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The Best Practices Show
43 minutes | Jul 23, 2021
Lower Risk – Increase Prognosis with Dr. Betsy Bakeman
Lower Risk – Increase PrognosisEpisode #321 with Dr. Betsy BakemanRisk assessment is the most important tool for designing the best treatment. And to share the most effective way to lower risks and have a good prognosis for your patients’ teeth, Kirk Behrendt brings in Dr. Betsy Bakeman to talk about a new system of thinking, the four diagnostic parameters, for better outcomes in patients. Veneers are useless if you lose your teeth! To learn more about treating patients comprehensively for the long run, listen to Episode 321 of The Best Practices Show!Main Takeaways:It’s important to figure out why something is happening to patients’ teeth.Always look to reduce risk in areas of perio, biomechanics, function, and esthetics.You can reduce risk, but you can't always eliminate risk.Risk is a moving target in patients — things change.It’s important to help your patients understand their level of risk.Treatment doesn’t need to be done all at once.Continuing education is the best gift you can give yourself.Quotes:“The whole concept of lowering risk, of looking at a patient and making a complete diagnosis and looking at where their risk factors for breakdown are and really categorizing that in a very simple way: low, medium, high. Periodontally, biomechanically — which is the structural integrity of the teeth. So, that's the patient’s risk for caries, erosion. And then, functionally, load-based failure. And then, also looking at the patient for esthetics, do the teeth show, because that has an influence on where we put the teeth and everything. So, you categorize in those four areas, are they low risk, medium risk, high risk.” (04:40—05:24)“You have to work to lower the risk. Now, that may be treating the decay. It may be saying the decay is too out of control, we need to remove the teeth and move toward implants. Load-based failures. Is this a parafunction patient? Is this just friction? Are the teeth rubbing together, and we can fix that, the way the teeth come together? So, we always are looking to lower risk. And the amazing thing that does when we really think about that and make a thorough diagnosis and we design our treatment plans to lower risk, we increase prognosis and predictability. And patients really get it.” (05:32—06:11)“It’s just a different way of looking at things and looking at the whole patient and making some decisions about where to go with things. And people are so appreciative. You end up treating the patient for the long term and you create very happy, very pleased patients. And it doesn't mean you have to do it all at once. Sometimes, we stage treatment over time. But you're going in that direction to lower risk and increase prognosis. And it feels really good. It feels like you're serving the patient.” (07:32—08:06)“You have to force yourself to think [in this way]. [John Kois], he has systems that go through that, that go through perio, biomechanics, structural integrity of the teeth, the function, and the esthetics. And you actually have to write down in those areas and think about it in that way. And in the beginning, you have to fill out the form. You have to start to get your brain to think that way. And you develop the risk assessment, and you say to yourself, ‘Okay. I know this patient wants veneers. But if I don't manage the function, the reason the teeth look this way, this whole thing is going to fail.’ Or if the patient doesn't treat the periodontal disease they have, I could do beautiful veneers, but they're going to lose their teeth. And so, you structure things that way.” (08:51—09:42)“The patient that needs the most dentistry, they're coming with the highest level of risk. And sometimes, we can lower risk. But in some areas, we’re not able to. We just have to manage it, and to the best of our ability, but we’re not able to eliminate it. And so, that's where I find risk assessment is really important as well, because I actually talk to the patient about their presenting risk. But I also say, ‘If we do treatment, I can help you with the way the teeth come together and bite and chew. But you're also a nighttime bruxer, and so you need to wear a night guard.’ Or patients of high-risk decay, we can treat the decay. But unless the causative factors of the decay are eliminated, which probably aren’t going to completely happen, you're still at risk.” (13:25—14:21)“What the patient has to understand is, oftentimes, the greater risk they are, there are going to be issues going forward. We want to minimize that. We’re designing things so things aren't falling apart, they're losing multiple teeth. But could they chip porcelain? Could they need a root canal going forward? I mean, yes. We aren't completely eliminating everything, and it’s important for patients to own their level of risk.” (14:27—14:57)“Patients can be frustrated. Sometimes, the more money they spend, that would be a reason to think you're never going to have a problem again. Right?” (15:17—15:24)“Risk is a big part that determines prognosis, but so does the age of the patient. So, an 18-year-old that's drinking a lot of soda and has a lot of erosion or maybe has gastric reflux, which is an intrinsic source of acid, which is much worse and harder on the teeth — so, you see, erosion on the teeth in an 18-year-old, that's a much different prognosis than it is in an 80-year-old. So, those pieces play into it. But things change.” (16:46—17:20)“Patients, in my opinion, do not decide what they're going to do while they're in the office. They decide when they're back home and they're with significant others. And that's when they're making their big decisions. So, they may say, ‘You know what? I'm not worried about this tooth. It’s been kind of the same. You tell me it’s significant, but it’s not bothering me.’ And I say, ‘When it does, or if it does, you just let me know.’ And sometimes, they’ll be in hygiene, and they’ll say, ‘This is getting worse,’ or, ‘My teeth are becoming sensitive. What can we do?’ And I'd say, ‘Well, before we figure out what to do, we need to figure out why it’s happening and make a diagnosis.’” (21:54—22:35)Snippets:Dr. Bakeman’s background. (02:40—04:06)Why risk assessment is an important topic. (04:39—08:06)How this system of thinking changed how she does dentistry. (08:50—12:32)You can't always eliminate risk. (13:22—15:24)Risk is a moving target in patients. (16:28—18:12)How to integrate these concepts with your team and specialists. (18:40—20:01)When patients don't understand their level of risk. (21:04—23:00)Pushbacks and misconceptions on risk assessment. (23:19—24:40)CE is the best gift you can give yourself. (25:19—26:31)Why the Kois experience is different than others. (26:46—28:51)Beyond the education. (29:05—30:07)The future of risk assessment in dentistry. (30:42—32:20)Find out more about The Kois Center. (32:39—33:12)Q&A for Dr. Bakeman and Kirk. (33:54—41:05)Dr. Bakeman’s contact information. (41:15—41:44)Reach Out to Dr. Bakeman:Dr. Bakeman’s email: firstname.lastname@example.org Dr. Bakeman’s website: http://www.micosmeticdentist.com/Dr. Bakeman’s Facebook: https://www.facebook.com/cosmeticdentistry.MI@betsybakemanddsResources:The Kois Center: www.koiscenter.comDr. Betsy Bakeman Bio:Dr. Bakeman teaches as an Adjunct Faculty member at the Kois Center in Seattle, Washington. She is a member of the American Academy of Restorative Dentistry and the American Academy of Esthetic Dentistry, and an Accredited Fellow of the American Academy of Cosmetic Dentistry (AACD). Dr. Bakeman is immediate Past-President for the AACD. She also serves as both Accreditation and Fellowship examiner for the AACD. She was the recipient of the AACD’s 2013 Award for Excellence in Cosmetic Dentistry Education. She maintains a full-time private practice in Grand Rapids, Michigan.
39 minutes | Jul 19, 2021
A Completely Different Perspective on How to Enjoy Dentistry with Dr. Kevin Kross
A Completely Different Perspective on How to Enjoy DentistryEpisode #320 with Dr. Kevin KrossThere is no real secret to enjoying dentistry, but there are ways to make it more pleasant for you, your staff, and your patients. To share some of those tips, Kirk Behrendt brings in Dr. Kevin Kross to help you enjoy more of your time at the office. His first tip: don't take things quite so seriously! Break the ice with new patients and spend time getting to know them. Most patients want to know about you and how you can help them, not the technical details of their teeth. For more of Dr. Kross’ tips and advice, listen to Episode 320 of The Best Practices Show!Main Takeaways:Take CE courses to learn what they don't teach you in dental school.Be open-minded toward different teaching philosophies.Show gratitude, especially towards your team.You don't need to work full-time!Be very intentional with your time.Figure out what you truly love about practicing dentistry and target that.Don't take things quite so seriously.Quotes:“I tell [students and mentees] all the time, ‘Listen, just don't take it quite so seriously.’ I think we get trained to, you know, everything is the end of the world. And early, early in my profession, I might’ve even been a dental student, when somebody told me, they kind of shrugged and said, ‘Well, at least it’s not brain surgery, right? We’re working on teeth here. But more importantly, we’re working on people. And they just want you to be honest. They want you to be straight up with them.’ It’s so rare, at least where we practice, that they want to know about their teeth. They want to know about you. They want to know how you can help them.” (08:09—08:42)“Get to know the patient. Find out what they're after, why they're even in the chair today, and what makes them tick. And just that level of communication, I think it — I hope — it displays that I'm interested in them first. Dentists can kind of get a bad reputation, I think, a lot of times, from telling them about what's wrong with them, ‘The patient wants to know what's wrong with them first.’ It’s like, don't do that. We’re all great diagnosticians, to some degree, and I think it’s just easier to get to know them on a personal level first.” (08:46—09:22)“There is no secret [to enjoying dentistry]. That's for sure. If I had to pick one word, it’s gratitude. And I've had some employees we had to get rid of. But I think we all have team members that didn't work the way you wanted to, and that kind of thing. But if you show gratitude towards a staff member, a team member, it’s not about the money so much with them. My thing is, I want to have the highest paid team around. But I think, more importantly, I want them all to always feel like they're effective at work. And I think that's really what we all want, right?” (10:16—10:58)“If you want to run a truly comprehensive practice, learn the stuff that they don't teach you in dental school. And you have to do it all-in. You can't tiptoe around this, and do a little of that, but then go back. You just have to dive in and trust the multitudes of people that have done it that way and developed really, really good practices because of it.” (17:03—17:28)“I think one thing that we maybe fail at in getting across to students is, yes, we can teach you how to do this. Yes, we can give you the protocols and all of the information and knowledge to really, really help patients far and wide. But you do have to figure out the way to implement that in a practice. It isn't going to be for every single patient that walks through your door. And that's okay.” (22:09—22:39)“For me, it took three to five years of really sitting down and focusing on a certain patient’s problem and just helping them understand it. It doesn't mean they're all going to say yes. It doesn't mean your revenue is instantly going to go from $50K to $100K to $200K a month. But over time, over a few years, if it takes 10 years, you're building these things one brick at a time, and we just have to be patient and enjoy that journey.” (22:54—23:27)“You never want to force people into doing treatment, because it isn't going to work well for you. It has to be their decision, and your job is to help them understand the problem. Pete [Dawson] used to say, ‘Any reasonable person will do the dentistry once they understand the problem.’ And that's always rung true with me, is, spend your time getting to know the patient and the patient’s circumstances and helping them understand what's going wrong.” (24:06—24:32)“John [Kois] told me a few years ago, ‘Everybody takes two months off throughout the year. But some people do it in 10-minute increments.’ And the other influence in my life is Kim Daxon, and she and I have this ongoing thing. I try and work, the joke is single-digit days. So, less than 10 days a month. I'm not as good as Kim is at this, but every year, I'd either cut hours or just shave things back. I learned to be able to take vacations and get out of the office and enjoy it. And I will tell you, every year, my revenues grow.” (30:46—31:30)“I would say take a step back and really understand what kind of dentist you want to be. Because what's neat with this job, with this profession, is you can carve out your little niche. You don't have to do it all. I just think it’s so important to identify the ways that you can help patients in what you enjoy doing and taking control of that. And if you don't enjoy it, or if it brings stress into your life, then don't do it. There are people around that are willing to help. If it means never doing another root canal, don't. You don't have to.” (33:18—34:01)“I feel bad when I hear people worried about financial pressures, or revenue, or trying to hit these financial goals in their practice because, to me, that just drives that stress. And so, my advice to a young dentist would be, find out what you really, really love about practicing dentistry and target that.” (34:03—34:26)Snippets:Dr. Kross’ background. (02:47—07:13)His philosophy on dentistry. (07:57—09:56)His secret to enjoying dentistry. (10:15—12:13)Invest in continuing education. (12:31—15:57)Learn what you didn't in dental school. (16:29—18:12)Have an open mind on different teaching philosophies. (18:53—20:26)Don't force patients into doing treatment. (21:29—24:52)Icebreakers and one-liners in the office. (25:20—26:08)Keeping the team together. (26:18—30:17)Being intentional with your time. (30:18—32:49)Advice to younger dentists. (33:12—34:26)Last thoughts. (34:47—37:01)Dr. Kross’ contact information. (37:16—37:33)Reach Out to Dr. Kross:Dr. Kross’ website: https://www.michiganavenuedentistry.com/Dr. Kross’ Facebook: https://www.facebook.com/kevin.kross.336Dr. Kevin Kross Bio:Dr. Kevin Kross received his undergraduate degree in Biomedical Science from Western Michigan University and his doctorate from the University of Michigan. He is professionally affiliated with the American Dental Association and the Michigan Dental Association. He also serves as an adjunct faculty member at the University of Michigan. Dr. Kross is also a member of the Dawson Academy, an incredible resource for providing complete and consistent dental care.Dr. Kross is married to Brittany Mailloux-Kross, DDS, who practices in Holland, Michigan. He keeps busy playing golf, fishing, cooking, and spending time with his nieces and nephews. He is also a fan of the Detroit Tigers and Michigan football.Favorite movie quote: “That’s in the lumberyard, Danny.”Favorite beverage: Cabernet Sauvignon.Pet peeves: Over-talkers.Personal trait that has gotten you in the most trouble: Oh boy, my mouth.If I could shop for free at one store, which one would it be? Costco; would be the most practical.Which of the Seven Dwarfs are you? Doc.If you were guaranteed you’d be successful in a different profession, what would you want to do? President of the United States.If you died tomorrow, what would your last meal be? Bern’s Steakhouse in Tampa.
40 minutes | Jul 16, 2021
The Future Foundation of Orthodontics with Dr. Drew McDonald
The Future Foundation of OrthodonticsEpisode #319 with Dr. Drew McDonaldOrthodontics is more than just straightening teeth. And today’s guest, Dr. Drew McDonald, explains how foundational knowledge of patients’ issues can lead to more successful treatment and happier patients. Kirk Behrendt and Dr. McDonald talk about the interconnectedness of airway and joints in ortho and how interdisciplinary understanding can help patients long term. Don't be led astray by the esthetic side of things! For more on the importance of foundations, listen to Episode 319 of The Best Practices Show!Main Takeaways:Look under the surface — the foundation — in patients’ issues.Airway and jaw joints influence structure, which leads patients into the ortho chair.Ortho is more than straightening patients’ teeth.Don't get lost in the esthetic side of things. Straight, white teeth isn't the endgame.Understand who’s in your chair so you can give them the best treatment.Quotes:“As an orthodontist, we see patients with teeth that don't fit together, teeth that are crowded, whatever it might be. But at the end of the day, when we start peeling back the layers, we’ve got to know where that came from. And what we’re starting to understand, it seems like more and more every day, is that the airway side of things, the TMJ side of things, the growth and development, that those two factors, especially, really influence and create an orthodontic patient. Somebody with a bad bite and bad teeth, under the surface, there's an airway issue, or a joint issue, or both, a lot of the times.” (06:09—06:41)“If we understand the foundation of our patients from a joint standpoint, from an airway standpoint, from even cervical, spine things, and the bone around their teeth, then we know what's going to be successful and stable long term because we’re addressing the under-the-surface things that got the patient into our chair.” (11:45—12:03)“The other nightmare of orthodontists is relapse. So, if we can understand the foundation of our patients and what got them, under the surface, into our orthodontic chair, then we set ourselves up for better success, stability, and ultimately, a happier patient.” (12:34—12:48)“Whenever I, quite honestly, wanted to be an orthodontist, I wasn't thinking about jaw joints or airway stuff. And some of that wasn't really a big part of what we were taught in school. And ultimately, I've gotten to know a lot of very influential people in my life who have taught me so much about the foundational side of joints, of airway. Dr. Mark Piper, he’s a big role model of mine. Jim McKee, in terms of the joints. They're not orthodontists. Those dudes, they put something in my head that did not come from orthodontic residency. But as I went back to patients after seeing them talk, I go, ‘This is my everyday patient. All of these Class II patients that all have clicks and pops, that's no coincidence.’” (13:26—14:15)“The things that can lead orthodontists astray is that we start thinking about the cosmetic side, the esthetics, that that's all the endgame is for these patients.” (16:48—16:56)“I think it’s easy in ortho, sadly, at this point in the game, to get led astray. And I will say, it’s a frustration of mine to see — and I'm not saying anything negative of the people that you see all over certain social media stuff. I'm just saying we have a better story to tell. And I think that the story to tell is that we can do more than straight teeth. It’s, we are the people most equipped to do more than straight teeth, and recognize it, and help people structurally.” (17:21—17:47)“You can't just diagnose something and tell somebody they need to do something. You have to be able to motivate them. And ultimately, you have to know why that person’s in the chair too.” (19:50—20:00)“I really do think that our place in the world as orthodontists is going to be involved in multidisciplinary health-related things. And again, I know that the flash is there right now of the smiles and all of that. And yes, we do that, and we’re the best at it because we know how to move teeth. We understand how to put teeth together. But wouldn't it be a good idea to put them together in the right spot, with the right airway, with the right joints, with everything else?” (31:04—31:33)“The foundational issues, if we know and embrace them as orthodontists and become specialists in the things that are really under the surface, then we open up so many new avenues to take care of patients.” (33:13—33:25)“We are equipped for this. We know how to move teeth. We know how to set up orthognathic surgery cases. We know how to get bites where they should be. And we essentially do a full-mouth rehabilitation on patients with natural teeth every day as an orthodontist. That's exactly what an ortho patient is. And if we set them up for success for what we do for them at 12, 13, 14, or even younger when we’re intercepting these things, we’ve done a way better service for our patients than just straight teeth.” (33:28—33:56)Snippets:Dr. McDonald’s background. (03:41—05:00)Why this has become important in dentistry. (05:43—08:01)Looking under the surface in patients’ issues. (08:24—12:48)Rethinking how treatment gets done right. (13:21—15:09)It’s easy to drift from the foundation. (15:45—18:58)Understand who’s in your chair. (19:40—21:20)How to differentiate yourself. (23:00—26:29)Advice for younger dentists. (26:56—30:35)The future of orthodontics is foundational. (31:03—34:21)Dr. McDonald’s contact information. (35:14—39:14)Reach Out to Dr. McDonald:Dr. McDonald’s Instagram: @drdrewmcdonald https://www.instagram.com/drdrewmcdonald/?hl=enDr. McDonald’s website: https://www.mcdonaldortho.com/Dr. McDonald’s Facebook: https://www.facebook.com/drew.mcdonald.984Dr. Drew McDonald Bio:Dr. Drew McDonald is a board-certified orthodontic specialist with a strong focus on airway and temporomandibular joint-focused treatment planning, surgically facilitated orthodontic treatment, and providing complex interdisciplinary care for patients. He lectures internationally on these topics and has contributed to literature and textbooks in these areas. Dr. McDonald is dedicated to advancing the profession of orthodontics and dentistry as a whole.Born and raised in Tucson, Arizona, Dr. McDonald’s love of baseball brought him to Albuquerque, where he played as a catcher for the Lobos from 2006 to 2008. While attending the University of New Mexico, he met his wife, Emily, a New Mexico native. He also fell in love with the Sandias, green chile, and the near-perfect weather. He graduated from the University of New Mexico in 2008 with a Bachelor of Science degree in biology and a minor in chemistry.Dr. McDonald attended dental school at the prestigious Creighton University in Omaha, Nebraska. Known for its rigorous academic curriculum and intense clinical training, Dr. McDonald received many academic accolades while at Creighton, including inductions into Omicron Kappa Upsilon (National Dental Honor Society) and Alpha Sigma Nu (Honor Society of Jesuit Universities). He also served in leadership positions as class president and student body president, and on alumni relations committees.After graduating cum laude from Creighton, Dr. McDonald was accepted as one of only three residents nationwide into the University of Missouri-Kansas City Orthodontics program, a renowned two-and-a-half-year, full-time residency known for its clinical excellence. Dr. McDonald graduated in December of 2016 with his certificate in orthodontics and master’s degree in Oral and Craniofacial Sciences.When away from the office, Dr. Drew is a “girl-Dad” to two daughters, a self-proclaimed grill master, and minimally talented yet enthusiastic golfer. You can find him taking in a Lobos game and spending time outdoors with his family.
50 minutes | Jul 9, 2021
The Top Thing Dentists Miss or Don't Ask with Patients with Dr. Tom Viola, R.Ph., C.C.P.
The Top Thing Dentists Miss or Don't Ask with PatientsEpisode #317 with Dr. Tom Viola, R.Ph., C.C.P.To make the best treatment planning decisions for patients, you need to know their medical history. And to do that, you need to ask the right questions. Today, Kirk Behrendt brings in Dr. Tom Viola to teach you the three key questions to ask patients to get their medical history. What you don't know about your patients could impact their care! To learn what you weren’t taught in dental school, listen to Episode 317 of The Best Practices Show!Main Takeaways:Know your patients’ medical history to make well-informed treatment planning decisions.All you need is the patient’s medication list and an understanding of pharmacology.Build a good team around you and teach them how to take a good medical history.Ask patients good, open-ended questions to get the information you need. The first question to ask patients is, “What do you take?”The second question to ask patients is, “Why do you take it?”The third question to ask patients is, “Did you take your medication today?”Asking those three questions will help you understand what you're getting into with patients. Substance abuse/use has an effect on dental therapy. Ask patients about it!Quotes:“We really sometimes miss [important] things when we take medical histories, when we inquire about patients’ medications. There are some things we miss because even we don't think it pertains to dentistry when, in fact, it does.” (08:00—08:12)“It goes well beyond medications and xerostomia and even system-induced xerostomia. It has to do with, do you know enough about the patient’s medical history to make well-informed, good clinical decisions in your treatment planning? And the only way you're going to really know that is if you know the patient well enough. And the only way that's going to happen is if you know their history. So, medical histories [are just as] important [as] almost anything else you do in your practice, because without knowing your patient intimately and sufficiently, you're not going to be able to make those decisions.” (08:23—08:57)“The greatest blessing ever bestowed upon dentistry was the fact that you could take the patient’s medical history directly from the patient themselves. They're right there. Right? What more convenience can there be? And the greatest curse ever inflicted upon dentistry was that you could take the patient’s medical history directly from the patient themselves. As in, if they don't know, you're not going to know. And if they don't want you to know, you're not going to know. But you can overcome that obstacle when you realize that all you really need is a list of their medications and a good working foundational knowledge in pharmacology.” (09:37—10:12)“I will tell you the thing I hear the most. In the beginning of the medical history, this is the question that gets asked, ‘Any changes to your medications?’ And immediately, the answer is, ‘No.’ Why? Because it’s easier to say no than it is to give me, the dental clinician, the information I need to be able to fill in the medical history. So, conditionally, I say, ‘No.’ And everybody’s like, ‘Okay. No.’ And we move on. But we missed so much of what we could've grabbed from that interaction.” (11:01—11:32)“Build a good team around you. You've got to invest the time and the money, if necessary, in your team to be able to teach them how to take a good medical history, what questions to ask, and how to ask leading questions and open-ended questions to get the patient to give up the information that maybe they don't want to give up, or maybe they don't know to give up.” (11:41—12:01)“Ask the right questions. So, you've had your teammate ask the questions. Now, you ask the question too, but in a different way. So, your team member could say, ‘Any change to your medications? What's new with your medications?’ Or something like that. But I have often said there’s got to be three questions from the clinician who’s actually intimately involved in that patient’s care. The first question is, not the D-word, drugs; not the M-word, medications. The first question is, ‘What do you take?’” (12:23—12:51)“I often say it like this, ‘What do you take?’ Say it with a little attitude. And that way, ‘What do you mean?’ ‘Do you take stuff?’ ‘Well, yes.’ ‘Well, what is it?’ So, that way, you get them a little bit like, ‘Whoa, should I be telling you all this?’ ‘Yes! I need to know what you're taking.’ But I don't want to say the word “drug” because that means, what? You're going to think little bottles. Or “M”, medication. Again, you're going to think little bottles. I want to know everything. I want to know prescription drugs you take, the nonprescription drugs you take. I want to know about the over-the-counter supplements you take. I want to know about the stuff you do on the weekends. I want to know everything. Give me all of it. And that way, I think I can get the best information I can from you. So, that's question number one.” (12:57—13:37)“Opportunity number two is, ‘Why do you take it?’ Because I know there are medications that people could take that are used for different things. A good example would be a drug like Norvasc, a calcium channel antagonist. I know that Norvasc is probably predominantly used for hypertension. But it can also be used to treat angina. It could also be used to treat arrhythmia. So, wait a second. How do I know what that patient’s taking that medication for? Because all I know is they said they take Norvasc. So, now, I have to ask, ‘Why do you take it?’ The first reason is so that I know what I'm treating can be influenced.” (17:22—18:00)“I want to know, number one, do [patients] understand their medical history enough to know why they take their medication, what their conditions are, and is there buy-in. Because I will get a sense of compliance if a patient tells me, ‘Oh, I take that medication for my blood pressure. That's very important.’ Or, ‘I don't know. The doc says I gotta take that pill every day.’ That means a lot to me so that I know if they're taking Norvasc and their blood pressure is high when I'm taking it right there in the office, I've got to wonder, ‘Did they take their medication?’ Because I know a lot of people who take blood pressure medications that don't take blood pressure medications. And so, that's the lead-in to opportunity number three, which is, ‘Did you take it today?’ I want to know if you bought into your drug therapy and if you are compliant. If not, that's going to mess up my understanding of your vitals, and that's going to affect the treatment planning in so many different ways.” (18:54—19:46)“Back then, if you had cardiovascular disease, you maybe took one or two drugs. If you had diabetes, you took maybe one drug like Diabinese, if you can remember that one. So, it was very rare to have people taking a lot of meds. Now, cardiovascular disease alone, you could be taking five, six, maybe even seven medications. Diabetes, you can be taking five or six medications. People say, ‘Why do you always pick on cardiovascular disease and diabetes? Well, you and I both know, and I'm sure everyone listening knows, that cardiovascular disease and diabetes and the inevitable triad that forms with periodontal disease and systemic inflammation. So, I pick on those two because those are the things, to me, that matter most in dentistry.” (23:25—24:08)“Choose cardiovascular disease and diabetes, and realize you've got at least 12 to 13 meds right there. Now, add in some issues with your GI, like reflux, heartburn, respiratory disease, especially if you're a smoker, central nervous system issues like if you have anxiety, or maybe you have difficulty sleeping. All of a sudden, I can easily get up to 20 medications without even blinking. And that's the medically complex patient, because now all those medications interact with all those other medications, and every one of them, either individually or together, can have an impact on dental therapy.” (24:23—25:01)“If my patient has cardiovascular disease, one of the first questions I'm going to ask them is, ‘When is the last time you had your cholesterol checked?’ I say this, and people say to me, ‘What the heck does that have to do with anything? Who cares about their cholesterol?’ But cholesterol is everything.” (25:49—26:04)“If you want to differentiate yourself, it’s not about marketing. It’s not about promoting yourself. It’s about giving such good care that that patient has no alternative in their mind but to see you again and again.” (32:33—32:45)“It’s an awkward and uneasy conversation to have, but you've got to ask your patients straight out, ‘Do you have, now, or have you had a history of substance use?’ If you don't want to use the word “abuse”, you don't want to use “addict”, don't. Just say “substance use” and just let them give you a positive yes or no, an affirmative or negative. Because that way, once that happens, then all the walls come down. And then, you can have the conversation like, ‘I'm not the police. I'm not here to report you to anybody. I'm not here to write anything down. I just want to know, because knowing is going to make me more informed in designing your treatment planning and knowing what's going to be safe for you and not safe for you. But if I don't know, it could be harmful.” (34:01—34:48)“With the advent of vaping, and dabbing, and all the cannabis extracts, your patient could be using cannabis, and you wouldn't even know it. ‘Okay. Well, why do I care? I don't need to know about cannabis.’ But you do, because cannabis has effects on dentistry that a lot of people aren't aware of. For example, cannabis can cause hypertension. Cannabis can cause tachycardia. Cannabis can cause immunosuppression. Well, okay, I couldn't think of three bigger things to worry about in dentistry than that.” (35:17—35:43)“Let's say I take Tagamet, or I take Prilosec. Both of those medications interfere with stomach acid production. So? So, that means you can't absorb as much calcium. So? That means you don't have normal bone homeostasis. So? That can lead to early implant failure. And I just had a conversation over the weekend with a doc at the Study Club. He’s like, ‘You know what, Viola? I never knew that. I've got all these cases where I don't know why their implant failed within the first four to six weeks, and you just told me that a drug for heartburn can have an impact.’ That's the kind of stuff that matters. Pharmacology is really more important than you thought it was in school.” (43:09—43:49)Snippets:Dr. Viola’s background. (4:00—05:32)Why this topic is important to dentistry. (07:03—09:03)Challenges on the patient and clinician side. (09:31—12:21)The first question to ask patients. (12:22—14:35)Follow-up questions to unknown medications. (14:49—15:50)Why pharmacology is important. (16:00—17:07)The second question to ask patients. (17:15—20:05)How transparent are patients about their medications? (20:16—21:45)Advice for younger dentists. (22:50—25:01)Other trends or things that are missed that are important. (25:20—30:04)Dentists and hygienists diagnose more diverse illnesses than other clinicians. (30:42—32:45)Other important things to pay attention to with medical history. (33:30—38:45)There will always be a place for opioids in dentistry. (39:27—44:13)Last thoughts. (44:28—46:00)Dr. Viola’s contact information. (46:22—48:29)Reach Out to Dr. Viola:Dr. Viola’s website: https://www.tomviola.com/Dr. Viola’s podcasts: https://www.tomviola.com/category/podcasts/Dr. Viola’s Instagram: @pharmacologydeclassified https://www.instagram.com/pharmacologydeclassified/?hl=enDr. Viola’s Facebook: https://www.facebook.com/tomviolarphDr. Tom Viola Bio:THOMAS A. VIOLA, R.Ph., C.C.P.With over 30 years of experience as a pharmacist, educator, speaker, and author, Tom Viola, R.Ph., C.C.P., has earned his reputation as the go-to specialist for delivering quality continuing education content through his informative, engaging presentations. Tom’s sellout programs provide an overview of the most prevalent oral and systemic diseases and the most frequently prescribed drugs used in their treatment. Special emphasis is given to dental considerations and strategies for effective patient care planning.As a clinical educator, Tom is a member of the faculty of 12 dental professional degree programs and has received several awards for Outstanding Teacher of the Year. Tom instructs dental hygiene students and practice dental hygienists in pharmacology and local anesthesia in preparation for national board exams. As a published writer, Tom is well-known internationally for his contributions to several professional journals in the areas of pharmacology, pain management, and local anesthesia. In addition, Tom has served as a contributor, chapter author, and peer reviewer for several pharmacology textbooks. As a professional speaker, Tom has presented continuing education courses to dental professionals internationally since 2001. Meeting planners agree that Tom is their choice to educate audiences within this specialty.
52 minutes | Jul 5, 2021
Whine About it With the WINEgenist with Katrina M. Sanders, RDH, BSDH, M.Ed, RF
Whine About it With the WINEgenistEpisode #316 with Katrina M. Sanders, RDH, BSDH, M.Ed, RFShe isn't everybody’s cup of tea, but she is someone’s glass of wine! Today, Kirk Behrendt introduces Katrina M. Sanders, The Dental WINEgenist, to share her passion for dental hygiene and good wine. Great conversations need great wine! And with the two combined, she hopes to support, encourage, and empower others to elevate dentistry. If you're a dental professional who needs to whine about dentistry with wine and a like-minded tribe, listen to Episode 316 of The Best Practices Show!Main Takeaways:COVID-19 exposed many existing problems in dentistry.The Dental WINEgenist sparks conversations about those problems.Dentistry can be isolating since professionals are siloed in their own operatories.And because dental professionals are isolated, it stops communication and great ideas.Join The Dental WINEgenist to share ideas and support one another in elevating dentistry.Great conversations require great wine!Quotes:“It is isolating. We’re stuck in this operatory where now, a lot of times, we don't have other colleagues to share ideas, ‘Hey, come look at this X-ray. What do you see?’ If you're a one-doctor practice, you don't have somebody aside from maybe your hygienist to share some of those ideas. And if you're one hygienist in the practice, you don't have somebody to help you sharpen instruments. Or if you're struggling to remove that piece of calculus, you don't have a colleague to bring into the operatory to help you out. And so, this is, I think, where a lot of ideas stop, a lot of high-level clinical practice care stops, and I wanted to be a part of the conversation that isn't happening in dentistry. And so, you want to have a fabulous conversation, you've got to bring some great wine. So, that's who we are. The birth of the WINEgenist.” (12:05—12:53)“I think dentistry was caught with its scrub pants around its ankles when the pandemic happened. And the reason for that, I think, first and foremost, is that a lot of things that we needed to address in dentistry but hadn't had been swept underneath the front office rug. There are things that we should've been talking about, like lack of leadership and efficiencies within the practice.” (17:35—17:57)“I think that what I do is highly essential. I'm not risking my life [during COVID-19] to just clean someone’s teeth. I'm an inflammatory specialist who’s highly trained in infection control. And before I go back to the operatory, I want to make sure that we’re doing this safely so that I'm not putting myself at exposed risk, nor am I putting the rest of the team members or other patients at risk. And that's where the conversation got away from us, is because these conversations that we should have been having about the essential nature of the work that we do, the responsibility that we have to the profession, that conversation went out the window. And it was more about us having fears about our safety, or lack thereof, when we go to work.” (19:48—20:27)“The concern really became, so much was swept underneath the rug. And with one wave of a regulatory hand, boom, everything got blown out and it was exposed — we were exposed as dental professionals — to the things that were inadequate in our profession, conversations that needed to be happening. And that's where I think we’ve had the opportunity since March 17th to do better as a profession, to take what it is that we’ve experienced during this global health and financial crisis and really create the pivots that dentistry has so desperately needed for so long.” (20:53—21:33)“We started to see patient screening taking effect [during the pandemic]. And what that did, that peeled back the layer that a lot of hygienists have had grief about for a long time. And that is, how do you update health history information on patients who are not interested in updating health history information? Well, now, it kind of became this societal norm that if you walk in somewhere, you want to get an eyebrow wax, you have to fill out a form stating where you've been, if you're experiencing any symptoms, etc. So, dentistry could help supplement a lot of those things.” (26:00—26:30)“The incredible amount of information out there linking oral inflammation, oral disease, oral biofilm right back to COVID-19 has been incredibly impactful. My provocative idea on that being, remove the word “COVID” from the conversation and add in stroke, heart disease, upper respiratory tract infections, certain types of cancers, diabetes, any other one of the 57 biological conditions or diseases that have a plausibility back to periodontal disease. And I think we can all agree that we now have a scintillating conversation that we can have with our patients.” (26:33—27:08)“In my opinion, the best thing that came out of this pandemic is we now have an educated community, a community that understands disease prevention, that understands infection control, and is now looking to the medical entities to help support them in health, wellness, and vitality.” (29:47—30:03)“A lot of us, early on, before this pandemic even happened, I was speaking about high-volume evacuation aerosol mitigation. And I had warned the dental community that we’re practicing in the petri dish of dentistry, so to speak, that there are aerosols everywhere and that we do need to be concerned about airborne infection. And quite honestly, I was trying to promote the use of high-volume evac, and the right PPE, and Level 3 masks, and wearing hair caps, and nobody wanted to listen to me. And then, March 17th rolls around, everyone’s drinking green beer and now sliding into my DMs like, ‘Hey, I'm ready to listen to you.’” (32:51—33:28)“I started to see a lot of non-dental professionals following a lot of my content because they wanted to understand appropriate infection control standards, or even what to expect from their dental professional when they go into their dental appointments. And so, I think we’re going to see a lot more curiosity on the general public side as well, which I'm excited about.” (33:48—34:09)“Early on, I gathered some data from the CDC about where the general public is gathering most of their information about COVID-19. And wouldn't you know it, right at the top was the news, followed shortly thereafter by social media, followed by looking at the newspaper, listening to the radio. And then, down toward the bottom of all of that was healthcare providers. That's us, way down at the bottom. So, social media, the news, what was happening on the internet, going to the grocery store, all of those pieces of information were providing more readily available content for the general public to metabolize versus [dentists and dental professionals]. And this is where we missed the mark.” (35:25—36:09)“The final piece that I want to share, this was a new statistic that came out. I read this in a research article a few weeks back, that now with people working from home, people are reading their snail mail more. So, a paper newsletter or a paper postcard with information to the general public, more people are reading that now more than ever because so many entities are going to a virtual platform with so much. So, maybe considering your patient population. Are they a patient population that you may get their attention a little bit more readily if you're sending a paper newsletter to them?” (37:59—38:35)“What you put out on social media, people can see. And dentistry seems to be one of those professions where we have no problem bullying each other and attacking each other, judging each other on social media platforms for our clinical decision-making or, ‘Why would you do that? Why would you say that to the patient?’ And I'd really love to implore people listening to be kind to each other, because we can't tear each other down. Now, more than ever, we have to come together. And now is the opportunity for us to have a collective conversation that helps elevate our profession and support the community in health, wellness, and vitality.” (39:35—40:13)Snippets:Katrina’s background. (05:11—07:09)Origins of The Dental WINEgenist. (07:46—11:10)Dentistry can be isolating. (11:30—13:10)Becoming a Level 1 sommelier. (13:50—15:59)Whining in dentistry. (16:44—21:36)Changes since the pandemic. (23:06—30:03)The future of dentistry. (31:30—34:09)Proactively educating your patients. (35:17—38:45)Last thoughts on whining in dentistry. (39:14—40:16)Katrina’s contact information. (40:43—41:43)Q&A: Do you make a pros and cons list, or just go with your gut? (42:36—44:16)Q&A: Who was the best boss you've ever had, and what made them the best? (44:30—48:02)Q&A: What is something that you love that is vintage? (48:12—50:09)Reach Out to Katrina:Katrina’s website: https://katrinasanders.com/Katrina’s email: email@example.com Katrina’s Facebook: https://www.facebook.com/katrina.sanders.948Katrina’s Instagram: @thedentalwinegenist https://www.instagram.com/thedentalwinegenist/?hl=enKatrina’s LinkedIn: https://www.linkedin.com/in/katrina-m-sanders-rdh-bsdh-m-ed-rf-39547bb4Katrina’s podcast: @toothordare.podcast https://www.instagram.com/toothordare.podcast/?hl=enKatrina M. Sanders, RDH, BSDH, M.Ed, RF Bio:In the ever-changing world of dental science where research, technology, and techniques for patient care are constantly evolving, dental professionals look to continuing education to provide insight, deliver actionable steps, empower, and create a dramatic impact within their clinical practice.With wit, charm, and a dash of humor, Katrina Sanders enchants dental professionals with her course deliverables, insightful content, and delightful inspiration. Her message of empowerment rings mighty throughout her lectures and stirs a deep sense of motivation amongst course participants.Katrina is the Clinical Liaison for AZPerio, the country's largest periodontal practice. She performs clinically, working alongside Diplomates to the American Board of Periodontology in the surgical operatory. Katrina perfected techniques during LANAP surgery, suture placement, IV therapy, and blood draws. She instructs on collaborative professionalism and standard of care protocols while delivering education through hygiene boot camps and study clubs.
37 minutes | Jul 2, 2021
Seeing the Clinical/Technical Reality with Dr. Bob Winter
Seeing the Clinical/Technical RealityEpisode #315 with Dr. Bob WinterThere is a lack of communication between dentists and the lab. And to explain why that is and how to close that gap, Kirk Behrendt brings in Dr. Bob Winter for his insight into both the clinical and technical sides of dentistry. Keeping standards and expectations high is great — but keep them grounded in reality! For more advice on communicating effectively, listen to Episode 315 of The Best Practices Show!Main Takeaways:Dental students aren't taught how to communicate and interact with dental labs.Because of this, there's a lack of effective communication between the two.Dentists expect perfection from the lab without communicating effectively. Dentists should make an effort to find the right dental lab to collaborate with.Learn to diagnose and treatment plan comprehensively.Technology helps simplify things but isn't a panacea.You still have to think analog in order to use digital technology. Digital isn't a prerequisite to becoming a quality dentist.Quotes:“In dental school, we learn a lot of basic concepts. And then, when we get into a practice, we’ve learned a lot of clinical steps. But unfortunately, in most schools, we don't learn a lot about the communication and interaction with dental laboratories. We just expect certain outcomes, and yet we don't communicate very effectively with dental laboratories. We just expect perfection, and we don't know how to interact and communicate because we’re not taught that in school.” (09:56—10:35)“Today’s technology is evolving so quickly because of the digital world, whether it’s digital photography or even things like we’re doing right now. We can communicate with individuals around the world, real-time. So, [technology] simplifies things, but it’s not necessarily the panacea that solves our problems. And in the digital world, there are some current weaknesses in how it relates to the traditional analog world. And so, I'm just super excited to see all of it evolve. And hopefully, sooner than later, there's a seamless transition from analog to 100% digital.” (12:05—12:47)“The only thing that makes me, as a specialist, a prosthodontist, different than anyone else is, I'm trained to look at patients comprehensively and to diagnose and treatment plan comprehensively. When it comes to procedures I do, it’s not different than any restorative person. So, it’s all about seeing the patient in a holistic manner and comprehensively. And in dental school, they get a reasonable exposure to that. But once you start seeing patients, you realize it goes beyond one tooth, or two teeth, or three teeth, or quadrants; it’s full-mouth evaluations.” (13:23—14:07)“We can treat individual teeth fairly predictably. But when you see people with debilitated dentition, severely worn dentitions, multiple missing teeth, then looking at the big picture and understanding comprehensively what the needs are, I think, is the key.” (14:21—14:42)“Unfortunately, there's a lack of effective communication between the dentist and dental laboratory. If you look at the percentage of prescription forms that are completely filled out, or at least to get enough information to do the cases comprehensively, it’s lacking. So, the expectations are really high of what you want in return, but the upfront communication is lacking.” (15:25—15:53)“Many dentists, the more comprehensive cases, they want the technicians to solve the problems. But the dentist has to realize technicians do not have a dental training background. They can look at photos, they can look at mounted casts, and they can look at how you make the nuts and bolts work. But it’s still relying on the dentist’s clinical skills and understanding to help really definitively drive the treatment plan.” (16:12—16:41)“The key is making the effort in finding the right laboratory that's willing to collaborate. And again, there're all kinds of laboratories, just like there’re all kinds of dentists. If the laboratory is on a good enough level and just trying to match your shade tab and send it out the door, they're doing higher volume, that's one approach. And it may service a lot of people well. But if you're trying to elevate your outcomes to patients, then you have to work with laboratories that want to put a little bit more effort into that collaboration. And that can certainly be found around the country where the digital world allows us to do that more effectively.” (18:09—18:53)“If you look at remakes in laboratories, the most common is shade. But after shade, it’s getting into the fit of the restoration. And the reason I'm mentioning this at the moment, it’s almost like a black-and-white issue. Either you can see the margin, or not. And those people working digitally have an opportunity to blow the image up on their monitor and try and discern the margins. And they can easily mark their margin and take the responsibility for their preparation finish line, where in the analog where you're working with silicone impressions and stone models, classically, the dental technician has to find the margin, mark the margin, and make the restoration to that.” (20:18—21:03)“I look forward to the day where the accuracy of printed models is the same as a polyvinyl impression in a stone model. So, I think that can revolutionize dentistry, honestly. And we’re getting closer. But that's maybe the weak link, so understanding of that, I think, is essential.” (22:16—22:37)“At the end of the day, I always say that you have to think as an analog dentist in order to use the digital technology. At least, it helps immensely. So, the more you learn on the analog side of things, because currently, we still have to use our hands and our brains to prep teeth and take impressions and do things like that.” (23:32—23:56)“I'm all for digital. I'm all for learning it. But you don't have to do that to become a quality dentist. If you're coming out of school, younger individuals, learning and doing the traditional approach is still a great option. It’s been the standard of care for a long time, and there's nothing wrong with doing that.” (24:58—25:20)“Keep your thoughts and expectations grounded in reality. I always talk about my perfect world, ‘If I have a perfect world, I would do this, this, this, and this, and have this outcome.’ But we realize that there is no perfect world, so you have to be grounded in the reality of what's currently available. And if you're challenged by certain things that you're getting back technically working with a dental laboratory, troubleshooting and trying to grow together as a team is important, and being grounded in the expectations of what's possible. Always shoot for the stars and always evolve and grow and develop, yet still grounded in the reality of what's current today.” (30:39—31:37)Snippets:Dr. Winter’s background. (02:59—04:23)How he got involved in the clinical and technical sides of dentistry. (04:44—07:30)How he got to California from Milwaukee. (07:37—09:27)Why this is an important topic in dentistry. (09:55—11:26)Technology simplifies things but isn't a panacea. (11:39—12:47)Biggest challenges for young dentists. (13:07—14:42)It’s all about effective communication and collaboration. (15:18—16:48)Find the right dental labs. (17:47—18:53)Discrepancies between clinical and technical realities. (19:16—22:37)Advice on digital versus analog. (23:13—25:20)It’s the thinking that gets polished, not so much the hands. (25:59—27:55)The future of this aspect in dentistry. (28:25—30:21)Last thoughts on the clinical and technical reality. (30:36—31:37)Dr. Winter’s lab and courses at Spear Education. (31:57—35:33)Reach Out to Dr. Winter:Dr. Winter’s website: https://winterdds.net/Dr. Winter’s Facebook: https://www.facebook.com/robert.winter.796Esthetics by Design: https://ebdlab.com/Dr. Bob Winter Bio:Dr. Winter graduated in 1981 from Marquette University School of Dentistry. In 1983, he completed his Prosthodontic Specialty Residency in Milwaukee, Wisconsin, at the VA Medical Center. Since 1983, he has maintained a private practice limited to prosthodontics and a commercial laboratory specializing in highly esthetic restorations. In addition, since 1984, he has taught clinical and technical courses worldwide to dentists and dental technicians. Dr. Winter is a principle instructor at Spear in Scottsdale, Arizona, the world’s largest private continuing dental education facility.He is a Past President of the American Academy of Esthetic Dentistry where he remains a member and is a member of the American Academy of Restorative Dentistry and the American Dental Association. Dr. Winter is a member of the graduate prosthodontics faculty at the University of Washington and the University of Southern California, and is on faculty at Midwestern University College of Dental Medicine in Phoenix, Arizona.Having taught more than 900 didactic, clinical, and technical courses in over 40 countries, Dr. Winter is recognized around the world as a premier clinician, dental technologist, and master ceramist. This unique blending of disciplines and talent continues to keep him in high demand as an educator and speaker. Dr. Winter sits on the advisory boards for the Journal of Esthetic and Restorative Dentistry, The International Journal of Periodontics & Restorative Dentistry, and the International Journal of Implant Dentistry. He is involved in research and product development pertaining to new dental materials.Dr. Winter has a line of specific preparation design burs developed for Brasseler USA, and was a co-developer of d.SIGN® dental ceramic for Ivoclar-Vivadent. In 1991, he was the second recipient of the Gordon Christensen Lecturer Recognition Award for Excellence in Restorative Education. In 2005, Dr. Winter was named Marquette University School of Dentistry Distinguished Alumni of the Year. In 2018, Dr. Winter received the inaugural Distinguished Lecturer Award from the prestigious American Academy of Esthetic Dentistry.
33 minutes | Jun 28, 2021
TeamSmile Gives Back with John McCarthy from TeamSmile
TeamSmile Gives BackEpisode #314 with John McCarthy from TeamSmileIn 2007, 12-year-old Deamonte Driver lost his life. And the cause was a treatable one — if only his mother had dental insurance. Enraged and inspired after hearing Deamonte’s story, Dr. Bill Busch created TeamSmile to provide free dental care for children in need. And today, Kirk Behrendt brings in John McCarthy from TeamSmile to share the impact and importance of dentists participating in this program. For more on why you should volunteer with TeamSmile, listen to Episode 314 of The Best Practices Show!Main Takeaways:A 12-year-old boy, Deamonte Driver, passed away from an untreated tooth infection.Upon hearing Deamonte’s story, Dr. Bill Busch was inspired to start TeamSmile.TeamSmile’s core is to provide free dental care for children in need through the power of sports.The TeamSmile model doesn't work without volunteers!These programs provide life-changing services and can also save lives.Quotes:“The mission of TeamSmile is to provide a life-changing dental experience through the power of sports. In a nutshell, what we do is we throw dental tailgate parties. We go into communities such as Milwaukee and we set up in a baseball stadium. We work with the Brewers. We work in Kansas City with the Chiefs, the Royals, in supporting KC. But we’re at the point now where we are truly national. We’re working in Fenway Park with the Boston Red Sox, and we’re in California with the Angels and the Rams, and so on. So, we’re literally coast to coast, north to south.” (05:34—06:08)“Prior to the pandemic, we conducted 33 programs in one calendar year, impacted 7,126 children, and did over $2.8 million in free dental care and oral health education. But in a nutshell, we create these large dental clinics in stadiums and arenas. We literally set up about $650,000 worth of equipment and supplies while we’re in Fenway Park, while we’re in Target Stadium in Minnesota, while we’re in Arrowhead in Kansas City, and on and on. We work in New Orleans at the Superdome, and Mercedes-Benz in Atlanta — which is spectacular, by the way. But we will set up enough where we’ve got 16 dental operatories.” (06:09—06:54)“The Deamonte Driver story, in short, was a little 12-year-old boy in the Baltimore D.C. area that had a toothache. Single mother, very little money. Had a toothache. But the mother said, ‘We can't go to the dentist because we don't have dental insurance. We don't have the money to pay for that.’ Well, it got more and more painful, and so he went to the hospital. Dr. [Bill] Busch is watching this at home in Kansas City on an NBC Nightly News special with Brian Williams. Well, [Deamonte] goes to the hospital, and the hospital doesn't have a dentist on staff. They tried to pat him on the back and do what they could for him there and sent him home. That toothache got infected. That infection spread to his brain. At 12 years old, Deamonte Driver passed away. And Dr. Busch — I talked to him a lot about this — he said, ‘I was mad. I was upset, thinking, ‘We live in the most wealthy country in the world, and we’ve got a 12-year-old boy that didn't have to die if he was treated appropriately. Could've been completely fine if he was treated. And here he is, dead.’ And he started thinking, ‘What can I do?’ (07:39—08:39)“I think this concept was just brilliant, looking at it, because what we do is, not only do we have stadiums and arenas, but we’ve got a DJ for all of our programs, we have face painters, we bring out the players, the cheerleaders, the mascot. And so, what the intent is, is to use these stadiums and use these teams — and by that, I mean players, cheerleaders, mascots — and create an environment that is cool, that is fun, takes the fear out of dentistry. There’re a lot of children that we’re dealing with that have never been to a dentist. They may be 10, 12 years old, and have either never been to the dentist, or they're scared of the dentist. They're a kid, they're afraid that it’s going to hurt, and they're scared. Well, all of a sudden, the fear tends to go away when you start dancing with a mascot, or you're dancing with the cheerleaders there in the stadium. And it creates the cool factor, if you will, for these kids, that they forget about going to the dentist.” (10:05—11:02)“The core of what we do is free dentistry for children that are at-risk that really need it. But while we’re doing that, we want to make it cool and fun so they're not scared of going to the dentist. We don't want their first dental experience to be one of fear. We want it to be fun and exciting. And through sports, we can do that. And we’re doing it.” (11:18—11:37)“TeamSmile doesn't work, the model doesn't work, without volunteers. And if you think about it, there were 4,000 people who took their day off to serve others through the TeamSmile model. I'm just awed by that. These dentists closed their practice for a day. Sometimes, it’s their day off. Sometimes, they’ll close their practice and bring their whole staff that'll come out, or even just take the day off. They could be making a lot of money on that day, and they choose to serve others rather than serve their own practice that day. That is so impressive to me. What a great community of people the dental community has provided.” (13:57—14:35)Snippets:John’s background. (03:20—05:11)What TeamSmile is, its evolution, and why it’s so unique. (05:31—09:46)Why this is an important concept, and why it works so well. (10:04—11:38)Localized support from the dental community. (12:15—14:41)The logistics of TeamSmile. (15:49—19:07)Potential impact of oral health on the world. (19:29—22:07)Trade support with providing these programs. (22:38—24:41)How to get involved and volunteer. (24:55—30:22)TeamSmile contact information. (30:49—31:14)Reach Out to John:TeamSmile website: www.teamsmile.orgTeamSmile Twitter: @teamsmile https://twitter.com/teamsmile?lang=enTeamSmile Facebook: https://www.facebook.com/teamsmileJohn McCarthy Bio:John McCarthy joined TeamSmile as Executive Director in May of 2017. He’s excited to help fulfill the mission of TeamSmile by using sports as a force for good in American society. He believes that this is a tremendous platform to make a positive impact on the lives of thousands of children, and seeks to inspire people to spread kindness, seek peace and happiness, and follow their passion.McCarthy has been involved in various capacities within college athletics for over 25 years. At the collegiate level, he’s been a Head Coach (Wilmington College, DE), Athletic Director (Lynn University), Founder of the Collegiate Basketball Invitational, and Director of the NAIA’s Division I Men’s Basketball National Championship. He’s currently the Founder and Owner of Small College Basketball (www.smallcollegebasketball.com).Additionally, McCarthy has been very engaged in the nonprofit community since 2013, as he’s served as Executive Director of Charlie’s House and Development Director of Miles of Smiles. During his time at Charlie’s House, the organization had their four highest fundraising years ever, while distributing more child safety materials and growing the website traffic to new heights.McCarthy has become one of the country’s preeminent authorities on small college basketball. He has been quoted in USA Today, Basketball Times, The Indianapolis Star, the Wilmington News Journal, The Kansas City Star, and Time-Out (NABC’s publication), among many others.He’s written the “Foreward” for Danny Stooksbury’s National Title and written articles in the Sports Business Journal, Time Out, Kansas City Star, HoopScoop, and many others.McCarthy also travels the country, speaking to coaches and athletic administrators at all levels, of all sports, through his nationally-renown presentation, “Lessons of the Legends”. More recently, his presentations, “Life Lessons” and “The Real Recruiting Process,” have become prominent on the speaking circuit as well.
38 minutes | Jun 25, 2021
A New Look at Occlusion with Dr. Jim McKee
A New Look at OcclusionEpisode #313 with Dr. Jim McKeeJoints are connected to everything in dentistry, yet no one wants to do it — or knows how! And to help you understand and rethink occlusion at the joint level, Kirk Behrendt brings in Dr. Jim McKee so you can build this into your dentistry. Don't let occlusion be the weak link in your practice! To learn more and gain confidence in treating occlusal problems, listen to Episode 313 of The Best Practices Show!Main Takeaways:Occlusion is the weak link for most dentists.How dentists define occlusion is actually not reality.When thinking about occlusion, think at the joint level, not just the tooth level.If you have a bad joint, you're going to have a bad bite.Gain confidence in occlusion at the joint level, and your practice will skyrocket.Quotes:“I really realized that occlusion was the weak link for most dentists because it’s what we come out of dental school with being the most — we’re not confident in it. We see occlusal problems, and we’re not totally sure what to do with them.” (05:09—05:24)“So many patients that sit in our chair have occlusal problems. But here’s the problem. When that young dentist talks about occlusion, what they're typically talking about is how the teeth fit together. Because as dentists, that's how we define occlusion. That's not reality though, because when you think about it, really, it’s how the lower jaw fits to the upper jaw.” (06:44—07:09)“I have to credit Mark Piper for this, because Mark was the first person that showed me an MRI back in 1990. And it changed the way I thought about occlusion, because I started thinking not just at the tooth level, but at the joint level. And really, I think we’ve had the thought process backwards. The discussion was always, ‘Does an uneven bite cause a change in the joint?’ Because typically, it might cause us to clench our teeth, we might start to brux, the muscles would pull on the disc, and eventually the disc will displace. What I've learned over the years is that I think we have to look at it the other way around.” (07:37—08:14)“There was just an article published in Cranio in January of this year that talked about if you have a malocclusion, your odds increase that you have structural changes at the joint. So, we’re really starting to get a better handle on it. And that's why I think we need to take a new look at occlusion. Because I will tell you, if as a restorative dentist you can gain confidence in occlusion, not only at the tooth level but at the joint level, your practice will explode.” (08:37—09:05)“I absolutely believe two things. There are more structural changes in the joints than, as a profession, we believe. We were taught five to 10% of people might've had significant intracapsular problems. The number is at least a third. The other thing is that, really, in order to gain confidence at the restorative level, I think we have to understand the joints.” (10:20—10:48)“Pete Dawson was the one who told me this many years ago: there has to be a reason why people are going to come to you — other than your insurance, other than the times you're open. They have to come to you for a clinical reason.” (11:07—11:18)“It’s interesting. Everyone wanted to be an esthetic dentist. Everyone wants to be an airway dentist. Everyone wants to do implants. No one wants to do joints. And yet, if you have an airway case, if you have an esthetic case, if you have an implant case, we have to know the condition of the joints in order to be able to treatment plan predictably.” (11:23—11:43)“The jaw joint, we don't think about it like an orthopedic joint. But in essence, that's what it is. And if we really think about it, it’s the first orthopedic joint that's injured in life. People don't tear their ACL when they're three years old. People don't tear their rotator cuff when they're three years old. People do fall out of the tub and hit their chin on the tub and start to injure a ligament, though, when they're three years old, at the jaw joint. They fall off a bike when they're five.” (12:40—13:06)“I don't think we see as much degenerative joint disease as we see developmental joint disease. That's the problem. We’re seeing patients that aren't growing. And one of the easiest ways to look at that on a CT scan is simply to measure the ramus length.” (19:45—19:59)“I'm going to borrow a quote from Mark Piper. Mark says the most expensive thing a patient can do is not get diagnosed. And what I have seen is patients who have spent thousands of dollars, and quite honestly, probably thousands of hours too, chasing after treatment that literally had no chance of being successful, but we didn't know that because we didn't see the joint anatomy. We have to do better at that.” (23:40—24:06)“There's no one looking at the joints. There is absolutely no one looking at the joints. And again, the question is, who does that fall to in dentistry? We had a study club meeting last night at home, and one of the questions was, ‘I don't understand why my orthodontists don't image the joints.’ And I'm going to throw a little different twist at it. Honestly, I think we’ve kind of hung orthodontists out to dry, and I think we need to support orthodontists better than we have in the past. I think that when you start to see these patients that may have a joint-based problem, instead of just sending them to the orthodontist to get the bite fixed, wouldn't it be great if we could take a look at their joints and then talk to the orthodontist about that before they start looking at how to move the teeth?” (27:17—28:05)Snippets:Dr. McKee’s background. (04:10—06:19)Why occlusion is an important conversation. (06:43—09:24)Are joints changing? (10:00—11:59)Ask the right questions about jaw joints. (12:26—13:34)What dentists get wrong. (13:54—15:27)Look closer at joints in young patients. (15:57—18:09)Females have a higher incidence of joint-based issues. (18:17—20:20)The relationship between the palate and joint. (20:45—22:04)Myths about crazy patients. (23:15—25:15)How treatment planning has changed. (25:32—26:53)Don't hang your orthodontists out to dry. (27:15—29:14)Occlusion impacts different cases. (29:51—30:43)The future of occlusion. (31:00—31:52)Dr. McKee’s courses at Spear Education. (32:08—35:38)Reach Out to Dr. McKee:Dr. McKee’s Facebook: https://firstname.lastname@example.orgFurther Reading:“Malocclusion complexity as an associated factor for temporomandibular disorders. A case-control study” by Iván Daniel Zúñiga-Herrera, et. al: https://pubmed.ncbi.nlm.nih.gov/33407059/ Dr. Jim McKee Bio:Dr. McKee is a member of the Spear Resident Faculty. He has maintained a private practice since 1984 in Downers Grove, Illinois, where he treats a wide variety of cases with a focus on predictable restorative dentistry. He is a member of the American Academy of Restorative Dentistry and former president of the American Equilibration Society. He has lectured both nationally and internationally for over 25 years and directs several study clubs. Dr. McKee graduated from the University of Notre Dame in 1980 and earned his dental degree from the University of Illinois College of Dentistry in 1984.
36 minutes | Jun 21, 2021
Could It Be Airway? with Dr. Tracey Nguyễn
Could It Be Airway?Episode #312 with Dr. Tracey NguyễnAirway isn't just appliance therapy — it’s about reducing the risk of sleep-related disorders for overall health. And today’s guest, who didn’t like or start out with sleep dentistry, is here to explain why all dentists should be thinking about airway in their practice. Kirk Behrendt and Dr. Tracey Nguyễn talk about focusing beyond just patients’ teeth, and how airway is connected to everything. To learn how to get started, listen to Episode 312 of The Best Practices Show!Main Takeaways:Disorders we see in children are related to airway issues.Dentists are as important as sleep physicians in managing sleep-related disorders. Other physicians need to know that dentists can help treat patients.Patients trust dentists. They spend more time with dentists than primary care physicians.Start with the medical history. Get to know patients before looking in their mouth.Reach out to different specialists for support.Airway is connected to everything!Quotes:“What's going on right now with all these diseases, especially with children, all the neurocognitive issues, the ADHD, I kind of realized that, ‘Wow. Could this all be airway issues?’ And the best person to manage the face is a dentist. And so, I didn't understand why we were not equally as important as a sleep physician. The first person that a child should get a referral to is the dentist.” (07:11—07:39)“I think the profession that has the most influence in change is dentistry. I mean, medicine is really all about management. I had a five-year-old on a CPAP, and I talked to the physician. I was like, ‘Okay. What's the endgame of this? What do I need to do to get this child off of CPAP?’ And the sleep physician said, ‘What do you mean?’ I was like, ‘What do you mean, you don't understand what I mean?’ I was like, ‘What is the endgame?’ And for them, they didn't even understand that, because medicine is about management.” (08:08—08:47)“You see [issues] in all ages. And the question you have to ask is, ‘Could it be airway, and could my dentistry impact the airway positively or negatively?’ So, I think that's a very important conversation to have. Patients trust the dentist. They spend more time at the dentist than they do at their primary care. And we connect the dots.” (10:54—11:20)“The way dentistry is working is, we’re trying to get beyond just looking at pictures of teeth and be like, ‘Well, let's start with the medical history. What's going on? Who is this patient?’ Your first class in treatment planning should be understanding the medical history. We kind of skip that. As physicians, we forget the medical history and we go straight to taking pictures of teeth. So, I'd like us to slow down. I think that when you slow down, you get to know the patient, then you develop that trust.” (12:01—12:35)“With airway dentistry, it’s no different than restorative dentistry. You're going to need your orthodontists. You're going to need your oral surgeons. You're going to need your specialists. So, it’s just a different way of managing it. And you're managing it from a health’s perspective now.” (14:27—14:43)“With kids, all the neurocognitive [consequences appear] before you see the malocclusion. So, when they come into your office for that first dental cleaning, that’s so important. You’ve got to recognize the sleep problems before you send them to the orthodontist. And the adult world is obviously a little bit different. But it always goes back to screening and understanding the signs and symptoms.” (15:06—15:35)“Before, I was just focused on the esthetics. But now, when you come from a health perspective, a perspective where you actually care about the patients’ well-being and things that you can do for them, your case acceptance for your treatment skyrockets. Because now, the communication is, ‘Wow, this person really cares about how I feel, how I look. And my dentistry could actually improve how I feel outside of how it makes me smile and the esthetics. I actually can feel better.’” (16:54—17:27)“I would say for new dentists, I get it, you're trying to make the money. You're trying to pay the bills. But you want to develop a loyalty, a trust. When the patient trusts you, they will pay whatever you tell them — they will accept whatever you think that they need. And that's the bottom line. And for them to trust you, they have to know that you care. And to know that you care, you have to know who they are.” (18:25—18:56)“Any time the patient sits down, the first thing we do is, ‘Who are you? Where have you been? How has your life been? What's your health?’ before I even look at your mouth. So, it’s a different relationship. So, I would say for new docs, slow it down. In this field, what I'm finding is you're going to have two classes. You're going to be the top or the bottom. The middle class, you're not going to survive.” (19:04—19:37)“I didn't jump into sleep dentistry. I didn't like sleep dentistry. I didn't like it because it was oral appliances. I was like, ‘Is this the best that I can do, just make an oral appliance and just be like, the teeth are going to be wherever they need to be, because that's where you need to be to live?’ And it was funny because that was what a lot of people told me, like, ‘Tracey, would you rather have them dead or alive?’ I was like, ‘Yeah, but can they be alive with good teeth too?’” (21:53—22:17)“I hope that we become a field that is more integrated in medicine. My hope is that if a medical doctor does a quick exam, they can look at risk factors and refer to the dentist, and vice versa. So, I hope there will be more communication with the dental community and the medical community because it’s all related.” (25:44—26:07)“As you get into this rabbit hole, I call it a rabbit hole, you start to think, ‘Oh my gosh, all the dentistry that I have been doing, there's an airway component.’ TND, airway component. Bruxism, airway component. Broken front teeth, airway component. We’re like, ‘Crap, how did I miss all of this?’ And so, with kids, you look at all this malocclusion, and it’s interesting because people are like, ‘Well, it’s a genetic component.’ I was like, ‘Yeah. But if the parents have airway issues, then that's an airway component.’ So, you see airway in everything.” (29:06—29:45)“One of the things I love about John Kois is he breaks everything down as risk management. And so, that's kind of how I see airway. I don't see us as fixing everybody. I see us as, through dentistry, how can we reduce everybody’s risk of developing airway problems.” (33:19—33:40)Snippets:Dr. Nguyễn’s background. (03:50—06:33)Why this is an important conversation. (07:05—10:11)Dentists connect the dots. (10:30—12:39)Is CE coming together on this topic? (14:05—15:35)How to implement this into a restorative practice. (16:46—19:38)Reach out to specialists for support. (20:23—23:16)What dentists get wrong about airway. (23:36—24:54)The future of airway. (25:38—26:58)Dr. Nguyễn’s online educational program. (27:20—29:50)Dr. Nguyễn’s AACD presentation. (30:49—31:28)ASAP Pathway and Dr. Nguyễn’s contact information. (32:06—34:54)Reach Out to Dr. Nguyễn:Dr. Nguyễn’s Instagram: @drtraceynguyen https://www.instagram.com/drtraceynguyen/?hl=enDr. Nguyễn’s Facebook: https://www.facebook.com/tracey.nguyen.9085ASAP Pathway: https://www.asappathway.com/Dr. Tracey Nguyễn, DDS, FAGD, AAACD Bio:Dr. Tracey Nguyễn, aka, “Dr. Tracey,” received her DDS, Magna Cum Laude at the Virginia Commonwealth University, Medical College of Virginia. Dr. Nguyễn pledges to treat each patient with the highest standard of oral health care.Dr. Nguyễn is very involved in the local, state, and regional organizations, i.e., Loudoun County Dental Study Group, Northern Virginia Dental Association, Virginia Dental Association, and the American Dental Association.She is a member of the American Academy of Laser Dentistry, the World Clinical Laser Institute, and the International Congress of Implantologists (ICOI). Dr. Nguyễn understands the importance of lasers in dentistry. She was one of the first doctors that introduced the hard tissue laser dentistry in Loudoun County.Dr. Nguyễn is also a Fellow of the American Academy of General Dentistry. She thus understands that providing great smiles and excellent oral health are the result of going above and beyond basic requirements. Dr. Nguyễn serves as an editor for the AGD peer-reviewed research manuscripts. She also has continued to advance her dental and clinical expertise by completing thousands of hours of advanced training at the most prestigious dental institutions across the country.
36 minutes | Jun 18, 2021
Crushing Candy: Pandemic Mental Health Strategies and Beyond with Kristy Menage Bernie, RDH
Crushing Candy: Pandemic Mental Health Strategies and BeyondEpisode #311 with Kristy Menage Bernie, RDHAccording to the World Health Organization, one in four people will suffer from mental illness in their lifetime. Since COVID-19, that number has nearly doubled! To explain why that is and how we can better prepare for the mental health pandemic, Kirk Behrendt brings in Kristy Menage Bernie to talk about ways to manage mental illness and eliminate the stigma attached to the subject. For resources to help improve your mental health, listen to Episode 311 of The Best Practices Show!Main Takeaways:According to the WHO, about 25% of people will suffer from mental illness in their lifetime.On average, people wait 10 to 11 years to seek care for mental illness.Taking care of yourself is an obligation, not a luxury!Yoga can improve your mood more than walking and vigorous exercise.There are many apps that can improve anxiety and depression.Have compassion for those with mental illness, and also their children and caretakers.Quotes:“Pre-pandemic, according to the World Health Organization, one in four of us will suffer from some type of mental illness in our lifetime. And then, recently released from the Center for Disease Control, that figure has nearly doubled. And that study ended at the end of February. So, we’re seeing this staggering impact. In fact, you'll find many experts who are saying we have a concurrent pandemic, and it’s mental health. The mental health pandemic is real.” (07:02—07:43)“What I think is just so fascinating is that we’re hesitant to talk about mental well-being, and rightly so. In fact, I thought, ‘Our family is so unique. There's no one like us out there,’ when in fact, it’s much more prevalent. And the World Health Organization says 25%, that's of what they could qualify, but what we know about mental health, on average, most people will not seek care for 10 to 11 years.” (08:51—09:26)“Another interesting statistic, Candy Crush is probably one of the most utilized app games in the world. I wasn't necessarily a fan. But as the pandemic hit, I started to realize that I was playing more — full disclosure, I think I'm on level 8,700. Gah! Why? Why was I so engaged in it? Well, first of all, it has a very addictive quality. But secondly, it takes you out of your current circumstances for a brief moment of time and gives you the opportunity to figure out an issue or a problem and solve it, and then level up. You get rewarded for that.” (12:50—13:33)“Candy Crush gave me some control back. I play it way too much. But get this, there are app technologies that will improve anxiety and depression. And Personal Zen is the one that really has the most science behind it.” (14:18—14:37)“Taking care of yourself, it’s not a luxury; it’s your obligation. So, don't feel bad about taking care of yourself.” (19:51—20:00)“At the end of the day, again, write down or think about it, ‘What did I do today that really impacted someone’s life?’ And I can't think of a profession more that does things every day for people than dentistry. But acknowledging that for yourself builds your self-esteem, helps release your own anxiety, and keeps you from slipping into depression.” (21:03—21:33)“Yoga increases GABA [gamma aminobutyric acid]. And that's the chemical that helps us feel better, aside from the obvious ones. GABA prevents the negative thoughts from coming in . . . So, we know that yoga increases that more than walking and vigorous exercise. And it’s that neurotransmitter that keeps us from thinking negative thoughts about ourselves.” (25:21—25:58)“Dentistry can shift. And what I like to say is, we can replace confusion with compassion. And not only those that may be facing a mental health challenge, but those who are children of those individuals, or those who care for those individuals, because it is a huge ripple effect that's pretty profound.” (29:49—30:14)“[Dentists] see people more than any other healthcare provider. And wow, I know we’re busy — right now, especially. Which, my heart goes out to every practicing clinician. I cannot thank you enough. You are on the front lines. You're making a difference. Take care of yourselves. That, I can't emphasize enough. It’s not a luxury. Go get that foot massage or pedicure. Take care of you. You've got to take care of you.” (33:23—33:58)Snippets:Kristy’s background. (04:24—06:19)The pandemic’s impact on mental health in dentistry. (06:59—07:43)Why this number has doubled in the last year. (08:08—09:26)How to navigate and make sense of this. (10:30—12:14)Candy Crush and other apps for mental health. (12:49—15:25)Parents and social media. (16:25—17:42)Basic Psychosocial Skills: A Guide for First Responders. (18:40—23:52)Other tools in navigating mental health challenges. (24:01—26:00)Other thoughts/data on this subject. (27:28—30:29)Trends in the dental community. (30:48—31:28)Last thoughts, Kristy’s seminar, and contact information. (31:50—34:30)Reach Out to Kristy:Kristy’s website, Educational Designs: https://educationaldesigns.com/Kristy’s Facebook: https://www.facebook.com/kristymenagebernie@kmbt3ndFurther Reading:Personal Zen app: https://personalzen.com/Calm app: https://www.calm.com/COVID Coach app: https://mobile.va.gov/app/covid-coachBasic Psychosocial Skills: A Guide for First Responders: https://www.who.int/news/item/01-06-2020-basic-psychosocial-skills-a-guide-for-covid-19-respondersNAMI: https://nami.org/HomeMental Health America: https://www.mhanational.org/Indian Health Service: https://www.ihs.gov/Kristy Menage Bernie Bio:Kristy’s career in dental hygiene has exceeded 30 years and includes a diverse and unique set of experiences. Clinician, change agent, educator, and advocate include a few of the roles she has embraced. Although Kristy practiced clinically after graduating with honors from the University of Maryland, she was soon ‘discovered’ at an evening study club by a hygienist involved in sales. She excelled at sales, and after relocating to California, she co-founded Educational Designs, Inc. (EDI), an oral healthcare industry consulting company focused on evidence-based marketing strategies, expanding the role of the dental hygienist in the oral healthcare industry and lifelong learning.Kristy graduated with honors from the master’s program in 2015 at the University of California San Francisco, where she is also an Assistant Clinical Professor, Oral Epidemiology and Dental Public Health, Preventive and Restorative Dental Sciences, and a course director for the MS-DH program. She received a research grant in 2015 from the American Dental Hygienists Association and is currently on the Editorial Review Board for the Journal of Dental Hygiene.As a member of the American Dental Hygienists Association, American Dental Education Association, the Academy of Cosmetic Dentistry, the Organization for Safety and Asepsis Procedures, and the American Academy of Dental Hygiene, she has received a variety of accolades and awards. Kristy has held numerous leadership roles over the years with a focus on future colleagues, and has contributed to numerous publications over the years, as well as having authored a chapter on oral malodor in the 2nd Edition of Mosby’s Dental Hygiene textbook. She has been quoted in Esquire Magazine, Women’s Health Magazine, interviewed by ESPN Radio, highlighted in digital media, and featured on the cover of RDH Magazine.Kristy has been an international continuing education facilitator for over 25 years on major dental and dental hygiene conventions, as well as an invited guest speaker to dental hygiene programs throughout California. Her interactive style demonstrates a commitment to implementing outcome-based teaching through humor, innovative use of technology, and participation. As a career-long advocate for future colleagues, she enjoys collaborating with graduates to expand their professional horizons.
86 minutes | Jun 14, 2021
Reshaping Dental Labs & Education with Dr. Mike DiTolla
Reshaping Dental Labs & EducationEpisode #310 with Dr. Mike DiTollaLabs will tell you that crowns take two weeks to make. But this isn't true — it could be made much quicker! And to teach you why you should start demanding three-day turnarounds, Kirk Behrendt brings in Dr. Mike DiTolla to explain the correlation between seating times and the need for adjustments. More adjustments mean loss of patient confidence, loss of time, and loss of opportunities. Don't just settle for “how it’s always been done”! To learn more about the benefits of a faster turnaround time, listen to Episode 310 of The Best Practices Show!Main Takeaways:Seat crowns in three days instead of two weeks, and the need to adjust almost disappears.Dental school normalizes the two-week turnaround time — but it should be three days.Not many dental labs are willing to turn a crown around in three days. Start demanding it!Check your dental assistant’s crown work for over-polishing before dismissing the patient.Polish zirconia crowns instead of glazing them.Quotes:“One thing that largely hasn't changed from when I graduated is the two-week turnaround time that a dentist takes from the time they prep a crown to where they seat a crown.” (14:07—14:17)“Going from waiting two weeks to cement a crown to three days is a game-changer. I mentioned earlier that I left and went to Sirona, where you can do same-day crowns. And that is an ideal that we should stretch for. But we’re still waiting for a really affordable value-based system that’s easy to use before most dentists dip their toe into making restorations chairside. But seating it the same day should certainly be our goal, at least for single-unit posterior crowns.” (15:17—15:47)“Every dentist knows that if a patient is away for six weeks, or eight weeks, or six months with a temporary on, when they come back to have that permanent crown be cemented, the chances of it fitting decreases as that time increases. And I'm here to tell younger dentists that the opposite is true, that when you start seating crowns after three days instead of two weeks, your need for adjustments almost disappears.” (15:47—16:11)“Most dental laboratories aren't willing to turn a crown around [in three days]. And they will actually tell you that it takes longer to fabricate a crown and make it, which just isn't true. You can make an E-MAX crown the same day. You can make a zirconia crown the same day. It needs to sinter overnight, but it’s ready on the second day. Really, what the problem is, the labs aren't hiring enough employees to be able to handle this workflow. And since dentists just have always said yes to two-week crowns, that's how it’s always been.” (16:14—16:44)“Any time we take a bur to a crown, even if you polish away all the scratches on the surface, there’re still tiny little microfractures under the surface that you can't see that connect over time and cause failure, and the crowns are less aesthetically pleasing. And any time a crown gets thinner, it’s more prone to break anyway, besides these microfractures that are in there. So, our goal should be not to have to touch any crowns. Our goal should be to drop a crown from a foot above the prep and it just sucks into place. And for that to happen, this three-day turnaround is really important. And there's just not that many labs willing to do this three-day turnaround, and we need to all implore our labs to do it.” (17:46—18:24)“Maybe we should all be heading to same-day dentistry. But that's $100,000 and a lot of training to learn how to design and make crowns. In the meantime, three-day crowns is a perfect stopgap. And it’s going to give you 90% of what you get from that same-day restoration.” (18:55—19:10)“It starts in dental school. In dental school, we don't even do most of our own lab work. It gets sent either to an outside laboratory or a central laboratory within the dental school. So, it might be two or three weeks till we see that. And we’re never taught in dental school, ‘Oh, by the way, this should be three days, but due to the constraints of a dental school, we can't get this done for three weeks.’ We just assume that’s the right way. In fact, there's no talk whatsoever, in my recollection, about why it is here.” (19:50—20:16)“You can Google it all day long and look for references, and you'll never see any research study showing that two weeks allows for the inflammation in the pulp to go down, or anything that happens good in two weeks. Nothing good happens while the temporary is on.” (20:17—20:33)“The best thing we could do is prep a crown and then immediately cement the crown in place, or like an hour later, with chairside CAD/CAM. So, anything we do besides that is a compromise. And the compromise just gets worse the longer that we let it go.” (20:44—20:58)“The issue is that our well-meaning dental assistants, especially if we don't reinforce this, they want to make sure the one part that they touch and have the final say over, in most practices it’s the temporary crown, and so a lot of dental assistants take a lot of pride in the temporary crown. But one thing they're going to do is make sure it’s insanely smooth so that it doesn't bother the patient’s tongue when they rub it up against there, or it’s not bothering their cheek or anything like that. And as a result, when they make the temporary crown, dental assistants with all the right intentions and with big hearts over-polish temporary crowns.” (20:58—21:31)“I noticed at Glidewell we had so many complaints about the bite was too high. I had to grind on the crown too much. And so, I started going down for the doctors who complained the most, and I would look at their cases as they went out on the FedEx trucks that day, and I checked their crowns. They were perfect on the models. And yet, the doctor would complain a week-and-a-half later that the bite was too high. And I began to realize my own assistant was [over-polishing temporary crowns] as well, because we don't reinforce the basics to them.” (21:54—22:23)“Follow Gordon and Rella Christensen’s recommendation . . . and that is, polish zirconia crowns instead of glazing them. So, all the crowns that you get from 38 Smiles, you get them back in three days if you send a digital impression. And the price is really good too. But also, it’s all polished zirconia. It’s not glazed, so you don't get that initial wear of the opposing tooth that you do with the glaze until the patient wears through that. I learned that from Gordon and Rella. Her SEMs have been showing that for years. But most labs won't polish zirconia crowns because it takes more time to polish in the occlusal surface. It’s way easier to spray some glaze on it and run it up in the oven while you do something else.” (25:55—26:35)“Frankly, dentists aren't asking for [three-day turnarounds], so there's no real reason for the labs to change. Labs didn't get Im.P.R.E.S. until dentists started asking for it. We launched Solid Zirconia, BruxZir, at Glidewell, and it wasn't until dentists started asking their labs for it that zirconia started being incorporated. So, dentists, you have a voice. You drive a lot of what the laboratory does way more so than you do with manufacturers.” (28:13—28:39)“The scary dentists are the ones with the 0% remake rate. If God were a dentist, he'd have a 2% remake rate, because you still can't control everything in the universe. And there’re dentists with 0% remake rates who send hundreds of units in a year to the lab, and you realize those are the dentists with no quality control filter.” (35:03—35:24)“For dentists who hate dentures like I do, or did — kind of still do — digital dentures represents a huge step forward. This is not just a marketing term. Digital occlusal splint, that's kind of a marketing term. But digital dentures are kind of the real deal, in the sense that from the very try-in, you're going to get something that fits way better than your old final dentures did. And so, not only is the fit going to be better, but you're going to know it right away, and you're going to be able to see. And that fit that you get initially when you try that in is going to follow you all the way to the finished product.” (41:46—42:19)Snippets:Dr. DiTolla’s background. (03:28—07:25)The craziest thing that ever happened to Dr. DiTolla while speaking. (07:55—11:22)A brief rant on microaggressions toward the follicularly challenged. (11:22—12:56)Where we’re currently at in dentistry. (13:31—19:10)Reshaping how people think about the lab process. (19:49—30:55)What lab techs would really say. (31:40—35:29)The economic impact of a remake. (36:15—37:40)The future of lab processes. (38:17—42:47)The future of education, AcciDental Geniuses podcast, and future events. (43:43—48:06)@mikeditollaislosingit. (48:07—56:22)The trend with audio education. (57:20—1:04:17)Comedians he follows, and social media. (1:05:02—1:14:04)How his speaking career started, and mental health. (1:14:33—1:24:54)Reach Out to Dr. DiTolla:Dr. DiTolla’s Facebook: https://www.facebook.com/michael.ditolla@mdt360Dr. DiTolla’s new Instagram: @mikeditollaislosingit https://www.instagram.com/mikeditollaislosingit/References:38 Smiles Dental Lab: https://38smileslab.com/Sebastian Maniscalco (comedian): https://sebastianlive.com/home/#tourNeal Brennan (comedian): https://www.nealbrennan.com/Anthony Jeselnik (comedian): https://www.anthonyjeselnik.com/Kyle Dunnigan (comedian): https://www.kyledunnigancomedy.com/Dr. Mike DiTolla Bio:As a dentist who practices within the largest lab in the U.S., Dr. DiTolla has access to tens of thousands of doctors’ preps and impressions on a monthly basis. As a result, he has an intimate knowledge of the common habits of the dentists getting the best restorative results. As a self-proclaimed “average dentist,” he has developed techniques that provide exceptional restorative results with a very average set of hands. His mission is to share these techniques with dentists to help them improve their preps, impressions, and restorations. When dentists perform better restorative dentistry, they are happier, more profitable, and most importantly, the patient receives excellent restorative dentistry.Dr. DiTolla graduated from the University of the Pacific School of Dentistry in 1988. He was awarded his Fellowship in the Academy of General Dentistry in 1995. He is a graduate of the Las Vegas Institute of Cosmetic Dentistry and is also a clinical evaluator for CRA. From 2001 – 2006, he was an Instructor for PAC-Live’s Live Patient Hands-On Veneer Course. In 2001, he became Director of Clinical Research and Education at Glidewell Labs.While writing for several journals, Dr. DiTolla has a monthly column on restorative dentistry in Dental Economics and is a contributing editor for Contemporary Esthetics and Restorative Practice. Dr. DiTolla helped launch Chairside Magazine and is the Clinical Editor of this quarterly publication that frequently presents his own clinical case studies.Referred to as one of dentistry’s most entertaining speakers, Dr. DiTolla’s blend of humor and entertainment keeps attendees awake and helps a day of education become much more pleasant. He uses live clinical videos in his presentations to reinforce the learning and increase retention of the techniques.
41 minutes | Jun 11, 2021
Form Meets Function: The Magic of Interdisciplinary Care with Dr. Tito Norris
Form Meets Function: The Magic of Interdisciplinary CareEpisode #309 with Dr. Tito NorrisAre you tired of the inefficient back-and-forth communication and guesswork with your specialists? Today’s guest will remind you that it can change! Kirk Behrendt brings in Dr. Tito Norris, creator of The Norris 20/26 Bracket System, to talk about the different ways to enhance interdisciplinary communication using modern advancements and technology. To hear more about the value of an interdisciplinary treatment plan and how to increase efficiency, listen to Episode 309 of The Best Practices Show!Main Takeaways:Orthodontic partners are one of the most important people to your practice.Spend time with your specialists to understand what they can and can't do.There is a need for talented orthodontists who can tackle challenging interdisciplinary cases.To do sophisticated dentistry, you need to change the patients’ oral landscape.Interdisciplinary dentistry needs a HIPAA-compliant, cloud-based EMR.Be willing to make investments in yourself to increase your skill level and differentiate yourself.Ortho doesn't have to be a two-year penalty box; there are many ways to increase efficiency.Quotes:“Something that I picked up a long time ago is, whenever possible, try to get your gingival margins placed at your correct positions in relationship to the CEJ first. In other words, if the patient is going to need some crown lengthening, do it on the front end. Because as an orthodontist, we need one of two things: we either need an accurate CEJ, or we need an accurate incisal edge. And if we can have both, then hallelujah.” (08:39—09:06)“If teeth have wear on them, we would much prefer — and this is critical — to do pre-orthodontic bonding. So, what does that mean? That means that I want the teeth to be restored provisionally to their natural shapes and forms that they used to be when the patient was a teenager. And you're like, ‘But Tito, how am I going to do that? The occlusion’s not going to allow that.’ Don't worry about the occlusion. That's my job. Your job as a restorative dentist is to restore those teeth and essentially give me back teenager-looking teeth.” (09:25—10:08)“It became apparent to me in a very early time that we needed a bracket slot dimension that was .020, something that would allow an .019 wire to fit in there and then have really great intimate contact and that's going to give you more control. And it just wasn't available. And why wasn't it available? I just didn't understand this. And the answer I got was, ‘Well, it’s just tradition. It’s just the way it’s always been.’ And I was like, ‘This is ridiculous. No one could give me a good reason as to why we don't have a .020 bracket slot, so I'm actually just going to make one.’ And so, I did.” (17:41—18:25)“The challenges I had to the previous bracket system was, we were using an .019 wire in an .022 slot. So, we had sloppiness in there. And so, it was difficult to finish the case because you'd have to put in enough torque in the wire to overcome the sloppiness, and then it would start to engage. And then, it was always a guessing game. And so, you'd guess a little too much, and then you'd guess a little too little. And so, there was just all this slop in play and too much tolerance, basically, between the bracket and wire interplay. And that's what made finishing cases challenging.” (19:56—20:35)“When you subscribe to restoring the teeth to their natural shapes, what you've done is you’ve created a three-dimensional blueprint for communication between the orthodontist and the restorative dentist. So, you've taken all the guesswork out of the communication, because what you've done is you’ve told that orthodontist, ‘I want these teeth exactly this long. I want these teeth exactly this wide. And I want you to take these teeth and couple them together.’ And so, that in and of itself is incredibly valuable because it eliminates that back-and-forth and, ‘Is this enough? Is this too much? Do you want this here? Do you want this there?’” (21:50—22:33)“I'm going to quote Bill Robbins on this. As a restorative dentist, you cannot do sophisticated dentistry by accepting the landscape that the patient has when they first walk in. You've got to be willing to change that landscape, whether it’s broadening the smile, whether it’s levelling your gingival margins, whether it’s correcting your open bite, correcting your deep bite, whether it’s correcting your gummy smile, correcting your cants. And there're so many different things that we can change as orthodontists to change the landscape. And most of those things are helping the airway as well.” (23:40—24:20)“It took years of some gentle handholding or arm-twisting, or whatever you want to call it, to finally get restorative dentist to understand the value of — because it’s a little extra work for them on the front end in terms of doing these provisionals. And, hey, charge for it. You charge for your time. You've got to make a living out of this thing. But the thing is, once people subscribe to it, there's really no turning back. It’s, by far, a superior way to treat patients.” (26:17—26:57)“There's a deficit in the world of interdisciplinary dentistry in that we don't — yet — have a HIPAA-compliant, cloud-based EMR, electronic medical record, where we can all share a common chart on a patient and we can all put our notes there, we can put all of our images there. And Carestream is actually working on it, and they just released an early version. It’s called ICC, interdisciplinary communication something-something. We’re actually beta testing that right now, and it shows some promise. But it still needs some work.” (28:12—28:49)“The advice I would give to a younger dentist is, if you do have an orthodontist that you enjoy working with, be willing to carve out a little time in your schedule to go over to their office, and even after work or during lunch, or something like that, and really sit down and look at these images together with the doctor. Talk about the cases just to throw out ideas, ‘Is there another way we can look at this thing?’” (29:01—29:27)“If you're going to dive into this realm of sophisticated dentistry, that's one of the things right now you're going to have to do, is to be willing to spend that time with your specialists to really understand what they can do, what they can't do, how they can best help you, and understand how deep is their bag of tricks.” (29:46—30:08)“You've got to find a way to differentiate yourself. And for me, that was by really going and educating myself, and being willing to invest in [myself] to keep raising the bar and keep learning more and more. Because we all came out of orthodontic residency with basically a union card. Right? It’s just kind of a license to practice orthodontics. But it’s at a pretty basic level. Most of what I've learned, I've learned after residency.” (30:56—31:33)“I think one of the biggest hurdles that adults have with orthodontic treatment is the fact that historically they’ve always been told, ‘Okay, orthodontic treatment. You're in the two-year penalty box.’ And I think that's perhaps one of the reasons why restorative dentists don't do that. It’s like, ‘Man, I'd like to finish this case. But if I go through ortho, we’re looking at two years.’ Well, it doesn't have to be that way. We’ve got so many other ways to increase efficiency.” (35:26—35:56)Snippets:Dr. Norris’ background. (03:37—07:34)Why this is an important conversation in dentistry. (08:13—10:42)Why this conversation is difficult. (11:16—13:58)How pre-orthodontic bonding works/Dr. Norris’ 20/26 Bracket System. (14:47—19:33)Challenges with the old bracket system. (19:51—20:35)The middle, end, and later on in pre-orthodontic bonding. (21:45—25:03)A superior way to treat patients. (25:40—26:57)Advice for younger dentists. (28:09—30:33)What orthodontists get wrong early in their career. (30:54—33:52)The future of interdisciplinary care and last thoughts. (34:39—37:24)Dr. Norris’ 20/26 Bracket System sold by DynaFlex. (38:18—39:33)Reach Out to Dr. Norris:Dr. Norris’ Facebook: https://www.facebook.com/tito.norrisDr. Norris’ Instagram: https://www.instagram.com/stoneoakorthodontics/?hl=enThe Norris Experience (October 1-2, 2021): https://www.dynaflex.com/the-norris-experience/The Norris 20/26 Bracket System: https://www.dynaflex.com/norris2026/Dr. Tito Norris Bio:Dr. Robert Norris is devoted to creating smiles for a lifetime. His unique background in mechanical engineering provides him with a distinct advantage in mastering the forces, vectors, and movements inherent in performing orthodontic treatment.Dr. Norris attended the University of Texas at Austin where he received his bachelor’s degree with honors in Biology and a minor in Mechanical Engineering.He was salutatorian of his dental school class at the University of Texas Health Science Center at San Antonio Dental School.He completed a General Practice Residency at the V.A. Hospital in Washington, D.C.He completed his orthodontics specialty training at Howard University, graduating as valedictorian with the highest GPA in the Orthodontic Department’s 25-year history.Dr. Norris joined the Air Force and served as Chief of Orthodontics at Misawa Air Base, Japan. Here, he provided orthodontic care to service members and their families.In 2007, Dr. Norris began work to make his office completely “green.” The office is part of a volunteer renewable energy program with CPS known as Windtricity. In April of 2008, he completed a solar energy project at his orthodontic practice with the installation of 80 solar panels, providing 16 kW of electricity.In 2010, he completed his office expansion, making it the first LEED-Certified orthodontic office in the world. LEED is Leadership in Engineering and Environmental Design and is the U.S. Government’s stamp of approval on environmentally responsible office construction.Dr. Norris is a resident of San Antonio, Texas, where he lives with his wife and three children. As a Texas native, he grew up in Kingsville, Texas. He enjoys snow skiing, cycling, swimming, strength training, boating, hiking, and kayaking. Dr. Norris has lectured throughout the United States, Europe, and Asia. His scientific papers have been published in the American Journal of Orthodontics and Dentofacial Orthopedics, Seminars in Orthodontics, as well as Clinical Impressions. To date, Dr. Norris and Simone are enjoying their proudest accomplishments, their three children.
48 minutes | Jun 7, 2021
How to Produce 30% More Without Adding Any Hours or Raising Your Fees with Curtis Marshall
(Audio)How to Produce 30% More Without Adding Any Hours or Raising Your FeesEpisode #308 with Curtis MarshallWork smarter, not harder! Increasing your hours isn't the surest way to produce more. And today, Kirk Behrendt brings in Curtis Marshall from Dental Intel to teach you how to produce 30% more in your practice. His secret is the morning huddle, and you can have more production without getting more chairs, working more hours, or raising your fees! For more on how Dental Intel can help you and your team, listen to Episode 308 of The Best Practices Show!Main Takeaways:Working more hours isn't a sure way to increase production.Data helps you know where you are so you can move forward in the right direction.Morning huddles are the secret to higher production.Don't undervalue the huddle, and make sure your team is on board.Have good, accurate information.Have actionable items and know what to focus on.Huddles should be quick — 15 minutes is almost too long.Make sure your patients have a future appointment.Make sure your patients accept treatment.Quotes:“[You can] produce more without doing what most people tell us, which is, ‘Get more new patients, open more hours, put more chairs in.’ That's typically the answer for producing more, is, ‘Well, you need to work harder,’ and that's not necessarily the truth.” (05:05—05:23)“Why is data important in your life? The same answer is what we’re saying for dental practices. The reason why data itself is more important now more than ever is because it’s giving us the true, actual status quo, ‘This is what's happening’ whether you like it or not.” (07:04—07:25)“If you don't know where you are today, then you cannot move forward in a timely fashion. That's why data is so important for every dental office in 2021 and in the future.” (07:58—08:11)“The more information we get, the easier it is to be more productive. For example, when I was in high school, for weight training, the main thing that they did was said, ‘Go do bench and go do squats. You need to get really good at your bench and get really good at your squats.’ That's how they trained you on how to become better, faster, stronger. Well, now, what they're focusing on is plyometrics. They're focusing on core. They're focusing on the true things, because now they’ve tested and truly found out that it’s not necessarily — even though you want the big guns for the girls — this right here isn't where it’s at. It’s more in the core.” (12:45—13:31)“The important information to know [about morning huddles] is, first, make sure everybody’s on board. The team members have got to be on board. Second is having good, accurate information. Lastly, actionable items, what to really focus on.” (15:52—16:07)“If I'm having a huddle, the main goal is to do, what? That's probably the biggest thing to realize when looking at the data, or the information, the reports, whatever it is, the discussion. What's the outcome that we’re wanting? Is it just to check off morning huddle? If it’s just to check off morning huddle, you will fail every time.” (21:04—21:27)“The morning huddle is not to say, ‘Hey, we need to do better as a company.’ That is a meeting. That’s your weekly, monthly meeting with your office managers. That is not what morning huddle is for. It’s to say, ‘How can I better care for my patients?’ And there's really only one of two ways that we can take better care of our patients when talking about the morning huddle. Number one, making sure that they have a future appointment. Simple, right? Number two, making sure that they accept the treatment that we’re presenting them.” (22:48—23:31)“New patients are not rescheduling, and we’re not discussing it. It’s okay that K.C. left without an appointment. My question is why, so that today we don't repeat what we did yesterday. And then, the follow-up is, ‘All right. Sam, the action item is for you to reach out to K.C. and make sure she gets a future appointment.’” (27:54—28:27)“If you do nothing else but focus on the patients who left yesterday and broke an appointment from yesterday and fixed that — that is why the morning huddle is so crucial. And you will see more production, 30% more production, than you would've without the morning huddle.” (33:40—34:01)“The things we focus on, that's what grows.” (34:16—34:18)“Those 24 patients, let's say they all come in. What are the chances, percentage wise, that I'm going to be able to talk with those patients? 100%. If I were to call them on the phone, what are the chances of me talking to them? 20%.” (36:43—37:05)“Your team members, when they have this information, are going to bloom. They know what to do if they have this information, but it’s not easily got. You have to spend a lot of extra time to pull those reports and data in order to have that information. But [Dental Intel] gives it to you in a click.” (42:01—42:18)Snippets:Curtis’ background. (03:56—05:23)Why data is so important to dental practice owners. (07:01—08:11)The secret to producing 30% more. (09:45—14:01)Elements of a well-run huddle. (15:51—19:37)Where to start. (20:38—21:31)How long should huddles be? (22:07—23:31)What to talk about in the morning huddle. (23:49—29:21)Ensure that every patient leaves with a future appointment. (31:05—34:18)Other things to focus on in morning huddles. (35:36—40:11)Give your team the opportunity to help you. (41:05—42:18)Last thoughts on the morning huddle. (43:47—44:52)Curtis’ contact information and Dental Intel. (45:11—45:52)Reach Out to Curtis:Dental Intel website: https://www.dentalintel.com/ (Hit the “demo” button and mention Kirk!)Curtis’ Instagram: @curtisagram https://www.instagram.com/curtisagram/?hl=enCurtis’ Facebook: https://www.facebook.com/dcm24Curtis Marshall Bio:Nationwide, dentists have allowed Curtis Marshall to utilize his passion and skills to take their practice to the next level. With over 10 years’ experience of marketing and communication and 8 years’ experience of practice management, dental coaching, and operations, dentists love the advantage they get through working with him.While working in a general practice, Curtis used his expertise with systems and marketing to help a single doctor grow from 20 new patients a month to being a three-doctor practice with 400 new patients a month, and 6 million annually.Curtis is a fantastic motivator and has helped our company with numerous successful marketing projects.He is energetic, charismatic, and personal. He is the kind of guy who makes friends wherever he goes.
67 minutes | May 28, 2021
How to Avoid Making the Worst Hiring Mistake of Your Life with David Harris
How to Avoid Making the Worst Hiring Mistake of Your LifeEpisode #305 with David HarrisHiring without due diligence will cost you your time, money, and mental health. To teach you how to make better hiring decisions for your practice, Kirk Behrendt brings back David Harris, CEO of Prosperident. From drug tests to social media, David gives you the best tips to weed out bad candidates early on. Want to know the habits of time thieves and embezzlers? Listen to Episode 305 of The Best Practices Show for more of David’s advice!Main Takeaways:Hiring the wrong person is costly — in time and money!Weed out unsuitable candidates as early as possible.Dental practices need to do drug tests and background checks.You can't reliably do background checks yourself!Broaden your applicant pool and don't hire in a hurry.Don't give predictable questions in interviews.Check applicants’ social media pages.Don't use phone numbers that applicants give you. Google it yourself.Confirm exact dates of employment, not approximate dates. Look for gaps.Ask former employers about applicants’ final positions.Also ask if they would rehire them.Use a reference number in the application to test if they follow instructions.Require applicants to record a brief video as part of the application.Make applicants invested from the beginning.Standardize your application form so that you're not influenced by visuals.Verify credentials and check photo IDs! And check IDs when they're not ready.Involve staff in the interview process.Be upfront about the scrutiny applicants will be under.Quotes:“If you put 200 dentists in a room and you asked them, ‘How many of you enjoy hiring staff?’ I'd be very surprised if anything more than two hands went up. Dentists hate this job. And like any job that you hate, when a shortcut magically appears in front of you, you're really tempted to take it. And that gets you into trouble when you're clearing snow off the roof of your house and you take shortcuts, and it equally gets you in trouble when you hire staff.” (05:33—06:06)“The reality is that most dentists make hiring decisions with less information than they should have. And the part that should get their attention is that, in most cases, that information is right there in front of them, and they just either didn't realize that it would help them or didn't realize how easy it was to get full information so that they can make a good decision.” (06:43—07:07)“If you want to play the HR lottery and hire people blindly in the hope that they turn out okay, when you're wrong — and I'm going to say “when” here as opposed to “if” — you're going to dump a lot more time into that than it ever would've taken you to vet this person properly at the beginning.” (08:03—08:26)“About 70 million Americans — so that's one in four adults — has a criminal record.” (08:33—08:39)“We’re entrusting dental practice employees with money, with protected health information, with sharp instruments. We just need to know a little bit more about them than traditionally dentists do.” (10:06—10:23)“There is no website you can go on to and pay $50 and have it reliably tell you whether or not somebody has a criminal record . . . Unfortunately, it’s not something you can do yourself and go to some website and get the answer.” (12:22—12:59)“One of the mistakes that a lot of people make is that they're hiring in a hurry. The reason that they're hiring in a hurry is that somebody leaves on short notice, and then the poor doctor is starting from zero and trying to build a relationship with somebody that they're going to hire and do it all within 48 hours. And that's never a good idea.” (15:01—15:24)“In your life, when you meet people who you think might be a good fit for your practice — and you can meet them in all kinds of different places — start keeping track of that.” (15:26—15:36)“If we have to choose, and most times we do, between personality and knowledge, personality should win. Knowledge wins in a couple of narrow circumstances.” (17:17—17:26)“[Dentists] fall into the trap of asking questions to which there are obvious answers: ‘Do you mind working evenings?’ If you want the job, there's only one possible answer to that question. ‘How are you with people?’ ‘Everybody likes me!’ Or, ‘Tell me three of your strengths and three of your weaknesses.’ Anybody who’s been coached on how to do a good interview will give weaknesses that are really hidden strengths.” (22:51—23:23)“You don't learn much by asking [applicants] questions with predictable answers. Put them on the spot. Give them that roleplay and see how they do.” (25:10—25:18)“There are lots of reasons why people change. Sometimes, it’s something you do that sets them off. Sometimes, it’s something in their own life. And there's not much that the hiring process can do about those people. Most times, that's not a hiring mistake, per se. It’s a failure to observe staff once you hire them.” (26:32—27:00)“One of the things I look at is time of day when they're posting. And really, what I want to know is, are they a time thief. If this is a person who’s posting on social media during working hours, then what's happening in the office they're working in is, there are a whole bunch of other people scurrying around doing their work while they're taking this extended bathroom break and catching up with their friends.” (29:01—29:25)“Another thing I look at is how well they express themselves, how they communicate with other people. Is this somebody who flames people? Do they talk at a level of articulation below what we want? . . . If somebody’s not gifted with the ability to communicate well, hopefully, they know that, and their resume and cover letter reflect a higher standard of communication because they’ve had some help. Well, nobody gets help with their Facebook posting. So, it’s a chance for us to see how they’ll be communicating if we hire them and decide if you like it or not.” (30:41—31:34)“Phone everybody who has employed this person in the past five years. When I get Dr. A on the phone, what I need to do is confirm dates of employment and get exact dates. Not approximate dates, exact dates. What was this person’s start date, and what was their end date? And compare those to the resume.” (33:33—33:51)“Look at gaps in employment, because the other option is I pretend I never worked for Dr. B. ‘I was traveling through Europe,’ or, ‘I was home with my children,’ or something. So, when somebody says that to you, what you say next is, ‘Great. I just need to verify that. So, you were traveling through Europe. Bring your passport in.’” (33:56—34:17)“Don't make the mistake a lot of dentists make. They get the former employer on the phone and they say, ‘This person says she worked for you from January of 2018 to October of 2020.’ Because if you say that to any human, they will all say the same thing: ‘Yeah, that sounds about right.’ What you need to do is ask the open-ended question: ‘What was this person’s start date and what was their last day with you?’” (35:08—35:34)“And the other good question to ask that's kind of along the same lines is, ‘What was their final position with you?’ Because we know this, a lot of people will give themselves that upgrade to first class. And the way the upgrade works is, they were a receptionist in their last position, but they're applying at your office now. And what does their resume say their last position was? Office manager. So, if they're lying about that before they’ve even started work for you, all hell is going to break loose when you hire them.” (35:34—36:08)“The one question I want answered, and I will pester the crap out of people till they answer it is, ‘Would you rehire this person?’ And if I get the sense that I'm dealing with somebody who’s a very linear thinker, sometimes I'll phrase that question a little more specifically, ‘If you had a position that this person was suitable for and if they were available, would you rehire them?’ Because sometimes, that’ll take away the prevarication that sometimes people will have.” (36:31—37:01)“You want people who are really unsuitable to separate themselves as early in the process as you can. Why? Because that stops you from investing time and energy, for example, in interviewing somebody who’s unsuitable. Start by setting up a couple of arbitrary rules. And the kind of thing that I'm talking about here is, when we hire, I always have a reference number and I tell people to quote that reference number in the cover letter. I make the reference number up; it means absolutely nothing. But I get two kinds of applications in. I get some who quote the reference number and some who don't. The ones who don't, I throw away immediately because they can't follow instructions.” (40:44—41:31)“Require people to record a brief video and send it to you as part of their application. That does a couple of things. It weeds out people who can't use computers. And, in my mind, you cannot function effectively in a dental practice if you can't handle the basics on a computer. And you're setting just a little obstacle there. And people who really aren't motivated for the job just won't bother.” (41:52—42:18)“If somebody’s being looked at for a credentialed position — so an assistant, a hygienist, or an associate, or conceivably a dental therapist in some states — we need to verify that they have that credential. We cannot simply accept a piece of paper from them because paper is not worth the paper it’s printed on anymore. Forgery is pretty easy in 2021.” (52:11—52:33)“Check photo ID. If you don't do that, you may end up hiring somebody whose sister is a hygienist as a hygienist. And the time to check photo ID is when you interview people. If you hire somebody, they know there's going to be an I-9 form coming. They know there's going to be an identification check then, so they’ll be ready. The trick is to catch them when they're not ready.” (52:55—53:24)“The person who says to you, ‘Well, I didn't bring [an ID] with me,’ I kind of wonder why any adult would wander around town without a credit card and a driver’s license. So, if what they're telling me is true, I'm sort of questioning them, and I'm very open at that point to the possibility that this person is trying to hide some baggage by pretending to be somebody else.” (53:41—54:12)“One obstacle that you'll run into, and I'll tell you exactly how to transcend it, is somebody says to you, ‘Please don't call my current employer because she doesn't know I'm leaving.’ And there are two possibilities here. One is that this is a legitimate request. The other possibility is this person actually got fired three weeks ago and this is their way of preventing you from calling somebody who just fired them . . . What you tell the person who says that to you is, ‘Look, I understand completely. And I certainly would never want to get you in trouble with your current employment relationship. But I am going to let you know that we don't hire anybody without speaking with their most recent employer. Now, in understanding this situation you're in, I'm happy to defer that and make it the very last step. But we do have to have that conversation.’” (56:32—57:27)“We saw one embezzler who had worked in 15 different practices and stolen from every one of them. And she was a great interviewer. Very polished, resume looked good. She knew how to use the practice management software — and I'll add, in ways that the doctor never imagined. She came well-dressed, well-groomed to the interviews. And the 15 victims — and I will say that word again, 15 victims — had all decided in the interview to hire her and didn't feel the need to probe in any way into her background. I mean, it was all there. She had a criminal record. And by the time she got to number 15, there were 14 other dentists who, if called, would say, ‘Run the other way from this woman.’ And clearly, those calls were never made.” (1:00:27—1:01:29)Snippets:David’s background. (03:27—03:58)Why this is an important topic in dentistry. (04:22—04:55)Don't be tempted by shortcuts. (05:30—07:07)Hiring the wrong person is costly. (07:37—09:37)Many dentists don't do background checks. (09:42—11:39)Where to start with background checks. (11:54—12:59)Where to start with drug tests. (13:04—14:09)Don't hire in a hurry. (14:42—19:03)Broaden your applicant pool. (19:33—21:03)Know what you want before you hire. (21:47—22:47)Ask better interview questions. (22:47—25:32)Unexpected employee performance change. (26:01—27:56)Don't hire without looking at a person’s social media. (27:56—31:34)Look for what's not there, and questions you should ask. (32:01—36:08)Other questions that should be answered. (36:29—37:19)A hesitant “yes” means no. (37:34—39:02)Ways to screen applicants. (39:39—43:02)Tips for standardizing your hiring process. (43:02—46:15)Additional advice to avoid big mistakes. (46:44—49:23)A bad hire is expensive. (50:23—52:02)More due diligence items to put in place. (52:03—54:42)Involving staff in the interview process. (55:02—56:07)Other non-negotiables in hiring. (56:29—59:57)Example of a serial embezzler. (1:00:25—1:02:23)David’s contact information, webinar series, and book. (1:02:48—1:05:22)Reach Out to David:David’s company website: https://www.prosperident.com/David’s Instagram: @davidharris9406 https://www.instagram.com/davidharris9406/David’s Facebook: https://www.facebook.com/davidharrisprosperidentFurther Reading:David’s book, Dental Embezzlement: The Art of Theft and the Science of Control https://www.amazon.com/Dental-Embezzlement-Theft-Science-Control/dp/0228818753Prosperident’s Hall of Shame: https://www.prosperident.com/prosperidents-hall-of-shame/Prosperident monthly webinars: https://www.prosperident.com/category/prosperident-webinar-pages/David Harris Bio:David Harris – CEO of Prosperident: Dentistry’s Embezzlement ExpertsUnder David’s leadership, Prosperident has expanded over the past three decades to become a team of more than 20 highly specialized fraud investigators, forensic accountants, IT specialists, and support staff. David’s vast investigative experience, coupled with his youth-filled misadventures and his past military service, have given him a unique insight into embezzlers’ mindsets and actions. He is passionate about sharing his wealth of knowledge with dentists and dental specialists.David is a much sought-after speaker and an accomplished author on the topic of dental embezzlement. Dental Embezzlement: The Art of Theft and the Science of Control is his most recently published book.David believes that the best educational experiences are enhanced using humor. His entertaining and insightful presentation style has made him a favorite presenter at regional, national, and international dental conferences.David’s professional qualifications include Certified Fraud Examiner, Certified in Financial Forensics, Forensic CPA, Chartered Professional Accountant, Certified Management Accountant, and Licensed Private Investigator.
52 minutes | May 24, 2021
The 2 Kinds of Dental Patients and Why It’s Important to You as a Dentist with Dr. Gary DeWood
The 2 Kinds of Dental Patients and Why It’s Important to You as a DentistEpisode #304 with Dr. Gary DeWoodThere are patients who believe they're healthy, and there are patients who believe they have significant issues. And today’s guest, Dr. Gary DeWood, explains how these mindsets develop and how it affects how you interact with them. Kirk Behrendt and Dr. DeWood talk about the importance of words and how it can change the way patients understand and value the services you provide in your practice. Words matter! For tips on attracting the right type of patients, listen to Episode 304 of The Best Practices Show!Main Takeaways:Dentists need to change their mindset and culture.Many dental patients think they're healthy, and dentists perpetuate that belief.Don't use “dental” and “insurance” in the same sentence. Say “benefit plans” or “benefits”.Value your hygienists and show it! Instead of “cleaning,” call it “hygiene therapy”.Ask patients what dental health means to them.Quotes:“People coming to the dentist is like people going to a Broadway show. They get there, they're not exactly sure what's going to happen. Sometimes, it can be unpleasant, or even unwanted. But whatever happens is going to create an experience. And if that experience is one that exceeds their expectations, it’s going to be remembered and valued.” (05:28—05:57)“If you ask the appropriate questions, some patients will decide that you are not the place for them to come. And that's important too, because one of the worst things that can happen is when that doesn't happen and they show up, and their expectations are not met because we were never really on the same page. And unfortunately, they go out and they tell other people about those things.” (07:07—07:28)“Patients who believe they're healthy think they're coming for the reason that we have trained the public to come to a dentist. And I will tell you that this isn't my question, this was Lisa’s question, a friend. She would ask people, ‘What significant dental issues are you dealing with right now?’ And most patients said, ‘I don't really have any issues. I just need to get my teeth cleaned.’” (08:07—08:30)“[Patients who] believe they're healthy, if they have an issue, it ain’t significant. And almost always, they already believe they know the answer. People who claim a significant issue are different. They're usually looking for answers. And so, that differentiation made it possible to have some idea who was coming.” (08:58—09:18)“If you want to change the mindset around dental benefit plans in your practice, there are two things you can do. First of all, answer this question: what minds have to change first? Ours. If we believe that dental benefit plans suck, we tell people that through our mindset. Because believe me, whatever you believe is being transmitted, no matter how you think you talk, I promise you it’s being transmitted. And the only thing that happens then is that you and the patient wind up in a little muddy hole whining about how terrible it is. Tell me how that benefits anybody.” (15:20—16:08)“I remember people walking in and plunking down, when they had to bring all the paperwork — you know, you had to sign all the forms ahead of time and they had to bring all this stuff — and they'd throw it down on the counter and they would go, ‘I have this, but it sucks.’ And you want to go, ‘Yeah, they all suck.’ Don't do that! Please don't do that.” (16:15—16:32)“I believe one way to change culture, which is part of mindset, it’s mindset now translated to action. So, here’s my recommendation: stop saying the words “dental” and “insurance” in the same sentence. In fact, stop saying those two words together in your practice, without exception. Say “benefit plans” and “dental benefits,” or “benefits”. People will start asking you things. Words are important. You want to change your mindset? Start talking about things differently.” (16:41—17:10)“I think most dental patients think they're healthy. And what's interesting to me is that lots of dentists perpetuate that by not telling people everything they see or what's possible.” (19:21—19:34)“I think that almost all dentists are doing the very best to help their patients see everything that they know. And unfortunately, a lot of dentists are practicing their first year of dentistry, even though they’ve been out there for 20 years. And things are different. Things change all the time. I was thinking about my initial exams, years ago. I mean, I didn't look at how people breathe. The joke that I say to our groups here at Spear, I say, ‘I've been looking up people’s noses for years. But now, I do it with intent.’” (19:39—20:11)“I learned that I am absolutely, totally, 100% a salesperson. So is everybody on my team, without exception. The number-one thing you sell is yourself. The second thing is, in our situation, health. And the patients’ understanding of health will drive that.” (20:48—21:10)“My job is not to sell you the dentistry that I think you need. My job is to sell you on your current situation so you can look at me and say, ‘What should I do?’” (21:49—21:59)“You have tons and tons of fee-for-service patients right now. They just happen to be enrolled in a PPO. But that's not the box they think they're in. We think they're in that box because that's how we view that group of people; they don't.” (28:56—29:16)“I was taught my job was to give everybody a list of what was wrong with them and then tell them I was going to fix it. And if they didn't say yes to that, it was just because I hadn’t educated them enough. And I'm going to tell you, I learned early on education is grossly overrated, folks. The education that's necessary is not that stuff, because it’s all too logical. It’s all logic stuff. We have to become better involved emotionally, on an emotional level with the people in our chair.” (34:29—34:56)“One of the things that I'm encouraging people to do right now is, if new patients are coming in through hygiene, I'm encouraging the hygienist that I get to spend some time with that they should introduce themselves as, ‘Welcome to Dr. Gary and Cheryl DeWood’s practice. I'm happy to be able to welcome you for your new patient visit,’ and especially because it’s a healthy new patient visit, ‘My name is Robin. I'm the periodontal co-therapist who works with Dr. DeWood.’ Say something that's a value statement about who you are and what you do — because you don't clean teeth.’” (39:22—39:56)“You want to change your mindset about something? Let's change how we talk about it. We stopped using the word “cleaning” in my practice. We don't have those. We have hygiene therapy visits.” (39:59—40:08)“This is what we would say when people would say “cleanings”. You don't want to correct people, but what I would say when people would say, ‘Yeah, I need to get that appointment to get my teeth cleaned,’ I would say, ‘You know, cleaning is what you're doing every day at home. You do a good job. Way to go. When you come for hygiene therapy, everything you accomplish in cleaning will be done. But there is way more than that happening.’ Why don't we say that on an ongoing basis to everybody who we get to have a chance to talk to so that they can hear that there's something different?” (40:10—40:37)“I found ways to invest in myself. And for me, that was continuing education. I learned how to look at patients differently, and that paid off. And I got that advice from somebody, my preceptor in dental school . . . I said, ‘Do you have any advice to give us as we depart?’ And he said, ‘Yeah. Sometime in the next three to five years, you're going to feel like buying new furniture for the living room. Go take some really good CE instead.’” (44:24—45:04)Snippets:Dr. DeWood’s background. (03:22—04:26)Why this is an important dialogue in dentistry. (05:18—07:57)The two types of patients. (08:07—11:01)Where is the future in this? (11:31—16:32)Change the mindset and culture. (16:33—17:10)Ask patients what dental health means to them. (17:30—21:59)Dentistry is 51% healthcare and 49% business. (22:20—26:20)How to move to more fee-for-service. (27:12—34:56)Dentists devalue hygiene. (36:11—41:55)Why Spear Education is valuable. (42:48—48:08)Spear workshops and Dr. DeWood’s contact information. (48:18—50:14)Reach Out to Dr. DeWood:Dr. DeWood’s email: email@example.com Dr. DeWood’s Facebook: https://www.facebook.com/drdewoodDr. DeWood’s Twitter: @garydewood https://twitter.com/garydewood?lang=enSpear Education website: https://www.speareducation.com/Further Reading:Mayo Clinic article: https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-doubling-the-size-of-its-phoenix-campus-to-meet-patient-demandDr. Gary DeWood Bio:Dr. DeWood is the Executive Vice President of Spear Education. As one of the founding members of Spear, he directed Curriculum and Clinical Education for nearly a decade prior to joining in the launch of Spear Practice Solutions. Today, he splits time between teaching and consulting.Dr. DeWood serves as an instructor in multiple Spear Workshops, including Facially Generated Treatment Planning, Occlusion in Clinical Practice, Advanced Occlusion, Sleep Medicine in the Dental Practice, and a special focus workshop on temporomandibular disorder. He also maintains a limited private practice on the Spear Campus in Scottsdale, Arizona, and lectures nationally and internationally on practice management, treatment planning, case management, case acceptance, TMD diagnosis, appliance therapy, occlusion, and esthetics.Prior to his contributions at Spear, Dr. DeWood maintained a private restorative general practice with his wife and fellow Spear Resident Faculty member, Dr. Cheryl DeWood, in Pemberville, Ohio, before dedicating most of his time to teaching full time. With 40 years in general dentistry, he provides a unique perspective to the application of the dental principles taught at Spear. He has spent years focused on diagnosing and treating functional occlusal problems and TMD, and as part of that focus completed the craniofacial pain mini-residency at the University of Florida College of Dentistry in the early 1990s.Dr. DeWood served as clinical director at The Pankey Institute from 2003 to 2008. He has held appointments as associate professor at the University of Tennessee College of Dentistry and assistant professor at the University of Toledo College of Medicine. He earned his D.D.S. from Case Western Reserve University in 1980 and an M.S. degree in biomedical sciences from the University of Toledo College of Medicine in 2004.
36 minutes | May 21, 2021
Getting the Dryness Out of Dry Mouth with Dr. John Cranham & Dr. Thomas Eschenroeder
Getting the Dryness Out of Dry MouthEpisode #303 with Dr. John Cranham & Dr. Thomas EschenroederChronic dry mouth doesn’t just affect the aging population. It can be a result of genetics, various medical conditions, or prescription medications, and can negatively affect a person’s quality of life. So, today, Kirk Behrendt brings in Dr. John Cranham and Dr. Thomas Eschenroeder to introduce Voutia, a new oral hydration device that provides continuous relief for people with chronic dry mouth. You don't have to suffer with xerostomia! Listen to Episode 303 of The Best Practices Show and find out if Voutia is for you!Main Takeaways:Dry mouth is a bigger problem than the dental/medical community is willing to admit.It’s not just head and neck cancer that affects saliva — other cancers and medications can too.Dry mouth can affect how a person talks, swallows, sleeps, and even what they eat. Voutia is a new oral hydration device that can be used during the day or night.Once you start using Voutia, your salivary flow will feel like normal again.Quotes:“I've restored thousands of mouths, and there's just nothing worse than having perfect margins and control over everything, and then something that is totally out of our control starts to rob the person of their saliva, and then they just start getting caries everywhere.” (06:53—07:09)“One of the things, to me, that was the most moving was the fact that when you have dry mouth, you basically lose the ability to have a normal feeling mucosa. Your mucosa basically turns like leather. And so, what happens is, once you start using this device . . . your mucosa feels normal again.” (13:23—13:50)“The other thing that happens is, people with dry mouth are constantly sipping water. And the problem with that is they feel bloated. And the water goes through their mouth so quickly that they can't really hydrate their mouth with it very well. And because of that, it’s never satisfied. So, by wearing this device, they actually feel like they have normal salivary flow again.” (13:53—14:16)“The other thing that makes it so complicated is, as we have this population in our practice that's getting older, particularly if you've done work on them and you're trying to maintain it, the very best-case scenario is that it holds up occlusally and it holds up biologically, and then they go off into the sunset. But when you start having increased medications, that usually means they're not as healthy. So, it’s harder and more dangerous to do procedures on them.” (15:29—16:03)“Nothing’s more scary when somebody walks in and you've got to go take a tooth out, or put an implant in, or do something like that on somebody that pulls out their medication list and it rolls across the table. And we’re seeing that more and more. So, anything that I can do in my practice to keep my dentistry lasting for as long as the patient does and minimizing the amount of work that I've got to do so if something does fail and it is a margin or something, maybe we can go in there and clean that margin out and put something in there without having to lose the tooth or take everything off.” (16:05—16:45)“[Voutia’s cannula] is almost like a human hair, practically, in terms of how thin it is. So, again, a very elegant way to solve a problem that’s larger than, I think, the dental community really wants to maybe admit.” (18:26—18:44)“Everybody’s familiar with lozenges, gums, rinses, artificial saliva, sprays, and whatnot that you can use. But the problem is, these things are limited to the fact that you can use them when you're awake. And you also have to keep in mind the fact that it’s a continuum. Certain people have a little bit of salivary function, certain people have none. And if you stick a piece of gum in somebody’s mouth and they have zero salivary function, it’s just not going to work.” (19:53—20:27)“I think people think that the only cancer that affects saliva is head and neck cancer. And there isn't any question that when they get the radiation of the head and neck, it’s bad. It’s not as bad as it once was because of the triangulation type radiation they have now. But there's somebody that I follow on Twitter that is a friend of mine through Hokie Sports, and he’s got colon cancer. Here’s a kid that's 27, 28 years old, that constantly is complaining about the chemotherapy drugs and how it just creates this horrible burning in his oral mucosa, and just miserable when he’s on that.” (21:34—22:18)“We have to understand that in this age of complete dentistry, which is Dr. Dawson’s word, but I think for a lot of the people that follow Kirk and ACT, that's what we’re trying to be. We’re trying to treat the whole human being. Well, it’s kind of nice to have some options for patients that are coming in when they have something that's completely unrelated to us that's going on, but then just creates a storm inside their mouth. And I just think that we need to have as many solutions as we possibly can.” (22:40—23:17)“The problems are broadly based across many branches of medicine. Oncology and rheumatology are the two big groups. But guess who gets these patients in their office, in their chair, and guess who really knows about it? I will tell you candidly that we’ve done a lot of talking with clinicians in the oncology field. And I'll never forget, one radiation oncologist actually said, ‘We just don't see that many xerostomia problems.’ And I just couldn't believe it when I heard that.” (24:13—24:46)“I think a lot of times, the surgeon does whatever cancer treatment. And say the cancer is cured. Their job is done at that point. And the side effect of xerostomia, who’s the patient going to talk to about that? Well, [dentists], because they view us as the person that's responsible for their mouth.” (26:26—26:47)“We always tell patients, ‘If you submit a claim and it gets rejected, don't be disheartened. Submit it again and talk to these people.’ Insurance companies are constantly rejecting things the first time. And then, when you pursue this and you press it, usually, they’ll take another look at it.” (29:19—29:39)“This device is principally designed and FDA-cleared for simply providing moisture. It makes acrylic prostheses more comfortable and easier to wear, and it also makes people with dry mouth with natural dentition feel more comfortable. Right now, we cannot make any claims that it will decrease the rate of caries in people with xerostomia. However, there are independent research projects going on right now, university-based research projects, to look into this.” (31:27—32:05)“[Voutia] simply delivers water to your mouth at the same rate that your salivary glands used to deliver to your mouth before you lost that ability. And there is a tremendous amount of research opportunity for this. And we are so excited to offer this to the world of dentistry and to all the creative minds in dentistry who will come up with research ideas that we feel will be applicable in the future that can be linked with nanotechnology, with sensors that could be cemented on teeth, with Bluetooth technology that can send a signal to your phone when the acidity of your mouth is at a certain rate. The possibilities are endless as the technology grows.” (32:08—32:57)Snippets:Dr. Cranham’s background. (03:35—05:15)How he and Dr. Eschenroeder met. (05:28—08:04)Dr. Eschenroeder’s background and how Voutia was developed. (08:14—14:16)Xerostomia is a big problem for dentists and patients. (15:27—18:44)Other solutions on the market. (19:31—21:02)What to be aware of when it comes to saliva. (21:32—26:55)Affordability, availability, and implementation of Voutia. (27:25—30:14)How to find Voutia, and last thoughts. (30:31—33:59)Reach Out to Dr. Cranham & Dr. Eschenroeder:Dr. Cranham’s Facebook: https://www.facebook.com/john.c.cranhamDr. Cranham’s Instagram: @johnccranhamddsDr. Eschenroeder’s Facebook: https://www.facebook.com/thomas.eschenroederDr. Eschenroeder’s Instagram: @chopseschenroederVoutia’s website: https://voutia.com/ Dr. John Cranham Bio:Dr. John C. Cranham is a highly respected and renowned dentist in Chesapeake, VA. At his state-of-the-art office, he delivers unsurpassed general dentistry, cosmetic dentistry, and restorative dentistry, including TMJ THERAPY and DENTAL IMPLANT SERVICES. Dr. Cranham uses his vast experience and expansive knowledge to create healthy, natural-looking smiles.Dr. Cranham was an honors graduate of the Medical College of Virginia in 1988. He’s an internationally recognized speaker on the esthetic principles of smile design, contemporary occlusal concepts, treatment planning, restoration selection, digital photography, laboratory communication, and happiness and fulfillment in dentistry.Dr. Cranham founded Cranham Dental Seminars, which provides lectures, mobile programs, and intensive hands-on experiences to dentists around the world. In 2008, Cranham Dental Seminars merged with THE DAWSON ACADEMY, a world-famous continuing education facility based in St. Petersburg, Florida.As The Dawson Academy’s acting Clinical Director, Dr. Cranham is involved with many of the courses and provides continuing education to dental professionals across the globe. He spends approximately two-thirds of his time in private practice and the other third as an educator. He believes this balance keeps him on the leading edge of both disciplines.A published author, Dr. Cranham is committed to providing the highest quality patient care, as well as developing sound educational programs that exceed the needs of today’s dental professionals.He is an active member of numerous professional organizations, including the American Dental Association, American Academy of Cosmetic Dentistry, American Academy of Fixed Prosthodontics, and American Equilibration Society.Peter E. Dawson, D.D.S., is considered to be one of the most influential clinicians and teachers in the history of dentistry. He is the founder of the “Concepts of Complete Dentistry” series as well as The Dawson Academy.Dr. Thomas Eschenroeder Bio:The answer is “Photography, woodworking, yoga, playing music with others, fly-fishing, and just about anything under the heading of outdoor activities.” This would be the correct Jeopardy response to: “What pursuits does Dr. Eschenroeder enjoy?”When asked how these interests relate to his practice, Dr. E explains: “There are many connections and common denominators found between these pursuits and the practice of oral surgery. Appreciation for esthetics, the need for precision, and the patience required for woodworking are also necessary to achieve favorable outcomes in oral surgery, whether it be dental implant surgery or corrective jaw surgery. Musical disciplines require constant practice and refinement to bring out the best. Appreciation for harmony and cooperation are essential components of these pursuits and for a successful private practice. Photography helps us to see things that we may have otherwise missed. Being aware of our connection with nature in any capacity is so necessary to remain balanced in this world. The best way to appreciate any field of interest is to immerse oneself. When you love what you do, becoming immersed is second nature. Finally, there is something special about sharing what you love. Whether it be through informing clinical staff about the reasoning behind different surgical techniques or sharing ideas with the oral surgery residents in training, I derive a great deal of satisfaction from teaching.”Born in Missouri, the son of a veterinarian, Dr. E’s love of animals comes naturally. The Eschenroeders have never been without pets and rounding out their family of five includes two cats, Finn and Piper, and a vocal, rambunctious but emotionally sensitive Plott Hound named Ted. Dr. Eschenroeder’s wife, Susan, is a college guidance counselor. She has visited many colleges and universities to get a boots-on-the-ground sense of what each institution is really like. This helps her to make her recommendations to her students with confidence. Dr. E’s three children are Becky, Caitlin, and Alex. All three are pursuing different careers now. Dr. E’s youngest, Alex, just became the first of this next generation of Eschenroeders to get married.
50 minutes | May 17, 2021
Mental Fitness: The Game Changer with Dr. Jackie Kinley
Mental Fitness: The Game ChangerEpisode #302 with Dr. Jackie KinleyPeople exercise to improve their physical fitness. But how often do people exercise their brain for mental health? To teach you how to build psychological resilience, Kirk Behrendt brings in Dr. Jackie Kinley, author of Mental Fitness: The Game Changer, to share a framework to help you adapt to and tolerate stress in a more positive way. Your brain is like any other muscle — keep it healthy with exercise! To begin developing your mental muscles, listen to Episode 302 of The Best Practices Show!Main Takeaways:Stress can wear you down physically and psychologically.Like physical illness, mental illness can occur in anyone if we’re not careful.There are mental habits you can build and develop to stay healthy through stressful times.People aren’t broken, they just haven't developed the skills to tolerate and cope with stress.Psychological strength needs to be built and maintained.It’s not about feeling better, it’s about getting better at feeling.Quotes:“When we first started to speak about this, everybody thought that this pandemic was going to be a sprint, that we just had to hunker down, we had to deal with things, we had to just buckle down and get through it. And what's become really clear is it’s a marathon. So, the stress has persisted. And as stress persists, it has a significant impact on us. Not just physically, our physical bodies, but psychologically, stress can really wear us down.” (05:22—05:51)“Your brain is like any other muscle, and we have to develop skills to be able to deal with stress.” (06:23—06:29)“Mental illness can occur in any of us if we’re not careful and if we don't take care of ourselves, just like physical illness can happen.” (06:47—06:54)“I talk about four mental muscle groups. If you can see fit, which is perspective; if you can think fit, which is keep your thinking brain calmed down and focused; if you can feel fit, which is deal with all those emotions that come up — anxiety and panic happen when emotion starts — and then the last one is act fit, is if you can reach out to other people, stay connected. And so, these are skills, these are habits of mind. You can learn these things. You can make connections in your brain and you can strengthen those through exercises so that it becomes second nature. You can build the muscle memory so when you're under stress, you know how to respond in a positive and adaptive way.” (09:09—09:56)“People aren’t broken; people just haven't developed skills. So, these are capacities that you can develop. When you don't have those capacities, if you get stretched and strained, then you can certainly develop symptoms — anybody can. Any of us can. Any of us can get anxious, depressed, even psychotic. Any of us can if our capacity is breached. And so, it’s not about judging people, it’s about understanding what resources individuals have, psychologically, and helping them to develop the skills they need. These aren't character flaws; these are skills deficits.” (10:50—11:26)“We have a lot of beliefs, ‘Anger is not safe. Anger is dangerous. Anger means I did something wrong, if somebody gets angry with me. Sadness is weak,’ all of those things. There's so much misinformation about emotions. And emotions are actually adaptive. They're empowering. They're very, very helpful. But like the truth, they can be used for good and evil. Anger can be used for advocacy and ambition and perseverance. It can also be used to be nasty and mean.” (13:12—13:42)“When we can't deal with anger, when we can't deal with sadness, when we can't deal with fear, and when we get stuck in emotions, that's when we get sick. So, stuck fear leads to anxiety. Stuck sadness leads to depression. Stuck anger leads to suspiciousness and paranoia, aggressive behaviors. And people will try to medicate away those symptoms. They try to get rid of them. But actually, it’s the opposite. The way we get rid of anxiety and depression is, we need to start to be able to feel our feelings better. It’s not about feeling better, it’s about getting better at feeling.” (13:58—14:40)“Sync into the emotion. When you're under stress and pressure, your emotion is information. Don't shoot the messenger.” (16:09—16:15)“When we’re under stress, when we’re fearful and under stress, it’s really easy to just see difference. It’s because you become narrow-minded; you don't see clearly. So, it’s really easy to fall into judgment and difference. And so, it’s really important when you're under stress to settle yourself down to think fit, to feel fit, and then to act fit, to lean into the other person, to empathize, to understand. When we’re under stress, it behooves us to understand.” (16:28—16:57)“Sometimes, people don't want to see [a mental health professional], because in order to work with somebody, you have to be ready, willing, and able. And the able piece is that you need to be with the right person.” (20:23—20:38)“We have focused so much on diagnosing people and putting a label on people — which can be really helpful in the short term. I'm not against that. But if they stick and get stuck, and if you don't actually move on and understand the person and help the person develop the skills they need, then they're not going to get better. They're going to keep coming back, and it’s going to get worse, because you haven't actually dealt with the problem.” (22:29—22:54)“Sometimes, people don't know how to read their emotions. They don't know how to tolerate them.” (24:37—24:43)“Some people don't deal with conflict. They don't empathize with people. They don't set boundaries. And it’s not because they're bad people, it’s because they’ve never thought about it. They’ve never really learned how. And these things are really important, not only for you to stay healthy, but for your relationships to be healthy and honest and not just superficial.” (36:45—37:07)“People are stretched beyond their capacity. And that's when illness happens. That's when anger turns to suspiciousness, and projection, and paranoia, and violence, and bad behavior. But it’s not that these are bad people at the core.” (42:16—42:34)“You have to help people build capacity. This is what I'm saying is psychological strength. We have to build it. And some people just have never exercised these muscles. They’ve never had to; they’ve never learned how. And we have to. We have to, because we’re going to be under stress. We’re going to be under strain. It’s not going to go away in the short-term. Things are changing, and we have to learn how to deal with it.” (43:03—43:29)“If we can get the word out, if we can get people thinking differently, if we can move away from an illness paradigm, if we can move away from that and stop blaming and stigmatizing people and labeling people, and start helping people identify their growth opportunities and help them learn the skills that they need, we can have a huge shift. We can create a tipping point. But it starts with consciousness. It starts with awareness.” (44:20—44:48)“We have the capacity to solve all of the problems that face us. But we have to start with ourselves. You have to start inside.” (45:03—45:15)Snippets:Dr. Kinley’s background. (04:06—04:47)Why mental fitness is important in dentistry. (05:19—06:57)The brain is like a muscle. (07:59—09:56)See fit, think fit, feel fit, and act fit. (10:36—12:51)What people get wrong about mental fitness. (13:00—14:59)Who are the right people to talk to about mental health? (15:35—17:18)Why there's resistance and hesitancy towards therapy. (17:57—21:34)Why mental health has come to the forefront of social awareness. (21:52—23:05)How to apply the framework of see fit, think fit, feel fit, and act fit. (23:32—27:03)Social media can negatively affect mental health. (28:24—30:57)Environmental aspects of healthy brain development and mental fitness. (32:35—34:23)Learn, develop, practice, and measure mental fitness skills. (34:53—37:11)See the potential in everybody. (37:41—40:15)People are more strained during the pandemic. (40:16—43:29)Thoughts on the future of mental fitness. (43:51—45:15)Dr. Kinley’s book and courses. (45:48—48:31)Reach Out to Dr. Kinley:Dr. Kinley’s Facebook: https://www.facebook.com/jackie.kinley.31Air Institutes website: https://air-institutes.com/Further Reading:Mental Fitness: The Game Changer by Dr. Jackie Kinley: https://www.amazon.com/Mental-Fitness-Psychological-Strength-Resilience/dp/1775358321Dr. Jackie Kinley Bio:Dr. Kinley is a Psychiatrist, Associate Professor (Dalhousie University), and Honorary Fellow of the Canadian Association for Group Therapy, Training, and Facilitation and a Fellow of the Canadian Psychiatric Association. Her expertise in psychiatry and research in the neuroscience of resilience was the inspiration behind Air Institutes, which delivers programs to enhance mental fitness, performance, and resilience.Jackie has provided resilience assessment, coaching, and training to corporate clients such as Emera, Air Canada, and Stewart McKelvey, as well as to professional associations such as The National Judicial Institute and Doctors Nova Scotia. She has worked with different departments in the public sector, including Health Canada and the NS provincial Public Service Commission. She has been providing resilience training for new recruits and the peer support team at Halifax Regional Fire Department, and partnered with non-profits that include the Canadian Mental Health Association and NS Division, as well as the YMCA.Dr. Kinley has published many research articles on the neurobiology of resilience, presents internationally on the subject of personal and organizational resilience, and has had multiple media appearances on CBC and CTV, and has been featured in popular magazines, including Atlantic Canada Business Journal and Optimyze, a national women’s health periodical.
51 minutes | May 14, 2021
This is Good Sh*t: What Every Dental Professional Should Know with Dr. Uche Odiatu
This is Good Sh*t: What Every Dental Professional Should KnowEpisode #301 with Dr. Uche OdiatuTwo apples a day could keep the doctor away! But very few North Americans — including dentists — consume the recommended amount of fiber and other nutrients. For a lesson on nutrition and its effects on the gut microbiome, Kirk Behrendt brings back Dr. Uche Odiatu to talk about how a healthy gut can lead to a better and longer life. It can also help you stay ahead of the curve in dentistry! For advice on becoming healthier and starting the health conversation with your patients, listen to Episode 301 of The Best Practices Show!Main Takeaways:All disease begins in the gut.Understand gut health to get ahead of the curve in dentistry.Learn about gut health, and overall health and wellness will become effortless.You can begin to change or improve your gut microbiome in a day.Intermittent fasting, time-restricted eating, and caloric restriction are ways to extend life.Get healthy yourself before giving your patients health advice.Enjoy food mindfully, and let food be your medicine!Quotes:“People often have heard about gut health, but they're not really sure how to apply it. You can tell they're not applying it because they show up sometimes tired. They're often not sure why they have brain fog. They're not at the weight they want. If you're literally not at the weight you want, you don't understand gut health, because when you understand gut health at a deep level, weight becomes effortless.” (06:06—06:27)“If you're one of the 50 million Americans suffering from [low] energy level, to immune system issues, to not ideal weight, to poor sleep, to brain fog, to accelerated aging — if you actually look like your driver’s license picture — you need to know more about gut health. Because when you understand it, health becomes effortless.” (06:54—07:12)“Total health is where to go. Patients are starving for healthcare providers that look at all of them and not just your little area, your little silo. That little silo is great, but you start with total health — medical history, anything new, how are you sleeping, are you tired, do you exercise, how are you eating lately. That’s how all my appointments start. Start with the bigger picture, then you go into the smaller picture.” (09:38—10:03)“The gut microbiome is an amazing modulator of gene expression. The whole idea is your genes load your gun; your lifestyle pulls the trigger. So, genes are basically just a blueprint.” (11:30—11:43)“A way to manipulate genes is to have the healthiest microbiome possible. In order to do that, you've got to look at a number of different things. The microbiome — a very esoteric subject. And people don't realize, you tweak it a bit, you could end up completely different. In how long? 24 hours. What you eat today, you can tweak your microbiome. In three days of junk food eating, you can actually lose 40% of your resident gut bacteria, which decimates you. And sure, you can get them back by having some good, healthy days. But some people lose species, and they lose them forever.” (12:13—12:48)“We have 100 trillion single-celled organisms in our bodies, and they outnumber the human cells, the cells of human origin, 10:1. So, 98% of them are in the GI tract. About 2% of them are on your skin, under armpits, hair, nose, etc. But they are a powerful manipulator of your genes. They also train your immune system, because 80% of your immune system lies in the 26 feet of your digestive tract. So, people with poor digestive health often have immune system problems.” (13:24—13:53)“If you have gut issues, digestive issues, from constipation to reflux to Crohn’s colitis, if you have a disrupted gut microbiome, it’s a precursor to prediabetes and diabetes. So, that being said, the microbiome is the collective, invisible, single-celled organisms that call you home, and they have a symbiotic relationship. You feed them, they feed you neurotransmitters. You rest them, they give you health. You exercise regularly, they become more diverse and slow down aging. You do intermittent fasting, all of a sudden, they're better able to make your metabolism work better.” (13:59—14:33)“We talk about poop because, basically, when you eat, you create tools and building blocks to reinvent yourself and recover and repair. However, there's lots of waste, just like when you're an athlete and you're breathing out CO2. But if you're poor at getting rid of waste, it’s like forgetting to take the garbage out three or four weeks in a row, months in a row. How does your garage smell? So, people who are very poor at getting rid of waste often have very toxic insides, which slows things down: brain fog, slow metabolism, poor neurotransmitters, poor sleep, or hormonal imbalance.” (15:59—16:33)“Science verified that the number-one way to extend life — the only thing that's been verified — is reducing calories.” (17:02—17:09)“Usually, you think you've got to feed people to live. But now, [scientists] realized when you feed something the same thing every day, the body gets lazy. The metabolism doesn't get as organized.” (17:35—17:43)“In 1956, there was a Spanish nursing home study. They had 120 residents. 60, they fed 1,600 calories every day for three years. The other half, they did 900 one day, 2,400 the next day. And they went back and forth, back and forth. Well, after three years, the group that had the variable feeding, so starving one day, overfed the next day — and not starving. It just means you didn't eat as much as you normally do — well, they had half the death rate.” (17:47—18:16)“Only half the adults in North America are eating the right amount of fiber; it’s about 10 to 12 grams they're eating. They need to eat 25 for women, 35 for men. So, most people are inflamed. And almost all modern degenerative diseases are inflammatory based, from cancer, stroke, heart disease. As Bale and Doneen said in The Heart Attack Gene, dementia is basically a lifetime of chronic inflammation.” (21:12—21:33)“One thing you do to mess with your microbiome is not eat enough fiber. And that's basically 97% of people, because 97% of people don't eat enough fiber.” (21:37—21:45)“If you're starving your microbiome, be prepared to accelerate aging. Be prepared to weigh more than you want to be. Be prepared to have a weaker immune system. And be prepared to have chronic inflammation percolating 24 hours a day, seven days a week, the rest of your life.” (22:05—22:17)“You can weave the conversation into patients because the dental disease process is all about inflammation. Periodontal disease, gingivitis, periodontitis — any disease that ends in -itis is inflammatory based. So, if you're not talking about the microbiome chairside, you've got to understand it, because there are people who do, and patients are reading about it at night. And if you pooh-pooh probiotics, or if you pooh-pooh fiber, if you don't talk about saliva and the enzymes in saliva and about GI issues, guess what? They're going to be asking, ‘Where’s the dentist that understands this?’” (22:25—22:56)“If someone literally added two apples a day [to their diet], you'd almost double your fiber. You slow down aging, make your metabolism work better, go to the bathroom more often, mental clarity, become more insulin-sensitive.” (23:54—24:05)“I tell a real estate agent, ‘Come in every three months, and we’ll lower your inflammatory burden.’ ‘Eh, I'm not sure, doc.’ ‘I can slow down aging.’ ‘Where do I sign up for that one?’ So, you've got to appeal, sometimes, to aesthetics. You talk about slowing down aging, now you've got a patient’s attention.” (24:28—24:44)“The minute you start taking better care of your mouth, less pocket depths, you get less bleeding, science has shown you actually improve a human being’s ability to manage blood sugar, which means you become a better fat-burner.” (25:05—25:17)“Any time you become better at burning fat, and any time you become better at managing blood sugar, you slow down aging, because the hallmark of accelerated aging is being insulin-resistant. Insulin resistance is a hallmark of accelerated aging, vascular disease, dementia, wrinkling, because of the collagen being disrupted in the skin.” (25:23—25:41)“Charles Mayo, founder of the Mayo Clinic, said the more teeth you have, the more chance you're going to make it to 100. So, you need every tooth.” (31:21—31:27)“If hygienists start that conversation, ‘People who chew better live longer. People who chew better are able to break down the food and they become healthier. You can repair that meniscus. The food you eat becomes your skin, your brain,’ when you say it with that much passion and authenticity, people go, ‘If I need to come every four months or three months, count me in. I want to keep my brain. I want to slow down aging.’” (31:48—32:10)“2,300 years ago, [Hippocrates] said all disease begins in the gut. He didn't have a microscope. He didn't know about bacteria. But he said all disease begins in the gut.” (33:04—33:13)“There's a whole concept called your “gut instinct”. The reason why they call it a gut instinct is because the vagus nerve gets information from the GI tract and it pumps it back to the brain, telling the brain what's going on. Your brain’s always eavesdropping, ‘How’s the bacteria? How is it going down there?’ Well, if they're disrupted, guess what? Foggy thoughts. So, what's the use of a stockbroker with foggy thoughts? What's the use of a mom with foggy thoughts? What's the use of a dentist with foggy thoughts? What's the use of a student with foggy thoughts? If you want to increase your mental clarity, get gut health, get your bacteria in order.” (33:59—34:28)“Most of the melatonin in your body, up to 90% of it, and serotonin, is made in the GI tract in the enterochromaffin cells. Serotonin, we know, is the peacekeeper. When you have good serotonin, you have good emotional well-being. You're a nice person to hang out with. If your serotonin is off balance, guess what? Now, you're depressed. Depression is one of the biggest reasons for long-term disability. So, most of the serotonin is made in the gut. That means you need to have good gut health to have peace of mind, to become more likable, to be less knee-jerked, to be less annoying.” (34:32—35:01)“The best way to make your gut happy is to change the way you eat. Eat healthier food.” (35:04—35:10)“[Dentists] have an intimate ability to impact patients’ lives. You've got to understand it, though. You've got to get back to your college weight. Get lean — I'm not saying for the aesthetics — just because it comes across a lot more authentic when you're living the part. If you smell like a cheeseburger and fries, guess what? It’s hard to talk about whole body health.” (35:25—35:43)“You really can't take the patient on a journey that you yourself haven't been on. So, if you're talking health but not looking the part, patients see right through you.” (42:19—42:26)“800,000 people, globally, die every year related to their intake of processed meat. Well, if you think about it, only 200,000 die from illicit drug use. So, four times the amount of people worldwide die from salami, hot dogs, and wieners.” (44:54—45:12)“The Global Burden of Disease showed that 4.8 million deaths, every year, could be prevented if people ate more fruit. Eating more fruit could save 4.8 million people’s lives.” (45:32—45:45)“You can change your microbiome. You can become a nicer, more well-adjusted person. I think most people work on the outside; they don't work on the inside. If you work on the inside, you become a nicer person to be around, less reactive and calm, like Kung Fu Panda.” (49:58—50:11)Snippets:Dr. Odiatu’s background. (04:17—05:35)Why gut health is an important topic in dentistry. (06:06—07:15)Look at total health when seeing patients. (07:38—10:03)Tweak your microbiome. (10:38—12:55)Dysbiosis and ill health. (13:13—16:33)Effects of calorie restriction on aging. (16:57—19:33)The number-one microbiome disruptor. (19:57—23:03)An apple a day keeps the doctor away. (23:34—25:57)Make good food choices. (27:04—28:37)How to start the conversation with patients. (29:25—32:15)Other things to consider about gut health. (33:00—36:27)Digestive health and the link to dry mouth. (36:43—39:10)Get healthy yourself before helping your patients. (39:41—43:12)Dr. Odiatu’s new book. (43:46—47:41)Dr. Odiatu’s contact information. (48:47—50:12)Reach Out to Dr. Odiatu:Dr. Odiatu’s website: http://www.druche.com/Dr. Odiatu’s Instagram: @fitspeakersDr. Odiatu’s email: firstname.lastname@example.org Further Reading:Beat the Heart Attack Gene by Bradley Bale: https://www.amazon.com/Beat-Heart-Attack-Gene-Revolutionary/dp/1681620227 “Effect of Restricted Feeding Upon Aging and Chronic Disease in Rats and Dogs” by Clive M. McCay: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1623629/pdf/amjphnation01116-0026.pdfThe Microbiome Solution by Robynne Chutkan: https://www.amazon.com/Microbiome-Solution-Radical-Heal-Inside-ebook/dp/B00RW1ZUCSGrain Brain by David Perlmutter: https://www.amazon.com/Grain-Brain-Surprising-Sugar-Your-Killers/dp/031623480XThe Power of Now by Eckhart Tolle: https://www.amazon.com/Power-Now-Guide-Spiritual-Enlightenment/dp/1577314808United Concordia dental study: https://www.unitedconcordia.com/dental-insurance/about/oral-health-research/**Stay tuned for Dr. Odiatu’s new book, coming fall of 2021!**Dr. Uche Odiatu Bio:Dr. Odiatu has a DMD (Doctor of Dental Medicine). He is a professional member of the ACSM (American College of Sports Medicine), a Certified Personal Trainer (National Strength & Conditioning Association) NSCA, and the Canadian Association of Fitness Professionals (canfitpro). He is the co-author of The Miracle of Health (c) 2009 John Wiley (hardcover) & (c) 2015 Harper Collins, and has lectured in Canada, the USA, the Caribbean, the UK, and Europe. He is an invited guest on over 400 TV and radio shows, from ABC 20/20, Canada CTV AM, Breakfast TV, to Magic Sunday Drum FM in Texas. This high-energy healthcare professional has done over 450 lectures in seven countries over the last 15 years. “I love my team-building sessions with individual dental offices on the road . . . From Florida, USA, to Alberta, Canada, I crisscross the continent to support offices in their wellness goals. Patients embrace an integrated treatment philosophy. Being comfortable chairside talking nutrition, posture, stress, and sleep doesn’t happen by accident. Mastering the terminology and integrating the latest science sets offices apart from the pack.” Want to know more about arranging an in-person office program? Send me a quick note in my CONTACT page. Or, to start with a LIVE personal webinar for your office or group practice, go to bit.ly/fitdentist.
38 minutes | May 10, 2021
Show and Tell or Show and Teach with Dr. M. Nader Sharifi
Show and Tell or Show and TeachEpisode #300 with Dr. M. Nader SharifiA teacher can forever change the trajectory of your life. Good teachers tell, and better ones teach — but the great ones inspire. And today, Kirk Behrendt brings on Dr. Nader Sharifi to talk about what makes a great teacher, how you can improve your teaching, and the future of learning. For more on how you can get the most out of your education, listen to Episode 300 of The Best Practices Show!Main Takeaways:Even bad teachers can benefit you in dentistry.Acknowledge your mistakes when teaching. Don't just show the successes. When you're teaching, it’s not about you — it’s about the people listening.Some teachers, you want to read. Others, you want to see.Past masters are also great teachers.Quotes:“By the time we get to this point in our careers where we’re dentists, we have seen every conceivable flavor of educator in front of us. We have to have embraced education in some way, because to leave high school and go to college, you need to be willing to learn. And then to even leave college and go to dental school, you're committed about learning and you're not shy of it. And to take that step is a significant challenge for some of us, partly because of who’s taught us. So, we need good teachers to help us continue on our processes.” (05:29—06:13)“To learn what's a good teacher, we also have to learn and understand what's a bad teacher. In dentistry, it seems to me that our bad teachers can also benefit us just a little bit, in some regard. So, that's really the “show and tell” part of it.” (06:15—06:32)“Sometimes, I'll go to a conference, and there’ll be a presenter who will be full of glitz and glamour, and a beautiful patient from out of town who travels to see them, and has this humongous, multi-disciplinary treatment plan that took three years to complete, and it’s just spectacular dentistry. And at the end of the presentation, I realize I haven't learned how to do that. I saw that it was possible, but I didn't learn how to do it.” (06:33—07:06)“The benefit [of show and tell] is, I see the potential for dentistry. I see the potential for myself. I see the opportunity. But I'm not able to do it. And that's okay. I just chose, in my path, I don't want to do that. I don't want to be that type of speaker. I don't want to be that type of teacher. I don't want to be that type of person. I want to be able to teach, and show a protocol, and show a process that's available to the participant in the audience. And so, that's not the show and tell, that's the show and teach.” (07:11—07:52)“If we only show success and we don't acknowledge the mistakes we made to get there, if we only show success and we don't show the trouble that occurs in achieving that, it’s really a false reality.” (13:58—14:11)“I was as far to one end of the scale as possible, being a presenter who would connect well with dentists much more so than I would connect with dental students, which was at the other end of the scale, because my first foray in teaching, which was inspired by some of my teachers, was in dental school. And it failed horribly. It didn't work well for me. I wasn't good at it, I didn't get positive results from the students. It wasn't working well, but I had a desire to do it. And I ended up evolving into having the opportunity to do it at the podium rather than in the classroom. And something resonated.” (19:14—20:02)“Zoom doesn't give us that opportunity [to interact] the way that the live meeting will. However, for the first time in my life, I sat down with my laptop in my favorite reading chair in my bedroom and attended a symposium. And when the speaker said something that just astounded me, I could pause it, reverse it 15 seconds, write it down, listen to it again and say, ‘Okay,’ and then pause it again, make a couple of notes to myself, and then press play and never miss a beat. And so, I realized that there is going to be benefit from having something available to me on my computer rather than solely live.” (21:59—22:49)“Learning from past masters is still something that I find valuable.” (31:41—31:47)“For somebody who’s getting started in teaching, talk about your personal experiences that are true, things that really happened and that are valid, because you can't be challenged on it and can't be questioned on it. You can have questions asked that you'll need to answer, of course, but you can't be questioned on your truth.” (35:55—36:16)Snippets:Dr. Sharifi’s background. (03:59—04:48)Why the concept of show and tell or show and teach is important in dentistry. (05:28—07:52)A trend of simple, applicable, high-quality teaching. (09:10—10:26)Dr. Sharifi’s three techniques for teaching. (10:38—12:53)An authentic vulnerability of the teacher. (13:56—15:56)Learn from and influence one another. (17:54—20:36)Where dental education is now, and its future. (21:21—26:15)Some of Dr. Sharifi’s favorite teachers. (27:20—32:48)Last thoughts on teaching in dentistry and the future of dental education. (34:33—36:16)Reach Out to Dr. Sharifi:Dr. Sharifi’s website: www.drsharifi.comDr. Sharifi’s Instagram: @naderonsocialDr. Nader Sharifi Bio:Having earned a certificate in prosthodontics, Dr. Sharifi is a refined general dentist with advanced training in the restorative aspects of dentistry. He received his DDS degree from the University of Illinois at Chicago, then continued his education to earn a certificate in prosthodontics from Northwestern University Dental School. Dr. Sharifi also earned a master’s degree in dental biomaterials from Northwestern University.Dr. Sharifi is a nationally recognized dental instructor on the topics of dental implants, full and partial dentures, overall patient care, and restoring root canal-treated teeth. He travels every other Friday to study clubs, associations, and dental meetings where he has presented several hundred lectures internationally and nationally, reaching nearly every state. Dr. Sharifi was named to the select American Dental Association (ADA) National Speakers Bureau in 1996. In 2007, he received the coveted Gordon J. Christensen Lecturer Recognition Award for excellence in teaching and loyalty to the profession.Dr. Sharifi has been honored with membership in the American Academy of Restorative Dentistry and American College of Dentists. He is active in the Chicago Dental Society, the Illinois State Dental Society, and the ADA – where he served for more than a decade on the Council on Dental Practice. Dr. Sharifi also is a member of the American College of Prosthodontics, for which he has chaired the Committee on Dental Insurance and Managed Care. For more than ten years, he has participated as a member in the Northern Illinois Dental Specialty Study Club, and recently joined as a charter member of the Seattle Study Club of Oak Brook.Outside of the office, Dr. Sharifi spends the majority of his time with his family. He has three amazing daughters whose exploits on stage keep him busy and proud. He loves to read novels and will ask about what you’re reading when you arrive with a book in hand. Dr. Sharifi enjoys hiking, skiing, and – because he has only daughters, was raised with only sisters, and works in a dental office with only women – likes to attend car shows and photograph the beautiful restorations to spend time with some of the guys.
35 minutes | May 7, 2021
The Missing Piece in Skeletal Growth and Development with Dr. Rebecca Bockow
The Missing Piece in Skeletal Growth and DevelopmentEpisode #299 with Dr. Rebecca BockowAirway dysfunction can lead to a number of comorbidities — anything from tooth decay to behavioral concerns. And to prevent them, it’s important to understand the possible causes. One of them is an undersized jaw, and Kirk Behrendt brings on Dr. Rebecca Bockow to talk about what influences skeletal growth and development, and the importance of early treatment and intervention. For more on identifying and treating tongue and respiratory dysfunctions, listen to Episode 299 of The Best Practices Show!Main Takeaways:Dentists may be the first providers to identify airway issues in patients.Key things in skeletal growth and development happen as early as during breastfeeding.Breathing and tongue placement habit strongly influences skeletal growth.Undersized jaws can lead to comorbidities.Ask patients open-ended questions to identify possible issues.Look to early treatment and early intervention.Treat the “why”. Look for tonsils, airway issues, and tongue-ties.Understand structure, function, and behavior.Quotes:“When we see malocclusion, we might be, as dentists, the first providers to identify for some of these patients that they do in fact have an airway issue. So, this can present, for example, grinding. Grinding in kids and adults is a sign that airway is not great. We can pick up tongue- ties. Certainly, the easy ones to pick up would be a crossbite, open bite, underbite, overbite. These are all linked to airway dysfunction. So, once you see it, you can't not see it. And you'll start to see how prevalent it is.” (05:11—05:48)“As care providers, we can sometimes ask open-ended questions for the patient, ‘How do you sleep?’ And it opens up Pandora’s box. ‘Oh, I wake up through the night. My child couldn't breastfeed. She’s still wearing Pull-Ups at age eight. We've got a lot of behavioral concerns, not paying attention in school, comes into my bed every night, tired during the day.’ And we, as orthodontists, see the crossbite. And so, all of a sudden, we’re tying things together for these families that they didn't even know were connected.” (05:49—06:28)“If we think about skeletal growth and development, a lot of the key things that happen happen really early on, going back even as early as breastfeeding.” (07:20—07:28)“Thinking about the tongue, all of those movements [when breastfeeding] require a great deal of coordination, as well as flexibility and strength. And so, if you have a child that has a condition called apraxia, and there's a lot of nuances to this, but globally thinking about a child’s ability to move the tongue in a way that's healthy, so getting that tongue up and forward, things like muscle incoordination or things like tongue-ties are going to adversely affect what's going to happen with the tongue.” (08:12—08:49)“The nose is a natural filter. When you have the ability to breathe through your nose, the nose is going to humidify the air. It moistens the air. You filter out all the dust, the allergens, the pollens. Adenoids and tonsils are hypertrophic tissue, so if you have a child that's a mouth-breather, we tend to see bigger tonsils, bigger adenoids. And so, this cycle continues because they're more driven to breathe through their mouth, because now they have nasal respiratory obstruction.” (10:21—10:48)“There's great documentation that links nasal respiratory obstruction with undersized jaws. And then, we start to see other comorbidities that we would notice as dentists, which include grinding, high carious incidents, hypertrophic tissue such as the gum tissue. And the cycle goes on and on. As orthodontists, we see this as crowding because the jaws are small. So, there's insufficient bone to accommodate the eruption of the adult dentition. And so, it’s sort of this aha moment when we start to link what goes on early with breathing and tongue function or dysfunction and the way that we see the jaws grow.” (10:49—11:32)“It’s the way we breathe and what we’re doing with our tongue that really influences skeletal growth. And so, you can take one child that has a deficient maxilla, maybe deficient mandible, and we expand, and we get growth back on track, tongue is able to come up and forward, we establish proper nasal breathing, we establish lips together. And that particular child’s growth is going to progress in a really positive, healthy way.” (14:30—14:55)“This young man, [at eight years old], we did expansion. But the tongue continued to come forward. He saw ENT. ENT said, ‘There’s nothing to do here.’ I don't think they made it to myofunctional therapy. But they saw the pediatrician, they saw a lot of other providers, and no one really had answers for them. And so, they did nothing. Now, we see him again at 12, and the lower jaw is still small. And so, was it a bad grower? Did we not do the right thing? Is it maybe that kids are breathing with their mouth open that that tongue is coming forward? . . . In orthodontics, we would label these as “bad growers”. But maybe we’re missing something.” (15:43—16:41)“Historically, a lot of orthodontists will use things like tongue tamers. Which, yes, it prevents that child from bringing their tongue forward. But once you take the tongue tamers away, who’s to say that's a stable change? We need to really try to identify the etiology. So, looking for tonsils, look for airway issues, and then look for tongue-ties.” (18:48—19:11)“Try to understand structure, function, behavior. So, structure, meaning the jaws. Function, meaning can a child breathe through his or her nose, does the tongue have the physical mobility to come up. And then behavior being, is the child or the adult able to breathe with lips together, able to breathe through their nose in a habitual manner.” (19:26—19:47)“I've seen adults that have had four teeth taken out, and orthodontic mechanics to try to retract everything, retract everything. The tongue pushing is going to lead to the teeth in this proclined manner. So, you could bring everything back, and you could go so far as to take out teeth to bring it back even more. But airway will always win.” (19:55—20:20)“If we see a child, let's say a five-year-old, six-year-old, and they constantly are biting their lower lip. So, now, they’ve become their own functional appliance, but in the wrong direction. So, that constant lower lip entrapment, if we as orthodontists do nothing about that and we let them continue into age 12, of course the mandible is going to be small. Of course they're going to have a persistent overbite. And then, talk about mouth-breathing, they can't get their lips around the teeth because the upper teeth are so protrusive. And so, the cannons of orthodontics say don't treat a small mandible until the patient is in their pubertal growth spurt. I can't say that that's wrong, but I also have a lot of questions about that. So, maybe we have to look at what's happening in terms of habits early on.” (26:46—27:36)“It’s forming these connections and looking at things in a really different way. We’ve never asked the question: why do we see crowding? As orthodontists, we’ve always thought, ‘How can we fit the teeth together?’ So, this is a real paradigm shift saying, ‘Why? Why is there crowding? Why do we have the open bite? Why do we have the crossbite, the underbite, the overbite?’ And when we treat the why, when we treat the etiology, not only can we get a more stable result, potentially, but we’re also going to hopefully have a healthier patient.” (30:45—31:14)Snippets:Dr. Bockow’s background. (03:27—04:22)Why this is an important topic in dentistry. (04:51—06:33)Apraxia, mouth-breathing, and mandible growth. (07:15—11:32)How the pandemic mask-wearing is changing how we breathe. (11:45—13:12)What influences skeletal growth? (13:52—16:45)Identify the etiology. (17:32—20:52)Work on structure, function, and behavior. (22:02—23:22)Advice for dentists looking for a myofunctional therapist. (23:53—24:44)Early treatment and early intervention. (25:12—28:21)Coaching for kids and adults. (28:56—29:56)The future of airway and orthodontics. (30:41—31:17)How to get started. (31:38—32:16)Dr. Bockow’s practice. (32:49—33:08)Reach Out to Dr. Bockow:Dr. Bockow’s website: https://inspiredortho.com/Dr. Bockow’s Instagram: @rbockowFurther Reading:Spear Education: https://www.speareducation.com/Dr. Rebecca Bockow Bio:Dr. Rebecca Bockow is a dual-trained orthodontist and periodontist – the only dual-trained provider in Seattle and one of only a handful in the country.She grew up in the Greater Seattle area and attended University Prep for high school. She received a B.S. in Biology with Honors at Haverford College, where she also played Soccer, Squash, Tennis, and ran Cross Country and Track. She completed her DDS training at the University of Washington Dental School in 2007. Dr. Bockow practiced as a general dentist in Seattle for two years while simultaneously teaching at the UW dental school.Dr. Bockow completed a highly selective dual-specialty program combining Orthodontics and Periodontics at the University of Pennsylvania. She is a board-certified orthodontist and periodontist. While simultaneously enrolled in two residency programs, she also received a Master of Science in Oral Biology, focusing on intranasal Ketorolac for postoperative implant pain management.Dr. Bockow lectures nationally on periodontics, orthodontics, interdisciplinary orthodontics, airway, and skeletal growth and development. She contributes to multiple professional journals as an author and editor. Dr. Bockow is also a resident faculty member at Spear Education.
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