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Interview with Damon Arne, April 8, 2005 | UNCW Archives and Special Collections Online Database

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Title:
Interview with Damon Arne, April 8, 2005
Date:
April 8, 2005
Description:
In this interview, Wilmington-based prosthodontist Dr. Damon Arné discusses his education and training, the details of his specialty, and his motivations for becoming a dentist.
Phys. Desc:

Interviewee: Arne, Damon Interviewer: Zarbock, Paul Date of Interview: 4/8/2005 Series: SENC Health Services (Dentistry) Length 35:30

Zarbock: Good Morning. My name is Paul (tape skipping) Library. Today is the 8th of April in the year 2005. We are videotaping in Wilmington, North Carolina. 1604 Physicians Drive (skipping) I'm doing well. What event (skipping)?

Damon Arné: I wanted to help people out. I knew I wanted to either go into medicine or dentistry. Um.. didn't know which- which avenue I wanted to take at the time. My- my wife, or my now wife, she was my girlfriend at the time, she was a dental assistant for one of the local dentists here in Wilmington. And my brother was in dental school at the time. Um.. we- I was talking with them and- and telling them my wishes (skipping) people out in the future and I (skipping) either between medicine or dentistry and d- didn't know which way to go. And- and we started talking and I started thinking about more and more, dentists aren't on call that often. Physicians get calls at 2:00, 3:00, 4:00 in the morning. There's not many dental emergencies that n- require me to be woken up in the middle of the night and- and come in. Now, every now and then I'll get my emergency patients on the weekends and stuff, but that's once every other month, once three times a year or so. (skipping) That's kind of what led to dentistry (skip) medicine. You- you get to see your results immediately. (skip) Medicine you- somewhat- you come in, you're sick. You get a pill- I give you a pill and say, "Okay, there you go." If I don't see you for two or three weeks, then I assume you got better. With dentistry, you come in with ugly teeth, I can fix you and will give you good teeth and immediately see a difference. So between those two things, that's probably- probably the primary reason why I went into it.

Zarbock: When did you graduate from dental school?

Damon Arné: In 1999.

Zarbock: And what school (skipping)?

Damon Arné: (skipping) went to school. I went to undergraduate here at UNC Wilmington and graduated in ninety-thr-- '93. Then I went to dental school, ah.. until '99. And then I went and did my residency in prosthodontics ah.. and graduated from there in 2002. Then I went to San Antonio.

Zarbock: What was the application process like in dental school?

Damon Arné: Dental school was- you take the DAT, the dental aptitude test. Um.. it's kind of like the MCAT for (skipping) to get into dental school. Um.. it was a series of (skipping) long applic-- you know, 4 or 5 page applications and then interviews. And then after the interviews they would- they wrote you a letter saying you were either accepted or you were not accepted. And fortunately, I was accepted.

Zarbock: Some people have said, that certainly graduated years before you graduated, that they were handed a piece of chalk and told "carve a tooth." They were, apparently, given a model of that. Was that your experience?

Damon Arné: No. We-- they-- it seems to be getting more and more lax, I guess, as far as the requirements. What they were doing, the older dentists, and they were analyzing the manual dexterity of- of the applicants to make sure that they could work with their hands. Um.. they, I guess, don't really care any-- or they didn't care, at least when I was applying. Um.. they figure they could teach you that and maybe it has been proven that they can teach you that. So we didn't have do to any kind of carving, wax carving or carving of chalk. O-On the dental aptitude test there are spatial-- they do kind of test it a little bit with spatial questions. They'll give you two sides of a 3-dimensional object and say, "What's the third side look like?" So they're- they're judging, I guess, that has taken the place of doing the- the chalk carving.

Zarbock: So it really is becoming perhaps a little more sophisticated than--

Damon Arné: Yes, I guess. Yes. (inaudible)

Zarbock: Go nail that onto the wall and see if it hangs. Are you glad that you made the decision to go into dentistry?

Damon Arné: Absolutely. I-I-I haven't done any other profession. I was a chemist-- I worked at Applied Analytical here, is a pharmaceutical company on 23rd Street. Um.. I was fortunate enough that my parents paid for my college, but with my si- my sister was in nursing school-- when I graduated from college, my sister was in nursing school and my brother was in dental school, and I was getting ready to go to dental school and they said, you know, we- you've tapped us out. We don't have any money. So what I figured I would do is I'd try to be smart and get a job and try to save up a little bit of money before I went to dental school. Um.. so I was a chemist for about a year and a half here in Wilmington. And just long enough to realize that I'm glad I'm not doing that as a- as a profession. But um.. but I'm glad that I'm- I'm doing what I'm doing. I'm happy it's- it's neat. It's very rewarding. Like I said, seeing the immediate results, seeing how much you can change people's lives from just your teeth.

Zarbock: I'm very, very interested in your subspecialty. First of all, what is your subspecialty and why did you pick it?

Damon Arné: My sub- or my specialty is prosthodontics. And what that is is- is a dentist that specializes in the reconstruction and rehabilitation of- of people's mouths. Um.. I do that with prostheses--crowns, bridges, dentures, partials, veneers, implants, any kind of prosthesis that goes in your mouth, that's what I do. The reason I went into that is I wanted to be able to treat everybody that came into my office. I wanted to know how to treat everybody that came into my office. In dental school they teach you the basics. They don't teach you- they teach you enough that you don't get in trouble the first couple years until you learn, I guess, real world dentistry. There's, you know, in- in dental school or in any kind of education you have that ivory tower. You know, this is the way to do it. This is the only way to do it. Well not everyone fal- falls into those um.. categories. And there are some rules that need to be bent or some things that you can't do exactly the way you want to get it, the way the ideal is. But I wanted to be able to treat patients- every single patient that came into my office, I wanted to be able to treat. And graduating from dental school and with the general dentistry knowledge, I would not have been able to do that. And I- I would hate to- would have hated a patient to come in that needed 25 crowns or 28 crowns and tell them to go down the street to go see Dr. Jones or Dr. Smith. I wanted to be ab- be the one who could treat them.

Zarbock: How long was your post-doctoral?

Damon Arné: Uh.. I had four years of dental school and then three years of residency.

Zarbock: Tell me about the residency. You're the only dentist whom I've interviewed with this specialty.

Damon Arné: It's-- there's not very many of us. Um.. and I- and I don't know why. E-especially in North Carolina. Now elsewhere, in the- in the northeast, there's a lot of prosthodontists. In the California area, there's a lot of prosthodontists. In the Midwest, there's a lot of prosthodontists. And I think that that is because the dental school here doesn't teach the dental students when to refer or the need for a prosthodontist. Um.. it- I don't think they do a very good job of- of educating the- the undergraduate students and saying, "Hey, this is when you're biting off more than you can chew," or "This is when you're going to get in trouble."

Zarbock: Was that a little pun?

Damon Arné: No, it wasn't. But it--

Zarbock: Not bad. Not bad.

Damon Arné: But it um.. and I-- unfortunately, I get a lot of patients who are halfway through the treatment. The dentists are fresh out of school and they think that they can do the 28 crowns or they think they can do this major treatment. And they get halfway into it and they realize they're over their head and then th- send the patient to me. And it just kind of-- it-- I think if they had the better training in dental school saying, "Refer this kind of patient. Refer that kind of patient. You can treat this patient. You can treat this- this type of patient." Then there would be more prosthodontists. Fortunately, there's not that many, so it, you know, works out well for me as far as my business goes and- and all that, but I-I think there should be more.

Zarbock: So your practice is thriving?

Damon Arné: It is. It is. Fortunately we um.. fortunately, we hit the ground running and we actually got busier-- busy quicker than I had anticipated, which is always a good thing. But I was expecting that when I opened up-- I didn't buy a practice, I just, you know, put my name on the door and said, "Come on in." Fortunately, I got busy and there was only one or two-- I think the first month I didn't make a profit. After that, I started- I started to make a profit, which is unusual, um.. as far as if you're starting your own practice or own business. Usually there's a couple months--two, three, six months--of- of you're in the negative and then you start getting- start getting a profit. But unfortunately, we got so busy-- or, we got busy quick enough that we didn't have all of our- our office policies set. So when employees would come and say, "Well, what about this, what about, you know, I want to take this day off." And we'd say, "Well, you can't really do that. We don't want you to do that." They be like, "Well, it's not in the manual." So we've had to revise the manual quite a few times. So um.. but I guess that's a good problem to have. I mean, I would rather be too busy than- than not be.

Zarbock: If you please, pick out a couple of patients, of course without divulging their names, and tell me what would be a couple of typical patients, what do you do, and how long does it take?

Damon Arné: A couple of typical patients that I would have. Um.. treatment is-- it can be as simple as someone who needs- someone who needs a set of dentures. It could be as complex as someone who needs a mouthful of dental implants and crowns on them. Um.. the- a full mouth rehab is- is what we would call doing 25, 28 crowns on someone's mouth. That can take anywhere from 9 months to a year from the day we start to the day we finish. Now they're always in temporaries and they're always able to chew and by no means do they ever have decreased function. But um.. it takes anywhere from 9 months to a year. Um.. it really, I'm 95% off of referrals from other dentists and- and specialists and physicians in town. Um.. so really, whatever they don't want to treat, what they don't know how to treat, they don't feel comfortable treating, or they don't have the time to treat. The difference- one of the differences between me and- and a lot of the general dentists in town is I'm- I don't have a hygienist, so I don't have anyone to clean teeth. All I do is I do crowns, bridges, dentures, partials. I do the prostheses. Um.. the general dentist maintains them. Th-the dentist would send me the patient, I do what they ask me to do or what the patient needs and then I send the patient back to them. So I usually only have 75 to 100 patients at any given time in my patient pool, where a general dentist will have-- a good general dentist or a good- a healthy practice will have two or three thousand. Um.. but it- it really ranges, I guess it all just depends on what the dentist- the referring dentist's comfort level is. Sometimes the dentists don't get along with the patients and I will get a patient that just needs one crown. And just because the-the-the-the patient or the dentist is scared that they're not going to be able to treat the patient; if you have a- an attractive 19-year-old female who has a broken front tooth who has, you know, very, very pretty e-- you know, beautiful smile, beautiful face, other than that one smile, they don't want the pressure and they don't have the time to devote to doing that. Because doing that one crown is a lot different than doing a crown on your very back tooth where no one sees. So a lot of times they get a little intimidated and say, "Look, I'm going to send you to Dr. Arné and this is what he does." And-and there is a-- my fees are little bit higher, because the lab that I use-- the dental lab that I use charges me a lot more to give me that crown that looks like all your r- the rest of your teeth.

Zarbock: Tell me about teeth implants. When did this start?

Damon Arné: Ah.. it started, I guess it ca- the moder-- the-the dental implants that we know of today i-in 2005, is they-they started probably-- there were ah.. 1978 is when ah.. they became th-the modern dental implants came into-into effect. They've had dental implants back in the '50s and '60s and-and 40s. Um.. but they were not very reliable. The-the dental implant, what it is, is a little titanium screw, anywhere from 6mm to 15, 16mm, so anywhere from 1/4 inch to 3/4 inch long, that go in your jaw. And on top of that screw we put a little connector and then we cement a crown on top of that connector. Um.. the dental implants were developed or invented by a-a-an orthopaedic surgeon over in Sweden. Um.. and he-- it's the same technology they use for replacing hips. Same type of screws, but just to a lot smaller extent. And he said, "If we can do this for hips, why can't we do it to replace teeth?" So they started doing it-- they-- the first models were done in dogs, but it came over to the U.S. or to the North American continent back in '78.

Zarbock: Is there such a thing as a tooth transplant?

Damon Arné: There is. Um.. they're not very successful, or w- questionable success. Um.. now I couldn't pull a tooth out of my mouth and put it in your mouth and have it live. But you can, in certain traumatic situations where a child loses a tooth or gets a tooth knocked out playing football and it pops out on the field, you can put it back in your mouth and as long as you splint it back together, there is about a 50 or 60% chance that that tooth will reintegrate or-or will survive. So yes, you can do tooth transplants. You can extract a tooth, one of your molars and move it to replace a different molar, if you wanted to. Again, questionable success, but it-it's reported and-and it can be done.

Zarbock: Where is the boundary between you and a plastic surgeon, a maxillofacial guy?

Damon Arné: I don't do much surgery at all. Um.. in fact, I don't do any surgery, really. Um.. the-the oral surgeons are the ones that will reconstruct your jaw as far as breaking your jaw, pulling teeth, um.. separating your top jaw from your skull and moving-moving the-the jaw around. Ah.. plastic surgeons do mostly soft tissue, you know, cheeks, eyes, breasts, you know, whatever. Um.. I do- I don't do much surgery. I just do the teeth. So I-I do work with plastic surgeons and with oral surgeons as far as if I see a patient who has- who needs certain work done, I will send- I'll refer to an oral surgeon to have the surgery done. If I need to refer to a plastic surgeon to have the plastic surgeon do certain things, then after they get finished, they come back to me.

Zarbock: How long have you been in practice?

Damon Arné: Two and a half years. October 14th of 2002 is when I opened.

Zarbock: In that time, have you seen any changes in equipment, materials, or anesthetics?

Damon Arné: Not anesthetics so much. There is a new-- technology is-is always evolving and th-they're always coming out with the latest, greatest thing. Um.. how long they last, I don't know. Um.. there's a new machine called a CEREC machine. And what that is is a-- that's, I guess, pushing the-the-the forefront or in the forefront of-of innovations.

Zarbock: I'm sorry, what was the name of the--

Damon Arné: It's called a CEREC, a CEREC 3D. And what it is, is instead of you getting a crown, you know, th-the way it-- a couple of years ago the way it was when you'd get a crown, you'd come in, the dentist would prepare the tooth for the crown, make the impression and send it off to the lab. Th-this new machine, the CEREC 3D is I prepare the tooth for the crown and I take a picture of the tooth and send that to a computer and the computer mills the crown itself. Um.. I think there's questionable applications for it. I-I think it's great technology. It's a- it's computer-aided design, CAD-CAM, and i-i-it's-it's a great theory. I don't think right now that it's there. I think maybe in a couple years it will be. There's a lot of dentists who have-- or, not a lot, but there's a few dentists, because the machine's $100,000, to do it. So there's not very many dentists who have them. Um.. I think in- for this practice, it's not a good- it's not a good mix, because doing 28 crowns with that CEREC is-- aesthetically, it doesn't give you all the options that you want. But if-- in a- in a healthy general dentistry practice, doing one or two crowns then I think is-is a- is a good- is a good thing. Mainly what's changing is the materials. Ah.. instead of using gold underneath-underneath crowns, they're starting to use zirconium and-and titanium and-and different, more aesthetic um.. materials.

Zarbock: Who keeps you up to speed on the new materials and the changes?

Damon Arné: Ah.. I go to courses, continuing education courses that are held throughout the year. Um.. once a month, the first Tuesday of each month, the Dental Society has a-a speaker come and talk for an hour or two, so there's-there's certain continuing education requirements. You have to have 15 hours a year of continuing education. So you just go to various seminars um.. and listen to the speakers.

Zarbock: Like everybody else, I really would enjoy any remarks that you could make about mercury.

Damon Arné: Mercu-- there is more mercury in a can of tuna fish than there is in any of the silver fillings that are in your mouth. The only way- the only way the mercury is released is when you get mercury vapors and mercury gases, and that's if you- if you ah.. start grinding on them, changing them a little bit. But again, if you eat a can of tuna fish, that's more mercury. If you swallowed all your silver fillings in your mouth, there's more mercury in a can of tuna fish than-than in all the fillings in your mouth. So the-the dentists-- there's-- the dentists who have made a living or-or made-- built their practice on mercury-free dentistry and-and I will ah.. you know, "If you have cystic fibrosis, it's because of the silver fillings that are in your mouth. Let's take the- take the silver fillings out of your mouth and you'll be cured." And there's a lot of people preying on-- and I can't blame the patients for believing it. If I had some kind of disease, I would try anything I could.

Zarbock: Sure.

Damon Arné: But I think that they're just preying on these people's emotions and-and the dentists who do that are no-- they are not members of the American Dental Association. They cannot be members of the American Dental Association. The-the ADA kicks them out, because they're practicing voodoo dentistry or they're-they're not practicing-- they're not being honest with the patients. If a patient wants a silver filling taken out because they don't like the way it looks, I have no problem doing that. If the patient wants a silver filling taken out because of the mercury, I don't take- I don't take the silver filling out.

Zarbock: Would you do it again?

Damon Arné: Dentistry?

Zarbock: Enter dentistry.

Damon Arné: Yes, I would. Like I said, i-it is very rewarding being able to s-see the difference that I can make on the patients, um.. the immediate results. Um.. people come in very shy, very ah.. despondent, very introverted, um.. because of their smile. You change their teeth, you know, and two hours later they're happy, they're walking out and they're smiling. I-It's amazing what a smile will do to someone's personality. I-It's amazing.

Zarbock: So this has been a frequent experience of yours?

Damon Arné: Yes. Hopefully, yes. But yes, it has been. Um.. if I'm doing my job correctly, then-then it does. I mean its-its-it really, i-it's fun. It's amazing, e-especially with what I do with prosthodontics, there's a lot of, I don't know, artistry. I-I sculpture-- I just-- it's-it's fun. I mean, I get to work with my hands a lot more than I- than I would being a general dentist. Being a general dentist, there's a lot of drilling and filling. You know, you have a cavity, you come and do the filling and you don't get to sculpt and you don't get to change too many-- too much of someone's smile, not on an everyday-- not on a daily occurrence. To me-- with me, with the practice that I have, it's two or three or four times a day people are coming in and I change-change their smile and they're ecstatic.

Zarbock: What's the role of diet in your profession and in your practice?

Damon Arné: In my practice, um.. diet varies when you're in-- when they're in their temporaries- when they're in their temporary crowns, which are just plastic crowns. You know, I tell them not to be chomping on peanuts and peanut brittle and things like that, because the plastic teeth will break. Um.. so as far as that, there's not that much- other than that, there's not much that I restrict the patients from eating. Um.. hopefully, they can eat-- when I get finished with them, they can eat and chew anything they want. Um.. but as far as diet-- as far as overall tooth-tooth health, sugary foods, sweets, the candies, um.. nursing bottle decay where parents ah.. put their kid to bed with a- with a bottle of milk. There's a lot of- there's a lot of sugar in milk. Um.. I don't see it in my practice, because I'm not a pediatric dentist. But pediatric dentists see it quite a bit where a baby will have- they have 20 primary teeth. Twenty of them have cavities in them and 20 that they-- you see these kids walk around with silver crowns all in their mouth and it's just because the parents have negle-- in my opinion, neglected and abused the kids as far as just putting them to bed with a bottle of milk, because the kid goes to sleep and the- and the milk just pools in their mouth and all the- all the lactose, the sugar, just eats through their teeth. And where they put them to bed with a can of Sundrop or, you know, they put Sundrop or Coke or Pepsi or something in-in the bottle. Um.. but obvious-- you know, taking care of your teeth, brushing your teeth, flossing your teeth, then there's-there's no difference with what I do than with any other-- no different instructions that I give the patients- my patients than any other dentist would.

Zarbock: I'm going to return to your graduation. How many graduated in your class?

Damon Arné: In my dental school class?

Zarbock: Yes.

Damon Arné: 75.

Zarbock: How many were women, roughly?

Damon Arné: Probably half. They-they-the dental school, fair or not, they have quotas that they-they try to get um.. they try to get a certain amount of minorities, a certain amount of women, a certain amount of men in there. And-and I think that quotas should actually be taken away with and just the top 75 people that qualify, whether they're all black females or whether they're all white males, or somewhere in between. I mean, I think those should be the-the ones that should get the- get the spot. Um.. it does work out- out, I'm sure I'm going to sound sexist with this, but it works out better for me the more women that are in dentistry, because women traditionally, you know, stay home with the kids. They have a kid and so they're- a lot of the women in town- a lot of women dentists work part-time. They work 2 or 3 days a week, which means that they don't have the time to see all their patients, so they send me more patients, because they need to be home with their family. Um.. with me, I'm fortunate enough that my wife stays home with the children, so I see my kids-- you know, I go to- come to work and-and I see my kids at 6:30, 7:00 at night. And-and so it's-it's not the best thing in the world. I mean, I'd like to see them a little bit sooner, but by the time I get out of-- and with traffic the way it is in Wilmington now, um.. it takes me anywhere from 30 minutes to, if there's an accident, an hour to get home. So, if I leave at 5:30, I'm getting home between 6:00 and 6:30.

Zarbock: A colleague of yours pointed out that his belief was that there's probably the same ratio of dentists to general population now as some years ago. However, he pointed out that the number of women dentists has increased. Then, he drew the conclusion, that there's still the same number of dentists, but there are fewer practice dental hours.

Damon Arné: Yes. There- I think there are fewer- there are fewer hours, I think just mainly because of the-the women dentists working--

Zarbock: Part-time.

Damon Arné: --two days a week or two and a half days a week. Um.. I think the-the dental- the dentist to general population ratio is-is decreasing. Um.. there are- there have been recent dental schools closing throughout the U.S. and two or three in the past five years who have said they just don't have the funding for it. So there's fewer dentists and especially with the population getting older, there's more population here. Um.. so I think it's a great time to be a dentist, especially a prosthodontist because my average patient is probably 50, 60, 70, 80 years old, who-who finally have the-the discretionary income to work on their teeth. They've paid for their last wedding and they've paid for all their kids to get out of- out of college. So now they can spend 15, 20, 30, 40 thousand dollars on their teeth. So i-it works out well for me that the population is getting older and that aesthetics is, you know, becoming more and more important to everyone. I-I have 80 year old women who come in who want veneers, who- or want the perfect smile. You know, and it's just- and which is great. You know, back 20, 30 years ago, you know, if you were- you'd be lucky if you were alive at 80. You know, and now-now people are, you know, saying, "I'm going to live for another 10 years and I want to look right." I have a patient who says she's going to spend-- her-her kids are-- she's spending probably between me and the oral surgeon, probably $60,000 on her mouth. And she said that her kids are just up in arms that she's spending this money. Her husband's all for her spending the money, but she said, "It's my money. What I want to do, I want to be able to chew my food until the day I die, and I want to be able to smile and have people say, "Wow, you have nice teeth," until the day I die. She said, "You know, I might die next year, but I'm going to have pretty teeth."

Zarbock: Is it cosmetic work that's going on, primarily?

Damon Arné: She-- yeah, she's-- it's-it's mainly cosmetic. I mean-- most of- most all dentistry is elective. I mean, people-- you're not going to die from not having teeth. So most of everything that I do is elective. Um.. you know, it's just what patients value. You know, they-- it's-- some of it's function. I mean, the-the particular patient I was talking about, she had some decay and she was just constantly being in the dental office. She'd, you know, this tooth would break, this tooth would break, and she would keep on getting them filled and-and doing this and that. And she said, "I'm sick of this. I want to do it- I want to do it one time and I want to do it right." So we are in the process of doing it the one time and doing it right. And she's happy as can be.

Zarbock: Could you do a total extraction here in your office?

Damon Arné: Um.. back when I first graduated from dental school, yes. I haven't pulled a tooth-- I pull probably about 3 teeth a year. And I pull the- I pull the teeth that are flapping in the breeze, that, you know, if you open your mouth and a strong breeze comes by, the tooth would get blown out. Um.. I'm just not set up for it. I don't feel um.. there are better people-- what I do, I do very well. Um.. what I don't do, there's reasons why I don't do it. And it's because there's better people in town to do it. Um.. I have focused what I do and I-- and I focus all my time and energy in trying to do what I do and do it better. Um--I don't do root canals, I don't do- I don't clean people's teeth, I don't ah..

Zarbock: You don't pull teeth?

Damon Arné: I don't. I-I've pulled, like I said, probably 3 teeth in the past year, and that is one of them came out with an impression when I was making and i- the lady needed- the lady needed some dentures and she wanted me to make another impression of her mouth, because sh- I saved her $150, because the surgeon charged $150 to pull the teeth. When I made my impression for her dentures, a tooth came out. So she wanted me to do it again and again and again until all of her teeth came out. Because I saved her $150, you know, each tooth that came out. But uh.. the other two teeth were, you know, very simple to pull out.

Zarbock: (chuckle) A curious question. In your clinical judgment, which group of people are more involved in restorative and cosmetic dentistry, men or women, girls or boys?

Damon Arné: I-I don't know. I mean, i-it-- the patients always want to have my dental assistants and my front desk and my office manager come in and give them their-- give the patient their opinion as to whether something looks right or not. Um.. they just like having that female eye. I don't know if there's- if females are better than males at telling the aesthetics of-of things. I mean, I think that I do a-a pretty good job. Um.. but the way I figure is the more opinions, the merrier. Some people might see things that-that I don't see. And-and when they do-- when my staff does point out things that they see, I-I look at it and say, "Well, I, you know, I-I can fix that" or "I can't fix that" or "I did that on purpose" or "I'd-- you know, so it's um.. I don't if-if there's one better than the other. They say that women can tell color better. You know, I-I don't-- more men are color blind than women are, but I, you know, I don't know if there's necessarily--

Zarbock: But that doesn't mean that all men are color blind.

Damon Arné: That's true. That's true. So I don't know if one per-- if one sex is better at determining what's aesthetic or not.

Zarbock: Words, trendy words. At one time "comprehensive." If you were going to write anything that had to do with health or health care delivery, it had to be comprehensive. That was then followed by "comprehensive and coordinated." Now comprehensive and coordinated disappeared immediately when somebody went into a Chicago storefront clinic which billed itself out as comprehensive and coordinated. They wanted to see a neurosurgeon. Now this is a storefront in a slum area of Chicago. Of course, it was a set-up deal. I don't know who set it up, but they didn't have a neurosurgeon. So they sued the clinic. Well, the word "comprehensive" disappeared. That leads to the current buzz word, "niche." One of the most popular words abroad in the land these days is niche. Your niche is a very specific piece of the healthcare delivery system, isn't it?

Damon Arné: Right. I-It is. I mean, it's-it's-- I-I do what I do and I-I have a very focused-- very limited practice as to what I do. And if someone comes in and says, "I need a root canal," I send them next door, because there's an endodontist right beside me. If someone comes in and says their teeth are crooked, I send them to go get braces. So, I mean, I-- although I say I'm comprehensive reconstruction, when I say "comprehensive," I-I think I can do the comprehensive stuff. I'm at least a quarterback of the comprehensive treatment. Um.. you know, I tell the other specialists or the other dentists what to do and when they do what they do, they come back to me.

Zarbock: The way around that, of course, is to always have in print, that for the purpose of our discussion, "comprehensive" is defined by me as...

Damon Arné: There you go.

Zarbock: You can put comprehensive as being you've got to have a shower before you come in. That's my definition of comprehension. That's ludicrous, of course, but if you define the phrase and set specific parameters. Your niche is not this, not this, not this, but... For the purpose of 50 years from now a student looking at this tape, what is your niche?

Damon Arné: My niche is-- wow, I don't even know, um.. pleasing the patients, doing what I can to please the patients. Um.. doing the crowns, the bridges, the partials, the veneers, doing what needs to be done to give the patient a ha- a healthy mouth, a healthy smile, improve their overall general health. Um.. you know, the oral-- the Surgeon General years ago, C. Everett Koop said, "Without dental health, there is no health." So it's, you know, I- and I think that's true as far as the patients who-- if you can't eat your food, if you can't chew your food, you're swallowing bigger chunks of food, which messes up your GI system. And-and you really do have poor health. So my niche is pleasing the patients, doing that, whether that means um.. fixing their teeth for functional reasons, um.. ah.. fixing their teeth for aesthetic reasons, or-or just fixing it for a combination of the two. That's what I do.

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