Smile Design with Dr. John Nosti

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Smile Design with Dr. John Nosti
by Chelsea Knorr, Editor, Dentaltown Magazine
Dr. John Nosti has become a well-recognized name among dentists in the last several years. From his presence on Dentaltown
to his co-taught Clinical Mastery Series, he's always seeking to
become better at dentistry, something he is already good at.
Herein we talk to Dr. Nosti about what motivates him, both inside
and outside the office.
Dr. Nosti, why did you go into cosmetic dentistry?
Nosti: Early on I recognized this was an area I wanted to
concentrate on because of the happiness it brought to patients.
Going through school we are taught that everyone hates the
dentist. When we start practicing we realize that many patients
are fearful and do express how much they dislike their visits,
regardless of how many times they have had great office visits
with you and how much they like you personally. Cosmetic
patients have an entirely different experience and outcome.
Their energy level is so much different during the process and
once they achieve their desired result. Having that level of effect
in someone’s life is deeply rewarding.
What drew you to cosmetic dentistry?
Nosti: It was seeing a before-and-after, close-up retracted
view of eight maxillary teeth in a journal. I thought it was the
coolest thing I had ever seen.
What’s your practice like? How is the layout?
Describe a normal day.
Nosti: I practice the majority of time in my Mays Landing,
New Jersey, location, which for the most part is a blue collar,
working community. I think most dentists would not believe
you could build a “cosmetic” based office in my area. We have
six ops in the practice and the average day is usually a mix general restorative, new patient exams or consults, and hygiene.
Tell us a little about your practice philosophy.
Nosti: I believe in treating patients as if they are my family
members. My staff ’s goal is to exceed patients’ expectations, to
be courteous, friendly and caring. When a new patient comes to
our practice, one of the most common things we hear is how
kind and friendly our office staff is. Most medical practices I feel
have forgotten this.
Photography by Diana Pappas Photography
Name: John Nosti, DMD, FAGD, FACE, FICOI
Do you have partners or associates?
Nosti: I have two partners, Drs. Milton Noveck and Steven
Katz. Steve is retiring in 2014 and we are fortunate his son
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Graduate From: University of Medicine and Dentistry
New Jersey Dental School
Practice Name: Advanced Cosmetic and General Dentistry
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Office Highlights
Bonding Agents
ExciTE – Ivoclar Vivadent
Prelude – Danville
Burs
Brasseler
Cements
SpeedCEM – Ivoclar Vivadent
Variolink Veneer – Ivoclar Vivadent
Impression Materials
Honigum – DMG America
Virtual – Ivoclar Vivadent
Laboratories
Gold Dust Dental Lab (fixed)
Precision Dental Restoration
Signature Dental Studio (removable/hybrid)
Patient Financing
Springstone
Restoratives
Filtek Supreme Ultra – 3M ESPE
Filtek Z250 – 3M ESPE
IPS Empress Direct – Ivoclar Vivadent
Tetric Ceram Bulkfill – Ivoclar Vivadent
Technology
Practice Location: Mays Landing and Somers Point, New Jersey; and
Manhattan, New York City, New York
Practice Size: Six operatories
Staff: 10
Website: www.CosmeticDentistryofSJ.com and www.SmiledesignNYC.com
Bien Air Electric Handpieces
Brasseler Electric Handpieces
Canon 60D
Digital Radiography
EMG Jaw Tracking
Joint Vibration Analysis
MLS Laser
Picasso Laser (AMD/Dentsply)
T-scan – Tekscan
Versawave Laser – Hoya ConBio
TMJ
NTI-Tss
TMJ Quick Splint
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Back Row: Theresa Bruno (L), Alyson Assadourian, MaryLynn Reed, Kathleen Cericola, Charlena Walker-Nichols, Carolee Krasnov / Front Row: Dr. Steven Katz (L), Dr. John
Nosti / Not Pictured: Jodi Sexton, Julee Standhope, Debbie Riley, Lisa Noveck, Dr. Milton Noveck
Bryan is joining the practice. I would not be able to practice the
way I do and teach without having the partners I do.
New York is second only to California in number of
practicing dentists. How do you set yourself apart?
Nosti: My home base is still in New Jersey. The reason why
I started practicing in New York City is to challenge myself to
be the best in my field. Word of mouth from specialists and
other general dentists is still my primary referral source. Of
course having a great website that patients can go to once
they have been referred is key.
Life story: Ready. Set. Go.
Nosti: I was born and raised in a close family with my parents, one older sister, and many uncles, aunts and cousins who all
lived in the same town of Nutley, New Jersey. We moved to the
“Jersey Shore” in 1990 once I graduated high school (and yes
many of my relatives moved to the same town as well). Growing
up, my father owned his own plumbing business, which I would
help out during the summers when I was older. These summers
helped build my work ethic and ability to relate to patients.
Everyone understands construction terminology, and I relate dentistry to construction many times when discussing large restorative cases. Also seeing how my father presented either “needed”
work or “wanted” work helped shape my people skills as well.
If you want to know how I became interested in dentistry all
together, it was a career report on “oral surgery” my sophomore year
in high school. From then on becoming a dentist was my goal.
What’s it like to own a practice?
Nosti: I don’t think there is anything in the work force world
like owning your own business. It obviously has moments of difficulty, but the positives far outweigh the negatives if you run
your business correctly.
What’s your favorite part? Your least favorite part?
Nosti: The freedom to practice the way I want to practice is my
favorite part. And honestly, every practice out there has “drama” or
complaints. This is by far my least favorite part of my practice.
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Describe how you integrate cosmetics into your
practice.
Nosti: I think most young dentists feel you have to market to try to get “cosmetic patients” into your practice. This
is completely untrue. The first type of cosmetic patients you
will find in your practice are patients who have wear from
attrition, erosion or abrasion. By simply educating your
patients on how you can reverse this process can be an easy
Clinical Mastery Series
Clinical Mastery is dedicated to excellence in practical restorative postgraduate education. Directed by Drs. John Nosti, Jason
Olitsky, LeeAnn Brady and Mike Smith. Look for live Implant
courses coming soon! For more information, call 480-489-5551
or visit www.clinicalmastery.com.
Spring/Fall 2014 Schedule
Mastering Functional Dentistry: Ultimate Occlusion Level I
April 11,12 – Wichita, Kansas
June 6, 7 – Philadelphia, Pennsylvania
September 26, 27 – Dallas, Texas
Mastering Full Mouth Rehabilitation: Ultimate Occlusion Level II
November 7, 8 – Tempe, Arizona
Mastering Complex Cases: Ultimate Occlusion III
October 10, 11 – Englewood Cliffs, New Jersey
Full Mouth Rehab Live
September 19, 20 & Oct 17, 18 – Englewood Cliffs, New Jersey
Anterior Aesthetics Live
October 10, 11 – Englewood Cliffs, New Jersey
Art of Digital Photography Hands On
June 6, 7 – Philadelphia, Pennsylvania
September 26, 27 – Dallas, Texas
November 7, 8 – Tempe, Arizona
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way to integrate cosmetics into your practice. I call this
“functionally-driven cosmetic dentistry.” The second type of
patient who is currently in your practice are the patients who
are unhappy with their smiles. They typically do not tell you
they are unhappy with their smile until you question them.
Because of this I recommend you have a way to bring this up
so you don’t offend your patient. Asking them to rate their
smile on a scale of 1-10 is an excellent way to start the cosmetic discussion. Always follow this up with “what would it
take for you to rate your smile a 10?” when they provide you
with any number less than 10. Don’t be fooled by the patient
who rates their smile a nine. Many times these patients want
“a straighter, whiter smile.”
What are your favorite marketing techniques?
Nosti: Hands down the must-have marketing piece required
these days is a website. It astonishes me the number of dentists
who are in practice and do not have a website, or who do not
keep up with the one they have. Where do you go to find something? Your iPhone? Your computer? Google? Without a website
you are invisible, and honestly, spending money, in other marketing avenues without a website to steer someone to is a waste
of money in my opinion.
You’re an active Townie and you post frequently on
Dentaltown.com. How did you learn about Dentaltown?
Nosti: I first learned of Dentaltown through the magazine
that came to my office one day. As much as I was intrigued by
it, it still took me a couple of years to go to the site and start
“poking around.”
You are very involved in the cosmetic and occlusion
forums on Dentaltown.com, and have several CE
courses on the website. What CE courses would you
recommend outside of Dentaltown? Nosti: When doctors send me emails on Dentaltown saying that they enjoy reading about the cases I post, I direct
them toward my Dentaltown CE. When they’ve exhausted
those options, I recommend the Clinical Mastery Series (see
sidebar on page 60).
How has Dentaltown affected your professional life
and your social life?
Nosti: I feel it has affected my office in a positive way
because when patients move into my town they are being
referred to me by their previous dentist. It has allowed me and
my dentistry to be visible on a world-wide level. My CE courses
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with Clinical Mastery Series have become more popular, and
more nationwide dental societies are asking me to speak at their
conferences. I feel this is because people who read my posts like
my teaching style, and know that I genuinely enjoy teaching.
I now get to meet Townies everywhere who come up to me
at meetings to introduce themselves. I love this. It has definitely
allowed me to meet more people than I would have otherwise.
What’s your favorite feature of Dentaltown?
Nosti: If you don’t know something in this field, there is
someone out there who does and is willing to help you. Post it
in the appropriate area and you will get an answer from someone who is a leader in that field. To me, that is amazing.
What is the greatest advancement or change you
have seen during your tenure as a dentist?
Nosti: Wow! There are so many. Veneers have become a
household name, direct composite material is preferred over
amalgam, the availability of implants, everything is digital… I
could go on and on.
Dr. Nosti’s Top Products
Joint Vibration Analysis (JVA)
Empress/Emax and
Variolink Veneer Cement
Electric Handpieces
T-scan
Around 2004
2005
2002-2005 (Empress 2002,
Variolink Veneer 2004, e.max
2004 or 2005).
Air-driven handpieces simply
do not cut as easily or efficiently. I would never be able
to be as efficient with reconstruction and cosmetic cases
without it.
Articulating paper is great to mark teeth, but
those marks have no bearing on sequence,
timing or force. To be able to test forces on
new ceramics, complete dentures, implants,
or even splints is invaluable. I have used two
labs over the past 9 years, both of which
report my fracture rate is around 2 percent
long-term on cosmetic, reconstruction
cases, and my all ceramics. I believe T-scan
has a big part to play in that.
These three materials have
allowed me to be provide outstanding cosmetic results and
be very predictable in my cosmetic cases.
On every patient.
Every time I treat more than three indirect
restorations, equilibrations, implants, dentures, splints, reconstructions, cosmetic
cases, etc.
Every “single unit” I do is an
e.max restoration. Cosmetic
cases are either Empress or
e.max, and they are all
cemented with Variolink Veneer.
Like the JVA, I don’t think patients fully
grasp the benefit to this item until it is used
on them.
My photo gallery is full of
these materials.
When did you start using it?
2002
Why can’t you practice without it?
It allows me to establish the
health of a patient’s TMJ and
detect any potential issues
prior to initiating any complex
reconstructions or cosmetic
cases.
When do you use it?
Every new patient gets a JVA
quick scan and obviously every
patient prior to restorative
dentistry is evaluated.
How do you market this item to your patients?
I don’t think patients fully
grasp the benefit to this item
until it is used on them, or
unless they are a pain patient
who has sought me out.
However, there is a page on my
website regarding JVA.
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APRIL 2014 » dentaltown.com
We tell patients prior to its use
that it is a quieter, more efficient hand piece than when
they were younger.
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Who are some of your mentors?
Nosti: On a day-to-day basis, my partners Drs. Katz and
Noveck have taught me a ton about running a business, and
dealing with patients and staff. I
would not be the dentist I am today
if I had not joined their practice.
Early on Drs. David Hornbrook,
Pete Dawson and Mark Piper each
had a strong impact on the way I
practice. Hornbrook was a great
mentor for my speaking/teaching as
well. Currently, Drs. Jason Olitsky
and Mike Smith are guys who push
me to continue to improve in both
areas. On Dentaltown you can never
go wrong reading the entire posts of guys like Drs. Lane Ochi
(velogeek), Barry Glassman, Mike Melkers, Thomas Mitchell
and DoctorEd!
Tell me about one of your favorite or most rewarding
cosmetic cases.
Nosti: One of my favorite patients from years past was a
patient who lost her husband on 9/11. She came to my office
one month or so after this tragic event and I can honestly tell
you that her and I cried together for about 30 minutes following the health history and “get to know you” introductions. I
ended up restoring her smile and she became one of those
patients who I hug when they come in and hug when they leave.
Many times hugs are better than words.
Currently I have a patient who is going through a complex implant reconstruction. The entire time, up until now,
she has been wearing an implant-supported denture that she
absolutely hates. About a week
ago, we did a “try in” of what her
new fixed prosthetic is going to
look like and she broke down in
tears. Up until now she believed I
could provide her with what she
wanted, but it was still a leap of
faith to her because of her bad previous experiences. Now she really
believes. Despite having other
people tear up with their new
smile, this patient isn’t the “crying
type,” so her response was humbling and provided for one of
those “moments” you don’t forget.
What do you do in real life (family, hobbies, community involvement, etc.)?
Nosti: I am a husband, a father of a nine-year-old girl
and one-year-old boy, a brother, a son, a cousin and a
nephew. I spend a lot of time with friends and family
members in my town. Dinners at my house or a relative’s
easily adds up to 20-30 people… love it! Living on the
Jersey Shore, I enjoy boating, fishing, hitting the beach,
riding my motorcycle and anything outside in the summer.
I am a big Giants fan and I hate shoveling snow (when will
this winter end?)! Do well. Do Good.
Imagine owning a dental practice that provides professional
fulﬁllment, along with work-life balance and an income you
couldn’t aspire to anywhere else.
With our business support, your focus is on your patients,
not administrative headaches.
A new smile can change a patient’s life, and our
unique business model enables dentists to do
good for others while doing well for themselves.
Are you ready for a better dental career?
Let’s talk! 1.888.837.3033
the perfect ﬁt for your career
EOE
www.affordabledentures.com/careers
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