How the Damon Ultima System Can Help Startup Practices

In this episode, Brady Petersen, DMD, MS and Kory Grahl, DMD, FAGD, co-owners of the Las Vegas practice Orthobar, talk about the key role the Damon Ultima system played in launching their new practice.

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Alison Werner: Hello, and
welcome to the Orthodontic

Products podcast. I'm your host,
Alison Warner. In this episode

sponsored by Armco. We're going
to talk about what it means to

be a startup practice and making
decisions around clinical

clinical products you use with a
focus on the Damon Ultima

system. And we're going to do
this with Dr. Brady Petersen and

Dr. Kory Grahl, who are in
private practice together in Las

Vegas under the practice name,
Orthobar, Dr. Petersen and Dr.

Grahl. Thank you for joining me.

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

Brady Petersen: Awesome. Excited
to be here.

Alison Werner: Great. Okay, so
to get started, can you talk

about how you two came together
to start your practice? I saw

that you both attended UNLV for
dental school and your

residencies? Were you in classes
together?

Kory Grahl: Yeah, Dr. Petersen
and I both graduated dental

school together, we're both
actually in the same team. UNLV

breaks their dental school up
into teams were the same team

for four years. And we remained
close and in contact with each

other ever since that point in
time.

Brady Petersen: I think we were?
Oh, sorry, I was gonna say even

if I remember being, we were at
the same day interview. And I

remember like seeing Kory over
there, Dr. Grahl. And just being

like, that's someone like very
similar to me. Day one, and that

was both when we hadn't even
gotten into dental school

together. And then we ended up
sitting across from each other

for four years. And our
interests are very similar, even

throughout dental schools,

Alison Werner: Okay. So how did
you to know you are kind of

compatible to start a practice
together?

Kory Grahl: You know, we kind of
overlap during orthodontic

residency. And, you know, both
of us had practiced general

dentistry as associates for
years prior to orthodontic

residency, which is a little bit
uncommon for most orthodontist

in their journeys. And one day,
I think I went up to Dr.

Petersen, I'm like, Hey, man,
let's build something together

here. It's so drastically needed
here in the Las Vegas Valley. I

don't want to work as an
associate for the rest of my

life. You know, there's
definitely pros and cons to

that. And having known Brady for
a long time, you know, knowing

his values and stuff very much
aligned with me, both in kind of

the same phases of life on
growth in development. And so it

kind of just kind of just a
match that just needed to

happen. To be quite honest.

Brady Petersen: Yeah, I think I
think a lot of that we touched,

we touched on it all the time,
every day in our practice, the

the years that we got in our
general practice, as general

dentists, the years that we got
there. You get a lot of those

learning experiences out of the
way. So you we've done the

associate chips we've done, you
know, are we interested in

buying this dental practice and
things like that, and we both

had experiences, where we had
both known where we'd gone out

into that world, we realized how
much we love orthodontics and

how we wanted to go back and the
importance of that specialty,

you know, we were both working
in practices that did some

orthodontics as general
dentists, but it just piqued my

interest that I get there's so
much more out there and then

talking with Dr. Grahl in
residency. I think that drive to

both build something of our own
be owners of a practice our own

keep that private practice
alive. And it's so needed here

in Las Vegas that we started
that day one I remember Dr.

Grahl coming over to me and
saying, Hey, are we doing this

together? Are we going to do
this against each other? I said

we're doing it together because
I'm not competing against Dr.

Grahl. By with you. We started
and we went from there so okay.

Alison Werner: Well so what were
you trying to strive with

setting up Orthobar which is the
name of your practice? What were

you looking, or how are you
looking to set yourself apart in

that Las Vegas area?

Brady Petersen: Yeah, I think
you know, I'm born and raised

here in Las Vegas. I absolutely
love Las Vegas. And I feel like

I have a really good
understanding of of, you know,

the what everyone thinks Las
Vegas is and then what it really

is and what it really is, is
it's a community and it's a

small town. Everyone knows
everybody and I know I know

there's there's great
orthodontist here in town I've

I've grown up with him I was
treated by them. But in our goal

for ortho bar was to we wanted
to raise the bar and

orthodontics and that's kind of
how we came up with that. And

and really there is another
level that whether it's just our

patient experience or the
products that we use in our

orthodontic practice, we want
that to be different than anyone

else here in Las Vegas. And so
everything from that private

practice feel, to a beautiful
office to the technology that we

use, we want everything to be
the best and, and I know that

everyone in Las Vegas, it's just
like any restaurant, any casino,

if you're not the best, I mean,
if you're a casino, they blow

you up, you won't last year
forever. So you have to be at

the top. So having that
understanding that that's where

we want to take Orthobar and and
we want to do that right from

the beginning.

Kory Grahl: Yeah, and, you know,
to piggyback off of that, I

worked with some incredible
dentists and one of the

differences that I found in most
practices is people don't really

know what you do, to an extent,
like there's certain levels and

degrees that things but it was
all how you made them feel. And

so the way we built Orthobar,
the way we structured our

practice, like when you walk in,
it does not give a, I'm in a

dental office vibe, it's I'm in
a spa like environment, you're

greeted by the front desk,
you're, everyone knows your

name, your hobbies, what you do.
And that's the structure of it.

And then just partnering with
really, really positive

companies in selecting products
and that rather than someone

coming to you about the latest
and greatest deal or cost or

whatever, but no companies I've
been around a long time just

made total sense and not cutting
corners in any bit of the

process. You know, when you come
in here, you're getting

authentic products, authentic
people at all stages throughout

your experience here and
hopefully starting here to

deliver you an incredible
Orthobar smile is what we're

trying to create. So it's a very
different feel than seven, your

insurance will verify that and
then here's the fees, and

whatever, it's very much like
no, come in and meet us we would

love to meet you get to know you
as a person, as a human and how

we can be part of your lifelong
bolt of confidence basically. So

it's very much structured off
soft components rather than hard

components in our practice. It's
it's high touch points. It's,

you know, understanding who were
who we're working with, not just

patients, but partners as well.
Yeah.

Alison Werner: Okay. So you
touched on this a little bit. My

next question a little bit,
considering the fact that you

are, by definition, a startup
practice? What are some of those

considerations in making a
product decision for your

practice? You talked about like,
not kind of taking the easy way

out? Or, you know, putting the
investment forward sooner? Can

you talk about that?

Kory Grahl: Yeah, I mean, from
the start, we've invested in a

lot of technology. You know, one
of the one of the early on

disagreements between Dr.
Petersen is what do we have a

sink in the lab or not? If we
don't have a sink in a lab, then

you're definitely not using
stone. And so we are fully

digital, we're an Apple based
practice, we have digital

scanning technology, we have 3D
cone beam X ray, all those

things, I think contribute to
finding and delivering the best

possible care we can and, you
know, finding good companies

that have been around a long
time, and not necessarily the

new latest and greatest, even
though, you know, we're talking

about Damon Ultima being the
latest and greatest technology

of self-ligation, Ormco, has
been around a long, long time.

And they've seen multiple
iterations of their bracket. And

so it's one of the things that,
you know, maybe there's this new

sexy other company out that says
they can do things better, but

tried and true. No, Ormco has
been around and done it for

years and years and even more
years to come.

Brady Petersen: I just think
too, with both Dr. Grahl and I,

we were orthodontist, but we
also have that entrepreneurship

mindset. And for us, it's really
investing in something that's

efficient. And then in the long
run speed is invaluable. So the

I love working with the Damon
Ultima system because I mean,

you're seeing these cases just
just come together in an initial

NiTi wires and and it's fun, you
know, I I had had more

experience not with the dam and
ultimate system, but with

previous versions and things
like that with self-ligation.

And, you know, we we went
directly to the manufacturing

site Envista's manufacturing
site and, you know, Dr. Frost is

teaching us these new torques
and what to use them with. And

so it's been a learning process.
But it's, it's it's tried and

true. I have faith in the other
docs that have been using it for

for longer than we have. But
it's in no point in the system,

are we questioning, there's even
days where Dr. Grahl is not here

and I'm here. We don't have to,
we don't have to call each

other. And hey, why are you
doing this? You know, it's a

system that that we've created
together that works with

Orthobar that works with the
Damon Ultima system. And and we

just continue to move these
patients along. And the best

thing for us is, the patients
notice it there. I mean, we get

compliments where the older
siblings been treated with a

different system. And we get the
younger sibling that's just

starting out and the moms
already telling us you know,

Wow, are you know, we're six
months in? Are we almost done?

And we're like, no, like, let us
we haven't got to the final

touches yet. So it's been
wonderful.

Alison Werner: So can you talk
to me a little bit more about

like, what are some of the
features of that self-ligating

system that stand out to you
that make you know that it's the

right thing for you clinically?

Kory Grahl: Well, for me, it's
personal experience. So I was

actually treated by Dr. Frost
and Dr. Nichols, two mentors of

mine, and I can call now dear
friends. And it was in I've been

treated three times not to get
in my case, crazy, but they did

it. What I started noticing as a
general dentist on social media

is you see like once you start
diving into cosmetics or

whatever, you start to see
things pop up on your feed and I

started to seeing orthodontics
come in. And a lot of those

orthodontics, all I was seeing
was a front 6 teeth. Okay, well

doing veneers at the time. I
mean, I'm doing eight to 10

teeth for arch width arch
development. And and then I

started coming across Frost
Orthodontics' page, and I'm

like, that's different that
looks like a veneer like finish,

I need to go learn how to that.
So I don't have to prepare teeth

and all that. And then that's
when my case came forward. And I

started feeling how this
particular system worked, and

the efficiencies of it, and how
I could live in Vegas, but get

treated potentially there. And
we're not taking any extra

longer of time. And so it's a
personal experience that I

started to go, Okay, this this
bracket, this system is

different. And, you know,
there's a lot of other products

out there that do different
movements. But at the end of the

day, if you talk to the majority
of orthodontists, the most

predictable development side of
things is width and this system

gets width almost every now
almost every single time with

solid predictability where I can
go into console and be like,

very, very confident and say
like, No, we're sub-18 months.

And you're gonna be closer to 14
months first most cases, because

of other things that we believe
in that that's why our

philosophy works in that way,
which we won't go into

orthodontic philosophy, but it's
the predictability that it's

like, no, it, it works well 100%
of time.

Alison Werner: So, in turn, so
you talked a little bit there

about how it kind of creates
efficiencies, or, you know, cuts

back on the length of treatment.
Can you talk about how this

system kind of plays into kind
of the practice management side

or appointment workflow? Or that
side? Because we talked a little

bit about clinical but in terms
of that, how is it helping your

Brady Petersen: Yeah, I think
just with all the learning,

practice there?

growing pains of a startup, too,
I mean, we're, we're hiring new

employees. We're growing.
There's there's all types of

things like that. And so we're
building our systems from the

ground up. And a lot of these
assistants have never seen even

self-ligation let alone. You
know, we're teaching them the

Damon Ultima bracket and how
it's unique. For me and Dr.

Grahl, I think it gives us a lot
of opportunity to teach. We we

are not, you know, every minute
of our day is not filled with

orthodontic patients right now.
So we have we have that

opportunity to really nail down
our systems, make sure that

everyone's understanding it. And
from what I see, I think our

systems, I think they love it. I
think they you know, once they

get the opening and closing of
the doors, you know, we've

talked to them, the different
dimensions of the wire systems

are a little different and
unique. But but they grasp it

and I think, you know, once you
get your hands on it and you you

feel it, you know that it's it's
a it's a strong bracket, it's

it's a clean bracket. A lot of
our patients, the hygiene is

better. And so those are those
are positives that we see with

that and not a lot of I don't
see a lot of negatives as far as

like the learning process. It's
been very streamlined. And

they're able to pick up on it
fast. It's still orthodontics.

It's just different, but nothing
that can't be learned.

Kory Grahl: And to piggyback on
that, Alison, I think, you know,

with the two-doctor practice,
right? Having similar

philosophies is really helpful
for not just the patient flow,

like someone comes in on a day,
I'm here and Dr Petersen's here,

it doesn't matter. We're
progressing through treatment,

but also for a treatment
coordinator, to walk in there

and be like, okay, is this okay?
I gotta maybe talk about this

because Dr. Grahl leans this
way, or Dr. Petersen leans this

way? Is he going to use a class
2 appliance first? No, most of

our patients, it's, it's pretty
set, what we're going to do, and

it's really dialing the fine
tuning at the end, but there's

no real guesswork. When we're
speaking with patients about

length of treatment time and
stuff like that. It's not, it

can get a little out of whack if
you have multiple doctors in a

particular practice using a
maybe not so systematic type of

system, where it's like, okay,
what stage of treatment? And are

we in on this patient and then
checking notes. It's like, No, I

can come in. And I know exactly
where we left off and where we

need to go and vice versa.

Alison Werner: That's
interesting that you say that,

because I know I've talked to
other practices with multiple

doctors, and they talk about how
systems are important. But it's

rare that they'll talk about how
the products play into creating

that system. So you're kind of
what you're saying is like that

product creates a system that
creates the predictability so

that you can kind of bounce off
each other and I'm guessing

share patients if need be. So
that you have that you know what

you're dealing with?

Kory Grahl: Yeah, absolutely. I
mean, it's a, essentially a four

wire, NiTi series that we do.
And then the determination is

the art of orthodontics. The
finishing orthodontics is when

you finish, you pick your final
wires. And you know, we're

working on systems and in that
time as we're starting to get to

that stage in our practice, but
it's not, there's no guesswork

involved. We're very systematic
on when we take photography for

certain stages within treatment.
So that we know, maybe next time

it's set up with Dr. Petersen
for a Pan reposition. And he

you'll know and I'll know like
this is where we're going next.

If there's anything off track,
or unique to a certain case,

like we already know, our
systematic approach to things go

up, pick that up and then come
right back to where we were. So

there it allows us to deal not
deal but to do other things in

the business and on the business
in the startup rather than

worrying about, you know, crazy
amounts of the orthodontic side

of things because we know that's
going to flow efficiently and

positive with zero hiccups
because it's there's less

guesswork involved. It's just
understanding the final

treatment goal and objective and
smile really.

Brady Petersen: I like to that
allows us to what we tell our

patients is what they're coming
to us for is they want an

Orthobar smile. And that's what
we've that's what we branded our

smile as butter north of our
smile. It touches on all the

points. It's what a Damon smile
is right. And that's that's been

the great thing about it. It's
not that Dr. Grahl you know, he

comes up with Dr. Grahl smiles
coming up with Dr. Petersen

smiles and this patient like
this one a little bit better.

And we got to do a transition in
the middle. They're coming from

day one. Our treatment
coordinators know the

expectations are front knows the
next what the end result is,

should be and will be. And
that's that gives us a lot of

confidence to just tell the
patients from the beginning I'm

gonna get you an Orthobar smile,
you're going to absolutely love

it and and then you go from
there and and I've used other

systems before, it's not doable
it would in the end it would be

Dr. Petersen likes to do this
bend and and he always does this

trick and and you get those
curveballs, which is which is

great. I mean, that's what
orthodontics is. There's always

going to be that as you get into
it, but it really does help.

Alison Werner: So what would
your advice be? I was going to

ask how long have you guys been
in operation at this point?

Kory Grahl: We just hit our nine
months of opening so we opened

October of 2023. Yeah, we shook
hands in January '22. So it was

a it was a 20-month journey to
finally open the door..

Alison Werner: So since you are
so close to your start date,

you're not yet a year yet.
What's your advice to practices

that are especially I think,
multiple doctor practices that

are really just starting out in
terms of making a decision

around a bracket system

Kory Grahl: What would be our
suggestion?

Alison Werner: What are your
tips? Or what would you tell

them to consider if someone came
to you?

Kory Grahl: I mean, I would say,
I would say do your research. So

one of the one of the things
that I found very interesting

in, you know, one of this is, is
speak with your reps too. But we

were able to go to Envista
Summit. And one thing that I

noticed, particularly at that
summit, is it not to not to

dummy, orthodontics down or
anything, but all the finishes,

looked the same at the Damon
conference, and I sat there, and

I was like that, that's really
interesting. And it's very

different than other conferences
you go to that are using all

different types of products.
Because you all get all

different types of finishes. And
it was very interesting going to

that conference. And I'm like,
you know, they're in all

different levels of providers. I
mean, one year out, five years

out, 20 years out, 30 year
veteran, all their finishes look

pretty close to one another. And
they all looked spectacular. And

I was like, again, I need to
learn how to do that. And then

looking at, you know, my case,
and you know, Dr. Frost's social

media, who was a mentor, and Dr.
Nichols, I was like, it seems to

me that this system works. And
that's one thing that I found

very safe or rewarding is like,
Hey, I'm a newer practicing

clinician in the orthodontic
side of things. I don't want to

reinvent the wheel, I want to be
able to walk into a consult room

and be very confident in what I
tell my patients and seeing that

and seeing, you know, new grads,
and, you know, veteran doctors

and treating out the same and
these finishes are spectacular,

I'm like, that's, that's the
system that I think we go with,

but for people choosing I mean,
there's, there's so many, so

much information out there, you
need to get a feel, and you need

to get a feel for the trust of
your rep in your area. I mean,

we have a spectacular rep here
in Las Vegas, we have a lot of

excellent support from not just
Damon but the Spark rep genie

has been amazing. Our Ormco rep
Ryan has been amazing. Their,

their VPs have been great window
they haven't been able to fill

in. So I mean, it's just having
that confidence in a full

company, a full scope of
products that you have access to

that I think is critical. Rather
than this newest product, they

do it they've just started it's
working out sort of for some

practices, but you can't beat
time. I mean, they've been

around a long time. And that's
why choosing a system, I think

it comes down to proof like show
me the results not not a white

paper or a case report or
whatever, like, show me and if

you go to one of their, their,
their forums, you see it all day

long. It's all the same.

Brady Petersen: My advice would
be especially, I mean, it's hard

to do broad statements, but
whether you're a newer doc or

you've been out and been out in
the field, what what me and Dr.

Grahl we, you got to know who
you are first and so you make

your own goals, but I would say
anyone that tells you, no, you

can't do it. Or and you hear
that a lot with I mean, we're

we're in a whole different
generation with with huge

student loans and you're going
to start up a practice where I

know so many of my co residents
and colleagues everyone that's

all our dream right? Like I
mean, we want to be the owner of

your practice you want to use
the products that you want to

use you want I I'm I love
simplicity I love efficiency.

And so I'm naturally drawn to
I'm I would say I'm just drawn

to Ormco, I like it. So if if
that's something that you're

fighting from the beginning,
then then maybe that's not it,

but if if you're if you're lined
up and you know that you know

your goals are set in that those
types of things. That's where I

think it makes it makes the
choice easy, like like Dr. Grahl

is saying you're going to the
forms. And it fits right I know

that that's what I want. I know
That's what my patients want

need. And it's, it's just a
matter of what I need to do then

to learn the process, learn the
system, and then and then do it.

And anyone that says anything to
you, as far as, you know, cost

or time or how you're going to
make that work, anything like

that. That's, I would say that's
going against what ultimately

you're gonna get to, you're
gonna get to that crossroad,

where you're gonna say, I should
have just done it sooner. And so

do it from the beginning. It all
works out you can make you can

make it work out. So it's,
there's bumps no matter what I,

I have friends that haven't
started their own practices.

We've started our own practice
everyone's in, everyone's in the

same boat, do it. And also,
yeah, it's orthodontics is

awesome. It's a great
profession. So we're all going

to be fine. But you might as
well enjoy doing it. Well, while

you're going through the
process.

Kory Grahl: One other thing I
would suggest, yeah, you know,

people picking a product to you
I just thought about is, when

you do meet with the reps, do
they talk majority about the

efficiencies of their product?
Or do they talk about other

products, downsides. Because you
get that a lot is they'll come

in, and they'll you know,
whatever rep comes in, it's

like, Well, why do you want to
do X, Y, or Z? Because they do

that? Well, in reality, all
systems have something you have

to work around. I mean, so a lot
of systems are really good at

certain things. I'm not very
good at other things, whatever,

whatever. But I found that to
where if they start talking

about another product, that's
not theirs, because they think

theirs is more superior or
whatnot. That's a red flag to me

of like, okay, why is that
company in your head to speak

about that product? Yeah, it's
because are you not as good? Are

you trying to emulate that
products? And so I would say

that too, you know, because
there's, I mean, you have, you

have choices in today's market,
what you choose to use. And

again, like with Dr. Petersen,
it's you got to know yourself

and what you want to do. And I'm
very much the same. I like

simplicity, I like to know
exactly. I don't like having

surprises. And so I would also
caution that that of if a

company starts talking about
another company, then I would

say, Okay, start asking
questions.

Alison Werner: Yeah. Well, to
follow up, I was going to ask

you about kind of how you're
using your reps. And so you

talked about how you using your
reps at that early stage, once

you've got the product? You've
talked about how valuable you

found your reps, but what are
some of the things you're

turning to them for that they've
been able to answer for you or

helped make easier for you, as
you've been onboarding and just

kind of working through the
system the last nine months with

your patients?

Brady Petersen: Yeah, I think
our reps have been fantastic. I

mean, everything from the first
question, hey, we're starting to

practice. I got patients here in
30 days, what do I need? Not and

knowing that they, they
absolutely, it wasn't trying to

sell you all this extra stuff.
It was this is what you're going

to need. Here's all the deals we
have available for you, you

know, the buy one, get one
frees, the financing, let's make

this work for you. Yeah. You
know, new grad discounts, all

kinds of stuff like that. We've
gotten, and we were just on a

texting relationship, or we'll
text our rep after hours,

responds immediately. I mean,
just fantastic. And these are

questions that, hey, we got a
patient coming in, in the next

hour. This is this is something
we haven't seen. I remember the

first, with the first purchase
that we made. It was we were

still in that learning process
of how to deal with the the

anterior torques. So the
procline, retrocline, and we

ordered, you know, pretty much
the percentage wise was equal

amounts of both. And as we got
into practice, we're like, I'm

never going to use that one. I
think I'm in love with this, you

know, proclining the threes,
like, why do we need a

retrocline and or rep
immediately just replaced those

out. You know, no questions
asked. No, no, well, you gotta

keep that you bought it already,
you know, none of that. And it's

just absolutely let's, that's,
that's what's best for your

practice. That's what you're
using. Let's do that. So, yeah,

that's

Kory Grahl: It's one of those
things. It's like anyone, you

know, like, once you become part
of the Orthobar family that we

treat you as such, and to what
are you saying, I mean, our

representative Ryan, you know,
he's, you know, two, three years

into the orthodontic side of
things I and, you know, he's

been amazing, you know,
transition, helping one another,

you know, build this up. And,
you know, most people are like

you crazy doing a start up. I
mean, all of them were like,

Yes, do it. It's awesome. We'll
support you throughout the

process. Um, you know, and in
taking our feedback, too. I

mean, some, some companies might
be like, Well, you guys are

just, you know, fairly new
practice. But no, I mean,

they'll they'll accept our
feedback and say, like, Hey,

this is what we have going. And
this is how I think it could

help future startups on a
financial basis, or whatever it

is. But no, they had been
spectacular lunch and learns,

coming in training our staff
about Ormco's direct bonding, or

Spark Aligner therapy, or,
again, ticking anterior torque

selection, what's kind of
generalities and all those sorts

of things, so it's, it's not
anything that's like, oh, man, I

gotta, I gotta call my
representative today. Or, or if

they don't know the answer, this
is the best part. They're humble

enough to be like, you know, let
me talk to Dr. so and so. And we

will, we'll get you guys in
touch or I'll find out the

answer for you. I mean, how
awesome is that? And so

especially for, you know, new
practice owners and stuff that

you know, there's there's
certainly stuff we haven't seen

in there's stuff we'll future
never seen, right, that someone

has attacked. And so that's
where they stand and they're so connected.

Brady Petersen: They've
connected us to multiple other

Damon practices, other doctors
and just welcomed us into that,

to that community of the field.

Kory Grahl: And staff, and team
members are our treatment

coordinator came from a Damon
practice in Colorado, and she

moved here to Vegas, and is an
amazing, amazing person. And has

helped us tremendously on on
that side of things.

Alison Werner: Well, we're gonna
wrap it up there. I really want

to say thank you for joining me
and kind of talking about your

experience, just as a startup,
getting that going and then also

with the Damon Ultima system. So
thank you so much.

Brady Petersen: Well, thanks for
having us, Alison.