Straight Up With Steph

Dental Coding, Fraud & the OPA: What Every Dental Professional Should Know 

Dental codes might not sound exciting—but using the wrong one could have much bigger consequences than you realize.

In this episode of Straight Up With Steph®, I’m joined by dental hygienist and coding expert Kathy Forbes, RDH, BS, FADHA, for an eye-opening conversation about CDT codes, insurance, fraud, and why dental professionals need to understand exactly what they’re documenting and billing.

Kathy explains why simply choosing the code insurance will pay for can become a serious problem—even when the intention is to help the patient. We also dig into the descriptors behind CDT codes, why they matter just as much as the code itself, and the surprising lack of coding education many hygienists and dentists receive.

Then we get into one of the biggest conversations happening in dental hygiene right now: the Oral Preventive Assistant (OPA). If an OPA is only permitted to scale supragingivally, can an office bill a traditional prophylaxis code? Kathy explains why the current descriptor creates a potential problem and what would need to change.

We also discuss:

• Common coding mistakes dental offices make without realizing it
• Why choosing a code based on insurance coverage can cross an ethical or legal line
• Why there technically isn't a “cleaning” code
• The difference between a code number, title, and descriptor
• Why CDT descriptors can change from year to year
• Why hygienists currently lack a voting seat on the Code Maintenance Committee
• How new treatments like desiccation therapy and non-fluoride varnishes are coded
• How using 999 codes can help demonstrate the need for future procedure codes
• The potential coding problem with supragingival-only scaling and the OPA
• Why assisted hygiene may offer another solution to the dental hygiene shortage
• How medical billing could become a bigger part of dentistry’s future

If you work in dentistry, understanding coding isn't just the business team's responsibility. What you document and what gets submitted can affect your patients, your practice, and potentially even your license.

Share this episode with a hygienist, dentist, assistant, or practice owner who needs to hear this conversation.

To watch on YouTube, click here

OPA Podcast

Topics Discussed: dental coding, CDT codes, dental hygiene codes, D1110, dental prophylaxis, dental insurance, dental billing fraud, OPA dental, Oral Preventive Assistant, dental hygienist, assisted hygiene, dental insurance billing

About Kathy 

Connect with Kathy:

Email: [email protected]   

Website: https://www.kathysforbes.com/

Disclaimer: The opinions expressed by guests on this podcast are their own and do not necessarily reflect the views of Polished Posture. The information shared in this podcast is for educational and entertainment purposes only and should not be considered medical advice. Always consult a qualified healthcare professional for any health concerns or before making significant lifestyle changes. 

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Have you ever walked into a room and completely forgotten why you were there, struggled to find a word you KNOW you know, or suddenly felt more anxious, irritable, or overwhelmed than ever before?

If you're in perimenopause or menopause, there may be a very real reason your brain feels different.

In this episode of Straight Up With Steph®, I’m joined again by Jules from Brain Body by Jules to break down what fluctuating hormones are actually doing to our brains during the menopause transition.

I also share my own experience with brain fog, anxiety, overstimulation, and cognitive changes—including the point when I genuinely worried I could be developing early-onset dementia.

In this episode, we discuss:

• What happens to the brain as estrogen and progesterone fluctuate
• Why perimenopause can affect memory, attention, focus, and decision-making
• The connection between hormones, GABA, anxiety, and irritability
• Why you may suddenly wake up feeling anxious for seemingly no reason
• Simple ways to calm and regulate your nervous system
• What “brain fog” actually means—and why it doesn’t necessarily mean your memory is failing
• Brain fog vs. cognitive changes that may warrant a conversation with your healthcare provider
• The potential role of hormone replacement therapy (HRT)
• Why advocating for yourself during the menopause transition matters
• Easy brain exercises you can use to challenge attention, memory, and cognitive flexibility

If your brain just doesn’t feel like YOUR brain anymore, this conversation may help you better understand what’s happening—and give you some practical ways to support yourself through it.

Share this episode with another woman who needs to hear that she isn’t the only one experiencing these changes.

Topics Discussed: perimenopause brain fog, menopause brain, menopause memory loss, perimenopause anxiety, menopause anxiety, estrogen and the brain, progesterone and anxiety, menopause cognitive changes, brain fog in women, hormone replacement therapy, HRT, women’s brain health

Ep 91: How to Train Your Brain for Better Focus, Memory & Mental Clarity

About Jules

Connect with Jules:

Insta: https://www.instagram.com/brainbodybyjules/

TikTok: https://www.tiktok.com/@brainbodybyjuless

Skool: https://www.skool.com/brainbodybyjules-9310  

To watch on YouTube, click here

Disclaimer: The opinions expressed by guests on this podcast are their own and do not necessarily reflect the views of Polished Posture. The information shared in this podcast is for educational and entertainment purposes only and should not be considered medical advice. Always consult a qualified healthcare professional for any health concerns or before making significant lifestyle changes.  

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Are carbs really making you gain weight—or have we been blaming the wrong thing?

I’ll admit, I’ve struggled with the “carbs are bad” mindset myself. But carbs play an important role in energy, exercise, and building muscle, and cutting them simply because we’re afraid of the scale may be working against our goals.

In this episode of Straight Up With Steph®, Hannah is back to help us rethink our relationship with carbs and get away from the all-or-nothing nutrition advice we constantly see online.

We talk about:

• Why carbs have been demonized for so long
• Whether eating carbs actually causes fat gain
• Why the scale can go UP when you increase your carbs
• The difference between water weight and actual fat gain
• Why carbs are important for energy and strength training
• Protein vs. carbs—and why your body needs both
• What to eat before and after a workout
• Fruit, potatoes, bread, pasta, and other carbs we’ve been taught to fear
• Why fueling properly matters for physically demanding jobs like dentistry
• How to stop obsessing over the scale and focus more on strength, energy, and body composition

Hannah also shares what happened when she intentionally increased her own calories and carbs to support her goal of gaining muscle—and why she started hitting new PRs in the gym almost immediately.

If you’ve spent years thinking you need to eat fewer carbs to stay lean, this conversation might make you look at your plate very differently.

About Hannah:

Hannah Hutson is a functional fitness, balanced nutrition, and mindset coach. She empowers entrepreneur women to build wellness into their lives to level up their businesses. Hannah has gone through the process of building her own business from the ground up and knows how detrimental burnout can be for not only your health but your business, too. She knows that the key to success in one’s career is to make sure your health is at its peak. When your health is diminished, your ability to think becomes impeded, which will reflect as poor work in your business. The pressure from work can lead to chronic stress, which can affect your sleep, cause an imbalance in your hormones, spike your blood pressure, cause weight gain, mood swings, brain fog, relationship issues, and so much more. If you don't take care of yourself, you won't be able to take care of your business. Her mission is to teach women how to implement health-promoting behaviors and habits into their daily lives to help them recharge and be the best boss they can be.

Connect with Hannah:

Instagram

To watch on YouTube, click here

Disclaimer: The opinions expressed by guests on this podcast are their own and do not necessarily reflect the views of Polished Posture. The information shared in this podcast is for educational and entertainment purposes only and should not be considered medical advice. Always consult a qualified healthcare professional for any health concerns or before making significant lifestyle changes. 

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If you’re walking, doing yoga, or taking Pilates several times a week, are you doing enough to protect your muscle as you age?

In this episode of Straight Up With Steph®, I’m welcoming back Pilates instructor and pelvic floor expert Emma Bromley for a conversation every woman approaching midlife needs to hear.

And here’s the surprising part: Emma is a Pilates instructor who says Pilates alone isn’t enough after 40.

As muscle mass begins to decline with age, strength training becomes increasingly important for maintaining strength, supporting our bones, and helping us stay independent later in life. Emma explains why progressive overload matters and how women can begin lifting heavier—even if they’ve never considered themselves “weight lifters.”

In this episode, we discuss:

• Why muscle becomes increasingly important as we age
• Why Pilates, yoga, and walking are valuable—but may not provide enough stimulus to build muscle
• What “lifting heavy” actually means
• How progressive overload works
• How many days per week women should strength train
• Why recovery is an important part of building muscle
• The fear that lifting weights will make women “bulky”
• Five foundational movements for women new to strength training
• Why breathing and pelvic floor function matter when lifting heavier
• Why it is never too late to start getting stronger

Emma also shares an important reframe: instead of asking whether you’re too old to start, ask yourself what waiting another year could cost you.

If you know a woman who thinks walking or Pilates is all she needs to stay strong as she ages, share this episode with her.

Topics discussed:  strength training for women over 40, lifting weights after 40, midlife muscle loss, Pilates after 40, progressive overload for women, women and muscle mass, strength training menopause, building muscle in midlife, healthy aging for women

About  Emma

Connect with Emma:

IG: @bromleymethod

FB: @bromleymethodofficial

Youtube: @bromleymethod 

To watch on YouTube, click here

Episode on Pelvic Floor

Disclaimer: The opinions expressed by guests on this podcast are their own and do not necessarily reflect the views of Polished Posture. The information shared in this podcast is for educational and entertainment purposes only and should not be considered medical advice. Always consult a qualified healthcare professional for any health concerns or before making significant lifestyle changes. 

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Why do some relationships feel easy and secure while others leave us overthinking every text, questioning ourselves, or constantly needing reassurance?

In this episode of Straight Up With Steph®, I’m joined by psychotherapist Emma Mead for a conversation about relationships at every stage—from navigating the early days of dating to building healthier, more secure long-term relationships.

We talk about dating apps, texting anxiety, ghosting, red and green flags, communication, people-pleasing, self-trust, and how our attachment styles can influence the way we connect with others. Emma also explains why anxious and avoidant people are often drawn to each other, how to recognize unhealthy patterns, and what secure relationships actually look like

We talk about:

• Secure, anxious, avoidant, and disorganized attachment
• Why anxious + avoidant relationships can feel so intense
• Dating apps, texting anxiety, and ghosting
• Red flags AND green flags in new relationships
• People-pleasing and self-abandonment
• Learning how to communicate what you actually need
• How to tell avoidance from a lack of interest
• Trusting your intuition again
• Whether attachment styles can change
• How attachment patterns can even show up at work

Emma also shares practical ways to recognize when old patterns are being activated and how we can begin responding differently instead of automatically reacting.

Whether you’re dating, in a relationship, or simply trying to understand yourself better, this conversation is packed with those “ohhh… THAT’S why I do that” moments.

About Emma

Connect with Emma:

Instagram - @perfectly_emmperfect    

To watch on YouTube, click here

Disclaimer: The opinions expressed by guests on this podcast are their own and do not necessarily reflect the views of Polished Posture. The information shared in this podcast is for educational and entertainment purposes only and should not be considered medical advice. Always consult a qualified healthcare professional for any health concerns or before making significant lifestyle changes. 

Click for Hygiene Month Sale

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Stop waiting until you feel "ready."

In this episode of Straight Up With Steph®, I'm joined by executive coach Thomas Passalacqua to explore one of the biggest obstacles standing between dental professionals and the career they actually want—not lack of talent, but limiting beliefs.

If you've ever thought "I'm just a hygienist," "I'm not qualified enough," or "Maybe someday when I'm more confident..." this episode is for you.

Together, we unpack the difference between a fixed mindset and a growth mindset, why discomfort is actually a sign of progress, and how taking imperfect action often creates the confidence you're waiting for.

In this episode, we discuss:

• Why so many clinicians feel trapped in the operatory
• Fixed mindset vs. growth mindset explained simply
• The stories we tell ourselves that quietly hold us back
• Why confidence comes after taking action
• How to overcome fear of judgment and social media
• Why failure is really just feedback
• Practical ways to start exploring life beyond clinical dentistry
• The importance of curiosity, pausing, and challenging your assumptions

If this episode encouraged you, share it with another dental professional who needs the reminder that they're capable of more than they realize.

Topics Discussed: dental careers, leaving clinical dentistry, growth mindset, executive coaching, limiting beliefs, entrepreneurship, dental hygienist career, professional development

About Thomas

Connect with Thomas:

https://www.linkedin.com/in/thomaspassalacqua/

https://ascendpropathways.com/   

To watch on YouTube, click here

Disclaimer: The opinions expressed by guests on this podcast are their own and do not necessarily reflect the views of Polished Posture. The information shared in this podcast is for educational and entertainment purposes only and should not be considered medical advice. Always consult a qualified healthcare professional for any health concerns or before making significant lifestyle changes.  

Click for Hygiene Month Sale

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 To connect with me: 

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Hormones don't just affect your mood—they can completely change your oral health.

In this episode of Straight Up With Steph®, Stephanie sits down with returning guest Barbara Tritz, RDH, to discuss one of the most overlooked topics in dentistry: how hormones influence the health of our gums, teeth, saliva, and supporting bone throughout every stage of life. 

In this episode:

• Why hormones affect oral health more than most clinicians realize
• Puberty, pregnancy and menopause through the dental lens
• The surprising connection between pregnancy and oral bacteria
• Why perimenopause often begins years before women expect
• Estrogen's role in protecting gum tissue, bone and saliva
• How dry mouth increases cavity risk
• Why Barbara believes salivary testing should become standard of care
• Practical strategies to protect your mouth during hormonal changes

If you enjoyed this conversation, please subscribe, leave a review, and share this episode with someone who could benefit from it.

Topics Discussed: hormones and oral health, pregnancy gingivitis, menopause dental health, perimenopause gums, dry mouth, bleeding gums, dental hygiene, women's health

Links mentioned:

Fn induces premature and term stillbirths: https://journals.asm.org/doi/full/10.1128/iai.72.4.2272-2279.2004 

Dry Mouth Blog:

https://queenofdentalhygiene.net/2023/12/defeat-dry-mouth/

Hormone Blog:

https://queenofdentalhygiene.net/2026/07/hormones-and-oral-health

About Barbara

Connect with Barbara:

Blog: queenofdentalhygiene.net

Facebook: Barbara Tritz RDH

LinkedIn: www.linkedin.com/in/barbara-tritz-2021 

To watch on YouTube, click here

Disclaimer: The opinions expressed by guests on this podcast are their own and do not necessarily reflect the views of Polished Posture. The information shared in this podcast is for educational and entertainment purposes only and should not be considered medical advice. Always consult a qualified healthcare professional for any health concerns or before making significant lifestyle changes. 

Click for Hygiene Month Sale

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(sale ends 10/31/26; discounts cannot be combined)

 To connect with me: 

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Could the solution to the hygiene shortage actually create new legal problems for dental practices?

In this episode of Straight Up With Steph®, I'm joined by Dr. Derik Sven for one of the most thought-provoking conversations we've had on the podcast. 

We dive into the legal, ethical, and regulatory issues surrounding Oral Preventive Assistants (OPAs), but the conversation quickly expands into something much bigger—the future of dental hygiene and why autonomy matters.

One of my biggest takeaways from this episode was learning how differently hygienists are viewed across the country. Dr. Sven has practiced in states with highly restrictive practice acts as well as Colorado, where hygienists have long enjoyed autonomy and independent practice. It completely changed how I think about the cultural differences that shape our profession.

In this episode, we discuss:

• The legal risks dentists should understand before implementing the OPA model

• Why "supragingival scaling" isn't as simple as it sounds

• Potential liability and False Claims Act concerns

• What autonomy actually means—and what it doesn't

• Why Colorado's collaborative model looks so different from many other states

• How regional culture influences the way hygienists are viewed, utilized, and even how they view themselves

• Antitrust, self-governance, and the future of the profession

• Why insurance reimbursement may be the biggest issue dentistry should be tackling together

If you've been following the conversations surrounding the hygiene shortage, OPAs, or autonomy, this episode offers a perspective you probably haven't heard before.

If you enjoyed this episode, please leave a review and share it with another dental professional

Topics Discussed: OPA dentistry, Oral Preventive Assistant, dental hygiene autonomy, dental hygiene shortage, dental law, False Claims Act dentistry, dental practice ownership, independent dental hygiene practice, dental reimbursement, Straight Up With Steph podcast.

About Dr Derik

Connect with Dr Derik:

@drderikrdh (Facebook, Instagram, TikTok and YouTube)  

Website: https://www.drderikrdh.com

To watch on YouTube, click here

Disclaimer: The opinions expressed by guests on this podcast are their own and do not necessarily reflect the views of Polished Posture. The information shared in this podcast is for educational and entertainment purposes only and should not be considered medical advice. Always consult a qualified healthcare professional for any health concerns or before making significant lifestyle changes. 

Click for Hygiene Month Sale

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 To connect with me: 

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Assisted hygiene - could it actually be one of the best solutions to today's hygiene shortage?

In this episode of Straight Up With Steph®, I sit down with hygienist and practice consultant Courtney Wager, RDH, to break down one of dentistry's most controversial topics.

After practicing assisted hygiene for over 20 years, Courtney shares why she believes the model has been misunderstood—and how, when done correctly, it can improve patient care, reduce scheduling bottlenecks, increase practice efficiency, and even create greater career flexibility for hygienists.

We also tackle the biggest criticisms surrounding assisted hygiene, including burnout, ethics, production-based pay, patient experience, and whether quality of care truly suffers.

In this episode we discuss:

• What assisted hygiene actually is (and what it isn't)
• The difference between assisted hygiene and accelerated hygiene
• How to delegate appropriately without sacrificing patient care
• Compensation models: hourly vs. production vs. bonuses
• Why assisted hygiene doesn't have to lead to burnout
• Common implementation mistakes practices make
• How patients actually respond to assisted hygiene

Topics Discussed: assisted hygiene, accelerated hygiene, dental hygiene shortage, dental practice management, production pay, hygiene efficiency, dental assistants, hygiene workflow, dental practice systems

About Courtney

Connect with Courtney:

https://www.wagerpracticesystems.com/

Linkedin: www.linkedin.com/in/courtney-wager-8992ba381

Instagram: https://www.instagram.com/wagerpracticesystems/   

To watch on YouTube, click here

Disclaimer: The opinions expressed by guests on this podcast are their own and do not necessarily reflect the views of Polished Posture. The information shared in this podcast is for educational and entertainment purposes only and should not be considered medical advice. Always consult a qualified healthcare professional for any health concerns or before making significant lifestyle changes. 

Click for Hygiene Month Sale

(Code POLISH200 for $200 off cordless polishers)

(sale ends 10/31/26; discounts cannot be combined)

 To connect with me: 

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Your stool might be costing you more than you realize.

Most dental professionals spend more than 1,500 hours per year sitting, yet very few of us think about whether our stool is helping or hurting us.

In this solo episode of Straight Up With Steph®, I share my personal journey with chronic low back pain, the ergonomic mistakes I made early in my career, and the one equipment change that completely transformed the way I practice dentistry.

We'll discuss the science behind sitting posture, why traditional operator stools may be contributing to pain and injury, and how proper stool selection and adjustment can support career longevity.

In this episode, we discuss:

• Why I ignored my stool for years—and paid the price
 • How chronic low back pain nearly changed my career path
 • The hidden emotional toll of persistent pain
 • The biomechanics of sitting and spinal loading
 • Why hip angle matters more than most clinicians realize
 • Traditional stools vs saddle stools: key differences
 • How to properly adjust your stool for better posture and positioning
 • Why practice owners should view ergonomic equipment as a retention strategy
 • The true financial cost of pain, injury, and missed work
 • Simple ways to incorporate more standing into your clinical day

Whether you're a dentist, hygienist, assistant, student, office manager, or practice owner, this episode will help you rethink one of the most important pieces of equipment in your operatory.

If you found value in this episode, please share it with a colleague, office manager, or practice owner who could benefit from learning more about ergonomics and career longevity.

If you’ll be at RDH UOR 2026, please come by Hager booth 513 7/18/2026 so we can meet in person! I’ll also be presenting my course “Are You A Slouch Potato” 7/18/26 from 10:30-12:30 and I’d love you to be there 😊

Topic Discussed: dental ergonomics, saddle stool dentistry, dental back pain, dental hygienist pain, low back pain dentistry, ergonomic dental stool, dental posture, career longevity in dentistry

To watch on YouTube, click here

Click here for stool adjustment video

Click here for Bambach stool (use code POSTURE15 FOR 15% discount)

Disclaimer: The opinions expressed by guests on this podcast are their own and do not necessarily reflect the views of Polished Posture. The information shared in this podcast is for educational and entertainment purposes only and should not be considered medical advice. Always consult a qualified healthcare professional for any health concerns or before making significant lifestyle changes. 

 To connect with me: 

🦷Polished Posture Club
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