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861: Dental Lab Secrets Exposed: What You Really Should Know About the Best Dentist & Lab Tech Relationships – Dr. Christopher Mazzola, Dr. Charlie Ward, & Joshua Polansky

Do you ever wonder what your dental techs really think about you? In this episode of Clinical Edge Fridays, Kirk Behrendt brings back Dr. Christopher Mazzola and Dr. Charlie Ward to pick the brain of Joshua Polansky, owner of Niche Dental Studio, to answer your burning questions and to reveal the secret to a great relationship and partnership with your dental techs. To hear one dental tech’s advice for becoming a better dentist, listen to Episode 861 of The Best Practices Show!

Learn More About Dr. Mazzola, Dr. Ward, & Joshua:

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Main Takeaways:

  • Don't be an asshole or an “ask hole”.
  • Stop making the job harder for dental techs.
  • Communication is key. Be open and receptive to feedback.
  • Manage your expectations. A great lab doesn't mean perfection.
  • Every dentist needs to go through the pain of developing their own style.
  • Set realistic expectations for yourself, your dental techs, and your patients.
  • For the best possible outcome, dentists and dental techs need to work together.
  • Social media is a highlight reel. Don't compare yourself to something that isn't real.

Quotes:

“When we think about planning complex cases and interdisciplinary treatment planning, the ceramist gets left out of that. The technician gets left out of that. I don't do any complicated cases or treatment planning without talking to Josh. I have to know, in order to finalize the plan — we had this conversation yesterday. We had two conversations. We had the implant conversation on something, that the design was off, and then we had a conversation about a complex plan that I'm presenting on Monday that, ‘Hey, what's this going to look like? We have to open vertical. I need to do ortho. I need to do these things. What sequence would make sense for you guys to make sure I get the design back that I want to?’ So that, to me, is a piece that's missing. We teach it at Pankey in the aesthetics class, which Josh teaches with me, that you need to find a ceramist that can deliver the type of work that you want and that you can have a relationship with to have these conversations, because they're going to have to deliver that case at the end for you. So, just like you're going to talk to perio and you're going to talk to ortho in these complex cases, the ceramist is 100% a part of your specialty team.” (7:21—8:37) -Dr. Ward

“People treatment plan in a silo. So, they're by themselves. One thing that we see quite a bit of is a lot of people have this knowledge. They can rattle off the facts to you. But when it comes to treatment planning and then setting up a plan and executing it, the confidence disappears. I think it's because, a lot of times, they don't know how good they are — and it's because they don't have working relationships with specialists like dental technicians. I know I've worked with Josh and I've spitballed some things. It's never like, ‘Hey, man. That's a terrible idea.’ It's like, ‘Okay, I see how that would work. I've also seen it fail this way, this way, and this way,’ because for every one case I do in my career, he's got 50 that have come across his desk — at the minimum. So, I think building that rapport with someone, whether it's another dentist, or your ceramist, or whomever, to be able to find that conversation is what's important. Josh knows we know what we're doing. But I know that he really appreciates it when we pick up the phone and he can put his input in to say like, ‘That's a great idea. But turn this way just a hair, and it's going to be so much smoother for me, you, and the patient.’” (8:53—10:22) -Dr. Mazzola

“A dental technician wants nothing more than to have dentists that “know what they're doing”. But I think, as a technician, what I appreciate the most is that I know these guys know that I know what I'm talking about. Meaning, I think dental technicians have a really big fear to voice their opinion because, on the totem pole, we're down here. We're at the bottom. I've definitely, I guess through hard work, punched my way up to the top to get their respect. But once I've gotten here, I appreciate the fact that I have dentists — and man, if you had access to my email, you would really see, I don't want to say how insecure, but the questions I get are very basic. But at the same time, I think from a maturity standpoint, I can step back and look at them with no judgment, that maybe I am their only resource because they're embarrassed to ask their colleagues or they're embarrassed to ask specialists. So, you'd be surprised at what I'm asked on a daily basis from dentists. I don't judge them because, at the end, they should grow and evolve and get better. But I think that I've appreciated, as a technician, that I am reached out to a lot. Before, it used to be a lot of pride. Now, I think it's better for the patient and better for the outcome because, in the end, the treatment plans are usually a combination of something the doctor wanted to do and something I wanted to do kind of melded together.” (10:30—12:00) -Joshua

“We work in an incredibly stressful environment. Technicians do behind the scenes, so you guys don't see our stress. So, you automatically think what we do is so easy — I just open a drawer, take teeth out, and close it. It's not that easy. But at the same time, I have to respect that you guys work in an incredibly intimate environment where it's very stressful. So, both of us have our own stresses. And I'm not going to work with somebody that — you know that whole thing of the abusive husband who comes home and kicks the dog? I'm not going to be the dog because I'm only here to help. If you make my job harder, you're an asshole, and I don't want to work with you. And here's the issue, and a whole other rant. That is the problem with dentistry, is because there are tons of labs that will work with the assholes, so they never change to become better, which in turn doesn't allow better dentistry to be done because that's just the way they do it.” (13:08—14:07) -Joshua

“I can't work with people that really make our job harder because, at the end, it doesn't give a good result from us. When we pick up a case at the lab, we want to feel good. When I pick up a case for Chris or Charlie, I want me and my team — not to smile, because I don't want to get cliché. But I can tell you my team likes Charlie Ward. He comes to the lab, and he sends us cookies and stuff. They like him. Never going to name names on a podcast, but there is definitely a group that when they see their case pan on the bench for the day, they're like, ‘Pfft. I hate this guy.’ I think you don't want to be that. For the young dentist listening to this podcast, you don't want to be that to the laboratory that is, in turn, the person who wants to make you look good.” (14:07—15:00) -Joshua

“My closing remarks on what an asshole is is that one of my old lab buddies owned a pretty successful lab in Georgia. Terry Fohey, he's a good guy. He's retired now, but I always went to him for business advice. He's from the South. He told me, ‘You want to work “foxhole dentistry”.’ He says when we're at war, and we're in the foxhole, and people are shooting at us, you want somebody that's going to look at you — and I don't want to say that, but there are situations in dentistry where the shit has hit the fan. You understand? Like, the hybrid cracked, and the patient is in the chair. It's not “war”. Let's not get crazy. But we're in the shit together. I need somebody that's going to look at me when the shit is going down and say, ‘Hey, man. Let's regroup. How do we get out of this?’ I don't need somebody yelling at me. Because if I was in the foxhole, and I was in that situation, and I had some guy yelling at me, I would take the gun, shoot him real quick, and then go back to war. That's hypothetically what I’d do with some of the doctors, is boom, boom, boom, and then we keep going.” (15:01—16:08) -Joshua

“What Chris did, we take that for granted. It is very complex, what he just said, transferring all that data from Michigan to a bench in New Jersey, and then back, and have it all fit, and using digital. I'm amazed all this stuff even works, sometimes. It is extremely complex. So, when working in such a complex situation, we've got to be on the same team, to emphasize what I was just saying. We have to be friendly. We must, or else we're working against each other, not with each other.” (17:23—17:56) -Joshua

“The expectation seems to be that if I work with a great lab, I'm going to get something back and never have to adjust it. It's impossible. It's a miracle any of this stuff fits to the degree that it fits. I don't even understand how it happens. But we get it back, and you can't take it from the digital world or the analog world on an articulator and then expect to put it in a mouth with soft tissue and muscle and bone and expect it to fit exactly how it did on the articulator or in the digital design. It's not going to happen. You have to do some work in the mouth.” . . . It's an unrealistic expectation that we have, as a profession, that things are going to come back, and they're going to drop into place.” (18:00—18:52) -Dr. Ward

“What you guys do is extremely hard. Dentists have very high expectations. And again, that puts those expectations on us. But we have to really determine, what are realistic expectations? I think sometimes we forget that we're making human body parts that have to function. A lot of people refer to lab technicians and ceramists as artists. I am not an artist. What we do is very technical. There are real things involved. It has to work. Art has no rules. Like, this behind me is art. There are no rules to this. If you want to take a picture of a heavy metal guy with no shirt on — it's art. The teeth I make have to work. They must function. Especially working with the caliber of dentists, either Kois, Pankey, or Spear, these people are on a different caliber, and they're checking things a lot differently than like a Medicaid office. They're really checking our work, so it has to work.” (19:06—20:09) -Joshua

“As an owner of a lab, I would say almost 100% of new clients, it's always the same. ‘I'm totally open. If you see anything wrong, call me. Please tell me if I could do anything better.’ It's always the same. I've become so numb to it because we do reach out, and a lot of them are saying, ‘No, it's fine. No, it's good.’ And you're going like, ‘What?’ So, that's not an asshole. That's what we would call an “ask hole”. They ask us questions. And then, when we answer them, they ignore everything. That's also difficult to work with.” (21:04—21:43) -Joshua

“There's been a doctor that we work with, and we're doing a lot of single central matches. We explained, ‘This is how we can get you the best match. Please don't use the filters on your camera because the filters are more for like “after” glamorous pictures. It's not good for us to read color. And they say, ‘Everything is okay. No problem, no problem. Everything is all good.’ We get the central. What is the picture? It has the [filter]. That's where it gets a little frustrating because, long term, I don't see this working. We're not even giving you criticism. We're just giving you general like, ‘Hey, this is going to make it better.’ When that's ignored, that's no good. So, I think that a lot of clients say they're open. The advice I would give is, really be open. Just listen. And you have the right to disagree. That's fine. But you should be receptive to . . . Like, I'm not going to tell the tailor how to make my clothes. Could you imagine if when I was getting my car fixed, I was like, ‘I don't like those screws. You should use those screws.’” (21:44—22:48) -Joshua

“Most lab owners have very thick skin because — I'm very fortunate. When we do a great job, they call me. When we do a poor job, they call me. They communicate all that. But I would say the majority of lab owners are only getting the problem calls. So, they develop thick skin over time. The issue is, it’s not that we don't care, but we hang up the phone and we move on to the next problem. But for you, as a dentist, that's still a problem. And you're beating yourself up. I see a lot of dentists wind up beating themselves up, and that's where the burnout comes from. That's where the depression comes from. It comes from them thinking it's their fault, they stink, they fail. And I think it's because they're not open. They're not receptive. That's my opinion. I don't know if I'm right or wrong, but that's what I see, from an outsider's perspective.” (24:36—25:21) -Joshua

“There are expectations that we need to set with the patient, and there are expectations that we need to set with the lab. We were talking a little bit about shade matches and colors, especially for doing single anterior teeth. That's difficult. I mean, it's my job as a dentist to prepare the patient for the fact that, ‘Hey, we're going to try this in next time. There's no guarantee this is going in. This is one of the most difficult things that we do.’ So, if I don't do that properly and the patient is not prepared, then nobody is happy when we try it and have to send it back to the lab. Josh is expecting to get that back. It's so hard to do it on the first try that it's probably going to need to be adjusted if you want it to match the way that we're trying to do the dentistry. So, there's an expectation that he would set with me that, ‘Hey, we're going to try this in. We've done everything. You sent me everything that I need. I've set the patient up for that so that they know, ‘Hey, we're going to try this in. I want it to be as perfect as possible.’ So, there are expectations on both ends that need to be discussed and then followed through with. Then, afterwards, we figure out, ‘Hey, was there something different either one of us could have done to make this better?’ That's why Josh gets a call, whether it went great or whether it went poorly. ‘Hey, why did it go so great?’ Let's have that conversation.” (25:22—26:43) -Dr. Ward

“[Social media] sets unreasonable expectations, in my opinion. They're unreasonable. And what I mean is this — I can tell you this firsthand. I work with a ton of dentists, and I work with very talented dentists who have young associates. Those young associates are in very good places. They can learn so much there. They get the right patients, fee-for-service, all that. Those guys and girls follow my Instagram and see the stuff we're doing because I'm pretty active being out there, lecturing and whatnot. And for some reason, I think it always comes to the grass is always greener, where they pull me aside and they're like, ‘Hey, man. We don't do that here. It kind of stinks here. What are you doing? Why are you doing that?’ And I just want to kind of [slap some sense into them]. Like, ‘You're doing that here. You just have to focus on here. You're looking outside too much. Everything I'm showing is what I do, actually, with your bosses. It's here. You're just not looking here.’ So, I think it affects young dentists — actually, all dentists — in two ways. I think, technically, it makes dentists think they're not good enough because they see what other people are doing and they feel insecure, and they're not either doing enough work, working with the right patients, making enough money. And then, I think it beats dentists up from a mental health aspect, from a confidence level, because they see these dentists on private jets, wearing suits, driving Ferraris and Porsches, and then they think they're not successful enough. So, I think it's a self-perpetuating misery.” (32:10—33:51) -Joshua

“I think people look at social media as if it were reality, and it's not. I work with a lot of people who, on social media, have very big accounts and personalities. And I'm going to tell you, they reach out to me with the same problems. I work with some of them who are probably clinically depressed, but online look like they're living this crazy life. So, on the back end, I see the reality from a lot of these dentists. It's not always what you see online. That's for sure.” (34:28—35:00) -Joshua

“How do you make those expectations realistic for any dentist — not just younger dentists, but any dentist? I can take a beautiful photo. Chris can take a beautiful photo. Josh can take a beautiful photo. It makes the work look that much better, and it's fantastic work. Younger dentists will see that, and they're like, ‘How do I do that?’ I'm like, ‘Well, it took me 15 years to do it. It's not going to happen tomorrow. You’ve got to go through the process to get there.’ No one wants to go through the work, and the pain, and the broken teeth, and all the things, the broken provisionals. There's a whole lot of stuff that got to that before-and-after that we need to talk about. We need to set that expectation for them.” (35:18—36:09) -Dr. Ward

“Instagram, like Charlie said, is really just a highlight reel of ideal, cherry-picked cases that unfortunately influence the public in an unrealistic way. And now, the public is coming to me, showing me Instagram with unreasonable expectations, to circle back to the word “expectations”. Patients, I think today, have very unreasonable expectations. Before, patients would come to a dental lab with that picture of like, the ten smiles, and they're like, ‘All right.’ Now, patients are coming with Instagram pages of — they're in the algorithm. Patients are stuck in the algorithm. Think about anything that you've wanted to buy. Like, I play pickleball a lot. So, on Google, the pickleball world is in my algorithm. So, like Charlie said, you're buying everything. So, you have to understand, when a patient is going to make an investment in veneers, they're now in the dental algorithm. They're getting bombarded. So now, all of a sudden, we have patients who call and say, ‘Can I talk to you again? I know we talked, but I want to show you something.’ They come in, they show me Instagram pages from guys in Dubai. And I'm like, ‘Oh. Uh-oh.’ Now, we're in trouble because it's unrealistic expectations for that patient situation. So, Instagram is dangerous. It's a double-edged sword. I use it all the time, but it's dangerous.” (39:09—40:31) -Joshua

“I work with so many dentists, and I think a trap is this: they see something on wherever — and let's not just shit on Instagram. They go to Kois, they go to Pankey, they go to whatever, and they're like — let's use Charlie. Students come to me all the time saying, ‘I just want to be like Charlie.’ And the thing is . . . What Chris said is super important. Chris will never be Charlie. Chris is Chris. What that means is every dentist is going to develop their own style. It takes a long time to develop your own style. I think you become an amazing dentist when you become confident in your own style.” (42:32—43:18) -Joshua

“I think that Instagram and teaching institutions kind of confuse dentists a little bit. They beat themselves up because they don't think they're good enough. But I think what they have to realize is they're going to have to go through the pain of style development, or what it is that they like. So, when a dentist calls me and says, ‘Work your magic,' I don't want to hear that. You might not like my magic. ‘What's your magic?’ is the important question.” (44:36—45:06) -Joshua

“To give advice is always the easiest thing. I'm guilty of it as well. Like, when someone tells me something, it's harder to do it. But if [dentists] can somehow eliminate fear, they would become a lot better. I can tell you, everything stems from fear, in my relationship with a dentist. That's fear of calling the patient back to bring them back in, fear of not making money on the case, fear of looking bad in front of your staff and your assistants. The list goes on, and on, and on, and on, and on. And it's way easier said than done. I get it. But if they can somehow break through that, they would become such amazing dentists.” (46:47—47:40) -Joshua

“Probably 80% to 90% of most dentists' career is, from start to finish, one long, drawn out, painful experience. And I'm not trying to be funny. I'm being honest. Like, I talk to dentists every day of my life. I've talked to 75-year-old dentists who are still telling me how much they hate being a dentist. I'm like, ‘God damn, dude. Just fucking retire already.’ But I hear it from young dentists who are burned out, to old dentists who are burned out.” (47:58—48:24) -Joshua

“There are bullets coming at every dentist’s head right now, and they don't even know it. So, they have to get rid of this fear that — again, I don't want to downplay it, but it matters. Because at the end of the day, it's going to be fine. If you have to call a patient back in, it's going to be fine. If you don't make money on this case, it's still going to be fine. I know it's easier for me to say that, but that's how we operate here. I would give them that advice. I would say, try not to be so fearful. And again, way easier said than done because it's hard. It is hard. And I would also say, this is going to sound a little kooky but it's what helped me, is get other interests other than dentistry and don't wrap your whole identity up in being a dentist. It's like the Fight Club thing. You are not your jeans. You are not your watch. You are not your shirt. If you wrap everything up in that, you're setting yourself up for failure because every day you're going to get kicked in the balls, or whatever.” (49:01—50:14) -Joshua

“Read books on how to be leaders if you own a practice, and depending on your personality style. You will make your life a whole lot easier if the people around you know who you are, and support you, and know the mission, vision, and purpose of the practice. And I think it's good for your laboratory to know that as well. Like, what's the soul of the practice that I'm working with?” (51:54—52:22) -Dr. Mazzola

“Be authentic, and I think your team will like you, the people around you will like you, the patients will like you, and your specialists will like you. So, I think what Chris is saying is super important, is to lean into your authenticity. It's very important.” (53:42—53:59) -Joshua

“A lot of technicians are a little fearful of technology. They think it's going to take their jobs, and it's going to take over. I can assure you it's not. Someone said this to me, and I liked it a lot. Artificial intelligence is not artificial, and AI doesn't mean artificial intelligence. AI means assisted intelligence. It's an assistant to what we do.” (55:16—55:40) -Joshua

“For the dentist listening, I would tell them to definitely hook up with their lab partner because, the trajectory of dentistry from the clinical side, what do you guys have every year that comes out, a new generation cement or something? On our side, it's like, to the moon. So many things are happening so fast that I'm talking to doctors that are ten years behind in the digital world but think that they're at the cutting edge. I'm like, ‘Uh-oh. You don't even know what we can do, do you?’ So, I would say partner with your laboratory to at least stay afloat on current technologies and events.” (56:46—57:28) -Joshua

“Go about this at your own pace. Rome wasn't built in a day. Be more patient with yourself, be more patient with your staff, be more patient with your specialists, and define what it is that you want.” (1:05:28—1:05:42) -Joshua

“The best advice that I can give, and it's one of the hardest things to do, is create vulnerability for yourself. You talk about knowing yourself. Be professionally vulnerable. Personal vulnerability is hard as well, but professional vulnerability, no one really talks about. And like these two guys, I can totally be that way and seek advice for things that aren't dental related. I had a very challenging year last year, and these guys were there for me. And it helps to build a stronger relationship for when shit does hit the fan, because they know who you are really far in there, not just this surface, ‘Oh, he's a good dentist. He sends me good stuff.’ It's, I've made myself vulnerable, and I want to be there for that guy. So, I would say professional and personal vulnerability, develop that skill. And it is also releasing for you. You're not pretending to be so professionally tough. Then, it opens the door for so much more help.” (1:08:13—1:09:29) -Dr. Mazzola

Snippets:

0:00 Introduction.

3:23 Joshua’s background.

7:10 Why this is an important topic.

12:04 Why Joshua won't work with assholes.

17:57 What dentists get wrong about working with a lab.

20:12 Biggest pitfalls in lab-dentist relationships.

26:43 Successfully managing expectations.

31:19 The influence of social media on dentists and patients.

45:44 Advice for becoming a better dentist.

54:00 The future of lab-dentist relationships.

57:55 The percentage of dentists who've gone to digital impressions.

1:00:23 The future of lab-dentist relationships, continued.

1:04:57 Final thoughts.

1:09:35 More about Joshua’s lab and how to get in touch.

Dr. Christopher Mazzola Bio:

Dr. Christopher Mazzola was born and raised in Ann Arbor, Michigan. He attended the University of Michigan for his undergraduate studies where he graduated with honors with a Chemical Engineering Degree. During his undergraduate studies, he conducted research with dental school faculty on materials to aid in patients’ healing after dental surgery. He then continued his education at Michigan where he completed his Doctor of Dental Surgery Degree. While in dental school, he was awarded the University of Michigan American Academy of Cosmetic Dentistry Award for his research in the clinical application of CAD/CAM technology in dentistry.

Prior to joining Traverse Dental Associates, Dr. Mazzola owned a practice in Colorado Springs, Colorado, where he was named one of the area’s 2013 TopDentists™. He continued with education focusing on communication and technology in private practice. He has also served as an instructor and mentor for new graduates focusing on patient interactions and CEREC CAD/CAM Technology.

In his spare time, Dr. Mazzola enjoys spending time with his wife, Christina, his children, Baylor and Eliana, and his three dogs, Isabelle, Lola, and Aspen. He tries to stay active through competitive CrossFit, golfing, running, and skiing. He is looking forward to watching his family grow in the amazing community that is Traverse City!

Dr. Charlie Ward Bio:

After graduating from the University of Maryland with a Bachelor of Science degree in 2004, he went straight into the University of Maryland School of Dentistry. He earned his DDS degree in 2008, and since then he has completed the Essentials courses and many others at the esteemed Pankey Institute, where he now serves as visiting faculty. He is currently a member of the Maryland State Dental Association and the Academy of General Dentistry.

Joshua Polansky Bio:

Joshua Polansky earned his Bachelor of Arts degree, Summa Cum Laude, from Rutgers University in 2004. While working part-time at a dental laboratory, he took advantage of an opportunity to apprentice with distinguished master technician, Olivier Tric, of Oral Design Chicago. His eyes were opened to a whole new world of possibilities, and he made the decision to become a master dental technician following the path that Tric had forged.

Joshua continued to acquire technical skills by studying in Europe with other mentors and experts in the field, such as Klaus Mutertheis. He earned his master’s degree in dental ceramics at the UCLA Center for Esthetic Dentistry under Dr. Edward Mclaren, and continued his training under Jungo Endo and Hiroaki Okabe at UCLA’s Advanced Prosthodontics and Maxillofacial Program working on faculty and residents cases.

Joshua currently resides in Cherry Hill, New Jersey, where he is the owner and operator of Niche Dental Studio.
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