Transcript
Speaker: Dental Fuel, the podcast that focuses on what no one else is talking about. Mistakes. The dental world is full of before and afters and no one is talking about the middle. Dental Fuel brings you the unspoken in -between. Welcome back to another episode of Dental Fuel. This episode of Dental Fuel is brought to you by Well -Received.
Speaker: Did you know 69 % of patients say they would switch providers for a better experience? To level up your practice, you need to ensure your patient experience is better than your competitors. So where do you start? From the very first hello. While received is a 24 -7 answering service for dental practices. Their team of professional receptionists are on hand 24 -7 to support your callers. That's day and night.
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Speaker: On this episode of Dental Fuel, I am excited to welcome someone you probably already know, Dr. Adamo Notarantoño, who is a highly respected figure in the field of dentistry. Dr. Adamo is known for his commitment to comprehensive dental care and education, as well as his contributions to the American Academy of Cosmetic Dentistry.
Speaker: We kick off the episode by talking about Adamo's exceptional career and how he became the Dr. Adamo. If you're like me, you probably think he doesn't have any mistakes, but Dr. Adamo shares some of the mistakes he has made along the way. Let's tune in. Adamo Notarantoño, welcome to Dental Fuel. How are you doing today? I'm doing very well. Thank you for having me.
Speaker: I am stoked to be connecting with you today. I am a huge fan, and I'm so excited to be talking about some mistakes that you have made, as I mentioned in our pre -conversation. I don't believe that you've made any, but I'm excited to see what you have to share for me and for our guests. But before we get into it, Adamo, how are you doing today? I'm doing very well. I'm doing very well. It's not so sunny, but sunny Las Vegas today, teaching a course this weekend. I arrived last night,
Speaker: I'm here until Sunday, so looking forward to the weekend. That's great. Well, welcome to this side of the world. I'm down in Texas, so we are close, geography -wise, as opposed to where you usually are. Yes, exactly. Before we get into these hot questions about mistakes, I would love if you would tell me and our listeners a little bit about yourself.
Speaker: How far back do you want me to go? Cause there's a lot of mistakes that happen along the way. I could get you started right on that train. Um, I would, I would, I would love to know a little bit about you and like your practice setting now and how you got to that point. Okay. So my story is a little interesting now you asked at a interesting time because I am, uh, I just,
Speaker: sold my or stepped down as a partner in my office. So I started in my practice in 2004, right straight from my residency. And I worked, I got hired by my dental school attending who had a fee for service practice in the town that I practice. And now I was the fifth associate at the time, I was the first male he ever hired. So I worked there for
Speaker: about four years and then I became a partner with him. Two years after that we took on a third partner and then
Speaker: The four years after that, the new partner and myself bought out the original owner and he left the practice. So it was myself and my partner, Dr. Fagari, Larissa Fagari. She's an awesome dentist. She's a quiz mentor, very well -trained doctor. And I knew her from dental school. So from 2014 until about two months ago, we owned the practice together.
Speaker: with the transformations in my life of lecturing and now being faculty at the Koy Center, I'll be spending a lot of time out at the center. The education side of my world got a lot bigger than
Speaker: I could handle. So I felt like something had to give. I worked two days a week in the office, even though they're 12 -hour days, and then the rest of the weeks on a plane. So I really didn't think it was fair to my team and to my
Speaker: partner to keep ownership because there's a lot of stuff that needs to be managed that I'm just not there to do. So I thought for myself and for the practice, I stepped down my associate who is amazing is now partner with my
Speaker: former partner. I don't like to call my former partner because she's always going to be my partner in my heart. Um, so yeah, that was, uh, how I ended up where I am right now. And it's super, super new. Um, it's scary. It's exciting. But, uh, I think, I think right now for me, trying to balance, um, a little bit of life, which I don't have much of at this point and, um, balanced ownership and my education schedule is insane. So.
Speaker: something had to give and I think I made the right decision in that direction. I remember when I first heard that you were working these two 12 -hour days and I was just kind of blown away. That's wild. I mean, I think that it's kind of cool in theory, but I can only imagine that those days and probably some of those days were kind of long for you all.
Speaker: Yeah, I mean, I used to do, when I was an associate, I did 12 hour days, Monday, Tuesday, Wednesday, Thursday, nine to three Friday and eight to two Saturdays every week. Wow. So I was used to the hours and then eventually I cut down and, you know, I,
Speaker: Actually, next Wednesday is my last Wednesday, and then I'll go down to two long Tuesdays. But I would do eight to eight Monday, Tuesday, and then eight to five or six on Wednesday. So it's a lot of hours packed in a day. And then, you know, jumping on a plane, and even though that life looks, it looks very glamorous on social media. It is not. Living out of a suitcase is not all that fun. So I think it was a good decision to free up a little time for me to breathe a little bit.
Speaker: Yeah. Well, I'm excited that you will have some bringing time, but I'm also excited to see what more knowledge you have to share with all of us lay people who need all the knowledge that we can get so that way we can become better clinicians. But it's only here. Go ahead. Yeah, go ahead.
Speaker: Oh, well, here at Dentalfield, we are dedicated to talking about our mistakes and learning from those mistakes and together collectively growing from them. And like I mentioned, I'm really excited to hear, you know, some of the mistakes that you've made and how they have shaped you as a clinician and how you're taking all of that forward in this new chapter for you. But, you know, kicking it off, clinical mistakes. We're in the clinic. We are learning. It's the practice of dentistry. What's a clinical mistake that you can remember that stands out to you that you made that really transformed the way that you've practiced dentistry?
Speaker: So I think one of the clinical mistakes I've made and it's haunted me over the years and sometimes I still do it. I'm a lot better at it now is I think the best word that I learned clinically is the word no. As you grow and as you get better and
Speaker: you feel like there's nothing I can't do. And that's probably true to a sense, right? I mean, I'm a pretty well trained clinician and I feel like there's not much that I can't do. But the question is, is that the time and the place to do it? So there are a lot of cases that I took on and I don't, not many people know this about me, but I am,
Speaker: big into surgery. I do a whole boatload of surgeries. I do implants, grafting, everything. There was a handful of cases that I just took on the whole case because I was like, why am I going to refer it out? I could do it just as good. And it wasn't the clinical part of it that was the problem. It's what happens after that. I mean, we don't really think about
Speaker: the after effect in the sense that what is the patient doing when they go home? Do they smoke three packs a day? Do they lie and they chew on chicken bones? And you know, you do all this beautiful implant work and grafting and then they come back with eight failed implants and like, well, I have to repay for it because I didn't know that. And then, you know, if when they go, you feel obligated, now you're redoing work that's costing you a bundle and you're doing it because you feel bad and the patient feels bad and you don't want a bad reputation. So I think,
Speaker: one of the biggest clinical mistakes I've made is trying to take on too much all the time. There are times when I know I can do it and I feel comfortable. And there are times where I should have probably punted to a surgeon, not because I couldn't do the procedure, but because it's very hard to manage so many different things that more complex a case gets, right? So full mouth rehabs,
Speaker: managing the restorative part and the surgical part is not very easy. Now, a single tooth is one thing or two teeth is another thing or a quadrant. But when you start managing occlusion and then habits and then surgeries, I mean, it's too much stress, right? So for me, if I could go back and the cases are doing okay, I would probably not have done all the work that I did on these people because it stressed me out too much.
Speaker: Yeah. I love that. I feel like, uh, with a, I guess earlier this year we spoke about, you know, the, the theory and the thought of being a super dentist and wanting to do it all and wanting to keep it all. Uh, but the emotional energy that you oftentimes have to put into these cases can be kind of challenging. And I think that it takes a smart and very brave person to recognize that and to kind of know your limits and to know that oftentimes you're better off just managing a certain
Speaker: Portion of it then the entire thing where you know, we know that many complications can come along the way Especially with big procedures like this like a full mouth rehab Yeah, I mean I had two consults yesterday for two full mouth rehabs and I mean I could have extracted the Wisdom teeth they were erupted and not near a nerve and I could have done the endo on 31 on one of them and they were like you don't do it I'm like nope everything goes out and it's only because I didn't want to manage all that and
Speaker: I didn't want to manage them. And then I didn't want to have to worry about every single aspect. So I know that I'm good at restorative dentistry. And I think I'm a good surgeon as well. But again, there's times where I don't want all that management on very high maintenance patients, right? It depends on the human being as well. So there's the psychological part that you learn over time.
Speaker: When red flags come up and went to avoid them and I had a couple sets of red flags yesterday, so I punted out a lot of work that I just don't want to deal with. Smart man, smart man. Adamo, I got to know what courses, who taught the master? What courses have you taken in your career that have transformed your clinical skills?
Speaker: Transform my clinical skills. I will say, so first and foremost, I believe in foundation. And I think I got a great, great foundation at the Dawson Academy. That was one of the first biggest CE I ever took. And I got a really good understanding of occlusion. But I think the biggest influence on me is John Cois and the Cois Center. I can't,
Speaker: say enough how much he's changed not only my life, but every dentist I know that's gone through the center. So he was very influential on me in that sense. In terms of aesthetics, the AACD was enormous for me. I mean, I remember many hands -on courses I took that I walked out loud. One of them would be Brian LeSage and Frank Milner teach the case type five hands -on composite course. That was pretty life -changing for me.
Speaker: And I had a phenomenal, phenomenal mentor, who's now retired, who practiced about a mile away from me. And he took me to Dawson and he took me to ACD. And it's kind of interesting because you would think he's competition, right? Because we're about a mile away. But when you're that good, there is no competition. He was just unbelievable. And
Speaker: and had, and still has an amazing reputation. So he, uh, I used to go to his office with models and I used to show him cases and he was very influential in me and helping me what I do. Um, you know, the courses were great and I do believe that they were life changing for me, especially the hands -on. Um, but what I think the difference between what I got out of them and what other people got out of them,
Speaker: is I went home and I practiced on that typodont for months and months and months and months till I could do it blindfolded. So I think the speed I have in clinic and the expertise I have with certain materials such as composite, which I think I do pretty well.
Speaker: is not because I'm better than anybody. It's because I worked really hard at understanding everything about composite and I practiced it to a high level. It's not just that I learned it from high level people, which is what we need first, but you know, not everybody
Speaker: goes out in the same direction. And I think what you do after the course is super, super important. For example, if you leave the Koi Center and you don't implement anything, then you just wasted the $12 ,000, $10 ,000 that it cost you for the week. So I think implementation and practice is huge. And I think people overlooked that they think because
Speaker: We're doctors. We don't have to practice. Once we do it once, we're awesome. And some people are. But to do it at the highest level, it requires a lot of work outside of what everybody sees. Aside from the hand skills and practicing over and over again, how did you personally build that confidence to take the knowledge that you gained and implemented in a clinical setting?
Speaker: I think it's just a mindset. I think you have to believe in yourself, you know, and you can't fear anything. And I think I see that a lot in some of the people that I educated and I educate now.
Speaker: in the course, they're fearful. And I'm like, listen, don't worry what you do to this thing. It's plastic. So practice on this thing 50 times. And then once you get to that confidence, and you're like, wow, I did this in 20 minutes, not now three hours, you start to implement and check, you just have to go into it. I mean,
Speaker: Let's, I hate to make this statement, but I'm gonna, it's a tooth. I mean, how bad are we really gonna do to the composite on that tooth? You tell the patient, you know what? I don't really love this, I'm gonna redo it for free. So you practice again, who cares? I mean, we're not doing brain surgery where we're gonna cost a life, you know? And most patients love what we do when I hate it and they're like, oh, it's amazing. I'm like, oh my God, don't tell anyone I did that and I'll redo it for free. But you just have to, you gotta just get out and do it. You have to,
Speaker: Really, again, you have to continue what you learned on Friday, Saturday in a class, practice it on Monday, Tuesday, and do it on someone on Wednesday. And yeah, take baby steps, but it's a mindset. If you don't believe that you're going to be able to pull it off, it's over before it starts. So I go into every procedure thinking that it will be the best MOD I've ever done in my life. Now, sometimes
Speaker: It is and other times I take a post -op bite ring and I'm like, oh my god, that's atrocious So, you know it happens to the best of us I had somebody shadow me not too long ago and I inserted an on -light and sure enough the distal was open and I didn't notice So, you know, I told the patient come back and I looked at that person I go look you came to shadow me even I make mistakes So don't think that I don't the key is it recognize it next time why did that happen? And I know exactly why it happened
Speaker: So I won't make that mistake again. And that's the important part of learning and growing. And I think people just are afraid to make mistakes, but you don't realize of all the posts of mine you see on Instagram, there's a thousand of them that don't look that good that I made mistakes on that I learned from and redid over and over again, until I got them to look to that level.
Speaker: I think we need some t -shirts that say it's a mindset. I think that that's excellent. Really, really, really great pearls there. And man, I have so many clinical questions and we could make this entire episode a clinical episode, but we have other mistakes to go through. Are you ready to level up your patient experience?
Speaker: Be sure to visit wellreceived .com slash IgniteDDS to find out how you can master patient communication and offer exceptional service 24 -7, 365 days a year, while getting valuable time back to focus on growing your practice. Be sure to tune into our next episode where Dr. Adamo and I talk about a financial mistake that he has made during his journey of dentistry.
