Problems Facing Pediatric Dentistry, and How We Fix Them, with Dr. Sean Whalen

[MUSIC] >> Set down your sleepy water in your Mr. Wessel. Take off that raincoat and grab a cold beer. It's time to have a real talk about pediatric dentistry. You're listening to Bruce and Tiny Teeth, the unfiltered pediatric dentistry podcast. [MUSIC] >> Yeah, that's such a great point. There's zero training or background or experience in how the world of dental insurance works. And you're expected to just figure it all out on the fly. >> Yeah, yeah. >> It's fucking annoying. >> It's like, I had a three-way syringe break today and I was like, this is great, I'll fix it real quick, like I don't mind doing that. That sticks really small and stupid and silly. But I want to figure out what some fucking insurance company rejected fluoride. I just don't know, I can't. >> Oh my God, I love it. Well, I'm doing a rolling start intro and I don't get to do these crack a beer live. So I saved a, since this is an evening podcast, I'm going to crack this beer. And I'm going to start this one off, Sean, a little different here. I didn't prep you for this, but just so because people might not have got to listen to our first episode, to get a sense of who you are and your vibe and why I like hanging out with you so much, I'm going to do, I've got a round of some speed questions that I'm going to start you out with. >> Am I correct in my beer right now? >> Dude, let's go. I didn't know if you were partaking. Are you doing a classic Miller light? >> I'm a Miller light guy. Everyone, everyone is drinking, you know, the noise taught. Every time I drink with Todd, he's doing something fancy, but. >> He's a fancy craft beer guy. >> Yeah, that's okay. >> You're out, I mean, isn't that brewed close to you out in Colorado? >> So it's Miller cores now, but they move their headquarters to Milwaukee. But cores is brewed really close to us. >> Okay, it's old in Colorado, I think, right? >> Yeah, that's cool. >> If you don't come out here with your family, you should. >> You mean shit, it's worth an afternoon. >> Yeah, I've been out there visiting some friends back before we had kids. If you're a craft beer guy, Denver's the hot spot to be. I don't know if it's the mountain water. That's what gets people fired up, but there's a lot of craft beer out there. >> It's good, but it's a problem when you grow up in the Midwest. I'm used to drinking like 10 of them, and I can't do, you can't drink 10 craft beers. >> You'll be floored, yeah, for sure. >> You could sick. >> Yeah, I mean, you drink Miller light, and this is, say, I'm going to become a problem slowly. >> Yeah, for sure. >> Managing. >> Yeah, people drink it like water. Yeah, it's just like, it's like hydration, Midwest hydration here. As I finished up, yeah. So these are some power, like quick hitter speed round questions, where you can kind of just give me your off the hip sort of your opinion on some, some different takes here. And this first one will give you a sense here. So let's say you got like a five year old who's got a DO on L, like DK just passed the DEJ. Are you putting SDF on it, or are you just going to fix it and do a restoration? >> I'm absolutely just going to fix it. I'm on block, I'm going to put a W3 clamp on, a rubber dam, Mickey Mouse punch, I'm not going to stretch it over the K9, and I'm going to do a classic class 2 prep, fill it with a regular resin. I actually heard you talking about a resin on gill straps thing that I want to talk about. But I'm just going to do a traditional class 2 restoration. >> I love it. >> Okay, so you're not like a put SDF on it three times and see what it does type of guy. >> No, I'm rage bait, I'm rage baiting you Sean. What's that? >> I'm rage baiting you as what I'm trying to do. >> Yeah, I mean, I'm not opposed to SDF, but I just, the kid's good, and I can fix it, and I can prevent it from becoming an M.O.N.K. I'm going to do it. >> Okay, fair enough. Premolar EXTs, if you get referrals for Premolar EXTs, are you shucking those, you're taking them out, or do you send those to oral surgery? Permit it, permit it. >> You give me a course on taking them out. >> For sure. >> Okay, I think that's becoming rare these days. I don't know if, I feel like I talk to more and more people, and a lot of people like to refer out a lot. Either there's pediatric dentistry on me that don't extract a single tooth. Like there's a guy I know, like every single extraction goes to oral surgeon, which is crazy to me, but you see that now. >> We'd have that going on around here too. There's a lot of pediatric dentists in Colorado that take out teeth, but I mean, I have people that refer other pediatric dentists refer me patients to take out teeth and do sedation. That's really weird, but I'm happy to do it. It's fine. >> Yeah, for sure. I know one sidebar, but one thing on our last podcast, I tell people a lot is you gave me your spiel about how you're very pro practicing things you're not good at, and you gave your whole lecture about how you realized that you weren't great at suturing. So you did sutures on every extraction you did for a year, but I tell people that story all the time. That stuck with me. That was my permanent oral surgeon, taught me that. >> Yeah, I'm like, I was in the oral with him and he was like, hey, I feel like I'm not very good at suturing. He's like, why don't you practice? I go, when do I get really good a chance to practice? He's like, well, everything I take it to that, if the kids are reasonably good, just throw one. It's not going to hurt anything. >> I remember being like, that's so simple. It's stupid, but it's right. >> Yeah, yeah. And now you've got a lot of reps that way, so that works. >> Okay. Pediatric dentist should be seeing Medicaid or should not be seeing Medicaid? >> Should be seeing Medicaid, 100%. >> 100%. DSOs, do they have a place in pediatric dentistry? >> Oh, my God. This is like somebody on TikTok asked me a day what I thought about Florida, and I was like, why are you doing this to me? I mean, I guess they have a place in the market place as far as how capitalism works, and there's plenty of people who don't want to own practices and work two to three days a week. So, like, a model that was more ethical and not revenue-driven, not Pribe, okay with? I don't like the idea of it in my core because I like to work in a smaller environment where I'm in control, and not me personally, but the dentist. Like, if you and I were in a practice together, even if I worked for you, I'm like, well, together we're a team we're in control. They're with not this, like you and Gil's shop are talking about, like, the invisible corporate agency. So, in an ideal, perfect world, everyone sees Medicaid, and we got plenty of pediatric dentist practicing everywhere, I would wish there wasn't DSOs, but it just is kind of what it is. So, I don't want to, and I have lots of friends who work for them. So, I mean, there's probably, there's a place for them. I think the bad ones kind of put a bad taste in all of our mouths. >> Yeah, don't disagree with anything you said. Like, you know, just the reality of it is, they're here for a reason, and they do feel a void in the marketplace to some degree. So, you just have to be realistic about it, yeah. Okay, this one's been a hot topic on I-Peto, but burnout in pediatric dentistry. Is it a real thing? Is it as bad as everybody makes it out to be? What are your thoughts? >> I think it's a real thing. I don't think, and I'm going to speak for you. I don't think people like me and you feel like it's real, because I think, even without pediatric dentistry, I would get up and start fixing stuff around the house. Like, I don't sit still. So, I think it kind of depends on your personality and what you expected when you came out of it. So, I've been teaching for a while now, and I think that students get out, and I think it's going to be, private doctors can be so much better. It's not going to be as much trouble. There's not going to be much paperwork. There's a pile of money. And the truth is, it's just a hard, stressful job, and we do dangerous things on little kids, and it's stressful. And I think it can wear you out, but I think you have to have a healthy perspective, keep your body in good shape, have good people in your environment, whether it be your assistance, your spouse, your friends, your family. So, I do think it's real. I don't have that. I mean, I'm 49. I still work four or five days a week. Now, one of those is teaching, obviously. And I'm like you, I like to do a lot of different things, and I'm not saying that everyone should do that. I think I have adult ADHD, and I like to be busy. So, I mean, if you like to be busy, it's like the world's perfect job, because that's like little procedures. Like, I'm guessing, if you and I had to do heart surgery, it wouldn't be a good thing. Because like, after I open up the chest, I'd be like, I'm done. I don't know that I can hang in there that long. So, I don't know. I think it's probably real. I certainly hear about it a lot. I hear a lot of people have been practicing two, three years. I've heard it from residents who haven't even finished their training yet. So, that's rough. That's going to, that's a rough start. Don't you think? It's crazy. Yeah. Yeah, I don't know. I think you're right. Like, you know, is it real? Sure. But, you know, it just maybe means you need to tweak the way you're practicing or the way you're conceptualizing things. Like, maybe that means you, you know, maybe there's a, it's probably a pseudonym for like, you don't like going into work because there's one employee who sucks, or maybe you're doing a lot of, maybe it's, you're not happy because you don't own the practice, or you're working for a DSO, you hate, or you're doing way too many procedures on parents, you don't like. So, maybe I think it's probably more people just need to change the way they practice to find a groove that fits them better. Because like, you know, you think about it like if you quit doing dentistry and stayed home for two weeks, I feel like most of us that even think that they're getting burnt out would still probably, you know, be like, man, I'd actually be kind of chomping to get back to work and get busy and like be productive. And it's like part of your identity. So, it's just like most things. There's there's a sweet spotter. I feel like a balance where it's real, but it's just, it's a buzzword. Do you get it thrown around a lot? Just tweak the way you're practicing. Yeah. My dad actually talks about a lot. He's a nephrologist. He's 78. He still works full time. And he just, he, he's just, you know, grind it. And it's not for money. He just, I don't know what else he would do. And I feel like I kind of fall into that category. I mean, I just really like it. And I think, I think when you talk about hard parents or doing things you don't want to do, or whatever, I do think there's a way to practice where if you can, and that one does it completely 100%. But if you can, the majority time be really authentic to who you are and your personality and not fake it, practice gets much easier. Like if you were just yourself all the time and drop an F-bomb in front of a mom here and there, you know what I mean? Like, at least they know you're real, like sometimes I look at a parent on like mouth words, this is fucking sucks, you know, like this is gonna be really hard, or like if I have to like put a kid in a one year old the papoo so they get toothed out, I'll look at the parents and like there's no sugar coating this, this sucks, and it's gonna be really hard. I'm sorry, and I don't want to do it, but it's what's best for your kid. You know, like I try to, I don't know, I try to really be myself. I think that helps, that's, I mean we can have a podcast on burnout, and I'm sure there's younger pediatric kind of soliciting me in there saying things like well, you don't understand you've under practiced for all the things, and I mean, I have someone who may or may not be related to me, I don't think she would listen to this, but you know, she kind of got burned out on medicine and at a young age, like my age, and I, she's always like, I just don't know how you can stand it, you know, the problems don't outweigh the benefits, and I just said, you know, well every day the good parts outweigh the bad parts, and that's what gets me to work, because I don't, I'm sure you're the same way, the things that fill me up or make me feel good about it, way, they wait, they so far outweigh the bad things, and we all have bad things, staff things, like crazy stuff, but I think of the day most of the bad things, I always look at them like, well, it's going to be a good story, it's this is something if I run into KC, I run into Todd at a meeting again, tell them, but I can't, can you believe this, this happened, you know, so I don't know, that's a long one to answer, so sorry. Yeah, no it is, it is, it's a, it's a, it's a, it's a big topic that we could definitely make a whole episode on, but maybe I'll, my last power question I had for you, just kind of steering the ship of the direction or conversation, this is very like holistic, but do you like the direction pediatric dentistry is go, and there's a lot of ways you could take that, but do you think the future is bright, do you, I know that's not necessarily a black and white answer, but what are the things that give you hope, what are the big things you're concerned about? Are you trying to make every pediatric dentist in the country hate me? I mean, I'm just, I'm just, I'm just, I'm shooting the questions here Sean. Yeah, I know, I know, I know what you're the host, I respect that. In general, I still think people are getting into it for the right reasons, because they love kids, they want to help kids. Do I like the direction that's going, no, I think we've kind of gotten away from our restorative roots. I don't mind minimally invasive dentistry, but you still got to be able to do all the things. I don't like that we haven't solved the tuition problem, you know, I met with Clark's, I had dinner with Clark Stanford from Iowa and I really am in favor of figuring, I would love for Iowa to be the leader in the country of like figuring out a way to crowdsource or almost sponsor tuition, like we're graduating people that are way way too, too much in debt. And then that kind of makes them go to the DSO route. I think we, our residency programs are GA factories, I think we're really low on faculty, I wish more private practitioners would get out teach in residency programs. We're not doing as much sedation as we should, we're not doing as many complex procedural stuff, we're really dumb and down operative, I mean, I could go on, but you get my point, like I could, yeah, could I ask a question, I have a question of really, like this is a great point, I just thought of this, but I mean, you might have to give me your background on how you've been involved, because I know you are increment like instrumental in getting this another residency program, I think in Colorado, so you might have a good perspective on this. But there's a big conversation on Ipedo a while back about, you know, there's arguably some dental schools and residencies popping up that are sponsored or backed by, you know, by Heartland or corporate dentistry of some kind or Aspen Dental's or like the Rick Workman School of Dentistry and the idea is like, it's just creating like a feeder pipeline, you know, and that, to be honest, kind of worries me a little bit, like I don't know if I want that direction or trying to continue where the big corporate entities with the deepest pockets are the ones opening up with limited accreditation, maybe to some degree, all these little pocket residencies that kind of just, you know, I mean, they're training residents, but not maybe to the degree that we really want to see and they're just pumping out tons and tons of residents to keep their DSO, you know, machine going. So I don't know if you have any insight to that or thoughts or if you've kind of encountered that, but that's a little bit of a topic lately too. I've had some insight into it as a, where I've had interns or people that applied to the program that ended up at places like that, and it's a really truncated model. So like, and I only have my experience, right? I don't have someone else's experience. So at the University of Iowa, I was back by the university, we rounded another clinics and other disciplines and medicine, and it was very structured, it was very traditional hospital academic program, it was like 50/50, and I thought we got really good training and we had really long-term faculty that were highly respected, they published all that stuff. And then, you know, you fast forward to now and they, there's entire programs where maybe the program director, it's this their first job out of school, they have no real-world experience, they're not publishers, and then they have some adjuncts that come in here and there that are retired, that are just kind of like doing whatever. I just say it's really hard to get, it's, you're better in like an academic, I don't want to say academic's hospital part's important too, but you're better off like, in an environment where you have all the specialties around you, at the dental school, you have the University of funding, you have the facility, you have all the things to make, all those things come together to make you better. And so if you're in some residency program out in the middle of nowhere, and, and let's just say Missouri because that's where you're from or wherever, there's no way, if you, you can't tell me that someone's not better off at a hospital setting where they have exposure to oral surgery, combo cases, ENT, they get direct anesthesia handy for anesthesiologists, they're getting operative dentistry from people who have been, you know, you get my point, but, and then as far as the DSO is running it, I mean like, I'm sure some slick salesman from a DSO could really like try to talk me out about how they're doing the, you know, the lords work, but I just don't buy it, I think they're doing it purposefully, and that's fine in business, we live in the capitalist country, and I'm all for that, but I think we can all agree at our core, put politics aside that it's not ideal, so they're not doing it for the kids, they're doing it for revenue. And the nice thing about universities is for the most part, especially 25, 30 years ago when I was there, it was a lot more altruistic as to where now people get arguments how much tuition they pay, but yeah, I don't know, I don't think it's good, this is my personal opinion. I'd rather graduate less and higher quality. For sure. This is another thing, you've, you've said things to me over the years that we've known each other that have really stuck, you know, I kind of, my, my whole way that I do dentistry, I feel like it's just little bits and pieces of things I've learned from other really smart pediatric dentists. And one thing that you said when I was a resident and you came and lectured to us was, you know, we can't as pediatric dentists, and I'm ad living, you're going to be able to expand upon this better than I will. Basically, like we can't just be circus monkeys, where all we're trained to do is just like throw SDF and hall crowns at every problem we have. Like it's important to be well-rounded pediatric dentists to, you know, to have a broad skillset to try new things. And I hark about that on the podcast all the time and you're really good at that. Like trying new technology dentistry is getting better, trying new things, you know, being good at sedation and having lots of tools in the tool belt. And you know, as soon as we start getting the point where we're just, all we know how to do is just slap an SDF on stuff. I'm picking on SDF, but you get the point like, you know, it kind of waters us down where general dentists are going to start taking our jobs and we're going to get crowded out of the marketplace. And it's just going to kind of dilute our profession down. And the way that you said that to me the first time has always really stuck with me. Yeah. And it's not just dilute the profession down. It's lowering, you think about it lowers the quality of care. Right. Mm-hmm. And it kind of forces like, you're saying, okay, I can no longer use behavior management. I can no longer use sedation. So suddenly kid has complex restorative needs before the age of five. If they can't do that nitrous, we're going to the OR or maybe I'm not, I'm more likely to go to the OR. Like the number of GA cases now compared to when I started, it's crazy, you know. So yeah, I just think it's important to be really well trained and like know how to do a lot of different things and challenge yourself to do those things because as a pediatric dentist, you should be the end of the line for those kids. Now like things you shouldn't be the end of the line for. Well, if a kid has traumatic bone system needs a biopsy, you probably shouldn't be doing that. If some pediatric dentists take out wisdom teeth, I do it occasionally in the OR. I'm sure you do too. But if the thing is going to be complex, I certainly don't. I respect the oral surgeon's territory, I guess. And they certainly do it. I always tell the parents, I want someone who's going to do this really well. They do it all day and they're really good at it. I don't do molar endo unless it's on a special needs kit in the OR because I just, I don't, I know I'm not good at it. Like I, I haven't done thousands of them. But if I had to do it, a pinch, I could do it. I'm sure you've taken out, especially where you practice lots of permanent sixes like that are badly broken down. And you're like, all right, I'm just going to rely on what doctor side end to be and I'm just going to elevate this, elevate this, elevate this and then I go for a walk and I'm going to come back. I'm going to elevate it some more and eventually it's going to come out. You know what I mean? Yeah, I don't know where I was going with that, but I think it's important to have like a really, like you just said, like to know how to do a lot of different things. If all you can do is like very minor restorative, SGF hot crowns and GA, I just don't think you're really. I mean, Art Norwalk used to say he'd ask people if they're doing sedation. And he'd be like, well, when did you stop doing pediatric dentistry? It just never, it made me laugh. And I just, I think about that now and I always want to be able to answer the question of like, well, I still do it, you know, I still do all the things. And there might come a day that I don't. But for the moment, I can, I can, I don't want to say I can do all the things. I can, I can do most of the stuff on, you know, on it, maybe we'll flip to a, I feel like I've started the podcast out with some like depressing, you know, topics about our profession. I feel like you put me in a really bad position. I did. Yeah. That, I mean, my, my speed questions were supposed to be, I, you know, again, what I appreciate about you is you're not afraid to tell people your opinion. And I think you have a lot of validity in your opinions. And that's what I was getting across. But I feel like I structured the questions where I sounded like a Debbie downer about I love, I love being a pediatric dentist. I don't, you know, I mean, like there's certainly long weeks and tough kids. But so I don't want to be, I don't want to spend the whole time being so down on our profession because there's a lot of really awesome pediatric dentists doing cool stuff out there. You know, for sure. Yeah. So maybe let me come up with a different question. We'll shift gears to something a little more current and positive. So for people that, you know, maybe don't know you, you know, you're an Iowa grad a little bit before my time. You own a couple of legacy practices in Colorado. And again, one thing I've always liked about you is you're really good about trying new things, trying like expanding skill sets. You came and lectured one time on you're using LSTR all the time, which it, you know, when it was kind of a newer thing. But that's one thing I've always liked is you're not afraid to experiment and say, yeah, this is working great or this sucked like it bombed. I don't do these anymore. So I was maybe wondering if you could kind of hit on some things in the last, you know, five years or so in your practice, either techniques or materials, things that you're using doing a lot of these days. I know you're, you know, like LSTR, you do a lot of zirks, even practice admin things. But what are some, what are some new things you're doing in your practice these days that you're, you know, that you think are kind of the trendy new future of pediatric dentistry things you're sold on? Okay. So I mean, I will tell you, I mean, there's so many things that have changed. There's so many things I'm like, oh, I'm never going to buy that stupid. You know, I went through the, the laser phase and I had like, at some one point, you had like five from, oh wow. And like they just didn't, I don't know. You kind of like, when you buy something expensive, you talk yourself and know that they work and they just, it just never really worked as well as I wanted it to. So I, I quit doing that. And I have, I have a, I have a diode that I still use. But anyway, but like recently, some things that I bought that make me no money, but I would, I would not practice without. Now, I use a scanner a lot. I don't know if you use a scanner. I do which model or which one do you have? I have the trios, which I know there's better ones, but that's just what I have. Excuse me. But like, I do a lot of, I so I use the scanner. I also, I just got a 3D printer last week. Oh, cool. Nice. So I'm going to start printing Circonia resin crowns. And I've been printing, I've been having Maryland bridges printed and no prep veneers for seven and 10. We need to talk more about that like off air because I, to your point, I have a scanner. I haven't met it scanner, but I'm a little too timid. I've done some permanent white crowns like on sixes, but I, you know, I've got lots of good pig lateral cases. And I just set, just send me the file and then I'll print them and send them to you for free because it's really cool. Okay. But it is so people are like, well, why would you, you know, you shouldn't be a veneering teeth. I'm like, well, I barely charge them for it. I don't want to build it up with composite. And it's just resin and Circonia in the, in the resin that you print. And you just glue it on. I'm like, what's the difference? Like it's, if I stack it and bond it, I'm still not drilling the two. Um, but yeah, we use this scanner a ton, like way more than I thought. And I don't think it makes us any money. Um, the CBCT is another one. Like I rarely were charged for it because it's such a weird code. But I love having that image. I take out a lot of museum ends and, um, showing the parents, like from an educational standpoint and they've come way down in price too. How much is a CBCT now? I don't even know. Yeah, I don't, I don't have one. I've, no, that's a great question. But, but that's a huge thing. Yeah, yeah, yeah. So, um, obviously we talked about LSTR. We called it tribates back in the day. I use that a ton, sure fell, sure fell SDR. I use that, I use that. That's why I use sealant material. Do you know what that is? Uh, isn't that a flowable? That's Phil text flow or, um, like, it's, those, I think, is it Voko? I don't know. I'm not great materials got. But yeah, I mean, like the scanner, CBCT, um, oh man, the other thing I use now, I use a buffering system, you ever tried that? Uh, I use that at my first job. I actually thought it was really cool. I thought it worked pretty well. It just a little, it was a little cumbersome and expensive when I first did the start-up. And then I never got back into it. But I probably showed it because it seemed to work really well back when I was using it. It's super cheap and like for hot teeth, like if you buffer your local, it works really well. And the people I have, I've used the zone a little bit. People like tend to love that. I don't know if you have one or not. I have one. Um, I've talked about this on podcast. I'm like middle of the road. I like using it for like hard to numb, lower sixes, like K and T. But like most of the time, like, especially on max layer, I still just do local infiltration because I'm impatient and it's faster. But it's nice if you like need a little belt and suspenders, some extra local, a tooth hard to get numb. I, I, I use it like, I use it a fair amount, I would say, but not like every tooth, like some people do. Yeah, like I, I think the same way. Like I like it. I think I believe that it works. I just don't have the patience and it doesn't really work into my workflow. For sure. Um, I don't know. Well, those are some things. I mean, like I, if you're in pediatric chemistry, I would get a scanner and I would start to end resin, Maryland bridges. I would start to, you know, no prep nears on peg laterals. I would get a CBCT. These are all, I mean, if I was starting a practice, like I'm actually opening a practice in the winter park on Friday, like bare bones, like I'm barely, I barely had anything up there. And I'm just like, I'm kind of going against what I say. Like I have an old, I like, we have a refurbished panel up there. I don't know. I'm using, like when you have a dental office for a long enough time, you have a bunch of old equipment, but, um, yeah, I know another thing, like besides materials, you were the one that kind of got me also, I wanted to talk about a little bit, but you got me turned on to like outsourcing, like some of these insurance concepts that you kind of changed the way I thought about it and you were the first guy I called, um, but you were kind of my inspiration for maybe experimenting with outsourcing insurance billing and like taking that off your plate and not trying to figure it out all by yourself. And, and so I kind of give you props for pioneering and kind of shift in me that direction. And I think you use, you know, billing as well, like, like I do, but, um, I don't know, I was like without me hogging the mic here. I was wondering if you could talk about like, that's another one. Like, could you talk about why you shifted when you shifted, like how that's been a part of your practice from like the administrative insurance side, like how that's helped with things? Yeah, so I look at it like two buckets. So, you know, we collect money in a dental office is like what's covered by insurance and then what's your out of pocket, right? So the out of pocket part is where you need like a human facing person for the most part. Like you can outsource that there's services that do it kind of depends on your community, but you want your front desk people to have a really reliable estimate of what they're going to owe. Have people pay the same day of service that helps your AR a ton. Well, what gets your AR behind because most offices will have an office manager. They'll have someone who's in charge of AR. We might do some other administrative things like answer the phone or whatever. Then you have your front desk people, then you have your dental assistance giving treatment plans. You might have a treatment coordinator. I don't personally, but so you have all this stuff, so it's like spaghetti. And it is so hard to get the insurance right. I mean, doesn't Delta have like 500 plans underneath? Yeah. And each state's different and they yeah, you can I'm in network with Delta and each Delta plan is different. Like, dude, I found out one of the Delta's pays as interest like Illinois Delta dental Illinois. I get you ever get like, I don't know if you pay attention to this anymore. But I'll get these like $5 checks from them because they pay interest because it takes them so long to pay you, but like you have to learn like each different Delta plan out of all 50 states. And then there's yeah, to your point, like it's not practical to try to like stay on top of all that when you're practicing full time. No. So like if you, you know, so if you look at like, so, you know, Prosper was, I remember you called me because you're the woman you have was was bleeding, right? Correct. My insurance gal was staying at home with the baby and that's what like made me panic. Like, I got to come up with a plan B. Yeah. So what turned us on to it is my partner, Grace, his husband was using a he's a perinoast. And I was like, I just don't know. And like the truth is like, I knew a little, I mean, I knew the structure of how insurance work, but I didn't realize like how arduous and tedious and it's, it goes against everything at pediatric dentist is trained to do like we see a problem solve a problem, you know? And like, you could spend two hours on one claim. Like that's not effective trying to get paid, trying to get paid, you know, $12 for a floor. $37 or something, right? Yeah. Yeah. So I mean, I said it, I mean, I, I said I did a little thing for, for Pito billing and I said it in there, I think it's like, this is like one of the most effective things I've done in my practice. That's how like new practice management software billing. There was one other thing, but it, it is such a game changer because it takes that load off your front desk, they do insurance verification to if you want them to, I mean, the service we're talking about is Pito billing. And for a grand total of 2.2% or 2.5, if you have one office, they will process all of your insurance claims. And the first thing is dentists like in general, like we tend to be really cheap and like, like we're trying to hold our cheese all the time, like you can't have two percent of my cheese. That's my money. My answer to that is so if we get a pito billing invoice and it's $10,000 for the month or something or whatever it is and I'm always people like some of my times my partner will be like oh my god that was so high and I'm like yeah that's how much they collected. I mean how much better it is so it is like it will be I don't want to over exaggerate but I bet we saw a seven to ten percent bump in insurance collection since we started using them. It's a better test. No. No 100 percent. I tell people a couple people have called and just asked when I started using pito billing like last year and I was like that first month I had such a glut of like 90 plus day claims that just weren't getting worked of like I tell pair a lot of like dual insured you know primary met life out of network secondary Medicaid and something was just hung up in limbo and they went through and they they like paid for themselves that first month by just like I had like an extra 70 grand land in my bank account from like old claims that they you know cleaned up so it's like like that first month I'm like even it's not perfect not for everybody they still make little mistakes here and there but like it's it makes it so like 95 percent of the workload just automatically happens you don't have to keep track of it you know and it's just makes everything so streamlined so much less and the people who like complain like oh they'll make errors I'm like you sound like my dad like my dad was like AI makes errors like yeah but AI makes errors like 0.1 percent humans make errors like 7 percent for sure and what happens like in your office especially you know because you're busy like eventually like so like they do the initial claims submitted you know they sent all the claims that came to the day some of them are going to get kicked back and then they go and do a pile well the next day they still to submit all those other claims and these this pile just keeps getting bigger and then eventually like well we're not going to worry about it because like they're literally like all of a sudden 180 days of pass and they're there for the next checkup you're going to give Mrs Smith a bill for the lack I mean it's just it is the best thing I mean I would recommend it for everybody and I'm not any others other companies like there's Lassie Pito bill yes is this is a big a big one yes yes yes is a huge one yeah that's a big one and I don't think Lassie works with I use curve and for my practice manager software and and they're all good I'm not saying curves the best but I just think it takes such a load off your plate and it's just something I don't have to think about anymore and they just they just do such a good job I've not been happier with any service I've hired that's been the number one thing I've hired that's cool I thought about this today Sean so I had GA today in office GA I had five cases the end of the day I'm like working on notes and doing everything else and my two front desk alls that were up there my office manager and the other front desk all I hear like a ruckus and they're up there working and they were like deep cleaning the front like there's the vents above the ceiling that blow all the the AC and the air and they had looked up and noticed that like our waiting rooms kind of gross like there's some there's dust in the vents so they're up there with vacuums like cleaning and scrubbing they're doing and I thought to myself like there they never used to be able to do those things like the little minutia details fixing the little broken stuff like calling the guy because stuff you know they're that kind of stuff they can be on top of because they both don't have to stay there till five o'clock every day running all you know sitting on hold with signa like why didn't those sealants pay you know you got people doing that and so it's just all the other little things in the office are so much more dialed in just because that's off of our plate so there's a lot of secondary benefits you don't see from it too yeah and it allows your staff to get your patients parents so much better customer service because it's they're buildings more correct it's more up to date um I don't know I had a good example I was going to say but yeah I just feel like they have so much more time to spend talking to the parent because they're not dealing with insurance like there were times when we had have I get clean and like I didn't really realize the workflow of it and you kind of mentioned it before trying to collect $12 but I'm like you get to a point where like wait a second you've on the phone for an hour because they won't pay for a crowd on D screw it right it off I don't care like move on to the next thing we can't we're seeing 112 kids today like I can't like who cares like move on yeah so yeah I I can't I can't stress enough like I think it's a worth it's worthwhile looking into and again just to repeat the companies there's e-assist as a version of it there's pito billing there's prospa and there's lasty and I know there's more and there's a couple other ones like you said this is such an evolving thing like this was something you said from the beginning like and I you've convinced me of this but like as AI and software and stuff get better this is the type of data mining that's just going to get better and better like three years from now it's all going to be overhauled again like it's it needs to get to the point where you know you do the dentistry at the end of the day you submit and then like boom it processes and like it the thing it the whole system from a 10,000 foot view is really fucked up to be totally honest like it doesn't make any sense it's super inefficient there's so many there's so much wasted time and money and resources like hopefully it just continues to get better and better and AI can extract all these this claim data so I think there's it's an area that's just ripe for an overhaul it's just going to continue to get better in my opinion I think yeah I I believe there to be fraud abuse and a waste in the way fraud abuse and a waste in some cases and so there needs to be checks and balances I don't disagree with that but when you first come out of dental school and you start submitting claims you realize that they're not giving you the benefit of the doubt you're basically on parole and there your your parole officer and like they're going to make you feel like if they don't cover something you're in trouble when it's usually not the case like you just forgot a number or there was some weird thing the way their insurance was written so um I don't know I don't need to pump it up that much but I I've never been happy or something let me ask you this if you were starting say say you're you're you're one of your residents at Colorado and you were going to go try to start your own practice does it make sense I wonder uh to you know if you're doing it again would you start trying to outsource and get help with your insurance billing and processing and stuff like that from the get go or do you think it makes sense to do it yourself in house for a year or two just to kind of learn the lingo and the systems I would learn it first learn it first I would learn it so I hit about 700 thousand in revenue it's good answer okay yeah I'm guess I'm going to make it again somewhere I mean yeah maybe on year two or two or three you're up and going then because you do need to know it because like when you talk to like when you talk to them and then you see a problem or you're like well that that's easy I think you just miss this or you know what I mean you need to have a working knowledge of it so okay but yeah yeah all good things I that's you know we're going back to what we're initially talking about like what's the future pediatric dentistry I think there's a lot of challenges and I think about that student loans uh starting up is expensive real estate costs are expensive it's a lot of debt there's you know you can get roasted on social media and reviews so there's a lot of challenges but on the flip side I also think back to like when you and Hepner and Matthews and all the old Iowa grads were out practicing like you guys didn't have chat GPT to like help fix all your problems you didn't have like you know if you wanted to know what's the most effective way to you know remove a mucus seal you didn't have YouTube to like watch video I'm just pulling out some examples but I feel like there's a lot of technology that's going to help kind of tip the scales back in providers favors to like kind of help make our jobs in our lives easier and that's just few examples of it yeah I hope so I mean it wasn't and I just feel like there was such a good core of human beings I got to be around I mean obviously you had Todd Gray on the podcast who's my one of my best friends and even my rights on the C class Amanda spits that's someone you've never you've had on but you know she opened seven practices and then folded it into a DSO and so it's hard for me to talk about about DSO because I love Amanda so much and to this day she's such a good friend um so um and again I go back to the DSO thing and there's a place for that model but I so instead of harping on that or saying that's wrong or people are doing the wrong thing I think it's more like we just we need to go back to focus really on educating people who can do all the things I mean it wouldn't hire a plumber that came to my house and he's like you know what I only fixed drains I can't anything on the hot side of the water I can't the pressurized I can't do that but I can fix the drains really well you know what I'm saying like it's a great example I love it yeah so what are some good electrician came here I was like I can only do light switches yeah I touch the lights worthless yeah so um yeah I mean I I just think we got to work on educating people we can need to invest more in it like we don't pay our faculty enough I think that's a problem it's a huge problem yeah that's a tough one to fix now I completely that's one I haven't really talked about on the on the show either like if you were paying you know academic positions and paying people four or five hundred grand to come and do like academic positions for like really good qualified pediatric dentists with a lot of experience like you fill those things up but the reality is like it's it's hard to find the right person that's so passionate about it that they're willing to take more of that pay cut even though it's it's an important job to have that's a tough one yeah I mean I think if I because I do think in the past the pay was competitive you know 23 years ago and I think it's just went down over time so um and I don't know exactly what academics make um a bit kind of an idea and the people have said things off the cuff but if it's any more near what they're saying it's not good enough not good enough and it comes with you know I think about and I don't mean to pick on Iowa because you and I are both Iowa grads but you know even my recent time in residency it just seems like every year there's more and more regulatory hoops and political BS and stuff you know that you got to kind of work through and I think that's kind of hard like you know people maybe don't want to go into academics not because they're not passionate about teaching the next generation but they don't want to have to go to five days a week of like bureaucracy and being scared about getting fired for saying the wrong thing you know what I mean like there I think there's a little degree of that maybe yeah I mean there's always a joke at Denver Health Plum teaching that they're like oh Dr. Whalen is going to have a punch card with HR, you know, like, not because I said anything like, you know, appropriate or the nothing weird just, but just like, because sometimes I don't hold my tongue if I think something's right or wrong or whatever. And like, I have to do, and I don't think it's bad, but like, there's like every year I have to do like six hours of training on the same thing, like getting catfish on email and all this stuff. Right. Training on epic. Fire extinguishers, safety or, you know, you know, your elder abuse training and, yeah, I get it. But I think all of us are like, well, I'm going to watch this stupid video and take this test and hopefully I get an 80 and remember, forget everything. So, I don't know, I'll probably get myself in trouble later, but no, it's, I tell Jenna my wife all the time, like, I'm next year, I think I'm going to go from, I'm going to start taking Fridays off because I, like, you work a lot of five day a week and my goal eventually is, you know, as I get in a good financial spot and the kids, I finally am done having kids eventually, like, I'd love to go back and drive to Iowa even once a month in adjunct just to kind of give perspective. I just, I, I, you kind of missed the residency days in that environment. So I don't really have a question or comment, but like, I look forward to the day when I can go back and do some adjuncting and teach people a few oddball things I picked up. Like, I do look forward. That's going to be a good day when I can make that happen. I think the best part about teaching and into your audience, I would just say, you know, anyone who's near a residency or feel like they do feel like they're getting burned out or just want a little change in the monarchy other day, like, teaching has been the best thing for me. I've been doing it for, I don't know, like six or seven years, it keeps me honest to, like, if I start cheating on something and I start teaching somebody something, like I'm cheating on a procedure, like everyone's done that, right? Where you're like, oh, I don't need to extend it here. I don't need to do whatever. I'm just going to, my prep doesn't look as good while no one's ever going to see it or whatever. When it's like show one or teach one, I was going to say C-1-1-2-1-2-1 or something. Yeah, yeah. But like if you're showing somebody, like, you know, want to be that faculty that as soon as you get done, they walk out of the room, they look at the resident, like, oh, God, Dr. Dr. Wayne, there's nobody's doing, you know, you don't want to be that guy. Yeah. So it keeps you really sharp and they're always reading new articles. They're prepping for boards. They're always kind of keeping you abreast of the new things. So I think it's really a good thing. Yeah, I think it's a great way to give back most residency programs will pay you a little bit to teach, not that anyone would do it for that reason. But I just think being in an academic environment, being around young people is really helpful for your psyche, your burnout rate, and I don't know, it's been one of the best things that I've done. I've really enjoyed it and a higher tool. So that's been good too. It's a good connection. Yeah. Secondary benefit there. Yeah. For the sake of wanting to make sure we got to this, the one additional thing I wanted to make sure we talked about at AAPD, like Todd, when your buddy Todd Gray was on, that was a really popular podcast. I didn't realize how important of a position he had at Sunlife and Dennequest until I got him on and was doing my homework and was like, man, he's like a very important guy in the world of like MCOs and Medicaid. That was a really good popular episode that had a lot of reach. But he was talking about the supply, kind of the supply ordering company that you guys came up with. And so I know we talked about this off-air before we got going. But I want to make sure you had time to talk about like what's changing, what's new, and the way that we order supplies. But my staff started ordering from your company and they love your fluoride. Like I feel like everybody's always hammering for a different place to get fluoride. And everybody's prices go up like, I've just bitched about this the other day. Key tech. Like what do you use to cement your stainless steel crowns? Fuji one. Fuji one. I feel like, man, I mean, this is a tall ass. But if you came up with an affordable way to get a really good cement for a stainless steel crown. Like I use those key tech max, key tech max, he caps a big, tight, tradable ones. They fill up like three crowns because we use those in residency. Even like five years ago when I opened a box of those was like 200 bucks or something. And now you can't get it for less than like five, 50, 600 bucks. And every year it just goes up, up, up. So it's like the price to fill up one stainless steel crown is ten bucks. And that's why I get so pissed. I try to be not mean about it, but when your assistant fills up a crown and then like drops it on the floor or, oh my god. You know, I'm just saying both, do they ever mix that and you're not ready? Oh, okay. Yeah. And you're not ready. Here's another one. Dude, when I first hired this last assistant, I love my girls to death in the training mode. They didn't, she forgot under stress. She forgot that those max caps. You got to put in a little stapler looking thing and, and hit it and click it to activate it. So she wasn't doing her nuts. She was just firing dust fuck everywhere, she, but she burned through like $40 worth a key tag. And I'm just like, just let me do it. And, and you know, you're trying to like not lose your cool in front of the mom. But I'm like, that stuff is so expensive. So man, if you could, besides the fluoride and some of the profile stuff you guys have solved, man, if you guys could, that smile, if you guys could come out with some like really good key or cement for like stainless steel crowns, there's a marketplace there to be had if it could be done affordably. But that's just me. Just, it's funny because you know, we just, and we don't have them on there yet. But so, our company's name is Smile.com. So S M I Y L. Yes. Yep. And anyone who's listening, if you're a first-time worker, if you put in Smile 20, you check out, you get 20% off. But Todd and I's idea was, well, we'll cut out the middleman, like, we wouldn't have any sales reps. We partnered with a larger company called MediDenta, which I think you use their hand pieces and stuff. And we're like, we'll test on the products, make sure we really like them things that would really usually put in our office. And then we're going to get, we're not going to do any like points or an advantage dollars or whatever. We're just going to give it to you as cheap as we can right off the bat and make a little margin. So the guy that, the company we partnered with, kind of the one of the things they always say is like, we're not going to be pigs. We're going to give a high quality product. So we started off with, like, prophy angles, fluoride, prophy based hand pieces, burrs. And so, you get on our website, you can see all the things we're trying to create with the p-dow. And kind of along the same lines with the cement, we're going to come out with a bond here pretty soon and we're going to have like, flowable edge bond. We're trying to get all the things that p-dow. And it's going to take us a while, but I mean, obviously I'd love for everyone listening to least try our products so you can get free samples on the website. Your fluoride's great. I wish you, I think I told you this, like, my girls are always, they want more flavors because right now, we're working on it. I got to admit that. It's great. Yeah. But it's like, the kids really like it compared, like, I've always been a wonderful guy because it's pretty cheap, but my big gripe, I've been guessing you've used a lot of the fluoride brands, probably, you know, the three amps historically. And wonderful is great. Like David, the founder's been on the podcast and his fluoride's good. It's just, sometimes it's a little inconsistent and the, you know, they all have their pros and cons. Some are kids complaining about the fleet. Yeah. We have problems too, but like back to your cement thing, I will look into that. If I can get a cement made, I will do it. But the other one that drives me nuts, you ever have an assistant like they pull up the bond, which is maybe the most expensive liquid on the planet, per volume, and they squeeze out a bunch for like an occlusal, you're like, one drop. Yeah. Because each drop, I mean, I don't know the math is, but it's expense. Yeah. But what do you use for a bond? What do you use for your bond or historically, if you use for your bond? I use prime and bond, but I'm switching. So the bond, I'm going to sell my website is the eight generation packed at bond, which has, it has the self edge. I still use the blue phosphoric edge before, but in a pinch, you don't have to. So, but I use prime and bond right now, I've used 3M's product, I've used, I don't even remember. I use those, I use those prompt L pops for a hot minute when they first came out. So I was like, cool. But they were really expensive on a unit dose. But yeah, the cement thing is funny because I've had all kinds of things where like, they didn't hit it with the gun before, they did it way before I was ready. Yeah. And then you're trying to push it down and it's like, God, this thing, I swear this fit. And then you look at the inside and the cement. And then you look at them, you're like, this one's toast. And then of course, the kids like losing at the mom's turn, you like, I got sweat running on my forehead. And they're like, we don't have any more in the room. I got to go, you know, and then it never fits good the second time. Like you take, because there's like extra cement. Like if you're doing A and B, like A's already set. And they're, you know, it's like, yes, it just, it, it, it, it, it turns it into a long out appointment when I would say to like one thing, like, and I, I know you have a ton of people that listen to this. But one thing I will tell the younger pediatric illness is like, man, I have days when I walk out. I'm like, I didn't do anything good today. And I have moments where I'm like, I think I'm just firing on all cylinders. I just like lay, I mean, I just do something that's just not good. Like I screw, I screw up plenty still. I'm the bigger, the better thing now is I'm better at winning it from my mistakes. But I still screw up all the time. It's hilarious. It's funny how that happens. I noticed that the more I practiced to your point, but like it comes in waves where you have days where you just feel like the man, like everything you do. You see all your recalls. It's like man, my class, class 2's look baller, everything, like everything I put in my little white box note that says GP, like garden prognosis, I did some hero dentistry on a strawberry bleeding pulp and it's like, it looks great. And you're just like, yeah, like let's go. And then you have days where like every kid's an F2, you know, your work looks terrible. You see some recurrent decay pop up and it's just like, I feel like I'm a hack dentist. Like it's just funny how it, it comes in waves, you know? Well, I like it when people are vulnerable to like, I remember I was taking oral boards. And for what reason Mike Matthews happened to be there at the same time. And we were hanging out and he said, he looked at me. I looked up to Matthews and all those guys, you know, in Cubivation, Tillion, Shankin and Tatray. And I really liked all those guys a lot. And he was like, man, he's like, I had a run last week where I couldn't get anyone numb. Just never be like, thank God, you're not, I'm not the only one because everyone's done that too. I feel like I'm really good at blocking kids, but I'll have like a day where I miss two or three and I feel like I'm about this big and I just. Yeah, I can't get it to see a little daughter, so what are some stupid? Anyway, so if you get a one star review that that'll ruin your day in a hurry like even if you tell yourself I mean that that could be a whole nother podcast So I shouldn't even really dive into that but yeah the cyber building with the reviews is bruised tough Yeah, that's so it's even it'll just ruin your day even if you know There's no validity to it like because I think we're just naturally people pleasers as kids Dennis You know, so when somebody doesn't doesn't like you even though you try your best like it's hard not to take it personally You know Well, and they like a reviews terrible because you don't have a chance to explain yourself or like Pass it out or yeah, I mean most of the time most pediatric Dennis and I think generous and Dennis in general are really generous I think and if something goes wrong or I'm always like I'll fix it. Don't worry about it. No charge This is get let's get it right and move on But when they do that and they walk out they're unhappy like well, you didn't give me a chance to like fix it. So Oh, yeah Yeah, we Like funny like side story about this But we we had a stretch of like two or three bad reviews in a row and they're all for just stupid reasons And we have a lot of like really good reviews too. So it's fine But you know, there it's it's never over like his filling fell out or you know or his his filling or the crown the crown came off For it's always like You know, we it's insurance or they say they they only missed one appointment in reality They missed four and we dismissed them and they're pissed about it. You know, it's it's always insurance or money Or something along those or something the front desk said. It's never like your dentistry was was garbage, you know, it's Yeah, which that's the part that we care about, but that's not what parents always person. No, I I had a family who When I swung at first start of my office we didn't take Medicaid and then I kind of forced Nell and Betty to try and then we'd have taken it and working out really well and But anyway, so long story short is like we have this family kept failing And they happen to go from private insurance to Medicaid. They've been coming to the office for a long time But they feel some crazy number of opponents like five And finally, I was like all right, well if they come like they we're gonna double book. I'm in like We'll see him if we get to him type of thing like I can't like five. It's crazy And they were like ops like that's a big deal And the mom wrote a one-star review and she was like man doctor Betty you are missed You won't believe what happened today And I didn't do it, but I wanted to write back home and be like yeah Dr. Betty is missed because when she was here, we didn't even take Medicaid So he wouldn't even have been in the chair But I but you know, you're never gonna win being a warrior with a keyboard So you just gotta let it go and know that you're gonna be stressed and anxious about it for two days But it'll go away it will yeah, for sure. Yeah, you just need to sleep it off a little bit That's funny the the Medicaid comment like the the course the one or two, you know bad reviews We've got or that we got recently like a month or two ago, you know It was for stupid reasons and turns and all that but it was funny because both of these moms You know, we're mad because we dismissed them one was really rude and just like whenever do x-rays and all the things The other one like failed all these appointments and the one mom that failed all these appointments They're both going back and forth. They're like, you know His office is always so busy and they don't have appointments and they have a strict fail policy because they see Medicaid And that's how they they fill their pockets. It's just greed. They just see as many Medicaid patients as possible And I'm like bitch you guys both have Medicaid like how are you complaining that like they were trying to paint the picture that We're bad because we Try to fill all of our gaps and our you know, we're staying busy by seeing a lot of kids with Medicaid And that like just chat my ass because I'm like it's it's how are you the one complaining when like nobody else for miles takes Medicaid I'm the only guy doing it and then you like use that as a reason to try to hate on the office You know, no no good deed goes unpunished. Yeah, and like it yeah, I don't know it's Those kind of people like I remember one time someone wrote a bad review and I looked at her reviews And she had given like Wendy's a bad or I was Taco Bell She wrote a bad review for a Taco Bell and I was like this is who we're dealing with like you got to remember who are you dealing with And like fighting with them's not gonna help and No one's ever wrote in a bad review and said it got dr. Sean is a huge jerk You know, or he wasn't nice to my kid or he hurt my kid. It's always like we called and You know, they wanted us to we our Medicaid wasn't active and they wanted to check our benefit. We was really mad I'm like you're mad about that. I mean This isn't a charity clinic like I have to pay all these people and like you know what I'm saying like it's just What are you gonna do? But yeah, this woman wrote a battery for Taco Bell and I felt like I remember I slept like so good that night Because normally like that would keep me up. I like this woman. What a bad review about food that is known to make you go to the bathroom So some people are just unhappy in life and like you have to think I try to make myself feel better I'm like I'm sure if you met this person at a bar. You be like this person kind of sucks Like you know, they're just probably not really happy people at baseline in life You know when the flip side of that is there's been sometimes when I deserved a bad review Like I didn't do a good job, right? It's up to fail and those people like Are so gracious Like you know like you do the things you worry about like sometimes they'll be like doctor shots. Okay. It was hard or something Like they're almost letting me off the hook and I'm just like You know, there's just there's all different heads of people in the world and Most people are really nice and understanding and I always go back to things people said to me and um I mean things like really important things like my canals used to say you're gonna make your your money one tooth at a time And I'll never forget that because it's just like you do every little procedure as good as you can and then move on to the next one And don't think about I'm gonna make so much money by the end of the day And my other my oldest partner Betty bar would always be like Sean run towards trouble That is stuck with me like anytime. There's a problem I don't know if I don't want to face it. I just face it and you just feel so much better like Especially with employee stuff like I'll tell all the young people on here like you be an employee that's a driving you Not's just address it and It usually like you feel so much better Even if they quit or what it doesn't matter. Usually they don't usually they You come to an agreement and everything's fine, but I don't know man. People are hard. They just are. There's no way around it Yeah, don't tell me who the minute out that you you said uh, you can have stress with money or without take your pick That's a good one. I think I have that too Yeah, I had one story. I've got to throw out your real quick and then we'll start wrapping up here But you're talking about the the things that stress us out as Dennis You know are are not always what we get bad reviews about but I remember like on year two of the startup um Uh, I was doing a GA case on like a six-year-old and uh He had a really small mouth and I was prepping a crown on L And I took my bur out and I had a I had an i-slide in for that one because he had partially erupted sixes that I was trying to get back and seal Whatever the case was I cut I cut his lip with my bur out a big diamond bur on in this tiny ass little mouth And I took it out and I just clipped the edge and it just cut right across the edge of his lip because he I had him pride open And uh, it just went across a vermilion border and it was bleeding and it was bleeding pretty good It's like dammit So I I sutured it. I felt like a little oral surgeon right across vermilion border sutured it cleaned it up Put some pressure look pretty good explain what happened dad was like yeah, okay, and I was like sweating bull So I'm calling on my oral surgery buddies documenting it all well then of course on the way home He's numb because I think I did an extraction to I don't whatever the case was he uh He rubbed the suture out on his way back to Hannibal like an hour away So then dad had to like go to the emergency room And they like held him down and glued it and mom told me all this like two days later because I'm like calling her She wasn't even at the appointment But I was just like I'm getting soon. I'm losing my license like done. Yeah, like close-up doors And like the mom's just like yeah, that's fine like like just felt like it was no big deal Like yeah, we handled it was okay like thanks for explaining or following up and You know a granted part of that is like rural Missouri for you like people just are a little more chill But yeah, I was like I thought I was done like stick of work me close-up shop and I'm out of here Yeah, I mean I've had that Not exact thing, but I've had that happen and Yeah, I mean if they wrote a bad review about me for something like that I'd just be like my comment reply would be that one's on me. Mm-hmm. You're right. Yep, you know like Because you're gonna screw up. We do hard things that are dangerous on little unpredictable kids and You're gonna screw up. You're gonna fail. You're gonna do things wrong. And it's hard to admit that because everyone wants to think they're so good And I think I'm good at it, but I make mistakes every day and I wish I didn't but I do I'll tell you one thing in the we wouldn't want to get into this, but um The x-ray reading software is gonna be a big help over the next 10 years Like that said you played around with that. No, but I haven't um, but are you using like pearl or overjad or some of these AI stuff? I'm not using any of them. I've just played with all of them I've even plugged x-rays into chat gbc and clawed. That's pretty amazing really Yeah, that's interesting. I haven't tried that yet, but I'm a big chat gp I pay for the premium level so I'll have to I'll have to plug that in and try it out do it throw some bike wings in there It's crazy see what it tells me I'll do that tomorrow. That's a great. That's a great exercise. We'll try it out Yeah, this is cool. We'll do another podcast a couple years from now and and the whole like you say It's just all gonna keep getting better and we're gonna have more tools at our disposal. So some exciting things coming Yeah, well, I appreciate you have me on I feel like you got you know I want to go back and just say like I don't have anything personally against DSOs It's just You know, I don't know. That's how I should have stated like I don't know. That's how I would do it It's kind of like sdf thing like I don't I use it occasionally, but I feel like you're gonna give me all in trouble with the No, I think people I think most people will agree to like there's plenty of people that are like It's just not for me and and I think that's you know Yeah, just not my cup of tea and I think that's I think most people will understand that most people know the pros and cons of them And the one of the last plug-all put in for like we talked about the changes in ordering and this has nothing to do with me or my company But you know the traditional ordering method was like, you know, you have a Henry Schein interrupt or a Patterson wrap like If your offices are not doing it like make sure whoever's doing your ordering and if it's you in your small office like Get on Zendolun get on source club Scout order net 32 like there's so many Ordering platforms and it turns out a cabbie wipes a cabbie wipe and you don't need to worry about getting advantage points or whatever the hell like Your second largest overhead. Well, it's like staff rent supplies, you know, those are the kind of the And benefits or whatever bit like Really taking the time to look at your supplies and your ordering like that can move your overhead like five points, you know like are even more So it's like worth the time to put into it So I don't know get on those on my platforms like Zendolun is a really good one like it's inexpensive and like that is a really good ordering platform They are they source the deal so you just put the products and vendors you want there and then It finds them, but since you know, we still use Patterson but since we switched away from it mainly like seeing a huge Change and are ordering You know how much we're ordering is you know to be honest I feel like I actually kind of feel bad for my I order a lot of Banko and Getzy stuff and I kind of feel bad for my rap because like I think she's like knows her sales or down because all the Younger docs everybody's doing that like you know using all these these suppliers to get stuff direct so I I don't love I feel like they're long term economic viability, you know those supply companies. I don't feel as great and I just feel bad Bath by rap because I've taken a lot of business But it's like at the end of the day you got to watch your overhead and get good deals where you can and be smart with your You're ordering and stuff to your point. Yeah, well, it's our money You know, I don't mean to say it like that like our rep came in last year And he's like we got to talk you guys are down 40% and I was like Well, you're upset. I'm thrilled We're still ordering the same stuff just not you know, I'm not I'm not I'm not vengeful like I don't want other nice people I'm not saying that but like I I don't know that that's that's just not the that's not the business anymore and you have to adjust and evolve and change so 100% I'm not doing that like you need to like take a closer to your supplies So yep, yeah, it's a good way to end it here Sean. We covered a lot of good stuff here But maybe we closed out with some contact info if somebody wants to ask a question about smile or residency or practicing in Denver Can you leave us with a good email or some contact info there? Yeah, and you guys can reach out to me about all those things You know, so I I helped start and work at the residency at Denver Health So if you're graduating dental student and you're interested in doing pito and want to interview at Denver Health or do an extern day or whatever You can email me at Sean Whale and [email protected] and my name's spelled S-E-A-N-W-H-A-L-E-N-D-D-S-A-G-M-L.com And then smile is just SM-I-Y-L.com And if you order any products from us Use code smell 20 and get 20% off And if you have questions about practicing in Denver or private practice in general, I have taken over I bought into a Legacy practice like Casey said I bought an old existing practice and bolder with my partners and then I'm starting I've scratched practice in Grand County winner park So I've made every single mistake you can make An opening and running a practice And I don't know that I could steer you in the right direction, but I can I'll answer any questions you may have My advice to everyone is keep your debt as small as possible That's good. Oh, that's a that's a we're gonna leave it at that because that's a great That's a whole podcast number three right there waiting to happen. So yeah another good one Sean buddy. Thanks for making it happen man. This is fun. I always enjoy talking to the manager I love to show a camaraderie. It's just it's great catching up talking shop here with you man. So I appreciate it Thanks for listening to the bruise and tiny teeth podcast Be sure to DM our hose Casey gets on social media with any listener questions Comments or tough clinical situations. We'll see you next week for another unfiltered episode [BLANK_AUDIO]