Ep. 5: How Long Should a Full-Arch Procedure Take?

Part 10:00

This is Podpopuli, podcast for the people. Hello and welcome to another episode of Beyond the Arches. I'm your host, Dr. Daniel Noorthoek, and with me today we have Lilia. Lilia is our treatment coordinator, and we are privileged to have her with us today. Thanks, I'm honored to be here. And today we're going to talk about why speed isn't the only thing to consider, right? Why speed isn't the only obsession that we should be thinking about. About speed, of course, being into teeth.

And so what we're going to talk about is sort of our timeline, why that works for us, but also what the other timelines are and what maybe the industry thinks versus what the patients really, really want. So I have a lot to talk about with this because, you know, I've done it the three-month, six-month way. I've also done it the 24-hour way, and then we've kind of settled on, for us, seven days. And, you know, occasionally we do...

We do it five days as well. We can kind of do whatever will work. Yeah, and I can even speak on, like, just the difference I see from patients doing, let's say, a little over a week process and even the five-day process. I've seen a shift in some patients and their thoughts on even that. Okay. Yeah, let's get into that in a second. So let's start with the traditional way. It works, as we've discussed. It's a good way.

It's replacing the teeth, and generally speaking, you're going to remand, and remand. And kind of tape and scotch glue and superglue a denture together in some way, shape, and fashion. Sometimes it's done at the time of surgery with the staff that's there. Sometimes that dentist will bring in another lab, and they can do that inside the office. And then also you can do it where you take the information, run it over to a lab real quick, and they do it in a little bit more of a controlled sense, and then bring it back.

Mm-hmm. Mm-hmm. Mm-hmm. Mm-hmm. Mm-hmm. Mm-hmm. Mm-hmm. It's stressful, and was at the time when we did it that way, because you have the transit time where you have a patient that's like, I want to get out of here. I'm done with this surgery. I'm sick of looking at your face. When is it going to get here? And you don't know, right? I can't even imagine them doing that. Yeah, it was insanely stressful. Sometimes you would just come up with excuses why you had to bring the case there and leave the patient with the other dentist and the staff, because you just didn't want to have to face.

You didn't want to have to face managing the patient. You would rather be managing the teeth. Yeah, I would rather be in the car driving. In the car. Yeah. How many hours are we talking for something like that? Generally, for a case like that, it would be maybe three hours start to finish from driving to bringing it back. But then, of course, you have the time of doing, picking up the impressions so that they could appropriately do it.

The biggest thing with doing the teeth, also switching back into doing the teeth on site, Mm-hmm. was there were a couple times, not a lot, but a couple times where we'd be working on teeth, and then all of a sudden you make a critical mistake, and this is a one-of-one copy, right? It's just handcrafted by you or someone else, and you or someone else would make a mistake or something or drop it, and it would shatter. And the times that I've had my throat, my stomach and my throat over that is just not worth it.

Yeah. I'd like to. I'd like to say I'm very grateful that you don't do it that way, and I was blessed to be able to start with Dun & One after that time period. Yeah, that was not a fun time. Yeah. But it does work. Yeah. It is something that you can do sort of on the fly. Like, you don't have to worry about leaving a patient in sort of an unknown period of time without the teeth.

But that's sort of the traditional way, right? ▶And you do that, and they wait three or six months, and then at the end of that, when you know that your implants are going to be finished healing, then you can go on to the finishing of the teeth, which is, I always say, it's about a six to 15 visit process. I know that's a big range, and it can even be a little bit less, depending on the techniques of the person and the people that are doing it, the protocol that they do.

But in general, it's about six to 15 visits. Yeah. Now, when you get to that point, there's a big... A lot of what we're going to... What we're going to talk about with speed has a lot to do with psychology. And so, you kind of have the psychological microcosm of what it's like to do teeth that day. You'll also have sort of that psychological microcosm of the patient having to deal with whatever ends up getting glued together on the day of the surgery.

And then you also have the other part that comes into it, which is the psychology of someone who has gone from bad teeth to... To something decent or acceptable, and then now is sort of tailor-fitting it into what they think is acceptable and a smile, with all of the three or six months of their friends and family weighing in. Having say, yeah. And we see it on a very small scale, but sometimes patients, friends, and family weighing in is not a good thing, right?

And so, you see it all when it comes to that. And you really almost have to be more of a... A psychologist than a dentist to do it the traditional way. And again, we're not talking about whether or not it works. It does work. It worked fine for me. I survived. ▶But you obviously always want... We always want to improve. Anybody wants to always improve. And so, over time, we worked away from that because of all of those things.

Yeah. Again, I can't even... I know other offices do it, and we always say, like, we're not here to bash on any... But I... I just can't imagine because of what I see and how I see how well it works for our patients. It's hard. And then, you know, again, it's just... Well, you would see, too, from being more of like the front face and that patient connection, you know, that would make your stressful... Your job, if we did it something like that, that makes you...

Your quality of life, your enjoyment of your job and what you do a little bit less. It makes the... The... The life... The span of your career gets shortened every time you have to interact with that. Not because the patient means anything by it, but it is just a very stressful, high-strung thing. It's a lot of money. It's a lot of pain and money and time and dealing with people. And so, it can be very frustrating. Yeah.

There's a... I think we have it nailed down the kind of the perfect, like, sweet spot in between. But I see, especially from doing consults with our patients, is... I see the one-day finals. I see the three to six months wait to the finals. ▶I see, you know, what we have, which is that, like, week or so process. And my thing is, I think patients, because we always talk about, like, their anxiety and, like, their nervousness around dentistry and especially this big step that they have to take with, like, extracting their teeth.

But I think they see finals in a day and they're like, oh, perfect. Like, one-stop shop. I don't even want to do this. Like, let's get it done. But... Yeah. I think it then causes problems in the end. It's like, you're not able to try the teeth out or have a say in your design as well. Maybe a little bit, but I think that anxiety plays a big role for patients thinking they want to do it in one day.

Absolutely. So... And it's tough to kind of combat that, too. There's so many things to unpackage here, but, you know, going back in through that... So, we went through a phase where we did a lot of cases the traditional way. And sort of to the point of the psychological aspect, you can see an office that's not very well bound and put together get shredded apart by full arch volume, right? So, you typically would get that good feel from getting teeth in and everyone's high-fiving and the patient loves you.

And then instantly that now starts this ticking time bomb of sort of... I always call it sort of the dark cloud, right? And there was always a dark cloud when we would do these at the tail end because the patient's really exhausted of going through the process. They're sick of seeing the dentist, right? And so, that dark cloud really can shred sort of the fabric of whatever amazing staff or not if they're not fully bound together and have good relationships with those patients that can shred it apart.

And it's a very, like, overbearing scenario. And so, I say all that because... When we started to get that dark cloud that was at the point that maybe it was going to shred the office that I worked at apart, we then started a foray, or my ex-business partner started this hard charge to find a way to do it in a much more comprehensive sort of shortened timeframe so that that wouldn't be such a big overwhelming task for everyone.

And what resulted out of that was buying the equipment. And getting into the lab and all of the stuff that we still hold near and dear to our heart. And we ended up doing 24-hour finals. At the time, I think we were the second people in the country, really close to being first, somewhere in that. So, the reason why I say that is because 24-hour finals is not a brand new thing. It's not invented by the big company that's out there.

And there's a lot of lessons that I think that... I haven't already learned them. They probably have some secret meetings talking about, well, what are these things that we're going to fix? Because I've been in there. I was the front charger. There were times in which I can remember my business partner and I, when we were first starting this, the reason why we went that way was the patient base and the issues with sort of aesthetics and stuff and the psychology that we talked about.

But there was also a side where we really saw the healing much improved. And so, we're saying, okay, psychology and the process for them is better, for their healing is better, and for us it's better. Why wouldn't we go this? Why wouldn't everybody want this, right? And it was very interesting to see. It was a very alienating experience because I can remember us going to conferences and things where they were specifically talking about full arch. Now, I didn't attend them, but we would be around.

And that's a separate... That's a separate thing because I was there all the time from Beth, my wife, having to be there. So, I was kind of like that, the kid that ends up having to go to school or go to their parents' work because they get off early and I was just kind of... Hanging out. ...bouncing around, right? But I can remember we would get these, we had these laminated little three-ring binders of all the positives, like slideshow on why somebody should do 24-hour finals and we had a way to do it.

We were in the lab at the beginning. And the disdain and disgust and the pushback from the dentist is something that will stick with me for the rest of my life because, granted, you want to have something that's a solidly based and research sort of concept, but as long as you're not doing any harm and you're working to improve, I feel like that's something that anyone should accept, right? Yeah. Yeah. Yeah. Yeah. Yeah. If you're trying to improve the process, that should be something that's somewhat accepted or you don't have to like it, but at least don't treat them like outcasts.

Yeah. I think a lot of, and not to bash any dentists, but I think they get, and maybe any doctor gets very stuck in their way of doing things and it could be a combination of they can't do it or they don't know how to do it, so maybe they're trying to make you feel lesser for doing so, but I think it's more so they can't imagine any other way of doing it their way. Yeah. Yeah. Yeah.

Every doctor, every dentist has their way of doing it. I think it's the ones like yourself that are open to change and learning and growing that like, then you see the possibilities of like, oh wow, you know, this can be done a different way. Yeah. Dentists are a very special breed that I happen to mostly on the whole don't really care for, but because they, they claim to be open. Yeah. Yeah. They're men of science, men and women of science.

Yeah. They are very open to any kind of concept. Conceptually, whatever, but then they're super hypercritical of anything that doesn't follow in their world. And that was very frustrating for me when we were starting that 24 hour process, you know, another one, and this isn't, this is, I guess a little bit plays into speed, but going back to when we would make teeth in that same day, sort of a trend that we kind of started to buck when we would go to the final right away was we weren't doing the temporaries.

And what I found was there's no pushback from the patient, right? Because the, one of the main reasons why the industry has pushed for teeth on the same day and that speed is because most dentists can't visualize or conceptually imagine them or any of their staff going without teeth for any period of time. Right. And that makes sense because for the most part, they're going to be people that took care of their teeth, didn't have any trauma, were able to have means enough to like fix it.

Have a nice smile. So they, they in their head say, well, I could never go without. Yeah. Well, who said you can't like the patient can't go without. Right. And so when we switched to not putting the pressure on a seven hour a day or five hour or six hour a day of working as hard as you can for ultimately a glued and scotch tape together piece of junk. Yeah. When we got away from that, we found some other benefits, right?

The, the bleeding doesn't happen underneath the teeth. Yeah. We get a lot less emergency calls, but also, and you deal with this too, like there really aren't any patients that say, well, wow, I have to go without teeth. You know, it's very few. And I think maybe the few in the consult that, you know, they're just hearing it for the first time from us, it takes about 2.5 seconds before we explain why. And they're like, okay, yeah, that makes sense.

I'm not going out to dinner. I'm not like you always say, you're not going to the movies. You're not going to the mall. You're going to be probably just resting. And, and I have seen, I hope we hope you're resting if you hear this rest, but no, but it's, it's true. I've seen one patient that had some bleeding in minor bleeding under maybe like their temporary prosthetic or something, but it's so much harder to control when you don't have that area to apply pressure to, if the, you know, if there's something instead of teeth over that wound.

Yeah. I mean, the whole thing about when we would. Yeah. Yeah. Even on the best glued together cases that we had, they, the surface is not perfectly smooth. It's not perfectly made. It's made under pressure and, you know, under the gun. And so it's not going to fit perfectly and you're not going to get great adaptation to create a good situation for the gum tissue to heal. But you're also going to get that bleeding because that, like we say all the time that that blood has not clotted yet.

Yeah. It's a brand new, fresh surgical wound. You're going to have residual bleeding. So why would you put something that's sort of poorly made in the way to then sort of have to then heal in, et cetera, and risk having to come in for an emergency visit? Yeah. So you started 24 hour finals. And then when did you realize that like the one week process, let's say like our Dunder one process timeline is preferred. So good question.

So, um, so yeah, so we were on. We were on the 24 hour thing. And I remember that it wasn't a push from my business partner, but I started to really get sick of getting good results for a patient, but not custom tailored for like maybe what they thought that their smile was. Yeah. And there's a, there's an aspect of them having a chance to pick out what they want to pick out and sort of feel the value of this big expense.

Yeah. But not everybody's going to want the same teeth. Like the shape of your teeth that you want are probably going to be different than mine. ▶So while you could still do your best and get them a good smile, um, with all the plant planning and things that we would do, it never, it didn't necessarily equate to the patient thinking that they were well cared for, that they were heard and that they got the results that they wanted.

And that sort of stuck with me for a little while, such that when we moved away from, from my old business partner and we kind of established ourselves on our own, I wanted to sort of incorporate a little bit more of that selection process and more or less just found that patients, if you gave them the opportunity to see another version, they were like, I want that. Right. They always jumped at it. Yeah. And, and they weren't so necessarily focused on getting it done.

They just wanted minimal time exposure to us. So eliminating all of the cutting and gluing and the temporary. And then they also wanted maximal input. And so how, how do you do that is you leave sort of an open-ended structure for them and say, listen, the surgery is going to be this. We're not going to work on gluing things together. We're going to invest a lot of money in perfect information on exactly where the implants are, where your gum tissue is and where I think your teeth need to go.

And then we're going to work towards that in a clean, sterile environment. We're going to get you a prototype and we're going to get your feedback. Right. Yeah. And so that's where that's kind of evolved. And it sort of, it wasn't we do 24 hours and now we do seven. It just sort of was one of those scenarios where we felt out where people sort of didn't need anymore. Right. In a safe space to say, look, I can get you done in seven days and you can be really picky or you can be not picky as at all.

Yeah. It doesn't say really it's case by case. I think it's a little bit more like typical now, I think kind of of what most patients are, but I think that's only patients see post-unlocked. And I think that's a little bit more like the baseline of other patients and now they want that like full process of seven days or whatever it might be. But I think like you said, it varies so much for some patients, second try in first, you know, try in and they're over the moon and boom, you can go to finals.

But I think them just mentally knowing, Hey, I have as much time as I need or as little time as I need. And they're here willing to like see me for another try. And if I need to, it's, I think that makes them feel comfortable to know that they're not being pushed to a final. Right away. Yeah. And you can give that control, right? So in essence, a patient that comes to see us in our world with a, with a seven day process or five, whatever it is, we're essentially giving them control.

Now we're to be able to give control. You'll have to be able to say in an expeditious or speedy fashion, I have to be able to do a good surgery that doesn't traumatize and beat them up too much. I have to be able to get the good information on where everything is and I need to be able to establish my landmarks as a dentist that cannot be screwed with right in a quick enough way that you're then involving the patient and still keeping them safe and doing it very predictably.

And so that's where sort of the paradigm shift came is because what we learned in 24 hours allowed us to get sort of that predictable surgery and then getting the machinery and everything else. And everything sort of built out gave us the predictability that we essentially can give the reins over to the patient. And we'll say reins of aesthetics and maybe some feel, right? So a lot of things go into it, what they think that their smile needs to be, how white it needs to be, where the teeth should show, how much gum tissue, a lot of things go into this.

And so I'll right here, we're going to talk about, we don't do, we don't do any typically we're going to back up for a second. Typically one of your jobs would be to have the initial discussion with a patient to review either a digital smile workup or sort of like a plastic or a paper smile to say, you know, what kind of things I see that yours, or maybe my job would be to say, I see yours are more square and this would be kind of where I lead you.

Maybe your job would be to say, Oh, you like those, but I think this, this might fit your face more. We would share that responsibility in the sale. And then when that patient went in, they would kind of go in with this preconceived notion. But whether it be digital or, or, or a physical copy that a person's sort of picking from, you're bringing in preconceived notions. And it's not that that's a bad thing, but it almost never at all relates to what that initial picture is.

I mean, we've, we've bought all of the fancy stuff. We've done all the scans. We bought all the TV monitors to show them and all of that stuff. And it really just comes down to the human interaction and them seeing a physical set of teeth inside their mouth for them to be really be able to tailor it. Yeah. My, I like to sell patients that want to have like some sort of like preview. And I always say, listen, it's like a shirt that you see in the store.

It's like a wedding dress. Like you think you have a great example. It's really like a wedding dress, because you go in. I don't know the thing about the wedding dress, but like, yeah, you have this perfect idea. You want, I wanted the lace and the long sleeve and all this. Oh my gosh, this is going to be the best dress I've ever. As soon as I put on, it's going to be magical. It's going to be the one despised it.

Done. Done. Get it out my face. Get that off me. So I like to think it's a similar concept of like, you won't know until you try it in your face. Everybody is so different. So patients will bring like a celebrity, a celebrity photo in which we love, you know, love, bring it in, but just go in knowing that like when you try and your faces, everything's going to be different, but that is why we try it in.

Like, that's why you get that. Okay. That didn't work out. Let's do another one. And it's hard to have this discussion without sounding like we're just fumbling through the dark. So like, you know, as we've talked through this, like we have the equipment to do it and we are using the resources that we do, but that isn't the only option or that isn't the only way you get to the final conclusion.

Part 223:21

Having that good information to build on a good foundation allows the freedom for the patient to sort of do whatever they would like and tailor everything in whatever you would like. And that, that selecting tooth size and shape and all of that kind of goes back to that whole dentist preconceived notion. The same thing with you must have immediate teeth is picking a shade and picking a tooth shape really, really, really, mostly kind of comes from if we need to do a crown on your front tooth or my front tooth, it needs to match.

It has to be the perfect shape. It has to, we have to have that verbiage to be able to relate in those pictures, to be able to relate to what it is. But when you're starting fresh, it doesn't matter as much. And the patient can then be given the whole keys to the castle, right? Yeah. And that process switching to that process has been absolutely probably one of the most amazing things. Things for our, our whole world because you get this, there's so many things that go into it, but one of them also is when we would do the old way, if you added up all of the visits, the fastest I can possibly imagine doing a top and a bottom, maybe 15 hours worth of total work.

And that was 15 hours of Dan Noorthoek work. And yeah, that's not even including you calming them in the psychology side that you had to do. You go through probably averages somewhere more like 20 to 25, 30 hours, somewhere in there. It's a, it's a lot. And right now, I think if you add it up total team time, you're looking at four to six hours. So we're gaining a lot of speed in those tools and things that we use, but also in that four to six hours, how many of that is the patient selection part?

Three or the vast majority. Yeah. And so, so that's really cool because of the old way with the 30 hours or whatever, we're going to settle on 27.5 hours. It doesn't sound like it when you say it, I'm like, Oh, that's not bad. But then when you compare it to what we do now, I'm like, wow, that is a lot in the chair. Yeah. And in zero hours of that was miss Betty or Jimmy picking anything out.

Zero. Yeah. That was leave me alone. I'm trying to get this done for you. Yeah. Yeah. Yeah. Your opinion is fine. Now it's like, okay, well we have 30 more minutes in the visit. Like, is there anything else? Yeah, totally. I think that's just a crazy idea. And like you said, we've, you've not even me. ▶Cause I started a few years back, but like you've tried all the ways that are out there. I feel majority of them.

So it's not that we can't do it. It's that you've already done it and you see why you don't want to do it. And this is how you do it now from, you know? Yeah. And that's something we talk about. And the console all the time is I can get you all of our equipment allows us

Part 326:22

to get you a final zirconia by the end of the day on your day of surgery. We can give a eight hour, an eight hour final, no problem. And it'll fit and the bite will be okay. No worries. But we're going to stop you there and say, think about it. We want you to be actively participating in deciding what you want. And we want to dial it in. And so it's perfect. I mean, you see it too.

We have patients all the time that come in and they want to make tweaks to the finals that they select then. ▶And that's another part of it too. I would say that those people are more of an example of your ideas of what you want as a, as a tooth situation, as a, as a smile are kind of constantly evolving and changing a little bit. Um, but not such that you would be able to dial it in.

And, and nail it on six months out either. Right. Cause a year and a half from there, they're wanting to make a tweak here and there. So there isn't a perfect amount of time that will get you there. I just know that with our process in seven days, I know that 99% of the issues are the 99% of the smile that you dreamed of is what we're going to be able to get out of it. Whereas maybe 99.1 might've been like the old way.

Well, well that's not worth the extra 30 hours. Yeah, no. And I think at least on my end in the consultations with patients prior to them, you know, agreeing or booking with us, I feel confident. Like I, I don't ever feel like I'm like miss miss. I don't know the word. Um, not like guiding them in the right direction. Like I, I feel like confident in what we're offering and I know they're going to be happy. So it makes it an easy job for me to persuade it to a patient.

Of Hey, this is what we do. We all trust it. We all believe in it. We all know you're going to have a great result. So it's a much easier job. Unlike if I had some, you know, whatever sleazy job that I knew didn't have like science back behind it and experience, I might be like, Oh gosh, I don't know if I want this patient to go through this, but I polar opposite. I know they're going to be in the best hand.

So, and that probably even relates to the psychology of our office, right? Like we always kind of brag about how our office, uh, dynamic is very free and feels very comfortable. Part of that is we have a very freeing protocol where we don't have to worry. Are we going to get the result that we want? Are you going to get the smile and the shape that you've always dreamed of? Are, and is the work going to be done?

There's really no stressful point at any point anymore. Right. And that the further we get along with this, the freer my life has become. It's just, it's hard to, to even look back at the old days, the old days and not cringe just how hard it is. It's very stressful. Yeah. But that, that allowed you to have the stepping stones, but it's true. I, and I think 99.9% of patients feel that and know that they're in good hands.

I, they, they know for some reason something doesn't go right. They have a warranty. They know we're not like have fine line behind our warranty if they have, you know, something we're going to take care of them. And I think that's the big message is like, yeah, this, the big message is speed. Isn't the only thing to consider. Yeah. Except for when it is. Yeah, it's true though, because there's lots of little finite little Taylor, you know, time is valuable to everyone.

So we don't want to waste a ton of time of theirs, right? We could have them live at the office and Taylor and tweak it in. But you want to be able to offer something that feels good to the patient, feels good to the staff and feels good to the doctor and feels good to the patient. And it's good to everyone involved. You know, that's a fair fee and a reasonable fee. It's expensive. It's a very expensive procedure to undertake, but you want to be able to provide value for that inside the marketplace.

You want to be able to provide a good living wage to everyone, a good, healthy environment where not everyone is stressed and be able to provide results that patients can then go and be excited for. And you know,

Part 430:42

every year goes by and I just, I look back and I, ▶I can't believe, okay, how much a little tweak here and there, but like how much different it's, it has and how much different it's changed, how much has changed and also how much better it's gotten almost every single year. Right. Now, probably the least amount of change that I've seen is really from when you came on and in spring of 22 till now in three years, all we've done is more or less gotten a little bit stronger, better, and a little bit more resolute in our process.

But for the most part, not much has changed because it just kind of works very well. You know, it's just very smooth. I was going to say, I think it's always been smooth, but it's just only getting smoother and I'm like, how's that even possible? I thought a year ago it was already so, but it just every day, you know? Yeah. And I see it, the staff that we always team, but like it's, so why don't you, why don't you weigh in on your five and seven day comments?

Cause I'm very curious to know what you, what your opinion is now. Yeah. Because you have a better firsthand experience on that. I see the person on for a five day visit versus a seven versus a 10 day. I see them all the exact same because I see them for the surgery and I see them throughout the process, but I don't see the last day and their reflection as much as you do. It's just a cool. And that's one thing that has changed as we've, you know, got some really cool lab, you know, machinery that allows us to, you know, produces zirconia and a little bit faster of time.

So we have, have options for some of our patients now to be in, you know, depending on the lab schedule in the week, but to have surgery on a Monday and have their finals on the following Friday, which I blows my mind even. And pretty cool. I will say patients, there's like a fine line, especially when discussing it in the consult of, I don't want to be rushed. Like I don't, and I'm like totally understandable. We are not here to rush you.

You have, we allow for, let's say double try-ins in a day, but it's a, it's quick to see, like you say, the psychology of wording it properly because they're not being rushed, but you, you don't want them to also feel in that way. It's such a hard thing to sort of communicate. It's almost like, think of it like watching my friend's parent, right? You have to be, let's say iPad time. Cause that's all the rage to discuss, right?

There's parents that don't let their kid touch an iPad, super strict and hard line about it. Yeah. And then there's people that don't care what amount of time that they're on a child on an iPad. The ones that are the healthiest kids that I see interact well with everyone and all the dangers of iPad time, whatever are the ones that kind of give a boundary, right? They, and so we have to, it's hard for us to sort of set that boundary and say, listen, like we're not strict with the 24 and 48 hour.

We're also not strict with anything beyond, you know, before two weeks, you know, if you want to come here and live here for two weeks and really, really, really dial it in, it's not going to cost you anything. Extra. You're more than welcome to come in as many times as you want. You know, inside that confines is the world's your oyster. Yeah. There's, there's a message that's tough to communicate. Like you want to do it fast, but not that fast.

Yeah. You know, and that's the, and, and as a treatment coordinator, I feel it's my job to kind of weigh out maybe who's a better candidate for

Part 534:05

something like that. And expressing that again, we're not here to rush anyone. Um, you know, and it's, it's a preference thing, but something that we could, we could physically do. So I'm curious to know the people that have had the extra weekend versus the people that have left on Friday. What, how does their experience differ? And what does that sort of look and feel like for them? I mean, not, I'm sure that they're both fine. Yeah. But what's, what's the sort of like deciding factor between the two usually, or what's the feedback like?

Really? Like the only thing I could think of as like physically healing a little bit and more so like maybe some bruising on a lip, you know, by Friday, still, but nothing that's like, Oh my gosh, like why? I mean, you know, nothing that makes me think like, Oh, I shouldn't offer this to patients and consults. Like, Oh, I feel bad. Like I think patients for the most part, love it. I think someone like myself and yourself, we need maybe less time off of work.

Like we need like a Monday through Friday if we were full arch patients. So this has allowed for patients, um, you know, who are good candidates for it to have proper time off from work, return to work a little bit quicker, return home quicker. If they're traveling. So again, I think it's only a positive thing. Um, you know, as of right now, we don't offer it for every patient, but it's, I'm sure in the works to come and.

Yeah. And well, that's hard too. Cause you don't want to just advertise as a five day because then the guys, it's like, uh, what's that movie where they go, um, I'm working on that thing. Six minute abs. And the guy goes, well, what if they come out with six minute abs? And he's like, Oh, I hadn't thought of that. Right. Five minute abs. Yeah. Five minute abs. Yeah. Um, so it's kind of like that. You don't want to, uh, alienate the, the seven day and the five day.

You also don't want to say like, we're totally wishy washy. Whatever you want is what we're going to do. No, again, it's one of those things like it's been more of a positive. And again, really like I, I think I can only think of like physical things. Like, like I said, it's a little swelling, a little bruising. Um, I think the sweet spot really is in that five to like two weeks window. I think the weekend, the weekend allows for patients, especially, you know, if you're one of the listeners out there, you probably are.

Most patients are travel patients. So that weekend, maybe more so like some R and R it's like they have that weekend to, I definitely see that maybe have a few days to like hit the beach or hit a, you know, whatever it is, museum. So I think that would be like the, the only real big positive is having a few days to have like a little downtime before going home. Yeah. Because it is a big expense. It is a big change.

It is in Boca Raton, Florida vacation. It is, it is. Yeah. Good weather. It is a vacation. Yeah. So you kind of get with a seven day, you kind of get, if you can afford to take the time off, you kind of get the window of both. ▶You do get a little opportunity to enjoy your time. Cause if it's a five day, it's not going to be the best vacation.

Part 637:05

It's more so like more point, not more appointment times, but more each day you see us. Whereas maybe like if you're here Monday through Tuesday, you might not have to see us on Friday and you know, you won't see us on the weekends. But again, both options work beautifully. And from my perspective, it's just what works better for that patient, you know? Yeah. And that's another point is that the, the time that we say, you know, say seven day or five day, regardless of what it is, the, the space for the amount of visits that are there are really just to see as many different prototypes as that patient desires, or, or wants.

And so sometimes we hit a home run on the first try. Sometimes that person wants an extra one. And so these patients that are coming, you know, sometimes they also don't have a ton of pain. It's just, it's however everything went. And so you can have a situation where person comes in for surgery on Monday and they're done by Wednesday, you know, maybe two, two prototypes. And if they're done on Wednesday and feeling well, you then have Thursday and Friday off.

It's not like, like you have to come. This is not a process that relies on you seeing us every single day. It's totally tailored to the patient. Yeah. And that's another easy thing I talk about in the consults. It's you're not going to be with us all day long. I, I couldn't even tell you what other offices are like with their process. You I'm sure waiting room is full. Exactly. Ours is not, we get patients right in because our schedule works so well.

And the patient is in for, you know, let's say an hour and a half at most a day. You know, four days, you know, of the week or three days in a row of the week. ▶I always say like, you're going to have more downtime. Like you're going to have more time to rest at the hotel or at home. Um, and then see us for those appointments. And you know, we should do a, we should do an episode on the empty way.

You should call it the empty waiting room because it's perceived. It can be perceived by patients as a negative thing that your waiting room is empty. But when I see it, of course we're seeing it from the other side. That's a positive for us that it's empty because it means that we're that efficient and that good at doing it, that it's empty, but it can look like you're not doing anything. I've had, it was like a crazy busy day.

Like we had, I don't even know how many arches a week, you know, crazy number. We know the weeks that happen. And, um, I had a patient come in and was like, are you guys only patient in the waiting room? Oh, you, you guys slow. And I was like, no, I said, something, like, no, we're not slow, but we're just really good with our time. And that goes to our team. Oh my gosh. They're amazing. Patient walks in five minutes early.

They, they'll get right back as long as they're done with their last patient. And again, I don't know what office I, I think I wait like 45 minutes at my doctor's offices to get back. It's solely a function that that sort of emptiness, if you will, is a function of time. It's a function of the efficiency of doing, it right. And resolute. Uh, and so typically when you're on an office, you know, one thing that you kind of get on your radar right away is that, that, that you want as many people happy and seated as possible.

And so as you're starting out, um, as a new dentist,

Part 740:34

you're paying attention to how much emphasis they put on kind of turning it over and not letting, making the patients wait. And it's a real struggle for, most dental procedures, just inherently to the dental procedures, but say full arch, you kind of just naturally run into these problems where it kind of runs over. And that, that starts also for the psychology for the patient of just being in that frustrating, like thinking that you're last place with the dentist.

And luckily for us, I've never once, we've never once discussed waiting times. Patients have been waiting longer than usual. And so that's been nice because we get all the benefits and we get to work. We get to achieve what most are out there trying to do with, while still maintaining quality, not rushing anyone. It's just a function of how efficient and resolute and straightforward the procedure is. Yeah. That's a funny, we should do a topic on that.

It's something we're so empty waiting room. I think we talked about it yesterday or today though. You know, our team, Dr. Lacks and I, we were like, it's amazing. Like how nobody really has to ever wait. And I'm like, you know, nobody ever wants to wait. It's always like the thought of, Oh, I'm going to the, the office, not our office, but like my off, my doctor's office, I'm going to have to take the half the day off.

Cause I'm going to have to wait. And it's refreshing to know that our patients, when we say it, we, we treat it almost like a nice boutique. Like we want you to have a nice cold water bottom. We want you to feel like we're friends and we get you right back because you, it's a big investment. And you know, we want patients to be overall comfortable on top of them making an investment. I'd fall over if I had to pay what we have to pay.

I just, it's a very expensive procedure and very difficult. I would, I will say though it is, but me hearing from consults and patients like, Oh my gosh, like I was quoted double this. Yeah. Not even a final, you know, whatever it might say. I, I had to own, I almost went out of the country for the same price. And I'm like, Oh my gosh. Like, so I feel better. ▶I know that their investment is well worth it.

It's not like, again, this goes back to like me having a good gut trust. Like I know we're, we're not doing something shady. I know we're not like offering them a bad product. So it's a big investment, but for patients in our Facebook group is a great, you know, place to see like patients say all the time, like it's a big investment, you know, it's something maybe they have to finance whatever the scenario, but very few would I ever think like regret it.

Yeah. Yeah. And, and another thing that goes into speed, I mean, everything kind of comes down to speed. This would be a seven hour topic, but it will, um, try to address it later. But another thing that goes into the speed is in order to have patients travel from out of state weekend and wake out, you have to have a protocol that is resolute and quick enough and addresses concerns fast enough that you can comprehensively treat a patient who does have a complication and then get them back on the road.

And so that's been another part of that's fun with sort of the way that we build cases and the way that we build information and the way that we build teeth. And so, you know, everything is speed. Like we said, sometimes speed is the only thing you should be focused on, but not always. Yeah, for sure.

Part 843:53

But, uh, I appreciate you coming in and having this conversation. It's been enjoyable and, uh, we've, we've had a good time, but, um, yeah, appreciate it. Thanks. Thanks.