The Best Practices Show with Kirk Behrendt

Lower Risk – Increase Prognosis

Episode #321 with Dr. Betsy Bakeman

Risk assessment is the most important tool for designing the best treatment. And to share the most effective way to lower risks and have a good prognosis for your patients’ teeth, Kirk Behrendt brings in Dr. Betsy Bakeman to talk about a new system of thinking, the four diagnostic parameters, for better outcomes in patients. Veneers are useless if you lose your teeth! To learn more about treating patients comprehensively for the long run, listen to Episode 321 of The Best Practices Show!

Main Takeaways:

It’s important to figure out why something is happening to patients’ teeth.

Always look to reduce risk in areas of perio, biomechanics, function, and esthetics.

You can reduce risk, but you can't always eliminate risk.

Risk is a moving target in patients — things change.

It’s important to help your patients understand their level of risk.

Treatment doesn’t need to be done all at once.

Continuing education is the best gift you can give yourself.

Quotes:

“The whole concept of lowering risk, of looking at a patient and making a complete diagnosis and looking at where their risk factors for breakdown are and really categorizing that in a very simple way: low, medium, high. Periodontally, biomechanically — which is the structural integrity of the teeth. So, that's the patient’s risk for caries, erosion. And then, functionally, load-based failure. And then, also looking at the patient for esthetics, do the teeth show, because that has an influence on where we put the teeth and everything. So, you categorize in those four areas, are they low risk, medium risk, high risk.” (04:40—05:24)

“You have to work to lower the risk. Now, that may be treating the decay. It may be saying the decay is too out of control, we need to remove the teeth and move toward implants. Load-based failures. Is this a parafunction patient? Is this just friction? Are the teeth rubbing together, and we can fix that, the way the teeth come together? So, we always are looking to lower risk. And the amazing thing that does when we really think about that and make a thorough diagnosis and we design our treatment plans to lower risk, we increase prognosis and predictability. And patients really get it.” (05:32—06:11)

“It’s just a different way of looking at things and looking at the whole patient and making some decisions about where to go with things. And people are so appreciative. You end up treating the patient for the long term and you create very happy, very pleased patients. And it doesn't mean you have to do it all at once. Sometimes, we stage treatment over time. But you're going in that direction to lower risk and increase prognosis. And it feels really good. It feels like you're serving the patient.” (07:32—08:06)

“You have to force yourself to think [in this way]. [John Kois], he has systems that go through that, that go through perio, biomechanics, structural integrity of the teeth, the function, and the esthetics. And you actually have to write down in those areas and think about it in that way. And in the beginning, you have to fill out the form. You have to start to get your brain to think that way. And you develop the risk assessment, and you say to yourself, ‘Okay. I know this patient wants veneers. But if I don't manage the function, the reason the teeth look this way, this whole thing is going to fail.’ Or if the patient doesn't treat the periodontal disease they have, I could do beautiful veneers, but they're going to lose their teeth. And so, you structure things that way.” (08:51—09:42)

“The patient that needs the most dentistry, they're coming with the highest level of risk. And sometimes, we can lower risk. But in some areas, we’re not able to. We just have to manage it, and to the...

A Completely Different Perspective on How to Enjoy Dentistry

Episode #320 with Dr. Kevin Kross

There is no real secret to enjoying dentistry, but there are ways to make it more pleasant for you, your staff, and your patients. To share some of those tips, Kirk Behrendt brings in Dr. Kevin Kross to help you enjoy more of your time at the office. His first tip: don't take things quite so seriously! Break the ice with new patients and spend time getting to know them. Most patients want to know about you and how you can help them, not the technical details of their teeth. For more of Dr. Kross’ tips and advice, listen to Episode 320 of The Best Practices Show!

Main Takeaways:

Take CE courses to learn what they don't teach you in dental school.

Be open-minded toward different teaching philosophies.

Show gratitude, especially towards your team.

You don't need to work full-time!

Be very intentional with your time.

Figure out what you truly love about practicing dentistry and target that.

Don't take things quite so seriously.

Quotes:

“I tell [students and mentees] all the time, ‘Listen, just don't take it quite so seriously.’ I think we get trained to, you know, everything is the end of the world. And early, early in my profession, I might’ve even been a dental student, when somebody told me, they kind of shrugged and said, ‘Well, at least it’s not brain surgery, right? We’re working on teeth here. But more importantly, we’re working on people. And they just want you to be honest. They want you to be straight up with them.’ It’s so rare, at least where we practice, that they want to know about their teeth. They want to know about you. They want to know how you can help them.” (08:09—08:42)

“Get to know the patient. Find out what they're after, why they're even in the chair today, and what makes them tick. And just that level of communication, I think it — I hope — it displays that I'm interested in them first. Dentists can kind of get a bad reputation, I think, a lot of times, from telling them about what's wrong with them, ‘The patient wants to know what's wrong with them first.’ It’s like, don't do that. We’re all great diagnosticians, to some degree, and I think it’s just easier to get to know them on a personal level first.” (08:46—09:22)

“There is no secret [to enjoying dentistry]. That's for sure. If I had to pick one word, it’s gratitude. And I've had some employees we had to get rid of. But I think we all have team members that didn't work the way you wanted to, and that kind of thing. But if you show gratitude towards a staff member, a team member, it’s not about the money so much with them. My thing is, I want to have the highest paid team around. But I think, more importantly, I want them all to always feel like they're effective at work. And I think that's really what we all want, right?” (10:16—10:58)

“If you want to run a truly comprehensive practice, learn the stuff that they don't teach you in dental school. And you have to do it all-in. You can't tiptoe around this, and do a little of that, but then go back. You just have to dive in and trust the multitudes of people that have done it that way and developed really, really good practices because of it.” (17:03—17:28)

“I think one thing that we maybe fail at in getting across to students is, yes, we can teach you how to do this. Yes, we can give you the protocols and all of the information and knowledge to really, really help patients far and wide. But you do have to figure out the way to implement that in a practice. It isn't going to be for every single patient that walks through your door. And that's okay.” (22:09—22:39)

“For me, it took three to five years of really sitting down and focusing on a certain patient’s problem and just helping them understand it. It doesn't

The Future Foundation of Orthodontics

Episode #319 with Dr. Drew McDonald

Orthodontics is more than just straightening teeth. And today’s guest, Dr. Drew McDonald, explains how foundational knowledge of patients’ issues can lead to more successful treatment and happier patients. Kirk Behrendt and Dr. McDonald talk about the interconnectedness of airway and joints in ortho and how interdisciplinary understanding can help patients long term. Don't be led astray by the esthetic side of things! For more on the importance of foundations, listen to Episode 319 of The Best Practices Show!

Main Takeaways:

Look under the surface — the foundation — in patients’ issues.

Airway and jaw joints influence structure, which leads patients into the ortho chair.

Ortho is more than straightening patients’ teeth.

Don't get lost in the esthetic side of things. Straight, white teeth isn't the endgame.

Understand who’s in your chair so you can give them the best treatment.

Quotes:

“As an orthodontist, we see patients with teeth that don't fit together, teeth that are crowded, whatever it might be. But at the end of the day, when we start peeling back the layers, we’ve got to know where that came from. And what we’re starting to understand, it seems like more and more every day, is that the airway side of things, the TMJ side of things, the growth and development, that those two factors, especially, really influence and create an orthodontic patient. Somebody with a bad bite and bad teeth, under the surface, there's an airway issue, or a joint issue, or both, a lot of the times.” (06:09—06:41)

“If we understand the foundation of our patients from a joint standpoint, from an airway standpoint, from even cervical, spine things, and the bone around their teeth, then we know what's going to be successful and stable long term because we’re addressing the under-the-surface things that got the patient into our chair.” (11:45—12:03)

“The other nightmare of orthodontists is relapse. So, if we can understand the foundation of our patients and what got them, under the surface, into our orthodontic chair, then we set ourselves up for better success, stability, and ultimately, a happier patient.” (12:34—12:48)

“Whenever I, quite honestly, wanted to be an orthodontist, I wasn't thinking about jaw joints or airway stuff. And some of that wasn't really a big part of what we were taught in school. And ultimately, I've gotten to know a lot of very influential people in my life who have taught me so much about the foundational side of joints, of airway. Dr. Mark Piper, he’s a big role model of mine. Jim McKee, in terms of the joints. They're not orthodontists. Those dudes, they put something in my head that did not come from orthodontic residency. But as I went back to patients after seeing them talk, I go, ‘This is my everyday patient. All of these Class II patients that all have clicks and pops, that's no coincidence.’” (13:26—14:15)

“The things that can lead orthodontists astray is that we start thinking about the cosmetic side, the esthetics, that that's all the endgame is for these patients.” (16:48—16:56)

“I think it’s easy in ortho, sadly, at this point in the game, to get led astray. And I will say, it’s a frustration of mine to see — and I'm not saying anything negative of the people that you see all over certain social media stuff. I'm just saying we have a better story to tell. And I think that the story to tell is that we can do more than straight teeth. It’s, we are the people most equipped to do more than straight teeth, and recognize it, and help people structurally.” (17:21—17:47)

“You can't just diagnose something and tell somebody they need to do something. You have to be able to motivate them. And ultimately, you have to know why that person’s in the chair too.”...

The Top Thing Dentists Miss or Don't Ask with Patients

Episode #317 with Dr. Tom Viola, R.Ph., C.C.P.

To make the best treatment planning decisions for patients, you need to know their medical history. And to do that, you need to ask the right questions. Today, Kirk Behrendt brings in Dr. Tom Viola to teach you the three key questions to ask patients to get their medical history. What you don't know about your patients could impact their care! To learn what you weren’t taught in dental school, listen to Episode 317 of The Best Practices Show!

Main Takeaways:

Know your patients’ medical history to make well-informed treatment planning decisions.

All you need is the patient’s medication list and an understanding of pharmacology.

Build a good team around you and teach them how to take a good medical history.

Ask patients good, open-ended questions to get the information you need.  

The first question to ask patients is, “What do you take?”

The second question to ask patients is, “Why do you take it?”

The third question to ask patients is, “Did you take your medication today?”

Asking those three questions will help you understand what you're getting into with patients.  

Substance abuse/use has an effect on dental therapy. Ask patients about it!

Quotes:

“We really sometimes miss [important] things when we take medical histories, when we inquire about patients’ medications. There are some things we miss because even we don't think it pertains to dentistry when, in fact, it does.” (08:00—08:12)

“It goes well beyond medications and xerostomia and even system-induced xerostomia. It has to do with, do you know enough about the patient’s medical history to make well-informed, good clinical decisions in your treatment planning? And the only way you're going to really know that is if you know the patient well enough. And the only way that's going to happen is if you know their history. So, medical histories [are just as] important [as] almost anything else you do in your practice, because without knowing your patient intimately and sufficiently, you're not going to be able to make those decisions.” (08:23—08:57)

“The greatest blessing ever bestowed upon dentistry was the fact that you could take the patient’s medical history directly from the patient themselves. They're right there. Right? What more convenience can there be? And the greatest curse ever inflicted upon dentistry was that you could take the patient’s medical history directly from the patient themselves. As in, if they don't know, you're not going to know. And if they don't want you to know, you're not going to know. But you can overcome that obstacle when you realize that all you really need is a list of their medications and a good working foundational knowledge in pharmacology.” (09:37—10:12)

“I will tell you the thing I hear the most. In the beginning of the medical history, this is the question that gets asked, ‘Any changes to your medications?’ And immediately, the answer is, ‘No.’ Why? Because it’s easier to say no than it is to give me, the dental clinician, the information I need to be able to fill in the medical history. So, conditionally, I say, ‘No.’ And everybody’s like, ‘Okay. No.’ And we move on. But we missed so much of what we could've grabbed from that interaction.” (11:01—11:32)

“Build a good team around you. You've got to invest the time and the money, if necessary, in your team to be able to teach them how to take a good medical history, what questions to ask, and how to ask leading questions and open-ended questions to get the patient to give up the information that maybe they don't want to give up, or maybe they don't know to give up.” (11:41—12:01)

“Ask the right questions. So, you've had your teammate ask the questions....

Whine About it With the WINEgenist

Episode #316 with Katrina M. Sanders, RDH, BSDH, M.Ed, RF

She isn't everybody’s cup of tea, but she is someone’s glass of wine! Today, Kirk Behrendt introduces Katrina M. Sanders, The Dental WINEgenist, to share her passion for dental hygiene and good wine. Great conversations need great wine! And with the two combined, she hopes to support, encourage, and empower others to elevate dentistry. If you're a dental professional who needs to whine about dentistry with wine and a like-minded tribe, listen to Episode 316 of The Best Practices Show!

Main Takeaways:

COVID-19 exposed many existing problems in dentistry.

The Dental WINEgenist sparks conversations about those problems.

Dentistry can be isolating since professionals are siloed in their own operatories.

And because dental professionals are isolated, it stops communication and great ideas.

Join The Dental WINEgenist to share ideas and support one another in elevating dentistry.

Great conversations require great wine!

Quotes:

“It is isolating. We’re stuck in this operatory where now, a lot of times, we don't have other colleagues to share ideas, ‘Hey, come look at this X-ray. What do you see?’ If you're a one-doctor practice, you don't have somebody aside from maybe your hygienist to share some of those ideas. And if you're one hygienist in the practice, you don't have somebody to help you sharpen instruments. Or if you're struggling to remove that piece of calculus, you don't have a colleague to bring into the operatory to help you out. And so, this is, I think, where a lot of ideas stop, a lot of high-level clinical practice care stops, and I wanted to be a part of the conversation that isn't happening in dentistry. And so, you want to have a fabulous conversation, you've got to bring some great wine. So, that's who we are. The birth of the WINEgenist.” (12:05—12:53)

“I think dentistry was caught with its scrub pants around its ankles when the pandemic happened. And the reason for that, I think, first and foremost, is that a lot of things that we needed to address in dentistry but hadn't had been swept underneath the front office rug. There are things that we should've been talking about, like lack of leadership and efficiencies within the practice.” (17:35—17:57)

“I think that what I do is highly essential. I'm not risking my life [during COVID-19] to just clean someone’s teeth. I'm an inflammatory specialist who’s highly trained in infection control. And before I go back to the operatory, I want to make sure that we’re doing this safely so that I'm not putting myself at exposed risk, nor am I putting the rest of the team members or other patients at risk. And that's where the conversation got away from us, is because these conversations that we should have been having about the essential nature of the work that we do, the responsibility that we have to the profession, that conversation went out the window. And it was more about us having fears about our safety, or lack thereof, when we go to work.” (19:48—20:27)

“The concern really became, so much was swept underneath the rug. And with one wave of a regulatory hand, boom, everything got blown out and it was exposed — we were exposed as dental professionals — to the things that were inadequate in our profession, conversations that needed to be happening. And that's where I think we’ve had the opportunity since March 17th to do better as a profession, to take what it is that we’ve experienced during this global health and financial crisis and really create the pivots that dentistry has so desperately needed for so long.” (20:53—21:33)

“We started to see patient screening taking effect [during the pandemic]. And what that did, that peeled back the layer that a lot of hygienists have had grief about for a long time. And...

Seeing the Clinical/Technical Reality

Episode #315 with Dr. Bob Winter

There is a lack of communication between dentists and the lab. And to explain why that is and how to close that gap, Kirk Behrendt brings in Dr. Bob Winter for his insight into both the clinical and technical sides of dentistry. Keeping standards and expectations high is great — but keep them grounded in reality! For more advice on communicating effectively, listen to Episode 315 of The Best Practices Show!

Main Takeaways:

Dental students aren't taught how to communicate and interact with dental labs.

Because of this, there's a lack of effective communication between the two.

Dentists expect perfection from the lab without communicating effectively.  

Dentists should make an effort to find the right dental lab to collaborate with.

Learn to diagnose and treatment plan comprehensively.

Technology helps simplify things but isn't a panacea.

You still have to think analog in order to use digital technology.  

Digital isn't a prerequisite to becoming a quality dentist.

Quotes:

“In dental school, we learn a lot of basic concepts. And then, when we get into a practice, we’ve learned a lot of clinical steps. But unfortunately, in most schools, we don't learn a lot about the communication and interaction with dental laboratories. We just expect certain outcomes, and yet we don't communicate very effectively with dental laboratories. We just expect perfection, and we don't know how to interact and communicate because we’re not taught that in school.” (09:56—10:35)

“Today’s technology is evolving so quickly because of the digital world, whether it’s digital photography or even things like we’re doing right now. We can communicate with individuals around the world, real-time. So, [technology] simplifies things, but it’s not necessarily the panacea that solves our problems. And in the digital world, there are some current weaknesses in how it relates to the traditional analog world. And so, I'm just super excited to see all of it evolve. And hopefully, sooner than later, there's a seamless transition from analog to 100% digital.” (12:05—12:47)

“The only thing that makes me, as a specialist, a prosthodontist, different than anyone else is, I'm trained to look at patients comprehensively and to diagnose and treatment plan comprehensively. When it comes to procedures I do, it’s not different than any restorative person. So, it’s all about seeing the patient in a holistic manner and comprehensively. And in dental school, they get a reasonable exposure to that. But once you start seeing patients, you realize it goes beyond one tooth, or two teeth, or three teeth, or quadrants; it’s full-mouth evaluations.” (13:23—14:07)

“We can treat individual teeth fairly predictably. But when you see people with debilitated dentition, severely worn dentitions, multiple missing teeth, then looking at the big picture and understanding comprehensively what the needs are, I think, is the key.” (14:21—14:42)

“Unfortunately, there's a lack of effective communication between the dentist and dental laboratory. If you look at the percentage of prescription forms that are completely filled out, or at least to get enough information to do the cases comprehensively, it’s lacking. So, the expectations are really high of what you want in return, but the upfront communication is lacking.” (15:25—15:53)

“Many dentists, the more comprehensive cases, they want the technicians to solve the problems. But the dentist has to realize technicians do not have a dental training background. They can look at photos, they can look at mounted casts, and they can look at how you make the nuts and bolts work. But it’s still relying on the dentist’s clinical skills and understanding to help really...

TeamSmile Gives Back

Episode #314 with John McCarthy from TeamSmile

In 2007, 12-year-old Deamonte Driver lost his life. And the cause was a treatable one — if only his mother had dental insurance. Enraged and inspired after hearing Deamonte’s story, Dr. Bill Busch created TeamSmile to provide free dental care for children in need. And today, Kirk Behrendt brings in John McCarthy from TeamSmile to share the impact and importance of dentists participating in this program. For more on why you should volunteer with TeamSmile, listen to Episode 314 of The Best Practices Show!

Main Takeaways:

A 12-year-old boy, Deamonte Driver, passed away from an untreated tooth infection.

Upon hearing Deamonte’s story, Dr. Bill Busch was inspired to start TeamSmile.

TeamSmile’s core is to provide free dental care for children in need through the power of sports.

The TeamSmile model doesn't work without volunteers!

These programs provide life-changing services and can also save lives.

Quotes:

“The mission of TeamSmile is to provide a life-changing dental experience through the power of sports. In a nutshell, what we do is we throw dental tailgate parties. We go into communities such as Milwaukee and we set up in a baseball stadium. We work with the Brewers. We work in Kansas City with the Chiefs, the Royals, in supporting KC. But we’re at the point now where we are truly national. We’re working in Fenway Park with the Boston Red Sox, and we’re in California with the Angels and the Rams, and so on. So, we’re literally coast to coast, north to south.” (05:34—06:08)

“Prior to the pandemic, we conducted 33 programs in one calendar year, impacted 7,126 children, and did over $2.8 million in free dental care and oral health education. But in a nutshell, we create these large dental clinics in stadiums and arenas. We literally set up about $650,000 worth of equipment and supplies while we’re in Fenway Park, while we’re in Target Stadium in Minnesota, while we’re in Arrowhead in Kansas City, and on and on. We work in New Orleans at the Superdome, and Mercedes-Benz in Atlanta — which is spectacular, by the way. But we will set up enough where we’ve got 16 dental operatories.” (06:09—06:54)

“The Deamonte Driver story, in short, was a little 12-year-old boy in the Baltimore D.C. area that had a toothache. Single mother, very little money. Had a toothache. But the mother said, ‘We can't go to the dentist because we don't have dental insurance. We don't have the money to pay for that.’ Well, it got more and more painful, and so he went to the hospital. Dr. [Bill] Busch is watching this at home in Kansas City on an NBC Nightly News special with Brian Williams. Well, [Deamonte] goes to the hospital, and the hospital doesn't have a dentist on staff. They tried to pat him on the back and do what they could for him there and sent him home. That toothache got infected. That infection spread to his brain. At 12 years old, Deamonte Driver passed away. And Dr. Busch — I talked to him a lot about this — he said, ‘I was mad. I was upset, thinking, ‘We live in the most wealthy country in the world, and we’ve got a 12-year-old boy that didn't have to die if he was treated appropriately. Could've been completely fine if he was treated. And here he is, dead.’ And he started thinking, ‘What can I do?’ (07:39—08:39)

“I think this concept was just brilliant, looking at it, because what we do is, not only do we have stadiums and arenas, but we’ve got a DJ for all of our programs, we have face painters, we bring out the players, the cheerleaders, the mascot. And so, what the intent is, is to use these stadiums and use these teams — and by that, I mean players, cheerleaders, mascots — and create an environment that is cool, that is fun, takes the fear out of dentistry. There’re a lot of children that we’re...

A New Look at Occlusion

Episode #313 with Dr. Jim McKee

Joints are connected to everything in dentistry, yet no one wants to do it — or knows how! And to help you understand and rethink occlusion at the joint level, Kirk Behrendt brings in Dr. Jim McKee so you can build this into your dentistry. Don't let occlusion be the weak link in your practice! To learn more and gain confidence in treating occlusal problems, listen to Episode 313 of The Best Practices Show!

Main Takeaways:

Occlusion is the weak link for most dentists.

How dentists define occlusion is actually not reality.

When thinking about occlusion, think at the joint level, not just the tooth level.

If you have a bad joint, you're going to have a bad bite.

Gain confidence in occlusion at the joint level, and your practice will skyrocket.

Quotes:

“I really realized that occlusion was the weak link for most dentists because it’s what we come out of dental school with being the most — we’re not confident in it. We see occlusal problems, and we’re not totally sure what to do with them.” (05:09—05:24)

“So many patients that sit in our chair have occlusal problems. But here’s the problem. When that young dentist talks about occlusion, what they're typically talking about is how the teeth fit together. Because as dentists, that's how we define occlusion. That's not reality though, because when you think about it, really, it’s how the lower jaw fits to the upper jaw.” (06:44—07:09)

“I have to credit Mark Piper for this, because Mark was the first person that showed me an MRI back in 1990. And it changed the way I thought about occlusion, because I started thinking not just at the tooth level, but at the joint level. And really, I think we’ve had the thought process backwards. The discussion was always, ‘Does an uneven bite cause a change in the joint?’ Because typically, it might cause us to clench our teeth, we might start to brux, the muscles would pull on the disc, and eventually the disc will displace. What I've learned over the years is that I think we have to look at it the other way around.” (07:37—08:14)

“There was just an article published in Cranio in January of this year that talked about if you have a malocclusion, your odds increase that you have structural changes at the joint. So, we’re really starting to get a better handle on it. And that's why I think we need to take a new look at occlusion. Because I will tell you, if as a restorative dentist you can gain confidence in occlusion, not only at the tooth level but at the joint level, your practice will explode.” (08:37—09:05)

“I absolutely believe two things. There are more structural changes in the joints than, as a profession, we believe. We were taught five to 10% of people might've had significant intracapsular problems. The number is at least a third. The other thing is that, really, in order to gain confidence at the restorative level, I think we have to understand the joints.” (10:20—10:48)

“Pete Dawson was the one who told me this many years ago: there has to be a reason why people are going to come to you — other than your insurance, other than the times you're open. They have to come to you for a clinical reason.” (11:07—11:18)

“It’s interesting. Everyone wanted to be an esthetic dentist. Everyone wants to be an airway dentist. Everyone wants to do implants. No one wants to do joints. And yet, if you have an airway case, if you have an esthetic case, if you have an implant case, we have to know the condition of the joints in order to be able to treatment plan predictably.” (11:23—11:43)

“The jaw joint, we don't think about it like an orthopedic joint. But in essence, that's what it is. And if we really think about it, it’s the first orthopedic joint that's injured in life. People don't tear...

Could It Be Airway?

Episode #312 with Dr. Tracey Nguyễn

Airway isn't just appliance therapy — it’s about reducing the risk of sleep-related disorders for overall health. And today’s guest, who didn’t like or start out with sleep dentistry, is here to explain why all dentists should be thinking about airway in their practice. Kirk Behrendt and Dr. Tracey Nguyễn talk about focusing beyond just patients’ teeth, and how airway is connected to everything. To learn how to get started, listen to Episode 312 of The Best Practices Show!

Main Takeaways:

Disorders we see in children are related to airway issues.

Dentists are as important as sleep physicians in managing sleep-related disorders.  

Other physicians need to know that dentists can help treat patients.

Patients trust dentists. They spend more time with dentists than primary care physicians.

Start with the medical history. Get to know patients before looking in their mouth.

Reach out to different specialists for support.

Airway is connected to everything!

Quotes:

“What's going on right now with all these diseases, especially with children, all the neurocognitive issues, the ADHD, I kind of realized that, ‘Wow. Could this all be airway issues?’ And the best person to manage the face is a dentist. And so, I didn't understand why we were not equally as important as a sleep physician. The first person that a child should get a referral to is the dentist.” (07:11—07:39)

“I think the profession that has the most influence in change is dentistry. I mean, medicine is really all about management. I had a five-year-old on a CPAP, and I talked to the physician. I was like, ‘Okay. What's the endgame of this? What do I need to do to get this child off of CPAP?’ And the sleep physician said, ‘What do you mean?’ I was like, ‘What do you mean, you don't understand what I mean?’ I was like, ‘What is the endgame?’ And for them, they didn't even understand that, because medicine is about management.” (08:08—08:47)

“You see [issues] in all ages. And the question you have to ask is, ‘Could it be airway, and could my dentistry impact the airway positively or negatively?’ So, I think that's a very important conversation to have. Patients trust the dentist. They spend more time at the dentist than they do at their primary care. And we connect the dots.” (10:54—11:20)

“The way dentistry is working is, we’re trying to get beyond just looking at pictures of teeth and be like, ‘Well, let's start with the medical history. What's going on? Who is this patient?’ Your first class in treatment planning should be understanding the medical history. We kind of skip that. As physicians, we forget the medical history and we go straight to taking pictures of teeth. So, I'd like us to slow down. I think that when you slow down, you get to know the patient, then you develop that trust.” (12:01—12:35)

“With airway dentistry, it’s no different than restorative dentistry. You're going to need your orthodontists. You're going to need your oral surgeons. You're going to need your specialists. So, it’s just a different way of managing it. And you're managing it from a health’s perspective now.” (14:27—14:43)

“With kids, all the neurocognitive [consequences appear] before you see the malocclusion. So, when they come into your office for that first dental cleaning, that’s so important. You’ve got to recognize the sleep problems before you send them to the orthodontist. And the adult world is obviously a little bit different. But it always goes back to screening and understanding the signs and symptoms.” (15:06—15:35)

“Before, I was just focused on the esthetics. But now, when you come from a health perspective, a perspective where you actually care about the patients’ well-being and things that you can do for them, your case...