Bart Knellinger: Um, okay, look, I’m gonna play… I’m going to show you guys a video here. You go through and do a critique. Now this is, um, Tracy and uh, and Dr. Chambers. Now Tracy’s a newer treatment coordinator. She, um, she started about a month ago and she hasn’t been to one of the boot camps yet. She’s just been going through the, uh, the online training and things like that. Uh, Dr. Chamber’s been to several of the… of the boot camps, but they just kind of converted their practice from a GP practice into a full arch center. And, uh, it was their first full 30 days and they closed 25 in the very first 30 days. So, and they’re in, um, Lexington, Kentucky. So they did- they did really really awesome. Um, you know, it- it always helps when you come out of the gate really strong. Um, but they made the most of the marketing, they closed a bunch of arches, 25 in the first, uh, in the first 30 days. So, I wanted to grab one of their videos.

Uh, she jumped right on everything. They record every consultation. They’re really really good about that. Um, and there’s uh, a lot here that, that we can learn. This is actually one of the, uh, one of the cases that got closed. Um, so I’m going to go through and play this and I’ve got the whole thing here. So, I’m going to play a little bit from the first 10, a little bit from the second 10, a little bit from the third 10, so you guys can see some different parts. Um, but you’re gonna see a lot of things that, that, that are done correctly. Um, and then some things, uh, that we can work on as well. So remember, if you guys have anything, any questions or anything like that, just type it into the, uh, into the chat. And I’ve got four ladies here in the room with me. [chuckle] They’re gonna look at it so I don’t miss one. This week, I want to make sure that I get to, uh, get to all the questions as well. So, I’m gonna go ahead and share the screen and start the video for you guys. Everybody make sure that your volume is up and make sure- let’s make sure everybody’s muted also. [clears throat] Okay, here we go.

Tracy: There you are. Let’s see how we did. Well, just another briefing. I’m Tracy. I’m your treatment coordinator. Um, my job is to kind of find out what your situation is. Kind of find out…

Bart: Sorry, guys. I just got a little bit of feedback on my end, there’s someone else here that needs to mute.

Trish: Nicole, are you muted?

Nicole: I’m muted.

Tracy: …what you’re having and to find out what you want, what your end goal is, and it’s my job to, um, kind of find the treatment that best fits everything you need and what you want. Okay? Um, to do that, though, I need you to be really honest with me and just, I don’t want you to hold back anything, all right?

Patient: All right.

Tracy: And be very honest with me and, and share anything that you need to share with me, okay?

Patient: Correct.

Tracy: Are you in pain anywhere, first of all?

Patient: Yes. More so, the upper front, this tooth here.

Tracy: Yeah.

Patient: I think I had some, some swelling or some inflammation in the gum about a week or so ago, and it was- it was causing me to hurt.

Tracy: It’s painful.

Patient: Yeah.

Woman 1: But he’s been part on and off…

Patient: The one that you can see, obviously, is loose.

Tracy: [crosstalk] Yeah. There’s no gum, no nothing anymore. Um, also there in the back. Yeah. Okay. So, tell me, tell me, I mean…

Patient: I want to try to get back to where, you know, normal basically, um, I’m interested in implants. Can I afford everything implanted? I don’t know. Maybe…

Tracy: Well, do you have, do you have a budget in mind? [crosstalk] That’s, I mean, that’s how I’m going to help you. I’m going to help you… it’s going to fit your budget too.

Patient: I mean, I know some of it’s going to have to be financed probably so. I mean…

Tracy: Okay. I can help you with that.

Patient: In less than 15?

Woman 1: I’m going to say 15 to 20,000.

Tracy: 15 to 20,000 and you’re trying to get both arches done?

Patient: Yes.

Tracy: Okay. Um, let’s see.

Patient: That might be some implants. I, I, if, if I can’t afford all implants, at least the front and then maybe, like, partial for some of the back teeth or…

Tracy: Okay. Um, well, tell me how…

Bart: Okay. Sorry. I’m just going to back it up a hair because I was getting tons of feedback. I had a little audio issue on my end, but I don’t want to miss that. Hold on one second. What just happened? As you can see, it happens really quickly and…

Patient: You know, normal basically, um, I’m interested in implants. Can I afford everything implanted? I don’t know. Maybe.

Tracy: Well, do you have, do you have a budget in mind? [crosstalk] That’s, I mean that’s how I’m going to help you. I’m going to help you… it’s got to fit your budget too.

Patient: I mean, I know some of it’s going to have to be financed probably, so I mean…

Tracy: I can help you with that.

Patient: In less than 15.

Woman 1: I’m going to say 15 to 20,000…

Bart: So guys, a couple of things to keep in mind here. Like… [clears throat] So, Tracy went ahead and jumped on the opportunity to, uh, to pre-qualify. Um, I would just… you want to keep in mind the- the flow of the call, right? The flow and the pace of the call. So when someone says something like, “Hey, you know, I don’t know if I can afford absolutely everything when it has to do with- with dental implants,” you don’t always have to necessarily triage right then, especially if it’s really soft like that. Like we’re trying to, you know, it, it’s a minute and a half in. Now if someone a minute and a half in said, “Hey, listen, I understand that’s what you’re here to do, but like, before we move forward any further, I just want you to know I don’t have a lot of money, I need to know how much it is so that I’m not wasting your time. I just really don’t want to waste a lot of time here. Right? Because I don’t have a lot.”

That, that’s one thing that, that you triage immediately. But if not, like, we’re still trying to get into rapport here and we want to make sure that- that, that, that’s, that’s what’s happening. So that we can… sometimes like you’ll hear this and you can just be, “Yeah, okay, I understand,” and just kind of keep going with where they are currently right now. Because it’s not like he said, “Hey, I don’t have a lot of money,” he said, “I don’t know if I can afford absolutely everything.” Um, but the guy’s kind of telling you that, that he has something. So, um, I think at, at this point in time, you want to try to not lose, try to fall… you don’t want to fall out of rapport this early on if it’s not something that’s, um, that’s a super, that’s a super hard objection or a super hard price question.

He just kind of floated it out there. So this is a point in time where you don’t necessarily have to get a budget right now, you can continue on with, uh, with figuring out the pain points and kind of understanding who’s in the room. Anytime you have two people in the room in the first 10 or you know, someone brings someone else with them in the consultation, you’re trying to ascertain whether or not that person is there to help you, uh, if they’re, if they’re an asset or they’re a liability. So, you don’t always have to triage right off the bat when you hear it, uh, it just kind of depends on how they say it.

Tracy: 15 to 20,000 and you’re trying to get both arches done?

Patient: Yes.

Tracy: Okay. Um, let’s see.

Patient: That might be some implants. I, I, if I can’t afford all implants, at least the front and then maybe like a partial for some of the back teeth or…

Tracy: Okay. Um, well, tell me how… what kind… I mean, how are you eating right now? Are you struggling with eating?

Patient: A little bit. I mean, I can’t eat everything that I want to simply because of the loose tooth.

Bart: And I like how she went right back to it, right? Because why? He gave her a number of like 15 to 20,000, so it’s fine. 15 to 20, the guy, he- he’s serious. So, this is not a triage, we don’t have to over-qualify it in any way, shape, or form. You just kind of got right back into the call, so that was really good.

Patient: …and then this one was hurting also. So I think it’s moving because the teeth below it, the one’s gone, so…

Tracy: Do you have cold sensitivity?

Patient: Not really.

Tracy: Hot and cold.

Patient: Not really.

Tracy: Um, and you did…

Patient: It’s hard to, it’s hard to look at that and say I don’t, but I really don’t. I mean, I can drink an ice-cold bottle of water right now.

Tracy: And swelling. You’ve had swelling off and on probably in different areas that are flaring up on you, and you’ve probably been going, I would imagine this has been going on for years. This is not something that’s…

Patient: Since these two, yeah, that’s pretty much since I lost that tooth a year and a half ago.

Tracy: But I mean…

Patient: About a year ago.

Tracy: And I’m sure like you’ve lost it some. So, this has been progressively happening over the last 10 to 15 years.

Patient: No, the last time I’ve seen a dentist was in 1994. I had all four of my wisdom teeth taken out and it wasn’t a pleasant experience. I was sore for about four months.

Tracy: After you did what?

Patient: After I had all the teeth taken out and I was, I was… I went back and it wasn’t, it wasn’t dry sockets, it was just, I don’t know, I was just sore but it- it ended up being like a three, four-month process and that’s kind of where- that started my phobia. I was like, “Man, if I got to go through that every time, I’ll just uh, kind of, roll on. But that- ’94 was probably the last time I saw a dentist.

Tracy: So, you had a little fear too?

Patient: Oh, yeah.

Tracy: Fearful. Would you say a little fear or a lot of fear?

Patient: Now, I’m to the point where it’s, “Oh, well, but that’s what’s kept me awake.”

Tracy: Okay. [crosstalk]

Patient: Now, I mean, you know, it’s…

Tracy: It’s okay. Do you have, do you… what is it about it that you feel?

Patient: Just the pain. I mean, you know, it can’t be much worse than what I went to.

Tracy: I’m going to tell you something. What we do, honestly, you don’t… we don’t even start until you are out.

Patient: All right.

Tracy: Everything’s done when you’re sound asleep. So, it’s- you don’t have to have any fear whatsoever. Okay?

Patient: I have done a little bit of research on my own and that’s kind of where I’ve kind of talked myself into it, you know, more the sedation side but…

Tracy: Yeah. And we don’t do… we don’t have to take a pill and come here. We wait till you’re asleep, sleep. We have CRNA that comes in and they put you to sleep. So no fear there. Okay? Don’t worry about that. So tell me a little bit about, like, let’s talk about do you want a short-term fix or long-term fix?

Patient: Long-term fix.

Tracy: Okay. Um, what kind of outcome are you hoping to get? I mean, I’m assuming you want…

Bart: So the one thing that’s kind of interesting here, I’m still, I’m still, like, looking for what- what is this guy’s hot button, right? Like what- what is it, you know? Um, yeah, like he’s in a little bit of pain, not a ton, you know what I mean? He can still eat most things, “Not all,” he said, but you- you see how this guy’s a little, he’s a little tougher as far as to read emotionally, you know what I mean? The guy’s not really emotionally invested into it yet, so I’m still wondering like, “Hey, you know, what is it?” Or is this, um, like, why is he here? You know. What got this… what, what, what got this guy in today? He hasn’t been to the dentist since 1994, like, what is it exactly? Does he not like the way that he looks? Is that his- is that his wife? Is his wife the one that’s, that’s bringing him in?

And guys, any time you have two people in the room, if you are going through their pain points, make sure that we get the pain points but you want to get a good idea of how those pain points are affecting them on a day-to-day basis, and if you’re having trouble pulling it out of them, right? Or they’re not showing much emotion, then just switch and rotate your chair and look at the other person in the room and ask them what they’ve noticed or, “Have you noticed the same thing? Have you noticed, um, you know, a difference in terms of your husband or your boyfriend? Have you noticed a difference in, you know, his ability to eat or, or his happiness or anything like that?” Sometimes you notice, you see things that they don’t, right? What have you seen? And… and switch and ask the other party, you want to do that anyways because you want to know what jersey they’re wearing always, um… [clears throat] but it’s also very useful as well, um, when you have somebody that doesn’t necessarily wear their emotions on- on their sleeve.

Trish: Hey, Brett. We have a question.

Bart: Mm-hmm.

Trish: They said, is this a good time to ask what made you decide to come in? [inaudible]

Bart: Yeah, yeah. Um, the question was – is this a good time to ask what made you come in? And yeah, that’s that- that’s the trigger point, you know, we get an account of their pain points and then how those pain points are affecting their lives on a day-to-day basis, and then it’s like, “Why now?” The ‘why-now’ is kind of, the straw that broke the camel’s back. That’s what I’m, that’s what I’m, I’m searching for here. Is what- wha- was that- what exactly is it here? You know. Because if I know what got to… what got the person, what got this patient in today, then I’m going to know how to create an emotion, right? Because that’s the one thing I’m thinking by looking at this guy, “Hmm, I’m going to have to figure out how to create some type of excitement, some type of enthusiasm, some type of emotion.” But in order to do that, I have to show him ex- exactly what he wants, right? Or the inverse of what he doesn’t want, one of the two. You just have to be clear on what that, um, what that is. [clears throat]

Tracy: …able to chew your food and eat.

Patient: I want to at least be able not to… just eat normally. There might be some times that I can’t eat because it’s too hard or…

Tracy: You can’t chew on the left side.

Patient: But… right.

Tracy: You can’t chew any steak or chicken or sandwiches or anything over there. Um…

Patient: And it’s…

Tracy: You really can’t do much on the right either so.

Patient: It’s a struggle. It’s a struggle a lot there. Just about…

Bart: I love what she just did. Do you see how she didn’t let him get away with kind of minimizing it? She’s like, “No, you can’t chew anything on the left side. You’re not eating anything over there. You’re barely eating anything over here.” Now, this is like she, she didn’t let him get away with that. You don’t allow them to get away with minimizing it. That was really really good.

Tracy: I would imagine you’re struggling even with a piece of pizza and food crust on pizza, you know? Or the bread.

Patient: [inaudible]

Tracy: No, it’s not. Um, so tell me, on a scale of 1 to 10, how important is a function?

Patient: 10.

Tracy: 10? And how about aesthetics? How important is aesthetics to you? How do I look?

Patient: They don’t have to look perfect but I want the teeth to be responsive.

Tracy: Okay, I’m a little bit getting to it because…

Patient: I mean, I am 42, 43, sorry I’m 43 years old, I just… [laughs]

Tracy: You can’t say who’s old. What are you saying? Tell them what you’re saying over there.

Patient: Well, it’s 94 to now, it’s been a while since I’ve been to a dentist.

Tracy: I can’t look at you so we’re going to skip right on past that.

Patient: I did smoke. I don’t smoke anymore, probably…

Tracy: Good. How long did we quit?

Patient: It’d be two years ago in August.

Tracy: Good for you.

Patient: [crosstalk] Yeah, you’re right. There’s some of… there’s plenty of nicotine stain so.

Tracy: We won’t worry about that because we can fix all of that. [crosstalk] You get to pick the color, the size, the shape, and how you want them to look. We don’t… you can get perfection. You can get… we want to look natural. Our goal is for you to look as natural as possible because, you know, you’ve seen people who are in their ’70s, they’ve got these perfectly white, glowing teeth. You know, it’s interesting. You know it is, you know they’re not their real teeth. We don’t want anybody to look at you and go… like this. We want somebody to look at you and go, “Dang, he looks healthy, he looks good, what do you- you know, he’s taking care of himself.” We can help with that a lot. One more thing, as far as, as far as…

Bart: Again, I would, I would love to see Tracy engage with the wife here a little bit more. She hasn’t said a peep, she hasn’t said one word, right? That’s something that, that you want to, that- that’s something that you want to remain cognizant of. You don’t want anybody in that room that quiet, right? Coz, coz, coz we’re just guessing, you know? And the other person, the more emotionally invested you can get the other person, right? It’s- they’re going to feed off of each other. They’re going to feed off of each other. So make sure that you’re engaging with both parties here.

Tracy: …as maintenance, do you want something that’s super easy to take care of you just brush them, use water, and you’re good to go? Or do you want something that you, that’s going to take, require more maintenance?

Patient: Less maintenance would be, you know, more, more so what I would rather have but I mean, you know, they’re probably going to have to settle in some areas, I’m sure.

Tracy: Okay. That’s okay. Um, like I told you when I sat down, my job is to get you where you’re going to be comfortable and get you in the best treatment option that we provide that’ll fit you. Okay. Um…

Bart: Now, I would, um, also that language right there, you guys want to make sure that we’re steering away from getting you the best treatment and steering towards getting you the best, get you the most ideal outcome. The outcome that’s right for you, right? We’re going to, it is going to be a treatment, but the treatment only exists to, to, um, to produce a very specific outcome. And that’s the reason for these questions, right? That’s why I ask you – how important is function, how important is aesthetics? How important is maintenance? Because we want to craft, it’s not like we have one thing and, and one thing that we do and one treatment and you’re stuck with it. The doctor’s going to create the treatment, to- to create the results that you want. So that’s the reason for all of the questions. And sometimes if, if you’re asking questions, if you feel like someone’s wondering where you’re going with all this, just kind of restate it for them.

Tracy: …tell me why you’re here now. I mean, this has been coming for many years. Aren’t you just tired? I mean, you’re not in pain, you have, you don’t have any kind of deadline in mind or you guys want this done by like…

Patient: Obviously, the sooner the better. But, you know, I, I’m, I’m not the professional here so I can’t, you know, I don’t know…

Tracy: But I mean, if you don’t have a deadline. You’re not trying to get this done by June 1st because you got a week… a wedding going on.

Patient: No, no.

Tracy: …you know, some kinda event in your life.

Patient: No.

Tracy: Okay. Tell me what you know about, um, implants. What do you know about them? Have you all done any research? Are you married?

Woman 1: We are not married.

Tracy: Okay. Make sure you don’t…

Bart: I wouldn’t have quite given up right there. I would’ve said, “And so, I mean, you haven’t been to the dentist since ’94, you’re not in a ton of pain.” Like, what was it that made you say, “You know what, forget this, I got to go in, I got to get this done?” Like was it something specific? Give me an idea. Like what, what, what was the, what was the final straw here where you said, “That’s it, I got to get this taken care of.”

Patient: I’d rather have that instead of that.

I can tell that the gum was inflamed and…

Dr. Chambers: Yeah, I can see.

Patient: Yeah, right there. Right.

Dr. Chambers: Right there.

Patient: Yeah.

Dr. Chambers: Um, these two here, you know, some of them are really easy to see that like, you know, down right on the bottom where these two, it’s just kind of floating right now it’s just held in soft tissue but there’s no bones surrounding it. Kind of the same with all of these three, right here, um, and then this being your right-hand side, you can tell where you’ve got a lot of decay. And these are infected as well.

Bart: We comment here on the second 10. So we want to make sure when the doctor comes in, that you guys have prepared the doctor. Make sure you prepare the doctor with the one sheet, uh, or the one-pager. And I like it when the doctor comes in, introduces himself, and does just a quick, a quick recap. “Hey, I had a chance to speak with Tracy and Trace- Tracy tells me this is kind of what you’re going through, this is what you’ve been struggling with, and this is kind of what we’re working towards, right? We look, we’re looking for something that’s long-term. Something that’s going to give you the right type of function. Um, really good aesthetics, something that’s low maintenance, something you can brush and floss as normal.” Um, and do a, a real quick recap before, um, jumping right into the, uh, right into the CT. It just helps build rapport, right? It just helps get in, get into rapport, and gives you something to, uh, kind of gives you a north star with the patient. It just justifies everything else that you’re going to say.

Dr. Chambers: …as you can see the bone that’s getting taken away around those teeth, um, and then obviously what we just talked about right here in the front, you can see the cavity here on your right-hand side with that guy. And then, uh, the other thing I start looking at is where’s the bone in relationship to the teeth? Because ideally you would always have two-thirds of the root or the tooth itself surrounded by bone and then this part being out of it. Um, and then we start looking at it here it’s, you can kind of tell there’s not a whole lot of bone supporting these teeth anymore. So yeah, mobility would be something that I would completely expect to experience right now. Uh, but the first thing I usually do is go through here and mark um, and kind of design your case. And what would I do if this were me or how would I plan this case?

Uh, what are your options? Cause that’s always the first thought is like what’s available to you, uh, so that you’re able to make an informed decision for yourself. So what I’m doing here is marking where the nerve is on the bottom. I see that dark line that runs across, uh, this, this dictates where my implant position is going to be on the lower arch. On the upper arch, we don’t have to worry about that. We have to worry more about the size. But on that, as you can see, and also let people know that you know, when I’ve designed these initially I kind of drop implants in to see what’s available to you and what your options are but as we proceed forward with the case I spent a whole lot more time designing your case is not just you dropping them in really quick and moving forward. Um, although it may seem like that sometimes but…

Woman 1: I don’t know if any of his teeth are salvageable, but is that something that you look at as well? If any of them can be saved.

Dr. Chambers: I look at it as a whole picture. Yeah, a lot of times what I would say in his scenario is no, ultimately, because you’re going to be putting money into something that you’re going to lose the teeth long term. So my goal is like what’s the best long-term result for you? Yeah, without having to like to continue to put money towards something. Because it can be one of those problems where it’s something that just never goes away, right? It’s like you do some implants or you have some options and then you, you base it on keeping some teeth, and then all of a sudden you lose those other teeth and now you’re spending more money on the case. Um, especially with the aggressive periodontal disease, um, like, you have, it’s going to be something that you battle forever and it’s always associated with those teeth. And so, ultimately, if we let the teeth go, you’ll get rid of the periodontal disease and you’ll stabilize that bone and your- your overall health. [inaudible]

Bart: What would you say this guy’s urgency level is right now? Do you guys think he’s got a high level of urgency? I wouldn’t say that, right? It’s very- it’s, it’s hard to tell with him, but I would say his urgency level of like, “I need this done right now.” It seems to me to be about four or five, right? Something like that. He’s kind of lukewarm there. Um, and you don’t know if it’s a personality thing or if he really ha- has more urgency, which we haven’t kind of uncovered that. But I like how, um, you know, that this is when the doctor can help to create a little bit more urgency, kind of like Dr. Chambers did out of the gate looking at the CT scan. Um, you know, and talking about periodontal disease and just going through the whole thing. Anytime you have somebody that’s a four or five, that’s where the doctors can really help in… in creating some urgency from, uh, from a clinical perspective. So I, I like how he did that too. You could even go a little bit, a little bit harder there as well.

Dr. Chambers: There’s decay and then we’re losing that bone. Uh, we got these two, um, and then here in the front, we’re going to lose these because there’s no bone supporting them. Uh, and then as we get back here, we get into very similar issues where we don’t have a whole lot of bone supporting these teeth. And once you start losing the bone that goes in between the roots of molars, that’s a hopeless prognosis because you just can’t physically clean those areas. No one can. It doesn’t really matter who you are and what tools you have, you’ll just continue to lose that bone, uh, that supports them. And right now these are non-functional. Um, on the top, again, we have one canine here and then we’ve got these two teeth that have infections around them. On both of these…

Bart: This is all just creating urgency. If you guys have somebody that’s in the consultation that’s already a 10 out of 10, then a lot of this language is not necessary, right? Like what the doctor’s doing is coming in. And basically if someone is a 10 out of 10 in terms of urgency and they’re ready to go and they’re, like, desperate to get it done, they don’t need all of this, um, all of this data, like, they, they don’t need it. They’re ready to go. They’re just praying that they’re a candidate. So, what the doctor is basically there to do is say, “Hey, are you a candidate or not? This is the clinical outcome that we’re trying to achieve and I think that you’re a very good candidate for it and I know exactly how to approach the case. Here’s what I would do to achieve this specific clinical outcome and I think you’re going to get a great result.”

And like that’s… in a nutshell, that’s all that they’re, that the doctor is there to do. If or if they have a high sense of urgency already. If they don’t have a high sense of urgency, then all of this is much more necessary, um, to make sure that the patient knows that the problem’s not going to get better on its own. It’s only going to get worse. It’s only going to cost them more money, more time, more energy. Um, so all of this is really good, um, but if you have somebody that’s, you know, desperate to have it done and they already have the urgency, then a lot of this wouldn’t be absolutely necessary.

Dr. Chambers: …the one next to it, we’ve got maybe four millimeters of bone supporting that tooth. So that one’s going to be mobile as well. Uh, and then we can start to see early infection around this one, which we know because it’s got a really big canopy. Uh, and then we’ve got this one canine and then this tooth again, hold this loosely. You know, that’s, and I would recommend a fixed prosthetic and I’ll kind of show you, uh, one because you have teeth, but, um, if we don’t fix it the day of surgery, then we have to allow the implants to kind of sleek and then you wear a regular denture and then we wait five months before we can load those implants, and then we snap it into that scenario. Whereas if we fix it the day of, you leave the teeth, they’re fixed to those implants that day.

So, you kind of jump the gun on everything and get back to where you want to be. And when you lose a bunch of bone like this, your denture fits poorly, especially initially because the denture relies on that underlying substructure to kind of grab onto. And when you lose this much bone, you have to remodel that area so it has to be smooth. You know or else you have these sharp spots that stick out and poke you underneath the denture um, and so for that initial healing period, it would be very uncomfortable cause you just had this piece of plastic in your mouth that you wouldn’t be able to do anything with. And it might kind of put you in a worse scenario because now you’re learning how to live with a conventional denture while you’re waiting for your implants to heal. Um, so four implants is the minimum. Uh, I always remind people, it’s like, think about legs on a chair, you know, you want that stability. Uh, in your case, I implant them a little bit differently because when I planted them in the office, I planted five on the lower.

Bart: And again, we want to make sure, depending on who we’re talking to, um, sometimes less is more in terms of information about the actual, about the actual treatment, right? So I need the doctor, they’re, they’re focusing on creating an urgency, building confidence with the patient and, and keeping it simple, right? So that we don’t create an obstacle that didn’t previously exist. And so that we didn’t confuse people either. I, I try to keep it as simple as possible. I don’t wanna put anything in their, in their head that, that might confuse them or might get them, uh, might get them worried. That’s the whole point of- of talking in a straight line from open to close is we’re not using any information or any language that’s not absolutely critical towards the close, right? So, remember those three things are really important – urgency, confidence, and simplicity. Okay? Um.

Dr. Chambers: So whenever possible I try to get more implants there. You know, four is the minimum, but if I get six, I’m going for six every single time. And there’s no cost difference between uh, 4, 6 implants, it’s just whatever it takes to get the case done the right way. So, when you look here, this is, uh, the bone width that exists from the front of your face to the tongue side, uh, this is what it looks like from above. So it’s like looking down on that area, uh, from the top of your head to your feet and then you don’t have much bone back here because we have infection. So what we do there is we place an implant in front of the nerve. The volume you do have, even though you’re losing a decent amount of bone that supports the teeth, you know once the teeth are gone like we said, we get rid of periodontal disease, we make this healthy again, and then replacing the implants in front of the nerve uh, because behind the nerve you have a lot of infection. And so, uh, it’s possible then I can place one behind the nerve, uh, that’s the goal. But this would easily support, uh, face arch on the bottom um, and really good support. Cause you got a good bone to do it with. The upper is thought very similar to the front. That’s all you see…

Bart: I think Dr. Chambers can keep this even more simple. I think he could abbreviate this um, at this point, he’s given uh, a lot of detail. I think he’s done a really good job of, I mean, the, the… he’s done a really good job of creating urgency although neither party is talking, right? And that- that’s the only part about this whole thing that is a little bit concerning for me to see, is the, the ratio of, of who’s doing all the talking. They’re not even talking 5% of the time, right? They’re very, very, very, very quiet, um, and when they’re quiet and like when you’re, when you’re watching them, it’s hard to read their emotion. I’m, I’m wondering like, “Hey, are they liking what they’re hearing? Are they not liking what they’re hearing? Are they tracking with all of this? Are they excited? Are they scared? Are they… what they are thinking” is what I’m trying to decipher and it’s very hard to tell with both of them. So, um, anytime you have that, we’ve got to engage with- with more questions, more questions get them open and up, get them talking. You know what I mean? Figure out where you’re going, and if push comes to shove when somebody starts to really quiet down, um, then it’s a good rule of thumb to assume that we’re giving too much information, right? Because when somebody just gets too much information, they’ll shut down and they won’t ask questions because they’re kind of lost, right?

They’re kind of trying to take it all in, right? And at the end of the day, you can look at the CT and go, “Hey, you know, there’s a lot of areas here that are, that are obviously problematic. You know, we’ve got to do this, this, and this, but at the end of the day, it’s a good thing that you’re here right now because I, I think this is going to be fairly straightforward for me, you know. I think that you’re a very, very good candidate still, um, and I think you’re going to get a great result and that’s what we’re going to work towards, right? The function that you want, the aesthetics, the maintenance and, you know, to where you can basically have a do-over with your teeth.” You just kind of bring it back, keep it simple, um, so that again, we’re not using information that’s not absolutely necessary to – to the close. They, they closed these guys, these guys got close, um, but I’m just kind of walking you through what I’m seeing here. That’s, that’s the main thing that concerns me is that they’re not contributing very much to the consultation. They’re not asking very many questions, they’re not elaborating at all and they’re not showing very much emotion. Both of them are like poker players right here.

Dr. Chambers: You’re losing that in a series as well. Hygiene is a big part of this thought process because that’s what’s going to help you keep these around for a long, long time, um, we’ve had to say a million times, it’s like the end goal is what I want in your long-term success, which is always the cases place of dense bone and get as many implants as we can to support that prosthetic. Um, on the upper, they’re all vertical, which already shows you that you have a good amount of bone volume to support the implant. So, once we design the case, we bounce back, you know, where the case that when the guy came back in last week to adjust on his temporary prosthetics, like I haven’t taken them out and you can’t take them out. But sometimes we’ll take them out for hygiene. It just depends on how much debris you build up and how clean you keep them. Uh, but they’re all screwed routine so that I can take them out and then I can clean and put it right back in. Yeah, I don’t want you- I don’t want you taking your teeth out. You know, that’s the goal. Was it? You can’t take them out yourself.

Patient: We’ll have her in there without one wrenching. [laughs]

Dr. Chambers: [laughs] Yeah. What other questions you guys got for me?

Patient: As of right now, none. I’m sure I’ll probably maybe think of some.

Dr. Chambers: Yeah.

Patient: Well, I’ve got plenty of time to think about those.

Dr. Chambers: Yeah, you let me know.

Patient: I’m ready. I mean, I’m ready to move on. Just be part of my daily life so.

Dr. Chambers: Like I say, you’re a great candidate for it. I mean, absolutely great candidate. It’s not often that I can angle implants in front of the nerve and get three in there with them. You know, that’s, that’s a really good sign, especially seeing density and six verticals on the upper, yeah, that’s, that will happen just a couple of times a week. Mostly angling, all these implants to try to get them into solid bone. But even though you’ve lost a decent amount, you do still have enough to support those implants right now. Absolutely.

Patient: That’s what I was afraid of because I knew that’s a possibility. Doing my research, I kind of- I knew that I’ve had a few teeth missing in quite a while.

Tracy: That’s why I said you have to have something in there to keep the bone around. So implants are going to do that for you.

Woman 1: How’s… I don’t, I guess I don’t know.

Dr. Chambers: Yeah, go ahead.

Woman 1: How long is this going to, I mean, I know it’s permanent, but you know if he lives another 40 years, you don’t wanna…

Dr. Chambers: It- it all depends on the individual, and so, my goal is to set him up so that if I can make it last 40 more years, that’s what I want or anything. I want it to last for the rest of my life if it is ideal. It all depends on hygiene and how you take care of it.

Patient: How do I take care of it, right?

Dr. Chambers: Mm-hmm. Yeah, that’s the big factor. So, I can promise people that it’ll last forever, but then I’ll see it when they come back for a six-month visit, it’s like, you didn’t clean this at all.

Patient: I’m not going to be able to treat them like I’ve been treating my teeth. So it’s going to take some changes on my part. I mean, I take care of them now, because…

Tracy: We’re partners. We’re partners…

Bart: Because the one thing that- that we didn’t necessarily hear is what type of prosthetic he was recommending, right? We didn’t hear that. We know we’re doing fixed but we didn’t get what kind of prosthetic, that’s why I was interested to hear how he was going to answer the question which says, “How long- how long is this going to last?” Um, because obviously a lot of that depends on what type of prosthetic you end up going with.

Tracy: …that’s it. Okay. Well, how do you feel? Relieved?

Patient: Yeah, pretty much. I mean, I was worried… I was worried about the cost aspect.

Tracy: Yeah. You don’t have to worry about that. You’re a great candidate. How do you like Chambers? You feel very pleased.

Patient: Yeah. Yeah, I read about him, too, online, so.

Tracy: How do you…

Woman 1: He’s something. He’s pretty fantastic.

Patient: You can tell he’s got a passion.

Tracy: As I said, I mean, the man, he sleeps and breathes implants. Um, he was so excited coming in this morning, telling me about a seminar that he’s going to. I was kind of like, what else could you learn about it? He’s going for it. Um, I briefed over this earlier, I was just kind of showing you what the implants look like. He recommends that you go into a fixed prosthesis, okay? Um, by fixed, it means it does not come in and out. Okay? This one comes in. Now, he said… I made it up when he was…

Bart: So, what did we miss in the second 10? What we missed is exactly what I said. We missed, we missed a primary recommendation, right? The primary recommendation is fixed but it doesn’t necessarily tell- we didn’t make a recommendation on wha- what are we going to go with. What- what type of prosthetic are we going to go with? And I would have liked to see that in the second 10 just because he did give a budget of like 15 to 20,000 so he said that, you know. So if, if you guys are in the second 10 and you’ve got somebody that has given you some type of price parameters, it’s not a bad idea to say, “Listen, I think definitely, working towards what you want, we’re looking at something fixed here that’s going to give you the function, um, and I’ve got one or two ways that I can approach this. There are pros and cons to both. There are different types of material for the teeth, right?”

And I would go through on then and I would come to some type of an agreement in terms of, are we going… are we recommending zirconia or are we recommending, um, you know, a printed prosthetic and I would have the conversation because, right- right now, Tracy has to have the conversation, um, and is she going to go with the zirconia? Or is she going to go with a PMMA right out of the gate to get closer to his budget? What’s she going to do? But either way, we- we didn’t go through it in the, um, in the second 10. So we just had a, basically, the recommendation is, um, is a fixed prosthetic but that’s about as detailed as we got.

Tracy: …talking you are not a candidate for a denture, okay? Um, he recommended the fixed prosthesis. By fixed, it means this would go like the implants are in the bone. This goes up against the gum. We take a screw, it goes down that little channel, we lock it, and then that little access channel gets filled, and then this doesn’t come out, okay? It doesn’t move.

Patient: Does the gum reattach to that?

Tracy: No, it doesn’t attach to it. But your gums…

Patient: It just sits on top and just kind of…

Tracy: Mm-hmm. And then like he was telling you, I think I can show you better on this one. Um, your gums are going to be really flush so see how that fits really well with that skin right down my finger? That’s what it would be like on you. Okay? And then you would just go in with your water pig, but it’s not going to be so tight that it blanches rings like that, but it’ll be nice and flush so that you let in some seeds. Nothing gets up underneath it like it does on dentures. And then all you do is brush them and then use your morphe to clean those little areas right there. Um, let me just tell you, um, in order to… now, you guys mentioned that you wanted something that lasts decades. Um, we are talking about the difference in materials, okay? Um, everybody goes home, there’s… we have two options in the fixed.

This is provisional. This is zirconia, okay? This is something we make here in our lab. Um, we can make it in about an hour, okay? It takes, it’s about an hour to make it. Um, these can chip and break a little bit like, if, you know, with wear and things like that, it might have to be replaced every few years, but it’s like… between the two. Um, I want to go for pricing with you. It takes all of these steps to get you from where you are now, A to Z, where you want to be. Okay? Um, this is per arch. Upper, 39,000 for upper, 39,000 for lower. That’s what it would cost if we itemize everything, but we don’t do that. He doesn’t charge you for the exam, um, the CT scan.

He doesn’t charge you for planning. He doesn’t charge you for surgical guides. He doesn’t charge you to be put to sleep. He doesn’t charge you for extraction. He doesn’t charge you for bone rafting. Those are all the things it takes to get you there. I mean, you can do these things anyway, he just, he’s not going to nickel and dime you with these things. That’s what it takes to- to get you where you need to be. Afterwards, um, he- he provides free maintenance business. He doesn’t charge you for that. And the bi-curves that he mentioned, if it’s one bi-curve like we’re not even going to charge you for that. And if it takes 3, we’re going to make you 3. We’re going to get you where you need to be. And like I said, when he was in here, we become your partner, okay?

We’re a team. We’re going to work together to get you there. This is not the price, okay? Um, to get you in the provisional, we should stand it. This is the one I told you that has to be replaced now and then. This one is $17,000 per arch. Okay? So that times 2 that would be 34,000 to do these, okay? And the only thing he’s charging you for is the actual implants. And like he said, that’s supposed to be 4. But if we can get 6, we’re going to put 6. We don’t charge you for the extra 2. If we, I mean, if can get the space to get them in there, we’ll put them in there because that’s going to set you up for success. The abutments are the part that this little gold part here, that’s part of… that’s called the abutment. So there’s the implant, the abutment, and the prosthesis. Okay? So, three parts. If you wanted to go to Zirconia and you wanted this one, um, this one is 25,000.

Bart: But this is the main problem right here, right? So this problem exists for Tracy because of what happened in the second 10, right? So, what’s happening now? Now, I’m giving them two options so you can’t run a close. There’s no close because there wasn’t a primary recommendation. I would have made a primary recommendation of, of zirconia right off the bat, you know? And, um, in the second 10, I would have gone through that and I, I will close on it, and then if there’s a financial, um, if there’s a financial obstacle that we can’t get over, we can roll it back. We can roll it back. But you want to try to avoid giving them two options to consider because the odds of them saying, “Let me think about it, let me go home. Let’s discuss it,” just skyrocket when you do that. Absolutely skyrocket.

So we never want to exit the second 10 without one primary recommendation, and that’s why I would have had the conversation in the second 10, specifically, because the price did come up, right? So you can talk, you can talk through it. And these are going to be some of the things I go through with, with the doctors this Friday at the power session, but those are things that you can talk through. That way when Tracy gets into the third 10, there- there is none of this, like, she’s going through the bundle, she’s going through zirconia, and she’s going to run a close. That’s it. If there’s an objection, then she’s going to handle it from there, right? She’ll run them through, get them finance, break it up, do whatever she can do to make it affordable and get it done, but she’s going to sell that, um, and if it can’t be done, then we can roll it back to the other type of material. But we’ve got to have one thing to go with it. I mean, you don’t have to, but it’s just much, much, much, much better.

Tracy: …dollars an arch. Times 2, that would be 50,000. As a courtesy, we will replace this, up to 10 years. And get something else. Tell me what you’re all thinking.

Bart: I can tell you what they’re thinking. They’re going to go- they are thinking, “Go with the cheaper one,” you know what I mean? That- that’s what they’re thinking right now. Plus the guy already said in the first 10 like, “Hey, anything you do is going to be better than where I am.” Do you know what I mean?

Woman 1: If he starts with the provision…

Tracy: Yes, he can always come back and move up to this at any time in the future. You just pay the difference.

Patient: Probably the provisional for now, I mean…

Tracy: All right. Let’s go back then to where we had the financing in there…

Bart: Hey, Tracy, how much did these guys get approved for? Can you- can you remind me, please?

Tracy: They got approved for 50, Bart.

Bart: 50? Okay. And the- the total for the zirconia, was what? 50? 52?

Tracy: 50,000.

Bart: That’s what I’m saying. I think that because they got approved for the amount, how we going in with the, with the zirconia with no other option, you probably get them done. You probably get them done right there and it’s over, right? But anytime… if you have somebody, they give a, they give a price object, they give a price or they ask you about price and they give you a real number 15, 20,000 bucks, you know that’s not, that’s not real, right? It’s always going to be drastically, drastically underestimated, um, but when you give them both and they’ve already mentioned money, it’s going to be 99% of the time, they’re going to opt for the lower one because they can talk themselves into it. That’s exactly what that question was for. “Hey, if we start here, can we upgrade later?” That’s telling her that she doesn’t have any downside to going on with the cheaper option.

Now, it’s not a bad option but again, this is what you’re going to run into if you don’t have one primary recommendation. I would have gone with Zirconia right off the bat. It’s a little bit more than he said he wants to spend. Let’s see what he gets approved for, he got approved for it. I bet you that if that was a primary recommendation, I bet you that Tracy closes this case for 50,000 bucks.

Tracy: Right. Let’s get the numbers right. So, let’s see.

Patient: Do you agree?

Tracy: Let’s go here. Let’s edit that. Let’s change this amount. If we’re doing 34,000, you got 2,000 down, we’re looking at 32,000. Let’s find out what your payment is going to be.

Bart: And again, keep in mind, before you run through financing, make sure that financing will help them, and then before you run through it, ask them. “Hey, would you rather put more money down? Right? And have a lower monthly payment or less money down and have a higher monthly payment? And then, what type of monthly payment would work if I can get something, are you looking for something 600, $700 a month, 500 a month, 800 a month, kind of give me an idea. Give me something to shoot for. That way, you know, right? That the number that they see, you’re- you’re going to know how to frame it, right? I don’t want to give them a number and say, “Aw, jeez. I can’t afford that.” So make sure that we do it in that, in that sequence there, make sure you ask them.

Wowan 1: …we can pay it off over.

Tracy: You- I’m sorry, yes, that’s something I should have told you. There’s no penalty for paying it off early. I love you for doing that all for me. [laughs]

Patient: Yeah, you know all the financial questions so.

Tracy: I love it.

Patient: That’s why I brought you here.

Tracy: And this is an unsecured loan. That’s why the interest rates are where they are. Um, but you can pay it off at any time, penalty-free.

Bart: And never bring up interest rates if they don’t bring it up, right? There’s just, there’s not much good that can come from, um, from pointing that out. Like, I mean, they’re going to get the information, they’re going to see it. So, don’t create a problem that- that doesn’t exist. [clears throat] But hey, at the end of the day, this is kind of an interesting one because neither one of these people talked very much throughout the entire consultation. Um, I think Tracy did, uh, a really, really, really good job here, um, and I think in the second 10, I think we could probably, we probably could have accomplished everything in the second 10 and half the time. Um, you know, instead of planning out the entire case probably could have accomplished everything that we did in half the time and then just close on one thing. Give Tracy one, uh, one treatment to close on and, and go from there. Um, but at the end of the day, hey, they closed 25 arches in the very first month.

Um, so it’s a, it’s a heck of a month to start off on. And, um, you know, a couple of takeaways from this I want you guys to be aware of is – in the very first 10, if there’s a third party in the room, engage with the third party. If you’re having trouble creating emotion with somebody, you gotta slow down, you got to ask questions, you got to ask penetrating questions and you have to almost force them to participate, right? If you’re dealing with somebody that’s really tough and you’re having a hard time opening them up to you, um, then switch and engage with the other person, right? See if they can get them to open up, you know. But you want that, you want these people talking as much as possible so that you know what they’re thinking. So that we, so that we’re not guessing here. We- we- and we want to know what their- what their urgency level is also. Are there any questions in the chat? Okay, cool. [clears throat] Um, hey, Tracy, are you on still?

Tracy: Yes, I’m here.

Bart: Hey, um, so these people that, they didn’t close at this particular- because the, the video, my video kind of got cut off. Did they close right here at this appointment? Or did they close the next day?

Tracy: No, they closed that day.

Bart: They closed that day?

Tracy: They closed that day.

Bart: Yup, and scheduled. That’s awesome, and they just went forward with the financing.

Tracy: Yeah, and we did his records appointment yesterday.

Bart: Okay, awesome, awesome. Well, what I want you to do, Tracy, is make sure that when you’re in the second 10 with Dr. Chambers no matter what happens in the second 10, if you, if the second 10 is about to be over and you don’t have a primary recommendation, then I want you to prompt the doctor to make a primary recommendation.

Tracy: I can do it.

Bart: Right? So you can just say, “Okay, so Dr. Chambers, so just to do, just for a quick recap, right? They’re a really good candidate and what we’re recommending is, um, all-on-four fixed with zirconia prosthetics, correct? That would be your primary recommendation?” Like, just prompt them. So that you go in there with one thing to close. Not two. Um, and, uh, that goes for all of you guys. Make sure that you have, you have something specific to close on the third 10. If you don’t, you guys can prompt your doctor there. Prompt, prompt the doctor, right? Because fixed, if you have two or three different fixed options, it still, you’re still going to have to go through every single one, um, or you’re just going to have to make a call. One of the two, which isn’t ideal, that’s, that’s really what…

That is the doctor’s number one function is to make sure, “Hey, yes, you’re a candidate. I think you’re going to get a great result, and here’s how I would approach the case to deliver the outcome that you want.” That’s 100% for the doctor and you guys are there to influence and create urgency and close. But, um, Tracy, really, really, really good job. I mean, from, for someone that is, is new, that hasn’t been to, um, a boot camp yet, that hasn’t been to a power session yet, only with the online training, I can tell you- you’ve really been taking it serious and you’ve been studying because you, you hit a lot of points.

You did very, very good. You looked extremely professional. You speak with a lot of certainty. Just keep in mind, anytime you have two people in the room, um, engage with both of them as much as you can and we’re always looking at different ways to generate emotion. The more emotion you can generate with the, uh, with the patients, the more likely we are to get a close, a same-day close, and sometimes they’ll be emotional. It’s just a personality. This is kind of like an odd couple. Typically, when you have a couple, one person is going to be more outgoing than the other, but they’re kind of both super like this. This is, this is not the most exciting dynamic couple I’ve ever seen in my life, but, um, it makes it, it makes it a little bit more challenging but, you know, you guys, you guys did, did a great job. Hey, is anyone on the call? Do any of you guys have any, uh, any questions before, before I let you go?

Woman 2: Ask him about the financing.

Woman 3: What do other financing, uh, companies do- does everybody use?

Bart: Why don’t we do this one because it’s a list? Why don’t we ’cause, because there’s a couple of new players, uh, as well? Um, Trish, why don’t you just send them a list of, like, maybe send them a list of like the top, the top five. But what I would do is make sure that you guys are sending out to proceed number one. Send out to proceed first and then utilize the other ones for secondary financing or, or a combination of the two, and you guys know that. I mean, if you have, if you have somebody that’s approved for say, 15,000 or 20,000, submit out to another one and try to get two, try to get two approvals for 15 or two approvals for 10 or 20 or whatever, and you can get them a 100% financed with two low affordable monthly payments. That’s all right. So, you know, use as many of them as you possibly can. Anyone else have any other questions related to this? Okay, hold on. I’ve got a couple of questions.

Swift Dental: If they give them an amount, plus the doctor still gets them a primary prosthetic, that is another price porch?

Bart: What do you mean? If they give them an amount?

Swift Dental: Swift Dental.

Bart: Swift Dental. What was your question from Swift Dental? Sorry, I didn’t- I didn’t understand it the way it was written. Just unmute yourself.

Swift Dental: This couple, they, they- you know how to say the price range from 15 to 20.

Bart: Mm-hmm.

Swift Dental: That’s the… do we let the doctor know that that’s uh, like, what they’re looking at, or can doctors just also give them the zirconia that is over the- what they were looking at?

Bart: Well, yeah. That’s where that one-pager comes in. So the one-pager that you- that you’re supposed to fill out and show the doctor, it does have a section, “Hey, did the money come up?” Yes. If it came up, what was the budget? What were the budget parameters? And you want, you want your doctor to know that because, um, you want them to have the ability to address it. So, yeah, absolutely. You want them to, to know that, but if they give you a budget of 15 to 20,000, um, you know, then that’s- that’s easily… 15 to 20,000 budget is easily probably 35, $40,000 at minimum, right?

They’re going to underestimate it by half, typically. Um, so, no, you make a, you go ahead and you know, “Hey, this person’s qualified. These persons on planet Earth here, they’re not thinking that it’s, you know, $500 or $2,000 for a case.” So, we’re going to move forward and I’m going to treatment plan to the outcome that they want. So if this person is saying the function is a 10 out of a 10, a 10 out of 10, we know it’s going to be fixed, right? He wants good aesthetics. He wants something that’s low maintenance, and he wants a long-term solution. To me, all of that screams, that outcome screams for all-on-four fixed zirconia. That’s… right?

So, I’m going to go ahead and… and, with the treatment plan to achieve the outcome that he’s- has stated that he wants, and we’re going to run a close and we can always go back and fall back into a different type of prosthetic to keep them in something fixed and make it more affordable if we can’t do it. But, no, if someone gives you a 15 to $20,000 budget, go, go, I wouldn’t worry about it. You know that, at the very least, you’re definitely closing on one arch today for something. That’s, that’s real money, especially if they end up having good credit. Even better.

Is there another question? Nope? Okay, guys. Um, anyone… if no one else has any other questions, I’ll let you guys, uh, I’ll let you guys go and make sure that you get signed up for the, uh, for the power session for next month. And, um, I got the doctors here on Friday so that’ll be fun. Any other questions, you guys go ahead and shoot them over and I’ll get to them, and then I will see you guys on the peer mentorship call later on in the month as well. All right? So, go close to somebody, go get them. Tracy, awesome job, first month, 25, girl, what a shark. I love it. Good job. All right, see you guys.

Tracy: Thank you.

Bart: All right. Bye-bye.

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