The Smile Now Dental Group: Transforming Full Arch Dentistry

Ready to revolutionize your dental practice? Join us on the Fixed Podcast as we welcome Dr. Caleb Stott, a dentist whose incredible journey spans from the military to mastering Full Arch dentistry. Discover how Caleb's experiences in Korea and Germany have shaped his career, and how his move into civilian practice led to a thriving dental career in Boise, Idaho. Gain unique insights into the challenges and triumphs of military life, and how those experiences have prepared him for success in his specialized dental practice.

Ever wondered about the transition from analog to digital in dental workflows? Caleb dives into his passion for enhancing Full Arch dental care, discussing the integration of photogrammetry, digital tools, and Platelet-Rich Fibrin (PRF) into his practice. He shares his dedication to continuous education through CE courses, mentorship, and international training. Learn from Caleb's real-world experiences, including the frustrations and breakthroughs that come with adopting cutting-edge technology and the value of rigorous training programs.

Running a successful Full Arch practice is no easy feat. Caleb reveals the strategic and operational aspects that have driven his practice to new heights. From improving efficiency and team selection to navigating market competition, Caleb’s journey offers a comprehensive look at what it takes to thrive in the dental field. Dive into the vision behind Smile Now, a dental group committed to exceptional clinical treatment and a supportive work environment. This episode is packed with actionable insights and inspiring stories that promise to elevate your dental practice to the next level.

Chapters

• 0:01 Dr. Caleb Stott's Full Arch Journey
• 7:04 Enhancing Full Arch Dental Care
• 11:16 Transitioning to Digital Full Arch Dentistry
• 20:38 Progression in Full Arch Dentistry
• 24:26 Improving Efficiency in Full Arch Dentistry
• 36:01 Launching a Booming Full Arch Practice
• 41:30 Navigating Full Arch Dentistry Challenges
• 50:02 Soft Skills and Dental Textbook Recommendations
• 56:37 Building a Thriving Dental Community
• 1:07:35 Opportunities for Ownership and Partnership
• 1:12:42 Vertical Growth Partnership Opportunities
• 1:16:31 Connecting With Full Arch Dentistry Community

Transcript

Tyler : 0:01

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

Tyler : 0:10

Hello and welcome back to the Fix Podcast. Soren and I have on a very special guest, as all of our guests are special, but this one's even more special than the other ones. This is Dr Caleb Stott. Some of you may recognize him, or at least recognize his voice. We have interviewed him in the past. This is the first time we've had him live and in charge through a video feed. He also has a beautiful purple and that really matches his inner radiance. Soren today is featuring a shiner on his left eye he can tell you about.

Tyler : 0:37

But altogether the three of us have gotten together just to talk to you about Dr Caleb Stott's journey into Full Arch and all the wonderful things he's been able to do. He has had a truly fast-tracked career, coming out of the military, getting into placing implants, then going straight into Full Arch and what he's been able to do in the past few years, just from getting off the ground to now solidifying what I think is an incredible model for doing Full Arch in a private office setting. And then we'll kind of go through and catch everybody up to what all of us are doing. But, Caleb, welcome to the show. I can't wait to talk to you. Thanks. Thank you, Tyler, Of course, of course. So for those of you who are uninitiated and don't know Caleb's story, would you mind just kind of going through? You know your journey just as a dentist, period up until you, up until the past few years and everything that's happened with Smile Now.

Caleb: 1:26

Yeah, okay. So I graduated from Midwestern University in Arizona in 2015. So it's been a little bit, and what I did to pay for school is I joined the military. I had a really good experience in the military. I know a lot of people kind of have mixed feelings about it and they should, but overall I had really good duty stations. I did an AGD in the military, which was very formative, and then I was able to practice in clinics where I had a lot of mentorship. So the OICs that I had, like the officers in charge were periodontists or oral surgeons or I got to work in hospitals and so that, in addition to like my one year of getting to feel, like getting to know everything was really formative and helping me love surgery, love the bloody field. You know, every single soldier that came in got his wisdom teeth out and I did them. I never, ever referred them and stuff like that. So, yeah, so that that was kind of straight out of school what I did, and I did it for seven years. So the average person is going to stay in the military for four to five years or for a lifetime, and I stayed in seven years. Part of that was COVID, part of that was duty station. So I was stationed in Korea, in Seoul, korea, for two years and that was awesome. And then I was stationed in Landstuhl, germany, for two years, which was also really great. And Landstuhl was really neat because it was a role three hospital, meaning that any kind of medical emergencies from like all of Europe, all of Africa or any soldiers that were deployed, that was their fallback clinic and if it was dentally related, then I got to be the doctor, the dentist that took care of them. So it was a fun deal. So that brought me to 2022, I think In 2022, we decided to separate from the military.

Caleb: 3:16

I have four children, my wife. We loved some aspects of the military, but we did not like some other aspects of the military and one of them was, just like my kids, their friends would come and go so quickly Every three to four months. They're making new friends. They didn't really have a lot of stability. We were pretty far away from family. So we decided to separate and so I separated straight into a full arch practice that was in Reno, nevada, which we loved.

Caleb: 3:41

Reno. It was a really fun place to be, a lot of benefits. I know it kind of gets a bad rap, but it does not have a bad rap in my book. And then, after a year of doing that, I decided to step away from that, that situation, and start my own full arch practice and so we moved to Boise, idaho, and so I'm originally from I claim Idaho, like I grew up in Coeur d'Alene. I went to high school in Coeur d'Alene and that's Northern Idaho and we loved it and it was good. And my wife's family is from Salt Lake. Her mom lives in Salt Lake, so we wanted to kind of have a happy medium between the families and being able to visit and kind of do the things that got us out of the military. So that's there we go, is that good?

Tyler : 4:26

No, no, that's great. I like the synopsis.

Soren: 4:30

I think Caleb's being a little humble here when he went to Reno. I would like to say that he crushed it in Reno, provided care for a lot of patients that needed it in that market, did a lot of excellent treatment and collected a lot of money in his office and then went on to Boise and crushed it further and beyond and is doing so well in a market that maybe you wouldn't expect would have been able to bring on another full arch office and be doing some of the numbers that he's currently doing at that office.

Caleb: 5:04

So I know, Tyler and I go ahead. Thank you, Soren. Thank you very much. Yeah, we're not done.

Tyler : 5:10

We're not done. I want to piggyback on the back padding here. So I actually. So I believe the year when we first started talking about it would have been and I think I was one of the first people to talk to you. We have a mutual friend and there was, I know that you had some interest in doing some implants and getting out of the military and and we talked over the phone.

Tyler : 5:26

I just remember, you know, I think you'd placed maybe eight implants by that time I think it's what you told me in the military and but you were just so passionate about surgery and getting into full large and you just had this fire in you and that was the first time I ever talked to you and I remember, like it was yesterday, and I mean you absolutely, you know, were a diamond made from tons of pressure and heat, because when you went to Reno that was an explosive, you know practice and very soon it was doing three $400,000 a month and I remember thinking to myself I was like man, how does this guy who I just spoke to had only placed eight implants, get up to speed to doing that and dealing with all the craziness around maintaining the surgery and doing the restorative and everything, and you, you caught on extremely quick and then you started incorporating things that I I at that time wasn't even incorporating either. You started taking soft tissue really seriously and getting into grafting and things like that. So hats off to you for, you know, taking what was already a challenging situation having a family with, with four kids and everything that was going on to be able to step up to that challenge and then decide to then walk away from a successful practice and say you know what I want to do things better. I have my own ideas about how this should be done, and to go and just pioneer that for yourself and recreate and even have even better success under your own name is really freaking cool and it's been an awesome thing as we've learned more about it and I've seen your skills progress. We trained together.

Tyler : 6:43

The three of us have actually been down to Brazil for the full arch club bootcamp and and we did some cases together and things. So we've all gotten bloody together and I think that formed a really strong bond. So but yeah, I say all that to say you know, hats off to Caleb. He's a very humble guy but what he's been able to accomplish in the past few years has been nothing short of remarkable, and I'm really happy to have you on the show and to work with you as well Awesome.

Caleb: 7:03

I appreciate that. So, yeah, and just to add to that too, yeah, in the kind of touching on some of the things you said, like in the military, you have to fight tooth and nail to get implant experience. So I was running I was running the little gathering of people to do implant placement and implant restorations because everybody had to have approval in order to even have an implant placed. I restorations because everybody had to have approval in order to even have an implant placed. I think it was for good reasons. A lot of implants that are placed are not really restorable. A lot of people don't really think about the crown first, they think about the implant first and then. So in order to avoid that, I headed up this implant meeting that we had once a month to make sure that anybody that was a candidate was a good candidate, that it was going to be a good case, that they had sufficient care, especially with people coming and going within the military environment. So I did that and then so, yeah, eight implants was actually a pretty big achievement in the military.

Caleb: 7:55

And, yeah, I was licking my lips to try to do more. To be surgical, I really heavily considered doing a perio residency. I really loved, like the care. You know the perio, the gum gardener type mentality of just like being meticulous and doing it right. So a lot of my experiences led me to want to do that. So when I had an option to do an implant practice, I think I was underprepared in some ways, but I was also very hungry for it and I did so much CE. You know like I watched Implant Ninja 100 times before anything. Yeah, you know what I'm talking about.

Caleb: 8:31

And then and then textbooks. Like I turned to textbooks big time, so I try to read three or four textbooks a year as part of my reading goals in general, and every single time like that I go through one is just a little bit more that you can pick up. And I do feel like the other day. You know, the other day I had a patient come in and I took off her hybrids and this was done at Clear Choice eight years ago and there was a little bit of bleeding when she came in initially, and then one of the x-rays didn't look great for one of the implants, so I thought it was going to be a pretty big concern. So taking it off her case was actually in pretty good situation, but it was a huge saddle, yeah, ridge lap over her tissues, completely convex everywhere, or concave everywhere, so anyway. So it was just kind of like me looking at transition line issue, though.

Caleb: 9:21

Yeah, there was no transition and there wouldn't have been either like this.

Caleb: 9:25

Didn't need the original, so um but yeah, I was looking at it and I was like, well, here, here's, you know, a highly trained prosthodontist, highly trained OMFS that would have placed these implants and they look really good and some of the tissue didn't look as good as it should have, but it wasn't causing issues with the implant eight years later and I was just like you know, I think I think I'm doing okay, like the things that I've been doing for a long time, I think, because I've been in the books, because I have good colleagues, like you guys, because I have good mentors, like some of the the CE that we've gone to together, I think that we kind of know more than we used to know 10 years ago in this field of doing these specific cases and a lot of that it's distilled upon me and it's become part of my everyday and it's kind of the standard of excellence that I hold myself to.

Caleb: 10:14

So, yeah, to add on what you're saying, it's been a lot of work, it's been really worth it and I've always felt up to it to get stuff like this done. Yeah, up to it to get stuff like this done. So yeah.

Tyler : 10:24

So I'm curious, you know, when you first you know set out to start your office at Smile Now in Eagle, idaho, what were some of the things that went through your mind that you know? I know you had a lot of ideas about innovations and how full arch specific practice is done, how we can make this better for the patient, continuity of care, things like that. Like what were some of your innovations when you decided to do this on your own?

Caleb: 10:45

Yeah, I mean, I don't know if I'd call them innovations, but what I was looking at was who is providing the highest standard of care, right? So highest standard of care means that you're going to stay with a patient super long-term, you're going to be able to follow them not just for six months or one year, but you need to have three, four, five years in order to know that you're really taking care of them in the appropriate manner. So I wanted continuity of care by having a stable environment, and so that was one one thing that I was really looking for. But then there was a lot of other stuff. Photogrammetry right, like today, I use my, my micron mapper. I used it seven times today, right.

Caleb: 11:24

So, here I am at a previous situation trying to figure out hey, how can I go digital? And I had purchased all my own equipment to kind of do it. It was like a Medit i700. And then I bought OptiSplints. I don't even know if I should be using these names, right.

Tyler : 11:39

And I was like, okay, I'm going to use an.

Caleb: 11:40

OptiSplint and I'm going to reuse it by knocking off the composite and afterwards, and I'm going to be able to like deliver better care. But that that was not a reality at all and it was just really frustrating, kind of being shackled right by wanting to provide the top most care, which I believe is digital, and not being able to do that. So that was a huge motivator for me and, like I bit the bullet right from the get go. I figured out the whole digital game all you know by watching YouTube videos and talking with people and I use JB lab. I went down and visited JB. I took yeah, awesome. Like you, you don't really think that JB, like where he's working, is going to be two warehouses of people designing and milling and doing like a 100% everything lab.

Tyler : 12:33

I did a walkthrough there and it was like walking through like an Amazon warehouse. It was insane Right?

Caleb: 12:38

So you don't really expect that, but when I went there it was like it just left a really big impression on me that know, this.

Caleb: 12:44

This is the type of stuff that I want to be a part of and this is the degree of care that I want to offer my patients. So so that was part of it. I went to SIN, you know, to Blake's ExoCAD course and that was really eyeopening. So I know enough enough ExoCAD to know that I don't have enough time in the day to do exocad. I know that, however, like when I'm, when I'm watching and seeing what they're doing, like I have a clear understanding of why they're doing it and that helps me be a better clinician.

Caleb: 13:15

You know, angle my MUAs in the right way, make sure that I'm using the right screws, make sure that I'm not just pumping out something that I was told, but that I actually have control over the products that I'm giving to my patients. So I mean there, yeah, there's just so much that goes into every single patient and they deserve the best. And especially, I feel very strongly that the cost of treatment to do this is prohibitive for a lot of people that need it. I wish that everybody could afford this. They obviously can't. And but I want to do this is prohibitive for a lot of people that need it. I wish that everybody could afford this.

Soren: 13:45

They obviously can't, and but I want to do my best at taking care of them when they can and giving them the best, the best situation long-term, nothing short-term, so yeah, absolutely, and I, you know, I kind of want to go into this a little bit too, because you know there's a lot of things that, on my journey to FullArch, I resonate a lot with as far as similar things that you did. As far as digital, when I first got into FullArch, I was kind of told that analog is a great way to start, and my opinion has definitely changed significantly since doing a lot of analog workflows. You know, when I first got into full arch, I was like, okay, from what I was told, it's good to get started. With analog. You learn a lot. You know this is a couple ways to maybe fast track the patient experience when doing analog based approaches. You know, maybe skipping a V jig and using the, the prosthetic that you picked up during the surgery you know there's different, there's. And using the, the prosthetic that you picked up during the surgery. You know there's different, there's different things that you can do right. However, I quickly saw a lot of cases that were being done analog in this, in this style, and saw a lot of prosthetics that weren't seated correctly, right and different prosthetic issues that arose when kind of taking this analog approach and not to not to say anything wrong with analog. I do think that there's a lot of wonderful opportunities to learn full arch workflow using analog.

Soren: 15:15

You know it's a lot of dentists that are getting into full arch. They maybe didn't have. There's been a really long time since they've done a lot of just the basic denture prosthetic workflows. So in that aspect of things, I think it's really important to hammer that down, to understand where the teeth should be, how to set teeth properly, how to manage the prosthetic side of things just with cosmetic and your patient's facial dimensions. And it's not just, you know, there's a lot that goes into just the record-taking of these patients and I think that analog is great for that. However, I don't think at all that analog is wonderful for skipping steps along the way.

Soren: 15:59

If you're going to do analog workflows, I think it's important to do V-jigs. It's important to take all the proper steps. Yes, it means that your patients are going to have more appointments. Yes, it means that it's going to take longer in your clinic to do so. However, when you come back Caleb's talking about seeing patients in five years you're going to feel a lot better about the work that you did five years ago if you're taking these steps properly and where I found that, incorporating digital and you know, at at smile now dental group, and we'll go into. We'll talk a little bit more about smile now dental group and you know it.

Soren: 16:34

I don't love that the first time that we're really like getting deep into to smile. Now I've got this. You know this black eye going on and everything. However, I want to want to say, though, that you know, when we form smile now, we wanted the best outcome for our patients and the best outcome for our doctors, so in order to do that, you know, our doctors need to be pretty well versed in full arch and and know these steps, the prosthetic workflows, and when they come on to to our group, we are giving them full digital protocols for everyone, and I think that is amazing for one. You know, in five years, we know that, because of photogrammetry, stuff is going to be seating properly right when we're fabricating our prosthetics. There's no real it. You really have to to mess up up to create prosthetics that are super concave, right.

Soren: 17:26

I feel like digital does do a wonderful job with some of these basic prosthetic principles and ensuring that patients we're setting our patients up for the best possible way to succeed in the future. We're making things cleansable. We're eliminating a lot of these appointments like verification jigs, bite rim, tooth setup. I see a lot of clinics that are doing analog approach. They're skipping the V-jig, they're skipping the wax rim. They're going right from a prosthetic that they picked up in surgery to a tooth try-in, to a final, and it's very easy to mess up.

Soren: 18:05

There's so many things that can go wrong along the way and if, in the end, you end up with a zirconia that has an area that doesn't seat well, that's on the clinician that provided that care. And you know, I think it's really important for those clinicians that are doing things in this style that they need to hold themselves accountable for making sure that their patients get the care that those patients deserve. And I think by incorporating some of these digital workflows, after you have a good basic understanding of full arch, you really can give that care to the patient. It makes your life easier because you don't need to, you know, have a full dental lab in your office. You can do things digitally, you can do things with less appointments, and you can do that with still providing optimal and even better care to those patients because they're getting a really nice prosthetic.

Soren: 18:58

So that was just kind of bouncing off of Caleb's journey into digital and I resonate a lot with it because I feel like there are a lot of dentists that want to journey into digital. And I resonate a lot with it because I feel like there are a lot of dentists that want to get into digital. They're scared about that initial fee to getting into it. However, my argument would be that I think it's well worth that fee and it's getting more and more reasonable. Right, these companies are learning quick. That it is kind of the steps to the future. And there's more competitors coming out, there's more people that are offering, you know, photogrammetry and designs and stuff. So things are getting more reasonable.

Soren: 19:33

So, you know, now's the time to really, you know, take that leap if you haven't yet. And it's going to be a very challenging. It's, you know, I would say, like my progression through full arch. The first thing was learning the surgery right, once you get the surgery down, wonderful. But the next really hard thing that I had in my clinic was learning digital. And I know I remember some old podcasts with tyler me talking about be careful going into digital because you are going to be pulling your hair out. And it's true, there is so much that can go wrong with the digital workflows Something doesn't print right or you can't get a photogrammetry scan, or you're having a really tough time scanning in a bloody field. There's so much that can happen. However, once you are comfortable with it, I think it's so much better than the other side of things. So there is a learning curve, there's a mountain to go up, but once you're on the top, I do think it's steady, steady going and it makes your life, your staff's life, your patient's life so much easier and I would urge you to take that leap if you have the ability to.

Soren: 20:38

That was my little rant about digital, but I do want to talk about too, caleb, something that I feel like maybe you forget or you don't really think about too much, but you know people, people that are watching you definitely see, and that's I'd love to just talk about your progression through.

Soren: 20:55

You know kind of full arch and the things you've learned from.

Soren: 20:58

You know just learning full arch to incorporating PRF into your surgeries, to to learning the digital protocols, to going to Portugal learning palatable approach and pterygoids and what that gave to your patients, to going to Brazil to perfect these techniques. You've probably taken more CE than most clinicians that are in your shoes and I think it's really important to let the audience know kind of your path, because it isn't. There's a lot of listeners that think that they can come out of dental school and start a practice that's doing $400,000 a month, $500,000 a month, when in reality there's a lot that is behind the curtain that you've done, and I think that it would be great for the audience to hear what CE you've taken, what you're doing for your patients to kind of make sure that your prosthetic and surgical outcomes are optimal. I know that, seeing that it's really easy, or seeing it from our point of view, it's inspirational to see kind of everything that you've done and Tyler and I have learned a ton from that. But the audience doesn't know these things.

Caleb: 22:07

Oh yeah, okay, perfect. You know, the best part of this is I was always told that, like, in wherever you are, you kind of want to find another racehorse so that you could, you can have, you can have your peripheral set on somebody else. That's like moving as fast as you can as motivation to move to where you want to become right, and I've always seen both of you as my peripheral racehorses, right, okay, so when we talk about you know we both worked in a similar environment and you guys were right out of school and it's always it's I also sit here and think, wow, like these guys have been able to accomplish in two years what I think it takes most clinicians 15 years to figure out, like where they want to be in their career, right. So hats off to you, and I think we both shared in that experience. So when, when I think about all the CECA, ce just became such an important part of my life immediately, like when I started getting into full arch, and I think part of it was I had to catch up, and then part of it, too was I needed to assure myself that I was doing what was best for the patients, right? So I've taken about a thousand hours of CE, probably in the past 18 months.

Caleb: 23:18

I finished the maxi course, which is like 300 hours. I finished the California Institute, which is 300 hours. I have, in addition to that, read six or seven textbooks and I am continually trying to do the best that I can, as far as like always educating myself about all things implants. You know, my ultimate goal is accreditation. So to get the diplomat of the American Board of Oral Implantology, because I feel like that is what I need to do, to kind of justify all the money that I'm spending on CE, to justify how much time and energy and effort that I put into to what I'm doing, right. So, talking about specific courses, right, I think the two most foundational things that I have in my, in my repertoire is would be Matthew, what's Matt's name? Matt Crager, as efficient as I think I could ever get Right.

Caleb: 24:26

So we I know that you did your podcast on efficiency, but the really fun thing about what you were talking about was like you and I were in a race to see who could finish a double the fastest and it wasn't like we were trying to get reckless with it. But I know that you like posted these times right when timestamps, and it would be like you did it in two hours and then you did it in an hour 40 minutes. But what nobody knows is that I was also racing you at the same time and then all of a sudden I'm like, oh, I got down to one 37 or I, and I think you ended up at one 20 and I've been at like one 30 before Right and nowadays, like my case today. So, like my, my case today took me three hours and I felt like it was so long and it was a double and it was tricky, you know, like I had to remove a couple implants.

Caleb: 25:08

I had to get the prosthesis out. The lower was just a really skinny, skinny mandible and when I was like torquing down the buckle plate kind of out fractured. So I had to find a new site and I had a graft and I had to use collagen membranes and just everything Right. So it was kind of like a full service, full arch, which I'm not used to. Typically it's very simple and it's just kind of like the process is second nature at this point. But today's was pretty tricky and you know I paid my anesthesia bill and I was like man, it's like $2,000 this time, that is. That's way more than.

Tyler : 25:41

I usually pay and anyway, I don't know why I'm bringing that up, but it's the subject of continual improvement, right? I?

Tyler : 25:48

mean you're trying to learn more skills, trying to get more efficient with those skills, while also incorporating all these new things. And while you do try to keep things simple and repetitive and rote, while maintaining that quality, you give a case of what it deserves. And sometimes you have to pull out of your bag of tricks and it sounds like you've accumulated quite a few things to pull out whenever the case. Yeah, for sure you know today.

Caleb: 26:09

Okay, so today I did that case. In the meantime, I have a patient show up that I haven't seen for six months and she was in her provisionals and one of her implants has failed and totally granulated it right. What did I do? I took out one and I placed two to replace it. One of them's a pterygoid right, so the pterygoid pterygoids are second nature at this point. You know, I.

Caleb: 26:32

I don't always go for them because it's not always indicated, but for the most part I want to get six implants in. That's kind of a philosophy that I have is, I want to over-engineer for tomorrow instead of under-engineer. Just because of today, right so, but but today I was able to rescue that because I'm digital. I was able to scan, get a design done, deliver her a new set of teeth At the same time I she actually I got her numb and I went and did my double and then I came back and I finished her case. Right so, but she had to wait a little bit longer because, you know, the total case time was like three hours. But I came out some of the, some of the stuff that was going on in. My assistants do like the digital, uh, photogrammetry and putting it on the way.

Caleb: 27:18

Yeah, and scanning. And you know, on this one we had to take it alginate because we weren't getting a good scan. So I use a prime scan and it usually does pretty good but like, sometimes in a bloody field it doesn't. It's just up to them to get it. At this point my assistants and and we even there was a mistake, like I sent it to jb and they said, hey, one, one of your markers is off from the micron to the tissue scan and we don't know which one it is. So so we were like, were like, okay, well, I'm just going to re micron that one. So that added like another you know 10 minutes to the case and stuff. But but the point is like today was a really hectic day for me and it was the accumulation of everything that I've done up to this point.

Tyler : 27:57

Yeah, it could have been a lot worse. Actually, it could have been a disastrous day and you would have rescheduled the podcast.

Caleb: 28:04

Oh, like, imagine, imagine it being analog right, and then you're sitting patient. That's what.

Tyler : 28:08

That's what I was thinking about when you brought that, brought up the pterygoid thing. I'm like, yeah, that's, that's literally. I used to lay awake at night thinking, man, if my, if my distal implant fails, I'm working out to make a whole new prosthetic and do this and that. Yeah, totally so.

Caleb: 28:20

So anyway, but yeah, going back to CE, like I said, I've done the big continuums and I loved them. I thought they were great. I also did Bernardo's courses, like both of them, and Bernardo is a foundational education for me, right, the more I learn, the more I realize that the full arch club Bernardo specifically just really knows what he's talking about. Arch club bernardo specifically just really knows what he's talking about and his, his wisdom that he brings to the group that he runs afterwards and to the access that you have to specialists all around the world, which I think is phenomenal, because sometimes we got to get outside the united states to kind of see what other people are doing. I just think it's invaluable.

Caleb: 29:02

And so I would say my most foundational stuff has been, you know, the maxi course was really good, but also, like textbooks, textbook I would rather learn from a textbook today than go to a course. For the most part it's more complete, you, you get better explanations of stuff and there's a lot of CE out there. That just isn't great, you know. And and CE is like a whole nother industry in and of itself so it's easy to get sponsorships.

Tyler : 29:26

There's marketing yeah, hard to tell the difference.

Caleb: 29:28

Yeah, totally yeah, so anyway. So, yeah, those are all the things that, like I, I'm pretty consistently involved in, and the ones that have been most pivotal for me have been, like bernardo's course, matt crager's uh blog, which is phenomenal for efficiency tips and what to do, and free, oh. And I would always find myself reading his blog too and being like, yeah, I had figured this out on my own and I'm so glad I'm seeing this in writing from somebody else. It's like a meme moment, you know.

Soren: 29:56

So yeah, I agree, and what's crazy about Matt's stuff is he's got so much in there and he just provides it for for free. So you know, if you're if you I wouldn't I would say that a lot of learning that I've done throughout full arch, it is very important. It's like it's like stepstones, almost right. Like you don't, you won't understand a lot of stuff in that blog post until you get to a certain level and and then you know it just. I like I remember I was doing a lot of analog stuff and I decided to take a digital course and I went to this digital course. I spent a good amount of money on it and I took zero away from it because I just wasn't implementing that in my office.

Soren: 30:39

And I would say one critical thing when you're looking at CE we talked about a lot about CE on this podcast quite a bit I would recommend getting your hands wet in some of this stuff yourself before jumping into a big CE course around it Now and I wouldn't necessarily say that makes sense for like pterygoid implants or you know surgical approaches, because those are things that you want to learn and then incorporate. But at least, like digital stuff, you know surgical approaches because those are things that you want to learn and then incorporate. But at least like digital stuff, you know, try to get. Try to get a good base, a good foundation, even even if you want to buy like a micron mapper and mess around with it a little bit and and then go to a course and you will take away so much more. And that's really what I found with with Matt's stuff. I mean, since it's free, I would recommend everybody just go read it.

Soren: 31:28

But if you're listening to this and you've done 10 arches, maybe 15, do another 40, read through it again and I guarantee that you will pick up so much more and be like wow, there's a big difference from getting. It's pretty easy to get from a five hour double to a three hour double just by implementing, you know, just by getting faster and getting consistent with with how prosthetics work right. You know, sticking your multi on. I remember, like my first couple of cases, I was sitting there just like trying to get the multi on for trying to get it in the hex for a while and then all of a sudden, you know, you just know, exactly like you. It's just like second nature anymore.

Soren: 32:10

You put it in grab the driver, you know exactly where it needs to go, right. But then you know the second arch. You're like the second arch you ever do. You're like, oh my God, like it, like you. Just it's all new feelings, right. But then getting from that three hours to the two hours, that's tough, right. Or two hours to an hour and a half, that's super tough.

Soren: 32:33

And that's where a lot of these efficiency tips really come into play. And when Caleb's talking about us racing to get the fastest double, I do want to put a disclaimer out there that I post and I know Caleb posts to all of the cases that we do there. That that I post and I know Caleb posts to all of the cases that we do in our like hour and a half double looks 10 times better than a lot of these cases that I see that you know are five hour doubles. I won't ever do a case that or take shortcuts during surgery for speed, ever Like I. Again, all my cases are posted. You'll see almost every single one looks the exact same. However, it is a something that's doable if you're, if you're efficient enough, and it really depends on the case too. Right, the teeth come out easy. Alveoloplast is easy, implant placement's easy, like it can go very quickly.

Soren: 33:21

However, you know, I totally agree with you in the fact that for me now, when I do a double or a single, that takes me longer than one hour per arch, I feel like I am dragging, I'm getting frustrated. I'm like man, this is taking forever. And I have a lot of dentists that come into my office and watch me do surgery and I remember I had one last week and I was like apologizing to him. I'm like sorry, man, this is taking a lot longer than normal. Like I hope you're still getting some, some tips out of this. And he's like, dude, this is like I've never seen something like so efficient before. So it's pretty cool when you get to that point, because it really shows you how far you've come and how far your team has come. I always talk about this like the probably the biggest efficiency stuff.

Soren: 34:10

I know that we're kind of like I feel like we're jumping all over the place with this podcast, like going from ce to efficiencies or whatever, but I still think it's all important. But the biggest efficiencies that I found is properly training your team, like your team should know exactly what to hand you, when to hand you it, what the next steps are. If you're like for me, when I'm placing my multi-units, my assistant's getting the Micromappers all ready and set up for me, because then she can just hand them to me. When I'm putting my Micromappers on, she's setting up the computer next to me getting everything loaded ready to go, so she can just hand them to me. When I'm putting my micro mappers on, she's setting up the computer next to me, getting everything loaded ready to go, so I can. She can just hand it to me and use it.

Soren: 34:49

And I would really, if you're looking for efficiency tips, I would really urge you to do some.

Soren: 34:53

Just do some like walkthrough surgeries with your assistants and make sure that they understand all the steps. You know a patient doesn't need to be there to do that stuff to get faster. You can just practice and you'll get much better with your team and more comfortable in surgery. And what I find is when you're able to do a surgery efficiently, when you have one, you know, you don't get as many of these like weird complications, like super bad bleeds, and I mean I get bleed, I get bleeds, everybody gets bleeds but you're able to just manage them better and I feel like when the patient comes back a week later they don't look as bad as they did when the surgery took five hours, you know, and they were flapped open for hours on end, and I think that when complications occur, you can you have that much more time to be like okay, how are we going to manage this? Let's manage this properly, and I feel like cases knock on wood right, Just go a little bit smoother.

Caleb: 35:55

When you kind of get to that level, yeah, I totally agree with everything you're talking about.

Caleb: 36:01

A couple things I do, just like nuggets, I guess, is on Fridays we don't usually see patients, but still, like once or twice a month we'll come in and we'll do trainings with, just with the staff, right, and that's like a get to know the process type situation. So it could be inter-roll scanning, because we all know that like there is a way to scan and get efficient at inter-roll scans, right. Another thing could be like the micro mapper just set it up and you can just lay them. You know photogrammetry, screw it in. What should it feel like? Just scan it, how does the equipment work, stuff like that.

Caleb: 36:35

So I always remember I don't know who said it, but like they said that if you're moving 100 miles an hour in a car, you can't do maintenance, and that always stuck with me that sometimes you got to park the car and open up the hood and see what's going on to do it.

Caleb: 36:49

And one thing I've really appreciated about our new relationship is I've been doing my own stuff for about a year and bringing you guys in. It's so much easier to be efficient and it's easier to like even improve so much on so many things that I wasn't doing before. So this is to me like the ability to park a car, because I didn't have time to park my car like on a big, a big business level type stuff, for such a long time because I was just moving, moving, moving. But now I've been able to park the car, take some time, look at stuff with other mechanics that are looking at things with me, and be able to figure out what's best, what's most efficient, what's going to save us money, what's going to make us money, and that's been a huge benefit in a short amount of time.

Tyler : 37:37

So I'd like to take a little bit of a departure from some of the clinical obstacles you faced the team training and everything and let's also just talk just about. You know how the business went in the first few months, so I'm really curious about that. So when you cut the marketing on, the lights on, you're ready to see patients. How did those first few weeks go? How did those first few months go? How did that evolve?

Caleb: 37:57

Yeah, yeah, right. So the very so. It was a little bit nerve wracking what we had and not really knowing what the future was going to look like. But I also like within my heart, I kind of figured, hey, if I only make 50% of what I made or 75% of what I made, but I'm my own boss and I get to control things and I don't have to be beholden to you know, a situation that I wasn't 100% happy with, then it would be worth it.

Caleb: 38:24

So that was kind of my mindset going in and I think that that was a really good mindset. However, I did a lot of really good things in in Reno. I had a really good team there that like really supported me and helped me and I'm like forever grateful for that. In addition to that, I've had months in Boise that I never had in Reno, like financially right. So the cases you know, my best month I've had here is 25 arches, a lot of collections, a lot you know, and this is Boise. Boise is way more competitive than Reno was. Boise, I think, is actually more competitive than a lot of places. And I there's four or five full arch clinics here. You know people that teach. There's a couple of them that like teach the surgeons are well versed in it. This is not what I would say is an easy area and not necessarily one that I would have chosen for business purposes. However, it's been really good.

Caleb: 39:19

So what did the first couple of months look like? I thought I was going to open up in June. I opened up in October. I originally had kind of like promised myself to another practice and I ended up totally reneging on that and opening up and doing construction on a building that was it's 4,500 square feet and it has 10 ops, so it's I went huge and looking back, sometimes I feel like, oh, I'm pretty fortunate that it worked out pretty well for me, cause it's like, looking back, it was a lot to bite off Right.

Caleb: 39:53

However, first month I think we I did 10 arches that month and it was like, oh, you want to do this tomorrow, that's no problem, we can do it Right. So somebody coming at four o'clock and because we're digital, I could take records right then and they could be in surgery at seven o'clock in the morning the next day. So so we did that. And then I had moments of really, really big growth for the first three to four months and like, really, by month three, it was like I was not thinking about was this the right decision at all. I was more thinking like, wow, I'm really busy and you really start as like a skeleton team at first.

Caleb: 40:28

Even now, I have three assistants and I have one office manager right, so these are really small teams. It's not. It's not big. In some days it's a lot of work, but, like by month three, I was definitely more worried about overworking staff and burnout for them than I was about more worried about overworking staff and burnout for them than I was about. Hey, is this going to work? Am I going to make money? You know, am I going to be around to see people in a couple of years? So does that kind of answer your question?

Tyler : 40:58

No, no, it totally does. And I'm curious too what would you kind of attribute you know you've moved from, you know, a much more favorable market in terms of saturation and when it's a lot more competitive? You know, what would you attribute that marginal success to, given that there were more challenges to come along with that?

Caleb: 41:12

Yeah, I think, I think there's still some forms of marketing that, like, really benefited this area. And then, you know, I like I had the ability to spend, to know how much I was spending on marketing, I had the ability to adjust that as much as I wanted. Yeah, yeah, and, and I never had any of that there.

Caleb: 41:30

It was just like you can get what you get, you don't throw a fit you know, and I never did have to throw a fit and just wring the towel for all, yeah, so and you know, like my, my office manager in Reno, she was really good at patient interactions, like phenomenal, like eight out of 10 type of like, probably more than that, like a nine out of 10, you know, and so that that was really impressive.

Caleb: 41:58

But I was able to take away and know what I wanted in an office manager. I'm actually on my second office manager here, but that's because I kind of realized that the first one she was more like a five out of 10. And the things that I felt were most important and at first I kind of thought that I could train her and bring her up to like maybe a seven or eight out of 10, but I really realized that that's never going to happen. And so just finding the right people that have the right aptitude for what you're you're looking for, that's just vital, it's super important and you're never going to take somebody that's a four and make them a seven or an eight.

Caleb: 42:30

That's just never going to happen. And as far as what we do, too, like I would say that us as providers, our tenacity, our drive, wanting to get stuff done, patient interactions, communicating in general, like all those things, I think we're all very high in our natural aptitude with those things and those all benefit us immensely. And so, if I okay, so let's go back. This is kind of advice. What can we give to somebody that's thinking about doing full arch? And they're new, maybe they're even in school and they want to plan ahead, or they're pretty fresh, or maybe they want to change in their career trajectory, which is really hard to do.

Caleb: 43:08

Right, I would say, be very comfortably surgically, you know. Take out wisdom teeth flip, do like aesthetic crown lengthening, just see blood, get comfortable with blood, be comfortable with periosteum, be comfortable like with extractions, things like that, things like that, that where otherwise you, you know, if you can't be comfortable there, you're never going to get comfortable when, when you're doing a huge alveolectomy and and stuff like that, right, but the second thing I would say is, like treatment planning.

Caleb: 43:37

That's a huge thing. Often I see dentists that like fumble over their words, don't have a lot of confidence in how they talk to patients about what they're seeing, don't really can't really put it together super quick as far as like how to recommend stuff and why. And then communication skills is huge too. I sold door-to-door for a really long time. I never could stay. I did. I could never stand working for somebody else like never, right, and I just don't work well for other people. And I used to do door-to-door.

Caleb: 44:06

I did it for seven years and I think, sitting on doors getting rejections, I did a Mormon mission. You know a lot, of, a lot of stuff going on there. All these things just kind of made me more comfortable being in uncomfortable situations, talking to people, communicating with them, you know, like doing checkdowns and repeating back to them what they're saying, making them feel heard, making them feel seen, and I think, like those, that natural aptitude is a huge thing. So if you don't have those things like those are the keys to being ultra successful, right and so, yeah, yeah, I like that, I think.

Tyler : 44:45

I think soft skills are incredibly important and there's nothing soft about them. They're actually very difficult, but no, especially when you're in an industry that's not insurance driven, right, people aren't coming to you because they looked you up on Delta's website and now they're coming. You're taking people who have sort of abdicated themselves from dentistry, who have given up on that. Now they're looking for a second chance, and in your market in particular, there's a lot of options that they have from dentistry who have given up on that. Now they're looking for a second chance, and in your market in particular, there's a lot of options that they have, and so they're having to really choose you. They're not choosing you because of their own circumstances. They're choosing you because they trust you and there's that aptitude and that competence there, and if you can't prove that, then, yeah, you'll be belly up before long in this type of model, and I think it's important too that I think the trap that comes along with you know, people might be kind of computing things as they're listening to this right now, right, okay, so you know, caleb, he opens up this office in this competitive market. He's doing these $40,000 cases, or what have you? You know he's. He's doing 10 arches this first month. He's doing 25 arches a month before long. He's, you know, clearly doing super well, you know, and he's only got a few people on the team, so the overhead must be great and it's you know what.

Tyler : 45:50

What might be going on in someone's head is like this is a really easy thing to do, you know you just you just hang a shingle and like you can do really well, just so long as you can get the clinical part down. And I don't think that's necessarily true. I mean, this is that it can be very up and down. It's very month to month. I call a year a marathon of sprints, because it's exactly what it is. No matter how good the last month was, this is a whole new month and you want to make sure you kill it.

Tyler : 46:15

And trying to create that sort of constancy of success is a very difficult thing to do in these models and you know, continual improvement is extremely necessary because there's always other people trying to implement it themselves.

Tyler : 46:26

And for you to have shown you know I think you're coming up pretty close on a on a year now and to have shown that that continued success to be at a three plus million dollar office before it's even completed its first year. It says a lot and I think a lot of people might fall into a trap of thinking that you know, just because they can do surgery, that they can just go and do this and this model is just a cheat code for dentistry, and maybe at one time that were true. But I don't believe that at all and you want to make sure that, however you're doing it and you know if you're doing it on your own, you want to make sure you're super well equipped to handle all the aspects of that. But then if you're looking to partner with a group or somebody like that, you got to make sure they have their ducks in a row and they. I appreciate that.

Soren: 47:00

I would definitely piggyback off that and I get a lot of doctors that listen to this podcast, listen to our last podcast, and they're like hey, you know I want to start my own. You know I've been looking into this, this and this, and, man, if I went back two years and I had limited full arch experience, you know I would say that it's it's nearly impossible to go from a GP level to a really well functioning full arch clinic like that without taking some serious stepping stones along the way. There is so much that goes on behind the scenes that people don't understand. Marketing is not easy, you know. Maybe it was like five years ago. It's not easy, man, it's really difficult, and that's something that I've at Smile and Identity Group, I've taken on fully and I work super hard to. You're constantly pulling levers left and right, trying to implement different systems, implement different strategies to ensure that when patients look up all on four, that you're the first one that pops up, that when someone reaches out to your clinic, that the staff is ready to go and can sell treatment to that patient and each call that you get. You might only get a handful of calls a week and you better be ready to go to sell that patient and each call that you get. You know you might only get a handful of calls a week and you better be ready to go to sell that treatment and if not, you know you can. I mean, don't get me wrong a lot of these clinics, like in order, the the breakeven point of them is 100k, 80 to $100,000 to even to even profit that month and there's a huge difference from. You know, I see a ton of these clinics and a ton of organizations that are trying to start these clinics up Like they're. They're popping up all over. You know affordables doing them. I heard that Heartland's getting into it. You know there's so many that are coming up all over the place and they don't realize how much money. Like there are groups out there that are spending 100k plus a month just on marketing and you have to do that if you want to be successful in this area. And I think that you know what I really appreciate and we, and I think that you know I want to get.

Soren: 49:21

I want to talk about one thing before we get into it, but I want to talk about what we're trying to build with Smile Now so that doctors can that are looking for you know they have these skill sets right. They, like Caleb talked about, they're comfortable with blood. They can take out wisdom teeth, they can take out teeth, they can place implants. They're looking for the next step. Maybe they're kind of sick of general dentistry. We were creating an environment for them where they can still feel like an owner in a business like this, not feel like they are an owner in a business like this, and still be able to do arches at the level you know, at a really good full arch clinic level. So we'll go into that a little bit.

Soren: 50:02

One thing I wanted to quick to just mention Caleb was talking about soft skills for full arch dentistry and man, it is. It is super critical and I remember, prior to even like getting into full arch and stuff like that, I my goal was to be a really good dental business owner and I didn't. I didn't do that. I didn't take those steps by by listening to dental podcasts or by, you know, trying to make my crowns faster. I did that by reading so many business books and I actually have a quick list here, that of books that I would really recommend for people to read to. You know, get some of these soft skills and I'll quick go through them and I think it's a really good nugget that I wish I would have heard I was in dental school or even coming out of dental school as a dentist.

Soren: 50:50

So one of my favorites and this is a pretty basic list that if you do a lot of self-help research, I think it's just a good basic list. But the first one is Rich Dad, poor Dad. I think this is a great one for just understanding that you want passive income. The next is how to Win Friends and Influence People Just a really good, well-rounded book about talking with people. E-myth Revisited is a great one for learning business skills and how to run a business Good to Great another good business one Built to Last is a great one. Start With why another excellent one. Everything is Marketing is a great marketing. Start with why Another excellent one. Everything is marketing is a great marketing. That's specific to dental business. Mastering the business of practice is a dental specific one. That's really good.

Soren: 51:39

And then I like the ultimate sales machine for just talking to people and getting them to, especially in full, know a lot of, especially in like full arch right. A lot of these patients are we know what they need, right, they want. They hate dentures. They need implants, and we're just like trying to get them to understand that you know how much better your life will be with a set of implants versus a new Ford F350 or whatever they. You know what I mean, man. Your life will be so much better than driving a cool car around they you know what I mean, man your life will be so much better than driving a cool car around, or, you know, getting that new toy. It's our responsibility maybe not responsibility, but it's it's. It's, if you want to do well in this industry, it's our job to just show the patients that, hey, this is good for your health, your livelihood, for everything. It's so much better than all of these toys combined. And I think Ultimate Sales Machine is great. Extreme Ownership is really good.

Soren: 52:35

Four Disciplines of Execution those are probably my top list, and I know Caleb loves books, so he probably has a bunch more that he could go into. But I just find that I've read all these books and a lot of them, three, four times. And if you want tips free or like very cheap CE on how to get soft skills with not only full arch dentistry but just life in general, I think these are some really, really good books and I would recommend reading them and I set them in the order of kind of like books that I liked and that I took, took a lot from and were able to implement throughout my life, whether it be in, you know, friendships, you know relationships, dentistry. So I just wanted a quick shout out that and then I would like to get into Smile. Now, what we've kind of built and where it can it, can you know, offer to not only patients but also dentists who maybe are looking to get into full arch. Do you guys want to jump in or do you want me to talk about a little bit?

Tyler : 53:37

I did want to get some textbook recommendations from the textbook Meister Caleb here on clinical as well. I remember you'd recommended the pink Bible and some different things. So if you could just name like a top three or something like that, that'd be great.

Caleb: 53:49

Um, you know. So right now I'm finishing up I think it's just called implant dentistry. It's by Dr Silverman, so if anybody has, ever seen Bart lecture.

Caleb: 53:58

He's phenomenal and his lectures are worth you know I would do 10 minutes. I would pay the same for 10 minutes of his lectures than for 60 minutes of most people's lectures, and so that one is like very much segmented and deals with very contemporary topics in dentistry, right, and it does have some old school players in it too. So it kind of like dives into some of the foundational stuff that we sometimes forget because we have so much at our fingertips with the new, new right. So I think that would be the big one. The PRF I've read both of Myron's books. Dr Myron.

Caleb: 54:37

Prf is super intriguing to me. I really love it. I want to do more with it. I think it's become a little bit less important, definitely less efficient when it comes to drawing the blood and spinning it and stuff like that, and sometimes you do get mixed results. However, I do really love what PRF can do for you and it's been really entertaining to read his books and kind of seeing the innovations of it and like a couple of things is like EPRF, like elastic PRF is. You can draw blood and we can do it where you do the liquid PRF, and then you can set it up in these molds and it creates a membrane that will last for six months. So you can actually create from your same biological materials. You can make membranes out of people's blood. So, instead of paying for collagen membranes, instead of doing like PTFE, you can create membranes from people's blood.

Caleb: 55:27

So I think that's pretty cool and I've tried it a couple of times with really good success. So those have been good. And then, man, some photography books. I don't know. I just feel like if there's a topic I'm going to go to it, it's going to be photography. I definitely read Carranza's, perio's books, and then I did the Pink Bible too. Those are, I feel like Perio is like the foundation for really good full arch. Not that OMFS can't do it, but usually it takes an OMFS that's willing to really take the time and suture as like a signature at the end, in such a way that they're they're proving that the work that they did was worth it at the end, you know. So I've I've read Holtzclaw's books, both of them, the Pterigoid book and the Zygo book. It was foundational, so I placed a couple Zygos. I do have a provider here in town, dr Stachowicz, who works for Affordable. He is very gracious with me to collaborate on cases with me. He has been phenomenal, I think, just as a human being. He's great too. There's just some of the textbooks right off the top. If that helps out, all right, let's do Smile Now.

Caleb: 56:36

Let me say a couple things. So when I was coming out I thought I came across Smile Now. First of all, I bought 100 main names, right, like, what could the name of my business be? And Smile Now was the one that really stayed with me. What I wanted it to represent was not only absolute top level clinical treatment for patients, but I also wanted it to be affordability and I also wanted it to be like a safe place for employees, right? So it's kind of a combination of the three.

Caleb: 57:09

I never, I always had. Look, when I, when I filed for my first business name, it was called Smile Now Dental Groups. All right, like from the very beginning I was thinking you know, if there's ever any opportunities in the future to kind of like do more than just me by myself, I want to do it. And part of that was being on an island, right? So from my first year there is an island. When you do full arch, you're on an island.

Caleb: 57:36

It's not like you want to be reaching out to every specialist to say, hey, look what I'm doing. It's not like you want to be kind of rubbing it in people's face. It can come across that way pretty easily, and so it's hard to make relationships when you go to the chat, like the local dental chapters and stuff like that. It's kind of hard to find things in common. In some ways I really appreciate that. Like I've had a background in restorative dentistry and general dentistry, I think it helps me a lot.

Caleb: 58:06

But now today it's dude, I don't care about, like, how fast you cut a crown and I don't really care about how many fillings you did, and I don't care if you hate amalgam or love composite, you know, like it, like it's neat and stuff like that, but it's just not what I'm spending my time doing and at the same time, so you can get really lonely. So smile now has emerged, like bringing on you guys. It's more of a relationship situation and I know that people, communities like people, thriving communities in general, like as human beings we have a hive mind and we're a bunch of termites, we're a bunch of ants, like we just really dwell well within a community, and so that's a big part of Smile Now also is having support, having people that have your back, treating you like an equal, not taking advantage of you, giving you opportunities to have ownership, real ownership with real tax benefits, you know those types of things. So I just I think that's a good start. Let's, let's see what you guys have to say.

Tyler : 59:08

Yeah, no, I think that's a fantastic start. I think you really gleaned a lot of the major points there. I think another thing that I really like about the way we're built out right now is that the leadership here at Smile Now is right here and we're all practicing dentists and we are practicing and under the exact same circumstances that everyone that's working for us is so there. So there's nothing that you know someone working for us is going to be going through that we're not. We understand these problems. We've run into them ourselves, we've done troubleshooting, we know how to handle those things and we're very empathetic to those types of situations.

Tyler : 59:44

I think in so many you know larger groups, you have people that are, you know you kind of get in this world where you're working from home a lot and you're not really getting your hands bloody and you're not in there in these cases and there can be a real cognitive dissonance between leadership and doctors that are doing this really complex and important work that you know.

Tyler : 1:00:02

It's easier to be very objective and numbers biased whenever you're not actually having to be in the office and deal with these cases and deal with direct patient care, and I think something that we take very seriously is patient care, making sure that those outcomes are sufficient and making sure that whenever issues come along for a patient, we make it right for the patient first and then we worry about the numbers in the business later. And that's something that we stand by because that's how we operate in our own offices. We're all a part of that and so you know we operate the entire group the same way. We operate our own offices and we aim to take care of patients and all of our locations. I think it's a big thing.

Soren: 1:00:35

Yeah, I love that, um, I can go. You know, I I don't know how much I kind of I kind of hate naming names, right, but we talked to a lot of Dennis inists in just so many different companies, right, there's so many of these groups that are emerging. Like I said, affordable, heartland, brightly, nuvia a lot of these groups. They, like Tyler said, they have people that aren't practicing all the time and they're having issues, from what I've heard from dentists with patient like trying to maybe like force care for patients that are medically compromised or, you know, not providing equipment necessary to do stuff like digital protocols or, you know, if the doctor wants to get into PRF or if the doctor wants to explore this or that, where that you know clinician and provider feels like that would benefit their patients. I love the fact that, as Tyler said, we are providers in our offices that have seen, basically I mean, almost everything that there is to be seen with Full Arch and we're able to very much understand those doctors, where they're coming from and how to provide care to their patients by implementing different strategies in the office. So I would say that I did a couple posts on Instagram about reaching out to us. If you're looking for maybe an opportunity to partner for, you know, maybe an opportunity to partner. And I would say that benefits that we provide for our providers are looking to partner are as follows you know, we one do have a very good pulse on our marketing. We are willing to take a risk, we're willing to try new things, we're willing to put our money where our mouth is to provide what is necessary and the means that are necessary in that market to make sure patients are getting in the door. Heard from some of these newer groups that are starting up of really difficult times with patients coming in the door because of just lack of marketing. And it does cost a lot of money to run these offices as far as marketing goes and not only, not only groups but just single providers like really struggling with getting their offices off the ground because they're not willing to spend what is necessary in that market to get patients in the door. And you know I'm in Denver, I'm in a super, super, one of the most competitive markets I would say. I mean you got Phoenix right, where every single I feel like there's a on every corner, there's a full arch practice. Denver is the heart of of clear choice. It's the heart of renew dent dental denture Anchorage solutions. We've got a really prominent new via here. One of the first ones are more affordables popping up all over. I think the new sets here just got bought out by Affordable. We got a couple of those. So I would say that I've got a lot of people in my backyard that are doing this and they're marketing this and you know it's cool.

Soren: 1:03:41

One thing I will say that's really cool about Denver is that you know all the providers talk to each other Like we are very open. We're like, hey, you know we help each other when needed. You know I love Michelle Caldwell at Brightly, Like she's helped me out in a pinch so many times and I think that's really important if you're a provider in your market, to make connections. You know it's not always. It shouldn't be a competition with all these people. Although it is on the marketing side right, it is 100%. But when there are patients that need to be treated, I think it's important to have those connections so you're able to properly treat those patients. So I think that's a big one, right, marketing is huge and I want to say that we're willing to take a risk where it's necessary to make sure that happens.

Soren: 1:04:25

The other thing is clinical workflow. So we already give a huge spiel about digital dentistry and what we think that it provides to our patients and what we think it provides to our providers, and we spare no expense when it comes to ensuring that we have top of the line equipment and we are ahead of the curve where marketing goes Luckily, equipment and we are ahead of the curve where where marketing goes luckily, you know we do have this podcast. We talk to a lot of people in the industry that are at the cutting edge of, you know, digital solutions me, caleb and tyler. We are very much, you know we love, like rick ferguson, wally renee. You know we follow these guys. We're up to date with what's going on in the industry and where you know the next best thing is and where can, we can provide that to our patients. So we love learning those things and I think that you know tyler's talking about how, like, people get out of touch. Right, they do. But the thing that's cool is we're learning these things day to day and making sure that where we see the next best thing, we'll implement that and give it to all of our providers to ensure that they have access to that so we can provide good care to our patients and the adequate equipment necessary to provide the best care to our providers. I think that's a big one.

Soren: 1:05:45

Caleb touched on this briefly but and I'm going to I'm going to pass it off to Caleb here in a second to talk about this. But providing real ownership right, there's a lot of of different ownership structures with with DSOs and all the industries. Right, gps or oral surgery, you know, implant dentistry there's when you get into the DSO level. Right, there's different means of selling to private equity that a lot of groups want to do and it's much more difficult to provide real equity. If you're planning on doing that. Our goal isn't to sell to private equity. Our goal is to have very well run offices that profit well for our doctors and I think we, you know, put our money where our mouth is and we provide that to our to. Caleb, do you want to go into that a little bit?

Caleb: 1:06:33

Yeah. So if there's one thing I hate, hate, hate, it's seeing dentists work for non-dentists like so much, right. I just think it creates this environment, like the majority of the time where it's it cannot be about patient experience and patient treatment. It has to be about dollars, right. And when somebody that's not even a lot of dentists will own other practices, right. But like when they, you got to understand that there's something built into that and that sometimes will take away from your clinical experience and be really hard on you. If you see what's really going on, I think my worst nightmare in the world is to be taken advantage of, like when I go to sleep, like the things that I dream about that give me that are nightmares, are me being taken advantage of. Hate it, right. So a couple of the things that you touched on that I'd never want to do is I never want people to feel like they're being taken advantage of, right, that they're here solely working for my benefit, because it's not like that at all.

Caleb: 1:07:35

One of the things that I really always wanted and it sounds like you guys wanted it too was like ownership, to feel like you're part of a team, feel like you're contributing to something bigger feeling like your voice is actually heard when it comes to it, feeling like you're not having to ask mom and dad for stuff all the time, just to be rebuffed, feeling like you can contribute in ways that like make a better whole out of everything.

Caleb: 1:07:59

And so, when you like Smile Now, we decided firmly that, like ownership is part of the program. We're not even looking for people that don't want ownership. If you want to come and be part of our team, like that's great, but you're going to do it in an ownership capacity where they're. You know, what we're doing is we're trying to make it easy for people to get into a really successful practice and but we're willing to do it as easy as possible for them. But it's in such a way that, like you're going to need an accountant, they're going to need to walk you through the ins and outs of, like how you can be setting money aside.

Caleb: 1:08:36

Like my situation I'm married, I have four kids. What can I do that benefits my kids? Now, what? What can I do that benefits my spouse? How much money can I put away in a 401k? How you know, like all these things, and ownership comes with so many benefits.

Caleb: 1:08:52

I was in the first three months of my practice. I was able to completely write off because of my write-offs for the startup, like all my income for those first three months, and I didn't have to pay any taxes at all for 2023. And and I made a pretty decent amount of money right. So those types of things are things that you get from ownership and you should be able to participate in those aspects of it. And then there's also, you know, when you're W2'd, like you, you are just going to get hit with the maximum amount of taxes, no matter what, and that's not, that's not how the wealthy do it. You know. That's not how people that have resources, how the wealthy do it. That's not how people that have resources at their fingertips do it. They don't pay as much as they can in taxes all the time. So I think that kind of touches on what you're talking about. Do you think I missed anything? Is there anything I should?

Soren: 1:09:41

add no, no, not at all. I just think, if you're interested in this, I do want people to reach out. We already have a lot of people that are reaching out. So I want people to understand that what Caleb is saying is very genuine. We're not looking for people that are coming out of school that are just looking for somewhere to hitch on to, to get some experience in full arch and then, you know, go do their own thing.

Soren: 1:10:05

We're looking for people that, for people that want to be with us for 5, 10, 15 years, that are ready to kind of settle down, and we have plenty of markets that we're interested in. So a lot of these markets aren't markets like Chicago or New York or stuff like that. I think that it's kind of become a time now in this industry because you know we've talked a lot about competition and stuff that if you want a successful office, you know there is a good amount of money to be made, but there are some sacrifices that also need to be made, one of those being location right, like Tyler just moved from Atlanta to Tri-Cities, washington.

Tyler : 1:10:49

I try to go as diametrically opposed to my previous market as possible, and that's one of our owners here.

Soren: 1:10:58

He's putting his money where his mouth is. He's going from, and I'm sure there was probably a lot of tough conversations with the girlfriend that happened, the fiance, that's a whole section.

Soren: 1:11:07

Yeah, right. So if you want to do a lot of arches and you want to be successful in this industry, it's going to come with a cost, and that being probably not the biggest metro area possible, I've already had a ton of doctors reach out from Phoenix and they're like, hey, I've got a family here, I'd love to live in Phoenix. And I'm like, hey, like I have got a family here, I'd love to to live in Phoenix. And I'm like, hey, man, you know, I hope the best for you, but if you're not, if you're looking to stick, stick around there, I probably would. You know we're going to pass on that just because that's not where we see ourselves going in the future.

Soren: 1:11:41

But if you are someone that you know, you might have a little bit of wiggle room as far as the ability to move and you're hungry. You've got a good skill set on your back. We would love to have that conversation with you and something that we can offer is real partnership. That means a buy-in and we can go into details when you give us a holler, but are providing real ownership and we are doing everything that we possibly can to create an environment where you have patients coming in the door, you're able to do arches, you're getting a 1099 income, that you can get tax benefits. We have accountants that we are providing for our doctors, that they can get a lot of this information about where they can get these tax benefits from, and a whole lot of other things I would love to go more into detail about on a private call. So you know, I think that that kind of sums everything up that I wanted to hit with this episode. Did you have anything else?

Tyler : 1:12:43

guys. Yeah, I wanted to just say something, just to provide a little bit more perspective to and and you know we're obviously talking up what we're doing a whole lot here. But just something I just want to bring to perspective is that you know this is not a big sales pitch for working with S&DG, because the fact of the matter is, is, what we're looking for is a few home runs here. Our whole growth strategy is so different from a lot of other groups, right? So we're not focused on horizontal growth and opening up 2030 offices next year. That's not our goal at all. We want to partner with people that are prepared to work with us long-term, who do want real ownership, who do want to, you know, really enjoy, uh, you know, all the benefits of practice ownership, and we want all these things to be home run. So, when we're talking about more rural markets and things like you know, like I've just engaged myself in, you know we're doing that because we want these offices to see to be a mirror of the success we've seen in other locations and and, uh, in Boise, like we've seen in Eugene, uh, which has been a fantastic and explosive. That's when we're that's our first, you know, satellite office and you know it's not like we're hurting for people that want to work with us.

Tyler : 1:13:47

There are a lot of people that are sending in applications and and you know it's not like we're trying to give everybody this opportunity and we're just going to open up an office for everybody, because we're so focused on vertical growth, not horizontal. This isn't just some big sell. You know we want to build some really awesome businesses with people, but I think, just in general, just to talk about, you know, if this is something you want to get into, this is a world you want to get into. There's a lot of people out there. They're vying for doctors that can do this kind of work, and one of the ways that they do that is by in treating you into this idea of owning a practice, right, and there's a whole lot of befuddled ways of giving that to you in a way that's not actually giving it to you. You know, if it takes five, ten minutes of a pitch for a company to explain to you how you own something, you don't really own something, and I just think that in whenever you're having those types of conversations with whatever group, I'm not talking about anything in particular, I'm really not Just keep that in mind.

Tyler : 1:14:35

Understand that ownership can be a lot more straightforward than that. Partnering can be a lot more straightforward than that. You can have all the benefits that Caleb's been talking about, that he's been able to enjoy in this past year, and that can be a very real thing, and I just hope that everyone kind of has that sieve as they're looking through different opportunities. Look for the real stuff. Look for the stuff that's not really that complicated, because it shouldn't be. And just like Al Caleb talked about, if all of your income is based off of W-2 income, that's just blood, sweat and tears on your way to retirement and it doesn't happen nearly as fast unless you're having actual wealth generation opportunities. You'll learn more about about if you read some of those textbooks that the storm was mentioning. So that's all I really wanted to say. You know, this was not all just a big sales pitch by any means. It's just to give some perspective and talk about what we're doing and we're all super excited about it and can't wait to work with some of you guys.

Soren: 1:15:17

Yeah, for sure, I hope. I hope I actually scared some people away with my pitch about yes, we don't want to be.

Tyler : 1:15:23

I don't want to be like I want.

Soren: 1:15:27

Tyler to not be fielding like hundreds of messages. No, just, please don't reach out unless you know you're interested in in settling down, you know you're willing to move your, you have a skill set behind you. If you see all these things being checked and I hope that I'm making the list you know long, so that you know you are kind of fielding yourself before reaching out then please hit us up and we would love to work with someone like that and I think that we could could grow something really great together. Agreed.

Tyler : 1:16:03

All right. Well, dr Caleb Stott, we covered your life, your career, your practice and now your DSO all up to this point and I really appreciate you coming on and sharing all that with us. I don't think we've ever done a podcast that you know covered in depth. You know things all the way from. You know bookend to bookend of you know the clinical tips and the business tips and everything in between. I think you did an incredible job in this. You know hour and a half and we really appreciate your time.

Caleb: 1:16:27

Thank you, Tyler.

Tyler : 1:16:30

For sure. So that wraps it up here for the Fixed Podcast. Thank you guys for listening and again, like what Soren was saying, you know, if all these boxes are checked, please do reach out to us. You can reach out to us at thefixedpodcastcom. You can reach out to me on Instagram, dr Tyler J Tolbert on Instagram. Soren has an Instagram as well. We all got Instagrams that all go in the show notes. But please do reach out, introduce yourself and even if you're not looking at partnership, just reach out because you want to talk about full art. It's what we do, it's what we're passionate about and it's why we stay late after work to talk about it. So thank you all for tagging along with us. Thank you again, Dr Stott, for coming on and talk about.