Straight Up With Steph

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. 

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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

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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
➡️Instagram
💻My Website
📨Email: [email protected]
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Dentistry is changing—and whether you love it or hate it, the conversation needs to happen.

In this episode of Straight Up With Steph®, I welcome back former ADA President Dr. Brett Kessler for an honest discussion about the future of dental hygiene, practice ownership, and the profession as a whole.

From the hygiene shortage and assisted hygiene to insurance reform, burnout, leadership, and medical-dental integration, we tackle some of the most controversial topics in dentistry today with the goal of encouraging thoughtful conversation—not creating more division.

In this episode:

• Is there really a dental hygiene shortage?
• Why hiring hygienists has become so difficult
• Foreign-trained dentists and dental students in hygiene
• Oral Preventive Assistants (OPAs)—pros, cons, and concerns
• Assisted hygiene as a possible solution
• Why hygienists create value far beyond production numbers
• Leadership lessons every practice owner should hear
• Insurance reimbursement and why it may be the biggest issue facing dentistry
• The future of dentistry and oral healthcare

If this episode challenged your perspective or gave you something new to think about, I’d love it if you shared with someone who would benefit from this conversation.

Topics discussed: dental hygiene shortage, assisted hygiene, dental practice ownership, dental leadership, insurance reform, oral preventive assistant, OPA, medical dental integration, dentistry podcast, dental hygienist, future of dentistry

About Dr Brett Kessler

Connect with Dr Brett:

Email: [email protected] 

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.  

Click for Hygiene Month Sale

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 To connect with me: 

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Hair thinning, collagen loss, and aging skin can feel like they happen overnight in midlife—but there’s actually a lot happening behind the scenes.

In this episode of Straight Up With Steph®, dermatologist and Menopause Society Certified Practitioner Dr. Corinne Erickson returns for part two of our conversation to answer listener questions about hair loss, collagen decline, red light therapy, skin treatments, and the lifestyle habits that impact how we age.

We discuss why so many women notice changes to their hair and skin during perimenopause, what treatments actually work, and how factors like sleep, stress, alcohol, and nutrition may be influencing your skin more than you realize.

In this episode we discuss:

• Why women experience hair thinning and shedding during perimenopause
 • The blood test many women should ask for when investigating hair loss
 • Oral minoxidil, red light therapy, and other hair loss treatments
 • The truth about the "collagen cliff" and collagen loss after menopause
 • Whether collagen powders actually improve your skin
 • How sleep, stress, cortisol, and alcohol impact skin health and aging
 • The reality of GLP-1 facial changes and volume loss
 • Whether you can actually shrink pores and if it's ever okay to pop a pimple

Dr. Erickson also shares practical advice for choosing aesthetic providers, navigating skin treatments safely, and focusing on the lifestyle habits that support healthy aging from the inside out.

If you know someone struggling with hair loss, aging skin, or perimenopause symptoms, send them this episode.

Topics discussed: hair thinning in women, perimenopause hair loss, collagen cliff, aging skin, oral minoxidil, red light therapy, GLP-1 face, cortisol and skin health, menopause, skin longevity.

To watch on YouTube, click here

About Dr Corinne

Connect with Dr Corinne:

Instagram: @themenopausederm

Website: https://www.clearaestheticsmd.com/

Substack: https://substack.com/@themenopausederm

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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In this episode of Straight Up With Steph®, I’m joined by certified nurse midwife and menopause specialist Sarah Shealy, CNM, MSCP, for a deep dive into one of the most talked-about—and misunderstood—topics in women’s health: hormone replacement therapy (HRT).

If you've ever wondered whether your anxiety, poor sleep, body aches, brain fog, gut issues, or lack of confidence could be related to perimenopause, this episode is for you. Sarah explains what’s really happening to our hormones during midlife, why symptoms can start years before menopause, and how estrogen, progesterone, and testosterone impact nearly every system in the body.

We also discuss the lifestyle foundations that matter just as much as hormone therapy, including nutrition, strength training, sleep, stress management, and maintaining long-term vitality and independence.

In this episode, we discuss:

• Why estrogen affects far more than reproduction
 • Early signs of perimenopause many women miss
 • The surprising connection between hormones, gut health, and inflammation
 • Why sleep and digestion can dramatically impact how you feel
 • How hormone therapy works and who may benefit
 • The role of progesterone in sleep, anxiety, and brain health
 • Why testosterone matters for women too
 • Common misconceptions about HRT and breast cancer
 • The importance of muscle, bone density, and preventing frailty as we age
 • How to advocate for yourself when seeking menopause care

If this episode helped you, please share it with a friend, leave a review, and follow the show so more women can access this information!

Topics Discussed: hormone replacement therapy, HRT for women, perimenopause symptoms, menopause symptoms, estrogen, progesterone, testosterone for women, women's hormones, menopause health, midlife women's health

About Sarah

Connect with Sarah:

@sarahthemidlifemidwife on TikTok and IG

https://sarahshealy.substack.com/   

Meno Learning Lab: https://www.menolearninglab.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

(Code POLISH200 for $200 off cordless polishers)

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

 To connect with me: 

🦷Polished Posture Club
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Leaking when you sneeze? Constantly running to the bathroom? Feeling pressure, heaviness, or disconnected from your core? These symptoms may have more to do with your pelvic floor than you realize.

In this episode of Straight Up With Steph®, I sit down with pelvic floor specialist Emma Bromley to discuss one of the most overlooked aspects of women's health: pelvic floor dysfunction.

Like many women, I never gave much thought to my pelvic floor until I started experiencing issues myself. After taking Emma's program, my understanding of breathing, movement, exercise, stress management, and pelvic health completely changed—and this conversation explains why.

We discuss the differences between a weak pelvic floor and a tight pelvic floor, why Kegels aren't always the answer, and how pregnancy, postpartum recovery, menopause, aging, and even surgery can affect pelvic floor function.

In this episode, we discuss:

✔️ What the pelvic floor actually is and what it does
 ✔️ Common signs of a weak pelvic floor vs. a tight pelvic floor
 ✔️ Why leaking urine is common—but not normal
 ✔️ Pelvic pressure, prolapse, and heaviness symptoms
 ✔️ How breathing affects your core and pelvic floor
 ✔️ The connection between stress, tension, and pelvic health
 ✔️ Why Kegels can sometimes make symptoms worse
 ✔️ Diastasis recti and pressure management
 ✔️ How pelvic floor dysfunction impacts intimacy, exercise, and quality of life
 ✔️ Simple strategies to start improving pelvic health today

Be sure to check out the YouTube version of this episode, where Emma uses a pelvic floor model to visually demonstrate many of the concepts we discuss.

If you enjoy this episode, please follow the podcast, leave a review, and share it with a friend. Your support helps us continue bringing you expert guests and important conversations.

To watch on YouTube, click here

About Emma

Connect with Emma:

IG: @bromleymethod

FB: @bromleymethodofficial

Youtube: @bromleymethod 

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.  

Topics Discussed: pelvic floor dysfunction, pelvic floor therapy, tight pelvic floor, weak pelvic floor, prolapse, diastasis recti, women's health, menopause, postpartum recovery, pelvic floor exercises 

Click for Hygiene Month Sale

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 To connect with me: 

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Is the hygiene department really a loss leader… or have we just been looking at it all wrong?

In this episode, I sit down with Shannon Richkowski, RDH, founder of Hygiene Mastery and managing partner of Fortune Management. Shannon is a nationally recognized speaker, consultant, and leader in dental practice growth, known for helping practices transform their hygiene departments into powerful drivers of both patient health and profitability.

We break down the misconceptions surrounding hygiene, the systems that are holding practices back, and what it actually takes to build a thriving, high-performing hygiene department in today’s dental landscape.

If you’ve ever felt like hygiene is undervalued—or you know your department could be doing more—this episode will challenge your thinking in the best way.

In this episode, we discuss:

• Why hygiene is not a loss leader—and where that belief comes from
• What a truly successful hygiene department looks like
• The concept of “service mix” and why prophies alone won’t cut it
• How hygiene drives restorative production (and why that matters)
• The importance of co-discovery between dentist and hygienist
• The biggest mistakes practices and hygienists are making
• Key production metrics and what hygienists should be producing
• The truth behind the “3x salary” rule
• Assisted hygiene—what works and what doesn’t
• Should dental assistants be doing hygiene procedures?
• The future of hygiene and solving the staffing shortage

If you found this episode helpful, share it with a colleague and help move our profession forward.

Topics Discussed: dental hygiene production, hygiene department profitability, assisted hygiene, dental practice growth, hygiene systems dentistry

To watch on YouTube, click here

About Shannon

Connect with Shannon:

https://www.instagram.com/hygienemastery/   

https://www.hygienemastery.com/index.cfm?Page=Bootcamp-Series  (Hygiene Mastery CE courses)

Hygiene Department Analysis

https://www.hygienemastery.com/index.cfm?Page=Hands-On-Laser-Certification  (Virtual Laser Certification Courses) 

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: 

🦷Polished Posture Club
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If you’ve ever thought, “Why am I still reacting like this even though I know better?” — this episode is going to hit.

In this episode of Straight Up With Steph®, I sit down with EMDR therapist Dana Carretta-Stein to break down what trauma actually is, how it shows up in your daily life, and why healing isn’t just about awareness — it’s about rewiring your nervous system.

We go way beyond surface-level mental health conversations and talk about why so many people stay stuck, how patterns form, and what actually creates lasting change.

I also share more of my personal journey with alcohol, getting sober, and how EMDR was the piece that truly helped me stop reacting the way I used to and start feeling more in control.

This episode is powerful, practical, and honestly… one I wish more people understood.

🎧 In this episode, we cover:

• What trauma actually is (and why it’s different for everyone)
• Signs you may have unresolved trauma without realizing it
• What EMDR therapy is and how it works
• Why insight alone doesn’t create change
• How your nervous system drives anxiety, burnout, and reactions
• The connection between trauma, coping behaviors, and addiction
• How EMDR helps you process — without re-traumatizing you
• Generational trauma and how patterns get passed down
• Why healing isn’t about “fixing” yourself, but understanding yourself
• What to look for in a therapist (and how to find the right fit)

If this episode resonated with you, share it with someone who needs it, follow the show, and leave a review — it helps more people find these conversations.

🔑 Topics Discussed: EMDR therapy, trauma healing, nervous system regulation, generational trauma, anxiety, burnout, mental health, therapy for trauma

About Dana

Connect with Dana:

Instagram: http://instagram.com/the_emdr_coach

Tiktok: https://www.tiktok.com/@the_emdr_coach

Youtube: https://www.youtube.com/@TheEMDRCoach

Facebook: https://www.facebook.com/theemdrcoach/

Websites:

The EMDR Coach: www.danacarretta.com

Peaceful Living Mental Health Couseling: www.peacefullivingmentalhealthcounseling.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

(Code POLISH200 for $200 off cordless polishers)

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

 To connect with me: 

🦷Polished Posture Club
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If you’ve ever felt like your body is changing and no one really explained why… this episode is for you.

In this episode of Straight Up With Steph®, I sit down with Dr. Jen Fraboni to break down what’s actually happening in women’s bodies through different life stages—and how to support yourself through it.

We talk about everything from menstrual cycles and workouts, to pregnancy myths, postpartum recovery, and the reality of perimenopause. Dr. Jen brings an evidence-based, practical approach to pain, posture, pelvic health, and recovery—without the overwhelm or rigid rules.

If you’ve been trying to “push through” or feel like your body isn’t responding the way it used to, this episode will help you understand why—and what to do about it.

In this episode, we cover:

• Why you don’t need to train differently based on your cycle—but you do need to listen to your body
• How hormones impact pain, recovery, and energy levels
• The truth about exercise during pregnancy (and outdated myths that still exist)
• What actually matters for postpartum recovery (and what most people skip)
• How pelvic health connects to pain, pressure, and performance
• What’s happening in perimenopause that affects joints, strength, and recovery
• Why strength training becomes more important as we age
• What soreness really means—and how to recover smarter
• Simple ways to support your body without overcomplicating it

If this episode helped you, share it with a friend or teammate who needs to hear it—and don’t forget to follow and leave a review so more people can find the show.

Topics discussed: women’s health, pelvic floor, perimenopause, postpartum recovery, strength training for women, hormone health, injury prevention, recovery tips 

About Dr Jen

Connect with Dr Jen:

Jen Health Platform

https://instagram.com/docjenfit

https://www.youtube.com/c/docjenfit?sub_confirmation=1

https://www.tiktok.com/@docjenfit?_r=1&_t=ZT-94HIlrqrgmD

https://facebook.com/docjenfit 

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: 

🦷Polished Posture Club
➡️Instagram
💻My Website
📨Email: [email protected]
💌Newsletter signup