Let's Talk Teeth

Dr. Mohaad Faraj's Journey to Prosthodontics and Private Practice

• Saadman Alamgir

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In this episode of Let's Talk Teeth, we welcome Dr. Mohaad Faraj, a skilled prosthodontist with an inspiring journey. Dr. Faraj takes us through his educational background, including his extensive 11-year tenure at the University of Connecticut, where he completed his undergrad, dental school, and prosthodontics training. Now practicing in Lubbock, Texas, Dr. Faraj discusses his current professional endeavors, including working as a contractor at two practices primarily focusing on surgeries, and the exciting process of opening his own practice. He offers insightful advice on choosing the right path in dentistry, the benefits of choosing the right residency program, and tips for new graduates navigating contract negotiations and career planning. Don't miss this engaging and informative conversation!


00:00 Introduction and Guest Welcome

00:33 Dr. Faraj's Background and Journey to Dentistry

01:22 Choosing Dentistry and Early Career Decisions

03:35 Residency and Specialization in Prosthodontics

05:46 Starting a Practice and Overcoming Challenges

11:39 Surgical Training and Immediate Implants

18:33 The Value of Residency Over CE Courses

19:22 Mentorship and Practical Training in Residency

20:36 Transitioning to Private Practice and Contract Work

22:56 Advice for New Graduates on Employment Contracts

29:50 Immediate Implants: Benefits and Techniques

35:31 Final Advice for Dental Students and New Grads

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Saad Alamgir:

Hi everyone. Welcome back to another episode of Let's Talk Teeth. Today we have the one and only Dr. Mohaad Faraj joining us. Dr. Faraj, if you don't mind just kind of introducing yourself, tell us a little about yourself, where you went to dental school, where you're practicing at, and we can kind of just go from there.

Mohaad Faraj:

Awesome. Thanks so much for having me guys. Third year dental school is a long time ago now. It's definitely time to look back on, so, yeah. I grew up in Syria. I was born in 93. I. We moved to the States when I was 14 years old. I grew up in Connecticut and I did everything at the University of Connecticut.

Victor Razi:

Oh, wow. My

Mohaad Faraj:

undergrad, my dental school. Wow. And my pro training. So 11 years all at the same school.

Victor Razi:

Yeah.

Mohaad Faraj:

And they were sick of me at that point, so they sent me all the way to West Texas. Yeah. Where I've been here for about two years now. In Lubbock, Texas, which is about five hours west of Dallas. And I work at two different practices as a contractor, basically doing mainly surgeries and currently I'm in the process of opening my own practice, like within the next 10 days or so, which should be nice. Nice.

Saad Alamgir:

Oh dude, that's awesome. Congrats. So it's

Mohaad Faraj:

Very busy time. Thank you so much. Yeah, so I did not really think about going to dentistry, but at the time of last year of high school, my dad and my brother were going at it. My brother wanted to be a goalie keeper. I come from Syria background. My dad was not having that. That's the

Victor Razi:

dream. That's the dream. Yep.

Mohaad Faraj:

Yeah, so I did not wanna get into that argument. My dad was like, either you become a contractor or you're gonna be a doctor for sure. And my brother is a dermatology surgeon right now, so my dad won, but at the time, yeah. I was trying to figure out what's gonna be the best route for me for the future and Right. Dentistry made sense financially. Time management wise, family's very important to me, so I wanted something that I could spend a lot of time with my family. And that was literally how I based my decision. And I went through the motion of going through undergrad, DAT, all that

Victor Razi:

stuff.

Mohaad Faraj:

Not until probably. The end of second year, basically, when I started doing hands-on seeing patients. That's when? I'm like, oh, I love this stuff.

Victor Razi:

Right? And

Mohaad Faraj:

I did not even know what pros was at the time. Then we started our denture course and I really loved just playing with wax. It was very relaxing, very, it was just, I felt like I was in the right space. And some of the faculty approached me, they're like, you should consider p. I was not on bliss. I wanted to do pediatrics. My nieces were like very cute and young at the time, and I was like all about kids. So then I had my first pediatric rotation. I'm like, yeah, I'm not doing that.

Victor Razi:

Yeah.

Mohaad Faraj:

So I started spending a lot of time with the cross residents at UConn and I was blown away. The first time I went in there, they were doing an upward O on four surgery as a cross resident and. That was it because after I gave up on pediatric, it was either general dentistry or surgery. Right? Because I love cosmetics, but also loved surgical aspects. And then I went and saw these cross residents are doing crazy surgeries that I've never seen before. I'm like, oh. So I spent more and more time with them and I was. Yeah, like after literally two, three months, I was like, that's it. This is what I wanna do for the rest of my life. So I finished dental school. I apply, I only rank two programs for residency Yukon and oh my God, I'm blanking on the name. In Baltimore, Maryland.

Victor Razi:

Maryland. Maryland, yeah.

Mohaad Faraj:

And I got into Yukon. That was my first choice. So to be years there. And it was the best decision I've ever made, honestly, because to be a pro honest is obviously a privilege to be able to understand dentistry, occlusion, aesthetics, everything. But to also have a program that is so. Strong in terms of surgery is a huge plus. So 99% of what I'm doing is basically implant surgery, but I also do the restorative aspect of it, so everything stays in house. I have a lot more control over the surgery part because I'm doing it prosthetically,'cause I know exactly where the teeth needs to be. But at the same time, I am controlling where the final, I'm working with amazing labs, so I'm getting better results than most of the doctors that are, let's say the all on four centers where. The doctor's doing surgery and Right. Everything's handed down to the lab tech.

Victor Razi:

Right. They take

Mohaad Faraj:

over. I get a lot more involved in the process, per se, and I like it. I may not be making as much money on these cases, but I take my time. I love what I do, and for sure, I think money's not everything. And that's one, one thing I would say is when I was trying to apply for residency, a lot of people, including my close friends and family were like. So you're gonna spend three more years going to residency and you potentially will end up working as a general dentist or a glorified general dentist doing basically everything that a general dentist does, but

Victor Razi:

Right. Maybe three more years. Yeah. So

Mohaad Faraj:

it did not make financial sense. I'm like, yes, but I'm a true believer if you do what you love and you commit to it and you do good quality work. Money will come.

Victor Razi:

For sure.

Mohaad Faraj:

And that has proven itself. I've only been out of residency two years and I'm opened my own practice. Yeah,

Victor Razi:

that's awesome. They are

Mohaad Faraj:

working out. Things are working out. Sweet. So, yeah. Nice. Finished residency, started applying for jobs. Literally Lubbock, Texas. They found me on a recruiting website. And I came, I've never heard of Lubbock, Texas, like Yeah. That's where Texas Tech

Saad Alamgir:

is, right?

Mohaad Faraj:

Yep. I have never heard of Texas Tech. I don't watch football. Yeah, and I came and I interviewed. I interviewed in Texas, in Arizona and Florida, just because we were trying to kinda get together as a family. That's where my brother was looking at the time.

Victor Razi:

Yeah.

Mohaad Faraj:

And I just kind of went with my gut feeling and things were working out.

Victor Razi:

Yeah. Yeah. First man, I wanna say congrats on soon, opening a new practice that's, I'm sure there's a lot of parts that you've been thinking of to put everything together. What on, honestly, while we're on the topic, like, how did you have a mentor during this time to kind of gather all these things for you, or a lot's been on you?

Mohaad Faraj:

So what I would say is, if the best and easiest way to go is when you graduate. Find a job where you're gonna end up being a partner and then eventually buy out the practice. That's the ideal situation. Easy transitioning into the system. Right. And that was my plan. I came here with the hopes that I was gonna be partnering up with the office that I'm currently working on part-time. Things just did not work out the way that I imagined them to be, so I decided not to persuade. That route, I still work with them really good terms. Right. Just not a partnership opportunity for me.

Victor Razi:

Yeah, sure.

Mohaad Faraj:

Then that put me in a position where I have to either try to find a practice that is trying to sell. Or open from scratch and doing what I do. It's very difficult to find a practice that kind of Taylors. Towards that market. Most of the practices that are for sale around me are GP offices that take all insurances without any emphasis on any surgical pros or anything like that. Sure. So that was out of the question for me. And I really liked the area, so I did not wanna move out of Lubbock. And so I decided I was gonna just go on my own and do it. And I'm doing it. I think the smart, the safe way. I'm not leaving my other two part-time jobs. Sure. I'm still there so I can kind of easing your way in.

Victor Razi:

Yep.

Mohaad Faraj:

And did not have a brand new building. I found something that was a pediatric office. Very smart. Small renovation the plumbing and all

Victor Razi:

was already set up Exactly.

Mohaad Faraj:

Everything was already set up and I'm only doing like two, two operatories. It's only me. I'm not even having hygiene. I'm only doing,

Saad Alamgir:

oh, wow.

Mohaad Faraj:

I'm only doing what I want to do. Right. Just surgery and pro. I don't wanna do general dentistry. I don't wanna do endo or filling anything like that really. Yeah. Yeah. Again, I went for pro with a mentality that I wanna see less patience. Make more money on those patients so I don't have to see a lot of patients. I don't have to take insurance. Yeah, right,

Victor Razi:

right.

Mohaad Faraj:

And just kind of have a chill kind of workflow. Yeah. Right now I'm working overtime to try to make this dream come ha, come true. But eventually the goal's kind of dial back, see like grief four or five patients a day. Yeah. Do good quality work and then show. That's awesome. So everything, it has been on my own, but. Not fully on my own. I don't have someone that's kind of holding my hands, washing every step. Sure. Just somebody and

Victor Razi:

text.

Mohaad Faraj:

Yeah. I have a lot of friends that have been through this, so I just check in with them whenever possible. I have Good, I. Reps that have been helping me navigate some of these things. Nice. And honestly, I try to keep close friends and family around me. So I reached out to one of my good friends who has been in the medical management. I. 20 plus years. Right, right. And I'm like, this is a good opportunity. And he basically came out from Connecticut to be my office manager. Nice. That's awesome. So having someone there with that experience, yeah. You can trust and I can trust. It just makes my life a lot easier because Yeah, again, there's a lot of. A lot of moving pieces that are still kind of going. I can imagine

Victor Razi:

that.

Mohaad Faraj:

But you know, everything will work out eventually.

Victor Razi:

It'll, yeah.

Mohaad Faraj:

As long as you have good intentions and you are doing your best to provide the best kind of care, things will work out for sure. It's a little bit tricky because I'm not gonna be in network with any insurance, so. It is gonna be a little bit different. A lot of people advise me not to do what I'm doing in terms of Yeah, I'm sure Only doing pros. As a practice, as a start of practice, the majority of people you talk to will tell you will have to do general dentistry. You'll have to do everything. You'll have to take all the insurance, at least initially. Just so you can build up your patient clientele and then reduce back. I just don't see myself doing that. Anything's

Victor Razi:

possible.

Mohaad Faraj:

I haven't done a filling for like. Five years, and I do wanna do quality work and I know my class two game is not it. So I have to be

Victor Razi:

me and you both.

Mohaad Faraj:

So, yeah, I mean, the thing is, everyone's gonna have their own story. Everyone's gonna have their own way of doing things. Everyone's gonna have their own way. They set up their own business and. No two are the same, and doesn't mean that one is gonna be better. It's just gonna be one that's fit for your own personality. For Yeah. And that's a big reason why I wanna open on my own. Like I make Okay money, good money, just doing what I do at these two offices. Right. And good relationship and everything. But there's something to be said about having something that is your own, that you, right.

Victor Razi:

Like a legacy kind of deal.

Mohaad Faraj:

Yeah. I mean, most of us are, immigrants and we have this dream, right? We've worked so hard to get here, might as well go all the way. And if it doesn't work, it doesn't work, but it'll,

Saad Alamgir:

yeah. At least you

Victor Razi:

try. Yeah. That's

Saad Alamgir:

part of the dream, isn't it?

Mohaad Faraj:

Yep. It's,

Saad Alamgir:

yeah. That's awesome, man. But switching gears just a little bit, obviously all this isn't possible without having gone through the cross training that you had and the amount of surgery that was in. UConns training residency program, I guess going back to your D four year and then just thinking about what programs you're thinking about applying to, was that like a big requirement for you to apply to programs that had that big surgical requirement?

Mohaad Faraj:

Correct. So I, so in D three is basically when I started making the decision, whether it's oral surgery. Versus pros. And then I was like, if I'm gonna do pros, it has to be surgical pros or I'm not gonna do pros.

Victor Razi:

Right, right,

Mohaad Faraj:

I'm not interested in doing dentures all day long. I love dentures. Yeah. I think understanding dentures is fundamental to everything that we do, but I have a need for blood, so to speak. So I needed to go with something surgical. Sure. So I narrowed down to four programs that were surgical. UIC was on that list, Maryland. Was it four? No, even three actually. Basically, UIC, Maryland and Yukon tho. Those were like the only three programs that I applied to, right? And I decided not to rank UIC because they took a lot more residents than the other two programs. I see.

Victor Razi:

And I needed,

Mohaad Faraj:

if I'm spending three years, I knew those three years are gonna be live in hell. I needed all the attention I can get from faculty and my co-resident group. So I can learn as much as possible. So I only ranked Yukon in Maryland, ended up with Yukon, which wasn't my number one choice. Both of these programs are very surgically heavy. I think number one program in the country is Yukon. I love my Maryland boys, but I think in terms of this surgical training that we get, it's unmatched. Unparalleled. Oh hundred percent we're doing That's awesome. More surgery. I mean, right now. We do everything from extraction to crown lengthening to gum grafting. Wow. Right. Bone grafting, sinus lift, that's crazy. All on for immediate implants and so there's not something that. Will come my way that I cannot tackle. And that was the biggest reason for me to go to pro.'cause as you guys know, in the dental school, whenever a treatment plan gets a little bit too complex, you always go back to the pros hedonist because Right, right. They know how they see the vision for what the final needs to be and they can work their way back. Yeah. And that was the main thing I wanted in cross residency. Obviously surgery was very important, but being able to. Tackle any case that comes in my way, even if I don't have the skills to actually do it.

Victor Razi:

For sure,

Mohaad Faraj:

understanding where and who to refer to and who to talk to, and what steps need to happen for that case to go from point A to point Z

Victor Razi:

for sure.

Mohaad Faraj:

So that was a huge thing for me. Pros. Then residency was an eye-opening because you realize that you don't know anything. Anything. Oh, I'm

Victor Razi:

sure.

Mohaad Faraj:

And then you finish residency and you go into the real world and then you get smacked with a face with the reality that you're not gonna be able to do all the cool cases that you did in residency because life doesn't work like that. People don't just have money, right? But you slowly build up. Right after residency, I mean, even through residency, I really wanted to get into immediate implants. We did few. Anterior cases, maybe premolar cases. So I understood the fundamentals. Sure. I really wanted to tackle immediate molars. Yeah. And like our program director was on the conservative side, which is a good thing. Yeah. When you have young doctors that are just learning how to do surgery, you don't wanna do crazy stuff. For sure. About six months after residency, I started doing immediate molars and that has literally changed. How I practice. That's awesome. 99% of my cases are immediates. Sure. It's very rare that I don't place an implant the day that I extract the tooth. I am strong believer that it is the best option we have for our patients in terms of preserving the bone, the soft tissue, one surgery, less headache, less discomfort, less pain, everything compact to the point where it kind of shifted me. I've never thought about teaching. But it kind of forced me into that world because I got a lot of requests, basically. Nice. So I post a lot of cases on social media to do courses. So we've been doing about four or five courses so far on immediate implants. Nice. And it has been an amazing experience. Never. In my life, I would've imagined myself teaching. Sure. I hate public speaking. I hate setting up presentations, but when it's something you're so passionate about, it

Victor Razi:

becomes natural. Oh

Mohaad Faraj:

yeah. Yeah. So I've been doing that and slowly working on some all on four courses as well for sure. And busy. Just good.

Victor Razi:

Yeah. Yeah. Nice man. Your story's awesome. We could talk about too a few more recent things, but to reflect on one more thing, in your past, how was your dental school training in preparation for your pro training at UConn?

Mohaad Faraj:

It was

Victor Razi:

because y'all have a small class size, right? So we

Mohaad Faraj:

had a very small class size. What I would say is Yukon Dental School training had a lot of emphasis on medical school curriculum.

Victor Razi:

I see.

Mohaad Faraj:

I would say about 50% if not more, of us actually specialize. So most of us get

Saad Alamgir:

Oh wow.

Mohaad Faraj:

Specialties. But the good thing is a lot of the faculty that was teaching us in dental school, pretty much all of'em were board certified prosthetics. So anyone that was teaching us any kind of counter bridge work, anything that had to do with pro, those were the same faculty that were teaching students as well as the residents. So I had very good foundation. But nothing surgical. Right. So everything in terms of regular pros. Sure. Traditional pross, I had really good foundation on, but not to the extreme level that we're doing. Right. We're doing just single unit, three unit bridges. Then I. I had like foundation of preparation, design and stuff like that, but not full treatment plan. And that's the biggest thing that cross residency gives you is how to become a great treatment planner, which is a skill that takes years to develop. We get into cross residency and then everything is just escalated. Right. Instead of doing three or one or two single units, you're. Prepping a full arch. I remember like literally my second or third week, I inherited a case that was already prepped for full arch, right? And I was supposed to take final impressions, and you're sitting there for literally like five, six hours packing cords on 14 tea. Drying everything. Trying to capture everything in one shot. It's

Victor Razi:

uhhuh.

Mohaad Faraj:

It's a whole, takes a lot grit, volume. Oh yeah. Never felt so like first two months of residency, literally I could feel my forearms are just like spasming. Gosh. Like it was just too much. It was too much work, but it just makes you so much better, so much faster, uhhuh. So I would say for anyone that's debating whether or not to go through residency for something that they have an interest in. I am a huge advocate for going through residency over going through CE courses, right? Yeah. You can learn a lot from CE courses, but no amount of CE courses will actually replace the formal training that you'll have in residency.

Victor Razi:

Imagine you're

Mohaad Faraj:

sitting there for literally three years learning not only a crap load of cases that you're doing yourself, but you're learning from all the cases from your co-residents being able to sit down, discuss all these cases in depth. You're never gonna have that time. In real life to go over that. So

Victor Razi:

Sure. If

Mohaad Faraj:

you're interested in residency, just do it. It is worth it. Surgical part was basically, I would say everything that I know in terms of surgery. Up until I graduated, everything was basically through our program director, Dr. Ra. He's an amazing clinician. Very practical. And that's what I loved about the program, is very practical. He has his own private practice, so everything related to that private practice. Yeah. That's good. And another mentor, man that I refer to all the time is Dr. B, our program director. That's awesome. So terms like even supplies, implant systems just kind of basic things in terms of running practice. Even in residency we used to order a lot of our own implants, so you get a feel for what real life is like, what things cost. Right. Which is very important. There's a lot of programs that are very academic in a sense that a lot of the doctors that are teaching have little to no experience clinically in the outside world, and it becomes really hard. To relate to the next step in your journey.

Victor Razi:

Right.

Mohaad Faraj:

So having a program faculty that that does have that experience also adds a lot to who you are and who you become after you graduate.

Saad Alamgir:

For sure. Yeah. Sweet. But moving forward to where you're practicing at now, you had mentioned that you are a contractor at two different locations and you're. Obviously plan on open up, opening up this new location. Is this new location first? I'm curious as to what the contract like work is. And then secondly, is your new clinic, are you mainly looking to do like full arch cases like immediate lo immediate loading implants, or kind of what's the day to day like ideal workflow that you want to have in your new clinic?

Mohaad Faraj:

When I first moved out here, I had a W2 contract. It was supposed to be three years. I think it had like a three mile radius non-compete, and then literally six months into that contract I realized that. I am not gonna wanna be partner in this. And I was upfront with the owner, and I came with the promise I was gonna do like more than just surgery. Right. I'm just graduating from pros. I wanted to do all the veneer cases, all the reconstruction cases. I wanted to do everything, but it turned out that I was only seeing surgical cases. So I decided to have a conversation with the owner. I was like. I don't see a future as a partner, but I think I'm making good money. You're making good money. If I was to stay here, I would want to change my contract to a 10 99. Basically just do a contract. Sure Didn't

Victor Razi:

work.

Mohaad Faraj:

Only work for you part-time.'cause they were not able to follow up my schedule anyways. And I want zero non-compete.'cause Lubbock is kind of a small area, right? Yeah. If you put a five mile radius, it puts me. Those were my conditions. One ten nine, nine two zero noncompete. I could literally work next door and that was the deal for, and they signed it and I'm like, okay, great. And so I actually, my second job opportunity is A DSO, but I'm also there as a contractor, basically just doing their surgery and past work. The two offices are like 30 seconds apart,

Victor Razi:

right? So

Mohaad Faraj:

a lot of times I'm going like back and forth between those practices, like between patients. I have an emergency implant, I go and do it. And when I decided to open, same thing, zero non-compete with both of'em, my new practice is about eight minutes away from those two practices.

Saad Alamgir:

Yeah.

Mohaad Faraj:

I see. So everything's gonna be very close together. What I would say as an advice for someone who is. Looking to, let's say you are just graduating and you wanna do cool big cases.

Victor Razi:

Sure.

Mohaad Faraj:

If you wanna do those cases, you cannot be picky in terms of location. If you go to a very saturated area, you're not gonna be doing those cases.

Saad Alamgir:

Right.

Mohaad Faraj:

They're gonna wanna do Right. Keep those work for people that are specialists and that, that's another thing. If you think you wanna finish dental school and just do full arch, then you need to specialize in that. You have much higher opportunity to be able to do that as a specialist versus as a gp, right? I have gps that are teaching other doctors to do full arch. It's not something about, oh, you have to be a specialist to be good at what it, what you're doing, but it's just the nature of the market. Easier workflow, right?

Victor Razi:

It's

Mohaad Faraj:

just the market, right? If you have more credentials, you're easier to get jobs, you're more likely to get paid more and so forth. In terms of how I imagined my practice to be, I never wanted a full arch practice and it's not a goal of mine.

Victor Razi:

Sure. I

Mohaad Faraj:

love everything that I do. I love spending an hour and a half. On a single immediate making contemporaries and taking photos and videos. So if I just do like full arch production line few times, yeah. I be able to do that, right? And there's nothing wrong with that model, it's just not something that I want to do, especially as a solo practitioner. Yeah, I wanna be able to enjoy everything that I do, so I'm hoping for. Full scale cross practice. Initially we're gonna be focusing on implants because that's what I've been doing for the last two years. Basically only been doing implants with me. Sure. And it's just gonna be easier to transition our private practice. Right. Just doing what we have been doing already. But slowly, hopefully we'll get in more smile makeovers, full math, reconstruction cases and all that process to offer.

Victor Razi:

Yeah. That'll be awesome, man. I'm excited to hear how it goes, dude. That'll be awesome. Congrats. So kind of just understanding everything, how as a prosthodontist is being a 10 99 employee, a little more beneficial than like a W2, what about it is appealing to you or what is even like the cons of it too, if there are any.

Mohaad Faraj:

So what I would say as a W2, as a new grad, it is a little bit easier to maneuver because you don't have to deal with all of the taxes and all the work that comes with, it's a 99. Typically you get more benefits if you're W2, like medical health. Pay time off and stuff like that, depending on the company or the office that you are working with, right? And a lot less headache, but a lot less autonomy. Right? You're employee. Sure. So you have to abide by a lot more standards. Everything you have to follow with the standard of that company or office you're working with. 10 to 99. On the other hand, it puts the taxes on you, right? So you have to pay. More taxes, but you have a lot more freedom in terms of how you manage your money, right? Sure. So you can do a lot more write-offs in terms of. Whatever it is. Sure. You're getting your laptop for work, you're getting new equipment, all that. Right. So you have a lot more flexibility in terms of how you manage your money. Right. And you have a lot more flexibility in terms of your work schedule, right? Sure. So I set up my schedule however I want. You can negotiate a lot more deals. Like I don't wanna. Be working these hours. I don't wanna be bound to this fee schedule. Right. You just basically you're your own company, right? You basically build your own LLC, you make your own rules. Obviously it has to be in somewhat compliance where you're working at, but you have a lot more flexibility. So especially for the DS OI work with DSOs are notorious for having a lot of regulations and a lot of hoops you have to jump through. Like if I wanted to introduce a new implant system, if I was an employee of that company. That would not happen, right? Because this is what the contractor policy and all that Exactly. But as a contractor, I can do whatever I want.

Victor Razi:

That's awesome.

Mohaad Faraj:

What implant system I want to use. What? Bone graft material, what sutures?

Victor Razi:

Sure. That's awesome. So

Mohaad Faraj:

full autonomy, which is, again, as doctors, I truly believe that you're the doctor. You should be able to make all your decisions.

Victor Razi:

Right?

Mohaad Faraj:

You should. You should have autonomy. And 10 99 gets you a little bit closer to that.

Victor Razi:

Sure,

Mohaad Faraj:

yeah. On the downside you just have a little bit more headache in terms of managing the money, managing taxes, and your taxes kind of stuff. But if you are planning on being an owner or opening your practice, I think having the 10 99 gets you a little bit more familiar with the process.

Victor Razi:

Sure.

Mohaad Faraj:

So you're not jumping. So like what I would say is like, so I did one year W2, second year I did a 10 99. Which basically I opened my own LLC, I hired my own assistant. I made my own contracts. I bought a lot of my own equipment. So basically just kind of baby steps into becoming an owner. Sure. And now opening my own practice. So it's kind of a good transition, I would say.

Victor Razi:

For sure. And kind of to, to back up that question, have you considered like what's your style of ownership you want to be for your practice? Like, are you gonna do. S Corp. C Corp. LLC.

Mohaad Faraj:

I'm an S corp. And don't ask me too much about those because it gets a little bit outta my head.

Victor Razi:

Me too. But I just wanted to see your thoughts.

Mohaad Faraj:

Yep. So I did an S corp because I was gonna be the sole owner. I'm the sole provider. Sure. So that was the most beneficial way in terms of tax bracket, I guess for sure. What I would say is most of us graduate dental school not knowing anything about. Yeah, that

Victor Razi:

world. Yeah. I

Saad Alamgir:

was about to say if y'all happen to know a little bit more'cause y'all elaborate because I'm like, I have no idea. My girlfriend's an accounting, so that's how I know of

Mohaad Faraj:

Exactly. So what I would say is hire someone that knows what they're doing so they can walk you through that stuff. So like, when I did my LLC and my corporate overall, I had an attorney that was doing all the paperwork and I had a. Cpa. That was drafting everything, making sure everything was up to regulation, all that. Because one, I don't have the time. I'd rather pay someone else to do it and see patients two. I'm not gonna do as good of a job and I just don't understand it. For me, I mean, they went to school forever to stuff. Right. Trust their professional

Victor Razi:

opinion.

Mohaad Faraj:

Exactly. I know there's a lot of doctors that are so into that stuff. I'm not one of those doctors. I don't even, I don't even do stock market stuff. You know what? Yeah. I'm very like physical. I need to see it. Yeah. I own this building. This is mine. That's it. I need to see the money. But you're smart in that

Victor Razi:

way.'cause you know yourself. You know that's not you, so why even bother?

Mohaad Faraj:

Yeah, exactly. I would be in so much hot waters if I try to go into that realm.

Saad Alamgir:

Yeah, agreed. But Mohaad, this is just kind of a very clinical question, I guess, You had mentioned you were, you placed immediate implants, and we're actually in our implant class right now, and so we're kind of hitting on that exact subject. So I'm just curious as to like what the reasoning is versus for an immediate implant and why you say that's better versus. Like, you know, placing the actual abutment and things like Crown like six months later.

Mohaad Faraj:

Okay. So one, if you go back to traditional teaching, even what I learned in residency, there's a lot of quote unquote contra indication for media implants. Right? If you have an infection, if you have a slightly missing buckle wall, if you have recession, all of these were like.

Victor Razi:

Sure.

Mohaad Faraj:

No for immediates, right? And as I practice and I try new things, which is the beauty of practicing in the real world, you can kind of expand your horizons a little bit. There's a lot that you can do with immediate implants. A lot of those contraindications are not really contraindications because I have had cases where I had huge infections. Most of the cases I have infections, right? We're taking teeth out for a reason, right? Whether it's a broken, there's an infection, there's something, right? It's not a healthy site. You don't just take a healthy tooth, place it. So for me, a lot of those contraindications are actually indications for immediates as long as you have the right system to do it, and predictably, right? For immediates, you need to have good primary stability. Good infection, control of the site, and good tissue support.

Victor Razi:

So

Mohaad Faraj:

traditional route you extract the tooth, you have one of two options, whether you graft and let it heal for like four or five months and come back in place.

Victor Razi:

Right. And at

Mohaad Faraj:

that point you're hoping that whatever you grafted became actual bone or your implants gonna be in fully grafted bone. Which we know is not really ideal biomechanically, right? So if you are eng grafted bone is not as good as if you're native bone. Yes. That's option one. Option two, you did not graft, then you're gonna have collapse of the soft tissue and bone. So when you finish up your final restoration, you're more likely to have food traps. You're not gonna have the pillows preserved. It's just a compromised situation. On the other hand, with the immediate workflow. One you have on just one surgery, extracting tooth, disinfecting the site, making sure everything's clean, you place in the implant at the same time. Many times. I would say right now, maybe about 50, 60% of the time, I'm not even grafting'cause I'm making my custom healing environment in such a way that it's preserving the bone and the soft tissue. In the course, we literally spend like hours talking about the design of the custom healing abutment once to graft, when not to graft, what kind of grafting material Yeah to use and so forth. And a lot of times when I'm grafting for immediate, I'm grafting above the neck of the implant only to support the tissue. So the biomechanics of where the implant is being loaded is still in fully native bone, right? We're allowing that blood to make bone so better soft tissue outcome. You'll see some of the cases. Where literally you cannot tell it's an implant restoration because you've preserved every single that's issue ounce of soft tissue and bone. And I would not be able to do that with delayed placements. Especially sites that are like big infections. The moment you take everything out and let it heal, it's just gonna collapse drastically.

Victor Razi:

And

Mohaad Faraj:

a lot of times when you do that, you're hoping the patient comes back in three to four months to do the implant placement. Many times they disappear for years and then you come back with a narrow ridge at that time you have to place the implant and you have to do grafting and you may need to do additional soft tissue grafting, and the outcome is not gonna be as ideal as if it was with an immediate implant placement.

Victor Razi:

It's just

Mohaad Faraj:

overall better from every aspect that we look at it. I

Victor Razi:

see. Yeah. I mean,

Mohaad Faraj:

surgery, money, comfort. Time For me, time is a byproduct, right? I don't do immediate just to save time, but if I truly did not believe it was a better outcome in terms of aesthetics, soft tissue and bone preservation, then I would not do it.

Saad Alamgir:

Okay? If I go into

Mohaad Faraj:

a site and I know that I'm not gonna be able to deliver a custom healing environment to help you preserve the bone and soft tissue, then. There's no need for me to do an immediate, and it is slightly higher risk, right? We're only like maybe three to 5% high risk for failure, but I think it's worth it if you were able to preserve the architecture of the actual Yeah. So the future restoration comes out as natural as possible.

Saad Alamgir:

Yeah, that makes sense. So, just so I'll make sure I understand. When you place the implant, you're making sure that most of the implant stays in the native bone. You, graft around the neck of the implant and then blo it above the neck. Above the neck. Okay,

Mohaad Faraj:

so above the neck. So basically if you're placed in the implant about four millimeters below the free gingival margin Then you are grafting from the neck. I see. Upwards to help support the tissue.

Victor Razi:

And

Mohaad Faraj:

for anterior cases, many times we are immediately loading. A lot of times the back teeth, we are immediately loading. It depends on the tooth, it depends on the patient. It depends on the stability that you get. But every patient gets either temporary or a socket ceiling abutment, which basically that's what's gonna help us preserve everything. It's holding the blood tissue.

Victor Razi:

Yeah.

Mohaad Faraj:

And preserves the bone and the soft tissue. Yeah. So you don't collapse.

Saad Alamgir:

Yeah, that makes a lot of sense. I was just curious as to. What that thought process was, but you explain it well. If

Mohaad Faraj:

you go through my Instagram, there's literally a bazillion case that you can learn how to do this on your own.

Victor Razi:

Yeah, I've seen your stuff, man. It's neat. And I know a lot of other people in dentistry appreciate the stuff you put out to take time. Yeah. Appreciate it. So as we wrap here, doc do you have any final advice for dental students or new grads that. Or kind of getting out into the world maybe the world you're in or just in the dental world in general, what do you recommend or have learned through your path?

Mohaad Faraj:

What I would say is two things. One, if it's not in writing, it's not gonna happen. So every conversation you have with a potential employer, potential position, unless it's in a written contract that you guys both signed, you cannot count that as something that's gonna happen. For

Victor Razi:

sure. I think

Mohaad Faraj:

a lot of doctors get into hot waters'cause oh, we talked about this. If it's not in writing and be upfront. If it's like they need to put it in a contract or I'm not gonna sign it, or I'm not gonna basically take the position if it is a deal breaker for you. Right. Number two. Do not be shocked'cause you will be, but try not to be because the real world, one, it's not as idealized as what you've learned in dental school. There's a lot of cotton corners, a lot of shady things that you see. Try your best to be as textbook as possible. Once you have mastered, at that point you can. Skip some steps. I'm not saying cut corners, but you can skip some stuff,

Victor Razi:

right. That

Mohaad Faraj:

you would, not in dental school, but as a new grad, try to do everything as good as possible. Third thing is you're gonna be faced with the dilemma of trying to find private practice owned or DSO owned.

Victor Razi:

Sure. And what I would

Mohaad Faraj:

say is not all DSOs are bad. And not all practices are good. So get to know the management, try to get. In contact with doctors have been in those positions before and ask them how they liked it, how the environment is. But I would say ideally don't sign any contract that's more than two to three years. Ideally try to keep it to two years in case you're not happy, you have the freedom to go.

Victor Razi:

That makes sense.

Mohaad Faraj:

Try to negotiate zero non-compete whenever possible because many times you go somewhere else, you start family, you bring your friends, whatever. You build a community. You don't wanna leave that area a lot more. Companies are open to that idea nowadays. So basically just have big lines of where you want to be. Like, I wanna be making this much, I don't wanna be leaving. This is like, all of these are like breaking points for me,

Victor Razi:

right? And

Mohaad Faraj:

just know what those are before you go into the market and start early. I would say at least six to nine months are looking for jobs.

Victor Razi:

Yeah, for sure. That makes sense, man. Well, we really appreciate you coming on today and taking your time to enlighten us and everyone else out there that's listening to this kind of what you do and. Your story on how you got to where you are today. And once again, a big congrats on starting this practice soon. If, you know, if you ever need any help or anything from me or so, reach out to us, man. We're here for you. Yeah,

Saad Alamgir:

for sure.

Victor Razi:

Yeah man, appreciate

Mohaad Faraj:

you guys. Thank you so much for having me. And good luck with the rest of your dental school and if you guys need, have you have any questions or need any help with anything or any of your listeners, honestly I'm more than happy to help anyone that needs it.

Victor Razi:

For sure. Yeah. Thanks Brad. Good luck to you. Well, we appreciate it.

Mohaad Faraj:

Of course. Take care guys. Peace.