Michael Tischler and Claudia Patch: Episode 142

Transcript

[0:00:22] Charlie Hoehn: You’re listening to Author Hour, enlightening conversations about books with the authors who wrote them. I’m Charlie Hoehn. Today’s episode is with Michael Tischler and Claudia Patch, the coauthors of Teeth Tomorrow. This conversation is for baby boomers who are really at the dental turning point. Maybe you’re ready to eat without pain or speak without feeling embarrassed. Most of all, you’re probably ready to smile confidently again. If any of those situations apply to you, this is your episode.Your smile and self-confidence are assets but as you get older, they get severely compromised by tooth decay, tooth loss and the health and psychological problems that often a company major dental issues. In this episode, Claudia and Michael lay out their unique solution that helps their patients with dental distress permanently and gives you a great smile that last a lifetime. Michael is the founder of the Teeth Tomorrow franchise network and the implant editor for Dentistry Today magazine. Claudia has been recognized as one of the top 25 women in dentistry by Dental Products Reporter. In this episode, they will give you all the information that you need in order to make the best decision about hour tooth replacement options so that you can ultimately improve the quality of your life. Now, here is our conversations with Michael and Claudia.

[0:02:19] MT: As we were providing this acrylic hybrid option, which has really have been the standard for most dentist for many years. That was what was accepted, it was often called all on four and it was made out of acrylic with a metal substructure. When we tried this, the success rate was so much worse than what I had done previously. At the same time though, I had opened up a dental lab in my office to cater to all the dental services that we needed, it was a large practice, Claudia just joined us and at the same time, two doctors in Barcelona came here, we believe things happen for a reason and they kind of handed us this Prettau bridge.

[0:02:56] CP: They weren’t even here for that reason, they just happened to bring it with them to show us because they thought we would find it interesting and just hold it in our hands. I felt like it was glowing, like a halo around it because we saw the potential of it meeting our needs and we trusted them and what they were telling us about the success that they had. Just to point out, there have been many research studies that show for acrylic hybrids, we’re not the only ones who were having about a 30% issue, that’s published in the literature, it’s just something that type of restoration was vulnerable to.

[0:03:36] MT: Yeah, it’s plastic. We saw this Zirconia Prettau bridge and we realized that this really has the potential to really be a solution for the problem that we saw. It looks similar and avoiding a lot of the complexities of the previous solutions that are mentioned in the book,, what’s called FP1, porous infused and metal bridges, removable, over dentures. And I really believed it, I believe them and I put two and two together and I said, I’m going to take a chance here and I basically reconfigured my dental lab to be able to mill cad cam, you know, with the computer design, this bridge and we started supplying it for our patients. At that point, there was really no articles to back up its success. Maybe there was one, and that was 2012, maybe about 2013 or 14 there was one article by doctor Rojas that showed some success with it, a limited study maybe a 15 arches, over three years but I knew that this was going to work. I knew it from the experience of people that introduced it to us and in Europe. It had a track record.

[0:04:39] CP: Also, a knowledge of the material, we were using Zirconia in other aspects of our practice in terms of crowns and bridges, it’s a very strong material and it has a lot of properties to it that are very favorable for its use in dentistry because it could be, it’s tooth colored, it could be stained and glazed and having something like Zirconia which is so strong and comparing that to something like acrylic. I mean, it’s beyond apples and oranges, just totally different ends of the spectrum in terms of quality.

[0:05:14] MT: Yeah, it also made sense to us because the fact that Zirconia has what’s called such a high modulus of elasticity, meaning, it’s very rigid. And dental implants are some of the fence post that you want to splint them together. In addition to that, it also was very cleans-able, zirconia, we knew that. We had opened up a lab in the office here and at this point now, this is about six years later, we’re actually – It’s been such a success, we’re the only lab in the US and possibly worldwide that is focused exclusively on making this full arch solution with Zirconia. With 25 employees, it’s grown rapidly.

[0:05:51] Charlie Hoehn: You’re the only lab doing this even though it’s that much more effective?

[0:05:55] MT: Yeah, it happens to be at this point in time, we’re the first and only lab that’s exclusively dedicated to this full arch solution with Prettau’s or zirconia. Which happens to be the oldest type of zirconia that’s been used for this in the world and we are the largest user of this product that’s made by this company called Zirkonzahn in the United States, it’s been quite a journey.

[0:06:15] CP: Yeah, I have to say Michael, you know, really, it started a tidal wave because once we started doing it, it didn’t take long until other labs started noticing it too and having some copycat type of products but yeah, it’s really changed the role of zirconia in the US dental market. I mean, I never used to see the type of advertisements like we started seeing after you started promoting it.

[0:06:44] MT: Yeah, I mean, I was key opinion leader for implants for years before that and when I made this move to hang my hat on this solution, it seems like a lot of people followed me. Now, over the last two years, we’ve had two articles published because what we’ve done is I’ve always documented my cases, first of all, we documented our cases in the office and then we also had the lab data and the article that came out and the journal Prosthetic Dentistry last year showed over 2,000 arches through different clients a hundred or so or 200 different dentist to US and Canada with a 99% success rate. This year, we came out with another study in our private office here with about almost $200 arches with a thousand dental implants, mimicking the same results with a 98% success in implants and then 99% of the prosthesis, the bridge. We’ve really substantiated ourselves as the leaders in this and we decided to write a book and tell this story and that’s what Teeth Tomorrow, The Turning Point for Baby Boomers is about, we’re here to take this solution that we found that we’ve really honed surgically and prosthetically here in Woodstock, New York at our practice. Which is actually two practices now because it is time here that Claudia and I have kind of merged our practices and separated our practices and merged in one way, we work together. We decided we were going to write a book that addresses this huge baby boomer need.

[0:08:09] CP: Also, really wanting to educate patients about what all of the available options are because there are different ways that this can be approached and just provide an educational resource for people to be able to look back on. You know, this is overwhelming amount of information for a lot of people and we want them to really be educated. It’s a big decision in a lot of people’s lives. Probably one of the biggest decisions they’re going to make for some time. It’s putting themselves through surgery, it’s financial investment. We want them to be able to really understand what the different options are and choose the best thing for a lot of people, wholeheartedly, either Michael or I would have this done for ourselves and in fact, we did it on Michael’s mother. It’s something that we really believe in and I think that’s evident to many patients. But it isn’t the only way to go, we just want people to choose what’s going to be best for them.

[0:09:13] Charlie Hoehn: In chapter one of your book, you talk about dental health and quality of life and what are the affects of people’s teeth failing? I understand the solution that you guys provide but let’s paint the picture a bit of how big the problem really is, just to get a sense of how many people this is affecting.

[0:09:32] MT: Sure, basically, what’s happening is, we’re primarily dealing with the baby boomer population and there is about 75 million baby boomers, it’s one of the largest segments in the US population, these people are between age 55 and 75 roughly and what’s happening is, every day, there is 10,000 of this baby boomers turning the age of 65. At the same time as this baby boomer population is out there and in some ways increasing as they get older, towards the older spectrum, their dentistry is aging and the reason that we wrote and entitled this book called The Dental Turning Point is that these baby boomers need to make some big decisions here. What’s happening is, these people are coming in from various marketing that we’re doing to advertise Teeth Tomorrow as a brand, it is a national franchise, we’re going to have 250 locations in the US, probably within the year or so or maybe a little bit more. Right now, we have almost 50. These patients are coming in and they’re frustrated and they’re frustrated because they’ve spent a lot of time and money over the years, they’re in their 50s, 60s and 70s. Some young or some older but that would be the basic, the median age I would say, our age group is right in that area, baby boomers and they’re frustrated because they’ve spent a lot of time and money and they’re looking for a solution as they’re entering the later years in life and I have to say, we’re very compassionate about the fact that you know, we don’t want people at that point in life to have dental frustrations because when you have dental frustrations, it really goes in so many areas of health, of financial concerns, self-esteem, nutrition and Claudia can really say more about that.

[0:11:17] CP: Yeah, I think there are two main categories of patients who are coming in where they’re really struggling with failing to eat. There’s a tremendous psychological impact because your teeth are not something that are easily hidden. We need to talk, if you’re not smiling, you come off as unfriendly or not as likable, there’s a big stigma associated with poor teeth in terms of assumptions about socioeconomics.

[0:11:46] MT: Which is an outcome in New York Times about a month ago talking about people’s employment is affected by having missing teeth because they’re less employable.

[0:11:53] CP: Absolutely, I mean, there are so many jobs that if somebody has awful teeth and their teeth are let’s say, black or really missing and just looking awful, well, I mean, if you’re out and you need to interact with the public or be on a job interview, it is impossible for that to not have some impact. Even if it didn’t, it still has impact on people’s self-esteem and how confident they are in themselves. Time and time again, we see people come in and when they come in to the office, they are at like 70% of what they are by the time they’re done. When they finish and they got like big smile on their face and just a restored sense of confidence, it’s really remarkable. There’s some people where it’s not a psychological issue for them but a functional issue and that’s certainly something we see as well, you know, people who often times maybe have accepted whatever the situation is in terms of their appearance. But they can’t eat, they can’t eat comfortably and they’re struggling with nutrition and that’s another thing that we see people come in with. I have to say quite frankly, more people come in with the psychological effects, being first and foremost before function.

[0:13:12] Charlie Hoehn: Yeah, definitely. As somebody who lost or got their two front teeth knocked out when they were 16, I can affirm that that is definitely first and foremost in the minds of folks with teeth problems. The people who come in, what are their biggest hesitations with getting – how would you call them? Is it dentures, implants, what’s the correct terminology again?

[0:13:37] MT: Well, you know, I kind of see them first because they come in and they’re put in my room for the initial, just assessment and then I have Claudia come in and what I see is people that are frustrated and they’re coming to us for a solution. They’ve done research, one of the things I feel good about is that on the website teethtomorrow.com, it really spells out that there’s different options out there and we feel that dental implants are the best option. Then when we go through the other choices that are possibly implant supported that are removable, we feel what we’re offering with Teeth Tomorrow on zirconia is really the ideal choice.

[0:14:14] CP: There is definitely a psychological component and like I said, that’s the motivator for so many people to see treatment, there’s a psychological component to having teeth that come in and out, even having an implant supported, restoration, that’s high quality if it comes in and out, it doesn’t feel like It’s your own. That’s something that people are really impacted by –

[0:14:37] Charlie Hoehn: I’m curious as well, as to some of the hesitations people might have to diving in. They’ve done their research at this point, they know it’s a huge problem, they’re ready for a solution, what kind of questions do they typically throw at you?

[0:14:52] CP: There is a large component of patients who are seeking this treatment who are faced with really seeing that there isn’t another choice, they have to do something but they’ve been held back by fear and I think in some ways, that fear is exacerbated because so many of them have had dentistry and then had problems with the dentistry and if you’ve had problems with your teeth and had things treated and retreated, you probably have some negative experiences under your belt and there’s some anxiety about that. That’s one of the things that I think really holds people back, it’s also an unknown, you know, they’re assuming that it’s going to be a very painful procedure so that that’s also fear provoking, through, quite frankly, it’s unfounded but that’s counterintuitive. That holds people back.

[0:15:45] Charlie Hoehn: Let’s talk about those two which is, how painful is it and how long is the procedure and am I going to have to keep coming back in, what’s it going to be like?

[0:15:55] CP: Can I share with you what my patient today said?

[0:15:57] Charlie Hoehn: Yeah.

[0:15:58] CP: We have a patient who I delivered their temporary screw retained temporaries today, he had surgery yesterday, he came in, I don’t know, should I tell what he actually said? He said, “Last night, he felt great, had sex with his wife, he feels fine.”

[0:16:15] Charlie Hoehn: After surgery?

[0:16:16] CP: I was like, okay, I haven’t had somebody tell me that before. He’s like, I feel great, I feel no pain, it’s like nothing was ever done. You know, that’s perhaps a little bit on the more extreme and – but I hear that all the time. That people are really not having pain and he left just ecstatic and he just had the surgery yesterday and he’s feeling really well. I hear that time and time again. People get bruising and swelling but they usually have less pain than they’re anticipating despite the fact that I have this same conversation with each of them.

[0:16:59] Charlie Hoehn: Author Hour is sponsored by Book in a Box. For anyone who has a great idea for a book but doesn’t have the time or patience to sit down and type it out, Book in a Box has created a new way to help you painlessly publish your book. Instead of sitting at a computer and typing for a year, hoping everything works out, Book in a Box takes you through a structured interview process that gets your ideas out of your head and into a book in just a few months. To learn more, head over to bookinabox.com and fill out the form at the bottom of the page. Don’t let another year go by where you put off writing your book. Let’s talk about actually taking responsibility for the investment in our health, right? So what does this ultimately mean? Like whenever people have to make this big decisions, they are on the fence, what do you tell them to encourage them about their vision of the future?

[0:18:02] MT: Well I always start with the fact that you can’t go back in time. I don’t want people to feel guilty about either not being able to afford it in the past or fear of the dentist or not going to the dentist.

[0:18:15] CP: I always say this is a judgment-free zone here because whenever it is somebody’s coming in with I probably have seen something worst and even if it is worst, who cares? You are here now.

[0:18:28] MT: Yeah and we always say that and Claudia really emphasizes that and these people are really at this point they are coming in from this huge choice and solution and they’re beaten up. I mean psychologically, they have been through a lot. And their scared and this is one of the reasons that we really are cognitive of that and we tell them we offer sedation. We don’t do these full mouth reconstructions with Teeth Tomorrow without a board certified anesthesiologist in the room to make sure it’s done safely, these patients are sedated and they are not going to have any kind of pain or apprehension about this. So we’re very cognitive of that. This is a big deal.

[0:19:06] CP: So you are asking about what do we say to encourage, to help push them?

[0:19:13] Charlie Hoehn: Well I am thinking more in terms of this is a financial investment, I’d assume a really costly procedure.

[0:19:20] CP: I ask the patients, “What is it that you want your future to be? How do you envision yourselves? And what do you want?” Because ultimately teeth are very important to me. I am a dentist, they are important to a lot of people but they are not necessarily important to every single person and these are personal decisions. It is a big decision to make and that has to come from within and what their desires are. We try to ask questions to make them think about what it is that they want so that we can work together to find a treatment that’s going to be most appropriate.

[0:19:57] MT: Yeah, we like to say we are treating people not teeth and we try to reach them and understand why they’re here, how did they find out about us, what do they do for a living. So the first thing I do is to try to get to break the ice with them psychologically and become friendly with them. They are interviewing us and we are interviewing them. This is going to be a small journey. The treatment time for Teeth Tomorrow in general takes about six months start to finish. The previous options that we had with other implant choices involve a lot more appointments and a lot more treatment time and that is one of the attractions that we had to this protocol that we have kind of developed.

[0:20:33] CP: And that’s how we originally got into working on those acrylic hybrids because a lot of people were priced out off or could not commit to a year, a year and a half treatment time required for the other solution that is not removable and stays in their mouth and the acrylic version offered some streamlining in terms of time and cost but obviously this was an inferior restoration and there are some issues with it because of that.

[0:21:05] MT: It is, so what we did was we developed these protocols for success over the last five years and what we have done is we have taken these protocols and turn it into a franchise. A franchise is a repeatable process and as we are growing this, we are able to teach these doctors what we’ve done as far as surgical positioning, techniques, prosthetic steps and it’s reproducible. And we’ve seen the same success rate with other doctors using our protocols and that’s the Teeth Tomorrow is about. And that’s what this book describes.

[0:21:37] Charlie Hoehn: What are the financing options for this sort of procedure? Can anybody get it? I mean the people that you mentioned who they associate with lower socioeconomic status who might have teeth problems can they get this as well?

[0:21:53] CP: So first of all, yes. Poor dental health and access to care is of course linked to socioeconomic status but what I think people fail to appreciate, the public fails to appreciate, the error, that is bad teeth happens to good people. They are people who could do everything really right or maybe they didn’t do things right in their youth but they have been doing it right since and they still are suffering the consequences of poor teeth. So in some ways that association is a misconception. That said, this is a financial investment. It is not inexpensive but the value is there and people buy cars that sometimes they’re expensive and a lot of those same financing options that are available for vehicles are available for this type of thing as well. There are some patients who can just put the full payment in cash although that is the minority but most people are looking at making payments over time and trying to find something that fits into their budget doing a home equity loan, tapping into their 401(k). I mean there are different options that people can look into. I would say most of the patients who we have who proceed with any of these treatments, they’re not rich. I mean we have done this on patients who have a lot of money and are quite affluent but the majority of patients –

[0:23:24] Charlie Hoehn: Sure Claudia, what I am looking for is maybe a range just to give the listener an idea of how much this stuff can cost.

[0:23:32] CP: Yeah, 25,000 to 35,000 an arch. Soup to nuts.

[0:23:38] Charlie Hoehn: Per arch so upper or lower?

[0:23:39] CP: Upper or lower.

[0:23:40] MT: Upper or lower. So the range overall nationally is around 25 to 35,000 and what we are doing when they come in, we understand that is a big investment but we are instilling such value to it that what we find is that people end up coming back and eventually doing it because they realize this is an investment in themselves. It’s as important as in some ways major surgery to improve the health.

[0:24:05] Charlie Hoehn: Yeah, so how do we find the right person to do this? I mean do we go to a Teeth Tomorrow franchise and that’s perfect? Or do we need to do a little bit of research to find the right dentist, the right treatment plan? What do you suggest?

[0:24:19] MT: So are you asking though how does a patient find the right doctor to have this full mouth reconstruction done with implants?

[0:24:25] Charlie Hoehn: Yes.

[0:24:26] MT: Okay, so that is interesting, I would say to answer that question 15 years ago or 10 years ago would be normally, you would go into an oral surgeon and they would place the implants and then a general dentist or another doctor would restore. The paradigm now more and more with the advent of CAT scans that are available and training that is available is that there are very qualified dentists that are oral surgeons that are periodontists but there are also some very well qualified general dentists that do this. And I would say looking at the credentials and training, experience. So one of the things we did as we grow Teeth Tomorrow is we have vetted these doctors so that their credential had full arch training on some level and now they have been also further trained by our techniques. Everybody who is part of the Teeth Tomorrow network has to come to the office here in Woodstock in our training center and really learn our protocols and we supply videos for them to follow and they come back and they watch surgeries. They bring their staff. So it is a holistic training environment for full arch. And that’s what you want to look for, someone that’s got experience.

[0:25:34] Charlie Hoehn: Yeah, it makes sense just like with anything. So if I am a patient and I got my upper arch and committed to going with you all, what should I expect during and after the procedure?

[0:25:49] MT: Well it starts surgically. It’s basically there’s a couple of appointments to prepare for this. We’ve got medical clearance, they are giving a bunch of informed consent forms, they are really informed on what is happening. So they arrive at the surgery, the average surgery takes a morning depending on what’s involved. It is never more than that and they basically go home and they basically go home and that’s what makes Teeth Tomorrow so advantageous for the patient. Because a lot of protocols involve the patient staying a good part of the day and then they leave with teeth but the temporary teeth that they leave with are really not ideal because they’re not made in a dental laboratory.

[0:26:26] Charlie Hoehn: They’re terrible, yes. So I had to spend weeks with temporary teeth and it was humiliating. It was like wearing Chickets.

[0:26:35] CP: Right, so that is really the thing. There is a temporary and then there’s a temporary, right?. So there are temporaries that are embarrassing and there are temporaries that are beautiful and a huge improvement over what somebody started with and with the protocol that we have in place now, I mean about 50 plus percent of upper arches and a good 80 plus percent of lower arches, that temporary, we nail it. It looks great. It looks great enough that that’s going to be the model for the final and we really believe in the protocol and I can go into all of the specific advantages of that, but in terms of the patient experience, you know I touch base before about how it is not as painful as people expect. During the time that you are healing, you are healing. There are things that we want you to do that are going to not just be doing whatever you want when it comes to your teeth. We are going to be making sure that you’re cleaning the device properly. We want our patients to be on a soft diet. This doesn’t mean that they have to just have smoothies and soup for three months but we do want them keeping it light because the implants are still healing. So they are not going to quite forget that they’re in treatment although I have had a lot of people say like, “I don’t realize that it’s there,” quite frankly, I want everybody to follow my instructions but this works even when people aren’t following every single instruction.

[0:28:06] MT: Yeah, I mean I think what makes the Teeth Tomorrow providers unique is that we have this protocol. What I see is that if a dentist is going to tackle this incredible realm of replacing someone’s teeth and you know Carl Misch, my mentor, I mentioned before used to say, you know we’re really replacing millions of years of evolution. When people’s teeth fail, nature and the universe or God has developed roots on certain teeth that support stress. We now have the task to replace that. So I think that’s the first thing you have to take in perspective and that’s what we do and we engineer these cases correctly and we put adequate implants in. So I mentioned this term ‘all on four.’ You know we feel that four implants in both arches either form the upper and lower is not really an adequate amount of implants. It is just our belief. It has worked, we feel having more implants of six on the top and five on the bottom is a better paradigm. So you want a doctor who understands a system and that’s what we have at Teeth Tomorrow. We feel that this is the best system out there from a surgical standpoint and a restorative standpoint and we have proven that with the articles and studies we have and the longevity we have.

[0:29:17] Charlie Hoehn: And by the way, I love you guys’ name Teeth Tomorrow which now makes perfect sense. That is great. Can you share your favorite case study in the book. You’ve got over a dozen case studies of people you’ve helped, what’s your personal favorite?

[0:29:31] CP: Yeah, one that I could think of, you know I relate to her. She’s my age and she came in, her teeth, they were black. She had a history of drug abuse and she was trying to restart her life. It was a really beautiful thing to see her going through that process of getting her life back together and then having this be part of her journey and then seeing her success and her continued success and commitment to changing her life since that. Since she become sober and also you know since she had the dental work done. So I mean that was a really touching story for me just because she’s a really nice person and awesome to just be able to be part of impacting someone’s life. There are people that I hear from honestly on a daily basis that thank me for improving their life and that’s incredible.

[0:30:25] MT: Letters come in, I mean it’s amazing.

[0:30:28] CP: So it makes a big deal for a lot of people. It is a huge change for them because they have been self-conscious about their teeth, probably for all of their life.

[0:30:39] Charlie Hoehn: That’s wonderful. So say a person’s listening to this episode and they’re like, “Man this is the exact solution. I want to talk to Claudia, I want to talk to Michael,” how can our listeners connect with you to follow what you are doing and potentially talk to you?

[0:30:54] CP: So we definite would recommend people check out our website which is teethtomorrow.com and take a look, do some research, better understand it or get the book. We go over all of the details there in depth and we have an office that everybody is so well versed in this and –

[0:31:14] MT: We’re a national franchise. We have offices in California, Florida, the Midwest, Texas and all over. You know find your nearest Teeth Tomorrow provider -

[0:31:23] CP: Yeah, although we see people from out of state all the time and we love that vote of confidence that people have.

[0:31:31] MT: Yeah but find that nearest Teeth Tomorrow provider and they’re recapitulating the services that we offer here in the same training. So that would be my recommendation. I mean if you start to really – and then we find a lot of these patients research things quite in-depthly online and they’re comparing other alternatives of other national chains and there’s only a few and we actually have on our home page of teethtomorrow.com a checklist. It’s about 16 questions where what is the final product, is it Zirconia, is there any published studies, what are the appointments numbers. And we find that when people go through that Teeth Tomorrow questionnaire which they can print out, they can bring to their dentist for a reference, they’re going to really choose this option. We whole heartedly believe that the Teeth Tomorrow brand and protocols are the ideal way to replace the same teeth or teeth that should be replaced.

[0:32:21] Charlie Hoehn: Excellent. Well thank you both so much, Michael and Claudia. The book is Teeth Tomorrow, thank you so much for being on the show.

[0:32:29] CP: Thank you very much for having us.

[0:32:29] MT: Well thank you.

[0:32:32] Charlie Hoehn: Many thanks to Michael and Claudia for being on the show. You can buy their book, Teeth Tomorrow, on amazon.com. Thanks again for listening to Author Hour, enlightening conversations about book with the authors who wrote them. We’ll see you next time.