Inside the Mind of Dental Pioneer Dr. Ed Feinberg

Is modern dentistry really advancing—or taking shortcuts? Dr. Edward Feinberg, a renowned lecturer and author, joins me to expose major flaws in today’s dental industry, the push for implants over saving natural teeth, and the lost techniques that actually stood the test of time.

Tune in for an eye-opening conversation that might just change how you view your next trip to the dentist!

You can find Dr. Feinberg's content on his website theonwardprogram.com

Transcript

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Intro Song

Rob Valincius: We are live for another beautiful, beautiful, uh, almost spring day. We're getting there. I hate the winter in the northeast and I know you're, uh, you're From New York, right? So I know that you're, uh, blessed to be in Arizona now, because I'm sure you don't have to deal with the crazy cold. Um, but this is the Drink O'Clock Podcast.

I'm your host, Rob Valencius. I have the pleasure of having with me Dr. Ed Feinberg. Now, Ed, you're a doctor in dentistry. You're a nationally recognized lecturer. And you're an author. Did I get it? Did I get that? Correct?

Edward Feinberg: Yes, correct.

Rob Valincius: Awesome. All right. Welcome to the podcast, man. How are you?

Edward Feinberg: Thank you. I'm terrific. And as you mentioned, I love being in Arizona, and I spent most of my life in New York, so I really do appreciate it.

Rob Valincius: I I gotta say i'm a so i'm a summer kid. I was born in july and uh, I just I hate the cold man. It's it is destiny for me at some point To be in somewhere warm, um, whether that's Florida, Arizona, I know I've actually, I, you know, I, I mean, I work in insurance, so I have traveled quite a bit and Arizona is one of the states I have yet to, to go to, and I've been to some weird spots like.

Jackson, Mississippi and random stuff like that, but I have never been Arizona. It's on the list Um of places i'd love to be able to check out the wifey's been in Arizona Um, so I I got I got to get there, you know, I know we love the dry heat

Edward Feinberg: It's really toasty here in the summer, but it's a beautiful place. The people are wonderful. There's a lot of opportunity, a lot of, a lot of things to do here. It's very different than the Northeast, but it's really fun.

Rob Valincius: Yeah, i'm down for that. I'll take the the 110 degree weather all day every day if i'm not getting you know 20 or negative we had this year was cold. We had some days where it was the windshield was like negative eight In Philadelphia and I, no, no, I hate it to know. Uh, but anyway, look, I was excited to have you on, um, because I know that, uh, a lot of people are afraid of the dentist, which is crazy to me because I actually, I don't mind the dentist at all.

I actually have a very, I feel like, especially when it comes to teeth, I have a pretty high pain. Threshold. So like a lot of times, uh, I'm, and maybe you can explain this to me when we'll get into the dentist side of it, but I have the worst. I always growing up had issues with plaque. It doesn't matter how many times I brush my teeth.

If I floss, whatever. I did drink a lot of energy drinks growing up, but I know I messed my teeth up doing that. I actually stopped, uh, over two years ago. I don't drink any, uh, energy drinks. I haven't had a sip. Um, you know, I dabble in a diet Coke here and there. Uh, which I know is terrible for your teeth.

Um, my, my main soda, if I'm going to drink soda, is, is Zevia. So it's the carbonated water and, you know, stevia leaf. So it's not as, not as horrendous. Um, but talk to me about, uh, growing up. You know, um, was, obviously your dad was a, was a pretty famous, uh, dentist. So, um, talk about what that was like. You know, having a dad that was, that was successful, um, in that field.

And did you always want to be a dentist? Did, did, did your dad talk you into it? Go into that a little bit.

Edward Feinberg: Well, as you mentioned, I grew up in dentistry. My dad was a master and pioneer of full mouth reconstruction, crown and bridge dentistry. And I started working in the office at age 16. And I recognized that my dad really was a genius. And he was very well known in his day. And that I had a very unique opportunity that nobody gets.

Um, but he was a very tough taskmaster, so it wasn't easy, um, and, uh, so we actually practiced together as dentists for 23 years. I learned everything from him, and everything that I learned is not taught in any dental school anywhere in the country or any institute. and my dad was brilliant. He started taking pictures in 1950.

So between he and I, we have 70 years of documented evidence for what we're doing, and I can show cases in the mouth 40 years with x rays and very few changes in the x rays. And there are very few. There are very definite it. basic principles that enable that success. And that's what I teach on my teaching website for, for dentists.

Unfortunately, what they're teaching in the schools violates a lot of these principles. So a lot of dentists are having difficulty with crown and bridge problems that were solved in the 1930s. Which is very upsetting to see that they're having so much trouble with specifically crowns falling out and decay under crowns.

Two problems that I don't have because my, my, my approach, my dad's approach and my dad's teacher approach, approach is very different from what's being taught today, completely. And so I think what happened was the professors. wanted to teach techniques that they thought might be easier for the students because they, in all fairness, they got to come out with something, um, because dental school can only give you a very rudimentary foundation.

Everything I learned was after dental school. And, uh, so when they get out, they're not prepared and They, they idolize their professors and the techniques they think is the only way to do things and the best way. And nothing could be further from the truth. So in a lot of ways, dentistry, in my area of dentistry, has gone backwards and not forwards.

And a lot of the technology also violates the basic principles that allowed my dad and I to have so much success. And it's very hard to get people to listen because they've got blinders on and they're so indoctrinated in doing things in a certain way that they don't know where the profession came from and what even can be done in dentistry.

And that's why You see the absolute epidemic of teeth being extracted and implants being placed. And, uh, I'm appalled at what I'm seeing. I, I have to sound the alarm because I know it's wrong. I save a lot of those teeth that they're being, that are being extracted in favor of implants. And implants, while they're wonderful where they're indicated, are not the solution to every restorative problem.

In fact, they are not the solution to most restorative problems. And they, they have problems themselves. And a lot of basic principles that are necessary for successful implant therapy are also being violated. And I see a lot of things going on that I'm very upset about. So that's why I want, um, to go on these podcasts and let people know that they should ask questions and not be afraid to accept what they've been told without examining it thoroughly.

Rob Valincius: Yeah, you're sounding the alarm. I, yeah, I mean, look, I said this, uh, I said this about modern medicine and it's funny that it's, it kind of coincides with dentistry as well, that, you know, a lot of the natural remedies and natural, uh, phenomenon was wiped from a lot of the school books for doctors by a man who was the, one of the richest men in the world to, Sell more of his oil, or was it oil?

Uh, it was something. Uh, but, uh, Rockefeller basically opened up, you know, medical schools and had doctors teach medicine with made up things and his oils and his products rather than utilizing, you know, um, Oh, well, this herb is good for this, or this herb can help you with this. And, and instead, and, and that's, he's basically pioneered what we do now, and it's, instead of trying to find the root cause of things, they are treating, it's, it's, it's like, um, plugging a hole with duct tape.

Yeah, it works for now, right? But eventually you might need more duct tape and you're just going to keep duct taping. You're not going to get to the root cause that there's, there's a hole there and you got to fix the hole permanently. Not, not just, you know, tape it. Um, and I've talked about that before on the podcast, which is, um, it's funny that it's, I guess it's also seeped into dentistry as well.

Yeah,

Edward Feinberg: but what you're saying is absolutely 100 percent right. Um, and uh, they absolutely, their focus is bottom line. Um, making profits and You know, collecting money for a pill or something like that. That is the motivation behind them. That wasn't the original motivation for dentistry.

I was brought up to look at patients with the idea of prevention. Longevity and health were my, my primary goals. What does it for me is when I get to see one of my patients and watch the work that, that I did come in last in health year after year. over decades. You know, you did something right for that patient.

That's, that's what does it for me. Today, I see there's an overemphasis on economics and workflow. You know, they want to do something in a hurry and slap it in. And, uh, that's not realistic. And that's, that's not going to give a high percentage of, of successful results. Um, if you skip steps. There's so many things that can go wrong because in dentistry, everything's in tenths of millimeters, and you're, if you're using materials that have to be heated up close to their melting points repeatedly, anything can go wrong, and if you skip steps and try to do everything all at once.

Errors are compounded and you can't even identify them, much less do anything about them. So you know that saying, there's never enough time to do it right, but always enough time to do it over? applies in dentistry. That's why it's so important to do things step by step and not be in a hurry. And the stuff that they have crowns in a day is such crap.

Um, and the most practitioners don't know it. And I'll tell you why. They, they, these are all ceramic crowns that are milled out of a, um, block of ceramic. And that is what you call a butt joint restoration. Meaning that you prepare a ledge on the tooth, and then you make the restoration to the ledge. And essentially, these crowns are no different than the old high fusing porcelain crowns that were baked in an oven in the 1960s.

You think we didn't know what was wrong with those things in the 1960s? The problem with butt joint type restorations is that they can never be sealed. Bacteria are microns, and so there's always an opening, and it's unrealistic to expect that the bonding crap or cement is going to cover everything up and seal everything up.

That's just really not possible when you're dealing with bacteria that are microns. So when I make crowns, when my dad made crowns, when my dad's teacher made crowns, we made them on the model of the mason jar cover. which is the best known thing ever devised for food preservation. So we almost never see decay under our crowns, and even in people who are highly susceptible to decay, um, you don't see that, except after many, many years, and there's been changes, and maybe roots are exposed that weren't exposed originally, those areas can become sensitive, susceptible to decay.

Otherwise, you don't see decay. It's not one of my problems. And that's a basic principle that really is not being taught in any dental school or dental institution. And it's been from the very roots of dentistry.

Rob Valincius: that's interesting. So let's, let's, uh, let's cycle back a little bit and talk about what it was like, uh, being trained by your dad. You know, you worked with him for over 20 years, like you

Edward Feinberg: My

Rob Valincius: uh, talk a little bit about that. And, and when you're done with that, go into a little bit about what you guys do differently.

Than what the regular dental, um, you know, textbook would necessarily say. So we can kind of get a feel for that.

Edward Feinberg: okay. Sure. I'd be glad to do that. First. I, uh, my dad was a tough cookie and a tough taskmaster and, uh, he was a genius though. I mean, I knew that when he gave courses in the office for 40 years to dentists and there would be like seven Wednesday mornings. And the dentist would get to see every step on a patient how to make a fixed bridge, and another seven Wednesday mornings how to make a precision attachment case, which nobody knows anything about, and that I wrote a textbook on.

And one of the best cases there is, and you can't get anybody to listen. That's terrible. Um, but anyway, when I started working with him, he was a crazy person and, uh, well, I admired him and it was amazing to watch him. I, I spent a lot of time watching him and assisting him at the chair so I could learn what he was doing.

And, uh, then he lined up some patients for me to do. In my very first year of practice, he lined up these patients. One, I had to prepare 32 teeth on this patient. My very first case! And that

Rob Valincius: That, that's awesome!

Edward Feinberg: You know, like, beginner's luck, everything went perfect. And, um, um, and, uh, that patient wore that case for at least 20 years, but I lost the patient because his son became a dentist.

So then he went to his son, but in the meantime, um, you know, he lined up the patients. The patients were going to pay very little money. He was going to check every single step and believe me, he did not hand out compliments. And if he did compliment you, you, what you did was extraordinary. So that's how I started.

And in the beginning. He was very intimidating, and I didn't understand him, and it was very, very hard. I know a lot of people couldn't, um, withstand some of the things that I had to endure. Um, he was, but, you know, he was very much like Frank Lloyd Wright. You know, we have the Frank Lloyd Wright House here in Arizona, and I remember when I went to visit that house, and I heard all the stories about Frank Lloyd Wright.

That sounded just like my dad, and I wonder how many young people today would put up with that stuff in order to learn, because the students of Frank Lloyd Wright, they, they would endure any kind of insult, any kind of mistreatment in order to learn from that man, and that's how it was when I started.

But after about a year or so, I recognized that my dad was the pussy cat wearing the lion suit. And after that, you want to yell, yell. I remember one, one particular time, he's a lot of yelling at a temper. And, um, we had, um, a patient who was sitting in the chair, and my dad was yelling over the phone in the hall, something like that, and the patient was sinking into the chair, like, wanted to, wanted to, like, flee the scene.

But then the patient saw all of us laughing and joking and not paying attention, and they caught on to who this person was. He wanted everything perfect. He was not only tough on everybody else, he was tough on himself. And he always told me that one of the hardest things was to be your own worst critic because there's nobody standing over your shoulder.

The patient is counting on you to, to, to do right by them. They have no idea what you're doing. And, uh,

Rob Valincius: clue.

Edward Feinberg: a lot of people are very easy to look the other way and say, Oh, that's the best we can do, or we'll have to see what happens. Bacteria are my crimes. You're not going to get away with it. If something isn't right, do it over.

Do what you have to do. Make it right. And that's what I got from him. That was who he was. And he was my teacher and mentor and role model. And that's what a lot of young people don't have today. I want to be somebody's mentor. I'm not going to scream and yell like my dad did. I don't have that kind of personality.

But I want to give to somebody what was given to me. I cannot even find one young professional who even wants a mentor. Think about that, how times have changed and what that means for the future of our profession.

Rob Valincius: That's, I mean, to me, that's crazy. Um, and maybe that's, uh, see, I'm old school. Okay. And I think, I think the way that your dad taught you, yes, I'm sure was, was tough, but that probably made you the better dentist. Then that you could have been if he was just, you know, sunshine and rainbows. Right?

Edward Feinberg: Oh, absolutely, without question. And once I understood him, we made a great team. And I, I would ask him questions all the time. Why is it this way? Um, he would say something in the courses and Every little detail meant something, and I picked up on it because I was there every day. And even I learned something, and I would say to Dad, I'd say, Dad, how come you never said this to me?

And it went over everybody's head. They, they, they, they were, they couldn't absorb it all. It was too much. Um, they didn't realize that there were a few who realized that every little detail was very important and they took the course a couple of times because of that, um, but most of them that went right over their heads.

And, uh, I picked up on it because I was there every day. And, uh, I learned everything from him. He was a genius. He was so way ahead of his time. And so I want to preserve our legacy. That's why I'm writing my second textbook and my third book. And, um, have a teaching website. So I can pass this material on to those who want to learn.

Because otherwise it's all going to go by the wayside. And, uh, Some of the new technology that violates basic principles is not an advancement. I really believe with all my heart that if anything new coming down the pike must be compared to the standard of what came before. Otherwise you are not advancing.

And while it's true that great advancements have been made in other areas of dentistry like endodontics and orthodontics, those are worlds ahead of when I graduated from dental school. I can't say the same about Crown and Bridge. And people are falsely impressed by technology because all we're really responsible for is the outcome, not the means by which we arrived at that outcome. And all the schools now have, have this state of the art technology. And when the students get out and go on their residency programs, they don't have access to this technology. What are they going to do?

Rob Valincius: yeah. I mean, we rely a lot on those technologies for, for everything. If it were to go away, people would definitely be screwed. And I would probably be 1 of them in certain ways. But, um, you know, it's, it's funny because I, when you said that you were specifically working on crowns and stuff, I, so I had a root canal.

And now I'll explain what happened. So, uh, in September, we were on a, we were on vacation and I'm not a sweets person and never really been a sweets person, but we got some ice cream. It was hot, you know, and, uh, I think it was a perfect thing of my teeth were cold and I decided to get mini Reese's Pieces in my ice cream and they were rock solid and I think what happened was it was my molar on the right side.

It was like a perfect bite where I guess it was at the perfect angle. And my tooth was cold, and that was rock solid, and it cracked my tooth in half. Um, and it's the first time that's ever happened in my life. My teeth have been relatively good. I have one crown from a long time ago, and that was because I just didn't take care of my teeth when I was a kid.

And, you know, it caught up with me. Um, but I So I let it go. I didn't go to the dentist, which I knew I should have, but it wasn't hurting me at the time. I just let it go. Uh, you know, food would get stuck in there. I'd try to get the food out and it'd be fine, right? Uh, which I'm sure is blasphemy for a dentist to hear, but I just let it go.

And then, um, maybe a month and a half ago, I woke up. It was a normal morning. I was fine. Um, I, I ate breakfast and I had, I did like a I could feel a change in my tooth when I bit, so I don't know what happened, but automatically for three days, my face was radiating pain. So it was just the one tooth that I cracked, but it wasn't even that spot that hurt.

It was my entire right side of my mouth. Uh, which come to find out, I, I had to go, I ended up going to an end endodonic, you know, to, to do it. But he had, uh, he had told me what happened was, is your brain, even though it's that one tooth, sometimes that signal is, gets mixed up and then your brain's like, oh, well it's, it's all of these.

And it felt like five of my teeth had cavities. That's how, and it was just pounding and pounding. So, uh, I went to a dentist. They, uh, they said to me, look, um, it's in a tough, it's a molar, right? They're like, it's in a tough spot. Um, you're going to, you should go to this endo person and, and, and have them.

They have the special tools and it, you should be okay. Um, so I went to an endo, uh, the next day they pulled my tooth out. Or I'm sorry, they took the root out. I made the decision to save it, which to me, maybe you can explain this to me. Why? Is it, in today's day and age, that to save a tooth, it costs ten times the amount to save the tooth than just pull the tooth out?

Edward Feinberg: Well, if you think that it's not going to cost you by extracting the tooth, that's just delaying problems, because one of the reasons why it's so important to save teeth is that when you have a tooth that's missing, the teeth around the spaces drift, and the teeth opposite the spaces erupt into the opposing space, and the teeth start taking forces in abnormal directions, and nobody knows at what point, the body's not going to tolerate that, because as you get older, the body can tolerate less.

And then what one of two things happens, either the bone goes or the teeth wear. And now you're talking about the collapse of the whole mouth. And that is what, that is why it's important to replace missing teeth. The, the cost is, everybody's different and they have to charge what they need to, to satisfy their overhead.

You need a team of people, um, to, to make, to do dentistry. And if you're going to work with the better materials, which are precious materials and not crappy materials, you can't help it. You have to charge more and you have to pay people to do laboratory work. So all those things figure into the cost and that's why that's the reason why.

But if you go to a good person and they, they've, they. They make dentistry that lasts. That's a good investment, especially if you have a good mouth. So what determines if you have a good mouth? To me, it's not anything you see sticking up above the gum. It's what's below. The, the bone and the roots. That would be like if you were going to build a house and you put the foundation in the ground.

And that is the foundation for the building and for the support. Well, it's exactly the same thing in the mouth. In fact, everything that we do in dentistry is really engineering. So we're trying to minimize forces, balance the forces, and distribute the load over the foundation so that the body can handle it and you can hold on to your teeth.

That is what I was trained to do and how to look at patients. That's I would say isn't what I would call an overall approach to dentistry. What is very common now is what I would call a piecemeal approach to dentistry, which is fill a hole or a space. That's what insurance companies like because that's all they want to pay for.

But very often that is not the right treatment. You can't change the architecture sometimes unless you do a few teeth and change the architecture and, and, and solve all the problems. And then that's the end of them. And you can't do piecemeal a lot of the time, that's not the right treatment. And that's one of the problems with implants, and I call that the signature of a piecemeal approach to dentistry, for that reason.

Because that's how most people are using implants. For example, if you have a perfect mouth, and one tooth is missing, that is a perfect place for an implant. Nobody says no. But when you go to the lectures and you look in the magazines, that is not what you see. You see the teeth surrounding the space where they're going to put the implant are falling apart.

They have periodontal bone loss. They have crowns or they're going to need crowns. They are not virginal teeth. That patient would be better off with bridge work that does something good for the entire area because you can bring the forces up close to the bone, you can make the teeth ideal architecture and smaller to put less stress on the bone, and you can tie them together so that They work together instead of each tooth having to carry the forces all by themselves.

A single tooth implant fills a hole or a space and that's it. And the patient's problems are never solved. So that's, that is what's going on in the profession. They're looking at things in a very piecemeal way. And one of the, one of the major problems is that implant therapy is very lucrative. And a lot of people are having trouble with crown and bridge.

So they're shying away from. Doing crown and bridge and doing implants instead, and I've seen professors from major institutes. There's one here in Arizona, and they'll do go with great lengths to avoid doing crown and bridge. So I've seen them. put a single tooth implant in the missing front tooth and then veneers on all the other teeth.

Does that make sense when you can do bridge work, which has a really good track record is you're going to prepare the teeth anyway, get a better result and have a much higher percentage of a synthetic result than you would have before. And then that's the end of the patient's problem. This is what I

Rob Valincius: can you, now can you do, do me one solid? All right. Um, pretend like my audience, cause I do have some younger kids that listen, pretend like they have no clue what you're talking about. Can you explain in layman's terms what, what a crown is? What a bridge is and what an implant is. And I, I mean, I know for the most part, but maybe I'll learn something

Edward Feinberg: Okay. Sure. No, I, I love to educate people and doctor means teacher and I spend a lot of time with my patients because I want them to know, I want them to know everything so they can make the best choices for themselves. So a crown is, uh, covers the tooth 360 degrees all the way around. That's, that would be a crown, um, a, uh, an

Rob Valincius: Which is what I still need. I still need a crown. I didn't, my insurance doesn't kick in until October. So I'm, I got it fixed, but I got to get the crown. That's next.

Edward Feinberg: An implant is when you have no tooth root at all. It's really an artificial root that's put into the bone and made of titanium. And, uh, in interestingly, they did not exist when I, um, graduated from dental school and this Dr. Branemark from Sweden invented the, what they call the Osseo integrated implant.

He did 20 years of studies before they ever came to this country. And he was a true scientist, and if you did things the way he said, then you knew you could get 85 to 95 percent success. And he, he was only doing people with no teeth, and um, he had a special way of handling the bone so that the implants could fuse with it.

And prior to that, the old fashioned implants would cause infections and they wouldn't hold up. And he discovered the reason why. And so did my dad. Because we did a lot of our own periodontal bone surgery, and they were the exact same basic principles. They turned out to be exactly the same. And, uh, that's, that's amazing when you think about it.

And, uh, you know, they, that's how they were done when they first came to this country. And then they started doing single teeth and, um, bridges in the 1990s. And in the 2000s, it's now the Wild West. The stuff that they're doing is horrifying, because they're taking this way beyond what it was designed for.

And there's a lot of failures now, because, as a result. So I could tell you a story. You want to hear a

Rob Valincius: Before you tell the story, before you tell the story, hit me with what a bridge is, because I think

Edward Feinberg: Okay. A bridge is simply crowns tacked together. That's all it is. They're connected. Okay, so sometimes a root might be missing under a bridge, but the teeth are all tacked together. But not always. Sometimes I, I connect teeth on purpose, especially if there's been periodontal bone loss, to distribute the load so each tooth helps each other rather than having to carry the load by itself, each tooth.

And then if you open up a food impaction space, that is the kiss of death, because food packs in between the teeth, and that can do irreversible periodontal damage. So, splinting is a major Um, technique that we have for preventing problems in people who are susceptible to periodontal bone loss.

Rob Valincius: Interesting. Okay. Alright, hit us with the story, man. I like it.

Edward Feinberg: Oh yeah, here's a story, um, and I think everybody should be aware of this. So anyway, there's an endodontist here in, um, Arizona who has his ad plastered all over the back of magazines. And you know, whenever I see that, I wonder, um, is it any good, you know? So I went to a lecture, Um, maybe two weeks ago when I just wrote a blog about this and, um, he turned out to be a fantastic practitioner because I could tell, I know what questions to ask and, um, he, he, he showed this case and there was, uh, it was a patient and he showed the x rays really good bone and good roots and she had gone to, uh, an amateur general practitioner who did surgery.

Horrible root canal therapy on her and it didn't work and she had a lot of back molars and they had to be retreated with endodontics before they could be restored. And he wanted to help her so that she could afford having, you know, all this, all this dentistry. He was going to really, you know, cut his fees and everything, which I think is admirable and I would have helped her too.

I would have done the same thing so that she could have afforded the dentistry. Um, But, uh, she decided she was going to go and get a second opinion. I could have saved every one of her teeth easily. Every one of them. She had a very good mouth. Otherwise, what I look at and what everyone else looks at are two different things.

And, uh, so she went to this other dentist and, um, he talked her into extracting all her teeth and having what they call all on four, where they put four implants in. And then they put this big screw, superstructure that screwed into the implants. And the patient was 23 years old. And, yeah, that's, this is, this is a true story.

The, um, All on 4 doesn't have a long track record. It hasn't been around that long. It's not a very good approach, in my opinion, because a lot of times you can't put good, long implants in. So that it can actually support these big superstructures that they're going to build on it and they're not going to make it easy for the patients to keep these things clean.

So if one implant goes, that, that patient's screwed. The whole case is no good. And then when they put the, these all on four cases in, they flatten the ridges and She may not be a candidate for more implants, so she might not even be able to wear a denture. When you think about that, LI implants are not lifetime.

That's a myth. It's a myth to think that they are. I have the patient where the implants only lasted 20 years and that was it, and they couldn't have any more implants after that. So. You have to take that into consideration, and I'm sure she was not told that, and she believes that, um, well, I'm going to do this and my dental problems will be solved forever.

That is not true, and I think people need to realize that, um, that there were limitations to everything, and they should really break their neck to save their own teeth whenever they can.

Rob Valincius: Yeah, I mean, look, have you ever run into anything, um, of people getting, uh, sepsis from leaving their teeth, um, you know, um,

Edward Feinberg: used to die from this in the, in the, in the 1800s. Um, a lot of people died from dental infections. It was before antibiotics. And yes, you have, you have infection in your mouth that can goes into your whole system and it can blow up and you can end up with a major infection that could kill you.

Absolutely true. So that's why you don't want to leave any kind of infection in your system. And also too, you know, one of the things that's about the mouth is that it's loaded with bacteria. If you have unhealthy gums, um, that that's a direct route for bacteria to enter the bloodstream. And they're very definite correlations between systemic disease and an oral disease.

Very, very strong correlations, especially with heart disease. So, um, that's, that's important. The single best thing anybody can do for their oral health is to have regular hygiene, because it removes that one factor that, that, that cause, that contribute to bone loss and problems systemically. So, um, the way, what happens is, is that if the gums become inflamed, that inflammation can spread to the underlying bone.

And once the bone is lost, we don't know how to grow it back. So everything that we do in dentistry, everything is geared toward prevention. So even when I was talking about restorative dentistry, basic principles of engineering are preventative. So you're going to change the architecture, distribute the forces so the body can handle them and bring the forces up close to the bone.

I can show cases where you do those things. That's the end of the periodontal disease. And then you could never tell that patient ever had bone loss. And that was the end of it. That's what Crown and Bridge can do. And most people just look at Crown and Bridge's tooth coverings and nothing else, and not as corrective or preventative.

And, and, and I think that's, that's unfortunate. that, that most doctors are looking at things that way instead of looking at things in, I would guess, a holistic way or prevention. What's going to happen to this patient down the road? So I was talking about the implant case where one of the implants on the all on four goes and that's the end of the case.

Well, if you have bridge work and one of the roots goes, all you have to do is extract the root and leave the bridge work alone. That's happened to me many times, and something with the root, nobody knows what to do when it has to come out. You don't touch the bridge work, you extract the root, and the patient doesn't have to do anything over.

So that's a really good contingency in the event that something does go wrong. And I think that's important when you're trying to plan a treatment for a patient. Because we're not gods, we don't know what's going to happen, but if you plan, if this might happen or that might happen, and you have a plan for it, then if it happens, You're still a hero because you predicted it and you planned for it and now the patient isn't up the creek and has to do the entire case over.

I think they're owed that kind of thinking, and they're not getting it.

Rob Valincius: Yeah. So, you know, we met, you mentioned this, uh, you know, as you were, you know, going through some of your stories, what, um, you know, what are the different specialties in dentistry and, and how does one decide which one to do?

Edward Feinberg: Well, there has to be a captain of the, of, like just in medicine, they have, you have your internist and you have all your specialists. There has to be a captain and that captain would be your general dentist. And if, if, if, If there's a situation that's beyond him, let's say a tooth needs root canal, then the patient should go to a root canal specialist and that's an endodontist.

If a patient has problems with unhealthy gum or bone loss, they may need to go to a periodontist because that's what they specialize in. And, uh, a prosthetic dentist, um, specializes in crowns and bridges or implants. Um, those are the basic specialties. Uh, in dentistry, there's a pain specialist, like oral facial pain.

There's some really good people here in Arizona who, who are experts in that. Um, I've gotten to, uh, in my short time here, I've gotten to meet a lot of people, and there's some very good practitioners here.

Rob Valincius: that's cool. Yeah. I mean, I'm lucky that I'm like 20 minutes from center city Philly. So I know that there's, there's always like a specialist for something typically in a major city like this, where if I need something, And it's a special, like when I got my, the root canal was, went fantastic. It was like an hour, hour and 20 minutes.

Didn't feel an ounce of pain. He had, uh, you, maybe you know the tool he used, but, um, it, it was like a hook. And I guess he used it to, to see how far down he was going. It would make some beeps. Um, and it would tell him, I guess, the depth

Edward Feinberg: that's an apex locator.

Rob Valincius: Yeah, yeah, I never had that. I, I don't, my, I don't think the guy, so my very first crown, I don't think he used that.

My, I know this crown is bad. My, when, when I went to go get my teeth checked on, I know I need scaling. Um, you know, but apparently I have very good bone density, so I have no bone loss, but they want to get me scaled. Um, and he told me my crown is, is kind of shoddy and needs to be replaced. Like it's an old, it's an old crown.

Edward Feinberg: Yeah, there's a, there's a point at which dentistry needs to be replaced, and it depends on changes that occur. So, I mentioned earlier that I have dentistry in the mouth. that I did that's in 40 years and the patient got away without replacing it because the changes were minimal and gradual. You could see very few changes over the years in their x rays.

But I have other patients after 10 or 15 years there's been changes and the dentistry should be replaced. And it can be a very tough call as to when you should step in and do it because The changes aren't happening quickly. They're happening a little at a time, but at a certain point, it should be replaced to compensate for the changes and everybody's different.

So there's no rule about that. But again, no dentistry is not really lifetime and we're not lifetime. So, um, but the one of the, you know, you're doing something right when you treat patients with. with systemic diseases like cancer and diabetes and heart disease and you get to, you get to watch your dentistry work in spite of those things.

Well, I've had that experience and my dad has had that experience. And I like to show those cases because most dentists don't think that's possible. Um, and that's what good dentistry can do. And, and, you know, doing something right, if it works in spite of all of that, well, you have everything against you and it works anyway.

That's amazing. I still get a big charge out of that because you don't expect that.

Rob Valincius: Yeah, I gotta tell ya, I am happy that, that my general dentistry, which was new for me, encouraged, they blatantly encouraged me. They didn't even give me the option to pull the tooth. I had to call them and ask them, uh, what it would cost. They, they were like, we really encourage you to go get the root canal.

We can really mess up your mouth. And I've gotten, if I was in my early twenties, I probably just would have had him pull it and be

Edward Feinberg: Well, it sounds like you're in really good hands because they gave you good advice.

Rob Valincius: Yeah. I, and, and, um, you know, I talked to the root canal guy now, you know, talking to you, it just kind of confirmed that I'm happy that I saved the tooth. And it was very, they're like, your tooth is very salvageable. Um, you just, you know, it's, it's not going to be the cheapest thing right now. So, um, I'm happy the advice they gave me was good, but I do have to ask this cause I work in insurance.

I deal with seniors. So I work in Medicare. Um, and, uh, you know, yeah. Medicare is, um, it's tough for some people, um, especially in the dental world. Um, but how does insurance and those costs impact the kind of treatment options that dentists can offer their patients? Because I know that's a big hurdle in any healthcare related industry.

Edward Feinberg: Well, dentistry is different than medicine because what they call insurance for dentistry is not insurance. If we had an honest country, We would have a definition of what insurance is, and I think in order to be called an insurance plan it should cover at least 80%. There is no such thing in dentistry.

All these plans are what I would call payment assistance. They might pay a little something, but uh, that, that's, that's not um, what they're designed for, and it's deceptive. That's what's really not fair. The patients think they're getting one thing, and they're not. And any doctor who accepts insurance as the entire payment, they have to make up the difference in one of two ways.

Either they're going to do volume and you're going to get shoddy work that way, or they're, and or, they're going to use inferior materials that are cheap, and so you're not going to get the same thing. So, that's being penny wise and dollar foolish. Yes, it might help, every little, every little bit helps, and it wouldn't pay for you to go out and buy your own dental insurance.

If your employer gives you that as a benefit, that's like a discount plan that gives you a discount of, of, of dentistry that you might need. And that's all you're gonna get because that's all there is right now, which is very sad. I wish we had better plans in dentistry. Um, but as you said early, uh, earlier, dentistry's very expensive.

And it's not profitable for insurance companies to, to pay the full cost of dental care.

Rob Valincius: Yeah, look, I sell dental insurance and I can tell I signed myself up and, uh, I think the craziest thing is, is I remember, uh, as a young adult working full time, my job offered dental and I think I'd pay three, three, it was like 3 a paycheck for dental and I could walk in and get whatever I needed done and I never had to pay a dime.

You know, this was what, 15, 20 years ago. Now, Uh, most plans that you sign someone up for, there is a 12, a 12 month wait to get any major work done. So if they need any sort of work, you have to wait 12 months. And in most cases, it only covers 50%. It doesn't even cover 70, 80, 90%. Some plans have an escalation clause where if you have it for three years, it'll go up to 80%.

I've seen that. Uh, but. They have to hold the plan and if they need dental work now, you know, what's it matter gonna matter in three years, um, you

Edward Feinberg: Well, actually that's a. That's a very good point that you give, because one of the, one of the problems that I see is that a lot of dentists don't know how to do things for patients who, let's say, aren't candidates for sophisticated dentistry. And I've done a lot of sophisticated dentistry, and that's how I was trained.

But I also know how to make temporary with copper bands that seal the teeth, like permanents do. And I've helped a lot of people, you know, people go through cycles in their lives. where they might be down and out, you know, and maybe they can't afford anything or, um, it's not a good time in their life to be going to the dentist.

I'll make them a good temporary with copper bands and put it with permanent cement. I want that tooth there so that when they're ready to do the work, it's there and they can do the work. But these people are being turned away because dentists don't know what to do for them. This is one of the things that I teach, and that person could end up being a great patient and a great referrer, because they will appreciate what you did for them, and how you got them through a very tough period in their lives.

You know, they still have to navigate socially, um. It's, it's, it's not easy out there. They don't want to walk around with no tooth. I, I always considered that a real emergency. I would never let a patient walk around with no tooth. Um, that's, I, I would, I would do something for them right then and there.

And because I knew

Rob Valincius: My dad and my brother each are missing a front tooth. I don't, I don't know what type of karma that they both had that they're both missing a front tooth. I wouldn't leave my house. If I was missing a front tooth, I couldn't do it. I mean, you know, they don't have dental coverage and they don't have the means to go get it fixed right now.

So I get it,

Edward Feinberg: so I wouldn't, I wouldn't even care if I

Rob Valincius: credit card. Whoop.

Edward Feinberg: I wouldn't even care if I got paid. I would do whatever I could to, to, to at least get them through. And then, um, one day, you know, you could do more definitive treatment, but at least the tooth would be there. And they'd be able to do it and that's, that's what's unfair.

It's not, it's not right. That's part of being a doctor, I think. And that's how I always, that's what my dad did. I learned everything from him. And so I did the same thing. You know, I would, I wouldn't let anybody walk around. That's a real emergency and I could have them out walking with it, with, with a tooth in, in, within 45 minutes and, uh.

A lot of times, if they needed to send them to the Entitonist, I would put it in with permanent cement, um, and, and then, you know, they'd just go through it and do it. I've done a lot of that. So I just made a little video. that I put on Facebook about how I treat all these teeth that are flush with the, with the gum and I don't put posts in it and I don't build them up and I don't do all this fancy orthodontics on it and I don't, um, have to do a lot of, uh, crown lengthening surgery either.

Because I was trained differently and most dentists are focused on whatever tooth structure is sticking above the gum. That's how they're all trained. So if they don't have tooth structure above the gum, they can't do it. Whereas I don't care if there's any tooth structure above the gum. I care about what's below and if you get a good grip on the root, That is all you need.

You don't need anything sticking up above the gum. They have boxes full of teeth that I did like this. And I'm trying to, um, get my profession to recognize what this could do for their practice and how you could really help people. And it's like a brick wall. They have tunnel vision. They're just so indoctrinated with what they learned in school.

That they, they're not open minded enough to, to absorb this. And this is what came from dentistry's roots, which is very sad when you think about it.

Rob Valincius: Do you think that they're not going with, with the kind of holistical style approach that you have because it's, well, one, they they're learned it, right. But, uh, while they're in, in school, but do you think it's because it's more profitable to them to do it the, the way that it's taught?

Edward Feinberg: Well, you know, what's going on with the epidemic of tooth extraction and implant placement. That's a major factor. See, one of the things that I would say about the young dentists is that they have two strikes against them that I didn't have one when they get out of school, they're half a million dollars in debt.

And when you get out of school, your, your skills are rudimentary. You have to concentrate on building your skills and knowledge. That's why it's important that they do a residency program or have a mentor to help teach them, you know, and continue their education. Your education begins the day you graduate.

These people, a lot of them are forced to go to work for these mills. Cause all they can think of is how am I going to pay this back? And they're never going to be good, like dentistry, or give back to their profession. This is a lose lose lose for everybody. And, um, and we have to do something about that.

This is the wrong direction. And especially now when you see all of the waste that was uncovered in government that went to everybody but Americans. This should never be. It should never be that anyone has to start their career in the hole like that. I didn't have that. My dad was able to pay for my entire education.

He couldn't do that today. It would be impossible. And that's not fair.

Rob Valincius: Today's rough to

Edward Feinberg: It is, it's impossible. It couldn't happen. And, uh, and so I had the advantage. I never had. the pressure of production on me ever, until I was really ready to look at things, you know, and from producing. So if you go in where you're going to do quality, you're going to start out, it's going to take you a long time to do everything.

And as you become better, you become faster. But if you start out on day one with a production mindset, you will never be any good. Um, because you, you can't, you can't acquire knowledge and skills that way. And a lot

Rob Valincius: Yeah, listen, I agree. I mean, I'm, I'm a teacher too. So like in, in my job, I'm a trainer. I, I teach internally and externally, and you have a lot of the, a lot of these guys that get into the insurance world and their main goal is to make money. And, and I. Typically flat out tell people like, look, you can do really well in this industry, but you have to take care of people.

That should be your number one. I sell, I sell things to people, especially seniors. I'll, I'll sell them drug plans for 0. I won't make a penny, but I know that they need help. And to be honest. For me, I don't give a crap because either way I'm not making a ton of money on those things anyway, but I'm really truly helping somebody and I believe and you know, you had mentioned that the referral thing earlier, I believe if you do good in this world, especially with, with, um, you know, doing things like, you know, what you're doing and in the insurance world, which gets a bad rap for, for, you know, bad act, some bad actors, right?

If you do what's right for the person, It will come back to you tenfold. You're going to get referrals. That person's never going to leave you as a client, as a client in your dentistry office if you do the right thing. If you just want to make a quick buck, yeah, you can make a couple hundred bucks, and that person might be your client for a couple years, but they're going to go away at some point because they're going to have somebody come in that really truly cares about them and do what's right by them.

I live the way I sell insurance. That's how I, I operate. It's, it's what's right for the client. And I, you know, I was helping somebody yesterday and I, I, I did a quote for somebody. I'm like, look, I don't work with this company. No, no agents work for this company. Um, they cut out agents, but it's the best plan for you.

It's 0. It's here. You're going to need to go here. I can't unfortunately help you with that, but this is where you need to go. I didn't make anything off of that, but I knew that I was doing right by that person. And I think that's important, especially for young people that are getting into this,

Edward Feinberg: I agree with you 100%. I've always been focused on the patient. Um, sometimes that patient, I wasn't the person who could really help them. Um, I would send them to where they could get the help that they needed that, uh, or something was beyond me. I, I wanted them to know everything about their mouth, what's good, what's bad, what their choices were, what I would recommend and why.

And then I don't push them to do anything. It's up to them. I'm there to help them. And one, one choice is to do nothing. You know, people decide, oh, I don't want to do anything. That's their choice. Um, you can't put your values on somebody else, but I do want them to be aware of everything. And then I'm actually making a choice because they made the choice rather than having things come by default and, uh, which is an unfortunate choice.

Um, but I, so my job, I look at myself, doctor means teacher, and I'm there to educate people about dentistry and how they can best do, do right by themselves. And uh, I don't have all the answers, but I'm not afraid to go and get them if I don't know. And I, one of the things that I do that I'm surprised so many other practitioners don't do, whenever I get a new patient with a complex case, I take a full series of x rays.

I take upper and lower study models. Um, and I also, um, do all of the other tests like probing that everybody else does. And, um, I will go and sit down with my orthodontist buddy. For example, what can you do for this patient? What can you do for that patient? And I really take the time to analyze what could be done for this patient.

What's the least invasive? What would what would I do if that was me? And this was my mouth. What would I do for myself? Because I think that's a very good yardstick, that more people should think of things in that way. Maybe they wouldn't be proposing so much invasive treatment, um, if that were the case.

And then, um, I'll sit down with the patient, and that's part of my presentation, and I'll, and they were impressed that I took the time to talk to somebody else about their case. Um, because people don't do that. And the orthodontist loves it because I'm going to send him that patient. Um, and that's what I do.

I don't do orthodontics. He usually treats me to lunch.

Rob Valincius: You always got to appreciate the referral system. I love it. It's a beautiful thing.

Edward Feinberg: It is, yeah, but I'm also learning too. Orthodontics is not my field. I want to know for myself, even if the patient says no, I want to know. And I think that's important to have that mindset. That's how you become good.

Rob Valincius: Oh, I would agree. I mean, I think, um, the learning aspect is you should always be learning, you know, every day. Um, what are some of the biggest myths about oral health that you wish more people knew? Let's kind of, uh, start to wind down on that.

Edward Feinberg: Oh wow, myths.

Rob Valincius: something I, yeah.

Edward Feinberg: You mean from the general public? Um, okay. One thing is about veneers. People are only concerned about how things look and not worried about health so much if they don't like what they look like. Um, I think people don't have all the information, very often do the wrong thing and then find out later.

Um, with veneers, um, it's, it's great for young people when done properly. Um, the problem with veneers is that you can't take off enough tooth structure that what you're putting back isn't bigger. Every single person who has veneers is committed to doing crowns one day. because at a certain point, dentistry needs to be replaced, and that will not be the right treatment.

In a young person, the nerves are very large, so if you go to do crown preparations, you're more likely to get involved with root canals and teeth needing root canals than an older person because the nerves shrink as you get older. So for those people, you, veneers are great, and a young person can tolerate a lot more than an older person.

But an older person who has already periodontal bone loss is not a good candidate for veneers. It's like a fingernail of porcelain that's bonded onto the tooth. And, uh, you can't really change the architecture very much. With a crown, you can make the teeth ideal shape and size, bring the forces up close to the bone, connect them together to, um, uh, avoid, uh, distribute the load and, and help prevent periodontal bone loss.

You can do a lot of things like that. You can, you can make the teeth smaller rather than bigger, which is what an older person needs in order to hold onto their teeth. It's straight engineering. You can't do that with a veneer. So when they get older, they should have crowns and not veneers. And a lot of dentists don't even know this.

So the public certainly doesn't know this. So, um, if there's a place for it. But it's really primarily for younger people, and the teeth have to be really bad looking, because if they're not so bad looking, maybe you'll get away with a little whitening. Um, it, that is an invasive treatment, and you will have to do crowns.

Everyone is committed to doing them one day, and that day is different for different people, because we're all different. And, uh, so I think people should be aware of that, and I don't think that they are. I don't think they're being told that.

Rob Valincius: So if, if, um, you get a full set of veneers, you're eventually, whatever tooth has a veneer on it, you're gonna have to get it replaced with a crown?

Edward Feinberg: I believe that, yes. I do. I don't think that's the right treatment. Um, and it has to be done properly. So, um, you know, the better people at doing veneers can minimize making them bigger and make them, you have to be very, very diligent, um, and pay very close attention to detail. A lot of people aren't detail oriented.

Their orientation is, so what can I stick something in and make a quick buck? Um, and I see a lot of that, but a really fine. Um, person who does veneers is one guy in California who is amazing. I don't know how he does it. Um, and he, he went to one of his lectures and he showed all these cases and he, they weren't oversized and that's very hard to do with veneers.

Um, but, uh, crowns are, are the only way you can really completely change the architecture. Um, that's, that's really the only way. And in order to do things right and then have it hold up because it's just to put something in for looks, what are you going to get a few years out of it? What happens then? And so what you want to do is in the long run.

So when you talked about expense, if you do. Something and it's very expensive and it lasts 40 years, then that was a really good investment. What if you got a cheap thing and you had to do that over every five years? That's a lot more expensive in the long run than what you paid for the work that you got for 40 years.

A lot more expensive. So, I think more and more people should look at things in that way, and they should go to the best people. I think you'll have the best results that way. That's my feeling.

Rob Valincius: I'm a long haul person, so if I'm gonna do something, I typically do it for the long haul, so I try to do it the right way first. Um, you know, when I tore my ACL, I did, I did, I did it the way that wouldn't affect me the most and I got a dead person's Achilles because I didn't want them to pull my hamstring through my, through my freaking leg.

Um, and, but the doctor always said to me, Hey, if this one breaks, you can always get another one. If your hamstring that we turn into your ACL tears, then you're screwed. You can't do that again. You know, you have to, you know, and, um, you'd have to go this way. So, um, I think people need to do their research and get better with that.

Um, you know, but listen, we're, we're, we're at that hour mark. Um, can you plug all of your stuff? Tell us where we can find when, when you're lecturing next. Maybe someone's in, you know, on the West coast. They didn't want to check you out. Plug your plug away, sir.

Edward Feinberg: Okay, well, I have my teaching website, which is www. theonwardprogram. com And, um, there's a lot of courses, there's a lot of information. Um, some courses are nominally, nominally expensive. Uh, there are a lot of free courses, too, on it, and there's a documents library that anybody can access. And, uh, nobody's checking to see who's a dentist and who's not a dentist.

Um, I have a lot of podcasts that I did on my, um, website. And I, which, because it all is to educate people, um, I have two books out, they're both on Amazon. One is a textbook on a very niche subject in dentistry called the Double Tilt Precision Attachment Case for Natural Teeth and Implants, and I think it's the only book of its kind.

And the other is a book of essays on issues in dentistry, uh, which I think. the average person would find very interesting called Open Wide, and that's also available on Amazon. And these are essentially the blogs that I have on my teaching website. I do a blog every month on some issue, um, that's bothering me about dentistry or something uplifting that I might want to communicate to my colleagues.

Um, but they're really, um, anybody can can get something out of those blogs and if you visit my website and you want to be on my mailing list, there's a little place you can put your name and an email address and then you get the blogs every month. Um, so I have that and I'm not too hard to find. Um, all my information is on my website, which is www.

theonwardprogram. com. O N W A R D and, um, program, TheOnwardProgram. com. And, uh, um, I'd be happy to help anybody in any way that I can. I wish I knew more dentists who were trained like me. Um, there were a few in New York that I know of, but not too many, um, elsewhere in other parts of the country, which is a very sad thing.

So one of the reasons why I have the teaching website is I, I know there were good practitioners who were interested everywhere and it's worldwide, the internet. So anybody from anywhere has access to this information. And, uh, we have to make sure that most dentists recognize the value of this information.

Seventy years of documented evidence for the techniques, that's, I don't know anyone who has that, and the cases, the courses are filled with that. And, uh, that's, that speaks for itself.

Rob Valincius: Yeah. Hey, look, I mean, it's not like you're coming on here saying I have evidence and here's, you know, 20 years, you got 70 like that's, uh, I mean, look, they, they, they made the COVID vaccine in six months. So if they can do that, I think 70 years,

Edward Feinberg: well, when they made that, they made, they just put poison into it. They didn't even make a real vaccine.

Rob Valincius: Yeah, listen, I don't want to talk about it. I got mine. I didn't want to, I waited a year, but in order to travel out of the country, I needed to do it, and I've regretted it every moment because now I have heart palpitations that I never had before I got the vaccine. I tell people this all the time, uh, look, I'm not anti medicine, but I'm definitely anti, like, you need to work on stuff.

Vaccines don't just get created in six months. It takes like five

Edward Feinberg: That's right, and that's why I suspected it from the beginning. There was something fishy about the whole thing. Um, it really didn't make sense to me. None of it did. And early on, the Spanish researchers pointed out what was in it, and I was horrified. That's all I'm going to say about that.

Rob Valincius: Yeah, yeah, I'm, I'm, I'm on, we're on the same page here, Ed. Uh, but listen, it was, it was fantastic having you on. I'm sure people definitely got some, some out of this. Hopefully we can get you, um, some traffic on your website. Um, my podcast is Drink O'Clock Podcast. Uh, anywhere you listen to podcasts, it'll be up.

Uh, and then on socials, there's Drink O'Clock Pod everywhere. So, um, look, it was a pleasure having you on. And, um, you know, let's do this again sometime soon.

Edward Feinberg: I would love, I would love that anytime. I'd be more than happy to. I love talking about dentistry. And anytime I could help somebody or educate somebody, that's, that's really a valuable experience for me.

Rob Valincius: Awesome, Ed. Well, it was a pleasure having you on, and um, you have a great night.

Edward Feinberg: Thank you. You too. Thanks. 

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