Best Implant Course Ever – Season 1 Episode 7

The Dr. Chris Griffin Show – Season 1 Episode 7

“We are realizing how health can be affected by the oral state and how somebody losing their teeth will lead to all kinds of systematic problems such as atherosclerosis or cancer.” Now who said that?

Welcome to the Dr. Chris Griffin Show. Your resource for leveraging systems and technology to easier workload, increase productivity and provide you with the time off you deserve to live the life of your dreams. It’s time to practice productivity in the passionate pursuit of a better life with your host, Dr. Chris Griffin. The doctor is in.

Hey sports fans, welcome to another episode. I just want to thanks everyone so much for being awesome listeners and downloading the podcast and going and subscribing. Thank you so much for helping us you know, our rank go up on iTunes, that’s been awesome. The quote I threw out at you before the intro. Now that when you’re probably not going to get you know, because it’s a little bit detailed. And this, I got to warn you on the front end, this episode is going to get a little bit geeky for the dentists. And even if you’re a dentist, it’s going to get kind of geeky for you too because if you could possibly not be into what I’m going to talk about, but maybe and you probably should have thought about it, I know you heard about it. And so hopefully after today I can do a little convincing for you and encourage you to get into this field. This still growing field that is just, you know, just an amazing place to be.

So the quote about how oral health affect everything and even lead to problems such as cancer, that was said by Dr. Michael McCracken, UAB professor and totally awesome guy who I just hang out with this past weekend. And that is another reason why that I’m doing this show right now while this is fresh in my mind because I just really had an amazing experience and I just felt like I, you know, if I’m going to have the Dr. Chris Griffin Show, I got to share my experiences and the ones that are totally awesome like the one I just had, we got to share that. There’s another quote that he had that I’ve never heard before, that’s really applicable to all of us dentists, who are all doing surgeries basically every day. And I’ll explain that one later. Well actually that quote is pretty cool; it is “Small incision, bad decision.” Now he may or may not have even come up with that. That possibly could be from somebody else, I don’t know but he did say that in his lecture. And so anyway, I thought I’d pass that on there for you.

If you’re looking at your mind map and you’re following along as you always know, we go clockwise. And for whatever reason, I always start these mind maps out if you’re looking like at it clockwise at the 10 o’clock position, we go around and in a clockwise fashion. And so obviously, I had a great experience this past week. What I did, let me just tell you guys what I did. I, after several years of badgering I was convinced to take another hands on implant course which I’ve taken many. I meant to pull my AGD transcript up and just see how many I’ve taken over the years. Rest assured the reason I have not yet gotten my Masters in the Academy, is not because of implant training because I certainly have enough hands on hours to do me for a while on that. But I had some friends that really encouraged me to go to this one particular course and we’ll get to that in a little bit later in the show too but I always resisted. And you know, implant dentistry has been around forever. I’ll never forget, I don’t know, I was freshman or sophomore year in UT. I was sitting in class with one of my best friends and we had a lecturer on implants. And back then it was not even like the cool, awesome titanium implants that we have now; it was you know blade implants. They were showing us these blade implants and even then I thought “Wow, this is the way of the future. This is so amazing. I want to be an Implantologist.” And he said the same thing, sitting in class. He didn’t remember doing it but he did, he said it. He said he also thought he wanted to go into implantology and we were so green, we didn’t even know that wasn’t a thing. We didn’t realize Implantology was not a specialty, we just saw the potential and thought “Wow! That could be awesome!”

But as things go, dental school got harder and harder. And I you know, I decided I was going to be just probably good enough I mean just to get my degree to be a dentist. And you know that’s good enough. Let’s forget these ideas of fancy implantology. But it’s been around for a long time. I think some of the cases they were showing us back in UT was from even the 80’s. And as things have gone by, more and more dentists are placing implants. I have seen statistics that ranged anywhere from 10% to 20% of dentists out there are placing them. I think some people say it’s closer to 20, some people say it’s a little bit more than 20. I don’t know, I mean I think of…I go around and lecture. And I think that of course, a lot of people restore implants but if you talk about the people who placed the implants, it’s really only about 10% of the general dental population that place them.

Now a lot of specialist place them and boy I didn’t know there’s a big turf world over implants. I mean Golly, the oral surgeons of course, they think that’s them. Endodontists like to place implants, I found out. Prosthodontist, who knew that? A lot of Prosthodontists think they should be the guys placing them because they know where they should go to make the prosthesis the best of. So and if you get real technical down to it, General dentists are some of the first ones that brought implants on to the scene an actual reality. So you know, there’s a lot of people who claim to be the ones that deserve to be the dentists who are truly qualified to place these implants. I’m not going to get to that argument because I love everybody. And if you’re good at placing implants, go for it. There’s plenty of missing teeth out there and there’s going to be more missing teeth, so I don’t see why it’s going to be a problem. Now if you’re a specialist, and you feel like you must charge way more than general dentists, because you’re a specialist and obviously that’s going to hamper your ability to do more cases. However, if you’re a general dentist you better darn well know what you’re doing when you’re placing them because you’re not a specialist. Alright?

And regardless of what price you placing them at, you better know your stuff because if a specialist really get kind of a pass, now they’re all…you know, specialists they’re all great and all professional but if you have more letters up behind your name, you know you get a little bit of a pass if something goes wrong. If you’re a general dentist you don’t necessarily get that pass. So if you’re going to place implants, I think that, I think you better know your stuff. And that’s kind of why I went to this course because I want to know how to do more types of implants and want to have my stuff together and I want to be really good at it, you know. I know there won’t be a problem. So I would say that one of the interesting things about, just talking about real quickly the people, the amount of people that are placing implants are only a very small percentage do what I would call a hard cases. You know where you’re going to potentially run in through things with a name and also Dr. McCracken said that during the lecture. I picked that up from him. I’m certainly not going to try to steal any of his quotes, I don’t know where he may have gotten them himself but most cases out there are “hard cases”. I mean, you know, I have a lot of patients interested in implants but for the most part, I’d refer them out because of some issue and it’s not just as simple as drilling a screw into a piece of wood; like one lecturer said years ago when I went to his lecture.

So why is it, why is it that we, as general dentists are so scared about implants? Or even some specialists out there. Why are you scared? I think it’s probably because of those worst case scenarios. In placing implants, some of the worst case scenarios are really worse than other things you do. Like you’re probably not going to have trouble, nerve damage or bleeding problems when you’re done of filling; it’s just not going to happen. Now you know, we all know, you could have extended numbness from a shot you give someone; an injection. You could have bleeding problems from extracting the tooth, you know. Instruments can slip, there’s all kind of…there’s why you have a formal consent because, you know, medicine’s not perfect. It’s called medical practice for a reason. It’s not…you’re never going to have that exact perfect result every single time. But I think that implants have had such a mystery and there’s been a lot of misinformation out there for so many years that a lot of dentists were just scared of them. I’ll include myself in that. I was just scared of them.

I mean I don’t want to cause irreversible damage. I don’t want to have lingering numbness because I encroached on a nerve that has a name. I don’t want to have a bleed that I can’t stop. That was maybe the biggest thing that scared me all these years. I, you know, I don’t want to hit the lingual artery. I mean I don’t want to…I just don’t want that to happen. And you know if you’re out there and you’re supporting your family and you’re making plenty of money, without doing things that run the risk of bleeding or numbness or irreversible damage, you know, what the heck are you doing, man? Why would you get into that and expose yourself? But as time went on, it just became more and more obvious that as more of my patients needed something like this, and I saw their hesitancy to go to the oral surgeons that I would refer to. And man the oral surgeons are so good, I love those guys. I mean they have saved my bacon so many times. And I’m not you know, I’m not an advocate for general dentist out there. I’m just trying to steal patients from your specialists or quit sending specialists to your patients. I think specialists play a major role in a general dentist’s life. If you got to have them, and you need to help them out and do stuff for them too because they really can help you on a tight.

But there’s just a large amount of patients who are not going to go to this specialist for anything in where I live. In big cities, it’s probably different specialists who are right down the street but where I live, a lot of people are asking for things and I just…if I’m not, if I don’t do it, nobody’s going to do it. So I knew that I had to get serious and after today, I’m going to teach you the things that I learned from taking this course I just took. That it’ll help you know where you can go, if you want to get really serious about dental implants so you won’t be so scared and confused. And I think that’s the major thing that we’re looking for. So hey, where did I go? I mean that’s the big question right? I went all the way to the big city of Birmingham, Alabama. Well two cities actually. I went to New Orleans, Louisiana and Birmingham, Alabama. It’s a course called Implant Dentistry Surgical Placement and Restoration Implants. It’s kind of a you know, I love you Dr. McCracken, but you now maybe not the most enticing title. I mean it’s not going to jump off the page at you. It’s a group, I think some people referred to them as Alabama Implant Education and you know, I guess I just always thought if something this life changing, earth shattering, amazing were this close to me. I mean Birmingham is 2 hours basically from my doorstep; why would I not know about it? I mean, would everyone would just not be running down there and telling everybody else to go? I mean that’s what I thought and so I resisted.

I guess maybe 3 or 4 years ago, I had a friend from Robertsdale, Alabama named Dr. Jason Northcutt. Now Jason has been and has a couple of claims to fame years ago was on a CD called something about future superstars of dentistry with Greg Stanley, who interviewed a bunch of dentists and Jason was one of them that he interviewed and years later I ran into Jason at some other courses and we struck up a friendship. He got really good at implants and you know, everyone…some of you have been to my seminars; my yearly events and I invited him to be a speaker at one of those. And he came and he was a great speaker. He talked a lot about implants, how it changed his practice. And the little thing there was he just had one little bit slide and he said “Hey guys, if you’re interested. You should go down to Birmingham and take this course.” And you know threw the slide up. I don’t know how many people from that course went but one of the people who went from that slide was Dr. Steve Deloach, one of my best friends up in Dickson, Tennessee.

Now Dr. Steve, he would tell you himself that for a while, he’d probably hadn’t been as excited about new things in Dentistry as he used to when we first got out of school. I mean he and I, we went all over the country literally trying to learn everything we could. We wanted to be these amazing cosmetic dentists right out of school, I know I’ve told you that story before. He was right in there with me. We both wanted to do this exact same thing. And then, you know, life took over, we started having kids, we both kind of got out of that. And you now, he’d be the first to tell you, we kind of lost interest of new things in dentistry. We saw that slide and he liked Dr. Northcutt’s presentation, so he goes down there and he takes their big course. They got a big course and a little course. I just took the little course but it was really big for me. But he took the 10 month course which is you know, it’s a big commitment but he goes down there and I got to tell you, I’ve never seen a change in a single person like I’ve seen in him over the past years.

So he is absolutely on fire for dentistry and he’s doing big cases left and right and it’s just amazing to see some of the work he’s doing. And he’s honestly gotten really advanced, more advanced than me in that area. And it kind of bugged me, you know and my competitive nature took over and I was you know, for a year he badgered me. “You got to go take this course, you got to go take this course.” It wasn’t just me either like they should be paying this guy a commission because he got me and I think 4 of our classmates. We all went down there pretty much together. And we all experienced it in the short course and you know what Dr. Northcutt and Dr. Steve, they know what they were seeing 110% true. It was an amazing experience. Who are these people that we just met? I mean, you know it’s crazy but I didn’t even really thought I’ve gone through hundreds of hours of implant training as always boring and stale. And I just you know I didn’t get it and the hands on portions are on pigs and you know dental forms and I just didn’t get it. And so I got it after this course.

So who are these people who finally got through this amazingly thick skull of mine and manage to teach me things that I’ve you know, after 20 years of practicing patients I did not know yet. Well I may get some of this wrong because I didn’t read like there are bibles or anything but from being around them, I guess 8 days or so, the whole course is run by this guy, Dr. Michael McCracken; the guy we talked about earlier with the quote. He is a professor at UAB but he runs this residency program that’s sponsored through another University that’s also in Birmingham. So it’s kind of you know, it’s not really UAB but he’s kind of he’s sort of from UAB. I guess he’s kind of associated with it. He was actually mentored by Dr. Carl Misch, you know the famous Implantologist guy. Who probably mentored a lot of this folks but he also did mentored Dr. McCracken. And you know Dr. McCracken is just an amazing lecturer by the way. If you have not heard him, amazing!

He’s just sort of has a way of getting through. He seems always be happy and not beat and has a smile on his face. But he talks about the tough stuff too. The stuff you need to know. I have been to a lot of implant courses where they don’t tell you the bad stuff, right? They tell you the good stuff, they say, “Whoa, you’ll make a lot of money, you know. It’s not that hard. It’s like screwing the pieces, screwing the piece of wood.” Well you know, he tells you you can do it but he’s going to tell you the stuff to watch out for and he’s going to be real clear about the dangers and everybody’s going to help you work through what you do about it if something bad happens. I think that was the beauty of the course is just finally learning the downsides, the worst case scenarios but what you do about that happens. And hey, this is not the end of the world. We’re just going to prepare for things to go the way they need to if something goes wrong, we know how to correct it and we’ll keep moving forward.

And it’s just so clear and he’s a very good educator, a very good educator. He put me to shame as far as speaking skills and so you know, I was just super impressed. We got down to this course in New Orleans and so there’s 3 days of lecture. It’s great! There’s some hands on stuff. kind of like the stuff I’ve done before on the dental forums. Blah blah blah…same old, same old. But the real magic came when we go to this place called The Foundry. Now this is close to Birmingham, in a city called Bessemer, Alabama you know. Not exactly the rich suburb of Birmingham but it’s a very special place because they have a recovery center there for addicts. And what they’ve done, Dr. McCracken and also his partner in crime, Dr. Guy Rosenstiel, who by the way, also amazing guy! He was just a great, just like the greatest guy in the world. They have, they run a residency program and they have like 10 or 11 residents running around. For sure I don’t know, school guys. Some of them stay 1 year I think some stay 2 years. If I have a son, graduating dental school, I would want him to be in this program. It is that good. It is amazing what these guys are learning!

But you know, so you got the 2 doctors, you got the 10 residents and a bunch of the staff are people who have recovered from this recovery center. And you know, as Dr. McCracken said in his lecture, if you’re own crystal meth for 10 years, you need to go see your dentist. Right? We all know that and if you’ve been on a bad drug for a while, you’re going to need some dentistry. A lot of these people need a lot of teeth pull, and then have gaps and implants are really a great way to fix that. And it just is sort of a place where you can help people that need it, very affordably and give experience to doctors, give experience to residents. And best, it’s like a, it’s a very magical place. On location they also teach IV sedation which you know I’ve been through a really good IV sedation program a few years ago but there’s, if it’s like the implants, it’s probably the best IV course too. Dr. Deloach is actually taking it now and so I need to quiz him and find out if he likes this IV course better than the one we took together in 2007.

So you know, what kind of surgeries do they…I’ll just tell you about the surgeries there that I got to do. So I get there, and we’re there for 3 days. And they don’t really promise you more than 1 surgery a day, but they do promise you you get at least 1 surgery a day. And just like anything else, if something happens, you may not be placing an implant. You may have to pack it with bone and put a membrane over it, stitch it up and send him home. If that’s the case, tough luck. But they’re really going to bend over backwards. See I, they’ll tell you that but I never saw that happen. There’s another cool guy that really kind of runs the show. He’s not a dentist but he works his butt off and I’ll just give a shout out to Scott McCalum because man this guy works so hard to make sure that I got surgeries and everybody that wanted surgeries. He tried so hard to help us get them. If you want a hard surgery, you can request it. If you want an easy surgery you can request it. And boy Scott just works so hard for us. I don’t have enough good things to say about these people.

The surgeries I got to do. I got to do first a number 19 missing tooth. So this guy comes in, he’s been missing number 19 for quite a while. Guess what I got to do on it? I got to turn it flap for the first time. Isn’t that crazy? You go through dental school and never do a flap. You go through 20 years of practice, never turn a big flap. You know I guess I’ve turned a flap. I do a lot of envelope flaps, right? I did a lot of envelope flaps. Occasionally we’ve done more than but this course had nothing else that taught me finally how to turn real big flaps and that goes back to Dr. McCracken’s quote, “Small incision, bad decision”, I was the guy who did small incisions. I did not really understand the reason you do big incisions. And so that’s 1 thing I took away from this. So we do a pretty big incision, flapped the guy back. Once you do that, man you could see that bone, you don’t have to guess at it. You’re not going to run through the bones and ruin out your implant, you’re just going to be able to make a whole on the bone, pop it in there. We did a really pretty good sized implant on because he just had a really good bone and the implants we used at this course were from a company called Bio Horizons and we put up at a big…what the…the blue color in there. Forget the size, it’s the biggest one in the kit. We put a nice big implant in there; 2 about 10 millimeters deep.

The best thing is, you know, when you do these flaps, you see the bone and you know how deep you’re going. You do not need to guess at it, bleeding is not a big problem. Something I just didn’t understand is that the bleeding is not a problem when you do a big flap, bones don’t bleed. So this is not a problem. There are a few things you things you have to watch out for, but is the flaps really help you. So the next case I did, I actually get to extract number 7, 8, 9 and 10 on a fellow. And we placed immediate implants in number 7 position and number 10 position. And I get to pack some bone graph material around those because the space was a little bit bigger than the implants; with 15 millimeter implants there. And then you know, it was awesome because we got to get a look at the cone beam before the surgery and we worked through it. That’s another thing that’s so awesome is before you set up surgeries, Dr. McCracken has his residents put together Powerpoint presentations. And they have x-rays and cone beams and you know all the part in the medical history is there.

And so we went over to how we need to angulate these implants to stay in the best bone. You know this is something I probably would not have known on my own. You know most of the time, you have to angle these interior implants to the palatal bone because it’s just thicker, I didn’t know that really. But now I do and once I did it, it was so much easier than I expect. So we put really nice implants on 7 and 10, put some bone graph material, put some collagen membrane over the cover screws of the implants. And also the extraction sagas of 8 and 9; stitched them up real good and send him home. Called in the next day, he said that he hadn’t had any pain yet. There’s another thing they taught us there, they taught us how to get patient steroids after implant surgeries. I would have never believed that patients would not feel pain anymore than they get right? It was crazy the things we learned and how to do this.

What else did I do? Oh, I did the biggest surgery I’ve ever done right? And so I’d requested one of these and Scott really helped took me up with what they call a foundry special. Now this is where a person’s getting a full amount of extraction on the lower and a couple of implants for a, for a denture that snaps into those. And you know, it’s crazy because you know I’m up and they follow the rules there. So they’re so strict with anesthesia, so hey, I was so glad I could get him numb. He was sedated, Dr. Deloach was actually doing his IV. So he’s sedated, he’s got a lot of drugs in his system. And they were monitoring thinks so closely but I numbed him up. He was able to get amazingly in my opinion because there were so many teeth. We started taking teeth out and get them out without incident. Now comes the fun part, we actually made an incision all the way across his lower jaw. And did this huge flap, pulled the, you know, pulled the gum away from the bone, on the lingual and then the facial.

Wow! That was an ordeal. I mean, I was in there for 3 hours because I’ve never done anything like that. And it was so, you know, it was so difficult getting that gum away from the bone. There was a resident that came in and it was my assistant, by the way. And this is another thing, the residents are so good. And if you go like he just took it upon himself to help me because he knew it was going to be hard because it was my first time to do something like that. So you’re doing surgery right there with a resident. Just right there, a foot away from you, telling you “Yes”, “No”, “Do this”, “Don’t do this”. It’s just it’s such an amazing experience. So we do that, placed two implants, stitched the guy up. Man, you got to stitch those guys up a lot. And the only thing that I would never know that you need to put that many stitches in somebody. But it’s a big surgery. Right? You take all the teeth out, smooth the bone, put the implants in, stitch them up, I mean that is a big surgery.

The last thing I got to do was, extracted tooth and put an implant in the socket; an immediate placement for them just to use right away. I had always thought that if you took a tooth out, you know. It’s really hard to put an implant in that place. But it was a lower pre molar and I guess the implant size just match the extraction size so well, we just basically extracted the tooth without drilling, screwing the implant right in and it was just such a snug tight fit, it was so great. And you know, that’s going to be such a…it was so easy. Like a dramatic extraction, screw the implant in and they’re ready to go. Right it was so, so good!

I learned about flaps and so many things like, Don’t be scared in the metal frame and just carefully find it and once you know where it is, now you have to even guess your x-rays right or you know you can take cone beams but you can take cone beams in many ways but if you’re looking at the metal frame in and you know where to put your implants right? But you’re not going to run right into it. Use your cone beam to find the big nerves like the inferior alveolar, the sinus, all that stuff. You can use x-rays too but you know, we can use both actually; x-rays and cone beams there. I get a lot of good training on that and you know, it was just I guess the big take away is just so much easier when you can see it hands on into your structure. Just right there on your shoulder and people are so nice and helpful in trying to help you learn instead of making you feel bad or stupid because you just don’t understand things.

So I just had a great time and I felt like I wanted to share it with everybody just so you could kind of get a little taste of what I just experienced and well hey, disclaimer, I’m getting a paid tuition. I paid my tuition for this course; full tuition. I didn’t get anything out of it. These guys are not paying me to say these. I just felt like it was worth one episode of my show just to share this to everyone. And I hope that some of you take them up on their course, I won’t get anything out of that either. I think everyone who’s serious about implants should go to this thing, especially if you’re in the Southeast United States. It’s a very, it’s close but it’s going to be good for any, if you’re form anywhere. Guys, this is going to be awesome.

So anyway, I guess the last thing to touch on would be I just got there talking about these flaps idea. Before I went down there, I just started getting into this guided placement and you know where you have stands made or you make your own stands. And you snap them into people’s teeth you know, they have these little sleeves in your implant drills fit in them and it let’s you know exactly what angle and all these you need to do to put your implants in. And when you do that, you really don’t flap. I mean you can’t flap anyway but the kind of purpose to these guided implant stands, is so you do not have to flap your patient open. Well after going to this course, I now kind of understand a little bit better the differences, right? So even though my cone beam I think is very accurate, you need a cone beam to be able to do a stand for this guided implant placement.

You know I think things could be a millimeter too off, honestly, on a cone beam. Maybe not 2 millimeters but it could be a millimeter off, I think. After I saw things among today, we went overcome things today at the Foundry. And I feel like, you know I feel like if you can see things and you can touch and feel them, it’s always going to be a little safer. Then if you can’t, then if you’re not flapping somebody, you can’t. That’s just plain and simple; certainly, less expensive to do a flap than to do a guided placement. You’re implant guides and stands, they’re going to be very you know, just going to add a hundred dollars to every case. And maybe that’s not a big deal to you, but it you know, that’s just a fact.

Now even down there they will tell you sometimes they’ll do a guide. Just if it’s a case that’s a slam dunk, it’ always better for the patient if you just have a tiniest you know, a tiny little hole and that’s that. But if there’s any, anything tricky about the case at all, I almost think you should just go ahead and flap it. And that’s me after 20 years of not doing big flaps, now I understand. And I did not understand before this past weekend and it just makes everything so much easier. So that’s my two cents. Once again, you know I’m not putting myself out there some kind of implant expert, there’s plenty. Lord knows there’s enough of those out there on the lecture circuit. But I just felt so strongly and I’ve taken so much away from this course, I just felt like I had to share with you guys because this is going to make a big deal in my practice, it’s made a big deal in Dr. Loach’s practice, Dr. Northcutt’s practice. These two guys, I know the facts and it has made the practice so much more strong and powerful and they had help so many people now that I took the course and now that I’ve meet everyone down there. I just have to say that one, I loved it and I want you guys to know about it too.

So I’ll try to get a link on here in the show notes where you can go in the website and just look. But man don’t let that, if you don’t like the website looks, don’t let that fool you because this course is the real deal and you can take it from me. So anyway, it’s been a whole episode talking about a CE course, I probably wouldn’t do that again for a while but I appreciate everyone’s attention. If you have any, any thoughts about trying to get more serious about your implants, I strongly recommend this course. And you know, I don’t know I’m probably not the kind of guy who’s ever going to get on here to bash a course but and as you know, I’m not the kind of guy who gets on here and brags on a course, either. In fact I’m kind of jealous, that if had never came for a course this awesome it would come passed the Academy but this place is real deal guys. So anyway, alright if you ever hear this Dr. McCracken, Dr. Rosenstiel, you guys were awesome! And I hope to see you again someday. Maybe one of these days, I’ll take the big 10 month course, right? So anyway, thanks everybody for listening. Stay tuned next week we’ll be coming at you with a new episode. We’re going to be talking about the practice achievement formula. So tune on that a while and I’m going to reveal it to you next week. So that will be a lot of fun. Alright see you guys next time. Thanks again.

We appreciate you joining us for this episode of the Dr. Chris Griffin Show. Be sure to visit drchrisgriffin.com for the latest resources and updates to keep you more productive every single day you’re at the practice. So when you’re not working, you can do the things that matter most in life. We look forward to having you join us in another episode of the Chris Griffin Show; where the doctor is always in.