The Future Of Dentistry
Does the ADA Need a Good Publicist?
with Dr. Ron Zeidler
Going to the dentist is mostly regarded as an experience to avoid. It immediately awakens a fearful feeling in most of us, so much so that we do everything to stay away from that office. We know very little about dentistry. It is not in the news much and teeth are usually the very last thing we take care of until it involves pain. I recently sat down with Dr. Ron Zeidler who brought me up to speed on what has happened during the last few years, and I learned that the technology relating to dentistry was going through a very interesting phase of evolution.
Dr. Zeidler explained: Up until the end of 2008, when the economy was going strong, we went through the cosmetic revolution. Everybody wanted veneers, smile makeovers and other procedures largely influenced by shows such as Extreme Makeover. The dentists who appeared on the show came out with a whitening product called Zoom! It became so popular because of the show that everybody knew the name. So the question in everyone’s mouth was ‘Do you do Zoom!?’ People were coming in and doing these cosmetic cases, getting their money from the equity in their homes. They were pulling a lot of money, that’s why everybody was going through such a boom. I didn’t have to convince anybody that they needed anything, Tthey would come in, “I want it,” and they would do it and they would pay for it and be done. We made a lot of money at that point. Then, all the banks started cutting back and by January 1, 2009, when it came to dentistry, and plastic surgery, it’s as if somebody put big signs up that said, ‘don’t come here anymore.’ Plastic surgery was down 90%, dentistry 70%. And then after the economy tanked, the whole real estate market tanked as well and people started losing their homes.
Everybody has changed their ways of spending completely. This has been going on for six years. And in the last couple of years, it’s been trickling back, and more and more people are coming in, but hardly anybody’s doing anything. Everybody wants to know to the dime what things cost and a lot of people lost benefits and insurances. Nobody wants to do anything. And I think the world has become such a complex and stressful place these days, that people seem to save their money for pleasurable things —entertainment and vacations, even though dentistry might be necessary.
We live in a very, very different time today. I don’t care what they say on the news — the recovery is happening at a snail’s pace or not happening at all.
Meanwhile, it’s as important to talk about a beautiful smile and getting a makeover as it is to talk about the high-tech that’s available today. It’s almost like we need to go back to basics, because the ADA — which is the American Dental Association — has done a horrible job keeping dentistry organized and united. And as a result, their membership is almost non-existent now.
What happened?
Everybody just doesn’t want to be members anymore. And what has happened is because the economy tanked, guess who came into the picture? Groupon and LivingSocial and the LA Times and this and that. Their coupons for 90 percent off and all that is great for the consumer.
But they don’t have the best.
I know. It’s great for the consumer, but the problem is, because it’s in our face all the time, it has completely removed value and this is a huge thing. It completely removes the value in dentistry, of what dentistry has to offer. It has reduced us to the level of nothing, and why? Because if you come in for a cleaning exam and x-ray, and a cleaning costs like $110, and then somebody down the street is offering a Groupon for $19 for a cleaning…
My hygienist costs me $70 an hour, between her hourly insurance and taxes. If I gave my cleaning away for twenty bucks where do I get the rest from?
With the price of advertising, Groupon keeps half. So if they advertise a cleaning for $20 or $30, they keep half and the doctor gets $10 or $15. He’s losing a ton of money every time a patient walks in.
Why can’t dentists do the same thing, like a “special of the month.”
Well, no, because that’s what I’m trying to tell you. The forces that came into play in this down economy have ripped everything to shreds. It became about survival. Do you know that in like Las Vegas, over the last few years, over 200 dental offices have closed? People have no work and here, people are struggling. Every dentist I talk to, they’re struggling, and I’m having my share of issues, too.
So what can we do as a society?
That’s what I’m saying about back to basics, even though maybe it’s not as fancy, it’s still something interesting to write about. In these troubled times, we still have to remember to come in to get a cleaning done, because the gums are what keep our mouth healthy. I get pregnant woman after pregnant woman talking about baby products. Do you know that with pregnant women during their pregnancy — because of their hormonal changes — their hormones drastically affect the gums? And women who have had one or two babies can develop severe gum disease, which can take 20 years to develop normally in a person, but in a small amount of time when they’re pregnant. And once you have gum disease, you’ll never get rid of it, so they’re supposed to come in every three months during their pregnancies, or every two and a half months. Most pregnant women stay away from the dental office completely during their pregnancies. They don't even know it.
Why not organize seminars and teach people?
Because people are not that interested. America’s built in a different way. In America, everybody is either chasing a dream or we’re like a retail society where we constantly buy new things. Would you rather hear about the new iPhone 6, or would you rather hear about how a healthy mouth will keep you alive for a long time?
They have related all the bacteria in the mouth to a lot of your health problems — heart disease, everything. That was a huge thing when it came out, and it’s still a huge thing, but no one’s paying attention. So you have two things going on here. On one hand, you got the whole high-tech thing, which a lot of people either can or can’t afford today, or don’t want to afford today.
And then you have the thing where there has been quite a loss of patient pool. I’m not saying I necessarily lost (these patients as patients), but they just don’t come anymore. They’ll reappear in two years or three years, or something, when there’s a problem. So dentistry is going through a very interesting time. Again, I’m going full circle, because on one hand, we’re at the most technologically advanced stage ever in dentistry. Ever. And at the same time, patients are not coming in to do anything.
Can’t you join forces with companies like Crest or Colgate or Rembrandt?
Unfortunately, they kind of stabbed us, too. They went behind our backs. I don’t hold grudges or anything, but this is America. It’s all about greed; it’s about making money. So Crest, for instance; whitening was so huge and companies like that were backing up the dentist. Then what does Crest do? They come out with Crest White Strips.
Right, but that doesn’t work.
The public doesn’t know that. They did such a nice job marketing it. The way whitening works is that you have to have a good quality, high-concentrated material in contact with enamel for a prolonged period of time under an isolated state, meaning no dilution with saliva and all that. What is Crest White Strips? If you’ve ever used it, it’s a band-Aid. I’m sure the material is quality, but it’s a band-Aid. How strong do you think the percentage is of the stuff you get from a dentist to put in these trays that they can whiten?
I have no idea.
Okay, the stuff you get from a dentist is around somewhere between thirty and thirty-six percent. The strongest you can ever use is forty percent, and those are used in the in-office system, like the Zoom! etc. How much percentage do you think Crest White Strips has?
0.05 percent.
It has 1.8 percent. Not only does it have 1.8 percent, it is a completely open band-Aid, which immediately gets diluted by the saliva and it’s not isolated.
Yeah, it doesn’t work.
Doesn’t work. But they went behind our back and they just took that show to the market. And now people don’t understand. Why should I go pay a couple of hundred dollars to get my teeth whitened when I can go get Crest White Strips for $30? It’s a retail society we live in and everybody wants the best price. It’s all about price here. Like if you wanted a Samsung TV, you can go to Costco and Best Buy and Sears and all these stores, and they all have the same TV. And of course you’ll buy it wherever it’s cheapest. But guess what, you get the same TV.
In dentistry, it doesn’t work like that. Let’s say you need a veneer or something, and the veneer is, let’s say, $800 or $1000 — whatever the cost is. And somebody is advertising $289 veneers — the perception people get is not, ‘Oh, this is an amazing deal.’ They have the perception that this guy is good, and all the other dentists are ripping them off, you see. And that’s where the ADA really screwed the dental profession. For example; implants are a big thing today. To get a good quality implant, you will pay between $1,800 to $2,500 per, however; I don’t know if you have noticed billboards all around town advertising cheap implants for $395. These are dentists that go and get a two day weekend course, in placing implants, and then why do you think it’s so cheap? It’s because it’s a no-name company from Korea or China that wants to emerge into the market. What they do is they train the doctor over the weekend, and then they give them everything for free, and they say, ‘here, go experiment on the people.’
I just heard a very, very interesting statistic from one of the specialists that I use. Because implants are very, very successful today, we’ve gotten them up to about a 98 percent success rate. They’re really amazing. With all the introduction level, all these no-name, cheap implants being put in by improperly trained dentists, he says the success rate of implants now has dropped to about 70 percent. And he goes, ‘These specialists, all they’re doing all day is fixing other people’s work.’
And it’s crazy. So again, where’s the ADA? The FDA is always regulating everything. Where is the ADA saying, ‘Hey, you can’t advertise something like this.’ They have to protect the public, so there’s a complete lack of organization and organized dentistry, but that’s not what I’m here to talk about.
Do you feel a duty to be the messenger?
People need to know. They need to know what’s right and what’s wrong and what’s good and what’s bad.
Where do you think people’s education should start?
There’s only one way to do it in this country, and it’s through the media. You know who put on a beautiful program? Kaiser. Kaiser revamped all of their hospitals and buildings. They remodeled from the outside; they look beautiful. But what they did was they put on a marketing campaign mostly through television ads and what they created was this whole marketing campaign, that’s still going on, about prevention. Amazing commercials to the point, clear, beautiful. Just really, they got the point across.
Well, what about going to the toothpaste companies?
Look, anything is possible. The one thing that I know, and you can ask anybody in today’s real world, is that when it comes to doing business, when it comes to acquiring new clients, nobody knows what works. All the consistency is gone. It used to be consistent; we used to have consistency. And now the biggest complaint you’ll hear from anybody is that there’s zero consistency. One month it’s up here, one month it’s way down here. Did you know that 60% of the population still does not go to the dentist? You know why? Because they don’t have a perception that there’s a problem.
However, I do understand, but you have to go to a good dentist, because going to a bad dentist may hurt you more. They may really do something to you that is going to really create a problem.
That’s another thing, you see. 1-800-DENTIST, for instance, advertises to the public that they find the best dentists in the neighborhood and in certain areas, and they check them out, and this and that. That’s not true. The way 1-800-DENTIST works is they have a limited number of dentists that they will allow in each area, but they want $2,000 a month, a minimum six-month contract signed. And whoever can pay is the one who gets on that list. They don’t go and find the best dentists in the area; it doesn’t work like that. It doesn’t work like that at all. It’s all about money — who can afford to pay.
The entire dental insurance policy needs a makeover as well. Most insurances do not cover anything except a cleaning. What are your thoughts on the matter?
That’s another thing: people are stuck to this dental insurance thing, and they say, ‘Oh, I don’t have dental insurance, so I can’t do it.’ Dental insurance, which started in the 50s, has always sucked and it has never changed. I don’t know if this will ever happen, but people have to sort of separate themselves from this whole thing of dental insurance, because dental insurance is like somebody coming up on the street to you and giving you a coupon, ‘Here’s $500 for your dental care.’ It’s not worth it.
On a positive note, I understand that dentistry is advancing at an incredible pace.
Dentistry right now is in its most advanced stages, and so ahead of its time that the public cannot comprehend it.
What does it mean that it’s so ahead of its time that the people don’t understand?
Dentistry has become digital today, which means that it’s much less invasive.
So does it hurt less?
Yeah, it has become painless. But the big technology with dentistry is the whole art of it. It’s kind of hard to explain it to somebody who doesn’t understand dentistry, and that’s why people don’t understand it. You know how in medicine, you have the CAT scans and the MRIs and all the 3-D imaging that allow us to see things that we could never see before?
So far I follow.
So up until now, in dentistry, if I wanted to make a crown for you, I would have to fill your mouth with a bunch of goop and take all these impressions and send it to a lab, and they’d take two weeks to make it. Today, if you need a crown, I still have to prepare the tooth, but then I take this wand and I put it in your mouth, and we take a picture of the tooth, and it creates a digital image of the tooth — a virtual image on the computer. It’s like special effects in the movies, and it’s an electronic file. That electronic file gets transferred over the internet to a 3-D printer and it mills the crown.
Dentists can purchase these machines for their practice. They are very expensive, but if you can afford it, you have access to the full system. Result; I put the wand in your mouth, and within seven minutes, I have your crown. The machine mills the crown on the spot. The other system — which most dentists use these days — is that the labs that used to make your crown by hand have these machines now.
So then you just send them the file.
Correct, Instead of taking all of these impressions, you send the file over the internet and it mills it. You don’t have to wait two weeks. It would be nice if every office had the milling machine, but these machines are anywhere from $150,000 to $200,000.
Where are these machines being made?
They’re made in America. There are a lot of different companies that make them. The biggest one is called CEREC
One great thing, progress continues in the right direction, therefore hope still exists. Dentistry should be at the forefront of reforms. Meanwhile, if anything, consult a dentist at least for a cleaning and speak to them about getting on a plan which works for you. As we just learned, it is essential to your health.
Dr. Ron Zeidler was born in Israel. In 1972, he migrated to Los Angeles with his family. Following in the footsteps of his parents and grandparents. (Entire family is in medicine and dentistry), Dr. Zeidler received his Bachelors of Science degree from the University Of Southern California in 1984, then his D.M.D. degree from Tufts University School of Dental Medicine in 1989 before becoming assistant professor Department of Periodontology USC Dental School between 1990-1995.
Giving back to the community, he volunteered his services to LA Free Clinic before starting a private practice, Inc. Located in Century City since 1990 and specializing in Cosmetic, Reconstructive and Implant Dentistry.
Dr. Zeidler resides in Sherman oaks raising 4 daughters Zoe, Mia, Ava and Noa.