The Best Practices Show with Kirk Behrendt

The Geriatric Tooth Fairy – Saving Our Seniors

Episode #450 with Sonya Dunbar

Some of our seniors become invisible. And that means they are not well-cared-for — especially when it comes to oral health. But there are ways that dentists can help, and Kirk Behrendt brings in Sonya Dunbar, speaker, educator, and CEO of The Geriatric Tooth Fairy, to share how mobile dentistry can save our seniors. Let's take care of our greatest generation! For the best advice from the tooth fairy, listen to Episode 450 of The Best Practices Show!

Main Takeaways:

Long-term care patients have a great need for oral care.

Mobile dentistry is for everyone, not just the underserved.

You can diversify your financial portfolio with mobile dentistry.

Teledentistry and mobile dentistry are great ways to branch out.

Spread smiles, love, and respect for seniors who come into your office.

Quotes:

“My grandmother had an upper denture and lower teeth, and I noticed that the CNAs in the nursing home weren't even taking out her denture — let alone brushing her teeth. So, of course, I didn't care because I was there every morning and every night, so I did it. But one day, when I was in her room, her roommate said, ‘Sweetie, can you brush my teeth? They don't come out like your grandmother’s.’ So, I said, ‘Of course!’ So, I went over to her bed and started looking through the drawers, and I didn't see a toothbrush. I went to the bathroom. There wasn't a toothbrush. I went to the nurse’s station. There wasn't a toothbrush in the building.” (2:59—3:32)

“A lot of home health care companies called me for me to train their home health aides on how to properly take care of the teeth. And one thing I noticed, I could train them all how to brush teeth and how to deal with a dementia patient. But they need to know the diseases and sicknesses connected to oral care. I connect the mouth to the body. But so many non-dental people separate the mouth from overall health. So, I draw a real good picture about diabetes, heart disease, even urinary tract infections — so many things that are connected. There are over 200 known diseases and sicknesses connected to the mouth.” (7:23—8:01)

“Some people think that mobile dentistry is just for the underserved. But no, it’s not. Mobile dentistry is for everyone.” (13:11—13:17)

“I encourage [dentists] to extend an arm outside of their practice with teledentistry and mobile dentistry. Maybe send your hygienists out to people that may be in a nursing home or to the school. Give them the teledentistry camera and let them do the exams. The dentists could do the exams. The hygienists could do the cleaning. And that frees up a chair in your office.”  (13:59—14:20)

“I think [dentists] least understand how to get started. People don't understand that there are steps in getting started. Just like there are steps in starting a brick-and-mortar practice, there are steps in getting started in mobile [dentistry].” (14:56—15:13)

“I met a young dentist out of California. She has the van, and she goes to stay-at-home moms. And she’ll get a whole zip code. And she targeted that, splashed it out with marketing. Those mothers are calling her. She has a waiting list in certain zip codes. And if it’s a mother and father and two or three kids, and you do all those exams and cleanings and whatever they need, and then go to another, you've made your production and you're staying in the area. Everybody knows gas is outrageous right now. But just staying in that same area, you're driving around, but you're bringing it to them.” (16:19—16:59)

“[Another dentist] does mobile ortho. He does mobile ortho and Invisalign. He goes to a space, texts all these people, tells them when they're going to be there. They line up and come to him. And he has a big bus. He has an old school bus. Can you tell me the overhead that this dentist is not paying?” (17:11—17:31)

“If someone wants to diversify their financial portfolio as a dental professional, they should really think about mobile dentistry.” (18:37—18:47)

“I don't want people to think that mobile dentistry is only in a van. There's pop-up mobile dentistry — there are so many different types of mobile dentistry that people do, and it’s an amazing opportunity.” (19:41—19:51)

“I can't do great things. But I can do a lot of small things, great.” (20:26—20:30)

“A lot of people feel, as we age, we fade. And during the pandemic, I was talking about going into the nursing homes and taking care of people’s teeth. And I got emails back and people texting me — and I knew they had to be younger people — saying, ‘Why do you even care about the dying?’ People just don't see seniors. They don't see older people. And that's a sad thing.” (28:33—28:56)

“I would encourage people to look around at our aging adults and just spread a little smile, a little love, and a little respect for them when they come into the office.” (32:06—32:16)

“Dental professionals — let's don't have invisible people.” (32:36—32:39)

Snippets:

0:00 Introduction.

1:38 How Sonya became The Geriatric Tooth Fairy.

6:39 How she started her business and conference.  

11:24 Taking dentistry to the people.

14:39 What most dentists get wrong about mobile dentistry.

15:56 What dentists least understand about the financial model.

19:11 Future National Mobile and Teledentistry Conference dates.

20:54 The Denobi Awards.

27:24 The future of mobile dentistry.

30:13 More about Sonya and how to get in touch.

31:58 Last thoughts and words of advice.  

Reach Out to Sonya:

Sonya’s website: https://sonyadunbar.com/

Sonya’s Facebook: https://www.facebook.com/sonya.carpenter

Sonya’s social media: @geriatric_toothfairy

Resources:

Jet Dental: https://www.jetdental.com/

National Mobile & Teledentistry Conference: https://nmdconference.com/

TelScope: https://hollandhealthcareinc.com/products/app/

Sonya Dunbar, RDH Bio:

Sonya Dunbar, also known as the Geriatric Tooth Fairy, is a Registered Dental Hygienist, TEDx, and national public speaker guided by 29 years of dental experience in private practice, skilled nursing facilities, and academia.

Sonya and her husband, Gerald Dunbar (Navy Veterans) are the proud parents of four successful children. Sonya and Gerald are the owners of Mobile Dental Xpress, which provides onsite comprehensive dental care to residents in long-term care facilities.

Sonya is the author of Golden Nuggets for Life. Furthermore, Sonya is the Co-Founder of the National Mobile and Teledentistry Conference, and Co-Founder of the American Mobile and Teledentistry Alliance. The National Day Archives proclaim and certify that November 9th of each calendar year is officially designated as The Geriatric Tooth Fairy Day. 

Expanding Your Thinking Beyond the Oral Cavity

Episode #449 with Dr. Steve Carstensen

People are more health-conscious than ever. And who are the best professionals to go to for better health? Dentists! But it’s not just about fixing teeth and cleaning gums. Today, Kirk Behrendt brings back Dr. Stephen Carstensen, co-founder of Premier Sleep Associates, to highlight the other side to dentistry, breathing and airway, so you can help people breathe better to live better. Don't just be another dentist — help solve airway issues before they happen. To learn how, listen to Episode 449 of The Best Practices Show!

Main Takeaways:

Start the sleep and airway conversation with your patients ASAP.

Only dentists can solve cranio-facial issues before they happen.

Be professionally curious and ask good questions.

Learn new ways to engage with your patients.

Have confidence in what you're doing.

Quotes:

“People who don't sleep well, they don't sleep well because they don't breathe well. And if we allow the body to breathe well — at any age — then the body will take care of its own sleeping problems. And the more we address this early in life, the better the physiology goes on through life.” (9:35—9:55)

“I treat 50 and 60 and 70-year-olds in my clinic. Well, all those people used to be five, six, and seven. Right? And so, what if we could treat a three-year-old and do something about breathing when they're tiny? Maybe they don't become 50 and 60 and 70-year-olds with massive problems.” (9:55—10:12)

“In dental school, we’re trained, ‘Well, these people need protection from themselves, so let's make them a nightguard.’ Nobody should have a nightguard without questions about their sleep and breathing while they sleep, because it’s so highly correlated — not cause it, but correlated. So, don't make any nightguards without asking, ‘Do you snore? Do you breathe well at nighttime? Do you wake up refreshed?’ those kinds of screening questions you can find from a STOP-BANG, for example.” (13:09—13:34)

“One of the things to consider is when patients come back to you and they say, ‘Well, I can't wear a nightguard,’ ‘Well, why not?’ ‘Well, it just doesn't feel comfortable.’ There are not very many reasons why a nightguard should feel uncomfortable. In Pankey training, early on, they said, ‘Well, it’s because you didn't have it fitted right, because you didn't have it adjusted right.’ So, we'd spend a lot of time doing that. But what we really need is more curiosity. Why didn’t it fit right? What’s going wrong? And you'll discover a lot of patients who don't breathe well. And when you start thinking about that, you can make a different appliance.” (13:44—14:13)

“Be professionally curious. Read some books. There are a lot of good books to read.” (14:20—14:24)

“Buy a copy of Breath [by James Nestor] and put it in the reception room, because people are going to have seen that. And when they see that, they might go to the dentist and say, ‘What should I think about that? I've heard of that book. Should I read it?’ or, ‘I read it. What are you going to do to help me?’ Just throw out the question. Start the conversations. And pay attention to what the answers are so that you can identify where it is that you need to learn some more stuff.” (15:04—15:28)

“Getting paid is not the biggest problem, any more than it used to be. The biggest thing is comfort and confidence in what you're doing.” (16:17—16:25)

“The key is the dentist has to get curious, and then train the team. Because in Washington State, I am legally obligated to do the exam, to ask the patient what their chief complaint is — and that's it. That's all I have to do, legally, to treat a patient with an oral appliance.” (17:02—17:25)

“People are wanting to find ways to improve their overall health. And as dentists are increasingly seen as part of the primary care network — not just the oral care network, but the primary care network, because we can see the results of bad health on the gums. We can listen to people’s stories and say, ‘Well, that could be because of allergies,’ or, ‘How are you breathing at night?’ or, ‘Are you eating right? Are you having too much of this or that?’” (18:59—19:29)

“Dentistry is going to take over little kids’ airway because it’s not about sleep. It’s about breathing patterns. It’s about jaw structure, growth, and development. And only we can do that.” (21:47—21:59)

“Nobody has any statistics about [whether children’s sleep issues are getting worse] because medicine has been focused on two things primarily. One is sleep issues. They framed that from their perspective of treating adults. They learned about sleep issues by watching people die in their sleep, not breathing well in their sleep — old guys. Old, fat guys in the original days. Then, they realized it’s not just old, fat guys. They have any adult.” (22:59—23:24)

“What medicine doesn't do very well is look for the reasons behind the symptoms that they're noticing. If you have a symptom, you get a pill. If you have a sleep problem, you get a sleep diagnosis. But the real reason is, behind many things, is the diet, the growth and development, the patterns. It’s the function of things. And so, if we don't have a good airway structure, if our bones aren't in the right place to support the soft tissues, it can't function well. And ultimately, it’s the function of things. It’s the function of respiration that allows the brain to have enough oxygen.” (23:33—24:10)

“Start with the questions, pay attention, and bring your dental assistants into the room with you. So, if you have an interview going on with a patient and you're curious about this, make sure your dental assistant is sitting there listening, or your front desk, anybody on your team . . . have them listen to the conversations. That way, they can support the conversation when you step out of the room. And learn together so the team learns together. It’s all new stuff. It’s not learning another composite. It’s learning a whole new way of engaging with your patients.” (25:26—26:05)

“When [patients] realize you're not there to try and sell them another filling, you're not trying to tell them they're being bad people because they don't brush and floss, they're sensing that you're really trying to help them get healthier, now, the patient engages with the office on a completely different level. And when that happens, now they have a different thing to talk about. ‘How was your checkup today?’ ‘Well, it was fine. My hygienist said I'm good. I should floss more.’ I mean, you don't want them saying that out in the community. You want them out there saying, ‘You know what? They asked me about my breathing. And they told me my gums were inflamed because I'm mouth-breathing. And so, I've got some strategies to be a better nose-breather so my lips won't be dry,’ and all the cool things that we can come up with, a different topic to spread the word in your community about your dental practice.” (26:09—26:56)

“If you think it’s simplistic enough that all you have to do is make a simple jaw-forward pulling device and that's it, well, then that's not enough.” (27:52—28:01)

“What we’re talking about here is what Dan Heath calls upstream problems. So, instead of dealing with things downstream, side effects and symptoms and things that medicine tries to do something about with pills, we go upstream. We get problems solved before they happen. So, it’s a whole new way of thinking. And that's only dentistry. Only dentists can do something about the growth and development of the cranio-facial-respiratory complex, nose, all the bone structures that support the airway. We’re the only part of medicine that could do anything about that.” (34:16—34:51)

Snippets:

0:00 Introduction.

2:23 Dr. Carstensen’s background.

4:04 Where his passion for his field comes from.

6:33 Dentists are well-suited for improving people’s health.

9:04 Treat patients as early as possible.

11:11 Dentists’ long history of being naysayers.

12:24 Be professionally curious.

15:29 How to introduce this sleep and airway into your practice.

18:10 More people are paying attention to their health.

19:51 Is the dental and medical community coming together?

22:26 Are children’s sleep issues getting worse?

25:00 Start by asking good questions.

27:29 What dentists get wrong about this area of dentistry.

30:39 What Dr. Carstensen teaches about the nasal cavity.  

35:18 More about Dr. Carstensen and how to get in touch.

Reach Out to Dr. Carstensen:

Dr. Carstensen’s website: https://stevecarstensendds.com/

Dr. Carstensen’s email: [email protected] 

Dr. Carstensen’s Facebook: https://www.facebook.com/steve.carstensen.35

Dr. Carstensen’s social media: @swcdds

Resources:

The Pankey Institute: https://www.pankey.org/

The Breathing Cure by Patrick McKeown: https://www.betterworldbooks.com/product/detail/THE-BREATHING-CURE--Exercises-to-Develop-New-Breathing-Habits-for-a-Healthier--Happier--and-Longer-Life-9781630061975

STOP-BANG questionnaire: http://www.stopbang.ca/osa/screening.php

The Clinician’s Handbook for Dental Sleep Medicine by Dr. Ken Berley and Dr. Stephen Carstensen: https://www.greatlakesdentaltech.com/the-clinicians-handbook-for-dental-sleep-medicine-authors-ken-berley-and-steve-carstensen_070-050.html

Breath by James Nestor: https://www.mrjamesnestor.com/

Sleep-Wrecked Kids by Sharon Moore: https://sleepwreckedkids.com/

Brave Parent by Dr. Susan Smallegan Maples: https://beabraveparent.com/

Upstream by Dan Heath: https://heathbrothers.com/books/upstream/

Dental Sleep Practice magazine: https://dentalsleeppractice.com/

Collaboration Cures September 15-18, 2022: https://www.aapmd.org/collaboration-cures-2022

ADA Children’s summit September 23-24, 2022: https://www.ada.org/education/continuing-education/ada-ce-live

Dr. Steve Carstensen Bio:

After Dr. Stephen Carstensen graduated from Baylor College of Dentistry in 1983, he and his wife, Midge, a dental hygienist, started a private practice of general dentistry in Texas before moving to native Seattle in 1990.

In 1996, he achieved Fellowship in the Academy of General Dentists in recognition of over 3,000 hours of advanced education in dentistry, with an increasing amount of time in both practice and classwork devoted to sleep medicine. A lifelong educator himself, Dr. Carstensen is currently the Sleep Education Director for both The Pankey Institute and Spear Education, recognized as among the finest places for dentists to further their education. As a volunteer leader for the American Dental Association, he was a Program Chairman and General Chairman for the Annual Session, the biggest educational event the Association sponsors.

He’s a Consultant to the American Dental Association for sleep-related breathing disorders and co-author of a textbook for dentists treating the disease.

For the American Academy of Dental Sleep Medicine, he’s been a Board Member, Secretary-Treasurer, and President-Elect. In 2006, he achieved Certification by the American Board of Dental Sleep Medicine. 

Top Lessons in Leadership in 2022

Episode #448 with Heather Crockett

Even the best dentists don't have it all figured out — and that's okay! Progress is what's important. And to help you in your journey for improvement, Kirk Behrendt brings back Heather Crockett, one of ACT’s amazing lead practice coaches, to reflect on some of the favorite lessons they’ve learned in becoming a better leader. It all starts with knowing yourself and the things you're bad, good, and great at. To hear some of the best advice for improving your leadership skills, listen to Episode 448 of The Best Practices Show!

Main Takeaways:

Find out who you are as quickly as possible.

Know your strengths and weaknesses.

Identify your unique abilities.

Be okay with being wrong.

Improvement never ends.

Learn to pause.

Quotes:

“I learn every day about leadership and the aspects of leadership. I don't have it all figured out quite yet. My inspiration from Kirk is to get from books. And so, that's where I have been getting a lot of my inspiration.” (2:28—2:43)

“When you're developing these other leaders, you're also leaning on them to help you in an area where you might not have the skill, the expertise. So, you might have a team member that does have that skill and expertise that you don't have. Developing them as a leader is only going to benefit you and the practice.” (4:46—5:05)

“I attended an education workshop a couple of months ago, and one of the speakers, what she was talking about really resonated with me . . . She highlighted this book called Humbitious [by Amer Kaissi]. Now, humbitious is not a word in the dictionary. But when she was talking about it, my interest was piqued because one of my own personal core values is humility. So, I wanted to learn more about what this humbitious meant, and it’s combining humility and drive and ambition in leadership and what that looks like.” (7:59—8:39)

“Humble people believe that they can become better people than what they currently are. And they understand and realize that they can't do it alone, and that they need other people to help them. So, what it looks like is being willing to and openly apologizing when you make a mistake or when you don't have it all figured out.” (9:11—9:33)

“I often see with our clients and practice owners, in general, that they want their team to see them as somebody that does have it all figured out.” (9:41—9:50)

“Everybody has room for improvement. Even the great doctors that I've worked for still had room for improvement and things that they could do to become a better leader.” (12:33—12:42)

“[The user’s manual is] really important because it helps to identify how to best communicate with each one of your team members. And it allows for the team to start being more vulnerable with one another to say, ‘Hey, this is how I feel about something.’ For example, in my user manual, I put that I value social time. If you come straight at me and you get straight down to business on something, I'm going to feel a little bit miffed because you didn't ask me how my weekend was. That just goes along with my preferred personality communication style. So, that's how important they are. Because even though another personality style might want to get right down to the research and the business, that approach would probably offend me. And it’s nothing that they did wrong, it’s just that they didn't understand. They didn't know how to communicate with me until the user manual was created.” (13:28—14:24)

“It’s all about identifying your weaknesses. And that's a really hard thing to do because we don't want to see ourselves in that negative light. We don't want to say, ‘Oh, I did something wrong,’ or, ‘I made a mistake,’ or, ‘I'm not as good as I could be.’ So, we really need to identify loving critics and then allow them to give us specific feedback.” (17:57—18:21)

“Don't be afraid to be transparent with yourself and with your team. Embrace humility. Grant yourself and your team grace. Understand that it’s okay to make mistakes because you learn — sometimes, the quickest, when you make that mistake. And allow your team members to make those mistakes as well.” (29:35—29:54)

Snippets:

0:00 Introduction.

2:13 Get inspiration from books.

2:52 Develop great leaders.

7:16 Be humbitious.

11:05 There's always room for improvement.

13:18 The importance of the user’s manual.

17:49 Identify your weaknesses.

18:57 Find your unique ability.

20:54 Know what you’re good at and not good at.

22:17 Learn to pause.

25:37 Tell the truth ASAP.

29:11 Last thoughts on leadership.

Reach Out to Heather:

Heather’s email: [email protected] 

Heather’s Facebook: https://www.facebook.com/heather.r.crockett

Heather’s social media: @actdental

Resources:

Traction by Gino Wickman: https://benbellabooks.com/shop/traction/

Humbitious by Amer Kaissi: https://www.porchlightbooks.com/product/humbitious-the-power-of-low-ego-high-drive-leadership--amer-kaissi

DiSC: https://www.discprofile.com/

Kolbe: https://www.kolbe.com/

StrengthsFinder: https://www.gallup.com/cliftonstrengths/en/254033/strengthsfinder.aspx

GaryVee Entrepreneurship Keynote | Gary Vaynerchuk at USC 2015: https://youtu.be/z5tugxy70MY?t=271

Unique Ability: https://uniqueability.com/  

Think Again by Adam Grant: https://adamgrant.net/book/think-again/

The 7 Habits of Highly Effective People by Stephen R. Covey: https://7habitsstore.com/7-habits-30th-anniversary-hard-cover-book

Heather Crockett Bio:

Heather Crockett is a Lead Practice Coach who finds joy in not only improving practices but improving the lives of those she coaches as well. With over 20 years of combined experience in assisting, office management, and clinical dental hygiene, her awareness supports many aspects of the practice setting.

Heather received her dental hygiene degree from the Utah College of Dental Hygiene in 2008. Networking in the dental community comes easy to her, and she loves to connect with like-minded colleagues on social media. Heather enjoys both attending and presenting continuing education to expand her knowledge and learn from her friends and colleagues.

She enjoys hanging out with her husband, three sons, and their dog, Moki, scrolling through social media, watching football, and traveling. 

How I Built Mommy Dentists in Business

Episode #447 with Dr. Grace Yum

Being a mom is hard. Being a mom, dentist, and business owner is even harder. You can't do it alone, so Kirk Behrendt brings in Dr. Grace Yum, founder and CEO of Mommy Dentists in Business, to help dentists who are moms find the community and support they need online. As the old saying goes, it takes a village to raise a child. To find your village that can help make your life better, listen to Episode 447 of The Best Practices Show!

Main Takeaways:

There will be some sacrifices being a dentist and a mom.

Find or create your “village” if you don't have one.

MDIB is a great resource to find a community.

It’s okay to not feel okay as a new mother.

If you're overwhelmed, hang in there!

Quotes:

“Nothing in life that's worthwhile is easy.” (7:52—7:56)

“You have to figure out who are the people that are going to help you because you cannot do this by yourself. It’s just a lot of work. So, whether it’s a part-time nanny, full-time nanny, whether it’s the grandparents, it takes a village. That expression is very true, and you need to figure out who your village is. And that support network is crucial to your success and your happiness.” (15:38—16:07)

“There are days where the school might call, ‘You need to pick up your kid. She’s got a fever,’ and you're in the middle of a procedure. So, you're going to have to send a dental assistant to go pick up your kid and bring them to the office. So, there are some modifications that we all have to make and do, and sacrifices, in order to be able to do both dentistry and be a mom.” (16:30—16:57)

“A lot of mothers have this feeling of guilt like, ‘I'm not there enough for my kid,’ or, ‘I am not present enough,’ or, ‘If I was a stay-at-home mom, my kid might be better off.’ And those are all emotions and feelings that a lot of mothers feel. That's normal. And you just have to do what's best for you. There are people like me that, I wouldn't be a good mother if I was a full-time mom. I just am not cut out to be a full-time mom. And God bless the full-time mothers because I think that's a harder job. For me, it’s easier to go to work — I have full control of my workspace — than it is to be at home full-time. And for me, I'm fulfilled, personally, with dentistry as my career, helping patients, seeing my patients and my team. That fulfills me. And if I didn't have that, then I'm not sure if staying at home while the kids are at school, I'd find something in lieu of that that would be fulfilling.” (16:58—18:01)

“What I found was that there wasn't really a space for me to ask questions such as, ‘Oh, I just got back from maternity leave. Did your schedule change?’ or, ‘My hygienist who’s working for me, she just got back from maternity, but she needs a place to pump or nurse.’ And the comments from the men — they think they're funny — were not helpful at all. They would say things like, ‘Well, tell her to pump in the car — and clock out, by the way,’ or, ‘Tell her to not come back to work until she’s done with that,’ just things that were very short-sighted or not helpful. Not that they aren't being polite or professional. It’s just, they don't get it.” (20:28—21:17)

“As a mom, you're at work and thinking about, ‘Okay, what am I making for dinner tonight?’ or, ‘Oh my gosh, Jimmy’s got his school play tomorrow. What do I need prepped for that?’ or, ‘Oh, the birthday party is this weekend. Did I buy the birthday gift? I need that wrapped. Oh, Christmas and Hanukkah. Oh, the play. The school.’ So, there are a gazillion things going on in a mom’s brain while she’s at work. And then, when she’s at home, she’s thinking, ‘That temporary crown that was rocking a little bit, I hope it stays on for the next two weeks. That patient who had a dry socket, I hope that he’s doing well. Oh, my phone’s ringing because I'm on-call, and little Benjamin just got whacked in the face with a baseball bat and cracked number eight and nine.’ So, you never turn off. Mothers’ brains don't ever turn off.” (21:46—22:42)

“As moms, the brains don't shut off. And so, that's why I felt that having Mommy Dentists in Business was really important, because my life completely changed after I had a kid. So, after work, I didn't get to go to the gym and work out. After work, I didn't get to go to the grocery store and go grocery shopping and food prep. After work, I didn't get to go to CE. I didn't get that time. So, once I became a mother, my whole life changed. And nobody can identify with that unless they are a mother, whether you're an adoptive mom, a foster mom, whatever, responsible for a human being in the house, in that role.” (22:49—23:38)

“I started the group, but it’s really the community. It’s really the group that is the glue. I am not the glue. The cloth has been cut, yes. But if you look at the quilt, it’s every single patch on the quilt that makes the quilt. I may have started the stitch, but these women have threaded it together. And that, to me, is so impressive. That, to me, is what I'm proud of.” (38:12—38:41)

“If you are a 32-year-old young mom who has children under the age of three, hang in there. The chaos will slow down. I think the very first year of a baby’s life is the most difficult. The first 12 months are so hard . . . Because as a first-time mom, you're nervous. You don't really know what you're doing. You feel self-doubt. You feel like your body is finally coming to. So, it’s not just the baby, it’s you physically, hormonally, how you're changing and morphing.” (42:41—43:19)

“When you're a mom, the last thing that falls into place is your self-care — the things that you did before the baby, like manicures, or going to get a massage, or even working out, exercise. You're so focused on that baby. And then, the second part is your spouse, having that relationship with your spouse. That gets thrown on the back burner. So, everyone’s focused on the baby. I think you just have to take the lens out and think, ‘Okay. It’s going to all come back together again. It just takes time.’” (43:44—44:17)

“It’s okay to feel frantic. It’s okay to feel the way you do. I used to pump in my car when I was nursing. I would drive to work and hook up my machine and pump as I drove. I remember being in the hospital OR. I had to pump in the bathroom. I remember trying to make it work, and it’s juggling. And you're going to have like 10 bags with you because you need 10 totes to put everything in. So, those things are overwhelming. But it’s a short minute in time, in the long run, and you can get through it.” (44:23—44:57)

“If you're 32 and you're in the thick of things, and you just want to give up and cry, cry it out. Have your cry session, and really think about how to make this work and what's doable for your sanity. And there's no right or wrong answer.” (44:57—45:13)

Snippets:

0:00 Introduction.

2:09 Dr. Yum’s background.

9:04 Your 30s and 40s can be a dynamic time in your life.

14:40 Figure out who your “village” is.

16:58 Being a dentist and being a mom.

18:27 How Dr. Yum got started with MDIB.

23:53 How the MDIB community grew.

30:54 Maintaining integrity and authenticity in a growing group.

36:26 The future of MDIB.

42:33 Advice for new mothers.

45:17 Books by Dr. Yum.

Reach Out to Dr. Yum:

Dr. Yum’s Facebook: https://www.facebook.com/profile.php?id=100075730122393

Dr. Yum’s social media: @dr_mrs_boss_mom

Resources:

Mommy Dentists in Business Podcast: https://mommydibs.com/podcast/

Mommy Dentists in Business: Juggling Family and Life While Running a Business by Dr. Grace Yum: https://www.betterworldbooks.com/product/detail/Mommy-Dentists-in-Business--Juggling-Family-and-Life-While-Running-a-Business-9781942707943

Mommy Dentists in Business: Advice to My Former Self by Dr. Grace Yum: https://www.abebooks.com/servlet/SearchResults?isbn=1950370038&cm_sp=mbc-_-1950370038-_-all

Dr. Grace Yum Bio:

Dr. Grace Yum is a lifelong resident of the Chicago area, where she grew up in Glenview. She is a mother and a certified pediatric dentist — a certification achieved by only 5% of all dentists in the U.S. Dr. Yum is the former founder and practice owner of Yummy Dental & Orthodontics for Kids, and she is also the founder and CEO of Mommy Dentists in Business.

In addition to managing the MDIB community, Dr. Yum hosts her own podcast, Mommy Dentists in Business Podcast. With 11 complete seasons, Dr. Yum’s podcast has been in the iTunes top 100, was ranked number 3 of 15 of the top dental podcasts by Patterson Dental’s Off the Cusp publication, and has been downloaded nearly 80,000 times.

Dr. Yum has quietly become nationally recognized in her field. She has appeared and was featured on the TODAY Show on NBC, NBC Chicago as a repeat guest, Parents magazine, Parenting magazine, and Chicago Parent magazine. She has also appeared on many podcasts, with topics covering dentistry, work/life balance, and business tips for the working mom. 

What Most People Get Wrong About Embezzlement

Episode #446 with David Harris

If you think embezzlement can never happen to you, take time to think again! No one is immune, and it’s impossible to prevent. All you can do is make it more challenging for the people who choose to steal. And to help you in that process, Kirk Behrendt brings back David Harris, CEO of Prosperident, to debunk common myths about thieves and embezzlement so you can outsmart them and reduce your chances of theft. Cash isn't the only thing an embezzler will take! To learn ways to protect your practice, listen to Episode 446 of The Best Practices Show!

Main Takeaways:

No dentist is immune to embezzlement.

75% of dentists are stolen from at some point.

Embezzlers may be smarter than you think.

Think beyond cash theft. Thieves will adapt.

Make it challenging to steal from your practice.

Always reach out to an expert for help.

Quotes:

“In 2019, [the American Dental Association] went to [17,000] dentists and they said, ‘Have you been stolen from?’ And I'll give you the good news first. 53% of the respondents said, ‘I don't think so,’ because this question doesn't always lead itself to absolute answers. Of course, the other 47% had been stolen from. So, the ADA asked them a follow-up question, ‘Okay, how many times?’ And now, it got a little bit interesting. 26% — so, about half of those who said they’ve been stolen from — said, ‘Once, as far as I know.’ 11%, twice. 2%, three times. And the one that really made me stand up and take notice was that 8% of the respondents said, ‘Four or more times.’” (3:55—4:44)

“Some things that we don't know here. For example, we don't know how many of the 53% [from the ADA study who] said, ‘I haven't been stolen from, to the best of my knowledge,’ will get victimized in the rest of their careers. And we don't know how many of the other 47% who had been will get stolen from again. We also don't know how many people were stolen from and just didn't realize it, or how many were stolen from and did realize it, and for whatever reason, chose not to disclose that to the ADA.” (5:07—5:37)

“If you start with 100 dentists, probably 75% of them will get stolen from sooner or later.” (5:41—5:46)

“[Embezzlement] is not a crime committed on you by a stranger. It’s a crime committed by somebody who you had a relationship with, you were almost like family to. And they used the trust and the faith that you placed in them and leveraged it into theft. So, it’s a very personal crime. The money is an issue — it has to be. But in a lot of cases, it’s the sense of violation. It’s that thought process where you say, ‘I was at her daughter’s wedding three months ago. And it’s just starting to occur to me how much of that wedding I paid for.’ It’s that, that really hurts.” (7:09—7:52)

“The first thing [dentists get wrong about embezzlement] is, ‘I have immunity because . . .’ And if we had a live audience with us today, there'd be some people sitting like this with their arms folded and their face tight. You could probably even see them bruxing a little bit. And what it all says is, ‘Well, it might be the person to my left, and it might be the person to my right. But it won't be me.’ And then, they have some algorithm that they’ve constructed that puts them in the immune category. For example, ‘My staff have been with me for 20-plus years.’ And every embezzlement has a first time. Sometimes, it’s a newly hired staff member who’s been with you for three months. And sometimes, it’s your office manager of 25 years.” (8:30—9:18)

“We can't control the external pressures that are exerted onto somebody that makes them wake up one morning and say, ‘Today’s the day I'm going to steal.’ And the backstory could be a lot of things.” (9:20—9:31)

“I've seen both sides of it where somebody who you think is almost too stupid to tie their shoes can successfully steal. And at the same time, you see some pretty creative, inventive thieves who come up with stuff that makes you want to salute and say, ‘Wow, that was so smart.’” (11:22—11:40)

“One thing that people often get wrong is what the response should be when they suspect embezzlement. And I've seen a couple of posts in Facebook groups in the past few months where somebody posts and says, ‘I'm pretty sure that my office manager or my financial coordinator is stealing from me. What should I do?’ And the next thing that happens is 20 or 25 dentists chime in, and they all are suggesting things that the original poster should do. And most of them are just dead wrong.” (11:58—12:31)

“What needs to happen is a proper investigation is done first. Once the investigation is done, then at that point, you can go to police and say, ‘Okay, the amount stolen was $112, 464.84. Here’s who did it. Here’s how they did it, and here’s where the money went.’ When you tell the police all that, they can work with us. Until then, it’s, ‘My car was stolen, and I'm not sure if it’s a Mercedes or a Toyota.’ And there's nothing they can do about that.” (14:53—15:30)

“If you think that $5,000 was stolen from you, you might say, ‘Okay. It’s not important to me that charges get pressed.’ But suppose, when we’re done, the number is $185,000. Do you feel differently? And if you don't, let's add another $100,000. And I ask the question again. And a lot of times, the initial conversation that I have with somebody is where they say, ‘Yeah, I don't want anything to happen to the thief. I mean, I would like to get back as much money as I can, and I certainly want them out of my practice. But they're a single mom, and I don't want them to go to prison.’ And seven or eight weeks later, when we’re talking about how much money was really stolen, the same person who said that to me will say, ‘Throw their ass in jail.’ Once they understand the amount of money — but not just that, the cynicism, the way that they realized they’ve been played by the thief — now, they feel very differently.” (17:03—18:05)

“If somebody has stolen from you, the best thing you can do to protect your profession is make them acquire a criminal record. Because if you simply are happy to see their taillights going down the road and you don't do anything beyond firing them, then you're setting up somebody else in your profession to have a repeat of what just happened to you.” (19:11—19:31)

“One of my team members, Amber Weber, said something very profound once. She said, ‘Transparency is one of the first casualties of embezzlement.’ People who are stealing do not want to be transparent with their doctor.” (20:48—21:05)

“A lot of people think that there's no chance they will get any money back from this, and that paying, for example, for us to investigate is simply throwing good money after bad. And the average return on investment on hiring us is about 400%.” (22:36—22:55)

“The mistake people make is they let the suspect know that they're a suspect. And believe it or not, people do this: they’ll call their office manager in and say, ‘I think you're stealing from me.’ And if I'm the office manager and I'm not stealing, you've antagonized me in a way we will never be able to repair. I mean, there's never going to be a working relationship after that if it isn't true. And if it is true, I'm expecting this conversation, and I've been expecting it for months or maybe years, I'm going to say, ‘No, I'm not!’ And what does the dentist do then, exactly?” (27:23—28:07)

“One of the other myths is that what thieves steal is cash. In other words, I've talked to some dentists about this issue, and one of the first things they say to me is, ‘Well, I don't take in much cash.’ And clearly, what's in their mind is that the only thing that thieves can steal is $20 bills. And don't take me wrong here — if I'm a thief, the thing I want to steal is cash. However, if there's not enough cash coming in, or I think that stealing what I want to steal from the cash that is coming in will get noticed, then I adapt.” (34:39—35:16)

“There's no system that will prevent embezzlement. When somebody wakes up tomorrow morning and decides, ‘Today’s the day I steal from my doctor,’ it’s going to happen for a period of time. The really operative question is, is that period of time a week, a month, or a decade? If somebody steals from you and they get caught in the first month, that's not a defeat. That's an overwhelming success. The person who gets away with it for about two years — which is the average, by the way — that's a different story.” (38:05—38:38)

“There are people who [check their deposits], and then there's the other 85%. So, if you're in that 85%, if you have no idea how much your deposit is today, and if you don't check your bank statement to see that that amount went in, the laziest, dumbest thief on the planet can successfully steal from you.” (39:00—39:22)

Snippets:

0:00 Introduction.

2:46 David’s background.

3:23 The reality of embezzlement in dentistry.

5:59 Unintended consequences with embezzlement.

7:54 Embezzlement myth: I have immunity.

10:05 Embezzlement myth: Embezzlers are dumb.

11:44 Embezzlement myth: Call the police immediately.  

16:00 Embezzlement myth: You decide about pressing charges.

18:35 Embezzlement myth: It’s enough to fire the thief.  

19:35 Your favorite people love accountability.

21:07 Delegation versus abdication.

22:31 Embezzlement myth: There's no chance you'll get money back.

26:35 Stop, drop, and think.

28:08 Beware of thieves’ drastic escape plans.

31:21 Insurance embezzlement versus cash embezzlement.

34:02 Embezzlement myth: Thieves only steal cash.

35:46 The model of a thief is not simplistic.

37:31 Ways to reduce your chances of embezzlement.

42:07 Try the Embezzlement Risk Assessment Questionnaire.

Reach Out to David:

David’s website: https://www.prosperident.com/

David’s Facebook: https://www.facebook.com/davidharrisprosperident

David’s social media: @davidharris9406

Resources:

**Email David for a free copy of his Embezzlement Risk Assessment Questionnaire: https://www.prosperident.com/contact-us/

Prosperident’s Hall of Shame: https://www.prosperident.com/hall-of-shame/

Dental Embezzlement: The Art of Theft and the Science of Control: by David Harris: https://www.betterworldbooks.com/product/detail/9780228818755?shipto=US&curcode=USD&gclid=CjwKCAjwt7SWBhAnEiwAx8ZLak0hQqCPFtBR8ZELN5m9humCDUwWW4FWaQuispvFtpfP9f6brSuZ6BoCR4oQAvD_BwE

David Harris Bio:

David Harris – CEO of Prosperident: Dentistry’s Embezzlement Experts

Under David’s leadership, Prosperident has expanded over the past three decades to become a team of more than 20 highly specialized fraud investigators, forensic accountants, IT specialists, and support staff. David’s vast investigative experience, coupled with his youth-filled misadventures and his past military service, have given him a unique insight into embezzlers’ mindsets and actions. He is passionate about sharing his wealth of knowledge with dentists and dental specialists.

David is a much sought-after speaker and an accomplished author on the topic of dental embezzlement. Dental Embezzlement: The Art of Theft and the Science of Control is his most recently published book.

David believes that the best educational experiences are enhanced using humor. His entertaining and insightful presentation style has made him a favorite presenter at regional, national, and international dental conferences.

David’s professional qualifications include Certified Fraud Examiner, Certified in Financial Forensics, Forensic CPA, Chartered Professional Accountant, Certified Management Accountant, and Licensed Private Investigator. 

How to Put Together a Crisis Coverage Plan

Episode #445 with Paul Sletten

Sometimes, you can't see bad things coming. And when it happens, you need to be prepared. One way is by having a crisis coverage plan, and Kirk Behrendt brings back Paul Sletten, founder of the Sletten Group, to share his expert advice on how to create a plan that will keep you covered and buy you time. Stay covered no matter your age, health, or financial situation! To learn how to check your boxes for coverage, listen to Episode 445 of The Best Practices Show!

Main Takeaways:

Join or create a practice coverage group.

Three or four dentists is not enough for a group.

Coverage groups should meet regularly and often.

Be selective in putting your coverage group together.

Plan out who makes the call in a crisis, and who to call.

Coverage groups can also help in non-crisis situations.

Quotes:

“[Having a crisis plan is] extremely important. Everybody needs to have a transition plan in place, regardless of what stage they're at in their career. In fact, they need to have two plans.” (3:39—3:54)

“Maybe the percentage of [a crisis happening] is smaller than five percent — but they happen. And when they happen, one of two things will occur: either the practice will go into a nosedive because they're not acting on it or putting a plan together or had never thought about it previously, or the practice will get covered.” (4:16—4:40)

“Simply defined, a crisis of this type would be something that alters the ability of the owner of the practice to be able to continue to be productive in the practice, either for a short period of time because they're ill but they're going to recover, or for an extended period of time because they were in an accident and can't physically perform and that puts them in a crisis, or because something happens tragically, and they die. But that's very rare compared to the likelihood of disability.” (5:36—6:16)

“The place to begin is to put together what we call a practice coverage group. A practice coverage group is a group of like-minded dentists who respect each other and who are in proximity to each other who would be capable of covering for one another in the event of disability or some kind of a crisis. And I've seen people put these groups together, but they’d only put three or four dentists in their coverage group. And that's a real tremendous strain on the covering dentists. That's not enough.” (7:41—8:23)

“If you only have three or four [dentists in your practice coverage group], they're going to run out of gas and put the practice back in jeopardy — even though it had been covered — because they just don't have the time to do it, because there's such a big time demand on each person. So, eight or nine, those are really good numbers.” (8:49—9:11)

“The commitments that the coverage group would be able to make would be to cover the practice for three months, let's say, pretty much at a max. It can go longer than that, but in our experience, that pretty well maxes it out. But that does buy you time, if it’s going to be a slow recovery, to find a locum tenens who can come in and be the dentist to cover it for several months, if needed.” (10:43—11:18)

“In some situations, we've seen where by the time we get called, a couple of months have gone by [since the crisis occurred]. The team has no idea what their future is, and the family is so grief-stricken, in the event of a death, that they haven't taken any action and they haven't called anybody. So, part of the plan you need there in the crisis coverage plan is there needs to be, ‘If this happens, who makes the call, and who do you call?’” (15:07—15:42)

“Insurance companies are very slow to pay with disability coverage too, as you all know . . . I would say five to six months. In the event of a death, in the event of life insurance, if your practice is worth a million dollars and you're in a partnership, for example, you need to carry insurance that will allow, upon your death, your estate to be paid off for your ownership share, which will allow the other partner to now be 100% owner and be able to take it forward. In a situation like that, I recommend over-insuring the risk. So, if it’s worth a million dollars, take out insurance, between the two of them, for a million-two, or a million-four.” (17:02—18:12)

“As your practice grows and as your income grows, you just have to stay with it and commit to it to continue to expand your [disability] coverage. People start out well-intended and have a base coverage at the beginning, and maybe take one or two increments of taking it higher, but then go to sleep on that issue and get into a situation where their coverage is puny compared to what they need. You can't have enough disability insurance.” (21:05—21:39)

“When you first start putting this together, the doctors who are going to be in this coverage group have to have meetings and talk about what they're going to do. It’s always so easy for them to overpromise one another about how much coverage they're going to be able to provide in the event that it’s needed. And that's why I really strongly recommend that you maybe go four months. But three months seems to be the max.” (22:19—22:49)

“Some people, with great intention, put a group like this together. And then, once they’ve got it together, they [only] meet every three to five years. And that just doesn't work.” (24:57—25:09)

Snippets:

0:00 Introduction.

2:01 Paul’s background.

3:31 Why it’s important to put a crisis plan in place.

5:04 Defining crisis.

6:56 Where to start with planning.

8:23 Things to know when putting together a coverage group.

10:30 Laying out expectations.

14:37 Plan who to call, and who makes the call.

15:43 Check every box when it comes to insurance.

19:49 Things to know about overhead insurance and disability insurance.

21:56 How to start putting the plan together.

24:31 How often the coverage group should meet.

25:38 Other things to know in planning.

27:04 Have a 100-day plan in place.

29:45 Get everything in writing.

31:15 Last thoughts on the crisis coverage plan.

31:56 More about Paul and how to get in touch.

Reach Out to Paul:

Paul’s email: [email protected] 

Paul Sletten Bio:

Paul D. Sletten founded the Sletten Group, Inc. in 1975 in Denver, Colorado. They are in their 47th year of business and have developed an international clientele, having assisted and completed transitions in all 50 states, six provinces in Canada, and two states in Australia. They continue to exclusively work with fee-for-service dentists and their teams around the country.

It is exciting to see both people and practices grow, and to know they have had a hand in so many transitions brings them enormous joy. Their wide-ranging experiences allow them to bring what they have learned to each new client situation. This experience helps them know how to tailor their services to the unique needs of each client and to be able to offer multiple options to almost any client situation. Due to this ability to customize their services, the Sletten Group also works with all of the specialty practices in the dental industry.

Paul has spoken at more than 285 dental meetings around the country. This includes almost all of the major dental meetings and numerous study clubs. The topics focus on all aspects of Practice Transitions — including buying a dental practice, selling a dental practice, and much more — as well as personal growth and development for dentists and team members.

Pam Sletten, a partner in the group, assists and works in the business and is very involved in helping their clients.

In an effort to expand their range of services for young dentists and prospective buyers, the Sletten Group helps in evaluating practice opportunities and sets a proper course for professional lives. All at the Sletten Group continue to focus on their own personal growth. They come to the world with a sense of wonder and are constantly on a quest to learn more and apply that learning to the benefit of their clients. 

Where is Your Vagus Nerve?

Episode #444 with Dr. Kevin Kwiecien

Whether it’s a bad patient, team member conflict, or just a not-so-great day, those are not life-or-death, fight-or-flight situations. Nothing in dentistry is a “saber-toothed tiger”. So, why do we respond to challenges as if they are? Your brain is the answer, and Kirk Behrendt brings back Dr. Kevin Kwiecien to explain what the vagus nerve is, why it’s important, and how you can use it to manage stress. Your energy can impact those around you! To learn how to create a calm, healthy environment for you, your team, and your patients, listen to Episode 444 of The Best Practices Show!

Main Takeaways:

Learn to change your brain.

Be calm to create calm around you.

Have awareness of your tendencies.

Practice meditation on a regular basis.

Create habits to be in parasympathetic tone.

Quotes:

“In 2022, there are no saber-toothed tigers out there. But our reaction if something crazy happens is like when we go back to caveman times when there must be a saber-toothed tiger and I need to be in my amygdala. And you don't. But we don't realize that in 2022, we’re safe. There's not a saber-toothed tiger. But our bodies still respond that way. And so, what can we do to realize that?” (10:52—11:22)

“If I walk in and I'm in fight-or-flight, you don't know and I don't tell you that I'm in fight-or-flight, but because you're another animal, you instinctively pick up on that. It’s the energy. One animal knows when another animal — especially in fight and certainly flight, and we all see freeze as well — the other animals pick up on it. And when we pick up on it, instinctively, we go, ‘Well, I guess I'm in fight-or-flight too. I guess we’re going to battle. I guess I need to be ready for something,’ and the whole energy in the room changes. And we didn't really need it to be. And so, if you, as a leader, as a dentist, are aware of that, think about the impact you have on your team and your patients and those around you.” (13:10—13:50)

“It starts with being aware of self. And if I am a very high D [on the DISC profile] and I am having a conversation with a very high S, I need to be aware of that and I need to flex towards the S. And if the S is flexing towards the D, we meet somewhere in the middle. But the beginning of that is, am I aware that I'm a D? And there are good things about a D. I get stuff done, I'm very direct, and I get stuff done fast. The dilemma of being a D is I can be a little abrasive sometimes. I can be overbearing. And if you don't do it with me, I'll just do it myself. And if I'm aware of that, then I embrace the strengths of my personality profile, my tendencies, and I embrace them and I use them, I maximize their potential.” (20:52—21:45)

“What habits are you creating so that you become — it could be setting your watch — but what are you doing to create new habits to remind you, ‘Oh my gosh, I need to be in parasympathetic tone. I need to take a few deep breaths. I need to tap into my vagus nerve’? And although it sounds simple, it’s not. But that is about the simplest way to start it, is think about how you're breathing, because that always gets you into parasympathetic tone.” (23:52—24:21)

“Your hygienist is not a saber-toothed tiger. The fact that the cord is not going in on the distal-buccal of 18 is not a saber-toothed tiger. The fact that you're even really close to the pulp — luckily, in dentistry, it’s not brain surgery. I don't mean to belittle dentistry, but it’s not a saber-toothed tiger. Our emergencies, our hygienists, everything that goes on in a dental office is not a saber-toothed tiger. But we respond like it is. Instinctively, we respond like it is because we’re humans. So, what can we do to realize that it’s 2022, and it’s not a saber-toothed tiger, and get back into your frontal cortex?” (26:40—27:22)

“We expect an immediate response. We think we have to, if we get texts, text them right back. If we need to know something, we can get it right now. We’re always on our cellphones. There's always constant stimulus. And I think that's why it’s resurging in a different way right now is, from what I read and from what I know, there's not a worse time in society for us to be in sympathetic tone. We really do feel like there's a saber-toothed tiger. Our bodies really are back to caveman times, except it’s not a saber-toothed tiger.” (28:16—28:49)

“I think the people we impact most are the people we’re with eight hours a day. The people we influence more are the people that are hanging around with us in fight-or-flight all day long. And if we’re all in parasympathetic tone, the day is better for everybody, including the patient.” (34:46—35:00)

“Start with yourself. Because if you start with yourself, your team will pick up on that. And then, you will be a different leader and you will be able to help people move toward health, because that's what we’re doing. We’re helping our patients move towards health. But if we’re not doing it for ourselves in some way, shape, or form, whether it’s systemically, nutritionally, psychologically, and we’re asking our patients to do it, there's a disconnect. And they pick up on that.” (37:01—37:28)

Snippets:

0:00 Introduction.

2:55 Dr. Kwiecien’s background.

4:59 Start with finding your WHY.  

9:23 The vagus nerve and why it’s important.

12:44 Get into your parasympathetic tone.

14:30 Change your brain.

18:37 It starts with self-awareness.

22:49 Start with breathing.

25:36 Create space between stimulus and response.

27:22 There's too much stimulus.  

29:56 Benefits of meditation and deep breathing.

35:08 Know your why and share your why.

36:27 Last thoughts on the vagus nerve.

38:55 More about Dr. Kwiecien and how to get in touch.

Reach Out to Dr. Kwiecien:

Dr. Kwiecien’s Facebook: https://www.facebook.com/kevinkwiecien

K² Facilitation Facebook: https://www.facebook.com/KsquaredFacilitation

K² Facilitation website: https://ksquaredfacilitation.com/

K² Facilitation social media: @ksquared_facilitation

Resources:

Start with Why by Simon Sinek: https://simonsinek.com/books/start-with-why/

WHY Institute: https://whyinstitute.com/

Beyond Your WHY podcast: https://whyinstitute.com/resources/#podcast

Spear Education: https://www.speareducation.com/

Books by Dr. Dan J. Siegel: https://drdansiegel.com/books/

Traction by Gino Wickman: https://www.eosworldwide.com/traction-book

Dr. Kevin Kwiecien Bio:

Dr. Kevin Kwiecien holds a master’s degree in healthcare administration and has more than 17 years of private practice experience, with eight years in academia.

Most recently, Dr. Kwiecien served as assistant professor of restorative dentistry at Oregon Health & Science University School of Dentistry and director of the university’s faculty dental practice, director of patient admissions, and director of the urgent care clinic, as well as course director of preclinical fixed prosthodontics and co-course director of advanced restorative concepts for third and fourth-year students.

Dr. Kwiecien’s appreciation for and dedication to high-level continuing education began with Dr. Frank Spear more than 13 years ago. He has completed the curriculum at The Pankey Institute, has belonged for several years to a Tucker Gold Study Club, and many additional accomplishments, including a fellowship in the Academy of General Dentistry. He has been a member of the Spear visiting faculty since its inception.

Dr. Kwiecien is a past-president of the Oregon Academy of General Dentistry. He also maintains memberships in the American Dental Association, Academy of Operative Dentistry, American Academy of Cosmetic Dentistry, American Equilibration Society, American Academy of Sleep Medicine, and the American Academy of Dental Sleep Medicine. 

Are Your Patients Getting Comfortably Numb?

Episode #443 with Dr. Alan Budenz

How sure are you that your patients are comfortably numb? Are you 100% sure? Do you just hope they are? There's a better way to know than just guessing! And to help you know with 99.9% certainty, Kirk Behrendt brings in Dr. Alan Budenz to share some techniques you can start using today. Numbing is the first step to high-quality dentistry! To learn how to give patients the most comfortable experience, listen to Episode 443 of The Best Practices Show!

Main Takeaways:

Learn as many anesthesia techniques as you possibly can.

Always ask patients about their history with anesthesia.

Tell patients what you're doing. Don't surprise them!

Know the best ways to assess anesthesia.

Even experts will miss from time to time.

Quotes:

“Getting your patients comfortably numb is incredibly important. You can't do good-quality dental work if the patient is feeling pain and fighting you, so you've got to have good control.” (2:28—2:40)

“I want to deliver local anesthesia as efficiently as possible, because I've never had a patient beg me to give them more shots. I always think of the movie, Little Shop of Horrors, with Steve Martin and Bill Murray, and Bill Murray’s like, ‘Oh, yeah, doc. Hurt me!’ It’s like, no, no, no, no, no. That's not real people. So, we’re not going there. I want to be really efficient with local anesthesia. And in giving the shot, inherently — you don't want to cause the patient pain giving the shot either.” (2:43—3:15)

“Although the injectable needles are still, by far and away, the most reliable, we’re still looking for better ways, easier ways, more comfortable ways to deliver the anesthetic. And that's encouraging.” (9:33—9:46)

“I think we’re still going to be using needles for a good while. But I think that some of these patch delivery techniques, like the iontophoresis, some of the things that have been developed more for medicine and trying to adapt them for dentistry. Part of the problem with dentistry is that versus putting a patch on the skin for anesthesia like they do in medicine, we’re dealing with a very moist environment. So, a patch may not stick well onto the mucosa. We’re usually trying to get deeper nerves. Like, the inferior alveolar nerve is rather deep through the tissue. It’s hard to direct the anesthetic that deep from a patch. So, I think these things may have promise, but I think it’s going to take quite a while to get developed.” (10:05—10:59)

“When I'm delivering local anesthesia to the patient, before I do it, I tell them what I'm going to do.” (15:39—15:47)

“As I go along, I'm walking through and I'm talking to the patient as I'm [administering the anesthesia]. I'm telling them what to expect, what they're going to feel. And so, for example, if I'm going to shake the cheek, I tell them, ‘I'm going to shake the cheek,’ rather than staying stoic and silent, and then I'm suddenly doing something, the patient is startled, ‘What? Why is this guy shaking my cheek?’ or these kinds of things. I want to avoid surprises.” (16:38—17:05)

“I'm trying to tell the patient what I'm doing and what to anticipate in terms of feeling and so forth. But I know that sometimes patients totally tune me out, and all they're hearing is, ‘Blah, blah, blah, blah, blah,’ in a calm, quiet voice. But you know what? If that's hypnotic to them, that's fine too. It still works to relax them and remove some of that anxiety. But the bottom line is that as I'm doing everything, I'm telling them what I'm doing to make this more comfortable for them. I'm telling them what I do to make this a better experience for them. That, to me, is extremely important.” (17:09—17:53)

“How do we normally assess anesthesia? We ask the patient, ‘Do you feel numb?’ ‘Uh, yeah. My lip feels kind of numb.’ So, you pick up an explorer and you poke around. Right? Well, hopefully, they don't feel that. And then, you pick up your drill or your curette, whatever, and you get ready to go to work. And it’s going through your mind, ‘God, I hope they don't feel this.’ Last thing I want is for the patient to jump. So, I got tired of that. It’s like, ‘This is killing me.’ So, simple thing to do, I squirt a little bit of Endo-Ice on a Q-tip, put that on the center of the tooth on the mandible. It’ll be the most posterior tooth that I'm going to work on. If the patient doesn't feel that cold, you've got pulpal anesthesia — 99.9% sure they're not going to feel anything. That's pretty darn good confidence.” (18:11—19:06)

“Learn as many different techniques as you can. Again, the first technique we teach you is the traditional inferior alveolar regional nerve block technique. And that's the one that most dentists use to anesthetize one side of the mandible. But there are other techniques. I'm a huge fan of the Gow-Gates. It’s far more efficient. It has a higher success rate once you learn how to do it well. But you have to practice it to learn how to do it well. And there's another technique, the Vazirani-Akinosi. You can also use infiltrations. There are different things that you can use, and you can use them in different combinations. So, learn them. Don't be afraid to apply them where you feel that they're going to help you. And the more you use them, the better you get at them.” (29:19—30:09)

“I miss injections, just like everybody — well, hopefully, I have a good success rate. But I do miss injections. Let's leave it at that. And so, the point is, I don't care how expert you are, you're never going to be perfect. And you do still have a lot of anatomical variation out there. People are built differently. As a dentist, I wish they were all identical. It would make giving anesthesia easy. But that's not the way the human race is. And it’s good, because it would be a boring world if we were all identical. So, my point is, again, knowing different techniques allows you to accommodate all the different variances of human anatomy.” (30:30—31:12)

“There's so much to learn, and there's no way you can learn it all, remember it all. I think, unfortunately, our students come from college, and our education up through college, students are largely memorizing information and then just spewing it back out for an exam. Dentistry, that's not going to work. You need to actually learn things. And so, it takes learning those facts and figuring out how do they apply, how do they integrate together, how do they work together, understanding why we do certain things the way we do.” (32:55—33:38)

“You're going to make mistakes. We all do. Try not to make big ones. Try not to make dangerous or costly ones. Pay attention. Learn from your mistakes. Don't be afraid to make a mistake. But don't be stupid enough to not learn from your mistake.” (34:03—34:21)

Snippets:

0:00 Introduction.

1:43 Dr. Budenz’s background.

4:39 How dental students learn about local anesthesia.

6:55 The evolution of local anesthesia.

9:46 What we can anticipate for the future of local anesthesia.

11:23 Understanding potential drug interactions with local anesthetics.

15:07 Defining comfortably numb.

17:55 How do you know when patients are comfortably numb?

19:22 Guidelines for anesthesia by state.

21:24 Dr. Budenz’s opinion on others administering anesthesia.

24:00 Ask patients about dental and anesthesia history.

26:27 Typical injection timeframes.

29:02 Last thoughts on local anesthesia.

32:26 Advice for dentists.

34:37 More about Dr. Budenz and how to get in touch.

Reach Out to Dr. Budenz:

Dr. Budenz’s email: [email protected] 

Dr. Budenz’s website: https://alanbudenz.com/

Resources:

Lexicomp: https://online.lexi.com/lco/action/login

Dr. Alan Budenz Bio:

Dr. Alan Budenz is a professor in the Department of Biomedical Sciences and the Department of Diagnostic Sciences at the University of the Pacific, Arthur A. Dugoni School of Dentistry in San Francisco. He received his graduate degree in Anatomy from UCLA, and his dental degree from UCSF. He has more than 35 years of general practice experience in San Francisco, as well as teaching clinical, preclinical, and anatomy courses at Pacific since 1984. Dr. Budenz has had the pleasure to lecture nationally and internationally on local anesthesia, human anatomy, cariology, and oral medicine/oral pathology topics. Since 2005, he has been recognized each year as an Annual Leader in Dental Continuing Education by Dentistry Today.

Why You Should Practice Breathwork

Episode #442 with Dr. Cristian Pavel

We breathe all day, every day. But how often do we think about the way we breathe? It turns out, we are overbreathing. And to explain how that affects the body and mind, Kirk Behrendt brings in Dr. Cristian Pavel, a dentist, life coach, and yoga instructor at YogaSix. As a yogi dentist, he will help you incorporate breathing into your dental practice so you can relax, reduce stress, and relieve anxiety. To master better breathing for a better practice and a better life, listen to Episode 442 of The Best Practices Show!

Main Takeaways:

We are all breathing too much and too fast.

Breathe less when you're stressed — not more.

High-quality breathing equals a high-quality life.

Deep breaths are tools you can use at any moment.  

Breathwork can help ease anxiety for your patients.

Quotes:

“Yoga, essentially, is the practice of finding ourselves, finding stillness, allowing the mind to do its thing without needing to control every element, because that is where a huge source of suffering starts from.” (4:42—4:58)

“Most people are on the overstimulated side. We’re constantly go, go, go, go, go. And it’s a deeply conditioned pattern in our culture. Technology is beautiful. And as incredible as it is, the utility of it has a double-edged sword effect because now that we are more efficient, we have to do more things. And we have this compulsion to do even more things.” (9:18—9:44)

“What I find myself doing — and a lot of other people — when there is finally time to rest, we’re unconsciously still scrolling aimlessly through social media feeds, or whatever cellphone ritual it is, keeping the mind constantly preoccupied and alert. And when this is unchecked, when we’re not aware of how we’re feeling about this, the body gets overstimulated. The fight-or-flight mechanism gets triggered over and over again, repeatedly, and it’s just not a sustainable function. So, we have this chronic stress that gets perpetuated and compounded and naturally progresses into chronic disease and chronic inflammation.” (9:44—10:26)

“Invite the notion that it’s okay to not be okay. I think we’ve all reached this false sense and false reality, especially in dentistry, because you're conditioned to have to be the top. You always have to be the best. And if you're not, you just don't feel good about yourself. And even though that technically ends once you graduate, it still continues, that conditioned reflex continues, like, ‘Oh, the guy down the street just opened up four more ops,’ or whatever the dialogue or the narrative. Or, ‘Oh, I have less patients this month. It must be saying something about me.’ And what I want to say first and foremost is, it’s okay to not be okay.” (13:56—14:39)

“What I say in almost all my yoga classes, the quality of your life is predicated by the quality of your breathing. How we breathe is how we live. And the goal of my yoga classes is to really let people feel that. And most of the time, that's accomplished, as long as they allow themselves to.” (17:58—18:14)

“Almost everyone I pay attention to is not paying any attention to their breath. This is the most fundamental process of our body, and it controls everything. Carbon dioxide is the ultimate hormone. It controls every biologic function in our body. It has its hand in something. So, it blows my mind how little attention is placed on the most important thing. In this health-and- wellness world now, every single calorie, every little thing is scrutinized. But our body can survive two weeks without food. How long can it survive without breathing?” (18:15—18:54)

“One of the things that a lot of people still find interesting and shocking is that we’re all overbreathing. The average adult, according to James Nestor’s book [Breath] and a lot of research that was done, takes about 12 breaths per minute. The average elite athlete takes about five-and-a-half breaths per minute. So, we’re all breathing way more than we should. And most of the time, it looks like short and shallow, quick breathing.” (19:08—19:36)

“Sometimes, it’s hard to recognize in the moment, but when you're feeling really stressed and overwhelmed, stop breathing. It’s very counterintuitive. Very different than, ‘Just breathe. Relax. Breathe.’ No. Stop breathing.” (20:17—20:31)

“So much inflammation comes from this overbreathing. It’s a highly inflammatory, ineffective process — especially if it’s coming from the mouth, mouth breathing and not nose breathing, because part of the nose’s job is to slow down the breathing.” (22:55—23:09)

“I think the reason that breathwork isn't the end-all be-all and everywhere is because it doesn't come in a pill form. And what I mean by that is it takes work, and it takes practice.” (23:49—24:00)

“I can only speak to my experience. And what I've noticed since avidly practicing yoga is I am more naturally calm. And especially in triggering moments, there's almost a natural pause now. And only in retrospect, I realize now that it’s helped me process my environment in a much healthier way.” (32:28—32:54)

Snippets:

0:00 Introduction.

1:29 Dr. Pavel’s background.

3:27 Yoga in a nutshell.

6:55 Why breathing is important for dentists.

12:11 It’s okay to not be okay.

16:58 The power of breathing.

20:31 Slow down your breathing.

24:50 Talking to patients about their breathing.

27:33 Improve your breath health over time.

31:38 Can you add years to your practice life with yoga?

34:44 More about Dr. Pavel and how to get in touch.

35:54 Deep breath exercise.

Reach Out to Dr. Pavel:

Dr. Pavel’s website: https://dentalyogis.com/

Dr. Pavel’s Facebook: https://www.facebook.com/profile.php?id=6829298

Dr. Pavel’s social media: @cristianpaveldds

Resources:

Breath by James Nestor: https://www.mrjamesnestor.com/

Dr. Cristian Pavel Bio:

Dr. Cristian Pavel attained his Doctor of Dental Surgery degree from the University of Illinois at Chicago. He received his Bachelor of Sciences degree from Indiana University.

Dr. Pavel is an active member of the Chicago Dentist Society, and he enjoys traveling, snowboarding, boxing, soccer, spending time with his family, and yoga. He is also a yoga instructor at YogaSix downtown!

From nutrition to intuition, our team is well-endowed in the most successful ways of obtaining optimal oral health and overall health. We would be delighted to share with you the benefits of caring for your teeth and gums, healthful eating, mindfulness, etc. — all the tools to help you in living a balanced, happy life.

How Technology is Influencing Dental Education

Episode #441 with Dr. Gerard Kugel

Now is an exciting time for dentistry. Things are becoming easier, faster, and more accurate, opening up new possibilities. But as much as we talk about technology, dental education has been behind. So, where is the big technology push? To explore that question, Kirk Behrendt brings in Dr. Gerard Kugel to explain the technology lag, its causes, and how we can work to move things forward. Embrace technology, no matter your age! To learn why and how, listen to Episode 441 of The Best Practices Show!

Main Takeaways:

Don't be the first or last to experiment.

Technology will always come and go.

There is no must-have product.

Always embrace technology.

Never stop learning.

Quotes:

“I think dental education has been a little bit behind. And why do you think they're behind? What's one major reason we don't see the big technology push in dental schools? Expense. It’s expensive. Technology is costly. In my private practice, different story. You're at a school that's got 200 kids, 150 kids, it’s expensive. And secondly, your faculty, which sounds funny. You’ve got an older faculty who haven't embraced technology. So, I think technology in dental education has always lagged a little behind.” (5:10—5:41)

“Even though technology, we talk about it, it still hasn’t been totally incorporated into the dental community the way you would think.” (6:20—6:28)

“Five days a week doesn't mean you're a better dentist. What means you're a better dentist is you take the care, you learn, you read, you practice, you're humble, and you know that you can improve. I tell dental students I learn every day. It doesn't matter how many years I've had under my belt in dentistry. I learn. That's why I embrace technology at my age.” (8:20—8:39)

“Even a technology that we take for granted today, which is bonding to dentin, posterior composites, there was a time when that was very controversial. And I lived through those battles.” (12:03—12:14)

“The guy or gal who gets up and says, ‘This is the must-have product,’ I get that all the time, no, there is no must-have. I could hand you five different composites, and you would be fine with those.” (13:30—13:41)

“I always say don't be the first on the block, don't be the last on the block. Do a little homework. Listen a little bit.” (14:33—14:40)

“Anybody who says digital scanning is not accurate — it’s easier, it’s accurate.” (27:32—27:36)

“We are going digital. Most schools are because it’s the way to go. And I'm not telling you — I can do a great job with a polyvinyl siloxane impression. They do a great job. But in this day and age, if they're sitting in front of you and you've got impression material and you've got a scanner, if you don't grab that scanner, then you're just living in the Dark Ages. You've got your head in the sand. My patients love — they think you're a better dentist, even if you're not, because you're [using] digital.” (28:35—29:06)

“Get into a good situation at a good practice. Never stop learning. Find some good educators that are not bought and sold by corporations that you can latch on to.” (30:42—30:57)

“One of the regrets I always have is, I restored implants since the ‘80s. I'd never placed implants. Be well-trained. Placing single-tooth implants with a surgical guide is not that complicated.” (31:33—31:44)

“I tell students all the time, it’s not the dentistry; it’s the person behind the teeth that is often the issue.” (33:43—33:49)

“If you've got a patient that you really don't feel comfortable working on, be careful. Because all that money means nothing if you're miserable. What does it take to make you miserable as a dentist? How many miserable patients to make you miserable? One. You need that one...