Digital Dentistry Evolution: A Conversation with Dr. Mike Skramstad
Episode Description
Join us for an insightful discussion with Dr. Mike Skramstad, a pioneer in digital dentistry and education. Learn about the evolution of CAD/CAM dentistry, the importance of foundational skills, and how artificial intelligence is shaping the future of dental technology. Dr. Skramstad shares valuable insights from his 20+ year journey in digital dentistry and his transition to Spear Education.
Episode Navigation
- 00:01 – Introduction and welcome
- 01:17 – Dr. Skramstad’s journey into dentistry
- 02:36 – Early adoption of CEREC technology
- 06:02 – Evolution of digital materials
- 13:26 – Importance of preparation fundamentals
- 15:45 – Integration of Spear and digital curriculum
- 21:37 – Future of AI in dentistry
- 27:06 – Scanner technology discussion
Key Takeaways
Digital Dentistry Evolution
- First decade: Early adoption with limited materials and success
- Second decade: E.max era with improved outcomes
- Current era: Zirconia bringing easier implementation and better results
- Foundation skills remain critical regardless of technology
Education Focus
- Emphasis on proper preparation techniques
- Integration of digital workflow with traditional principles
- Importance of understanding the “why” behind treatment planning
- Scanner-agnostic approach to digital education
Featured Guest
Dr. Mike Skramstad: 2000 graduate of University of Minnesota School of Dentistry, certified advanced digital dentistry trainer, international lecturer on technology and implantology. Former leader in CEREC education (CDOCS) and current resident faculty member at Spear Education. Maintains a successful restorative practice in Orono, Minnesota.
Featured Discussion Topics
- Evolution of digital dentistry
- Material science advancement
- Digital education development
- AI integration in dentistry
- Scanner technology comparison
- Treatment planning principles
- Clinical workflow optimization
Connect With Simplify Dentistry
- Website: simplifydds.com
- Facebook Community: Simplify Dentistry
Topics: digital dentistry, CAD/CAM, dental education, zirconia, dental technology, treatment planning, dental materials, dental scanners, artificial intelligence, dental preparation, CEREC, Spear Education
Transcript
00:01
Intro
Welcome to the Simplify Dentistry Podcast. Join us as we discuss clinical, operational, and financial aspects of your practice, help you enjoy life, and dare to simplify dentistry.
00:13
Dr. Mustafa Shah-Khan
Hello and welcome back to the Simplify Dentistry podcast. I am Dr. Mustafa Shah-Khan, and along with my co hosts, Dr. Richard Offutt and Dr. Murtuza Shah-Khan, we’d like to introduce today’s guest, Dr. Mike Skramstad. Dr. Skramstad is a 2000 graduate of the University of Minnesota School of Dentistry, is a certified advanced digital dentistry trainer, and has lectured internationally on technology, implantology and digital dentistry. He has tested and evaluated many products prior to their market launch and has published numerous articles on materials and CAD CAM technology. Mike was the leader in the development and instruction of CDOCs, the premier CEREC educational program. Dr. Scramstad is a resident faculty member at Speer Education and maintains a successful restorative practice in Orono, Minnesota, focusing on aesthetic implant and CAD CAM dentistry. Dr. Skramstad, thank you for being with us today. Mike. Your career has been fantastic.
01:10
Dr. Mustafa Shah-Khan
Kind of. You know, one thing we wanted to talk about a little bit is kind of your journey. Can you take us through your journey a little bit?
01:17
Dr. Mike Skramstad
Yeah, you know, it’s a. It’s an interesting one. You know, I didn’t. I didn’t grow up wanting to be a dentist for sure. You know, it was. It was just something that came up last minute. You know, I went to. I went to Purdue indiana for college, and I liked the sciences, so I went into biology. And then when it came down to make a decision, you know, really, I didn’t. It was either medical school, go to grad school, or go to dental school. And I had a good buddy that went and wanted to go to dental school, and I said, that sounds kind of good. I think I’ll do that. And I applied to dental school, and that’s. That’s how I ended up there. So I remember. It’s interesting because when you’re in.
01:53
Dr. Mike Skramstad
When you go to dental school, you know, most people have had that kind of site in mind for a long time or that plan in mind for a long time. And I didn’t even know what a crown was. I had no idea, no clue. And so I went in there literally knowing nothing when I went into dental school, which is probably an unusual path, especially these days where, you know, just to get into dental school, you need so much, you know, background probably, and interning. And so I went through dental school, you know, did pretty well. And then when I went into private practice, you know, it was Back in the day where, you know, I ended up buying a practice right out of dental school, which is probably a little bit unusual.
02:36
Dr. Mike Skramstad
She worked for me for six, I worked for her for six months, she worked for me for six months and then it was mine. And so very quickly after that, I kind of partnered up about a couple of years later with another dentist and we built our first kind of joint office. And when we did that is, you know, I think I was always a young looking guy and so I was looking for a way to distinguish myself. So the bat, we ended up buying our first Cerec machine. I think it was 2002. I just fell in love with it immediately. I just thought it was the coolest thing ever. It was just as expensive back then as it is now. So it was a big purchase for us, but we bought it immediately.
03:17
Dr. Mike Skramstad
And you know, ever since then, that’s kind of been the focus of my whole entire professional life has been like the digital dentistry angle. You know, people always ask how I got into education. I think it’s different now where education is so much more accessible as social media. You know, everybody kind of can do what they want. They can make videos, they can put it on YouTube. And back then the community was just so small that there was really just a few of us kind of knocking around dental town, kind of getting beat up by people that thought the dentistry were doing was horrible. So the community back then in the early 2000s got really tight, really quick. And so most of my closest friends to this day are from that community, Sam included.
04:03
Dr. Mike Skramstad
And you know, we just started doing stuff and making training videos and from then it just kind of got more and more into kind of let me where I’m at today. So it was almost by accident that all of us became, you know, educators. You know, we didn’t certainly set out to do that. We just set out to kind of show people the things that we’d like to do and try to help them and really believed in what were doing. And we wanted more people to, to kind of believe in themselves so they could do it. And so that’s basically how CIDOX was formed, is just trying us trying to form a community and helping people enjoy the success that were having.
04:41
Dr. Mustafa Shah-Khan
So the, I guess when you jumped into it in 2002, I guess. Is that Redcam or is that before redcam?
04:46
Dr. Mike Skramstad
It was Cerec 3. And so it was before, it was right before when we bought it was right before Cerec 3D came out. So Cerec 3D, the first machine that was actually in three dimensions where you could use that little track ball to rotate things around, that was introduced in 2003. So were right before that. So still in two dimensions, still drawing lines and yeah, I still have that machine, I think somewhere in storage, but it was a nightmare.
05:15
Dr. Mustafa Shah-Khan
So what got you thinking about? Obviously I graduated in 2002 and you know, our whole world was analog. Everything were taught was analog. You know, I mean everybody tells you the best dentistry is this way, PBS impression, maybe even polyether. And you know, looking at, you know, you’d always hear about these guys that were doing CAD CAM dentistry and you know, like, man, sounds cool, but I mean, obviously it doesn’t work. You know, I mean, but you know, how did, what got you looking at it and you know, I mean, I think for me once I jumped into it was kind of the congruence of material. Technology had advanced. You know, the, you know, I think my first one was the omnicam. And I felt like all of it. Well, what got you into it so early?
06:02
Dr. Mike Skramstad
You know, I think it was just a way, what got me into it and got me interested mostly was just a way to separate. Like I just felt like I wanted to do something different. I didn’t know a ton about dentistry. I was very. But I already knew that I wanted to kind of separate myself from other. I don’t others. I didn’t want to do the same thing. So that’s kind of what got me into it, I would say initially or what was driving me towards that type of dentistry. Now to your point, you know, I look back at those times in the early 2000s and I think that I can probably agree that the dentistry probably wasn’t as good as it was analog. You know, we didn’t have the materials available.
06:43
Dr. Mike Skramstad
You know, I, when I talk to people, I, I kind of say that I’ve been separating my career into 10 year chunks, you know, and if I look at those first 10 years that I use CAD Cam, I would probably say that those were the least successful years of my career. And what I mean by that is that that we were driving ourselves forward to kind of, you know, prepare ourselves for success now, but we just didn’t have the materials. So we were, we were using, you know, feldspathic ceramic or VITA material. We were putting it everywhere and I think that the machine worked, we would get good results. But longevity wise, you know, I just don’t think that it was there. I think that you end up replacing a lot of the work. I ended up with more failures probably than most.
07:33
Dr. Mike Skramstad
But in the end I’ve always looked at that as a way to learn. You learn, you learn how to prep better, you learn how to bond better. Which leads me to the next 10 years, which would have, I would classify as the Emax years. And that’s kind of where you jumped in, it sounds like, and those years are successful, you know. You know, really the first material that we can use, that, that really you can put anywhere, it was strong. It’s still being used today. But there’s still issues. You know, there’s still, you have to really be good at prepping, you have to really be good at bonding. And, and now I would say these next 10 years are kind of, we’re entering the zirconia kind of age where I think that it’s just becoming easier and easier.
08:14
Dr. Mike Skramstad
It’s just, you know, the knowledge that we developed in those first, you know, the first 20 years is kind of leading us to be, I think, really successful with the materials that we have now. It fits better, you can cement it. You don’t have to worry as much about bonding. I just think that everything is setting us up to be like super successful in the future with CAD Cam.
08:34
Dr. Mustafa Shah-Khan
Yeah. You know, kind of when I, like you said, I jumped in the Emacs era is kind of what I started. And the thing that I learned real quick, I was, when I first started Emacs, it was lab fabricated emacs and it was pressed Emax because I think they were having trouble with marginal chipping. Once I got a cerec, you learned real quick. You have to better. Yeah, you have to better at what you do. You know, you cannot let a lab tech kind of make up for your deficiencies. So I do think it definitely improves your clinical skill. But I do feel like at that point in time you’d get this mixed feedback. People would be like, oh man, I see these CEREC restorations and they’re not very good. Now that, well, that’s the practitioner, right?
09:17
Dr. Richard Offutt
There’s huge operator variants.
09:19
Dr. Murtuza Shah-Khan
You’d see that in there. Those people that would always, the, some of those non circ docs that would always call it, you know, C wreck or whatever. You’re wrecking these people’s teeth with these, you know, machine made restorations. Like we’re not, as I give the clinicians, good, then the restoration is good. If the cliche is not, then, you know, I, I had crap in, crap out.
09:38
Dr. Mike Skramstad
Yeah, yeah.
09:39
Dr. Richard Offutt
I had the benefit of being a periodontist during that whole time frame. And you know, you kind of, you open up a case and you kind of see who’s, who’s doing it on the right page, you know. And so it was very interesting to see the variation and the learning curves. Right. The learning curve was quite, and quite sharp.
09:58
Dr. Murtuza Shah-Khan
And I was kind of newer to see you. I’m the newer doc, I guess. And out of the four of us, and thankfully I’ve gotten to learn from you and Rick and Moose. But I remember Moose and I had lots of conversations about, you know, zirconia because I got, you know, primes came when it came out. I got the M6 out that could mill the zirconia and he, you know, Emax had worked great for him. I was like, man, you really need to take this next step. And a lot of it was stuff, you know, courses at CDocs with you and Mina and Sam showing me how that stuff works and how it gives you a better result and better for the patient and all that. And slowly but surely my older brother decided to, you know, see the light.
10:39
Dr. Mike Skramstad
Yeah.
10:40
Dr. Richard Offutt
You know, the interesting thing is that, you know, if so say you’re young. Very few people are going to take the route that you took where you had the exposure and the, and I guess the circle of of colleagues that helped you kind of navigate the course. A young kid comes out of dental school, guy or girl comes out of dental school today, and they’re, and they’re thinking much like you, they’ve had some exposure in school. You know, they, they, they think that’s the direction they want to go. How should they proceed? What, where, how should they go from, from like the new graduate to be acquiring the skills.
11:16
Dr. Mike Skramstad
It’s so much different now than it was, you know, 20 years ago. It’s just, it’s just there’s, you know, social media has changed everything. There’s more options, you know, specifically with digital. Like when I got into digital, there was one option, so if you wanted to start, it was Sarek or nothing. And now there’s, you know, there’s so many decisions that need to be made. You know, what scanner do you want to go with, Sarek? You know, it’s a bigger investment that is probably easier. Or do you want to put together your own system? You know, there’s tons of different softwares and milling units. But I would say that one thing that everything has in common is. Is that the skill set to use them well is. Is pretty basic. And that’s learning how to prep, right? It’s learning how to prep.
12:00
Dr. Mike Skramstad
And so whenever I teach, like, I. I stress that so much. I spend so much time on preparation, on how to, you know, spend a little extra time, you know, polishing your margins, you know, get magnification. Because if you can prep well, you’re going to be successful in anything that you do. It doesn’t matter if you do it analog, it doesn’t matter if you do it digital. And I think that in dental school, what I’m finding here is dental schools even change, because when I was in dental school, we did kind of a lot of crowns. And I’m starting to hear now that some of these dental students are coming out doing like, two crowns. Oh, wow. They’re doing like two, three crowns. So very little exposure on indirect restorations.
12:43
Dr. Mike Skramstad
Then when you get into private practice, especially if you’re just a gp, a crown is going to be a pretty darn, you know, common procedure that you’re going to do. You know, you’re going to be doing these every single day, hopefully. And if you don’t have the skill set right out of dental school to. To prep the right way or even understand how to prep the right way, you know, that’s the education I would seek out. So, you know, there’s courses everywhere, but they’re a little bit harder to find because most of the courses are going to focus on, you know, how do I make digital dentures or how do I. How do I do all these advanced procedures, how do Implants, how do I do. You know, but my recommendation would be you. You need to back up, like three steps.
13:26
Dr. Mike Skramstad
You know, you need to get the foundations and take, you know, a preparation course. You know, I don’t know if any of you three have taken, you know.
13:34
Dr. Murtuza Shah-Khan
Doctor, if you’re talking about Bob’s course. Yeah, Winter’s course.
13:37
Dr. Mike Skramstad
But it’s. It’s just like, I don’t think new dentists think that’s kind of the route that they want to take. You know, why would I spend time and money to Go learn how to prep. But if you take that course, you understand how super valuable it is. You just. Because I would tell a dentist that any case that I struggle with or any case that I make a mistake on, specifically if it’s anteriors, whether that’s veneers or crowns, it’s always my prep. 100% of the time. It’s my problem. You know, you think that I may be okay, I don’t need to do a reduction guide for this case. I think I know where I’m at. And then you under prep the case and then it becomes difficult.
14:17
Dr. Mike Skramstad
So I think that if I was talking to a dental student, my advice to them would be to take a step back, you know, look at what you’re going to be doing every day, which would be crowns, you know, not implants, not dentures, and focus your education on that. Because if you learn how to do that well, then all these other decisions when moving into digital are going to be much easier because it’s not going to matter as much.
14:40
Dr. Mustafa Shah-Khan
Yeah. So kind of focusing on that, you know, obviously, with you moving from C docs ever into spear, are y’all shifting the curriculum a little bit more to having the congruence of the preparation side or the educational side from. From spear, which I’ve always thought was the. The greatest with digital dentistry and how to. How to merge the two?
15:06
Dr. Mike Skramstad
Yeah, I think that’s the main focus. You know, where the way that I would describe it is when were C docs or, you know, previously CEREC doctors, we’re more teaching people like, how to do things. You know, this is how you do this is how you do that, you know, so it’s more about execution. And I would say SPEAR is more about understanding the why, like, why would you do something? Why would you choose a certain route? Why would you treatment plan in a certain way when combining these. It’s a challenge because we want to keep the same basic core foundations that SPIR has in the treatment planning, but introduce digital when it helps.
15:45
Dr. Mike Skramstad
I would basically say that the idea would be learning how to use digital to be able to execute some of the core principles of treatment planning, how to use scanners to diagnose things like that. So it’s less about how we’re going to mill restorations or how we’re going to print restorations. It’s like, how can we use digital tools to make, you know, some of these aspects that we’ve taught for years a little bit more, you know, Accessible and a little bit more efficient, so to speak.
16:15
Dr. Richard Offutt
I mean, the foundational spear courses are, I mean, are amazing. I mean, even as a non restorative dentist, I took some of those and it was, the takeaways were just incredible. And so I hear what you’re saying, I think that’s the right strategy because lots of times people want to start swimming in the deep end of the pool and lots of times you have to start in the shallow end of the pool. And that’s great to hear. So it’s kind of an AI. That’s kind of how I was going to ask you the questions on the bolt on of not only digital, but bolt on of AI. And bolt on of all those things is that they’re not foundational, but they are not add ons. That’s the wrong word, but they are progressive. Yeah, it’s something that you can move to, to. To add.
17:06
Dr. Richard Offutt
To, to add. Add to the skill set.
17:09
Dr. Mike Skramstad
Well, I think you’re a specialist and so like one of the things, excuse me, that we’re really concentrating on is how can I better collaborate with my specialists? You know, how can we work as a team? And honestly with. I would, I wouldn’t really be as effective as I feel like I can be if I didn’t use digital, you know, learning how to send videos or scans or whatever it may be, cone beams. How can I send this fast and efficiently to my, you know, periodontist or my orthodontist to develop a plan and collaborate? So some of the softwares that we’re using now we can actually form in the cloud, you know, an area where everything is shared so I can have all my pictures, all my cbcts, all my X rays, all my plans, and then I can invite you to collaborate it.
17:52
Dr. Mike Skramstad
So we’re kind of chatting back and forth looking at the same thing. So digital in collaboration with specialists, when you’re doing comprehensive dentistry, is really becoming a big thing. Then there’s another one that is called Smile Cloud. Smile Cloud is a smile design program that was developed by a prosthodontist in Romania. His name is Florin Kofar. And then it was purchased by Straumann. And so they both have advantages and disadvantages. Obviously Smile Cloud has Smile design software that’s very effective in there, but it also allows a team collaboration where dscore has great advantages because dscore will allow you to sync everything that you do automatically. So I like them both, I use them both. To your question on facially generated treatment planning, we’ve Broken it up in two different things. Number one, we changed the name. It’s now called Treatment Planning with Confidence.
18:50
Dr. Murtuza Shah-Khan
Okay.
18:50
Dr. Mike Skramstad
The course is generally the same, but instead of, you know, some simple things, you know, when you learn how to use templates in that course where you’re drawing templates, you know, to do those templates, you generally need a computer and PowerPoint or Keynote. Sure. And so it doesn’t make it super simple to, for people to implement it. So we’ve started implementing or using iPads in that course. So how can we get these pictures on the iPad and use the templates on the iPads? You can actually do it in a more collaborative way. So that would be one of the changes. And the second change is we kind of made a part two, which is what I teach called Integrating Digital Technology into Treatment Planning and Case Acceptance.
19:34
Dr. Mike Skramstad
And then that’s basically the idea would be you take treatment Planning with confidence first, learn all those foundations. It’s more or less the same course. But I think that the biggest problem that we found is people take a course like that, they get so excited to implement this in their office and they’re flying back and, you know, we’re going to change our office. We’re going to take pictures on everybody, we’re going to do all this different stuff. And then, you know, real life just kind of slaps you in the face a little bit. It’s hard, it’s hard to implement these things in your office. So with the integrating course that I teach, we’re. We’re trying to take concepts like photography, treatment planning, scanning, and how can we actually implement this stuff in an effective way?
20:18
Dr. Mike Skramstad
By using your team to do all these different things to help you implement this.
20:24
Dr. Richard Offutt
Can you take in your course? Do you teach the being able to superimpose CBCT scan with your clinical scans to treatment plan from the surgical phase to where you can deliver at least a temporary restoration on that same day. I mean, is it totally digitally driven or is there analog component that, that you people use as well?
20:51
Dr. Mike Skramstad
Yeah, so, so my course is all digital. The one that I teach, you know, the, the original facially generated treatment planning will still have analog stuff in it, but we’re moving more towards yokes. I think that when you’re teaching a course like that, you have to give people both sides of the story because there’s going to be some dentists that don’t have any interest in being digital. So we have to teach them how to do it the traditional way, but then we’ll say you also can do this digitally. Now to your question about merging CVCTs, there’s many with intraoral scans. There’s many softwares that do this. We don’t really get into the specifics of, you know, I’m not interested in teaching like an exocad course, for instance, you know, but there is software like Smile Cloud, for instance, that I mentioned.
21:37
Dr. Mike Skramstad
You know, there is an update coming where this all happens automatically. So I think that the future of this is using AI, which that software does, and you can have an intraoral scan, you can have pictures, you could have a cbct. And you hit one button and it merges it all together.
21:56
Dr. Richard Offutt
Oh, wow. That, that’s amazing.
21:58
Dr. Mike Skramstad
Actually. It’s, it’s, we’re testing it now. It’s, it’s, it was supposed to be out in September, but it’s a little bit behind. But they’re showing it in lectures. We had the inventor at our faculty club summit in June and he showed a preview. And then based on that, you could even take, if you had something like Modja, which is the jaw tracking software, you can even implement motion through AI where it will imagine taking a face scan, a picture, an upper and lower scan and a CBCT and just hit one button and have a totally digital moving patient. So that is where the future is going to go. And with a software like that, then you can actually export STLs of anything that you want and you can export an STL of like the upper jaw and the cdct.
22:49
Dr. Mike Skramstad
If you wanted a surgical model, you can export just the tooth, if you just wanted the tooth. And then where Smile Design would be is now we’re doing three dimensional smile design in a software like that where if you move, it’s actually super helpful to see where the bone is because if you want to move the tissue, you’re going to be able to see in three dimensions. Okay, here’s where the tissue is. And if I move it here, I’m starting to get too close to the bone. So now I need to move the bone and you can design and see and visualize this all live in three dimensions.
23:21
Dr. Richard Offutt
Yeah.
23:21
Dr. Mike Skramstad
So it’s pretty cool.
23:23
Dr. Mustafa Shah-Khan
That’s, that’s pretty crazy. Yeah. I think somebody asked a question on our Facebook group the other day about how could you kind of merge all of this sort of stuff together? And I think they were talking about Cycad or something like that was supposed to have done that a long time ago. And I Think they were talking about like virtual articulators and being able to digitally just put it all together. Is modja kind of. And the AI components allowing us to do that sort of stuff now or in the future.
23:50
Dr. Mike Skramstad
I think with a software like ccat. CCAT was like, it’s a fantastic software and I use that, but it’s more of like an implant planning type of software. You know, where you take your scan and you take your CBCT and you can plan implants and export guides. It really works. Well, I, I like that software quite a bit because it’s simple. I know there’s probably more advanced ones out there, but I like that one just because of the simplicity. But that doesn’t allow you to do kind of what were talking about before, where you’re actually planning more restorative treatment or different surgical treatment or crown lengthening.
24:25
Dr. Mike Skramstad
I mean, with some of these new AI softwares that are coming out, you could do all this in three dimensions and move the bone and move the tissue and then create surgical guides to help, like crown lengthening guides, for instance. You know, all this is going to be possible to design and plan in your Office and then 3D Print in your office. So the capabilities are getting more and more every single day.
24:52
Dr. Mustafa Shah-Khan
That’s pretty crazy. Especially the crown lengthening guide.
24:54
Dr. Richard Offutt
You know, the tissue reduction guys are great.
24:57
Dr. Mustafa Shah-Khan
When I would send that stuff to Dr. Offit, you know, I just feel like, man, I hope this thing comes back. Right.
25:03
Dr. Richard Offutt
I hope that too.
25:07
Dr. Mike Skramstad
I said this is where I want it to be. Yeah, just do what you got to do.
25:11
Dr. Richard Offutt
Yeah, yeah, yeah. Because the vast majority of the cases, you don’t have a tissue reduction guide, you know, and that’s kind of where the have it. The clinical skill of having done a gazillion of them, you know, everything, it takes reps, you know, you got to have reps to get good at it. And so a lot of times the.
25:31
Dr. Mike Skramstad
Way that I would learn is I would just remove the tissue with a, like a diode laser and I would put the teeth where I need the teeth to go. And oftentimes they would be almost resting on the bone, you know, and then I would send the provisionals back to the periodontist and said, this is where the teeth go. They’re bleeding a lot right now. So now you need to. Yeah, Legend, you need to do the crown lengthening to make this work.
25:55
Dr. Murtuza Shah-Khan
Yeah.
25:55
Dr. Mike Skramstad
And I think that something like that is super helpful because at least you know, where the final in Essence, you.
26:00
Dr. Richard Offutt
Were giving them a, a tissue reduction guide because it was the provisional, right?
26:04
Dr. Murtuza Shah-Khan
Yeah, right.
26:05
Dr. Mustafa Shah-Khan
The crazy thing is I would, it.
26:06
Dr. Mike Skramstad
Might be easier if we could do that digitally and not have to go through that stage because it is kind of a bloody mess when you do it.
26:12
Dr. Murtuza Shah-Khan
Oh yeah.
26:13
Dr. Mike Skramstad
Oh yeah.
26:14
Dr. Mustafa Shah-Khan
I would get pissed off a lot.
26:15
Dr. Mike Skramstad
Ahead of time and then maybe that would better.
26:18
Dr. Mustafa Shah-Khan
I’d send something to Rick and Rick would be like, hey, you need to prep this and put in a temporary. And I was like, man, I do digital dentistry. I don’t want to put this thing in a temporary. I want to prep it once, put the crown on it, you do your job, but then you understand why and it makes sense.
26:34
Dr. Richard Offutt
And it basically was the creation of a surgical tissue reduction guide.
26:38
Dr. Murtuza Shah-Khan
Yeah.
26:40
Dr. Mustafa Shah-Khan
So with you not being obviously CDOCS focused and which means you, it removes you from the CEREC world exclusively. Are you, are you looking at other scanners? Do you talk about other scanners in your curriculum? You know, you were talking about, do you build a, do you build your own design scanning system or do you go with the cerec? What, what are, where’s your head and where’s your teaching?
27:06
Dr. Mike Skramstad
Yeah, so of course we look at other scanners, you know, because the. I think our goal when we teach these courses is we want them to be completely scanner agnostic, meaning what we teach in the spirit curriculum. With scanners, any scanner will work if you have an ITERO or if you have a three shape or if you have a prime scan. We don’t really get into, in the sphere side of things, at least we don’t really get into. You need to use something super specific in that sense that yes, we’ve tried different scanners. I think that there’s so many scanners that we can’t possibly try them all. So we separate them into what do we feel are the premium options out there. So I think most of our focus has been on prime scan and three shape.
27:53
Dr. Mike Skramstad
But we also are looking at that new AORAL Elite scanner just specifically because that’s the one, if you haven’t heard of it, that has the photogrammetry built into the scanner. So you can actually scan those scan bodies for all NX and you can think about using a scanner and get away from the bigger photogrammetry units. So one of our faculty is looking at that scanner. But for me personally, the scanners that I’ve used in my office are three shape and in the prime scans. So I still kind of focus on those, But I have tried other ones. We do have an itero sitting around as well. But I need to know a lot about these for the education so I can build a curriculum that allows all of our attendees, because they have different scanners, to be successful.
28:41
Dr. Mike Skramstad
But in my clinic, when I’m doing dentistry, I work with the scanners that work best for the workflow that I.
28:47
Dr. Mustafa Shah-Khan
Do not to shift from clinical too much. But I was texting with Mina yesterday and I was like, we got Mike on tomorrow. Anything I should give him grief about? He goes, well, ask him if his damn golf game’s gotten any better place. Four times a week.
29:05
Dr. Mike Skramstad
I had the best summer of golf I’ve had in probably five years. And the reason is because I’ve been home more. So I played more golf. I don’t even want to tell you how much golf I play because it’s almost embarrassing. But, yes, my golf game has been pretty solid this year. I started getting back into competition. I played like the senior amateur and all this different stuff. And so, yeah, so I’m doing good.
29:26
Dr. Mustafa Shah-Khan
So, you know, the U. S. Senior Am in 2025 is at a club that I’m a member of, Biltmore forest. Oh, you’re gonna play. You’re trying to play.
29:36
Dr. Mike Skramstad
We will see. I have to. I’ll have to take a look at that. That these. The funny thing about this is I turned 50 this year. And, you know, people think, you know, okay, seniors, but you just gotta be 55. It means nothing in golf. Right? So. So. So like the. The guys that I played with my whole life growing up, when I played with in college, everybody’s 50 now. And, you know, they’re just as good as these. Some of these college kids. You know, we can’t hit the ball quite as far anymore, but we’re. But there’s. There’s lots of under par rounds being shot. Let’s just say that.
30:09
Dr. Murtuza Shah-Khan
Nice.
30:10
Dr. Mike Skramstad
So.
30:10
Dr. Mustafa Shah-Khan
So are you back to. I mean, you have. You played at Purdue, right?
30:13
Dr. Mike Skramstad
I did, yep.
30:14
Dr. Mustafa Shah-Khan
So are you back to the zero plus one plus two plus three?
30:18
Dr. Mike Skramstad
I’m. My handicap index right now is exactly 0.0.
30:22
Dr. Murtuza Shah-Khan
Oh, wow.
30:24
Dr. Mike Skramstad
It was. It was. I think I’ve been as low as like a plus one or something like that this year, But I would prefer it to be like a three, honestly.
30:34
Dr. Mustafa Shah-Khan
Sure.
30:35
Dr. Murtuza Shah-Khan
So. So you don’t lose as much money on the golf course.
30:37
Dr. Mike Skramstad
That’s 100, right?
30:38
Dr. Murtuza Shah-Khan
Yes.
30:39
Dr. Mike Skramstad
It’s very hard. It’s very. It’s very hard to. To compete when you’re giving everybody shots, so. Yeah. But no, we have fun. Mina missed our golf trip this year. Usually we take one every single year and he couldn’t go this year, which was a shame because we have so much fun.
30:55
Dr. Murtuza Shah-Khan
Where’d y’all go this year?
30:57
Dr. Mike Skramstad
We went down to the Ozarks, actually, in Southern Missouri. It’s, it’s. It was very surprising how good it was. They have.
31:06
Dr. Mustafa Shah-Khan
What is it?
31:07
Dr. Murtuza Shah-Khan
That one, the Tiger’s course. Was it big?
31:10
Dr. Mike Skramstad
Yeah, it’s called Payne’s Valley.
31:13
Dr. Murtuza Shah-Khan
Yeah, Payne’s Valley. Yeah.
31:14
Dr. Mike Skramstad
Yeah, Valley. And that was good. It’s more of a resort type course. It’s not. I mean, it’s great. But they have one called Ozark National.
31:22
Dr. Mustafa Shah-Khan
Yeah.
31:22
Dr. Mike Skramstad
Which was fantastic. And so, you know, it’s. I recommend to do it. We had a really good time. A little hard to get there, but it’s. It’s great.
31:31
Dr. Mustafa Shah-Khan
That’s all encompassed by Big Cedar Lodge, right? Is it what it is? Yeah.
31:37
Dr. Mike Skramstad
Have you been there before?
31:39
Dr. Mustafa Shah-Khan
We haven’t. We’ve been talking about trying to get down there, trying to figure out the right time of year to go where mosquitoes won’t carry you away or it’s too cold. Yeah.
31:47
Dr. Richard Offutt
January is when the mosquitoes are gone.
31:49
Dr. Mustafa Shah-Khan
Yeah, that’s right.
31:51
Dr. Richard Offutt
That’s right.
31:52
Dr. Mike Skramstad
It was nice. We. I really liked it. I recommend it.
31:55
Dr. Mustafa Shah-Khan
When did you guys go?
31:57
Dr. Mike Skramstad
August.
31:58
Dr. Mustafa Shah-Khan
Okay. And the mosquitoes didn’t carry away.
32:00
Dr. Murtuza Shah-Khan
What’s that?
32:01
Dr. Mustafa Shah-Khan
Mosquitoes didn’t carry you away in August.
32:03
Dr. Mike Skramstad
I didn’t really have any issues with mosquitoes, but really, you know, it’s. When you’re golfing as much as we do, we’re not like spending a lot of time outside later at night. You know, you golf all day, you eat dinner and you go to bed.
32:16
Dr. Mustafa Shah-Khan
Yeah, yeah. Other question I have for you. Obviously there’s a lot of shoe game going on these days. I’m wearing some Jordans. Looks like my brother’s wearing some Jordans today. What’s. What are the shoes in the back left corner that you have in that picture?
32:33
Dr. Mike Skramstad
The back left right there?
32:35
Dr. Mustafa Shah-Khan
Yeah.
32:35
Dr. Murtuza Shah-Khan
Looks like a pair of Air Force ones or something.
32:40
Dr. Mike Skramstad
That is like. That is a picture my daughter made.
32:43
Dr. Murtuza Shah-Khan
She drew this.
32:47
Dr. Mike Skramstad
So, yeah, she entered this into art projects. This is just a drawing of some Jordans that my daughter. My, my 12 year old daughter did.
32:55
Dr. Mustafa Shah-Khan
Awesome.
32:56
Dr. Mike Skramstad
So she. Yeah, so it was when she was in sixth grade. She did this.
33:02
Dr. Mustafa Shah-Khan
That’s pretty cool, dude.
33:04
Dr. Murtuza Shah-Khan
That’s awesome.
33:04
Dr. Mike Skramstad
Yeah. So I, I can’t afford to have Nice shoes. Because I’ve had three kids and they all want nice shoes. So all my shoe money goes to them.
33:11
Dr. Mustafa Shah-Khan
It’s a, it’s amazing what shoe game will cost you. Yeah, it’s crazy.
33:15
Dr. Mike Skramstad
It’s. And they gross like every, you know, and unfortunately I have a basketball player, like a high school basketball player. And you know, we got had to get to the point where you need to like put some of your money into these. You need to, you know, earn some money because these shoes are like $500.
33:31
Dr. Murtuza Shah-Khan
Yeah, it’s.
33:33
Dr. Mustafa Shah-Khan
Yeah, yeah.
33:35
Dr. Murtuza Shah-Khan
I gotta, I got a soccer player and that stuff is killing me right now.
33:39
Dr. Mike Skramstad
Yeah, yeah.
33:41
Dr. Mustafa Shah-Khan
Mike, thank you for spending some time with us today. It’s been a pleasure to know you, call you a friend for over 15 years. Kind of for our audience. What would you say is a takeaway message for them from today?
33:53
Dr. Mike Skramstad
Well, I think that, you know, if we’re specifically talking about digital, I think my take home message is, you know, you have to slow down a little bit. All these systems are going to work. You know, I think concentrate on the fundamentals, like learn how to do the dentistry. You know, the dentistry, in my opinion is actually getting easier when you start looking at some of the materials. We didn’t really talk much about materials, but you know, some of the zirconia and the posterior is making life easier. I don’t think I’ve ever been as happy as I am now as a dentist. Just, you know, making zirconia. That’s fitting, fantastic. It’s looking good and I can cement it. The cementing, yeah. I mean, I’m just in love with it.
34:32
Dr. Mike Skramstad
But, but slow down a little bit would be one, you know, learn how to prepare a tooth properly. And the second message I would have is, is don’t be afraid of spending a little bit extra as an investment to get the right workflow, you know, because for some people it’s not going to be as simple as I can put together the cheapest option and make it work. You know, a cohesive workflow with digital, in my opinion, is worth a lot. So I’ve never been afraid of spending a little bit extra money to make my office run more efficiently. And just a quick example of that would be, you know, if you’re getting slow, if I was getting slowed down by multiple dentists in one milling unit, the solution is never to buy more scanners. It’s always to buy more milling units.
35:21
Dr. Mike Skramstad
If you’re getting slowed down by too many people doing zirconia in your office, then maybe you need another sintering furnace. So it’s always been, I want my office to run as smoothly and as efficiently as I possibly can, but I also want it to be super cohesive and have everything. Talk to each other, work to each other. And sometimes solutions like that cost a little bit more money. So don’t be afraid of doing that if that works for you. Now, there’s other offices that have made some of these systems they put together work fantastic. But for me, I need something simple and easy. And so I’ve always been. My advice would be don’t be afraid if it’s right for you to invest a little bit more in better systems that will create increased efficiency.
36:02
Dr. Mustafa Shah-Khan
Well, thank you again and thank you all for joining the Simplify Dentistry podcast. Be sure to join our community by registering to receive future episodes at simplifydds.com. And please join our Facebook community. Simplify dentistry. Dentistry is a hard profession. We hope that our community can help make it a little more simple. Thank you again, Mike. We appreciate your time.
36:22
Dr. Mike Skramstad
Appreciate it.
36:23
Dr. Murtuza Shah-Khan
Thanks, Mike.
36:24
Dr. Mike Skramstad
Thank you.