The Fixed Podcast

The FIXED Podcast Inaugural Episode: Meet Dr. Tolbert and Dr. Paape

May 29, 2024 • Season 1 • Episode 1

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Join us, Dr. Tyler Tolbert and Dr. Soren Paape, as we recount our unique journeys into implant dentistry. In our first episode, you'll discover how Tyler's unexpected dental issues in college sparked his passion for dentistry and how Soren's summer job on charter fishing boats, and an encounter with dentists, shifted his career from computer science to dental care. We'll share our backgrounds, extensive training, and how our paths converged to shape our vision for this podcast.

We dive into our hands-on experiences and the educational paths that shaped our expertise in full arch dentistry. Hear about our rigorous training, including 600 hours of continuing education, has led to impressive surgical milestones. Dr. Paape reflects on his transformative experiences at the University of Wisconsin-Madison, shadowing dentists, and serving at a local free clinic.

As we transition from the Full Arch Podcast to The FIXED Podcast, we're excited to introduce new interactive features designed to engage and educate our listeners. From a dedicated website for submitting questions and cases to leveraging Instagram and TikTok for visual learning, we aim to make implant dentistry more accessible. We'll share personal cases, including those with multiple revisions, to prepare general dentists for the complexities of implant dentistry. Whether it's managing over-dentures, single implants, or grafting techniques, we hope to equip you with the skills and knowledge to excel in your practice.

Tyler:

My name is Dr Tyler Tolbert and I'm Dr Soren Paape, and you're listening to the Fix Podcast, your source for all things implant dentistry.

Tyler:

Hello and welcome to the inaugural episode of the Fix Podcast. So you may or may not know us. We'll certainly get into who we are. But, like I said, this is the Fix Podcast. This is our first ever episode using a video medium, so definitely bear with us as we learn through this whole process. But we want to take some time out today to talk about what the Fix Podcast is, who we are, why you might want to watch the show and learn from us and just sort of establish a basis of how the operations are going to be going here. I am Dr Tyler Tolbert and I'm here with my co-host, dr Zoran Papi. How are you doing, zoran?

Soren:

Good man, I'm so excited to be here. Yeah, we've been kind of juggling this video content trying to get it going for us. I think we finally hit it. So we're really excited for this next step here and, being on the first episode, I will, like Tyler said, discuss some different things that we'll be transitioning into. We're going to talk a little bit about us, our background, why you should listen to us. We're going to talk a little bit about us, our background, why you should listen to us, and you guys can hear our background, what CE we've done, and then we'll talk about what we're going to be doing differently with the Fixed Podcast. So I think, to start, tyler, it'd be great to give an introduction, maybe talk a little bit about what got you into dentistry, where you went to dental school, and kind of what transitioned you into the implant dental world.

Tyler:

Yeah, so that's. That's a great question, a loaded question. Yeah, I've been through it enough times. So, to start off, what got me into dentistry? So for me, in undergrad I spent about the first two years of having a totally undeclared major, had no idea what I was going to do, just had a decent idea of some things that I was fairly good at and certainly had some people pushing me in the realm of health care. No idea what I was going to do, just had a decent idea of some things that I was fairly good at and certainly had some people pushing me in the realm of healthcare, engineering and all kinds of other things. Definitely did not have a mind for engineering, but it was actually around. I think it was late freshman year, no sophomore year, I guess that would make sense.

Tyler:

I developed this really rampant and acute gum infection. So I was in college and I guess I was really stressed and I kind of fit this demographic for this particular condition and I just noticed, over a period of several weeks, I was having like really sore gums and they were like bleeding, as if I weren't brushing my teeth or something I always been really good about my teeth and my breath started smelling bad and I was like, okay, this is starting to get really weird. I didn't even notice that the areas between my teeth, which I didn't have a word for at the time my papillae were shrinking and actually sloughing off. So it was really scary and so I finally went to see the dentist at the clinic at University of Georgia and they could immediately tell that something was way off, ended up referring me out to Periodonus.

Tyler:

It was a very scary thing for me being able to breathe air through my and like having bad breath and not feeling like smiling. It was actually taking a lot away from my college life. You know, I'm like 20 years old and trying to have a great time and I'm like ashamed of my mouth, so pretty much had like advanced perio. All of a sudden, and after seeing the specialist and going through around the treatment and things like that which I don't even know what it was now cause I had no vocabulary for it at the time I saw them and then did some followups with my like childhood dentist and stuff and through all of that, just to kind of, I guess, take some of the some of the stress out of it and anxiety, instead of just talking about how my gums were dying just to like talk about something else.

Tyler:

I was asking them about why they became dentists, why they became periodontists, why they did what they did. And it gave me enough reason to, you know, seriously consider it. And because I didn't really have a whole lot of other alternatives, I said, okay, well, why don't I just kind of lean into this and maybe we can call this a turn of fate? Maybe me getting acute, necrotizing, ulcerative gingivitis is a sign that maybe I should do this. So I really went deep into it, started listening to some dental podcasts. I didn't really know much about podcasts at all at the time, but I had started working at a dental lab called Newcraft Dental out of Athens, georgia, and I was working in their CAD CAM department, basically just scanning models, preparing cases in ExoCAD and then pushing them off to the designer. So it was a very procedural type of thing, but it did kind of help me learn some things. But I was so quick at just like getting that very menial task down that I was usually done with all of my work halfway through the day, and so that engendered me to you know, seek out more things to learn about dentistry. Because my boss was was really cool and he basically just told me you know, I don't care what you do, as long as you get all your work done and what you're doing with your time is relevant to dentistry, that's perfectly fine. Like I come over there and you're studying dentistry Cool, we're good. So I got really deep into YouTube videos on dental surgeries and dental business and it kind of occurred to me that, you know, there was just a whole world of things that you could do as a dentist, either being a very dedicated clinician or a businessman or business person or just some mixture of the two. And through that process I actually found the share practice podcast, which was super, super influential for me. I had a few others that I had reached out to the shows to see if they needed any help, anything I could assist with, to be sort of like an intern, if you will and SharePraxis got back to me. It was George Rear that reached out to me with an email. I had written him like a two page email and I'm pretty sure he never actually read the whole thing, but he sort of took me under his wing and gave me a lot of busy work that the show was undertaking at the time and so for the next two years I was spending time evaluating people's dental practices, learning all about dental consulting, doing some coaching myself, actually coaching dental students on. You know, getting out of school and going directly into dental business and you know I was all dentalpreneur type of person. That was all I really cared about.

Tyler:

But sometime into my sophomore junior summer I think it was it was the summer after sophomore going to junior year I got a scholarship through some of the connections I've made through the podcast to do implant pathway pretty much the entire series sessions one through four. And of course nowadays if you're familiar with implant pathway, they have tons of courses and continuance available and they're really amazing top notch education right here in America. But at the time I just did one through four and that was just taking people from zero to one of implant placement. Obviously I wasn't licensed at the time so never actually ended up placing implants.

Tyler:

But by the time I got to session four and I was walking around seeing all these surgeries and like really growing to understand it and just couldn't wait to do it myself, I realized that I kind of did have a little bit of a bug for clinical dentistry.

Tyler:

It just wasn't fillings and crowns and all these things that I found to be, you know, not so stimulating and so I decided I want to do dental surgery and implants and things like that figured out pretty quickly that residency wasn't really going to be for me. So I really built my dental school career around learning as much as I could about implant dentistry and the business of dentistry as well, and neither of those things were really the forte of the Dental College of Georgia or really, to be fair, any dental school for the most part, with maybe a few exceptions and got really deep into that. And then SharePractice group had started a few dental implant practices around the country. So my first job right out of school was actually a Valley Dentures and Implants in Phoenix where I did my first upper lower all in four on my first licensed day of dentistry.

Soren:

So that was a really harrowing experience.

Tyler:

I've learned a lot since then, and I certainly learned a lot on that day that I've been able to help people out with, and so I guess my story kind of came became emblematic of someone that you know, if you have like a really good vision before you want to get out of school, there's a lot of you know, really amazing things you can do that people would usually assume that you can't do that early on in your career, you know, with caution, of course. So, yeah, that was my time out in Arizona, spent a couple, almost a year there until I decided to start a practice back here in Atlanta. So I moved back to Atlanta where I'm from originally I'm actually from Macon, georgia, but you know it's all the same so moved back here, started Peachtree Dentures and Implants, been there for a little over two years and so that's been. You know me running my own shop and you know really getting the experience of learning the ins and outs of full arched dentistry without really having anyone else there to help you. When I was at Valley, I was there with Dr Alyssa Mancini, who was certainly a mentor to me and helped bail me out of a lot of really tough cases, and you know, once you kind of break out and start doing this stuff on your own. Now you have to learn all the lessons the hard way and that was extremely educational, sometimes very frustrating, harrowing, scary, all that. But all in all I couldn't be more thankful for it.

Tyler:

And so through that process we, zoran and I, also started the Full Arch podcast, which some of you may be familiar with. That's something that you know. We have a fairly niche audience, but we have fans all over the world, people who you know had followed us through our journey doing all kinds of different CE and had a whole lot of listeners that were just really into Full Arch. And the thing about it was it was very limited to an audio only medium. So in making this show we wanted to branch out a little bit and add video components and all that. But we'll get into the dynamics of the show itself a little bit more.

Tyler:

But just to talk a little bit more about my background things that I've learned from. So I already mentioned Implant Pathway. I also went through the Full Arch Club, continuing with Dr Bernardo, where I learned some advanced full arch techniques like palatal approach, trans sinus, a modified transnasal technique from the Vanderlim technique that a lot of people are familiar with and pterygoids as well, but it was very conceptual and working on models and then watching a surgery Super inspired by that really opened up a lot of horizons for me, and we'll talk about that some more too. I've also taken, you know, some case acceptance courses with the Closing Institute, did things like that, you know know, learning more about dental business and case acceptance, which, of course, is an important part of full arch dentistry, where you're selling these big cases.

Tyler:

The Texas implant Institute with dr Clark Damon and the late and great dr Rick Klein god rest his soul where I learned a little bit about zygomatic implants, a lot a bit about pterygoid implants and just general fundamentals, and we would, you know, go there with some of the other doctors in our group and you know that was a beautiful educational experience and you know, all in all, I think I've probably done, you know, three or 400 hours actually now, if you include some of the digital stuff, like 600 hours worth of CE and implants and full arch. And so I really have a passion for taking all that information, disseminating it, distilling it down to something that's, you know, palatable for an audience so you can quickly pick it up and figure it out if you want to go to a course, if it's going to be beneficial to you and ultimately, you know, implement it in your office. So that's something really fun. Couldn't be more excited about, you know, doing that with a video medium and some other books that I really enjoy, a few of Zygo books you know there's a whole lot out there.

Tyler:

Carl Misch's modern implant dentistry, as well as the complications book, is one that you know I keep handy all the time. And then as far as things that I do in my office, so I've always worked in full arch implant specific offices, so the one in Arizona and the one I'm currently in in, so the one in Arizona and the one I'm currently in in Atlanta. So really the bulk of my procedural mix is full arch fix. So I've done a whole lot of hybrids, several hundred cases that I've documented, done some overdentures as well, probably more than a hundred arches ish. I do some single implants and things like that, and I think I've cut a grand, grand total of six crowns in the past two and a half years.

Tyler:

It's a lot more than I ever wanted to. I don't think any of them were ever entirely voluntary, they were just sort of necessary for the situation. But I'm going to try and keep those numbers down. Hopefully this next year we can keep it below one. So but yeah, I think that's. That's pretty much sums it up. I'd say, on a weekly basis, you know, probably doing anywhere from three to seven fixed arches a week. So nothing totally crazy, but it is steady and I'm able to apply a lot of new concepts pretty quickly. And then production level. You know, in this type of model it can it can vary a lot, but last year I did myself about $2.3 million worth of surgical production. So yeah, I think that's that's that's awesome, yeah, so how about you kind of run through the same gamut?

Tyler:

unless you have any questions about my background, I'd be happy to to flesh that out.

Soren:

Yeah, yeah, well, I could jump in. You know it's funny because my background is going to be very similar to Tyler's. We've followed a very similar path and you know you'll hear a lot of overlap. But what's different for sure is what got us into dentistry. You know, I went to University of Wisconsin-Madison for undergrad and I initially went there for computer science. I was trying to figure out. You know I was big into computers. I like built my own computer at the age of 12. It like triple booted Linux OS and Windows.

Tyler:

You should have been a crypto billionaire man. You went the wrong way. Yeah, I know.

Soren:

Sorry, I might have, but I was super into that. However, when I got to college and I started coding, I was like I don't know if I like this coding thing and computer stuff was more of like, you know, it was fun for me. I didn't want it to turn into a job. But while I was in college and all through high school I worked on these charter fishing boats. So we basically piloted charters out of Lake Michigan out of Lake Michigan and we would bring groups of like five or six guys out every morning and every afternoon to fish for king salmon, rainbow trout, lake trout, stuff like that. And one day we had a group of dentists on the boat and this was the summer after my freshman year, when I was kind of starting to transition out of computer science and trying to figure out another option, and they kind of were just like leaning into it. Into it. They're like, hey, you should really check out dentistry. I mean, you know, of course it didn't help that the, the guy pulled up in like a brand new bmw like, and you know he owned a couple offices. I think he was doing very well, but he talked about the lifestyle piece and how you know he worked four days a week or whatever, and got to spend a lot of time with his family and I was like man, that sounds kind of nice. Like you know, I'd love to to get involved in that.

Soren:

So I started shadowing some dentists and honestly, the dentists I shadowed weren't weren't the best best dentist to see, but for some reason I still was like, yep, this is what I want to do. And I started working at like the local, like free dental clinic in UW Madison and just really like kind of stepped on the gas as far as getting getting my grades like where they needed to be for dental school. Studying for the DHC. I had a similar job as yours where I worked at in school the physics department, but I was able to like just listen to podcasts while I was working and you know I would just cruise through like Mark Costas podcast what is it? Dentalpreneur? That's where I got involved with shared practices podcast. You know I listened to all of shared practices podcast. I did the course that that they had at the time like the business course what was it called?

Tyler:

do you remember the ownership accelerator? Yeah, the ownership accelerator I was a beta tester for that one.

Soren:

Yeah, yeah so I did that like before I even got to dental school and I was like just gung-ho about dental business. I'm like, if I do this, I'm gonna get out, start a dental office and get ripping and you know. Then I ended up getting in dental school.

Tyler:

I went to Marquette. I want to interject just a little bit.

Soren:

Yeah, go ahead.

Tyler:

Oh wait, you're about to talk about getting into dental school. Yeah, okay, okay, keep going, keep going. I'll interject later.

Soren:

All right, go ahead please, so you know, you know, I went to Marquette for dental school and I was like immediately planning on going oral surgery. So all my first year, second year, I was just glued to the library. I knew I had to be, you know, in the top of the class if I wanted to get in. Didn't really have a social life at all, just studied a lot. And then I was studying for the oral surgery exam exam, the CBSC, which is basically step one of the, the med school exams, and I just like got to a point where I'm like man I you know, I like don't have a life.

Soren:

I'm all I'm doing is studying. It's just like study, study, study. And I'm like do I want to go back to school? And I and I had done some externships at this point, so I'd like seen the rotations and oral surgery. And I was like I just don'tships at this point, so I'd like seen the rotations and oral surgery, and I was like I just don't know if this is what I want to do for the next four to six years. And I'm and I'm also kind of a uh, if I'm doing something, I like put my full soul into it. So I was like looking at six-year programs with the, with med school attached, and I'm like, if I do this, I'm gonna do two more years, it's gonna be med school, and then four years and I'm gonna get out when I'm, you know, like 30. Actually it'd be what it'd be when I was like 32, yeah, 32, yeah. And I'm like I just don't know if that's what I want to do. And I actually jumped on a call with tyler okay, this is where I want to interject.

Tyler:

I want to make sure that I was a part of your story. So, yeah, yeah, okay.

Soren:

So I called tyler up I'm like, hey, man, like what do you think? Like you know, I'm thinking about oral surgery, but I'm really into the business side of dentistry and I think tyler just gave me some words of wisdom, or if he was like you know, man, like I know a lot, of, a lot of people that own practices that make more than oral surgeons do and and like the lifestyle is better, or something like that. And I'm in my head, I'm like, okay, so if I do six years, what? That's a lot of like. Um, you know, missed income in those six years and and you know, I like at that day I remember just like calling on my parents. I'm like, hey, guys, I'm not doing oral surgery, I'm doing I'm doing, I'm doing.

Soren:

Oh, that's great, I'm doing. I'm doing general dentistry and I'm gonna see where that takes me. And you know, at this point I think this is when I reached out to richard, low at shared practices, and I bugged him like over and over and over and over again until finally he's like, hey, why don't you? I just was, like you know, asking for any kind of role with shared practices and I ended up doing assisting work for him, which in hindsight was not fun. It was like every morning we got up at like five o'clock, I'd go over his day for like 30 minutes or something like that. But I learned a ton, I learned a lot and I got to be involved in the initial stages of sharedared Practice's implant dentistry path.

Soren:

I went with Richard to Austin Davis's office where we were there for like three days just watching surgery. And then I basically was, I helped Richard with starting his office up, which was one of the first implant offices that we had. With starting his office up, which was one of the first, you know, implant offices that we had, and me and Tyler went to Austin's office to do a recorded a bunch of fixed surgeries. And then and this is when I was like, okay, I need to, this is what I want to do. Like I love this. You know I love doing, I love surgery. I love being able to just change someone's life in a day. It was just being able to watch, you know, how someone transitioned through the surgery, get up and have a new set of teeth. I was like this is so freaking cool. So I dove headfirst in. I was like you know what? This is what I want to do. I'm going to get as much surgical experience as I can in dental school. I'm going to get as much full arch experience as I can in dental school. And I did that. You know.

Soren:

I finished all my requirements D3 year and at my school, Marquette, we were able to then work in an outside clinic. So my whole D4 year I just worked under an oral surgeon. We would do cases in his office from 8 to 5 every day. So I did a lot of thirds, you know, extraction stuff like that, and then also some like crown and bridge and whatever, and then after a five o'clock every day we would go to the hospital and he would round out of four hospitals where we just identilated people. And he was amazing to me. His name is Dr he Kiliana Dr G, out of Milwaukee, Wisconsin, and he was just a wonderful, wonderful mentor. He let me do everything under the sun, he would just assist for me and you know, looking back on it now, I was like man, like how did he have so much patience?

Soren:

Cause I even me you know, when I go and train doctors I'm like just kind of sitting there like jumping at the bit to get in there and he just let me struggle away and make sure that that I knew what I was doing. And I took out you know 1000s of teeth in a year in dental school because every day we were probably doing you know five, four or five identulations and it was just such a wonderful experience. So while I was doing that I also would drive to Indy, indianapolis and do all of the conversions that Richard were doing in his office. So when I graduated dental school I had done thousands of extraction, tons of conversions, and I was ready to go and right out of dental school I jumped into Denver, started Denver Dentures and Implants and we, you know, have a pretty really, I mean, I think it's it's one of the best implant offices in Denver. That's my opinion. I'm sure other A little biased, I'm sure other.

Soren:

Yeah, it's biased, but I am very proud of what we've accomplished there. My office is pretty similar to Tyler's in that we probably do around 10 to 15 arches a month consistently. That falls right around $250,000 a month in production. Last year, our first full year open, we did $2.5 million and so we have a really good production base and I'm really happy with how the office has done. I'm really happy with the experiences I've had there and I get to work with people like Tyler every day, which is pretty exciting.

Soren:

But that's kind of my background, how I got involved in implant dentistry and I can talk a little bit about some of the CE and stuff I've done to prepare me. We'll probably do an episode specifically on how to get into it, but this is just some of the stuff I did on top of all the extractions. And that's my thing. When people ask me, how do you start getting involved in this, I'm like you got to know how to take teeth out quickly. You need to know how to flap quickly. You need to know how to alveolo quickly and efficiently. I mean efficiently and well.

Soren:

Like you know, when I say quickly, I don't mean just get in there and start breaking off buckle plates. I mean it just needs to be efficient and if you can do that, then the implants are the easy part. I think you know, if you get all the teeth out, clean alveolo, once you get to the implants it's like okay, this is, this is like the fastest part of the whole surgery. But you know, I've I've taken very similar, similar CE to Tyler. I think my first one that I don't think Tyler was involved in was a CE course by Travis Kendall and it was all on digital dentistry which at the time we weren't doing digital, we were doing everything analog.

Soren:

But I was really curious about this digital world everyone was talking about and this was three, four years ago now, so it was even newer. Then that was like right when photogrammetry was coming out. I remember someone talking about photogrammetry and I was like what the hell is? Photogrammetry was coming out.

Tyler:

I remember someone talking about photogrammetry and I was like what the hell is photogrammetry?

Soren:

like it's just, and I got to see it, you know, at this course and I'm like oh damn, like I really want to start getting involved in that. But then I also was like, oh damn, to get into digital, it's like another 100 grand. So that's gonna, you know, it's gonna take a while to get into that so then changed so much, since you even just took that course.

Soren:

It's crazy, I know know it's super crazy, but it was a good you know good foundation, good building blocks to getting into it. But then I went to the full arch club. I didn't go to the same one Tyler did, but I did go to the one in Porto. And then I went to Brazil to place a bunch of implants there and that's where, you know, I also learned palatal approach, pterygoids. You know I was pretty consistently doing just traditional all-on-four. I was really happy with my cases, but I wanted something to enable me to do more cases and to bail me out if I were to get a failed implant here or there. I've done the Closing Institute. I did that with Tyler, learning how to sell treatment, which is critical for this type of dentistry learning how to sell treatment, which is critical for this type of dentistry.

Soren:

I've done the Texas Implant Institute with Clark Damon and Rick Klein who, you know, unfortunately recently passed away. Everybody's pretty in shock about that. So you know he was such a great clinician and I learned a lot from him. So I'm happy to have known him while he was here and I've been. I've done the oral conscious sedation by docs and I've done the California Implant Institute, which is like 300 CE hours online. I've received my fellowship of the International Congress of Oral Implantology, the FICOI, and I'm now working on getting my diplomat of the ABOI, which I think also comes with the FAAID or whatever that is. Hopefully end of this year, maybe end of next year. I'll have a lot of letters behind my name, but that's not the important part. The important part is being able to offer good treatment to my patients. The reason that I'm pursuing some of these avenues is so, you know, maybe I can. You know, more patients are like, hey, this guy obviously has done a lot of implants. You know, I want to go to him and, as I said, I think my team does some really good work in Denver. So the more patients we can treat, the happier I am and the more people that can be eating steaks instead of dentures coming out when they're when they're eating anything.

Soren:

Favorite books, you know, and and I've read a ton of dental business books that are are wonderful, but I'm, you know, favorite books around implants I would say you know, same as Tyler Mish's. Contemporary implant dentistry is a great one. His complications is a great one. Zero bone Loss Concepts is wonderful. Pterygoid Implants by Dan Holtzclaw is great and we'll have Dan on the podcast here at some point. Remote Anchorage is a wonderful book and I'm guessing we'll have a bunch of the authors that are on there on this podcast. And yeah, so I think that sums up a lot of my story how I got involved in implants, what I'm currently doing, why you should listen to anything we have to say. The fact of the matter is, our goal with this podcast is to disseminate as much information as we can and be as transparent as we can and we want.

Soren:

I don't think every single dentist should be doing implants definitely not, but I think that you know. I want you to have an idea of what the benefits are of doing implants, but also what the negatives are, so you as a clinician can decide if this is a path that you want to take and it's not an easy one one. It's it's a very hard one, comes with a lot of patient management, it comes with a lot of failed implants and I think that's probably one of the biggest things is, like, you know, so many people are like they jump in and do a fixed arch or two fixed arches or whatever you know, and then all of a sudden they come back and they have an implant failure and they're like, oh my god, what do I do now? And it's like, okay, you know, if you get involved in failure. And they're like, oh my God, what do I do now?

Soren:

And it's like, okay, you know, if you get involved in this and you're placing hundreds of implants a month, you know, even if if 5% fail, that's still, that's still five implants. You know five, 10 implants a month. Yeah, so, like you know it, it happens and it's part of the, it's part of the game. You just have to you to take those and you can't beat yourself up too much. But yes, that is my background. I think a good transition now would be Tyler, why don't you tell everybody what the Fixed Podcast is? Let's talk about what we're going to be changing from the Full Arch podcast and why you should listen to us.

Tyler:

Yeah for sure. So you know, I think, a good segue for that is something that we both were kind of remiss in talking about, with our experience and kind of what makes us, hopefully, someone worth listening to, and I think that as part of the dynamics of our job. So we've been working for the past couple of years within the same DSO that'd be shared practices group, and we were both clinical directors for the group, and so what that really encompassed was we were responsible for making all of the educational material and onboarding material that every doctor that came in to the group would have to go through and we track their progress through it and you know kind of see how that was landing with them. And we'd host these monthly calls where we talk with all the doctors about how some of that stuff was going questions, they had things like that and ultimately, most importantly, you know, we'd have our quarterly retreats and we'd teach. You know, anywhere from 30 to 40 doctors at a time doing model exercises and going through different presentations and case presentations. So we're very familiar with teaching these things. But our most important function, I think, was traveling all around the country going to all these different offices, and I think right now we're, you know, the group is around 36. There's been over 40 doctors that have, you know, kind of come in, some of whom have come out. But we've seen people at so many different stages of their careers and we've actually gone into these offices for their first, second, third surgeries or maybe, if it was a really complex surgery that had failed, it was a case that had failed and we had to go in and revise it.

Tyler:

We had to save some things, and so we've seen people go from having placed, you know, less than 10 implants to doing full arch. We saw people that had placed more than a thousand implants to doing full arch. I've seen people that have been doing overdentures for a long time and had to work to transition them to fixed, people that have been doing dentistry for 20 years, people that have been doing it for two years, and so we interface with people that had just about every type of entry point that you can imagine into implant dentistry and got them, you know, up to that certain level, or it may be, if they didn't get to that level, we kind of saw the trends along the way that kind of stopped people, you know, mental obstacles people had, physical obstacles people had and we saw people get really, really jazzed about implant dentistry and then get totally disenfranchised by it after having a few you know early obstacles in that. First, you know, six months, which can be really hellish trying to do this for the first time, and we'd seen, you know, seasoned people who you know really new surgery still kind of struggle with it, seeing people do amazing. So we've just seen all the different incomes and outcomes of people trying to do full arch and I think that's made us acutely adapted this and certainly we're not, you know, the best people in the world to be teaching this kind of thing.

Tyler:

But one thing I do like is that we're still both pretty early on in our journey but we've also made it pretty far in a short period of time and so what makes that easy, I think, for people that are trying to learn this is, you know, soren, you and I we both learned from people that have been doing surgery for a long time. They forget about the things, the really hard lessons they had to learn super, super early on, doing just the most fundamental stuff pulling teeth, laying flaps, getting a patient numb Right but that kind of stuff has not only happened somewhat recently for us. We we can still very patently remember not having any idea what we were doing, but we've also seen so many other people be at that stage and at any given time there's people that have, you know, reached out to us asking us questions about how to approach different cases. And I mean, I think between the two of us we've we probably seen thousands of cases just from you know, the the early initial records, appointment going in, remoting into their computers, reviewing that, doing the surgery, following up on it. So we, we have experience beyond what we've actually done with our two hands. And we've had experience going into different offices we've never been into before and, you know, if you've never done that before, it is an incredible experience because it can be really challenging. You don't know where things are, it's not your home environment. You have to learn to think on your feet and adapt and honestly, that's what full arch is all about. Really, as we kind of get into this, you'll really get that sense of things.

Tyler:

But yeah, so to kind of transition to what we want to do with the Fix podcast. So we want to take, you know, all those strengths that we have that allow us to, you know, be able to teach this to people and ask important questions, and you know what we want to do is put it into the most easily digestible but very educational format that we can imagine. So I think that trying to do this with audio only, just doing it in podcast format, it's stimulating, it's a great thing to listen to on your way to work or during a workout or whatever. But if you can't actually see the things that are being done, if you can't visualize them, they can really only go so far, because ultimately you want to see a surgery, you want to see how a case is done, it's very hard to talk about what the palatal. Some people just don't really care for audio, only podcasts in the first place.

Tyler:

But now you'll see us on Facebook, you'll see us on Instagram, you might see us on Tik TOK and Twitter or X or whatever it is, because we're going to be sort of chopping all these videos up into like easily digestible, you know, anywhere from 10 seconds to a minute long videos with captions and screen captures, and you know little videos we take of us actually doing model work, and so I think that's really going to drive home a lot of things that we want to talk about. In addition, whenever we're having guests on that maybe aren't so equipped for video recording and have nice microphones and things, we actually are going to be shipping equipment to them just to kind of raise the overall quality of these recordings. I mean, we recorded with people in the past that, you know it might be in a in a random public area with not so great wifi and we're just using some wired headphones for our audio and our and our audio, and that, you know, while there might be great content, it's not, it's sometimes at the expense of our listeners, and so we wanted something that would be really easy to listen to, really fun to watch. They would just be all the more educational and really drive these points home. And you know Soren did mention the concept of full transparency. So that's something that we started, you know, with the Full Arch podcast, and what that really meant for us was that we didn't really have any affiliations beyond the group itself. That would, you know, create biases for us and the sort of guests that we would have on. We never took any money for the podcast. We never did any ads, any sponsorships or anything like that.

Tyler:

One thing that's a little bit different about the fixed podcast is we are going to be doing ads, we are going to be having sponsorships in a few different ways. So you'll be seeing, you know, pre-roll, mid-roll ad, post-rolls that's like little ads that happened before, during and after the show at times, and we'll work very hard to not make that annoying and or at least easily skippable if it must be done. We'll also have exclusive episodes with you know, people that are trying to promote a course or a particular product or things like that, and you'll be very well aware of that. There will be always be disclaimers about where those biases are and who we're talking to. And then we may also be setting up some recurring episode relationships with different people that want to come in and maybe do like a monthly or quarterly episode or something just catching up with what their company is doing.

Tyler:

But what's really important to us is that while we are doing that to help grow the show and further develop it and pay for all this fancy equipment that we're using to to make this a whole lot more entertaining, we never want people to think for even a second that that is actually biasing us towards a certain opinion. We are always going to be very transparent about exactly what we think about our product the good, the bad and ugly and we'll always be letting you guys know what sort of relationship we've had, relationships we have, so you can sort of interpret that and understand what those biases are. So that's just something really important I want this to be. You know we both want this to be an educational, the sort of educational resource that we would want if we were first starting out.

Tyler:

Or you know really any other phase looking to just get into full arch or really optimize your full arch, or you know really any other phase looking to just get into full arch or buy a source and workflows should support techniques, not the other way around. You know we've been to courses and seen shows and things like that, where you know it all kind of becomes about. You know, this is how you're going to do the dentistry so that you can use this service right, there's some kind of catered service. We're going to pay some fee to have this fabricated and this prefabricated and this design and all this wrapped in, and we find ourselves kind of going through a whole bunch of hoops to do something that's not really fundamentally necessary to full arch dentistry, and so we keep things extremely simple. You know, as we talk through our surgical workflows or restorative workflows, these things work with any array of products. It's never really a specific to any one brand or anything like that. We'll talk about pros and cons of different uh brands, but you know we never are teaching this with the intent of you need to do this exactly the way we do with the products that we use and things like that. That's. That's not the kind of show we want to have. So I think that's a couple of different ways that it'll be different.

Tyler:

We also really want to open it up more to the audience.

Tyler:

We try doing that with a full arch podcast here and there, but I think we never really quite had the follow through that it needed.

Tyler:

So what we're doing is you guys will be seeing a website that we're preparing where you can actually submit some questions about different topics that you want to discuss, questions about episodes you already saw.

Tyler:

If you have a case that you want to share, we're going to have a whole form where you can upload case photos with records.

Tyler:

You know, pre and post op panos or just a pre op pano If you're looking for, you know, advice on an approach for giving case photos, things like that, so we can actually come on here and you can have this posted anonymously or not, it doesn't matter to us and we can kind of walk you through how we would do that case. If you even wanted to be on the show and we could discuss cases and other issues that you're having, that's something we could do, and so you know, I think this is really going to open the floor for a ton of really awesome content that people are really fiending for, and it's just going to be able to deliver so much more than just, you know, an audio-only podcast where you just check every Friday and see what we're talking about this week. This is going to be a much more live, feedback-based show and we look forward toacing with what will now be the fixed podcast audience, so super excited about that.

Soren:

Did I miss anything there, soren? Yeah, the acronym. What does fixed podcast stand for? I probably should have started there. Yeah, it's okay, it's still the outline title.

Tyler:

So the fixed podcast. It is an acronym F-I-X-E-D, so that stands for Frameworks for Implant Excellence in Every Dentition, and so we're really trying to open up the concept of what we really mean, you know, by instead of just talking about full arch dentistry. This is, you know, anything that has you know, you know, an implant uses Anchorage. It's anything fixed, it's the idea that we're going to fixate something in the mouth that's going to enable it to do XYZ. So we'll still be talking full arch, that I mean full arch fixes really are, but we'll also be talking about overdentures. We'll be talking about single implants.

Tyler:

We will also be talking about grafting. You know GBR, soft tissue, heart tissue, grafting, things like that All the things that really factor into. You know what we do because it's not all just about full arch, and so that's something we kind of want to break out of and be a little bit more generalist about it, because the truth is is that when you're doing these cases, so many things can come up for you, so many challenges. You know so when you talk about failure, failure is absolutely a critical part of doing this. You have to be willing to face failure where you're going to find yourself just running all over the country running away from your failures, and so there's a lot of skills that you may not think that are really that necessary for full arch. You know there are some things in the philosophy of all on four or as other people refer to as all on X, where you know, hey, we're avoiding grafting, we don't need it, or we're doing a palatal approach, so we don't need to build anything out. And you know all of it's most of these techniques that we talk about. You're taking the first blush at a case and you're doing this for the first time. You haven't faced that failure yet, but when you do run into complications, you find out there's a lot of other skills that are adjunctive to do in full arch implant dentistry and you don't.

Tyler:

If you don't have some of those things, you can run into situations where you just kind of shrug your shoulders and don't really know where else to go. And I think it's really important that you know when you're trying to do this at volume, you're taking on a whole lot of full arch. To shift the plan and take a case through to completion is really important because if you only know how to do it successfully and predictably and you only know how to do the case and see it through the end and then restore it, that's not really enough. You need to have to know how to problem solve. You have no critical thinking. You have to know how to, how to move if your plan a doesn't work like plan A is supposed to work and you have to go to plan B, c, d. We'll both be sharing some cases where we had to do multiple revisions on cases. I think Soren has a record where he fixed a case about six or seven times and every single surgery looks immaculate, but it just would not go, for whatever reason.

Tyler:

I think we finally resolved that one. Yeah, it did, but for now at least right. I mean, you might get more down the road, but yeah. So we really just wanted to open this up to all the sorts of techniques that can be really useful in implant dentistry and all the different disciplines that play into that, because none of them are any less important than the others. We don't want to just talk about your cookie cutter all in four case, because I think people are getting pretty familiar with that. So, yeah, we want to talk about the complex stuff too.

Soren:

For sure. I think I want to point out too, which I was talking about, adjunctive procedures that this is what you know gets people in trouble, as far as like, if you don't know how to do some of these adjunctive things, then your case ends up in the hands of, maybe, a specialist who then, you know, maybe already thinks that general dentist shouldn't be doing these kind of procedures. So knowing, getting like a good, well rounded education prior to starting this, and being fully prepared for anything that comes your way, is important, for you know us as general dentists, having the ability ability to even do these cases, and I think that that's really important to not jump into these until you're you're ready and getting a full rounded education prior to jumping in is definitely critical. I think Tyler hit everything that we wanted to discuss about the podcast and what will be changing, what we'll be doing. I do want to point out that something that we do offer is on our individual Instagrams.

Soren:

I know Tyler does a little bit, but one of my big things is I share every single case that I do Good, bad, ugly, failures, every single full arch that I've done. It's been posted on my Instagram so you can see what all of my cases look like. I'm not hiding behind anything. I want you guys to see what it looks like for a general dentist to be doing these cases and what good cases look like, what it looks like to fix these cases. I will do everything I can to be as transparent as possible on those social media platforms. Now, you know there's some patients who don't want me to show their picture of, like the before and after. But I can show, you know, their, their panos, their CTs after the cases, and you know you can look. You can find my Instagram. It's Dr Soren Poppy. I know Tyler's is Dr Tyler Tolbert, and we will be posting all of our cases on there.

Soren:

And then, as far as the Fixed Podcast goes, I'm sure we'll be relaying a lot of those cases onto that platform as well. Additionally, as Tyler said, we'll be hitting TikTok, we'll be hitting Instagram Reels. Hopefully you'll be seeing us pop up on your For you page. We'll see. But our goal is to get this information out to as many dentists as possible so those dentists can make a decision whether or not they want to get into implant dentistry. And if they do get into implant dentistry, I want them to be as prepared as possible and to do that we will be having all of the top dogs on this podcast so they can relay as much of their gold nuggets, their best tips, to you guys as possible, so you can be as prepared as possible going into this journey. But yeah, I think that you know that covers everything. Is there anything else you wanted to talk about, tyler?

Tyler:

Yeah, no, I think you summed it up well. I would just add that you know that covers everything. Is there anything else you wanted to talk about, tyler? Yeah, no, I think you summed it up well. I would just add that you know, in terms of the things that we'll be discussing, the people we're going to be having on, you know, we kind of tread this line of making this show something that's going to be palatable for a widespread audience, with different levels of experience and reps under their belt, but we want this to be something that's valuable from the person that is just thinking about doing this and trying to learn a few, you know, surgical principles all the way to someone that's been doing this a while and it's just trying to push it to the next level.

Tyler:

I think where Soren and I both are is that we've gotten very comfortable in dealing with atrophic cases in the maxilla, dealing with tough cases in the mandible, with hourglass mandibles and thin mandibles, things like that, some grafting, things like that. We've waded our way into zygos as well, and so we're kind of getting into the far reaches of, you know, remote anchorage and handling really difficult cases, be they primary cases that are being treated for the first time, or secondary revision cases, or tertiary cases where even a revision has failed too. We're both getting pretty comfortable with that, and so we want this to be something that is beneficial to everybody. We want all the experts to be able to come on here too and still be able to glean some little nuggets of information, like you were talking about, and totally open-minded to the different guests that you guys would want to see on here the content that you want to hear about.

Tyler:

This is a show that we want to keep rolling for a long time and just build a wealth of information that's going to further enrich our little Full Arch community, and I think that we've made a lot of friends in this industry some of the best doctors, not just in the country but the world and there's a lot of integrations that can come from that.

Tyler:

So if you're listening to this and you're well-to-do in the Full Arch world, please do reach out to us emailcom with any inquiries or questions you have, any ideas you might have about collaboration. We're very open to that and very excited about making as much content as we can and just spreading the word to people and, you know, enriching this wonderful world of dentistry that we engage in, which is unquestionably the most life-changing dentistry that you can do, not just for your patients, but for you as well, depending on what it is that you're looking out for in your career, the goals that you have. There's a lot of amazing things can come out of really diving deep into full arch, and so we want to help pave that path for everyone and, you know, make it a whole little bit easier, so maybe you don't have to learn so many hard lessons, and yeah, so I think that pretty much sums it up so.

Soren:

Perfect man. I'm so excited to be releasing these episodes for you guys, and you should be hearing from us bi-weekly. We'll have episodes out every other week, at least to start, and then, maybe, going forward, we'll switch to every week. But again, if you want to contact us now Tyler mentioned the email my Instagram is Dr Soren Poppy, tyler's is Dr Tyler Tober. Feel free to DM us on those accounts and please go follow us at the Fix Podcast. That's the Instagram handle as well. Thanks so much for listening to us today. If you've made it this far, that you know I'm happy and we will see you next time.

Tyler:

Thanks so much.