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October 02, 2024 #14 Who's Who in the Dental Office - Dental Hygienist Edition
Dental offices are made up of a lot of different team members. We dove into some of the roles in a couple previous episodes, but today we are talking all things dental hygienist. What do dental hygienists do and how do they operate within a dental practice? Let’s dive in.

SIDE NOTED: We are not only rounding off this segment of “who’s who in the dental office”, but we are also rounding off season 1! We have enjoyed having you all on this journey and can’t wait to see you in season 2! We will still be active on all our socials so drop us a line. Don’t be a stranger!

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As always, feel free to reach out through our instagram @YourDailyDoseOfDental or through our website http://www.DoseOfDental.com. We would love to hear from you and hope your questions can be featured on our show!
Instagram: https://www.instagram.com/yourdailydoseofdental/
Website: https://doseofdental.com/
TikTok: https://www.tiktok.com/@dmadentist

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Transcript:
Well, well, welcome back to another episode.
I’m Dr. Mike.
– And I’m Dr. Rusty.
– And we’re two general dentists
practicing in Portland, Oregon.
– Welcome back to our podcast, DM a dentist.
– In today’s episode, we’re talking about our final team member
in the who’s who in the dental office.
This is part three, and we’re talking about
the dental hygienist.
– The hygienist?
You mean the cornerstone of the dental office?
– You mean the boss?
– Yeah, basically the boss.
– They’re kind of in charge, it seems like.
– The boss, sometimes, you know.
– My boss, day to day.
– We love our hygienists, but you know.
– Yeah, but they run the place.
– They do.
– Yeah, in a lot of ways, they do keep the office running.
And keep a lot of things.
– Absolutely.
– Systems running, recall patients coming through.
I mean, hygienist is important.
– I mean, does your hygienist or does your hygienist?
Does your patients say, “Hey, I wanna see you”
or they wanna see the hygienist?
– Oh, for sure.
They request a hygienist.
They build a relationship with them.
You know, the hygienist is like the bread and butter
of the practice.
It’s bringing people through to get exams.
And I mean, they’re coming back to see the hygienist though.
They build a relationship with them.
They’re not coming to see me.
– No, they wanna see Vonda, or Sam, or Angela.
Any of you all that are amazing.
– Yeah.
– But when they’re in their chair, they’re happy.
They’re getting their teeth clean, things are good.
When they’re in my chair, it’s ’cause they need something more.
So typically, patients are just happier,
I think, when they’re coming for a hygiene visit.
‘Cause they’re– – Yeah, it’s like a real spa day.
– Yeah, it’s basically– – Yeah, it’s a treatment.
Yeah. – Something crazy.
– But what is a role of a hygienist?
I mean, you know, we talked a little bit
about some of the roles.
What are they called?
– Dental nurses.
– Dental nurse.
– Yeah, so are dental nurses?
– As you all know, they’re not dental nurses.
– Yeah, if you listened to our early episodes,
no one in the dental office is called a nurse.
So y’all better know that if not go back in with
then I think it was the assistant– – Listen to a different one.
– Yeah.
– These are what we’re talking today about dental hygienist,
not dental nurses.
So yeah, what are they?
– The hygienists, they’re really involved.
So they’re providers of the office too, right?
They’re licensed in a similar way to the dentist or license.
By the state, they have to go to a lot of school,
a lot of training.
So they’re super involved in oral health,
in treating oral disease,
and a lot more ways than just cleaning your mouth.
They have a few kind of main functions I would say.
As a dental hygienist, your number one is they’re gonna be
providing hygiene, aka cleaning your teeth.
The other thing they’re gonna be doing a big part is education,
you know, oral hygiene instructions, education,
types of toothbrush, water picks, different, you know,
maltherinces and things that are gonna be really helpful.
So aka teaching you how to clean your teeth.
And then the other thing they’re gonna do,
we kind of lump this one together is providing, you know,
more information or applying medications, you know,
things like different toothpaste, maltherinces,
you know, they’re seeing, you know, maybe fungal
or viral infections that they can spot and have us,
have us, you know, prescribed medication for.
So that’s another kind of big role for them.
– Yeah, no, I love that you described it that way.
I mean, your dental hygienist are involved
in your overall oral care more than you think, right?
Like patients often mention,
oh, just here for a cleaning, just, we hear that a lot,
like just a cleaning, but no, their primary focus
is the dental hygienist is improving your oral health
and that is through different types of cleanings
or what you said, like application of medications,
things like that, but their roles and responsibilities
are more an extend far beyond just cleaning teeth.
Wouldn’t you say that?
– Absolutely, yeah.
– They have a lot more duties of just cleaning teeth.
I mean, sometimes they have a quote unquote,
you know, simple cleaning where it’s someone
who is really exceptional home care, you know,
they’ve been educated on how to clean their teeth
and keep it clean.
– Like a rusty cane to get it cleaning.
– Sometimes it’s quote unquote just a cleaning
because there’s not so much going on,
not a lot of disease, right?
‘Cause a lot of patients are great,
but a lot of times there’s a lot of buildup,
a lot of areas are missing stuff, infections,
things that patients aren’t even aware of,
that hygienist can see in spot.
So, you know, at our school, I don’t know if it was,
like this at VCU, I assume maybe similar,
but like we took a lot of classes with our hygienist,
you know, like some of the anatomy
and some of those basic dental terminology
and stuff like that was with some of the hygiene class.
– Yeah, we had a lot of dental hygienist
and with the dental students learning like oral path,
then all anatomy, radiology.
I mean, we were like cohorts in that class.
– Right. – Which is great.
– So we have the same backbone
in terms of didactic knowledge.
– For sure.
– So yeah, we would consider the dentist
and the hygienist as providers in the office.
– Right, yeah.
– Totally, totally.
I mean, and a lot of times, you know, like,
it’s very state by state, but some states,
you can have like indirect supervision of hygienists
to where a dentist doesn’t even have to actually
be in the building for a hygienist to be there working
because their providers, their license, their educated,
their trained in CPR and basic life support.
Like, they’re fully capable of providing care.
They have to have an exam.
– In a lot of states, I want you to need me,
but you don’t really need, you know, the rest of you.
(laughing)
– They need us.
They need us, they need us.
– They need us, they need us.
Well, they need us, you know, we need them.
I think it’s a working relationship.
– It is, right. – We can’t do it.
They do, we can’t do it without us and vice versa.
– Yeah, no, agreed.
You know, and like you said, they’re trained in all the classes too,
right, they’re taking oral pathology and anatomy
and all that stuff too.
So, they’re not just in their cleaning your teeth,
they’re doing oral cancer screenings
and looking for those same lumps and bumps we look for.
– Yeah.
– And a lot of times, they’re in there for so much longer
than I am for an exam, they’re seeing stuff
that’s really small and just starting, so.
– Yeah, I mean, so when your hygienist is in their
cleaning your teeth, they’re looking for all these things
and trying to address other health concerns.
So, they’re doing an exam not only inside the mouth
but also outside the mouth, extra-orally.
They’re looking for things that shouldn’t be there.
Gross, they’ll refer you to a dermatologist.
I mean, they’ll talk to a breastly and I first,
but they’ll know to refer you to a dermatologist
and we will ultimately make that decision,
but they know what they’re doing.
– Right, for sure. – Which is right.
– And not only just the soft stuff,
the lumps and bumps and whatever else,
but they’re also looking at the teeth for cavities,
gum disease, all that, obviously.
– I mean, your hygienist brings it up to you all the time, didn’t they?
– For sure. – Yeah.
– Yeah, they’re very good about that.
– Cavity on number two. – Yeah.
– And not only do they bring it up to me,
they can kind of start that discussion
with the patient as well.
You know, hygienists can’t technically diagnose
like a cavity, for example, that has to be
per organ state law.
A dentist who diagnosis that, but they’ve looked a lot of x-rays.
I promise you if my hygienist is looking at your teeth,
she can tell if you have a cavity.
– Yeah. – Especially if she’s got an x-ray to look at.
– But you’ll let you tell them.
– But not necessarily.
I mean, a lot of times they’re gonna tell the patients,
like, hey, you know, I’m seeing this on some x-rays,
I’m seeing this when I’m looking at your teeth,
looking like, you know, this might be what’s going on here.
Doctor may recommend this for you.
So they can kind of start that process.
And that’s something that I think is super valuable
for hygienists.
It’s called what we, it’s co-diagnosis, right?
– Oh, yeah. – So they’re looking at stuff,
we’re looking at stuff.
Before I go in for an exam, I talk with my hygienist.
We look through the x-rays together,
we’re looking through scans,
we’re looking through everything
and we’re talking about it.
We’re seeing stuff, I’m seeing stuff,
they’re seeing stuff, we’re seeing the same stuff,
different stuff.
Yeah, we’re talking about what’s going on,
what the patient’s concerns are,
what they may or may not have talked to the patient about.
Hygenists have different levels of comfort
talking with patients about stuff too,
based on their experience.
So some of our hygienists are really great about,
hey, this is looking like this is gonna need a filling,
this is maybe gonna need a crown here
and kind of starting that conversation,
which makes it easier when I come in the room
and makes it just more efficient
and helps the patient own the problem
if there’s a lot of people seeing the same thing.
Yeah, I feel like the aspect you mentioned,
co-diagnosis, right?
Someone brings it up, someone else brings it up,
it kind of makes it, it gives it more impact, right?
Like it’s not just me walking and saying,
hey, I’m meeting you maybe the first time
or just I’m in there for five minutes.
Your hygienist is there for 60 minutes at least,
or sometimes more.
But yeah, they spend more time in your mouth,
they notice what’s going on, they can bring these up to you
and then the hygienist and us, we work together
to come up with a treatment plan
that is beneficial to your oral health, right?
And we all know that oral health is systemic health,
it’s all connected.
So it’s something that’s very important.
So yeah, co-diagnosis is very important,
we love our hygienist.
So.
And we’re all looking at like the gums and the teeth,
I would say just as like a general perspective,
maybe hygienists focus a little bit more on gum health
while we’re focused on, you know, tooth health
and rebuilding teeth.
Obviously it’s all cohesive unit,
you can’t have gums without teeth,
you know, vice versa.
So like piggyback of that, what would you say is like
a specific job responsibility of a hygienist?
Like what, what do they do?
Like if someone didn’t know what a hygienist was,
what do they do?
So yeah, dental hygienist, I mean number one,
and the most obvious thing is they’re just the champions
of oral health and oral hygiene.
So they do, you know, cleaning of teeth,
is the number one job and responsibility
that they do have their hygienists
or their responsible for dental hygiene.
So they do this through gum exams, you know,
the measurements when they go around,
three, two, three, three, two, three,
measuring everywhere, cleaning your teeth
and scraping the plaque and tartar off
to make your gums and teeth healthier.
– Yeah, and if your gums aren’t healthy,
hygienists are able to diagnose with us or independently
of what’s going on with your gums.
So periodontal disease, gender vitis,
what you’ve talked about in previous things,
and provide cleanings that are necessary
for what you’ve been diagnosed with.
So we get that a lot where it’s like,
do I need a deep cleaning or regular cleaning?
Hi, hygienists can help you figure that out.
And then if you need a deep cleaning,
they can help numb you, make sure you’re comfortable.
There’s a lot of things they’re capable of doing.
But yeah, they can deal with a lot of that.
– Yeah, providing local anesthetic is one job,
responsibility or ability hygienists have,
maybe a lot of people don’t, you know?
– Yeah, that’s true.
– Right, even for us, like our procedures.
– Right, yeah, so a lot of times, you know,
like if I’m, my schedule is tied,
and hygienist has a moment free,
sometimes they’ll numb my next patient for me
and add some anesthetic and get them numb for me,
which is great.
– It’s awesome.
– And, you know, for people that have had
a quote unquote regular cleaning, not a deeper cleaning,
like they may have not been numb for a cleaning before,
but sometimes there are, you know,
gum disease that gets away from people
where you need to be numb for that cleaning,
and hygienists obviously can do that.
So treating gum disease is so important, you know,
not just for your oral health,
but for everything systemically.
Like gum disease contributes to your risk of heart attack,
your risk of stroke, your risk of, you know,
Alzheimer’s dementia, cognitive decline.
There’s so much that inflammation in your mouth
goes to the rest of your body,
and hygienists, you know, help reduce inflammation a lot.
– Oh, yeah.
And as we know, from a lot of things coming out,
like you just don’t want generalized inflammation
in your body, right?
Even if it’s in your mouth,
but you just inflammatory processes
are a sign of disease.
You don’t want that going on.
So they help with that.
And apart from cleaning teeth,
I mean, they do many other things,
like they help, you know, gum disease obviously.
They’re also involved in things around the office,
like they take x-rays, they’re certified in that.
They do local anesthetic, which you talked about.
They co-diagnose with us, which is awesome.
They flip rooms, they run sterile, they educate patients,
but I even have a hygienist I work with, Kristen,
this is a plug for you.
She’s a restorative hygienist.
And that is amazing.
– So what is a restorative hygienist?
– So she did extra training.
So I will prep teeth, right?
Prepare them for a filling, remove the cavity,
make sure everything’s on sound to structure.
And she’s been trained in a way where she can go in
and restore the tooth with composite fillings,
and then polish it and then I come back and check it.
– So basically you do all the drilling,
get the cavity cleaned up, and then Kristen comes in
and places the filling, you just come to a final check.
– Yeah, so I remove the decay process,
but she’s learned and done all these classes
to know how to do all that.
Which is cool.
So hygienist, I think like dental rolls, like we’re expanding,
but it’s nice to see these auxiliary rolls expand.
– Yeah, for sure.
Especially if you think about areas that need,
like there’s no dentist.
Hygienists are capable of doing a lot of things.
– And some hygienists really are passionate about
expanding their rolls and doing that some aren’t.
Everyone’s unique.
Dentists, some dentists want to really grow in this field,
but not the other way.
Hygienists are gonna be unique that way too, right?
So we’re gonna really wanna focus on gum hygiene
and health there, and not so much on filling placement
and maybe they’ll take different torps of
continuing education based on what their interests are.
But that option’s there, and I mean,
hygiene is just so important to like the overall heartbeat
of the office, the flow of the office.
Like many of our new patients are seen by hygienists first.
They come in that hygiene is meeting them,
greeting them, bringing them to the back,
taking their extra rays, you know, doing the gum evaluation,
giving them a cleaning, going through stuff they’re seeing,
then the hygienists come and talk to me.
And then I finally meet the patient and confirm
what they’ve been doing for the last hour.
– So they’ve burned their own patients’ trust?
– Exactly.
And then a lot of times, you know,
they’ve built a good relationship, you know,
so and so she’s been so amazing, made this easy,
it’s been the best cleaning ever.
You know, they told me there might be some stuff going on,
so see what you think, you know.
And it makes it, makes it a lot easier.
So they spend a lot of time with patients
and grow that, like you said, that trust,
and they’ll start to build a little rapport
with that patient, so.
– Yeah, it’s so helpful.
– I mean, it’s hard, as you can imagine,
being a new patient in an office,
you don’t know anyone, the trust is not there.
And I think hygienists, just, they care a lot about dentistry.
Not that we don’t care.
But they care a lot.
And they can really show that to a patient.
I think that’s, I mean, every hygienist I’ve met,
it’s just, it’s amazing.
– Yeah.
– Yeah, yeah, they’ve been great.
So, I mean, all the hygienists out there,
especially the ones that are offices.
– We appreciate it.
– We appreciate what y’all love you guys.
(laughing)
And, you know, education, I would say education is maybe,
one of the most important factors of cleaning teeth,
because, you know, it’s like, give a man a fish,
or leave for a day, teach him and a fish,
and he’ll leave for the rest of his life.
– And he’ll keep his teeth.
– He’ll keep his teeth, you know.
Clean a man’s teeth, he’s good,
till he goes and starts eating again.
Teach him and a clean his teeth.
– Yeah, I’m gonna go and get a lot of teeth forever.
– ‘Cause it, I mean, before I started in dentistry,
I didn’t realize that so many people
didn’t know the property of cleaning their teeth.
– Right.
– And I think that’s so important.
Like, if you’re not taught, you don’t know.
– Right, and if it’s not, like,
if your parents didn’t learn and passed on,
good habits to you,
– How would you know?
– Maybe you never learned.
And so, coming to an office where hygienist cares
and can show you, hey, look, you’re missing right here.
You’re doing a good job here and here,
but you’re not getting this part here, focus on this.
This is how you do that.
This is the better way to floss, you know,
do this type or that.
– Kavya, I had a patient in dental school
that did not know the property of brush is teeth
and he moved his toothbrush up and down
but did not move beyond, like, any change in direction,
didn’t get the gum, nothing.
He went up and down.
So, like, he’s like, no one ever told me,
this man was 75.
– Right.
– Yeah, education, it starts from the dental home
and Rusty, we see kids, hopefully,
when they’re one years old, establish the care,
we establish the patient, meet the hygienist
and then hopefully we have this little community
and we educate and go from there.
– And education, like you said,
it’s such an important aspect, you know,
for everyone’s health, we’re super passionate about it,
the hygienist we work with, they’re super passionate about it,
our assistants, our front desk, you know,
everyone’s trying to educate you on what they know, right?
So, front desk, we’re gonna educate you on your insurance.
Us and hygienists are gonna educate you on your teeth,
the assistants, same thing, they’re gonna be educating you
on what the procedures like, what you’re going through that day,
whatever it is.
And, you know, the educational aspect
is the huge reason that we created this podcast
was to help educate you all, and help you, you know,
learn a little bit about the way that two random dentists think.
(laughing)
– I mean, ’cause you wouldn’t know, right?
You don’t know how dentists think, right?
So, I mean, speaking of the podcast, right?
We’ve been starting to move into our new studio space,
I know we mentioned it last time, but yeah,
we’re building out a new studio space, we’re excited about it.
And, during this transition, we’re gonna take a little bit of a break,
so we’ll probably end up seeing you when do you think, New Year?
– Probably New Year, probably in the New Year.
– In the New Year, we’re–
– January 25, but we’ve got a lot of work left to do.
– Yeah, so this will be the last podcast from this studio space,
which is wild, so.
– It’s sad to think about saying goodbye, but.
– I know.
– Here it’s been functional, it’ll be good.
– Yeah.
– We’re excited for some change, we’re excited for a little bigger space
and a little bit on the room.
– Designer on space.
– And have, yeah, some freedom in the design
and how things are, so.
I expect to hear from us in a few months,
in the New Year and in new space.
– Yeah, we’re excited.
And, during our break between season one,
which is now, right, last episode,
in season two of our podcast,
we’ll still be on active on all of our socials,
we’ll answer your questions,
compiling your DMs, writing blogs,
so yeah, keep out, and keep messaging us,
we’ll hopefully you’ll be featured on season two.
– Yeah, for sure.
And then again, if you wanna find us on socials,
if you’re not following us already, please do so.
Our TikTok is, same name is the podcast,
so on TikTok, we are DM a dentist.
– Yep.
– On Instagram, we’re under your daily dose of dental.
So please reach out to us on there, send us DMs,
send us weird videos, you see articles, you read.
– Okay, I’m not weird.
– We wanna help you a deep bunk stuff,
we wanna, you know, tooth related, mouth related,
oral disease related, please, not anything.
– Mouth related.
There’s a lot of weird stuff on TikTok, okay?
Be careful what you’re sending us.
– You know, some stuff we see is not mouth related.
We are speaking to mouth only.
– Mouth related, please.
– Thank you.
– Mouth related, tooth related, dentistry related.
– So yeah, we’re passionate about this,
we love it, we love hearing from you,
so yeah, thanks for tagging along,
and hopefully we’ll see you,
I mean, we will see you, you’re not gonna leave us.
We’ll see you in season two.
– We’ll see you in season two.
– Have a good rest of your year.
– Bye. – Bye.
19 min
September 04, 2024 #13 Who's Who in the Dental Office - Dental Assistant Edition
There are many team members that make up a dental office. This is Part 2 of our three part series on “Who’s Who in the Dental Office”. This week we talk to two dental assistants as they share what its like being a dental assistant. They answer some of your most pressing questions and share some fun stories. Tune in as Roxy and Diego join us on the show and share some insight into the world of dental assisting.

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As always, feel free to reach out through our instagram @YourDailyDoseOfDental or through our website http://www.DoseOfDental.com. We would love to hear from you and hope your questions can be featured on our show!
Instagram: https://www.instagram.com/yourdailydoseofdental/
Website: https://doseofdental.com/
TikTok: https://www.tiktok.com/@dmadentist

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Audio Transcript:

Welcome to DM Adentist, your friendly neighborhood podcast where Dr. Rusty and Dr. Mike
are here to make dental care approachable for everyone because everyone deserves a healthy
smile without the fear.
Well, welcome back!
Today we have two special guests for our next interview series, Who’s Who in the
Dental Office Part 2.
Today we have two of our dental assistants.
We have Roxy and Diego, two of my favorites.
Roxy, how long have you been a dental assistant?
I’ve been a dental assistant for about 10 years now.
Okay, awesome.
And Diego, what about you?
Been a dental assistant for about 7 years now.
Okay, nice, love it, love it, okay.
And you know, I know a lot of people, you know, we talked about it previously in our basic
introduction to The Who’s Who about like the dental assistant roles and things, but a lot
of people aren’t familiar with what a dental assistant, some people haven’t called
a dental nurse to do, right?
How would you describe what you all do on a day to day?
You know, I feel like we’re honestly the doctors right hand.
We do a lot that I feel like the patients don’t necessarily see.
We welcome the patients, we triage the patients.
We do a little bit of everything, honestly.
So triage, what is that like if a new patient is coming in or like they have a problem,
like what do you mean by triage?
So we will sit the patient down and kind of figure out what’s going on with the patient
and let the doctor know we, there’s a lot of communication with what we do.
So just kind of communicating with what the patient tells us and then letting the doctor
know what is going on.
So the patient doesn’t feel like they are repeating themselves.
True.
Yeah, that’s important because a lot of times I feel like that’ll happen where you know,
they come in and they’re like, hey, this tooth is hurting me.
It happened X amount of days ago.
And then I come in and I’m like, hey, what’s going on?
And then like this tooth broke.
It happened X amount of days ago.
I just told them that I feel like patients really are eyes along when they have to repeat
themselves.
So if I can limit that, that’s great.
But yeah, we do, we do a lot that people don’t necessarily see.
For sure, a lot of behind the scene stuff too, right?
Like all the like sterilization, like slipping room, setting up rooms, helping chair side,
like tons of rolls that you all have in the office for sure.
So, and another big role I think that the dental assistant has is to like help chair side
with patients, right?
A lot of patients that are coming are really anxious or nervous to be there, right?
Like being in the dental chair isn’t the most fun experience.
We get it.
So like what are some things that you can do to help keep patients more calm and more relaxed
and just kind of help them have like an overall better experience, especially for someone
who may be like kind of nervous or scared.
Exactly.
But Diego and myself, we both have a calming demeanor about us.
Right.
So, I mean, he’s so soft spoken.
I’m so soft spoken.
So I feel like that’s a big thing.
Right.
We’re not really rushing the procedure or whatever it is that we’re getting done.
We, I mean, just making sure patients feel comfortable and letting them know we have the
time for them today and letting, asking them what maybe their fear might be of the dentist.
Right.
So we can reassure them that.
I mean, we’re here for you.
Right.
So I feel like you’re pretty soft spoken.
So like, Diego, what are like some common fears that people will have in the dental office?
Like, what are some things that people will be afraid of and what are some ways we can
kind of make that better for them?
Yeah, like usually like shots, noises that are coming out of the instruments.
Yeah.
I feel like a big one is the childhood trauma.
Childhood trauma.
Right.
Because it is the childhood trauma.
I mean, just knowing I said it back in the day.
Yeah.
I mean, we’re not that old, but I mean, we get it a lot.
I’ve heard that so many times where it’s like the dentist in New Sanesthetic.
I wasn’t fully numb.
And like those childhood traumas were really stick with you.
And now they’re coming as an adult when dentistry has changed a lot in the past few decades,
right?
Like, we’re much more updated with like digital stuff with, you know, techniques.
And I think younger dentists are more, I don’t know, patient focused.
I guess there’s a way to put it, right?
Where we’re really focused on the patient experience.
It’s kind of like customer service is a super important part of our job.
And especially what y’all do as assistants, like, you know, they’re going to come in and
I’m the dentist, so I’m wearing the white code.
And so they’re going to just immediately, like, I have a level of authority.
They’re going to trust, right?
Because I’m the doctor and I have the white code.
But for y’all, they’re not going to immediately have that trust.
And so it’s super important that you guys like build that rapport with them and you both
do such a good job, you know, just like making small talk, making conversation, getting them
comfortable.
And then I think just figuring out what specific triggers are going to like cause anxiety
for someone or fear.
And then, you know, like, at our practice, we have like that comfort menu, right?
And it’s like, well, we have noise canceling headphones.
We have weighted blankets.
We have all these things to help people just be like a little bit more comfortable.
So I feel like personally the blanket tops it.
I mean, just you’re kick your shoes off.
Yeah.
Yeah.
Kick comfy.
I mean, and it’s hot for us in the office because we’re wearing like coats and gowns and I
wear this whole, you know, monkey suit while I work.
And so here we are.
And it gets hot for us.
So we keep it cool in the office.
And though you colictus is not my favorite.
That’s what I was going to say.
Essential oil.
But, smells.
That smells.
I will handle it.
Okay, so we have what peppermint, eucalyptus, lavender.
What are you going to choose?
We also have orange.
Orange?
We have lemon.
Whoa.
I didn’t know that.
Okay.
We’ll go with lavender for sure.
Lavender?
Lavender?
Lavender?
Okay.
Okay.
Lavender?
Dr. Moodie’s voted for lavender.
Okay.
But you don’t know how many drops people are bringing on.
How many drops?
Yeah.
I did three in my mask the other day.
And I was like, I can still smell her.
But yeah.
It lingers.
It lingers.
It lingers.
But hey, it’s all good.
So, you know, again, it’s super important, I think, to help people just feel more comfortable,
especially with new patients, right?
Because it’s like the first time they’re coming to the practice, the first time they’re
meeting the team, they’re seeing the front desk.
Maybe it’s new insurance.
They’re using for the first time.
So it’s a lot of like scary things going on.
They also have the box on the health history that says, your level of dental anxiety.
True.
And a lot of people deny their level of dental anxiety.
But we know it’s there.
Yeah, it’s there.
We’re here to calm your nerves.
And I want to say also at this point, I think it’s important to say it’s totally normal for
you to have dental anxiety when you’re in the chair.
Like, when I’m in the chair, I’m nervous.
My heart rates up.
Like, I don’t know.
Are you all, if you’re in the patient?
The pressure is always up.
Yeah, right?
It’s normal to like be a little bit tense, a little anxious, so totally normal, totally normal.
So since it’s so normal, like if you have a new patient that’s coming in, do you have like
a good icebreaker or a good question you’re asking, something to kind of help ease that
tension and just help them start to build that rapport?
Like, how do you initiate that?
Yeah.
What do you do?
I’m usually just asking them about their day, how they’re going, something that will distract
them from them being in the chair.
Right.
A personable, like, personable, really, a little bit of a thing.
It’s like, yeah, we’re health care, but we’re also customer service, right?
So it’s like, it’s like a bartender.
It’s like someone at Trader Joe’s, the cashier, right?
They’re going to try to be friends with you in that moment to help make that experience
better for you.
And no one’s scared to check out at Trader Joe’s.
I can usually tell my new patients anxiety level by their blood pressure.
And I will comment on their blood pressure every time.
Right.
I mean, and we always have that box checked, like, what kind of, what is your level?
I, a dental anxiety, like, for the most part, like, are you anxious?
Like, what, and just trying to get to the bottom of what is making you anxious about your
appointment today?
I feel like different things like trigger people.
Like, for example, the shot, yeah, for example, um, X-rays, yeah, we don’t know what kind
of experience they’ve had with X-rays.
Right.
Because I know so does they’re uncomfortable.
They can’t be.
Yeah, they are.
They are.
I mean, the digital X-rays are super great because it’s immediate and I know they’re, I can
see what we get.
But the sensor is hard.
Yeah.
It’s harder than the old school film X-rays.
So it’s not comfortable.
So I mean, a lot of the time, like, the vitals are new to some patients.
Like, a lot of patients aren’t used to having their blood pressure taken.
Yeah.
So when we do take it, they are like alert and they’re just like, well, that’s high
for me.
Right.
So let’s try to calm them down.
Like, we tend to elevate people’s blood pressure.
Right.
That’s true.
I mean, in some people have that white coat syndrome.
Right.
Right.
I’ve had providers that have been patients.
I’m like, is it possible for providers to have that white coat syndrome?
Yeah, it is.
There is an aisle.
Yeah.
But it is.
It is.
It is.
It is.
Yeah.
Yeah.
Well, and that’s a super important step that we do, you know, we do it for all of our patients,
but especially patients we’re giving anesthetic to.
Right.
Because anesthetic that we give, it has adrenaline in it.
And so it’s going to like raise your blood pressure a little bit just from giving you that
shot.
And so knowing that kind of baseline is important.
But a lot of people, you know, we’ve gotten some some feedback, you know, like, hey, why are
you taking my blood pressure?
This isn’t a doctor’s office.
Why are you doing this?
And it’s so important.
And I think there’s so many things we do in dentistry that people aren’t necessarily
aware of.
And they don’t really know.
As an assistant, is there anything that either of you feel like people may be surprised
about that you do or maybe think you do and you don’t do in the office?
Definitely the blood pressure.
Yeah.
Yeah.
I always get like, why are you taking my blood pressure?
I’ve never had a dentist or an dental get a blood pressure.
Take him in, right?
Right.
Oxygen or like the oxygen.
Yeah.
Even temperature.
Right.
We’re very thorough.
We do.
Not only blood pressure, but we do like pulse oximetry.
We do temperature on every single patient.
We do it all.
And it’s important to check because the blood pressure, if we’re giving anesthetic, that’s
going to affect you.
If we’re doing sedation, the amount of oxygen you have in your blood, breathing normal
air is important.
So these things are important just to keep you safe.
Not only is it required by me by law, but it’s important to keep you safe.
And that’s where my heart is.
And the most important thing to me is to keep our patient safe.
Yeah.
And the most important thing is that we take vital, vital, vital, vital, vital, vital,
vital, vital, vital, vital, vital, vital, vital, vital, vital, vital, vital, vital, vital,
vital, vital, vital, vital, vital, vital, vital, vital, vital, vital, vital, vital, vital,
vital, vital, vital, vital, vital, vital, vital, vital, vital, vital, vital, vital, vital,
vital, vital, vital, vital, vital, vital, vital, vital, vital, vital, vital, vital, vital, vital, but we’ve, I mean, in my history of dentistry, we’ve caught a lot of high blood pressure.
And patients are grateful that we do take that because they don’t see their primary care as much as they do.
And they’re like, “I never even knew I had high blood pressure.”
Like, you know, thank you for figuring this out and telling me something.
We’ve been able to get blood pressure monitors at home just to keep them safe.
For sure.
For sure.
So this is a little bit of a trending thing on TikTok that I’ve seen.
And I just wanted to get y’all’s too opinion.
I know how I feel about it, for sure, but I want to see what the two of y’all think about it.
So when you’re a patient in a chair, right, you’re laying there, they’re, they’re drilling on your teeth, they’re doing whatever.
Should you keep your eyes open or closed during treatment?
I think it depends on your anxiety level.
Okay.
Okay.
Me personally, I would probably give my eyes closed.
I don’t see, I don’t want to see a drill coming into my mouth.
I don’t want to see a needle coming into my mouth.
Yeah, right, right.
But I think it depends on your anxiety level.
Yeah, yeah.
I agree.
I feel like eyes closed for sure.
I mean, I feel like you have that reaction to pull back when you do see a 20 gauge needle coming towards your feet.
Right, right.
Yeah, they’re long.
I mean, they’re big and it’s coming to your mouth.
You don’t want to see what we’re doing.
I mean, generally, I feel like patients are, yeah, hey, I’m getting a filling here.
Yeah.
But there’s a lot that goes into the filling process that they don’t know.
Yeah.
That it doesn’t really benefit them to see.
And so, you know, like one of my friends was, I was, he was telling me about a filling he had.
And he was like, the dentist seemed like there was like something going wrong and he was like blowing air a lot.
And like, I don’t know, he like squirted something up there and did a do and he like mentioned blood.
And I was like, I’m bleeding.
What’s going on?
Like, why am I bleeding?
Right?
Yeah.
You bleed every single time you get a filling, even in a really healthy mouth.
You’re gonna bleed.
Your gums are gonna bleed.
We’re cutting into your tooth.
And then you’re gonna be able to do something, you’re gonna be able to do something, you’re gonna be able to do something.
And then you’re gonna be able to do something, you’re gonna be able to do something, you’re gonna be able to do something.
And then you’re gonna be able to do something, you’re gonna be able to do something, you’re gonna be able to do something.
And then you’re gonna be able to do something, you’re gonna be able to do something, you’re gonna be able to do something.
And then you’re gonna be able to do something, you’re gonna be able to do something, you’re gonna be able to do something.
True, true.
Yeah.
Yeah.
Yeah.
So, you know, apart from keeping eyes open, what would be, do you have any like big pet peeves or things that as if you’re a dental patient, you know, what do you not want to do that might annoy an assistant or a dentist?
Like what’s some of your pet peeves?
I would say one of my pet peeves is patients refusing x-rays.
And that’s okay, I get it, like the radiation scares a lot of patients.
Right.
But for us as dental providers, I’m the first face that you see.
And so when you tell me you don’t want x-rays, I have to go to the dentist, you don’t want x-rays and then the dentist is concerned on how he’s going to, I mean, diagnose what you might need.
So, it’s tough. So, I think we’re never gonna overexpose you to radiation, but just kind of you’re coming into the dental office, we need, I mean, x-rays.
So, bottle line just refusing x-rays, I think.
Yeah.
I might not be a pet peeve, but I mean, you definitely need those x-rays.
Well, and people are really worried about, like, I think radiation, maybe some people because they’re uncomfortable, but I think the majority of the concern is radiation.
Yeah.
And with digital x-rays, like, the radiation is so low.
Like, you get a couple bananas, you fly across the country, you’ve got that radiation.
The same amount you’re gonna get in a typical set of x-rays.
So, like, don’t eat bananas, don’t fly.
Don’t leave your house, don’t use a phone.
Like, all these things that give you, like, minor amounts of radiation add up to significantly more.
And, like, a medical CT is so much higher than a dental set of x-rays is.
And, like, no one’s ever, like, hey, I don’t want to get this medical CT for this massive procedure I need.
Yeah.
But, we’re about to drill in something a bone in your mouth that, you know, you only got 32 of them.
Maximum.
Yeah.
And, if we don’t know what’s going on, you know, like, I don’t know.
And, I really like to express, like, the full series of x-rays that you do need.
You only need every five years.
True.
Not gonna be exposing you this much.
When you come in for your dental cleanings, but it is important.
And, we also, like, our office, we take a full-mouth series.
So, it’s, what, 18 images inside and the panoramic, right, that spins around the head.
Insurance companies don’t pay for both.
And, it’s so stupid.
But, I’m not gonna limit myself on the information I can get for you as a patient based on what your insurance is gonna pay for.
And, so, what we do is we take the full-mouth series, we build that to your insurance,
we take the panoramic that spins around the head at no charge.
And, I think that’s a fantastic way to do it.
I mean, we could very well charge for that.
And, and produce a lot.
It’s expensive.
And, we could, we could make a lot more money to be quite frank.
But, you know, at the end of the day, I don’t want my patients to pay for something that they don’t necessarily value.
But, it gives me a lot of helpful information.
We’re screening for pathology in the job.
We’re looking for, you know, your TMJ, your jaw joint, all sorts of soft tissue neck, you know.
You’ve seen, what is it that?
The carotid artery, right?
Like, the carotid artery we see in that panor.
We saw a guy, again, back to blood pressure.
His blood pressure was like 190 over 120, outrageously high.
And, he had like thick plaques in his carotid artery.
So, he’s at like such a high risk for a stroke.
Yeah.
And, we alerted him to this and he was super thankful, right?
He’s like, I’m going to go find a doctor right now and get my blood pressure on control.
He’s probably going to have to have his arteries cleaned out because it’s just, it’s built up.
But, it’s such an important screening tool.
So, the exercises are good.
And, offices I haven’t worked at, and we take that pre-extra before we go to do treatment.
And, you see an abscess at the root, because we weren’t taking those extra’s regularly.
So, then it’s like, okay, a change of treatment.
It’s very important to take those extra’s.
Yeah.
Diego, besides X-rays, any pet peeves that you have?
I think you’re questioning the treatment plan.
Because obviously, you’re there for the best interest of the patient.
And, you want the best for them.
So, when you’re asking, oh, you’re going to need a crown here.
You’re hoping that they will trust your judgment.
You’re like, okay, I do need a crown here.
Because there’s been a few patients where it’s like, oh, I don’t need that.
I don’t need this.
Sure, sure.
It’s like, in reality, you really do.
Because it’s going to affect your, your biting or your, you know, your, your living day by day.
Something’s going to break on the weekend.
It’s going to turn into a emergency.
Like, you’re paying us as dentists for our expertise and our experience.
And so when someone comes in and we’re like, hey, I see this tooth.
I see this problem.
You know, we do a good job explaining that I think where we’re showing them pictures of their tooth.
We’re showing them X-rays.
We’re, we’re explaining things why it’s needed to people.
And then for them to be like, I’m good.
You know, it is frustrating.
It’s tough when you explain it very thoroughly at one appointment in the patient returns.
And they don’t quite understand.
But I feel like it’s overwhelming.
You come and see us.
You don’t think anything is going on.
And then we explain to you.
You need treatment.
And then they come back for their appointment.
And they just want to be reassured, which we’re, I mean, happy to do.
Yeah, happy to do.
Yeah, happy to do.
And we’ll explain it as many times as you need, you know, answer questions, all the things.
Yeah.
It is like you say, it’s really overwhelming, right?
For us, this is our every day.
Yeah.
For patients, it’s at best twice a year.
Yeah.
And so for them, it can be really overwhelming.
Like, oh my gosh, I have something on every single tooth you’re watching or treatment planning
or something.
But we’re just trying to be thorough.
We’re trying to be the best interest of them.
And can we touch based on patients that come to us for second opinion?
Oh, yeah.
Yeah, definitely, definitely.
What are your thoughts on that?
I’m okay with second opinions because there are dentist out there.
I mean, maybe bigger corporations that might overdiagnose for smaller things.
Sure.
And so, I mean, we’re here to reassure you that you might need that done, but you might not
need that done.
So, I feel like we’re great at that because, I mean, I don’t feel like our doctors are overdiagnosed
by any means, but.
Well, it’s like the old saying, you know, you ask nine dentists for treatment planning and you’ll get ten different ideas.
So, one of them is going to have two.
Yeah.
You know, it’s everyone’s a little different in how they see things, how their training is, where they’re at in their career, what their confidence level is.
Are we charging for second opinions or what?
It depends.
How do you feel about that?
It depends.
I mean, as long as we have, you know, receiving their x-rays from the other office, that’s a huge thing.
So, signing like a record’s release if you want a second opinion so that your old dentist or last office you saw can send those x-rays.
So, you can avoid that radiation, you can avoid the uncomfortability of it.
I can see them though, as long as they come over in a decent format and not like a single crappy blurry PDF.
As long as we can know what their treatment plan was, I think that’s super helpful.
But it does still take a lot of our time.
And so, I think at least, charging for a limited exam or things of that nature is really reasonable.
Because a lot of times these patients are going to be just needing a little more time.
They’re very aware of what’s going on in their mouth and they’re concerned about it.
And they’re wanting to figure out more information about it.
And so, typically, they’re going to have a lot of questions.
It’s just going to require more of my time.
Time is money.
Of course, we’re going to have to charge a little bit for a second opinion.
But I’m not going to charge you for the full set of x-rays if we can get them in all the things.
And one thing I feel like our office does is we take time with our patients.
I mean, we’re smaller because our office is very big.
But we just have that more…
I feel like we have a more personal feel for our office though.
Our dentists are going to take more time to explain.
And I feel like a lot of patients have come in on the way you explain.
Over-explain, which is not a bad thing.
I talk a lot.
Yeah, he loves answering questions.
So ask them all your questions.
I get done with the most basic feeling, Albert.
I’m like, “What questions do you have?”
Okay, no more questions.
We got to go.
DM the dentist.
I love answering questions.
No more questions.
He’s on a time-cr��
But no.
No, the more questions, the better.
You definitely…you and all the doctors that we work with are very thorough with the questions.
So I feel like patients are more just at ease with our treatment plans.
If it is a second opinion, they definitely understand what we’re coming from.
And the technology we use.
We use the digital scans.
We’re showing people their teeth.
You’re seeing it.
I’m seeing it.
You’re like, “Hey, maybe there’s something here.
You know, legally you can’t diagnose stuff.”
But you’ve looked at what…
You’ve been in dentistry longer than I have both of you.
So you see stuff on X-rays and you’re like, “Maybe doctors are going to recommend this here.”
And I think that’s helpful to show the patient their problem, help them own that problem,
and kind of roll with it from that stuff.
Do you think technologies come along with this?
From going from an office that would still use fixer and developer?
And going to digital?
Do you even know what that is, doctor?
I know, I learned about it in dental history 101.
Never changed.
He’s never used film.
He’s never used film.
Okay, never.
Okay, when us…
In dental assisting school, we were still changing the fixer and developer.
Well, that’s good because what if you got a job at a dentist just so using it?
When I was…
When I got to school, we were changing the paper charts.
Oh, yeah.
A paper charts.
The last office I worked at had paper charts.
But they were now digital.
And I would have to reference some of the paper charts.
And I was like, “Don’t even read that.”
You can’t even read that.
Don’t even get…
Like, literally that wastes my time.
Because I still don’t know what’s going on.
And it just wastes my time to try to read this cursive writing that is illegible.
And it says, like, best case scenario number 12 filling completed.
Yeah, what is it?
What is it?
How’d you do it?
How much NSSAC did you get?
Were they nervous?
Like, I write a note a mile long for something like this.
And it’s like filling complete number 12 done.
So, which granted, if you had to write all of our notes by hand, could you imagine?
They wouldn’t be nearly as thorough.
We have templates.
Yep.
Fill in the blanks.
Because granted, if you’re coming in for a filling, you’re coming in for a filling.
If it’s the same tooth and the same filling, I’m doing almost the same exact thing.
Every time.
Yeah.
If there’s something out of the norm that happens, patients acting weird, the cavity is bigger
than we thought.
You know, weird stuff occasionally happens.
We’ll add on to the template, but it’s usually like the same note.
Yeah.
Any of the sparring toys?
Yeah.
And if you have a special need, we’re going to make note of that.
If you like two pillows over one pillow, we’re going to bring you two pillows.
Two pillows.
And we’re ready.
You open the patient and start saying, “Oller, oller, oller, five pillows.
No anesthet, duh, duh, duh, duh.”
You know, you know, like the epinephrine.
There’s some patients that don’t react with epinephrine, as some other patients would.
Yeah.
We have big elites that pop up.
Yep.
Epinephrine, that’s the adrenaline in the anesthetic.
Kind of gets that heart thumping, so some people really hate it.
Yeah.
You know, the dental office, it can be scary, right?
It’s very scary for people, but there’s also a lot of fun things, especially as a back office.
We’re laughing a lot of the day at different things that happen.
What are some like funny moments that you’ve had as an assistant?
We like to prank people.
We do.
Yeah.
We like to take the batteries out of the keyboards in the mice in your office.
Nice.
Yeah.
Yeah, pranking the doctors, pranking the doctors.
That’s good.
The other day.
Do we?
The sticky note attacks, right?
The sticky note.
The sticky note all over his computer, or monitor, right?
You wrapped his desk?
Yeah.
Like it was his birthday, but it wasn’t, and they like wrapped it in, you know, if you’ve seen
the office like when they wrapped a white desk up, it was kind of like that.
But we have cameras in our office, so.
Yeah.
Don’t go pulling batteries out of things.
Yeah.
Or, I mean.
Or getting in the corner and scaring someone.
Yeah.
There’s a lot of jump scares at the office.
Yeah.
Any funny moments with patients, Roxy?
Um, yes.
When the doctor pronounces the patient’s name wrong.
The entire appointment.
Who could, who could that be?
Dr. Croc’s figure.
I mean, that was me.
That was me.
And I gave him all the warnings and all the heads up, but the whole appointment.
It was like a, how many times you called in the wrong name?
Okay.
Try to use people’s name a lot.
And usually it’s beneficial, but not if you’re saying it wrong.
Yeah.
With the patient corrects you the first time.
Well, the patient corrected you.
Yeah.
And then you corrected and then changed it on the little paper where I could clearly see.
And you like underlined the part of this guy’s name that was like the pronunciation part.
Yeah.
And I just didn’t even see it or think of it.
I’m just focused on the teeth and the mouth, the shoes handle and everything else, right?
And over here, like, it’s right.
But he never corrected me once.
And I said this guy’s name wrong, like what, 15 times maybe?
I feel like you overused his name.
That appointment.
I’ve never heard you say a patient’s name so many times it was wrong.
That’s one reason we put tags on the side.
Yeah.
So I immediately know their name.
Yeah.
It’s very uncomfortable when the patient corrects you but not the dentist.
And a lot of times they’ll say that like they’ll be rude to you all or they’ll be like.
That’s another thing.
That’s not my name.
I’m not taking X-rays.
I’m not doing this.
But then I walk in and they’re like, hey, they love the white coat.
They love hate the white coat.
For example, like when you’re telling them, okay, you’re coming in for an emergency.
What’s the problem?
They’ll tell you one thing.
Dentist comes in.
They’ll tell you.
Hold their friends.
Hold their friends.
I’m like, that doesn’t come on.
Absolutely.
Yeah.
Yeah.
Yeah.
You know.
What did you tell a patient the other you did not hear it from me?
You heard it from the front office.
I don’t remember.
Oh.
It was when they called in.
They told the front office one thing.
I got it.
And he came in and said, oh, so Roxy told me this about you and I’m like, I just never told
me that.
Because we have these like notes, right?
It’s like this patient is nervous about this or they’re concerned about this or they’re
from here or they’re here for this, right?
But I don’t necessarily know exactly who put that note in, right?
Like it’s there and I see there’s information.
I just assume it’s you.
Not always the case.
So if I say, but I will say, I mean, honestly, do our patients know your Roxy and that’s
Rene maybe, maybe not, if they’re really, really focusing maybe, but I mean, a lot of times
they’re like, what was your name again?
They’re like, Oh, and I can see them thinking that they want to remember your name, but they’re
so overwhelmed with everything.
They’re like, what did what’s your name again?
You know, and a lot of times that they’re just overwhelmed.
Yeah.
So it’s, it’s, and again, we’re trying to build that connection, build that rapport.
So it’s like, you know, I know you express this concern.
I’m trying to touch base on that soon when I walk in the room so I can see your concern
and address that first.
But I feel like it’s awkward sometimes.
I feel like it’s awkward sometimes.
We’re like, this way she has all these concerns.
You have to remember all those concerns.
And they don’t want any x-rays.
Yeah.
Yeah, I know.
Yeah, yeah, yeah, yeah.
Anyways, it’s hard.
So since “Denistry” is so hard, you know, if you weren’t going to be a dental assistant, what career would you choose?
I think for me would be audio engineer because from probably six years old, I’ve learned to play piano, accordion, and want to go out of here.
Nice.
Okay.
Wow.
Something, you played piano?
Yeah.
So music was always my thing.
Wow.
So audio engineer was like, nice.
So you’re going to do our next podcast, intro, music, and stuff, right?
Yeah.
When we decide to change it, it’s easy.
Nice.
Okay.
Okay.
Good stuff.
Roxy, what would you choose as a second career?
I think I would be in the beauty industry.
Yeah.
I do have my esotation license.
Okay.
I love to work with beauty staff, facials, boxing, all of that.
Botox, facial aesthetics, all of that.
So more medically.
Yeah.
What are you doing to do like fillers, like all that sort of stuff?
Yeah.
And I mean, nursing still in my mind, so.
Yeah.
Yeah.
Right now.
I know a lot of people call you guys a dental nurse, which, again, it’s not a dental nurse, dental assistant.
Nursing is a different, different type of.
I have my esotation license in, honestly, there was a lot of dental assistants in my class.
Okay.
Okay.
Right.
You’re right there.
You’re comfortable already.
Yeah.
It’s totally my sense.
So let’s say you’re not going to change careers, you’re going to stay in dentistry.
You’re both working at a general dentist office, but let’s say you wanted to work with like
a dental specialty.
Is there any like specialty that either of you would want to work with?
I think surgery.
Surgery?
Surgery?
Just because I love extractions.
Okay.
Yeah.
Yeah.
Yeah.
Yeah.
Yeah.
Yeah.
Okay.
Okay.
Okay.
I love it.
What do you like about surgery?
Do you go like just?
I think it’s just taking something out that’s not healthy.
Yeah.
Right.
And then just fixing it up, fixing the area up, either with an implant or partial or a
surgery.
It’s so satisfying to have this like really broken down big cavity tooth, big infection.
You take it out, you scoop out all the infection, you clean it up, you place some bone, you
put some stitches.
Look at Roxie’s face.
I love surgery.
I agree.
I’m the same as you, Diego.
I love surgery.
Surgery is my favorite thing to do.
Yeah.
I feel like that’s my least favorite.
Yeah.
I will give high.
I will.
Here’s the section.
Yeah, it’s like, yeah, I know.
I know.
You know, I don’t want surgery.
And that’s fine, right?
I feel like I’ve been trauma time.
Would you maybe be ortho?
I feel like ortho would be a good one.
Yeah.
Just because there’s a lot of hands on it.
Like if you had to do a specialty, right?
Yeah.
And there’s ortho.
I feel like there’s minimal blood.
Yeah.
I feel like it’s the blood part for me.
For sure.
Yeah.
I feel like it’s the blood part for me.
It’s the blood part for me.
Yeah.
I mean, I feel like it’s a lot of hands on for you.
If you’re bleeding when your wires are getting changed, there’s probably something
wrong.
Yeah.
But oral surgery would be my last.
OK.
OK.
So hate oral surgery.
Right.
What do you like?
What’s your most rewarding part of your job?
You know, just making my patients feel comfortable.
Winning my patients over.
Yeah.
The ones that come in very fearful.
I just had a patient this week.
She kind of– she gave us a heads up when she was making her appointment.
She called herself a bad patient.
Yeah, quote unquote, bad patient.
So Dr. Crofts and I were like, well, what kind of bad patient could she be?
Is she a bad patient?
Or is she just fearful?
And when I met her, I won her over.
I mean, just trying to figure out why she’s fearful of the dentist.
And she just doesn’t like it.
She’s had bad experience.
Right.
And she just has a high anxiety.
And so we offered her all the situation options.
Yeah.
And we offered her nitrous.
She was laughing gas.
She’s never tried it.
And so she needed– she needed a root canal in a crown.
And we were able to get her in the next day with that nitrous.
And I mean, she was– it was tough for her, but we definitely won her over.
So I feel like that’s a rewarding aspect of my job.
So just–
And I think that it’s so important for you all to be there to help comfort patients and
help them be more comfortable because this patient, you know, she was on this patient
to close her eyes.
Right.
So she had her eyes closed, glasses on.
I was doing my thing and a couple times, you know, the patient’s like reaching out to hold
the– like I was numbing her.
She’s holding her– she’s holding her– her hand.
I’m doing something.
She’s like nervous and just like reaching for a proxy.
And a couple times she just would like find her– her leg.
And just like put her hand on the leg.
And that gave her some comfort.
Right?
She doesn’t want to touch me.
She’s afraid of me.
And that’s totally fine.
But, you know, she found a lot of comfort in you just being there and just being that comforting
presence, you know, like, hey, we’re okay.
It’s all good.
You’re in good hands.
We’re taking good care of you because that’s our ultimate goal, right?
Like we want–
We want her to come back.
Right.
We want her to come back because she has other stuff going on.
And we want her to have a good experience so that not only she comes back to see us to,
you know, help us be busy, but more importantly, and the most important is for her mouth to
be healthier because she’s got other stuff going on.
And I want to know if the laughing gas helped her.
Right.
Right.
And I was sure to ask her at the end, like, did this helper, like, what– because she did cry
in the middle of the appointment.
Yep.
She did.
I mean, she said it was personal.
It wasn’t us.
Okay.
Yeah.
So just kind of trying to figure out how we can make her next appointment better.
Yep.
And she did say the laughing gas is super helpful.
Yeah.
And she was like, you all were both great.
Yeah.
You know, you helped me feel comfortable.
You know, I want to come back again and see you.
Um, and it’s so important.
It’s so important because–
Makes my day.
And it’s, I mean, you want to come back and see me.
Right.
You’re not for any out of that off-screen.
And they don’t want to see me again.
Yeah.
They want to see y’all off-screen.
But I also feel like–
Yeah.
Rewarding for me is, I feel like we both have that calming presence.
Yeah.
And so the doctor that you work for might not have that calming presence.
And they know that.
This is the thing, especially when they have a trauma.
And they come into the office and they get received in a different, different way.
Yeah.
And like changes their aspect of like, oh, I’m going to the death all in a, like–
Like we’re not judging that.
Right.
We’re not like you.
It’s totally understandable why you have this anxiety.
We’re not judging you.
Yeah.
There’s no judgment in our office.
We’re here to help you.
Yeah.
And we get it.
I hate being in the chair.
These two hate being in the chair.
I hate–
It’s not fun.
Yeah.
Right.
I get it.
I get it.
It’s worse than any of us.
He’s a little baby-backed.
I’ve told you all this before.
Yeah.
But, like in the morning, for people to know that we both have worked with Dennis that don’t have
that patient.
Right.
They’re in, they want to anesthetize you as quickly as possible.
And then also sharing your experience, like, for example, with me, like anytime I have a patient
coming in for an implant scan and an implant, an implant C, I let them know is like, oh,
I’ve had an implant scan.
You’ve done it.
You’ve been there.
Yeah.
Right.
I’ll let you know, like, you know your tongue is going to be going crazy right now because it’s
not used to having an implant.
You feel in a whole new thing, right?
Yeah, but you can relate.
You’re giving them, yeah, exactly.
Giving them, like, my experience.
Yeah.
That’s awesome.
That’s awesome.
Yeah.
Because what we do is not fun.
It sucks.
It sucks.
Yeah.
But you guys doing it, it’s just, it’s so much better.
And it’s, you all help keep people so much more comfortable.
And it’s so important.
I’m trying nitrous.
I don’t like nitrous.
But if my patient’s like nitrous, I’m going to support that.
Yeah, sure.
It’s different for everyone.
It’s not.
It’s not.
And some people just want local.
And that’s fine.
Some people want to not be numb at all.
And I just, it’s fine.
You want to dance?
Yeah.
Oh, okay.
Okay.
Oh, I see.
Yeah.
Yeah.
I agree with that.
Did you want to wear your head?
No.
Just a couple more questions that we had for y’all.
What is something that you wish patients understood more about their mouth?
I wish patients knew the importance of flossing because a lot of patients try to get away with
the floss picks.
And those are great.
But honestly, like, you’re putting that bacteria back into your mouth if you’re not changing
the area that you’re flossing with, I guess.
So traditional floss is always going to be the best floss.
It is.
It is.
It patients come in with cavities in their proximal in between your teeth and they don’t understand
why.
Right.
And so we want to floss the teeth that we want to keep.
Yep.
Yep.
Yep.
Love it.
Love it.
Yeah.
Patients really want to know the, I mean, the pros and cons of the water flossers these days.
Yeah.
So how do you feel about the water flossers?
Yeah.
Oh, my doctor, Mike, and I have gone back and forth on this.
Already once or twice.
I wouldn’t know if it was.
I think they’re pretty damn good.
Dr. Mike thinks they’re not worth anything.
Traditional floss.
I mean, and I will say, I will say, string floss, 100% better.
It’s better.
But I say whatever you’re going to floss with more.
So if you know yourself and you’re like, I hate grabbing that thing out and flossing,
I’m not going to do it.
But the water, I’ll shoot that stuff in there and it’s fine.
Do that.
Do whatever you’re going to do more.
Yeah.
String floss is better.
Yes.
String floss better.
So floss those teeth.
Get in there, hug them.
Yep.
It’s like, it’s a hug them.
How did the phone in front, hug the one in back, did it do it?
I always see it as, okay, you’re going to, you’re going to brush your teeth.
Yeah.
You’re going to take a shower.
You’re never going to brush your, are you going to brush your armpits?
Right.
It’s the same thing.
Good point.
Good point.
You’re going to do the arm.
That’s it.
You’re going to arm like the side of it.
But you ain’t going to hit the distinct.
You can.
Yeah.
Right.
And another thing with, I don’t know if it’s today or what, but the sparkling water is
to become a big thing.
Yeah.
It is.
The acidity in that type of water, I mean, it’s not great for your teeth, but I think patients
don’t realize how bad acidity is for your teeth.
Yeah.
So, I mean, patient.
I’m guilty of that, like, I hate water.
So I always go for something.
It’s got some carbonation.
Yeah.
It’s got like something.
But in reality, it’s not doing any good for you.
Right.
Or, you know, the rest of your calorie intake, all the things, right?
But you want to talk about one more thing.
What’s your last thing?
The charcoal tooth thing.
The charcoal tooth phase.
I would love it.
I actually just got a message, a DM about this.
Like, what whitening options do you recommend?
I literally just had this yesterday.
So yeah.
So, the charcoal is a whitening toothpaste, right?
It seems like Dr. Moody is a big fan.
He said he’s not for anyone who can’t hear him.
What do you think of it, Roxy Diego?
I disagree.
You know what?
Perd mixed.
Yeah.
Mixed things.
Yeah.
Yeah.
Sure.
Sure.
I hear it is abrasive.
So abrasive.
It’s so abrasive.
Okay.
So charcoal, right?
It’s like a rock.
Basically, just take a rock and just scrape your tooth and take some a mammal away.
And that’s what charcoal is doing.
So it’s super abrasive.
It’s super aggressive.
The most abrasive, you know, whitening option that I recommend is going to be like the
armen hammer with baking soda.
That’s about as abrasive as I want to be.
And abrasive, what that means is that you’re like rubbing shit away.
And so if you’re doing really abrasive stuff on your teeth, you’re kind of chalking
into that anamol.
And especially if you’re using like a hard brush and scrubbing, scrubbing, scrubbing,
you’re taking an amole.
Okay.
Talking about abrasiveness, the night guards and the retainers.
Mm-hmm.
Patients always ask how to care for their night guards and the retainers.
Yeah.
And they don’t understand why they can’t use toothpicks.
Right.
But they don’t know that toothpicks is abrasive as well.
It’s true.
It has little particles in it that are super abrasive, super aggressive.
I give y’all 100% of those instructions.
So why don’t you like tell someone how to take care of their night guard?
I say warm water was soap.
That’s usually what I say to them.
Warm water was soap.
Yeah.
So pour a grab your toothbrush, clean up all this.
Yeah.
But not with no toothpaste.
Yeah, no toothpaste.
It is abrasive in an amole.
Soapy water.
Like micro tears in your night guard.
And patients wonder why it’s collecting stain, bacteria over time.
We had one recently where she was like brushing it aggressively with a hard brush.
And she brought this night guard to us in Samantha or her.
Dennis was like, I don’t want to touch that thing because it was thick black mold on the entire
inside.
And this patient had been wearing it for months like this.
They’re putting black mold in their mouth because they’re scrubbing it with a hard brush.
Yeah.
Don’t do that.
Warm soapy water.
My retainers, I don’t even brush.
Yeah.
I just rinse them off.
Yeah.
And I just like rub my fingers on it.
Clean hands, rub my fingers.
That’s all you got to do.
Don’t brush it.
Yeah.
So, yeah.
Yeah.
Yeah.
I don’t think.
And there’s so many things in dentistry that like people aren’t aware of.
And so like seeing a dentist, seeing an assistant that the two of you I’m super impressed
with, by the way, you all are super great assistants and just like so informed, so educational
for our patients, so helpful to help ease their anxiety, help them be more comfortable
for when I walk in the room because they’re going to be scared.
I’m such a scary guy, I know.
So they’re going to be terrified of me.
So the two of you all are making it better, right?
And so I just want to kind of end this podcast with saying truly, truly appreciate the
two of you all.
We have some great team members.
I wish I could interview them all because they’re all amazing and all have unique perspectives
on dentistry.
I know.
I know.
Okay.
Last question.
What advice would you give to someone who’s considering a career in dentistry?
Juan Diego Celeste.
I think there’s a lot of opportunity in the dental.
You can either be a dental assistant, hygienist, or even go as for dentists.
And from dentists you can stem off into oral surgery, right, right?
Right, right.
Right, right.
Right, right.
Yes, it’s rewarding.
I feel like it’s very rewarding.
Yeah.
I mean, you had to be a people person.
Yeah, yeah, no bad days, but we all have bad days.
We all have bad days, but you can’t show that patient is having a bad day because they’re
there getting something done.
So you’re not adding your bad attitude onto their bad.
We have great job security.
Yeah.
I mean, I don’t think that’s true.
That’s true.
AI is going to take us over.
Yeah, true, true.
Yeah.
We can’t work from home, you guys.
And it’s never too late.
It’s never too late to be a job.
You’re a dentist, a dental assistant, a hygienist, right?
Like, you’re a stepdad went to school really late, right?
Yeah, you guys are going to have 40.
40.
Very accessible.
Wow.
Yeah.
And he’s doing great.
I mean, I’ve not met him.
I’ve met him since the health of dentists.
Yeah.
I’ve met him a lot of dentists.
Yeah.
Right.
Yes.
Yeah.
The field’s there and anyone who’s in dentistry is there, you know, for their patient’s benefit.
And our end goal is always going to be the same, right?
Mental offices do things a little bit differently, a little bit unique, but our end goal is always
the same to help you as the patient.
And I could not do what I do without these guys.
So, appreciate y’all.
Yeah.
And again, not only thank you for my day today, but thank you for being here.
Thanks for having us.
Yeah.
Yeah.
We’ll see y’all next time.
Bye.
Thank you for listening to today’s episode of DM a Dentist brought to you by Doe Sipdental.
And thank you for your interest in improving your oral health.
If you’d like your questions answered by Dr. Rusty and Dr. Mike, visit us at doeSipdental.com
or DM us on Instagram @YourDailyDoseOpDental.
[MUSIC]
49 min
August 14, 2024 #12 What Do Dentists and the Olympic Games have in Common?
The Olympic Games have dominated TV screens for the past few weeks and sadly have come to an end. The US pulled off the win with medal count, but tied China for number of gold medals. Gold is so coveted, but did you know dentists have been using gold to restore teeth longer than the Olympic Games have been using gold to signify victory? Yep. You heard that right. In this episode Dr. Mike and Dr. Rusty chat about gold in dentistry and other common materials used to restore teeth!
_______________________________________________
As always, feel free to reach out through our instagram @YourDailyDoseOfDental or through our website http://www.DoseOfDental.com. We would love to hear from you and hope your questions can be featured on our show!
Instagram: https://www.instagram.com/yourdailydoseofdental/
Website: https://doseofdental.com/
TikTok: https://www.tiktok.com/@dmadentist
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Transcript:
Welcome to DM A Dentist, your friendly neighborhood podcast where Dr. Rusty and Dr. Mike
are here to make dental care approachable for everyone because everyone deserves a healthy
smile without the fear.
Welcome back!
We are back! It’s been a little while since we put out an episode, but we’re really
excited to be back.
I know Rusty, it’s been like a busy summer, man.
Yeah, we’ve been out hiking and camping, backpacking, I think you’ve been to a couple weddings.
Concerts.
Yeah, all the summer things.
Yeah, now mention our exciting news coming up too.
We have a new podcast studio.
So we’ve been in the process of moving studios, sorry, we’ve been a little behind on the
content, but yeah, we’re excited.
We’re almost moved into our new place.
No promises.
I don’t know when we’ll be done getting it ready.
Yeah, new place.
Yeah, so we’re still in our original studio as you can see, but I’m super excited to show
you the new space as we get moving into the air and as we get set up in the new space,
so can’t wait to show you all what happens.
Yeah, super excited about that.
It’ll be awesome, but I’m also super excited about the Olympics.
It’s been great.
We just finished up this past week.
Yeah, and USA with the overall win.
Yeah.
I saw you know we…
Hey.
You said…
You said…
Yeah, we had a tight China with 40 gold medals, but we got the overall medal count because
we got more silver and bronze than they did.
Yeah, I think USA ended up with a total of 126 medals.
Yep.
China had 91, so we got them there.
So beat them by a size of a amount.
Overall medal count is nice, but we know it’s gold that matters, and we tied them there
40-40, but got the overall count.
True.
Yeah, and funny, funny you say that.
The gold was first given out at the Olympics in 1904 in St. Louis, so that was like the first
gold medal, which is…
Yeah, yeah.
Yeah, so it’s been around a long time, yeah, the common thing.
Yeah.
And the Olympics have obviously been around a lot longer than that, but gold, yeah, just
surpassed 100 and so years, 100 and a little over that.
But gold has also been used in dentistry actually for a lot longer than it’s been used
in the Olympics.
Gold was used, you know, at least 2,500 years ago, maybe a little bit further back than
that too.
Wow.
Yeah, cool, very cool.
Yeah, so it’s very old, isn’t it?
It is.
It’s been around thousands of years, and I would say the most common use was like to replace
missing teeth and to help, you know, like reattach or form of a false tooth with gold, or,
you know, various other things gold was used for, like, you know, thousands years ago.
Gold used in jewelry, even back in the days, using like cosmetic things for a while, kind
of like tooth gems today.
Right.
Tuth gems are a BC jewelry for your teeth.
Yeah, they are.
They are, seriously.
They’ve got a little line in the enamel and then pops some gold in there, set it up and
have a little bit of bling in the gold.
Some people are still doing that today with tooth gems or various things like you mentioned.
So, yeah.
It’s definitely still commonly used today as well, gold.
I would say most of the tooth gem type stuff are going to be like, you know, gems, diamonds,
sapphire, things of that nature, but gold is definitely still common commonly used.
I would say it’s more and more common within the last 100 years in dentistry.
Yeah.
But still definitely commonly used today.
Yeah, definitely very commonly used in mouths and jewelry, things like that.
I mean, I still do gold crowns and gold crowns.
I do at least four to five a month.
Right.
And so would you say that’s what if you’re using gold in your practice today or using it
mostly for gold crowns?
Yeah.
I would say mostly gold crowns.
Yeah.
That’s what we normally do.
I mean, crowns, right, which is something that covers the top of a tooth.
So crown is like a covering, kind of like you’d have like a porcelain crown or a cap people
think of.
Right.
Yeah.
Right.
And gold, I would say definitely is going to be more common to use like for back teeth for
people, right?
Yeah.
There’s obviously other options as well for crowns, tooth colored options that will get into
a little bit more.
But if you’re going to use gold in a case for a crown, why would you use gold like what’s
your reasoning on that?
Yeah.
So like especially in back teeth, I don’t know if people like a mouth kind of operates like
a hinge.
So sometimes in the back, we have less space.
So when we’re preparing that tooth for a crown, we need space for the tooth, but also
the material.
And sometimes we don’t have enough space.
So gold can still be thinner than like a porcelain crown you think of and we can still be
just as strong.
So that’s sometimes I ask patients, hey, it’s in the back of your mouth, you okay?
Have a gold because we can get away with a little bit less space.
Right.
So yeah, especially useful in the back teeth where kind of those very back teeth can be
pretty short to begin with and allows us to keep as much tooth there as possible.
And you know, some people I will say also like gold in the front like we were saying tooth
gems, gold, a whole gold crown in the front.
That’s totally an option as well.
I’ve never done anything so so far forward that it’s right in someone’s smile with gold,
but the option is certainly there and they’re definitely patients.
Yeah, actually at the VA, we did some gold in the front.
It’s a good idea.
Correct.
Like crowns in the front.
I mean older people generally like gold and they’ll do it in the front.
It can be beautiful.
And when it’s really nicely high polished, it’s like a high noble gold with a lot of really
really nice quality gold in there.
It’s beautiful and it’s really nicely polished.
So it can be good, but I would say a majority people would probably not choose gold, especially
on a front tooth.
So what other types of options are there for people that need a crown up front?
Yeah.
So people often say like porcelain, but we have a couple of types of, I say porcelain and quotes,
but we have traditional porcelain, which is just porcelain, Emax and then zirconia.
These are kind of the main three that look like teeth.
Right.
And zirconia, let’s start into that one.
What is zirconia?
Well, okay, Rusty.
So zirconia, it is a metal.
So I often tell people like, I don’t want metal on my mouth, is zirconia is a metal, but
it’s different than the amalgam.
We’ll kind of get in that later.
Zirconia is a white powdered metal oxide and it’s in the titanium family and it can be
pretty thin, but it can also be pretty strong, right?
So like we, so yeah, that’s zirconia.
I’ll let Rusty talk about the next thing.
So I would say zirconia is one you would use typically again, like on a back tooth.
If you have space.
If you have space and it can also be on the thinner side, like it doesn’t need as much room
as a porcelain crown would need.
So zirconia can be pretty thin as well.
Also zirconia is a really good material for people that are going to like heavily grind
their teeth because it’s super, super strong.
And so I think zirconia is going to be a good option in that case as well as gold, you
know, for back teeth.
Zirconia has come a long way recently as well where it’s more and more translucent
and it means more, which means it’s more aesthetic.
It looks nicer essentially because translucent is super important in a material, another
tooth colored material that has great translucent is called emax.
And that’s the material that I use most commonly when I do crowns.
It’s formerly called lithium disillicate, but it just goes by emax and it’s basically like
a tooth colored glass or a quartz material that has a lot of translucent.
So you can look really nice.
Yeah, absolutely.
And that’s nice when you have like strength, but also aesthetics, right?
Because we often think of metal is strong, porcelain is weak, but now we have, we’re kind of blending
the two, which is great.
And translucent is important because that material looks more like a tooth.
Things like that.
Yep, yep.
And another reason I like emax is the way that it kind of is glued onto the tooth because
with any crown, there’s like a dental glue that’s used to leave the crown in place.
And with the emax material, you can actually chemically bond it to the tooth.
Whereas kind of those gold and zirconias are going to be more reliant on like the physical
properties or mechanical retention, mechanical retention.
Yeah, mechanical.
What is that mechanical?
So, you know, basically for the older materials is kind of like a glue or like think of like
a mortar between bricks.
It’s kind of a material that goes there as an intermediate and kind of holds the tooth
and the crown together as like a super glue.
Huh, I mean, yeah, that sounds great.
And like, I guess the opposite or not the opposite, but a different option from that would
be where we say bonding, right?
So bonding instead of like adding another material, bonding penetrates the tooth and crown
kind of like essentially blends the molecules creating a chemical bond that is stronger.
Right.
Right.
For sure.
You know, newer things in dentistry.
Yep.
So we’re kind of getting into the weeds a little bit about some of the, you know, chemical
properties and the mechanics of some of these materials.
But why does any of this matter?
Like, if you’re a patient and you need a crown, a crown is a crown.
If it’s a front tooth, you’re probably going to choose a tooth colored option.
If it’s a back tooth, you might have a little bit more leeway in that again, some people
want gold in the front, which is totally cool as well.
But why does any of this matter?
Like, what is, what are all these different materials or bonding?
What, what, why does any of this matter?
Well, it matters.
So we have different materials based on, you know, just like we have different things and
electronics, iPhones like that.
We kind of progress through the timeline.
That’s true.
Yeah.
And, and I think, you know, advances in medicine is important, right?
Like, the different type of materials, like these Emax materials kind of allow you to
save more healthy tooth structure because we can actually chemically bond it and don’t
rely just on like the physical properties.
So getting into a little bit of the, the, the weedy stuff of it, but it’s, it’s just cool
to see the advances and it’s a cool time to be a, be a dentist.
Yeah.
I mean, that’s true.
And it’s nice to be able to save more tooth structure.
True.
But people often ask me like, you know, we, we talked about what crowns are made of.
But what are like we do probably a lot of fillings?
What are those made of?
Like what, what comprises of that?
What we call composite resin, the tooth colored natural looking filling.
Yeah.
So kind of like how we broke down crowns into like the metal options versus kind of the tooth
colored options.
I would say fillings are kind of the same way.
There’s going to be two big buckets of fillings.
It’s going to be a tooth colored filling or it’s going to be a metal silver amalgam type
filling.
Yeah.
And so, you know, like you said, people often ask you a lot of times what fillings are
made of.
And, you know, I would say most of what we’re going to do is kind of the tooth colored
option.
So, you know, I would say that’s majority of what people are going to ask of what is the
tooth colored?
Yeah.
The composite resin.
Ah, okay.
Because everyone pretty much knows these metal fillings, but they’re made of, we’ll talk
about it in a second.
But a composite resin tooth colored.
It’s made of tiny particles like silica, glass, quartz, these molecules chemically
cure.
Once we add that blue light that we close our eyes to.
But, yeah.
If you add that blue light, it kind of allows it to shape it hardened.
And, yeah, then that’s what that is.
So, it’s made of like silica, things like that, like harder material.
Yeah.
So, basically processed, you know, we’re going to remove like the cavity from the tooth.
And then we’re going to, you know, fill it up with this tooth colored composite resin
material, shape it, set it up and just make sure everything feels just like it does when
you had your normal tooth there.
Yeah.
Brushes, eats, flosses, does all the things just like normal.
And, again, like you said, the good analogy is this composite resin is the newer, more
updated version.
Whereas the older kind of, you know, older version is the silver amalgam.
Yeah.
I mean, you can think of it like the amalgams is like when the iPhone first came out in 2007.
Exactly.
And then it’s kind of comparing that to today’s model.
Like, it’s dramatically different.
I mean, I had it.
Did you have it?
I didn’t have an iPhone originally.
I actually just recently converted.
I had an Android guy forever.
But, iPhone, I’m on an iPhone.
We’re not judging him.
I’m sure Android’s are great.
But iPhone is, I don’t know if the band.
It’s been good so far.
I’m not gonna lie.
Guys, it took over a year for him to say that he liked it.
Yeah.
I do like it.
It’s been great for the podcast as well.
Air drop.
Air drops the word.
Air drops the word, yeah.
I think goodness.
But, yeah, you know, these, again, kind of like most patients are probably not going to
want a gold crown in the front.
Some do.
Most patients today are not going to want a silver filling.
But there’s a lot of dentists out there that still use them.
It’s not a bad thing.
Right.
And I think there are certain circumstances that amalgam can be really useful too.
Like, I liked my flip phone for a lot of free time.
And you know, like moisture control.
Things like that.
It’s like actual, you know, reasons and then it’s decided that amalgam is very useful.
It does work.
And good.
But most people are not going to opt for that.
So most of it’s going to be tooth colored.
So.
Yeah.
Exactly.
I mean, I can’t even offer amalgam.
I don’t have it.
Yeah.
We don’t have it in our office either.
I have not done an amalgam since the dental school.
Have you?
The VA.
Do you do them in the VA?
Yeah.
Fair, fair.
Yeah.
So I mean- The VA, we still do it.
And the military is at work set these like military readiness events.
And most of those are going to be amalgam feelings too because it’s a lot less materials that
are needed and-
That is true of bonding, the edge, you know, the count, the-
And the military ones tried and true.
Yeah.
Yeah.
And the amalgam has been around for, you know, tried and true for decades.
But again, we’re not against amalgam and has its uses out there.
It’s still a great material, but it’s just kind of an update to what things are done.
It’s kind of like, you know, the way impressions are taken for our patients.
Traditionally, impressions are kind of-
A big, goopy material going in a tray that kind of sets up in your mouth.
And nowadays it’s mostly digital scans, not mostly, but definitely trending that direction.
My office does digital scans for all of our crowns and just overall cases and things as
well.
Yeah.
You still have to do traditional impressions for everything.
So, it’s awesome.
Yep.
What is Alginate made of, Rusty?
ALGINATE
So that’s one of those kind of goopy-
Fun fact.
And materials that goes, you know, to help make these models or impressions of your mouth.
And it’s made of brown algae.
Actually.
So kind of the organic, yeah.
Yeah.
Exactly.
The brown algae, Algiante.
But, you know, guys, we missed you.
We’re happy to be back.
Sorry for the break.
Summer gets a little crazy.
Of course, we’re out there enjoying everything.
And we hope you all are too.
But we’re happy to be back.
And again, we’re having that new podcast studio coming soon.
So we’re stay tuned for that.
Yeah.
Bye.
[MUSIC]
Thank you for listening to today’s episode of DM A Dentist brought to you by Dose of Dental.
And thank you for your interest in improving your oral health.
If you like your questions answered by Dr. Rusty and Dr. Mike, visit us at doseofdental.com
or DM us on Instagram @yourdailydoseofdental.
[MUSIC]

15 min
July 17, 2024 #11 DM Debrief - All Your DMs Answered
In this episode Dr. Rusty and Dr. Mike round up all the DMs you all have sent in. They hit the topics of “waterpik vs string floss” to “can I rinse my mouth with urine” (yes someone really sent that question in). And that goes to say…if you ask it…they’ll answer it. So tune in, this episode is a wild ride.
———————————————————————————————
As always, feel free to reach out through our instagram @YourDailyDoseOfDental or through our website http://www.DoseOfDental.com. We would love to hear from you and hope your questions can be featured on our show!
Instagram: https://www.instagram.com/yourdailydoseofdental/
Website: https://doseofdental.com/
TikTok: https://www.tiktok.com/@dmadentist
Transcript:
Welcome to DM A dentist, your friendly neighborhood podcast where Dr. Rusty and Dr. Mike
are here to make dental care approachable for everyone because everyone deserves a healthy
smile without the fear.
Well, well, welcome back everybody to another episode of DM A dentist.
It feels really good to be back in the podcast studio.
We took a little two-week hiatus for, you know, Fourth of July, been doing some camping
and stuff, so it feels good to be back.
It’s been good.
It’s also been pretty hot, so we took a little bit of break.
True.
But this week had some big news.
It did.
It did.
You know, officially, I think we can call it Mike, but politicians are officially more hated
than Dentists.
Jesus.
It’s like, it’s insane that we had an assassination attempt.
Yeah.
I mean, it definitely is wild.
I can’t believe it happened, honestly, you know, at least, I guess the Secret Service had
a quick escape route, so, you know, Trump was able to just get in the van and go’ed.
Right?
Right?
You get it?
No!
Sorry, sorry, y’all.
What an eerie feeling.
But anyway, I mean, in all seriousness, that’s terrifying that that’s happening.
I mean, we should not live in a nation that we have to deal with this, regardless of the
party you’re involved in, right?
Like, insane.
Well, I’m living a country that we are even making light of it.
Of course, it’s a very serious thing, and we’re not taking it lightly.
Regardless of what side of the street you live on, you know, violence is never the answer,
and doing something like this isn’t going to help our situation as a country at all.
Yeah.
It’s completely unacceptable, which we all know that, and honestly, our thoughts in
Paris, well, to everyone involved, because it’s terrifying and scary.
Even if you’re the president, it’s scary to deal with that, so.
Right, so.
We definitely need to come together as a country so this stops happening.
And, yeah.
Yeah.
Anyway, let’s, I know that’s a tough subject, but let’s dive in today’s episode in.
I hope you’re all ears for this one.
Oh, all ears, all ears.
Today’s episode is DM deBrief number one.
So, debrief, debrief, debrief.
So our goal with the podcast, again, you may have heard this if you’ve listened or tuned
in before, but our goal with the podcast is to be too done as here answering your
questions.
And the best way that you can do that is to ask us questions.
I mean, that’s the only way we’re going to be able to help you is if you let us know what
kind of content you want to see from us, send it our way, send us questions, send us videos,
you don’t know what they are if they make sense if they’re real.
Help us help you because that’s really what we’re here for.
Yeah.
So let’s dive into our first DMD brief and get to the questions.
So our first question is from LaRie.
So her question was, how often should the dental hygienist or dentist check the depth
pockets between the bone and the gum?
Yeah.
So what she’s referring to is when you get a parietal chart done.
So it’s when we go three, two, three, check all the spots around the teeth.
And we talk about pockets.
So ideally, it should be done at least once a year.
But Rusty and I typically try to do it at least every six months because something that’s
caught earlier is more predictable.
So if you have something that’s happening below the gums we’d like to see it earlier
than later.
Yep.
Definitely.
And if you’re just establishing care with a dentist too, they should be doing this as a comprehensive
exam.
And then sometimes if you need some deeper cleanings or you have a lot of build up in there,
a lot of times people are going to need to have a re-evaluation essentially where after
around a deep cleaning, those gums are going to be measured again to kind of monitor and
make sure you’re healing up and getting healthier so that those gums are on their rhythm
proving.
So thanks for sending that question, LaRie.
Yeah.
Thanks.
And we’re going on the next one.
I was supposed to get twin block, but my orthodontist gave me braces to straighten one of my teeth.
I got them removed recently and my dentist told me that I’ll be getting twin block soon.
But he didn’t give me retainers and now my teeth are wonked.
So Rusty, you want to feel that one?
I will.
I will.
Thank you, Eliana, for your question.
I’ll preface this one with neither Mike or I are orthodontists.
We’re both a general dentist.
A twin block is a little bit of an advanced to orthodontic removable appliance that you’re
going to be wearing to correct some jaw structure.
And so, Eliana, it sounds like there’s some consistent, some big movement, rather, that
you’re going to be having, right?
Where you’re changing your jaw structure, changing your shape as you’re growing.
It’s a lot of movement.
And so a lot of times, these orthodontic treatments are going to take a long time.
It’s going to be several years to be able to get the movement that you need.
It sounds like your orthodontist likely has a plan for you with a twin block.
And I would continue to follow your doctor’s recommendation so that your teeth, as you
said, are less wonked.
Good.
Yeah, less wonked is good, right?
Very good.
Very good.
I mean, no one likes wonky teeth.
For our next question, so the next few questions kind of dive into a little bit of some
oral hygiene.
So this first one is from Joe and Joe just really simply asked floss versus waterpeck.
What do you say, Dr. Mike?
Well, Joe Biden, I would like to first start by saying thank you.
And second, start by saying something is better than nothing, Joe.
So when you and Kamala are flossing, it’s important that you use string floss.
And the reason I say that is string floss is tried and true, kind of like you.
And the mechanical action of string floss is what’s really going to divide those teeth
clean up the bacteria and kind of scrub.
Waterpeck is great.
It’s kind of like a high powered, it’s a pressure washer for your mouth.
I think they’re great.
So if you’re going to pick one floss, but if you’re going to do nothing, and if not a water
pick, we’d rather use a water pick.
I mean, they’re great.
Yeah, water pick is better than nothing for sure, but again, string floss is probably better
than a water pick.
Both is ideal.
Yeah.
And waterpeck is going to be useful for other things too.
Like some of my patients have tonsill stones, for example.
And sometimes that’s pretty far back in the throat can be hard to get to.
So like a water pick to kind of jet some water back there can be really helpful for things
like that.
Or just a quick rinse in between meals and stuff.
Yeah, exactly.
It can be pretty helpful.
And again, if you want to learn more about these oral hygiene topics, we went into a really
in-depth dive in episode four of our podcast, oral health tips and tricks from two DENIS.
So dive in to episode four if you want to learn more.
The next question is very important and it’s something that’s very dear to my heart.
So Timothy asks, does rinsing with urine provide any benefit?
Very near to your heart, is it Mike?
Okay, well, there is some history with urine being used in dentistry.
So maybe that’s why it’s near and dear to your heart.
I’m hoping because you learned about it in dental school and you’re not going to kink
shape this part.
Of that.
Yeah, no kink shaming, you’re right.
Whatever you’re into, do your thing.
I’m not into that.
But let’s be very clear.
Let’s talk about if there’s any scientific basis for the benefit of urine as a mouth rinse.
Mike, what is urine made of?
Urine is 95% water.
So it’s mostly water.
Yeah.
And honestly, it leans towards the side of being neutral, but I say generally, probably acidic.
Probably.
Yeah, because it has what uric acid, urea is a big, big amount of it.
Ideally.
Just rinsed with water.
But if you want to rinse with urine.
And this can kind of come from some place that we actually looked into this and did some research.
And there’s actually some historical basis for this question where urine was used for an
extensive amount of time.
What did we find when we dove into that, Mike?
Yeah, we found that the Romans used to use it as a rinse for their teeth and they thought
the ammonia in it would cleanse the bacteria, but also whiten their teeth, which is wild.
And what, like it became so popular that what, Resty?
Not only were they drinking their own urine, rinsing their own urine, they were buying bottles
of Portuguese urine and importing them.
And they got so advanced or so common, I guess, that they imposed attacks on the import
of urine into the, into the, into the, Rome.
That’s just no.
We don’t want to tax urine tax.
That’s the last thing we need.
Yeah, so.
But if y’all want to buy your, uh, if y’all want to buy Resty’s urine, we’re going to
start selling it on the website.
Another surprise to me, but, you know, uh, DMS, we’ll see.
Again, we don’t want to get too political in this episode at all, but a urine tax sounds
pretty insane.
Yeah, not doing that.
No, no, no more.
No more.
Mm-hmm.
Uh, onto the next question, kind of back into some more oral hygiene stuff.
Um, this question comes.
We were just talking about oral hygiene.
Uh, okay, more, I guess, uh, modern, really, right, relatable, more modern oral hygiene,
we’ll say.
This one comes from one of our listeners, Jamie, uh, and Jamie asked, what do you think
of this type of toothbrush?
With this DM, she sent us a photo of one of the type, uh, you may have seen them.
We’ll post a video along with this, uh, that we’ll show what we’re talking about.
But it’s one of the kind of full arch type toothbrushes.
It’s basically like a big, you shaped thing that you put into your full mouth, bite into
it, and then it has kind of the brushes around them.
Uh, what do you think of those, Dr. Mike?
I, honestly, I like them.
I like them for two reasons.
One, for people that don’t have a lot of dexterity or lower dexterity than average, and
also for nursing homes.
So like if your mom, dad, sibling is in like a nursing home or assisted living, something
of that variety, uh, the worker is there typically don’t have enough time to do like two minutes
brush all your teeth.
So this is better than nothing because it’s, it’s essentially a bite guard that has bristles
on every aspect of it.
So you can really get in there and touch every, every part of the tooth.
Is it a replacement for brushing with a toothbrush for two minutes for your average person?
No.
But I think it’s a great addition to our special needs dentistry.
Yeah.
It’s something that can definitely be used there.
Or kids or just anything like that.
Yeah.
But for a regular average patient, it’s probably not going to be doing the type of plaque removal
that you really need.
It’s going to be better than nothing.
Yeah, like like Michael Sam for those special needs, those difficult, um, you know, limited
dexterity, I think Parkinson’s disease or people with severe, you know, handicaps and things
of those mattress.
Yeah.
They’re like a tremor like it’s a lot.
Right.
Yeah.
Yeah.
And I’ve even seen people attach them to a wall if they don’t have the capacity to do it.
Oh.
And then like use it that way, which is awesome.
Okay.
Plug and play.
Yeah.
Yeah.
Yeah.
So the next question is, um, also near and dear to my heart.
It comes from a gal named Heather.
So Heather, thank you so much.
And the question is, do I have to brush my teeth?
Emphasis on the half.
Half is all types of people.
It was in capital.
It was in capital.
Half to brush my teeth.
So yeah, Rusty, if you don’t mind fielding this one.
I mean, I’d love to.
You don’t have to do anything, you know.
You have absolute free will.
You certainly do not have to brush your teeth.
I always tell my patients, brush the teeth you want to keep.
So if you don’t want to keep them, you’re not interested.
You don’t mind bad breath.
You don’t mind all the negative things that come with it.
You know, you don’t have to brush.
Some people let their oral hygiene or oral health get in such bad shape that brushing
can be really painful.
So if you’re someone that’s in that scenario that’s avoiding brushing for a particular reason,
go see a dentist and get some help because you know, it’s important, but you don’t have
to do anything.
Again, episode four, give that a listen if you want to learn why it’s important.
Yeah, I’ll send it to you.
We have a next few questions.
So one of our listeners sent in several questions.
So thank you, Trudy, for sending those questions.
These next three are all going to be from Trudy.
So this first one, Mike, why does my back muller trap in bacteria?
I floss and I brush regularly.
So there’s a couple things without seeing your mouth or an x-rayer photo, but sometimes
the back teeth have a different contour to them.
So maybe it’s not as concave or convex as it should be.
So you have kind of an area where plaque or bacteria, food gets stuck in it.
So that’s one reason.
And sometimes the floss is not able to kind of contact the tooth the way that the food
is caught.
So that’s where water pick comes in handy because it kind of sprays everywhere.
So if you floss and use a water pick, then you’re kind of getting every aspect of the
tooth.
But also sometimes if you’ve had a filling done back there, maybe the contact between
the teeth is not as good.
So contact between teeth are important, right?
So it’s what really keeps the food and bacteria from kind of getting below the gum, things
like that.
So when you floss, we like to hear that nice snap with the floss.
So sometimes even if you didn’t have a filling done, sometimes when your teeth grow in,
you have spaces.
So spaces kind of lead to food impactions.
So I’m thinking along the lines of that.
Do you want to talk about maybe an opurculum, like something like that, maybe?
Sure.
So an opurculum is what Mike just said and what that is is basically a piece of like
extra gum.
Typically it’s going to be on your lower teeth behind your very back molar.
And it’s just a piece of like extra gum that grows up and over the tooth.
And that’s an area that’s definitely going to be trapping a lot of food, a lot of bacteria.
That’s a scenario where a water pick can be really effective and really helpful to get
down there and get underneath that inflamed gum tissue and clean that out.
And a lot of times that’s going to be successful.
Some people that have really bad gum overgrowth sometimes have to have it removed to really
effectively clean it.
But typically it’s not going to be that.
And like Mike was saying, spacing and alignment is so important.
If you have too much or too little space, it can cause food trapping.
So if there’s a big gap between your teeth, if there’s any crowding, crookedness, rotations,
there’s a bunch of stuff that can cause food trapping, the more food that you get stuck,
the more bacteria you’re going to have, the more likely you’re going to be to develop
things like cavities, gum disease, bad breath, all the above.
So if you’re having this issue and it’s been a chronic problem for you, go see
a dentist, get a trucked out and have someone look at it to see what might be going on.
Yeah, agreed.
And just like anything, too much of anything is bad.
So too much space, too much contact, things like that.
So for sure.
Yeah, it’s important.
Next one’s pretty quick as well from Trudy.
She asked, is a manual toothbrush or an electric toothbrush better?
Well Trudy, electric.
Yeah.
That’s the way to go.
Electric toothbrushes are more user friendly.
A lot of them have timers.
They tell you if you’re pressing too hard, things like that.
So yeah, electric toothbrushes are great.
Plus the oscillating factor disrupts bacteria better.
So I’m a big advocate of electric toothbrushes.
Yes, electric is great.
And I got the question a lot from patients, which brand is there a brand specific you like?
Personally, I’m a fan of the Sonic care brand.
Brand joy use.
The brand joy use.
Again, all the electric ones are going to be good.
There’s a lot of them on the market.
So just get something be consistent with it.
Yeah, agreed.
All right.
So when getting a regular checkup, do I have to get the electric.
Electronic pick.
I find it’s really aggressive and hurts.
I would prefer the manual pick.
You want to feel that one?
Yes, I’d love to.
So thanks Trudy for this last question you sent us.
So I think you’re talking about kind of the cleaning instruments that are used during your
dental cleaning.
And so the manual pick is kind of the hand instruments that the dentist or hygienist typically
will use.
And a lot of times those are less scary to the patient because they don’t make any noise.
There’s no water.
There’s less vibration.
It’s all just kind of there.
The electronic one is something like a piezo or a cavern.
It has a bunch of vibration and it puts some water out that allows the hygienist to really
get in there and disrupt a lot of stuff that’s below the gumbline.
And it cleans a lot of that stuff that’s below.
But for some people, it’s really uncomfortable.
And it sounds like that might be the case.
So Trudy, there are options.
Your hygienist can do typically like some topical numbing jelly, some spray, some material
or even numb, you know, if things are uncomfortable.
And they can also use the hand instruments more than the electronic ones.
Some hygienists will only use the manual ones as well.
But I will say most hygienists I think are typically going to prefer the electric ones.
It’s easier to get things cleaned.
It’s going to be faster, quicker.
And they’re going to be able to do a better job for you.
But talk to your hygienists.
See if there’s a way that they can make it less painful or seem less aggressive or if
they can maybe do a little bit more of the manual.
Well, Trudy, I agree with you.
I don’t like it either.
I’m really sensitive teeth.
It hurts.
It hurts.
No matter what setting it’s on.
But honestly, the cappodron of piezo is like the best way to clean your teeth.
Yeah.
And I’m the type of psychopath that like went in there and they’re like, oh, it kind of
feels good.
No, it kind of like hurts just a little bit.
It feels good.
Just zing.
But I know they’re getting in there and they’re getting in there at the ball.
It’s like the best way to clean.
All that stuff they’re getting in there at it.
It feels good.
Yeah.
I’m weird, so don’t trust me.
Next question is from Bonnie.
So Bonnie asked, would you suggest getting extensive treatment like crowns of an ears done
outside the US?
You know, it’s hard because there are people that don’t live in the US, right?
But there’s good dentists everywhere.
The US is not the best dentist that ever existed.
We all have different countries of different standards.
So just make sure you find a dentist that has the standard of care that you would expect
from what you’re getting, so what you’re paying for.
I mean, obviously money talks, I get it.
But also the issue.
So if you are from the US and you go outside and get dental care somewhere else, if you’re
getting extensive dental care done, you’re not going to have the follow up you would have
if you got it done like in the US.
That’s the issue.
So like it’s cheaper on the front end, but if you go get it done somewhere else and then
you’re not going to have someone that’s going to warranty it, take care of it, do things
like that in the home that you live.
So you’re going to be traveling back and forth and by that, it just seems more expensive
to me, but I get it.
I understand wanting something for cheaper.
So just make sure you do your research and if you’re thinking about going somewhere, we’re
happy to check them out for you.
There’s good people everywhere, right?
For sure.
There’s good people.
Yeah, absolutely.
There’s good and bad people everywhere you go.
But definitely do your research.
Again, like Mike just said, we’d be happy to check into some places, give you our opinion
on what we think of the clinic or whatever.
I’ve seen a lot of videos where recently people having worked on abroad and then having
to go back and having it redone abroad.
And then some of the redoes, I’m still like, oh, I don’t know about that.
So just do your research because it’s your teeth.
You only get one set of adult permanent teeth and that’s all you have for life.
I mean, there’s replacement options nowadays, but those are expensive and just be careful
before you go and get your teeth shaved down to these little pegs.
I’m sure you’ve seen the videos on TikToks and those full mouth, veneers, crown situations
that are a lot of preparation of two structures that may not be totally necessary.
Yeah.
So just make sure you’re doing it.
Once it’s prepped away, it’s gone.
Yeah.
Yeah.
And then you get it replaced, more is gone.
So just be mindful of it.
Yeah.
Yeah.
We did have this me or you.
I don’t forget.
We had a video sent in from Jerry.
So thank you.
And it was a video of a microscope looking at a sample of a lidocaine, so the liquid we
used to numb you in the needle.
And the person doing the video was saying that they see nanotechnology particles within
this like image on a slide and they’re looking at it.
So what do you say about that, Rusty?
Because I saw it.
It’s square and it looks weird.
It looks like a weird little floating thing within this solution, right?
Again, please don’t believe everything you see on the internet, right?
Lidocaine, any of these anesthetics are, it’s like lidocaine, excuse me, lidocaine hydrochloride,
right?
And so that’s a crystal.
And so what you’re looking at under this microscope is the crystal structure floating
within the liquid of the anesthetic.
And so you’re literally just seeing the lidocaine crystal structure once you take it out
and it starts to be exposed to air and things.
These things crystallize and that’s why the sterilization, the packaging is so important
for them.
Once you start to expose them to air and they start being in a way they shouldn’t be stored,
they’re going to start to crystallize and do weird stuff.
So don’t believe everything you see.
This video actually cracked me out because it was saying Novacaine, Novacaine, Novacaine,
right?
I’ve never even seen Novacaine as a dentist.
Novacaine is an outdated, it is a local anesthetic and a lot of people think, oh he’s giving
me the Novacaine shot.
I’ve never even held Novacaine in my hands and I’ve been a dentist for years, right?
Novacaine is not used anymore in the US because there was a lot of allergic reactions to
it.
We use Lidocaine, Zylycane, Prylycane, Bipyvacane, lots of canes, no Novacane, no cocaine
anymore.
Yeah, no cocaine either, but that used to be an anesthetic too, actually, yeah.
Rub a little of that on the gums and that’s what they used to use.
How do you know that?
From studying dental history.
I see.
So the last question is, hey funny dentist, tell us why white spots form my gums.
Thank you, Barbara.
Yeah, yeah, Barbara, great question.
This could be due to a lot.
It’s hard to say, yeah, there’s a lot, so it’s like, let’s piggyback it.
Yeah, piggyback in it, you know, one thing without seeing you, it could be plaque or food
debris.
You could do that.
You have dry mouth.
We see a lot where things start to stick to the gums, things turn white in the mouth
when they’ve been there for a hot minute.
Yep, could be a difference in pigmentation.
Systemic conditions.
Yeah, like what?
It could be something like vitamin deficiencies in terms of, it could be like a fungal infection.
Yeah, autoimmune conditions, canes, sores, you know, signs of, yeah, lots of stuff.
So if you’re seeing any new growth or bump, lump in your mouth, go get it checked out.
It could be normal.
It could just be your normal healthy gum tissue that has different texture, different
uniqueness to it.
It could be something growing.
That’s an infection.
It could be a sign of a systemic condition.
It could be nothing at all in a piece of food, right?
Yeah, so I always say, if you can rub it away, good.
If it comes back, go see a dentist.
If it’s something that’s there, goes away.
Good.
If it’s two weeks, it doesn’t go away, go see a dentist.
Yeah, gentle rubbing, too.
Don’t like it.
Yeah, I’m not saying it’s your gum.
Damn, it’s sandpaper.
Yeah, yeah, yeah, be cautious.
Yeah, if it goes away, then that’s good, but it’s always good to get things checked
out.
Sometimes anything new, growing anywhere in your body, especially your mouth, go get it
checked out.
But not by me.
We do hear up.
I’ve had people in the dental chair that are like, can you look at this rash?
Here to hear.
And they lift their fur about.
I’m at least five times.
And sometimes the rash can be connected, right?
I mean, we talked about–
And it was.
–cifalus.
You’re talking about your syphilus case, I think, where we talked about oral STDs in a previous
episode that can have systemic conditions.
Yeah, so.
So people just like to talk about weird things sometimes.
So, yeah.
Anywho, I hope you enjoyed this dissection of our DMs.
Yeah, thanks for tuning in.
And please send us more DMs like we said in the beginning.
We want to be here.
We want to be a voice for you to answer the questions that you want to hear.
So if you don’t send us questions, we don’t know what to talk about.
So send us some questions.
Yeah, we’d love to hear from you.
Yeah.
Bye.
Bye.
See you later.
[MUSIC PLAYING]
Thank you for listening to today’s episode of DM Adentus.
Brought to you by Dose of Dental.
And thank you for your interest in improving your oral health.
If you’d like your questions answered by Dr. Rusty and Dr. Mike,
visit us at doseofdental.com or DM us on Instagram @yourdalidoseofdental.
[MUSIC PLAYING]
[MUSIC PLAYING]
24 min
July 04, 2024 #10 Root Canals Explained: How Dangerous Are They?
Root canals are often associated with pain. And…we get it…15 years ago, dentistry was still thought of as a painful experience. Many of you may still view a trip to the dentist as a painful experience…But, Dr. Mike and Dr. Rusty are here to tell you root canals have come a long way.
So for this episode, we wanted to talk about root canals: what they are and why we do them. Dr. Mike and Dr. Rusty breakdown the symptoms that my lead you to think you need a root canal, what to expect during the procedure, and even address some of the misinformation out there about root canals. So tune in, you don’t want to miss this one!
As always, feel free to reach out through our instagram @YourDailyDoseOfDental or through our website http://www.DoseOfDental.com. We would love to hear from you and hope your questions can be featured on our show!
Instagram: https://www.instagram.com/yourdailydoseofdental/
Website: https://doseofdental.com/
TikTok: https://www.tiktok.com/@dmadentist
24 min
June 26, 2024 #9 Saliva, Mastication, and Oral Sex
By now, we have all seen the “Hawk Tuah” girl. So why don’t we talk about saliva and what it does for you? Just so we’re all on the same page: saliva does a lot more than you think. In this episode, Dr. Mike and Dr. Rusty talk about all things saliva: the good, the bad, and the ugly. They finally answer the question that’s on everyone’s mind (apparently, because we’ve received SO many messages in our inbox about this): “Can my dentist tell when I’ve performed oral sex?”. Okay, maybe the questions are worded differently than that, but you get my point. Tune in to today’s episode to figure out if we can tell.
As always, feel free to reach out through our instagram @YourDailyDoseOfDental or through our website http://www.DoseOfDental.com. We would love to hear from you and hope your questions can be featured on our show!
Instagram: https://www.instagram.com/yourdailydoseofdental/
Website: https://doseofdental.com/
TikTok: https://www.tiktok.com/@dmadentist
Transcript:
Welcome to DM Adentist, your friendly neighborhood podcast where Dr. Rusty and Dr. Mike
are here to make dental care approachable for everyone because everyone deserves a healthy
smile without the fear.
Welcome back to another episode of DM Adentist, I’m Dr. Mike and I’m Dr. Rusty.
Today’s episode is going to get into a little bit of a spicy topic if you couldn’t tell
from the title of our episode.
Our topic today will be for a bit of an older audience so make sure the little ones
ears are closed.
It’s not per se inappropriate but you know 18 and up would be great.
Yeah, we’ll be talking about a few different topics, some things ranging from saliva and
then we’ll get into things like swap and spit and even oral sex at the end so be sure
to stick around for the big finish.
We wanted to break down a couple basics of what saliva is made up and then follow that
up with the question we get pretty frequently which is can my dentist tell that I’ve given
oral sex?
If you guys ask me that one more time, I swear.
We definitely got that question a lot, I know there’s been some videos that have gone around
tick-tock and Instagram and stuff that say your dentist can or cannot so we’ll definitely
dive into that but we don’t want to be too premature here so let’s start from the beginning,
Mike.
Yeah and it’s important to start from the beginning so like in Genesis 1-1 in the beginning
God created the heavens in the earth.
Okay, okay.
The very first sin was a woman who ate.
Oh my god, come on back to the podcast please.
Okay, so let’s start with the basics, right?
We know everyone has saliva, right?
And it’s so it must be important because evolutionarily we’ve not gotten rid of it.
So what makes up saliva?
Well evolutionarily or when you’re just talking about Genesis in the beginning so.
Do not catch me in a lie.
Either way, saliva has stuck around and it’s very important.
What do you think makes it so important, Mike?
It has a couple of key ingredients, Rusty and I think those key ingredients are what makes
it important.
So let’s talk about what makes up saliva.
So saliva is made up of mostly water and proteins and salt and electrolytes.
Look at you guys.
That’s probably the most of of what it’s made up of.
So I would say it’s how much of how much of that do I make per day?
You make anywhere between a half a liter to one and a half liter per day on average for
most people, that’s the amount of saliva that you’re going to be making.
So you know, like imagine a two liter or a thing of soda or whatever, not quite one of
those all the way somewhere between one quarter to three quarters of that full of saliva
a day.
Again, most of that like 99% of that is going to be water.
But there’s a bunch of other stuff mixed in it with the water that’s super important as
well.
So mostly water, but there’s some proteins floating around.
Yeah, I mean, there’s definitely a lot of protein in saliva too.
I think there’s over a thousand different individual types of protein that are in saliva
and they all have different important functions and purposes.
I mean, they’re all there for a reason and they all contribute and do things.
So what are some of the proteins that you can find in saliva?
Yeah, so that’s important.
The majority of, thanks for asking, Resty.
The majority of proteins in saliva are a type of protein called an enzyme.
Okay, so going back to bio 101 here.
Correct.
Enzymes are proteins and they’re a type of protein that breaks stuff down.
So we have a lot of that in our saliva and that’s important because why?
What type of stuff?
You said these proteins in saliva are called enzymes.
Yeah.
Inzymes break stuff down.
So what type of stuff are they going to be breaking down in saliva?
So we have things.
So when you start to chew, you have things that break down carbohydrates.
You have things that break down fats.
So you have amylase in your saliva which breaks down carbs and then you have lipase which
breaks down fats.
So that’s kind of the start of your digestion in your mouth because of saliva.
Okay, wow.
So digestion doesn’t just happen in the stomach.
No, it happens in the mouth.
It starts.
It definitely starts in the mouth and I like you were saying chewing it up is the first
step right?
Yeah, so like digestion starts in the mouth with mastication.
Oh, mastication.
Yes, that’s right.
I’m chewing.
Mastication.
Oh, mastication.
Mastication.
Chewing.
I know we’re getting into something later on in the episode but mastication is chewing that
breaks down your food into smaller pieces.
Then the enzymes in your saliva, the lipase, the amylase, break down those fats and carbohydrates
a little bit more.
So then your body is ready to digest it in the stomach intestines blah, blah, blah.
So it kind of breaks it up into smaller particles and makes it much more digestible and even
actually starts the digestion process before you even swallow your food and it goes to the
stomach.
Correct.
That’s pretty cool.
So our listeners would love to know more about this riveting topic, Rusty.
I know.
What else to saliva do?
Well, you’re probably wondering what the other functions of saliva are apart from just
listening.
I know it’s such exciting.
But we do have a lot of purposes of our saliva apart from just breaking down food and starting
that digestion process.
We talked a little bit in the past about how it can help prevent cavities and help fight
that off.
And so the main way that it does that is through buffering.
So buffering is basically like making acidic things less acidic and making it a more
neutral area.
You guys remember when Rusty talked about he’d rather you drink a liter of soda in one
sitting versus a liter of soda over the course of the entire day.
This is why.
That’s because of that acid.
Again, if your mouth is always acidic, then your saliva isn’t going to have time to buffer
that acid.
And again, the acid is what’s going to cause cavities for people.
So yeah.
So, saliva has different chemicals in it.
They’re called bicarbonates that neutralize that acid.
So that’s just a fancy way of saying it’s going to make the mouth less acidic and less
likely for you to cause cavities.
And then the saliva can put your mouth in more of a protective state where your teeth can
actually remineralize or heal a little bit.
Wow.
So, your saliva breaks down food, right?
So your body can digest it easier.
But also it seems to buffer or help with the pH of your mouth to prevent cavities and
remineralize the teeth.
Correct.
Is that what you’re saying?
Correct.
Wow.
That’s exactly right.
That’s remarkable.
I know.
Make your cheeks and lips and tongues moist so that you can speak and move around and make
disgusting noises like that.
But it also has other important benefits, particularly with the immune system.
So there’s a bunch of different types of immune cells that can be found in the saliva.
That’s correct.
So what type of stuff in that regard can you find in that?
So in your saliva you’re going to find white blood cells and other antimicrobial agents.
And that’s important because I know we talked about saliva being 99% water, right?
But it’s also the first, it’s one of the openings to your body, right?
So you have this oral cavity.
It’s where things enter.
You need some sort of like stop agent.
You need something to protect you there.
So you have immune cells in the saliva that protect your body from these various attacks
and they attack being like viruses, bacteria, things like that.
So your saliva contains these important cells to help protect your body, which is great.
So it gives you a chance to fight off infection before it even interests the body.
It’s kind of like that.
One of the first lines of defense or like a barrier that your body has, as I applied
off these, you know, small bacteria viruses, these little diseases that can lead to causing
a lot of stuff.
And you know, obviously it’s a barrier that you have or that everyone has.
And so that’s a good first line of defense to help fight off those bacteria, those viruses,
things that can lead to specific, you know, things.
And you know, one interesting thing that a lot of people don’t know is that if you let
people into your barrier, into your mouth through things like swap and sweat, kissing or
even oral sex, right?
So there’s things that we do with our mouths with other people that you can swap not only
the spit or the saliva, but your swap and everything that’s in there.
So these proteins, wait, wait, wait, wait, wait, wait, wait, you’re saying kissing, swapping
spit, tons of hockey, whatever you kids are calling it these days, spreads things around
other than spit.
It does.
It does.
So any bacteria or viruses that are in your mouth, you’re having the potential to spread that
to whoever you’re kissing too.
So you’re saying I can spread the bacteria that causes cavities?
Definitely.
So if you have that bacteria, you can be spreading that.
No.
Not only just the ones that cause cavities, but bacteria that contribute to cavities, gum
disease, even potentially like oral STDs.
You can be spreading all of that through things like kissing, swapping, oral sex, all of
that.
So if you see an eye kiss, I can give him parodontoses if I have it.
I mean, theoretically, you’re not going to be exchanging the disease directly though.
And I think that’s an important point to me.
So you won’t say I have a cavity and I kiss somebody.
I’m not going to be spreading that cavity directly to them because cavities aren’t directly
a contagious disease.
Okay.
So you’re spreading the bacteria that has the possibility of causing a cavity?
Correct.
Exactly.
Exactly.
Exactly.
You can be spreading it through to gum disease or STDs, cavities, a whole bunch of stuff.
And good bacteria too, right?
There’s good bacteria that live in your mouth.
Yeah.
You’re going to be switching that around to anytime you’re kissing people or, and it’s not
just kissing.
There’s other things you do, you know, things like sharing straws, taking a drink after somebody,
sharing a cigarette or a joint or something.
A cigarette?
You’ve made it so edified.
A cigarette.
I did just find out that I am Italian by birth, so that’s exciting.
Anywho?
To change back?
So maybe you should say cigarette.
A cigarette?
Yeah, there you go.
So basically, Rusty, what you’re saying is a single kiss, which we found from research,
can actually transmit tens of millions of bacteria, colony forming units.
So it’s essentially individual bacteria that have the possibility to cause a certain disease.
Correct.
Why can pass that on to whoever I’m kissing?
Correct.
Or smoking after or sucking straws after or whatever.
Anything.
Yeah, wow.
It’s not just the kissing.
And that’s also how, you know, children from a young age get these bacteria introduced
to them is oftentimes, unfortunately, it’s from mom or dad, Antarong, Goliath, you know,
everyone kisses babies.
Everyone’s kissing the baby.
I love meeting the baby and they want to kiss all over it.
And that’s how they’re introducing these cavity forming things.
And so a lot of times, we ask people ask me, hey, is our cavity’s genetic or is it hereditary?
And there’s not a genetic direct link to cavities.
But the bacteria are certainly passed on from individuals within families.
And if mom and dad have a bunch of cavity causing bacteria and they’re kissing all over
baby, then baby is going to have a high bacterial load of that too and may have an uphill
battle to prevent cavity formation.
Fair.
Yeah.
Yeah, side note, in the future, if you feel like you’re getting more cavities than you
showed you take care of your mouth and resting up talked about this before, ask your dentist
to do a bacteria swab or something.
So that’s important.
But you have to realize you need to be doing all the other things first, brushing, flossing.
And I mean, you know, internalize that, figure that out if you’re actually not doing it, do
that first.
But that’s a caveat.
So it can sound kind of gross to think about it from, you know, microscopic level when you
think about all the things that are insoliva, you’re swapping that around.
Ten millions of bacteria.
Yeah.
And again, majority of those are probably going to be good, healthy, normal things that you’re
going to have in your mouth anyway already.
But you know, the people that you interact and associate with the most are going to have
the most similar kind of microbial composition of their mouth, their body, their hands,
their skin, their skin.
Still yucky.
Yucky.
Mike is so gross.
I don’t love like wet things.
Wet things are gross to me.
Wet things like saliva.
I don’t particularly love saliva.
I wouldn’t say I love saliva.
You got into the wrong.
Rusty’s like, oh, you’re a dentist because you love saliva.
No, I don’t love saliva.
I don’t, I wouldn’t say I love it either.
I’m happy with its existence, but I’m not dying to have more of it.
Yeah.
You know, it’s like when you pull something out of a patient’s mouth and it has a drool
of saliva behind it.
That doesn’t make me super happy.
No, I wouldn’t say that I’m jumping for joy.
But that’s good for the patient because they have all these protective things, right?
Digest.
Yeah, no.
I’m happy that we have it.
I just don’t particularly love it.
That’s life.
So saliva is really important.
It does a lot of positive things for patients and everyone’s mouth and it has a lot of benefits.
People that have no or little saliva have a lot more problem problems.
Yeah.
It’s important.
So for what you’ve all been waiting for, the topic of discussion that’s for older ears.
Yeah.
We’ll get into other things you can do with your mouth since we’re talking about saliva
and kind of segue into oral sex.
Again, one of the questions we get repeatedly.
We’ve had several DMs and even some of our friends have asked us directly this question.
Can your dentist tell if you’ve given oral sex?
So Dr. Mike, what do you think in your tail?
Well, this time we’d like to thank Timothy for asking that question.
And yeah, the answer to can my dentist tell if I’ve given oral sex is sometimes.
And Rusty, let’s dive into why?
So sometimes, yeah, I mean, why only sometimes?
How can you tell what is it exactly that you’re looking for?
Yeah.
Walk us through that process.
So it’s important to know, like Rusty said last a couple episodes ago is everybody is
different literally, right?
So some people can give oral sex and we’ll have no idea, right?
But the reason we can see this is we’re not necessarily looking for it.
But when we do an oral cancer screening and we’re looking at all the parts of your mouth,
we can see bruising in the back of your throat.
And that is a sign that you’ve done something.
Potentially oral sex related.
But there’s other things it could be, right?
Right, right.
And I mean, we’re not just going in specifically looking for for this individual thing either.
It’s part of both of our comprehensive exams for every patient.
We’re looking around it.
All the stuff in your mouth, both hard and soft.
All the stuff in there.
We’re looking for anything, any abnormal pathology, right?
Yeah, anything abnormal.
Any sort of like what I tell my patient, lumps, bumps or things that are growing in there
that shouldn’t be.
So when we’re doing that sort of exam, we’re looking everywhere.
And I don’t necessarily bring up like what we call this palatal particular, right?
Which is just bruising of the palate, small bumps up there.
Because it’s not like a lesion that typically goes into something that’s cancerous, right?
It’s more of a trauma to the palate, which can tell us that you’ve done something.
Whether that’s what, it can be oral sex, it can also be.
I mean, it can be like really vigorous coughing.
So if you have like respiratory infection or strep throat, if you have anything, you know,
dramatically hitting the roof of your mouth, like sucking on a lollipop a little too hard,
could be a lollipop.
Could be anything, right?
So we don’t make assumptions and we don’t judge.
Again, we just see what we see as we’re looking around.
And if we see anything that’s concerning or abnormal, we’re going to talk to our patient
about it.
And it’s concerning.
If it’s something that’s very minor, a lot of times this is something we don’t even necessarily
bring up because it’s part of normal living.
And if it’s not something that’s concerning, it’s not something that necessarily is going
to always be brought up.
But if a patient’s asking me about it, definitely happy to have that discussion.
And again, so you had kind of mentioned the name of them, again, they’re called palatal
peticia.
And what would this look like?
Like say someone was just interested.
Like they look at them.
They could see it on themselves.
Where would they look for?
What are they looking for?
So if you go to the mirror and you open your mouth and you tilt your head back and you
look back there, you can see towards the little dangly thing in the back of your throat,
the uvula.
The uvula as Nicki Minaj would say differently.
Near that area, you’ll see what’s called palatal peticia, which is if you were to bruise
your arm, it’s essentially the similar thing, right?
It’s just like bruising of the palate.
They’re kind of like little small pinpoint bruises that can be around the uvula, the soft
palate, or even sometimes for the forward on like the hard palate.
Yeah.
And we don’t care.
I mean, I literally have never brought this up to someone unless they ask.
I’ve had people that ask and they’re like, hey, I had a good night last night and I want
to know if you can tell and they like, well, like, we’ll discuss it in detail.
And then we’ll discuss it in detail.
But other than that, I don’t bring it up because it’s not a concern.
What do you do?
I put it up a couple of times with patients the only time once was in dental school and I
was unsure what it was exactly.
So it was anything abnormal had to bring it up to the instructor and we kind of had the
discussion and found out that’s what it was from.
I could have awkward as a dental student.
Yeah, don’t worry.
And then another time was one of my hygienists had brought it up and she was unsure of
what she was looking at as well and then brought it up with the patient.
And so then I come into the room and the patient had been pretty concerned about it because
the hygienist was talking about it and just wasn’t sure what it was.
And so, hey, the way she had phrased it was, hey, there’s something here on the roof of
the mouth, I’m not sure what it is.
We’ll have Dr. Take a look and she had taken some intral photographs of it and so the
patient was a little bit concerned about, hey, what is this weird bump or lump or thing
growing in my mouth?
What is this?
I would think my hygienist is setting me up.
I mean, then again, maybe she wasn’t sure.
I know she knows.
This was a pretty severe case of palatal pituitia, I will say.
It was pretty large bruising in this case and so it was a little abnormal but again, further
discussion with the patient, they had had owned up to, hey, I was doing that last night and
yep, that happened and good, that’s all that was from and all was well.
Usually people are not uncomfortable about it.
Right.
As long as it’s something that’s not scary and there’s a reason for it, there’s an explanation
for it, that’s what’s important.
So to answer the question, yeah, your dentist can sometimes tell if you’ve given oral sex.
Are there other things besides, okay, so patients, oral sex, whatever, who cares?
But are there other things that we can see like STDs?
Yeah, yeah, there are some STDs that can manifest in the mouth for sure and that’s one of the
bigger, I guess, risks of performing oral sex, especially if it’s with new partners, unfamiliar
partners, things like that because STDs can spread through oral sex and I think Mike, you’ve
seen a couple of specific cases, right?
The one that stands out in my mind is I had a patient come in and they had this thing on
their cheek which honestly, if I was doing a head of neck exam, I like wouldn’t, I think
it was like, they were just biting their cheek but it was something that wasn’t going
away for them and they’d been seeing many providers over and over and over and we looked
at it and then just, it looked like something familiar, it comes to find out it was syphilis.
Oh, really?
In the mouth.
Wow.
And this was growing on the person’s cheek?
On the person’s cheek.
Okay.
Yeah, so it didn’t really hurt them, they just noticed it and what was sad about the story
is that it ended up being like the patient didn’t realize that their partner was cheating
on them and that’s how they found out it was a whole thing.
Oh my goodness.
But, yeah, I mean, I’ve seen a couple of STDs in the mouth and I did not realize I’d
have to deliver that news to the patient so that was exciting for me.
And typically, how are you going to, like, with that syphilis case, how did you find out
it was syphilis?
Did you know looking at it directly?
We do more testing.
Okay.
So we send the patient to their primary care or to like quest agnostics, get some blood
work drawn and like figure out what that is.
We could also biopsy it but there’s, I don’t biopsy all the time.
It just kind of depends.
Dang.
So syphilis.
Wow.
Wow.
Yeah, so syphilis happens in the mouth.
STDs can you see in the mouth?
Climidia, gonorrhea, herpes.
Herpes I’d say is probably the most common.
Yeah.
Yeah, you want to talk about herpes?
Yeah, since that’s probably the most…
That means you probably don’t want that.
Happily, happily.
I will say it is probably the most common STD that you’re going to have or that we’re
going to see in the most common manifestation of herpes is just going to be a cold sore
on people’s lips.
It is so common.
I mean, people worry about it.
Right.
I mean, I don’t think it should be a big…
You have it.
Don’t worry about it.
Right.
But, I mean, can people see their dentist for herpes?
Absolutely.
Herpes is something you definitely can see your dentist for and people may not know but your
dentist can actually prescribe medication.
You know, Valtrac, a cyclovier is a type of medication you can get from your dentist to
prevent herpes.
Yeah, we also use our laser.
Oh, yeah.
There’s laser treatment.
If they come in and they’re like, “Hey, I feel this, we call the pro-dromal phase.”
Yeah.
When it starts to tingle near the lip before that sore comes out, we can use the laser
and then you won’t get as much of an impact on your lip, which is great.
And that’s great.
Yeah.
And that’s great.
That’s when you notice it is, like Mike said, the pro-dromal phase.
That’s kind of that, if you ever had a cold sore, it’s that like tingling or burning or
itching sensation that you get right before the actual blister forms on the lip.
And if you take the medication or can get to see someone to laser it off before, it’s
going to make it way less severe of an impact and way happier, way healthier to heal
a lot.
And I felt that at night and the next day, I would be calling a dentist to see if I could
get in because in that pro-dromal phase is when you can treat it and like prevent the
visual aspect of it.
Treat is probably the wrong word, but treat the symptom, not necessarily the herpes itself.
Right.
And because there’s also the over-the-counter creams and stuff that are great, but those
are going to be more symptomatic treatment and introduce the length of treatment, not
so much preventing the actual sore from forming.
But like you said, the herpes virus, it’s crazy, it lives in your nerves of your intradreminal
nerve is where it lives.
And it’s with you forever, certain things like stress, sunlight, heavy alcohol use, things
like that can cause it to break out.
A lot of patients get it after dental care too.
So if you have trauma or manipulation of the soft tissue, that can cause an outbreak
of herpes.
And also like if you have one cold sore here, a lot of dentists, a lot of times will defer
the patient if it’s right in that kind of really outbroken phase because you can cause it
if you have the lips but open right by the cold sore and then getting around other areas
when you’re doing normal dental work, that can cause that to spread.
Yeah, so you don’t want that spread.
So it is important that as dentists, we look at more than just teeth, right?
Yeah.
So we look at things that are just like soft tissue, which is just the lips, cheeks, things
like that.
Right.
Speaking of teeth, I’ve had this question a couple of times where like we’ll do an extraction
on a patient and they’re like, so when can I get back to normally scheduled activities?
And then they’re deciding in terms of activities as adult activity.
Do you have any sort of like post-op instructions for patients that are like, hey, I had a tooth
extracted?
I’d like to get back to the normally scheduled programming.
Yeah, right, right.
I think I’m catching your attention.
Okay.
I’m thinking about every week.
Let’s see.
One piece of advice I always tell my patients after a surgery, after an extraction is, is
I don’t want you doing anything that gets your heart rate up for a day or two.
No.
No, no.
Literally nothing.
Pumping, you know?
At the gym or at home?
Okay.
No pumping.
You heard him.
For at least 24 hours.
At least a day or two.
At least a day or two.
Nothing that gets our heart rate really thumping.
Again, you want that blood to clot.
Yes.
And if that can be bad.
But for real.
Other instructions that revolve around this sort of topic as far as tooth extractions and
surgery, right?
We always are concerned about dry socket after after we pull teeth.
So dry socket is when you lose the blood clot from the site and you get some exposed bone.
And what are the really painful?
Five S’s to a boy.
The five S’s.
Yeah, that’s something.
I always tell my patients it’s easy to remember.
After a surgery, especially a tooth extraction, none of the five S’s.
So no smoking, no straws, no swishing, no spitting and no sucking.
None of the five S’s.
And what does that include, Rusty?
Everything.
Everything.
Everything.
No, no sucking on straws or lollipop or candy or cough drops or lozenges or anything else
you may want to suck up.
So to break that down further.
Eyes tell patients, no oral sex for seven days.
After a tooth extraction.
Seven days.
Yep, yep.
Rusty, can I have oral sex after four days?
Nope.
You said seven, Doc.
Seven.
You said seven.
Please.
Also, you know, there are stitches in there.
Stuff is healing.
I mean, I get it.
If you’ve got a high libido and you want to do it, but just wait.
Please.
Just wait.
Let your stuff heal.
Let the stitches heal.
We bring this up because this question comes up far too often.
Yep.
And also, no vigorous, you know, tonsil hockey, like might call it earlier for three days,
you know?
Yeah.
At least, please.
Some packing, some kissing.
She’ll love your partner, do what you need to do.
But, you know, let your mouth heal.
It’s a very delicate area where there was some very small stitches a lot of times, some
grafting, all sorts of stuff can be going on in there.
I don’t think people realize when we say, like, suction in the mouth is what causes the
disruption of the blood clot.
So if you have a tooth extracted, even if it was just a cut on your arm, any sort of
movement on that’s going to disrupt the blood flow, things like that.
You’re healing a scab.
Your mouth’s trying to get a scab.
Any suction is going to be problematic.
Right.
So we say no straws.
So then, you know, kissing causes suction.
Yeah.
So just don’t do that.
Anything that causes your cheeks to kind of literally suction in, you want to avoid that.
So straws and smoking are going to be the biggest things, but swishing, spitting, sucking
of any kind can cause all sorts of dry soccer problems, problems with healing, everything.
Yep.
So just avoid it.
Take it easy.
Cut on your arm or an injury on your arm.
You’re going to wrap it up, bandage it, put it in a cast.
You can’t really do that on your mouth because you’ve got to speak and function in chew and
live your life, but certain things you can avoid just take it easy and not the area heal.
Cause, you know, dry sockets know fun.
No, I’ve had it.
It’s awful.
It’s just better to let it wait.
Let it heal.
Wait the seven days.
Yeah.
Even two weeks, you know, as far as like none of the five S’s, I tell my patients minimum
two weeks for that and hope that they’ll do 10 days, but correct.
You know, minimum two weeks is really what I tell people.
And I have one patient recently.
He’s like, Hey, I’m going to use this as an excuse to quit smoking.
I’ve been trying to.
Yeah.
So fingers crossed for him that he can actually hold true.
And if you guys need help, we can also do tobacco cessation.
We can go in that into another podcast.
Yeah, but we talked about that a lot last last week actually tobacco nicotine.
Oh, we did.
Yeah.
If you need help with that, we can help.
Yeah.
On that note, you know, protection is the best form of prevention.
I do want to say that real quick.
That’s true.
It’s important to use protection.
So we’ll go from there.
But yeah, we hope this podcast was helpful.
Yeah.
On that note, stay safe out there and keep those questions coming.
Bye.
Bye.
Thank you for listening to today’s episode of DM Adentist brought to you by dose of
dental.
And thank you for your interest in improving your oral health.
If you’d like your questions answered by Dr. Rusty and Dr. Mike, visit us at doseofdental.com
or DM us on Instagram @YourDailyDoseOpDental.
[MUSIC]
29 min
June 19, 2024 #8 Does Zyn Cause Cancer? - A Patient's Perspective on Nicotine
Did you know that your dentist checks for oral cancer during your exam? Do you know if Zyn, chewing tobacco, or cigarettes can contribute to your risk of developing oral cancer? Today’s guest episode welcomes Jack, whose great questions prompt a discussion on the risks of various forms of nicotine consumption, which have the potential to cause oral cancer, gum recession, tooth staining, and a whole host of problems with oral health. We discuss the importance of making informed choices for maintaining a healthy smile as it relates to the use of these various nicotine-containing substances.
As always, feel free to reach out through our instagram @YourDailyDoseOfDental or through our website http://www.DoseOfDental.com. We would love to hear from you and hope your questions can be featured on our show!
Instagram: https://www.instagram.com/yourdailydoseofdental/
Website: https://doseofdental.com/
TikTok: https://www.tiktok.com/@dmadentist
Welcome to DM A dentist, your friendly neighborhood podcast where Dr. Rusty and Dr. Mike
are here to make dental care approachable for everyone because everyone deserves a healthy
smile without the fear.
Well, welcome back to another episode of a DM A dentist.
My name is Dr. Mike and we have someone else in the chair today.
Hey, my name is Jack.
I’m literally in the chair.
I’m solely a patient.
Oh, so we have someone that’s familiar with the dental chair, not that he is bad teeth,
but he just, you know, the other side, I don’t sit in the dental chair much, but he does.
So we’re going to get his perspective today.
Thanks for having me.
I know nothing about dentistry except from the patient’s perspective.
So I’m just going to kind of ask questions and, you know, hopefully represent the audience
at large.
Representing the crowd.
There you go.
So today, we’re actually going to tackle something that’s been on the market recently,
nicotine, especially with the use.
That’s good stuff.
So yeah, we’re going to dive into that.
So welcome back and let’s get rolling.
Cool.
So one thing I wanted to talk about was Zyns in particular.
I feel like in the last couple of years, there’s been a rise of different nicotine products
and, you know, admittedly, I’ve used Zyns.
Yeah.
I know people who use Zyns daily all day.
And they think that it’s safer because there’s no tobacco in it.
You know, it’s easy.
There’s no smoke.
And so they think it’s a safer alternative, but I kind of get the feeling that maybe
that that’s not true.
Well, from a cancer perspective, Zyns have a lower risk of cancer incidents, which is
good.
So that’s something that it’s better in terms of to get your nicotine from a Zin than it
is from a cigarette because the propensity for cancerous from a cigarette is much higher
than that of a Zin.
Right.
Because cigarettes have so many additives and from aldehyde and a bunch of other products
that are not products.
But, you know, content that are harmful to the human body at large.
But like, so why, I guess my question is, would be like, why is Zyn so bad?
For me, my first thought is just not knowing anything about teeth, right?
It’s just you’re putting it directly against your gum.
It burns.
Yeah.
That can’t be good.
Yeah.
So what, like, so the thing that the problem with Zyns is it’s not necessarily like a cancer
thing, even though you can probably get cancer from a Zin in dental school, we learned about
smokeless tobacco and the incidence of cancers very low from smokeless tobacco.
You might say like Zyns are the new age of like, uh, dipping.
Stuff.
Yeah.
Exactly.
Yeah.
So, but the problem with Zyns is if you put it in the location and continually put it in
that location, you start to get what’s called tobacco keratosis and keratosis is a pathology.
Like it is an abnormal tissue development that when you have cells that are changing, that’s
a problem, right?
So you have something that’s going from normal to abnormal, even if abnormal is not cancerous,
you still have something that’s problematic.
So you don’t want to continually have those cells change over, then you have more of a possibility
of cancer.
Okay.
So same more about that because you say is the word keratosis?
Yeah.
Because you say pathology, pathology makes me think of cancer.
So what exactly does that mean?
Like, why do I care if the cells are, are, are not changing over in my gums?
Fair.
Yeah.
I mean, fair.
Why would you care if it’s not going to cause cancer?
So what you’ll, so what we notice, so like, okay, say you don’t go to dentist, right?
You want to look in the mirror and be like, do I have a problem with my yn pouch?
Sure.
If I look in the mirror and I look at the spot that I put the Zin pouch at and I see
like, white, like, scaly looking tissue or oral mucosa or..
Gums.
Yeah.
If that looks, I don’t know what you’re talking about.
If that looks like a white scaly little lesion, that’s telling me that that Zyn, you’ve been
using it for so long, it’s starting to cause some change in how the, the gums look, right?
So change is not necessarily bad, but change is something that’s happening, right?
So you’re having some sort of pathology, whether it’s some sort of like cancer or not, it’s
changing.
So the longer you do it, the more possibility you have of some sort of cancerous cell
getting in there, right?
Okay.
Also, with that type of thing, you have a decrease in the gum.
So the gum covers the tooth, the tooth’s in the bone.
The gum will recede over time because it doesn’t like being rubbed by this tobacco pouch.
Okay.
So it’s rather lack of tobacco pouch, right?
Because there’s no tobacco in it’s in.
It’s just nicotine.
Correct.
I guess.
Yeah.
Okay.
So needless to say, the gum doesn’t like being irritated.
So I mean, who likes to be irritated?
I mean, I’m irritated all of the time.
Yeah.
It’s just a constant state.
Yeah.
So that’s interesting.
So you mentioned like white lesions, sort of like visual indicators that maybe your gum
is not happy.
Is there anything other than that that Zyn users might look for?
For me personally, just looking at my teeth, sometimes I’m like, I feel like my gum looks
too red.
Is that a thing?
Or am I making that up?
Yeah.
It wouldn’t necessarily be red.
Maybe from like inflammation, things like that.
But typically tobacco keratosis has more of a whiteness to it.
So yeah, that is something to like.
So if you look in the mirror and you’re like, okay, I have like this white little spot and
spot is not right.
It would be the same size as the pouch typically.
Or you have gum recession.
That’s kind of a sign that there’s some impact of using the Zyn on your oral health, right?
Some people don’t even notice the visual aspect to it.
They notice like, oh, this area of my mouth is more sensitive.
And you get more sensitivity when your gums stop covering the tooth.
So if your gums are not covering your tooth, you’re more prone to sensitivity.
So that’s kind of what people brings people in.
They’re like, oh, what’s going on?
Why is this happening?
Interesting.
I actually never thought of the impact of gum recession to the tooth.
I always thought it would be how the gum feels.
Mm-hmm.
Yeah, the gum covers the tooth.
It’s like an insulation almost.
Interesting.
Yeah.
You don’t usually notice how their gums feel in terms of like, usually like a tooth-borne
problem.
Like, oh, my teeth are sensitive.
And like, well, your gums were seated.
So like, that’s how we get down to that.
I see.
The issue with gum recession, I will say, is you can’t really grow it back.
And I say that with a caveat because you can technically grow it back with a graft.
I don’t even actually know what a gum graft is.
So like, if you were to burn your skin, right?
And you got skin from another area of your body and you made like a graft, right?
Like, you know, people know what a skin graft is for they typically cover parts.
Sure.
So it’s basically replacing what’s missing, what’s missing with additional material.
Yeah.
And I’m actually going to have my friend who’s a periodontist in Colorado, Annika, on
some time.
So she’ll really dive into that.
So a period honest, a periodontist that differ from like a general dentist?
A periodontist does extra schooling and they specialize in the period on shim.
So the part that supports the tooth.
The bone and the gums and the structures that hold the teeth in place.
They specialize in that.
So as we talk about gum recession, that would lean itself more toward a periodontist.
Right.
And in some general dentists do treat gum recession with grafting.
It’s just, I don’t do that.
But we would refer to a periodontist.
And what they do is they take gum tissue off of the roof of your mouth and they place it
and stitch it down where the recession is happening.
It’s a bit ironic because the roof of my mouth is most often where I burn my mouth.
Yeah, same.
Hot pockets.
So that’s kind of a weird segue.
But like when I burn the roof of my mouth with hot pizza or hot pockets or whatever, that
fixes itself on its own, right?
Right.
So is the difference between like burning the roof of my mouth from like a one off incident
of hot pizza versus repeatedly using a Zyn on my gum?
Is it that I’m not burning my mouth every day with pizza?
Right.
If you burned your mouth twice a day with pizza for the rest of your life, that would be
a problem.
It wouldn’t be a good candidate for a graft for the other part of my gum.
Correct.
Got it.
You also would be at a higher, higher possibility of cancer because your cells are turning
over. More damage to cells is the more possibility of some sort of cancer.
Interesting.
So it’s not really per se what you’re putting in your mouth.
It’s how often you might be.
It matters how often, but it also matters what it is.
So like, of course, like if we, okay, cigarettes, right?
Okay.
You’re not just breathing in hot air.
Hot air would not be great because it doesn’t, the gums don’t particularly love or
the teeth or the supporting structures don’t love hot gas in the mouth, right?
It’s funny because I’ve been called a hothead in my whole life.
Wow.
It’s not full of hot air.
Wow.
Yeah.
That wouldn’t be great, but the problem is when you smoke, you’re breathing in a bunch
of other things on top of the hot air.
Right.
So it’s smoke.
I’ve never thought about it this way.
That way it’s kind of interesting, right?
So like hot pizza, it’s really hot pizza, hot air irritation.
It’s the impact of how that is affecting your mouth.
It seems to be more of a temperature disrupts than the disruption by the temperature plus
the addition of the chemicals that you’re putting in your mouth.
So it’s like twofold.
Yeah.
So like with cigarettes, you, so if someone who smokes cigarettes, the problem with cigarettes
is the tobacco with the hot smoke restricts blood flow in the gums.
And that limits the nutrients that are necessary to provide supply to the bones in the teeth.
So that’s why people that smoke cigarettes tend to get more like periodontal disease or
like things like that progress faster because you have the smoke and you have the chemicals.
And that is decreasing blood supply.
Blood supply is what provides nutrients to certain things, right?
So you need blood supply to organs, new blood supply to fingers, gums, teeth, all that
things.
When you smoke, you are diminishing that blood supply.
So then those teeth, everything’s not getting what it needs.
So that’s why people get like loose teeth or like then you start to get stained teeth.
Right.
Yeah, I mean, that’s, it’s funny because smoking back in the day, I feel like the anti-smoking
campaign started more so with like, oh, you don’t want yellow teeth.
It was less about the health and it was never about the gums for sure.
Yeah.
And so I’m curious like for those who smoke today, like if they’re teeth are yellowing,
if they’re teeth are starting to hurt, you know, is it like you have to quit smoking?
Otherwise, you’re going to lose your teeth or are there any alternatives that people can
look into?
Does vaping is vaping better?
I mean, you know, I think that’s why there’s been such a rise in these cigarette alternatives,
like Zyns and like vapes because they’ve been initially deemed healthier, but we really
don’t know that much about them at this point, even though they’ve been around for, you
know, 10, 15 years.
Yeah, it’s a bit harder.
Like, I don’t know as much about vapes in terms of like long term health for the gums
and things because it’s not been around as much.
Right.
But there are some studies coming out with the lung health and it’s not great so far.
Right.
But I was not to deviate too far away from teeth, but yeah, no, it’s hard because we
don’t have as much in from it.
Just like Zyns or, you know, way more common is there now.
Whereas it used to be like, smokeless tobacco was a thing and that, you know, so we’re kind
of here.
Right.
It’s kind of like, it’s a little bit of a devil’s advocate scenario.
I feel like in the nicotine world, the tobacco world, rather do.
Right.
I mean, anything’s better than, I don’t say anything, some are better than cigarettes.
Like cigarettes is kind of like the gold standard of the worst.
Yeah.
But a big tobacco.
Big tobacco.
But the problem is like you’re breathing in a chemical, the chemical is hot and all
that has negative effects not only on your entire body, but specifically where it hits
first your mouth.
So we have people that are, you know, losing teeth or their teeth are becoming discolored
and that’s not going to happen to everyone because everybody is different literally.
So it’s just important to recognize those things and that can maybe be a motivating factor
to quit.
Yeah.
I mean, I think that’s a good point.
Like everybody is different.
I’ve heard my whole, I’ve had maybe four cavities and I think three have been on the same
tooth.
And you know, I’m not admittedly, I’m not the best dental patient per se, but you know,
I try my best.
And at one point in my life, it was told to me like, you could do everything right and
you’re still going to get a cavity on this, on this tooth.
And so I think it’s, it’s an interesting point that you bring up that, you know, people
are different.
Everybody’s mouths and their compositions are different and you could do the same, let’s
say, you know, tobacco or nicotine, Zyn, cigarette use as another person and you might get
Periodontal disease way earlier.
Yeah.
Another person may not, I don’t know.
Yeah.
There’s, there’s a biological component.
So like we have like genetic makeup that has a propensity to certain things, right?
Yeah.
And then you also have a biological, we also have environmental.
So like if you have a biological, and then you also are doing something environmentally,
you are just setting yourself up for failure.
Right.
But there are some people that don’t have a biological, right?
They’re not, they’re not prone to that.
So like if they do an environmental issue like smoking, they’re not going to be, at, their
teeth are not going to be as bad.
And environmental meaning like the environment in which you surround yourself.
Right.
And you choose to do.
Yeah.
So, okay.
People that are more prone to periodontal disease, they have the bacteria make up things like
that in their mouth.
Like they are going to get it regardless of what they do.
That’s so interesting to me.
So like what are some of the contributing factors to that?
Like one thing I’ve always been really interested in is like, why do we produce saliva?
I don’t really understand it.
Yeah.
Um, I know that like, for example, when I, when I did use this in, I was spitting a lot
more.
I felt like my mouth was full of salivating.
I was salivating a lot.
Well, that’s the thing about also doing, or doing also like smoking.
Do you do cigarette smoke?
Do you cigarette?
Is the problem with that is you also are, when you smoke like that, you’re causing inflammation
to the salivary glands.
So the salivary glands decrease the amount of saliva they’re producing.
When they do that, you don’t have as much saliva, right?
Hmm.
So the problem with that is saliva is important for decreasing cavities and it’s also important
for buffering.
So the way you get cavities is you have an acidic attack on, in your mouth.
So that means like you’re eating sugar or doing things like that.
So you’re changing the pH of your mouth.
Saliva helps to buffer that.
So that’s why when people are like, I don’t brush, hmm, I only brush once a day.
I’m like, if you’re going to brush once a day, brush it night, but it, brush twice.
But if you’re going to brush once, brush it night, because when you’re sleeping, you’re
not talking, swallowing, speaking, talking, you’re not doing all those, doing hopefully one
of those things.
Yeah, you’re not doing those things.
So saliva is not moving through your mouth.
So it’s not able to like wash the teeth, coat the teeth.
I see.
So when you sleep, the bacteria just has a field day.
So things like that are kind of important to recognize, brush twice a day, but if you’re
going to choose one, brush it night.
Right.
What I kind of heard based on my, my limited experience is that I might be salivating
more during a zin use, but it’s, it’s because my mouth is overcompensating for what is happening
inside of it.
It is funny.
Like when you do eat things, or like lemons, your mouth does salivate more to like prepare.
Right.
But yeah, I don’t know.
I don’t know the answer to that.
Yeah, that’s fair.
I mean, it’s, it’s more just like a, a theoretical, right?
I’m just like thinking about saliva and the mouth and what happens as you use certain products.
And I think lemons and other things that are, are shocking maybe to the mouth is, is
it good analogy?
Right.
Because your mouth is overcompensating for almost like an attack.
Like no one, at least not in my experience, loves eating sour things like you salivate
for a reason.
Yeah.
Well, I, I have patients that love lemons.
So.
I’m just like, please.
So I do want to hit on a couple of things, right?
So smokeless tobacco, I’m going to put Zyns in there as well, whatever.
I know it’s not, but whatever.
So it causes a keratosis of the tissue, which is caused by the constant friction of the
pouch.
And keratosis, let’s just go back to remind ourselves is what?
Keratosis is a tissue change.
So it’s a change in color and appearance of the gum itself.
Got it.
Okay.
So it’s no longer that red pink color.
It’s our certain white and scaly.
That’s what tobacco care to says.
So I consider that even if it is then a tobacco care to say sure.
So it’s a change in the color shape, texture of the tissue itself.
Okay.
So that tells us you’ve been using it a long time or you use it frequently.
So the lesion develops, yeah, as a habitual chewing habit, right?
So that’s kind of assigned to us.
And then it’s also important to realize that smoking cigarettes in terms of what we’re
going to discuss nicotine, smoking cigarettes twofold, right?
The chemicals that go into your body, bad for your body, chemicals are also bad for your
teeth and gums, sure.
But you have heat, the heat component is not good for the teeth, right?
The positive bacteria, positive cells, things like that, don’t love the heat.
Second, the smoke is not good for things, right?
You’re depriving things of oxygen.
And then you have this idea that you’re reducing blood flow in certain areas, reducing blood
flow, things don’t like that.
So you don’t get as much tissue support.
So you don’t get as much nutrients to certain areas of the body, but specifically we’re talking
about the mouth.
You don’t get as much blood supply.
So then you’re lacking nutrients.
So the body, the body is the use it or lose it.
So it’ll start to decrease the gums, decrease the supporting tissue of the teeth.
So that’s like why it’s important to kind of avoid those things.
Yeah.
It’s really interesting talking about this to me because I’ve never thought about the heat
component as it relates to damaging the gums of the teeth or just the mouth in general.
And it’s almost like a double whammy, right?
It’s like, I think heat and then also irritation.
Maybe I can combine those two if we’re talking about cigarettes and then sins.
It’s the initial impact to the mouth that kind of like hurts it.
And then it’s what’s inside that like further hurts it.
Yeah.
Does that make sense?
Yeah.
No, that’s true.
So it’s like it’s something that we need to combat, but the youth love it.
Yeah.
Yeah.
You know, it’s, yeah, it’s a tricky subject.
I agree.
So if we get to, so if you were to have a patient in your chair and I guess coming from
someone who would be maybe embarrassed to admit it, right?
They say, do you smoke, do you do sins, smokeless tobacco?
Even if I did it occasionally, I would say no.
Yeah.
And so you can tell, right?
Typically.
Yeah.
I would say it’s not 100%.
It’s not 100%.
I mean, if someone’s been using it for a long time, totally.
Yeah.
Right.
And so if I say no as a patient and you’re like, okay, I can tell that they do, let’s say
I need a graft, right?
How do you, as a dentist, maybe approach that conversation or how do you maybe suggest
as a patient that I be more forthcoming?
Because it’s something that I think tobacco use, nicotine use in general is shame.
I don’t, I don’t, I don’t, I don’t want to speak for everybody, but I feel like typically
people are ashamed to say like, yes, I do that.
Yeah.
And so do you care?
I mean, sort of what’s your opinion on?
Yeah, I don’t, I think that everyone has a vice, I don’t care what people do.
Yeah.
So they get some credit.
You’re not there to judge us.
No.
I think that, you know, this brings back to some point when like someone was talking to
me about like, so in Portland, we are still trying to figure out a way to ethically help
homeless people like, you know, throwing money at the problem is not fixing the problem,
right?
We’re trying to figure that out.
People told me like, you can’t get mad, like people get mad at, uh, houseless people for
using drugs or things like that, right?
And they were like, well, what, what do like, we do when we have a hard day, we go get a beer.
What do we do when we, we go?
Some people like, we’ll smoke a joint.
Like, you know what I mean?
Right.
So like, it’s important to recognize that everyone has something in their life that they
use to cope.
Yeah, absolutely.
Whether it’s good or bad coping.
Yeah.
So if I may interject in your stream of consciousness, you know, there’s a very famous author, his name’s Alan Carr and he writes books about how to quit different vices if you want to call it that.
He has one on alcohol, he has ones on cigarettes, et cetera.
And one thing, and I did read one of them and one thing that stuck out to me was he compared
to nicotine addicts to like drug addicts.
And he’s like, the mindset is the same, right?
And you, you don’t look at it the same way because it’s accepted by society that people
smoke.
It’s okay.
It’s okay that you have a couple of beers after work or whatever.
And we don’t view it the same as something that something like heroin.
Yeah.
It’s viewed.
And I think it’s important to realize that everyone has their own thing, right?
So don’t, don’t feel like you’re being judged.
I mean, we ask it on our intake form, obviously, and I’m sure people don’t really answer it.
Yeah.
But no, it’s important.
I mean, I would bring it up and just say something like, you know, I’ve noticed something
on your gums.
I wouldn’t say it’s concerning, but it’s something I want to address, right?
Like it’s important that we’ve a figure out why it’s happening, but be kind of come up
with a game plan long term to see what we want to do about it.
So we go into that discussion and I mean, we do tobacco counseling at work, really as
dentists, yeah.
It’s the same more.
We can prescribe drugs to help quit, like Chantix, like we can do all of that.
But yeah, we talk about tobacco, we talk about, yeah, that’s part of our training.
That’s interesting.
I don’t think a lot of people know how much dentist can provide outside of your, just your
teeth.
Yeah.
No, we do tobacco counseling.
Hygienists do it.
We were taught it.
Yeah, it’s wild.
You also do a sleep apnea.
We do do sleep apnea, right?
Yeah, we should talk about that in another podcast.
That’d be fun.
Yeah, it’s a good idea.
We definitely will.
Well, I hope everyone enjoyed this little nicotine adventure.
Jack, thanks for being here.
I hope you enjoyed it.
Thanks for having me.
Yeah, of course.
And thanks again for tuning into DM a Dentist.
We’ll see you next week.
Bye.
26 min
June 12, 2024 #7 Who's Who in the Dental Office? Part 1 - The Business Team Talks Dental Insurance
Last week we talked about the various positions that make up a dental office. There were quite a few followup questions asking us to expand on some of the job descriptions. So, we decided to start a series of “who’s who in the dental office”. This will be a 3 part series and we are starting off strong with the business team. This week Bonnie Kost is joining us and talking about all things related to dental insurance. She explains the difference between medical insurance and dental insurance, dives into some insurance nuances to look out for when choosing a dental plan, and gives you some tips to help you maximize your benefits. You don’t want to miss this episode!
As always, feel free to reach out through our instagram @YourDailyDoseOfDental or through our website http://www.DoseOfDental.com. We would love to hear from you and hope your questions can be featured on our show!
Instagram: https://www.instagram.com/yourdailydoseofdental/
Website: https://doseofdental.com/
TikTok: https://www.tiktok.com/@dmadentist

Ashley 00:00:02
Welcome to DM, a dentist, your friendly neighborhood podcast, where doctor Rusty and doctor Mike are here to make dental care approachable for everyone because everyone deserves a healthy smile without the fear.
Dr. Mike 00:00:24
Alrighty, so I have Bonnie with us today. Say hello, Bonnie.
Bonnie 00:00:28
Hello. Well, hello, everyone.
Dr. Mike 00:00:29
This is Bonnie. She’s been working in dental for how long now?
Bonnie 00:00:33
About ten years now. I started in the back.
Dr. Mike 00:00:36
Start in the back.
Bonnie 00:00:37
We talked about that last week.
Dr. Mike 00:00:38
So what is back?
Bonnie 00:00:40
Back office is being a dental assistant, being a hygienist, being a dentist. So front office does everything up front. So we push the paper and do all of the insurance and scheduling, and back does everything else for us.
Dr. Mike 00:00:58
So, yeah. Like clinical versus business team.
Bonnie 00:01:01
Yes, absolutely.
Dr. Mike 00:01:02
So, yeah, Bonnie’s been doing this for a while, so we had her on the show. I know we talked about last week, what are the different roles in the dental office? And this week we decided, why not talk to someone who does it for a living?
Bonnie 00:01:13
I do do it for a living. I am technically a finance coordinator, which is a fancy way of saying, I tell you how much everything’s gonna cost.
Dr. Mike 00:01:22
So you would say you are well versed in the insurances, eh?
Bonnie 00:01:27
I have so much knowledge of insurance that sometimes it hurts. There are thousands of different plans out there, and our goal is always to know as much as we possibly can in order for our patients to get the most out of their benefits.
Dr. Mike 00:01:43
And it’s hard. Cause it’s always. You were saying earlier, it’s always a moving scale, right?
Bonnie 00:01:47
Yes. Sometimes it does feel like we’re on a little bit of quicksand. Like, say anything is an absolute, and it changes every January. So every January, we have a big push to rediscover every dental plan that we have coming into our offices.
Dr. Mike 00:02:09
That’s wild. So they change a lot.
Bonnie 00:02:10
They change quite a bit, actually. And I will call it frustrating, but it’s also, you know, that is just how our country is ran with dental insurance currently.
Dr. Mike 00:02:23
And the bad thing is I will do things in the back and, like, treatment plan all these things and get all excited, and then I’m like, oh, it’s probably covered. Who knows?
Bonnie 00:02:32
And it’s not.
Dr. Mike 00:02:34
So I’m the one that gets Bonnie in trouble, but he does quite a bit. Hey, we’re very good friends, so I’m allowed to do that.
Bonnie 00:02:39
Yes, absolutely.
Dr. Mike 00:02:41
Okay, Bonnie, let’s dive in. So the one thing that gets me into hot water as the dentist is I don’t know much about dental insurance. That’s why Bonnie’s here.
Bonnie 00:02:48
Yep.
Dr. Mike 00:02:49
And I think it’s good. I don’t like, I’m here to give the clinical side of things not necessarily be dictated by corporate America.
Bonnie 00:02:56
Thank you. Yep. And I do, I do actually prefer it that way. When I am looking for an office to work at, I, while it’s nice for the doctor to acknowledge costs of things, I think their job is to plan the best smile for you and whatever that looks like. And we can always come up with alternatives, but the dentist should not be even considering cost because it changes how they do things. And we want what’s best for each person that comes into our offices.
Dr. Mike 00:03:29
Right. We want what’s best for you. So we’re not going to be driven by insurance.
Bonnie 00:03:33
Exactly.
Dr. Mike 00:03:33
We want you to maximize your benefits. So that’s why we’re having this talk today. Yep. So I wanted to start because I first, when I, so when I had dental insurance a long time ago, I assumed it was like medical insurance.
Bonnie 00:03:46
Uh huh.
Dr. Mike 00:03:46
Which seems to be a common theme.
Bonnie 00:03:48
Yes, it is.
Dr. Mike 00:03:49
So can you touch on that a little bit? What is the difference?
Bonnie 00:03:53
So that’s a very little question.
Dr. Mike 00:03:56
Go on.
Bonnie 00:03:57
First and foremost, usually your medical has a deductible that you have to reach before they will cover anything. And you will see costs from 500 to 7000 just depending on your plan. And dental insurance is not even the reverse of that, but it is its own separate entity. Most plans cover anywhere between 1000 to like 3500 for your annual maximum. And your deductible tends to be fifty dollars to one hundred dollars. And so your dental insurance will only cover up to whatever your annual maximum is with of course, a bunch of caveats.
Dr. Mike 00:04:39
Asterisk, asterisk, asterisk, asterisk. So you’re saying if my dental insurance plan says 1500, they’re not going to pay 100% after I pay 1500?
Bonnie 00:04:49
No, they will pay $1,500 towards whatever you’re doing, depending on what you’re doing and what percentage they cover each procedure at.
Dr. Mike 00:05:00
Okay. So it’s essentially they’re, they’re basically telling me that is all we’ll pay.
Bonnie 00:05:04
Yes.
Dr. Mike 00:05:05
For the year, no matter if I need more.
Bonnie 00:05:07
Yes. And if you need more, your insurance won’t cover more just because you need more.
Dr. Mike 00:05:14
And then, okay, good to know.
Bonnie 00:05:16
Yes.
Dr. Mike 00:05:17
So then, okay, so that’s the major difference between medical and dental.
Bonnie 00:05:20
Yes.
Dr. Mike 00:05:21
So then in terms of annual maximums, what’s like an example? Like, I know that probably varies a lot, right?
Bonnie 00:05:27
Yeah. Our most common is anywhere between 1503 thousand 500, especially here in the Portland area. And I will say, though, that those numbers have not changed since about the 1980s. And so a lot of people are finding dental to be more and more expensive out of pocket. And it is because those annual maximums have not gone up with the times, whether it be inflation or just the fact that it’s been 30 plus years that they have not increased.
Dr. Mike 00:05:58
So, yeah, everything is pretty much costing two, three times. And it’s not just your supermarket. No, everything. Our supplies, our staff costs, it’s all gone up.
Bonnie 00:06:08
Gloves, masks, especially post pandemic, we have seen, oh, gosh, I don’t even know what the latest percentage is, but at a certain time, I know it was almost a hundred percent more just for gloves and masks in order for us to have them. Because, you know, as we work with people, we do have to change those out. And because there was such a huge shift in how we needed to make things, they shifted a lot of materials to masks specifically, and hospitals, of course, got it first, but the prices increased. And of course, just like your groceries have gone up, those prices have decreased a little bit, but they are going to remain that higher price forever.
Dr. Mike 00:06:54
Now, that’s what upsets me. I remember Bonnie and had this discussion and it was like the cost of chicken has gone up and it just doesn’t go back down.
Bonnie 00:07:01
No.
Dr. Mike 00:07:01
And that sucks.
Bonnie 00:07:03
Yeah. Shop locally if possible.
Dr. Mike 00:07:05
Shop local?
Bonnie 00:07:07
No, go get your chicken butchered at the farm and then buy it that way if you’re able to.
Dr. Mike 00:07:13
There you go. So, okay, so then with dental insurance, we have annual maximums that they’ll pay. So how do they determine what they’ll pay? Is it broken down into anything?
Bonnie 00:07:24
Yes, we end up having categories. So your insurance is three major categories. Preventative, basic and major preventative will be your exams, your x rays, your simple cleanings. Major would be like crowns and bridges, implants, dentures, things like that. And then basic would be just fillings. And usually it is. Basic is covered at 80, major is covered at 50, and then preventative is supposed to be covered at 100%. But as we see, quite often, those fees don’t match how much we charge. And so it’s more like about 90%, depending, again, on your coverage. Cause it’s really hard to talk about insurance because there are thousands of plans and they all handle them slightly differently.
Dr. Mike 00:08:19
And they’re all different, which is wild. Yes, it does upset me that I found out, well, I found this out from Bonnie recently, that if it says it’s 100% covered, it doesn’t mean it’s 100%, correct.
Bonnie 00:08:28
No, it doesn’t.
Dr. Mike 00:08:29
That is insane to me.
Bonnie 00:08:32
It is probably one of the harder things to talk to about with people, especially, we always encourage people to log on, find out their benefits, read every little piece of paper about it. So you understand your plan. Because, again, any office, especially like the office that I work at, we are a small office. There is no way for me to know thousands and thousands of plans. And they will do certain caps even though they, quote unquote, cover it to 100%. We see that very, very frequently. Especially, like, with something like a night guard. Night guards are expensive for the labs to make. It’s not cheap, it’s not free, and it’s not free. And insurance usually only covers, again, quote unquote, 100% up to, let’s say, $150. And so if the night guard is.
Dr. Mike 00:09:34
$400, I tell the patient it’s 100% covered. Because I, like, look quickly, it’s 100% covered, up to $150. That’s shady.
Bonnie 00:09:48
I’m like, if I had a nickel for every time that I just was flabbergasted by insurance and how they word things, I would have a bunch of nickels.
Dr. Mike 00:10:00
So it’s hard to understand.
Bonnie 00:10:02
So it is so hard to understand.
Dr. Mike 00:10:05
Bonnie gets a breakdown of your insurance. Like, she has to find it. It’s not like she just knows it. I do gets it all detailed. Right. So do patients have access to this? Like, can they look this up?
Bonnie 00:10:15
And again, I really recommend that everyone looks up their own insurance benefits. Usually you do have to create a login, but you should be able to see everything that I see and probably actually a little bit more.
Dr. Mike 00:10:29
It’s probably easier to get ahold of somebody.
Bonnie 00:10:31
Yes. And especially right now, post pandemic, it is near impossible to get ahold of people at insurance companies. We have seen a huge, huge increase of just. They hang up on you. You’ll be on. Yeah. Or it’s, you know, and AI can’t answer it, and so they just hang up on you.
Dr. Mike 00:10:54
I had that with Comcast.
Bonnie 00:10:56
Yeah.
Dr. Mike 00:10:56
The other day, I called. I call Comcast all the time. My Internet does not work.
Bonnie 00:10:59
Yeah.
Dr. Mike 00:11:00
And it was a. I bought, and then the bot was like, until you’ve tried the steps that I’ve said, yeah, I’m gonna end this call and end of the call.
Bonnie 00:11:07
Yeah. And they just hang up on.
Dr. Mike 00:11:08
And then you call. It says, call back if you need help.
Bonnie 00:11:10
Really? But I still need help. I don’t get a person.
Dr. Mike 00:11:12
And they’re like, you don’t get a person till you do this.
Bonnie 00:11:15
No. Yeah. It’s, it’s been very interesting to see the shift after, you know, post pandemic, but it’s also the life that we live now. And there’s a few things that I think is really important to know, especially because most people, when you have whatever career that you have and you have benefits, a part of it, dental does tend to change. Every January. Your company tends to decide where you go. And unfortunately, with that, there’s a few things that end up coming up. And probably the biggest thing that we see are like missing tooth clauses.
Dr. Mike 00:11:56
Oh, yeah. Where define that. Let’s go into that. That’s important.
Bonnie 00:12:00
So a missing tooth clause is if you are already missing that tooth and you start this new dental plan, they will not cover anything to go, quote unquote, on top of it. So they won’t cover, it’s called a pontic, if you get a bridge, and it’s that middle part that takes over the spot where your missing tooth was, they don’t cover that at all. They don’t cover implants. They don’t cover implant crowns. So even if it’s a covered benefit, partials that have. That you want to have a. Again, it’s called a pontic, but the fake tooth on a flipper, they will not cover it because it’s part of their missing tooth cloths. Which again, like we’re always talking about the asterisks of every plan, that it is very important to understand what those are in order to maximize your benefits.
Dr. Mike 00:12:52
Pre existing condition?
Bonnie 00:12:53
Yes, kind of, yes.
Dr. Mike 00:12:55
So they will. Even if I have a benefit plan that covers implants, like all these things, if this missing tooth clause is part of that, I will not get replacement.
Bonnie 00:13:05
Zero coverage on it.
Dr. Mike 00:13:06
Is there a timeline?
Bonnie 00:13:08
No, it’s just until you no longer have that plan that has that missing tooth cough.
Dr. Mike 00:13:12
That’s insane.
Bonnie 00:13:14
It is very frustrating.
Dr. Mike 00:13:16
What if you were born without the tooth?
Bonnie 00:13:18
Um, you know, it’s still the same. I think that you can appeal it if you have something that is like a genetic defect of some sort missing. I have seen success with that. That tends to be with children, though. So we’re talking about under 18, that they would cover something like that. Um, but you do have to prove it, right? And so a lot of times, you know, you move or whatever happens, or your old dentist is no longer around, and you had x rays taken when you were eight, and now you’re 17 and your bone’s ready for an implant, but you can’t prove that you’ve always had this missing. And if your plan has a missing tooth clause. They will deny it.
Dr. Mike 00:14:04
That is wild.
Bonnie 00:14:05
Yes. And what is also really hard with dental is we don’t have a central database where like, everyone’s records are. So, like when you go to Kaiser or peace, health or legacy, and if you’ve seen other specialists, they all have your records. Like, they can look at your medical chart and read anything that they need to about you. Right. We do not have that in dental. And so if it’s lost, it’s lost. And some older dentists will keep those records, but you are only required to keep them for seven years. So anything past seven years, you, I mean, you’re pushing a boulder up a hill.
Dr. Mike 00:14:50
I mean, especially if people were in paper charts.
Bonnie 00:14:52
Yes.
Dr. Mike 00:14:53
Like, how are you going to find that?
Bonnie 00:14:54
Yeah. And so, again, children tend to be a little bit more lenient, but anything proving as an adult is very, very hard. If you have that type of clause on your plan, which we see more and more missing tooth clauses, that’s wild. Waiting periods, age limits, sky’s the limit. On what?
Dr. Mike 00:15:17
So if I see in a plan that I’m like, oh, so and so has 100% coverage, I need to check for these little caveats.
Bonnie 00:15:22
Yes.
Dr. Mike 00:15:22
So what if I.
Bonnie 00:15:23
They’re buried. They’re buried.
Dr. Mike 00:15:24
So, through paper. I mean, you should see these PDF’s. It is so confusing.
Bonnie 00:15:29
Yeah.
Dr. Mike 00:15:29
Control find doesn’t even do it. So if I am starting a new job and I want to get dental insurance, I should kind of weigh these options then. Like, if I think I need a lot of work done or something, I should make sure my plan has certain coverages. Is that something I can see? That is what you’re saying, yeah.
Bonnie 00:15:44
And you should, as much as you can get as much information as you can for each. Like, if there’s different tiers that you can choose from and understanding which each tier has, because again, sometimes the higher tiers will have more clauses set to them and not always. Again, it’s really hard to say anything, you know, definitively, but that’s been probably, you know, people think they’re choosing a really great plan, but they’re actually not because it has something like that.
Dr. Mike 00:16:15
So check the coverage, then check the clauses.
Bonnie 00:16:18
Yes, absolutely.
Dr. Mike 00:16:18
And double check it.
Bonnie 00:16:19
And then double check it. And I always tell anyone that I’ve ever talked to on the phone, any questions, you have to call me back. And I will, as much as I can help them, even if, like, I know that they’re not going to be a patient here or they’re moving because I know that it is near impossible sometimes to find these answers or to understand what it means or to find someone to explain it to you. And so really good offices have front people that are always willing to do that for you, because we do understand out of the thousands of plans and.
Dr. Mike 00:16:59
Also some people questions to ask. Yeah, I would not. So if I called and I’m like, hey, do I have coverage for this? And Delta’s like, you have coverage for that? I don’t know. To ask if I have a missing tooth clause.
Bonnie 00:17:10
Yeah.
Dr. Mike 00:17:11
So, like, yeah, that’s.
Bonnie 00:17:13
I know, that’s insane. It’s rough, too. It’s been a very weird journey of understanding dental insurance because you can’t keep anything straight. What I know this year will be different than what I know next year, because all. Not all, but most insurance plans will change. And I will say that none of them have changed for the better. I have not seen them get better. I have seen them actually decrease what they cover. One of our major things that we’ve seen happen is annual limits used to not include any preventative. So your cleanings, x rays, exams with your doctor were not a part of that. And now we are seeing that it is a part of that. So anytime you go to the dentist for your cleaning, your x rays, and your exam, which should be, you know, twice a year for at least your cleanings, sometimes up to four, those are now being taken out of your annual limit. So you no longer, if you crack a tooth. Cause you eat almonds or, you know, whatever happens, you’re hiking, you’re biking, you’re rock climbing. All the things that people wonder. Where she lives in the Pacific Northwest. Do you end up burning through so much of your benefits just through doing your preventative, which is what you’re supposed to do, you know, just like you’re supposed to go to the doctor and get certain things done at certain timelines. Dentistry, you are supposed to get your teeth cleaned every six months and see your doctor a minimum of once a year and have your x rays every year. That’s how we get early.
Dr. Mike 00:18:50
I was telling someone the other day, like, I appreciate yearly x rays. One. Because now dental x rays, the dose is so low, like, radiation is almost negligible.
Bonnie 00:19:00
Right.
Dr. Mike 00:19:00
But also, if we catch something, it’s a banana. Yeah. It’s like eating a banana, which is wild, but it’s like, the most predictable treatment we can give you is when it’s caught early.
Bonnie 00:19:10
Yes, absolutely.
Dr. Mike 00:19:10
Just like anything in medicine. If we see a small cavity on the x ray, I’m happy because then we’ve caught it. It’s more predictable. But if we wait and wait and wait, God knows what it’s going to be.
Bonnie 00:19:20
Yeah. And, you know, again, having been in dentistry for about ten years now, it never ceases to amaze me how much we end up do. See, you know, we have so many people that for whatever reasons, they weren’t able to go to the dentist for even like, three years and how much things can grow and, I mean, dealing with, I guess, disappointment, maybe even in themselves, of, like, I let this go for so long, and now it’s. I mean, it. It’s a higher, higher cost every single time.
Dr. Mike 00:19:55
Yep. The more work that has to be.
Bonnie 00:19:57
Done, the more it costs and just.
Dr. Mike 00:19:59
You know, save for any profession.
Bonnie 00:20:00
Right. And decay does its thing. It doesn’t parties and it gets bigger. It does party in your mouth. Absolutely.
Dr. Mike 00:20:08
Well, Bonnie, this has been lovely.
Bonnie 00:20:10
Yeah.
Dr. Mike 00:20:10
Any more final words?
Bonnie 00:20:12
Oh, jeez.
Dr. Mike 00:20:12
People need, almost need to probably make a part two because there’s a lot we have not covered.
Bonnie 00:20:16
But, yeah, it is really hard because, again, it does always change. But just being aware of what your benefits are, what your limits are, and what you can actually expect your insurance to cover is very. I think it just, everyone needs to know exactly what it is. And then I do think that will actually help lead some change if people start actually not fighting back. But speaking up about dental coverage, coverage here in the United States, we often get blamed. Yes.
Dr. Mike 00:20:55
Even though it’s not us that’s doing the dictating in terms of coverage. But it’s important that people like you that have dental insurance complain like, hey, this should be covered, or, why is this denied? Or things like that. So I think that maybe there needs to be more involvement in patients with their dental insurance.
Bonnie 00:21:11
Absolutely. And again, most of the time, it’s just, you know, most of the time, it’s an app on your phone, if we’re being real. But, you know, getting that breakdown from your employer and getting that breakdown from your actual insurance company. And again, any questions that you have, I’m not the only one that is willing to answer any questions. Most people I know that work upfront, especially as financial or treatment advice coordinators, we will always be willing to talk to people to make sure that they’re maximizing everything that they can do.
Dr. Mike 00:21:42
They know it all.
Bonnie 00:21:43
Yeah. All of it.
Dr. Mike 00:21:45
Everything. Well, Bonnie, this has been great. Yeah, absolutely.
Bonnie 00:21:48
Yeah. Thanks for having me.
Dr. Mike 00:21:49
Of course.
Bonnie 00:21:50
Good, good.
Dr. Mike 00:21:51
She’ll be back. Don’t worry.
Bonnie 00:21:52
Always.
Dr. Mike 00:21:53
All right, everybody have a good night. Thanks for tuning in. Bye.
Bonnie 00:21:56
Thank you.
Ashley 00:21:59
Thank you for listening to today’s episode of DM a Dentist, brought to you by dose of dental. And thank you for your interest in improving your oral health. If you’d like your questions answered by Doctor Rusty and Doctor Mike, visit us at http://www.doseofdental.com or dm us on instagram at yourdailydose of dental.

23 min
June 05, 2024 #6 Role Call - Who's Who In The Dental Office
There are many team members that make up a dental office. Dr. Mike and Dr. Rusty had quite a few DMs last week asking about the roles certain people in the dental office have (SPOILER: no, we do not call our dental assistants nurses). So, tune in as we talk about who's who in the dental office.
As always, feel free to reach out through our instagram @YourDailyDoseOfDental or through our website http://www.DoseOfDental.com. We would love to hear from you and hope your questions can be featured on our show!
Instagram: https://www.instagram.com/yourdailydoseofdental/
Website: https://doseofdental.com/
TikTok: https://www.tiktok.com/@dmadentist

Ashley 00:00:02Welcome to DM a dentist, your friendly neighborhood podcast, where Doctor Rusty and Doctor Mike are here to make dental care approachable for everyone, because everyone deserves a healthy smile without the fear.
Dr. Mike 00:00:24Well, well, welcome back.
Dr. Rusty 00:00:26Welcome to another episode of DM a dentist.
Dr. Mike 00:00:28I'm Mike.
Dr. Rusty 00:00:28And I'm rusty, and let's talk teeth. So happy that you're here listening just again. So, today's June 2, officially. I love it. I love it. Yeah. Barely, though.
Dr. Mike 00:00:38Summer.
Dr. Rusty 00:00:39Summer. You know, June always typically feels like summer, but in Portland this year, it's a bit wet. Yeah. There's an atmospheric river coming through, which, actually, until I moved to Portland, I didn't even know that was a thing.
Dr. Mike 00:00:49Yeah, but everyone talks about it, so I'm like, okay, here it is.
Dr. Rusty 00:00:52All it is. It's a bunch of rain in June. But another great thing about June is that it's officially pride month, as well. So happy pride to everyone out there.
Dr. Mike 00:01:02Happy pride. Hope you all celebrate, and, yeah, it's great. So, speaking of pride, did you see the Adele snippet online that's going viral?
Dr. Rusty 00:01:10I don't think I've seen this.
Dr. Mike 00:01:12Someone. Dell was talking about work weeks, and someone yelled like, pride sucks. Now, there's context. People think he might have said, work sucks, but Adele heard pride sucks, and she was basically like, no, you don't come to my show and say, pride sucks. You're wrong. And so it was. It's an. It's a funny little video.
Dr. Rusty 00:01:28This was like a heckler at her concert. Okay. Okay.
Dr. Mike 00:01:30So that was kind of cool. But she was talking about her work week, I think. And I think everyone misheard the guy. I don't know. It's hard. It's hard to hear, but it was funny.
Dr. Rusty 00:01:38Well, who knows? I mean, there is definitely a lot of hate against the community that celebrates pride, for sure. So I wouldn't be surprised that we celebrate it. Yeah, definitely should be celebrated. And, you know, I wouldn't be surprised, unfortunately, if there was a heckler that said something negative. So hopefully it wasn't that. But if it was, shame on you, because Pride's definitely shame. Pride definitely should be celebrated. Something that deserves.
Dr. Mike 00:01:58Things need to be celebrated. We've come a long way, so.
Dr. Rusty 00:02:00Yeah, and just, like, you know, we talked about last week, women's rights and women coming a long way. I think, you know, the. The support for the lgbt community has definitely come a long way. Yep. And still has a long, long way to come, for sure. But June is an important time to think about it and celebrate. You know, I know that there's some things coming up in Portland. Although Portland, I found out, waits until July to do, like, their big pride. They do. Yeah. Which maybe it's because of all this rain out there.
Dr. Mike 00:02:25So apparently because of other festivals that are going on, they're like, oh, we're gonna move it. But it's kind of odds, like, the.
Dr. Rusty 00:02:30Road out of festival and stuff. I get it.
Dr. Mike 00:02:33But we'll see what we can get into. Maybe something fun will be going on. No, no, something will be going on. We'll figure out what we want to do. But. So we had a DM that came in, and I love this question because I hear this a lot, where we have a patient sit down, and then the dental assistant leaves the room, and the patient was like, I really like your nurse.
Dr. Rusty 00:02:53Yeah. Yeah.
Dr. Mike 00:02:54So I feel like this question fits the bill. And anonymous wrote, what does the dental nurse do? So that's what we're gonna talk about.
Dr. Rusty 00:03:04Yeah. We're assuming you don't probably mean dental nurse. Maybe you mean, you know, the dental assistant, dental hygienist. There's. There's a bunch of team members, and maybe everyone's not familiar with who everyone is in the office and the roles they have. So we're gonna talk about, you know. Yeah, exactly. The different team members, the different people that you'll see.
Dr. Mike 00:03:21I think it's important to know who's who and what's what. So we'll go through that a little bit. Um, but in my office, we don't have a nurse. Also, Resi doesn't. But I could assume some dentists do have, like, dental anesthesiologist or something. Like. Like a nurse anesthetist or something that. So that could be a bit confusing. But the things that we see the most are people confusing dental assistants with nurses.
Dr. Rusty 00:03:44Right. Right.
Dr. Mike 00:03:44So let's chat a little bit about, you know, roles and things like that. Let's start with a dentist.
Dr. Rusty 00:03:49Yeah.
Dr. Mike 00:03:49What is the dentist? Rusty, what does the dentist do?
Dr. Rusty 00:03:53Well, I think everyone knows, basically, the dentist is the one who is going to be doing any of the drilling, filling, all of that sort of scary stuff. The person, a lot of times they wear a white coat. It's kind of the person who has the dental degree, whether it's a DMD or a dds.
Dr. Mike 00:04:12And DDS is a more significant degree, and it holds up. It's an upper echelon degree.
Dr. Rusty 00:04:18He's lying to you, folks. Don't let him. Dds. And I'm a DMD, so he likes to talk a little smack from here to there.
Dr. Mike 00:04:25So us dds's are just more edified.
Dr. Rusty 00:04:29Definitely not true at all. What does DDs stand for, Mike?
Dr. Mike 00:04:32Doctor of dental surgery.
Dr. Rusty 00:04:34I think in residency we called it the dumb, dumb, stupid degree, but, yeah, doctor of dental surgery. Sure, we'll go.
Dr. Mike 00:04:41What is DMD? Rusty?
Dr. Rusty 00:04:43Doctor of medicine in dentistry.
Dr. Mike 00:04:45Oh, yes. Interesting.
Dr. Rusty 00:04:47So basically, DMD, DDs, each of us is one of them, obviously. And we're both dentists. We're both general dentists. There's actually no difference.
Dr. Mike 00:04:56No, it's the same requirements, DMD versus DDs. We take the same boards, pretty much the same curriculum. But why do we have two different degrees?
Dr. Rusty 00:05:05I mean, the only difference is kind of the school you go to, some of the dental programs are DMD, some of them are dds. And so it really just depends. So he went to VCU, which is a dds, I went to Louisville, which is a DMD program, and it's just different.
Dr. Mike 00:05:19VCU is just better. So we did dds instead.
Dr. Rusty 00:05:22Right, right, exactly. Definitely not right. He thinks again, he's funny. Ha ha.
Dr. Mike 00:05:29Michael, it is the exact same, but people get confused because they're like, well, do versus an MD, which essentially do the same board requirements, things like that. But there's different philosophies with do and MD. Sometimes not with physicians, but not really with dds and DMD. The philosophy is pretty much the same. It just depends on where you went to school. Would you say that?
Dr. Rusty 00:05:50Yeah, I would say that the similarities between dds and DMD programs are much closer than do and MD programs for the physicians. I mean, you're all going to learn a lot of the same stuff the first and second year, whether you're in dental school or med school, to be honest. I mean, you're taking anatomy, physiology, all those things, but basically, DMD, dds, it doesn't matter who you're seeing. The dentist is obviously, you know, everyone knows who the dentist is.
Dr. Mike 00:06:14I have to cut him off because it does matter, because dds was original dental degree dating back to the 18 hundreds.
Dr. Rusty 00:06:22Here he goes again. Here he goes again.
Dr. Mike 00:06:24But Rusty Stans tries to stand on this little platform because Harvard, I think, is who introduced the DMD, which, if.
Dr. Rusty 00:06:30You talk about any prestigious Ivy League school in the US, a lot of people think Harvard would be the most.
Dr. Mike 00:06:36But with age wisdom.
Dr. Rusty 00:06:40DMD is better.
Dr. Mike 00:06:42Anywho, they're the same.
Dr. Rusty 00:06:45Other team members, so we've kind of exhausted the dentist you've listened into. You listen to us. You know that we're dentists. You know who the dentist is. Who else do you see in the office? Like, who, when you walk into a dental office, who would you say is the first people that you'd see?
Dr. Mike 00:07:00I call them our business team. So a lot of people call them the front office. Those are like people at the front desk that check you in, check your insurance, do things like that. They do a lot of the financial things. Yeah, yeah. Business team, super friendly.
Dr. Rusty 00:07:13I mean, you know, our office, they're. They're amazing. They're super intelligent on the treatment plans, the insurance stuff. They're very friendly. They're there to welcome you with a nice, warm, friendly smile. Deal with scheduling. Yeah. Coordination, all that sort of stuff.
Dr. Mike 00:07:26Yeah, we couldn't do what we do. We didn't have them. Definitely also make sure that, you know, things are covered or, like, you have your appointment for the correct time, correct place, like.
Dr. Rusty 00:07:35Yep, yep.
Dr. Mike 00:07:35Yeah. We couldn't do anything with, like, you.
Dr. Rusty 00:07:37Know, coordination with different offices, getting x rays received or sent over when we're getting a patient from an office or sending a patient to an office, they help with all that sort of stuff, and they're there to help answer your questions as a patient, too. So if you have questions about the treatment plan, payment plan, options, financing, how your insurance works, different deductibles, I mean, all of those sort of things, that's what they're there, and they're not super.
Dr. Mike 00:08:01We are not your guy for that. And it's kind of nice because a lot of them were. We often in dentals, separate things from front office and back office. Front office is the people that greet you, things like that. Back office is like chair side. Right. Doing dentistry. And a lot of the front office that we have on our team used to be back office, and sometimes it flips. So that's kind of nice. They know the ins and outs of the office, things like that, which helps.
Dr. Rusty 00:08:24Them be more involved, too. Like. Yeah, like you, one of our front office gals is, was an assistant for a lot of years, and so now she knows a lot of the procedures and what's being done, so she has a lot better understanding of that different, you know, codes we're using for different treatment and stuff.
Dr. Mike 00:08:38And they typically know a lot about dentistry and can answer a lot of your questions, which is great.
Dr. Rusty 00:08:42Absolutely.
Dr. Mike 00:08:42Yeah.
Dr. Rusty 00:08:43Yep. So you talked about chairside, so that's kind of the front office. The back office is going to be the chairside people who is in the.
Dr. Mike 00:08:49Chairside besides the dentist, so not the.
Dr. Rusty 00:08:52Nurse, unless unless, again, there are some dental offices that may utilize a nurse if you're doing sedation. I would say that's most common.
Dr. Mike 00:09:01I've even seen, like, botox, things like that.
Dr. Rusty 00:09:03Yep. Yep. So nurse anesthetists, nurse injectors, phlebotomists, maybe two if you're doing, like, blood draws for. Get your lobotomy, frontal lobotomy, phlebotomy. Yeah.
Dr. Mike 00:09:17No, we have dental hygienist. Dental assistant is typically dentist, dentist, dental hygienist, and dental assistant is. Who's in the back? There's one more sterile tech, which is.
Dr. Rusty 00:09:29Yeah, kind of like a dental assistant has that. That role, too.
Dr. Mike 00:09:32So typically four roles in the back. Right?
Dr. Rusty 00:09:34Would you say the dentist, the hygienist, the assistant, and I guess, like sterile. Yeah.
Dr. Mike 00:09:40Okay.
Dr. Rusty 00:09:40Which is assistants are also.
Dr. Mike 00:09:42So let's talk about the dental nurse. I mean, dental assistant.
Dr. Rusty 00:09:45Dental assistant. Yeah. So there's. There's various levels of assistance, too, on training and different, you know, abilities they perform. Perform a whole wide range of tasks in the back office. Everything from assisting and helping us. Chairside. You know, they're the person. They're sucking your spit, doing the suction, handing us instruments, doing all of the things right there. Chairside. Helping keep, you know, a dry field when replacing fillings are so important in helping keep the patient safe and help keeping it a lot easier for me for us to be more efficient while we're working. Chairside.
Dr. Mike 00:10:14And they also deal with a lot of, like, compliance. So, like, they know what state regulations are. They help maintain cleanliness. They do all of these things. And they also are. They take tests to be able to do dental assisting.
Dr. Rusty 00:10:25Right.
Dr. Mike 00:10:25So, like, they know dental materials. They know a lot of things. They also. Certifications. They go through.
Dr. Rusty 00:10:30Yep. And they have, like, OSHA training. You know, they're trained in BLS, life support, CPR, all those things. So really knowledgeable. Couldn't do it without them, for sure.
Dr. Mike 00:10:39No.
Dr. Rusty 00:10:39And they also, like you were saying, are important for the sterile procedures, too. So, you know, cleaning the rooms, cleaning the instruments, running them through sterilization autoclaves, setting rooms up, taking x rays. I mean, they perform a whole range of duties, for sure.
Dr. Mike 00:10:54Yeah. They keep everything nice and tidy, too. So they do a lot. They wear mini hats.
Dr. Rusty 00:10:59Yeah.
Dr. Mike 00:11:00So, I mean, it's important we have them, too, because did you see in the news there was, you know, we talked about these veneer techs, but there's also people that are doing, like, these vampire facials, and they're taking. They're taking your blood, then they're doing these facials with your blood to do all these whatever health benefits, but they're doing it without the proper sterilization techniques. And people are getting hiv from these offices. We're just getting a regular. So it's important that you have regulatory bodies in place, but it's also important that your staff are trained.
Dr. Rusty 00:11:29Yeah. And they're trained to have kind of universal protocols, universal precautions, where no matter what the medical history of the patient is, you know, we're using the same precautions to treat you as if you may have something that you don't know about or you're not telling us about.
Dr. Mike 00:11:43Right.
Dr. Rusty 00:11:43Yeah.
Dr. Mike 00:11:44Everyone's treated the same.
Dr. Rusty 00:11:45Everyone's treated the same. Regardless of your medical conditions, medical history. We're still cleaning all the instruments, all the rooms, doing our procedures with our PPE, our personal protective equipment, gloves, masks, glasses, things like that. That's all the same. And the assistants are really knowledgeable and all that stuff, for sure.
Dr. Mike 00:12:03Yeah. So in conjunction with an assistant, we also have a dental hygienist.
Dr. Rusty 00:12:07Correct.
Dr. Mike 00:12:08Which people confuse with the dental assistant a lot. So talk a little bit about that.
Dr. Rusty 00:12:12Yeah. So the hygienist is another role in the office. They're the person who's typically going to be cleaning your teeth. And so that's when you, you know, you go for your regular six month thing. That's what most people go to the office for, six month visits. And you're going to be seeing the hygienist typically, you know, at our office, our routine patients that have been there, they're going to see the hygienist first that day. They're going to take them back. The hygienist again goes to school, and they're fully able to take x rays. They also do a lot of the roles. The assistants do things from sterile procedures, x rays, all that sort of stuff, too. But they're also capable of doing, you know, the cleanings, giving injections, doing a bunch of stuff as well.
Dr. Mike 00:12:50They wear a lot of hats. I mean, they, and there's some dental hygienists that even place fillings so they can go into further schooling. And a dental hygienist usually has a bachelor's degree. So they don't just clean teeth like, they're also involved in your oral health in terms of, like, nutrition counseling, like to do a lot of things, which is great. They can interpret x rays. They went, they were actually in radiology with us. They, by law can't diagnose off of an x ray, but they know how to read x rays, so, I mean, yeah, dental hygienists do a lot.
Dr. Rusty 00:13:18Yeah. They also are going to be the ones doing the most thorough examination of your gums. You know, doing that gum measurements and getting that gum health going through different, you know, regular cleanings, deep cleanings where you need to be numb. They're capable of doing all that stuff. And, um, to be honest, there's been a couple times when there's been, you know, a piece of something stubborn stuck on a tooth or calculus or something, and I couldn't quite get. And I'll ask one of the hygienists with a little more experience to, hey, come grab this. And they'll. They'll be able to get it out a lot of times. So they're. They're super knowledgeable. Super.
Dr. Mike 00:13:47Yeah. They're buddies.
Dr. Rusty 00:13:49Yeah.
Dr. Mike 00:13:50Yeah. And I mean, we co diagnosed with hygienist, which is great.
Dr. Rusty 00:13:53Like you said, you can't, they can't legally, in most states or any state, I think, like, truly diagnosed, that has to be the dentist, just per state law, who's actually diagnosing and treatment planning. But the hygienist is in there and knows how to look at x rays, knows how to look at things clinically. They're super informed, and it's super important for them to, you know, start to educate the patient on what they might be seeing and what, you know, potential treatment options might be. And they make my life a lot easier, too, when they've kind of already kind of talked to the patient about these things and started that education process because at least the hygienist at my office, and I think most of them are super passionate about educating.
Dr. Mike 00:14:30Yeah. And they're in your mouth for 60 minutes.
Dr. Rusty 00:14:32Right.
Dr. Mike 00:14:33Sometimes I only get ten. So, I mean, they're in there for a long time.
Dr. Rusty 00:14:36Right?
Dr. Mike 00:14:36Yeah.
Dr. Rusty 00:14:37Right.
Dr. Mike 00:14:37So, I mean, they see a lot of things.
Dr. Rusty 00:14:39They do, yeah. And it's awesome to have all these team members, everyone from the front office, the dental assistants, the dental hygienists, you know, a really good dental office is going to have a really cohesive feel to it where everyone's on the same page and, you know, everyone is, is kind of going through the same thing and has the same standards, whether it's sterilization, you know, friendliness when they're chair side or welcoming you back from the front office to the back office, reintroducing you back to checkout at the end. You know, there's a whole kind of system of things that can be in place to make it a smooth transition for the patients in the office. And, you know, our support team is so important for all of those things.
Dr. Mike 00:15:17Absolutely. Yeah. We couldn't do what we do without any of these people, so.
Dr. Rusty 00:15:21Right.
Dr. Mike 00:15:21Yeah.
Dr. Rusty 00:15:23And I think that's what makes you not only successful as a dentist, but also a successful dental office where your patients can have the best experience, because, you know, they're going to be seeing, you know, the hygienist, the assistant in the front office, speaking and talking with them when they're getting scheduled, when they're showing up at the office, when they're checking in, filling out paperwork, when you're being brought back, they're going to be the ones taking your x rays. They're going to be doing a lot of discussion and signing consent forms and a bunch of stuff with you before you meet either Mike or I. Yeah.
Dr. Mike 00:15:52A lot of your time is spent with the other team members.
Dr. Rusty 00:15:54Right.
Dr. Mike 00:15:54So, yeah, I think that kind of brings a good point. That's kind of how, you know, you know, a lot of people like their dental office because they're hygienist, but, you know, you're in a good office when the team seems cohesive, and I think that's a good thing to kind of pick up on. The more you go, the more you see. And then if the team is cohesive, it seems like a happy work environment, then I'd say you're in a pretty good place because we all go to school. I mean, there's good and bad dentists out there. But, like, the majority of your time spent at the dental office traditionally is not with a dentist. You want to make sure you have a good team in place. So.
Dr. Rusty 00:16:23Well, it's like the running joke, you know, I've heard it like it should be called going to the dental hygienist featuring the dentist. Yeah.
Dr. Mike 00:16:29Correct.
Dr. Rusty 00:16:30If you have a good, healthy mouth, you know, we're only in there for five or ten minutes to talk to you, say, hey, take a look around, look at the x rays over and make sure nothing is going on, see if there's any questions you have to address. And, you know, ideally that's what you want. You want us to just be in there for five or ten minutes? Because if I'm having a more lengthy discussion with you, typically that means that there's going to be more treatment needed, and we're going through options for treatment and answering more in depth questions and which, you know, that we obviously spend the time to do that a lot, too. That's our job. But if it's just a quick visit from us, that's kind of your goal. So you're seeing all these, these other people in the office. Definitely is great.
Dr. Mike 00:17:06Yeah, just the hygienist is great. And I'll come say hello, featuring Mike. But, yeah, I think that people are often like, you know, I don't want to get x rays. I don't want to do an exam this time. I never have cavities. And it's like, you don't have cavities because of the team effort that's put into place. So it's important we talk about the team, but, like you, your home care is great. Your hygienist sees you every six months. We talk about things, we direct things. That's, that's what makes a good oral health, normal routine. So I think it's important, you know, the team makes it up.
Dr. Rusty 00:17:35Yep. A quick, easy exam where things have already been looked over by the hygienist, by the assistant. We've chatted about it. We do a quick, quick exam. You know, a lot of times I say, hey, nothing's going on. Pretty boring. But this is a good place to be. Boring at the dentist, boring exam. So nothing going on. Hey, no new news, nothing changing. I love it. Everything's stable. That's my goal in all my patients, that we're seeing them coming back and being healthy, and the team plays such a vital role in seeing that. And, you know, like, one of my hygienists at my office recently saw a little spot on the roof of the mouth of a patient. It was just kind of a little red, swollen area. The patient hadn't felt it or known anything, just kind of felt it. It was a hard kind of lump on the roof of the mouth. Sent it to a surgeon to have it looked at deeper and came back as a cancer, actually. And so, you know, these, that was a dental hygienist. But a lot of the team members are trained, and we'll see a lot of stuff. A lot of times, like you said, they're in there for an hour or more looking around, doing, you know, their cleaning or whatever, and so they're going to see stuff. And, you know, it's, it's all a team effort. And the more people that you have looking, the more things you're going to see. Fair. Two sets of eyes is always going to be better than one. Three is better than two. And so there may be a lot of people taking x rays or taking impressions, looking in your mouth doing different stuff depending on what you're you're needing. But the more. More people that look around, the better.
Dr. Mike 00:18:57Agreed. So team is everything. And, yeah, that makes up the dental team.
Dr. Rusty 00:19:02So thank you to our teams. Yeah, I know some of our staff listens to the podcast, so thanks. Thanks to the team at both of our offices. We couldn't do without you. So appreciate all of you. Really, really appreciate you all.
Dr. Mike 00:19:14Don't cry, Rusty.
Dr. Rusty 00:19:15I might.
Dr. Mike 00:19:16We couldn't do what we do without you guys, so thank you so much.
Dr. Rusty 00:19:18The other reason I might cry is this podcast is over this episode, so I'm going to cry because we're done.
Dr. Mike 00:19:24Cry off, Cam, please.
Dr. Rusty 00:19:25Okay. Goodbye.
Dr. Mike 00:19:26All right, everybody, see you next week. Thank you. Bye bye.
Ashley 00:19:30Thank you for listening to today's episode of DM a dentist, brought to you by dose of Dental. And thank you for your interest in improving your oral health. If you'd like your questions answered by doctor Rusty and doctor Mike, visit [email protected] or dm us on Instagram at your daily dose of dental.

20 min
May 29, 2024 #5 Here's The Kicker - Football, Our First Interview, And Women In Dentistry
Women did not earn the right to vote until 1920. Let that sink in and listen to Dr. Rusty and Dr. Mike discuss a recent speech given by Harrison Butker AND interview their first podcast guest!!!! Dr. Liu talks about her experiences being a woman in a male-dominated field and a little bit about her educational background. So, if you like football, but also care about women's rights, this episode is for you.
As always, feel free to reach out through our instagram @YourDailyDoseOfDental or through our website http://www.DoseOfDental.com. We would love to hear from you and hope your questions can be featured on our show!
Instagram: https://www.instagram.com/yourdailydoseofdental/
Website: https://doseofdental.com/
TikTok: https://www.tiktok.com/@dmadentist
Ashley 00:00:02Welcome to DM a dentist, your friendly neighborhood podcast, where Doctor Rusty and Doctor Mike are here to make dental care approachable for everyone because everyone deserves a healthy smile without the fear.
Dr. Mike 00:00:24Well, well, welcome back.
Dr. Rusty 00:00:26Welcome to another episode of DM a dentist.
Dr. Mike 00:00:28I'm Mike. I'm Rusty, and we're here to chit chat about teeth.
Dr. Rusty 00:00:32We are sorta, sorta. Today is definitely about teeth. It's always about teeth. But on today's segment of what? The filling.
Dr. Mike 00:00:43Oh, we almost slipped up there.
Dr. Rusty 00:00:44I really wanted to say the other one today because today's is, you know, a little weird.
Dr. Mike 00:00:50Yeah, we had a. To say the least, there was a recent commencement speech that we had.
Dr. Rusty 00:00:55Yeah. So I'm sure if you've seen it, if you've watched social media at all, this guy's been getting ripped apart. Harrison. But Kerr, he's the Kansas City chiefs kicker, if you don't know. Regardless, who cares what he does, really? But he gave a commencement speech at, like, a catholic school. Right. And, you know, he's basically getting ripped apart on social media, I think, for good reason, based upon what he said.
Dr. Mike 00:01:21Yeah, let's read in that.
Dr. Rusty 00:01:23Yeah. Just for any of you who haven't heard, Mike, please, please read. Please read what he said.
Dr. Mike 00:01:27This is a direct quote, I think it is. You, the women who have had the most diabolical lies told to you. How many of you are sitting here now about to cross this stage and thinking about all the promotions and titles you're going to get in your career? Some of you may go on to lead successful careers in the world, but I would venture to guess that the majority of you are most excited about your marriage and the children you will bring into this world. Now, for context, this was said at a commencement speech.
Dr. Rusty 00:01:58A commencement speech.
Dr. Mike 00:01:59So women and men are graduating because they chose to pursue education in a career. So it's just. It's odd content.
Dr. Rusty 00:02:09I hate it.
Dr. Mike 00:02:09I hate it.
Dr. Rusty 00:02:10The most diabolical lie at their graduation is that they can get promotions and titles in their career. I mean, that's what they've just spent years working for.
Dr. Mike 00:02:18Right? And we're saying that basically being a mother and having children, basically we're going back to gender roles, is what it feels like, whether he meant it or not. That's just not it. That's not.
Dr. Rusty 00:02:28It seems like you meant it. But anyways, as we said, it's not directly tooth related, but we felt it really important to talk about and highlight. Women in dentistry are becoming more and more common, thankfully. But dentistry has been predominantly a male dominated field for majority of history. Right, Mike?
Dr. Mike 00:02:46Yeah, it has. I mean, even so, looking at this, this lady named Lucy Hobbs Taylor was the first woman to get a dental degree in the US in what year, Rusty?
Dr. Rusty 00:02:571866.
Dr. Mike 00:02:59So, like, it feels like a long time ago, but it's not if you think about generations. 1866. Like, my grandmother, great grandmother, were born in the early nineties. Like, we're not that far removed.
Dr. Rusty 00:03:09Right, right.
Dr. Mike 00:03:10So, yeah. And then there's a couple more we want to highlight.
Dr. Rusty 00:03:12Yeah. Sarah Kraut was the first us navy dentist.
Dr. Mike 00:03:16What year was that?
Dr. Rusty 00:03:171944.
Dr. Mike 00:03:19So that is relatively recent. I mean, some of our parents were born.
Dr. Rusty 00:03:22Yeah, World War two.
Dr. Mike 00:03:24Yeah, that's not that long ago for sure. And then this is even a bit more alarming.
Dr. Rusty 00:03:29So we both practice in Oregon, so we wanted to talk about something specific to Oregon. So the first female oral surgeon in the state of Oregon, Mike, when was that?
Dr. Mike 00:03:39In the 1990s. Yeah, 1990s.
Dr. Rusty 00:03:42What was her name?
Dr. Mike 00:03:44Stacy Geisler, I believe.
Dr. Rusty 00:03:46I hope that's how you say it, Doctor Stacy.
Dr. Mike 00:03:47And when she became an omfs, 1% of omfs. So oral maxillofacial surgeons were women, 1% in the nineties. Today, still under 10%. 7% of oral maxillofacial surgeons are women.
Dr. Rusty 00:04:05And these are all, like, statistics that we pulled just from the ADA website based on, like, you know, reporting statistics of dentists throughout the country. Um, some other things that we found. In 2023, the percentage of female dentists in the US, across the whole us, not just Oregon, was 37.7%.
Dr. Mike 00:04:26Yeah.
Dr. Rusty 00:04:26So getting better, especially compared to what it was, you know, just a couple decades ago, even. Mike, what was it in 2001?
Dr. Mike 00:04:322001, it was 16.1%. So we've doubled.
Dr. Rusty 00:04:36Yeah.
Dr. Mike 00:04:36But we're still. We've got a long way to come. Although, good news. My graduating class, we had a little bit over 50% were women.
Dr. Rusty 00:04:44Yeah.
Dr. Mike 00:04:45Which is great.
Dr. Rusty 00:04:45Yeah. I think mine was right at. Or maybe slightly over two. I can't remember exactly, because when you.
Dr. Mike 00:04:49Look back, so when you, like, go to dental school or whatnot, you look in the hallways, there's photographs of all the graduating classes. When you look at the beginning, the majority of the time it's men, mostly white men. But it's just men. Men. And finally, we're coming to this turn. So it feels like this speech just didn't hit. I mean, that is not it.
Dr. Rusty 00:05:10No.
Dr. Mike 00:05:10Nope.
Dr. Rusty 00:05:12And regardless of what intentions he had, even if you're someone who agrees with what he says and you're trying to defend him, it's not the right time to replace for that as they're getting their degree. And they literally have just spent years. I mean, we both went to years of school. We know what it's like from at least that perspective, just studying alone, not being a woman, obviously. But you know, what a ridiculous thing.
Dr. Mike 00:05:37For him to say devalues the work.
Dr. Rusty 00:05:39Yeah.
Dr. Mike 00:05:40No, there are people that want to be mothers, and that's okay. And if that's something you value, I support that. But if you're gonna. This speech was performed at an event where women are graduating to become something other than a mother. Maybe they still want to be a mother, but at this moment in time, they are being rewarded for this degree they've earned. Like, yeah, it bothers me a lot.
Dr. Rusty 00:06:04Yeah. Let alone what he said. The timing alone was also terrible.
Dr. Mike 00:06:08So, basically, for context, rusty and I were walking around this conference with three other women who are our co residents, who are also dentists. Right. So we're walking from vendor to vendor.
Dr. Rusty 00:06:18Yep. So we're walking around vendor to vendor, you know, introducing ourselves to the sales rep, doing all the things, and, you know, as the female dentists, the co residents that are females, we're introducing to themselves. They were asked by multiple male vendors, oh, are you an assistant or a hygienist?
Dr. Mike 00:06:38And that was the question. It wasn't. And what's mind blowing is we all had name tags, and it said dentist.
Dr. Rusty 00:06:46On the name tag and doctor so and so. Like, literally their name. Yeah.
Dr. Mike 00:06:50So you're like. No one approached me and asked me what I was. No, they just assumed. They assumed that the women we were with worked for. For us, which is. It's crazy that this is still happening.
Dr. Rusty 00:07:03So even though things are getting better in dentistry, specifically, with a more even ratio, it's still a male dominated field, and it's still a bias and a stigma against females in dentistry that some people have. And this guy, in his speech, is just biased against women in general, I feel.
Dr. Mike 00:07:20Yeah, it feels very biased, and it feels awful, in my opinion. And I don't wanna go any further because.
Dr. Rusty 00:07:27Exactly. And after all, we're just two guys, and we felt it really important to let you all hear from someone who has a much better perspective on this issue. And one of our close friends agreed to be on the podcast as our first guest. We're super excited.
Dr. Mike 00:07:43Yeah. And she's great and funny. She went to Washington University in St. Louis, which is in the same state as what's his face.
Dr. Rusty 00:07:52Yeah. Missouri.
Dr. Mike 00:07:53The man who shall not be named yeah, she majored in biochemistry, which is awesome. And she had a minor in american culture studies.
Dr. Rusty 00:08:00Yep, yep. So that was her undergrad, and then she did dental school at OHSU here in Portland, Oregon. So Oregon Health Sciences University, graduated in 2021, and then she did residency with us at the Portland, Va. Her name is Doctor Victoria Liu, and she loves Meg thee. Stallion relevancy.
Dr. Mike 00:08:20But, yeah, we're excited to have her on the show. So, yeah, she'll be our first interview, so welcome, Doctor Victoria Liu.
Dr. Rusty 00:08:27All right. Doctor Victoria Liu, welcome to the show. We're so happy to have you. Hello.
Dr. Liu 00:08:32I'm excited to be here. Friend of the pod.
Dr. Rusty 00:08:35Thanks again for being here. Really appreciate you. I know Mike is out of town this weekend, but I can definitely speak for him on this one. Him and I are both honored to have you here as our first guest on the show.
Dr. Liu 00:08:45I know. I'm excited, really.
Dr. Rusty 00:08:46Thanks. Thanks for being here. Appreciate you.
Dr. Liu 00:08:48Yeah, of course.
Dr. Rusty 00:08:49So, you know, we gave you a little brief intro. So, as you know, Victoria went to dental school. So why did you want to be a dentist or what inspired you to become a dentist, Victoria?
Dr. Liu 00:08:59So I went to undergrad thinking that I was going to go to medical school, and while I was there, my sister was actually in dental school. So I told her a lot about my struggles with the pros and cons of medical school, and as she kept telling me more and more about dentistry, I found it more appealing. So then I decided to just go for it. I didn't take a gap year. I just graduated and went straight into dental school at OHSU.
Dr. Rusty 00:09:28Perfect. Yeah, that's exactly what I did. I went to undergrad. No gap year. Just went through. It's nice to kind of get done sooner rather than later, especially with the many years it takes to become a dentist and all the hard work and dedication. It's good to get young. Done as young as you can.
Dr. Liu 00:09:41Definitely.
Dr. Rusty 00:09:42That's what I did, too, so it's nice. Why did you choose to go to undergrad in St. Louis?
Dr. Liu 00:09:47So originally, I grew up in the Bay area, California, and I had grown up in the same town my whole life, and I was just sort of itching to get out. And Washoe was a really good midsize school. It was smaller than, you know, University of California, big state school. So I felt like it was a really good opportunity for me to, you know, move away from home, explore myself, and then also most of the people who were there were also from out of state. So I felt like I got to meet a wide range of people from, you know, all different parts of the US. So it was really great school.
Dr. Rusty 00:10:27Nice. Nice. It's fun. I know it's a fun thing. I mean, I moved across the country for dental school, and it's fun to, like, live in a different part of the country. I mean, it's still all the US, but it's still fun to explore, like, a little bit of a different culture or a different group of people, kind of, and just like, a little bit of, I don't know, different, you know, southern culture or different groups and different part of the country, different scenery, things like that. Like, it's so fun. And the Midwest, like, kind of St. Louis and stuff, is pretty central to a lot of stuff. Did you go check out any of the, like, surrounding area while you were there? Much.
Dr. Liu 00:10:53Mostly. Quite a few trips to Chicago, but also drove to Iowa City, which I never would have gone to, honestly, otherwise. Iowa City never made it out to Kansas City, but I also made it out to Nashville. So it was just like a cool road tripping experience. And, you know, getting to honestly think about life outside of, like, California and Texas.
Dr. Rusty 00:11:20It's very isolating to be from California, for sure. For sure. And then you moved to Oregon for dental school.
Dr. Liu 00:11:26Yes. Yeah. So I chose Ohsu because I wanted to be closer to my family a little bit, at least be in the same time zone, the West coast.
Dr. Rusty 00:11:37Right?
Dr. Liu 00:11:37Yeah. But honestly, I feel like Portland's a great sized city and very walkable, so I'm glad I decided to come out here.
Dr. Rusty 00:11:46Nice. Yeah, Portland is beautiful.
Dr. Liu 00:11:48Clearly, I'm still here, so I'm having a good time.
Dr. Rusty 00:11:50Couple years after residency, definitely. Was your class, like, pretty, because I know Mike and I's classes were pretty close to 50 50, like, male female split. What was your class?
Dr. Liu 00:11:59It was very similar. Yeah, 50 50, I would say, at that point.
Dr. Rusty 00:12:03Nice. Yeah. And we talked earlier about a lot of stats Mike and I did about different. Just the increase of women in dentistry, which has been a huge upward trend, which is awesome. And I think it's becoming more and more popular in predominantly, what has been a male dominated field, is definitely becoming more and more of an even split, which is cool. So what's your take on that? That.
Dr. Liu 00:12:25Well, I think, you know, for a lot of reasons, it's great. I think women are just being, you know, are more prominent in all kinds of, you know, arenas, like, you know, sports, with the WNBA and March madness being popular this year. You know, I know more and more of my own female friends from Wash U. Who are now in medical school specializing in, you know, surgery, anesthesiology. So I think women are just, you know, it's less common for there to only be, you know, male dominated industries, but also specifically for general dentistry, because I'm a general dentist, I would say, you know, for the same reasons dentistry could be appealing to anybody. I think it's especially appealing for women who are wanting, you know, to find a little bit of that work life balance if they're planning on having a family. You can be as involved, you know, dentistry can be, you know, as involved as, as you want to be. You can still own while having children. You know, if you manage your time really well, you can choose to work one to two days a week. You know, I think that there's a lot of freedom in that and how you want your career to go. And I think, you know, the longer you spend in the industry, the more you find, you know, you thought that maybe doing XYZ things weren't possible, you know, wanting to balance other stuff, like as a woman, you know, out in your career. But I think the longer that I've been out of dentistry and meeting women who are in the field, I've realized that there's a lot of different paths that you can take, and they're all very much possible.
Dr. Rusty 00:14:08True. Yeah, that's. That's great. That's a great point. And, you know, there are definitely some badass women in dentistry and healthcare, medicine, and really every field now, which is awesome to see. And, I mean, it's just so cool to see. I mean, there's awesome clinical dentist owner Dennis, like you said, leadership and different, you know, academies and groups and, you know, like the group associations, like the Oda, Ada, there's a lot of female leadership, which is really awesome to see as well. So, you know, it's cool. And, you know, I know firsthand you're an awesome dentist. You know, I worked with you, worked with you during residency at the VA, and she's amazing. I think you're a great dentist, too. Thank you. Thank you. But, you know, I know that you firsthand are awesome, but has there been anything that's been particularly hard for you to overcome on kind of your path to dentistry or any particular obstacles or challenge that you feel like you faced?
Dr. Liu 00:15:01Yeah, I mean, I feel like as somebody with my background, the way that I was raised, you know, it was just me and my older sister and my family very much emphasized the importance of education for us. And, you know, pursuing education, higher education, was something that was in my life only encouraged. And it was never something where I was even told that I might have to choose one day. I think that as I meet more and more females in the field and find older women who've been practicing for a while and, you know, they are serving as my mentors, it, you know, is, it's really easy to see that there are small obstacles, but anything that you want to do, it's very much possible. But I would say that, you know, all of this has been a recent, somewhat recent change. And, you know, everything change always, you know, takes time. I've noticed that the faculty at our dental school tend to be older dentists who they have, you know, practiced for decades. They've sold their practice, and they just come to volunteer at the dental school almost for fun. And there were a lot of comments about, you know, my female classmates, just like, small jokes, just like, oh, like, you know, my friend is asking this clinical faculty a lot of questions, and then the faculty looks at somebody else and they're like, oh, well, you know, she's slow, and she just needs a little bit of, like, help, you know, how women are, things like that.
Dr. Rusty 00:16:46Right? Make some offhanded comments.
Dr. Liu 00:16:48Yeah. So there's definitely, like, the offhand comment. There's definitely, like the whole, I would say, if anything, there's more of an expectation almost that you will dial down your career if you have. Decide to have children or if there is an expectation to have children. And, you know, I think a lot of women, not just in dentistry, but just in general in our generation, are kind of, like, constantly battling with that idea, like, oh, do I need to, you know, how much of having a family is, you know, related to my identity as a woman. So I feel like there are obstacles. There have definitely been times where, you know, patients will make comments about female providers. There's definitely times when networking, talking to somebody, there's an assumption that you're running this yourself. So who else is helping you with all of this? It's, I think, kind of doubting you.
Dr. Rusty 00:17:52A little bit in some ways.
Dr. Liu 00:17:54And I think for men, there's never a thought about, oh, I don't think people ask you, like, do you plan to have a family? And there's concern about your wanting to have a family with your career where that is something that women are faced with all the time, for sure.
Dr. Rusty 00:18:14Definitely different.
Dr. Liu 00:18:15So I would say, yes, there are obstacles. I think it's still very much possible to combat the obstacles and face them. But a lot of it is very subtle things that you notice and pay attention to constantly. But it very much, it's not in your face or it's very different. Maybe me being in dental school now compared to somebody who, one of these females who was the first female in the dental class for the first time.
Dr. Rusty 00:18:45Right, right. I mean, it definitely has came a long way, which is awesome to see, but there are definitely, I feel like particularly people of older generations that have some more biases and things on that because things were different and times were different, the world is changing, and it's awesome to see this positive shift. And, you know, I think that's why I think, you know, Harrison Butker, the chief's kicker's comments come off as so drastic and weird because he's so young. I think part of it, too. And so for someone to say that, especially, you know, at a graduation, a commencement ceremony, where, you know, the biggest lies you as a woman have been told is that you can have promotions and titles and things in your career, which it's just weird thing to say. So what are your thoughts on his comments and, you know, some of his speech of what he said?
Dr. Liu 00:19:32Yeah, I mean, I thought that overall, the quote was pretty reductive. It kind of seemed like, you know, the way that, you know, he was talking, it was almost like there was no way to win. Like, let's say you did decide, you know, you, you are graduating, you're excited to work, and you do end up meeting somebody and, you know, having a family and possibly not working anymore, then, you know, then whatever he said that all of that is very positive, you know, and that's still a good way to have a well rounded life if that's what you want out of your life. But the way that he was talking just made that seem like, well, that's what I expect you to do. And in that way, you know, you having a successful family, that's not, you know, a win for me at all. And if you decide to have a career, you know, you will, you know, be passed up for promotions or you will earn less than men. And, you know, all of this is true. I mean, these are all things that women are very much aware of.
Dr. Rusty 00:20:34Right, right.
Dr. Liu 00:20:36So it was just a really odd comment to point out that, you know, there are, you know, more and more people in America overall are pursuing higher education. And yes, you know, a large percentage of those people are, you know, women. So it was very strange for him to bring it up, I think, and also not celebrate any of that in a positive way. It just felt like from the way that he was talking, no matter what women decided to do, there was no way to really, like, succeed or, like, win in his eyes. And I think that that is something that, you know, women in general, again, face in terms of working career, deciding to have a family, it feels like, you know, trying to have it all. You're not really winning, not having a career and possibly being a stay at home mom, you're not winning or not having a family at all and focusing on your career. It just feels like there are a lot of expectations that are placed on us. And it is a constant feeling of just basically, like, what would I want out of my life, and how do I manage that against what I feel society wants of me?
Dr. Rusty 00:21:59Well, and I think that's the most important point, is what you want out of your life as an individual human being, as a woman, as a dentist, as whatever it is you're doing as a career. It's all about what you want. You know, it's not about what society's expectations are on you or what some random person at a college speech thinks or whatever. It really doesn't matter. At the end of the day, what's most important is what you do with your life and that you're happy and fulfilled and whether that's being a mom, whether that's being a dentist, whether that's owning a practice, whether that's whatever you're going to be capable of doing anything you set your mind to. And obviously, you know that. So, you know, I'm just awesome. It's awesome to know you, and I'm happy to be your friend. So, you know, well, it was an.
Dr. Liu 00:22:43Honor to be on the podcast. Happy to do it again anytime.
Dr. Rusty 00:22:46Right on. Well, thank you, Victoria. We love your insight, and we'll definitely have you back.
Dr. Liu 00:22:50Awesome. Great.
Dr. Rusty 00:22:51Thank you. Thanks for listening, y'all.
Dr. Liu 00:22:54Bye bye.
Ashley 00:22:57Thank you for listening to today's episode of DM a dentist, brought to you by dose of dental. And thank you for your interest in improving your oral health. If you'd like your questions answered by doctor Rusty and doctor Mike, visit [email protected] or dm us on Instagram at yourdailydoseofdental.
24 min

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