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The Value of Dental Mentorships with Dr. Nick Ciardiello, DMD

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Our guest this week on the Dental Up Podcast is Dr. Nick Ciardiello, DMD. We sat down with Dr. Ciardiello and talked about why it’s important to find the right mentors at an early stage in your career. How utilizing their advice and knowledge, can potentially help you figure out your specialty, assess your workflow, and get the inside scoop on what it takes to run a dental practice before you graduate.

Important talking points in this episode
:
-Dr. Ciardiello’s experience with a Dental Internship Program
-How he balanced his passion for sports and his dental career while in school.
-Why Dr.Ciardiello is overloading on CE and online educational courses.
-How he utilizes Instagram and how he acquired opportunities from social media.

For more information on Dr. Ciardiello check out his website by clicking here:
https://drnickciardiello.com

Check out his social media:
https://www.instagram.com/dr.nickc/?hl=en
https://www.facebook.com/drnickciardiello/

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Announcer 1: 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 host, Shaun Keating.

Shaun Keating: Hey everyone, Shaun here. Welcome to another episode of the Dental Up podcast. Our guest this week is a New Jersey native, graduating from Rutgers School of Dental Medicine. He completed a general practice residency at Jersey Shore University Medical Center and has been certified by the American Academy of Facial Aesthetics. Currently practicing from Manhattan, New York and also in New Jersey City, New Jersey. Please welcome Dr. Nick Ciardiello, DMD. How’s it going, Dr. Ciardiello?

Dr. Ciardiello: Hi. It’s going great. How are you doing today?

Shaun Keating: Dude, thank you so much, man. I hope I didn’t … Your name, that’s a awesome
name, man. I loved it.

Dr. Ciardiello: Yeah. You got it close enough.

Shaun Keating: Dr. Ciardiello. I’ll call you Dr. Nick, man.

Dr. Ciardiello: That works.

Shaun Keating: I take it you’re Italian, huh?

Dr. Ciardiello: Yes, I am. My father’s side 100%.

Shaun Keating: [crosstalk 00:01:24]. Yeah, you look like a big Italian, man. It’s pretty huge where we found you. You’re in a big time on the Instagram and it’s just really neat to see how many followers you got and just, for a dentist, you’re just crushing it. I got a lot of doctors in Jersey and a lot in New York, but not in both, but that’s cool that you’re working both sides of the bridge there, I guess I would say, huh?

Dr. Ciardiello: Yeah. I always wanted to do that. I wanted to work in the city a little bit, but I also wanted to be … Right now, I actually live right in Jersey City. The place I work in Jersey City, it’s Jersey City Dental. I literally live walking distance from there.

Shaun Keating: Oh, you’re kidding me.

Dr. Ciardiello: And then, yeah, so it’s really convenient, and then two or three days a week I work in Manhattan at Manhattan Dental Spa, and that’s in Midtown. I get the best of both worlds, I think, because I live over here. I can have my car. I still feel like I get a city vibe but I’m not in the city all the time living there dealing with the traffic and all that crazy stuff.

Shaun Keating: Oh, absolutely.

Dr. Ciardiello: Get a little bit of both.

Shaun Keating: When we come into New York we always fly into Newark, and so we get a little feel of New Jersey a little bit but I always remember that’s …

Dr. Ciardiello: That’s my airport.

Shaun Keating: Is it? Oh, that’s great, man. I always remember The Sopranos, though. I never really thought New Jersey was like that. It’s just beautiful and wooded areas.

Dr. Ciardiello: No, it’s like that. It’s like The Sopranos.

Shaun Keating: They got the “Bada-bing” place out there, a little strip joint?

Dr. Ciardiello: Oh, yeah. They have everything.

Shaun Keating: They got it out here, too. Naw, I love it there, man and I love my Jersey dentists are tough guys. They’re not …

Dr. Ciardiello: You got a lot over here?

Shaun Keating: No, not a whole lot, but they use their voices with me quite a bit when things … Usually things are always going good, but when they don’t they’ll let me know and yeah they’re … Newark and New Jersey.

Dr. Ciardiello: That’s Jersey mentality. Tri-state mentality, that’s how it is.

Shaun Keating: They’re tough dudes. And we got the California guys here and they’re probably like, “Shaun, don’t mess with me dude. Let’s get this.” No, no. They don’t say the dude, but no, that’s awesome, man. Good job. Hey, I always start off talking a little bit about sports, so what do you think are you a New Jersey Nets guy or are a New York Knicks and basketball, football? Tell me who you like.

Dr. Ciardiello: Basketball-wise, I’m not a huge basketball guy. I did play a little bit in high
school, but my big sport is baseball, so I played college in baseball, too.

Shaun Keating: Yeah, I heard that.

Dr. Ciardiello: I did baseball in college. Yeah, and my team, I’m a Yankees fan. Ride or die with the Yankees. You know how that goes. And then, football guy. I’m a little bit weird. I’m a Packers fan. That’s just because my father is a Packers fan and his father is a Packers fan and something just got passed down.

Shaun Keating: That’s awesome. I got a lot of different dentists that when we talk about it, they’re in different states but Green Bay Packers are their team and it’s just a very …

Dr. Ciardiello: They travel well. They have fans all over the country, you know.

Shaun Keating: Yeah. It’s a trip how all the fans own the franchise, too, and it’s like, I think they got a 20 year waiting list for people to come on or to even get seats. It’s nuts.

Dr. Ciardiello: It’s crazy. Die hards.

Shaun Keating: Oh, it totally is. That’s cool. What about with you and baseball, you’re a D1 playing baseball there. What position did you play?

Dr. Ciardiello: Initially, I started as a catcher my first two years. I was a hitter who was a secondary catcher. By my junior year the coach was just like, “You know, we don’t really want to even mess with your knees or anything like that,” because I’m a pretty tall guy for being a catcher, too. 6’3″ was tough. They were like, “Why don’t we just put you in left field and you kind of just smash the ball?” And then, that’s pretty much what I did. I batted third or fourth. I just hit home runs. I relaxed in left field and it actually went pretty well junior and senior year.

Shaun Keating: No kidding.

Dr. Ciardiello: So, I have no complaints. I did pretty well. I had the home run record at my school, RBI record. I was a good hitter but fielding-wise, I would say I was a left fielder who hit the cut-off man, like Manny Ramirez. I didn’t really worry about the events too much. But I did have some interests from some major league programs but, to be honest, my parents, they were always like … Especially my mother, was always instilling in me, “Baseball is secondary, academics is first.”

Shaun Keating: No kidding.

Dr. Ciardiello: Yeah. That’s pretty much, so I just had my head set on going to dental school and I didn’t even bother with the kicking around the minors for a year. I have a couple friends who did that. They did two or three years in the minors and didn’t really get them anywhere and I didn’t really want to do that.

Shaun Keating: Oh, I know. Hey, my best friend I grew up with, he was in the minors for 11
years.

Dr. Ciardiello: Oh, my God. That’s a lot of years.

Shaun Keating: Like Bull Durham movie. He got up for one game with the New York Mets, and then one game he got up with the Atlanta Braves and it was at Angel Stadium.

Dr. Ciardiello: [crosstalk 00:06:33].

Shaun Keating: But that dude, he’s made a career out of it since. He’s been a scout for different … I think he’s with the Seattle Mariners or whatever, but he has a batting CD and he goes around and talks to little leagues. It’s like Rudy Ruettiger.

Dr. Ciardiello: Yeah. You do what you got to do.

Shaun Keating: Rudy Ruettiger, he played one play but yet he’s a speaker.

Dr. Ciardiello: Lifer.

Shaun Keating: Yeah, life coach type thing.

Dr. Ciardiello: I think there’s some point, too, in the minors … There’s a certain amount of years, don’t they start getting them … How many years do they start getting money after? [crosstalk 00:07:10].

Shaun Keating: Yeah, I think he get a little bit of a retirement or something after. I think it’s five or something. But yeah, he’s not every going to get rich, but he has a little bit of income from that, I think.

Dr. Ciardiello: [crosstalk 00:07:18]. As many years as he could.

Shaun Keating: Oh, I know. I just see him. I made his teeth about 15, 20 years ago and we did these veneers. And there I seen him a while back like a year ago. I said, “Steve, we got to redo this.” We sent him in a few months ago and we redid them all. He just got a full set of teeth and he loves it, man. He goes everywhere and tells everyone about, “My buddy Shaun makes teeth,” and it’s like, “Oh, gosh.” That’s funny.

Dr. Ciardiello: That’s the way to do it.

Shaun Keating: Absolutely. Well, dude, let’s go ahead and Dental Up. Tell me, Nick, why did you get into dentistry and at what point did you think, “I want to be a dentist.”

Dr. Ciardiello: My parents, they both didn’t do any sort of … They didn’t even go to college, my parents, so I had no direction in terms of what I wanted to do. My brother went to college, and then he was the first and I was the second. I would say my first year of college, I knew I wanted to do something medical, I just wasn’t a hundred percent sure where I wanted to go with that. And I remember coming actually back to my dentist in New Jersey, Dr. Vitale, and I just went for a regular check up cleaning and he asked me, he was asking me the same thing, he was like, “What do you want to do?” And I was like, “To be honest, I have no idea.” He said, “You know what, why don’t you come in and shadow me for a few days and see how you like it.” I think he was the MJDA president, so obviously he loved the dentistry side. I came in and I shadowed him for a few days and I really fell in love with it. That’s where that came from.

Shaun Keating: No kidding.

Dr. Ciardiello: Yeah.

Shaun Keating: As I’m looking, too, dude, it’s like you majored in the mathematics, the premedical dental. Mathematics is so tough, man. It’s just some guys get it and some guys don’t.

Dr. Ciardiello: That wasn’t easy. I fell into it because for the way my school was, I went to Holy Cross in Massachusetts, you had to apply to the pre-med and pre-dental program. If you started that your first year you had to apply for that in high school. At the point when I was in high school I didn’t know I wanted to do medical, so I was starting with the math, because they had a requirement for calculus for the pre-med thing. I started with that, and then I did good in calculus and I took another math course, and then by sophomore year when I declared, I was like, “Well, I’ve already taken like four math courses and I got A’s in them, so why don’t I just major in that and do the pre-med, pre-dental concentration.”

Shaun Keating: Oh, man. I couldn’t even get through basic algebra in high school.

Dr. Ciardiello: It was tough by the end. We had some courses my senior year, so my fourth year, the first semester it was like a dynamic analysis course. There was only eight or nine students in the class. And then, the second semester, obviously during baseball season, it was the continuation of that course and it was only three students in the class and that included with me and I was missing all these classes to go to baseball games on Friday, so I ended up missing half the course work just because I was going to baseball games every weekend. It wasn’t easy.

Shaun Keating: But you still passed.

Dr. Ciardiello: Oh, I still passed. Yeah, I still passed.

Shaun Keating: For us, it was D for diploma, man. It was hard but that’s crazy. That’s awesome. I just remember with algebra if you miss one or two steps, at the beginning, you’re just lost.

Dr. Ciardiello: The whole thing’s messed up.

Shaun Keating: Those letters and stuff. What the heck are those letters? Even, too, with arithmetic, you got to bring down the zero or two zeros after two times.

Dr. Ciardiello: Don’t carry something you’re in trouble.

Shaun Keating: Yeah. I forgot, it was back in elementary school. Nowadays, you get a CFO to do your numbers for you, you got a calculator and it’s just …

Dr. Ciardiello: Not a big deal.

Shaun Keating: I used to worry so much that I was too dumb where I wouldn’t really good at math and it was just weird and the sciences were tough for me. I was a big sports guy, too. I did gymnastics and football and I just thought that was going to be my life. Then my oldest brother, Kevin, was going to dental school and I was in high school. He was making me my mouth guards and I’m like, “Dude, I’m going to be a pro,” and then when you’re five foot nothing and a hundred and nothing, you’re not going to be a pro. He goes, “Shaun, you could be a dental tech.” And I’m like, “Okay.” I always knew from eighth grade on, I knew I was going to be a dental tech because …

Dr. Ciardiello: Oh, wow.

Shaun Keating: I wasn’t the sharpest tool in the shed, for sure, but, hey, it all worked out, baby. Now, I got one of the biggest labs in the nation.

Dr. Ciardiello: Yeah, it did. That’s awesome.

Shaun Keating: It’s pretty cool. So, tell me, dude. Tell me a little bit about your school. Now, my dad was born and raised in Dorchester, Massachusetts, Boston area there. How did you like being in Boston there, isn’t that a bitching place there? Isn’t that awesome?

Dr. Ciardiello: Where my school was, it was in Worcester. It’s forty minutes west of Boston. I don’t like the cold weather.

Shaun Keating: Exactly.

Dr. Ciardiello: We were on … I think it was Mount Saint James, like a little bit of a mountain and I think we got the worst snow in Massachusetts. They’d be two inches everywhere else, it’d be 10 inches for us.

Shaun Keating: No kidding.

Dr. Ciardiello: And it was just like from where we were it was cold all year round. Besides that, the community was great there. It’s a small school. I think there was 2,500 students there, just liberal arts, good, small school but, man, the weather, I couldn’t take it. I was pretty happy to at least come back a little further down to Jersey.

Shaun Keating: Oh, it’s so crazy cold. We were just in Chicago for the mid-winter and my bones were aching, man, it was so fricking cold. It was only 20 degrees. They were saying like a month …

Dr. Ciardiello: It’s hard to get up in the morning when it’s cold out.

Shaun Keating: Wait until you get older. It’s real tough.

Dr. Ciardiello: Everything starts creaking.

Shaun Keating: Yeah. And it was 50 below a month ago. It was the coldest in Chicago for years, but it was 30 to 50 degrees with a wind chill factor below and that’s nuts with the wind going.

Dr. Ciardiello: Terrible. Oh, yeah. You can’t even go outside.

Shaun Keating: Oh, I know. They cabbie that was driving us around, they said for two days, a month ago when it was real 30 to 40 below or whatever, he said the whole town just shut down and everyone stayed in the house. I said, “Dude, you got to count nine months from now that there are going to be like a million babies,” because what do you do when you got nothing to do but go in the house? You make whoopee with your woman or whatever.

Dr. Ciardiello: I think that’s right.

Shaun Keating: We were trying to calculate it. So, say there’s a thousand babies born every day in Chicago or 500, I bet you when it comes nine months from that date, there’s going to be like 4,000 kids that day.

Dr. Ciardiello: Oh, it’s going to be a boom.

Shaun Keating: It’s like, “What the heck happened?” And they’re going to go, “Oh, that was the great freeze or whatever.” That’s weird. I don’t know why I went there.

Dr. Ciardiello: No. It makes sense. It makes sense. Nothing else to do.

Shaun Keating: Yeah, that’s funny. Tell me, did you start out as an associate or did you purchase practice? Tell me a little bit about when you got out of college, what you did and how it went for you.

Dr. Ciardiello: After college, I actually took two years off.

Shaun Keating: Did you do a missionary or something?

Dr. Ciardiello: No. The way it was, I didn’t finish my labs until the end of my fourth year because I was delayed with baseball. I couldn’t fit the labs in, so I knew I was going to take one year off just because I wanted to be first for the admissions cycles and how the DAT goes, I needed time to study for it and I didn’t want to really do that during my fourth year, second semester while playing baseball. It just wouldn’t have worked out. So, what I did was, I actually was a personal trainer. I worked at a fancy restaurant in town that my mother used to work at, so I was like a waiter/bartender for a little bit.

And then, when I did that, I took my DAT’s. I did so-so on them, and what I did was I actually did an internship at Rutgers School of Dental Medicine. It’s called The Gateway to Dentistry program. It’s a two or three week internship where you have to apply to, to get in. The great thing about that is they give you stuff to do hands-on, to see if you obviously wanted to do dentistry and besides that you get to talk to the admissions faculty there and you can ask them straight up, like, “Hey, this is my GPA from college. This is what I got on my DAT’s. What are my chances of getting in?”

Shaun Keating: No kidding.

Dr. Ciardiello: At that point, when I did that, she was like, “Your GPA is great. We don’t have many Division 1 athletes applying to this school. But, you know, your DAT’s are a little borderline right now, so maybe you should take it again and try to get it a little bit higher,” because I only took it once at that point. At that point, I was like, “Yeah, let’s take it one more time.” By the time I did it the second time I was going to be a very late application in the cycle, and I obviously know that’s not good in terms of applying to dental school. They want you to apply the first week just so you’re on top of the list.

That’s what ended up happening. At that point, I was like, “That’s fine. I’ll take one more year. Keep working, try to save some money.” And then, that’s what happened. Then I applied to, I think, 13 schools, pretty much every one in the Northeast, and then got 12 interviews, I think. And then, I ended up obviously at Rutgers Dental School, in-state tuition, it made sense.

Shaun Keating: No kidding. That’s awesome. Did you go to a practice in New Jersey first or New York first?

Dr. Ciardiello: After I did the four years of Rutgers Dental, I did the one year of residency. That was down the shore, in Neptune. And while I did that I actually … Because in New Jersey, you’re not required to have a residency, so I was moonlighting during my residency. Where I was moonlighting, I was actually moonlighting down the shore in Manalapan, New Jersey. I was there for six months, or so, and then when I was done with the residency, I got hooked up through one of my attendings said he knew a guy in Jersey City that was looking for someone, so he got me in contact to them. I started talking to him. Meanwhile, during my residency, the practice that I work at in New York City actually found me on Instagram.

Shaun Keating: No kidding.

Dr. Ciardiello: Yeah. And at that point I only had 15 or maybe 20,000 followers but the owner in the Manhattan place started contacting me and we were talking. Actually, I think after six months of talking he was like … I was approaching the end of my residency. He was like, “Hey, why don’t you come in for an interview?” So, I went in to him, I interviewed once, and then I went in one more time to meet the other partner there and that’s how I ended up getting the job in the city. That was pretty much strictly through Instagram, which is wild.

Shaun Keating: That’s crazy. And that’s Dr. Vargas, right?

Dr. Ciardiello: Yeah.

Shaun Keating: Is that Dr. Vargas or no?

Dr. Ciardiello: Dr. Vargas and Dr. Charnas. Dr. Charnas is the elder partner, and then Dr. Vargas is a little bit younger.

Shaun Keating: Yeah, Vargas looks pretty cool, got longer hair there.

Dr. Ciardiello: Yeah. He’s a cool one. He knows his stuff, too. He’s taken all those Kois, Spear, Dawson. He knows his stuff.

Shaun Keating: That’s awesome, to learn from a guy like that. Are you doing any CE like that. Have you been out to see a Spear course yet or anything? Tell me a little bit about your CE.

Dr. Ciardiello: He was suggesting, personally, Dr. Vargas was saying he liked Spear the best but I’ve been speaking to some people … Because I’m friends with a lot of these Instagram dentists now, too. So, I was speaking to a lot of them, asking around and, to be honest, I think I’m going to start with the Kois one. That’s what I’ve heard is the …

Shaun Keating: Dr. John Kois, he is such a stud. I had him here at my lab a few years back where we I paid for him to come out and picked him up at the airport and brought him to the hotel but brought him to the lab. That dude, man, it starts at seven in the morning and he’ll go non-stop until six at night.

Dr. Ciardiello: [crosstalk 00:19:22].

Shaun Keating: He just makes it so easy and breaks it down. He is just all about teaching. What he does is, he teaches at TN. He makes it to where you understand it and it’s just amazing. I know the two, Spear and Kois. I just talked to Frank Spear at the Cal lab meeting. I pulled him to the side. He was our keynote speaker. I was in his face. I got a picture. My wife took a picture of me and him talking. I got my hands in his face talking and his look at me is like, “What the heck is this dude doing?”

Dr. Ciardiello: “What is this guy doing?”

Shaun Keating: No, if you could, either one of them are great, but going out to Seattle is …

Dr. Ciardiello: Yeah, two great things.

Shaun Keating: Neat but you need to do that. You’re a young gun.

Dr. Ciardiello: Oh, of course.

Shaun Keating: Shit, you’re not even 30, are you, man? What are you, 29?

Dr. Ciardiello: 29, yeah. I want to take these courses. Now, I’m good at the marketing stuff and doing the social media, and now it’s just like I want to get the clinical mastery that all these dentists get from taking all these CE courses. That’s why I was like, “I’m going to price out the Kois one.” You know how expensive those ones are. I think the one I was looking at, it was a double one, so it was like 10 or $11,000. I was like, “Damn, that kind of sucks but it’s going to be worth it.” I know it.

Shaun Keating: Well, maybe we can help sponsor you a little bit. Maybe help sponsor you a little bit and we’ll get you going so we can start doing those full rehabs together, baby.

Dr. Ciardiello: Oh, yeah.

Shaun Keating: That’s awesome. You know, what’s also neat is, a lot of these guys do have the … It’s better hands-on, for sure, being there but they have some also online courses that are pretty neat. It’s just something, too, with if you can do a crown prep here and there and you can connect the dots, it’s just all treatment planning …

Dr. Ciardiello: Exactly.

Shaun Keating: That’s where a great lab comes in. Let’s just get study models and let’s work it up together. That’s a whole thing with a collaboration between the dental office and the lab is so important. It’s so easy once you get it down but it’s a neat thing and you got the hard part licked right now because most doctors wish they had what you have with all the audience. You have got such a big following in social media. It’s freaking nuts, dude. There’s one picture of you Macho Man. Dude, you got juice there or something, you’re beefy. That’s a beefy picture, man. How are you doing that?

Dr. Ciardiello: I’ve always been working out. I was a personal trainer for two years. Man, I’ve been working out since what, I was like 14 at this point. I’m probably 15 years into working out.

Shaun Keating: Now, that’s just huge.

Dr. Ciardiello: It’s constant. Man, I was doing six or seven days a week. I still do five or six days every single week. I’m just used to it at this point. I was the one during dental school who would wake up at 4:00 in the morning and go to the gym and everyone thought I was crazy but I did it every single day. It was something I was used to.

Shaun Keating: Oh, no. It’s really, you got some fricking huge guns but you’re just ripped. You could tell it’s a lot to do with diet and stuff, right? I’m sure, you know.

Dr. Ciardiello: It’s pretty much mostly diet. I can take a couple of days off here and there but if the diets on point it’s not that big of a deal. It’s all the calories then, man.

Shaun Keating: The four or five thousand calories I’m eating a day and the six pack of beer each night, I can’t really get that ripped anymore, can I?

Dr. Ciardiello: No, I can’t do that. Hey, I still have my cookies and sweets. I have a big sweet tooth, so on the weekends I relax a little bit and have some cookies, but during the week, I’m super strict during the week, I just like laser focused. When I’m working it’s easier for me to not pig out because I’m just focused all day working.

Shaun Keating: Oh, absolutely. I see how you work hard on the weekday. You got almost 100,000 followers on Instagram and they’re all real followers. That’s just a real neat thing. It shows your dental …

Dr. Ciardiello: It’s like a part-time job.

Shaun Keating: Exactly. Oh, I bet. I see that, “I work hard on the weekday and I party hard on the weekend.” It shows you with this shirt off at a concert with the horns up and it’s like, “Yeah.” I’m like, “Look at this dude.” That’s awesome, man.

Dr. Ciardiello: People love that one. They love seeing professionals able to have fun. It connects with a lot of the audience because we’re all like that. We all like going out and having fun and doing what we like to do.

Shaun Keating: Heck yeah.

Dr. Ciardiello: But not many professionals are willing to show that.

Shaun Keating: No.

Dr. Ciardiello: I think that’s the thing that’s also tough and you have to be careful about it.

Shaun Keating: They’re all scared. Let it out there, baby. It’s like, just be real and it’s like, most people, I go 100% in everything I do. I work hard but I play hard.

Dr. Ciardiello: Exactly. And me, too.

Shaun Keating: And, I think the Lord likes that. He like his children to go full out on everything.

Dr. Ciardiello: Oh, full throttle.

Shaun Keating: Not just sitting there being meek at home and being safe. He wants you to live your life and rewards those who do. But you also can hurt yourself here and there when you get stupid like I do sometimes.

Dr. Ciardiello: Oh, yeah. You just got to keep it …

Shaun Keating: Kind of under control, somewhat.

Dr. Ciardiello: Keep the reigns in a little bit.

Shaun Keating: I try to but no, that’s so awesome, dude. Tell me a little bit about what you do on some of the newer technologies. Are you looking into any of them, like the scanners? At the practices you’re at, do they have any different things? Tell me a little bit about some of the equipments and some of the newer technologies.

Dr. Ciardiello: So, where I’m working at and when I was at my residency we had … Not the iTero, the Trios, which I loved. That was my favorite scanner, so far. Now, in Jersey City, we have the iTero and we also have the CAD/CAM, the Omnicam one. So, we do mill our in-house crowns, usually posterior crowns. We’re using the Straumann nice blocks, which aren’t bad. I think they come out actually pretty good. And then, I know my city place we do pretty much the iTero, because we do a lot of Invisalign there. We’re not just getting into using the restorative aspect of iTero, which I haven’t really seen any yet from that. But I’m just used to the Trios and the Trios, for me, that was …

Shaun Keating: Oh, 3 Shape, yeah.

Dr. Ciardiello: That was awesome.

Shaun Keating: That’s the bomb, it really is. It is so neat but it’s the most expensive one.

Dr. Ciardiello: You guys worked with all the …

Shaun Keating: Oh, yeah.

Dr. Ciardiello: You guys worked with all those?

Shaun Keating: Oh, heck yeah. It’s Trios, number one, iTero second, and then Tru Def from 3M is third but not a whole lot of CEREC.

Dr. Ciardiello: Dentsply just came out with Primescan, I think the other one is.

Shaun Keating: Yeah, Primescan. Can you believe that? It’s a CEREC, basically, but yeah, it’s the Primescan. It’s crazy but I think they’re a little late to the show, but we’ll see. Heck, several other companies are going to be coming out with more of them. I think they just need to get the pricing down on these. Get them down to 25 grand.

Dr. Ciardiello: The Trios one just dropped a lot, didn’t it? I think I just saw some that was 20 or $21,000 for the Trios.

Shaun Keating: Oh, I hope so.

Dr. Ciardiello: Which is cheaper compared to what it was. Yeah, I saw something, I think, at the Chicago Mid-Winter, they made an announcement like that. They made it more affordable for everyone.

Shaun Keating: Oh, that’ll be good. They’ll get some market share there, because they’re getting beat up with that Align stuff with some of the not being accepted.

Dr. Ciardiello: That’s the thing, if they could only work with Align they would have it.

Shaun Keating: That’s crazy but Align keeps wanting to meeting up with me because they got these new programs for dentists to … I don’t know. I don’t even want to get into it. It’s just … Now that their trademark and patents are all done, now they want to go and try to do what they have to do to get their market share back but I don’t know. I think it wasn’t cool what they did, where they closed it to where only iTero guys can do Invisalign.

Dr. Ciardiello: Are you guys doing a lot of your anterior study cases with digital scanning or are you also using, I guess, impressions for your veneers and stuff?

Shaun Keating: We still have a ton of regular impressions but we’re up to about 30% now where it’s all digital coming in. We’re doing a lot of these where it’s even modelis and it’s so freaking amazing. We’re taking a virtual oppose and you guys are scanning it and we’re doing it day in, day out and it’s so freaking accurate.

Dr. Ciardiello: How are the aesthetics on that, though, for the anteriors? The aesthetics were great when I was using the Trios at the lab but, in terms of veneers and stuff, I was always afraid that it wouldn’t be quite on as it would be a eMax.

Shaun Keating: Most of the guys on veneers, they’re taking those impressions. I’m not getting a lot of scans for veneers, but it’s something for full coverage, I can do any material I want. I can do a PFM, I can do an eMax, I can do a stacked jacket crown. We can pretty much do it however we want but it’s just such a accurate system where impression material likes to shrink, and burp, and bubble and do all that stuff but it’s just changing to where more and more dentists are going to be scanning the stuff in the mouth. You’ll still do your little temp.

Dr. Ciardiello: It’s just easier, it’s more efficient.

Shaun Keating: Yeah. It really is. I got some guys, with the CEREC’s, you can do two, three crowns a day or maybe three or four, or whatever in a couple hours each time. But with this, if you can go on and scan 20 preps just like that, boom, send it off digitally.

Dr. Ciardiello: Oh, yeah. Send it right to you guys.

Shaun Keating: You still got to have assistant do the temps or however that works out with your practice.

Dr. Ciardiello: That’s the one thing, having the CEREC is great, don’t get me wrong, but it takes a lot of chair time up and my assistants here aren’t trained yet on how to do a lot of the scanning. For me, if it’s a single crown I have to schedule them for an hour and a half to two hours. It can get a little frustrating. If one thing goes wrong with the system, sometimes if it’s a freeze in it or something like that, then all of a sudden you start sweating and you’re like, “Oh, darn. I just wasted these two hours.”

Shaun Keating: Oh, it happens all the time and you have a chip margin or [crosstalk 00:29:20].

Dr. Ciardiello: Oh, exactly. It happened to me the other day. I was doing two crowns on a patient and I milled them both but one of them I was just about to seat and it chipped and I was like, “Oh, God. I just wasted two and a half hours.” I had to take another impression for that one and send it out.

Shaun Keating: Can you believe that? I know, man. And it’s tough but you got all those hotshots out there online, and they’re saying the CEREC stuff, but that’s the top 1% that has the hands of God.

Dr. Ciardiello: A lot of that stuff you see on Instagram. They’re doing these composites and they unreal and you’re like, “How are they? What kind of practice are they working at that they’ll be able to spend the time to do this?”

Shaun Keating: And it’s the most talented dudes out there and just the average Joe that’s trying to get their hands and it’s harder than heck. I always use the analogy where you look in the magazine at puppies, say you’re getting a purebred puppy and you’re looking at French Bulldogs, or whatever, and you look at the picture of the one in a million dog for this place and that’s what they’re showing and everything else they’re not the same. It’s like same thing with the restorations. When Dr. Smith goes and does that CEREC in the mouth, well, it’s behind the lip, it fits, baby. I ain’t going to take no pictures.

Dr. Ciardiello: Exactly. Exactly. And especially when you start taking into a factor insurance and stuff like that, and then you have these dentists who would need to stack these patients in order for them to make any sort of money.

Shaun Keating: Yeah. It’s just amazing how that stuff works out like that. What advice can you give some of our newer dentists just starting out because you’ve been in there a while, man? Tell me what kind of advice can you give some of the other people starting off?

Dr. Ciardiello: I think the most important thing is to find a practice that you really like and who’s going to teach you because I’ve gotten lucky with the two places that I’ve worked at. I have very good bosses. They’re willing to teach me a lot. This is essentially free learning. I’m still learning and I can learn from these guys every single day. Obviously there’s plus and minuses to both places but being able to have these mentors who are here every single day teaching me, I’m constantly learning and I’m not just coming in and drilling and filling. I’m actually learning different stuff every day.

Shaun Keating: That’s awesome.

Dr. Ciardiello: I think that’s probably the most important thing because, to me, I just want to keep increasing my clinical skills every day. That’s my goal. That’s definitely probably, what I think, one of the most important things for a new dentist.

Shaun Keating: No kidding. Yep, that’s good words right there, buddy. For being so young and you’re crushing it already, man.

Dr. Ciardiello: Thank you.

Shaun Keating: Just with your media presence and all that. I know how tough it is. Like you said, it’s almost another job but I think …

Dr. Ciardiello: Oh, exactly.

Shaun Keating: You’re really set for greatness, being so young there.

Dr. Ciardiello: Thank you.

Shaun Keating: I see you really, in the very near future, maybe you work for these guys for a while, but maybe down the line you do your own practices and as you grow, you got to put your time in, but I think if you can harness … Because I see you being up, you’ll be at a half million people before you know it. I think if you can get through to that audience that, “Hey, you know, Dr. Nick will take care of your teeth.” So, wherever you’re at over the US, they’re going to go in and say, “I want to go to Dr. Nick.”

Dr. Ciardiello: Oh, yeah. I’ve already gotten a lot of that, so far. It’s already been working and I haven’t even … You can tell my patients, I’m not a big promoter of like, “Come in to see me. Come in to see me.” I try to keep it fun and try to stay funny like that. I’m not promoting myself too much for some of these patients like they’re promoting themselves every single post.

Shaun Keating: Exactly.

Dr. Ciardiello: I think it’s better to form the personal connection with these people, with the followers and patients, rather than just trying to push myself and tell these people to come because they will come. I’ve already had a lot of patients come through Instagram, it’s been great.

Shaun Keating: Oh, that’s so cool and it’s so true there and the words there, soft sell or no sell and the people will see that and they’ll come to you and that’s what we try to do but, man, it’s just something. You really got it down and my hat’s off to you, man.

Dr. Ciardiello: Thank you. Thank you.

Shaun Keating: I can’t thank you enough for coming on the podcast here and I want to do another …

Dr. Ciardiello: Yeah. Thank you for having me.

Shaun Keating: I want to do another one and maybe we’ll do six months or a year out, we’ll do it again and we’ll see how things have changed for you and maybe we can talk about some of the cases we’re doing and stuff like that but, man, that’s so awesome, dude.

Dr. Ciardiello: Yeah. That would be awesome.

Shaun Keating: Oh, man. Thanks again for coming on the Dental Up podcast.

Dr. Ciardiello: Thank you for having me. Yeah, I love it. Thank you.

Shaun Keating: Oh, man. Well, thanks again, Dr. Nick, and we’ll talk to you again real soon.

Dr. Ciardiello: All right. Sounds good. Thanks again for having me.

Shaun Keating: All right, buddy.

Announcer 1: Thanks for joining us on the Dental Up podcast show this week. Make sure to
follow us on Facebook, Instagram and Twitter or search the Dental Up podcast on iTunes for our weekly feed. Don’t forget to visit keatingdentallab.com/promo for exclusive offers. Keating Dental Lab is a full service dental laboratory and we’re nationwide. We’d love for you to send us a case so we can show you the Keating Difference. If you dig what you heard, please leave a review on iTunes and we’ll be back next week.

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