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Episode 2-
Dr. Douglas A Young

Doug Young on Building a Vision and Revolutionizing Dentistry

Tooth decay, or dental caries, is the number one disease dentists treat. Yet, the common practice of drilling teeth does not cure the disease. Dr. Doug Young was one of the first to ask a seemingly simple question: If drilling does not cure the disease, why does it remain the first, and often only, option? Finding the answer led him to establish one of the pillars of modern dentistry.

 

Dr. Young describes his younger self as a "normal dentist." Not a famous researcher. No impressive background. He sought advanced degrees, determined to make real changes in the lives of patients. Thanks to his work, the outdated 'drill' and 'fill' approach to dentistry is increasingly replaced by cariology, a study of decay that includes treatment, prevention, and interruption of damage.

 

His work has directly impacted the organizations that worked to bring this change to light. Dr. Young is one of the founders of the Caries Management by Risk Assessment Coalition or CAMBRA, American Dental Education Association, Cariology Section, and the American Academy of Cariology or AAC.

 

Today, Dr. Young discusses how his experiences early in life shaped the man that he is today. His success is a testament to the selfless pursuit of knowledge for the greater good. He also reveals the origin of his love for the outdoors.

Resources

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Dr. Kim Kutsch on LinkedIn

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Dr. Doug Young Bio

American Academy of Cariology

American Dental Education Association

Caries Management by Risk Assessment Coalition

What's In This Episode

  • What impact did mentorship have on the trajectory of Dr. Young's life?

  • How Dr. Young saw where her wanted to be and made a plan to achieve his vision.

  • Why the infrastructure around patient care needs to shift from 'pay per tooth' to preventative care.

  • A deeper look into the heart of Dr. Young.

Transcript

Recording:

Extraordinary.

Innovative.

Integrity.

Honest.

Courageous.

Curious.

Thoughtful.

Brave.

Unafraid.

Dr. Kim Kutsch:

There is a place where technology and art meet, where work and play are one and the same. When the threads of curiosity are pulled in this place, the spark of innovation ripples across industries. Those who make this place their home are giants, titans who pursue creative passion while leaving their mark.

Recording:

Creative.

Flexible.

Brilliant.

Clever.

Confident.

Dr. Kim Kutsch:

They are courageous thought leaders set on changing the practice of dentistry and their corner of the world.

More than the sum of their parts, we deconstruct the traits that bind these uncommon innovators.

Opening voiceover:

Humble.

Daring.

Disciplined.

Playful.

Principled.

Spontaneous.

Dr. Kim Kutsch:

To discover what makes them contrary to ordinary, where we explore the extraordinary.

Hi there. I'm Dr. Kim Kutsch, host and founder at CariFree. I'm fascinated by what makes the paradigm shifters, world shakers and art makers tick. Let's embark on a journey. Extraordinary is a place where ordinary people choose to exist. Together, we will trek the peaks of possibility, illuminate the depths of resilience, and navigate the boundless landscape of innovation to discover how some of the most innovative dentists and thought leaders unlocked their potential and became extraordinary.

On this season of Contrary to Ordinary, we explore the motivation, lives, and character of the innovators who see limitless potential around them, the people behind some of the largest paradigm shifts in the practice of dentistry.

Dental caries, or tooth decay, is the number one disease we dentists treat. Yet before Dr. Doug Young and the councils he co-chaired, no advanced section was dedicated to managing and treating dental caries as a disease. A visionary with a passion of change and industry, Dr. Young is one of the founders of the Caries Management by Risk Assessment Coalition, or CAMBRA, American Dental Education Association, Cariology Section, and the American Academy of Cariology, or AAC. Thanks to Doug, cariology, which includes the interruption and prevention of damage to the tissues of the teeth, is replacing the outdated drill and fill approach to dentistry.

Innovators don't set out to make little changes. They're visionaries who want to change the world, or at least their corner of it. Doug is no exception. While attending a lecture, he heard a prominent caries management reformer ask a simple question that cracked open the door to a new way of thinking.

Dr. Doug Young:

Treating disease with the drill is not treating the disease, so why am I only drilling teeth? So I felt uncomfortable because I really got into dentistry, like all of us, to help people, and if we're just fixing something and not looking at the root cause of what's causing it, I didn't feel like we were doing the right thing for the patient. So I started getting more education. And the second thing is, like all dentists, I didn't want to lose my hearing, and that was a problem with me because I got my hearing tested and my hearing was dropping precipitously. And so I was looking for maybe another crack in the door to see if that's the way I should go. So as I learned more about it, I got more interested in it.

And all these degrees, believe it or not, were well thought out to try to move the profession in a different direction. So I thought, well, of course, getting my MS and specializing in cariology with John Featherstone was going to be a great professional help to me. It would give me the knowledge to change the way people are practicing. And then the MBA, of course, innovation, leadership, all the training for the MBA was tremendously helpful. And then finally, the doctorate. I wanted to get this disseminated through dental schools across the country, and that's how I became interested in that degree.

I live among giants like you, Featherstone, other people that really change the world. And my goal is just to use that information and to try to make life better for people, just one patient at a time. And don't expect it to happen overnight, but you can make a difference just one patient at a time. That's all it takes. Because if you don't treat that patient in your chair as a person, the way that you would treat your own loved one, you got to ask yourself, well, is that okay with you?

Dr. Kim Kutsch:

So, Doug, looking at your career as a dentist, as a dental professional, because you're not a "dentist", you're a scientist, you're an educator, looking at your career in the big picture, what would you consider your greatest accomplishment?

Dr. Doug Young:

I think, overall, the umbrella is the dream of changing the way people practice actually started to happen. In hindsight, when we began all this journey, we didn't have optimistic hopes that this was going to happen anytime soon. I thought, I'm going to be dead before this happens, right?

Dr. Kim Kutsch:

Well, dentistry, I mean, we kind of have a very slow adoption curve. I think we're more careful and thoughtful about when we make major changes. Obviously, there has to be disruption. We have to make progress. But as I look back on our educations in that, it was always... I mean, the first thing I was taught was, "Well, there's a new material. Let me see your 15-year study," right? Well, there's not a material that even has a lifespan anymore of 15 years hardly. And those studies have become so expensive to conduct, particularly clinical trials, that it's like, now we're sitting in a situation where there's a new material, it's brought to the market, and we have to make a decision, really the 15-year clinical trial we're doing on our patients.

And so it's interesting to me, looking back at where we've come from and then how we make change in the profession. And I would say, we're maybe sometimes a little too cautious, because certainly, what you've brought up, the whole concept of making people healthier, treating the disease rather than just treating the signs and symptoms, treating the cause, rather than treating the kind of end result of the disease, which is what we've traditionally done in dentistry. And that's a huge paradigm shift.

Dr. Doug Young:

Yeah. No doubt.

Dr. Kim Kutsch:

Yeah. I think you played, I think, a very important role. You were on the committee, ADEA, that helped kind of create that standard for caries risk management in the dental education process, which is kind of training our future dentists on how to look at treating causes, taking a step back and treating the cause of disease, rather than just drilling and filling.

Dr. Doug Young:

Yeah. No. The organized dentistry is, when you say one of my accomplishments, I'm very proud of because I was just a normal dentist. I wasn't a famous researcher. I didn't have the background to make change in this process. So I thought, well, how would I be able to do this? And so being a dental educator, being involved with ADEA, American Dental Education Association, was one way to make change. And back then, they had no section on cariology, believe it or not. There was nothing about treating disease of dental caries.

Dr. Kim Kutsch:

I mean, it's the number one disease in the world. This is the number one disease that we treat as dentists. And the fact that there was no section on cariology at that level seems kind of crazy to me when I stop and think about that.

Dr. Doug Young:

Yeah. So we immediately got to work on that, and we started our first cariology section that is still going today. And same thing with the ADEA. I feel one of my accomplishments is just to be lucky, to be blessed that I was asked to be on the council because I didn't deserve to be there. I was not a researcher. I was a general dentist. I practice on patients. So-

Dr. Kim Kutsch:

Okay. We're going to let that one go, Doug, because certainly, of all the people that are on those types of committees, you deserve to be there, if anybody that I know deserves there.

And I would say too, Doug, I would tell you, looking from the outside, but not really the outside because I was kind of on the inside of the whole CAMBRA movement with John Featherstone and you, a lot of people early on, 20 some years ago. I felt fortunate because I was a hundred percent clinician at that time to be able to be participating in that. But I would say, Doug, literally, what I see happening in caries risk management and that whole philosophy of care would not have happened but for you and John Featherstone. A lot of names that we could add to that list, but really, Doug, I can't picture it happening without the two of you moving that whole thought process forward.

Dr. Doug Young:

Looking back, I think you're right. And I think we made a good team because he was that world-renowned researcher in caries, but he was a chemist. He wasn't a dentist. He didn't treat patients. And what I brought to the table was, I took his knowledge and tried to put it to clinical use, which at that time was unheard of.

Dr. Kim Kutsch:

Right, exactly.

Dr. Doug Young:

And ultimately, that's why the ADEA said, "No, we need you on the council because you treat patients."

Dr. Kim Kutsch:

It's hard to imagine the dental industry as we know it without Doug's guidance and vision. But he did not start out life wanting to be a dentist. Instead, his father laid out clear options.

Dr. Doug Young:

He said, "You're going to be a doctor or you're going to be a lawyer." He was guiding me to try to get a better life than he had. So he gave me those two choices. And I started looking at both those things and I'm going, "I like medicine, but I don't know if I want to be around sick people all the time." So in high school, I remember getting introduced to dentistry and I just thought, "Hey, that's a doctor, and they don't have to see really sick people that are going to maybe pass away on you, and then you have to deal with that."

I've always liked to work in my hands, and traditional dentistry is like, "Oh, a lot of hand skills. This is like wood shop. I love that. That's cool." So I said, if it's meant to be, I'll take the first step. And if it's meant to me, the door will open for the second step and the third step and the fourth step. So I just kept taking one step at a time and there was no red flags. There was nothing that said, "Don't do it." So I just kept going.

Dr. Kim Kutsch:

I know your dad has a very interesting life story, and that was really foundational for you. What happened to your dad, how he came here, where they're from, and actually, where you grew up as a child and how that might have influenced you as becoming who you are today?

Dr. Doug Young:

So I'm Chinese, I'm Asian American. And he came, at age 13, with his father to take care of him, with the sole purpose of his father making money, trying to get a better life for the family in China. And the plan was, if he were to get funds, he would send back the money and get them back to America eventually. So that was a plan. And one year after he got here at age 12, his father passed away. So he was basically homeless in Chinatown in San Francisco at the age of 13.

Dr. Kim Kutsch:

So he is 13. He is in a foreign country. He is basically orphaned in a country that he didn't speak the language, and he's on his own and he is homeless. I can't imagine.

Dr. Doug Young:

Well, it's more amazing because I didn't know a thing about this. I learned of this at his death. Somebody at the memorial stood up and talked about his early childhood, and I'm going, "Oh my gosh. Why didn't he ever mention this to me?" He had every opportunity to jab at me when I wanted a new bicycle or something. He could have said, "Hey, I was homeless at 13."

Dr. Kim Kutsch:

What happened to him after that then?

Dr. Doug Young:

According to the story that was told, he was selling newspapers on the corner in Chinatown, and his elementary school teacher walked by and asked him, "What are you doing? Why are you on the street?" And she took him in basically. And then his life was meager as far as he didn't have the opportunity to go to college. He picked fruit with the farm workers to make some money. He immediately joined the Naval Air Station to serve the military.

And there was another story that he told at the memorial where he fell off a plane that he was fixing and broke his arm. And the next week, his platoon shipped out and not many of them came back. So another amazing story that made you wonder, this was not all by chance.

Dr. Kim Kutsch:

Growing up, Doug saw the great outdoors through the reflective glass of the television in his parents' home. He was captivated.

Dr. Doug Young:

I wanted to do that. I wanted to go hunting. I wanted to go fishing. I wanted to shoot guns. I wanted to be in the outdoors.

Dr. Kim Kutsch:

There was only one problem.

Dr. Doug Young:

My family didn't do any of that. We had no tradition for that. There was no way for a young kid, no matter how much he begged his parents was to take him out camping or something. My parents were smart. They got me into scouting. I was in the Boy Scouts, eventually got my Eagle Scout, and my mentor for my whole young life was my scout master. His name was Dr. Albert Bowles. He was a tremendous man. To this day, don't know of a better man that I could have as my mentor. He was an elderly scout master. A lot of the scouts made fun of him because he was so old. But the people in our troop, we really stood up for him because he would have the best heart. He taught us the best morals. We knew right from wrong. He took me out every weekend. I was bird watching with him. The scouts, we did something every weekend.

Dr. Kim Kutsch:

Well, you were doing a lot because it's not an easy accomplishment to become an Eagle Scout. I mean, there's a long list of things required to be able to qualify for that.

Dr. Doug Young:

Right. But he was also a MD, so he really guided me in my career. And I remember, when I finally got to dental school, he was pretty proud.

Dr. Kim Kutsch:

In today's society, maybe we kind of underestimate the value of having those kind of relationships and mentors. Obviously, he played a tremendous role in influencing your life and where you ended up.

Dr. Doug Young:

He was like my second father.

Dr. Kim Kutsch:

Doug is able to look at the dental landscape with uncommon clarity, see a problem and push for innovation. And while he is proud of how far the industry has come, he remains an unsatisfied visionary who sees opportunity for growth around every corner. He worked hard to make cariology a widely recognized treatment for tooth decay. However, it is not the standard of treatment in most practices, a frustration we both share.

Dr. Doug Young:

Because of the reimbursement system we have, the fee for service, if they don't drill a tooth, they don't get paid. They don't get paid to prevent. They don't get paid for their time to do risk assessment and the products that need to be dispensed to patients. How do they get paid for? That's not moving fast enough for me.

Dr. Kim Kutsch:

Well, there's a huge headwind against us in that regard from the standpoint that, if you're not a practicing dentist, you can't appreciate what a huge paradigm shift that is to get away from just identifying cavities and drilling and filling them, to backing up to say, "What's causing these cavities? And let's treat that," because that's not how we're really... Well, we weren't trained in dental school, and so most of the dentists practicing today weren't really trained to think that way. And then you get out there and you don't have that whole support of the infrastructure around you that helps create that shift or that change in practices in philosophy, so I'm frustrated by that as well.

Looking back over the last 20 years, I thought it would go much faster than it did. But at the same point in time, I think one of the things I identify in exceptional people are that, they tend to be visionary. They tend to see things that other people don't see. And so, you see a future for the profession and for how people are treated or outcomes, et cetera, that we haven't fully embraced or been able to accomplish yet. So I think, that visionary part of you, I can understand you being a little disappointed at how long it takes. And quite frankly, it's probably a generational change. I mean, this could take 30, 40 years, really. But the good news is, the change has started, right? The ball is moving.

Dr. Doug Young:

Well, I think we're at crossroads, because medicine clearly has seen the value of this method. They're going into person-centered care and how to make people healthier, more of a value-based model of reimbursement. So if dentistry was smart, they'd keep an eye on what medicine is doing, and instead of going their own way, maybe looking at that model, because truly, from a public health standpoint, that's where things are going to happen.

Dr. Kim Kutsch:

That's where we need to go to get our population healthy, and I appreciate your thoughts on that. I would also argue back that medicine hasn't gone there very far because there's a lot of traditional medicine yet that's still just looking at treating symptoms and not really getting to the core of like, why do you have diabetes? Because those aren't conversations that are, I think, comfortable to have. It's easier to hand somebody a prescription, "Here, take this for your blood sugar," rather than talk about, "Well, let's talk about exercise and diet, and how your lifestyle is maybe influencing this disease." And physicians, I don't think we're quite there yet.

And the same thing. There isn't an infrastructure to support that. They don't get paid to sit down and counsel somebody or coach somebody on lifestyle type issues. So there's a lot of change that needs to occur. But for me, I see opportunity. But again, while I'm frustrated on the timeline, I think that it will happen, and at least we're headed in that direction. But it's probably going to take longer than, certainly, I thought it was going to take.

Dr. Doug Young:

Yeah, no. I totally agree with you. I can't even find a doctor, a medical physician that will treat me the way I want to be treated.

Dr. Kim Kutsch:

Right. And at this point in time, you have to demand care, the care that you want.

Dr. Doug Young:

Or travel long distance.

Dr. Kim Kutsch:

Or travel long distance to, in fact, maybe to Spokane, that one of those people there is going to be on this podcast, which I think everybody will find interesting.

Doug, so where do you see dentistry in five years or 10 years down the road then?

Dr. Doug Young:

Oh gosh. I think we're on a good trajectory to get to value-based care and to get rewarded for making people healthier. I think we're really close to making that shift. How do we do that? I'm not quite sure. I think we need to start more collaboration, tag team with medicine, because a lot of these public health oriented clinics and organizations are partnering with medicine. We're trying to get other people other than dentists to do some of the preventive care work. They're trying to expand duties for dental hygienists. And the development of dental therapy, I think, is huge for populations that won't normally get care. I'm heavily involved with those things.

Dr. Kim Kutsch:

Doug is passionate about the future of dental care. His interests extend well beyond the world of dentistry. He still likes to get away from it all.

Dr. Doug Young:

Being outdoors.

Dr. Kim Kutsch:

Just being outdoors.

Dr. Doug Young:

Being outdoors. Hunting and fishing are my top two.

Dr. Kim Kutsch:

Hunting and fishing. Anything in particular in that? Is it fly fishing or trout? Warm water?

Dr. Doug Young:

Kim's laughing right now, you can't see it, but he got me into a majority of the hunting and fishing I'm doing right now, so talk about mentors. You're one of my heroes as far as that. Taught me a lot about hunting and fly fishing. I was always a good bass fisherman, but you brought me to the level of fly fishing that I'm continuing to learn.

Dr. Kim Kutsch:

Yep. Nope. You are an incredible shot, Doug, in the field, and you are a great fisherman. I would certainly say that about you.

So what's one thing about you probably that people don't know.

Dr. Doug Young:

If I had to get a little sappy for a minute, I would say, people don't know what's in my heart. Getting back to the early days that I talked about. When I was growing up, I lived in Oakland. I learned right and wrong, but I wouldn't say I grew up on the streets. But there were a lot of kids out there that were my friends that we did sports together, and there was a lot of trouble on the streets at that time. So I got really introduced into a lot of diverse ethnic communities, and that's one of the positive things about growing up in Oakland. I just love it. We had every kind of culture there was.

Unfortunately, I didn't have a background, as a child, a religious background, so I didn't know God. And so I grew up on the streets where there were kind of no rules. And it wasn't until dental school that I got interested in researching, well, what is really God all about? So that's when I became a Christian. And when you compare my early life before knowing Jesus Christ, to the life after that, that's where my heart shifted. And a lot of people don't know that about me, because if you grew up with me when I was young, that's who I was, Doug before Jesus Christ. And then afterwards, little different person in the heart. I'm still struggling to be better, but at least in my heart, there's a big shift there. So I think that's something most people don't know about.

Dr. Kim Kutsch:

So spirituality is a really important piece of who you are.

Dr. Doug Young:

I think it's, yeah, it's-

Dr. Kim Kutsch:

At the core.

Dr. Doug Young:

At the core.

Dr. Kim Kutsch:

Right. So what do you have kind of career goals for yourself for the rest of your career at this point in time?

Dr. Doug Young:

Oh gosh. Like I said, I'm working on implementation right now. I'm trying to help people. Anybody out there that is listening that needs help in setting up, because I know how to do it, I can set you up so that you know how to treat disease. And it takes a lot of different things that I've learned over 30 years. So I'm trying to help clinics and practices that want to implement this today, and not wait for more research to be possibly or not possibly done.

Dr. Kim Kutsch:

Right.

Dr. Doug Young:

I'd like to do that right now.

Dr. Kim Kutsch:

Doug, if you could go back and talk to the 25-year old Doug or the 30-year old Doug, what kind of advice would you give yourself? Now that you're in your sixties, looking back 30 years with your life experience, what kind of advice would you give yourself as a young person? Is there anything you would say, "Doug, here's a piece of advice. Let me bend your ear here."

Dr. Doug Young:

Yeah. Again, you're getting into deep in my heart, but if I had the traditional dream, if I had to do it all over again, what would you do different? And I think the Doug Young that is post knowing Jesus Christ, I would go back and I would correct every wrong that I did, that I know I could have done better. That's what I would do.

Dr. Kim Kutsch:

Paradigm shifters and innovators like Doug never stop learning and care deeply for the people they serve. And they make time for their hobbies that ground them. As Doug has shown us today, extraordinary people tap into their curiosity. They identify and then pursue what lights them up. For Doug, early on, it was the great outdoors, a pasttime he still enjoys today.

Doug chose to innovate. He made the choice to shift the paradigm. He didn't wait for permission. He saw a problem, how he could help, and then got to work. No matter how far he leads the industry, he knows there is more to do. He looks at the progress made and refuses to rest on his laurels.

Thank you so much to Doug Young, dental practitioner, educator, and avid outdoorsmen for helping grow our community of extraordinary minds. And thank you for coming on this journey with me today. Around here, we aim to inspire and create connections. We can't do it without you. If this conversation moved you, made you smile, or scratched that little itch of curiosity today, please share it with the extraordinary people in your life. And if you do one thing today, let it be extraordinary.

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