The field of endodontics is undergoing a continual evolution in terms of materials and techniques, as well as growth in the number of patients who can benefit from endodontic treatment. In order to gain insight into the current and future status of this important clinical area...
An Interview with Cliff Ruddle The Journey to Becoming “Cliff”
This show features Cliff Ruddle’s journey through his youth and dental school, and finishes by focusing on some of the more defining moments of his career. Highlights include photographs through the years, along with some key insights into what makes Cliff, “Cliff”. Also enjoy the Quick Answer closing segment for additional detail!
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This transcript is made available by The Ruddle Show in an effort to share opinions and information, and as an added service. Since all show text has been transcribed by a third party, grammatical errors and/or misspellings may occur. As such, we encourage you to listen/watch the show whenever possible and use the transcript for your own general, personal information. Any reproduction of show content (visual, audio or written) is strictly forbidden.
INTRO: Why the Ruddle Show?
Welcome to The Ruddle Show. I’m Lisette, and this is my dad, Cliff Ruddle. And this is our first show, and we’re really excited about it. We thought, ‘What better way to start our first show, than to start off with an interview’, with – I’m gonna interview my dad. And we’ll get to that, momentarily. But, first, why don’t you tell us a little bit why you even wanna do The Ruddle Show?
I’m really excited to do The Ruddle Show, for many, many reasons. In no particular order, I wanted to work even closer with my family. And, at 72 years old, this could be Ruddle’s final run. So, we could be building a family legacy, because right here, I have my oldest daughter. We stole her from Cal Berkeley. You know, she’s a Ph.D. type person. My daughter, Lori, dual in finance, we stole her from Peat Marwick. And my wife of 52 years, she’s central to all these moving pieces, and my grandson’s the shooter. Okay? So, what a chance to be able to be with my family and create educational content.
It dawned on me, last year, when Phyllis and I were tallying up the lecture miles, over many, many years, that we had five million. My face looks like it wore out two bodies, okay? So, to have a chance to reach out and stay connected and massively increase my connectivity around the world, with my friends that I’ve met over the decades, The Ruddle Show certainly seems like a really nice way to do that. And, of course, The Ruddle Show not only needs to bring you a lot of fun and education, but it’s a chance for us to all learn together.
Well, let’s talk a little bit about our philosophy behind The Ruddle Show. So, the symbol for our show is this rotating tetrahedron, or you can just call it a triangular pyramid, with four faces. And these four words we have over here, Education, Innovation, Community, and Lifestyle are the four aspects of The Ruddle Show. And they’re pretty much like the parts of a clinician’s journey in life. We think they’re the four crucial parts of a clinician’s journey, but they’re also like the four parts of any person’s life. So, let’s first talk a little bit about education. How do you see that, on The Ruddle Show?
Well, education is – at the end of the day, it’s to improve performance. So, we educate, and, by education, not just psychobabble and one way. It should be learning, co-learning, together. So, we wanna improve our performance, and that means we can improve the level of care we provide our patients. As we learn, we have other opportunities with other colleagues. And so, those opportunities become possibilities. So, education is a really wonderful thing to have, and G.V. Black said it the best. He’s the father of North American dentistry. He said, ‘No professional has any right, other than to be a continuous student, for life.’
Well, that’s great. Yeah. We can always learn. Also, community is one of the aspects of our show. And it’s really important for clinicians to get out in the community and see what others are doing, and – and I don’t just mean your community, your little town that you live in. I mean like the international community, because they’re doing things differently, all over the world. And it’s really interesting, and we can learn a lot. It also means getting out in the community, to be of service to others, because that also enriches our lives. So, humans are not solitary human beings. We need to get out and interact with others, see what others are doing, and communicate our ideas.
Awesome. Well, if you were to look at another face on this tetrahedron, you would notice that there is innovation. Innovation can be easily interpreted to be maybe a new invention. I’m not really talking about that kind of innovation. I’m talking about the kind of innovation where we challenge ourselves. We understand best and uniquely best where our deficiencies lie, so we train up. As we train up, sometimes we have to give up hard-fought-for proficiencies, to get to the next level. So, then, there’s periods of awkwardness, and maybe we feel clumsy, and we have a little self-doubt. But the effort to be more than we are drives us closer to be all we can be.
Yeah. I think important with that, the innovation part of our show, is, we really wanna emphasize creativity and maybe thinking in a different way that you’re used to, breaking down paradigms, that kind of thing.
And then, last, we have lifestyle, and that’s because it’s not just all about work, work, work, because human beings are a lot more than just their productivity. It’s also important to have fun, to laugh, to get out of the workplace, and definitely, we want you to see what Cliff Ruddle does, to inspire himself, outside of the office as well.
Okay. So, basically, what the show is supposed to bring to you, each time, every time, all the time, is a high level of education. Some of it will be considered quite basic, but, remember, it’s the fundamentals that win. It’s not the magic machine. It’s not the Rube Goldberg machine that can come up for deficiencies and overcome our deficiencies with technology. Technology is an adjunct. So, we wanna be sure you have education, fun, and you learn a lot. But I want you to laugh a little bit. You know, find that million-dollar smile! Exhibit it!
You’ll make people around you smile, and as you’re smiling, you’re inspired! And all of a sudden, there’s something good happening here, and we don’t even know what’s goin’ on, but we wanna be part of it! So, we wanna inspire you to have a lot of fun, and the smiling and the laughing – be sure to laugh at yourself. Life is not that serious. So, when you laugh a little bit, and you inspire others, all this goes together like a big cocktail. It becomes the new you.
[Music playing] So, that’s kinda just the whole idea behind our show. And now, we’re gonna take that energy, that we just saw, here, and start our interview. [Music playing]
SEGMENT 1: The Interview of Dr. Clifford J. Ruddle – Part I
So, today, I’m gonna interview my dad, Cliff Ruddle. And I have to say that when I first suggested that I thought it might be a good idea to have our first show be an interview, where I interview him, and he wasn’t totally excited about that, because he’s actually very humble. And he said, ‘No one wants to hear about Ruddle’s life.’ And I said, ‘Well, absolutely, they wanna [laughs] hear about Ruddle’s life.’ So, let’s get started with the interview.
What made you decide to go into dentistry? Was it something that you had wanted to do, since you were a child?
Not really. Always wanted to play pro sports, but let’s go to the 60s. I was at Cal Berkeley, and I was taking a PChem major, Physical Chemistry, and guys that were twice as smart as me were pumpin’ gas. And that had to do with the economy, and it had to do with oil shortages and standing in lines to gas your car up. So, I decided to talk to my – well, Carl, your uncle, but my son-in-law. Anyway – brother-in-law.
I’m gettin’ this straight, aren’t I?
Yeah. So, anyway, Carl Rosich [sounds like] is a dentist, and he was a young dentist at that time. He said, ‘Well, why don’t you apply to dental school? And if you get in, you have a decision to make. And if you don’t get in, nothing ventured, nothing gained.’ So, what got me interested is my brother-in-law, Carl Rosich. And he’s a dentist, and he’s retired.
Okay. So, actually, let’s talk a little bit about your family, growing up. What was your – what was your life like, growing up, with your family?
Oh, I had a really cool life, growing up. Lots of moving. I didn’t like that part, but I got to meet a lot of people because of the moving. My pop was a minister. And so, we lived in many, many states in the Northwest, Montana, Idaho, Washington, California. So, we were moving about every two or three years. So, growing up, we went to many different states, saw different lifestyles and how people lived, lived in cities like Seattle, lived in more rural towns like Bozeman, Montana. So, it was a really good life, filled with a lot of sports.
Okay. You – so, I’ve heard ‘sports’ mentioned, a couple times now, that you wanted to be a professional athlete and that you had – your childhood was filled with sports. So, why don’t you tell us a little bit more about how you envisioned your dream career?
Well, I played a lot of baseball, growing up, a lot of Little League, Babe Ruth League, Legion. I was always playing with kids about three or four years older than me. I had pretty good skill, at that time, [laughs] a little eroded, today. But, anyway, I had visions of playing centerfield. So, I was on the City All-Star Team, the State All-Star Team, and we went to a five-state playoff, and I just thought that would continue on.
I think that, even though you went into dentistry, I think sports has always stayed really important in your life, because I remember, even as a kid, you taking me and Lori out and playing basketball with us, teaching us how to throw a Frisbee, just a – even getting together neighbors and friends and playing baseball. So, yeah. We – we had sports in our childhood, too, and it was all coming from you.
Yeah. It was fun.
Okay. So, the next question I have is, where did you meet Mom, and when did you guys get married?
Well, I met Phyllis in high school, as a junior, and we got married in 1967. So, I met her a little earlier than that. And she was a great find, but she always says she found me. I was so busy dribbling the basketball and making plays, I didn’t see that play. [laughs]
I think Mom worked, too, while you went to school, right? And she became a computer programmer.
Well, Phyllis was actually the brains of the family. If you think of being a woman in the Bay Area, in San Francisco, in the ‘60s, Phyllis was working as a computer programmer, programming, as it was in that era, punch cards and all that stuff, and computers as big as a room. So, it’s all different, now. We have a handheld. But Phyllis worked in several places in the city and actually put our family – made it possible for our family [laughs] to survive.
Because you went – you were in school that – at that time.
Yeah. I was workin’ on construction for many years, and I was also going to school. So, Phyllis was working during my years in construction in Oakland and also during the dental school period. Yeah.
Why don’t you tell us a little bit about those dental school years.
Well, I went to the University of the Pacific, in San Francisco. At that time, it was on Webster Street, Webster Street campus. And I loved dental school. I was one of the nerds. When I went to dental school, they seated us alphabetical, and so, I was down in the R’s. And it seems like everybody around me, their dad or their mother was a dentist. They were in the dentistry field. And so, I’ll never forget, when we checked in, on day one, there was a box, bigger than this chair.
And this guy stood with a microphone, and he said, ‘Take the black box handpiece, and put it in drawer three.’ Well, I didn’t even know what a handpiece was. And all these other guys were, ‘Oh, look at the impression material. Look at the clamps. Look at’ – so, anyway, it was interesting. I was insecure immediately, because I thought, ‘I’m way behind.’ But it was a really great period. UOP was like family. And everybody in the world, I think, knows Art Dugoni. He was our hero Dean. He was one of the Deans, and Art Dugoni is known around the world. He was the ADA President, and we all loved Art.
And I think I would say, about the school, they really treated us with huge respect. We had wonderful teachers. So, they made it fun.
So, you go to dental school, and you get a degree so you can practice, I guess, general dentistry at that point. But, then, you decide to be an endodontist. So, why did you want to be an endodontist?
Well, out of all the disciplines at UOP that I was learning, without reciting them, I was failing endodontics. So, fear is the mother of excellence. So, it wasn’t just me, but our whole class, basically, failed. In fact, the first class I took, there was 100 questions. The top score in the class was 20. And this was in endodontics. I think I had a 15 or a 14. And anything that I used to struggle at, that was something to really work on. And, as I started to work on it, it was really fun.
And it was kind of a mysterious black-box stuff, because everything, in all the disciplines, you visualized, and you looked directly, and you saw. In endodontics, we [laughs] cut an access, and then, we disappeared into a hole. And we couldn’t see our files moving through multiplanar curvature to link. We didn’t even know what we were doing. But, at that time, it was a lot of fun, not knowing what we were doing.
[laughs] So, then, I guess, you applied to Harvard and got in. So, what made you choose Harvard?
Okay. So, I really became passionate, my last year in dental school, my senior year. And I decided to think, ‘There’s a lot more here.’ And I really upset the Department of Prosthetics, his name was Herb Ward. Chairman of the Department Ward always saw me as going to pros school, prosthodontics. And I did get the Pros Award of the Year, so he saw me already penciled in. And when he heard I was going to endo, he said, ‘Well, any monkey can do this, all day long.’ He said, ‘Why would you waste your God-given talents, doing endo? Anybody can do it.’
But I loved endo a lot more than I liked pros, and I liked it because you have control of a case, up to the restorative part. In pros, you’re doin’ removable, fixed, single-crown splint dentistry, and there’s a lot of responsibility with labs and allied professionals. So, it just seemed like I had a lot of control here. I applied to two schools in Philadelphia, Temple and Penn, University of Penn, and Harvard and BU, Boston University, the Goldman School of Graduate Dentistry. I chose Harvard. It was a pretty easy decision. I got into all of them, but I like Harvard, because it was family.
And Al Krakow was like my second Pop. He was a reincarnation of my own dad, and all the things I didn’t like about my dad, Al was perfect. And all the things I didn’t like about Al, Dad was perfect [laughs]. So, I had two fathers in my life. And another reason, I didn’t know I didn’t know, back then, but I had always been told, ‘Go to Boston, somewhere in Boston.’ Well, not Tufts, but, ‘Go to BU or Harvard, because you’ll learn warm gutta-percha.’ And the – in the – if you think about the ‘70s and where dentistry was in that era, people weren’t filling root canal systems. When I went to Boston, they were treating systems. That was completely different from the West Coast, treating canals.
So, Al Krakow was Herb Schilder’s second student. Herb Schilder was the father of modern warm gutta-percha.
And he was at BU?
He was at BU. And everybody knows Herb Schilder, internationally, that’s even remotely attached to endodontics. He’s written some wonderful chapters in “Dental Clinics of North America” and stuff. But, anyway, I thought I got the best of both worlds. I got the Schilder philosophy, at Harvard, and then, I got a wonderful father figure, who was really inspiring. And could Al tell stories.
Oh, he was a great storyteller.
So, you actually had a good relationship with both Al Krakow and Herb Schilder.
Absolutely, yeah. They were two of the people I most look up to, in clinical endodontics.
So, how is it that you decided to start practicing in Santa Barbara? Did you always know that you wanted to live in California?
Well, we had been in California, as – when I was in dental school, San Francisco Bay Area. So, we always figured we’d come home. And home meant, to me, back to the Bay Area. But the Bay Area had changed quite a bit, just the two years that I’d been at Harvard. And so, we saw some advertisement for an endodontist wanted, in Santa Barbara. I’d never been to Santa Barbara. So, all the years I’d lived in California, most of our time was in the Tahoe area or the North Beach areas, you know, north of Stinson Beach, Bolinas, and up through there, but we’d never really hung out in Southern California.
So, there was this ad. Phyllis followed up on it, and it was a group of multi-disciplinary dentists, about 17 or 18. They had an oral surgeon, pedodontist, periodontist, orthodontist. They were all represented, except they didn’t have endo. So, there seemed like there was an opening, they wanted me, and I came.
Oh, so, you actually started in that practice?
I came to the group practice.
Oh, okay. I see what you mean, that building, the – okay. Never mind. Sorry.
No, it’s good. It’s – it’s called Patterson Professional Plaza, and it was a group of dentists that had individual practices, all over the city. And they didn’t like their landlords. They didn’t like their buildings. They didn’t like parking and all that. So, these guys decided to build a complex, and it was called the Patterson Professional. When I came, there was just framed.
And everybody had their suite chosen. There was three left, and I chose the – one of those three. And two of ‘em were downstairs, and one was upstairs, and this old guy said, ‘Cliff, take the high ground.’ I said, ‘Why?’ He said, ‘Because, in dentistry, you have a lot of lines, and stuff can break. And you wanna be above the water.’
[laughs] So, then, what got you into lecturing and teaching? Because you are known to be an excellent speaker and lecturer, around the world. So, what made you start taking that path?
It was forced upon me. [laughs] I was a practitioner. I was doin’ 10-hour days, week after week, year after year. And I was filling a lot of root canal systems. And back in this day, we need to tell our audience, ‘We probably should set this up.’ If you look at the early ‘70s, I was the third of fourth guy in the state of California that did warm gutta-percha. So, most were doing lateral condensation, as it was taught all over the country. When you do warm gutta-percha, and you develop hydraulics in well-shaped canals that have been cleaned, you fill root canal systems. So, I was filling root canal systems.
Well, a lot of the dentists wouldn’t restore the tooth that I had just treated, because they said, ‘You have a puff.’ So, Schilder coined the word, ‘the sealer puff’. The puff ensures the seal. So, when dentists saw filling material beyond the confines of the root, they thought it was an overfill, and that was deemed inappropriate. And overfills were known in that era -- ha, ha, ha – to contribute to longitudinal failures. So, my friends pulled me aside and said, ‘You know, you need to tell them what you’re doing.’ Well, I’d passed on telling the world what I was doing, for several years.
And finally, my friend Earl Ness, at that time, he said, ‘Look, Cliff. You have a lot to give. We wanna know what you’re doing. I wanna start the study club. You run it, Cliff, but I’ll get together 20 guys. I’ll tell you when we meet. Will you give us a day, once a month?’ So, I finally said, after several years of prompting, ‘I’ll be happy to start coming in with my slides [laughs] and showing you a little glimpse of what I’m doing.’ So, it started very innocently, in a bar, to 20 guys. We took the back room in a bar. And then, it went to hotels, and then, it became two study clubs, because we would never make the study club bigger. We wanted to keep it small.
And we did seven sessions a year. And then, there were two sessions, and I had three study clubs going, simultaneously. Then, people found out in LA, and wanted to know if they could come. We had people coming down from San Francisco. Finally, your mother said, ‘Why don’t you just make an international study club?’ So, it started, just like that. And just to end it all, we did that for 37 years. We didn’t quit because of lack of business. The day your mom sent out letters to everybody that was on the books, that was yet to come to Santa Barbara, she wanted a return receipt, so they didn’t just show up.
Because that – those study clubs evolved into the Santa Barbara seminars.
And so, basically, we were two years booked ahead, when we stopped the study clubs. It took on different forms. I went to Arizona and did the Scottsdale Center for Dentistry for two years. That was the continuation, but in a $60 million facility. Came back to Santa Barbara as you perfectly know. We did Santa Barbara seminars out of a hotel, because we went from our office to a hotel, because the office was 10 at a time. The hotel, we did 15 a time, so it helped a little bit on the margins. Because what people don’t know that are watching this, there’s enormous cost expenses behind the scenes. So, sometimes your last two doctors are your margin.
So, we always, though, wanted high level. It wasn’t numbers. We could’ve had big numbers, but it wasn’t about the numbers. It was about the performance and transferring knowledge, making people better. So, that was a little glimpse of how the study clubs started.
It’s interesting. I think we should point out to our audience the difference in technology at that time, because I remember when I was a kid, walking in, and you were sitting at your slide library, with the drawers pulled out. And I could see all of your slides, your – all of your cases, and you would just be sitting there, looking at them. And I remember asking you what you were doing, and you said you would look at a slide, and you would kinda think in your head what you were gonna say about that slide. I just always remember that, watching you work, when you would --
Yeah. I guess I’ll play off of you. This isn’t part of the interview, per se, but by reviewing one’s work in the quiet of your own time, you can reflect on what you didn’t do, what you could’ve done, what was missing, that if you integrated that, it could’ve gone from an okay case to a fabulous case. So, I learned a lot, by looking at my work when the patients are gone, the staff’s gone, and it’s just over a glass of wine, or whatever. Maybe we had a beer, I don’t know.
-- [laughs] that’s interesting. Okay. The next question I have for you is, what was endodontics like, entering the mid- to late 1980s?
Well, there’s been a big evaluation in endodontics. So, let’s just say, forever, we had files, reamers, we had Hedstroms, we had Gates-Gliddens, and that was about it. Rubber dam clamps, forceps, et cetera. But endodontics was pretty much the same old, same old, for all – forever. Then, in the ‘80s, the early ‘80s, Apotheker [sounds like], a general dentist, first wrote a paper and described the use of a dental microscope. And there was no pictures, there was really no – it was two pages. I read it and was very, very intrigued.
Then, I ran into Noah Chivian, at the AAE meeting, I believe in ’86, and he had a booth. I said, ‘What are you doing in a booth? You’re an endodontist.’ He said, ‘I’m selling the Chayes Virginia Microscope. You need one, Cliff. You’re teaching.’ So, you know, I thought I should – he had a flower, and I looked down in the petal, and I could see things that were amazing. So, I thought, ‘This would help me, chairside, on the isolated tooth, under a rubber dam.’ So, I got the first microscope on the West Coast, started gettin’ some slides, wasn’t very comfortable. My ass was always about that far off the chair, because there was no ergonomics. But I knew I could never go back.
So, through a series of microscopes, got a Global, had it for 10 years, got a ZEISS, and had it from 2000 to the present, the last 19 years. So, the microscope was a huge part of the practice, and it changed everything about how we practice endo. Right on that – heels of the microscope introduction, there was MTA, mineral trioxide aggregate, out of Loma Linda, Mahmoud Torabinejad. And that was the first time we had a repair material that was biocompatible, Sharpey’s fibres could grow into the cementum, 400 microns or so. And so, we could get a biological attachment with a repair material, which was unheard of.
And then, a little bit after that, ultrasonics was born. Gary Carr gets the credit, because he introduced them as surgical tools, whereas I was primarily introducing ideas, non-surgical, like trephining around a broken instrument, vibrating MTA like mud, like concrete, around root curvatures in the root defects. So, we had the microscope, we could see a lot of stuff. So, then, we had a great material, MTA. Then, we had ultrasonics, and that allowed us to do so much with removal of posts, broken instruments.
And then, finally, I guess the whole thing closed, that 10-year period, with the rotary instruments, NTI, early ‘90s. ’92, ’93, we saw our first rotary files. Those four changes were game changers, and they forever changed how we practiced endodontics.
So, a lot of technological advancements at the end of the ‘80s.
Technology drove it all.
Okay. Well, 1995 was a very pivotal year for you. What happened in 1995?
Well, that year, if I didn’t have bad luck, I’d have no luck.
My mom passed away. You had a health issue that we will talk about, at another time. But you’re healthy and perfect. Look at this. She’s not perfect? Is this perfect?
All right. So, black-belt perfect, okay? So, anyway, there was a lot of things. My mom died, you had a health problem, and I was lecturing in Italy. I was doing a 3-day conference to about 600 people, and in the middle of the day my eyes started flashing, and I thought it was a bad contact. Long story short, I had a torn, detached retina, didn’t know it, decided to do the third day, not to let the colleagues down. Message: When you have a health problem, it trumps everything! Take care of it! So, I did not take care of it and gave the third day, and it takes a day to get home.
Long story short, I end up, through a series of referrals, to a ophthalmology – ophthalmology surgeon, and he said, ‘Cliff, you’re just about ready to go blind. Your macula’ll be off in another half hour to an hour, and then, you are dead in the water with eyesight.’ So, he said, ‘You’re gonna need a scleral buckle. We’re gonna do a procedure, put a band around your eye. And then, we’ll have support, and then, we can lase your retina back to your eye. And you’ll probably be fine.’ So, that was a big deal. I was out of practice for a year.
But through those adversities, that’s what I want the audience to hear, every one made me a better person. Every one opened up possibilities I never had seen, from her, to my mom, to my eye. That’s when I started inventing. That – during that year, I needed to keep the staff together, because they were my family. So, we decided to work on things to make dentistry better. And, of course, I was still teaching my two-day seminars.
Well, that leads us right into the next question, which is, you have over 15 patents and have invented, I think, 13 or 14 dental products that are sold every day, internationally. So, how ¬– so, I was gonna ask how you got started inventing. Well, you kinda just answered that. But did you wanna talk anymore about that?
Dentists think, because they have a DMD behind their name or a DDS, that the doctor, and there’s this reverence, this halo appears over their head. But what we don’t realize when we’re doctors, there’s many things we can do, besides just serving patients. We can teach, we can educate, we can invent, we can go back to academics, so we can get back to students. So, I think that we should look at our adversities in our life as steppingstones and opportunities, and inventions aren’t good or bad. They just are.
But we’re all doing something chair side, and when you’re chair side, you’re using a tool or a piece of armamentarium, or some diagnostic technology, and it really helps the profession. So, if you have an indication or an inclination to do things like that, take action.
So, maybe the adversity in your life actually sparked some creativity and thinking in a different way, so that you were able to sort of change the path of your life, a little bit.
My butt would still be tacked down to a dental chair, and I’d still be 24, 7, 4-waller. And so, now, I get the best of all worlds. I get to publish a little bit, get to invent a little bit, get to see a few patients a little bit, and all that’s still endodontics. But it keeps you fresh.
Well, you’ve actually published countless articles, over a few decades, and are known to be a very good writer, very clear writer. So, what – have you always been a good writer? What kind of got you into writing?
I’ve just been phenomenal.
I mean, my writing has been impeccable. No, I write like probably doctors write records, right? Can hardly read it, and there’s just enough information, but it’s all there, for legal, liability reasons. But I had two daughters, and, for about 10 years, a lot of my papers were massaged and contributed to by your sister. Then, when we snatched you out of Berkeley, Cal Berkeley, the University of California, Cal Berkeley, Berkeley, you came in, and you were a literature major. And I could just sit down – the audience should know, I can just sit down, and she almost interviews me like this. She’s taking notes. And all of a sudden, we have the makings of a paper.
And a few rounds later, it begins to evolve, it begins to get exciting. Then, we get clean copies. Now, we get creating, and you’re helping me move stuff around. But it’s really been fun working with you, and I would say, ‘You’re looking at the writer.’
We should clarify that my degree was in French literature, but still, I’m still able to help him [laughs].
[laughs] Papers will now be in French.
Do you remember the title of your first article and where it was published?
There was one or two earlier, but the one I can recall is my good friend Barry Vilkin. This is back in 1985, I believe, or ’86, and I wrote, “Treatment Considerations of the MB Root of Maxillary First Molars”. I might have switched a few words around, but that was – it was emphasizing maxillary first molars, MB root, and the second canal, the MB2, or the MB3.
Okay. I don’t remember -- do we even – I don’t know if we – do we have that article in the office, because I actually might wanna read it? [laughs]
I actually have it at home, and Barry Vilkin’s – he did these little quarterly. They were like “Winter”, “Spring”, “Summer”, “Fall”. So, it was a booklet that came out four times. It was a beautiful booklet. It had maybe five or six articles in each one, by different people, and at that time it was visual, like you’d never seen before, and it was much more than pre- and post-op x-rays in that era. There was photographs. That was kind of unusual. Barry did a great job. I just saw him recently at Terry Pannkuk’s, during a live demo. Great to see Barry.
Yeah. Go ahead.
The last question I wanna ask you, before we take the interview outside, is, can you briefly describe your endodontic philosophy?
Well, I guess, first of all, there’s a patient. So, anything we have philosophically in our heads, in our hearts, in our minds, and through our hands, it should be addressed to taking care of people. So, I think I exist, we all exist, even in your level of life, whatever you’re doing, we all exist to help others. So, dentistry’s pretty obvious. People come in with a toothache and so, you wanna help make sick people well. So, that’d be number one. And then, relentlessly work on your performance. Performance can always be improved, and that’s fun. Never gets stale. Challenge yourself. Challenge yourself.
You know, people don’t’ realize this, but we wake up in a big industry, and every day you go to work, and you’re one of one million international dentists that trudge in to do your daily job. You join a big machine. It’s huge. It’s over $6, $7 billion a year, and it’s easy to get caught up in being a little cog in a big machine and finding, ‘Where’s the relevancy?’ So, I think to stay relevant, we need to do little things, like count something. It should be something that is fun, like midnesials [sounds like] or MB2s or radix [laughs] paramolaris, radix paramolaris. Count something! Something that you’re interested in.
Write something, something little, something that three people read, five people. But you begin to connect, and it’s that connectivity, where you go outside yourself, where the real learning can happen.
Okay. So, pretty much to keep learning and keep staying relevant.
Yeah. Never stop your education. And I think we’ve said it before, but we can say it again. Education should be inspiring, and by talking to others -- like, just talking to you, I learn a lot every day. You don’t even think I do. You think it’s – I’m pullin’ your chain. Like the Italians say, ‘You’re pushin’ my leg!’ But you know what? You learn from everybody. I learn from Isaac, my grandson, the shooter. He’s always tellin’ me somethin’ he’s discovered, some space thing he’s creating for the next Star Wars stuff. It’s fun to talk to people and find out what they’re doing. It’s – it keeps you engaged. And a lot of times, I see stuff in other endeavors that I can bring right back into endo.
Okay. Well, thanks. I think we’ll continue with our interview, outside.
I was afraid of that.
Thanks. [Music playing]
SEGMENT 2: The Interview of Dr. Clifford J. Ruddle – Part II
Okay. That was some pretty intense interviewing, inside, there. So, I – I needed a little bit of fresh air. So, here we are, outside, enjoying the nice day and the nice view. But I wanted to ask you the next question. How has endodontics evolved in recent years, and where do you see the future of it?
Well, there’s probably several futures I can imagine. I know you can’t, but one of the futures that would be best is if we focused on education and really taught our residents, and certainly our dental students, the value of fundamentals. Because a lot of times, there’s this – the young kids, they want to do everything with technology, which is fabulous. But technology must be seen as an adjunct to fundamental skills. So, the future could involve new technologies that are relevant, and then, it could involve serious education, with a hands-on component.
And then, always training, endlessly training, because most of life is in the plateau. And we spend years in the plateau, learning and practicing what we did, from another era. But every now and then, we learn something, and when there’s growth, you can jump up a little bit and create a new, higher plateau. So, we should be loving the plateau, because that’s where most of our education and our skills are gonna be refined and honed.
So, I’m also hearing you say, though, that even in the future, there still needs to be an emphasis on the fundamentals.
I hear that. I hear you say that, all the time.
Yeah. Because I – I guess I haven’t said this yet, but over 90 percent of my practice, for 15 years of my longer career, it was like creeping, 50 percent, 75, but 90 percent was retreatment. So, I lot of my life has been spent redoing other people’s endodontics. And I can tell you from all those thousands and thousands of failures, it’s almost always failure to follow fundamentals.
So, you’ve been in endodontics a long time, like several decades. And you’ve done – you’ve practiced for many years. Then, you invented, and you get out and teach. But what would you say inspires you daily? Where do you get your inspiration from?
Ha, family. For me, it all starts with family. So, when you and I are good, when Philly and I are good, when my camera guy, the – Isaac, the shooter, when he’s good, when Lori’s good, when the grandkids are playin’ well on their tennis, and they’re gettin’ their strokes back, I’m really excited, and I know everything’s gonna fall into place. So, I get a lot of inspiration from family.
I get a lot of inspiration from, not the travel, but the people I meet on the other side of the plane trip. And through that travel, you meet really interesting people from all walks of life, and see how they approach their work, what they’re thinking, what they think are limitations, what they have as breakthroughs that maybe we haven’t seen, over here. So, I’d say family and fellow dentists.
Yeah [laughs]. Sports is always inspiring, for sure.
Yeah. Because winning, losing, playing together, common goals, you know, working hard.
Okay. I guess, for the last thing I wanna ask you, is about this thing called ‘A Path with Heart’. So, you and Mom went on some retreat a while ago. I guess it was in 2003.
And you had an experience that you call ‘A Path with Heart’. Can you tell us what that was about? Because I think it’s a very inspiring story to end this interview with.
Oh. Well, that was a [laughs] – Phyllis and I had completely different visions of the trip. I had my vision, she had hers, but it wasn’t the same vision. But it was a guy named Marc B. Cooper, MBC. And I did a little bit of coursework with him, over the years, in different areas of my life that needed heavy lifting. But we went up to the San Juan Islands, out of Seattle, and it was a week-long course. So, we took a little puddle-hopper from SEATAC in the international airport, out to Orcas Island. And Orcas Island is fabulous. It’s one of the first places from the West Coast where you can see all the volcanic peaks, Rainier, Baker, Hood, all that. And that was the setting.
The island has deep inlets, because there’s islands everywhere, Friday Harbor, Lopez, Shaw, and we went to Orcas. And on Orcas Island, we met – in the meeting, there was about 20 of us, the way I recall. And our – he just got up in front of the group and said, ‘What you’re gonna do, this is gonna be the week. You’re going to meet here every day, for five minutes. Then, you’re gonna go outside, find a really spiritual place of enlightenment, and you’re going to sit down, and you’re gonna write your life story. And not just up to where you are, but all the way, what you can’t even see, at the end.’
So, he had us write down all these things. Well, for the first few days, I didn’t write anything. I was like skipping rocks. There was Orca whales coming through the channel. It was fabulous, and their blow holes and water spewing up. It was [laughs] a thing of beauty! Phyllis kept saying, ‘Gotta write, gotta write.’ And I’m going, ‘Ah, come on!’ Anyway, because at the end of the week we were supposed to write our – read our obituary. So, all this writing, Monday, Tuesday, Wednesday, Thursday, was about getting to writing our obituary and presenting our obituary to the class.
So, finally, on Thursday, I started writing like crazy. Oh, I wrote like you wouldn’t – I was prolific, just pouring out of me, like a vessel. I dumped it all. And then, we had to read our obituary. And so, when we did that assignment, he said, ‘Well, very good.’ He said, ‘You know how it all happened, up to now. You know what you wrote on your tombstone, your obituary. So’, he said, ‘Now that you have it all mapped out, best wishes. Have a good life. See you at the next course.’
Well, that was profound for me, because at that time in my life, when you think about what you want on your stone or whatever it is, your urn --
Like how you wanna be remembered?
-- yeah. Well, then, if you actually jot those things down and have, like, ‘Here lies a man that did 37,000 root canals.’ Well, for me, that’d be like, ‘Bullshit’. You know, ‘Here lies somebody that was honest, did good work, helped a lot of people.’ So, having that idea planted so clearly in my head, it – then, you can live every day with a map. You have a road map to get to the future.
So, now maybe it will say, ‘Ruddle, creator of The Ruddle Show”. [laughs]
Well, MBC was pretty good at giving that course, ‘Path with a Heart’, and Marc B. Cooper has helped a lot of dentists around the world. Yeah.
Well, thanks, Dad. That was a great interview.
I feel actually honored that I get to interview you. So, thanks. [Music playing]
CLOSE: Quick Questions with Ruddle
Okay. So, we’d like to close our show today with some quick questions for Cliff Ruddle. And if you could just answer these in one or two words, that’d be great. And I’ll just keep ‘em coming at you quickly. Okay?
Do I have to worry?
[laughs] Favorite color.
Baseball and basketball.
Favorite Yogi Berra quote.
Oh, ‘When you get to the Y in the road, take it.’
A food you absolutely refuse to eat.
[laughs] The last book you read.
“Outliers”, Malcolm Gladwell.
Most intriguing dental invention in the last couple years, that isn’t your own.
Well, a little more than two years would be CVCT, for me.
Okay. Do you have a favorite dental instrument or burr that is your go-to?
Well, from the world of Shape-Clean-Pack, it’d be ProTaper SX.
Do you watch “Game of Thrones”?
And I haven’t watched it, either. So, hopefully there will no questions in the future about “Game of Thrones”.
Favorite movie of all time.
“Stand with Me”.
“Stand by Me”?
Oh, “Stand by Me”. Yes.
And “Private Ryan”, and “Titanic”, and “Rocky”. Yeah. I have a few.
[laughs] Michael Jordan or LeBron James.
Oh, that’s easy. Michael Jordan.
[laughs] Rolling Stones or the Beatles?
Best thing about practicing.
Ah, helping people.
Worst thing about practicing.
Favorite international city you have visited.
If you didn’t live in Santa Barbara, where would you wanna live?
[laughs] Nike or Adidas?
Three all-time favorite athletes.
Oh, baseball, Mickey Mantle. Football would be Ken “The Snake” Stabler. And basketball, Magic Johnson, “Showtime”.
[laughs] Favorite pastime when you are not working.
Is there someplace you have never been, where you would like to travel to?
Yeah. I’d like to do a walking tour of the Alps.
Is there something --
-- [laughs] is there something you would like to do, that you’ve never done before?
A walking tour of the Alps, Dolomites.
[laughs] Okay. In less than five words, the future of endo.
I have to pause on that one, because I see several futures. But the preferred future is knowledge, training, and performance, and get ‘em all up.
[laughs] Favorite daughter. [laughs]
Oh, Lisa, Lori, both.
[laughs] Okay. So, that’s our show for today. See you next time, on The Ruddle Show. [Music playing]
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Who Pays for Treatment if it Fails & Access Refinement
Assessing Case Difficulty & Clinical Findings
CBCT & Incorporating New Technology
Zoom with Prof. Shanon Patel and Q&A
Best Sealer & Best Dental Team
Kerr Pulp Canal Sealer EWT & Hiring Staff
Ideation & the Covid Era
Zoom with Dr. Gary Glassman and Post-Interview Discussion
Medications & Silver Points
Dental Medications Q&A and How to Remove Silver Points
Tough Questions & Choices
The Appropriate Canal Shape & Treatment Options
Q&A and Recently Published Articles
Glide Path/Working Length and 2 Endo Articles
Hot Topic with Dr. Gordon Christensen
Dr. Christensen Presents the Latest on Glass Ionomers
Annual AAE Meeting and Q&A
Who is Presenting and Glide Path/Working Length, Part 2
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The content presented in this show is made available in an effort to share opinions and information. Note the opinions expressed by Dr. Cliff Ruddle are his opinions only and are based on over 40 years of endodontic practice and product development, direct personal observation, fellow colleague reports, and/or information gathered from online sources. Any opinions expressed by the hosts and/or guests reflect their opinions and are not necessarily the views of The Ruddle Show. While we have taken every precaution to ensure that the content of this material is both current and accurate, errors can occur. The Ruddle Show, Advanced Endodontics, and its hosts/guests assume no responsibility or liability for any errors or omissions. Any reproduction of show content is strictly forbidden.