From Dental Grad to Zygo Specialist: Dr. Drew Phillips' Journey: Part 2

Episode Transcript

Speaker 1 (00:01):
My name is Dr Tyler Tolbert and I'm Dr Soren Papi,
and you're listening to the FixPodcast, your source for all
things implant dentistry,awesome, awesome.
So, like what's so, while we'reon the subject of CE, what's
kind of on the cutting edge foryou right now?
Like, what kind of courses aregetting you excited?

Speaker 2 (00:19):
Man, that's a good question.
I feel like I've taken all ofthem at this point.
Uh, I'd like to take some morelike perio type courses.
Um, you know which I got.
We'll probably get into alittle bit as like what's like
my future looking like.
But you know I I took a uh ayear I was living in California.
I did take like a a tissuegrafting course with uh Dimitri.

(00:40):
Um, he's become a good friendof mine.
Um, you know, we I did a littletissue grafting in my, in my
residency, but nothing like thatI would ever remember how to do
.
Uh, I do a lot of free gingivalgrafting now.
Um, cool, I think in the lastyear I've fixed a couple of mine

(01:00):
and more of other people's uhlike oral antial communications.
So just, you know, tissuemanagement is is a huge thing
that you know I'd like to learnmore about.
And you know, like connectivetissue grafts, for sure, free
general grafts like to me islike it's just whatever, like
you just do them.
And you know, I think morepeople should learn how to do it

(01:20):
because it's pretty hard toscrew up.
But I would like to learn somemore tissue grafting around
teeth, you know, of course, themore like remote anchorage stuff
.
It doesn't matter how manycourses you take.
You're going to learn somethingnew from every single person.

Speaker 1 (01:35):
Right.

Speaker 2 (01:38):
You know, there's just I feel like I'm starting to
run out of courses, but it'slike as soon as I started
thinking that something elsepops up.
You know, I at one point Idabbled into learning a little
bit of design.

Speaker 1 (01:50):
Yeah.

Speaker 2 (01:51):
Again, that's something that I want to do in
the back of my head, but thenevery time I sit down to do it,
I'm like I don't want to do this.
This is hard yeah.

Speaker 1 (01:57):
This is hard.
There's a lot of steps, it'sit's immaterial and it's not in
my hands.

Speaker 2 (02:01):
Yeah, I totally understand that.

Speaker 1 (02:03):
Yeah, I took a, I took a course with uh, with uh
Wally Renee, over at the uh MODInstitute.
Um, just trying to learn how todo like digital uh removable,
and I figured that would give mea pretty good you know,
understanding of, you know justExoCAD and how that works.
And uh, yeah, I mean I, I, uh,I loved it and I think for on
that day I felt confident that Icould design like an immediate

(02:24):
venture and some partials andstuff.
And then right after that I waslike, yeah, if you put that
software in front of me, Icouldn't, I wouldn't know the
first thing to do oh yeah, dude,I have an xcat donald.

Speaker 2 (02:32):
I couldn't even, I don't even know how to, I don't
even know how to open it.
It's like, it's like hard justto even open the application I
don't think people realize, likedesigners don't get enough
credit, Like their job isincredible.
It is so hard to be a gooddesigner and be, you know, good,
quick, you know efficient, butagain, it's something you know

(02:53):
like, while Renee's, like, youknow, the modern suit that's.
That's on my list of things todo.

Speaker 1 (02:57):
I took a great course , by the way.
Yeah, yeah, it was fantastic.
Oh, for sure, it's me.
I'm shitting on.

Speaker 2 (03:03):
Yeah, oh, dude, I hear only great things about his
courses.

Speaker 1 (03:05):
Yeah, no, it's great.

Speaker 2 (03:11):
You know I took the first like two COIS courses of
kind of the COIS curriculum.
I was signed up for another onein March that you know again I
signed up for like a year and ahalf ago.
It's like.
It's like when they don't evenknow what I'm doing tomorrow you
know you had to book thesecourses like year and a half ago
, so I end up having to cancelthat.
I think I'm signing up foranother one later this year.
I should probably figure outwhen it is.

(03:31):
Um, yeah, yeah, but like youknow, you have all these, like
you know, have like dawson spear, coice, you know whoever knows
like train of thought of, likeocclusion and treatment plan and
things like that.
Before I kind of decided whichone I wanted to like resonate
with, I kind of like did what Icould research wise and like I

(03:52):
feel like I I identify with thecoice the most.
Um, so I took his first courseand like pretty quickly became
obsessed, along with everyoneelse, and that's why his courses
, his courses, are sold out forlike yeah, a year and a half in
advance now, because it's likehe does not say something if he
doesn't have a research articleto back it up.

(04:15):
And I think there's very, very,very few ce courses that you
will go to, where whoever'slecturing does like these people
and I'm not bashing thembecause, like I don't want to
read research all day longeither but like people, people
say things without like thestudies to back it up, like he
truly like in like your manualyou get.

(04:37):
It's like he says something andit's like, okay, these are my
sources and they're recent too.
It's not like they're from the1980s, it's like they're all
recent articles and it's likeholy cow, like this is what?
Like the?
You know the dentistry that wewere taught we're supposed to
practice in school, like thisguy's actually doing it yeah,
that's fantastic, yeah, that'svery cool.

Speaker 1 (04:57):
well, I mean, I I'm impressed too that you know
you've gone so far down therabbit hole of remote anchorage
and you know being able to usehard tissue architecture to make
you know full arch work andit's very easy to just kind of,
once you get comfortable doingthat, I mean you can really just
kind of do that and not reallybe worried about other
disciplines, restorativedisciplines, soft tissue, which

(05:17):
is such a, you know, oftenlooked over aspect of what we do
, and it couldn't be moreimportant for the longterm
stability of what we do.
You know, the side benefit isyou get a lot more practice if
you don't pay attention to softtissue stuff.

Speaker 2 (05:31):
but it's not exactly productive practice, soft tissue
is not done enough, like Ican't trust enough to people
like how important it is so.

Speaker 1 (05:41):
So obviously that's a , that's a big, big note.
So where would you suggestpeople go first for good soft
tissue applications specific toimplants for large?

Speaker 2 (05:51):
um, you know, I think , like dimitri perio amigos,
like I think that they do anamazing job nowadays, I they
might have a live patient onenow.
But you know, I did it on a.
Um, I did take a course down inTijuana, uh, which is a
hilarious course, cause it waslike a.
It was like an education centerwhere they were they would also

(06:12):
teach implants, and we were, wewere, I was doing tissue
grafting around a three-year-oldimplant that had still not been
restored at its.
You know what we call theMexican crown, which is just the
healing abutment on it.
Why are we?
whatever you know, but, uh, youknow, I don't.
I don't know of any livepatient tissue grafting courses.

(06:35):
I know there is one in uh, inBrazil and Sao Paulo that uh,
I've heard really good thingsabout.
Um, you know, there probably issome something in Tijuana, you
know.
However, it's like, you know,when people hit me up and it's
like, hey, like what should Ilearn to do what you're doing,

(06:55):
or to do full arch, and it'slike, man, like first, learn
dentures, learn how to flap,learn how to take out teeth, um,
you know, learn immediateimplants.
You know, learn tissue grafting, cause it all, it all comes
together.
And you know, like, when I, whenI mentor people and new people,
it's like okay, let's, let'slook at what's going to take you

(07:16):
the longest, right, like foryour case, cause like there's
too many people out therespending like eight hours on a
double arch, like I hear it fromthe, the CRNAs I work with, and
it's like they're like, dude,you have no idea, like what we
did yesterday, and it's likethis was an eight hour case and
I'm like what the hell took solong.
And it's like, make the flap,you know, taking the teeth out,

(07:40):
suturing, those three things aregoing to take just the majority
of the time.
I mean, it's all thefundamentals, it's like, but
people really want to like skipover the fundamentals and just
go straight to four.
It's because it's like the sexything to do when, like,
realistically, a single, asingle posterior implant is
going to make you more money inyour practice than full arches

(08:00):
like.
Especially if you, especiallyif you're not efficient at your
full arch and I don't care whatyou charge, you're gonna lose
money on that case I mean, yeah,it's gratifying the anesthesia
bill for eight hours exactly.
Oh my god I mean.
But it's like people, that'swhat really like kind of
frustrates me.
A lot of us, like you know, newpeople coming out of dental
school like wanting to like Imean, some of them want to go

(08:21):
straight to zygote.
It's like, dude, you have tolearn the fundamentals, like
you're, because you placing theimplants for, like I would say,
like 80, 90 of the full archcases that I do or anyone does
like, to me the implantplacement's the easiest part.
Yeah, right, it's like, yeah, golearn how to take out teeth, go
learn how to flap like quickly,efficiently, like without

(08:44):
tearing flaps, because thebetter your flap, the better
they're going to heal, the lesspost-op issues you're going to
have, patients going to be inless pain.
Um, you know so and that kindof goes back to my residency of
of them forcing us, like youtake out a tooth, like cool, you
can do it flapless, but no,we're going to make a flap
because you're gonna graft it,you know, you're gonna put a
membrane in, and so I wish, Iwish there were more courses on

(09:10):
fundamentals than just peopleones like, all right, I want to
go learn full art.

Speaker 1 (09:15):
So I'm like, oh my gosh yeah, no, I totally
appreciate where you're comingfrom and I think you know, uh,
like in the first part of aconversation where we're talking
about how you got into remoteanchorage and Zygos, there
wasn't a whole lot of CE kind ofon the front end it was, but it
was really like you had done somuch work to be an efficient
surgeon, to know how to do flaps, to understand the fundamentals

(09:35):
through your GPR, that you wentto one course for Zygos and you
were able to do that eightmonths later because you had
those fundamental skills down sowell, because you had those
fundamental skills down so well.
And you know, for me, that'sreally where my evolution, um,
as a surgeon was is when Ilearned that I needed to focus a
lot less on drilling implantsand focus a lot more on just
creating the stage.
And in my mind I was alwayslike, okay, I want to take this

(09:58):
case where it's at and I justwant to get it to the point
where I'm looking at the archand it looks like a model, like
it.
Just it's clean, um, thealveolus nice and flat and it's
round.
Anybody can do surgery on amodel, literally anybody, if you
see the anatomy, if you seewhere you need to go.
There's there's absolutely noskill involved.
I can say that myself, cause Ihave very little skill.
But if you just know how to getto that point and establish the

(10:19):
case, then everything else iseasy.
And that comes down to beingable to lay that flap very
quickly and efficiently and notcreate a massive bloody mess, uh
, being able to take teeth outvery easily.
So you're not terribly fatiguedand you know seeing stars by
the time you get to the point ofactually placing implants Right
.
So if you can just set thatstage efficiently, the whole
thing is just so much easier.
But it is the most overlookedpart of it and everyone just

(10:41):
kind of wants to get to that end.
Result that really sexy post-opCT with, you know, implants at
crazy angles in in in remotebone.
And uh, and I and I think thatthat really speaks, like your
story speaks to that now, nowthat you've taken tons of
courses, you know great you,you've done that but you're able
to utilize those and retainthem so much better because you
have all those fundamentalskills that you established

(11:02):
early on in your career, likeright out the bat, and it wasn't
all about oh, I'm going to dofull arch.
I didn't, you didn't have thatin your mind in school.
Even for the immediate periodoutside of school, you didn't
know you want to do that.
You thought you were going tobe, you know, apa or whoever I
don't know Exactly yeah.
Yeah, but you had all thoseskills you know already kind of
laid down.
So, yeah, no, I mean I thinkthat's a, that's a huge takeaway

(11:23):
.
And you know I get peoplereaching out to me all the time
too about you know where do Istart, and you know it's it's
the fundamentals all the time,and I know a lot of people roll
their eyes at that, but itcouldn't be more true, and most
of the people that come on theshow and we ask them what do
they need to do?

Speaker 2 (11:40):
Like that's got to flap, you've got to take out
teeth, you've got to right,you've got to make a good enough
flap to where you can reallysmooth the bone and, like you
know, do your alveoplasty andyou have to suture Right and and
it's, and it's so low riskbecause that's all going to heal
, like worst case scenario.
You got to go back in and likealveoplasty a little bit more
but you don't have the implantaspect of it and people can try

(12:02):
to sue you because your denturedoesn't fit well, but like it's
gonna go nowhere.
But like as soon as you placeimplants, like you've just
opened up like pandora's box ofyeah, of risk and it's like dude
go do like go to a hundreddentures.
You could arguably like I thinklike this whole like full arts
thing is like becoming like it'slike it's cool to do, but like

(12:27):
realistically, like everythingelse, like might be a little
more profitable for your office,um, but it is harder too, like
I would rather do force and Iwould rather do like a implant
like snap denture, like that'shard every day, oh, yeah, it's
so hard, that's so hard implantsgot to be parallel, like yeah

(12:47):
um, you know, like bones got tobe like extra smooth patient
management, like like go back tothe fun models.
If you can do that efficientlyand well, like the full arch
stuff is going to become so easyyeah, yeah, no, I couldn't
agree more.

Speaker 1 (13:03):
Um and and two I wanted to ask you.
So you were doing, um, you knowa fair amount of just going to
other offices and doing fullerover there, doing you know,
travel, dentistry, essentiallyRight, yeah.
So I'm curious about what thedynamics of that looked like,
like you would just kind of walkin, do the surgery, walk out to
where you responsiblerestorative aspect of it.
What were kind of like thehighs and lows of that
experience and how did itcontribute to?

Speaker 2 (13:24):
yeah, so I still do a lot.
Um, I'm learning a lot nowwhere it's like I'm a lot more
picky of where I go.
Um, so a lot of the officeswhere I was traveling to it was
either like they were kind ofdoing full arch but nothing well
, or it was like they were doingnone and I was having to teach

(13:44):
them the whole kind ofrestorative process of it.
Um, yeah, and a lot of theplaces like didn't have the
right thing.
So I was, you know, for thelongest time I was traveling
with a trio, so I was travelingwith my I cam, um, traveling
with you know, and I still today, like have this little, like
kind of toolkit I'd goeverywhere with.
It's like, if, like, shit hitsthe fan, like I at least I have

(14:07):
something that I'm comfortablewith.
It's kind of like my teddy bearof stuff.
Where it's like I know that,like I, it's like it could be
little things.
Where it's like it's like astrip, screw, removal thing or
it's like, yeah, sure, you know,like an extra, you know a
couple extra, like implantdrivers, because like cool, you
can drill holes all you want,but if you don't have anything
to place the implant in with,like you know, like it's just

(14:29):
like things that I've like kindof like over traveling that I
that I do, and it's in mybackpack, like it doesn't like
we're going to vegas, so we canwrite, like it's not going to
leave my backpack because it'salways in there.

Speaker 1 (14:38):
Yeah, yeah, yeah I had a rosen driver confiscated
at the TSA one time.

Speaker 2 (14:44):
Really it's under seven inches.
They shouldn't have done thatman.

Speaker 1 (14:47):
Well, I mean I say confiscated.
They searched it, they werelooking at it.
They're like what the hell isthis?
And I talked to him about itand it was okay, but I had to
have a conversation.

Speaker 2 (14:55):
I made the mistake once I think I had a whole Zygo
kit and I said the word drillbit, because I was like, oh,
this is in my mind, I'm likethis is gonna be really easy for
them to understand like whatthese are.
I was like, oh, they're justdrill bits for dental implants
and they're like drill bits,like that's against, that's

(15:17):
against our rules.
And I'm like, okay, whoa,they're not like real drill bits
.
Come on now.
Yeah, yeah, yeah.

Speaker 1 (15:25):
But I now, I now know like don't, yeah, they don't,
they don't fit in an impactdriver, yeah, don't call them
drill bits.

Speaker 2 (15:28):
They're, yeah, they're burrs yeah, yeah um, but
yeah, the traveling gig is uh,it's, it's good, it's stressful.
You know, last year I took 141flights, it's about 150 odd days
, and hotels, maybe more.
Um, wow, I did.
You know, I don't think I didmy total calculation of arches

(15:50):
last year.
Um, I know at the end of lastyear I'd hit a thousand arches
wow, fantastic so, yeah, I thinklast year.
I don't even know how many I didlast year, um, but uh, it's,
it's good.
But again, the thing thatpeople don't think about how
many I did last year but it'sgood but again the thing that
people don't think about is likewho's doing your post-op?
And there are offices that I'vestopped going to because I

(16:14):
don't know who's doing mypost-op.
And again, like it's my patient.
I did the surgery, it's myreputation, it's my license.
You know, if I don't, if Ican't trust who's doing the
post-ups, or if post-ups areeven being done, that's how big
infections happen and that's howpeople end up in the hospital
and that's how people get sued.

(16:36):
So I know people want to do thetraveling gig.
It's good, it's great foroffices to keep stuff in-house,
but you have to be selfish inthe fact that it's like this is
your license and you've got tobe careful and you've got to
know who's doing your post-opand you've got to know who the
patient is before you even gointo surgery too.
I mean the amount of times Ishowed up and it's like patient.

(17:00):
I mean there's.
The most recent case was I wassent to CBCT.
I was prepared for it.
I showed up, they told me thepatient was at nine.
Turns out the patient was ateight eight 30.
They call me.
It's like hey man, where areyou?
And I was like I'm in my hotelroom when are you, when are you?

Speaker 1 (17:17):
And they're like oh, the patient's here.

Speaker 2 (17:19):
They, they, this was an office, like they brought it.
Oh, the anesthesiologist here.
I'm like, oh, you guys told menine, two days ago.
I show up patient's alreadyasleep.
I walk in the room like, heyguys, what's going on, you know
whatever.
I look down and there's adenture on the table and I'm
like, okay, well, the CBCT.

(17:41):
I saw the patient had teeth.
Oh my God.
So I don't know what this isall about.
And it was also weird toobecause, like the the
anesthesiologist was like, yeah,she said something about like a
sinus lift.
Well, I'm like I don't do sinuslifts on full arch, like maybe
one or two a year.
I might do that.
I mean, this is weird.
I'm like, okay, well, so youguys got a cbct for this patient

(18:02):
?
Um, yeah, the other office does, but they're not open today, so
we can't get it.
And I'm like, well, we're gonnahave to wake her up, guys.
Like, oh my god, wake her uptake they take a ct, there is a
floating implant in the sinus,one implant that's in just
tissue and it's a quad zygotecase with like mega thin zygote

(18:27):
and this office has no zygote.
And that was my.
That was my final straw.
I was like, no, this is liketerrible for me, but like I feel
bad for the patient.
So I was like, well, we need toremove this implant.
So I was like, at minimum, Iflapped.
I opened up the sinus, got theimplant out.

Speaker 1 (18:46):
We'll go fishing Sure .

Speaker 2 (18:47):
But after that I was like man, like you've really got
to know what office you'regoing to Again, who's doing your
post-ops, who's doing yourpre-ops, Um, so, so the
traveling thing, like I still doit um more selective on where I
go.
Um, you know, I like this year,I really want to chill a lot

(19:10):
more this year, like I was.
I feel like I was gone lastyear more than I was home.

Speaker 1 (19:15):
Um, yeah, that doesn't sound very sustainable.
No, I was literally spendinghalf of the year in hotels.

Speaker 2 (19:20):
Yeah, yeah, I just want to like this winter, I just
want to ski.
Um, there you go, that's all Iwant to do right now.
Um, yeah, that's awesome.
And uh, I, I kind of like I'mseeing a little bit of a shift
of like what I want to do indentistry.
Like I do miss like the kind oflike the quote-unquote, like
multi-specialty cases wherewe're doing some crowns and some
single implants and things likethat, like the more complicated

(19:43):
stuff.
I like, like you know, 80 offull arches is just like you
know, whatever, like we'll justtoss some implants in.
It's a pretty straightforwardcase.
But I, I do miss like kind ofthose more complex type cases.
Um, so I I'm trying to figureout a way to kind of get back
into doing those, because I domiss a lot.

(20:05):
Um, I want to get back into somelike aesthetic type stuff.
Um, so you know, looking at CE,like what's next?
I I probably some CE for someaesthetics.
I mean, like the only veneers Iever did was in dental school.
Um, so it's something I'd liketo learn how to do again.
Um, you know, I the one thing Iwill never do is insurance

(20:26):
driven single tooth dentistry,and it's not because I don't
want to do it.
I don't believe in that.
I think that, uh, dentalinsurance is well.
First of all, it's not.
It's not insurance, right, it'sa benefit plan, yes, um.
So I I refuse to be dictatedwhat I can and cannot do from
dental insurance.

(20:47):
Um.
So you know, what I want to doeventually is is build something
where it's like we just do fullmouth dentistry.

Speaker 1 (20:55):
Yeah, no, I, I definitely think that's.
That's really where a lot ofthis is going, because, you know
, when we get too into thementality of that, you know,
fixes the hammer, we makeeverything a nail.
Um, Not only is that, I mean.
I mean, put it, put aside.
This isn't good for patients.
That doesn't really make sense.
And you know we took an oathtype of thing, but it's a.

(21:16):
You know, I think it ends upbeing pretty shallow, you know,
when your only way of thinkingabout dentistry is in terms of
eliminating someone's naturaldentition and replacing it with
something fake that we know isnot going to be, it's not going
to outlive the patient in mostcases.
I think that that's not asrewarding and there's definitely
a reward that comes fromtackling a complex case and
being able to solve it.

(21:39):
Solve the problem and givesomeone a fixed rehabilitation
for sure, that's great.
But there's a world of thatwith natural dentition as well.
That's still very lucrative.
It's still very, um, veryengaging.
It does a lot for patients.
It makes massive differences.
And it's not just about, uh,the artificial dentition.
It's not just about, um, youknow, the implants and all these

(22:00):
crazy places.
You know, it's aboutcomprehensive dentistry and
that's really what makes a bigdifference for patients.
And and you can do it much inthe same vein of okay, we're
going to, you know, you're goingto come in and we're going to
do a whole bunch of stuff at onetime and we're going to change
your life in one day.
And you can do that, not justwith, you know, fixed full arch.
You can do it with a whole lotof stuff that's a lot more

(22:22):
conservative.
Um, you know that works.
There's a lot of virtue in that.
I respect it for sure.

Speaker 2 (22:27):
So what do you like?
You know what goes through yourhead when you look at a patient
that could go either way Right,like cause, like I'm seeing,
and I'm sure you're seeing it, Ithink you know, when I talk to
people like we're all seeingthis where it's like and this is
something again, like I don'tthink talked enough about it's
like you have these patientswhere it's like, you have these
patients where it's like we canrestore it, we can remove all

(22:48):
your teeth.
And it's like where, where doyou draw the line?
And like which way do you go?
Because the patients, thepatient is always going to take,
you know, most of the time, Ithink they're going to take like
the cheaper, faster option,which is generally going to be
the full arch, that's the pathof least resistance.
But like I mean dude, theamount of people like mean I did
a double arch yesterdayafternoon on a 31 year old, I

(23:11):
mean granted, like that was heronly option, like she had two,
she had eight, nine were theonly crowns.
Like everything else was brokenoff at the root line, like
bombed out.
And it's like I'm like you knowthat same day I saw a console
yesterday.
This chick was 41 years old.
She was missing.
She had.
She was missing one premolarand the other premolar is broken
off at the gum line.
No periodontal disease.

(23:32):
You know, aesthetics was anissue.
Yeah, uh, bite was reasonablyreasonable.
Um and a few cavities, and shewas like I want them all out and
I'm like no.

Speaker 1 (23:50):
Yeah, totally Right Right.

Speaker 2 (23:51):
Yeah, and she can, she can get it done, like she'll
find a place, like it'll getdone, I know.
And so, like I spent all thistime, like like I paused my day
to like educate these people.
But this is what's scary, andit's like I don't know like what
your rule of thumb on, likewhen you decided to pull the
trigger on doing full arch onsomeone, or or or either you
know giving them the restorativeplan and doing it yourself,

(24:11):
referring them to someone thatcan do it well, or or just
saying no, like I'm not treatingyou.

Speaker 1 (24:17):
Yeah, I mean it's.
It's not something that's easyto be black and white about it,
I think.
And um, you know, first I'malways looking at um, age is
obviously a huge factor.
That's probably the easiest oneto be looking at Someone in
their 30s.
You know, there's nothing youcan do.
That's going to be permanent.
You have to consider thatAssessing whether or not the
patient fully understands thatthere is options is important.

(24:40):
I've had patients thatliterally just sit in the chair
and I ask them why do they wantto do this?
Why is this the modality theywant to do this, like, why, why
is this, um, the modality thatI'm going to go with?
And they've seen multipledoctors and they're like, well,
I just don't want to see thedentist again.
And it's like, well, that's not.
You know, that's not, that'snot even a reality.
You know that that's a fantasy,that you've been sold and I'm
not.
I'm not is not, uh, an exitramp.

(25:00):
You know, it's just a differentinterstate, you know.

Speaker 2 (25:10):
And uh, um, you know, it requires more maintenance.
I think everyone.

Speaker 1 (25:16):
Yeah, absolutely it does.
And it's not uh, it's not aseasy really as trying to
maintain your teeth because it'snot self-preserving right Like
our.
You know what what God gave usis is is it's a, it's a self
regenerative system.
We're doing everything we canin science to to recapitulate
that and regrow teeth and youknow, regrow tissue and you
started with that.
You know, like everything elseis is much shorter.

(25:37):
So you know it's very difficultsometimes when you have those
borderline cases and I thinkthere's probably not enough
people saying no when, when it'sappropriate.
But ultimately, you know, itdoes come down to patient
autonomy, but also patienteducation and if we really feel
that we've done our job thereand this really is, you know,
economically, someone's onlyoption for getting to where they

(25:59):
want to go, sure, but they haveto understand that there's
drawbacks to it.
They have to understand thisisn't a permanent solution.
They have to understand thatthey might be doing this again
and as long as that's there andwe're on the same page, I feel
more comfortable about it.
But I think that there's a lotof gigs out there where, you
know, everyone's just trying tomake their month and you know if

(26:19):
it's in the chair and someone'swilling to say yes.
That's about their onlycriteria and that's really
myopic and I think it's notwithout consequences.

Speaker 2 (26:26):
They're just not immediate consequences yeah, you
know, I'm really hoping that.
Uh, you know, with like the new, you know basically, with like
the way 3d printing is going, wecan basically do full mouth
dentistry under sedation, yes,um, and immediately load it with
like a 3d printed material.
That might last them, you know,hopefully it will last them

(26:47):
five years, yeah yeah, and thatway we can reduce that cost of
of saving teeth down.
You know, when you can print itall, like in the same amount of
time, it is going to put us toprint an arch.
Um, yeah, to me that's like.
That's what I'm really excitedabout in the future is not
necessarily just doing full arch, but being able to, like, save

(27:07):
teeth in the same amount of time.
Uh, and for the same price.
It is for us to do full arch.

Speaker 1 (27:15):
Yeah, no, I, I totally agree with that and I
think that one of the strongestdriving factors that leads
patients who do have otheroptions towards full arch is
fatigue, because they understandwhat saving teeth means is.
They're going to go through alitany of appointments over
years of time and it's going tocost a lot of money and there's
going to be root canals andcrowns and stuff, stuff that

(27:37):
breaks before the whole thing iseven done.
Right like that's.
That's their perception of it.

Speaker 2 (27:41):
Um, because it's going to take so long.
But you know, for me, like,dental insurance dictates a lot
of that mentality, because it'slike, yeah, I this, I have this
conversation with patients.
Sorry to interrupt, like, but Ihave this conversation,
conversations like all the timewith patients where it's like
you know they're like, you knowthey, they roll their eyes about
something right, and I'm likeI'm like, okay, you know, like
let's, let's discuss dentalinsurance and let's discuss why

(28:04):
dentists have such a badreputation.
Yes, there are, like thedentists out there that are
ethically not doing the rightthing because they want to make
money.
That's in any business, anyindustry worldwide.
Like you're going to have thosepeople and it sucks, and I, I
hope they don't have dentallicense, cause, like I think

(28:26):
that's terrible.
But what, what, the, the what'shappening in dentistry that I
see with especially these likeinsurance driven dental offices,
right, is you come in, you'vegot, I don't know, eight
cavities, two crowns, maybe youhave SRP too.
Well, your dental insurance isnot going to cover all that.
Your dental insurance is goingto cover like a thousand, like a

(28:47):
couple fillings and use thepatients like, well, my dental
insurance is only covering this.
So, in my mind, as a patientand I know this because I've
spoken to patients about this,spoken to friends about this
where they're like oh well, mydental insurance, so it must not
be that important, because myinsurance doesn't cover this.
And I'm like okay, so let'stalk this through.

(29:10):
So your insurance is only goingto cover one crown, right?
So you're going to get that onecrown and then you're going to
wait till next year hits.
Well, next year you're going tocome in for your cleaning and
not only are all the things thatwere there last year that we
found still there, but nowthey're going to be worse and

(29:31):
you've got disease in your mouthstill.
So there's going to be newthings.
And now we've got this likeendless cycle to where it's like
, yeah, and that's where thewhole like, you know other than
the shitty dentist out there.
But that's where the whole,like patients like, oh well,
like every time I go to thedentist, they just find
something new.
And it's like, well, no, theseare things that we've known
about but you haven't gottentreated because your dental

(29:53):
insurance company isn't coveringthem.
But you know, we shouldn't becalling it an insurance company,
it's not, it's a benefits plan.
It's like I explained to people.
It's like I had.
I had this conversation with afriend the other day.
It was like okay,hypothetically you get in a car
accident, it's your fault, youknock out your front four teeth,
you break your leg right.
You pay your $500 deductible onyour car insurance.

(30:16):
You get a new car, you pay yourwhatever your deductible on
your medical insurance and theyfix your broken leg.
Yeah, you get $1,000 to fixyour anterior teeth and and and
they might not even, and if youwant to do implants, they might
not even cover it.
They might just tell you have toget a flipper like I'm, like

(30:37):
what, what is?

Speaker 1 (30:38):
wrong with this?

Speaker 2 (30:39):
yeah, that's not insurance like this is not
insurance.
Like this is what gives thedentist such a bad reputation.
It's like so frustrating to melike I left the idaho dental
association and I don't pay mydues for that.
I don't pay my dues 88s,because like they're getting in
bed with these freaking dentalinsurance companies.
I'm like you guys should begoing to war against these
people, not taking money fromthem.

Speaker 1 (31:01):
Right be the resistance.

Speaker 2 (31:02):
Yeah, sure, it's like man I could talk all day about
dental insurance.
It's like the worst thing inthe world, but the one.
Dental insurance is good forpeople that have a healthy mouth
, that have no issues, right?
Yeah, you get your cleaningspaid for, you get your x-rays
paid for, but that's all it'sgood for.
Yeah.

Speaker 1 (31:23):
If you got one or two problems a year, great.
But you know, if got one or twoproblems a year, great.
But you know if you're in a ina rehab situation it's just not
going to, not going to go.
And then that's why, you know,full arch becomes uh.
Or you know, fixed full archwith the dentilation becomes the
off-ramp because the thingthere's too many problems that
insurance is not going to catchup for well and they wait.

Speaker 2 (31:41):
These patients wait too long and then, yeah, the
full arch is their only option.
And the other thing I explainedto them is, like your dental
insurance company wants us toextract your tooth because it's
cheaper than a crown, it'scheaper than a root canal, it's
cheaper than a filling, andguess what?

Speaker 1 (31:58):
It can't be retreated , yeah guess what?

Speaker 2 (32:00):
They never have to pay on that tooth again.

Speaker 1 (32:03):
Yeah, they've eliminated their liability.

Speaker 2 (32:07):
Let's talk about it it.

Speaker 1 (32:08):
This is a huge problem yeah, absolutely, and,
like a lot of these fixed cases,patients ask me if they can
utilize their insurance.
If they've got a lot of teeth,you'll get your insurance.
Maximum insurance companieslove when they pull teeth and
you'll get that, but they're notgoing to cover anything else
and that's pretty much what thathas amounted to, like

(32:30):
everything you've been payingfor.
That's what it amounts to isthey're going to help you get
rid of your teeth.
That's not a healthcareincentive, you know.
But you know again, we couldwax philosophically about
insurance for quite some time,but you know, the overarching
theme here is a very importantpoint that you made that digital
workflows, comprehensivedentistry, being able to do more

(32:53):
at one time and providesolutions for patients is a huge
boon and it's not relegatedjust to implant dentistry.
Like, you can absolutely dothat with a natural dentition
and I think that's that's ourthird wave.
Like, that's where things aregoing to be going, because we
are able to do much morecomprehensive things in a
cheaper way.
Um, because of the, the adventof, you know, digital and 3d

(33:13):
printing, and how quickly thesematerials are advancing.
It's absolutely unbelievable.
I mean, when we graduated, thethings that we're doing now did
not exist.
When we graduated and like thematerials that are out there,
they, it wasn't even a thing.
Um, so what we're going to beable to do in the next five
years or so, um, you know, withthe natural dentition, with
crowns, with veneers, you knowyou name it.
Um, it's going to be incredibleand I think you're you're

(33:35):
laying a really good foundationfor yourself.
Um, in, in going to, you know,some of these occlusion courses
with you know Kois and you knowDawson, you know you name it.
Uh, to understand those things,because those are going to
become a whole lot moreimportant when it comes to
working with the existingcompetition.
So that's fantastic yeah, forsure.

Speaker 2 (33:51):
So yeah, as far as like what ce I'm taking next,
it's I think that's the type ofce like, um, what's that like?
Was it the brum strut and brumlike?
I think, yeah, I think I'mgonna go try to take that course
, like you should.
Great things.
And yeah, yeah, I took it.

Speaker 1 (34:07):
I took it my D2 year actually, really, yeah, I went
and I shadowed their office andI took their course and I
understood probably 30% of it,you know.

Speaker 2 (34:16):
Yeah, I've heard great things and it's like, yeah
, it's good, they're good guys.
That's the type of you know, Idon't know.
I feel like it's like theethically.
Like ethically, it's the rightthing for me to do and that's
going to give me more joy thanjust ripping teeth out all day
long their bonding and what theydo.

Speaker 1 (34:36):
I mean, I've seen them do a full arch case, Like
I've seen how they prep andimpress and everything, and you
know they've got the in-houselab and they make the indirect

(34:56):
temps and stuff and it's areally beautiful thing and it
was so.
It was funny because, you know,going through Augusta, like we
received such a traditionaleducation but it was very
occlusion focused and it wasvery analog, of course.
And but it was very occlusionfocused and it was very analog,
of course, and it was stonemodels and stuff.
And here I was in this likesuper, super well-renowned
cosmetic practice, seeing thosesame things that we were doing

(35:17):
in school, because they, theystick with those tried and true
things and they're doing amazingdentistry with it, really
helping people out and solvingproblems that so many people
just you know, they just theyjumped to that off ramp.
They just take the teeth outand throw in some screws and
call it a day and, uh, there'sno art in that really, yeah for
sure, yeah, yeah, so, um, well,yeah, so let's talk about uh, so

(35:40):
you're, you're, we kind of knowwhere you're headed, uh, in
terms of CE and treatmentphilosophies and different
things that you want to kind ofopen yourself up to.
What does it look for?
What does that look like foryou professionally?
Are you still going to be doingthe travel stuff?
Are you looking to kind ofsettle on some roots?
What's, what's your idea there?

Speaker 2 (35:53):
Um, you know I, it's hard to give up the travel stuff
.
Um, yeah, you know, I'm, uh,I'm licensed in five States now.
I'm licensed in California,utah, idaho, oregon and
Washington.
Um, uh, and so I I'm workingwith a few different people, um,
you know, looking at takingover some offices things like

(36:16):
that to you know, that are fullarch or that are trying to do
full arch.
Um, so, yeah, I mean there'sI've got more things going on
than I know what to do withright now.
Um and uh, it's, it's good.
Um, I work with a really goodteam that helps me on a lot of
that stuff.
Um, yeah, so I mean I'm excitedbut, like I said, like this

(36:40):
year is for me as more of a yearto kind of like try to relax a
little bit and cool and justkind of, you know, reassess
everything and uh, you know liketry to be home.
Um, so, yeah, and, and you know, not take really surgery, ce
take, yeah, take somethingdifferent, learn something new.

Speaker 1 (37:03):
That's awesome.

Speaker 2 (37:03):
Yeah, yeah.

Speaker 1 (37:04):
I mean there, I think there definitely is like
diminishing returns in terms ofthe, uh, the surgical courses
out there.
It's so important to takedifferent courses, learn
different approaches and things,but, um, you know, there's
definitely something to be saidfor going back to the basics,
the fundamentals that you'vebeen talking about, and there's
so much more to learn, um, inthat world.
Um, so, yeah, I definitely uhencourage people to take a

(37:24):
similar route go back to thebasics and then, you know, get
more complex from there.
Um, so, yeah, that's awesome,that's awesome.
So, uh, one question that uh,we always want to ask, and and
you know, I know that we'vealready covered a number of, uh,
controversial topics that mayruffle some feathers but, um,
what's your most controversialopinion in full arch dentistry?

Speaker 2 (37:54):
Man, that's a good question.
I don't even know, um, um, Idon't know if I have much of
like a controversial opinion.
Um, like, I see the sides toeverything, so much you know.
Like, like, I think that whatwe just spoke about, where it's
like I think there's too manypeople taking teeth, that they
don't be taken out, like that's.
I mean, that's one thing I canpreach about a lot, and it's
like my rule of thumb where Itell patients where it's like,
if my treatment is not going tolast you more than five years,

(38:15):
then we should look at adifferent treatment because,
like, if what I'm doing to yougranted, if the patient takes
care of it, what I'm doing foryou is not going to last you
five years, then we should lookat something different.
Yeah, fair and know, some, likesome of these massive full arch
groups have these crazy consentforms for patients that don't

(38:37):
need all their teeth taken outand patients are cause you can't
.
And I, I know, I know of adentist that has been sued for
doing full arch and someone thatdidn't need it and going to
lose that case.
I mean, consent forms are aspeed bump.
Man, lawyers don't care aboutconsent forms.
Um, you know I do, you knowsome controversial like.

(38:58):
I do think this whole like raceto the bottom thing is just
going to eat, it's just going toscrew everyone in the long run.
Um, you know, and that's kindof one of the things where it's
like, uh, you know, in the lastthree, four months, where I've
kind of like taken a step backand it's like okay, like you
know, what else can I do?
Because, man, when you'recharging such low fees for full

(39:20):
arts like it's just you got tokeep your doors open, like
you've got to pay staff like youknow, being a business like, I
think one of like the mostrewarding things about being a
business owner is is havingemployees like being able to
help other people provide forthemselves and their family is
is, I think, is a privilege.
Um, and I think people take thatfor granted, that you know,

(39:42):
employees are employees.
They deserve a fair wage.
They, you know, like, dude,being a dental assistant's hard,
I wouldn't, I couldn't do it.
It's a.
It's a brutal job like and.
And you know, like, dude, beinga dental assistant's hard like
I wouldn't, I couldn't do it.
It's a.
It's a brutal job like and andyou know, I don't think that
they're appreciated enough.
So like, yeah, the office has tomake money, like I have to make
money, but my staff have tomake money and to me that's

(40:06):
really important, um, yeah, solike that's the other reason I
kind of like am looking at otherthings and potentially, like
you know, I will never give upfull arch, but like opening my
my, my toolbox to other thingsto do more profitable things in
the office so that, like I canhave more employees, I can pay
my employees better, like I mean, like I would love to be the

(40:28):
you know, I would love to be thedentist.
You know, I would love to bethe dentist that pays their
employees more than anyone else.
You know, like, like that to meis like super rewarding, um,
and so, you know, find the bestpeople when you pay them.
So awesome.

Speaker 1 (40:44):
Yeah, no, that's solid.
And um, you know there'sthere's just a lot to be said
for for becoming that dentist,and you know that takes some
really good systems and somereally sound philosophies and
some long-term thinking as well.
Um, and I think you you'vedefinitely laid a framework to
to build that kind of uh, workenvironment around you and, and
you know, have some people thatare going to stick with you for
a long time.
Um, so that's awesome and uh,and yeah, drew, so I really

(41:07):
appreciate you coming on andtalking about your journey.
So far.
It's not been a very longjourney, neither is mine, but
you have done some reallyincredible things, I would argue
.
You've done more than most duewith your entire career and I'm
so excited to see what you endup doing with it.
I think you're leading the wayfor us DCG alumni, yeah, so I
really appreciate that.

Speaker 2 (41:28):
It's funny, I had a DCG alumni to sit me up the
other day.

Speaker 1 (41:32):
Oh yeah.

Speaker 2 (41:32):
Yeah, I don't know who it was, but yeah, man, I
love it.
Man, I think the future ofdentistry is bright.
I do too, so it's exciting,awesome.

Speaker 1 (41:44):
Well, again, man, thank you so much.
You brought a whole lot ofwisdom onto the pod today, and
we even got out of the world ofimplants and I got a little bit
cynical about it, which isfantastic, because I think we're
due for that, so I reallyappreciate it.
Thank you so much for coming on.
Of course, you'd be welcomeback anytime and, you know, if
anybody's interested in learningmore about Drew and everything
he's doing, what's yourInstagram handle?

Speaker 2 (42:12):
It's the underscore drew underscore phillips.
Okay, yeah, man, hit me up likeask me questions, recommend ce
courses for me because uh, I'mI'm still addicted to ce and,
with you know, people have gotgood courses to go to like I'd
love to to go, and you know, theother great thing about ce is
where you meet people.
Man, yeah, like, that to me islike, honestly, the best part is
like the connections you makewith people and uh, it's, that's

(42:33):
sometimes more fun than justlike I mean, dude, I went to aid
and I went to like two lectures, oh yeah, yeah yeah I mean,
there's there's usually somenuggets of information, for sure
.

Speaker 1 (42:44):
but, um, you know, we're we're both going to orca
here this weekend and, um, Icouldn't be more excited.
I mean, the lineup isincredible, one of the best
speaking lineups I've ever seen.
As far as you know, full archis concerned, they've done an
amazing job organizing that.
But you know, I just can't waitto see who's going to be there
and who's going to be a cocktailhour.
So it's going to be really fun.
Yeah, man Cool.
All right, man.

(43:05):
Well, I'll see you in a coupleof days.
Thank you so much.
I appreciate it.
See ya.