Cosmetic vs healthcare dentistry: Coffee Break with Coachman podcast

This transcript has been reviewed by AI and may contain inaccuracies.

Christian Coachman: Impact of what we do in the mouth in systemic health. How much do we actually know about how much harm we do to our patients through dental treatments? How much do we know about the link between what we do with the bite and the posture of an individual? How much do we know about chronic pain, chronic inflammation, chronic infection, and these things that may be happening in the mouth and, little by little, may be ruining the long-term health of our patients?

And three, two, one, and we are back live with Coffee Break with Coachman, with me, Christian Coachman, and my dear friend Kirk Behrendt, where we bring some great guests but also just discuss and brainstorm topics that we think are relevant to make dentistry better. Today, my new hottest topic, the topic that I'm dreaming about and thinking about, has become my new living motto: cosmetic dentistry versus healthcare dentistry. What does it mean? What is this difference? Where are we heading, and what do we believe should change to make dentistry better?

As an advisory note, today, right now in Madrid, it is 5:00 PM. I just came back from lunch, and I did have a glass of wine, so if I'm speaking a little slower, it's because of that. But it does give you a good feeling to brainstorm about philosophical topics like the one we're going to talk about today.

Kirk Behrendt: Yeah, now this is a big topic. You actually had a meeting with your team, and this is your new communication mission. Can you explain what that means?

Christian Coachman: As communicators, we are always trying to find our new purpose, right? Our new tagline, our new topic, the new battle that we want to embrace, the new trend that we want to defend, the new message that we want to share. Of course, 15 years ago, it was about smile design and the importance of starting modern dentistry with the smile design project, seeing where you want to be. The importance of the diagnostic design, the facially driven design, reverse-engineering your plan, design before you plan—all these messages were at the core of DSD at the beginning. Then we started to talk about emotional dentistry and how to onboard the patient, how to create perceived value, how to create differentiation, and this became the hot topic of DSD. Then we entered the 3D technology phase about 12 years ago, and we started to talk about 3D visualization, 3D simulations, translating 2D into 3D, the importance of bringing 3D software into the diagnosis and treatment planning phase, using software pre-acceptance, making 3D software become a routine.

Then we continued to evolve, and we started to really embrace scanners and say, 'You know, you have to start from the scanner. Scanning is the gateway to modern dentistry.' Then we realized that the new communication, the new tagline, should be about team communication, asynchronous communication, and visual communication, collective intelligence, empowering decision-making by improving communication, building professional communication systems, and that became the main message for a few years, you know, and the main story of our course. So we are constantly picking our new battles and creating communication around these new stories. Of course, that guides the content that we share on social media, that guides the content that we share with our key opinion leaders, that guides the content in my lectures and our courses, and so on.

Then we entered the airway space about four years ago, and it became the thing for us. It's not just facially driven smile design; it's facially driven and airway-driven smile design. The starting point is not just the aesthetic diagnostic design but also an airway-driven tooth position, arch form, and arch position in the face. If it's good for the face and it's good for the airway, that's our new starting point. Then we're going to reverse engineer the treatment planning based on these two parameters, and we started to learn from all the best experts and so on. For several years, orthodontics became our new topic. We were huge advocates of empowering ortho in the restorative world, a huge number of restorative cases that could benefit from ortho before restorative, preparing a restorative case with ortho, becoming more minimally invasive because of ortho, improving the communication between restorative dentists and orthodontists, creating a better link, and we developed this really groundbreaking workflow, DSD and Invisalign, for the first time linking both worlds in the digital 3D environment. That became this new product from Align called Smile Architect, which we are very proud to have been part of the inception of, the beginning, the conceptualization of this workflow. We know that every single ortho company will follow. So that was another big story for us for a while.

But as we know, innovation comes in waves, and these waves come and go. If you stay with only one story, it's going to fade, and you're going to become part of history. We still have a lot of energy and creativity, and we want to always be jumping on the new wave and, even more, helping create the new waves as we did in the past. For many reasons, recently, I've been very open, like I always am, to new topics. The impact of what we do in the mouth on systemic health—how much do we actually know about how much harm we do to our patients through dental treatments? How much do we know about the link between what we do with the bite and the posture of an individual? How much do we know about oral health and systemic health? How much do we know about the toxicity of everything we do in the mouth? How much do we know about chronic pain, chronic inflammation, chronic infection, and these things that may be happening in the mouth and little by little may be ruining the long-term health of our patients?

I was always very open to this topic because my father was always very open to this. My father always said, 'We don't know what we don't know,' and we know very little about all these topics. My uncle, also a dentist, is a pioneer in biological dentistry in Brazil, a big pioneer in alternative treatments in healthcare and dentistry. He started the movement of using ozone in dentistry, for example, using laser therapies in dentistry, and so on. So I kind of grew up listening to these things and realizing that there's a big dogma around most of these things. People don't like to talk about these things. Even the best dentists in the world prefer to believe that there's nothing there because it's going to mess up many things that they believe or many things that they do to patients. Unfortunately, many dentists, like everything in life, when you see something in a gray zone, you have the opportunistic doctors embracing these things and calling themselves holistic dentists and creating this bad perception of that.

Everything that is not scientifically proven, people say, is wrong instead of saying everything that is not scientifically proven is just not scientifically proven. It doesn't mean it's right or wrong; it means we don't have enough information, or we don't know, or maybe the industry doesn't even want to know about these things. Then, on top of all of this, we put aesthetics and the revolution that aesthetics brought to dentistry 40 years ago, 30 years ago, but still, you know, in the '80s, starting the story of aesthetic dentistry, in the '90s, becoming societies, the American Academy of Aesthetic Dentistry, the European Academy of Aesthetic Dentistry, still amazing clinicians really focused on scientifically based dentistry, really focused on the patient, adding an extra layer that was very important and relevant: making smiles look beautiful. Then we get into the 2000s, and suddenly it becomes the thing, and people just take over this as a business. The business becomes huge, and people start to talk about the numbers around aesthetic dentistry. Then you have corporate dentistry coming in, and then you have social media with the superstar dentists promoting themselves as the aesthetic dentist. Then you have all the strategies to make patients believe that all that matters is to have a beautiful smile. All these trends made me very, very worried year after year, starting, I would say, 10 years ago when I first started to question myself and even question myself, 'How much, you, Christian, through DSD, are you helping this become worse?'

Kirk Behrendt: Yeah.

Christian Coachman: And what can you do to not contribute to this? So, for the past 10 years, I've been working very hard first not to make it worse and second, what can we do to make it better?

Kirk Behrendt: Yeah. Now let's make this clear for the listener. You're not against aesthetic dentistry or cosmetic dentistry. You've gone on the record by saying aesthetics shouldn't be the priority but the beautiful consequence of the right treatment, correct?

Christian Coachman: That's it.

Kirk Behrendt: Aesthetics shouldn't be the priority.

Christian Coachman: So, that is the reason why we're talking about this topic because I came up with this statement around six months ago. I wrote it down. I was training for the marathon on the treadmill for like two hours running, and usually, when I run, I meditate, and I have my best ideas. Many times I have to write them down as I'm running to continue to think about other things. I wrote that down: aesthetics shouldn't be the priority but the beautiful consequence of the right treatment. Initially, I was repeating it to myself and saying, 'Do I really think that's right?' Now, 100%, aesthetic dentistry is not necessarily bad, and I mentioned it came into dentistry as an added value. The problem is that when we start to persuade patients and harm their long-term health in the name of aesthetics without educating them properly, by just telling them what they want to hear, of course, everybody wants to hear, 'Look, we have this amazing procedure that is going to make you look much younger. There's no contraindications. It's only positive. You're going to feel great about yourself.' Who's going to say no?

In medicine, physicians are obliged to really disclaim everything that can go wrong, almost like pushing you out of the procedure, almost like trying to convince you not to do the procedure. This is what aesthetic dentists should do, but we do the opposite. We even say that aesthetic dentistry is healthcare dentistry when it's not. My comparison is with plastic surgery for example. The medical world is far from ideal; it's also a disaster in many other aspects. But when it comes to plastic surgery, you don't go to a plastic surgeon to live longer. You don't expect that. You know that you're going there just because of pure vanity. You want just to look better, even if you may take some risks. You know the risks. You know you're going to go through surgeries. You know they can cause negative effects on you. You know you're going to take medication that is not necessarily good for your health, and you know it's clear. I just want to look better. And the plastic surgeon is not fooling you about, 'No, your system is going to work better because I'm going to give you bigger boobs.' No, because I'm going to stretch your face, your heart is going to function better. No, it has nothing to do with that. I'm here just to superficially make you look better for a little while. For a little while, because everything else will come back, right? Do you want to look better for a little while? I'm the guy. And I think that's fair, you know? That's okay. It's really honest, right? If you want to live longer, if you want to be healthier, you know who to look for—the physicians that are really looking into longevity and prevention and healthcare. If you have a disease, you go to people to fix your disease. If you want to be healthier, you go to a different doctor than the one who takes care of diseases. And if you want to look better superficially, you go to a plastic surgeon. This is maybe just one little aspect of the medical world that we should bring to dentistry.

Imagine that you go to a cosmetic dentist, and upfront he's very honest about, 'Look, not only am I not going to make you healthier, but I'm going to create harm to make you look better. I'm going to extract teeth that don't need to be extracted, and I'm going to grind down teeth that don't need to be ground. I will make your bite less efficient because there's nothing more efficient than natural dentition biting together. I'm going to make you less efficient with aligners. I'm going to make you less efficient with veneers and crowns. You will be less efficient.' Telling people that you're going to do 24 restorations and make them bite better is usually nonsense. In 90% of the cases, you're biting better with your natural dentition, not with your artificial teeth. I'm going to try to make you bite as best as possible, but usually not better than your natural dentition. If you don't have a TMJ problem, if you don't have a bite problem, if your natural dentition is there, even if it doesn't look great, even if it's worn down, they're functioning usually very well together. You've been using them against each other for decades, and now comes a cosmetic dentist saying, 'I'm going to do 24 restorations, and I'm going to make you bite better.' No, you will not.

Now, do you want to pay the price to destroy enamel that doesn't need to be destroyed, to extract teeth that don't need to be extracted, to maybe make your bite slightly less efficient just to look better for the next five to 10 years? Because in 10 years, you're going to look bad again, and we're going to have to redo it. Maybe in 15 if we are lucky, but I can guarantee probably in 10 years. Not because restorations are failing. Even if the restorations are not failing, you will be coming back saying, 'They don't look good anymore. What can we do about it?' So, I'm going to tell you upfront all of this information. Do you still want to do your 20 crowns or your 20 veneers? Because I'm just a cosmetic dentist. If you want to be healthier, you need to go to a healthcare dentist. That's why I'm suggesting, proposing that we create the definition. Are you a disease dentist, are you a cosmetic dentist, or are you a healthcare dentist?

If you are a periodontist and you treat periodontal disease, you are a disease dentist, and we need that. If you are a TMJ TMD expert, you treat disease. If you are an airway dentist, if you are a chronic pain dentist, you are treating disease. You're not an expert in preventing disease; you're an expert in fixing it when the problem is already there, and we need these experts. It's also okay to have cosmetic dentists—this new type of cosmetic, honest cosmetic dentist that is not trying to take over healthcare, pretending they're delivering healthcare. So, we have them as well. But now we need to find a way to empower this new generation of healthcare dentists, preventive dentists, amazing super diagnosticians, amazing on minimally invasive procedures, amazing on systemic issues, amazing on preventing TMD, preventing issues starting with babies, starting with young kids, preventing functional disorders, all of these issues. I believe that this is something that we need to talk much more about, and we need to find a way to deliver, to create a business model that will reward the brave dentists that are willing to work for healthcare prevention, diagnosis, and longevity.

Kirk Behrendt: Okay, you got to open up that. I want you to go back to that. You use the phrase longevity approach in tooth preservation. So, go back to that. When you say the longevity dentist, the business model, explain that.

Christian Coachman: First, we need to understand what is known in dentistry: the death cycle of the teeth. Two things we need to know: death cycle of the teeth and the oral systemic link. People don't talk enough about it. So, we need to repeat to every dentist and to ourselves over and over again what is obvious and what we already know. When you prep the teeth of a 22-year-old to make beautiful 12 veneers, you're touching virgin and beautiful enamel unnecessarily, and you're telling this patient that it looks so much better, and blah, blah, blah. In 15-20 years, probably after 10 years, they're going to come back. You're going to have to remove them, and as you remove them, you're going to have to retouch and remove more enamel—100%. Second cycle: five more years, probably a few will fail. Because on the second time you touch, you may expose a little bit more dentin here and there. Longevity will be even less, and you're going to start having more problems, and you're going to have to change even faster. You're going to chip one here, you're going to debond one there. As you're getting into your 40s, you're probably entering the third cycle, prepping even deeper, transforming some veneers into crowns for sure. Then you have already some functional issues, and then you try to improve function by extending the prep as well.

And this I'm talking about the average dentist. If you're unlucky to face a horrible dentist on the first cycle or second cycle, you may even destroy everything faster, right? But with an average dentist, you're talking about the third cycle. You're into the 40s. You start having problems—sensitivity here, sensitivity there, other problems that we many times don't even disclose to the patient that do happen. You have to treat the canal of some teeth. Suddenly you're getting into endo here and there. Endo—not even touching the biological impact of doing endo on teeth that people don't know enough about the real impact of. Having endo treatments in your teeth in the mouth, then we are talking about the fourth cycle, having problems that are irreversible, cracking a root because of lack of structure, pulp exposure, and then suddenly you have some extractions. So now you're into implants here and there. You're getting into your 50s with implants. You may have some soft tissue loss, black triangles, exposure. Patients don't like it, so you need to redo the restorations again, prep even deeper, try to close the spaces. Many times the gum doesn't like that. You create more recession, harder to clean, bone recession, losing some teeth, more implants. Now with implants, we know peri-implantitis is unavoidable. It comes. So now you're into your 50s, 60s with peri-implantitis. Maybe you need to extract an implant, one of the few that you have.

Besides the fact that we don't know the impact, the real impact of having metal in your mouth, the toxicity of metal and other issues that may happen—chronic issues, systemic issues that people don't even talk about. And you get into the fourth, fifth cycle, and then more extractions. If the patient doesn't behave properly, doesn't care properly, you know, it causes mental issues. Then you have depression, you have medical issues, medications, and going down with the immune system and infections in the mouth that affect your brain, affect your heart. We don't, you know, people don't talk enough about it. So, I'm not an expert on all these topics, but we know that this is what happens.

Kirk Behrendt: Right.

Christian Coachman: And suddenly you are 75, and you have an overdenture. You have an implant prosthesis, and you don't have teeth anymore in one arch maybe. There's amazing science proving that when you don't have teeth in the mouth, the fewer teeth you have in the mouth, the more prone you are to dementia, mental diseases. Teeth play a key role in longevity, systemically and mentally. Old people that have teeth, they live longer for many reasons, but also because they have teeth. Even psychologically, it plays a huge impact, knowing you have your own teeth. The connection between what you feel in the mouth and what goes on in your brain, what it stimulates in your brain when you have your own teeth, that it doesn't happen when you have implants or dentures. There's amazing connections between the mouth and the body. There's absolutely nothing better in the mouth than your own dentition, even if it doesn't look perfectly aesthetically. It's such a stupid, dumb decision to destroy teeth in the name of aesthetics. The problem is that people don't even have that perception, and dentists don't talk enough about it.

Kirk Behrendt: You said we should change the reward system to maybe tooth preservation.

Christian Coachman: Yeah, so I have this amazing speaker, one of the best implant dentists in the world. I remember it as if it was today, him lecturing and saying, 'The more I know about implants, the more I love teeth.' Now, this guy is one of the best in the world. For me, he's the best in the world with implants. So, it's not someone who is bad with implants saying that teeth are better. We're talking about the best guy in the world with implants. His name is Dr. Inaki Gamborena, and he's saying, 'The more I know about implants, the more I love teeth.' He's talking about the biological perspective, the aesthetic perspective, and the functional perspective. He was probably, I don't know, I don't think he was even touching the systemic perspective, the mental health perspective, all these other things that we are starting to realize today. The dental tooth should be sacred for a dentist. Thirty years ago, my father told me the number one enemy of teeth is the dentist. In a very sad way, he told me that. Like, it's very sad to say that the biggest enemy of teeth is the dentist. Thirty years ago. And we are seeing this getting worse and worse and worse.

Kirk Behrendt: Yeah, so go into just a little bit more of the business model. So, if I'm a dentist listening, longevity...

Christian Coachman: The problem, of course, is that every time you put money on top of the patient, it's a disaster. This is obvious. So, every dentist says, 'I never put money on top of patients.' Really? I'm not judging or pointing fingers. I'm just saying that it's very hard because we all deserve to make money. We have to make those decisions in so many moments as a dentist. But I believe, as an optimistic person that I am, that most dentists have good intentions. Every good dentist is placing patients first. When you have those tough moments where you see the money so close, but it's not necessarily the best for the patient, you put the patient first, and you sleep with yourself so well, right?

Kirk Behrendt: Right.

Christian Coachman: Now, once you have dental practices that are owned by corporations, you lose that. Corporations, DSOs, are not stupid, and they're learning that they need to deliver quality; otherwise, they don't have a business. But quality for corporations is the same as in any business, like phones. If you don't build great phones, you're not going to have a business. So, you need to build quality phones. Oh, that's obvious. But if you own a company that builds phones and you have a moment where you need to decide profit over quality, many times you will decide on profit. And there's nothing bad about it. It's a conscious decision, and it's just the phone. You're going to drop the quality a little bit here, a little bit there. You're going to increase your profit. You're going to improve the marketing on the other side and make people feel like it's still great or whatever. Fair. Marketing, persuasion, profit over quality. Every company has their own standards. Now, when you come to healthcare, that shouldn't be a discussion, but it is a discussion. Hospitals that are run by business people, they put numbers over patients, right? Pretty obvious. Dental practices that are owned by corporations, they put numbers over patients. Period.

So, the reward in dentistry today, even for privately owned practices, is on the treatments, not on prevention, not on diagnosis, not on longevity. You don't make more money in dentistry because you're fighting for longevity. You may even make less money, unfortunately. You don't make more money because you are an amazing diagnostician, and you're preventing stuff, and you are honestly educating your patient that the best treatment is no treatment. Many times, you don't make more money because you're investing in an amazing hygiene department and prevention. As much money as you can make with fitting every patient in the same box and doing hundreds of all-on-fours and hundreds of veneers and hundreds of aligners per month. The best way to make money in dentistry is to try to fit patients into the same box. That's why practices that are only focused on aligners, practices that are only focused on veneers, practices that are only focused on all-on-Xs are usually the most profitable ones. And all they do is master the process of attracting more patients into that workflow, converting more patients into that workflow, convincing patients that that is the best for the patient, repeating as much as possible, not complicating by trying to analyze, 'Is this the best for this person?' So, the actual business model of dentistry rewards the wrong dentistry. That's why I said it's easier to sell the wrong dentistry than it is to sell the right dentistry.

Kirk Behrendt: If you believe philosophically that you do the right thing and you know functions are a byproduct of this, you'll always be okay in the end. Let me throw one more thing at you, Christian. You mentioned this. We're not only battling the costs of dentistry and the trends in dentistry, but we're also battling society—society's exacerbation of beauty. Can you talk about that?

Christian Coachman: So, the problem comes from all directions, right? The medical system is a huge problem. I mentioned to you before we started recording, I'm not a socialist, politically speaking. I would call myself centered, central, whatever name you...centered, right, left, right in the middle. But there is one aspect that I think in society that should be socialized, and that is healthcare. Imagine a perfect non-socialist society where only healthcare is socialized. Meaning it's just about the patient. Because the moment that it's not a matter of profit, because profit will always prioritize procedures. Because yes, if you really need a heart surgery, a heart surgery is the best for you. If you're going to die if you don't have that surgery, the heart surgery is the best for you. And to do a heart surgery very well is very expensive, and it should be. So, whoever is doing that will make a lot of money with that procedure, and that's fine because it's very hard. But the moment that it's all about a business, you try to fit more people into that pipeline. That's the problem.

Now, if you think socialistically only on this matter of healthcare, actually what we are trying to do is, since nobody's going to actually make more money if we do that, it's going to actually cost more for everybody if more people do that. The whole system will work to prevent the need for it, right? And only do it when it's like, pretend like this: you have a country with 100 million people living in it, and every time somebody needs a heart surgery, all inhabitants need to share the cost of that heart surgery. Oh, this month we have 10,000 people needing a heart surgery, and they really need it; otherwise, they're going to die. Let's all share it. Okay, you're going to see that after a few months, everybody's going to be sitting at the table and say, 'Okay, look, how can we prevent this from happening? Okay, how can we improve diet? How can we stop screwing up with people's health?' You know, because, you know, last month we had to pay like 100,000 of these procedures. So, what I'm trying to say is that the business model is screwed up, is wrong, right? And we are rewarding procedures. We are rewarding immediate success. We are rewarding shallow, superficial, short-term benefits. Shallow, superficial, short-term benefits. That's the 12 veneer thing. We are not only not disclosing the real harm, we are pretending it's great, and we are even fooling patients by saying that it's a healthcare procedure. 'I'm going to do a nose job, plastic surgery on you, and your heart is going to be better.' That's what we do in dentistry. We fool people, and we try to camouflage by saying, 'No, you're going to be more confident, right? And because you're more confident, you're going to be mentally healthier. And because you're mentally healthier, it impacts your systemic health. You're going to be healthier.' Oh, and that's actually true, but it's a big loop that you need to make to justify, and you're not balancing the pros and the cons, right? So, the business model is wrong.

So, what is the solution? Is that we need...I don't have the solution, but what I do think is that we need to brainstorm more. If dentistry, healthcare dentistry, is all about prevention, diagnosis, and longevity, every ethical dentist, I believe, would agree with that. And you know what? What is the proof of this? That when dentists have dental issues, they are the worst to actually do something about it. They postpone, and I'm saying myself, we as dentists, we postpone our dental procedures as much as possible. True, because consciously or unconsciously, we know the number one enemy of teeth is the dentist. And we know that the best thing that we can do to ourselves is prevention, diagnosis, and longevity. That's why you see dentists with crooked teeth, lower teeth, and say, 'You're not going to align these teeth?' No, you know what? I'm going to leave it like that because the dentist knows that the percentage of cases with aligners that actually mess up your bite, that actually leave some kind of issue that will harm your TMJ, that down the road in 15 years, you're going to be, 'Why did I bother aligning my lower teeth? They were fine.' So, they don't align their teeth. They don't prep that extra enamel to do 12 veneers. Many times, they need to be really a disaster to actually do dental treatment because we know the problem, right?

So, what is the solution? We all need to sit at the table, start discussing this more often, and the solution will come when we can develop a business model that rewards prevention, diagnosis, and longevity. It means, like it's happening in medicine, medical clinics that are specializing in prevention and longevity. Every smart human being that has resources is going to these clinics. 'I don't want to be sick, and I'm willing to pay very good money to prevent, to diagnose, and to live longer.' And physicians that are getting experts on that, they're making very decent money for sure.

Kirk Behrendt: Even myself. I mean, the privatization of some of these executive health program systems here, they're full of people paying out of pocket to proactively prevent. I do it every two years, and it's a great investment. And you get so much time one-on-one. I want you to go back to that framework: prevention, diagnosis, longevity. And if I'm a dentist listening, really paint a picture for me, Christian. What's the real link between function and aesthetics? You're not saying one or the other. Put those two together for me.

Christian Coachman: So, that's another thing, right? People like to disguise patients by saying prevention, aesthetics, and function come together. So, if you improve aesthetics, you improve function. If you improve function, you improve aesthetics. And they create this story to justify whatever we are doing, right? The link between function and aesthetics is the natural link between function and aesthetics. When you function better, you look better, right? When you look naturally better, it's probably because you're functioning better. But we twist this story, and we say, 'Look, we're going to put you 10 veneers that look great. You're going to look better, and according to science, aesthetic and function are linked. So, if you look better, you function better.' That's the nonsense, right? The real story is that if you can position the parts of the puzzle in the right position, you're going to function better. And function better is not only the bite. As I said, restorations usually make the bite worse, not better. So, when we say function better, we are saying systemically functioning better. Your brain is functioning better. Your heart is functioning better. Your posture is functioning better, right? Your airway is functioning better. So, first, as dentists, how can we treat our patients without making our patients worse systemically, right? Second, how can we even help real doctors improve systemic health? And because of that, the patient will look better. Because if you're functioning better, if you have a better system, if you're breathing better, right? If you have a better posture, if your body is functioning better, you're going to sleep better, you're going to feel better, your skin is going to be better, your jaws will be better, your collagen will be better, your muscles will be better. People will look at you and say, 'Wow, you look more beautiful.' That's why we love, for example, airway dentistry, because it's really about improving your quality of life, and naturally, because of that, looking better. And it's beautiful to see the link between if you position the teeth and the bone properly in the face, you will improve airway, and because of that, you're going to improve aesthetics. But if you do camouflage dentistry, that's what we call camouflage dentistry. Camouflage is the short-term reward, the short-term benefit, the superficial benefit, meaning the veneers are the restorations that look cute but don't treat the underlying problem, don't address the hidden problems, don't really take care of health. You look better for a few years, but you're not really improving health. And because of that, you're not generating natural beauty.

Kirk Behrendt: So well said, Christian. Now, I know I can't keep you all day. I have a couple more questions, but let's do this. Give us some final thoughts on cosmetic dentistry versus healthcare dentistry.

Christian Coachman: Look, you know that many times as I'm talking about topics, I get very excited and strong and even aggressive about certain topics, right? It's just the way I am. I'm really excited about things when they become clear to me, and I just want to share this to learn the perspective of others. But even though I really, really believe in what I'm saying here, and I really believe that we need to discuss much more about these things, I first confess that I'm the first one to say I have so much to learn about it. I don't have solutions. I just have openness. I believe there's space for everybody. There's space for disease dentists, there's space for cosmetic dentists, but there's a huge space for healthcare dentists that are almost untouched, untapped. And this should be the majority. This should be the main dentistry, right? I also believe that there is space for cosmetic dentistry, but we need to change completely the way we sell it, the way we educate patients about it. We need to help, as you said, you mentioned we didn't cover this topic, but you asked me, and I ended up not talking about it. We need to help change the perception of beauty. We need to work on the right side of history. This obsession with perfection and perfect beauty is harmful. We know that. And social media, of course, is making it a disaster. It's a disaster, right? We need to change the definition of beauty, and cosmetic dentists and plastic surgeons play a key role. Instead of helping educate people, they are making it worse. We are making it worse. We're also making it worse by creating a huge generation of younger doctors that want to be very successful, and what they see are the super successful cosmetic and plastic surgeons because, for some reason, these are usually the doctors that are most valued, right? The ones that have the biggest rewards, that make more money, they're more successful on social media, unfortunately. So, you see that guy developing the cure for cancer, nobody cares. But the plastic surgeon that has a private jet, oh my God, everybody wants to be like that guy. I don't know, man. I think I just feel that's something wrong.

Kirk Behrendt: Well, it's a good place to start the conversation, and we have plenty of topics to open up. I just love the fact that you're putting a name and some words to what a lot of us have been feeling for a long time. Now, I want you to do this. If I'm listening to this podcast for the first time, and I want to learn more about DSD—I've experienced it myself, it's phenomenal—I'm going to encourage you to check it out. Where do I go, Christian? Where do I go to learn more? Where do I even start?

Christian Coachman: You know, I always mention digitalsmiledesign.com. Our website is very, very complete and has a lot of information. It is a learning experience by itself. DigitalSmileDesign.com. My podcast, where we share this type of content, Coffee Break with Coachman, and my Instagram, ChrisCoachman, where I always answer all the questions and listen carefully to all feedback and learn from everybody. I'm constantly learning. I'm open to any feedback, to any discussion, any different idea, any disagreement. I think I'm just throwing these ideas in the air and hoping that more and more people will join us in this movement of trying to make dentistry more about healthcare.

Kirk Behrendt: Amen, brother. Very, very well said. Well, I appreciate you as always, and we're going to keep doing this and presenting new thoughts to not only improve our thinking but everybody else's that's listening.