Lessons Learned from a 30-Year Career in Aesthetic Dentistry

I used to have a practice with over 10 employees. I had a big practice. Five chairs going at once, two hygienists. I had it all. It got to the point where I said, I can't do the dentistry I want to do, so what am I going to do to make it that way? And I made the changes. Welcome to the Phil Klein Dental Podcast. One of the most valuable steps a new dentist can take is finding a mentor, someone who's been in the field for over 25 years or more and has learned through experience, including their own mistakes. A mentor offers a chance to see what lies ahead, helping you avoid getting caught up in the moment and make well-thought-out decisions about the kind of practice you want to build and the investments you'll need to make. Today, we're sitting down with Dr. Chris Pescatore, a general dentist with over 30 years of experience. He has been a pioneer in digital dentistry since the early 90s. and has seen it all when it comes to creating aesthetic restorations. As you listen to Dr. Pescatore's insights, we hope you gain invaluable advice to help guide you as you embark on your own dental career. Dr. Pescatore, thanks for joining us. Thank you very much. A pleasure to be here. So you've been in this for a long time. We discussed offline about that. You've been doing this for decades. You started doing digital dentistry before most people knew what digital dentistry was. in the early 90s. And then, of course, it took off in the late 90s. So you've been through all of it, basically all the hype, hyperbole, what people promised, the claims, what we should all be doing. And you gave a phenomenal webinar, which I want to allude to, which is called Utilizing Digital Dentistry in Today's Dental Practice. That was on VivaLearning.com. Anybody listening to this podcast who wants to get a really comprehensive view of digital dentistry. It's amazing how much Dr. Pescatore covers in a single hour. Really phenomenal stuff. He covers every aspect of digital dentistry. Just look him up on vivalearning.com. Go to the search bar, type in Pescator, and you'll find it, P-E-S-C-A-T-O -R-E, and I guarantee you'll thank me. Send me an email, thank me. for the recommendation. So I'm glad we have you on the show today. And, you know, we only have 25 minutes or so to talk about so many different things. But let's begin with your career. What made you focus your career on cosmetic adhesive restorative dentistry? How did that all start? Well, a couple of things, really. When I was... First of all, I wasn't really that thrilled when I was taught in dental school in the 80s, meaning it seemed too destructive. So then in 1990, the year I graduated, I was able to place two ceramic veneers on the central incisors. Very minimal prep. And from then on, I was sold. I decided at that point, really the first day of my career. pretty much, that this is what I was going to focus the rest of my career on, was this kind of conservative cosmetic adhesive dentistry. Yeah. And I remember there was a time where there was some very aggressive key opinion leaders, depth cutting teeth, doing veneers that were, as an endodontist, I was looking at it in horror. Why are we taking such good tooth structure? And for the goal of making it more cosmetic, we're obliterating the most important part of the tooth, which is the outer surface of the tooth, which keeps it strong and resistant to decay. So I guess you were in the same camp as I was as far as conservative, minimally invasive dentistry. Well, back then we didn't have... adhesives that we have today. I mean, the first really amazing adhesive, I believe, was Allbond first coming out. They were at first called dentinal adhesives because it was kind of saying to the profession, hey, we can really bond to dentin. We have proof. And then it's moved on. So once we had those adhesives, we could bond very predictably. But as far as preparation, Back before those adhesives, it had to be conservative because really bonding into enamel was the only thing we could do. Now, dentists aren't typically prepping virgin teeth that much anymore. We have a lot of teeth with restorations in them. So the preparations are going to get more aggressive. But when they don't have to be, we can revert back to being very conservative. And that's always the goal. Someone told me very early in my career, be careful how you prep the tooth because more than likely it's going to have to be re-restored again. So give the next. as much too structured to work with as possible. That's very interesting advice. Yeah. Humble advice. Humble advice from one dental professional to another. So how has the evolution of materials, both laboratory and chair side, helped you achieve your restorative goals? Well, you know, and materials and equipment is changing so rapidly these days. You know, when I first started, feldspathic porcelain was the only porcelain. and older adhesives like I alluded to earlier. But now the choices are simply amazing. So today we can restore teeth, say, for instance, molar teeth, in ways we could never think about before. I've been doing partial coverage posterior restorations my whole career. The only time I crammed a tooth was when it usually had an existing crown. So, of course, you're going to take occlusion into account. That's the most important factor when you're looking at longevity of a restoration, really. But, you know, it enables us to do so many more... conservative things like the adhesives, bonding, molar onlays. A lot of people called them tops to teeth, you know, or I hear people call them a molar veneer, whatever you want to call them. We can really, even an endodontically treated tooth does not need a post and core and crown. We can restore those very, very conservatively. So that's a great thing. Also. You know, indirect resins were a great material in the day. I did so many of them in the 90s and early 2000s. But, you know, once the ceramic materials really started developing, I really stopped using indirect resins for the most part. I know they're getting pushed again with the advent of resin printers, and that's great. But I think most people realize that indirect resin restorations just do a ceramic and call it a day. I think it's a better option most of the time. Now, with these new materials, and Zirconia is one of the popular ones, How does that affect the prep design? What are the key things that a dentist has to keep in mind when preparing that tooth, knowing the material that's going to be on top of that preparation, either they do it chair side or through a lab? Tell us about that. Well, I think you just said something really valuable. You have to think about how you're going to restore the tooth and what material, and that dictates. preparation. Also, you have to think about how ultimately you're going to insert it. And that will also affect material. And zirconia has come into the rage as a very popular material, replacing the typical PFM. As far as preparation guidelines, You know, I do a lot of work with labs, do a lot of consulting. I have in-office CAD CAM in my office. I've had it for 20 years plus. I've had resin printers for five years plus. So, you know, but what I see is I don't see a prep difference when people are prepping for zirconia versus PFF. Can you be a little more conservative with zirconia? Yeah, you can. You can. But you have to have definitive margins. I see people carrying over their PFM techniques into zirconia and some people who use more feather edge margins. Well, those don't work with the ceramics. You know, the materials are dictating clinical changes. And one of them is chamfer margins, shoulder margins are really what we need. But zirconia is one of those materials that. I don't use a ton of personally, but, you know, you have to be. leery, zirconia can break. It's not indestructible. It's not the panacea material we all think it is. So I've seen it break. I've heard laboratory technicians talk to me about breakage. And I think most of it is because people are grinding on them with really coarse diamonds because it's such a hard material. What I found a while back were the X-Rex burrs by Alpen, which is coltine. The X-Rex burrs really cut zirconia like butter. So you can feel your grinding into this tooth without imparting these cracks that will eventually cause the restoration to fail. So your armamentarium is very key here too. So I use those erect burrs all the time, even for... -zirconia materials. So why wouldn't you be using zirconia more often? I mean, it certainly gives us the strength in those restorations that are thin because we're lacking the interocclusal distance perhaps that we need between the prep and the occluding tooth. So we're being more conservative with our tooth prep, knowing that we have the strength in a thinner material. Isn't that a reason to be a big fan of zirconia? Because I haven't, clinically, I haven't seen the need to. I'm a, I was, you know, once felspathic had its day, and I did a lot of felspathic molar onlays, and they're still in the mouth to this day. It's all occlusion. Empress came along. One of the materials I still love to this day, unfortunately, discontinued. It was replaced by Emacs. So Emacs is my go-to material. I just haven't seen the need. I can prep. just as minimal for for emacs uh like zirconia and zirconia i think really we talk about minimums all the time but that's how we get into fractures we have to give the proper proper thickness to the lab or our in-office machine so there's also some issues You see a lot of people talking about zirconia bonding because there are potential issues with zirconia bonding. Zirconia bonding, you really need to follow those steps to the T or you're going to get a problem. Emax is a general ceramic, general protocol, I think much easier than most. And when I talk to fellow clinicians or if I'm out doing a program, I always have people coming up to me and go, how do you keep those zirconia restorations in? I think there's a little bit of a detachment there on technique. And so, like I said, I haven't needed to. I haven't needed that kind of strength in a material. I would rather see a ceramic material that mimics gold. Give me that material any day. But yeah, but zirconia to me is overkill for the most part. I know a lot of people love it and God bless them. But for me, clinically, I haven't seen the need to. Yeah, sometimes what I'm noticing in dentistry and not only in dentistry, but other healthcare verticals and other industries outside of healthcare, when something new comes out. There's like this big hype and then there's a big push to get people to use this technology. Now you are a little bit of an iconoclast when it comes to that. Given the wisdom you have and the experience you have for so many decades of practicing, you don't particularly think you need to 3D print an appliance necessarily. You could do it the old fashioned way. So you have kind of a hybrid office, right? So what I'd like you to tell us about is what's your mindset regarding being an analog dentist? part of the time, a digital dentist, another part of the time. And some dentists would rather just make the switch and go total digital, no impressions, no alginate, no stone, no mixing in a lab, breathing all that dust. You're not one that sits in that camp. So tell us about that. Well, like I said in that webinar I did, I came out of the closet. I'm anigital. I'm both. I'm analog and digital. I don't see why we need to eliminate impression material. I'll give you an example. I have a dentist in my complex here. And he and I have had these discussions about in-office CAD CAM and digital for a long time. And I see his patients every now and then. And I've seen nothing but the most exemplary, beautiful restorations, beautiful dentistry, sealed margins, great occlusion. And he takes impressions and uses a lab. It's not the tool. It's the person using it. So for me, I still offer single visit restorations, but I take probably a little longer than most because I want to actually look like a tooth and not a temporary. And you have to. I think what we have to decide is what kind of dentistry do we want to put in the mouth? And no one talks about that because I get a lot of patients coming in and they've had in-office CAD CAM done in other offices. And most of the time it looks like a temporary. That's the common theme because dentists aren't doing it. Assistants are. And some assistants are amazing. Don't get me wrong. But I think if you're getting this equipment and all your focus is on speed and quantity, quality is in the equation and therefore you don't produce it. So I use the stuff, the equipment I have in the right situation. When I do a single visit restoration, everything is done digitally. scanned, designed, it's milled, but I still take an impression and pour up a solid model. Why? Because I don't want to take that restoration all finished, try it in the mouth and adjust contacts. And when I take that restoration, it better just drop because I have a stone model. I'll adjust all the contacts perfectly. If they're not perfect already, I will make sure all the margins are tightly sealed and polished heavily. And so when I go, it just drops. And I hear from a lot of patients over these years, I've heard, wow, it just went in. A lot of times they've had to grind them in the past. And I'm thinking, what's your image? What kind of image do you want? And we've gotten away from that. I mean, again, being an older practitioner who's done this a long time, I'll get on my little soapbox and everything now is being advertised. It's all about speed and how much more you can make. Before, when I got into cosmetics and doing it in the 90s and stuff, it was all about quality. We knew the money and the speed would come with time. But it's kind of changed. And digital is great. I love digital. I have two scanners in my office as well. It's great. But if you don't know how to prep properly and manage tissue, that scanner is worthless. You're better off taking an impression where the physical attributes of the impression material. are going to enable you to capture the margins. So I really think dentists getting out of school today or running, they haven't learned to walk yet. If you can't do things in the analog way, digital is not going to make you a better dentist. Just like getting a new handpiece isn't going to make your preps better. In your webinar, Dr. Pescatore, I noticed that you showed a picture of a dental laboratory. There were quite a few laboratory employees sitting behind desks. They were kind of like open cubicles in front of a screen. with a mouse and a keyboard, and they were doing some design work through software that's designed for crowns and bridges and so forth. And you made a point to say that most of these individuals are probably not certified dental technicians, which means they don't have the training when it comes to anatomy, occlusion, interferences, all that stuff that's really important to get a better understanding of the occlusion. So what are the ramifications of this for the general practice and for the patient themselves? Well, I think it's I mean, and I've been there. I've been in labs training these people. I've seen some of them have a week or two training program, you know, that they go through and stuff. And, you know, a certified dental technician is just going to understand so much more than someone just being trained on software. Not saying that some of these designers can't get very good. I'm not saying that. But they don't know about occlusion. I mean, I think if you ask them what the curve of SPI or the curve of Wilson was, they. would look at you like, what? And I told a friend of mine, I said, next time you get, I knew which lab he was using. And it was, I know they're a complete digital lab. And I said, next time you get a molar crown back from me, do me a favor. Tell me if the lingual cusps are higher than the buckle. And they are. You got a number 30 back, lingual cusp or higher than the buckle. So a lot of these people just don't understand the basics of occlusion and interferences that they're imparting into these restorations. And I always see people talk about AI and it's going to generate the most beautiful tooth. But yet they'll return to you a tooth with beautiful anatomy, like pristine anatomy for some 60 or 70 year old person who has worn teeth all next to it. It doesn't make sense. So I think it's potentially a problem. I think dentists have maybe just gotten used to adjusting the heck out of some of these crowns or the interferences or something like this. Ultimately, I think a certified dental technician would understand things a little better, hopefully. But that's not the way the industry is going. It's just too easy to hire people off the street, give them a couple of weeks of training and put out something that dentists have learned to work with. Versus when I get a case back from a lab, I don't care how big or how small, it better seat. There better be no contact issues. I supplied you good digital impressions or good polyvinyl impressions. It better seat. The big issue now is that the dentist has to... selective in their laboratory. They got to find a lab that they could work with where what you're saying is actually what happens in that laboratory. These people are CDTs, they're trained, and they're going to give you a final product that's going to make your life a lot easier on delivery. Let me ask you another question about your hybrid approach. So when do you use traditional impression materials versus a scan? Because I know you're a big scanner. You've been doing it forever. You've evaluated almost every scan that's on the market. And you know the nuances. But here you're still using impression material, the goop that we stick into trays where patients abhor it. And tell us what kind of material you like and why, you know, what is the application clinically for doing it the old-fashioned way? You know, I often say to patients sometimes when I'm scanning and they'll say to me, you're still taking an impression. And I said, yeah, this is my backup. I do it like that. When I'm doing a single visit, they don't really ask. But if I'm doing a full arch case, 10 veneers, something like that, I still take an impression. Will I scan it too? Maybe. I just believe in not having to get the patient back to take off temps and take another impression. I believe in stacking things in my favor. And sometimes it's just easier to throw an impression in. If you have a big arch and, you know, the impression material is key too. I always say, you know, tissue management, you got to, you know, cord placement is optimal, retraction pace. But I go, people don't talk about. an impression material. And I used the Affinus impression material by Colteen. And when I first got it, I was a little taken back because it flowed too well. I wasn't used to a material, even a heavy body that flowed amazing. So the detail I captured with this material is great. And this aided in tissue retraction. So sometimes if you're scanning a full arch or 10 teeth and some of the tissue could fall back on the prep. Well, that's what the great thing about impression material is, because you can essentially put that tip right in the sulcus and syringe the material. And boy, you can retract and get that perfect crisp margin all the time. So I still use both all the time. I'd like to say one versus the other, but I still use them because it gives me the ability to double check things and make sure things are absolutely perfect when I put them in. And that's really the key of what I need to do. Yeah. Well, I mean, you're a very, very particular kind of dentist that is obviously not in a volume practice. Everything is based on quality and premium care. I mean, what I heard in that webinar is that you actually send your endodontist. one of those burrs if it's zirconia oh yeah for that and i'm a retired endodontist so i thought that was hilarious it's great i mean yeah you send them one of those uh coltine zirconium burrs what's the name of that yeah the z-rex the z-rex burrs z-rex right so you send them they're amazing burrs yeah because you don't want to traumatize the zirconia crown that that endodontist is going through which would possibly cause these craze marks and cracks. And then you end up with a, I mean, who does that? But it's great, but they're great for it. Well, you know, I used to supply my periodontist with porcelain polishing paste because they'd be seeing my patients. I'm like, you know, you're not going to polish those ceramic restorations with anything but this. And they would. Why not? But, you know, the Xerox burrs are great for just drilling on Emacs or Empress. I mean, I still have, I'd probably say. a good, maybe probably more than half my cases or more that come in are still Empress porcelain. So it's good. They're great for any ceramic, any burr that has that kind of high quality and cutting like butter is not going to impart any problems later to a ceramic. And I used to see that with my endodontist when they would have to drill through a ceramic crown to do a root canal. Later, something would chip or break. And I'd be like, why is that happening? Well, since they use those burrs, I haven't seen it happen. But, you know, you said earlier about me, I have a different kind of practice. I didn't always. I used to have a practice with over 10 employees. I had a big practice. Five chairs going at once, two hygienists. I had it all. It got to the point where I said, I can't do the dentistry I want to do. So what am I going to do to make it that way? And I made the changes. Where do you practice? I practice now in Northern California, Danville, California. Oh yeah, sure. Yeah. Danville is famous for the Danville. Danville had an air abrasion machine or something that they, or a sandblaster at one time. Right. And actually I still have their air abrasion stuff. Yeah. Danville material. They're actually right down the street from me. Yeah. Great part of the country. Fantastic weather. Oh my gosh. Northern California is so beautiful. Well, it's been hot. But we get used to it. Yeah. I used to live in San Diego 15 years. So I was in the southern part. We're in Austin, Texas now. That's beautiful. Yeah, it is. It is. Let me ask you this, Dr. Pescatore. With all the equipment that is now available, such as printers, mills, et cetera, and you know the whole list, do you think laboratories will one day become a thing of the past? Or do you think there's always going to be that dental laboratory? When I say always. You know, you can never say always, but for many, many decades to come, is there going to be the traditional lab that a dentist could always refer to to have all their restorations made, their indirect stuff made? Is that what we're looking at? Well, you know, that's a great question. And the short answer is no. I don't think laboratories will become a thing of the past, but I do think the integration we have with them will be different. What I see is because laboratories are all digital. I mean. It's it's both a great businesses decision for them and also practicality. And it's all these digital tools, I say, really at their core, their communication tools. That's what they are. And I think what we're seeing and what you're going to see more of is the laboratories communicating, say, via more Zoom discussions with the doctor. So, you know, a doctor sends in a case for a wax up for, say, 10 upper veneers. Well, they're going to. schedule a time to go online and say, and the technician is going to show them in the 3D software, this is what it looks like, and this is the function, and look how they bite. What do you think? Do you want any changes? I think that rapport... So therefore, the doctor can actually make all the changes or give advice or say, no, that looks great. Then they fabricate it and they get something back at the office. And that'll even happen with your cases. So and that's really important. I mean, I have that rapport with my technician who I use, and she ends up actually sending me a lot of photos as well. But I can get online. And because how many dentists really want to learn 3D software? That's not why we became dentists, right? Or how many dentists really want to print their stuff? I think all that stuff's great. And dentists love toys. And I love them. I have them. But there are some months where I barely use my in-office CAD cam because everything's going to the lab. If I have bigger cases that month, I'm not using it. But I think it really comes down, the bottom line with all this stuff is do you have the numbers to support it? And that doesn't mean you're a bad practice if you don't. You just... you're just going a different direction or maybe you concentrate on different things. But I always say to anybody interested in getting any of these products, resin printers, in-office CAD cam, that kind of stuff, do yourself a favor and keep track for three months. Keep track for three months and then sit down with your account and see if it makes sense. Now, the one variable is, hey, if you just want it because you can afford it and you want a toy, go get it. But I think we're going to end up starting to see the people either go all in or just touch the surface. And what I mean by the surface is just get a scanner. Because if you're all in, when you go digital, you're locked into those costs. I just got an additional cost for my storage for my scans. And, you know, there's always going to be additional costs, additional upgrades, maintenance contracts. There's always going to be those costs. So if you go all in and you're not using a lab anymore. OK, great. But you better have a staff that does it because now you're paying someone in-house to be your lab tech. So understand it's you're just shifting the money where you're paying it. You're still paying money out. And but if you want to go all in for control. That's great. Otherwise, I think people who buy this and don't really use it, they're going to see it's more of a money pet. So I think we're going to start to see people either go, I'm just getting a scanner and I'm not going to learn the 3D software or I'm going all in and this is what I'm doing. Yeah. And you showed some interesting clips on the webinar on how a dentist bought a printer. assuming that that appliance that intraoral appliance could be fabricated very quickly and then when they sped up the film and they showed all the polishing and trimming and my goodness there was so much work involved with that and the way it sounds when they i'm not saying for people not to look into buying a 3d printer because i think there's some tremendous advantages to it but check out that film it's it's very enlightening to understand that there's more than just pushing the button and having the 3D printer interpret the 3D design from the software and print this beautiful intraoral plants. Well, yeah, and that's why I showed that video and I did speed it up because it is long, but it shows it's not a push of a button. And that goes the same within office milling. None of this is pushing a button and doing it, especially if you're... doing zirconia in office. There's no push button, get a restoration out of the box and it goes in. Resin printing, I always tell people, you know, be a little careful with resin printing. Now, I do love resin printing, but be careful because resin is a very dangerous material when it's not cured. You know, the liquid resin. Now, there's some printers that have it, you know, totally encased and all that stuff. But believe me, you're going to pay to have that protection. A lot of people don't get those, but you have to be very careful. I have my printer in a very well-ventilated room. We wear masks. We wear gloves. We wear eye protection. You got to be careful of this stuff. But yeah, there's a lot more to go into it. I don't want to discourage people because I have it. But know what you're getting into. Know why you're doing it. And if you're strictly looking at ROI. Profit only. That's the only reason why you want to get it. I think most people will say it's not going to cut it because long term costs. If you don't have the constant, constant volume, how many night guards can you really make the people in your practice? I mean, at some point it's done. So do you have a facial scanner? Do you have. In addition to the scanner that you have intraoral, do you do anything else digitally to reproduce the patient for the laboratory so essentially they can make that restoration or that bridge or whatever they're doing almost as if the patient was in the laboratory with all the digital information they're getting these days? Well, I can do a facial scan. There are facial scan apps on the iPhone you can use. I do all my digital mock-ups myself and I send them to the lab. So, I mean, I'm a little bit of a 3D geek that way. You know, I've made my own set of teeth I like to use, and I made them in such a way as when they function, we're not going to have interference. There's no extra crazy anatomy. It looks great, but it doesn't function well. So I've made my own set of teeth. I make my own wax ups. I either send the printed models to the lab or I'll send the 3D file to the lab. But you can go ahead and use facial scans. I can do that all the time. Do you need to? Or are photographs enough? I think it just depends on what you're comfortable with, what your experience level is. There's a lot of ways, a lot of tools out there. I think for just a regular practice to get a 3D facial scanner is kind of overkill because like I said, you can get a really amazing 3D facial scanners on your iPhone. It's that amazing. I've done them. I've printed stuff off just to see the accuracy. And it's quite accurate. The iPhone could just about do everything except walk your dog. Yeah, I can't walk your dog. So in closing, doctor, I want to ask you, you mentioned that you had a five chair fully operating practice, you know. I don't know, 12 hours a day, whatever number, whatever you said. Years ago. Yeah, years ago. Right. So you had to give up something to make that change. You decided, OK, obviously, you weren't getting the quality that you wanted or you were spending more time managing HR with all the people working there. So there was a hectic, chaotic kind of situation that you just said, you know, I don't know if I want to do this for the rest of my career. So you cut back to more of a boutique practice. What did you give up and what did you gain? Why I changed was I noticed I wasn't able to sit down, thoroughly diagnose, thoroughly treat the patient. I was always getting up for a hygiene exam. It just interrupted the quality I wanted to do. And I've been really lucky. I've had some people drop words of wisdom on me through the years. Like I said, the one before about, you know, someone else might restore the tooth, save as much as possible when you restore it. And someone said to me, you want to do better dentistry? I said, yeah, just do it tomorrow. Start. There's no one over our shoulder like in dental school checking our preps. So who's checking? Who's who's saying I should refine that margin a little more? Oh, no, it's good enough. Or, oh, I should make sure everything's polished beautifully. No, it's good enough. You have to set a very high bar for yourself. And yeah, it can be tedious. It can be frustrating. But the reward is you see your dentistry decades later still working beautifully. And you say to yourself, OK, it was worth it. So I decided, listen, I can't do the dentistry I ultimately want to do if I'm in this environment. So I started changing it. So when you have a practice more like mine, I don't say it's boutique. I say it's and this is a probably a very often used term, but very patient centered. It's relationship centered. I know my patients exceptionally well. They know me exceptionally. well. We have a great rapport. You know, when I get patients coming in in the morning and they're bringing me breakfast just for the heck of it, I know I have a great relationship with my patients. And I charge appropriately. That doesn't mean I charge outrageous amounts. It means I charge appropriately because if you look at my overhead, I don't have nearly as much staff as most offices. My overhead is very lean and mean. It's all a question of how you want to do it. And I always, when I was in dental school, I always thought to myself, I want to get out and I want to work on people I really like and their friends and family. I want to do that. And I lost that for years because you're trying to be a businessman as well. Concierge is probably more than boutique. Yeah, concierge. Yeah, yeah. Concierge, it's really relationship. I mean, yeah, concierge, it is. And I can't think of practicing any other way. It's just when you have that rapport with your patients and I can sit down. and talk to patients in depth about their treatment and why we need to do this. And some don't agree. Some want to do something less. And I could say, okay, but if this happens, we're on the same page. And, you know, you want to cover yourself because that's how relationships don't work is when you don't tell them everything or you think you did. Patients know everything about their treatment before, after, and during. I just find it a much nicer way to practice. I get to sleep better at night. And when I see people out socially, they're always the ones smiling big and, you know, we have a good time. Yeah, people appreciate it. In this day and age, Dr. Pescatore, you don't see that very often in dentistry and medicine or anything. There are some dentists out there with the same practice. ideology that you have the same philosophy of how to treat patients or Hippocratic Oath but dentistry has become such a big business with DSOs and volume and the insurance companies the insurance companies are dictating what what we can can't do and everybody's pushing equipment on us so that we get into more debt and we have more production on our mind to cover the bills and you know you have to choose your path and it's you probably are gleaning great career satisfaction now that you're you've built your practice the way you want to practice and it aligns with the way you live your life so that's really important i think we need to have you on a separate podcast talking about that, changing the way you practice based on what makes you happy. And it turns out you'll end up making just as much or more money anyway. Absolutely. People worry about that. And you're right. Absolutely. Everything you said, there's a lot of pressures on the industry, especially for younger practitioners. And I always tell people, if you just stick to your guns and you stick to the right reasons why you got in this profession to begin with. Ultimately, you're going to win. You're going to go over some bumps. You're going to have some setbacks. I did. But you're going to you're going to actually come out in a career that you determined and you really enjoy versus letting someone else determine your career path. Yeah, very well said. Thank you very much, Dr. Pescatore. We appreciate your input. And yeah, very happy to have you on the show. Have a good evening. Thanks. You too. Take care, everyone.