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You Still Have to Earn It · Death Before Decay

• speaker-0: All right. speaker-1: ⁓ welcome to the Death Before Decay podcast. I'm Doctor Elliott Hummeston. The show is about confidence, craft, and building something real. ⁓ speaker-0: Man. Damn, you're rolling. I know. speaker-1: His head it it really like reflects a lot. ⁓ Welc okay. Welcome to the Death Before Decay podcast. I'm Dr. Elliot Hummiston. The show is about confidence, craft, and building something real in dentistry, in business, and in life. This season is brought to you by Taylor Drive Dental Care. Today I'm sitting down with Dr. Ethan Just. He's a local orthodontist here in Sheboygan, fourth generation dentist. Yes. Third generation orthodontist. Yes. And you're someone who's building your own name in this community. And well and we're today we're going to talk about legacy, about how ortho and dentist get along and how what we do together and what it actually takes to build something of your own from something that was built by your predecessor. Right. Yes, we do. So ⁓ speaker-0: It's something that we both know quite well. speaker-1: Let's get some background on you, man. ⁓ like why the hell did you become an Orthodonist? speaker-0: So ⁓ pretty long story. ⁓ I was really into sports growing up. ⁓ more action sports. I was really into skiing. I competed at the X Games course, but I speaker-1: Yeah, you were in the X Games, right? speaker-0: Yeah, right. so I was really into skiing growing up and I I really liked ⁓ the individual sports where you could push yourself. I really like setting goals for myself and ⁓ skiing was something that I just found really interesting and it's something that you could really push yourself and grow every year. ⁓ so I was skiing a lot during ⁓ kind of my middle school, high school years and then I also played football and ⁓ Yeah. speaker-1: Played football? speaker-0: I was a running back for Manitowak Liverpool. Yeah. ⁓ and ⁓ I mean I loved all of that and ⁓ going into college I was gonna play football for University of St. Thomas. ⁓ I did have a little bit of a knee injury, so ⁓ couldn't didn't really want to play, wanted to more focus on school and you know, the future of what I could do in academics. So ⁓ from that point forward I just kinda shifted my focus from you know, the athletics into more of education and all that stuff. So ⁓ growing up and seeing, you know, my my dad's an orthodontics, my grandpa was an orthodontist and great grandpa was a dentist. It was there's a lot of dentistry in my family and I've I really liked science. So those things kind of mesh together really good. So in undergrad I just kind of get really dove deep into the, you know, the science, biology, chemistry and just kind of found that dentistry could be something really ⁓ great for me. And it was really fascinating. And ⁓ the more that I got into the sciences, the more I I found that dentistry was the route that I wanted to go. And ⁓ again not not at all, no. Really? But it was more of ⁓ just kind of another way to push myself. Sure. ⁓ I won't say that I was speaker-1: Okay. speaker-0: a stellar student in high school but I was okay. But you know, it's like in high school you have a lot of distractions. Like I was playing all these sports where in ⁓ in college you just kinda focus more on on your studies and so that was where I was able to push myself and see what I was able to do. And then ⁓ just applying to dental school, getting in and ⁓ yeah, I actually went to California for dental school, which they have some good skiing out there too. So yeah. It was actually a big positive. ⁓ but that was my Yeah, you gotta try to limit those things. You know it's out there, but it's like you gotta focus on your schooling. But ⁓ yeah, so I didn't get to ski too much in in dental school, but ⁓ I th I think in dental school was where I really excelled because you're you're studying things that you're interested in. So I was combining the the dentistry aspect with the science background that I already had. So that was really fascinating. and then probably around my second or third. third year of dental school, that was when I really realized how orthodontics plays into the dent the dental world. Right. That was it, that yeah, that would have changed my mind. speaker-1: You were straightening a paper clip and you're like That is a real exercise in dental school is you straighten a paper clip. Did you guys have to do that? speaker-0: No we didn't. We that would have turned me off right away. speaker-1: Right. And if it rolled like oddly, they they took points. ⁓ speaker-0: It's hard. Yeah. Yeah, I've done it before. Yeah, it's tough. ⁓ so yeah, I just I started to see the impact that occlusion can have kind of on the overall ⁓ health of the mouth. But occlusion is how the teeth are biting together ⁓ for long term, right? So I guess growing up I saw you know the crazy transformations between you know before and after photos with ⁓ orthodontic treatment, but I didn't really understand how important. speaker-1: Seclusion. speaker-0: it can be to the whole mouth. And that's really what you start learning in in dental school is how everything fits together. And that was when it really clicked for me. Like orthodontics it's not just about straightening teeth. It's more about building the foundation to have healthy teeth for the whole life. So that was what was really intriguing to me. And I think once I once I saw that, once I had that moment, then ⁓ that was like this is what I want to do. ⁓ my my dad's already in it and I can learn from him and it's just been you know, it's been really great working with him ⁓ s for this whole time. So it's been great. Right on. Yeah. I question. speaker-1: So if you get braces once, does that mean the work is done or is there sometimes multiple phases? speaker-0: ⁓ well it kind of depends. ⁓ I would say nowadays we're focusing more on being proactive about orthodontic. So, you know, treating kids younger can help encourage the permanent teeth to come in relatively where they should. And then that can help be a more stable position for them the long term because speaker-1: Okay. speaker-0: If we wait for all the permanent teeth to come in, then we have to force them to go into the correct position and that's where we start seeing these relapses where we have to start, you know, doing another or that we have to speaker-1: Good. Yeah. speaker-0: Yeah. Yeah. So treating kids early, I think that's ⁓ one of Right, right, right. Very very malleable at that age. And there's really not much that we can't accomplish if we see kids early enough. So ⁓ I think that's kind of the route that Orthodonics is going is being more proactive than waiting. speaker-1: Stretchy. I think you're cutting yours ⁓ like like cutting yourself a little short here because I don't think enough orthodontists think of it that way right now. Like I th we're really lucky in this community to have you and one of the other orthodontists that do care about that like deeply. ⁓ the two stage orthodontic approach is really important to me. It's why I'm recomm like I've we have five year olds, six year olds in the chair that were like, Hey, just go get the evaluation. Like I'm trained enough to like identify NFI when things are real bad. speaker-0: Right. speaker-1: But he's trained from a developmental biology aspect to identify, hey, where's the cascade effect happening? Is that what you're like and that's what you're focused on, right? speaker-0: Right. And ⁓ especially looking, you know, we can when we take x rays at a younger age, we can help predict how they're gonna grow. And that's what my my master's thesis was on is craniofacial growth and development of younger kids, so then we can help predict how they're gonna grow and then we can really get on top of some of these problems that we see arise that are sometimes only fixable at a younger age, and if it goes untreated, then it becomes more of a surgical case down the road. speaker-1: 100%. ⁓ you know, one thing that's I think is interesting, and maybe you can like hit on this, like we have a lot of parallels. Like my dad's a dentist. My dad worked with your grandfather and your father back in the day. ⁓ because he used to practice up in Manitowak. ⁓ but we're not practicing dentistry or orthodontics the same as our parents. We're you're right. You're more focused on airway. I'm more focused on rehabilitation. But like the ⁓ one thing that I like noticed early on is I had a lot of adults with these narrow palates, like their teeth are constricted. Right and there's nothing I can do about that without going surgical, where if we had intervened when they were six or seven years old, they wouldn't have that problem. speaker-0: Thank you. Yeah. speaker-1: It's something my dad would have never considered. speaker-0: Right. And ⁓ you know, orthodontics, you know, it's somewhat newer, like, you know, it started in the nineteen thirties, forties. So I mean, some of this stuff took a while to develop and see the outcomes of treatment that was done back in the nineteen hundreds to see the results. And we're able to learn now, you know, how we should be treating and really being proactive about all this stuff. So that's why I it's just so important that we can see kids younger So that we can avoid some of these problems that come down the road with narrower palettes. ⁓ so really, you know, over the years it's been interesting to see the changes between dental treatment, orthodontic treatment over the past couple of generations, just to see how far we've come. And at the end of the day, it's being able to use technology to make things more efficient for our patients because their time matters a lot. And the more efficient that we can be to get great outcomes, that's Better for everyone. ⁓ less appointments to the doctor speaker-1: I especially with an ortho 'cause you guys see your patients so much more often than I do. speaker-0: Right. So that's where it just comes down to proper treatment planning, diagnosing and having a clear goal in mind of where we're trying to go. Right. ⁓ so that's you know, and that's where some of the newer technology is coming in to help us be more precise with bracket placement and all of this stuff, just to make treatment be ⁓ more predictive so that we can have great outcomes with less appointments. ⁓ so the goal is to usually have around thirteen, fourteen appointments or so. speaker-1: Yeah. speaker-0: And ⁓ yeah. speaker-1: What's up? Yeah. Right. Yep. You're y so okay. ⁓ so when you're talking about technology and what we can do ⁓ with prediction, like I dabble in ortho, I d do quite a bit of clear liners. ⁓ there's a bunch of different companies. I know you do Angel, Invisalign, there's a bunch of others. ⁓ but what's really nice about those programs is we can do outcome based simulations. Right. Are you using that a lot? speaker-0: Yeah, absolutely. So one of the nice things about having these simulations is you can predict how the teeth are gonna lay in the patient's smile afterwards. And that's huge because you know in the past it's like you're just straightening teeth and you're not able to really see it in three dimensional space on how it's gonna look on on the patient. Yeah. So really seeing the outcome beforehand and then being able to know what type of orthodontic movements we need to incorporate to get to that end result. ⁓ that's something that's really, really big right now and that can help ⁓ just kind of make us focus on the outcome and have a specific goal in mind on what we need to get really nice outcome. ⁓ we we don't. We do when we need them. Okay. speaker-1: Yes. Are you doing CTs yet? Because the p the two big x rays in in in orthodontics are your cephalometric, which is like a side view of the skull, right? Right. And then you've got your panoramic, which is that big thing that you step into and it spins around your head when you go to the dentist and it shows all the teeth at once. ⁓ but you're you're using those x rays to build predictability where ⁓ CTs are coming into things now. speaker-0: But when do you use those? ⁓ we use them when we s when we think that there is a problem that goes beyond just looking at the teeth. So if it's a skeletal problem, ⁓ that's something where we would use a C T. I think in our office, you know, we take a lot of X rays. We take a lot of progress X rays too. So doing a full C T on a lot of patients and might I Yeah, so ⁓ we kind of pick and choose. ⁓ and I think speaker-1: We wanna do that for progress. Right. speaker-0: right now that's probably the best way to go as kind of the ⁓ data's coming out on all that. ⁓ but I do think that the CTs are giving us a lot of data that's re that people are doing research on. And I think that's what's really driving some of these ⁓ changes in our treatment planning because we're able to see the outcomes and be able to see the skeletal change that orthodontists can make. And that's something that we didn't have in the past because we were dealing with two D X rays. We're now we're looking at things in three D. So, you know, back in nineteen eighties, nineties, you know, it it was we didn't know. Right. Right. So ⁓ back then it's like you knew that we were straightening teeth, you thought that maybe it was having some skeletal change, but you couldn't quantify it. Where now speaker-1: Ten years ago they weren't using C. speaker-0: Where we can use three D imaging, we can have really detailed data points to see the before and after and the impact that orthodontics is making. And so that's really what's driving a lot of the change in orthodontics. speaker-1: Yeah, it's a big change in dentistry in general, I think. I wouldn't even work with I I would r pretty much refuse to work without a C T machine these days. Right. Like we catch pathologies that went missed for years in people's mouths, developmental cysts, ridicular cysts that are impacting their overall health that you just simply can't see ⁓ in a two D image. It's ⁓ like for people's perspective, it's like looking at the side of a car and trying to figure out how the engine works. You know it if you're if you're de like having that ability and that ⁓ that ⁓ technology available to diagnose just improves the patient's speaker-0: Right. Right. And then we can even take these 3D images and pair it up with scans and see right where the roots are going and making sure. So it's all about the the patient experience and the predictability of treatment so that we can get good results with the least amount of appointments. And that's where all of this technology is really helping us. ⁓ so speaker-1: Predictability not necessarily doing it better, it's better predictability. speaker-0: Yeah. speaker-1: Right on Okay. so let let's talk about the legacy aspect of things. So like I came in and I took over my dad's practice pretty early. He got sick. I've s I've told this story on other episodes, but ⁓ you know, like carrying that forward and being an individual while still like honoring like what my dad did. ⁓ you know, your dad I didn't know him until I became I got my DDS and w started working. But I knew who just Ortho was because the sticker was on everybody's bumper. Yeah. Like what like what are you doing to carry it forward right now? speaker-0: Right. ⁓ so I you know, going back to the efficiency part of orthodontics, right? So if you're just starting a practice from scratch, you know, you don't really have systems in place or maybe you loosely have systems in place to see the the amount of patience that you that you're currently seeing. ⁓ but you know, over the years as your practice builds up, you're gonna have to build in more of these efficient ⁓ programs into your office to make sure that these systems are running correctly for more patients. And so with having my dad be an orthodontist for 30 plus years, some of our systems are really dialed in. And that's something that's amazing because that's like the we can see a lot of patients. It's again more predictable outcomes, shorter treatment times, things like that. But We still have to build on that, right? We have to be our individual person coming into the practice. speaker-1: I almost found it a burden at times when I would run into a system that was so well established that we weren't willing to shift on it at all. ⁓ that's frustrating, but it also shows that we've the the culture was built that way. ⁓ you know, for me, like wha when I came into the practice, it was earning trust not just in the patient, but in the staff. Like ⁓ speaker-0: Right. speaker-1: Like I think a lot of people think I walked in and inherited that trust. Sure. It wasn't like that for me. Like there was plenty of patients who are like, ⁓ your doctor's son, that's fine. And then I'd watch associates come in, and that trust didn't necessarily transfer to them. I had to build the trust with a lot of patients. Absolutely. And my favorite example, and you'll probably relate to this because you're an airway-driven guy, is I've started asking patients if they snore or not, because I can definitely see it on their teeth. speaker-0: Right. Right. speaker-1: And you should wear a night guard. Why hasn't anyone told me that before? Your dad never said anything like that. And then you have to have this discussion of like this wasn't a focus of dentistry. We were still discovering things. Like, ⁓ you have generalized sensitivity and a lot of recession on your teeth. You're probably clenching and grinding. Right. speaker-0: Right. Yeah, and I think ⁓ especially with orthodontics, how in the past there used to be a lot of extraction cases, right? That was like speaker-1: ⁓ yep, I I'm missing four teeth because of speaker-0: Right. You guys. Yeah. Yeah. And that shouldn't be the case. And we can pretty confidently say that if a patient comes in early, you know, for the early phase one of treatment, if they have crowding issues, that we can create enough space for all of their permanent teeth to come in and there's a very high chance that they won't have to ever have a tooth extracted. Besides maybe wisdom teeth. Sure. speaker-1: Yeah. ⁓ wisdom teeth are useless. ⁓ but but but let's like clarify though too. Like my orthodontist didn't destroy my life because he had four teeth taken out of my mouth. Like but for some people it did cause complications. I lucked out my palate didn't narrow ⁓ it's probably not ideal, but it didn't narrow as much as some people's did. But you have to like respect what your dad was doing and what And I had to respect what my dad was doing, but also be willing to be like have those conversations of things are changing. And you have a really, really powerful story that you had said at the at your big event the other day. Do you mind just giving us the cliff notes of that? Because your dad's not wasn't necessarily an airway guy. speaker-0: Yeah. He he is, but I he didn't really know ⁓ what we were exact the what the outcomes were lucky that I came into a practice where he already is treating that way. That's good. It's just it we're just starting now to make that connection. And it's not just us, it's the whole orthodontic field. Yeah, so I mean that's great that he was already speaker-1: Mm-hmm. speaker-0: treating this way but I think now kinda looking at it looking at things in a different lens to see how orthodontic can orthodontic treatment can benefit these patients. speaker-1: Can we specifically talk about your patient? That the bed wedding thing? speaker-0: Sure. So we had a patient come in last last summer. ⁓ they've been having bed wedding issues for like four years or so. speaker-1: They're they're not four years old. They were like seven. speaker-0: They're seven now. Yeah. ⁓ so this has been going on and ⁓ to be honest, it's at the time when we first started treating her, I didn't really think about how im how much that could impact someone's life. ⁓ but the more I was talking to the mom and just all of the all of the treatment that they have gone through and nothing had worked everything that they had been trying. ⁓ just really understanding how much of an impact that can have on a whole family and especially, you know, the young girl. So ⁓ we went forward, I mean we did our you know initial, you know, ⁓ consultation, really delve deep into medical history, ⁓ x-rays, all that stuff scans. And she had a really narrow palate and especially on the lower two, really, really narrow. She already had adenoids and tonsils taken out. So she had like everything else done, but her palate is still super small. ⁓ so what we did is we expanded She couldn't breathe. She she couldn't. No. Yeah. So that was if it's if they're having sleep problems because there's something in the mouth, like if it's the arch shape or if things are really narrow, ⁓ she was able to benefit quite a bit from orthodontic treatment at that age. speaker-1: So she went through expansion. You guys expanded her palate and the bed wedding stopped. Right. That's a powerful, powerful story. Right. But there wasn't a dry eye except for my like emotionless ass, like in that entire building, like listening to the mom. speaker-0: ⁓ Yeah, it's it's an amazing story and yeah, when she tells it, you know, it really ⁓ it really shows the significance of what orthodontic treatment can do. Yeah. And I think, you know, it's you know, all of us were teary eyed after that. Because it's just, you know, you get so caught up in what we're doing and ⁓ you just kinda get numb to it at some point. Like the outcomes and ⁓ just seeing the impact that we can make beyond just straight teeth is super Super powerful. speaker-1: So let's let's hit on expansion a little bit because it's a bigger and bigger topic in dentistry. I was at the Spear Summit and airway and breath and being able to and how the teeth impact breathing and the narrowness of the palate. Because the the roof of the mouth is the floor of the nose. So why would that have any impact on bedwetting? speaker-0: So the roof of your mouth is the floor of the nose, which is correct. ⁓ and if you expand you can increase some of the nasal cavity volume. And ⁓ that can obviously help some some with they're breathing through their nose. ⁓ but the ⁓ the more important part is how the air is getting into the body. So usually we're breathing through our mouths. ⁓ even if you're if you're sleeping at night If the your airway's small through your mouth, you h still have to get the same amount of air into your body. Yeah. And sometimes there's a discrepancy in kids because they're growing fast. Maybe their mouth and lungs aren't keeping up at the same rate, or there's a little bit of a discrepancy between their growth pattern, between their their ⁓ oral cavity versus how much air they need. speaker-1: After listening to surgeons at that last conference, I'm convinced that ninety nine percent of human beings don't develop quite right. Right. Varying degrees, obviously. speaker-0: Yeah, and it's and that right. And I think that's part of it is that as we're growing up as kids, ⁓ you're just growing at different rates, different speeds. And if someone has a really narrow mouth at that age and they still need to get the same amount of oxygen into their body, what happens is the air that comes through their mouth it has to come in faster because the airway's smaller. And I always make the ⁓ connection between when you turn the shower on and the shower curtain comes in towards you. That that's the increased velocity of the shower with the the water coming down and that sucks the curtain in. And that's the same thing that happens with kids is when things are so narrow they have to breathe harder to get that amount of air that they need to survive, and that's what collapses all of the tissue around them. And so at night, if this is happening, it's waking them up. It might not wake them up completely, but they're not able to sleep as fully as they should be. Right. And then it can either they their body can wake themselves up through bed wetting or speaker-1: Hormonal speaker-0: Right, because it's it's a sympathetic response. They they're choking. So that's what's going on. So that's the that's the connection between all of speaker-1: the non conscious part of the brain is I need to become conscious. I will wet the bed to wake up to start getting here. speaker-0: Right. Right. Yeah. Yeah. So that's really the easiest way to put it together. And I know it's it's surprising and I think we're just kind of really starting to realize the impact that orthodontics can have. speaker-1: Yeah, we were talking about this on a on a different episode that ⁓ you know, a physician friend of mine's like, you know, I've never a lot of my colleagues will kind of dismiss dentistry at times as a soft sort of area of medicine, but you know, breathing, eating, and drinking all go through the mouth. That's probably a pretty important area. speaker-0: Right. Yeah. Yeah, exactly. Yeah, and I actually I went to a meeting and ⁓ someone had mentioned that Marpe No, I did go there. Yeah, yeah. ⁓ but ⁓ this was out in California, it was ⁓ about sleep dentistry and orthodontics mostly. But ⁓ they were saying that Marpees, which are it's yeah, in adults. ⁓ that speaker-1: It's a way of expanding the palette. ⁓ Yeah. speaker-0: is the most cited dental appliance in medical journals. Yeah. And so that just kinda shows speaker-1: Marpia is. That's crazy. Like mandibular advancement and things. speaker-0: Yeah. Okay. Because that's where all the research is going into is that it can have an impact on, you know, breathing issues even in a in adults. And I think, you know, having those treatments as an adult is probably Yeah. But I think the impact can be bigger because you've been living your whole life, you know, kind of with this constriction or different airway and then now all of a sudden there's a change and speaker-1: It was way more brutal. speaker-0: People just experience a huge difference in in how they're sleeping and breathing. speaker-1: Well then that leads to better mental health, better confidence, better overall health, just the improvement in quality. speaker-0: Right. Drastically. And so that's when we start looking at younger kids, that's where you start seeing these overlaps in behavioral conditions. So if they're not sleeping well at night, then they're restless in school, they're not learning correctly. ⁓ and all of those things tie into their behavior at school. Yeah. And it's such a critical window when they're, you know, six, seven, eight years old, their learning has to be really good. They have to be sleeping really good. And so if that's impacted, that can have a huge impact on their whole life. speaker-1: For sure. And I I you know, and I don't think you're saying this, and I'm definitely not saying this, not every kid who gets diagnosed with ADD it's because of a s ⁓ a constriction in their airway. There are plenty of us, myself included, that are just biochemically a little out of whack. ⁓ but if I wasn't able to breathe or sleep at night and I've just been getting over a cold, yeah, my day's awful. Like I couldn't imagine going through it every night. speaker-0: Right. Yeah. Right. And then imagine that a as a young kid growing. Yeah. And that can have an impact on how their brain's developing. And I know there's just there's a lot of research going into this and ⁓ you know, I think some of it can be quantified now because we have those three D X-rays. speaker-1: Yeah, for sure. Let's move on to go ahead and talk about ⁓ like the business side of things, man. Like, ⁓ so I got out of dental school and and joined my dad's practice. I invested heavily in technology. I was fortunate that my dad was a big gadget guy. Like he already had a three D scanner. They weren't using enough. He had a he had a C B C T. Again, they weren't using it enough. But I had those tools involved. And I could get I upgraded our scanners and systems that we had, bought three D printers. ⁓ speaker-0: Right. speaker-1: You know, ended up building a med spa or facial aesthetics center out of my other business because I'm just a glutton for punishment, I guess. And now we just built like a state of the art surgery room. ⁓ we just finished it yesterday actually. Yeah. So but you've also been expanding. You guys bought another orthodontist office. Like why? speaker-0: They see it. so you know in dentistry speaker-1: Was that your idea or your dad's speaker-0: ⁓ it just kinda came on us because, you know, in dentistry we have to help each other out. And ⁓ he wanted to retire kinda on a specific time frame and speaker-1: And selling an orthodontic practice is difficult. speaker-0: It's difficult. Yeah. And ⁓ we're able to help him finish up his cases. So ⁓ we're really lucky to be able to work with him just to finish up his cases so that he can retire on time. So I mean that's the majority of of how it happened. And ⁓ again it just comes down to these efficiency things, these ⁓ systems that we've had in place and That's what allows us to help see his patients and be able to wrap up his cases ⁓ while keeping our practice going. So ⁓ you know, we're really ⁓ glad that he can retire on time. But yeah, I think again, the efficiency that's just where where we can make, you know, treatment go a lot faster. speaker-1: So was this like was this was there also some motivation to expand as well? speaker-0: ⁓ yeah, I mean I think there's always some motivation to expand a little bit. Right. ⁓ especially if you see fit that you can see more patients or that you have these systems in place. Is again all the technology, all of this stuff is really, you know, improving outcomes and treatment times. So as we're seeing that and being able to build systems around it, then you know, if there are opportunities to expand and grow, then that's obviously the best thing that we can do for our team in practice. speaker-1: Yeah. One thing that I learned about myself when I started practicing was that ⁓ I was never gonna be satisfied with where I was that I always wanted to continue learning. I've invested a lot of a lot of time and money into continuing education and becoming familiar with my my specialists in the area to create really great dentistry. and I learned that ⁓ speaker-0: ⁓ Right. speaker-1: I need to balance that with life. But what have you learned about yourself and like 'cause it's probably been a bit of an adventure taking over for dad. speaker-0: Yeah, I think it's ⁓ definitely just staying really organized with things and again just relying on the systems in place because that's it's just key. And ⁓ that's how that's how we're able to grow. ⁓ so that's ⁓ you know, obviously I I'm really into working out and have different hobbies and stuff like that. So I mean we went skiing. Yeah, we went we didn't We're doing fun stuff like that. I I mean I love it. So ⁓ having a good work life balance is w good as well. speaker-1: ⁓ what made you dec so you grew up in Manitowoc, which is a little north of here, about twenty minutes. It's actually where I was born. ⁓ What made you decide to like you moved back ⁓ with your girlfriend at the time? Why'd you settle in Sheboygan instead of Manitowak? speaker-0: Right. Well Well, we both grew up in Manitouak. So ⁓ I think we just wanted to try something a little different. Yeah. A little bit. A couple more people. But yeah, I think we just you know, we spent all of our lives growing up in Manitouk and we wanted something a little bit different. And living in Manitouk, you don't really come down to Sheboygan. It's either like you're going up to Green Bay or going down to Milwaukee for things. ⁓ so we speaker-1: Boy, it's so different. I would say the same thing is true if you live in Sheboy going to Manitoba. ⁓ speaker-0: You're not going to Manit's Walk. So ⁓ I think just you know, knowing that we could still be close to family but kinda living separate. And ⁓ yeah, I think that was kind of the main driver behind it and ⁓ we love it. So speaker-1: Separate. Nice man. Yeah. What have you ⁓ so you're planning your wedding right now, which is awesome. Like congratulations. Does and I are super excited for you too. Thank you. ⁓ like what's that been like trying to like balance that personal life of planning a wedding with both of you guys working full time? And both of you work in dentistry too. Right. And not in the same building. No. So it's not like you can sit down at lunch and plan your wedding. No. speaker-0: Well no, that's been mostly in off hour off hours, right? Some planning. ⁓ but yeah, I mean we really what was nice is w we have a plan we had a plan right away on where our venue is gonna be. So that made things quite a bit easier because we're like, okay, we have that nailed down. Then what's the next thing? Looking for, you know, food and photographers, things like that and just kinda chipping away at those things and we were able to do that kind of straight from the start. Good. Where I know You know, if you're looking for a venue for a a while, that can kinda hold things up because you might you know, you might have to set your date based on that venue. ⁓ so that really helped us out quite a bit. So I'd say we we've been on top of it so far. But it's going good. speaker-1: ⁓ I think one of the most in like like when you first graduated and I went to your the just orthodontist like event, like it was the first time I went actually. Yeah. ⁓ and you're up and like everyone's introducing you and like yeah, Ethan skied in the X games, no big deal. I like, Okay, I need to be friends with this dude. Like, tell me what did you do in skiing, man? I don't think we like 'cause I think that's one of the coolest things. Like like I was in a metal band, that's that's the thing I did. But like You were flying fifty feet into the air with two pieces of wood strapped to your feet. speaker-0: Yeah. I mean, yeah, my skiing background has is kinda interesting 'cause ⁓ interesting. Right. ⁓ be so humble. I know I'm too I'm too humble about it. ⁓ Sure. Right. Sure. Right. so speaker-1: How much skiing were you doing? You weren't just going down the hill. speaker-0: So I think a lot of my skiing kinda stemmed off of when I was really young and my brother was into skateboarding and I was into like rollerblading, like kind of trick rollerblading, like grinding rails, stuff like that. And ⁓ then there you know, my parents ⁓ skied pretty often too, so we'd go on ski trips with them and ⁓ I started, you know, kinda relaying what I knew from rollerblading into skiing. Which was a lot of the grinding rails, chunk not right away, no. But I really didn't start skiing a lot until I was like ten or so. And ⁓ then I s we would go up to Granite Peak on Saturday, come home, drive back up there on Sunday. It was a lot of driving, but ⁓ my brother started a whole ⁓ video company and ⁓ speaker-1: Getting jumps right away. speaker-0: People if I go skiing even to this day, people still recognize us. But ⁓ yeah, so then we would just ski a lot. And like I was saying, I just loved it because you could push yourself, kinda go at your own pace, but it was something that you could set goals for yourself. and so we're just really a filming company and this was right when YouTube was first starting. I mean, this was like two thousand and ten, two thousand and eleven. And so we had YouTube channels and we were making ski videos and they were getting a lot of views and attention. ⁓ they were at one point, yeah. ⁓ but that kind of evolved into doing some more competitions because there's ⁓ different series. So there's the Midwest Best, that's a series that's in the Midwest here, and you compete at different, you know, different ski hills and I was doing slopestyle speaker-1: Yeah. speaker-0: which jumps and rails. And so you would compete at all these competitions and you would rack up points. And then by the end of the end of the year they would have a nationals competition. So it's called the the USASA, which is kinda there's some skiers that come out of it that, you know, are pros. Mm-hmm. But ⁓ I wouldn't I had went to the Nationals Three different times. Two of them were on the X Games course and then one of them was at Copper Mountain. Nice. And so that was kinda my later years of skiing. Cause when you're into filming, that's kind of separate from being in competitions. 'Cause filming you're you're just out there trying to get different shots. You're maybe trying to Right. And you're maybe trying to land like a once in a speaker-1: Shot on the speaker-0: you know, ten or fifteen try trick just to get it on film or skiing in competitions, you're trying to be consistent. speaker-1: I think that relates to a lot of things in life. We thought I think we use this metaphor too of watching a skateboarder do the same tri try the same trick in the park over and over and over getting up again and again. And that's that's dental school. ⁓ but I think your competitive nature probably helps you get in get through ortho programs because they are highly competitive. speaker-0: Right. Right. Right. ⁓ Yeah, and there's like for the filming aspect, ⁓ there was this trick that I was trying the whole season. Yeah. The whole ⁓ every run I would hit the same rail and try it. And there I got it once and we got it on film and we smit I don't even know what you would call it. There's a kink rail. ⁓ so it was a double kink and I did a switch up to a one foot slide on the last down part to a two seventy off. Okay. And at that time I hadn't seen anyone do that before. Yeah. And we submitted it into a best trick competition and it was one of the finalists. That's awesome. Which was yeah, it was it was cool to it was cool it was a cool time to be a skier because again that sport at the time it was progress. Things were progressing. Now it's to a point where it's all like futuristic, like there's crazy Right. And so I I'm really fortunate to have experienced that moment in skiing history. Just where we would go out there, have fun, film, you know, make videos. That was a really cool time to be a skier. speaker-1: Yeah. You should see John Snowboard, he's like pretty close to professional. He gets off the green circles some speaker-0: There you go. Nice, nice. Yeah. There we go. Show ⁓ who's boss. speaker-1: ⁓ let's talk about like ⁓ how Dennis and Orthodonis interact and work together. ⁓ I think we've hit on that a little bit, but for me, ⁓ the biggest challenge whenever I'm looking at a case of somebody who has a lot of problems ⁓ with their teeth is usually they're missing multiple teeth and teeth have moved into the wrong place or they just never erupted into the right place. So for you And me to communicate is the we have to mock up that final positioning early on. Right. How are you supposed to know where to put the teeth? So it's not just about me sending kids to you because adult adult orthodontics are becoming more and more speaker-0: Right. More bullet. Right. And so you know, it's important 'cause a a lot of like what you do is a lot of implants and more permanent things. Right. So speaker-1: I always tell a patient, like, before we even do the implant, I'm like, Are you ever planning on straightening your teeth? 'Cause it's if it's even in your mind. As soon as I put that implant in, it either needs to come out or we have to move everything in reference to it. speaker-0: Right. Right. Yeah. So that's you know, that's something that we have to really keep in mind as well. ⁓ speaker-1: Would that be a message that you would give to general dentists is to notify patients of right that speaker-0: Yeah, just ⁓ you know, 'cause if there is, you know, any inkling that they want speaker-1: I don't care how old they are. I've had patients in Invisalign in their seventies. speaker-0: Right. Yeah, same. It's yeah. And ⁓ you know, it's amazing the outcomes that you can get, you know, at any age. So it's ⁓ it's really important when we're doing work like that to make sure that we have a game plan together to make sure that the outcome is again good for the patient's overall health. speaker-1: So what yeah, so if you're looking for a dentist or even an orthodontist to work with to like improve your smile, it's really important that you make sure that they have a great working relationship with either their specialists or their general practitioner. Because those two people, they need to be in sync with what they want that final income outcome to be. Because the worst feeling ever, and I've had to deal with it more than once, is when I get a kid who comes in and they're missing one of their tooth congenitally. speaker-0: Right. speaker-1: Usually the lateral. And they have not made enough space for that tooth. And I have to tell the patient there's nothing I can do for you unless you go back to the orchid honest and get your braces put back on. Right. And when they're two weeks of being out of their braces and I tell them that don't do anything or you put your braces. Yeah. So that that communication has to be super important. Yeah. And I'm fortunate that I have you and one of the other Doctor Meinhart in the area that we have speaker-0: Right. Yeah. Right. speaker-1: Awesome communication back and forth. speaker-0: Right. Yeah, and I think that's what helps with being able to scan patients as well and acting. Right. Yeah. So you know, just the communication and again the technology's just making it simpler and simpler for us and then that just kinda dials us all in and keeps us on the same page. So yeah, definitely sometimes those missing teeth, you know, if we need to make enough space 'cause implants are always kind of deceiving on especially for laterals on how small it's but yeah. speaker-1: Yeah. You know, we ⁓ You know, it's just this constant like ⁓ like also knowing each other's limitations. Like I'm not I'm not an orthodontist. I do some ⁓ mild to moderate cases on Invisalign. But like it's important for me to understand how teeth move. Mm-hmm. And it's also important for you to know how I can actually if I can or cannot restore them. Like space is at a premium when it comes to the mouth. If there's not enough space, we're not doing anything. speaker-0: Right. Yeah, exactly. And ⁓ that has helped me quite a bit, ⁓ because of how much I just loved dentistry and restorative when I was in dental school. Yeah. Like that that was like I Yeah, I just really like it. I don't wanna abandon it. I think it's all part of it. So yeah, that was I really love that doing ⁓ you know, full mouth cases and you know speaker-1: They're super fun. And it's like a a chance to like sh both of us show off what a case came to fruition. And sometimes we get the periodontal surgeon involved with cases, especially with expansion. And again, you and I are fortunate to be in a community where the the competition there's plenty of patients to go around. We don't have to compete with each other. Right. ⁓ and the same thing with me and Dr. Hoage, the periodontist in town. You know, if I place an implant, it doesn't bother him any 'cause there's still plenty for him to do. But also him and I have the relationship that if I have an issue with an implant or I need his help on a case we have we're like synced up with where we need to be and when it comes to these expansion cases we need him synced up with all with both of us. speaker-0: Right. Right. Yeah, absolutely. So again, just really optimizing patient outcomes by working together. That's really, you know, what we need to be focused on. And ⁓ I think we do a really good job of that here. And that's something that, you know, down the road I think that's gonna be ⁓ more beneficial for dentistry as a whole is everyone working together. speaker-1: Could so a good question that we we've asked a couple of times ⁓ is if you could ⁓ give one piece of ⁓ advice to a ki ⁓ a ⁓ a student about to graduate dental school. Mm-hmm. So whether they're going into specialties or not, like what would it be? speaker-0: School. ⁓ I would say right away try to start you know, try to find someone to be a a good mentor for you. Yeah. Because I I feel like those years are critical in learning because you just came out of school and you're still you don't have any bad habits or anything like that, hopefully. ⁓ speaker-1: ⁓ speaker-0: ⁓ but yeah, just having that good first mentor to really show you how dentistry's done. Yeah, definitely. But also I mean everyone at Marquette too, like there's a lot of the faculty there that I still talk to and I think that's what's important because I was able to learn orthodontics from, you know, different faculty than my speaker-1: Was that mentor for you, your dad? speaker-0: Dad had when he was in school. So it's trying to bring all of these ideas together so that we can really optimize our experience at just orthodontics so that it it can be a a good outcome. So ⁓ that would be my advice for a younger doc is to really find someone. speaker-1: Agree. I mean, I I had a lot of mentors that I relied on. ⁓ my dad, ⁓ I relied on from like a business perspective. Like, how are we running this up until now? ⁓ we I don't do things exactly like my father did, but there's there's a lot of overlap. ⁓ you could also learn from a mentor how not to do things. Like if they're doing one one way and you're like, man, that doesn't make sense. It gives you the initiative to to go and look for things. You don't need to be a carbon copy of your mentor. speaker-0: Right. speaker-1: ⁓ what's one misconception that people seem to have about orthodontics? Asient wise. speaker-0: ⁓ Yeah. I think right now the misconception is that in the past orthodontists were treating one way and now we're we're still treating how we were, you know, twenty, thirty, forty years ago. Well we're yeah, unless yeah. No it's just it's just ⁓ speaker-1: Guys aren't using headgears anyway. speaker-0: Things are a lot different now and ⁓ maybe the the parent experience, you know, thirty years ago isn't what it is these days. So the the braces experience is a lot better. ⁓ it's more efficient, ⁓ with better outcomes. speaker-1: And cranking on roots like you used to. speaker-0: ⁓ so I the overall experience has gotten a lot better. ⁓ and especially when we're treating kids younger, then that really helps us create the foundation to make things even easier. speaker-1: That's it's such an important time of life. Like I'm not a pediatric dentist. Again, we're fortunate in this community to have three excellent pediatric dentists. and when I have a kid in the chair that I know I cannot deliver a good experience to and I know that's gonna impact how he views dent he or she views dentistry in the future, it's time for me to step away and let the pediatric dentist. take charge because I have too many patients who come in and they have an idea of what dentistry is gonna be like right in their mouth. And they're fearful, they're they they become argumentative. Like I c it's hard it's it becomes more difficult. I don't want that kid coming into my chair in 15 years and being having the same biases. Right. Because dentistry now I'm not gonna say that every experience you're gonna have at a dental office is gonna be a hundred percent positive. Right. But you know, our local anesthetics are way better than they used to be. Electric hand pieces have made it so we can be way more precise in our preparation of the teeth. ⁓ there's a we can do a lot that we haven't been able to do. Have you heard of Cyridont yet? speaker-0: Okay. I believe so. Supposed to help seal teeth? speaker-1: Okay. Yeah, reverse carries. So if Curidont wants to sponsor this podcast, ⁓ you can hit me up at Taylor Drive Dental Care. But ⁓ Curidont's this like it's a new it's like one of the fastest growing products on the market and it can reverse enamel carries. So things that we traditionally in dentistry we would have looked at and and for those who don't know, we don't really call something a cavity until it's all the way through the outer shell of your tooth called the enamel. Once it hits that inner layer called the dentin, that's what we would call a cavity. Because that's when the decay has permeated the hard shell of your tooth to the soft shell. If it wasn't we can see it on X-rays and if it's not going all the way through, we would watch that lesion. Right. I don't know what we were watching it to do. Right. But if you ever heard the doctor say they're gonna watch it, it means that it's not a cavity yet, and we're hoping it doesn't become one. Curot can reverse some of those. And we've been working with it a lot. And speaker-0: Yeah. speaker-1: I mean that alone it should tell you where the difference in the exact speaker-0: I think there's gonna be a lot with peptides coming out too. I think that's gonna be maybe a game changer. Yeah. Because I know you know some of the growth factors and all that can obvious probably has some sort of impact on the perio, I would assume. So speaker-1: I've been hearing more. Which is ⁓ the gum tissue and bone around the teeth. speaker-0: Right. So I could see, you know, down the line. Yeah. Yeah. Yeah, maybe. So yeah, I think the you know, the technology keeps progressing and I think it's our job to keep utilizing it ⁓ to help our patient experience. speaker-1: We'd be able to improve saliva. I saw ⁓ really cool article. I mean, you probably heard about the testing they're doing on regrowing teeth. Sure. They're doing in Korea, I think. Yeah. But that's that's way in the future. Like that's gonna be so expensive to do. Right. Like anyone who thinks that they can lose their teeth that 'cause they can regrow, sorry, that technology's probably twenty five, forty years away. But ⁓ yeah, it's it's changing and the experience is gonna be different. We have to speaker-0: But Right. speaker-1: But in dentistry, what we have to make sure is that that personal touch doesn't go away. Right. That we don't become a conveyor belt of of a robot and an AI assistant doing all of our work. ⁓ You and I have both explored AI quite a bit from like organizing our thoughts and I I I'm assuming you use it for notes at times too, will you use a GPT to like that's where it can organize, but it our impressions and our experience and making the patient feel comfortable, that's something AI cannot speaker-0: No, no. And it won't. And especially in dentistry where, you know, there is a lot of communication between the doctor and patient. You know, making really making them feel welcome to our practice. That's so important. And especially when you're talking about dental anxiety and how we can help with that. ⁓ and especially with younger kids. I mean that's that's key is to to really, you know, set the stage that going to the dentist is okay. speaker-1: It's okay. speaker-0: It's okay. Yeah. speaker-1: We're here to make you feel better, we're not here to make you feel pain. speaker-0: Right. And I I also think that orthodontics can play a role in that as well. Because although we're not dentists, they think that we are. Yeah. And we they generally have a a good experience at the orthodontist, which I think can kinda help set that stage. Yeah, your guys is Yeah. Yeah. It has to Right, like yeah. So I think, you know, kinda building that too, ⁓ that it has to help kids as well, just feeling more comfortable with going to the dentist. speaker-1: I would agree. ⁓ because it's like th we are working in a very intimate area and anyone is going to feel slightly vulnerable. Like the comparisons would be your proctologist or urologist or an OBG. Those are the only other ones that you're as vulnerable as probably when you're in the dentist chair. ⁓ but you know, we have to accept that the the patient we have To like your the patient is in a vulnerable position. They're gonna feel vulnerable and we have to be empathetic to that. Absolutely. Right on, man. ⁓ well let's wrap it up here. This was really fun. ⁓ you know, we'll be able to have more conversations in the future probably. But ⁓ why don't you ⁓ just let's just kinda tie it up. Do you have ⁓ Instagram, social media handles, anything like that you wanna share with people? Sure. And where what and remind us where you're practicing again? speaker-0: Right. ⁓ so you can reach our practice ⁓ Instagram at just Ortho and then we're Just Orthodonics on Facebook. We have location a location in Manitowak, Sheboygan and Chilton coming in the future. speaker-1: Right on, man. Yeah. All right. Well thanks Ethan for joining us. This has been another ⁓ episode of the Death Before Decay podcast and I hope you all have a great day. Thanks. Yeah, man. speaker-0: Thank you. Did you have fun? Yeah, that was good.