In this episode, Dr. Erin Elliott and Jason Tierney sit down with Dr. Madan Kandula to explore a part of airway care that too often gets overlooked: the nose.

Dr. Kandula is a board-certified ENT and the founder/CEO of ADVENT, an ENT practice built around treating airway concerns across what he calls the "breathing triangle." In just a few years, what started as a single location in Milwaukee has grown into 40 clinics across 6 states.

The conversation makes the case that nasal breathing is one of the foundations of successful sleep treatment. Dentists are often the first to notice nasal obstruction in their patients, but the field hasn't always given them a clear next step or a trusted ENT partner to hand it off to. Dr. Kandula explains how improving nasal function can help patients better tolerate and benefit from CPAP or oral appliance therapy, and how the right partnerships can close that gap.

This one is for anyone who has ever spotted an airway problem they weren't equipped to solve alone.

What's on the Menu

• Why nasal breathing is essential to airway health
• Understanding the breathing triangle
• Expanding access to nasal and oral appliance treatment
• Strengthening collaboration between dentists and ENTs
• Balancing clinical quality, growth, and mission

The Breathing Triangle
Dr. Kandula describes the breathing triangle as a simple framework for understanding the airway.

The two nostrils form the top points of the triangle, and the back of the throat forms the bottom point. Together, these areas represent the three passages through which a person can breathe.

Patients dealing with snoring, sleep apnea, nasal obstruction, or recurring sinus concerns may have problems in more than one part of this connected system. Treating the throat without evaluating the nose can leave an important part of the airway unaddressed.

The framework gives patients and providers a clearer way to see how the nose and throat work together.

Nasal Breathing as the Foundation

Dentists working in airway care already understand how much nasal breathing matters. What's often missing is a clear path for what to do once a concern is identified.

Without a trusted ENT who understands sleep, oral appliances, and collaborative care, a provider may have little choice but to note the obstruction and move forward with treatment. 

Dr. Kandula argues that nasal breathing can play a major role in maximizing the effectiveness and tolerability of both CPAP and oral appliance therapy. His goal with ADVENT has been to provide patients access to effective outpatient nasal and sinus treatments while partnering with dentists who provide OAT. 

Good breathing starts with nasal breathing.

Simple Solutions Before Bigger Surgery
One of ADVENT's central principles is to start with the simplest appropriate treatment.

Dr. Kandula explains that many nasal and sinus procedures can be performed in the office under local anesthesia. Depending on the patient, these may include turbinate reduction, treatment of the nasal swell body, or balloon sinuplasty.

The point isn't to claim every patient can avoid an operating room. It's to make sure patients have access to less invasive options before moving straight to more intensive surgery.

Dr. Kandula describes this as harvesting the low-hanging fruit first. Address the internal obstruction, evaluate the result, and move further up the treatment ladder only when necessary.

Nasal Collapse and Root Causes
The same principle applies when a patient experiences nasal sidewall or valve collapse.

External nasal dilators and similar products can provide relief in the right situation. But Dr. Kandula cautions against assuming the visible collapse is the only concern.

Internal narrowness may be increasing the effort required to breathe through the nose. Treating that internal obstruction first can reduce or eliminate the collapse without requiring additional treatment to the nasal valve.

When the valve still needs support, options may include radiofrequency treatment to stiffen the cartilage or a small dissolvable implant placed beneath the tissue.

The sequence matters: identify the root cause, begin with the simplest effective option, and escalate only when needed.

Oral Appliance Therapy and Access
Oral appliance therapy has an important place within ADVENT's breathing triangle approach.

Opening the nasal passages can improve breathing, but it doesn't automatically resolve the throat-related obstruction associated with sleep apnea. Patients may still need CPAP, an oral appliance, surgery, or another appropriate treatment.

As ADVENT expanded, partnering with local sleep-focused dentists became more complicated and difficult to scale. The availability and experience of potential partners varied from one market to the next.

That raised a bigger question: how can an organization consistently provide appropriate oral appliance therapy across dozens of locations without sacrificing quality?

Dr. Kandula doesn't claim to have the final answer. He describes it instead as an ongoing effort to expand access while continuing to work with capable clinicians, companies, and technologies.

The Direct-to-Consumer Debate
The conversation also takes on direct-to-consumer oral devices.

Dr. Kandula views these companies as attempts to solve a legitimate problem: many patients simply don't have access to oral appliance therapy. Their goal of expanding access has real value, even when providers disagree with how the service is currently delivered.

Jason adds an important distinction. The goal of delivering treatment at scale may be admirable, but some current models raise concerns about impressions, clinical oversight, fit, and the quality of care.

The challenge isn't choosing between access and quality. It's building a model capable of delivering both.

Collaboration Across ENT and Dentistry
Dr. Kandula believes sleep and breathing concerns give ENTs a real opportunity to make a difference in patients' lives. Yet many specialists stay focused on the narrower set of procedures they were trained on.

Dentists can find themselves in the same position, and for the same understandable reason.

A general dentist may be comfortable providing a familiar appliance, while sleep testing, airway evaluation, medical collaboration, and long-term follow-up sit outside the systems the practice was built around. That's a training and infrastructure gap, not a lack of ability.

Better airway care asks professionals on both sides to look beyond their own corner of the problem. Dentists need dependable partners for nasal and sinus concerns. ENTs need to recognize when a patient may benefit from oral appliance therapy or another sleep-focused intervention.

Patients do better when the providers responsible for the nose, throat, teeth, and sleep condition stop treating those areas as separate territories.

Retraining Mouth Breathing
Opening the nose doesn't automatically undo a long-standing mouth-breathing habit.

A patient may have relied on mouth breathing for years because nasal breathing was difficult or impossible. Once t...

In this episode, Dr. Elliott and Jason Tierney sit down with Dr. Mark Murphy to discuss the skill no one wants to talk about that goes ignored at your detriment: communication.

Dr. Murphy has spent more than 30 years in dental sleep medicine, from teaching alongside Dr. Keith Thornton at the Pankey Institute to practicing in Michigan, working in education, and helping launch a sleep program at the University of Detroit Mercy School of Dentistry.

The conversation centers on Dr. Murphy’s “learning ladder,” a framework for helping patients move from being unaware of a problem to understanding it, becoming interested in it, building trust, and eventually deciding what to do next.

Too often, dentists identify a concern and immediately jump to the solution. They explain testing, treatment, or devices before the patient fully understands why the issue matters. Dr. Murphy explains why better conversations begin with questions, listening, and helping patients discover the concern for themselves.

This episode also tackles the discomfort many dentists feel around selling. The hosts argue that presenting a meaningful health solution is not pressure or manipulation. When communication is rooted in care, the goal is not simply to close a case. It is to help someone make an informed decision that may improve their health.

What’s on the Menu

• Dr. Murphy’s career journey and lessons from dental sleep medicine
• Bridging the gap between clinical expertise, communication, and business leadership
• Building patient trust through education, questions, and the Learning Ladder
• Improving case acceptance through needs-based conversations
• Strengthening physician relationships and team performance

The Learning Ladder
Dr. Murphy describes a series of steps patients move through before they are ready to accept a recommendation:

• Unaware: The patient does not recognize the concern.
• Aware: The patient begins to understand that a problem may exist.
• Interested: The patient wants to know more about how it affects them.
• Trust: The patient believes the provider understands the issue and cares about their health.
• Commitment: The patient asks what they should do next or shows readiness to act.
• Solution: The provider recommends testing, treatment, or another appropriate step.

The mistake many dentists make is moving directly from awareness to the solution. The patient has not yet had time to understand the concern, become interested, or trust the recommendation.

Co-Discovery
Instead of overwhelming patients with information, Dr. Murphy encourages dentists to ask questions that help patients connect the dots themselves.

The provider and patient discover the problem together. This makes the conversation feel collaborative rather than like a lecture or sales presentation.

Ethical Selling
The group reframes selling as helping someone move toward a solution that may improve their health.

Dr. Murphy explains that he would not feel comfortable using sales skills to promote something harmful. But he can get excited about helping someone say yes to testing, better health, or a device that may support their airway.

As Dr. Elliott puts it, when you do the right things for the right reasons, the money follows.

Needs-Based Communication
The learning ladder also applies to physician relationships.

Rather than walking into a referral meeting and immediately explaining what the practice offers, Dr. Murphy recommends beginning with questions:

• What are you currently doing?
• What is working well?
• What do you wish worked better?
• Who is involved in the decision?
• Is there a solution we can provide that addresses that need?

This keeps the conversation focused on the physician, their patients, and their workflow rather than on the dentist’s desire for referrals.

Professional Organizations & Collaboration

The Pankey Institute
Dr. Murphy originally attended the Pankey Institute expecting advanced technical training. Instead, he found a broader focus on communication, personal philosophy, relationships, and building a balanced career.

The experience helped shape his belief that clinical excellence alone is not enough. Dentists also need to understand people.

University of Detroit Mercy School of Dentistry
Dr. Murphy helped establish a sleep program at his alma mater that included student education and clinical experience for orthodontic residents.

He also explains why sleep remains difficult to fit into dental school curricula. When a topic is not included on board examinations, schools have little accountability for it or space to teach it within an already crowded curriculum.

Physician and Team Collaboration
Better communication is just as important with referral partners and team members as it is with patients.

Physicians are more likely to collaborate when dentists begin by understanding their needs. Team members are more likely to grow when leaders provide clear expectations, useful feedback, and the freedom to make honest mistakes.

The Big Idea
Communication is not an optional soft skill. It is part of good patient care.

Dentists spend years learning science, clinical techniques, and how to work inside a small clinical space. Then they graduate and are expected to lead teams, build referral relationships, discuss money, earn trust, and help people make important health decisions.

Those skills do not appear automatically.

The answer is not to educate harder or talk longer. It is to understand where the other person is on the learning ladder.

Create awareness before presenting the answer.

Build interest before asking for action.

Earn trust before offering the solution.

Whether the conversation is with a patient, physician, or team member, the same principle applies: ask better questions, listen carefully, and help people take the next right step.

In this episode, the co-hosts take a step back and tell you who they are, how they got here, and why Sleep Matters.

Jason's path into dental sleep started nearly 20 years ago at a large dental lab. Early demand for snore devices sent him down a rabbit hole that never ended — device inventors, sleep labs, key opinion leaders, CE courses, software, publishing, and eventually Transform Dental Sleep, an annual meeting built around one core idea: practical education that actually works in the real world.

Erin's story is even better. From Orange County to Houghton College to Creighton Dental School to a practice in Post Falls, Idaho — she heard a sleep physician and Dr. Jamison Spencer speak at the Idaho State Dental meeting and it clicked. Even after a consultant told her "this doesn't work," she pushed forward. She figured out medical billing, built sleep into her practice from the ground up, and eventually started teaching other dentists how to do the same.

This episode sets the tone for everything the show is building: honest stories, real implementation, and a simple filter applied to every conversation — So what? Now what?

What's on the Menu

• Who they are and how they got here — Jason's path through dental labs, devices, and education; Erin's path through dental school and a practice in Idaho
• Why sleep matters — Drowsy driving, sleep deprivation, and why this field is bigger than most dentists realize
• Transform Dental Sleep — What it is, why Jason built it, and what makes it different
• Erin's lightbulb moment — The state dental meeting that changed her dental career
• Real-world implementation — Medical billing, home sleep testing, physician relationships, and making it work in an actual practice
• The "So what? Now what?" framework — The filter Jason and Erin apply to every guest and topic on the show
• Building a career worth having — Why dental sleep medicine can make dentistry more rewarding and more sustainable

Clinical Concepts & Terminology

• Dental Sleep Medicine — The area of care where dentists help identify and manage sleep-related breathing concerns through screening, education, devices, and collaboration with physicians. This is the world both hosts have built their careers around.
• Sleep Apnea — The central clinical issue that pulled both Erin and Jason deeper into the sleep world and the condition driving most of the work dentists can do in this space.
• Oral Sleep Appliances — Jason walks through early experience with devices like TAP and EMA and explains how these tools introduced many dentists to sleep-related care long before it became mainstream.
• Home Sleep Testing — Erin's practice invested early in a home sleep test unit. She explains how it became a key part of building a real sleep workflow rather than just referring patients out.
• Medical Billing — One of the biggest implementation hurdles in dental sleep, and one of the first things Erin figured out in her own practice and later built into her two-day course for other dentists.
• CE and Practical Education — Both hosts push hard for education that skips the theory and hands dentists something they can actually use on Monday morning.

Professional Organizations & Collaboration

• Transform Dental Sleep — Jason's annual meeting focused on bringing experienced, practical, and engaging voices in dental sleep medicine together for education that moves the needle.
• Post Falls Family Dental — Erin's practice in Idaho, where she proved the concept in a real clinical setting before ever teaching it to anyone else.
• Idaho State Dental Meeting — Where Erin first heard Jamison Spencer and a sleep physician speak, setting off a chain of events that reshaped her entire career.
• Dental Sleep Community — The educators, clinicians, vendors, physicians, and colleagues across the industry who have helped shape both hosts' paths — and who show up throughout the show.

The Big Idea

Sleep affects nearly everything. And dentists have a real shot at being part of the solution.

That's the premise behind Sleep Matters, and it's what this episode is really about. Jason came to dental sleep through labs, devices, and education. Erin came through clinical practice and figuring it out in real time. Different paths, same destination: this work matters, and most dentists are still leaving it on the table.

Sleep Matters isn't here for abstract ideas or academic conversations. It's here to give listeners the so what and the now what — every episode, every guest, every topic. Knowing something is interesting is fine. Knowing what to do with it is the whole point.

In this episode of Sleep Matters, Dr. Erin Elliott and Jason Tierney are joined by inventor Jim Marsh and sleep researcher Dr. Poppy May Gardiner to explore an unconventional but increasingly talked-about sleep technology: SleepVibe.

Jim Marsh, a mechanical engineer turned sleep device inventor, shares the touching personal story that led him to develop SleepVibe after a period of extreme sleep deprivation while caring for his wife. What began as experimentation with binaural beats and low-level magnetic fields evolved into a simple bedside device designed to support sleep without sound, wearables, or medication.

Dr. Poppy May Gardiner brings a research lens to the conversation, discussing how her team is currently conducting early-stage trials in shift workers using validated sleep surveys and research-grade actigraphy to better understand outcomes beyond anecdotal reports.

Throughout the discussion, the group explores binaural beats, brainwave entrainment, magnetic field stimulation, and how emerging sleep technologies compare with existing approaches such as white noise, vagus nerve stimulation devices, and clinical interventions like TMS (transcranial magnetic stimulation).

The conversation balances personal experience, early user feedback, and scientific caution, raising important questions about how sleep technologies should be evaluated, validated, and communicated to clinicians and patients alike.

What’s on the Menu:

• Origin Story: Severe caregiver sleep deprivation led Jim Marsh to develop SleepVibe, a prototype utilizing binaural beats and low-level magnetic fields.
• Binaural Beats: The group explains how presenting different frequencies to each ear creates a perceived third frequency, impacting sleep and mood.
• Magnetic Stimulation: Marsh transitioned from audio to silent, low-power magnetic fields, inspired by low-intensity transcranial magnetic stimulation (TMS).
• Research Status: Dr. Gardiner notes that while literature exists, her team is currently gathering controlled data from healthcare shift workers.
• Placebo Testing: Marsh’s informal A/B testing with blinded users showed improvements only with active devices, not placebos.
• Cognitive Impact: The discussion covers how sleep loss impairs memory, emotional regulation, and overall cognitive performance.
• High-Risk Populations: Dr. Gardiner focuses on ongoing clinical trials assessing sleep quality and daytime function in shift workers.

Professional Organizations & Collaboration:

• Washington State University – Dr. Poppy May Gardiner’s research affiliation
• SleepVibe – Developed by Jim Marsh as a consumer sleep technology based on binaural beats and low-level magnetic fields
• Ongoing clinical-style trials in shift-working healthcare populations using actigraphy and validated sleep questionnaires
• Collaboration between engineering, clinical dentistry, and sleep research to evaluate non-pharmacologic sleep interventions

The Big Idea:

Sleep is not just a passive biological process; it is deeply tied to cognition, emotional regulation, and overall health. While traditional sleep medicine focuses on airway, behavior, and pharmacology, a growing wave of consumer technologies seeks to influence sleep through neurophysiological pathways such as sound-frequency entrainment and low-level magnetic stimulation.

This episode highlights both the promise and the caution needed when evaluating emerging sleep tools. Personal experience and early user feedback can be compelling, but rigorous clinical validation is essential before drawing conclusions about efficacy.

Ultimately, the conversation underscores a broader shift in sleep health: from isolated treatments to an ecosystem approach that combines airway management, behavioral interventions, and emerging neurotechnology to pursue better, more restorative sleep.

In this episode, Dr. Anthony Bolamperti joins Dr. Erin Elliott and Jason Tierney to talk about how laser dentistry transformed his practice, why tethered oral tissues are often overlooked in sleep medicine, and how functional frenuloplasty can become a powerful tool for treating airway patients.

After years of trying different laser systems and struggling to find the right technology, Dr. Bolamperti built a niche practice in Omaha, Nebraska, centered on airway health and treatment of tethered oral tissues via laser dentistry for both children and adults. The conversation explores how laser dentistry evolved from restorative procedures into a full-body, airway-centered approach to patient care.

Dr. Bolamperti explains the difference between a superficial tongue-tie release and a true functional frenuloplasty, why myofunctional therapy is essential for long-term success, and how dentists can begin to recognize airway signs they may have previously missed during routine exams.
This episode is especially valuable for dentists interested in airway management, laser dentistry, sleep medicine, tethered oral tissues, or in building a more comprehensive and less invasive approach to patient care.

What’s on the Menu:

• How Laser Dentistry Changed His Practice: Dr. Bolamperti shares how years of trial and error with different laser systems eventually led him to build Omaha Laser Dentistry into a thriving airway-focused practice.
• Why the Right Technology Matters: The conversation explores how different laser wavelengths interact with tissue differently, and why understanding the science behind the technology is critical before investing.
• From Drill, Fill, and Bill to Airway-Focused Dentistry: Dr. Bolamperti reflects on moving beyond traditional restorative dentistry into a practice centered around sleep, breathing, and functional health.
• The Difference Between a Frenectomy and Functional Frenuloplasty: He explains why many tongue-tie procedures fail because they remain superficial and do not address deeper fascial restrictions.
• Why Myofunctional Therapy Is Essential: Dr. Bolamperti discusses how myofunctional therapists help retrain tongue posture, breathing patterns, and muscle function before and after treatment.
• How Tethered Tissue Impacts Sleep & Airway: The episode dives into how low tongue posture, mouth breathing, and restricted tongue mobility can contribute to airway obstruction and poor sleep quality.
• Educating Patients on Why They Have Sleep Apnea: Rather than simply prescribing a CPAP or oral appliance, Dr. Bolamperti focuses on helping patients understand the anatomy and root causes behind their sleep-disordered breathing.
• Signs Dentists Should Look for During Exams: The hosts discuss common airway indicators, including scalloped tongues, excessive rugae, anterior wear patterns, tori, mouth breathing, dry mouth, and low tongue posture.
• Why Patients Are Seeking Laser Dentistry: Dr. Bolamperti shares how patients increasingly seek less invasive, less traumatic alternatives to traditional dental procedures, especially treatments that reduce the need for anesthesia and improve comfort.
• The Business Impact of Becoming “The Laser Dentist”: By creating a unique niche around laser dentistry and airway care, Dr. Bolamperti has attracted patients from across the region seeking specialized treatment.
• Hands-On Training for Dentists: Dr. Bolamperti discusses his small-group courses in Omaha, where dentists receive hands-on education in airway evaluation, anatomy, laser protocols, functional frenuloplasty, and patient communication.

Professional Organizations & Collaboration:

Omaha Laser Dentistry: Dr. Bolamperti discusses how his airway-focused laser practice evolved into a regional referral destination for restorative laser dentistry and tethered tissue treatment.

The Big Idea:

Sleep-disordered breathing is rarely just about snoring or a CPAP prescription. Dentists who understand airway anatomy, tongue posture, nasal breathing, tethered tissues, and functional therapy can uncover root causes that many patients have never had explained to them before.

Dr. Bolamperti’s approach is a reminder that modern dentistry is moving beyond simply fixing teeth. The future belongs to clinicians who educate patients, understand the connection between oral function and whole-body health, and build treatment systems that improve the way people breathe, sleep, and live.

In this episode, Dr. Craig Harder joins Dr. Erin Elliott and Jason Tierney to talk about the kind of career shift most dentists hope they never have to face, but every practice owner should be prepared for.

After nearly 30 years in private practice, Dr. Harder was diagnosed with Parkinson’s disease. The diagnosis changed his timeline, his relationship with clinical dentistry, and the way he thought about identity, ownership, retirement, and what comes next.

Our hosts explore what happens when dentistry is not just your job, but a major part of who you are. Dr. Harder shares what it felt like to sit in his car after receiving the diagnosis, how he moved from panic to planning, and how dental sleep medicine gave him a way to keep using his clinical mind when his hands could no longer carry the same load.

This episode is especially valuable for dentists who are nearing a transition, considering a shift in their schedule, dabbling in sleep medicine, or avoiding the hard planning conversations around disability, retirement, practice value, and life outside the operatory.

What’s on the Menu:

A Real Career Transition Story: Dr. Harder shares how he built a successful practice in Moses Lake, Washington, after purchasing it in 1996 and spending nearly 30 years in private practice.

The Diagnosis That Changed the Timeline: He walks through the early hand tremor, the essential tremor diagnosis, and the eventual Parkinson’s diagnosis that forced him to rethink how long he could continue practicing.

When Dentistry Becomes Your Identity: Dr. Harder talks honestly about what it feels like to lose the version of yourself that was known as “the dentist” in your community.

The Three Emotional Stages After Diagnosis: He describes moving from selfishness to panic over his family and team, to finally accepting the diagnosis.

Why Sleep Medicine Became the Bridge: As hand skills became less reliable, Dr. Harder began shifting toward dental sleep medicine, telemedicine, sleep study review, and patient education.

The Difference Between Dabbling and Going All In: Dr. Harder reflects on his earlier attempt to “half-ass” sleep medicine and why the field requires systems, commitment, and real ownership.

What Practice Owners Should Prepare Now: The episode highlights the importance of keeping a practice ready to sell, maintaining strong systems, updating equipment, training the team, and protecting the people who depend on the business.

Why Financial Safety Nets Matter: Dr. Harder discusses disability insurance, long-term care insurance, wills, investments, and the painful reality of realizing too late that some options are no longer available.

Living Before Retirement: One of the strongest themes in the episode is not waiting until 65 to take the trip, write the book, coach your kids, or make time for the things that bring you joy.

Professional Organizations & Collaboration:

Star Sleep & Wellness: Dr. Harder discusses joining Dr. Kent Smith’s team and moving into a structured dental sleep medicine environment.

The Big Idea:

Do not wait for a diagnosis, retirement, or crisis to start planning your next chapter.

Dr. Harder’s story is a reminder that dentistry can become deeply tied to identity, but life can change the timeline without asking permission. The dentists who protect themselves best are the ones who build strong systems, plan early, care for their health, and create a life that is not postponed until “someday.”

In this episode, Ryan Javanbakht joins Jason Tierney and Dr. Erin Elliott to break down one of the biggest issues in dental sleep medicine: patient follow-through on testing.

Most practices think they have a testing problem. They don’t; they have a communication problem.

Patients drop off because they don’t fully understand why it matters, what happens next, or what it will cost. Without that clarity, even motivated patients hesitate and disappear.

Sleep testing is the inflection point. It’s where patients either connect the dots and commit, or get confused and disappear. Clarity creates momentum. Confusion kills it.

What’s on the Menu:

Why Patients Drop Out of the Funnel
Ryan breaks down the real failure points: unclear communication, a lack of urgency around the problem, and poor expectation-setting regarding process and cost. When those pieces are missing, drop-off is inevitable.

The “Magical” Moment: Diagnosis
Dr. Elliott highlights the moment everything clicks, when patients see their results and connect the data to how they feel. That’s when urgency builds, motivation increases, and cost becomes less of a barrier.

Why Communication Beats Technology
Tools don’t drive case acceptance; conversations do. Patients move forward when they feel heard, understand the process, and know what to expect at each step.

The Two-Option Close That Works
Ryan shares a simple framework: give patients two clear paths, a traditional referral or an immediate home sleep test. Clear options reduce hesitation and increase follow-through.

Why Dental Patients Resist
Dental patients aren’t expecting a sleep conversation; they’re expecting a cleaning. That mismatch creates friction. The solution is to slow down, separate consults, and build trust before making recommendations.

How to Handle Objections Effectively
Ryan outlines a simple structure: empathize, clarify, isolate, respond. It keeps conversations human and builds trust instead of pressure.

The Power of “Selling the Next Step”
Dr. Elliott emphasizes a key shift: don’t sell treatment. Don’t even sell the test. Focus on the next step. That’s how momentum builds without overwhelming the patient.

Why Patients Need to “Want It”
The goal isn’t compliance, it’s ownership. When patients reach the point of “I want this” and “I need this,” moving forward becomes natural.

Clinical Concepts & Terminology

Home Sleep Test (HST)
A diagnostic tool that allows patients to test for sleep apnea at home, improving accessibility and completion rates.

Sleep Testing Funnel
The patient journey from awareness to treatment. Breakdowns at any stage reduce overall case acceptance.

Conversion Rate
The gap between patients referred for testing and those who actually complete it is a key measure of system effectiveness.

STOP-BANG Screening
A widely used screening tool to identify patients at risk for sleep apnea.

Professional Organizations & Collaboration

Third-Party Testing Partnerships
Services like SleepTest.com help streamline insurance verification, patient communication, test completion, and physician review—reducing friction across the process.

Featured Experts to Follow
Ryan C. Javanbakht: CEO of SleepTest.com, focused on improving access and conversion in sleep diagnostics

Recommended Tools & Resources

STOP-BANG Questionnaire
A simple way to begin identifying patients at risk for sleep apnea.

Home Sleep Testing (HST)
A patient-friendly diagnostic option that improves follow-through.

SleepTest CRM
A platform designed to manage patient communication, insurance verification, test coordination, and reporting.

Communication Frameworks
Empathize → Clarify → Isolate → Respond
Two-option close strategy
Consult-first workflow

In this episode, Jason Tierney and Dr. Erin Elliott talk with Dr. Johnny Ukich about the slow shift from focusing mainly on cavities and traditional pediatric care to recognizing the early signs of sleep-disordered breathing in kids.

What does it take for a busy pediatric dentist to start seeing airway differently?

For Dr. Ukich, that shift didn’t come from one lecture or a EUREKA! moment. It came through years of conversations, his father’s background in early orthodontic thinking, and eventually what he began noticing in his own child. Once the pieces connected, he started seeing open-mouth breathing, snoring, bedwetting, poor sleep quality, and arch development in a completely different light.

This is a grounded conversation for dentists who may not feel ready to treat every airway case, but do need to know what to look for. Dr. Ukich makes the case that awareness alone can change lives, especially when it leads to earlier questions, better screening, and stronger collaboration.

What’s on the Menu:

• A Real Conversion Story: Dr. Ukich shares how airway was not part of his early training and how it took years in practice before the dots finally connected.
• Why Personal Experience Changed Everything: Like many clinicians, the turning point came when he began seeing these patterns in his own child and could no longer dismiss them as isolated issues.
• What Early Treatment Started to Reveal: Once he began expanding earlier, he saw changes parents could notice quickly, including better nasal breathing, less bedwetting, and improved sleep.
• Screen Even If You Don’t Treat: One of the clearest takeaways is that pediatric dentists do not need every tool or every service in-house, but they do need to recognize the signs and start the conversation.
• How He Talks to Parents Without Sounding “Salesy”: Dr. Ukich focuses on sleep quality, growth, and what parents are actually seeing at home rather than jumping straight into treatment.
• Why This Has to Be a Team Approach: The episode highlights the need for collaboration with orthodontists, ENTs, lactation consultants, myofunctional therapists, and other providers.

The Value Add:

• It Makes Pediatric Airway Feel Practical: This episode shows what early airway awareness can look like in a real pediatric office, not just in theory.
• It Reminds Providers They Can Start Smaller: Dr. Ukich makes it clear that simply asking better questions and knowing when to refer can make a real difference.

Clinical Concepts & Terminology

• Pediatric Sleep Questionnaire (PSQ): A screening tool Dr. Ukich uses to identify symptoms that may point to sleep-disordered breathing.
• Early Expansion: Discussed as a way to support arch development, nasal breathing, and better sleep patterns when started young enough.
• Myobrace: A removable appliance mentioned as part of habit correction and functional development, especially around breathing and oral posture.
• Myofunctional Therapy: Referenced as part of follow-up care to help children use their lips, tongue, and oral muscles more effectively after expansion.
• Acoustic Rhinometry: A tool Dr. Ukich uses to help measure nasal capacity and airway function.
• Tongue-Tie Release: Discussed in the context of infant feeding, latch, and early oral development.

Professional Organizations & Collaboration

• AAPD Guidelines: Dr. Ukich and Dr. Elliott discuss the importance of pediatric dentistry guidelines now addressing airway screening and treatment more directly.
• Collaborative Pediatric Airway Care: The conversation emphasizes working with orthodontists, ENTs, lactation consultants, craniofacial chiropractors, and myofunctional therapists rather than trying to solve everything alone.

Featured Experts to Follow

• Dr. Johnny Ukich: A pediatric dentist sharing a practical perspective on how airway awareness changed the way he screens and treats children.
• Dr. Erin Elliott: Co-host of the episode and one of the early voices who helped push this conversation forward in her community.
• Dr. Boyd Simpkins: Mentioned in the episode as another pediatric dentist involved in this space.

Recommended Tools & Reading

• Gasp: The book Dr. Ukich credits as the moment everything clicked for him.
• Breath by James Nestor: A recommended read for clinicians who want a more accessible entry point into breathing and airway concepts.
• Pediatric Sleep Questionnaire (PSQ): A practical screening resource for identifying airway-related symptoms in children.
• Myobrace: Mentioned as a tool for encouraging better breathing habits and oral function.
• CO2 Laser: Discussed as a valuable tool for infant tongue-tie releases because of comfort, speed, and healing.

Why do the thousands of dollars you spend on dental consultants evaporate the moment your team gets busy? Dr. Max Kerr breaks down the real reason your practice falls back into bad habits, office drama, and useless meetings. Learn how the EOS framework forces total team accountability, kills breakroom gossip, and builds a structural foundation that permanently solves your biggest operational headaches.

What We Discuss with Dr. Max Kerr:

• The Issues List: Why an organization with a lot of issues is actually a healthy one—as long as you have a system to capture them instead of letting them fester in the breakroom.
• IDS (Identify, Discuss, Solve): The exact psychological framework to prevent endless meeting debates and force actual, tangible solutions with assigned to-dos.
• Stopping Office Drama: How to empower your team to bring problems to the light, and why you should enforce a strict "don't vent to me, do something about it" culture.
• The 80/20 Rule of Process: Why you don't need a 100-page SOP manual that no one reads. Learn how documenting just 20% of your core processes gets 80% of the work done safely.
• The Level 10 Meeting: The strict 90-minute weekly agenda that guarantees accountability, keeps everyone on track, and eliminates the "this could have been an email" feeling.
• The Foundation First: Why getting EOS off the ground takes a solid two years, and why expensive clinical consultants won't save your business if your foundational "underwear and socks" aren't properly in place.
• And much more…

Episode Summary:

You’ve hired the consultants, read the books, and maybe even had a few productive team meetings. But two months later, the demands of the practice get in the way, and everyone reverts to their old habits. Your team is venting to each other in the hallways, administrative balls are being dropped, and your clinical excellence is being overshadowed by 1-star reviews complaining about billing errors.

In this episode, Jason Tierney and Dr. Erin Elliott welcome back Dr. Kerr to dive deep into the final key components of the EOS (Traction) framework: Issues, Process, and Traction. Dr. Kerr explains why avoiding problems is a recipe for disaster and how implementing a strict, time-blocked "Level 10" weekly meeting can completely transform your practice's culture. He shares exactly how to track issues, force actionable solutions instead of allowing endless discussion, and hold team members accountable week over week.

Whether you are running a single dental sleep practice or managing multiple locations, this conversation strips away the "rainbow unicorn mumbo jumbo" and gives you the essential blocking and tackling strategies needed to run a highly profitable, stress-free business.

Resources and References Mentioned:

• Traction: Get a Grip on Your Business by Gino Wickman
  • Value Add: This is the foundational textbook for the Entrepreneurial Operating System (EOS) discussed in this episode. If you are tired of hitting a ceiling in your practice growth, start here to understand the Six Key Components of a successful business.
• EOS Worldwide (Find an Implementer)
  • Dr. Kerr mentions that while you can self-implement EOS, the most successful and busiest dental sleep practices in the world often hire a professional implementer. Use this directory if you want a professional to hold your leadership team accountable and fast-track your success.
• Productive Dentist Academy (PDA)
  • Mentioned by Dr. Kerr as an incredible resource for patient interaction and team alignment. However, as Dr. Kerr notes, PDA is "downstream" from EOS. Build your EOS communication lanes and business foundation first, so that when you bring in heavy-hitting consultants like PDA, your team can actually execute their strategies.
• Connect with Dr. Max Kerr:
  • Reach out directly via email at: [email protected]

The "business of dental sleep medicine" shouldn’t feel like a dirty secret - and PROFIT shouldn’t be a curse word in sleep. In this episode, Jason Tierney, Dr. Erin Elliott, and Dr. Max Kerr stop apologizing for building healthy businesses. Dr. Kerr explains how his own "rheostat regret"—a deep-seated dislike for traditional drilling and filling—led him to master the Entrepreneurial Operating System (EOS) and scale a massive sleep practice.

From identifying the "Toxic Tammys" in your office to setting the 90-day "Rocks" that move the needle, this conversation is a roadmap for any dentist who wants to stop being the bottleneck in their own business.

What’s on the Menu:

• The Handpiece Allergy: Why Max traded the handpiece for systems and how that shift allowed him to scale patient care without burning out.
• The Foundational “Underwear” of Business: Max explains why EOS is the "base layer" of a successful practice—if your socks and underwear have holes, your whole outfit (and your day) is ruined.
• The "Screw Tammy" Protocol: How to handle the high-performing "Toxic Tammy" who is a hit with patients but a cancer to your team culture.
• Vision vs. Hallucination: Why a mission statement isn’t enough. You need the Vision Traction Organizer (VTO) to ensure your team is actually following the map.
• Setting DSM "Rocks": A breakdown of the 90-day sprint and how to keep your team focused on big-picture projects instead of just daily fires.
• Voted Off the Island: Erin and Max discuss building a culture so strong that toxic employees self-select out before you even have to fire them.
• Managing by the Scorecard: How to use objective data to predict your month's success before you even look at a revenue report.

The Value Add:

• It Connects Business Health to Patient Care: This episode makes it clear that strong care and strong operations belong together. A healthy practice can serve more people, more consistently.
• It Gives Owners a Clearer Leadership Framework: Instead of living in constant reaction mode, listeners get a practical model for building alignment, accountability, and better decision-making.
• Cross-Functional Buy-In: Dr. Kerr emphasizes involving key team members in vision and accountability so the practice runs with more alignment and less confusion.

The Wisdom of Max:
"None of us are doing this for free. If you don’t care about people, dentistry will eat you alive—but you can quantify that you’re helping someone live years longer. What is that worth to bring to market?"

Clinical Concepts & Terminology:

• EOS (Entrepreneurial Operating System): A proven set of simple concepts and practical tools used by entrepreneurs to get what they want from their businesses.
• Rocks: The 3 to 7 most important things (objectives) the company must get done in the next 90 days.
• The People Analyzer: An EOS tool used to clarify if you have the "Right People" in the "Right Seats."
• VTO (Vision Traction Organizer): A powerful tool that helps a leadership team get 100% on the same page with where they are going and how they are going to get there.
• Scorecard: A weekly tracking tool of 5–15 high-level numbers that allow you to feel the pulse of your business.

Featured Experts & Resources:

• Dr. Max Kerr: Clinical Director of Sleep Better Austin and a certified EOS implementer.
• Traction by Gino Wickman: The essential reading for any practice owner looking to implement EOS.
• Sleep Better Austin: The systems-driven sleep practice referenced as a case study in this episode.