Welcome to the Group Dentistry Now Show, the voice of the DSO industry. Kim Larson and Bill Newman talk to industry leaders about their challenges, successes, and the future of Group Dentistry. Visit groupdentistrynow.com for more DSO analysis, news, and events. Looking for a job or have a job to fill? Visit jointdso.com. We hope you enjoy today's show. Welcome everyone to the Group Dentistry Now Show, I'm Bill Newman, and as always, we appreciate you watching us or maybe you're listening in. However, you consume a content that we put out there on this great podcast. We appreciate you because without great listeners like you, we wouldn't get these great guests like we have today. One of the faces is familiar. Sean Taylor has been on this podcast before. Sean is the director of special markets for air techniques. Good to see you again. Thanks for being here. Thanks, Bill. Great to be here. Yep. And then we also have Daniel Shoemaker. And Daniel has been in the industry. Do I have this right here? I saw something about 1974. So you have been in dental for a long time and we're going to talk a lot and get your expertise because you're also a board member of the NFPA, which some people might not know about. So find out what that is, why it's important to dentistry and why it's important to your DSO as well. So Daniel, thank you for being here. We appreciate it today. You also had a long stint at Accutron and also worked for a division, well, worked for a company that became part of Midmark as well. So a little bit about your background. Sure. Thank you. And thanks for the invitation here. I love working with Sean. We've been working together for the last three years on a lot of projects. And it's a real privilege to be here with you. I started as a service tech in 1974. I've referred to this often as my accidental career. I needed a job to support a wife and a new baby on the way. And it was just the perfect thing for a mechanical guy who had a good experience or a good background in electrical and plumbing and mechanical things. So I suddenly became a service tech. And I've been, this September will be complete my 50th year. So during that time, I was a service tech service manager, ran the International Service Center for a company called PDFs later on. We were bought by Frazier and became a media, later became matrix, three different versions of matrix and then midmark bodice and then next thing you do, I'm working at Accutron for 10 years and was able to introduce some really good products there. One of the things in my roles is that I've always, whether I was in service or sales, it didn't matter where I've always been directly involved with the vision of the future. What's the next product? Where are we going? Where's the industry going? And I focused, though I've sold and been involved with all aspects of dentistry, my real expertise is vacuum compressed air, nitrous anoxy. So those specialty plumbing things, that's my background. That's my richest part of my background. And then 19, oh, go ahead. Yeah, sorry, Dan. For those that are listening and don't know you, most people refer to you as the Godfather of nitrous. That's going to be the title of this. I've been called worse, but not better, right? It's been a lot of fun to open up catalogs and see products that I had direct contact with and to work with great people like Chris Wilson who had all those years at Porter and then working with me and that go two of us working together at Accutron. And now here we are, there are techniques introducing seed product line and what a great privilege to work with great people that have such a vision for all of it, for the safety or the quality, better dentistry. That's my favorite part of it. And so in 1994 I was invited to join the NFPA subcommittee on medical gas piping. His part of NFPA 99 and for many years was under chapter five. One of the biggest moments of my career was working with a great team in the NFPA committee and introducing the new dental chapter, chapter 15 back in 2018. It has been a major change in dentistry's acceptance of codification and safety code. It seems like dentistry was always lost in chapter five along with every other medical thing using different vocabulary, lots of confusion. And when we got chapter 15 dentistry, suddenly the ADA, everybody started to really look into the code and the code is written all for safety. So that's been a real fun second part of this career. Hey, Daniel, just briefly for some of the people in the audience who may not know what the NFPA is, it's really important to the safety of dental practices and medical practices. But what is this organization, you've been involved there for a while, so there's a lot of people who may not know who that is and why it's important to the industry. Well, that's a really good question. It's the National Fire Protection Association, NFPA. But it has extended the scope from not just piping, but a lot more towards piping and devices and patient safety. So it has become the standard code. There are other codes. There's a California code out there now, but it has many references over to the NFPA. If nobody's paid any on this committee, it is all voluntary, thousands of hours over the years for all of us who were there to try to make it safe for every, you know, man, woman and child in the United States, you know, feel like I need an apple pot and an American flag behind me. It's the standard code that says take all the incidents and all the things that have happened to patients across the country over these decades. What can we do to make it safer? And that's what this committee does is put together a safety code that says if you follow this, then your patients will have the greatest safety and treatment. And Danny, you've been a member for 30 years now. And to talk a little bit about the way, you know, you being on the board there advocate for dental practices, like what's what's your role and I mean, you are, how many people on the board are part of because this isn't just dental, right? This is dental and medical. Yeah, in fact, until just the last couple of years, it, when I first got there, it was Dave Wyrick from Old Cambiard was there for by himself. And then when I was appointed and joined in with him a couple of years later, he went and retired on me for a long time. I was the only person representing dentistry, then we had a doctor from the ADA join us and he was great help. And currently we have two or three people now with dental backgrounds, you know, Dr. Wong and the ADA's got a representative and myself that's at least the three of us that are directly attached to dentistry. And again, since chapter 15 was introduced, there is now a greater willingness for compliance. And I might just add something here, something happened in the late '80s, all across the country, almost every state, every state that we've been able to talk to so far, they passed legislation taking dental sedation out from under the local state sedation standards and put it under the state dental boards. But the state dental boards do not have any facilities for construction safety. So all of the things that the NFPA puts in place for construction safety, to say this is how you have to run the pipes, the kind of pipes you have to run, the kind of fitting you have to use, all of that, and how to be to installed by an AFSE-6010 medical gas installer and has to be verified by an AFSE-6030 barifier. All of those standards that are in there, there is a tremendous lack of oversight on the state level. So kind of tying this over to the DSO, we're seeing better compliance in the DSOs than we've seen in the standard dental, if there's such a thing in the typical dental office. Because the DSOs are looking at this authority having jurisdiction, which is them. And without very much oversight on many of these states, it's falling to the DSO and their people to seek out AFSE-6010s and AFSE-6030s and to find planners who understand these different categories of sedation delivery in chapter 15 to make sure that they're complying with the level of sedation that's being offered in the facility. Because there's a big difference between a nitrous oxide oxygen delivery and somebody who's going into deep and general sedation with general anesthesia or IV sedation, deep sedation. So that's where a lot of this comes to play, is that those safety standards are there in black and white, that if these are followed, your patients have the very best chance of good, safe delivery of sedation. Thanks, Daniel. I wanted to bring Sean Taylor in here in this next topic, maybe have you both provide some feedback there. But Sean, I didn't give you the chance for the people that didn't see the first podcast and maybe don't know you. Could you give the audience a little bit about your background and what you've done in dentistry and what you're currently doing for air tech? Yeah. No problem. I started almost 27 years ago as a distributor rep at Henry Shine, and today for the last six years I've been part of air techniques, the director of special markets work closely with some of the largest DSOs in the country. They put their faith in one of the most, the most important room in the office, the air and vacuum, the utility room, where we all know that it's usually out of sight out of mind until there's an issue. So we take a lot of pride in building the highest quality air compressors and vacuums in the market. And this addition of nitrous just fits our portfolio just tremendously, and we're excited to talk about later some of the new programs and the educational programs we have on board for our current customers and customers that want to join the air techniques family. Thank you, Sean. Talked a good bit about safety at the beginning of this show. So maybe here's a question. How many, do you have a feel for how many dental practices are using nitrous right now as a percentage? Sean? I have heard, you know, this is not official, but at least 35% to 40% of offices are currently using nitrous, whether it's a portable cart or it's directly plumped in the opertories. Gotcha. Okay. So it's still, it's still not the majority. And it looks like Daniel's got some input here too. So I'll give you one second there. But so we, so safety is certainly a concern or we wouldn't have brought it up. But why would somebody, a dental practice, a DSO want to actually bring nitrous into the practice or into their group for patient sedation and Daniel, go ahead. I just key off to something Sean said, probably 95% if not all pediatric practices have nitrous plumb, all the oral surgeons, most of the specialties here, endodontics and periodontics, you know, most of them have it. There's been numbers that say anywhere from 35 to 50% of all offices probably have it. It's also a growing segment right now because of the question you just asked. And it's got a tiny bit of complexity to it, but it's actually pretty simple. There is a cycle of anxiety among dental patients. And anxiety drives people different levels from just, they're nervous about it to outright fear and dread. And those numbers are anywhere from 35 to 90% depending on who you're talking to. But anyway, you spin it. There is a spiraling fear among many patients have had going to the dentist. And what's the result of that? Well, they don't go until they're driven there by severe pain. So it's a balancing act. How much pain is it before I finally go? And we all know what happens is that that tooth doesn't just heal by itself. So what might have started out to be a slight leap around the crown into the easeliner that they're taking care of is now an endo procedure or maybe even a complete removal and an implant. And the cost skyrocket because the simple solution was not followed. So taking this fear or this anxiety away from the patient by using nitrous oxide oxygen sedation, these patients are able to receive a sedation that has never been addictive. It has never had an allergic reaction in the history since way back in the 15th, 16th century. This medication, it is a medication of oxygen and nitrous is dispensed from the safest machines that we've ever had. And for probably the last 30 years, they have all kinds of safety factors in them that you cannot over an exercise of patient. So we've got a safe product that no matter how long they're on using it from five minute procedure to a couple of hour procedure, it does not metabolize in the body. It goes lungs bloodstream lungs out, lungs bloodstream lungs out, therefore five minutes of pure oxygen, it's out of the system, that patient is fully able to drive home. But more than anything, the anxiety has been reduced. The patient, the duration of the patient procedures have been known to be shorter. The stress on the staff to have anxiety free patients is, I mean, it's a tremendous benefit for the whole staff, but more than anything, because the patients are now losing their fear of dentistry, their willingness to follow the treatment plan is greatly enhanced. And now we see them receiving better dentistry, better healthcare by following these treatment plan. So we see a whole practice changes by the use of nitrous on the patients. There's many practices that operate to every patient, whether they pay or not, and not advocating which way or which not to do something, I'm just saying that practices where the majority of the patients are administered nitrous oxide oxygen sedation, that these patients are so much more willing to come and get their dentistry, they don't leave insurance money sitting on the table at the end of the year because they're too afraid to go to the dentist, which has been documented that it's a pretty high number. They refer friends and family, oh, you can't believe how wonderful this practice is, how well they treat me. I come out of there so relaxed, no oral medications, it's got this two cycles that spend, one, the fear and the anxiety, and the other, when you get rid of it, the increase of patient care, and believe me, when the patients get healthy, the practice gets healthy. Thanks, Daniel. It's interesting. We've got a lot of activity in the DSOs. There's always a lot of activity, a lot of M&A going on, but recently, in the past couple of months, we've seen some interesting moves by groups such as Sage Dental, we've seen moves by Stream Dental Management, which have typically been focused on general dentistry. They're acquiring pediatric practices and orthodontic practices. Those practices are probably already using, like you had mentioned, Daniel, nitrous, so there may be opportunities to bring these from just using them in a pediatric setting to using them in some of their other practices, and I'd like to get your thoughts on that because it sounds like oral surgery, endodontics, a lot of the specialty, nitrous, they're pretty comfortable using it, a lot of them are using it, but what about the opportunities beyond that? Let the hear thoughts on that. I got schooled by a wonderful dentist, and I apologize that I forget her name now. In Northern California, at the meeting probably 10 years ago, and she gave me all of the statistics on how she had changed her practice that every patient was given nitrous oxide, whether they could pay for it or not, and that at the beginning of the process that she was experimenting with, about 20% of the patients either paid or their insurance would cover it. After five years, that number was 80% were either paying or were covered by insurance, but it didn't matter. Any patients who couldn't pay or insurance didn't cover, she offered nitrous oxide to them. She came back to us and said that she was able to add an extra patient per day per room, and her five opportunity office suddenly had five, 10, 15, 20, 25 more patients per week. She says it's like she had a sixth opportunity without paying for a sixth opportunity. She was pretty clever, but she had her number, she had her statistics, and the amount of money that was coming in just for the cost of the nitrous was sizable of thousands of dollars between the cost of the gas and the cost of the nasal hood, but she pointed out that that was insignificant in the big picture, which was her patient's oral health had improved, and her profits from them following the treatment plans parallel to patient health. It's like this one thing benefited her. The patient got healthy, the practice got healthy. As we see them just making the decision whether they're going to pipe it or if they're going to put a portable in, that's one of your next questions, I assume. That can be a real big difference too, but we see that the offices that are catching on to the benefit of the nitrous in the practice, it is one of the best things they can do for their practice and their patients. What about objections? I'm sure the one, Dennis, that aren't using nitrous, what do you run into and maybe why is there some hesitation from certain clinicians? There's actually, it's been reported, I haven't been in the school class to hear it, but it's been reported that some educational facilities teach that nitrous is a crutch and that they're not a very good Dennis if they have to have nitrous for their patients. That's too bad in my evaluation or estimation because I'm discounting the patient's real anxiety, fear, and trauma. I mean, I tease people about it, but I'm serious as a heart attack, eight-year-old Danny Schumacher and Dr. Massero's office on North High Street in Columbus, Ohio opened the second story on the west side of the street in the right operator when I got my first injection from a needle back then that were not disposable, they were sharpened between uses and cleaned with scolds, cold sterile. It was so traumatic to me that even though I worked on dental equipment all the time, when I'm in the chair, I'm sorry, that was so traumatic, I yelled for my mother and she held me down. It's comical if you think about it, but when I sit in the chair, a certain amount of anxiety starts to come over me from that traumatic experience. And if you really were to have honest communication and question and answer with your patients when they first come in there, you would find that there's more of them that have these bad experiences than you can imagine. And it's up to 90% of the patients admit to some kind of level of anxiety. To say that your anxiety and your fear is non-admissible, it's of no consequence, is not respectful to the patient in a lot of our thinking. It's a true thing, and if I had anything else that was that high a percentage, think about the investment, if I had over 20% of my patients who had any certain condition that they shared, my practice would focus on a resolution of that. And here I have numbers that far exceed that, and many people just slough it off as unimportant. There's just too much in, you get the handbook of nitrous oxide by Morris Clark and Ann Bird Runic. This booklet really goes into detail as to how nitrous oxide can benefit the practice. And I'm sorry if somebody takes a fence at it, but I think it's one of the best things you can do for your patients. And you know, a certain amount of patients are a little macho, they may not even admit, like I just did my traumatic experience in 1960. You know, most people won't admit to that, but it's the reality, in more people than you can imagine. So my number one answer is that it's safe, it's effective, it's easy to use, it's so reversible. Five minutes of pure oxygen, it's out of the bloodstream, and they walk out and get in their car and drive away, safely, unimpaired. I don't know, there's very many medications that you can make that claim. And you also talked about the value of, or should I say, the, as we talk about same store sales growth and the opportunity at the practice level, when you said that the dentist had said it was like adding an additional operatory, or you could almost look at it as, you know, bringing in additional patients, patients that had stress that maybe wouldn't want to come in, or maybe are more comfortable to actually accept more treatment because they realize it's going to be a pleasant experience. So it really does add more revenue, and you talked about it being, you know, relatively inexpensive and easy to use, and you mentioned that handbook, I'm going to make sure we put that handbook information in the show notes for some of these clinicians that maybe haven't used nitrous before, but are interested in kind of learning out, and you have a team that can help as well. Sean, you were going to say something. Yeah, no, I was going to say one of the main objections I got back when I was selling the equipment on the distributor side was, you know, we didn't have the money up front to plummet in the operatories directly, or I don't want to put a flow meter, a digital flow meter in each 12 o'clock, it's just too expensive. There are so many different ways now that we can use portable carts, and by using the portable carts with tanks, that gets, that's, you know, that opens the door and gets you into nitrous if you're just in a startup and you're strapped for cash. But if you do have the money up front, it's always better to directly plummet, and Dan can testify to this that those e-tanks on a portable system, they are four times more expensive than the large tanks that are used in the back that are directly plumbed. So cost of ownership over time, if you can't afford it in the beginning, it makes sense to plummet in direct operatories directly into the operatory, and you could go two routes with that. So a portable cart with a flow meter that connects to quick connects in each operatory to reduce cost, or if you really expect to use it in each and every operatory, then go ahead and invest in the flow meters built into each one of your cabinets. And so this actually leads into a really good question, which is, you have flow meters that look like they're available in analog and digital, and let's say you're a DSL, and you're building a de novo. Do you have recommendations on which is better? I mean, do you go at analog, do you go digital, what are the pros and cons of each? You certainly have a lot of options out there, maybe that can be a little overwhelming for a DSL that hasn't really used nitrous before. Yeah, Dan, do you want to explain some advantages of our digital first? You know, I was saying that we've used for many years, and that if it's hard to use, they hardly use it. So there is a nice article by Don Hobbs that was in one of the regarding DSOs and setting up dental offices some years back, and he pointed out that setting up every operatory identical to the next was such a blessing and efficiency, because let's say they had the patient in hygiene, and they needed to have something done. The doctor comes in and checks it, and it's like instead of taking them to another room and having to turn that room, treat them in place, bring that trait and go to it. The hygienist goes to the next room, because maybe it doesn't have the kitty cat to hang in there or all the little things they like to have, but they can perform every hygiene procedure in any room and any dental procedure in any room. This plays into the concept that by having the gas plumbed every room and having the flow meter built into the cabinetry and having the hoses go under the floor and come up into and mounted on the dental chair, this has been the largest growth spurt in dentistry. As one doctor said, it was the single biggest improvement in nitrous oxide use in dentistry, since nitrous came out, and we started doing that, some of us, in the 1980s, but it was hard to get companies to catch on, and when Chris and I got to Accutron, we were given a full, you know, freeze wheeled, if you will, to go out and to find every dental chair we can mount it on. And now it is the preferred way of delivery. There's no longer hoses from this 12 o'clock unit draped across the patient's head. It goes against the class 1, 2, 3 of dentistry that the patient or the doctor should never go past class 3 movements, but should move around the patient's head instead of moving their head. And this whole concept plays into building it in to the cabinets, having the hoses come up on the chair and then draped over and onto the patient. It's so efficient, it's so easy, it's the opposite of hard to use, it's so easy to put it on every single patient, and then you start to see that cycle of anxiety break down. And now the whole practice changes, the whole mood of the practice changes when this occurs. And his numbers are real close, the latest numbers we had, Sean, are as much as 500% more expensive to use affordable than to use the built-in pipe system. And with the rapid depreciation that you can use, even if you put a lot of money in to building in and putting it in every room, within just a few years you have depreciated it and it's paid for itself. And then every year after that is just your profitability, but more than anything, it's the patient compliance with the treatment plan. I can't emphasize it enough. That's our biggest battle. How do we convince patients to follow the treatment plan? Now the nitrous oxide doesn't make them incapable of making good decisions, that's not the point. It gives them that relaxation and takes away the anxiety, it takes away the resistance, and now it's down to insurance and payment, et cetera. But we're seeing people's whole lives change as the appearances changes, their oral health changes, it's all based on being able to get the patients comfortable. Again, such a high number of patients with so much anxiety, make that go away, build it in every room, make it easy to use, and it's one of those things that pays itself back so quickly that no matter what the cost is, it's difficult to justify not doing. Daniel, what's with all this buzz around the new FlowStar nasal mask? Well, it centers on two main things. One is there are nasal masks out in the marketplace right now that have eliminated the breathing back, and they have actual holes in the things or holes in the masks that make it very easy for the gas to be diluted when the patient inhales, and sometimes exhales even into the room and it gets past the scavenging system. I'm not mentioning any names, I'm not looking for a liability conversation, but the standard way of delivery is with the breathing bag that is a reservoir that when the patient takes an inhalation through the mask, it brings the gas up, and we use the word hood, nasal hoods in our company. Some people say masks either way, we're talking about the same thing, but the nasal hood that we make at air techniques is German engineered and manufactured, and it is of a soft material that is so soft that we can't even package it by just throwing them in a bag in a box. We have to package them in a carton-style system. When we just throw them in a box, they kind of melt together because they're so soft that it's very simple to fit the patient's face. The first thing you notice when you look at this is that it's squared up on top, so that view of the anteriors, it doesn't have that big bulb over the top, it gives a better view. Of course, there is the pediatric and the adult sizes, and that's one of the first things they notice, the soft material that warms up and fits the face even better, no longer. It's on the patient, all of this makes for a real good fit, so when the patient inhales, they bring up gas from the reservoir back. There's another piece of it, and I'm going to just disassemble this right here real quick. The other piece, the big story, is this piece right here, this is the valve, and the purpose of this valve is when the patient inhales, it seals and forces you to draw the gas up from the reservoir back, but when the patient exhales, the valve opens easily. This valve is made of silicone and it's have a flat material. We see in many of the other nasal masks that are out there, that there are a round-dist material that comes off of a big roll, and they get what we call a potato chip effect to them, to the point that they don't seal up. The simple process of taking the nasal hood, you know, like this and putting it up against my face and sealing off both sides to see how well that fits. I've done this with many other nasal masks by other companies, and when I do that, I can't get it to seal against my face because there's so much leaky around here, or leaky around here. So our story is we have superb sealing to the face, we have superb sealing of the valve, we have great visibility with the flattened-off piece of the outer mask, and this is really why the conversion rate for this product is so high. It's not the cheapest on the market, I'll give you that, but we're telling people to turn their nitrous down about 20% from what they're used to giving when they start a patient on this new nasal hood, because the first complaints we had is that for some reason when they used the air techniques in nasal hood, the patients were getting sick. Well, there's nothing here to make them sick. What was happening was they were getting the full nitrous setting. There was nothing leaking air in and out of these at the valve or the mask, you know, where it fits on the face, so suddenly patients who they've been administering nitrous for years were getting the full effect, none of it was being wasted, less being blown into the room, less being blown down the scavenging, just taking the money and throwing it out. It's so much more efficient, and that's the reason why this nasal hood is starting to get such a good, strong following. So, Sean, what is your team doing, really, to help DSOs implement a nitrous strategy? What is your team, what are you doing, what's the role of air techniques to really help DSOs, and to figure out how to make this work and get more patients in and get that treatment acceptance up and create that overall general better feeling at the practice, right, increase the culture there. Yep, you know, with the interest rates going up and not seeing as many de novos, like you mentioned earlier about strain in them, maybe acquiring other specialties, we're seeing, you know, this, especially the last year or so, where the novos are down, and just because access to money, the rates are up, and so we're seeing a lot of DSOs focus on same-store sales and revenue, and what a fantastic way to increase revenue and case acceptance is to implement a nitrous strategy from top to bottom of the office, you know, whether you own 10 offices or 800, consistency and compliance across all of your offices is pretty much the most difficult thing. I think if you talk to any COO or clinical director of clinical affairs, and how do we educate the frontal office, how do we educate the dental assistant, the hygienist and the doctor to be on the same page and to treat the patient like they want to be, like we want to be treated and to be consistent day in and day out, patient by patient. So one of the programs we have put together from a special markets team is a customized solution based on the needs and wants of a DSO, and we've done several of these already where we've gone live like we are right now and trained key staff members on how to present nitrous, whether it's in hygiene or restorative, how to seek the patient and go ahead and get the commitment for nitrous that day, whether you're charging for it like Dan said earlier or you're doing it for free on every patient, whatever it is, just be consistent with it and use it day in and day out. There's so many times I walk in an office and I see a card in the corner, there's no tanks on it or they said network, we just don't use it anymore, but it could just be simple as they had some turnover with the staff and these new staff members don't know the policies or the procedures, so it's important to keep educating from the top to bottom down every person in the organization and hopefully that turns into a more happy patient and they keep coming back and tell their friends like Dan mentioned earlier. Thanks Sean, as we wrap this podcast up and you kind of, maybe if you were just listening to the audio version, Daniel was doing a little bit of a demo so you're going to have to jump over to YouTube and check that out, but Daniel, if people want to get in touch with the godfather of nitrous, what is your email address so they can reach you and if they have any questions about the flow star nasal mask or you just want that 40 years of knowledge or is it almost 50 years of knowledge, right? Okay, sorry, it's almost 50 years. How do they find out? How do they connect? I might have forgotten 10 years worth there all of a sudden. It's easy, Daniel.shumaker@airtechniques.com, but the best way to do it is work through Sean's team. He's got a really good team on the ground, work with them. They know a lot of it and then they funnel upwards to myself or to Chris as needed. That's the easiest way to do it. Sean, if anyone in the audience wants to reach out to your team or you to find out more, how do they do so? Sean, if anyone in the audience wants to get in touch with your team, find out more about nitrous and how it can be useful in their DSO or just, I know your team's had a lot of the different shows, but if they want to reach out, is email the best way, is there contact information on your website, how do they get in touch with you and your team? Yeah, you'll find it under special markets on our website and we'll also put it on the screen here for you. You can also call me directly at 516-780-1374. We would be more than happy to schedule some time with you and the clinical directors of the organizations and put together a customized program, an educational program for each one of you based on what you want in your practices and how you want to execute this new nitrous strategy. Thank you, Sean. Thank you, Daniel. Thanks for having me. Yeah, and please, if you heard Daniel speaking and he was doing a lot of show and tell, so you're going to want to jump over to the YouTube video and make sure you watch this so you can see the nasal mask, the flow star, and what he was demoing there. So I'll drop that in the audio show notes so you have access to the YouTube video and I'll give you Daniel's contact information and we'll get you access to Sean and his team as well. So great. Great hour of education here. We're going to make sure that we have a lot of our clinical directors on this podcast, they're paying attention to this, and I think even the people I think on the executive side of things that maybe are interested in nitrous, haven't used it in a lot of the practices, or maybe have a couple of pediatric practices that are using it and looking for the benefits beyond just PEDO and some of the specialties. So until next time, I'm Bill Newman, and this is the Group Dentistry Now Show. Thanks for watching. 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