Clear Aligners, Clear Growth: Dr. Yan Kalika on Practice Success

You know, some of my general dentists that I work with who are referring patients to me, they say, you're the best salesman for us because when the patient finishes ortho, they already know they need to get veneers. They know they need to get some restorative. They're ready for implant because I emphasize that throughout my treatment and they've seen it at the beginning. So, you know, the problem is before the patient was a little bit out of the loop and the Stroman ecosystem brings the patient back in the loop. Welcome to Austin, Texas for the Phil Klein Dental Podcast. Today we're diving into one of the most exciting growth opportunities in dentistry, clear aligner therapy, and specifically how clear correct by Straumann can help take your practice to the next level. Our guest today is Dr. Jan Kalika. He's a certified specialist in orthodontics and dental facial orthopedics. He earned his dental degree with honors from Harvard School of Dental Medicine and completed his orthodontic training along with a master's degree in oral biology at the University of California, San Francisco. With over two decades of experience, Dr. Kalika has been delivering innovative, patient-centered orthodontic care that consistently exceeds expectations. We'll be talking with him about how he leverages clear correct, artificial intelligence, and digital workflows to attract new patients, streamline operations, and grow a profitable practice, all while keeping patients at the center of care. So if you're looking for practical strategies to expand your practice, motivate your team, and harness the full potential of clear aligner therapy, stay with us. I think you'll enjoy this episode. Before we bring in our guest, I do want to say that if you're enjoying these episodes and want to support the show, please follow us on Apple Podcasts or Spotify. You'll be the first to know about our new releases and our entire production team will really appreciate it. Dr. Kalika, it's a pleasure to have you on the show. Thank you for having me. I very much appreciate it. Yeah, we're very happy to have you. And you've done quite a lot in your career, including Chess Master, which is quite impressive. And I listened to you speak on a couple of other podcasts and videos, and you talk about... The advantage of having the mindset of a chess master where it actually lets you think many moves ahead. And I think it's important being a dentist diagnostically is to start looking at the patient, not just what's in front of you, but what you could do in the future and where things could go if you don't plan things correctly. So to begin this podcast episode, when it comes to scaling a dental practice, what do you think are the most important elements? And where does clear aligner therapy fit into that growth strategy? So to scale a dental practice, one of the most important elements is the team. You really want to surround yourself with a great culture and amazing people that will translate into a better patient experience. And I think patient experience is a culprit of the success of the practice and how to scale it. But the other piece that's very important is efficiency. So it's not just how... the patient feels within your practice because you could be not so good of an orthodontist and patients have a this very good customer experience but then the case is not turning out to be beautiful so you need this you need this precision and have somebody be be proud of their work but at the same time accommodate patients needs and really listen to patients to find out how fast do they want to be done what are the main concerns And efficiency. And efficiency has to do with a lot of digital workflow. That's where the aligners come in. The aligners allowed us, and I've been at the four steps of the aligners when the Invisalign started. They allow us to really create these digital workflows with efficiency. At the same time, accommodate patient schedules. Yeah, so let's talk about that efficiency and let's bring in AI into the picture. There's no question that AI is changing the orthodontic landscape and it's doing it very quickly. I mean, I had clear aligners myself and I think for most visits, the orthodontist didn't spend more than a few minutes with me. And then he had a staff member do some interproximal reduction, but everything was completely AI generated for the most part. How are you currently utilizing AI in your ortho workflow from case selection to actual treatment planning and then to monitoring progress of the case? Yeah, just a few corrections. The staff member cannot do IPR, so hopefully the orthodontist did it on you. But also, we do a lot of planning. It's almost like the analogy to the chess, right? You want to create your strategy at the beginning to be able to have a good outcome. So coming back to AI and how I use it, I'm a very early adapter of pretty much anything technology that comes to the market. But I also use a lot of science to make sure that that technology has a scientific basis and useful for my patients. I'm one of the co-founders of AI companies called Diagnacad in the past. And, you know, I was the CEO of a company for a few years. And that's a diagnostic AI company that does. So when you take x-rays in the photos, you load it to this 3D diagonal cadets in the cloud, and it gives you a very, very detailed analysis of your airways. It could actually segment the airway in three dimensions so you could see how wide or how narrow the airways to give you some clues to then ask further questions. How is the patient breathing? What are the airway considerations? That's how we start the case. And then we usually... do an intraoral scan that also uses AI to be able to see how the teeth are going to look after we're done. And we use SmileCloud by Strowman. And SmileCloud is a software where you could use the natural tooth library and you could actually predict and show the patient, this is where we can get your teeth orthodontically. And this is what you need to make it to the next level if you need a restorative treatment with your dentist. So patients now could see. the whole outcome before they even start the treatment and it's very helpful for us because we know exactly where we need to go now do you think this is appropriate by the way before i ask that question i'm in texas so the person did do ipr uh interpersonal reduction i mean they used a diamond strip yes and this one person came in who was very nice and she she said this is what i basically am doing all day is ipr because i'm a dentist and i sat there saying you know I'm not going to grow more enamel. Be careful here. And she used these diamond strips that are like, you know, 0.03 millimeters, whatever. Whatever the software indicated, each time I'd go back, which was every five weeks, they would check the progress of how my trays were fitting. And then they would do whatever appropriate IPR was necessary. But it wasn't the orthodontist that was doing it. So maybe Texas has different rules here. Getting back to what you said, that's all fascinating stuff. And that's where things are going. How does this apply to the general dentist? Should a general dentist... be involved with clear aligner therapy with the AI behind them to help them in the way you just described? I mean, the answer is yes. I think general dentists, depending on the education level and the interest, should definitely be involved in aligner therapy. It made it available for general dentists. I think there's a boundary to really understand how to put it all together. And, you know, they need to be almost measuring themselves at the same level as specialists. and trying to figure out, is that a skeletal problem? Meaning, is that a jaw problem? Is that a teeth problem? You know, have I done CT scan to see how much bone there is to move the teeth into? So I think general dentists can absolutely do it because then they can follow up with their sort of treatment. But I would say, you know, they need to... understand the level of education, level of comfort, and try to stay away from the cases that are beyond their level of competence. But again, the general dentist can take advanced learning and really learn just as much or even more as orthodontists. They keep learning and taking courses and visiting offices. So it's the matter of not a degree, but more of an education and staying away from... the things that are maybe above their level of expertise. Yeah, and that goes along with everything a GP does, right? I mean, you want to stay away from that. Anything above your comfort zone, you should be careful of or, like you said, take some continued education because what we learn in dental school, of course, is very restricted to what the necessities are and most of what we do in the real world, we learn afterwards. I want to ask you about the importance of aligning teeth when it comes to adult crowding, because a lot of the orthodontists and general dentists that are doing clear aligner therapy are doing it on patients that are not kids. These people are over 50, over 60. Even in their 70s, they're getting orthodontic treatment using clear aligner therapy, which was something that was not done with brackets and wires in the past. How important is it to straighten these lower... teeth in the case of adult crowding when it comes to doing this in preparation of restorative work? In the long run, you're going to be reducing the tooth structure much less when these teeth are aligned. Yeah, I think orthodontics overall is a conservative treatment, especially as it comes to understanding if people keep their teeth, they need to have the properly designed engineering forces. And orthodontic really provides the proper engineering. Same analogy as with a house. If you had a good architect and a good engineer, you should be able to, you know, enjoy things without fixing them. And as we get older, the balance between the bones and the tongue and the soft tissue changes. Also, you know, the way that we breathe changes. Obviously, you know, with age, a lot of people starting to show airway problems. So the way we approach orthodontics, we'll look at airway first. And then we think about phase and then T, right? And that's where your previous question about general dentists, if they don't know how to evaluate airways, because some of those patients, even older, they might need expansion. We use this Marty expanders that use some of the mini screws that I think most orthodontists know how to put in, but some general dentists really haven't learned that. And that creates a system where everything kind of works together because we keep learning that the dental health is very much connected to overall health. And so in order for us to really have a good outcome, we have to think of a whole patient together. And we think of those three things that I mentioned, airway, face, teeth, to be able to get the patient in a better health. And that brings me to answer to your question, the lower teeth alignment sometimes. Number one, creates an area where the bacteria can grow. And by straightening out, you know, you have better oral hygiene. And we know now the bacterial byproducts and bacteria themselves can travel through the bloodstream to different organs. And then the second thing is the proper forces between the teeth allow you to have your teeth for the rest of your life, which is very, very important as you age. I think your point about... Worrying about airway, face, and teeth in that order is so critical. I mean, anybody listening to this podcast, if you just glean that main concept that Dr. Kalika just mentioned, I think it was worth listening to this podcast. I think it's well known, Dr. Kalika, that in the dental profession, clear aligner therapy has become a powerful practice builder. I think that when patients see the... potential for how their teeth can be straightened by the AI tools that you described, and they see where it can go. Once they're through that part of the case acceptance phase, they're going to say, you know, now that you got them straight, what can we do to make them look better? So it keeps going to another level. So in your experience, and I know you're a ClearCorrect guy, you use that system by Straumann, how has offering ClearCorrect impacted your case acceptance, your production? and your overall patient flow to your practice? I mean, the ClearCorrect is part of a bigger ecosystem with Stroman, right? Open architecture, we use some of the scanners that Stroman has that are very convenient and fast. We use their access system that we're able to put different softwares. And again, the patient becomes a project that you could share with other dentists, but also share it with the patient so they can understand what they're getting. And so ClearCorrect is really part of the system. We use the dental monitoring, which is remote monitoring with ClearCorrect, so they can do a lot of monitoring themselves, and it shows how the teeth are tracking. Obviously, ClearCorrect has this clear quartz material that I think, in my opinion, is an amazing material, and it creates a lot of opportunity to get. aligners to act like brackets. I mean, it's not, of course, the braces give us a little bit more control, but the material is very, very important. And the clear eye therapy and clear quartz is one of the best materials that I've seen in the market. So being part of that ecosystem and what I've also mentioned, the smile cloud, when the patients come in, you know, I scan their teeth, but I scan their faces and the smile. I use the architecture to show it to them. and to show how the teeth are going to look and what's restorative and what can orthodontics do. That obviously improves the patient acceptance because they could see, here's my benefits. And some of my general dentists that I work with who are referring patients to me, they say, you're the best salesman for us because when the patient finishes ortho, they already know they need to get veneers. They know they need to get some restorative. They're ready for implant because I emphasize that. throughout my treatment, and they've seen it at the beginning. So, you know, the problem is before the patient was a little bit out of the loop, and the Stroman ecosystem brings the patient back in the loop. Now, the material that you mentioned that ClearCorrect's trays are made out of, do they need attachments similar to the big competitor, like Invisalign? Every aligner therapy needs attachment in some place because attachments help us. create certain movements or improve the probability that those movements are going to happen. Because the clear-correct trays are longer trimmed and they kind of have a little bit more coverage for the aligner, you need less attachments. That patient's really light because they don't want to see attachments on the front teeth. So if you have longer trimmed aligners, you're able to avoid a lot of the aesthetic concerns because Patients really go to aligners because of aesthetics. And then you put attachment on every tooth and you almost ruin that whole aesthetic experience that they're looking for. The ClearCorrect provides the system with those longer trimmed aligners that compensates for some of the attachments on the front teeth especially. And the dentist can design the tray any way he or she wishes. The ClearCorrect has different choices. depending on how the orthodontist designs it. So you could have a longer trim, scalloped aligners. You could also have shorter trim. You could have those aligners being as short as you want and don't extend to the gums. But if you need some control over the torque of the teeth and some of the deep bite cases, you want those longer trims to help you in efficiency. Again, with the forces, yeah. And get the treatment efficient. You can't stand. three, four hours on the adult who wants to be done in six months. Yeah. Are you seeing most of your patients track? appropriately with their treatment, and that's obviously based on compliance, right? I mean, if a patient's not wearing their trays the correct number of hours or the recommended number of hours during the day, the next set of trays ain't going to fit. Are you seeing compliance pretty much across the board? I mean, to be honest with you, the compliance is better with teenagers than with adults, which is counterintuitive because we always thought teenagers are not going to wear it, but they're actually very good at aligner therapy. And we use a lot of compliance tools to reinforce the compliance. So do we see compliance in our offices? Yes. But we use the red light therapy. We call it, you know, BioLux. We use a light that under a certain frequency, it improves the predictability. So even if the compliance is not 20 hours a day, we usually try to get those movements happen with the use of the light, what they call a photobiomodulation. And then in addition to that, we use the remote monitoring. And so when we use the remote monitoring, the patient gets little notices and the patients feel like somebody's watching. You know, my doctor is watching all the time. So when they do the scan at home, we usually tell them, hey, your tooth is not tracking. You can wear the saline a little bit longer. And so I like the fact that we have this AI automatic system because it's impossible for me to really look at every scan for every week. But AI does a really good job in tracking that and making patients feel more compliant, which translates into higher compliance, less refinements, faster treatments. Yeah. Let's assume that dentists have taken the continued education that they should to be knowledgeable enough to know when to say, know that this is beyond my competency level and refer that out. But they understand where their base comfort zone is and they're willing to begin. doing clear aligner therapy on their patients. And now they want to market it. Now, some dentists struggle with that marketing of clear aligner therapy. What strategies have worked best for you, Dr. Kalika, to promote clear aligner therapy and convert interest into treatment? On the marketing side, again, we use Stroman Marketing Agency. That's why I like, you know, so the clear correct is only one part of Stroman. The Stroman has a marketing agency that we use. And they're phenomenal. And they really kind of put everything together based on the level of education of our partners. And we have a partnership organization. We have multiple partners that manage their own offices called Image Specialty Partners. So Strowman really helps put us all together. What is special about me versus somebody else? And they really try to individualize that marketing. And so for dentists, I would say that digital marketing is very important, but also... Really trying to figure out how do I fit into this overall picture? What is my level of expertise? How do I communicate it to my patients? And patient referral is still the best way to market. And one of the ideas is I'm trying to find another company in AI and we're creating a loyalty agent. And the loyalty AI agent will be able to help the patients that are happy and excited in your practice generate other leads. That's the best marketing, literally, like to get your patients happy and to have them give you good references. Yeah, there's no question about that. I do two shows a week on this program and I hear it all the time. Once they get that patient excited about their treatment, they're telling everybody. The value of that from one patient to another or one family member to another family member and then friends, it happens very quickly where your practice will start to fill, the chairs will start to fill up. What role does team training play in the success, for instance, of clear line of therapy? Let's talk about clear, correct program. How do you ensure that everyone from the front desk to the clinical staff, that they all understand the value of what this brings to the patients and to the practice? I think it's super important. And again, AI is now substituting some of the team members, or I would say assisting them. There's still a human touch. But we have an AI receptionist. We use a company called NUO, N-E-W-O, that picks up all of the calls after hours. So we train our NUO, which is AI receptionist, the same way as we train our team. Speak the same language, answer the question. If the patient is asking, what's the benefit of one system to another? You know, the fact that the team is uniform and really can speak that same language and understand the benefit of certain treatment. but also some of the side effects. If a patient calls and says, hey, I lost my aligner, I was on vacation, what do I do? The team member needs to provide the same answer as the doctor. Well, you can move to the next one and then be able to track most of your changes. So I think team training is super important. And again, since we're talking about AI, I think we're building an AI receptionist that's already built and the outgoing calls are built. But now we're building AI concierge and treatment coordinator to have a patient have that companion that they can ask questions and follow up on their treatment that will increase compliance, but also educate the team to be on the same page. Yeah, I mean, it sounds like to me that if you're a dentist and you're not thinking about or in the process of integrating AI into your practice, you're going to be left in the dust. And they're competing with other practices that have a lot of this integration. I mean, the possibility of scalability for your practice. patient experience, lowering costs, efficiency. It's just amazing. And it's not happening just in dentistry. It's happening, of course, it's happening in so many different verticals. You couldn't practice without it now, Dr. Kalika, I don't think. I don't think I can go back. Yes, that's correct. And I feel like we talked about marketing the aligners, but you're spending all this money and time and energy making patients feel happy and this is all good. And then they call your office and the phone calls don't get picked up. or, you know, some other little thing, little experience that make the patient decide I'm going to go somewhere else. And so incorporating this AI, you know, front desk person, like we use Nuo or Dentif AI and Dentify. And so, you know, the fact that we're not missing any phone calls, there's zero missed calls. And the fact that patients can ask questions to AI assistant. Tell me more about clear aligners. What do you think clear correct does? How does it work? You know, they're able to talk to them at midnight and really understand. And so what we started seeing is 10% more new patients by incorporating AI just on the phone side. Now we're using AI for diagnosis. We're using AI for treatment planning. And so I, you know, if I had to do what I had to do, like trace the cephalometric x-ray by hand, you know, right now I put my, you know, I click a button and all of my diagnostic x-rays. You know, a trace diagnosed and it shows me and the patient like where the problems are. And it's very visual. The interface, the digital interface is phenomenal now where patients can see, oh, I have this problem. I can see it. You don't even need to explain it. Makes it very good to be able to provide them good experience. Yeah, there's no question about it. Like you said earlier in this program, if you have the orthodontic skill set and you're producing good orthodontic services. To have all this patient experience on top of that, the combination is a big win. You just have to hope those data centers keep the energy flowing because that's the biggest problem we're going to have in this world is these data centers supporting all this AI dependency, running these AI chips. You have to have a full source of energy. That's one of the challenges we're having. But I think we'll get through it. Finally, as we get to the bottom of this podcast, and it's been really good stuff, Dr. Kalika, if a dentist listening today wants to grow their practice with, for instance, ClearCorrect, but doesn't know where to start, they have a lot on their plate, they're only practicing a couple of years, and they're trying to figure things out, what would be your best piece of advice to help them take that first step toward integration and growth? Well, I would say the first step, if I was in that position, is to find an orthodontist who's willing to work with them. and who's willing to help them set up the cases and take them through the logic and really work through some of the problems. But I also feel like they have a backup. If they get a difficult case and they get stuck, the orthodontist can bail them out, right? That's the partnership that they need to find locally. The second one is talk to the reps because, you know, I'm sure if Stroman is such a... high quality company it touches them in some aspect either on the implant side or restorative side or the scanning side and so when you get into this resource they can ask who is the rep locally how do i learn about it i mean stroman has very good education part and it's been a dna of the company is they have this ortho campus where they could come in and take courses, how to treat different, you know, conditions and, you know, how do you face it? And ask your reps for resources. And I think reps are very resourceful in a way that they could not only pair you up with a proper practitioner, but also help you get more education and more training. And I think that's the key to be able to be successful and feel confident. And know that, you know, we say 10% of our cases create 90% of our problems. Because if you can identify what are those 10% cases and trouble are and not get them, you will have a much better successful practice, but also easier life with less stress. And so getting to understand how to identify it takes a little bit of time, experience and education. Yeah, I think those are all great points. I'm just wondering if it's a challenge for some GPs to find an orthodontist mentor, because in a sense, the orthodontist is... helping the general dentist do orthodontic work that otherwise would be referred to them. But you don't see that as a conflict of interest in any way. I mean, not for me or our partners. They would always like to mentor general dentists because it's a partnership, right? We work together. And the fact that general dentist has more actually opportunity to see the problems that they haven't seen before. Because once you start doing, you will start understanding how important it is to do orthodontics. And it is part of conservative treatment instead of, you know, for example, shaving the teeth right away. You could put them in the right place and then maybe you're shaving a little bit less. So when the dentists start getting more experience, they start seeing things and they become more aware of what the problems and how they could solve orthodontically. You know, multidisciplinary treatment, which I've been always a part of different study clubs and I'm still learning, is a very powerful thing when you kind of share those cases together. And I feel every orthodontist should be very open to have this kind of relationship with general dentists. And if they're not, general dentists have choices, right? There's plenty of orthodontists who will say yes. And I feel that's what it needs to be. Yeah, no, excellent stuff. Really fantastic discussion, Dr. Kalika. Very inspiring. And you still playing chess? I'm not playing chess anymore. My last game was a long time ago at the kids' elastic tournament. Unfortunately, that grandmaster that I played just passed away. And he's all over in the news, that Stanford kid. That was my last game. And I feel terrible about the loss to chess. I don't know what, nobody knows what really happened. But I think it's part of the mental stress. That really got into that situation. But that was my last game, and it was maybe 15 years ago. How high did you get as far as world ranking in chess? I was an international master, so I never became a grandmaster. And when I immigrated here at the age of 19, I played several tournaments, and then I had to make my living and go to college, and I always had a full-time job. I didn't have time to play chess. My hope is when I get a little closer to retirement, which is for me never going to happen, because I don't see myself as a retired person. You and me both. When I find time to play chess, I will do it again. But like a bad musician, you know, your memory and it's not as plastic. So I don't think I will ever be as good as I used to be when I was 16 year old. Fantastic stuff that you've accomplished in your career. Thank you so much, Dr. Kalika. Pleasure and honor for you to be on the show, and hopefully we'll have you again. Thank you so much. Very much appreciated. Thank you.