High Capacity (Quality) Dentistry

see the video: http://vimeo.com/66419383

Dr. Lavine:

Well, we’re going to go ahead and get started here.  Welcome, everyone.  This is Dr. Lorne Lavine.  Many of you know me as the Digital Dentist.  Many of you are aware of the fact that I’ve been doing these webinars for a number of years.  I’ve done close to 160 webinars, and anytime I present a new speaker, a new topic, I’m always a little nervous.  I never know how many people are going to register. My fears were very much unfounded tonight because, as of this morning, we had over 725 people that were registered for the webinar, and a good chunk of you are already here.

I’m only going to speak for a couple of minutes.  I want to make sure that Dr. Griffin can talk for as long as he’d like.  He also said he wants to leave as much time as possible for questions in the end.  All of you, on your screen, if you haven’t been on a webinar before, you should see a little webinar Go To Panel.  You can go ahead and type your questions as you think about them.  We’re probably not going to get to the questions until Chris is done speaking, but as you think about them, type them in.  We’re going to do our best to get to all those questions by the end of the evening.

Within a couple of days, you’re all going to get a number of things.  First off, when you log out tonight, just indicate if you would like Dr. Griffin or myself to follow up with you.  That only takes a few seconds to fill that out.  We are recording this webinar.  So, in case you can’t stay until the end or you get distracted, don’t worry about it.  All of you will be sent a link the next day or so that you can download the entire webinar so that you won’t miss a thing.

Again, for those of you who don’t know me, I’m Dr. Lorne Lavine, and many of you have hear of me before.  I’m sure.  Many call me the Digital Dentist.  What I’ve tried to do over the last number of years is present webinars that I think are interesting.  They may not be my areas of expertise, which is technology and computers and networking and data backup, but, really, the focus here is just to provide some content that I think is interesting and stimulating.  If it’s controversial, it’s okay, but at the end of the day, it’s got to be something valuable.  I have no doubt that we’re going to hit on all those things tonight.

Tonight’s presentation is called “High Capacity Dentistry”, and I was talking to our speaker before.  It’s just amazing some of the concepts that he has been able to develop.  There’s something which he calls his high capacity dental blueprint, which was created over 100 years ago, but it’s only been recently that it’s been rediscovered and translated into modern practice.  It pretty much works every time it’s tried.  We’re certainly going to hit on that.

What are the seven deadly dental waste that almost every practice suffers, and how do you get rid of it?  Does is really require terminating people, which is what we all want to avoid?   What about the seven ways to stay relevant within the next three years and lay a foundation for the practice of tomorrow?  I’m sure many of you are wondering what the most overlooked daily production booster in the history of practice is.  We’ll talk about that.  When it comes to something like diagnosing, is there a process? We’re going to look at his three step diagnosis that pretty much eliminates case rejection.  These are all things.

It really gives me great pleasure tonight to introduce Dr. Chris Griffin.  Most of us know Dr. Woody.  He’s one of the most educated dental educators.  He’s called Dr. Griffin as “Ripley’s Believe or Not Dentist”, and it’s a play on the fact that his practice is in a town called Ripley, Mississippi.  It’s a small town.  There’s five other dentists there, but he is not competing with them.  He’s just dominating over them.

He’s got 3000 active patients. He routinely schedules over 50 patients each and every month.  He’s been called the most efficient man in dentistry, and he’s practically giving away some of his practice secrets.  So, it really gives me great pleasure to turn the screen and the mic over to Chris.  Chris, we are so excited to have you hear tonight and really looking forward to tonight’s presentation.

 

Dr. Griffin:

Lorne, hey man.  It is such an honor and such a pleasure to be talking to you and your folks.  Honestly, I don’t speak a lot to people.  I know there are a lot of people who have registered for this, it looks like, are on the West Coast and of course all over the country and all over North America, too, but I don’t speak a lot to people out West.

So, first off, let me just apologize for my accent.  I promise you I’ve tried to get rid of it.  There’s not much I can do about it.  I’m from Mississippi, born and raised.  I grew up in a farm.  It’s the truth, and that’s just the way that I talk.  So, forgive me for that, but I think I got a lot to share with everybody that’ll help everybody out.  So, whenever you say “go” Lorne, I’ll just head out and start talking about it.  I guess that’s my okay.

 

Dr. Lavine:

Yeah.  You go for it, Chris.  We’re ready.

 

Dr. Griffin:

Okay.  Alright.  So, first off, let me just go ahead and show this.  I went ahead and took the liberty because a couple of things I’m going to be talking about, when I’m giving lectures like this to big groups, a lot of times, we’ll print out worksheets that help you follow along with the lecture.  It’s not completely necessary that you have this worksheet, but I put a couple of items on a website for you.

So, if you get a chance, you can go to my company website, www.thecapacityacademy.com/digital-dentist. That’s for Dr. Lorne, and we put these sheets on there just to help you follow along.  We’re not going to even talk about the part of the worksheet probably for a little while, but it’s there if you need it.

Alright, about me.  Let’s just talk a touch about me, and I don’t want to talk long about me because that’s not why you’re here.  You here to help your practice, and I want you to help your practice.  You probably need to know where I’m coming from and how I came to these conclusions that I’ve drawn.

In high school, I was the kid that was always really good at math.  So, that led me to think that I wanted a career in engineering.  I went to Mississippi State University.  That’s 110 miles from my house.  That’s the furthest I’ve been from home at that time, and I go down there.  I’m happy as could be in engineering school.  Actually, I had a roommate, a good friend from [06:39].  This will just show you how jealous I am.  He just had his company valued at $1 billion, and I just couldn’t be happier.  I was the guy that was pulling him through all those classes at State, but now he’s the famous guy.  That’s okay.

So, we’re down in Mississippi State.  We’re doing engineering, and we love it.  About my junior year, it came time to decide if I was going to be serious about engineering.  I had to go get a job at an engineering firm for a summer job.  So, I was getting ready to do that.  About that time, I was approached by my family dentist, and he said, “Well, Chris.  I believe you’d do real well in dental school.   Why don’t you go to dental school and come back and be my partner in Ripley, Mississippi?”  I thought, “That sounds a lot better than me going to Houston, Texas to work for an old company,” because I’d never really been far from home.

So, I had the engineering background, but in my third year at Mississippi State, I went ahead and swapped my majors.  I finished up all my core curriculum, got accepted in dental school after three years, went to University of Tennessee, and I got out.  I thought, “Hey, the rest of my life I’m going to go with my family dentist, and we’re going to be happy.  This is going to last forever.  We’re going to have one of the best practices in North Mississippi.”

How many times does it work out when you’re going with your hometown dentist and you just think it’s going to work out?  Well, I can tell you.  In my class of 90 people, about 70 went in with someone in their first year out of school, and I think 69 of them did not work out.  So, it’s very uncommon for it to work out.  I was no different.  We had a split up.  It got a little bit ugly.

I ended up building a practice here in Ripley because I didn’t sign a [08:23] because I’m from here.  I wouldn’t have done that.  So, I’m building a practice, and it’s tough.  Actually, a lot of building, bought some land and remodeled it in less than 90 days.  We remodeled the whole thing, me and one guy doing all the work ourselves, working 14 hour days.  I personally did that, did the construction work myself, and I build the building.  We’re open.

Things are going good.  I’m thinking, “Great.  We’re going to have a great general practice.”  Within six months, I started liking cosmetic dentistry.  Now, if you think back to the 1990s when I was doing this, it was probably the peak of cosmetic dentistry.  So, what did I do?  I thought, “Let’s just go ahead and sign up for the big institutes.”

So, I went out to one institute out West a bunch of times, a bunch of money.  I got pretty good at doing veneers, pretty good at doing all porcelain work.  I was somewhat good at doing full mouth reconstruction, and then, I thought, “These full mouth reconstructions.  They work sometimes, but other times they don’t work that well.”

So, I went down to an institute down in Florida, went there a bunch of times, and I got in.  So, I felt I’m really educated.  So, I come back to Ripley, and what do you do when you think you’re so well educated?  You say, “I have a nice general practice, but I think I’m just going to try to have a completely cosmetic boutique practice in a town of 6,500 blue collar workers whose main industry which is a furniture factory just closed.”

Now, you would have I would have better common sense that that, but I didn’t because I thought I’m such an amazingly skilled great dentist now that I can just do it anywhere. At the institutes they tell you that you can do any kind of practice anywhere, and I believed them.  I was gullible and young.  I got out of dental school when I was 24 so at this time, I was still 25, 26.  I’m obviously not very wise, but I tried it for a few years.

I just about ran the practice into the ground.  I just about went broke, and that’s embarrassing.  My grandfather had actually put down some money for me to start the practice.  It’s all very embarrassing. I’m not doing well.  I was always the golden child. I always thought I was going to be the guy to beat the world, and here I am failing.

3D Cat Scans in Dentistry P2

As biologic dentist we go with the concept of trying to see the whole body, the head and neck is part of the whole. Frond, Darwin, Einstein, Adam, Smith were considered hedgehogs. Even though it may seem to be simple it’s not really. He had a model that you could look at and these three spheres in the centre, the black area that he called the hedgehog concept.

 

What are you deeply passionate about? This is for companies, this sent for us. What can you be the best in the world at?  Those were his words and I thought it was intimidating but at least what can you be great at and what drives your economic engine. He talks about technology and I think that’s important because he says technology can become an accelerator of momentum but not a creator of it and so I thought that it was important to talk to this group about. I’m not here to tell you that if you get a  cat scan you are now a biologic dentist and you’ve got all the answers but the technology is important and he goes on to say ” does the technology fit directly with your hedgehog concept? If it does then you need to become a pioneer in it “and I think that’s true. my hedgehog concepts gets rid of mercury , eliminate infection , reduce  or eliminate  metals , do excellent dentistry  and compliment the dentistry with physiological support.

 

I’ve spent a lot of time looking at the whole body. I’ve spent the time with D Trek and Dr Amira and I’ve went for  almost ten years of spending at least  forty years in CE. You guys are the exception but you also know that the average dentist in the country gets one day of CE per year. The 3D act scan as I say is a state of the art for detecting infections today. it shows us what we already knew about root canal therapy, protects  us from even more problems and you can see  that  with the technology it’s going to give us a leg  up and an advantage with dealing with anybody that comes in  and say ” why did you do this?” I did this because I had hard evidence that this is a problem.  It absolutely creates more dentistry.  If you find problems and the patient sees the problem then they want to OD something about it almost always.  From a practise management point of view it sets us apart from the state of the art and it does a lot more.

 

This is a traditional scat that we are all somewhat familiar   with. How does it work? A single rotation similar to a panoramic film, cone spade beam, 85 kilovolts and these Rona they claimed to have less than some of the other manufacturers. This is what it looks like. It looks very   similar to a panoramic. Patients can stand up in it or you can sit down if there’s a wheelchair.   This is the traditional medical model of the CAT scan.

 

The dental 3D uses a cone shaped beam and captures the entire area in a single rotation. There’s a little bit of a difference between the hospital CAT scan and the dental cone beam you can tell full body and a facial. There has been some people that’s concerned about having a brain illusion. There almost designed to not include the brain. They only include the areas that we are licenced to practise and diagnoses in.  Patient radiation dose is pretty insignificant. The Galileo is 1.6 times the normal or traditional film.  These clinical results can be achieved with very low radiation dose to the patient. This high resolution scan is equivalent to 5-9 background days of radiation we all absorb in every day. Galileo 3D represents the lowest dose, 29 mic receivers of systems made for dental, 1-8% of the Maxwell facial CAT scan. The lose dose and high image shows the evolution is possible due to the seamless image that employs and capture technology. You can tell that is something from the company. Again I’m not pushing this brand.  The reason I bought this one is it had the lowest radiation dose and I think that is significant. It was judged clinically by university studies to have the clearest image and it has a lot f of potential to connect with the Dirac system that have in the office and use. This just talks about the radiation dose and the <inaudible> radiation exposure to the public is on this one.

 

This is what I see infections and this is the big part. Implants are probably the biggest reasons that the 3d cat scans are being sold. That’s not why I bought one it still has some <inaudible>. This is me in our fire truck on the ranch that we keep to have brush fires or burning brush. I think od  cat scan , you have to have Rollick and Harris they  have great memories of  a late night adventure on a country road with the sirens owing  and the whistle blowing and I think this was  after some maker’s march UT we  won’t go there.

 

Dr Amira, I’ve spent about 15 years studying   with him.  He’s an MD who developed an Orange technique, PhD in acupuncture, he’s also a she gong master in college residence from Columbia University. We set up a series of lectures or sessions with hi apart from the ones in New York. He does a lot in new you’re for physicians but that’s usually cantered around cancer and they were a bout twenty of us that were dentist that spent about twenty weekends and it was basically about infection. I almost saw every weekend I was there he would bring in or somebody would call and bring in a cancer patient so I saw a lot of that. The take how for me almost all disease was including cancer is caused by an infection with a heavy metal component. That’s what saw, that’s what still see.

 

This is one of my first cases after I got the CAT scan. She’s a 24 year old female, her mother said she spent 20 000 looking for diagnosis she had severe pain. I used  to do a lot  of temperament  , it’s a joint treatment  also , it’s not  a TMJ problem, I did a cat scan I thought is aw something on the cat scan but I  only had the unit for a couple of month so I wasn’t really sure. I sent it off to a radiologist who was an MD. We got on the phone and he said there was nothing there and I thought who was I to argue you with him but I thought there was. Three weeks later she took the daughter to OU dental school, by this time there’s a fistula on the second molar. My patients have three choices with an infection, you can do nothing, you can have a root canal done the first time or the second time or you can elect to have it extracted. She opted to have the second molar extracted.  This is that tooth and nothing showed up on digital x-rays and PA. This is the illusion, that’s not a big illusion. when I first saw  it I thought that can’t be  normal that’s illusion but the radiologist said it was  ok.

 

Lessons learnt you can’t be a little pregnant. It’s either an infection or an abyss to me or not. Small legions are still legions. Sometimes that’s easier said than done. Look at the other teeth on the same patient in your cat scan. Sometimes it’s ok to just not know. This is a great naturopathic physician, sent her out of state, sent her receptionist scan, we did cat scan we saw three root canal treated teeth. They all have small legions, gave her that information and she went home.  They physician called me maybe a month later and said Christina, that was her name, had been in the emergency twice in the last two weeks. She has symptoms that are like a stroke. The hospital says that they think she had a heart attack, nothing shows up, nobody knows what’s wrong with her. This was a four year naturopathic degree woman, she was very bright. Other people told me this naturopathic physician has treated over 3, 000 cancer patient successfully. Bright girl, had a lot of faith in her she said “if you don’t do something she’s probably not going to be alive in 60 days”. She came down and we took out those three teeth. The physician call me a week later and said “all the symptoms are gone”

 

I did a little table clinic at the dental society meeting not long after   that and I was showing her the cat scan  and I talked with  doctor Tom Blast who has a DS , PHD  in micro biology , teaches  at the dental school and the medical school. I told him the story and I found it fascinating that he didn’t blink an eye. He said “I get that. Aim for a five bacteria in the mouth and it could be an infection. Those end up in a circle of wellness and all kinds of things would happen”.  I thought that was pretty interesting because my experience has been the most educated people and the more knowledgeable they are the more understandable what they see and what we see happens.

 

This patient had sinus problems, Lowe energy and some of these later ones I just pulled up within the last three or four weeks. I didn’t have to go back and look for weeks and weeks to find examples to show you that show up every day. On the left this was his right sinus totally occluded. here’s what I’m getting to  you’ll  see later as we go through the slides that there’s going to be  a lot of stuff like this, not big legions . I actually had to blow this up. I’m looking for the pregnancy, I’m looking for the small illusion I can see the big legions and I believe it’s either heavy or it’s not. This is looking from the axial view and I’ll show you later how we do that. This a tangential view of the same thing and there’s nothing that says   that the root canal has to fail.

 

Big legions, you pick this up on a traditional digital x-ray, however, virgin teeth on either side, patient is a naturopath, very aware of energy, very grate energy person, it was a cosmetic and an attractive women.  She wanted a replacement she did not want a bridge. She was ok with an implant and we’ll talk about that later. There must be different opinions in this audience abbot implants so I’ll tell you what my experience has been.  She wanted an implant. She had the knowledge and the training to be able to give me an intelligent answer.  You don’t get this on a traditional digital x-ray. Looking at a cross sectional view this is very easy to see. There is no buckle bone, you have to decide if you need it what you are going to do for this patient. If you do need it how are you going to preserve it?  It gives you the option to make those decision.

 

Is this an abyss?  This is a 3d cat scan. I don’t see this very often but sometimes you’ll see this. what I sometimes  tell patients  when I’m going over the cat scan I say ” let’s pretend that this hand is the  root of  your tooth and this is bone . It will look like this. If it looks like this something caused that”.  This is what we see a lot of time. This is a little bit bigger than what I would do see without picking it up on the elms but it does happen.  Granted this is not a good radio graph and ice a talk about that.  Maybe in your office you get perfect PAs every time. I don’t in my office. Look at this, it’s not a big illusion, look at the coast lining of the sinus. Is this the coincidence I don’t really know that this tooth is causing that but it certainly looks suspicious. Look at this now from the axial view. You see the sinus inflammation and look at this around the tooth. That’s not normal, that’s not healthy, and that’s an abysses in my book. A slight thickening of the period=oral membrane space.  With the cat scan you strap their head in. it only takes 14 seconds. It’s very rare to not get a very good cat scan.  With this one you can pick up on a digital x-ray. This case isn’t to show you that it’s to show you this. This patient had the same three choices, do nothing, root canal, extraction. Patient elected to have this tooth removed. I think I did a pretty good job with cleaning out the socket and I flush it with ozone.

 

in the past I did a  lot of nice surgery I’ve done surgery where I get into the mandible and I’ve moved  the inferior off the other  bundle to one side and curated around it. It’s not that I’m not capable of doing that but I’ve got this tooth extracted. This is a small illusion here so this tells me in this case maybe I’m not going to curate quite aggressively here as I would. Maybe you would and that’s your choice but it tells me I’m going to back off just a little bit.

 

For me this alone makes the cone beam essential. Every year I get to go to the national’s filings rodeo in Las Vegas. It started because a patient came in from outer state, wonderful couple. He was a Vietnam veteran of grunt, went back to San Diego made a trillion dollars in development.  He’s had front row seat to the national filling rodeo for twenty years. five years ago he said ” I’ve got two tickets you want to  buy them ” I said yes  and we’ve been going  for the last five years. This guy is getting ready to get on a brown key horse and look at the guy’s expression here. I don’t know who is more nervous. This looks like this is side of Bronx. They only had to stay on for 18 seconds.

 

Let’s just pretend for a second that this horse is the root canal. Let’s pretend that this person here is the patient. The guy here is the pickup rider. If this guy makes it 8 seconds then the pickup rider comes along and tries to help him to get off of that bucking horse safely. You have to decide who you’re going to be. I don’t want to be the person on that horse. I would rather be the pickup guy trying to get him off of that safely. I don’t want to be this guy. It looks like this guy is about to get run over. I have believed that root canal is often a problem. The difficulty for me is how do I stay in standard of care and still care. I’ve done things that I knew in my gut was right to do but  occasional and rarely I wasn’t sure I had all the documentation  I width I would have had.  Two years ago I took an implant course from Russell Bayes from the University of Chicago dental school. In his Couse he said he had done research on the literature. There is two studies that he found a ten years failure rate and one study with 35% and the other one was 46%. Anecdotally every 3d CAT scan user that I have talked to say give me a break. We’re talking 60-70% failure and that’s what I see. The nice thing is you can see it, the patients can see it. How often have you heard “it never felt right, I’ve been to two dentist, and they tell me they have taken x-rays and its ok??” I’ve heard that a lot. This is fascinating, have you guys seen this article?  In august of last year those patients with toe or more root canal treated teeth were more likely to have heart diseases than those who reported no root canal treatment. I can’t believe they published it. To me this is the tip of the iceberg. I’m old enough to remember back in the seventies when you have the seventy KPB x-ray.  we could see  an incipient decay and it was  wonderful but right I way we decided we needed a  high speed  film that cut back the radiation, go digital and it’s not as easy to see  things but today with a cat scan we  can see small says.  Use the CAT scan like a microscope. I went through capital university and the president of capital  university was Dr Ali who was a pathologist for  30 years and I did  dark view of micros went to  Germany and studied   over there but Dr Ali  would say when you’re using a  micros keep focusing in and to and do the same  thing with the cat scan . Continually scan in ND out to view the image. The first part of what I’m going to show you they’re going to be still slides. Before this is over we’ll pull up a cat scan that we can see and I’ll show you how you can do that and it will blow your mind. I’ve told you earlier I’ve seen one patient in fifteen years who had   cancer or major illness that didn’t have a lot of dentistry. That’s what I see.   I hope that you will look into getting a cat scan. some of these decisions aren’t early same patient that’s east but I had to scroll in and out like I told you because we all know that if we’re doing a traditional x ray we got a block of bone and tooth this bug . If there   is a lot of dense bone on the buckle or the lingual and we have a small illusion paced in the middle it may not shop up. I actually had to scroll in and out.  Look at the sinus membrane small illusion and look at this. There’s some reaction to that. Four of the sinus here is eroded. I’ve only had a couple of patients that have shown up with mild calicks and I’m not picking on bio calicks I’m just showing you this is what I saw. This was eighteen months ago. If you look at in an axiom crew we can see that this guy is failing here. How often have you seen it, patients have said it never felt right, digital x-ray don’t rely see anything. Look at the bone here. It’s a pretty big illusion and that’s probably why id dint show up very well and there is also a small illusion at the apex there. what I have seen and what I’m showing you is some of the small ones, I could have just gone back and  pick up the big ones  and you would look  at those and say I can see  those on my digital PA  why would I want to spend   $200 000 for this thing.


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