How Damon Ultima Can Help Startup Practices Succeed

Alison Werner
Hello, and welcome to the Orthodontic Products podcast. I’m your host, Alison Werner. In this episode sponsored by Ormco. We’re going to talk about what it means to be a startup practice and making decisions around clinical products you use with a focus on the Damon Ultima system. And we’re going to do this with Dr. Brady Petersen and Dr. Kory Grahl, who are in private practice together in Las Vegas under the practice name, Orthobar, Dr. Petersen and Dr. Grahl. Thank you for joining me.

Kory Grahl
Yeah, thanks for having us, Alison. Thanks.

Brady Petersen
Awesome. Excited to be here.

Alison Werner
Great. Okay, so to get started, can you talk about how you two came together to start your practice? I saw that you both attended UNLV for dental school and your residencies? Were you in classes together?

Kory Grahl
Yeah, Dr. Petersen and I both graduated dental school together, we’re both actually in the same team. UNLV breaks their dental school up into teams were the same team for four years. And we remained close and in contact with each other ever since that point in time.

Brady Petersen
I think we were? Oh, sorry, I was gonna say even if I remember being, we were at the same day interview. And I remember like seeing Kory over there, Dr. Grahl. And just being like, that’s someone like very similar to me. Day one, and that was both when we hadn’t even gotten into dental school together. And then we ended up sitting across from each other for four years. And our interests are very similar, even throughout dental schools,

Alison Werner
Okay. So how did you know you were compatible enough to start a practice together?

Kory Grahl
You know, we kind of overlap during orthodontic residency. And, you know, both of us had practiced general dentistry as associates for years prior to orthodontic residency, which is a little bit uncommon for most orthodontist in their journeys. And one day, I think I went up to Dr. Petersen, I’m like, Hey, man, let’s build something together here. It’s so drastically needed here in the Las Vegas Valley. I don’t want to work as an associate for the rest of my life. You know, there’s definitely pros and cons to that. And having known Brady for a long time, you know, knowing his values and stuff very much aligned with me, both in kind of the same phases of life on growth in development. And so it kind of just kind of just a match that just needed to happen. To be quite honest.

Brady Petersen
Yeah, I think I think a lot of that we touched, we touched on it all the time, every day in our practice, the the years that we got in our general practice, as general dentists, the years that we got there. You get a lot of those learning experiences out of the way. So you we’ve done the associate chips we’ve done, you know, are we interested in buying this dental practice and things like that, and we both had experiences, where we had both known where we’d gone out into that world, we realized how much we love orthodontics and how we wanted to go back and the importance of that specialty, you know, we were both working in practices that did some orthodontics as general dentists, but it just piqued my interest that I get there’s so much more out there and then talking with Dr. Grahl in residency. I think that drive to both build something of our own be owners of a practice our own keep that private practice alive. And it’s so needed here in Las Vegas that we started that day one I remember Dr. Grahl coming over to me and saying, Hey, are we doing this together? Are we going to do this against each other? I said we’re doing it together because I’m not competing against Dr. Grahl. By with you. We started and we went from there so okay.

Alison Werner
What were you trying to strive for in setting up Orthobar? How are you looking to set yourself apart in that Las Vegas area?

Brady Petersen
Yeah, I think you know, I’m born and raised here in Las Vegas. I absolutely love Las Vegas. And I feel like I have a really good understanding of of, you know, the what everyone thinks Las Vegas is and then what it really is and what it really is, is it’s a community and it’s a small town. Everyone knows everybody and I know I know there’s there’s great orthodontist here in town I’ve I’ve grown up with him I was treated by them. But in our goal for ortho bar was to we wanted to raise the bar and orthodontics and that’s kind of how we came up with that. And and really there is another level that whether it’s just our patient experience or the products that we use in our orthodontic practice, we want that to be different than anyone else here in Las Vegas. And so everything from that private practice feel, to a beautiful office to the technology that we use, we want everything to be the best and, and I know that everyone in Las Vegas, it’s just like any restaurant, any casino, if you’re not the best, I mean, if you’re a casino, they blow you up, you won’t last year forever. So you have to be at the top. So having that understanding that that’s where we want to take Orthobar and and we want to do that right from the beginning.

Kory Grahl
Yeah, and, you know, to piggyback off of that, I worked with some incredible dentists and one of the differences that I found in most practices is people don’t really know what you do, to an extent, like there’s certain levels and degrees that things but it was all how you made them feel. And so the way we built Orthobar, the way we structured our practice, like when you walk in, it does not give a, I’m in a dental office vibe, it’s I’m in a spa like environment, you’re greeted by the front desk, you’re, everyone knows your name, your hobbies, what you do. And that’s the structure of it. And then just partnering with really, really positive companies in selecting products and that rather than someone coming to you about the latest and greatest deal or cost or whatever, but no companies I’ve been around a long time just made total sense and not cutting corners in any bit of the process. You know, when you come in here, you’re getting authentic products, authentic people at all stages throughout your experience here and hopefully starting here to deliver you an incredible Orthobar smile is what we’re trying to create. So it’s a very different feel than seven, your insurance will verify that and then here’s the fees, and whatever, it’s very much like no, come in and meet us we would love to meet you get to know you as a person, as a human and how we can be part of your lifelong bolt of confidence basically. So it’s very much structured off soft components rather than hard components in our practice. It’s it’s high touch points. It’s, you know, understanding who were who we’re working with, not just patients, but partners as well. Yeah.

Alison Werner
Okay. So you touched on this a little bit. Considering the fact that you are, by definition, a startup practice, what are some of the considerations in making a product decision for your practice? You talked about not taking the easy way out, or putting the investment forward sooner. Can you talk about that?

Kory Grahl
Yeah, I mean, from the start, we’ve invested in a lot of technology. You know, one of the one of the early on disagreements between Dr. Petersen is what do we have a sink in the lab or not? If we don’t have a sink in a lab, then you’re definitely not using stone. And so we are fully digital, we’re an Apple based practice, we have digital scanning technology, we have 3D cone beam X ray, all those things, I think contribute to finding and delivering the best possible care we can and, you know, finding good companies that have been around a long time, and not necessarily the new latest and greatest, even though, you know, we’re talking about Damon Ultima being the latest and greatest technology of self-ligation, Ormco, has been around a long, long time. And they’ve seen multiple iterations of their bracket. And so it’s one of the things that, you know, maybe there’s this new sexy other company out that says they can do things better, but tried and true. No, Ormco has been around and done it for years and years and even more years to come.

Brady Petersen
I just think too, with both Dr. Grahl and I, we were orthodontist, but we also have that entrepreneurship mindset. And for us, it’s really investing in something that’s efficient. And then in the long run speed is invaluable. So the I love working with the Damon Ultima system because I mean, you’re seeing these cases just just come together in an initial NiTi wires and and it’s fun, you know, I I had had more experience not with the dam and ultimate system, but with previous versions and things like that with self-ligation. And, you know, we we went directly to the manufacturing site Envista’s manufacturing site and, you know, Dr. Frost is teaching us these new torques and what to use them with. And so it’s been a learning process. But it’s, it’s it’s tried and true. I have faith in the other docs that have been using it for for longer than we have. But it’s in no point in the system, are we questioning, there’s even days where Dr. Grahl is not here and I’m here. We don’t have to, we don’t have to call each other. And hey, why are you doing this? You know, it’s a system that that we’ve created together that works with Orthobar that works with the Damon Ultima system. And and we just continue to move these patients along. And the best thing for us is, the patients notice it there. I mean, we get compliments where the older siblings been treated with a different system. And we get the younger sibling that’s just starting out and the moms already telling us you know, Wow, are you know, we’re six months in? Are we almost done? And we’re like, no, like, let us we haven’t got to the final touches yet. So it’s been wonderful.

Alison Werner
So can you talk to me a little bit more about what are some of the features of that self-ligating system that stand out to you, that make you know that it’s the right thing for you clinically?

Kory Grahl
Well, for me, it’s personal experience. So I was actually treated by Dr. Frost and Dr. Nichols, two mentors of mine, and I can call now dear friends. And it was in I’ve been treated three times not to get in my case, crazy, but they did it. What I started noticing as a general dentist on social media is you see like once you start diving into cosmetics or whatever, you start to see things pop up on your feed and I started to seeing orthodontics come in. And a lot of those orthodontics, all I was seeing was a front 6 teeth. Okay, well doing veneers at the time. I mean, I’m doing eight to 10 teeth for arch width arch development. And and then I started coming across Frost Orthodontics’ page, and I’m like, that’s different that looks like a veneer like finish, I need to go learn how to that. So I don’t have to prepare teeth and all that. And then that’s when my case came forward. And I started feeling how this particular system worked, and the efficiencies of it, and how I could live in Vegas, but get treated potentially there. And we’re not taking any extra longer of time. And so it’s a personal experience that I started to go, Okay, this this bracket, this system is different. And, you know, there’s a lot of other products out there that do different movements. But at the end of the day, if you talk to the majority of orthodontists, the most predictable development side of things is width and this system gets width almost every now almost every single time with solid predictability where I can go into console and be like, very, very confident and say like, No, we’re sub-18 months. And you’re gonna be closer to 14 months first most cases, because of other things that we believe in that that’s why our philosophy works in that way, which we won’t go into orthodontic philosophy, but it’s the predictability that it’s like, no, it, it works well 100% of time.

Alison Werner
So, in turn, so you talked a little bit there about how it kind of creates efficiencies, or, you know, cuts back on the length of treatment. Can you talk about how this system kind of plays into kind of the practice management side or appointment workflow? Because we talked a little bit about clinical but in terms of that, how is it helping your practice there?

Brady Petersen
Yeah, I think just with all the learning, growing pains of a startup, too, I mean, we’re, we’re hiring new employees. We’re growing. There’s there’s all types of things like that. And so we’re building our systems from the ground up. And a lot of these assistants have never seen even self-ligation let alone. You know, we’re teaching them the Damon Ultima bracket and how it’s unique. For me and Dr. Grahl, I think it gives us a lot of opportunity to teach. We we are not, you know, every minute of our day is not filled with orthodontic patients right now. So we have we have that opportunity to really nail down our systems, make sure that everyone’s understanding it. And from what I see, I think our systems, I think they love it. I think they you know, once they get the opening and closing of the doors, you know, we’ve talked to them, the different dimensions of the wire systems are a little different and unique. But but they grasp it and I think, you know, once you get your hands on it and you you feel it, you know that it’s it’s a it’s a strong bracket, it’s it’s a clean bracket. A lot of our patients, the hygiene is better. And so those are those are positives that we see with that and not a lot of I don’t see a lot of negatives as far as like the learning process. It’s been very streamlined. And they’re able to pick up on it fast. It’s still orthodontics. It’s just different, but nothing that can’t be learned.

Kory Grahl
And to piggyback on that, Alison, I think, you know, with the two-doctor practice, right? Having similar philosophies is really helpful for not just the patient flow, like someone comes in on a day, I’m here and Dr Petersen’s here, it doesn’t matter. We’re progressing through treatment, but also for a treatment coordinator, to walk in there and be like, okay, is this okay? I gotta maybe talk about this because Dr. Grahl leans this way, or Dr. Petersen leans this way? Is he going to use a class 2 appliance first? No, most of our patients, it’s, it’s pretty set, what we’re going to do, and it’s really dialing the fine tuning at the end, but there’s no real guesswork. When we’re speaking with patients about length of treatment time and stuff like that. It’s not, it can get a little out of whack if you have multiple doctors in a particular practice using a maybe not so systematic type of system, where it’s like, okay, what stage of treatment? And are we in on this patient and then checking notes. It’s like, No, I can come in. And I know exactly where we left off and where we need to go and vice versa.

Alison Werner
That’s interesting that you say that, because I know I’ve talked to other practices with multiple doctors, and they talk about how systems are important. But it’s rare that they’ll talk about how the products play into creating that system. So what you’re saying is that the product creates a system that creates the predictability so that you can bounce off each other and, I’m guessing, share patients if need be, and know what you’re dealing with?

Kory Grahl
Yeah, absolutely. I mean, it’s a, essentially a four wire, NiTi series that we do. And then the determination is the art of orthodontics. The finishing orthodontics is when you finish, you pick your final wires. And you know, we’re working on systems and in that time as we’re starting to get to that stage in our practice, but it’s not, there’s no guesswork involved. We’re very systematic on when we take photography for certain stages within treatment. So that we know, maybe next time it’s set up with Dr. Petersen for a Pan reposition. And he you’ll know and I’ll know like this is where we’re going next. If there’s anything off track, or unique to a certain case, like we already know, our systematic approach to things go up, pick that up and then come right back to where we were. So there it allows us to deal not deal but to do other things in the business and on the business in the startup rather than worrying about, you know, crazy amounts of the orthodontic side of things because we know that’s going to flow efficiently and positive with zero hiccups because it’s there’s less guesswork involved. It’s just understanding the final treatment goal and objective and smile really.

Brady Petersen
I like too, that it allows us to what we tell our patients is what they’re coming to us for is they want an Orthobar smile. And that’s what we’ve that’s what we branded our smile as but an Orthobar smile. It touches on all the points. It’s what a Damon smile is right. And that’s that’s been the great thing about it. It’s not that Dr. Grahl you know, he comes up with Dr. Grahl smiles coming up with Dr. Petersen smiles and this patient like this one a little bit better. And we got to do a transition in the middle. They’re coming from day one. Our treatment coordinators know the expectations are front knows the next what the end result is, should be and will be. And that’s that gives us a lot of confidence to just tell the patients from the beginning I’m gonna get you an Orthobar smile, you’re going to absolutely love it and and then you go from there and and I’ve used other systems before, it’s not doable it would in the end it would be Dr. Petersen likes to do this bend and and he always does this trick and and you get those curveballs, which is which is great. I mean, that’s what orthodontics is. There’s always going to be that as you get into it, but it really does help.

Alison Werner
How long have you guys been in operation at this point?

Kory Grahl
We just hit our nine months of opening so we opened October of 2023. Yeah, we shook hands in January ’22. So it was a it was a 20-month journey to finally open the door..

Alison Werner
So since you are so close to your start date, you’re not at a year yet. What’s your advice to practices, especially multiple doctor practices, that are starting out in terms of making a decision around a bracket system?

Kory Grahl
What would be our suggestion?

Alison Werner
What are your tips? Or what would you tell them to consider if someone came to you?

Kory Grahl
I mean, I would say, I would say do your research. So one of the one of the things that I found very interesting in, you know, one of this is, is speak with your reps too. But we were able to go to Envista Summit. And one thing that I noticed, particularly at that summit, is it not to not to dummy, orthodontics down or anything, but all the finishes, looked the same at the Damon conference, and I sat there, and I was like that, that’s really interesting. And it’s very different than other conferences you go to that are using all different types of products. Because you all get all different types of finishes. And it was very interesting going to that conference. And I’m like, you know, they’re in all different levels of providers. I mean, one year out, five years out, 20 years out, 30 year veteran, all their finishes look pretty close to one another. And they all looked spectacular. And I was like, again, I need to learn how to do that. And then looking at, you know, my case, and you know, Dr. Frost’s social media, who was a mentor, and Dr. Nichols, I was like, it seems to me that this system works. And that’s one thing that I found very safe or rewarding is like, Hey, I’m a newer practicing clinician in the orthodontic side of things. I don’t want to reinvent the wheel, I want to be able to walk into a consult room and be very confident in what I tell my patients and seeing that and seeing, you know, new grads, and, you know, veteran doctors and treating out the same and these finishes are spectacular, I’m like, that’s, that’s the system that I think we go with, but for people choosing I mean, there’s, there’s so many, so much information out there, you need to get a feel, and you need to get a feel for the trust of your rep in your area. I mean, we have a spectacular rep here in Las Vegas, we have a lot of excellent support from not just Damon but the Spark rep genie has been amazing. Our Ormco rep Ryan has been amazing. Their, their VPs have been great window they haven’t been able to fill in. So I mean, it’s just having that confidence in a full company, a full scope of products that you have access to that I think is critical. Rather than this newest product, they do it they’ve just started it’s working out sort of for some practices, but you can’t beat time. I mean, they’ve been around a long time. And that’s why choosing a system, I think it comes down to proof like show me the results not not a white paper or a case report or whatever, like, show me and if you go to one of their, their, their forums, you see it all day long. It’s all the same.

Brady Petersen
My advice would be especially, I mean, it’s hard to do broad statements, but whether you’re a newer doc or you’ve been out and been out in the field, what what me and Dr. Grahl we, you got to know who you are first and so you make your own goals, but I would say anyone that tells you, no, you can’t do it. Or and you hear that a lot with I mean, we’re we’re in a whole different generation with with huge student loans and you’re going to start up a practice where I know so many of my co residents and colleagues everyone that’s all our dream right? Like I mean, we want to be the owner of your practice you want to use the products that you want to use you want I I’m I love simplicity I love efficiency. And so I’m naturally drawn to I’m I would say I’m just drawn to Ormco, I like it. So if if that’s something that you’re fighting from the beginning, then then maybe that’s not it, but if if you’re if you’re lined up and you know that you know your goals are set in that those types of things. That’s where I think it makes it makes the choice easy, like like Dr. Grahl is saying you’re going to the forms. And it fits right I know that that’s what I want. I know That’s what my patients want need. And it’s, it’s just a matter of what I need to do then to learn the process, learn the system, and then and then do it. And anyone that says anything to you, as far as, you know, cost or time or how you’re going to make that work, anything like that. That’s, I would say that’s going against what ultimately you’re gonna get to, you’re gonna get to that crossroad, where you’re gonna say, I should have just done it sooner. And so do it from the beginning. It all works out you can make you can make it work out. So it’s, there’s bumps no matter what I, I have friends that haven’t started their own practices. We’ve started our own practice everyone’s in, everyone’s in the same boat, do it. And also, yeah, it’s orthodontics is awesome. It’s a great profession. So we’re all going to be fine. But you might as well enjoy doing it. Well, while you’re going through the process.

Kory Grahl
One other thing I would suggest, yeah, you know, people picking a product to you I just thought about is, when you do meet with the reps, do they talk majority about the efficiencies of their product? Or do they talk about other products, downsides. Because you get that a lot is they’ll come in, and they’ll you know, whatever rep comes in, it’s like, Well, why do you want to do X, Y, or Z? Because they do that? Well, in reality, all systems have something you have to work around. I mean, so a lot of systems are really good at certain things. I’m not very good at other things, whatever, whatever. But I found that to where if they start talking about another product, that’s not theirs, because they think theirs is more superior or whatnot. That’s a red flag to me of like, okay, why is that company in your head to speak about that product? Yeah, it’s because are you not as good? Are you trying to emulate that products? And so I would say that too, you know, because there’s, I mean, you have, you have choices in today’s market, what you choose to use. And again, like with Dr. Petersen, it’s you got to know yourself and what you want to do. And I’m very much the same. I like simplicity, I like to know exactly. I don’t like having surprises. And so I would also caution that that of if a company starts talking about another company, then I would say, Okay, start asking questions.

Alison Werner
Yeah. Well, to follow up, I was going to ask you about kind of how you’re using your reps. And so you talked about how you’re using your reps at that early stage, once you’ve got the product? You’ve talked about how valuable you found your reps, but what are some of the things you’re turning to them for that they’ve been able to answer for you or helped make easier for you, as you’ve been onboarding and just kind of working through the system the last nine months with your patients?

Brady Petersen
Yeah, I think our reps have been fantastic. I mean, everything from the first question, hey, we’re starting to practice. I got patients here in 30 days, what do I need? Not and knowing that they, they absolutely, it wasn’t trying to sell you all this extra stuff. It was this is what you’re going to need. Here’s all the deals we have available for you, you know, the buy one, get one frees, the financing, let’s make this work for you. Yeah. You know, new grad discounts, all kinds of stuff like that. We’ve gotten, and we were just on a texting relationship, or we’ll text our rep after hours, responds immediately. I mean, just fantastic. And these are questions that, hey, we got a patient coming in, in the next hour. This is this is something we haven’t seen. I remember the first, with the first purchase that we made. It was we were still in that learning process of how to deal with the the anterior torques. So the procline, retrocline, and we ordered, you know, pretty much the percentage wise was equal amounts of both. And as we got into practice, we’re like, I’m never going to use that one. I think I’m in love with this, you know, proclining the threes, like, why do we need a retrocline and or rep immediately just replaced those out. You know, no questions asked. No, no, well, you gotta keep that you bought it already, you know, none of that. And it’s just absolutely let’s, that’s, that’s what’s best for your practice. That’s what you’re using. Let’s do that. So, yeah, that’s

Kory Grahl
It’s one of those things. It’s like anyone, you know, like, once you become part of the Orthobar family that we treat you as such, and to what are you saying, I mean, our representative Ryan, you know, he’s, you know, two, three years into the orthodontic side of things I and, you know, he’s been amazing, you know, transition, helping one another, you know, build this up. And, you know, most people are like you crazy doing a start up. I mean, all of them were like, Yes, do it. It’s awesome. We’ll support you throughout the process. Um, you know, and in taking our feedback, too. I mean, some, some companies might be like, Well, you guys are just, you know, fairly new practice. But no, I mean, they’ll they’ll accept our feedback and say, like, Hey, this is what we have going. And this is how I think it could help future startups on a financial basis, or whatever it is. But no, they had been spectacular lunch and learns, coming in training our staff about Ormco’s direct bonding, or Spark Aligner therapy, or, again, ticking anterior torque selection, what’s kind of generalities and all those sorts of things, so it’s, it’s not anything that’s like, oh, man, I gotta, I gotta call my representative today. Or, or if they don’t know the answer, this is the best part. They’re humble enough to be like, you know, let me talk to Dr. so and so. And we will, we’ll get you guys in touch or I’ll find out the answer for you. I mean, how awesome is that? And so especially for, you know, new practice owners and stuff that you know, there’s there’s certainly stuff we haven’t seen in there’s stuff we’ll future never seen, right, that someone has attacked. And so that’s where they stand and they’re so connected.

Brady Petersen
They’ve connected us to multiple other Damon practices, other doctors and just welcomed us into that, to that community of the field.

Kory Grahl
And staff, and team members are our treatment coordinator came from a Damon practice in Colorado, and she moved here to Vegas, and is an amazing, amazing person. And has helped us tremendously on on that side of things.

Alison Werner
Well, we’re gonna wrap it up there. I really want to say thank you for joining me and kind of talking about your experience, just as a startup, getting that going and then also with the Damon Ultima system. So thank you so much.

Brady Petersen
Well, thanks for having us, Alison.