Smile Business Diaries Conversation with Dr Jan Kielhorn

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Smile Business Diaries Conversation with Dr Jan Kielhorn

This transcript has been reviewed by AI and may contain inaccuracies

Maria Cabanellas: Welcome Dr. Jan Kielhorn! How are you today?

Dr. Jan Kielhorn: I'm fine, thank you.

Maria Cabanellas: From what I can see, you look like you're on a trip somewhere, on vacation maybe. You look good! Can you tell our listeners where you're at and who you are as a person? Just kind of set the stage for us.

Dr. Jan Kielhorn: Okay, I will do that. So, I'm in Belek at the moment, which is a Robinson Club. We do a yearly team event where we go for one week with some external lectures to any place in the world, Morocco, or now it's Turkey, and just to form the team and have lectures and get them in a different setting. So, we overthink all our protocols and how we behave at home, and that's where I am right now. I think this is an important part. It looks nice, but it's very important for team building.

Maria Cabanellas: Awesome! So, you're located in the southern part of Germany, your office, correct?

Dr. Jan Kielhorn: Yeah, that's right. It's close to Stuttgart, about 40 minutes away from Stuttgart, between Heidelberg and Stuttgart, that's what most people know, I think, of Germany. So, in the South, that's where we are.

Maria Cabanellas: What is it like having an office there? What's the culture, the type of patients you treat, and your team? What is it like being a southern German dentist?

Dr. Jan Kielhorn: Well, I'm not originally from Southern Germany, actually. But we did a lot of statistics looking at where people are located who have the random amount of income for all treatments, where there are a lot of people living, where there's infrastructure, hospitals, schools, people own a house and have at least two cars and all that. So, we did a lot of statistics to see where we want to be located. And then we found that spot where we hadn't been before ever. Just according to statistics, it seemed like the perfect spot to go, so we built a clinic on 800 square meters there just to give it a chance. And luckily, it worked out amazing.

Maria Cabanellas: And what thought process, besides the statistics, went into the design of the office and the experience? Can you explain how your office operates at the moment?

Dr. Jan Kielhorn: Well, my wife and myself, we are coming from big clinics that are structured, having at least six, eight, ten chairs, and all specialized clinics with a high frequency of patients. So, we wanted to have a very structured practice, and that's why we built the building actually, to give it the follow-up for the patients. We thought about how they walk, how they’re treated, and where the rooms are. So, everything is designed so that we’re not using rooms that have been there. We had to build the building to make that possible. And that's why we made it bigger than you actually would need, just to create the space and that feeling for the patients, and the possibility to adapt to any kind of changes in dentistry, see if you need more digital rooms, more surgical theaters, more waiting areas, or less waiting areas, more reception, or less front desk. We can react to everything because we don’t have any walls that can't be moved. Actually, we have an 800 square meter hall, and we can do whatever we want. And that was how we started because we didn’t know where dentistry would be in the future.

Maria Cabanellas: And how has that worked out for you now that you're sort of in the future a little bit?

Dr. Jan Kielhorn: Well, it worked out fine, but still, there are a lot of changes. See, starting with DSD was changing. You need something to take photos, of course. You need a room to talk to the patient, a presentation area. So it's still changing a lot. So, actually, you have to realize that what you did yesterday will be different tomorrow. You can't stop. Whenever you make it really nice, you change that. And we reconstructed the clinic just four years ago and put a lot of money into that, saying we have to keep on doing this, because otherwise, we won't be on the top list anymore.

Maria Cabanellas: Absolutely. And you know, I did a little research on you before. My God, you have a really impressive clinical background. I want to learn more about that a little bit. You're an oral surgeon first, right?

Dr. Jan Kielhorn: Yes, that's correct.

Maria Cabanellas: And your wife, what type of dentistry is she involved in?

Dr. Jan Kielhorn: She's a pediatric dentist, so she's a child specialist.

Maria Cabanellas: Oh, interesting! That's like a great dynamic. How does that operate in your office, working together?

Maria Cabanellas: That was the perfect deal when we did that. We were the only ones doing that. In the end, now everybody's copying that system. Because what it does is when you treat the children, of course, then the people have a high trust in your clinic because children are the most important part of the family. When that happens, you know, the mother doesn't want to go somewhere else because, of course, she wants an appointment, you know, with her kids. She’s taxiing them around all the time for her kids, so she makes an appointment there. So, she will stay in the clinic, and then she will tell her husband, "You have to go there." So, that's why you get the whole family. And if they pay for the children, they're ready for a good treatment. They trust in that. If you pay for expertise, it's worth it. Then also, you don't have to tell them that it will be worth it. They trust in you. So, if I tell them my treatment plan, it will of course be not the cheapest treatment but probably the best treatment. Then they have the trust in me, which my wife built up. So, that was a very successful story.

Maria Cabanellas: Wow! And do you find it challenging? Because, you know, the cultures amongst different countries obviously are different. The German culture is very unique to us, some states in Spain as well. Do you find it being challenging or different in any way, you know, with the patient base that you have? Or is it easier compared to the US, compared to the world really?

Dr. Jan Kielhorn: Well, I know Spain. I know the US well. Well, compared to the other countries, Germany is a bit more tough. Because the problem is that we really can't choose the patients we treat. You're obliged to treat any patient, and actually, you're obliged to offer them every treatment, whether it's through the National Health System or if it's private. And that's really not as easy to make a protocol like a full DSD clinic, like in the US, where you can say, "No, you have to pay $200 to get in there." This is my protocol. If you don't follow it, you're not my patient. You can't do that in Germany. They say, "No, I don't care about that. I don’t want to be treated that way. I just want my toothpaste treated okay." I just want, with national health care, I don't have to do that. So, that makes it a bit more difficult, of course, to have a reputation that only people come to you who say, "Okay, this is high-class treatment." To get rid of people who don't want that kind of treatment, it's very difficult. Yeah, especially in the aesthetic treatments.

Maria Cabanellas: So, I just want to make sure I understood right. You have the National Health System, but your office can still have your own private pricing and everything outside of that?

Dr. Jan Kielhorn: Yes, that's correct.

Maria Cabanellas: That's good. Do you find that you’ve lost a lot of patients by going that direction?

Dr. Jan Kielhorn: No, not at all. We started, when we started 20 years ago, we just did full ceramic. Everybody said, "Okay, you want metal crowns?" We had to compromise them somehow out of the clinic without them going somewhere else saying, "This doctor will not treat me." That’s the game in Germany. But we said, "No, I only will do full ceramic. I have no amalgam. I will only do full arch if the... is not right. I will not give you a single crown without periodontal treatment. I will not give you crowns at all without vitamin D or whatever, or diabetes or whatever." I will not treat you. This is medicine, and dental is both. We did that. And in the beginning, it was of course tough because we sent a lot of people away. But the people who stayed, they brought us more patients, and the people who trusted in us brought others. So now we developed that reputation that only people who already know what we do will come to us.

Maria Cabanellas: Hello, I'm just taking a quick break from this podcast interview to tell you how you can get started with DSD. If there was anything that our guest has mentioned that strikes a chord with you, or if you are curious about becoming a DSD Clinic, I encourage you to book a call with me. This is a 30-minute, no-obligation information-sharing session in which I can answer your questions about DSD and discuss your options based on your unique circumstances. The link to schedule a call with me can be found in the notes on this episode. Now, back to the interview.

Maria Cabanellas: Yeah, I find this so fascinating because in the States, there's a lot of pushback when it comes from DSD. Even, you know, when you recommend, "Hey, invest in your office, invest in the experience, and of course your CE and your knowledge and your skill set." But there's a lot of pushback because this concept of, you know, what's working for me now will work for me tomorrow. And we don't have in the States this National Health System that requires and mandates, you know, that we offer at this price and at this type of Dentistry.

Dr. Jan Kielhorn: Yeah, that's true.

Maria Cabanellas: And it's nice to see that, you know, even with extra barriers in another country, and we'll talk more, I think, about, you know, the paperwork involved and everything else that's on top of how you have to practice in Germany, you're showing the proof of it that, you know, regardless of the barriers around you, the experience that you give the patient, the quality of the Dentistry overcomes that, right? And it does work. So I think that's wonderful that you've been able to show this firsthand in a country that, you know, just puts those barriers up for you. So that's wonderful. Now, when you are working with these patients, are they difficult in any way because I've heard that there's a lot of paperwork involved in with treating in Germany. Can you explain all that?

Dr. Jan Kielhorn: Yeah, there is a lot of paperwork. The problem is that we really have to, because of the National Health System, so mainly it's a mixture between a private treatment and some money they get from the national health system. So we have to have a lot of papers, which we have to hand in, and they have to sign. And it's not just a contract, "I want this treatment, assign it, finished, that's it." But we have to get the improvement of the National Health and all that, so that's a lot of work behind the scenes that makes it complicated for the staff. And that's why I think the most people are working is actually in the back office, okay, because that's a lot, it gets more and more and more and more to do that. That's a great barrier of expense, but it works. We’re used to it, but it's not the way I want it, of course.

Maria Cabanellas: Of course. We work with what we have, right?

Dr. Jan Kielhorn: Exactly.

Maria Cabanellas: So with that, I mean, if the majority of the team wants to be in the back office, how is it for you in the hiring process to find the right people for the front?

Dr. Jan Kielhorn: Well, we have had not the best experience with hiring people who are already trained, because we train them differently from what is traditional in Germany. We take all startups, so we take all the learners and we treat them. And usually, you learn three years for that job in Germany, and then actually you should know everything you do. But most assistants don't do that because they are not trained by the doctors. The doctor says, "No, I can only do that. I can only scan, you can't scan. I have to change the band, I have to change the gingiva formers, you can take the sutures out." Okay, they all don't do that. So we always had, because I come from a clinic where this was usual, I give a lot of trust to my assistants, so we train them. And even if they start up, in one year, they can assist in all the surgery, they can take out the sutures, they can, of course, scan with any system. They should, and so they are very self-dependent. So we train our own staff, and each doctor works with at least two to three systems because you should never turn your head away from the patient. So every instrument should be given to you into your hands, and your hand should not move more than 10 centimeters. And then you're ready to go, and you're very fast. And then, parallel to that, all your assistant staff is scanning, taking out sutures, changing general formers, doing trims. Then you're very, very fast because you have parallel work, and then you can do a lot of patients, a lot of good work, and still have the time to do it perfectly.

Maria Cabanellas: It sounds like you have a lot of experience with the systems that you've implemented in your office. Can you just elaborate more on how the office runs right now as far as what systems you're using and just standard operating procedures that are must-haves for your practice today?

Dr. Jan Kielhorn: According to the kind of treatments we use?

Maria Cabanellas: Yeah, we could talk about that. I noticed that you get a lot of the natural restorations from us, and I'm just curious how this has impacted your office overall. You know, what made you change to go with DSD systems or any systems that you've encountered and implemented, and how they've helped really overall?

Dr. Jan Kielhorn: Okay, the biggest task was that, of course, you have a lot of things you learn the hard way in Dentistry. So one thing I learned the hard way in Dentistry is that staff is only a snapshot, okay? So the staff is dynamic, the staff will not last forever. So I only believe in protocols and training, because I believe in protocols and training, I can take everybody off the street, okay, and I can just implement them in that system, say that is the protocol, just really do that, and I can keep on working. There's a replacement for everybody, okay? There's not a single one, even me, that could not be replaced. So as long as the training is good and the protocols are good, you can have a high level of Dentistry. So that's what I believe in. That's what we learned the hard way. Of course, if stuff on here can do that, and I'm dependent on that, no we're not dependent. We're dependent on protocol and training. Everybody knows how to do that. Everybody has to know that. Okay, so I can take every staff in the clinic and everybody can do everything, of course.

Maria Cabanellas: Okay.

Dr. Jan Kielhorn: If you don't invest in training and you have bad assistants and they stay, that's a problem. If you invest in training and they leave, okay, but if they stay, that's a problem if they don't know what to do. So that's why we really believe in that. Everybody knows what to do, and everybody does it the same way. So every room is equal. In every room, the instrument is at the same spot, okay? There's always the same material. They all stand at the same side, they always take the same hand to give you something. So it's a very high training, like a military training in a good sense, but it makes it so fast and so perfect, and it's just exchangeable. So one goes out, the room, next one comes in. You will not notice that you have different systems.

Maria Cabanellas: Amazing. How did you come to terms with that? Was this something you set up early on or did it progress?

Dr. Jan Kielhorn: Well, I was trained in the clinic of the inventor of the den like C system, which is Dr. D. Hesler. He's a very renowned maxillofacial surgeon, and I learned two things from him, but the one thing I learned is that you can be a perfect surgeon and a perfect periodontist, which people still deny today that it is possible because he was a mix of facial and was still such a good periodontist, it’s unbelievable. So I learned that, and that was the start of my career saying I will do both, and he showed me the magic of having all tools in your hand. And he had a highly trained staff, which was amazing. Everybody had at least two to three assistants, which was new to me at that point. And they were trained to do it exactly the same way. And then it was so good because you were so concentrated just on the work. You didn't have to look after your assistant. You look at where’s that instrument, and nobody’s running out to get it from a different room or a different drawer. Nothing like this will happen. So I said, when I opened my own clinic, I will, of course, do that. I will only take young staff and train them. I will not take trained staff because turnaround is not possible and takes a lot of energy just starting. It’s so easy to do.

Maria Cabanellas: Oh, so you had two to three assistants per doctor?

Dr. Jan Kielhorn: Yeah.

Maria Cabanellas: That’s amazing. That's an amazing differentiator, I believe. You know, I’ve never heard that, so I can imagine how helpful that is to have so much help in one room. Are there any other mentors that you can say have impacted you in your career?

Dr. Jan Kielhorn: Yeah, of course. Professor Vovi, who I think is one of the most brilliant periodontists of all time in Europe, at least. He taught me not to do something fancy, just do something that works. Just do that. It works. Don’t do it fancy, don’t do it for the beauty of the X-ray, don’t do it for the beauty of whatever photographs, or whatever, or that it looks good in the room. What you do, or how you behave, just do what works. It may look messy, whatever. If it works, it’s good. And he said, if it works, you’re right. So he taught me to not believe in traditional protocols or to question them, to say, "Okay, we’ve been doing this for 20 years, maybe it’s 20 years false. Maybe it wasn’t right for 20 years anyway." So he said question it, because if it works, you must be doing something right. A doctor has a clinic, people coming in, they come back, you must be doing something right. So just look at these people, see what they do, copy it. It might work in your hands, it might not work in your hands, but question everything. And that helped me a lot because that was when I was the dental lecturer. They called me the implant hooligan because I was always saying, "Do it differently. Forget the evidence-based stuff. It works." I’m just the private clinician. It works. I don’t know if it works in your hands, but it works in my hands. It’s not written. Just try. So that’s what I learned from Professor Gdowski. That was a great impact. So Dr. Hesler and Professor Gdowski were the main influences, and the last impact, of course, was when the pandemic came. COVID came to Germany, and the mood in the country was very bad, and we were really forced to shut down completely because we were not important for the health system, which the German government said. They said, “Because of the errors, we should all be shut down.” And that was a very difficult time. And in that time, something very strange happened. I was always looking at DSD, of course, and Christian Coachman, who I knew from a long time ago as a technician. I said, "Okay, DSD, yeah, might be, but no time. I’m going to Brazil, whatever. I don’t know, I don’t know." And then it happened that Christian brought the first DSD one to Hamburg. I think it was Hamburg, or somewhere, and it was allowed to go. And I said, "Okay, just get out of here. This is all crazy. I’m going to do that." Despite that bad mood, and people looking at how to survive, this energy, and this enthusiasm for creating smiles, and this spirit was still there. I said, "Oh my God, okay, this is still so good, what we do." You know, the pandemic, and I said, "This is so good." And that really, you know, lit that fire again. So I’m so thankful for that. I said, "I’m a believer. I see the light." You know, Blues Brothers, just going, "I see the light. I’m a believer. I’m a believer." So, okay, I will just follow that. I will follow that and run against the wall. I don’t even care. Just do that and see where it goes. I don’t think too much, just do it, and see what comes out of it. And that was a good way to do it, and I’m still very thankful for that, and for the spirit and inspiration. Because we did a lot of that consulting, or emotional dentistry, but not in that kind of protocol structure, and that gave me structure. Because, you know, I’m more of a working ant, I’m a creative person, I’m somebody who can work 24 hours, no problem. But it gave me structure, and that really boosted my CL.

Maria Cabanellas: That’s amazing, and it’s fascinating that, you know, being – I mean, you’re such a high-level clinician already, and I believe even before you were introduced to DSD. So it’s interesting that you still found DSD to be so helpful, you know? Because again, I hear from people that it’s like, “Oh, I’m totally fine, everything’s working, everything’s great.” But you don’t know what you don’t know, right? And until you’re in it, sometimes you don’t realize. But you were able to put the pieces together in the course, it sounds like, or maybe a little before, and know this was the direction that you wanted to head with your systems at that point. Can you elaborate a little bit more on, you know, what was it that stood out to you specifically from the course itself and the system of DSD, and how it’s really helped you? Because again, you’re one of our greatest customers for the natural restoration veneers. So I see that you use it a lot in your practice, and I’d be really curious to know exactly how that works out for you and how it’s different from before.

Dr. Jan Kielhorn: Well, the difference is we would train by European, you know, aesthetic specialists, and all they do is, of course, they do a mock-up. It was not 3D, of course; it was not printed – that’s all coming now. It was a lot of handwork. It’s for obsessed maniacs, you know? I’m working 12 hours every day, I’m not a fan of doing models and hinging models after that and spending more time in that. I’m not – I do it myself kind of thing, which is very popular in the U.S. – “I do my own veneers, and we color them.” I said, “Oh my God, okay, good for you. I’m with my family; you can call your veneers, I pay somebody for it.” So that was different, of course. We tried to do a lot of handwork to be analytic, creative, to do a lot of stuff yourself. But actually, the magic of DSD is, first of all, doing that emotional stuff. Of course, we’re doing a mock-up, you know, but putting the mock-up or the test drive in the middle of it, or at the start of it, saying, “That’s to put the end first.” You know, I’ve been doing a lot of navigated implantology, and there we said we’re doing backward planning, but nobody was talking about backward planning, okay? So that is actually backward planning. We just define what there is completely with a bite, with everything, you know, with ortho – not just saying, “That’s looking good, I’m just aesthetic, I’m just an endodontist, I’m just doing that, I’m just doing the functional stuff.” No. That’s where we find the full final result, and then we go backward. What can we do? What can I do? What do I have to transform? If I have to refer that to another doctor, I can tell him what I want. Not like in the old times where you called an orthodontist and said, “Ah, a little bit more to the left, can you shift a little bit more to the left? It’s not enough for my veneer.” Okay, that’s stupid, and drawing on models. So here you have a digital workflow. They know exactly where to put it. It’s good for the collaboration of doctors in an interdisciplinary way, and to put that in the front – that is a different set, and to do that strictly all the time. And then you see that even people understand where you said, “Okay, that’s not a video patient,” and now you have been arrogant. You know, doctors are always a little bit arrogant and say, “Okay, they don’t have the money, they’re not patients, they’re told, or whatever.” Okay. That is not the truth. The truth is you have to tell them what’s wrong, and they have to decide. It’s not your job to decide. It’s not your job to show them what actually is lacking off, and they say, “Oh my God, nobody told me that. Oh my God, of course!” And you’ll be amazed – people get money somewhere, you know, and pay for it. Where they say, “Okay, I don’t have so much money for a veneer.” I said, “Oh, let me think about it.” Okay? So, amazing. And that really changed a lot. Despite we’ve been doing a lot of, you know, first talking to patients in a separate room – we did that for all the time. We never talked to a patient about treatment in the treatment room. We never talked about paper in the treatment room. There’s a new patient. Okay, we got to know him in a meeting room, and then we meet him, and we got to know each other, and we’re talking about his wishes. We did that all the time. That was what separates us. If there’s paperwork, we take our time at night, late after all the treatment, and I sit with a patient for one or two hours or three hours. He can have all my time, and we will talk to him. And he appreciates I take that time, and then when I do the treatment, I don’t have to say anything. Then trust me 100%, I can just work. We did that all the time. But, you know, putting the end in the front and showing them what to do gave the boost. That’s actually what was missing. And no matter what you do, if you do it as a standard, or if you do it European techniques, it doesn’t matter. And they changed it. It’s a rule, and as I said, I believe in the protocols because you lose everything. If you have a career that’s long enough, you will have seen everything. Okay? But you have a structure, you will not lose that, and that was the main takeaway from Christian, I guess. And the second is that, of course, you can do beautiful veneers on platinum foil. We have a beautiful technician, which is D Lorensen in Hamburg, one of the best veneer people ever, with platinum foil and all that crap. But that’s not for the masses. Why is it? You have to have a very perfect bite; no practice, it will break. Okay? Of course, it’s not Empress, and then to learn, it’s all about shape and value. And that Empress can look very nice in the mouth if you do it the right way, and that’s for a lot of cases. There was something different, and I said, “Okay, see? You can do a very good work, very structured. You can open high aesthetics to more people.” They changed a lot. That changed a lot from doing just a high-class blend foil, highly specialist, to “I can make perfect smiles. Okay, don’t worry about it, and you won’t break any Empress and all that.” So, that was a changer.

Maria Cabanellas: Amazing. You know, you have so much insight into a lot of different subjects of dentistry. I'm curious to know from you, what is something that you, you know, if you could pick one thing in dentistry to change, what would it be?

Dr. Jan Kielhorn: The biggest topic would be that I try to be digital all my life. Okay? I couldn’t be digital because of our government, to some aspects. Okay? Because we have to sign that you can’t do a digital signature under that and all that crap. Okay, so I’m not fully digital. Okay? But for the digital workflow and digital dentistry, I would say that it shouldn’t be allowed for the companies to block interfaces. Because we would be far more advanced in digital dentistry if companies like, uh, if it’s S, Z, now, or if it’s THR, if it’s Aero, if it’s ES, or whatever, they wouldn’t block the interfaces for money reasons. They should be forbidden. Okay? Actually, it's the data. All the data actually is belonging to the patient, and he has a right on having that. But still, companies are making it very difficult to get that data out of it or to share it without losing quality. Yeah. So, that I would change. I would say, “You’re not allowed to do that.” That SkyM SDL data, it has to be given out. It has to be, uh, able to be exported to any system. Okay? Every system has to be able to read it. Also, on cone beam, it’s just, you know, it’s an absolute no-go that one cone beam can’t be read, you know, by the other software, and you have to have a special software. All that should be forbidden. Okay? That’s all patient data, and just for many reasons, there should be a rule not to do that, because that is actually blocking development. We have so much stress and all that, and we have so many workarounds that cost us a lot of money, and actually, the only question in DSD meetings is, “How do you do that? What’s your workaround? You know, how can you do that?” Or asking Angelo, “Can I get that data out somewhere, and how do we do that?” I wanted to have it on ExoCut, and even DSD has to use three softwares, you know, just to make the magic work. It does. That should be forbidden. That better. I would change immediately.

Maria Cabanellas: Now, that’s really shocking, to be honest, because I... my perception of Germany is that you guys are cutting-edge technology at all times, and that may be the case, but I had no idea that there were either no rules behind it or hidden laws that wouldn’t allow you to use it to its fullest potential.

Dr. Jan Kielhorn: No, it’s like the companies block it for many reasons. If you look at Dan Spona, it’s a closed drop. So closed drop means, okay, if you buy all the machinery, of course you can do that, but if not, you can only use a little. So, I mean, with what’s here now, AI and augmented reality and everything coming out, what is your idea, your opinion on that, and how do you think that’s going to affect Germany in your practice?

Maria Cabanellas: Yeah, that’s an interesting point.

Dr. Jan Kielhorn: I think all that artificial intelligence will be very important. We’re already using that for the documentation. So, all our DVTs, or cone beams, as you say, are first looked at by, of course, artificial intelligence, so that we don’t oversee any kind of aspect of that X-ray, because sometimes you don’t have just the time. And that’s more, it’s so perfect. It works perfectly. Yeah. Okay? Also, okay, an NL clinic in South Africa is using it; we’re using it. That’s perfect for AI. The second thing is that if we have plans which are not signed yet and all that, we also have AI searching for that and automatically writing a WhatsApp to the patient saying, “See, do you need more information? This is a treatment plan. Have you got everything you want? We need your signature,” and all that. So we have AI using the follow-up on treatments. Is all done fully by AI. Okay? That is very important for us, too. So, that’s where AI gets into it.

Maria Cabanellas: That's fantastic.

Dr. Jan Kielhorn: Where I would like AI to go with, of course, analytic more function, that it works together, of course, like Modo, or all the functional aspects of B-registration, but still, it’s not working together with everything. You know, that’s again that the interfaces are not dope enough. Okay? Because, of course, actually, it should just make the move, should work on its own. It should analyze the bite, and it should make you suggest that is possible. It’s just not wanted. Okay? That is one problem, and the second thing I would like to have is, when Google Glass came out, I was the first investor in Google Glass. Uh, unfortunately, it was not developed any further. Um, because Google Glass would have been perfect to implement, um, cone beam data, um, during surgery on the patient. That means, actually, that you, uh, implement, um, radiographic, uh, data, uh, into your sight during surgery. But they, they should use it for, uh, for professional business, you know, because it’s easy to just implement. Every pilot has that. Okay? It’s a military technique. It’s easy in every jet helmet, you implement that. Okay? Navigation and all that. Uh, um, you could also do that for surgeries, and surgery would be so far, so far better if you have all the data. You don’t look at any of these screens and you see it all inside. That would be perfect to do.

Maria Cabanellas: It’s always seemed that, you know, dentistry falls behind medicine and is always a little later in their advancements. I mean, how do you see this playing out? Do you believe that one day we will be fully digital in our offices and in workflows?

Dr. Jan Kielhorn: Well, I really hope for it. The problem is that we are niche. We just... you know how many dentists there are? Don’t know. 2,000? That’s three working on that class in Germany. Okay, that’s it. Um, so actually, that’s a niche. Nobody wants to invest in it. That’s the problem, why we get so many things so late. The first navigation templates for implantology were materialized. Materialized is a medical company that hasn’t been developed for dentistry. It was just misused for dentistry. That’s how navigation came up. So we are always, always, will be late.

Dr. Jan Kielhorn: That's why my biggest suggestion to everybody starting a clinic is be a first starter, an early adopter. You know, take when there’s new technology, grow up with it, just use it, and you will learn it through using it. You will make it better. If we don’t do that, okay, we will always be behind. If we wait till something works, that is history already. Okay, we have to say, "Uh, there’s new machinery there, I have to use it tomorrow. We have to invest in that." If you only look at the money, that’s the end of it. Okay? If you say, "No, I will do this. It’s only 20 more years. You know, my x-ray is still good," say, "No, don’t do that." Okay? There’s another possibility. I can do more. Invest in it. Okay? You will have more fun, you’ll be highly motivated, you’ll get more patience from that. And as a doctor, I think you’re obliged to do the best possible treatment. You’re obliged. Otherwise, you shouldn’t be a doctor. You should be, I don’t know, work somewhere else in Walmart or I don’t know. Okay? So, you’re obliged to do that. Same thing as medicine, you know? I think we, it’s medicine in Germany, so it's dental and medicine.

Maria Cabanellas: What about the medicine part?

Dr. Jan Kielhorn: Okay, that’s the most important part. So, before we do surgery on you, you have to prove to me, or I will test it, that you have at least 60–65 vitamin D, that you have no diabetes, that you, you have to sign that you drink at least two liters of water, three to four weeks before the bigger surgery, and all that. You know, we have to be more medical. We have to do more blood analysis. We have to do more IVs, which a lot of people do, like K2 and whatever. A lot of DSD people already do that, and we do that. So, I think it should be more nutritional. It’s a big topic, nutritional coaching, to get the patient, you know. Because if you see a patient with periodontitis, is actually, you’re diagnosing something the body has. Okay? So it’s an illness. Okay? So you have to actually see what is wrong with the body, and most doctors, they will not find the problem because they don’t see the periodontitis, they don’t check them out for anything. Uh, and you have to check the immune system because you cannot treat him without saying, "Okay, first, you have to be healthy, otherwise I will not be able to help you." And that is neglected, and we should be allowed to do more medicine, and medicine should be built as a must, as a prerequisite for if you do surgery. Okay? You can’t do that.

Dr. Jan Kielhorn: We have one doctor from the University of Frankfurt, who is a great guy on fibrin, on PRGF membranes and all that, on all blood products used during surgery, and he’s very strict. So if the people don’t have the right immune system, he won’t do surgery at all. And that is the right topic, because he’s seen if he takes fibrin from the patient and they haven’t had enough water the last weeks, you will not get enough fibrin. The fibrin is not good quality and all that, of course. So there should be more medical parts in it. We should do more medical treatment or medical analysis, which is interacting with our dental treatment.

Maria Cabanellas: Absolutely. Is that the direction you see yourself going?

Dr. Jan Kielhorn: Of course. But that’s longevity. That’s coming. That’s also longevity. You can buy aesthetics, you know, you buy aesthetics, then it goes to beautiful teeth, then it comes to healthy, then it comes to lip advancement, then it comes to Botox and Hyaluron. Okay? Then it comes to longevity, which is a big topic. And actually, it’s not just aesthetic or just Instagram aesthetics, it’s actually doing a great gain for the patient. So that’s what you should offer. As a doctor, you know, we see the patient so often. No doctors see the patient four times or three times a year. We do because they come for professional cleaning. So, of course, we do the testing. Yeah, we can do this, and they get to a point where the doctor takes, I don’t know, four, six months, they go once every two or three years. That’s what they do.

Maria Cabanellas: Absolutely. I completely agree. Um, you know, as far as you’ve come in your career, is there anything that, looking back, that you would have done earlier or differently?

Dr. Jan Kielhorn: Of course. I would have loved to have had a lot more time. Uh, I wasted a lot of time in my building, actually memories, and going worldwide with a backpack, uh, which is a great experience. And so, actually, I have nothing to lose. I’ve seen it all. So I feel very good with myself. But if I, from a professional standpoint... Um, oh my God, you know, I’m doing a lot of endodontics. Um, I would have gone to Pennsylvania for, um, a dress endo boot camp and done that. Okay? And then I would go to Italy for high training, Istrat cage. I would not do the classical, um, courses like we do where you say, "Okay, I just get this two-day overview of what we do." Okay? And then you have to do follow-up courses and that and that and to learn it. So, I say, who’s the best, and just go there, no matter what. Just see this guy. I did this with Gutov, which is really the basis of my success, I would say. Uh, but, uh, then, you know, when you start working, uh, you don’t have the time, and you’re building up a career. It makes it difficult. Um, but that’s what you should do: go to the best, learn from the best. Just sit there and don’t believe in your country’s, uh, um, protocols, traditional protocols. Because lecturing gave me one thing: I didn’t earn more money lecturing than I could earn in my own clinic. Okay? So that is not the thing. I did it for one thing: of course, you see countries and you learn from people, and you have a network that is unpayable. Okay? That’s the one reason.

Dr. Jan Kielhorn: The second reason is, I have seen soft tissue surgeons in Japan who are so good and nobody knows them because they would not publish in English. It's not their honor; they only publish in Japanese, and they're not known outside of Japan, but they don’t care because that’s the highest rank they want to have. But they're so good, and they have techniques you wouldn’t even know just because Germany traditionally— all the lectures choose one country, and in one country, you always see the same lecturers. So, you have to look where you go. You know, the same in Brazil. If you go to Brazil, there are perfect composite technicians or doctors who do direct composite bonding techniques. Nobody knows them here. They all think, "Oh, the perfect composite technicians, they all come from Italy." Not true. Brazil has a lot of good people. So that’s what you should do: look worldwide. And that’s what, of course, YouTube and Instagram gives you now. You see more people doing great stuff, and you should just go there, sit there, pay all the money they want, just steal with your eyes, as we say. Okay? Steal with your eyes and just say, no matter how good you are, there’s always something you can be better at the next day.

Maria Cabanellas: Right. That’s a great point. You know, I’m guilty of it myself. I grew up in the field of dentistry in the States, and, you know, you're almost conditioned to believe that we’re the best, that the best education is right here at home. But you're completely right in that now when you look for your CE's, or your mentors, or any form of education, what is your checklist? What is your thought process? Because you said find the best. What is the best to you, and how do you get to that point of knowing, okay, these are the aspects for me to qualify as the best person to go to for this information?

Dr. Jan Kielhorn: Well, the best is if somebody is doing something with a lot of passion. If he believes in what he’s doing, he’s not doing it just because it’s nice, but he believes in it. That he burns for it. Okay? Say if you look at Christian talking about what he likes, okay, you say, "I don’t give a...," but you have to accept that this guy is loving what he’s doing. Okay? And that is the spirit. And people who have that, they are never bad. They’re never bad. Uh, the second thing is that you just have to look at the technique, see the outcome. Like Kowski said, okay, when it works, it’s right. So, if you see Kelly, okay, and you look at all the people doing recession coverage and pin techniques, it’s all nice. Okay? It’s all nice. They can do that case, and they can do that case, and, uh, they say, okay, case selection is key. You only have to do that and that, and then SEC says, "What is case selection?" I don’t know. This case number three. Okay, but he’s doing all the cases, and all 100%. So, I say, okay, I’d rather go to see Kelly, but so Kelly is a person who will yell at you or kick you out of the lecture room if you say something bad. Okay? He’s that... that’s what he’s doing. If you don’t like it, you can go. That’s Italian. But he’s... he’s PR. Okay?

Dr. Jan Kielhorn: Or like Professor Kurri, Professor Cy was nearly banned when he started, you know, doing bone plates, doing thin little bone transplantation, building a container for implants. Everybody said, "Oh no, you have to take a full block, and that’s all rubbish, and it will not work." And he was showing beautiful cases for 20–30 years and the mass of it. Okay? Um, what the person... because I was trained actually by Cy, and then I invented the MaxCraft cortico, which is a bone plate where you can also do a biological container but without taking out bone from the lower jaw or region with less risk, less complication, with the safe material. And then it really went through the roof because Bisco produced it, and then Dentsply bought it. They went through the roof, and still, he said, "Okay, I hate you for this, but it’s a good technique." Okay?

Dr. Jan Kielhorn: So, that’s... that’s people. You have a certain greatness, okay? Um, where you feel that they love what they’re doing, and they only do that. You know, they’re not doing... we have two, three, five different methods. You know, in this case, I will do this. I use that material. I have four or five different composite materials. You say, "Oh, no way." If you're really good, you just need one knife. You don’t need a Teflon knife and two scalpels or three U- whatever. You don’t... the good ones don’t. And then you can see it’s always good. But you have to look over the frontiers. You have to look at Italy. You have to look at France. You have to look outside Europe to the U.S. You know, but the same is said. KY deprogrammer, a long time, all the U.S. people thought, "Okay, KY was the only one who’s doing deprogramming with the deprogrammer." That is not true at all. There’s a Chesan guy who’s done it before KY. Okay? So, he didn’t really invent it. He modified it. So, nothing came up, you know, like falling from heaven. Um, so, we have to look outside our boundaries, and that’s what actually we don’t do, but that’s what we should do. Actually, that’s why DSD became so important. Okay? Because it’s outside the boundaries. You know, it’s not just a well-fed clinic. It’s... it’s just... and it’s not just us.

Dr. Jan Kielhorn: And the good thing about DSD, when all the KEs meet and the DSD clinics, that you get people from Europe and the U.S., and you see how different the judgment is. It’s just amazing when they say, "They do this." I say, "Oh my God, I would never do this." "Can you do this?" "But he’s successful. That’s in the U.S. way. That’s fine." Okay, but it’s different. Yeah, and different’s good. You know, it’s... it’s not just the education, right? It’s the continuing education that you get being surrounded by those people.

Maria Cabanellas: It sounds like you've created this network for yourself of the best in their fields. And so, I think a good point to make on this is not just, you know, go to a CE or go to a course or a lesson or anything and learn one subject. It’s go there, learn it from the best, and then connect with these people. Because in time, maybe you invent something or develop something, reinvent the wheel, and you have those people surrounding you that have done it already. Right? And so, it seems like it’s complemented a lot in the clinical skills that you have today. Would you say so?

Dr. Jan Kielhorn: Yes, and the thing in the US is also that the US is very commercial. You know, it’s about CE, it’s about what it costs, it’s about the K Institute. It has to be an Institute, and it’s all good because it comes from that Institute. If you go to Pennsylvania, you know, it’s all good. It’s not good. They have some very good endodontists, but they have a lot of rubbish also in their universities. Okay, so it’s not all good. We have a lot of people flying in from the US who have been treated not in a good way because in the US, they do this, and when this is done, we can’t do anything more. Go away. Okay? Go to a specialist. They’re very... because they’re always afraid. The US system is always, you’re afraid of getting sued, so you always do things through the protocol, not because it’s a good protocol, but because of not getting sued. Right? So that makes it... makes it stupid. Okay? So a lot of Americans come to us because we do it differently. Because we are not afraid of course, and it’s of course cheaper, also with the flight. But, um, that’s where US caps become very commercial. That’s, um, when all these lectures in the implant business, for example, when we did all these lectures, also there were US lectures from Dent’s Fly, and they were coming in. All the European lectures were flying business class to the US. Uh, US lectures, of course, flying first class to Europe. Okay? Why is that? Okay. Second thing is when there’s a US lecture, what he did is, first of all, he said, “You’re not allowed to film anything, whatever.” Okay? And then after the lecture, he will sell you his DVT, DVD, or whatever. You know, “You can buy my movie, uh, for my financial, um, background.” Right? Stuff like that. Okay? European people would say, “You’re free, steal with your eyes.” Okay? Because I’m good. If you want something more, you will come back to me because I just... I know I’m good, and you will learn from me, and I’m happy to show you. Okay? That is more your pro. That’s why I like it about if people share knowledge and not say, you know, every little tiny bit, “I will be rich on it.” Okay? There’s a lot of money talk in US dental business.

Maria Cabanellas: Absolutely. I think DSD is, you know, because we’re founded from Brazilians and Spanish people, and so the same culture is there where it’s just share, just share the knowledge and grow together. And I think, you know, that’s a big part of the community that, um, that we represent. You trust it because it’s not for the money. You just believe the people love what they do. It’s like, if you go to the DSD lab, you know, whatever they do, whatever they just love what they do. You know, they love what they do. That’s... that makes a community, and that’s why you follow that. And you say, “Okay, whatever mistakes, whatever we can do, uh, this is swarm intelligence. We will grow together.” You know, whatever, how bad natural restorations were or good they were. You know, from... from not so good, for example, for All-on-4, from not so good to the perfect, uh, All-on-4, uh dentures I had. Okay? Now, we... we went a big way. Uh, we have to work together. That’s the good thing about it: the people work together, and they change, and they invest in it, and you believe them. And it’s different to just go to an Institute because I get CE and I pay $2,000. Okay? Uh, and it’s a very famous Institute, and now I’m good. No, you’re not.

Maria Cabanellas: Absolutely. I completely agree. Um, we’re getting close to the end of our time. I want to ask you one more question. Um, we have a question from a previous guest that is going to be asked to you, and then I’ll ask the same from you. So, Yan, from our previous guests, they want to know: What do you see as an absolute top three benefit that you get from being a DSD Clinic that you don’t get from other companies? So, what are the top three benefits that you receive as a DSD Clinic that you don’t see in other companies around the world?

Dr. Jan Kielhorn: Okay, number one, number one tool, number one is that you have a network of clinicians, um, in a sort of a family surrounding, which are willing to share, uh, in an honesty that is not normal among dentists, um, every knowledge they have and ask any questions you have, and even be willing to invite you wherever you visit them. They will take you to their home, you can, of course, stay with them, you can of course see the clinic, and they’re proud of it and they’re happy to share with you. That family, um, is great, and then it’s a family of really grand CR, grand CR technicians, which is so good, uh, where you can learn so much from them. And you have the international specialists sticking together like a family, being honest, and you have, like, a day I can write in any chat, and I will get an answer the next day. Okay? And they share the protocol and all the secrets. Unpayable. Nobody has that, and that’s why I also told DSD that is the value. That’s the biggest value of it.

Maria Cabanellas: Yeah.

Dr. Jan Kielhorn: Okay? Last time, you said at 2:00 at night, uh, at the bar, that’s where you get the honest answers, you know, not at the congress. Okay? Totally drunk too, okay, then you can ask somebody. That is so great, and that’s why I said the community, that has to be taken care of because if you lose that, DSD is gone. That is the magic body, the magic number one about DSD. Okay? That is far better than anything else.

Maria Cabanellas: Absolutely.

Dr. Jan Kielhorn: Number two is that if you look at, uh, it's getting better, but if you look at the competitors like SP, by Stro, and all that, they fly and all the others, you get a lot of, uh, STL data and all that aesthetic, but of course you have not the support, um, that you actually have an interdisciplinary approach from people who actually have knowledge on that. Okay? So, uh, with DSD, I could have the design, but I could have the knowledge from a renowned, uh, speaker on orthodontics and say, "Come on, what can I do about this? Okay? How do we solve it?" So, I actually have a real interdisciplinary, a worldwide interdisciplinary approach. Unbelievable. Okay? All the others just give you data and do something with it. Okay? You can download it, you can print it yourself, that’s it. Okay? They have some fancy things that I find very important, which DSD should change, but they don’t have that. Okay? They just give you a product you pay for, but they don’t give you, uh, the medical aspect of it, the doctor aspect of it, the interdisciplinary work of it. Okay? It doesn’t give you that. That is the main difference, and that makes the difference. That should be taken care of also.

Maria Cabanellas: Yeah, absolutely.

Dr. Jan Kielhorn: Third, of course, is that you know the people you’re treating with. Okay? So, if I have a problem, it’s like I call my technician. If I call Angelo, it’s like if I call my uncle and say, “Hey, Uncle Angelo, okay, I have a problem.” Okay? Please help me, and he will help me. You know, that’s... how can you do that? Okay? The others just give you, say, a product. You don’t even know who. Okay? Somebody’s designing that crap, some CAD designers designing that, and you just download it, and then you write a message. You get an answer from, I don’t know, a secretary or whoever that is. I don’t know his profession. Maybe a doctor, maybe he’s never worked. Maybe he’s a very, very bad one. I don’t know what he’s doing. Okay? So, um, you actually know the people, and it’s like... with DSD, you get the feeling, despite the 120 grams, whatever, you get the feeling that it’s your lab, and it’s your doctor, and it’s your surgeon that’s helping you, you know, being talked. Oh, it’s your orthodontist. Okay? And he will help you through it. Okay? It’s like, uh, it’s at a fingertip, you have your dental network, uh, which is not in your country, but it’s like they would be in the neighborhood. Right? And that is just perfect.

Maria Cabanellas: Amazing. Thank you for sharing that. I mean, I’m on the outskirts of it all. I’m not, you know, practicing and working in that regard with DSD, but I see it all the time, not just with you, but every single DSD Clinic. I can say pretty much it feels the same way, right? I hear it all the time, and so it’s wonderful that you put it in such great words. Thank you so much for your time. I know that you're traveling, and you're with your team right now, so we really appreciate you know you taking this moment to speak with us and share.

Dr. Jan Kielhorn: Sure, my pleasure. Thanks.