorative, yeah.

Dr. Geissberger: “Listen, you’re in a group of three when you teach, so if you’re not comfortable with rem. pros., one of the two other guys will be.” “You’ll be good. You’ll teach what your strength is, but you need a background on these other things. You can’t work in isolation. You’re going to develop a comprehensive treatment plan, so you need to understand, even if you’re going to do the rem pros or the implants, you’d better understand what goes into that comprehensive plan.” It’s been great.

Dr. Hornbrook: It makes sense. I mean, that’s how a dental practice is. We can’t all go in and say, “Monday, this is my operative day. If you’ve [crosstalk 07:10], we’ll reschedule you for Tuesday or …”

Dr. Geissberger: Exactly. “I can’t do that today,” you don’t do that.

Dr. Hornbrook: … “When [inaudible 07:14] is here.” I’m a faculty member at about five dental schools and so, I see, obviously, evolution in the last 20 years of dental schools in what they’re teaching, but I also see a mixed bag of what people are teaching.

Dr. Geissberger: Oh, yeah.[crosstalk 00:07:27] It’s all over the map.

Dr. Hornbrook: There’s dental schools that it’s like, “Composites don’t work, only amalgams,” and they still make custom trays for quadrants. It’s like, “Really? Shouldn’t they be doing something else to learn?” We’re a GOP, very progressive … Let’s talk about ideals. Patient comes in with an MOD amalgam, like some mesial buccal cusp off. Most school, you and I learned, you crown it. Your missing a cusp you crown it. Typical day with that group of three, what would the diagnosis be?

Dr. Geissberger: So patient comes in with a fractured mesial buccal cusp, hopefully, one of those three says, “We should probably do a e. Max onlay.”

Dr. Hornbrook: It’s kind of faculty driven.

Dr. Geissberger: Its faculty driven. They all have the right of choosing what they are comfortable with. With that said I’ve closely, closely, tracked this. 2012 we were doing posterior direct restorations. We were doing about 40% amalgams, 60% composites. Now that’s not what private practice was. That’s 2011, 2012. 2013 it changed to about 80% composite, 20% amalgam. Last year we were down to 10% amalgam and 90% posterior composite. Now that’s not the norm with dental schools, but one of the tenants we set up in our department was we want our students to be practice ready. If we don’t teach what practitioners do, we’re not following our mission. I’ll call the question, “Guys what are we doing with ceramic crowns? Where are those numbers at?” Those numbers have changed dramatically. About 55% of what we are now doing are ceramic crowns versus [crosstalk 00:09:17] PFM …

Dr. Hornbrook: What percent is gold?

Dr. Geissberger: Gold is down to about 12%.

Dr. Hornbrook: Too expensive.

Dr. Geissberger: Too expensive. I mean literally what we charge in dental school for a crown, we eat the cost. It’s just prehibitive. Those have shifted. PFM’s are way down. Ceramic restorations are way up. Onlay [crosstalk 00:09:36]

Dr. Hornbrook: They should be. That’s what we see … at Keating we see that as well. In the industry, overall, modeled with zirconia or lithium disilica like e.Max. The growth is like this and that’s what these students should be learning. When I was in dental school, I graduated in ’86. When did you graduate?

Dr. Geissberger: ’91.

Dr. Hornbrook: From EOP?

Dr. Geissberger: Yep.

Dr. Hornbrook: We were not allowed to do posterior composites and we talked about this this weekend. If we etched, we were selective etchers only because dical covered all our dentin. [crosstalk 00:10:05] We couldn’t, we wouldn’t dare get phosphoric acid on dentin and the patient dies. Turns into a mongol or something. Something strange is going to happen. All I did were amalgams and gold foils, cause we had to do those then. Of course my first day in private practice the patient says, “I want a white filling.” Its like okay, let me see. Put my tofflemire on, put my slim Jim wedge. Bulk filled, it looked like crap and the patient said it’s sensitive. Cut it out and did something different. I didn’t have that training. These young men and women, coming from EOP, or any dental school they are going to be doing [crosstalk 00:10:42].

Dr. Geissberger: Its all over the map. There’s some dental schools, and I’m not knocking other dental schools, that are still pretty traditional. They are teaching things we did 15, 20 years ago. Their grads will come out and need some retraining and I really wish they’d change things. The concept of basing every restoration. We did that with amalgam because it thermo-conductive but I’ll find dentists even out in the CE circuit that are saying, “Do you cover every bit of dentin with something?” Absolutely not. “Well when do you base?” Rarely. Those type of things but that was left over from amalgam dentistry.

Dr. Hornbrook: Pins.

Dr. Geissberger: Pins. [crosstalk 00:11:26]

Dr. Hornbrook: Do you still have to teach pins?

Dr. Geissberger: God no. We don’t have pins in the building. [crosstalk 00:11:28] You can search high and low for a pin and you’re not going to find them. We rarely teach post. If its a post its a fiber post.

Dr. Hornbrook: That’s awesome. These are … well for one its better dentistry in my opinion. That’s my bias. This skills that these young people that need to go out and do it in real life. Where are you … I know also EOP is very advanced in the CAD/CAM world and technological advances. Are the students coming out, are they learning digital impressions? Is this something they’ve already had exposure to?

Dr. Geissberger: It’s really quit interesting. We have three primary digital impression machines. We have True Def. We have the iTero system and we have Three Shape. We pride ourselves on being the first for a lot of things. The first we implemented was a requirement of a digital impression. We wanted our students not only to have the opportunity but be required to do it.

Dr. Hornbrook: Do you make them design it as well?

Dr. Geissberger: We don’t necessarily make them design it. They could take a digital impression, it could be for invisalign, if they wanted. Or conventional crown and bridge. They’ll do a digital impression. They’re not told which system to use. They have the freedom to use all three systems. We pride ourselves on that. This year we introduced a test case on digital impressions. Not only do you need to do them, but you need to show us [crosstalk 00:12:57] that you can do it right. We aren’t going to help you. We’ll help them with the first one then they’ll do a digital impression test case to show they can do it. In the CAD world we’ve taken a little different position. We have E40. Honestly, in the time there is in a curriculum, there isn’t enough time to teach CAD dentistry right. They get a sample of it. They get exposed to it. The reality is with our curriculum, you can’t do everything. While we’re really having digital impressions we’re probably lite in the CAD dentistry.

Dr. Hornbrook: Which I don’t have a problem with because more likely these kids … I was talking to Dr. Luke Graham last week and we were talking about average debts [inaudible 00:13:40] I know EOP is what $100,000 grand a year?

Dr. Geissberger: We just topped $100,000 grand.

Dr. Hornbrook: These kids are coming out with $400,000 debt. Easily. They aren’t going to out and buy an E40 or [crosstalk 00:13:50] They could buy True Def at 16. They want to get at that because … I was talking to Michael Miller and we were talking about how it’s changed so much. When I was in school we had note pool cause you just couldn’t keep up. Monday morning at 8 a.m. it was Dave Adams, took notes, and he printed them for everyone. At 9 o’clock it was Bobby Baker, you know. You hope they can spell and they’re paying attention recording it and what not. Today the kids pullout an Ipad and boom. They just snap a picture of a screen or you put your PowerPoint online. The kids can be doing other things and they can go home and pull up your power point. They’re so digitally advanced. Whether they play Call Of Duty or World of Warcraft and they want to use their hands and they’re good at it. Is that a cool moment for a student when its your day to do digital or do they like that?

Dr. Geissberger: They love it and they take to it very quickly. Where the bigger struggle is with faculty getting up to speed. You’re like really I have to do that? Those that have used it in practice it’s great. Those that didn’t, again a learning curve. We don’t want to set up the faculty to look stupid so we’ll train them first. Make sure they’re comfortable and confident so they can train the students. Honestly the learning curve for the faculty is higher than the students. They pick … they’re gamers they can scan probably more quickly than we can and they push us. They push us to be better at it.

Dr. Hornbrook: They’re very good at it. I’ve trained some … they’re faster than me on the second try and its like, “How did you do that? What did you push?” I’ve had this thing for a year and I can’t figure it out. I know you have your own bias as I do. Do you find a student gravitating toward one of those three more than another.

Dr. Geissberger: Honestly, its all over the map. I think with the original, we had the original LavaCOS and it just didn’t scan well. It was a problem. Right now, because we’re only scanning quadrants for a single unit crown, they’ll probably default to True Def. Even though its powdered. It’s fast, really fast.

Dr. Hornbrook: [crosstalk 00:16:04] The camera size is all easy.

Dr. Geissberger: Camera size is totally manageable. The iTero still a great machine but the way it captures data, the weight of the camera is a problem. Three Shape, a lot of students like. Honestly the True Def seems to be the most popular.[crosstalk 00:16:20]

Dr. Hornbrook: Which is actually good. I still think True Def is the farari of [crosstalk 00:16:25] Its $60 grand, $57 grand. Where the True Def is $16, $17,000. If they’re going to get out and they’re going to say. “I want to go to this digital world, it’s totally doable. That’s the big question, is powder-free worth $50 grand? For some that can afford it, absolutely. For a new grad, if they’re looking at technology, they’re going cheap. I think that’s the biggest reason CAD, in office, hasn’t really stuck like they thought it would with the young kids. Not that they don’t want to do it. A lot of them simply can’t afford it. That’s so low on their list to buy.

Dr. Geissberger: $120,000.

Dr. Hornbrook: Well their going to get a digital radiography system, if they buy … [crosstalk 00:17:06] CBCT or they’re going to buy a digital impression machine. The decision used to be, if I’m going to do CAD dentistry, I’m either all in it $100,000+ or I buy a digital impression machine. There wasn’t much in between. Really I think the future holds these systems you can build on. You want to add to it. Okay, I’ll add a scanner. Now I’ll add my milling machine and I’ll add my design center and kind of build up. That whole big jump to 120 or whatever the system costs is a tough nut to swallow. [crosstalk 00:17:49]

Dr. Geissberger: For anybody.

Dr. Hornbrook: For anybody

Dr. Geissberger: In private practice its been fifty years old.

Dr. Hornbrook: If you think of the technology you’d list in your practice. This is what I’ve got to buy and I have limited source to do it. Frankly that’s lower on my list than about 5 or 6 things. It’s not number one.

Dr. Geissberger: Where is the school as far as … I’m a huge laser guy and I know you do it in your practice as well. Where’s the school on philosophy of lasers?

Dr. Hornbrook: We’ve embraced soft tissue lasers for the last 15 years. Actually, you were the one to introduce them at Pacific through Packlife. Seriously right? You brought them in and you taught us get rid of the electro serge. You can’t find electro serge in our building any more. It’s all soft tissue lasers.

Dr. Geissberger: Are you using it for gingivectomies and … are you using it for packing retraction cord?

Dr. Hornbrook: Not particularly. We’ll still retract. If we are retracting we will retract with retraction cord. Rather than burn away tissue. We’ll use it in those cases where we can’t get retraction with cord. Our default would be retract with cord first, second you think laser.

Dr. Geissberger: How about perio treatment?

Dr. Hornbrook: You know that’s not in our pervue, that’s perio department. They’re looking at some of the laser technology. Where we haven’t really gone yet is to hard tissue lasers. Not as efficient, for me, personally.

Dr. Geissberger: Its a big nut, we’re $80 grand. [crosstalk 00:19:14]

Dr. Hornbrook: Its a big nut to swallow. We haven’t hit those as heavily as the other lasers. Our students are all laser certified, ready to go.

Dr. Geissberger: They go through a certification process?

Dr. Hornbrook: Yeah they go through certificatioin. Same with Invisalign. All our students graduate Invisalign certified.

Dr. Geissberger: I know EOP was very instrumental in the development of what we’re doing with Invisalign now, huge. I’m going to back to digital scans, intraoral scanners, are you guys doing any soft tissue stuff? Denture, any?

Dr. Hornbrook: We haven’t. We are looking at the True Def, we are doing some pilots with partial dentures and scanning with those. We’ve done some cases with the [inaudible 00:19:53] system and [inaudible 00:19:56] new product. We haven’t gone there yet with digital scans.

Dr. Geissberger: I think that’s a huge opportunity to have better dentures. I don’t do dentures [crosstalk 00:20:07] but you cannot take a passive denture impression. That’s why we have to put IPE and figure out where the spots are. The lightest impression material we have. If we could take a, literally, a virtual impression without touching the tissue we would be able to get a perfect reproduction of open gingival embrasures. We can’t get that with polyvinyl.

Dr. Hornbrook: Its something we’re really dabbling with. We’ll see how it pans out. You know one of the problems initially was stitching across the arch and soft tissue. I think that’s behind us and then the time to scan, you know. You get an hour and a half to scan an arch, well forget it. I’ll just take an impression. A six minute impression.

Dr. Geissberger: Exactly, I think that’s going to be a big, big future for us. A lot of fun.

Dr. Hornbrook: I know you’re not involved in missions but I know, that obviously you know, dentistry right now … huge amount of applicants per spot now. Do you know the approximity now?

Dr. Geissberger: I think nationally I think it’s one applicant, twenty five applicants for every spot nationally. I know we get upwards of 5,000 applications for our 140 spots. Highly competitive.

Dr. Hornbrook: Best and the brightest aren’t going into medicine any more; their dentistry.

Dr. Geissberger: Their going into dentistry, they’re doing other things. So we get a super smart group of students. Super enthusiastic. I am not part of the admissions committee. I kind of get them after they’ve been admitted. I sat on admission committee, its a tough job. Its a tough job for them. You’re dealing with hundreds and hundreds of students that are essentially the same and its tough to make those calls and say, “No” to some people. I’ve had that, its tough. So I’m glad I don’t serve in that roll. It would be really tough.

Dr. Hornbrook: How many days are you practicing in private practice? I know you have a practice …

Dr. Geissberger: Its interesting, when I started this chair of the department I talked to Art and said, “I want to be able to do everything that my faculty does and do it well. I want to consider myself one of the best clinicians on the faculty.” Not the best but one of the best. You know, whatever.

Dr. Hornbrook: The top 3 of 400.

Dr. Geissberger: Right, exactly, you know. I said, “I want to stay in private practice. If I pull out of practice, my skill set will diminish. I don’t care who you are.” He was like, “Great.” We kinda negotiated this two and a half of practice the rest of the time in dental school. Between practice and lecturing outside the dental school, I probably average two days a week. In practice.

Dr. Hornbrook: Which gives you tremendous amount of credibility. You think about again my instructors or as I go around to other schools, a lot of faculty members, you have this problem I’m sure. They haven’t really been in private practice in … maybe never. Academia, military, and armed forces. I think its kinda hard for them I think to sit down with some of the students and say, “You know, these are some important decisions you’ve got to make.” First five years of practice its going to be a tough road. Its hard to relate, its nice that you can.

Dr. Geissberger: I’ve actually recruited with that mindset. Rather than recruit someone for 5 days a week or 4 days a week, I rather hire 2, 3 day a week people and say listen, you’re in private practice, figure a way to make that work 2 days a week. Its different from a faculty practice cause generally speaking a dental school faculty practice is ran by the university. You don’t manage the business you don’t do those type of things, you don’t bring that skill set with you.

Dr. Hornbrook: You are not looking at a PNL …

Dr. Geissberger: No, you’re not doing that stuff. In fact, some dental schools, ours would never do this, but some dental schools mandate if your on faculty and your going to practice the only place you can practice is in the building. That fact for me just doesn’t work. I’d rather have my faculty say, “Listen, I just came across this same situation in my practice.” That’s refreshing. The students, at least at our university, are attracted to those of us who are in practice. Tell me what you do. This is exactly what I did, in fact I did it yesterday, and now we’re going to do it here. Not, “Oh, I did this 30 years ago.”

Dr. Hornbrook: With rubber base.

Dr. Geissberger: Exactly, exactly. I used tofflemire and composite. Oh good lets go with that.

Dr. Hornbrook: What’s this plastic wedge. Obviously your personality type, and we’ve known each other a long time and you speak from the heart. You care about your kids, as your kids being your students, not your only kids, but your real kids, but your students. I assume they’re coming back at 1 and 2 and 3 years and interacting with you whether it be an alumni meeting or they see you on a convention floor, or they see you lecture they stop by the school. These kids that’d … less than 5 years out of EOP. What are some of the tribulations they’re encountering? What would be a typical conversation? You know I come back and say, “Hey Dr. Geissberger remember me? I graduated in 2013.” You say, “What are you doing now?” What are some of the things you hear?

Dr. Geissberger: What I hear with the newer grads, they’re really managing their debt. That’s a big deal for these kids. That’s number one. Is how do I continue my clinical skills, not necessarily work for someone else. A lot of them are trying to get their debt load down so their position, if they want to go into practice. Pacific’s always been a private practice oriented school. Not a lot of our alumns say, “I want to graduate and work for a big corporation.” Now some of them do out of necessity, but that not their long range goal. They still aspire to own a business or at least be in a small group practice with 3 or 4 other people. May not want to own the business, but they want to get to that point in their career. What I see at the five year point is, out of necessity, they’ll go work for these institutions. That’s not their long range plan. That’s just serving their debt. Their long range plan is doing what you and I do. That’s be in practice, maybe by yourself or with somebody else, and they still want to own their own business.

That’s shifting though. A lot of dental schools are not like that. Their kids are wired to think, “I’m going to work for someone else. I’m going to be in a corporate environment” and those type of things. One of the biggest things I struggle with is attracting young faculty because for what we pay them and their debt load, they can’t afford it unless they are independently wealthy or they have a spouse that has tons of dough. They can come back. That’s the ones I can attract. We say, “What does your spouse do?” We say, “Okay, great. Self made millionaire.”

Dr. Hornbrook: He has a .com company, in fact seven of them he sold.

Dr. Geissberger: That’s right, he owns Google, whatever. We can attract those but outside of that its really a challenge, its really a challenge.

Dr. Hornbrook: I would think so.

Dr. Geissberger: That’s the biggest thing our kids, our students are struggling with. They’re all super enthusiastic. I remember in dental school, I was always told, “No you can’t do that.”

Dr. Hornbrook: Its a world of can’t s.[crosstalk 00:27:12] That’s what I say. You can’t do that. That can’t be done.

Dr. Geissberger: Can I put on another crown? No, go put on a temporary. Its really funny, I’ve always considered myself kind of a yes person. When a student come up, “Can I do that?” Yeah sure go for it, “Really?” Yeah go for it, we can try it, no worries. I’ve learned so much more by watching students try things and do things. Sometimes they can and sometimes they can’t. Falling down is okay. As long as you get up and dust off and mo …[crosstalk 00:27:36]

Dr. Hornbrook: You’ve got to make the mistakes. They’re going real dentists like you and I in one month as they graduate from [crosstalk 00:27:41].

Dr. Geissberger: If they see that energy, that’s what they become.

Dr. Hornbrook: I think its important, again I think similar, where EOP is a little different. UCLA is … EOP is a little different. Even when you went to school possibly where … Mostly the faculty at UCLA was not really about me as a student. Dental school typically was like joining the marines. The first week they break you down to nothing. The marines, four years later, they kick you out and you’re a better man than you’ve ever been. Dental school they break you down and four years later kick you out the door and, “Good luck sucker!”

Dr. Geissberger: Then they ask you for money. They give us money and most people say, “No, not ever will I do that.”

Dr. Hornbrook: Its funny cause I go lecture around and I’ll talk to people and I always ask them where do you go to dental school? Then I’ll ask them, “Hey, what do you think of your dental school?” I’m shocked at the number of practicing dentists that literally hate the school they went to. I have to say that’s the majority. Not, “Oh I love my school.”

They’ll see my passion for Pacific and dental education, and they’ll like, “Really, you like?” Yeah. I wouldn’t work there for 25 years if I didn’t like the place. I had certain people that literally turned on the light for me. They were super, super supportive. One of my mentors, now long gone, but Larry Loose was the chair fix pros. Super nice guy. He never told me I couldn’t do anything. I was fortunate, back in ’91 to get to do 6 veneers in dental school. Working directly with him. I had a friend who needed veneers, she wanted veneers. I said, “Hey, Dr. Loose can I do veneers with you?” Right out of his mouth, “Of course, I’d love to show you how to do that.” He taught me a lot. He could have said, “No, you don’t have the skill set to do that. You’ve never done those before. I’m not doing that.” That would have been the norm, but his attitude was, ” No, we’ll do it and we’ll do it well.” Eighteen years later she still had the veneers. Finally go to redo them, but you know.[crosstalk 00:29:39]

Dr. Hornbrook: I kind of have a similar story but it didn’t work out that way. I had seen Bob Dixon when I was Senior in dental school. Queen Mary in Long Beach. Of course I get back the next day and a friend of a friend had tetracycline and some spaces and I thought, “Oh this is going to be awesome.” I went to my instructor, who I wouldn’t name who it was, and I said, “Can I do veneers on this?” He said, “Veneers don’t work. She needs …” I ended up cutting PFMs and at UCLA we couldn’t put porcelain [inaudible 00:30:07] margins. So I actually had a point 2mm metal collar, on a facial. I buried it subgingivally, 8mm or something. That’s how my aesthetic case, six ugly PFMs, buried margins. Same instructor, about 8 years later I was lecturing at the CDA and he’s in the front row and I said, “Remember you told me veneers don’t work?” He says, “You know I was wrong, I was wrong.”

Dr. Geissberger: That’s nice to hear. [crosstalk 00:30:34] At least he … at least he did say that.

Dr. Hornbrook: We got to wrap up, we are about a half hour. Its amazing how fast … we could talk for hours. You probably will at the bar, I’m sure. So I hope you enjoyed Mark. Mark you know, I know you’re lecturing a lot and you’re doing some cool things. How would our viewers and listeners get a hold of you?

Dr. Geissberger: Through Catapult, definitely. I’m in the Catapult group as well, or at the dental school. My email address is right on our website. Just search my name and …

Dr. Hornbrook: Mark Geissberger

Dr. Geissberger:

Dr. Hornbrook: Awesome. All right [crosstalk 00:31:08] we are going to go ahead and wrap up. I hope you enjoyed our session a little different than we’ve done in the past. Very enlightening, I could have spent another two hours just talking about, this is the future of where dentistry is going. Having these dental students learn these cool things that we didn’t learn. Most of us did not learn in dental school. Its nice to have someone who is enthusiastic and taking these young men and women and allowing them to enter our profession with high spirits and learning cool things. Be sure to check out some of our videos and other pod casts at We’re doing some very cool things at Keating. We’re in Orange County. 5 or 6 miles from Newport Beach, 5 or 10 miles from Disney land. If you’re ever in the area give us a call and stop by. Hope you have a great week.

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