Smile Business Diaries Conversation with Dr Karla Soto

This transcript has been reviewed by AI and may contain inaccuracies

Maria Cabanellas: This is Smile Business Diaries, a DSD podcast. Thank you for joining me for another episode of Smile Business Diaries. I am so thrilled to bring you this honest, big-hearted, and energizing talk with my guest, Dr. Karla Soto. She talks about what happens when things don't always go as planned, what her non-negotiables are, and what inspires her every day. Here we go.

Maria Cabanellas: Dr. Karla Soto is a leading advocate for digital dentistry, emphasizing comprehensive treatment planning and emotional patient connection. With a global presence, she shares her expertise through presentations and leadership roles in various dental organizations. Dr. Soto is recognized for her clinical excellence, winning awards such as the DSD Speaker of the Year and the Spirit and Purpose Award. She co-founded Smile Again, a nonprofit providing smile makeovers to domestic violence survivors, and actively participates in marketing campaigns representing brands like Invisalign. A dedicated leader, Dr. Soto is involved in numerous continuing education programs and launched an educational platform called Key Elements. She practices cosmetic, implant, and general dentistry in Boca Raton, Florida, after graduating from the University of Maryland School of Dentistry and completing a GPR at the Baltimore VA. Welcome, Dr. Karla Soto.

Dr. Karla Soto: Thank you so much, Maria. Thank you so much for having me. It's exciting.

Maria Cabanellas: Absolutely, absolutely. I feel like you're the superstar guest, and we have so much to learn from you, so I'm super excited to get into it.

Dr. Karla Soto: Every time I hear you speak, I feel like I'm in the presence of someone who knows herself and exudes confidence. By the way, your feedback from your presentations at Key Elements is like, you know, NPS 100%, so congratulations. It's my honor to be in your process.

Maria Cabanellas: Oh, goodness, well thank you, thank you. But, you know, I think you're one of the pillars in this, of surrounding yourself with good people, right? I feel the same way; we have such a good circle. I appreciate having DSD and myself in your Key Elements group and everything you're doing. Really, I know we’ve grown together over the years.

So, you know, share with the audience, what is your story in a nutshell? Where did you start, what was the transition like, and where are you now? How is it going?

Dr. Karla Soto: Oh my gosh, how long do you have? I don’t even know where to start, and that's like a million questions in one. But I think, you know, when people ask me, "What's your story?" I always kind of freeze because I don’t know from what perspective to talk about it. It’s so interesting. JJ, when he met me—again, I met JJ in 2017 or early 2018—I was just a general dentist doing dentistry the way that I knew how to do, always loving it and being passionate about it.

If you know JJ, you know he hates getting out of Miami, Florida—like he loves to stay in his little five-block area. Somehow, someone at DSD made him come visit me in Boca Raton, which is about an hour drive. That story has many layers, but I remember we had a 15-minute meeting. I was like, "I’ll just take you to Panera." He had never been to Panera in his entire life, and this is now a joke about how we met. Long story short, we sat down, and he’s like, "So, what’s your story? Why am I here?" Literally, that's what JJ said to me.

And I didn’t know what to say. Every time someone asks me that, I don’t know what to say. What I can tell you about my story is that it’s about someone who sees the magic in creating things, relationships, and connecting with people. It's about the power of always pushing and seeing what happens on the other end. My journey has always been about trying to create something, pushing the limit, and exploring new opportunities. And I think the Cinderella story in all of this is being surrounded by the right people.

You talked about the circle—being surrounded by people who saw something in me before I even saw it in myself. That’s literally, no exaggeration, what happened to me. After DSD, it was like a renaissance in my mind, it just exploded. But it was way more than that; it was Christian. I really felt like, somehow, I was handpicked by him. He took me under his wing and believed in the things he was seeing, which I hadn’t even seen or believed in myself.

So when the DSD Speaker of the Year award happened, that’s what I said. I thanked them for believing in me before I even believed in myself for what I could do. I mean, I was kind of emotional at that moment because, during the awards, I was up against people like Miguel Stanley, Coachman, and other legends in the industry. It’s like, how can I even be at the same level as these gods? So, it's really, really cool.

The journey has been one of being passionate about creating, about caring for people, and surrounding myself with the right people. It's about opening doors, going in, and seeing what's on the other side.

Maria Cabanellas: Absolutely. Your story is super interesting because you even said you were just a traditional, regular dentist, right? Nothing that you thought was going to explode into what it is today. Taking you back to that moment, did you ever feel like, "I’m going to these CE courses, I’m doing the same things everyone else is doing, but I’m going to be on that stage one day"? Or, "I’m going to be on the freaking billboard of the conventions that everyone’s going to"? Those are huge bragging rights. How did you feel back then, and did it ever occur to you that this was possible?

Dr. Karla Soto: It's so surreal. I mean, we’re in 2024, so I’m well into six years of this journey since it started and kept going. But it’s still very surreal. I still get a call or an opportunity, and I think to myself, "I can’t believe I get to do this." I still get goosebumps, like, "Wow, I’m here." So many things are happening now that have come to pass this year or are on the horizon, and it’s very surreal.

What did it feel like back then? I think that the one moment where it was really like, "Whoa, something is happening," was when I started diving into digital. Traditional dentistry was my foundation, but when I took DSD and jumped into digital, I was all in—like, fully in. When you go to a DSD course, and you take what used to be the DSD Residency, it's overwhelming. I remember leaving there thinking, "This is what I’m doing, and I’m going to do whatever it takes to make it happen."

Very quickly, I started doing a little more, implementing more, and then I got the opportunity to talk about it. And share that knowledge. I had never lectured in my life before. I was practicing dentistry, and suddenly, I was up there, sharing my experience. I still remember my first DSD presentation, just a few months after taking my residency. Christian invited people who were implementing the concepts to show how DSD impacted their practice.

Dr. Karla Soto: So we were co-presenting, which, even that, was already like, "I've made it in life." I had already presented with him before, but this was clinical, right? Live, on stage. And, you know, like, okay, that's still kind of a big deal. But the day before, we were walking in to rehearse, and I was walking with Christian. We were walking to the Javits Center, which is, of course, huge. I don’t know how to describe it; it's like a conference center, but it’s like, you know, they talk about the glass ceiling and all of that. And then there was this massive, massive, huge poster, I mean, probably like two stories high, I don’t even know. And I was in it!

Maria Cabanellas: Yes!

Dr. Karla Soto: And it wasn't just the fact that it was there, but it was crazy. And Christian was like, "That's you!" My hero saw it before I did, you know? It was just like a full-on moment where I was like, "Maybe something is happening here."

Maria Cabanellas: Yes, absolutely. I think everyone saw it. I don’t think you could miss it. It’s like, "Karla is there" as soon as you walk in!

Dr. Karla Soto: Yeah, that picture, by the way—I hate, I absolutely hate that picture, and it’s still being used! But it doesn’t... I mean, it’s personally not my favorite because they even had a copy of it on a wall where you could stand next to it. I'm like taking selfies next to you on the wall!

Maria Cabanellas: No way!

Dr. Karla Soto: Yeah, that picture is everywhere. It's a little bit embarrassing, but I've learned to just roll with it, you know? My friends always like to send me pictures, like, you know, of them kissing or pretending to kiss the poster, so it's always fun.

Maria Cabanellas: Yeah, you're everywhere!

Maria Cabanellas: Now, 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're 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 of this episode. Now, back to the interview.

Maria Cabanellas: It’s amazing. Now that you're there and, you know, you're obviously practicing at the same time—I think that’s something listeners need to know about you—you’re not just talking the talk; you’re walking the walk at the same time, synchronously, doing it. Can you tell us about your day-to-day? How is it managing all these different components that you're into right now?

Dr. Karla Soto: It's definitely a roller coaster. Talking the talk without walking the walk—I know that there are a lot of people who are just on stage, right? And it's not just about being on stage because it's incredibly time-consuming and requires lots of sacrifices for whoever goes on stage. But I feel that it feeds each other, right? Like, me being able to practice and being out there in the day-to-day, being able to keep trying things and keep creating, then feeds into being able to share that. And then being on stage as a clinician as well gives that real reliability, like, you know, that person is going through my same pain and tribulations of being a practice owner, dealing with HR, and all the things that come with it.

Dr. Karla Soto: So my day-to-day has definitely changed. I mean, I went on a streak where, for 10 weeks, I was gone from home for 10 weekends out of 12. So it definitely has changed, and I’m still practicing, right? It's not like when I'm home, I'm chilling. When I'm home, I'm actually in my true job, which is my practice and my patients, which is always a priority. So it’s changed in a way, and in another way, it hasn't.

Dr. Karla Soto: It's definitely a roller coaster, but I think it depends on how you're looking at it. How has it changed after I became this digital-mindset clinician? That's a change. I think now it's still a roller coaster because no matter how much you learn, it almost becomes harder because you’re learning so much, and you want to implement so much, and your team's like, "Can we just stick with this? Can we try it for a month, please? Let us do this for at least a quarter." It's this roller coaster of things because no matter how much you learn, the knowledge, the systems, the training, the workflows—all of that—no matter what, you’re still treating people.

Dr. Karla Soto: And if you care about people deeply and you’re really passionate about the results, you will still go through those motions. But it’s now more meaningful and more fulfilling because I get to do it with more predictability. But it doesn’t change because the core of it is just taking care of people, and the difficulties of that will never change because we’re taking care of human beings. Even a simple case can be difficult if it’s a psychologically or emotionally challenging situation.

Dr. Karla Soto: So the way I practice now, I think it’s just become more predictable, most importantly with more confidence because it’s not just my knowledge and my hands, but I have all of these resources behind me. That helps me with the confidence to present and to believe in what I’m doing. It’s not just the training from Kois and Spear, comprehensive dentistry, DSD, and all of that, but also the day-to-day when I’m designing a case, planning a case, or brainstorming a case with the DSD Planning Center.

Dr. Karla Soto: I think it's changed like that, but what’s changed the most is that sense of purpose, almost, that sense of purpose not just for me and being intentional about things but also for the team. I think that’s the biggest change in how I practice now because it’s about the team and being able to surround yourself not only with the people you choose but also the people that elevate your purpose.

Dr. Karla Soto: You know, there’s this whole idea that you are the average of the 10 closest people around you. It goes beyond just your circle of colleagues and family or influential people in your life. It's about surrounding yourself with a team that is truly invested. The way it has changed in the practice, with intention, is that the team is no longer just someone clocking in and out; they’re much more empowered and proud of what we're doing. It’s a little more meaningful instead of just suctioning, cleaning up chairs, making appointments, or doing fillings.

Dr. Karla Soto: I’m not judging that—I’m a general dentist who does a lot of general dentistry—but there’s something about going through the motions of that which can lead to burnout. That’s why dentists burn out all the time, because of the regular repetitive stuff, right? And it can be as simple as the way a patient talks to you every day. They might not mean to, but if they’re saying the same thing to you repeatedly, it can really wear you down mentally and physically.

Dr. Karla Soto: So the way it’s changed is that the team now understands the purpose and the intention behind what we do. We focus on the magic and the life-changing things we’re doing because, I know it's cheesy, but we literally change lives. I mean, I have it in writing, in cards, in reviews, in videos, in tears—we change lives. Even if those moments aren’t an everyday occurrence, when they do happen, they serve as a reset, reminding us, "This is why we’re doing this."

Maria Cabanellas: Amazing. So what would you say was the special sauce that made that happen? Because I hear from a lot of doctors, "Oh, it’s hard to get my team on board; it’s hard to get them to understand." If you could list off the exact items that made a difference, what would they be?

Dr. Karla Soto: The exact items... the exact items, Maria... If I asked you that same question, it would be tough to come up with a list, right?

Maria Cabanellas: Yes, but what are the things that come to mind? You know, there has to be something where you're like, "Without this, it wouldn’t have happened."

Dr. Karla Soto: Well, for sure, without digital and the philosophy of DSD—seeing the possibilities before they become real—it’s all about the ability to communicate. You could have all these resources, but if you’re an awful communicator, it doesn’t matter what technology, visuals, or mockups you have; it wouldn’t make a difference. The special sauce is maximizing all of those incredible resources with the emotional and communication components—the human-to-human interaction.

Dr. Karla Soto: Their own, um, philosophy. Some people are incredible communicators but they're awful at organizing a sequence or workflow. And that's when, you know, maybe you're really good with patients, and you can maximize with DSD, with Align—you know, like all the digital platforms—everything that's available. There are so many things out there that we can use, but if you're an average communicator and you have all these resources, forget it. You can conquer anything, right?

And then, let's not forget that you have to back it up with clinical skills, right? Like, sure, you can be a great communicator, and sure, you can have all that, but if you can’t deliver on your promise, you're going to be okay for maybe a year, then you're going to be stuck. Exactly, because that's kind of it. The secret sauce is just doing the work, you know? Like, it's not going to be handed to you—you have to care.

I think even with communication, it comes down to accepting when you make a mistake or when something's not right. It's not just about saying, "Oh, I made a mistake," but owning up to it and making up for it. I think that goes a long way. There's nothing wrong with that, you know—it's the practice of dentistry. Sometimes things that work in 99% of people might not work in 1%, you know?

And I think the ultimate secret sauce is trying the most difficult thing, which is really surrounding yourself with a team that believes in that vision, that empowers you to continue with that vision, or inspires you to keep working hard because it is hard work. It's an everyday task to build that culture. And, you know, even during tough days, it's about maintaining good vibes.

I had a really tough day yesterday. I had a full arch case. You see, the way that I teach and what I teach is because of predictability and practical, real-life dentistry—real-life practice. You know, we see so many people on stage showing absolutely incredible cases that took five years to do, and I'm like, "I have real people coming to me wanting results, and they don’t want them in five years." Because if that's the case, they likely won’t do it. So I have a very real patient population; it’s not like a specific subset.

The hardest thing sometimes is when you’re not able to have the vibe and the energy toward that. And I had a really tough day because even though I focus on predictability and I deliver, once I've gone through my workflows, once I've over-communicated the results, done my provisionals, done the DSD design, done all of that—by the time I’m delivering, I deliver. But, oh, yesterday I had a full arch that I didn’t deliver. I had a design that didn’t fit, and I was like, "What is going on?"

And it’s almost one of those reminders, like, you've been spoiled with good resources, knowledge, and the combination of the team coming together. Because it’s common that maybe a full set of veneers—it’s not to say common, but it happens often—or at least that's what people tell me, that they couldn’t deliver the case, and the patient was like this, and the situation was like that. But I don’t even bring the patient back with provisionals because I've over-communicated, I’ve done so much ahead of time that, with the provisionals, I don’t see the patient again until I deliver, right?

So, it hit me hard that I've been almost spoiled with all that predictability that digital and working with the best in the industry brings, because it just didn’t work yesterday—one time. It’s so, so frustrating, and it makes you realize how most people are practicing and why it’s so frustrating. It’s almost like a trial-and-error situation, but on the patient, physically on the patient. And that’s kind of what digital and the predictability of designing with people who know what they’re doing brings to the table.

Success isn’t just the fact that you’re doing the case; it’s about how you’re doing the case and with what comfort you’re doing it.

Maria Cabanellas: Right, and that’s a good point to make. The digital technologies have had such a tremendous effect on your success. And now, it’s interesting to me because I’ve seen you grow with Key Elements and everything that’s positioned to help those like yourself in the beginning because you lived it, you did it, right? You came from a place of traditional dentistry into digital. When you came along—and I tell this example a lot when I’m talking to those interested in DSD—you know, people like Dr. Karla Soto didn’t have all the systems in place like we do now.

I know that this was not easy for you to implement all the digital technologies that Christian and everyone else were talking about back then, five or maybe even ten years ago at this point. It was a different time, right? It was a lot harder to understand, not just DSD's technologies, but Invisalign’s and everything else that was out there. So, can you explain what Key Elements is, how you're connecting the dots, and your journey in creating it?

Dr. Karla Soto: Yeah, so Key Elements was actually born from my own frustration of wanting to implement something. And then, once I started lecturing, the hunger was out there. If you're listening, I know that you're hungry to practice in a way that makes your life easier and more fulfilling.

So, right now, you guys at DSD have done such an amazing job with implementation and providing resources, but back then, when I was starting out, it was literally Christian and JJ—just the two of them. Now, it’s like an army of you guys. At least at the events, that’s what it feels like. I know there was more behind the scenes, but at the time, it was just the two of them.

I was so into it, and I remember thinking, "Why don’t you guys have an implementation kit or a tool?" And I was like, "I'm going to make it!" And I wasn't even lecturing yet, not at all. I thought, maybe I could talk to Christian, and we could have something—call it DSD Light, which then became Light Dent, and then became something else. In my head, it was like a light version—just a package with a ring light, a black backdrop, and a few tools. I was trying to think of what I needed because when I implemented it, I wasn’t even the owner of my practice.

I bought my own iTero scanner from my own pocket because I was like, "I am doing this." Back then, it was very difficult, and implementation is still difficult, to be completely honest. I think it has to do with mindset. I had my mind set, no pun intended. And once you conquer that and understand why you want to do it, then you can do the rest. But it's still a bit of an uphill battle, and it’s still intimidating.

Then, somehow, I started speaking and lecturing. Christian was inviting me to the residencies, and people were coming to me, asking for help. "I want to do what you do; I want to do it how you’re doing it," especially because, at that time, I had a small practice with just three operatories. I wasn’t the owner; I wasn’t in a position to make big decisions, but I still made it happen. Back then, I did every single step of the patient journey myself.

It was fun, to the point where my daughters were literally helping me submit cases to DSD! But it was also overwhelming because it’s a lot, and you still have to do the clinical dentistry.

About a year went by, and then Brandon, who is now the CEO—back then, I don't think he was even officially part of DSD—he gave me this idea. He said, "You should really think about creating something because people are connecting with you." And he gave me some ideas. Truthfully, Brandon’s mind is so ahead of its time. I had no clue how to implement something like that.

The idea started, and Marita was involved too; she’s brilliant. But I didn’t do anything with it at first. I just started recording some stuff, but I never did anything with it. The reason why Key Elements finally came to be was that I was lecturing more, the demand was growing, and I was getting overwhelmed with people asking me to help. It’s in my nature to want to help, but I couldn’t justify it because I wasn’t even spending enough time with my family or with things that were priorities in my life.

So, I decided, why not have this one place where I could deposit all of my knowledge—everything that I've learned, how-to videos, tutorials, 24/7 resources, and a community chat on Discord where people could help each other? And then we get to meet in person. It’s this like-minded community.

Dr. Karla Soto: I created what I thought I would have needed when I wanted to implement comprehensive digital dentistry. Back then, DSD didn't have the online way of doing that; there wasn't the kind of structured support that exists now. Of course, you guys have developed your own tools and resources that people can implement.

The difference with Key Elements is that it’s a smaller, more intimate community. There’s this sense that DSD can feel really big sometimes. I remember when I would see what people with DSD Clinics were doing, and I was like, "Wow, that’s just not for me—though it’s amazing and maybe one day, but that’s not for me now." So I feel that people see me with a regular practice, and the fact that I was able to become a DSD Clinic and do all the things that I’m doing makes it feel more relatable, like something within reach.

I think that’s why people gravitate toward it. There's so much DSD DNA embedded within Key Elements. But it's also about having fun, which is definitely something that I learned from DSD events that I absolutely love to attend because the energy is always amazing.

The cool thing is that we’ve been meeting virtually, and then we get together, and there’s this energy. Of course, we prepare fun, interactive, and engaging stuff, but also it’s with people who are already friends. They’re seeing each other for the first time, and then we get to practice everything hands-on that we’ve been talking about for months.

To me, it was like a combination of all of my favorite continuing education experiences that I’ve spent hundreds of thousands of dollars on, trying to curate into this little package for people. So that’s the long story of why Key Elements came to be. It came from what I thought I would have needed at that moment to jump into comprehensive digital dentistry.

Maria Cabanellas: I've had the honor of being at two of your events now, and I can personally speak on it—it’s truly brilliant, first of all, to have created it. But it’s so amazing to have a source for knowing how to connect all the pieces together. Because you learn, just like anything else, you learn one thing at a time, but nobody talks about how to learn it all at once, how to bring everything together simultaneously and make it happen.

And Key Elements does that job. No matter what the technology is, no matter what your workflow is, you cover it. I want to say thank you because it alleviates my pressures of trying to teach people all these different things.

Dr. Karla Soto: Thank you! You’re very welcome. I mean, it’s funny because I think about it every day, for a multitude of reasons, but I think of Christian a lot. You know, I remember going to DSD residencies back-to-back, and I would think, "Oh, that’s different." Like, yes, the concept is still the concept, but they’ve updated it.

And that was before I became a full-time educator like I am now, which is truthfully like half my life now. The beauty and the curse that I have with being in this field is that it’s all about technology—workflows, innovations—and the technology keeps changing. Every single time I have to change something, it’s to introduce a new workflow, new technology, new everything. It never stops.

I could spend hours teaching very exact techniques on how to scan full arches and bites, the different bite types, what to do if you’re increasing the vertical dimension, how to set up the scanner, everything. And then, literally by the next Key Elements event, it's all changed.

Maria Cabanellas: Yes, exactly!

Dr. Karla Soto: Now I have to cover both the new technologies and the ones that people are still using. It’s never-ending, and it’s a lot of work—not just to learn it but also to put it into practice and then teach it. So, if anything, hopefully, Key Elements will never go out of style because I can't keep repeating the same thing over and over. I have faith that it’ll continue to evolve.

Maria Cabanellas: Let’s talk about the reality of implementing digital dentistry. I know this is an ongoing conversation, but I know there are people listening who might still be in that analog phase of life and haven’t yet taken the leap into digital. Can you talk about your personal experience in the beginning and how it's helped you now?

Dr. Karla Soto: It’s funny you say that because I usually don’t engage much on social media, especially on big accounts that post general content. But there was this post on a page called "How Things Work," or something like that, where they showed a picture of this upper arch impression, with all the impression material everywhere, and they were asking, "Who knows what this is?"

I couldn’t help myself. I thought, "I need to say something—this is so old school! Why do they keep showing this as if it's still the standard in dentistry?" I don’t usually comment on these things, but seeing this kind of post really made me react because I feel like it perpetuates the stigma that dentistry is outdated.

So, I commented on it, saying that this is old school, and a lot of people started replying, "My modern dentist still does this," and "This is the way my dentist did it." I never said it didn’t work; I said it was old school, which it is! It's like using a rotary phone—it still works, but it's outdated.

People need to understand that I was trained and practiced for a really long time before I made the switch to digital. I graduated in 2006, completed my residency in 2007, and didn’t have my first CEREC or digital scanner until 2017. That’s a full decade of analog impression material frustrations! It’s not that it doesn’t work, but come on—it’s not an enjoyable experience for the patient.

For a long time, that’s how I was trained, and that’s how I practiced. But when I took the DSD Residency, I realized how much more was possible with digital tools. I started seeing everything differently. My transition was really about wanting to do DSD. For me, DSD wasn’t just about doing dentistry; it was about creating a whole new patient experience.

At first, I thought it was mainly about using digital tools to do aligners without taking traditional impressions, which was already a big improvement. Imagine someone’s super excited to get Invisalign, and you have to take all these messy impressions—it just doesn’t fit the high-tech experience they’re expecting.

So, my introduction to digital dentistry was through Invisalign, but it quickly became so much more. The real switch happened when I did the DSD Residency in São Paulo. I saw comprehensive and complex dentistry being done entirely with digital workflows, including things like full-arch scans and injectable composites.

Watching people like Francis guide an all-on-X case digitally, I was like, "Wow, I can do this too!" I already had the training to place implants the traditional way, but seeing it done with this level of predictability opened up a whole new world for me.

I started with just using digital tools for models and designs, and then I moved into fully comprehensive workflows. It empowered me to tackle cases that I might not have considered before because I knew I had the digital support to make it predictable and efficient.

To anyone listening who’s still in that analog world, I get it—it’s scary to jump into something so abstract at the beginning. But now, I can’t even picture doing things without digital models. I rely on them to evaluate, diagnose, and plan everything before I even touch a patient.

Dr. Karla Soto: ...analysis, looking at all the details. There was a period when I was already doing comprehensive work, but I was still in the traditional analog world—not at the level that I'm doing it now. There was definitely a hybrid point where I thought, "Okay, I'm jumping in, I'm doing it," but then I'd still say, "I'm going to take an impression just in case."

Maria Cabanellas: Yes, yes!

Dr. Karla Soto: So, I did that for a little while until I reached the point where I realized it was working well. I just started trusting the technology. It evolved with me, too, because now it’s getting better and better, especially with all the advancements in digital scanning that companies like 3Shape and iTero are bringing to the table. The accuracy and visuals they offer now are remarkable. The way we can even communicate with these technologies—it's just fascinating! Talk about being in the right place at the right time, wanting to do something at a moment when everything was exploding in this field.

I do think there's a lot of right place, right time, and a little bit of luck involved. JJ often says I’m very lucky because I always seem to be in the right spot when these opportunities come up. He doesn't quite put it that way, but that's the gist of it. [Laughter]

Now, it’s all digital—I don't use impression material at all.

Maria Cabanellas: Yeah, and do you see yourself ever going back to traditional methods for any situation?

Dr. Karla Soto: Absolutely not. I’m telling you, I can't even picture it. I'm at the point where I can't see things without a scan. I need to evaluate everything through a scan. I’m done with the limitations of what I could see in the mouth using traditional methods.

Of course, I still do a full exam, checking the occlusion and pathways—those things you can only do in the mouth. But when it comes to planning and performing the surgeries, especially with the guided all-on-X procedures that DSD offers, I can't imagine doing it without having already done it digitally. It’s like having the blueprint ready before you even start construction.

Maria Cabanellas: Right, who wouldn’t want to see the result before they begin?

Dr. Karla Soto: Exactly. I can’t understand anyone wanting to go back. I don't think anybody in the history of dentistry has ever gone back to analog once they’ve gone digital.

Maria Cabanellas: I would agree with that. It’s like, you have an iPhone, and then you go back to a rotary phone—no, thank you!

Dr. Karla Soto: Exactly! [Laughter]

Maria Cabanellas: I want to switch gears a little bit because there’s a specific subject I’d love to talk about with you. You mentioned it earlier—your appeal to DSD. I’m going to put words in your mouth, but I’m confident you’ll agree with me: it’s the emotional dentistry part of DSD that has really stood out for you.

Out of everyone who has gone through DSD, you’ve been able to demonstrate your emotional presentations and patient reactions to the mockup presentation so beautifully. The first time I got to see you speak was at the Invisalign Summit, and I’m positive you remember that experience because it was the largest standing ovation I’ve ever seen in a dental presentation. I truly believe it’s because of how great you are at delivering these emotional presentations. Could you share your experience with that and what you believe makes it so impactful?

Dr. Karla Soto: Wow, Maria, you just brought up a core memory. That was a very special moment. Thank you for being there. It’s so cool that you were there—I hadn’t connected it before you just mentioned it now, but yes, that was surreal.

I joke that my claim to fame is emotional dentistry. People always tease me about having tissues or onions ready in the background to make people cry during my presentations! It’s this standing joke that somehow I always get the tears flowing. But honestly, I didn’t come up with all of it on my own; I was just mimicking what I learned and then adding my own twist and personality to it.

When I did my DSD residency, Eduardo was the one presenting on emotional dentistry, and we became really good friends. He played a huge part in helping me understand how to implement these techniques. Even my presentation to this day is very simple. You guys have a template for the DSD presentation that you provide to the clinics, and mine is still inspired by that original, very simple format. It was inspired by Eduardo’s style, but with my own personal touch.

I think it goes back to being truly authentic and in the moment—really caring about what you’re doing. I don’t think there’s a specific formula to it. It’s about being in the moment and understanding the significance of that moment.

I’ve done my fair share of mockups at this point, and not every mockup ends with tears. That doesn’t make them any less powerful; it’s just that people react differently. There are plenty of mockups where there’s no visible reaction, but it’s still a yes. And there are times when there are tears, and they want to do it, but for some reason, they can’t, so it’s a no—or more often, a “not yet.”

I have so many cases where it was a “not yet,” but years later, they ended up going through with it because that initial moment was so powerful.

To be truthful, I don’t have a concrete answer for what makes these moments so impactful. I still get nervous before every presentation, even before jumping into this conversation. It’s that feeling of respect for the significance of the moment and what’s literally in your hands—the responsibility you have. If you don’t genuinely care about the person in front of you, it just won’t translate.

I think the magic really comes down to who you are as a person, what your core values are, and what your intentions are. If you’re only in it to close a $20,000, $30,000, or $50,000 case just for the money, that connection won’t happen. Patients can sense that energy. There’s nothing wrong with making money, of course—you’re working hard for it, and you’re going to do a great job—but if your intentions aren’t in the right place, the magic won’t be there.

Maria Cabanellas: That’s a really good point because I hear from DSD clinics all the time that they want more case acceptance. That’s the general wish of every office out there—more case acceptance, more yeses.

Dr. Karla Soto: Of course, we all want more yeses in life!

Maria Cabanellas: But it's important to realize that you already have everything you need to get that yes. It’s just about the communication. I think that’s the secret to emotional presentations; it’s not a trick to get a yes. It’s a way to help you say what you’ve already been saying, to help demonstrate and visualize to the patient what’s already there.

Dr. Karla Soto: Absolutely. It's about elevating that conversation, not just doing a routine presentation.

Maria Cabanellas: Exactly, and if your intention is to genuinely help the person in front of you but you don’t know how to tell them or show them, that’s where the emotional presentation makes all the difference.

Dr. Karla Soto: Definitely! You know, Christian always talks about how it’s a universal language, and I completely agree. I’ve lectured in South Africa, Europe, South America, North America, and soon Asia. No matter where you go, this approach to dentistry resonates. Even when I do webinars where I’m not specifically focusing on emotional dentistry, I’ll still show a little bit of it to demonstrate its power, and people all over the world respond to it the same way.

Dr. Karla Soto: It’s a universal language—that moment, you know. It's both ways. It's like, wow, what the patient is experiencing and also, wow, this is what I can do with my hands. I can show it this way, and I can have this moment. Even if I wasn’t doing the case, even if they were all no's, I would still do it. If they were all no's, I promise you, I would still do it because the high, the energy, and the moment—it feeds my soul so much.

Sometimes, it might almost be a selfish reason why you want to do it, but as you said, everything Christian talks about—it's like, even if you're Russian or from anywhere else, the reaction is the same. When people tell me they want to feel what I’m feeling, the truth is that’s impossible because you can't transfer that exact feeling. But what I tell everyone is that even if you don't get the exact same reaction, you will still get the high of the experience for yourself and for your patient.

If you’re not naturally an emotional person, don’t expect to be tearing up next to your patient, but the feeling is still there. At the last Key Elements event, you were there. We did a DSD mockup on a patient, and doing mockups in front of an audience while you're teaching is tricky because you want to focus on the patient while also balancing the educator role and the clinician role. You were there, and he had a positive reaction. He was like, "Wow, cool, okay, yeah, I like it."

Maria Cabanellas: Yes, yes, I remember!

Dr. Karla Soto: Since then, I've had kind conversations with that live patient—text messages and stuff—and he said it was such an overwhelming feeling that he didn’t know how to react at the time. He told me, "I haven’t felt this high in years. I've never felt like an attractive, handsome person that people would look at, but that day I felt handsome. That day, I felt like this was the best version of myself."

That was in front of an audience, in a non-intimate setup, which shows the power of this universal language. No matter what personality you have, that power is definitely there. We're actually going forward with the case—he's flying in.

Maria Cabanellas: Amazing! And I think it’s good to point out that he was an Align employee, correct? So, he knew of the DSD mockup. It wasn’t a complete surprise to him. He knew what to expect, yet he didn’t show much emotion during the mockup itself. He was an older gentleman, very reserved in his body language, so it was hard to read his reaction.

Dr. Karla Soto: Right! And we did have some technical issues with the mockup process itself. It wasn’t the best mockup, and yet we were still able to get this strong reaction from him. That’s what's so powerful about this—things can go wrong along the way, but with your intention and the power of that visual communication, you still have the upper hand.

Maria Cabanellas: Absolutely, the intention is key.

Dr. Karla Soto: It's in two ways—having the mockup itself, but also how it empowers you to troubleshoot in the moment. Even with technical difficulties, I was ready to adapt and work through it. It’s about making the most of the situation.

This is literally what happened to me yesterday with a mockup. The first DSD mockup ever that I didn’t show! If a good mockup is incredibly powerful, then a bad mockup can also be incredibly powerful in a negative way. But you go back to your regular way of presenting, still using pictures, still creating an experience for the patient.

The secret sauce, in the end, is your own X-factor and how you manage those situations. With the live patient at the Key Elements event, I’ve been doing this long enough to know better, but I was so into the lecturing and the moment that I didn't fully realize the impact we had until afterward. I was teaching, focusing on the technical stuff, and I didn’t expect him to be so open and vulnerable later on.

His girlfriend told me he was on cloud nine. She said he called her, and he couldn’t stop talking about how he felt like he’d won the lottery. So, you see, what you witness in the moment isn’t always the full picture of what’s actually happening internally with these patients.

Maria Cabanellas: Wow, that’s so powerful.

Dr. Karla Soto: Absolutely, it's about understanding the power of the moment and how transformative it can be for the patient.

Maria Cabanellas: We’re nearing the end of our time together. Before we conclude, what advice would you give to doctors or offices out there who are trying to grow their practice, move beyond traditional methods, and look to you for guidance?

Dr. Karla Soto: My advice is to always bet on yourself—invest in yourself, in high-end education, in technology, and in believing that you can do it. Surround yourself with people who show you what’s possible. Even during tough times like COVID, I doubled down on myself. I invested in new equipment and education because I knew that when you move forward with confidence and purpose, this industry is forgiving. It’s hard to go wrong.

But if you’re only half in, trying to test the waters without fully committing, it’s not going to work. You have to be all in—not just investing in technology, but also in your team. Find those key people with incredible attitudes, invest in them, and help them see the vision of what you’re trying to achieve.

Investing in your team can be tough because it means getting attached to people, and sometimes things don’t work out. I’ve experienced heartbreak in professional relationships with team members I thought would be with me forever. But despite that, you can’t let those experiences jade you. You have to keep investing in people because that’s where the magic happens.

And don’t forget to maintain balance in your life. Work hard, but also play hard. Take time to enjoy your life outside of dentistry, to travel, to have fun, and to create experiences that fuel your passion for what you do. That balance helps justify the hard work and craziness.

Maria Cabanellas: Amazing! Thank you so much, Karla. If someone wants to get in touch with you to learn more, what’s the best way?

Dr. Karla Soto: Instagram is a great way to reach me. My handle is @drkarlasoto. I do answer my messages there. Of course, if you’re interested in joining the Key Elements community, we’d love to have you. It’s been amazing to see the success stories of people doing incredible things. My email is also drkarlasoto@gmail.com, but Instagram is probably the easiest way to connect.

Maria Cabanellas: Thank you so much, Karla. I hope we get to see each other very soon.

Dr. Karla Soto: Absolutely, Maria! Hopefully at the next Key Elements event or somewhere fun before then. And, yes, people do say we look and sound alike, which is such a compliment!

Maria Cabanellas: It’s been such a pleasure, Karla. You are such a blessing in the dental world, and I know a lot of people are going to learn so much from you. Thank you!

Dr. Karla Soto: Thank you, Maria! [Music]

Maria Cabanellas: Thank you for joining me. Remember to subscribe to this podcast on your preferred channel so that you don’t miss any of our upcoming episodes. Talk soon!