Latest / Orthodontic Products Podcast / What Happens When a Practice Trades Traditional Indirect Bonding for Digital Bonding
Transcript
- Alison Werner (00:06) For Orthodonists who've spent years meticulously placing each bracket by hand, letting go of that control can feel like a leap of faith. But when a partner's sudden departure leaves you carrying the load of a two or three doctor practice on your own, finding new efficiencies isn't optional, it's survival. Sometimes the answer isn't working harder after hours. It's handing the busy work to a system built for consistency every single time. Welcome to the Orthodontic Products Podcast. I'm your host, Alison Werner. In this episode, sponsored by Solventum, I'm speaking with Dr. Sam Wise, who has a thriving multi-chair practice in North Canton, Ohio. We discuss his two decade journey from hand prepping traditional indirect bonding trays at his makeshift kitchen lab to fully embracing digital bonding with Solventum's Clarity Digital Bonding Workflow, which includes the APC Flash Free Adhesive. He shares how the switch not only helped him absorb the workload of a growing practice solo, but allowed him to delegate tray prep to his clinical team. He also shares how the Clarity Digital Bonding Workflow cut chair time for a bonding appointment in his practice down to just a minute or two and all but eliminated the s eliminated the staining and micro leakage that came with traditional bonding methods. Here's our conversation. Alison Werner (01:17) Doctor Wise, thank you for joining me, I appreciate it. Dr Sam Wise (01:19) Thank you guys for having me. I really appreciate the opportunity. Alison Werner (01:23) Yeah. Okay, so just to get started, tell me about your journey into orthodontics and your practice. Dr Sam Wise (01:31) So a little bit about myself. I actually grew up in western Pennsylvania, Alison Werner (01:35) Mm-hmm. Dr Sam Wise (01:36) about thirty minutes northeast of Pittsburgh. And as a kid, I was able to caddy at Oakmont Country Club. and and for those of you who are golfers, that's that's a pretty exclusive place. And you know, caddying taught me a lot about hard work and discipline. but it also taught me that the real doctors only got to play golf on the weekends and that the dentist the dentist got to play golf Wednesdays and Fridays too. Alison Werner (02:01) Okay. Dr Sam Wise (02:02) Yeah. So I I learned that pretty quick. But it the probably the most important thing it taught me was the importance of relationships. And so I found out pretty early on that if you didn't make a connection with your golfer by the end of a four-hour round of golf, you didn't get paid very well. And Alison Werner (02:16) Mm. Dr Sam Wise (02:17) so that's something that I've ki it's kind of carried through my life. I even when I walk in the the new patient exam room today, I don't talk about their teeth until I build that connection with the patient. And so I always tell my audience that you can have all the technology in the world, but if you don't make a connection with your your patient, the rest really doesn't matter. And so Alison Werner (02:36) Mm-hmm. Yeah. Dr Sam Wise (02:38) in in nineteen ninety five my family moved to northeast Ohio and my dad had a job transfer which moved me to at the Akron area. So I graduated from Stowe High School, which is about ten minutes outside of Akron, Ohio. And From Stowe, I went to the Ohio State University for college and for dental school. And Alison Werner (02:59) Mm-hmm. Dr Sam Wise (03:02) I spent seven of the best years of my life in Columbus, Ohio. Alison Werner (03:05) Yeah. Dr Sam Wise (03:06) And graduating in 2004, I became an Air Force dentist for a couple of years. So Alison Werner (03:12) Okay. Dr Sam Wise (03:13) I so I traveled around the country with the Air Force and finally completed my orthodontic training in Detroit in two thousand nine. And if you remember it around 2008, there was this little thing called the Great Recession. Alison Werner (03:27) Right. Dr Sam Wise (03:28) So not a not a great time to be graduating. Alison Werner (03:30) Yeah, exactly. Dr Sam Wise (03:31) so my plan all along was to move back to Ohio and get closer to my family, but because the economy was so rocky, I I ended up working in a practice just north of Detroit for about a year and a half before I made my return home to the Cleveland area. Alison Werner (03:47) Mm. Dr Sam Wise (03:47) And so in 2010, I moved back to northeast Ohio and I joined my partner, Dr. Dave Fleming. And Dave had started the practice from scratch in 2005, which is still really difficult to do to start from scratch. Alison Werner (04:01) Yeah. Dr Sam Wise (04:02) And at the time, the practice was barely big enough for one orthodontist, let alone the both of us. Alison Werner (04:07) Mm-hmm. Dr Sam Wise (04:07) And so he and I would have these brainstorming sessions where we try to figure out ways that we could grow our practice. And so working together, the question mark was, you know, how could we differentiate ourselves and grow this thing? Because When I first joined Dr. Fleming, the practice was only doing about $500,000 in total production, which is barely enough for, like I said, one orthodontist. So Alison Werner (04:30) Right. Dr Sam Wise (04:31) starting in 2010, the first thing that we did was we brought in indirect bonding. And we told our patients and our and our referring doctors and our parents that hey, this is the this is the new way versus the old way. What I didn't tell them is indirect bonding had been around since 1972. But Part of it is is the delivery, right? And so we told our patients, hey, this is the way to do all the braces at the same time in less time and better. And that kind of became our office mantra. And we told so many people about it that I I hosted so many lunch and learns with our referring doctors that I actually got tired of eating Panera at the time. Alison Werner (05:10) Ha ha ha Dr Sam Wise (05:12) For a while I could I couldn't even look at a a Sierra turkey sandwich for a couple of years. Alison Werner (05:16) my god. Dr Sam Wise (05:18) but we our goal was was to differentiate ourselves and set ourselves apart. And so that was c that was kind of the start. the problem with traditional indirect bonding is it was a ton of work. Alison Werner (05:30) Yeah. Dr Sam Wise (05:30) And so for for a decade and for e you know, evening after evening, my job was to put braces individually one by one on models of the teeth, which eventually became unsustainable. Alison Werner (05:43) Yeah. Yeah. Dr Sam Wise (05:44) Our practice is currently located in North Canton, Ohio. it's in between Akron and Canton. Alison Werner (05:51) Mm-hmm. Dr Sam Wise (05:52) It's about about fifth 50 miles south of Cleveland. And Alison Werner (05:55) Okay. Dr Sam Wise (05:56) we we have a very traditional practice. Our practice has we we just actually completed a expansion and a remodel which is which is very exciting. We lived out of a shoebox for a long time and now we finally finally expanded our space. Alison Werner (06:08) some space. Dr Sam Wise (06:11) And so we've got nine clinical chairs, we've got seven semi private chairs, and we've got two private rooms that we use for for kids that need TLC and and adults that need privacy. And so our practice has continued to grow from the time that I joined Dr. Fleming back in two thousand ten and kind of the rest is history. Alison Werner (06:34) okay. All right. Well you talked a little bit there, but I want you to go a little bit further. How has digital technology changed the way you approach bracket treatment today and then I guess indirect bonding? How has that evolved? Dr Sam Wise (06:51) So one of our core values is always innovation and technology. And so we've always tried to keep up with the things that are coming down the pipeline. Alison Werner (06:58) Mm-hmm. Dr Sam Wise (06:58) And digital bonding has honestly changed everything for us. So as our practice grew, it got to the point by 2019 that we were starting to do four to five bondings a day. And it became increasingly difficult to make all those indirect bonding trays. Alison Werner (07:16) Mm. Dr Sam Wise (07:17) And so we started looking around at different ways that we could maybe offload that work. Alison Werner (07:22) Yeah. Dr Sam Wise (07:23) we all know what happened in twenty twenty. COVID hit. Alison Werner (07:26) Mm-hmm. Dr Sam Wise (07:27) at the time I had brought out I had brought a junior partner onto my practice. and the the idea was basically to I was looking to get less busy and I was trying to make him more busy. And then and then in twenty twenty, in the midst of COVID he tells me that hey, by the way, my wife and I want to move back to Michigan. And so I ended up becoming his retirement plan. But it left me with a practice that was probably large enough for two or three doctors on my own. My Alison Werner (07:57) Okay. Dr Sam Wise (07:57) my senior partner at this point had gone down to about one day a month, actually, which is I'm not that's not a miss typo, it's one day a month. And and so I had to find a way to carry that load. And so when 3M at the time, which is now Solventum, and excuse me if I say 3M today, Alison Werner (08:18) It's okay. Dr Sam Wise (08:19) Years and years of saying Solvent or 3M is hard to get right. So Alison Werner (08:22) I know. It's it's hard it's a hard switch. Dr Sam Wise (08:26) when they introduced their own digital bonding in the fall of 2020, Alison Werner (08:30) Mm-hmm. Dr Sam Wise (08:30) we jumped all in. And we know that 3M and Solventum do their homework and Alison Werner (08:35) Mm-hmm. Dr Sam Wise (08:35) it was gonna be a home run for us. So that has changed our entire process. You know, back I I'm I'm old enough. I still remember when the we when people would come in, they would take alginates on every patient. Alison Werner (08:47) Yeah. Dr Sam Wise (08:48) And back and back then we didn't take we didn't take records until the patient was committed. Why? It was time consuming. Alison Werner (08:55) Mm-hmm. Dr Sam Wise (08:56) If the patient wasn't going to start treatment, we didn't bother taking records. There was no reason to. Alison Werner (09:01) Right. Dr Sam Wise (09:01) and so once we made the switch to digital bonding, we started taking photographs and x rays and scans on every new patient, right, right off the rip. And Alison Werner (09:11) Okay. Dr Sam Wise (09:12) that allowed us to be more efficient. We didn't have we didn't have to wait for the patient to come back for records anymore. Alison Werner (09:16) Mm, okay. Dr Sam Wise (09:17) And so we started combining our our appointments. Our our new patient and our records appointment became one. And that has allowed us now to order digital bonding trays when the patient is ready. So for those people out there who are worried about same-day starts, that's a big buzzword in the orthodontic world. Alison Werner (09:37) Right. Yeah. Dr Sam Wise (09:39) I d I do what's called a same-day contract start, which basically gets the patient to buy into our office. and make the commitment. And I I tell the patient, hey, go home, enjoy the next couple of weeks, eat all the hard candies and things you're not supposed to have with braces. And then Alison Werner (09:54) Uh-huh. Dr Sam Wise (09:56) and then we're gonna but we're gonna bring you back and do it the new high tech way. So we're always building this story of the new way versus the old way. And that's become a that's kind of become our office philosophy. And go ahead. Alison Werner (10:09) Okay. Yeah. Well I was gonna ask, so for someone who is still doing traditional bonding, talk about that transition to well, you haven't you haven't done traditional bonding a lot. So talk to me about indirect bonding and switching to a tr a digital format. How does that adjust the way you are getting those cases ready? Dr Sam Wise (10:35) Yeah, so you know, when we first started doing it, there was a concern of the delivery time. And so, you know, all of a sudden you go from, hey, a patient can walk in today, and you're either gonna direct bond them, which I never did, or Alison Werner (10:50) Mm-hmm. Dr Sam Wise (10:51) or you're gonna do a setup overnight and you could indirect bond them the following day. And so when we started the process, we said, Hey, we've got to figure out a way to make that switch, right? And so we started planning our schedule, I would say two to three weeks out. We said, okay, for the next two to three weeks out, we're gonna do a lot more of everything else except for putting braces on. Alison Werner (11:12) Mm-hmm. Dr Sam Wise (11:12) And I explained to the patient, hey, I could put your braces on like the guy down the street one by one, or we can wait two to three weeks and we can do it the new high tech way. And they almost always say, let's do it the new high tech way. You know, so it's it's also it's painting that picture to the patient that, hey, this is gonna be better if we wait two to three weeks. And then what did it do for me? You know, my kids and my wife always teased me because I would bring bonding cases home to do in my kitchen. And they would call that my kitchen lab. And so I spent hours. I I don't even want to think about it. I went I went back for this presentation, I said, okay, how many indirect bonding cases do we do from 2010 to 2020? And we had done 8,000 indirect bonding cases. The traditional way, which if Alison Werner (11:59) Okay. Right. Dr Sam Wise (12:02) if you know how that method works, it's very lab intensive. Alison Werner (12:05) Right. Dr Sam Wise (12:05) You've got to really enjoy lab work to commit yourself to doing that. Right. And I probably needed to get out a little bit more back then. Alison Werner (12:15) Ha ha ha. Dr Sam Wise (12:16) I was spending my time at my at my desk or at my kitchen island putting Alison Werner (12:19) god, yeah. Dr Sam Wise (12:19) putting putting braces on models. And then the final straw for me was when my partner said, Hey, by the way, guess what? I'm moving to Michigan. Alison Werner (12:27) Mm-hmm. Dr Sam Wise (12:27) I said, Okay, I gotta find a better way. And Alison Werner (12:30) Yeah. Dr Sam Wise (12:30) and so we knew that there was no better way than doing something indirectly. Alison Werner (12:35) Mm-hmm. Dr Sam Wise (12:35) And we started looking at different processes. And I think the concerns that we had as far as needing 3D printers or a 3D printing lab or having a lab technician in your office that would process these digital models, all Alison Werner (12:49) Right. Dr Sam Wise (12:50) all those problems, 3M and Solventum solved for us. Alison Werner (12:55) Okay. Dr Sam Wise (12:55) They they made that they make the trays for us and they become our digital lab tech that's behind the scenes processing those digital models. Alison Werner (13:04) Mm-hmm. Dr Sam Wise (13:05) And so it just it it's made my life so much easier. I think to answer your question, it just I I in in all the things I worry about every day as a practice owner, it's just one less thing for me to worry about. Because I know now that weight is lifted off my shoulders. I can do we've done eight to ten bondings in a day, and and Alison Werner (13:25) Okay. Dr Sam Wise (13:26) those bondings now don't require nearly the time they required before. Alison Werner (13:33) So once you have that digital treatment plan, you have that indirect bonding tray that digital indirect direct bonding tray, how important is the bonding appointment bonding appointment in bringing that plan to life? Dr Sam Wise (13:49) I mean, that's that's ultimately that could make or break the whole outcome. So I I Alison Werner (13:54) Mm-hmm. Dr Sam Wise (13:55) tell my staff, I say, listen girls, I put a ton of energy into making sure that those setups are accurate. Alison Werner (14:00) Yeah. Dr Sam Wise (14:01) And they are required to then transfer that information from the computer to the patient's mouth. And I always ask the patient, I say, listen, do you think we can do a better job putting brackets on on the computer or in your mouth? And they always say, well, of course, Dr. Wise, you know, on the computer, right? So I tell my I tell my girls, okay, every step of that process is gonna be important. From tracking those trays to make sure they come in on time, to ordering them and then to loading them. And so my girls are very tuned into the fact that, hey, we've got to make sure that we're putting the correct brackets into the trays. And we gotta make sure that those brackets are fully seated in the trays. The the nice thing is, is if you look around the digital bonding world, most other trays just have a little vertical slot the bracket slides down into. It's held in place by kind of a friction fit. The solventum trays, the clarity trays, they have a little custom pocket at the bottom of that slot. That the bracket actually snaps into. And so my girls Alison Werner (15:11) Okay. Dr Sam Wise (15:11) have this positive reinforcement that hey, the bracket's in the correct place. And then once those trays are ready, we have a really strict protocol on making sure that the patient is prepped appropriately. Because you could do every other step correctly. And when people tell me that indirect bonding doesn't work, I say there's some step that's being missed. And Alison Werner (15:33) Mm. Okay. Dr Sam Wise (15:34) so when it comes to the chair. When it comes to the chair, my girls are following a pretty strict protocol and we're Alison Werner (15:40) Mm-hmm. Dr Sam Wise (15:40) making sure that we've got great isolation before we prep prep the teeth. Alison Werner (15:45) Okay. H a key part of like the Clarity Bonding With the APC Flash Free Adhesive. What role has it played in supporting that digital bonding workflow and your staff's your staff's workflow? Dr Sam Wise (16:04) I mean, I think you know it's it's super important. The the ability to put a high tech bracket into a high tech tray, Alison Werner (16:13) Mm-hmm. Dr Sam Wise (16:14) it just kind of reinforces the fact that hey, this this is different than it used to be, right? Alison Werner (16:19) Mm-hmm. Dr Sam Wise (16:19) And when I when I first started in orthodontics, we had girls in our office who had been practicing for thirty or forty years. that generation is g is gone. You know, Alison Werner (16:31) Yeah. Dr Sam Wise (16:31) most most assistants today in most practices last roughly five years. And then they're off to do something else. And so the the Alison Werner (16:39) Mm-hmm. Dr Sam Wise (16:40) the the more variables that I can control Alison Werner (16:43) Yeah. Dr Sam Wise (16:44) the better. And I I feel like the the more consistent and more repeatable that process is going to be. You know when I when I when I think about those girls who had 30, 40 years, they could butter the back of a bracket with adhesive like my grandma iced a cake. Alison Werner (17:01) Yeah. Dr Sam Wise (17:03) today, I got one if I had my girls doing that, one girl would put too much glue on, one girl would put too little glue on. And Alison Werner (17:10) Mm-hmm. Dr Sam Wise (17:10) so it's just made that whole process repeatable. Alison Werner (17:13) Yeah. Dr Sam Wise (17:14) And so my my partner and I were both military, and we look for we look for lots of systems and ways that we can eliminate eliminate variability. Alison Werner (17:22) Yeah. Dr Sam Wise (17:23) And and it's definitely helped us eliminate variability. Alison Werner (17:26) Yeah. No, that's a great point. I mean, you know, there is a staffing shortage, crisis, however you want to phrase it, but the ability to eliminate that variability when you do have employees who are coming in with different levels of experience. So, you know, many doctors will th think that think of adhesive flash as simply a cleanup issue related to the adhesive. Why should they think about it more broadly? Dr Sam Wise (17:56) I think it just, you know, every time every time we can solve a problem versus trying to correct the problem, Alison Werner (18:02) Mm-hmm. Dr Sam Wise (18:02) it it's better in the long run. So I I think, you know, let's just go back to when we were putting traditional indirect bonding trays in. We were always adding glue to the back of the bracket. Alison Werner (18:11) Mm-hmm. Yeah. Dr Sam Wise (18:13) And and no and no matter how hard we tried to put a little dot of glue on the back of the bracket, there was always residual flash. And that flash doesn't show up day one. It it shows up after a few weeks of drinking coffee and drinking red and drinking red wine and drinking tea. And so Alison Werner (18:29) Mm-hmm. Yeah. Dr Sam Wise (18:31) I have patients coming back. We're trying to offer a a high class experience with ceramic braces and things. And now they have they have a brown stain around their their teeth that looks like mahogany. Alison Werner (18:44) Yeah. Dr Sam Wise (18:45) And so I I just think it speaks volumes to the patient that hey this this is a this is a different these are very clean. Right? The and and the process is is is is just better in in the long run. I think they they they go, no, these look these braces look different. I I'll hear that a lot. They'll go, they look so clean and different versus what we Alison Werner (19:05) Mm-hmm. Dr Sam Wise (19:05) used to use. They had this perception in their mind that the braces were gonna be very dingy and and they're they're gonna yellow. And and a lot of times it was really just that stain around the bracket. Alison Werner (19:16) okay. Dr Sam Wise (19:16) So so the more I can eliminate the that the the better. Alison Werner (19:19) Yeah. Dr Sam Wise (19:19) Two, I think the technology of that flash-free bracket, I think it seals a little bit better. When we used to do traditional indirect bonding, I noticed a lot of times that we would have stain building up underneath the corners of the bracket where the bracket wasn't fully secured. there there used to be a product called ProSeal. Pro Seal would seal the enamel. In my mind, the flash-free bracket for me is kind of like my version of ProSeal because Alison Werner (19:47) Okay. Dr Sam Wise (19:47) it's actually sealing that bracket so that we're not getting leakage or micro leakage underneath the bracket. Every once in a while it would be a bummer, but I would take a bracket off and I would see decalcification under the corner of a bracket. And so it's eliminating that possibility for me, or at least reducing the possibility of having that micro leakage and having Alison Werner (20:06) Mm-hmm. Dr Sam Wise (20:07) that that decalcification. Alison Werner (20:09) Yeah. You talked about the efficiency of being able to have your you know, be able to do your imaging on that first appointment and then, you know, being able to then that next appointment do the bonding. What other effici what efficiencies have you seen as the case progresses then? Dr Sam Wise (20:31) So people always ask me, they go, all right, just be honest with me. How many repositions do you do in your practice? Alison Werner (20:38) Mm-hmm. Dr Sam Wise (20:39) And so we are a very conscientious practice. We want to make sure we we are following each case very carefully. People trust me with their kids, and I'm gonna make sure I do my best job. So midway through, we do still take progress records, which is photos and x-rays, and I'm looking for I'm looking for things to adjust. And the reality is that by the time we get to a full-dimension wire, I have very little very few things to adjust. And Alison Werner (21:04) Hm. Dr Sam Wise (21:05) so in my practice, it would be very, very rare to me for me to actually reposition a bracket. Alison Werner (21:10) Okay. Dr Sam Wise (21:11) And that saves that saves me tremendous time in the clinic. And it saves the patient from going further more months in their treatment time. So it keeps their treatment completion date on time. Alison Werner (21:24) Mm. Dr Sam Wise (21:27) I still need to do some fine tuning to the wire, but thankfully because the brackets were put on so close to where I want them that the the the arch wire bends are very minimal and straightforward. And so we're not having to adjust, we're not having to adjust the wires even very much. But I always tell my staff, I like to do a few adjustments because I feel like it shows the parent that I'm putting my finishing touches on the base. So part of it part of it is part of the show to say, hey. You know, I'm actually gonna really, really fine-tune this, Alison Werner (21:58) Yeah. Dr Sam Wise (21:59) but the reality is there are very minor details that need corrected. And so that that has allowed me to, when I was on my own, on my own, carry the load of that two, three doctor practice where I'm not tied up in the clinic doing tons of arch wire adjustments. Alison Werner (22:16) Yeah. Dr Sam Wise (22:17) And if I am if I am at the chair, it's it's it's pretty straightforward. Alison Werner (22:23) Okay. What okay, so what impact would you say that the Clarity Digital Bonding and the APC Flash Free Adhesive have had on your team, on your workflow overall, and your patients? Dr Sam Wise (22:38) well I know my my team and my patients, they they love it. the the first digital bonding case we ever did, we actually did on a Facebook live on our Facebook page. And that's that's taking a big risk. I was like, these these things better stay on, right? Alison Werner (22:50) really? Yeah. Dr Sam Wise (22:58) but if you listen to my assistant on my Facebook page video, the first thing she goes, she goes, Wow, that was really easy. Alison Werner (23:06) Mm. Dr Sam Wise (23:06) Because as indirect bonding changed over the years, one of the major things that was difficult was the tray materials changed. And so back in the old days, I would order this material from Rocky Mountain, and it was like perfect. It was like Goldilocks. It was just right. You Alison Werner (23:20) Yeah. Yeah. Dr Sam Wise (23:21) know, it could hold the bracket well enough to hold it, but not so firmly. I couldn't get the tray off. Alison Werner (23:27) Mm-hmm. Dr Sam Wise (23:27) And as those trays changed over the years, that material became very, very rigid. And my girls were always holding their breath to see if the tray would peel the bracket off. Alison Werner (23:36) Yeah. Dr Sam Wise (23:37) So digital bonding, that that was the first thing I noticed was wow, these trays peel off super easy. And for the girls of today, where you're like, they're they don't have as much experience as those senior girls did, Alison Werner (23:49) I Dr Sam Wise (23:50) that's another variable that you're eliminating. Two, I feel like I used to have to be in control that entire process. You know, we we we knew how technique sensitive indirect bonding was back in the old days. And so it was hard to delegate that to your staff. We never delegated that process. We we made every single tray ourselves. And so when digital bonding came around, I was able to assign a digital lab person she she now is taking complete ownership of that part of our office. And Alison Werner (24:22) Okay. Dr Sam Wise (24:22) she honestly she loves it. You know, she's she knows that she's responsible for making sure that every patient has what they need. And so I'm I'm letting her now order the trays. I'm letting her now track the trays. And I'm letting her now load the trays. So, Alison Werner (24:39) Mm. Dr Sam Wise (24:39) you know, we started when we first started the process, we had dem demo boxes and trays that would with my girls practice on. Alison Werner (24:46) Yeah. Dr Sam Wise (24:46) And it was kind of like arts and crafts time for them. Alison Werner (24:49) Yeah. Dr Sam Wise (24:50) they they got to play, they got to play with the you know the models and the trays. Alison Werner (24:54) Yeah. Dr Sam Wise (24:55) it it it's like it's like therapy for those girls loading those trays in the morning. Alison Werner (25:00) Ha ha ha. Dr Sam Wise (25:00) I I I come in in the morning and there's a there's a couple girls, let's just say we have five or six bondings that day. We always load Alison Werner (25:06) Mm-hmm. Dr Sam Wise (25:06) our trays the mo the mornings of the bondings. Alison Werner (25:09) Okay. Dr Sam Wise (25:10) And I'll come in in the morning and they'll be sitting there loading trays, talking, drinking coffee, having a nice time, right? They're they're locked in on the bracket design summary, which is telling them which brackets to put in those trays. So Alison Werner (25:22) Mm-hmm. Dr Sam Wise (25:23) they know, hey, this is a serious task, right? And then I'd say the final part of it is back when we were doing traditional indirect bonding, Dr. Fleming and I always seated our own trays. Why? Because they were very rigid, there was very little room for error. And these new trays, after doing them enough times, I said, hey, my girls have watched me do this 50 times. Alison Werner (25:52) Yeah. Dr Sam Wise (25:53) I first I first started with having my most senior girls seat the trays. And now every single girl in my office is able to seat those trays. And so what what has that done? That has Alison Werner (26:01) Mm. Okay. Yeah. Dr Sam Wise (26:04) taken my chair time at the chair for a bonding down to about one or two minutes. I live Alison Werner (26:09) Mm, okay. Dr Sam Wise (26:10) I I literally stop I stop by the chair to make sure the mama know mom and dad know that I'm there. Alison Werner (26:15) He's Dr Sam Wise (26:17) But my my girls are talking up the fact that hey the doctor has planned this this for your child. He put a lot of effort into making sure these brackets are in the perfect position, and then her job is now to deliver those brackets to the mouth. And so I think that that brings a lot of comfort to the parent knowing that, hey, it's not this just some random thing that's going on my kid's teeth. That Alison Werner (26:38) Yeah. Dr Sam Wise (26:39) hey, Dr. Dr. Wise and Dr. Fleming actually created this specifically for my kid. And now when those when those trays come off, I hear this throughout the office all the time. The parents always say, Wow, that's a lot different than when I had my braces. And I and I would hope so. I I always tell the the patients, I go, listen, I don't want to do things the way they did them twenty, thirty years ago. Alison Werner (27:02) Mm-hmm. Dr Sam Wise (27:02) I I've been out of dental school now twenty-two years. Hopefully Alison Werner (27:05) Right. Dr Sam Wise (27:05) I'm not still doing it the way I learned it back in 2000. Alison Werner (27:08) Mm-hmm. Dr Sam Wise (27:09) And so, you know, as things continue to change, we'll try to keep up with those changes and we're gonna try to keep doing it the the best way. Alison Werner (27:16) Yeah. Well, in on that note, looking ahead, where do you see digital bonding technology going and what advice would you give to doctors considering a more digital workflow for this aspect of their clinical workflow? Dr Sam Wise (27:32) I mean I d I just see it continu continuing to get better and better. even since you know twenty twenty they would ask for feedback and Alison Werner (27:40) Mm-hmm. Dr Sam Wise (27:42) for instance the thickness of the trays, the trays have become thinner. Why is that important? It's easier to seat the trays in the mouth. Alison Werner (27:48) Mm-hmm. Dr Sam Wise (27:50) they have added advancements like bite turbos. Now the bite turbos are in the trays. They've allowed they allow us to do now many, many, mini molar tubes. So now if I have a tooth that's partially erupted, I can get that seven bracket on. So Alison Werner (28:02) Mm. Dr Sam Wise (28:03) I think that technology is getting better and better. I think as things progress, you're gonna see the trays get better, you're gonna see possibly pre-loaded trays where now that tray actually comes to your office. It's already got all the brackets in it. Alison Werner (28:19) Yeah. Dr Sam Wise (28:19) It's eliminating even more variables. No more having my girls load those brackets into the trays. Alison Werner (28:26) Mm-hmm. Dr Sam Wise (28:26) The amount of inventory that I'll have to have in my office will be a lot less because I'm not gonna have to carry all that bracket inventory. Alison Werner (28:33) Right. Dr Sam Wise (28:34) Right? So hey, it's gonna be a one-stop shop. You order the trays, the trays are gonna come to your office already with flash-free pre-pasted brackets, and they're in a sealed container that allows you to then go ahead and put those on the teeth. Alison Werner (28:47) Yeah. Dr Sam Wise (28:49) I think that AI will probably help us with the setups. You know, the setups are becoming more sophisticated. I'm Alison Werner (28:55) Mm-hmm. Dr Sam Wise (28:56) I'm noticing I'm not having to adjust as many things anymore. Yeah, Alison Werner (29:00) Okay. Dr Sam Wise (29:00) you know, things are starting to learn that hey, Dr. Wise, we all like things in a certain way. Right. Alison Werner (29:05) Mm-hmm. Dr Sam Wise (29:06) and and I always tell the doctors, like, listen, you got you still have to be the doctor. You know, I I don't know who the lab technician is that's setting up those brackets. They're doing their best job, but we still have to be the doctor. Right? But I think as the technology advances, if they're able to learn, this is where Dr. Wise sees the center of that tooth, right? Alison Werner (29:25) Mm. Dr Sam Wise (29:26) Then it's gonna be it's gonna be even less modification at at the computer. And I I think as far as advice goes, I would tell doctors that, hey, you know, maybe maybe don't go all in. Maybe start trying a mix. But I feel like if you don't get ahead of it, the technology is either gonna pass you by or your competition's gonna pass you by. Alison Werner (29:49) Yeah. Dr Sam Wise (29:50) And I also want the doctors to know that, hey, when you start using these things, it's not enough just to have that technology in your office. Alison Werner (29:57) Mm-hmm. Dr Sam Wise (29:57) You've got to tell people about it. Alison Werner (30:00) Mm. Dr Sam Wise (30:00) So every day I'm talking to my patients, I'm talking to my parents, and I'm explaining them the difference between the old way and the new way. I'm I'm still hosting Lunch and Learns. I'm still talking to doctors' offices about, hey, this is the new way to put brackets on. Alison Werner (30:15) Mm-hmm. Dr Sam Wise (30:15) Right? And so I think for them, it's like, hey, once once you get comfortable with it, it's gonna make your life easier. but you you know, make sure you tell people about you, you've gotta let them know. Alison Werner (30:27) Yeah. Yeah, absolutely. Well, Doctor Wise, I really appreciate you taking the time to talk to me today. Thanks so much. Dr Sam Wise (30:34) Thank you so much for having me.