The Smile Now Dental Group: Transforming Full Arch Dentistry

Episode Transcript
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Tyler (00:01):
My name is Dr Tyler Tolbert and I'm Dr Soren Poppy,
and you're listening to the FixPodcast, your source for all
things implant dentistry.
Hello and welcome back to theFix Podcast.
Soren and I have on a veryspecial guest, as all of our
guests are special, but thisone's even more special than the
other ones.
This is Dr Caleb Stott.
Some of you may recognize him,or at least recognize his voice.

(00:24):
We have interviewed him in thepast.
This is the first time we'vehad him live and in charge
through a video feed.
He also has a beautiful purpleand that really matches his
inner radiance.
Soren today is featuring ashiner on his left eye he can
tell you about.
But altogether the three of ushave gotten together just to
talk to you about Dr CalebStott's journey into Full Arch

(00:44):
and all the wonderful thingshe's been able to do.
He has had a truly fast-trackedcareer, coming out of the
military, getting into placingimplants, then going straight
into Full Arch and what he'sbeen able to do in the past few
years, just from getting off theground to now solidifying what
I think is an incredible modelfor doing Full Arch in a private
office setting.
And then we'll kind of gothrough and catch everybody up

(01:06):
to what all of us are doing.
But, Caleb, welcome to the show.
I can't wait to talk to you.
Thanks.
Thank you, Tyler, Of course, ofcourse.
So for those of you who areuninitiated and don't know
Caleb's story, would you mindjust kind of going through?
You know your journey just as adentist, period up until you,
up until the past few years andeverything that's happened with
Smile Now.

Caleb (01:26):
Yeah, okay.
So I graduated from MidwesternUniversity in Arizona in 2015.
So it's been a little bit, andwhat I did to pay for school is
I joined the military.
I had a really good experiencein the military.
I know a lot of people kind ofhave mixed feelings about it and
they should, but overall I hadreally good duty stations.
I did an AGD in the military,which was very formative, and

(01:50):
then I was able to practice inclinics where I had a lot of
mentorship.
So the OICs that I had, likethe officers in charge were
periodontists or oral surgeonsor I got to work in hospitals
and so that, in addition to likemy one year of getting to feel,
like getting to know everythingwas really formative and

(02:10):
helping me love surgery, lovethe bloody field.
You know, every single soldierthat came in got his wisdom
teeth out and I did them.
I never, ever referred them andstuff like that.
So, yeah, so that that was kindof straight out of school what
I did, and I did it for sevenyears.
So the average person is goingto stay in the military for four
to five years or for a lifetime, and I stayed in seven years.

(02:32):
Part of that was COVID, part ofthat was duty station.
So I was stationed in Korea, inSeoul, korea, for two years and
that was awesome.
And then I was stationed inLandstuhl, germany, for two
years, which was also reallygreat.
And Landstuhl was really neatbecause it was a role three
hospital, meaning that any kindof medical emergencies from like

(02:55):
all of Europe, all of Africa orany soldiers that were deployed
, that was their fallback clinicand if it was dentally related,
then I got to be the doctor,the dentist that took care of
them.
So it was a fun deal.
So that brought me to 2022, Ithink In 2022, we decided to
separate from the military.

(03:16):
I have four children, my wife.
We loved some aspects of themilitary, but we did not like
some other aspects of themilitary and one of them was,
just like my kids, their friendswould come and go so quickly
Every three to four months.
They're making new friends.
They didn't really have a lotof stability.
We were pretty far away fromfamily.
So we decided to separate andso I separated straight into a

(03:37):
full arch practice that was inReno, nevada, which we loved.
Reno.
It was a really fun place to be, a lot of benefits.
I know it kind of gets a badrap, but it does not have a bad
rap in my book.
And then, after a year of doingthat, I decided to step away
from that, that situation, andstart my own full arch practice

(03:57):
and so we moved to Boise, idaho,and so I'm originally from I
claim Idaho, like I grew up inCoeur d'Alene.
I went to high school in Coeurd'Alene and that's Northern
Idaho and we loved it and it wasgood.
And my wife's family is fromSalt Lake.
Her mom lives in Salt Lake, sowe wanted to kind of have a
happy medium between thefamilies and being able to visit

(04:19):
and kind of do the things thatgot us out of the military.
So that's there we go, is thatgood?

Tyler (04:26):
No, no, that's great.
I like the synopsis.

Soren (04:30):
I think Caleb's being a little humble here when he went
to Reno.
I would like to say that hecrushed it in Reno, provided
care for a lot of patients thatneeded it in that market, did a
lot of excellent treatment andcollected a lot of money in his
office and then went on to Boiseand crushed it further and
beyond and is doing so well in amarket that maybe you wouldn't

(04:54):
expect would have been able tobring on another full arch
office and be doing some of thenumbers that he's currently
doing at that office.

Caleb (05:04):
So I know, Tyler and I go ahead.
Thank you, Soren.
Thank you very much.
Yeah, we're not done.

Tyler (05:10):
We're not done.
I want to piggyback on the backpadding here.
So I actually.
So I believe the year when wefirst started talking about it
would have been and I think Iwas one of the first people to
talk to you.
We have a mutual friend andthere was, I know that you had
some interest in doing someimplants and getting out of the
military and and we talked overthe phone.
I just remember, you know, Ithink you'd placed maybe eight
implants by that time I thinkit's what you told me in the

(05:31):
military and but you were justso passionate about surgery and
getting into full large and youjust had this fire in you and
that was the first time I evertalked to you and I remember,
like it was yesterday, and Imean you absolutely, you know,
were a diamond made from tons ofpressure and heat, because when
you went to Reno that was anexplosive, you know practice and
very soon it was doing three$400,000 a month and I remember

(05:53):
thinking to myself I was likeman, how does this guy who I
just spoke to had only placedeight implants, get up to speed
to doing that and dealing withall the craziness around
maintaining the surgery anddoing the restorative and
everything, and you, you caughton extremely quick and then you
started incorporating thingsthat I I at that time wasn't
even incorporating either.
You started taking soft tissuereally seriously and getting
into grafting and things likethat.

(06:14):
So hats off to you for, youknow, taking what was already a
challenging situation having afamily with, with four kids and
everything that was going on tobe able to step up to that
challenge and then decide tothen walk away from a successful
practice and say you know whatI want to do things better.
I have my own ideas about howthis should be done, and to go
and just pioneer that foryourself and recreate and even

(06:34):
have even better success underyour own name is really freaking
cool and it's been an awesomething as we've learned more
about it and I've seen yourskills progress.
We trained together.
The three of us have actuallybeen down to Brazil for the full
arch club bootcamp and and wedid some cases together and
things.
So we've all gotten bloodytogether and I think that formed
a really strong bond.
So but yeah, I say all that tosay you know, hats off to Caleb.

(06:56):
He's a very humble guy but whathe's been able to accomplish in
the past few years has beennothing short of remarkable, and
I'm really happy to have you onthe show and to work with you
as well Awesome.

Caleb (07:03):
I appreciate that.
So, yeah, and just to add tothat too, yeah, in the kind of
touching on some of the thingsyou said, like in the military,
you have to fight tooth and nailto get implant experience.
So I was running I was runningthe little gathering of people
to do implant placement andimplant restorations because
everybody had to have approvalin order to even have an implant

(07:24):
placed.
I restorations becauseeverybody had to have approval
in order to even have an implantplaced.
I think it was for good reasons.
A lot of implants that areplaced are not really restorable
.
A lot of people don't reallythink about the crown first,
they think about the implantfirst and then.
So in order to avoid that, Iheaded up this implant meeting
that we had once a month to makesure that anybody that was a
candidate was a good candidate,that it was going to be a good

(07:44):
case, that they had sufficientcare, especially with people
coming and going within themilitary environment.
So I did that and then so, yeah, eight implants was actually a
pretty big achievement in themilitary.
And, yeah, I was licking my lipsto try to do more.
To be surgical, I reallyheavily considered doing a perio
residency.
I really loved, like the care.

(08:04):
You know the perio, the gumgardener type mentality of just
like being meticulous and doingit right.
So a lot of my experiences ledme to want to do that.
So when I had an option to doan implant practice, I think I
was underprepared in some ways,but I was also very hungry for
it and I did so much CE.

(08:25):
You know like I watched ImplantNinja 100 times before anything
.
Yeah, you know what I'm talkingabout.
And then and then textbooks.
Like I turned to textbooks bigtime, so I try to read three or
four textbooks a year as part ofmy reading goals in general,
and every single time like thatI go through one is just a
little bit more that you canpick up.

(08:45):
And I do feel like the otherday.
You know, the other day I had apatient come in and I took off
her hybrids and this was done atClear Choice eight years ago
and there was a little bit ofbleeding when she came in
initially, and then one of thex-rays didn't look great for one
of the implants, so I thoughtit was going to be a pretty big
concern.
So taking it off her case wasactually in pretty good

(09:13):
situation, but it was a hugesaddle, yeah, ridge lap over her
tissues, completely convexeverywhere, or concave
everywhere, so anyway.
So it was just kind of like melooking at transition line issue
, though.
Yeah, there was no transitionand there wouldn't have been
either like this.
Didn't need the original, so umbut yeah, I was looking at it
and I was like, well, here,here's, you know, a highly

(09:33):
trained prosthodontist, highlytrained OMFS that would have
placed these implants and theylook really good and some of the
tissue didn't look as good asit should have, but it wasn't
causing issues with the implanteight years later and I was just
like you know, I think I thinkI'm doing okay, like the things
that I've been doing for a longtime, I think, because I've been
in the books, because I havegood colleagues, like you guys,
because I have good mentors,like some of the the CE that

(09:57):
we've gone to together, I thinkthat we kind of know more than
we used to know 10 years ago inthis field of doing these
specific cases and a lot of thatit's distilled upon me and it's
become part of my everyday andit's kind of the standard of
excellence that I hold myself to.
So, yeah, to add on what you'resaying, it's been a lot of work,
it's been really worth it andI've always felt up to it to get

(10:20):
stuff like this done.
Yeah, up to it to get stufflike this done.
So yeah.

Tyler (10:24):
So I'm curious, you know , when you first you know set
out to start your office atSmile Now in Eagle, idaho, what
were some of the things thatwent through your mind that you
know?
I know you had a lot of ideasabout innovations and how full
arch specific practice is done,how we can make this better for
the patient, continuity of care,things like that.
Like what were some of yourinnovations when you decided to

(10:44):
do this on your own?

Caleb (10:45):
Yeah, I mean, I don't know if I'd call them
innovations, but what I waslooking at was who is providing
the highest standard of care,right?
So highest standard of caremeans that you're going to stay
with a patient super long-term,you're going to be able to
follow them not just for sixmonths or one year, but you need
to have three, four, five yearsin order to know that you're

(11:07):
really taking care of them inthe appropriate manner.
So I wanted continuity of careby having a stable environment,
and so that was one one thingthat I was really looking for.
But then there was a lot ofother stuff.
Photogrammetry right, liketoday, I use my, my micron
mapper.
I used it seven times today,right.
So, here I am at a previoussituation trying to figure out

(11:29):
hey, how can I go digital?
And I had purchased all my ownequipment to kind of do it.
It was like a Medit i700.
And then I bought OptiSplints.
I don't even know if I shouldbe using these names, right.

Tyler (11:39):
And I was like, okay, I'm going to use an.

Caleb (11:40):
OptiSplint and I'm going to reuse it by knocking off the
composite and afterwards, andI'm going to be able to like
deliver better care.
But that that was not a realityat all and it was just really
frustrating, kind of beingshackled right by wanting to
provide the top most care, whichI believe is digital, and not

(12:01):
being able to do that.
So that was a huge motivatorfor me and, like I bit the
bullet right from the get go.
I figured out the whole digitalgame all you know by watching
YouTube videos and talking withpeople and I use JB lab.
I went down and visited JB.
I took yeah, awesome.
Like you, you don't reallythink that JB, like where he's

(12:23):
working, is going to be twowarehouses of people designing
and milling and doing like a100% everything lab.

Tyler (12:33):
I did a walkthrough there and it was like walking
through like an Amazon warehouse.
It was insane Right?

Caleb (12:38):
So you don't really expect that, but when I went
there it was like it just left areally big impression on me
that know, this.
This is the type of stuff that Iwant to be a part of and this
is the degree of care that Iwant to offer my patients.
So so that was part of it.
I went to SIN, you know, toBlake's ExoCAD course and that

(12:59):
was really eyeopening.
So I know enough enough ExoCADto know that I don't have enough
time in the day to do exocad.
I know that, however, like whenI'm, when I'm watching and
seeing what they're doing, likeI have a clear understanding of
why they're doing it and thathelps me be a better clinician.
You know, angle my MUAs in theright way, make sure that I'm
using the right screws, makesure that I'm not just pumping

(13:22):
out something that I was told,but that I actually have control
over the products that I'mgiving to my patients.
So I mean there, yeah, there'sjust so much that goes into
every single patient and theydeserve the best.
And especially, I feel verystrongly that the cost of
treatment to do this isprohibitive for a lot of people
that need it.

(13:43):
I wish that everybody couldafford this.
They obviously can't.
And but I want to do this isprohibitive for a lot of people
that need it.
I wish that everybody couldafford this.

Soren (13:45):
They obviously can't, and but I want to do my best at
taking care of them when theycan and giving them the best,
the best situation long-term,nothing short-term, so yeah,
absolutely, and I, you know, Ikind of want to go into this a
little bit too, because you knowthere's a lot of things that,
on my journey to FullArch, Iresonate a lot with as far as

(14:08):
similar things that you did.
As far as digital, when I firstgot into FullArch, I was kind
of told that analog is a greatway to start, and my opinion has
definitely changedsignificantly since doing a lot
of analog workflows.
You know, when I first got intofull arch, I was like, okay,
from what I was told, it's goodto get started.

(14:30):
With analog.
You learn a lot.
You know this is a couple waysto maybe fast track the patient
experience when doing analogbased approaches.
You know, maybe skipping a Vjig and using the, the
prosthetic that you picked upduring the surgery you know
there's different, there's.
And using the, the prostheticthat you picked up during the
surgery.
You know there's different,there's different things that
you can do right.
However, I quickly saw a lot ofcases that were being done

(14:52):
analog in this, in this style,and saw a lot of prosthetics
that weren't seated correctly,right and different prosthetic
issues that arose when kind oftaking this analog approach and
not to not to say anything wrongwith analog.
I do think that there's a lotof wonderful opportunities to

(15:12):
learn full arch workflow usinganalog.
You know it's a lot of dentiststhat are getting into full arch.
They maybe didn't have.
There's been a really long timesince they've done a lot of
just the basic dentureprosthetic workflows.
So in that aspect of things, Ithink it's really important to
hammer that down, to understandwhere the teeth should be, how

(15:35):
to set teeth properly, how tomanage the prosthetic side of
things just with cosmetic andyour patient's facial dimensions
.
And it's not just, you know,there's a lot that goes into
just the record-taking of thesepatients and I think that analog
is great for that.
However, I don't think at allthat analog is wonderful for

(15:58):
skipping steps along the way.
If you're going to do analogworkflows, I think it's
important to do V-jigs.
It's important to take all theproper steps.
Yes, it means that yourpatients are going to have more
appointments.
Yes, it means that it's goingto take longer in your clinic to
do so.
However, when you come backCaleb's talking about seeing

(16:18):
patients in five years you'regoing to feel a lot better about
the work that you did fiveyears ago if you're taking these
steps properly and where Ifound that, incorporating
digital and you know, at atsmile now dental group, and
we'll go into.
We'll talk a little bit moreabout smile now dental group and
you know it.
I don't love that the first timethat we're really like getting
deep into to smile.

(16:38):
Now I've got this.
You know this black eye goingon and everything.
However, I want to want to say,though, that you know, when we
form smile now, we wanted thebest outcome for our patients
and the best outcome for ourdoctors, so in order to do that,
you know, our doctors need tobe pretty well versed in full
arch and and know these steps,the prosthetic workflows, and

(17:02):
when they come on to to ourgroup, we are giving them full
digital protocols for everyone,and I think that is amazing for
one.
You know, in five years, weknow that, because of
photogrammetry, stuff is goingto be seating properly right
when we're fabricating ourprosthetics.
There's no real it.
You really have to to mess upup to create prosthetics that

(17:24):
are super concave, right.
I feel like digital does do awonderful job with some of these
basic prosthetic principles andensuring that patients we're
setting our patients up for thebest possible way to succeed in
the future.
We're making things cleansable.
We're eliminating a lot ofthese appointments like
verification jigs, bite rim,tooth setup.

(17:48):
I see a lot of clinics that aredoing analog approach.
They're skipping the V-jig,they're skipping the wax rim.
They're going right from aprosthetic that they picked up
in surgery to a tooth try-in, toa final, and it's very easy to
mess up.
There's so many things that cango wrong along the way and if,

(18:09):
in the end, you end up with azirconia that has an area that
doesn't seat well, that's on theclinician that provided that
care.
And you know, I think it'sreally important for those
clinicians that are doing thingsin this style that they need to
hold themselves accountable formaking sure that their patients
get the care that thosepatients deserve.
And I think by incorporatingsome of these digital workflows,

(18:31):
after you have a good basicunderstanding of full arch, you
really can give that care to thepatient.
It makes your life easierbecause you don't need to, you
know, have a full dental lab inyour office.
You can do things digitally,you can do things with less
appointments, and you can dothat with still providing

(18:53):
optimal and even better care tothose patients because they're
getting a really nice prosthetic.
So that was just kind ofbouncing off of Caleb's journey
into digital and I resonate alot with it because I feel like
there are a lot of dentists thatwant to journey into digital.
And I resonate a lot with itbecause I feel like there are a
lot of dentists that want to getinto digital.
They're scared about thatinitial fee to getting into it.
However, my argument would bethat I think it's well worth

(19:17):
that fee and it's getting moreand more reasonable.
Right, these companies arelearning quick.
That it is kind of the steps tothe future.
And there's more competitorscoming out, there's more people
that are offering, you know,photogrammetry and designs and
stuff.
So things are getting morereasonable.
So, you know, now's the time toreally, you know, take that leap
if you haven't yet.

(19:37):
And it's going to be a verychallenging.
It's, you know, I would say,like my progression through full
arch.
The first thing was learningthe surgery right, once you get
the surgery down, wonderful.
But the next really hard thingthat I had in my clinic was
learning digital.
And I know I remember some oldpodcasts with tyler me talking

(19:58):
about be careful going intodigital because you are going to
be pulling your hair out.
And it's true, there is so muchthat can go wrong with the
digital workflows Somethingdoesn't print right or you can't
get a photogrammetry scan, oryou're having a really tough
time scanning in a bloody field.
There's so much that can happen.
However, once you arecomfortable with it, I think

(20:20):
it's so much better than theother side of things.
So there is a learning curve,there's a mountain to go up, but
once you're on the top, I dothink it's steady, steady going
and it makes your life, yourstaff's life, your patient's
life so much easier and I wouldurge you to take that leap if
you have the ability to.
That was my little rant aboutdigital, but I do want to talk

(20:41):
about too, caleb, something thatI feel like maybe you forget or
you don't really think abouttoo much, but you know people,
people that are watching youdefinitely see, and that's I'd
love to just talk about yourprogression through.
You know kind of full arch andthe things you've learned from.
You know just learning full archto incorporating PRF into your

(21:03):
surgeries, to to learning thedigital protocols, to going to
Portugal learning palatableapproach and pterygoids and what
that gave to your patients, togoing to Brazil to perfect these
techniques.
You've probably taken more CEthan most clinicians that are in
your shoes and I think it'sreally important to let the

(21:23):
audience know kind of your path,because it isn't.
There's a lot of listeners thatthink that they can come out of
dental school and start apractice that's doing $400,000 a
month, $500,000 a month, whenin reality there's a lot that is
behind the curtain that you'vedone, and I think that it would
be great for the audience tohear what CE you've taken, what

(21:50):
you're doing for your patientsto kind of make sure that your
prosthetic and surgical outcomesare optimal.
I know that, seeing that it'sreally easy, or seeing it from
our point of view, it'sinspirational to see kind of
everything that you've done andTyler and I have learned a ton
from that.
But the audience doesn't knowthese things.

Caleb (22:07):
Oh yeah, okay, perfect.
You know, the best part of thisis I was always told that, like
, in wherever you are, you kindof want to find another
racehorse so that you could, youcan have, you can have your
peripheral set on somebody else.
That's like moving as fast asyou can as motivation to move to
where you want to become right,and I've always seen both of

(22:27):
you as my peripheral racehorses,right, okay, so when we talk
about you know we both worked ina similar environment and you
guys were right out of schooland it's always it's I also sit
here and think, wow, like theseguys have been able to
accomplish in two years what Ithink it takes most clinicians
15 years to figure out, likewhere they want to be in their

(22:49):
career, right.
So hats off to you, and I thinkwe both shared in that
experience.
So when, when I think about allthe CECA, ce just became such
an important part of my lifeimmediately, like when I started
getting into full arch, and Ithink part of it was I had to
catch up, and then part of it,too was I needed to assure
myself that I was doing what wasbest for the patients, right?

(23:12):
So I've taken about a thousandhours of CE, probably in the
past 18 months.
I finished the maxi course,which is like 300 hours.
I finished the CaliforniaInstitute, which is 300 hours.
I have, in addition to that,read six or seven textbooks and
I am continually trying to dothe best that I can, as far as

(23:34):
like always educating myselfabout all things implants.
You know, my ultimate goal isaccreditation.
So to get the diplomat of theAmerican Board of Oral
Implantology, because I feellike that is what I need to do,
to kind of justify all the moneythat I'm spending on CE, to
justify how much time and energyand effort that I put into to

(23:56):
what I'm doing, right.
So, talking about specificcourses, right, I think the two
most foundational things that Ihave in my, in my repertoire is
would be Matthew, what's Matt'sname?
Matt Crager, as efficient as Ithink I could ever get Right.

(24:26):
So we I know that you did yourpodcast on efficiency, but the
really fun thing about what youwere talking about was like you
and I were in a race to see whocould finish a double the
fastest and it wasn't like wewere trying to get reckless with
it.
But I know that you like postedthese times right when
timestamps, and it would be likeyou did it in two hours and
then you did it in an hour 40minutes.
But what nobody knows is that Iwas also racing you at the same

(24:47):
time and then all of a suddenI'm like, oh, I got down to one
37 or I, and I think you endedup at one 20 and I've been at
like one 30 before Right andnowadays, like my case today.
So, like my, my case today tookme three hours and I felt like
it was so long and it was adouble and it was tricky, you
know, like I had to remove acouple implants.

(25:08):
I had to get the prosthesis out.
The lower was just a reallyskinny, skinny mandible and when
I was like torquing down thebuckle plate kind of out
fractured.
So I had to find a new site andI had a graft and I had to use
collagen membranes and justeverything Right.
So it was kind of like a fullservice, full arch, which I'm
not used to.
Typically it's very simple andit's just kind of like the

(25:31):
process is second nature at thispoint.
But today's was pretty trickyand you know I paid my
anesthesia bill and I was likeman, it's like $2,000 this time,
that is.
That's way more than.

Tyler (25:41):
I usually pay and anyway , I don't know why I'm bringing
that up, but it's the subject ofcontinual improvement, right?
I?
mean you're trying to learn moreskills, trying to get more
efficient with those skills,while also incorporating all
these new things.
And while you do try to keepthings simple and repetitive and
rote, while maintaining thatquality, you give a case of what
it deserves.
And sometimes you have to pullout of your bag of tricks and it

(26:03):
sounds like you've accumulatedquite a few things to pull out
whenever the case.
Yeah, for sure you know today.

Caleb (26:09):
Okay, so today I did that case.
In the meantime, I have apatient show up that I haven't
seen for six months and she wasin her provisionals and one of
her implants has failed andtotally granulated it right.
What did I do?
I took out one and I placed twoto replace it.
One of them's a pterygoid right, so the pterygoid pterygoids
are second nature at this point.

(26:30):
You know, I.
I don't always go for thembecause it's not always
indicated, but for the most partI want to get six implants in.
That's kind of a philosophythat I have is, I want to
over-engineer for tomorrowinstead of under-engineer.
Just because of today, right so, but but today I was able to
rescue that because I'm digital.

(26:52):
I was able to scan, get adesign done, deliver her a new
set of teeth At the same time Ishe actually I got her numb and
I went and did my double andthen I came back and I finished
her case.
Right so, but she had to wait alittle bit longer because, you
know, the total case time waslike three hours.
But I came out some of the,some of the stuff that was going

(27:12):
on in.
My assistants do like thedigital, uh, photogrammetry and
putting it on the way.
Yeah, and scanning.
And you know, on this one wehad to take it alginate because
we weren't getting a good scan.
So I use a prime scan and itusually does pretty good but
like, sometimes in a bloodyfield it doesn't.
It's just up to them to get it.

(27:33):
At this point my assistants andand we even there was a mistake
, like I sent it to jb and theysaid, hey, one, one of your
markers is off from the micronto the tissue scan and we don't
know which one it is.
So so we were like, were like,okay, well, I'm just going to re
micron that one.
So that added like another youknow 10 minutes to the case and
stuff.
But but the point is like todaywas a really hectic day for me

(27:54):
and it was the accumulation ofeverything that I've done up to
this point.

Tyler (27:57):
Yeah, it could have been a lot worse.
Actually, it could have been adisastrous day and you would
have rescheduled the podcast.

Caleb (28:04):
Oh, like, imagine, imagine it being analog right,
and then you're sitting patient.
That's what.

Tyler (28:08):
That's what I was thinking about when you brought
that, brought up the pterygoidthing.
I'm like, yeah, that's, that'sliterally.
I used to lay awake at nightthinking, man, if my, if my
distal implant fails, I'mworking out to make a whole new
prosthetic and do this and that.
Yeah, totally so.

Caleb (28:20):
So anyway, but yeah, going back to CE, like I said,
I've done the big continuums andI loved them.
I thought they were great.
I also did Bernardo's courses,like both of them, and Bernardo
is a foundational education forme, right, the more I learn, the
more I realize that the fullarch club Bernardo specifically

(28:42):
just really knows what he'stalking about.
Arch club bernardo specificallyjust really knows what he's
talking about and his, hiswisdom that he brings to the
group that he runs afterwardsand to the access that you have
to specialists all around theworld, which I think is
phenomenal, because sometimes wegot to get outside the united
states to kind of see what otherpeople are doing.
I just think it's invaluable.

(29:02):
And so I would say my mostfoundational stuff has been, you
know, the maxi course wasreally good, but also, like
textbooks, textbook I wouldrather learn from a textbook
today than go to a course.
For the most part it's morecomplete, you, you get better
explanations of stuff andthere's a lot of CE out there.
That just isn't great, you know.
And and CE is like a wholenother industry in and of itself

(29:24):
so it's easy to getsponsorships.

Tyler (29:26):
There's marketing yeah, hard to tell the difference.

Caleb (29:28):
Yeah, totally yeah, so anyway.
So, yeah, those are all thethings that, like I, I'm pretty
consistently involved in, andthe ones that have been most
pivotal for me have been, likebernardo's course, matt crager's
uh blog, which is phenomenalfor efficiency tips and what to
do, and free, oh.
And I would always find myselfreading his blog too and being
like, yeah, I had figured thisout on my own and I'm so glad

(29:52):
I'm seeing this in writing fromsomebody else.
It's like a meme moment, youknow.

Soren (29:56):
So yeah, I agree, and what's crazy about Matt's stuff
is he's got so much in there andhe just provides it for for
free.
So you know, if you're if you Iwouldn't I would say that a lot
of learning that I've donethroughout full arch, it is very
important.
It's like it's like stepstones,almost right.

(30:16):
Like you don't, you won'tunderstand a lot of stuff in
that blog post until you get toa certain level and and then you
know it just.
I like I remember I was doing alot of analog stuff and I
decided to take a digital courseand I went to this digital
course.
I spent a good amount of moneyon it and I took zero away from
it because I just wasn'timplementing that in my office.

(30:39):
And I would say one criticalthing when you're looking at CE
we talked about a lot about CEon this podcast quite a bit I
would recommend getting yourhands wet in some of this stuff
yourself before jumping into abig CE course around it Now and
I wouldn't necessarily say thatmakes sense for like pterygoid

(30:59):
implants or you know surgicalapproaches, because those are
things that you want to learnand then incorporate.
But at least, like digitalstuff, you know surgical
approaches because those arethings that you want to learn
and then incorporate.
But at least like digital stuff, you know, try to get.
Try to get a good base, a goodfoundation, even even if you
want to buy like a micron mapperand mess around with it a
little bit and and then go to acourse and you will take away so
much more.

(31:19):
And that's really what I foundwith with Matt's stuff.
I mean, since it's free, Iwould recommend everybody just
go read it.
But if you're listening to thisand you've done 10 arches, maybe
15, do another 40, read throughit again and I guarantee that
you will pick up so much moreand be like wow, there's a big

(31:44):
difference from getting.
It's pretty easy to get from afive hour double to a three hour
double just by implementing,you know, just by getting faster
and getting consistent withwith how prosthetics work right.
You know, sticking your multion.
I remember, like my firstcouple of cases, I was sitting
there just like trying to getthe multi on for trying to get
it in the hex for a while andthen all of a sudden, you know,

(32:06):
you just know, exactly like you.
It's just like second natureanymore.
You put it in grab the driver,you know exactly where it needs
to go, right.
But then you know the secondarch.
You're like the second arch youever do.
You're like, oh my God, like it, like you.
Just it's all new feelings,right.
But then getting from thatthree hours to the two hours,
that's tough, right.
Or two hours to an hour and ahalf, that's super tough.

(32:33):
And that's where a lot of theseefficiency tips really come into
play.
And when Caleb's talking aboutus racing to get the fastest
double, I do want to put adisclaimer out there that I post
and I know Caleb posts to allof the cases that we do there.
That that I post and I knowCaleb posts to all of the cases
that we do in our like hour anda half double looks 10 times
better than a lot of these casesthat I see that you know are
five hour doubles.
I won't ever do a case that ortake shortcuts during surgery

(33:00):
for speed, ever Like I.
Again, all my cases are posted.
You'll see almost every singleone looks the exact same.
However, it is a somethingthat's doable if you're, if
you're efficient enough, and itreally depends on the case too.
Right, the teeth come out easy.
Alveoloplast is easy, implantplacement's easy, like it can go
very quickly.

(33:21):
However, you know, I totallyagree with you in the fact that
for me now, when I do a doubleor a single, that takes me
longer than one hour per arch, Ifeel like I am dragging, I'm
getting frustrated.
I'm like man, this is takingforever.
And I have a lot of dentiststhat come into my office and

(33:43):
watch me do surgery and Iremember I had one last week and
I was like apologizing to him.
I'm like sorry, man, this istaking a lot longer than normal.
Like I hope you're stillgetting some, some tips out of
this.
And he's like, dude, this islike I've never seen something
like so efficient before.
So it's pretty cool when youget to that point, because it
really shows you how far you'vecome and how far your team has

(34:05):
come.
I always talk about this likethe probably the biggest
efficiency stuff.
I know that we're kind of like Ifeel like we're jumping all
over the place with this podcast, like going from ce to
efficiencies or whatever, but Istill think it's all important.
But the biggest efficienciesthat I found is properly
training your team, like yourteam should know exactly what to

(34:25):
hand you, when to hand you it,what the next steps are.
If you're like for me, when I'mplacing my multi-units, my
assistant's getting theMicromappers all ready and set
up for me, because then she canjust hand them to me.
When I'm putting myMicromappers on, she's setting
up the computer next to megetting everything loaded ready
to go, so she can just hand themto me.
When I'm putting my micromappers on, she's setting up the

(34:46):
computer next to me, gettingeverything loaded ready to go,
so I can.
She can just hand it to me anduse it.
And I would really, if you'relooking for efficiency tips, I
would really urge you to do some.
Just do some like walkthroughsurgeries with your assistants
and make sure that theyunderstand all the steps.
You know a patient doesn't needto be there to do that stuff to
get faster.
You can just practice andyou'll get much better with your

(35:08):
team and more comfortable insurgery.
And what I find is when you'reable to do a surgery efficiently
, when you have one, you know,you don't get as many of these
like weird complications, likesuper bad bleeds, and I mean I
get bleed, I get bleeds,everybody gets bleeds but you're
able to just manage them betterand I feel like when the

(35:31):
patient comes back a week laterthey don't look as bad as they
did when the surgery took fivehours, you know, and they were
flapped open for hours on end,and I think that when
complications occur, you can youhave that much more time to be
like okay, how are we going tomanage this?
Let's manage this properly, andI feel like cases knock on wood

(35:52):
right, Just go a little bitsmoother.

Caleb (35:55):
When you kind of get to that level, yeah, I totally
agree with everything you'retalking about.
A couple things I do, just likenuggets, I guess, is on Fridays
we don't usually see patients,but still, like once or twice a
month we'll come in and we'll dotrainings with, just with the
staff, right, and that's like aget to know the process type
situation.
So it could be inter-rollscanning, because we all know

(36:17):
that like there is a way to scanand get efficient at inter-roll
scans, right.
Another thing could be like themicro mapper just set it up and
you can just lay them.
You know photogrammetry, screwit in.
What should it feel like?
Just scan it, how does theequipment work, stuff like that.
So I always remember I don'tknow who said it, but like they

(36:38):
said that if you're moving 100miles an hour in a car, you
can't do maintenance, and thatalways stuck with me that
sometimes you got to park thecar and open up the hood and see
what's going on to do it.
And one thing I've reallyappreciated about our new
relationship is I've been doingmy own stuff for about a year
and bringing you guys in.

(36:59):
It's so much easier to beefficient and it's easier to
like even improve so much on somany things that I wasn't doing
before.
So this is to me like theability to park a car, because I
didn't have time to park my carlike on a big, a big business
level type stuff, for such along time because I was just
moving, moving, moving.

(37:19):
But now I've been able to parkthe car, take some time, look at
stuff with other mechanics thatare looking at things with me,
and be able to figure out what'sbest, what's most efficient,
what's going to save us money,what's going to make us money,
and that's been a huge benefitin a short amount of time.

Tyler (37:37):
So I'd like to take a little bit of a departure from
some of the clinical obstaclesyou faced the team training and
everything and let's also justtalk just about.
You know how the business wentin the first few months, so I'm
really curious about that.
So when you cut the marketingon, the lights on, you're ready
to see patients.
How did those first few weeksgo?
How did those first few monthsgo?
How did that evolve?

Caleb (37:57):
Yeah, yeah, right.
So the very so.
It was a little bit nervewracking what we had and not
really knowing what the futurewas going to look like.
But I also like within my heart, I kind of figured, hey, if I
only make 50% of what I made or75% of what I made, but I'm my
own boss and I get to controlthings and I don't have to be

(38:17):
beholden to you know, asituation that I wasn't 100%
happy with, then it would beworth it.
So that was kind of my mindsetgoing in and I think that that
was a really good mindset.
However, I did a lot of reallygood things in in Reno.
I had a really good team therethat like really supported me
and helped me and I'm likeforever grateful for that.
In addition to that, I've hadmonths in Boise that I never had

(38:44):
in Reno, like financially right.
So the cases you know, my bestmonth I've had here is 25 arches
, a lot of collections, a lotyou know, and this is Boise.
Boise is way more competitivethan Reno was.
Boise, I think, is actuallymore competitive than a lot of
places.
And I there's four or five fullarch clinics here.

(39:05):
You know people that teach.
There's a couple of them thatlike teach the surgeons are well
versed in it.
This is not what I would say isan easy area and not
necessarily one that I wouldhave chosen for business
purposes.
However, it's been really good.
So what did the first couple ofmonths look like?
I thought I was going to openup in June.
I opened up in October.

(39:25):
I originally had kind of likepromised myself to another
practice and I ended up totallyreneging on that and opening up
and doing construction on abuilding that was it's 4,500
square feet and it has 10 ops,so it's I went huge and looking
back, sometimes I feel like, oh,I'm pretty fortunate that it
worked out pretty well for me,cause it's like, looking back,

(39:46):
it was a lot to bite off Right.
However, first month I think weI did 10 arches that month and
it was like, oh, you want to dothis tomorrow, that's no problem
, we can do it Right.
So somebody coming at fouro'clock and because we're
digital, I could take recordsright then and they could be in
surgery at seven o'clock in themorning the next day.
So so we did that.
And then I had moments ofreally, really big growth for

(40:09):
the first three to four monthsand like, really, by month three
, it was like I was not thinkingabout was this the right
decision at all.
I was more thinking like, wow,I'm really busy and you really
start as like a skeleton team atfirst.
Even now, I have threeassistants and I have one office

(40:31):
manager right, so these arereally small teams.
It's not.
It's not big.
In some days it's a lot of work, but, like by month three, I
was definitely more worriedabout overworking staff and
burnout for them than I wasabout more worried about
overworking staff and burnoutfor them than I was about.
Hey, is this going to work?

(40:52):
Am I going to make money?
You know, am I going to bearound to see people in a couple
of years?
So does that kind of answeryour question?

Tyler (40:58):
No, no, it totally does.
And I'm curious too what wouldyou kind of attribute you know
you've moved from, you know, amuch more favorable market in
terms of saturation and whenit's a lot more competitive?
You know, what would youattribute that marginal success
to, given that there were morechallenges to come along with
that?

Caleb (41:12):
Yeah, I think, I think there's still some forms of
marketing that, like, reallybenefited this area.
And then, you know, I like Ihad the ability to spend, to
know how much I was spending onmarketing, I had the ability to
adjust that as much as I wanted.
Yeah, yeah, and, and I neverhad any of that there.
It was just like you can getwhat you get, you don't throw a

(41:33):
fit you know, and I never didhave to throw a fit and just
wring the towel for all, yeah,so and you know, like my, my
office manager in Reno, she wasreally good at patient
interactions, like phenomenal,like eight out of 10 type of
like, probably more than that,like a nine out of 10, you know,

(41:57):
and so that that was reallyimpressive.
But I was able to take away andknow what I wanted in an office
manager.
I'm actually on my secondoffice manager here, but that's
because I kind of realized thatthe first one she was more like
a five out of 10.
And the things that I felt weremost important and at first I
kind of thought that I couldtrain her and bring her up to
like maybe a seven or eight outof 10, but I really realized
that that's never going tohappen.
And so just finding the rightpeople that have the right

(42:21):
aptitude for what you're you'relooking for, that's just vital,
it's super important and you'renever going to take somebody
that's a four and make them aseven or an eight.
That's just never going tohappen.
And as far as what we do, too,like I would say that us as
providers, our tenacity, ourdrive, wanting to get stuff done
, patient interactions,communicating in general, like

(42:43):
all those things, I think we'reall very high in our natural
aptitude with those things andthose all benefit us immensely.
And so, if I okay, so let's goback.
This is kind of advice.
What can we give to somebodythat's thinking about doing full
arch?
And they're new, maybe they'reeven in school and they want to
plan ahead, or they're prettyfresh, or maybe they want to

(43:04):
change in their careertrajectory, which is really hard
to do.
Right, I would say, be verycomfortably surgically, you know
.
Take out wisdom teeth flip, dolike aesthetic crown lengthening
, just see blood, getcomfortable with blood, be
comfortable with periosteum, becomfortable like with
extractions, things like that,things like that, that where

(43:28):
otherwise you, you know, if youcan't be comfortable there,
you're never going to getcomfortable when, when you're
doing a huge alveolectomy andand stuff like that, right, but
the second thing I would say is,like treatment planning.
That's a huge thing.
Often I see dentists that likefumble over their words, don't
have a lot of confidence in howthey talk to patients about what
they're seeing, don't reallycan't really put it together
super quick as far as like howto recommend stuff and why.

(43:50):
And then communication skillsis huge too.
I sold door-to-door for areally long time.
I never could stay.
I did.
I could never stand working forsomebody else like never, right
, and I just don't work well forother people.
And I used to do door-to-door.
I did it for seven years and Ithink, sitting on doors getting
rejections, I did a Mormonmission.

(44:11):
You know a lot, of, a lot ofstuff going on there.
All these things just kind ofmade me more comfortable being
in uncomfortable situations,talking to people, communicating
with them, you know, like doingcheckdowns and repeating back
to them what they're saying,making them feel heard, making
them feel seen, and I think,like those, that natural

(44:33):
aptitude is a huge thing.
So if you don't have thosethings like those are the keys
to being ultra successful, rightand so, yeah, yeah, I like that
, I think.

Tyler (44:45):
I think soft skills are incredibly important and there's
nothing soft about them.
They're actually very difficult, but no, especially when you're
in an industry that's notinsurance driven, right, people
aren't coming to you becausethey looked you up on Delta's
website and now they're coming.
You're taking people who havesort of abdicated themselves
from dentistry, who have givenup on that.

(45:06):
Now they're looking for asecond chance, and in your
market in particular, there's alot of options that they have
from dentistry who have given upon that.
Now they're looking for asecond chance, and in your
market in particular, there's alot of options that they have,
and so they're having to reallychoose you.
They're not choosing youbecause of their own
circumstances.
They're choosing you becausethey trust you and there's that
aptitude and that competencethere, and if you can't prove
that, then, yeah, you'll bebelly up before long in this
type of model, and I think it'simportant too that I think the
trap that comes along with youknow, people might be kind of

(45:29):
computing things as they'relistening to this right now,
right, okay, so you know, caleb,he opens up this office in this
competitive market.
He's doing these $40,000 cases,or what have you?
You know he's.
He's doing 10 arches this firstmonth.
He's doing 25 arches a monthbefore long.
He's, you know, clearly doingsuper well, you know, and he's
only got a few people on theteam, so the overhead must be
great and it's you know what.

(45:50):
What might be going on insomeone's head is like this is a
really easy thing to do, youknow you just you just hang a
shingle and like you can doreally well, just so long as you
can get the clinical part down.
And I don't think that'snecessarily true.
I mean, this is that it can bevery up and down.
It's very month to month.
I call a year a marathon ofsprints, because it's exactly

(46:10):
what it is.
No matter how good the lastmonth was, this is a whole new
month and you want to make sureyou kill it.
And trying to create that sortof constancy of success is a
very difficult thing to do inthese models and you know,
continual improvement isextremely necessary because
there's always other peopletrying to implement it
themselves.
And for you to have shown youknow I think you're coming up
pretty close on a on a year nowand to have shown that that

(46:31):
continued success to be at athree plus million dollar office
before it's even completed itsfirst year.
It says a lot and I think a lotof people might fall into a
trap of thinking that you know,just because they can do surgery
, that they can just go and dothis and this model is just a
cheat code for dentistry, andmaybe at one time that were true
.
But I don't believe that at alland you want to make sure that,
however you're doing it and youknow if you're doing it on your
own, you want to make sureyou're super well equipped to

(46:53):
handle all the aspects of that.
But then if you're looking topartner with a group or somebody
like that, you got to make surethey have their ducks in a row
and they.
I appreciate that.

Soren (47:00):
I would definitely piggyback off that and I get a
lot of doctors that listen tothis podcast, listen to our last
podcast, and they're like hey,you know I want to start my own.

(47:21):
You know I've been looking intothis, this and this, and, man,
if I went back two years and Ihad limited full arch experience
, you know I would say that it'sit's nearly impossible to go
from a GP level to a really wellfunctioning full arch clinic
like that without taking someserious stepping stones along

(47:42):
the way.
There is so much that goes onbehind the scenes that people
don't understand.
Marketing is not easy, you know.
Maybe it was like five yearsago.
It's not easy, man, it's reallydifficult, and that's something
that I've at Smile and IdentityGroup, I've taken on fully and
I work super hard to.
You're constantly pullinglevers left and right, trying to

(48:04):
implement different systems,implement different strategies
to ensure that when patientslook up all on four, that you're
the first one that pops up,that when someone reaches out to
your clinic, that the staff isready to go and can sell
treatment to that patient andeach call that you get.

(48:25):
You might only get a handful ofcalls a week and you better be
ready to go to sell that patientand each call that you get.
You know you might only get ahandful of calls a week and you
better be ready to go to sellthat treatment and if not, you
know you can.
I mean, don't get me wrong alot of these clinics, like in
order, the the breakeven pointof them is 100k, 80 to $100,000
to even to even profit thatmonth and there's a huge

(48:46):
difference from.
You know, I see a ton of theseclinics and a ton of
organizations that are trying tostart these clinics up Like
they're.
They're popping up all over.
You know affordables doing them.
I heard that Heartland'sgetting into it.
You know there's so many thatare coming up all over the place
and they don't realize how muchmoney.
Like there are groups out therethat are spending 100k plus a

(49:09):
month just on marketing and youhave to do that if you want to
be successful in this area.
And I think that you know whatI really appreciate and we, and
I think that you know I want toget.
I want to talk about one thingbefore we get into it, but I
want to talk about what we'retrying to build with Smile Now
so that doctors can that arelooking for you know they have

(49:32):
these skill sets right.
They, like Caleb talked about,they're comfortable with blood.
They can take out wisdom teeth,they can take out teeth, they
can place implants.
They're looking for the nextstep.
Maybe they're kind of sick ofgeneral dentistry.
We were creating an environmentfor them where they can still
feel like an owner in a businesslike this, not feel like they
are an owner in a business likethis, and still be able to do

(49:56):
arches at the level you know, ata really good full arch clinic
level.
So we'll go into that a littlebit.
One thing I wanted to quick tojust mention Caleb was talking
about soft skills for full archdentistry and man, it is.
It is super critical and Iremember, prior to even like
getting into full arch and stufflike that, I my goal was to be

(50:19):
a really good dental businessowner and I didn't.
I didn't do that.
I didn't take those steps by bylistening to dental podcasts or
by, you know, trying to make mycrowns faster.
I did that by reading so manybusiness books and I actually
have a quick list here, that ofbooks that I would really
recommend for people to read to.

(50:39):
You know, get some of thesesoft skills and I'll quick go
through them and I think it's areally good nugget that I wish I
would have heard I was indental school or even coming out
of dental school as a dentist.
So one of my favorites and thisis a pretty basic list that if
you do a lot of self-helpresearch, I think it's just a

(51:00):
good basic list.
But the first one is Rich Dad,poor Dad.
I think this is a great one forjust understanding that you
want passive income.
The next is how to Win Friendsand Influence People Just a
really good, well-rounded bookabout talking with people.
E-myth Revisited is a great onefor learning business skills
and how to run a business Goodto Great another good business

(51:22):
one Built to Last is a great one.
Start With why anotherexcellent one.
Everything is Marketing is agreat marketing.
Start with why Anotherexcellent one.
Everything is marketing is agreat marketing.
That's specific to dentalbusiness.
Mastering the business ofpractice is a dental specific
one.
That's really good.
And then I like the ultimatesales machine for just talking

(51:43):
to people and getting them to,especially in full, know a lot
of, especially in like full archright.
A lot of these patients are weknow what they need, right, they
want.
They hate dentures.
They need implants, and we'rejust like trying to get them to
understand that you know howmuch better your life will be
with a set of implants versus anew Ford F350 or whatever they.

(52:06):
You know what I mean, man.
Your life will be so muchbetter than driving a cool car
around they you know what I mean, man your life will be so much
better than driving a cool cararound, or, you know, getting
that new toy.
It's our responsibility maybenot responsibility, but it's
it's.
It's, if you want to do well inthis industry, it's our job to
just show the patients that, hey, this is good for your health,

(52:27):
your livelihood, for everything.
It's so much better than all ofthese toys combined.
And I think Ultimate SalesMachine is great.
Extreme Ownership is reallygood.
Four Disciplines of Executionthose are probably my top list,
and I know Caleb loves books, sohe probably has a bunch more
that he could go into.
But I just find that I've readall these books and a lot of

(52:48):
them, three, four times.
And if you want tips free orlike very cheap CE on how to get
soft skills with not only fullarch dentistry but just life in
general, I think these are somereally, really good books and I
would recommend reading them andI set them in the order of kind
of like books that I liked andthat I took, took a lot from and

(53:09):
were able to implementthroughout my life, whether it
be in, you know, friendships,you know relationships,
dentistry.
So I just wanted a quick shoutout that and then I would like
to get into Smile.
Now, what we've kind of builtand where it can it, can you
know, offer to not only patientsbut also dentists who maybe are

(53:31):
looking to get into full arch.
Do you guys want to jump in ordo you want me to talk about a
little bit?

Tyler (53:37):
I did want to get some textbook recommendations from
the textbook Meister Caleb hereon clinical as well.
I remember you'd recommendedthe pink Bible and some
different things.
So if you could just name likea top three or something like
that, that'd be great.

Caleb (53:49):
Um, you know.
So right now I'm finishing up Ithink it's just called implant
dentistry.
It's by Dr Silverman, so ifanybody has, ever seen Bart
lecture.
He's phenomenal and his lecturesare worth you know I would do
10 minutes.
I would pay the same for 10minutes of his lectures than for
60 minutes of most people'slectures, and so that one is

(54:10):
like very much segmented anddeals with very contemporary
topics in dentistry, right, andit does have some old school
players in it too.
So it kind of like dives intosome of the foundational stuff
that we sometimes forget becausewe have so much at our
fingertips with the new, newright.
So I think that would be thebig one.

(54:32):
The PRF I've read both ofMyron's books.
Dr Myron.
Prf is super intriguing to me.
I really love it.
I want to do more with it.
I think it's become a littlebit less important, definitely
less efficient when it comes todrawing the blood and spinning
it and stuff like that, andsometimes you do get mixed
results.
However, I do really love whatPRF can do for you and it's been

(54:55):
really entertaining to read hisbooks and kind of seeing the
innovations of it and like acouple of things is like EPRF,
like elastic PRF is.
You can draw blood and we cando it where you do the liquid
PRF, and then you can set it upin these molds and it creates a
membrane that will last for sixmonths.
So you can actually create fromyour same biological materials.
You can make membranes out ofpeople's blood.

(55:19):
So, instead of paying forcollagen membranes, instead of
doing like PTFE, you can createmembranes from people's blood.
So I think that's pretty cooland I've tried it a couple of
times with really good success.
So those have been good.
And then, man, some photographybooks.
I don't know.
I just feel like if there's atopic I'm going to go to it,
it's going to be photography.

(55:40):
I definitely read Carranza's,perio's books, and then I did
the Pink Bible too.
Those are, I feel like Perio islike the foundation for really
good full arch.
Not that OMFS can't do it, butusually it takes an OMFS that's
willing to really take the timeand suture as like a signature
at the end, in such a way thatthey're they're proving that the
work that they did was worth itat the end, you know.

(56:02):
So I've I've read Holtzclaw'sbooks, both of them, the
Pterigoid book and the Zygo book.
It was foundational, so Iplaced a couple Zygos.
I do have a provider here intown, dr Stachowicz, who works
for Affordable.
He is very gracious with me tocollaborate on cases with me.
He has been phenomenal, I think, just as a human being.

(56:26):
He's great too.
There's just some of thetextbooks right off the top.
If that helps out, all right,let's do Smile Now.
Let me say a couple things.
So when I was coming out Ithought I came across Smile Now.
First of all, I bought 100 mainnames, right, like, what could
the name of my business be?

(56:47):
And Smile Now was the one thatreally stayed with me.
What I wanted it to representwas not only absolute top level
clinical treatment for patients,but I also wanted it to be
affordability and I also wantedit to be like a safe place for
employees, right?
So it's kind of a combinationof the three.

(57:09):
I never, I always had.
Look, when I, when I filed formy first business name, it was
called Smile Now Dental Groups.
All right, like from the verybeginning I was thinking you
know, if there's ever anyopportunities in the future to
kind of like do more than justme by myself, I want to do it.
And part of that was being onan island, right?

(57:30):
So from my first year there isan island.
When you do full arch, you'reon an island.
It's not like you want to bereaching out to every specialist
to say, hey, look what I'mdoing.
It's not like you want to bekind of rubbing it in people's
face.
It can come across that waypretty easily, and so it's hard
to make relationships when yougo to the chat, like the local

(57:53):
dental chapters and stuff likethat.
It's kind of hard to findthings in common.
In some ways I reallyappreciate that.
Like I've had a background inrestorative dentistry and
general dentistry, I think ithelps me a lot.
But now today it's dude, I don'tcare about, like, how fast you
cut a crown and I don't reallycare about how many fillings you
did, and I don't care if youhate amalgam or love composite,

(58:16):
you know, like it, like it'sneat and stuff like that, but
it's just not what I'm spendingmy time doing and at the same
time, so you can get reallylonely.
So smile now has emerged, likebringing on you guys.
It's more of a relationshipsituation and I know that people
, communities like people,thriving communities in general,
like as human beings we have ahive mind and we're a bunch of

(58:38):
termites, we're a bunch of ants,like we just really dwell well
within a community, and sothat's a big part of Smile Now
also is having support, havingpeople that have your back,
treating you like an equal, nottaking advantage of you, giving
you opportunities to haveownership, real ownership with
real tax benefits, you knowthose types of things.

(59:02):
So I just I think that's a goodstart.
Let's, let's see what you guyshave to say.

Tyler (59:08):
Yeah, no, I think that's a fantastic start.
I think you really gleaned alot of the major points there.
I think another thing that Ireally like about the way we're
built out right now is that theleadership here at Smile Now is
right here and we're allpracticing dentists and we are
practicing and under the exactsame circumstances that everyone
that's working for us is sothere.
So there's nothing that youknow someone working for us is

(59:30):
going to be going through thatwe're not.
We understand these problems.
We've run into them ourselves,we've done troubleshooting, we
know how to handle those thingsand we're very empathetic to
those types of situations.
I think in so many you knowlarger groups, you have people
that are, you know you kind ofget in this world where you're
working from home a lot andyou're not really getting your

(59:51):
hands bloody and you're not inthere in these cases and there
can be a real cognitivedissonance between leadership
and doctors that are doing thisreally complex and important
work that you know.
It's easier to be very objectiveand numbers biased whenever
you're not actually having to bein the office and deal with
these cases and deal with directpatient care, and I think
something that we take veryseriously is patient care,

(01:00:14):
making sure that those outcomesare sufficient and making sure
that whenever issues come alongfor a patient, we make it right
for the patient first and thenwe worry about the numbers in
the business later.
And that's something that westand by because that's how we
operate in our own offices.
We're all a part of that and soyou know we operate the entire
group the same way.
We operate our own offices andwe aim to take care of patients
and all of our locations.
I think it's a big thing.

Soren (01:00:35):
Yeah, I love that, um, I can go.
You know, I I don't know howmuch I kind of I kind of hate
naming names, right, but wetalked to a lot of Dennis inists
in just so many differentcompanies, right, there's so
many of these groups that areemerging.
Like I said, affordable,heartland, brightly, nuvia a lot
of these groups.
They, like Tyler said, theyhave people that aren't

(01:00:58):
practicing all the time andthey're having issues, from what
I've heard from dentists withpatient like trying to maybe
like force care for patientsthat are medically compromised
or, you know, not providingequipment necessary to do stuff
like digital protocols or, youknow, if the doctor wants to get

(01:01:20):
into PRF or if the doctor wantsto explore this or that, where
that you know clinician andprovider feels like that would
benefit their patients.
I love the fact that, as Tylersaid, we are providers in our
offices that have seen,basically I mean, almost
everything that there is to beseen with Full Arch and we're

(01:01:44):
able to very much understandthose doctors, where they're
coming from and how to providecare to their patients by
implementing differentstrategies in the office.
So I would say that I did acouple posts on Instagram about
reaching out to us.
If you're looking for maybe anopportunity to partner for, you

(01:02:11):
know, maybe an opportunity topartner.
And I would say that benefitsthat we provide for our
providers are looking to partnerare as follows you know, we one
do have a very good pulse onour marketing.
We are willing to take a risk,we're willing to try new things,
we're willing to put our moneywhere our mouth is to provide
what is necessary and the meansthat are necessary in that

(01:02:33):
market to make sure patients aregetting in the door.
Heard from some of these newergroups that are starting up of
really difficult times withpatients coming in the door
because of just lack ofmarketing.
And it does cost a lot of moneyto run these offices as far as
marketing goes and not only, notonly groups but just single

(01:02:54):
providers like really strugglingwith getting their offices off
the ground because they're notwilling to spend what is
necessary in that market to getpatients in the door.
And you know I'm in Denver, I'min a super, super, one of the
most competitive markets I wouldsay.
I mean you got Phoenix right,where every single I feel like
there's a on every corner,there's a full arch practice.

(01:03:15):
Denver is the heart of of clearchoice.
It's the heart of renew dentdental denture Anchorage
solutions.
We've got a really prominentnew via here.
One of the first ones are moreaffordables popping up all over.
I think the new sets here justgot bought out by Affordable.
We got a couple of those.
So I would say that I've got alot of people in my backyard

(01:03:37):
that are doing this and they'remarketing this and you know it's
cool.
One thing I will say that'sreally cool about Denver is that
you know all the providers talkto each other Like we are very
open.
We're like, hey, you know wehelp each other when needed.
You know I love MichelleCaldwell at Brightly, Like she's
helped me out in a pinch somany times and I think that's

(01:03:59):
really important if you're aprovider in your market, to make
connections.
You know it's not always.
It shouldn't be a competitionwith all these people.
Although it is on the marketingside right, it is 100%.
But when there are patientsthat need to be treated, I think
it's important to have thoseconnections so you're able to
properly treat those patients.
So I think that's a big one,right, marketing is huge and I

(01:04:19):
want to say that we're willingto take a risk where it's
necessary to make sure thathappens.
The other thing is clinicalworkflow.
So we already give a huge spielabout digital dentistry and
what we think that it providesto our patients and what we
think it provides to ourproviders, and we spare no
expense when it comes toensuring that we have top of the

(01:04:42):
line equipment and we are aheadof the curve where marketing
goes Luckily, equipment and weare ahead of the curve where
where marketing goes luckily,you know we do have this podcast
.
We talk to a lot of people inthe industry that are at the
cutting edge of, you know,digital solutions me, caleb and
tyler.
We are very much, you know welove, like rick ferguson, wally

(01:05:05):
renee.
You know we follow these guys.
We're up to date with what'sgoing on in the industry and
where you know the next bestthing is and where can, we can
provide that to our patients.
So we love learning thosethings and I think that you know
tyler's talking about how, like, people get out of touch.
Right, they do.
But the thing that's cool iswe're learning these things day

(01:05:26):
to day and making sure thatwhere we see the next best thing
, we'll implement that and giveit to all of our providers to
ensure that they have access tothat so we can provide good care
to our patients and theadequate equipment necessary to
provide the best care to ourproviders.
I think that's a big one.
Caleb touched on this brieflybut and I'm going to I'm going

(01:05:48):
to pass it off to Caleb here ina second to talk about this.
But providing real ownershipright, there's a lot of of
different ownership structureswith with DSOs and all the
industries.
Right, gps or oral surgery, youknow, implant dentistry there's
when you get into the DSO level.
Right, there's different meansof selling to private equity

(01:06:10):
that a lot of groups want to doand it's much more difficult to
provide real equity.
If you're planning on doingthat.
Our goal isn't to sell toprivate equity.
Our goal is to have very wellrun offices that profit well for
our doctors and I think we, youknow, put our money where our
mouth is and we provide that toour to.

(01:06:31):
Caleb, do you want to go intothat a little bit?

Caleb (01:06:33):
Yeah.
So if there's one thing I hate,hate, hate, it's seeing
dentists work for non-dentistslike so much, right.
I just think it creates thisenvironment, like the majority
of the time where it's it cannotbe about patient experience and
patient treatment.
It has to be about dollars,right.

(01:06:55):
And when somebody that's noteven a lot of dentists will own
other practices, right.
But like when they, you got tounderstand that there's
something built into that andthat sometimes will take away
from your clinical experienceand be really hard on you.
If you see what's really goingon, I think my worst nightmare
in the world is to be takenadvantage of, like when I go to

(01:07:17):
sleep, like the things that Idream about that give me that
are nightmares, are me beingtaken advantage of.
Hate it, right.
So a couple of the things thatyou touched on that I'd never
want to do is I never wantpeople to feel like they're
being taken advantage of, right,that they're here solely
working for my benefit, becauseit's not like that at all.
One of the things that I reallyalways wanted and it sounds like

(01:07:39):
you guys wanted it too was likeownership, to feel like you're
part of a team, feel like you'recontributing to something
bigger feeling like your voiceis actually heard when it comes
to it, feeling like you're nothaving to ask mom and dad for
stuff all the time, just to berebuffed, feeling like you can
contribute in ways that likemake a better whole out of
everything.
And so, when you like Smile Now,we decided firmly that, like

(01:08:04):
ownership is part of the program.
We're not even looking forpeople that don't want ownership
.
If you want to come and be partof our team, like that's great,
but you're going to do it in anownership capacity where
they're.
You know, what we're doing iswe're trying to make it easy for
people to get into a reallysuccessful practice and but
we're willing to do it as easyas possible for them.

(01:08:25):
But it's in such a way that,like you're going to need an
accountant, they're going toneed to walk you through the ins
and outs of, like how you canbe setting money aside.
Like my situation I'm married, Ihave four kids.
What can I do that benefits mykids?
Now, what?
What can I do that benefits myspouse?
How much money can I put awayin a 401k?

(01:08:46):
How you know, like all thesethings, and ownership comes with
so many benefits.
I was in the first three monthsof my practice.
I was able to completely writeoff because of my write-offs for
the startup, like all my incomefor those first three months,
and I didn't have to pay anytaxes at all for 2023.
And and I made a pretty decentamount of money right.

(01:09:09):
So those types of things arethings that you get from
ownership and you should be ableto participate in those aspects
of it.
And then there's also, you know, when you're W2'd, like you,
you are just going to get hitwith the maximum amount of taxes
, no matter what, and that's not, that's not how the wealthy do
it.
You know.
That's not how people that haveresources, how the wealthy do
it.
That's not how people that haveresources at their fingertips

(01:09:29):
do it.
They don't pay as much as theycan in taxes all the time.
So I think that kind of toucheson what you're talking about.
Do you think I missed anything?
Is there anything I should?

Soren (01:09:41):
add no, no, not at all.
I just think, if you'reinterested in this, I do want
people to reach out.
We already have a lot of peoplethat are reaching out.
So I want people to understandthat what Caleb is saying is
very genuine.
We're not looking for peoplethat are coming out of school
that are just looking forsomewhere to hitch on to, to get

(01:10:02):
some experience in full archand then, you know, go do their
own thing.
We're looking for people that,for people that want to be with
us for 5, 10, 15 years, that areready to kind of settle down,
and we have plenty of marketsthat we're interested in.
So a lot of these marketsaren't markets like Chicago or

(01:10:24):
New York or stuff like that.
I think that it's kind ofbecome a time now in this
industry because you know we'vetalked a lot about competition
and stuff that if you want asuccessful office, you know
there is a good amount of moneyto be made, but there are some
sacrifices that also need to bemade, one of those being
location right, like Tyler justmoved from Atlanta to Tri-Cities

(01:10:47):
, washington.

Tyler (01:10:49):
I try to go as diametrically opposed to my
previous market as possible, andthat's one of our owners here.

Soren (01:10:58):
He's putting his money where his mouth is.
He's going from, and I'm surethere was probably a lot of
tough conversations with thegirlfriend that happened, the
fiance, that's a whole section.
Yeah, right.
So if you want to do a lot ofarches and you want to be
successful in this industry,it's going to come with a cost,
and that being probably not thebiggest metro area possible,

(01:11:21):
I've already had a ton ofdoctors reach out from Phoenix
and they're like, hey, I've gota family here, I'd love to live
in Phoenix.
And I'm like, hey, like I havegot a family here, I'd love to
to live in Phoenix.
And I'm like, hey, man, youknow, I hope the best for you,
but if you're not, if you'relooking to stick, stick around
there, I probably would.
You know we're going to pass onthat just because that's not
where we see ourselves going inthe future.

(01:11:41):
But if you are someone that youknow, you might have a little
bit of wiggle room as far as theability to move and you're
hungry.
You've got a good skill set onyour back.
We would love to have thatconversation with you and
something that we can offer isreal partnership.
That means a buy-in and we cango into details when you give us

(01:12:02):
a holler, but are providingreal ownership and we are doing
everything that we possibly canto create an environment where
you have patients coming in thedoor, you're able to do arches,
you're getting a 1099 income,that you can get tax benefits.
We have accountants that we areproviding for our doctors, that

(01:12:24):
they can get a lot of thisinformation about where they can
get these tax benefits from,and a whole lot of other things
I would love to go more intodetail about on a private call.
So you know, I think that thatkind of sums everything up that
I wanted to hit with thisepisode.
Did you have anything else?

Tyler (01:12:43):
guys.
Yeah, I wanted to just saysomething, just to provide a
little bit more perspective toand and you know we're obviously
talking up what we're doing awhole lot here.
But just something I just wantto bring to perspective is that
you know this is not a big salespitch for working with S&DG,
because the fact of the matteris, is, what we're looking for
is a few home runs here.

(01:13:03):
Our whole growth strategy is sodifferent from a lot of other
groups, right?
So we're not focused onhorizontal growth and opening up
2030 offices next year.
That's not our goal at all.
We want to partner with peoplethat are prepared to work with
us long-term, who do want realownership, who do want to, you
know, really enjoy, uh, you know, all the benefits of practice
ownership, and we want all thesethings to be home run.

(01:13:25):
So, when we're talking aboutmore rural markets and things
like you know, like I've justengaged myself in, you know
we're doing that because we wantthese offices to see to be a
mirror of the success we've seenin other locations and and, uh,
in Boise, like we've seen inEugene, uh, which has been a
fantastic and explosive.
That's when we're that's ourfirst, you know, satellite
office and you know it's notlike we're hurting for people

(01:13:46):
that want to work with us.
There are a lot of people thatare sending in applications and
and you know it's not like we'retrying to give everybody this
opportunity and we're just goingto open up an office for
everybody, because we're sofocused on vertical growth, not
horizontal.
This isn't just some big sell.
You know we want to build somereally awesome businesses with
people, but I think, just ingeneral, just to talk about, you
know, if this is something youwant to get into, this is a
world you want to get into.
There's a lot of people outthere.

(01:14:07):
They're vying for doctors thatcan do this kind of work, and
one of the ways that they dothat is by in treating you into
this idea of owning a practice,right, and there's a whole lot
of befuddled ways of giving thatto you in a way that's not
actually giving it to you.
You know, if it takes five, tenminutes of a pitch for a
company to explain to you howyou own something, you don't
really own something, and I justthink that in whenever you're

(01:14:30):
having those types ofconversations with whatever
group, I'm not talking aboutanything in particular, I'm
really not Just keep that inmind.
Understand that ownership can bea lot more straightforward than
that.
Partnering can be a lot morestraightforward than that.
You can have all the benefitsthat Caleb's been talking about,
that he's been able to enjoy inthis past year, and that can be
a very real thing, and I justhope that everyone kind of has
that sieve as they're lookingthrough different opportunities.
Look for the real stuff.
Look for the stuff that's notreally that complicated, because

(01:14:52):
it shouldn't be.
And just like Al Caleb talkedabout, if all of your income is
based off of W-2 income, that'sjust blood, sweat and tears on
your way to retirement and itdoesn't happen nearly as fast
unless you're having actualwealth generation opportunities.
You'll learn more about aboutif you read some of those
textbooks that the storm wasmentioning.
So that's all I really wantedto say.
You know, this was not all justa big sales pitch by any means.

(01:15:13):
It's just to give someperspective and talk about what
we're doing and we're all superexcited about it and can't wait
to work with some of you guys.

Soren (01:15:17):
Yeah, for sure, I hope.
I hope I actually scared somepeople away with my pitch about
yes, we don't want to be.

Tyler (01:15:23):
I don't want to be like I want.

Soren (01:15:27):
Tyler to not be fielding like hundreds of messages.
No, just, please don't reachout unless you know you're
interested in in settling down,you know you're willing to move
your, you have a skill setbehind you.
If you see all these thingsbeing checked and I hope that

(01:15:54):
I'm making the list you knowlong, so that you know you are
kind of fielding yourself beforereaching out then please hit us
up and we would love to workwith someone like that and I
think that we could could growsomething really great together.
Agreed.

Tyler (01:16:03):
All right.
Well, dr Caleb Stott, wecovered your life, your career,
your practice and now your DSOall up to this point and I
really appreciate you coming onand sharing all that with us.
I don't think we've ever done apodcast that you know covered
in depth.
You know things all the wayfrom.
You know bookend to bookend ofyou know the clinical tips and
the business tips and everythingin between.
I think you did an incrediblejob in this.

(01:16:24):
You know hour and a half and wereally appreciate your time.

Caleb (01:16:27):
Thank you, Tyler.

Tyler (01:16:30):
For sure.
So that wraps it up here forthe Fixed Podcast.
Thank you guys for listeningand again, like what Soren was
saying, you know, if all theseboxes are checked, please do
reach out to us.
You can reach out to us atthefixedpodcastcom.
You can reach out to me onInstagram, dr Tyler J Tolbert on
Instagram.
Soren has an Instagram as well.
We all got Instagrams that allgo in the show notes.
But please do reach out,introduce yourself and even if

(01:16:52):
you're not looking atpartnership, just reach out
because you want to talk aboutfull art.
It's what we do, it's whatwe're passionate about and it's
why we stay late after work totalk about it.
So thank you all for taggingalong with us.
Thank you again, Dr Stott, forcoming on and talk about.

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