Hello and welcome to another episode of the Beyond the Arches podcast. I'm your host, Dr. Daniel Noorthoek, and with me today we are blessed with the presence of Lilia. Lilia is our treatment coordinator, whom we've talked to before. We also have a special guest announcement and introduction: Blake Hauer.

Blake is soon to be the new surgeon on the street at the Boca location. We're very excited to announce his arrival and bring him on for a meet-and-greet conversation—an episode where we discuss who you are, where you come from, your background, and that kind of thing. So, welcome to the room, if you will.

I’m happy to be here. I’m really glad that Dan and I crossed paths. We’re going to be working together in Boca. To start, I can share a little bit about myself. Let’s talk about where you went to school, why you went to school, and how long you’ve been in school.

How long? I think I'm in the 23rd grade! Anyway, I grew up in South Florida, just outside of Coral Springs. I went to college and dental school at the University of Florida. Go Gators! Triple Gator, actually. I’m a triple. Right now, I’m finishing up my Periodontics residency at Nova Southeastern, so I’ve been happy to stay in Florida all this time. I met really great people along the way, and I am going straight from residency into private practice. I’m really excited for that.

For those who don't know, Nova Southeastern is in Fort Lauderdale, right down the street. We met you through the guy who used to run my program—more or less—the assistant director, Dr. Tucus. So, tell us about what motivated you to go into dentistry. Why did you become a periodontist? What is your background? Where did you grow up?

I was lucky to have a household that showed me what dentistry was early on. My father is a periodontist working in Hollywood, Florida, towards the tail end of his career. What I saw was that as a periodontist—a "quarterback" in the discipline—you are fundamental in setting strategic treatment plans for patients and being alongside them for the entire road. You’re not just a prescription provider; you’re here to maintain people’s health, help them recover from periodontal disease, and really help either replace teeth or keep teeth in people’s mouths for a long time.

I got to see the relationships my dad had with his patients. Being a kid going to the office, I just felt that good vibe of being in the dental chair. When I went to college, I was interested in the sciences. A funny fact about me: I was an organic chemistry TA for a while, and that was my favorite class. I just fell in love with that angle of science. I wanted to be in a profession where I could always be with people, work with my hands, and be able to talk to and understand people. I’m always outside doing things; I’m really into basketball and tennis. I just wanted to be in a job where I could be social, get to know people, and build those relationships.

That's probably one of the most exciting things as we’ve had him come through the office: the interaction has been very comfortable and positive, wouldn't you say? Definitely. I was just telling Dr. Hauer this five minutes before we started the podcast, but as soon as he leaves, Dr. Dan is always talking about how great he is and how much he likes him. We have a really cool, fun team, and it’s a great fit. It’s hard to find the right vibe.

I would tout that one of our best skills, in addition to doing full arch, is probably building a team and forming that team around whatever nucleus is there. We have different offices—the Tampa office, the Boca Periodontics office—and then we have our own "baby," if you will, the lab, etc. We have a lot of different microcosms, and they all require a different vibe and energy. Blake fits in really well with ours, which has been really fun.

Something that I’ve really liked while coming from residency and starting to shadow within the practice is seeing how they’ve evolved and the technology they use. I’m used to performing everything from the most basic to the most sophisticated protocols because, in residency, you learn it all. To see the pinnacle of what we have to offer patients with all the technology is really exciting, and I can't wait to use it.

So, going back—I didn't grow up in a dental household, and Lilia didn't grow up in a dental household. What is it like growing up with a dad that's a periodontist? Everyone thinks you grow up and the expectation is to be a dentist; that’s the destiny. It was probably the opposite. Circling back to the University of Florida, I started off as a general business major and eventually shifted that to be a minor, but I wasn't really sure what I wanted to do and there wasn't any pressure. I think that anyone who goes into dentistry can't just do it because they want to have a good living.

It’s a lot of hard work, time, and commitment to your patients. I think it's a privilege to see what dentistry is from the background—what happens both in and out of the office. That is what really motivated me.

When you were at home, let’s say on steak night, did you guys have really sharp utensils and perfect knives? If they were dull, did your dad throw a temper tantrum?

There are a couple of things there. Unfortunately, my mom is not a dentist, though my brother is also a periodonist. When we are at the dinner table—especially as I evolved later into my dental career and was finishing school—there were a lot of dental conversations. My poor mom has to listen to them all, but maybe she's getting a better education now and could work in an office if she wanted to. I'm sure she's proud. Adding to the point about steak knives, I don't think any of our dogs at home are using a scaler at least a couple of times a month, so we make sure to sharpen them as much as we can.

As we've gone through this, you're coming to the end of the education portion of your journey, but it's really not ending. As we've discussed, part of your whole journey has been figuring out what you want to do. This is true for myself and everyone else. You figure out what you want to do, head in that direction toward dental school, and then really tailor it during your residency.

What’s exciting for me is that I get to be the one who polishes everything off. I get to be the person who finishes the "creating" phase. Of course, practicing dentistry is a lifelong thing and you’re never perfect at it; you’re always polishing your skills, but you are entering that last little phase. Being the person responsible for those finishing touches is going to be really fun and exciting. We’ve already started getting things going. Over the next few years, we will constantly be pushing the limits and polishing things up. I’m really excited about having that relationship where we tag-team things back and forth while getting you trained and established in the way we do things.

I think we hold the same goal. Anyone in this field has to continue learning all the time. Everything changes with technology and new techniques. Something I'm doing now is becoming a diplomate for the American Board of Periodontology, just as you are. Studying for those exams and continuing to learn is so important. Joining the practice is going to create great synergy; I’m at the point in my career where I really want to learn, and Dan wants to do a lot of teaching. We’re entering at amazing time points that are mutually beneficial.

It took a long time. Patients really trust Dr. Dan, and I know they will trust anyone he brings in—especially now as a surgeon. I know they’ll trust Dr. Hauer. When they meet him, they’ll love him, but because you are teaching him and bringing him in, it will be a good fit.

The number one thing I'm looking forward to—not that I'm ungrateful for it—is the time when the reviews don't mention my name at all. What happens currently is that it can get in the way when an assistant's name constantly pops up; the public or the patient might initially look at that and say, "Oh, they put me with somebody who isn't all over the reviews. They put me with a second-rate person."

That is not true. They wouldn't be inside the confines of Done In One if they weren't top-rate. It’s just that some people have a longer established history, so those names show up. I'm excited to see when Dr. Hauer's name starts to pop up. That will take the pressure off the idea that a patient is being given to a "second-rate guy," which won't be the case. The minute we have Dr. Hauer here rolling up his sleeves, he is someone I trust. Patients shouldn't worry about it; it’s the same as if I were doing it myself.

Honestly, I think the minute you start doing consultations, patients will connect. That’s where it all starts. Moving forward, as you do consultations and meet patients, it will be a quick click for them to trust you.

Interestingly enough, we randomly ran into a situation last week. I went home to Michigan, where I’m originally from, and ended up there through Memorial Day weekend. Today was my first day back in essentially a week.

It was my first day doing surgery back. Yesterday, we were in the office, and I had to do some consultations. Today, I had some surgeries. Interestingly, I'm just thinking of this now: I don't know if there is a period of time where I would feel "rusty" doing surgery. It did feel a little bit foreign because it hasn't been a day-in, day-out thing for a little while, but I don't think you can really get too much rust there.

However, where you constantly have to be in practice is with the consultations. Yesterday, I absolutely felt like a fish out of water. It was funny because I was stumbling over my words; I usually have a pattern, and that pattern comes from dialing in the message we want to send to the patients. It's not necessarily from a "salesy" perspective, but it is about hitting the important key points. I have to hit every single one of those points so that we know our patient is educated and ready for what they are about to undergo.

Dr. Hauer, did you always want to do full arch, or how did that come about?

With periodontics, you have a deep appreciation for maintaining teeth and building a foundation, whether it's through guided bone regeneration (GBR). You get a background in all these techniques, and then you have patients who come in who maybe don't qualify for those techniques. Maybe they want something faster, or maybe they just aren't good candidates for that type of treatment.

My angle is that I want to be able to provide all that expertise. Full arch was interesting to me because there is a significant need for it with aging populations, patients who wear dentures, and people who want to change their lives and function in a fixed manner with their tooth replacement. While at Nova, I had a great chance to do a good amount of cases and work on protocols while shadowing in different offices. Being able to give people that chance to smile and function again is motivating for me, especially being on both the surgical and the prosthetic sides.

What you’re going to find is that you are intimately involved in seeing the results. That is something you don't typically find when practicing as a traditional periodontist. Typically, you might see a patient here and there who had their teeth done on a bridge for the implants you placed. You might see them in passing, or perhaps the next time they need a different tooth addressed, but you aren't intimately involved in that end-to-end situation. That is really where a lot of my motivation came from.

The sad part for you—and I was thinking about this earlier—is that this niche has changed. When it first became possible to take a person who had broken or embarrassing teeth and give them a full smile back without it being dentures, it was mind-blowing. The wave of appreciation, gratitude, and emotion you would get from that patient was awesome.

However, that has somewhat faded. Just as a Tesla being able to drive itself has faded into being "just a feature," the same thing has happened with full arch. We don't always get that same wave or endorphin rush anymore. It’s a little disappointing as you come into it; you’re entering a time where patients might say, "Yeah, these are nice, but there are 62 things I want to change about them." You’ve probably seen a bit of that change too.

The good thing about how we do things at Done In One is that it isn't a situation where you do the surgery and the patient has to go to a different office. Even though you may not be doing the restorative side—let’s say Dr. Lax is doing that—it is still in the same office and the same building. You can always pop over and check in on the patient. I know Dr. Dan does that a lot. Perhaps that is when you will see that gratification and the patients being grateful for the final result.

I do see a shift, and I think it's driven by online forums and YouTube videos. Patients are seeing so much more now that they have a very exact idea of what they want. That can be a good thing and a bad thing.

All I'm saying is that you’ll miss that initial rush of endorphins from getting immediate feedback. Now, there are other things that are very beneficial, and it’s great that we’re at a point where this is such an accepted technique that people expect it to work that way. There is a lot of stuff we’re going to talk through, and there are new things you get to be a part of that address the shortcomings of the old way. There were a lot of frustrations back then; there are a lot of extra gray hairs on my head because of them.

Those frustrations probably won't make it to your head, which is awesome. We could probably do a whole series on the things you saw that you had to go through—the "Gray Hair Series." I don't know if you'd like that, but I think listeners would. I'll just sit here, listen, and say, "You don't have to do this or this; I already went through it."

Absolutely. As a company grows and a team builds—we were just talking about that in the office the other day—that’s the beauty of it. We’ve gone through it, and we know what to do and what not to do. When you've seen every scenario, you know who to talk to and how to talk to them. Getting you those "reps" is going to be fun to watch over time.

Visiting the office so far has been awesome. Seeing everyone in their role and how clean the protocol is—from the front desk interacting with patients, to the team picking patients up from the airport, to everyone facilitating hygiene, surgery, and the prosthetic side—is impressive. Everyone has a defined role and works together. It’s a really good operation, and I feel like everyone at the office is happy and always in a good mood, which is encouraging.

Getting that predictability is what really was able to shift everything. Getting a predictable message from the front, a predictable message from the consultation, and a predictable message out in public with patients reviewing on their Facebook pages creates an entire ecosystem. That has probably been the biggest quantum leap we’ve ever made, more so than any technology or help of any sort. Just having a buttoned-up package has been amazing.

It’s such a big procedure for patients. It’s a big investment involving travel and other factors. If one thing goes wrong in that chain of links, patients can get upset very easily. But that is what we do best: we never let there be a weak link. We are all human, and mistakes can happen, but for the most part, very few mistakes occur.

One thing to add, going back to the education side: what really encouraged me to come here is that our surgeons are periodontists and specialists. Dan can speak to why that’s important, but for me, it's vital to know we are on the same page about having a formal education to provide this service.

It’s a difficult thing to wrap up into a couple of sentences, but it makes a big difference. There are plenty of cases that can be done by a general dentist, and it's not to say they shouldn't be doing them. It’s within their scope. The problem is that you might be missing some education in the management of complications. When things go bad, they can go real bad. You really need to know how to handle it to prevent a situation from escalating. You want to keep a "bad" situation at just "bad."

A lot of the parameters we think about during residency aren't necessarily just about what you’re learning; it’s about the process of how you think about a problem, how you approach it, and the background of the issue. Keeping those things in your flowchart and being able to manage a case from start to finish is very important to us at Done In One from a surgical side. We don't want the surgeon doing the whole thing, because there are prosthetic aspects to the teeth that we leave to the restorative dentist. They have their place; it's just not for us in surgery.

As an example, I saw a clip on Instagram the other day. I won't say the person's name, but instead of calling it an "incision" and "reflecting a flap," he used verbiage that grated on my ears—something like "scraping and pushing." That’s not what we do. You are taught a very particular set of terminology because when you incise tissue, you are making an exact cut. You don't want ragged edges, and you don't want to traumatize that tissue.

Not knowing that distinction scares me for the person getting surgery from that individual. It might seem like minor hair-splitting, but you need to know that it must be done with a sharp instrument and clean margins so the patient can heal well. This isn't just "flipping it off" or "scraping it off." There is a very particular way of doing things that manages trauma.

So, does Dr. Dan "lay" a flap or "raise" a flap?

I lay flaps. That was important.

Let’s get into some personal stuff. You mentioned basketball and tennis. What kind of cars do you like? Where do you want to live? Tell us more about you.

Are you the type of guy who lives in a studio apartment and travels all over the world? Do you have any hobbies of interest, like learning Japanese, drawing, painting, or playing the guitar? I guess we should go one category at a time. We could do this for a couple of hours, right?

Let's go with traveling; that's a good topic for me right now. I love to travel. I love to see different cultures, try different food, and just see it all. I'm actually going to Japan in two weeks to celebrate a little end-of-residency trip. We'll be going to Tokyo, Kyoto, and Osaka. Then we're going to take a plane to Okinawa, which is like the Hawaii of Japan. I'm really pumped for that.

Congratulations, that is well-deserved. I'm going to interrupt you for a second. You've obviously done research and read the guides. What's the weirdest thing that you're excited to experience or try? They say it's like showing up in a different reality. What's the craziest thing you want to see, eat, or experience based on your research?

That's a tough one. I would say I'm open to just trying random street food. I know that in Asian countries, there is just random stuff like, "Hey, eat the scorpion," or crazy raw fish and tuna. I think it's part of the experience. I’ll probably bring some Imodium, but I think trying all the foods is going to be awesome. One thing I researched that I really want to do is visit the tuna capital of the world, which I believe is just outside of Tokyo. I love sushi and tuna, and that's where they fly in a lot of the products for the restaurants. They have this crazy market where they apparently sell tunas worth millions of dollars. I want to check that out.

Before I started the residency, I traveled for two weeks to Thailand. I had an amazing time there just being immersed in a different culture. It's also very inexpensive there, so you live like a king. Being active every day—waking up early, getting your steps in, seeing the nature, experiencing the cuisine, going to temples, and going out on the water—is great. I've been to spots in Europe, the Caribbean, Mexico, and Asia. Traveling is fun. It will definitely be harder once I start getting acclimated to working full-time, but I think it's important to make time for myself. I really want to be able to travel for the rest of my life.

You mentioned the guitar. I played guitar until about middle school and then I stopped. Once in a while, I'll go back to it. My favorite band to play is probably the Red Hot Chili Peppers. You will probably hear me playing "Californication" a thousand times; it's the only song I'm actually good at. Music is great. I love going to concerts and traveling to see good bands.

We wanted to hit travel and music. What else did you want to hit? I asked what your favorite car brand is. Are you a car guy? A truck guy? Or do you not care?

I'm not a truck guy. I'm actually a scrubs guy when it comes to attire. Dan and I have been talking about this. He tries to push his points, but it's not going to happen, pal. He's a polo and pants guy. He pushed his point and got me five polos, so now I have to buy some pants.

Is this like a topic in school that you have to—?

No, I just keep bringing it up; I don't know why. You go one of two ways when you graduate. But car-wise, I drive an Audi. I like it, but I don't think I'm a huge car guy. At home, I have a two-year-old Labradoodle named Peaches; she’s about 50 pounds. I think my next car will be a little bigger, just to have something to get around with her. My girlfriend, Beth, and I take the dog to the beach.

Beth and Beth? Interestingly enough, both significant others are named Beth, which is crazy.

My husband's name is not Beth, so that was my next question. I can't contribute to that, but his name does start with a B.

The "two Beths" scenario was a cool find, for sure. It's very funny. But yeah, I'm not a huge car guy. Maybe that will come, but maybe not. You'll probably save yourself a lot of money not being a car guy.

Yeah, maybe I'll just Uber everywhere. That idea could work, too.

We might wonder about your criminal past. We actually had a guy come in who was late because his girlfriend had to drop him off. We legitimately did a full background check on him just to see if he had a checkered past or a reason why he wasn't driving his own car. It seemed a little strange to show up for the first time at an office without a driver's license or a car. I hope you're not listening out there, unnamed individual! I wasn't part of that story. We aren't judging; nobody is safe from stories. We just won't say names.

That's true. And he also asked where I live. I don't live in a shack or a hut, or whatever question you had.

I said a studio. Are you in a studio apartment?

I'm in an apartment. I live in East Fort Lauderdale, which I love. I'm really passionate about Fort Lauderdale—just being able to walk to places and go to the beach. Like I said before, I love walking to the tennis and basketball courts. I may stop playing basketball soon, though, because I have to keep my hands healthy.

I didn't even think of that. Don't lose any fingers! But then again, we have a woodworker over here, so maybe we're both high-risk.

You can't do full arches without fingers, I guess.

Well, that's where you come in. You'll be taking over for me. I suppose when Blake is here, Dan will exponentially increase his amount of woodworking. The risks will increase.

The risk we have here is that we have a tennis and Japan-travel guy, and then we have a golfer. I'm also taking an exotic trip this summer down to Key Largo.

I was like, "Where are you going?" I felt like we would have discussed this.

All the way down to the Keys, which is risky. It’s very far outside my bubble. So, the bottom line is that I'll only see Dan in the office, because he won't be on the tennis court and he won't be in Japan.

Exactly. Well, I appreciate you coming in, Blake. This has been good to get to know you—for both future and present patients. It’s a great introduction. A long time ago, I did a podcast with a good friend of mine, Craig Spodak, and his partner about full arch. To this day, new patients still come in and say, "I listened to your podcast." This will be something that will live on for a long time to let people know who you are and what you're about. This won't be the last time we have you on, but it's a good introduction. It's good for people to know more than just the fact that you like teeth. Talking about going to Japan gives a good background and makes you human.

Patients get really nervous. The thought of a doctor or dentist makes a lot of patients very anxious, perhaps due to a bad past history. Maybe I'm being biased, but we have the coolest, nicest doctors, and every patient knows that. Adding you to the team is a perfect fit. I know they'll be really excited.

I appreciate it. As we evolve together, there will be a lot more content to provide to our community and more episodes. Maybe we'll talk about the things we do in the office and our protocols. I know we have a lot of episodes planned, so I'm looking forward to it. It was great to introduce myself to everybody, and we'll take it from there.

Real quick, I forgotten: what does Beth do?

Beth is a consultant. She works with Deloitte, which is a large company. Luckily, she works from home, which is really great for her. We met at the University of Florida. She was living in DC and New York City, but she was able to take her job to Fort Lauderdale and work remotely. It's been awesome for us. She's really enjoying her job, and everything is good.

How did you guys meet again?

Funny enough, we met on Hinge at the University of Florida. We both were in relationships that ended and then went on Hinge. Apparently, it was the first date for both of us on that app. Who knows who is being truthful there? I can't say.

I'm so old I don't even know what Hinge is.

I guess we can take a whole new angle on dating apps now. He met his girlfriend at a "door."

Shout out to Hinge. If you guys want to collaborate, this is a real story.

Well, now that this will be posted to the internet forever, you have to stay with Beth forever. Beth, you don't have to worry if you're listening; Done In One likes Beths.

Yes, we are "Beth people." All right, I appreciate you coming in, and Lilia, thanks for introducing our new talent. We're excited. Out with the old and in with the new!

Goodbye! See you later. He's not very old—he's lying!

We appreciate you, Blake, and we appreciate everyone out there listening. We look forward to another episode. Remember to follow, like, and subscribe. We appreciate it. Thanks.