Teaching the Next Generation of Dentists with Dr. John McLaren BSE, DDS, MS

Shaun Keating: Ladies and gentlemen, this is The Dental Up Podcast, brought to you by Keating Dental Lab, a full-service, award-winning dental laboratory. Each week, you’ll learn tips and techniques from real-world dentists, bringing you in-depth interviews, motivating stories, current events and sports. Here’s your special host, the General Manager of Keating Dental Lab, Bob Brandon. Bob Brandon: Hey everyone, Bob Brandon here. Welcome to another episode of The Dental Up Podcast. Our guest this week attended the University of Michigan and graduated with a Bachelor’s Degree in Material Science Engineering, a D.D.S. Degree, and then a Master’s Degree in Restorative Dentistry. His scientific background has helped him bridge the gap between research and clinical practice. Currently practicing in Midland, Michigan, please welcome back to the program, Dr. John McLaren. How’s it going, Dr. McLaren? Dr. McLaren: I’m very good. Thanks for having me. Bob Brandon: Thank you again. Thank you first for being our customer. You and your brother are always in the top ten of our customers in terms of sales and units sold and delivered, so I want to thank you for being an extremely valued customer of Keating Dental Lab. Dr. McLaren: Thanks for your communication and your service the last dozen or so years, you’ve helped our office grow immensely. Bob Brandon: Well that’s very nice to hear and it’s a two-way street. We wouldn’t be growing without your dedication and support as well so thank you for that. Dr. McLaren: My pleasure. Bob Brandon: Tell us about your day. I know that you’ve been a clinical instructor at the University of Michigan for some time. Tell us about your day today in particular and what you do. Dr. McLaren: Absolutely. Today started out at the University of Michigan Dental School. If you don’t know it the dental school now undergoing $140 million dollar renovation. There’s pipe’s being put in, electrical work being done, and pretty much constant pounding in the school all day long. That was in the morning where I talked in 4th year, junior, and senior year dental students in the clinic and in the afternoon is my free time to catch up on anything I didn’t get to during the week. Bob Brandon: What is the clinic floor like? Is it 3rd and 4th year, are they together? Is it a mentorship program? Do you have a pod of four students that you’re overseeing? Dr. McLaren: Essentially at the university right now, there’s going to be anywhere from 6-8 teachers, mentors or professors that are going to teach up to 20-25 dental students in the morning or in an afternoon. It depends on what the student is doing, if they’re doing a cleaning, they’re going to work with periodontal faculty; if they’re doing a restoration, a crown, an emergency exam, they’re going to work with restorative faculty; if they’re doing a denture or a partial or sometimes even restoring an implant they’ll work with [inaudible 00:03:27] faculty. Bob Brandon: Excellent. So this is essentially open scheduling? The clinic isn’t broken up into blocks like on Thursday morning you see perio, Thursday afternoon is endo. It’s all just a free for all. Dr. McLaren: Yeah, sort to speak. Sometimes it feels like a free for all. Absolutely. As is with clinical dentistry, sometimes you think you’re doing a crown and it turns into an endo. Or sometimes we’re doing a filling and you find out you have to talk to a patient about doing a crown. Every once in a while we have to change gears in the clinic but for the most part we’re pretty consistent about keeping on schedule, keeping on track. What’s planned is typically what’s done. Bob Brandon: That’s great. It sounds like the clinic environment is more applicable to everyday life as a dentist when they get out into actual practice. Dr. McLaren: Yeah, absolutely. Except it’s about one-tenth the speed. Bob Brandon: Right. So tell me about the renovation. Is the university expanding class size? Or was this just outgrowing old equipment and infrastructure? Dr. McLaren: I went to the university and graduated in 2000 so I’m coming up on 20 years, which is hard to believe, but 20 years ago the same equipment that’s in there now I was using. They probably realized that dental equipment isn’t meant to last 20 years and so they’re basically doing an all across the board sweep of all the dental equipment, they’re going to upgrade electronics, computers, they’re adding on so- I don’t know if they’re going to add a lot of students at this point but I certainly think there’s the potential for that in the future. Bob Brandon: That sounds fun. Are you at the university one day a week? Dr. McLaren: Yep, just a day a week. Bob Brandon: How about your brother? Is he there as well? Dr. McLaren: He used to teach. In fact, we both used to teach a couple days a week. As our practice just starting roaring and expanding, we just got more wrapped up in the clinical dentistry and working at the office, but it’s something in the future he might go back and start teaching a day a week as well. Bob Brandon: It sounds like the clinical practice and we definitely see it from our end on the numbers, on the number of patients you send us and the restorations and the sales. I can tell that you’re growing. Tell me a little bit about the practice layout, about your new associate and how many patients and what types of procedures you guys are doing on a daily basis and what you have to send out, or refer out. Dr. McLaren: Sure. Right now we got three dentists, so it’s a [inaudible 00:06:31], me and my twin brother, and then our associate who we hired last year who was one of the top dental students out of the university. I didn’t say this, but one of my goals was when I went back to the university was to find someone who was going to fit into my practice as an associate. That’s worked out great, because I basically got to screen everybody without them knowing it. It’s worked out great; from her junior year essentially at the university, I worked with her and she knew she was going to be coming on board. So from day one when she started, she already knew the practice philosophy, how we operated, how we liked to do things and it’s been pretty seamless. Dr. McLaren: We probably see between 50 and 70 patients a day in the practice. When we expanded our practice, we basically doubled in size I want to say, 8-9 years ago. I remember at the planning board committee meeting, they looked at the drawing and said, ‘Are you really going to need 32 parking spots in your practice?’ I said, ‘Yeah, I sure hope so.’ Bob Brandon: I was on your website probably a month or so ago and the photos are fantastic. It looks like this is a freestanding structure, but was this a house that was remodeled or did you just make it look like one? Dr. McLaren: It was a building that was put together by the previous owner who was a dentist who had taken over, but it was really wasn’t designed for dental and so we underwent a renovation first. This was probably in early 2000s, and then 8 years ago we did an expansion and doubled the size. Eventually, the nice thing is I was a part of the process designing and remodeling the entire building so that was a great experience, we didn’t just leave it up to a company but both doctors were involved at every step of the way. Bob Brandon: I know you’ve written a lot of articles and teach and have an interest in that, but what’s your favorite part or procedure of dentistry? Dr. McLaren: Just a couple years ago we started placing implants in our practice and it’s been kind of life changing for a lot of patients. It’s horrible to have to tell a patient, ‘Well, you need a tooth taken out,’ because then the next question is, ‘Well, what am I going to do to replace it?’ I say, ‘Well, you have to go see an oral surgeon, it’s about a year process, you may need a bone graft.’ It doesn’t sound real appealing to have a tooth out then, and now I tell a patient, ‘Hey, we’ll take it out and three months later you’ll have a brand new tooth in there.’ That sounds a lot better for them, and I wouldn’t say implants are my favorite procedure/favorite part of dentistry, what I realized in placing implants, the best part is actually three months after you place it and you actually get to see the results from the patient. I think it’s the same with anything, whether it’s a crown or even a filling, or even a periodontal procedure; it’s not the procedure, it’s what it provides the patient for the rest of their life. Bob Brandon: I know you obviously incorporated implant placement into your daily practice. Are there any procedures that you guys still refer out? Dr. McLaren: Not a lot. If it’s a complex oral surgery procedure we’ll refer it out, complex endo treatment we’ll refer it out. We’re in somewhat a small town, not a huge city and so by nature we’ve been kind of forced to do a lot of roles, specialty aspects in our dentist practice. I can’t say that we refer out more than once or twice a week. Bob Brandon: Going back 8-9 years ago when you decided to expand the office, did you incorporate any new marketing strategies or did you just have this vision of ‘you’re going to build it and the patients will come’ or how did that all transpire? Dr. McLaren: To a certain extent, I’m thinking about opening another office and I realize the thing that’s holding me back and I think the thing that holds a lot of dentists back is the fear that when they jump in with both feet, it’s not going to turn out as expected. When we expanded it was about $600,000 expansion. Instead of thinking, ‘Well, how are we going to make up this $600,000 expansion?’ We said, ‘Well, we just got to buckle down and continue to do what we’re doing and ask patients to spread the word,’ and we didn’t honestly change a lot. If you do things right and communicate well with people and treat them well, we just grew naturally. We didn’t have to put a lot into marketing. Bob Brandon: I know you and your brother and your new associate have a lot of new toys to play with and we see the iTero cases coming through. What’s the most recent purchase, like high-tech purchase that you’ve made for the practice? Dr. McLaren: We’re constantly looking at things we can upgrade but it may come as a shock to people that the most recent piece of equipment that we’re upgrading is actually our server and our infrastructure. It sounds weird but we realized what’s coming in the next 5-10 years and if that part isn’t taken care of first, we’re going to be locked out of a lot of these new toys so we made an investment in the server this week. The guy’s coming in to re-wire and re-network everything for us so that’s probably our biggest investment right now. Bob Brandon: That’s a wise investment. We’re constantly doing that here as well. Tell the audience about your patient portal and how they can schedule their own appointments and pay their bill and download their health history forms and all that. I thought that was a really neat addition to your website. Dr. McLaren: Absolutely. It’s something we recently implemented. We’re not one of those organizations, we’re not one of those dental offices that starts up right away as soon as something’s available, but when we do start it we kind of go full blast with it. We had the opportunity through a company called Solution Reach to introduce an online portal for payments, scheduling, for looking up appointments, communicating through text messaging with the office, and so that’s been great and it’s all been incorporated through the website. I think that’s kind of where the industry is going. As people get busier, they don’t want to have to pick up the phone if they can avoid it. When they pick up the phone, it’s actually to text or look something up. It’s not to make a phone call. Bob Brandon: Absolutely. I get text reminders from my son’s orthodontist. Dr. McLaren: I get texts from my wife from just the other room. Bob Brandon: I’m the same. Sometimes it’s easier to communicate through technology than face to face. Dr. McLaren: I think that’s safer too. Bob Brandon: Yes, it is. So going back to the iTero and the Invisalign, where do you see some of these technological advances taking dentistry in the future? Dr. McLaren: I think it opens up a new possibility for treatment planning and when I say that, up till this point every office that I’ve seen that uses the 3-D scanners, they’re doing it for scanners, they’re using it for arches and simulations. The way we’re using it in our offices is do a scan, basically, and tell the new patient a full arch of what they have in their mouth. Then we let the scan do all the talking for us, so patients can’t see tooth #2, they can’t see the [inaudible 00:15:43] above tooth #30, but if you show them a full scan, they can certainly see it. Instead of us telling them what they need, the patients start asking questions about why something looks dark or what can they do to improve their smile. Bob Brandon: Wow, that’s fantastic. That’s something that I had not heard before. But yeah, let the scan and the image help the patient understand their condition and what needs to be fixed. That’s fantastic. Dr. McLaren: Absolutely. You’d be surprised how that facilitates communication with the patient and they ask, ‘Well how come it looks so yellow on the screen?’ I say, ‘Well, here, let me show you a crown and we’ll scan the same crown, but B1 instead of your shade’ and they’re able to see visually rather than throwing them on a chart what’s going on in their mouth. I think it makes a world of difference. Bob Brandon: Going back now to your new associate and where do you see the future of dentistry going? Do you have any concerns about her future practice, any trends that you’re noticing either worrisome or hopeful about? Dr. McLaren: Technology can help outgrow still. That’s sort of the one trend I’m starting to see as teaching. Back when I was in school, we had to whack stuff off, we had to carve stuff, you had to prep everything pretty much perfectly, you had to do both inlays and onlays. Most schools aren’t teaching gold anymore, there’s not a lot of gold restorations being done and so the magic of porcelain is it covers up a lot. White restorations and composite can cover up a lot but it can’t cover up mistakes in preparation. You can’t cover mistakes in material selection. What I’m seeing is the final result might look but a year or two later, something’s falling apart on one of the patients that we’re seeing in the dental school. I think we have to go back to the focus on materials and preparation design so that the actual CAD-CAM and 3-D printing and the 3-D scanning can actually be what it was meant for. Bob Brandon: I could not agree more. In fact, we generate a case list on a daily basis here every morning on customers we have to contact that the preparations are either under-reduced or there’s undercut and your name has never appeared on there because you have that focus and you have that very high skill set and I’m very happy to hear you’re teaching the next generation of dentists. The things you described at the dental school with not waxing gold crowns and until you wax on your own prep and figure out what works and what doesn’t work, it can be either a very humbling experience or a very pleasant final outcome. Thank you for all you do. Thank you for all you do for this laboratory, for the high level of skill and dedication you treat your patients and for the teaching that you’re doing for the next generation. It’s really amazing what you do, Dr. McLaren. Thank you so much. Dr. McLaren: It’s my pleasure. It’s been an honor for us to be able to associate with your lab over the last dozen years. You guys have been great and anybody that I’m teaching and they ask for advice I send them to your lab. Bob Brandon: Wow, I can’t thank you enough. That really means the world to us and the partnership- it’s a beautiful thing and it’s a mutual thing, I hope that we can continue to deliver the types of restorations you and your brother and your associate are proud to give to the patients of Midland and the peninsula of Michigan. Dr. McLaren, thank you, I know you’re tremendously busy and this has probably put you behind in your schedule but I really appreciate you stepping in on such short notice for us. It really means the world to us. Dr. McLaren: No problem, I really appreciate it. Thanks so much. Bob Brandon: Dr. McLaren, thank you. All the best. Take care. Dr. McLaren: You too, bye, bye. Bob Brandon: Bye, bye. Shaun Keating: Thanks for joining us on the Dental Up Podcast show this week. 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