The DOC Podcast

In this episode, I welcome the amazing Dr. Claudia Pinter, an internationally renowned orthodontist and faculty member in the Department of Orthodontics at Nova Southeastern University.  Dr. Pinter shares her journey from Vienna, Austria to becoming a pioneer in clear aligner therapy. The discussion delves into the importance of blending art and science in orthodontics, the value of studying post-treatment records, and the necessity of screening patients for airway issues. 

Dr. Pinter also shares her innovative techniques in maxillary expansion using bone-borne expanders, the role of social media in patient education, and the significance of being transparent and proactive with patients. The episode highlights the evolving landscape of orthodontics, driven by new technologies and multidisciplinary approaches to improve patient outcomes.

00:00 Introduction and Guest Introduction

00:47 Dr. Pinter's Journey and Philosophy

01:35 Discussion on Clinical Practices and Innovations

08:23 Pediatric Orthodontics and Airway Issues

16:48 Advanced Techniques in Orthodontics

37:32 Embracing Change in Orthodontics

38:16 The Impact of Maxillary Expansion

38:45 Challenges and Criticisms in Modern Orthodontics

42:44 Innovations in Orthognathic Surgery

48:04 The Role of AI in Orthodontics

51:41 Educating Patients and Colleagues

01:01:03 Personal Journeys in Orthodontics

LINKS: 
Dr. Pinter on Instagram: https://www.instagram.com/drclaudiapinter?utm_source=ig_web_button_share_sheet&igsh=ZDNlZDc0MzIxNw==

Transforming Oral Surgery: Insights from Dr. David Alfi

In this episode of the 'Doc Podcast,' host Dr. Mike DeLuke interviews acclaimed oral surgeon Dr. David Alfi from Los Angeles, California. They discuss Dr. Alfi's journey through Columbia University, his evolution from academic practice to private practice in Houston, and the development of his groundbreaking surgical techniques. Dr. Alfi shares his innovative approaches in orthognathic surgery, including the use of custom-printed titanium guides and plates, which have significantly improved surgical outcomes, efficiency, and patient recovery times. The conversation extends to the crucial topic of airway issues and TMJ disorders, addressing how modern surgical practices can provide better resolutions and improve overall patient health. Dr. Alfi also highlights the importance of continuous learning, research, and bridging the gap between academia and private practice to advance the field.

00:00 Introduction and Guest Welcome

01:57 Dr. Alfi's Journey to Oral Surgery

03:30 Orthodontic Experiences and Reflections

07:04 Transition to Private Practice

10:06 Bridging Academia and Private Practice

17:19 Innovations in Jaw Surgery

24:00 Efficiency in Surgical Procedures

24:07 Advancements in Incision Techniques

24:47 Accurate Surgical Outcomes

25:26 Orthodontic Innovations

25:52 Airway Considerations in Surgery

27:26 Custom Plates and Stability

31:24 Patient Case Studies and Outcomes

33:29 Debate on Malocclusion Causes

43:03 TMJ and Airway Correlation

47:48 Future Directions and Acknowledgements

LINKS
-Dr. Alfi's Instagram: https://www.instagram.com/dr.davidalfi/

Money, retirement, wealth, prosperity.  All terms we are familiar with but do any of us know how to achieve them?  That is why I wanted to have my friend and colleague, Dr. Mart McClellan on the show.  Mart is an orthodontist AND a financial advisor and he is a wealth (pun intended 😊) of knowledge.  He will share how he feels all of us can achieve financial prosperity both pre-and post-retirement. 

We discuss:

·         What motivated Mart to pursue a career in financial advisement while he was practicing orthodontics full-time.

·         How a conference Mart went to as a resident changed his perspective on money.

·         What to do about debt, including student loan debt, mortgage debt, consumer debt, etc.

·         If Dave Ramsey has the right idea by recommending to aggressively pay down debt.

·         Whether to get a 15-year or 30-year mortgage.

·         Ways to change your mindset towards money.

·         The importance of setting goals for your financial future.

·         The flaws with the traditional financial model.

·         How to get off the traditional linear model of accumulating wealth and accelerate your wealth curve.

·         The importance of thinking about how to distribute your assets, not just accumulate them.

·         Who the “rulesmakers” are and how they attack our money 365 days/year.

·         The percentage of your earnings that you should be saving every year.

·         What a “Wealth Freedom Account” is and why you need one.

·         If you need an Emergency Fund and, if so, how much to put in it.

·         Which is more important, a savings rate or a rate of return.

·         The difference between “new money” and “old money” when it comes to investing.

·         Why we don’t believe in “evidence-based financial planning.” 

·         What a “diversified portfolio” really means, and what it is not. 

·         When to expect the next downturn in the real estate market.

·         The difference between average rate of return and annualized rate of return, and which is more important.

·         How many different income streams wealthy people typically have.

·         Whether or not you should fund a retirement plan.

·         Mart’s thoughts on the “Die with Zero” mentality. 

·         What can be done to help students/residents get a better financial education.

·         Strategies for older docs can do to maximize their retirement income.

·         And much more!

LINKS:

-Mart’s Book “Your Retirement Smile”: https://a.co/d/9y6fTRU 

-Mart’s Website: www.Macro-Wealth.com

-Mart’s Email: [email protected] 

-Mart’s Cell: (847) 363-5502

-Rich Dad, Poor Dad: https://a.co/d/6nkfQFS 

-Smart Couples Finish Rich: https://a.co/d/6nkfQFS 

I had the pleasure of interviewing Dr. Kalli Hale, an amazing general dentist who transformed her practice into one that focuses on the overall health and well-being of her patients.  In addition to being a wealth of knowledge on airway and early treatment, she is a business owner, wife, mom, and national lecturer.  

We discuss:

• How dentistry is a family affair for Kalli.
• The lack of training and education in dental school surrounding sleep and airway.
• The relationship between sleep bruxism and OSA.
• Why Kalli developed such a passion for airway-focused treatment.
• What Kalli has to say to her colleagues who do not believe that we can or should be addressing airway.
• The importance of being a good communicator and having a passion for what you do.
• How powerful it is when parents are brought to tears by what you were able to do for their child.
• The importance of mouth breathing for the growth and development of the face and teeth.
• The potential liability of dentists who are not screening patients for airway issues and their associated comorbidities.
• The benefits of habit correctors/eruption appliances to improve muscular dysfunction and facilitate nasal breathing.
• The need for a mindset change in orthodontics from one that is reactive to one that is proactive.
• The role that insurance plays in the decision to wait to begin orthodontic treatment.
• The misdiagnosis of sleep-disordered breathing as ADHD.
• The fact that the medical community is now prescribing “speed” for kids as young as 2 years of age.
• Some of the many flaws with the 2019 AAO White Paper.
• The best way to gain a greater understanding of the power of recognizing sleep/airway issues in our patients.
• The challenges Kalli faces as a mom, wife, dentist, entrepreneur, practice owner, and national lecturer.
• And much more!!

LINKS:

-Link to DOC Interceptive Ortho Tx Course: https://theorthocoach.com/courses/phase-i-arch-development/?portfolioCats=99

-Episode w/Eric Ploumis: https://podcasts.apple.com/us/podcast/answers-to-common-legal-questions-w-eric-ploumis-dmd-jd-ep-29/id1689703392?i=1000637849977

-Find Kalli on Instagram: https://www.instagram.com/theairwaycentereddentist?utm_source=ig_web_button_share_sheet&igsh=ZDNlZDc0MzIxNw==

Dentists and orthodontists often debate the role we play in the detection and management of airway compromise, especially in children.  I had a fascinating conversation with Dr. David McIntosh, a highly regarded ENT from Australia, who offered his thoughts on the topic from a medical perspective. 

 We discuss:

• How David became passionate about airway and sleep, and why he is passionate about treating children.
• The influence that the 2012 paper by Karen Bonuck, MD about the impact of snoring and mouth breathing on the cognitive development of children had on David.
• The reason why ENTs and dentists should be collaborating more often.
• The fact that 80% of the children presenting to the orthodontist have an airway problem.
• The fact that pediatric sleep-disordered breathing is more common than asthma and diabetes combined.
• The role that cognitive dissonance plays in the resistance of both orthodontists and ENTs to change their approach to the diagnosis and treatment of patients with airway compromise.
• The signs and symptoms of airway compromise that ALL ENTs and dentists should be looking for in their patients.
• Why straightening teeth is great, but saving someone’s life is next-level rewarding.
• How the medical insurance industry is impacting the ability of ENTs to perform adenotonsillectomy on children.
• How the 2019 AAO White Paper got it wrong and the 2017 ADA Position Statement got it right.
• The reason why a sleep study and AHI are NOT reliable indicators of airway compromise in children.
• The AADSM position statement about the efficacy of monotherapies.
• The efficacy of CPAP versus mandibular advancement splint therapy.
• The importance of phenotyping to determine the etiology of airway disease before initiating treatment.
• What David feels about expanding on patients as young as 4 years old.
• Why orthodontists would feel differently about airway-focused treatment if they saw their patients 20-30 years after treatment.
• The importance of early detection and treatment of airway issues.
• Why saying that OSA is analogous to Stage 4 cancer IS appropriate from a medical perspective.
• And much more!!

LINKS:

-Dr. McIntosh’s books: 

>Snored to Death: https://a.co/d/0700GJj

>Don’t Ignore the Snore: https://a.co/d/3P9lpXA 

>A Parent’s Guide to Pediatric Sleep Disordered Breathing: https://a.co/d/7qDRuJS 

-Karen Bonuck paper: https://pmc.ncbi.nlm.nih.gov/articles/PMC3313633/ 

-Chervin paper: https://pubmed.ncbi.nlm.nih.gov/11875140/ 

Life is a journey and today’s guest, Lauren Gueits, truly exemplifies that fact.  She has worked in private practice, as a high-level rep with Align, and is now on a mission to help children by advancing awareness of airway health.  Lauren has an amazing ability to persevere through whatever life puts in front of her and has a deep passion for promoting the connection between our mouth and our overall health.  We discuss:

·         How Lauren ended up pursuing dental hygiene as a career, and why she feels she was called to dentistry.

·         Her role with Dr. Lorne Golub and Dr. Maria Ryan in promoting Periostat.

·         Why she has always had a passion for the connection between oral and systemic health.

·         How Lauren’s endless curiosity began as a child.

·         How she impressed Align CEO, Joe Hogan, during one of her lectures at Invisalign Summit.

·         Her creation of the position of Hygiene Education Manager at Align and assembling the hygiene team.

·         Her transition from private practice to corporate to entrepreneurship.

·         The critical role of the hygienist to create value from the hygiene chair.

·         Why once you see the impact that orthodontics can have on airway, you can’t unsee it.

·         The need to redefine malocclusion as craniofacial dystrophy.

·         What motivated Lauren to launch Airway Health Solutions in 2018.

·         How she plans to advance airway health care in the upcoming years.

·         The need to have in person discussions versus hiding behind our computers debating online.

·         The importance of keeping the faith through life’s highs and lows.

·         The need to develop more thorough and consistent screening tools for airway compromise.

·         That the AAO guidelines do NOT say to wait until 7yo to initiate orthodontic treatment.

·         Why orthodontic residents don’t do much Phase I treatment in residency.

·         How OSA is like Stage 4 cancer, and we need to address it when we notice it at Stage 1 (SDB).

·         The reasons why changing your mindset regarding early treatment and airway can be emotionally challenging.

·         How Lauren balanced being a mom of 3 children with her career aspirations and obligations. 

·         How she judges her success as a mother.

·         And much more!!

LINKS:

-Dew Life Article highlighting Lauren: https://issuu.com/dentalentrepreneur/docs/dew_spring2024_issu

-www.airwayhealthsolutions.com

-www.childrensairwayfirst.org 

Melissa Methven is a dental hygienist whose husband, Scott, a dentist, committed suicide in 2022, leaving behind Melissa and her two young children.  She shares her incredible story of emerging from a time of great darkness and tragedy with the hope of helping others who are struggling with depression.  

We discuss:

·         Scott’s tremendous passion for dentistry.

·         What led Scott to take his own life and, in hindsight, some of the warning signs that were there.

·         How Scott’s cycle of depression spun deeper and deeper.

·         The role that suppression plays in our physical and mental health.

·         The way Melissa explained Scott’s suicide to her children.

·         How she picked herself up after Scott’s passing.

·         Strategies that Melissa uses to help her young children cope with the loss of their father.

·         Scott’s fear of having a formal diagnosis and what it would do to his reputation and career.

·         The darkness that can surround people who are suffering from depression.

·         The role that prayer, belief in God (or any higher power), and breathwork have played in the healing journey.

·         The difference between religion and faith.

·         Healthy techniques for releasing your stress and anxiety. 

·         The steps that can and should be taken in dental school to better equip dentists to handle the rigor and stress of their job.

·         The need for a dental community to help dentists who are struggling, and the pushback Melissa is receiving trying to bring awareness to this issue.

·         How to recognize the signs that your body and mind are not healthy.

·         How Melissa and her kids know that Scott is with them in spirit.

·         The value of being of service to others and how it has helped their family heal.

·         Tips on how to find and live your truth.

·         And much more!!

LINKS:

-To Purchase Melissa’s Book: https://a.co/d/8nYzyTO

-Contact Melissa: www.melissagratitude.life 

Dentistry is a very physical profession and many dental professionals suffer from chronic pain in their neck, back, wrists, and forearms.  The pain can be so severe that it forces us to reduce our workload and can even lead to depression, chemical dependence, and suicide.  Unfortunately, most dental professionals were never taught correct ergonomics and posture, and that’s why I wanted to have Kevin McLaughlin, PT, Cert MDT on the show!  Kevin specializes in treating mechanical disorders of the spine and extremities, and he and I discuss the following:

• How Kevin got interested in physical therapy and how his approach to treatment has changed over his 28 years in private practice.
• Why dentists, hygienists, and dental assistants frequently suffer from pain related to poor ergonomics and posture.
• What is the McKenzie Method and how does it differ from traditional physical therapy.
• The role of modalities like E-stim/TENS, ultrasound, etc.
• When it’s best to use ice versus heat.
• The difference between intermittent versus continuous pain and how that changes the approach to treatment.
• How to differentiate a mechanical issue from one that is inflammatory.
• The importance of getting to the true mechanical etiology of the pain before initiating treatment.
• Some of the differences between physical therapy and chiropractic.
• The best ergonomics for dental professionals.
• Stretches dental professionals can do to before, during and after work to minimize their risk of injury and chronic pain.
• The importance of not only addressing a patient’s pain, but teaching them how to maintain the improvement.
• Whether you (or a patient) can send a patient directly to the PT or if a referral is needed.
• How pain in the extremities can originate in the neck.
• When and how TMD pain can originate in the neck.
• How PT can help your patients who are suffering from TMD and/or headaches.
• The importance of focusing on what you do well and being comfortable with referring what you haven’t mastered to other professionals.
• And much more!!

LINKS:

-Stretching exercises for dental professionals:  https://www.my-exercise-code.com/code/xrxTL?u=BLUQ&c=8GG9SB7

-Kevin’s Website: https://www.mjphysicaltherapyny.com/

-APTA Website: https://www.apta.org/

As you know, my goal with this show is to help you succeed both personally and professionally.  In that light, I decided to have Dr. Brett Gilbert on to discuss mental health and wellness.  This is a deep and powerful conversation that will help you regardless of where you are in your life/professional journey! 

We discuss:

• Why dentists are so prone to stress, anxiety, and burnout.
• How to recognize if you are “out of balance” and what to do about it.
• Why you need to invest in yourself first before you can achieve wellness and fulfillment.
• How and why burnout and fulfillment have changed between generations.
• The step that is absolutely necessary to be your best self.
• The role that prior trauma plays in our current decision-making and how it impacts wellness.
• The importance of creating a vision for who and what you want to be.
• Practices to ground yourself and create joy in your life.
• Why it can be difficult for scientific minds to believe in a higher power or something greater than ourselves.
• How the thoughts we put out to the universe can become a self-fulfilling prophecy (Law of Attraction). 
• The importance of recognizing that life is happening FOR YOU, not to you.
• How to view suffering and disappointment as a blessing and a natural part of the human experience.
• The importance of finding your true inner self and purpose, and how to do it.
• The value that Brett found in emotional intelligence training and how it helped him overcome burnout.
• How to keep your failures and disappointments in perspective. 
• Strategies to change your mindset from one of stress and anxiety to one of peace and gratitude. 
• The blessing and curse of perfectionism.
• What gratitude practice is and how to do it.
• How to reimagine the way you want your professional and personal life to look.
• And much, much more!

 LINKS:

-Dr. Brett’s Instagram: @DrBrettGilbert

-Dr. Brett’s Podcast (On The Cusp): https://plinkhq.com/i/1704062186/e/?to=page

-Dr. Brett’s Coaching Platform (Access Endo): https://www.accessendo.org/

-The Truth Behind the Smiles (book by Melissa Methven): https://a.co/d/4fEQOj4

-A Man’s Search for Meaning (by Victor Frankel): https://a.co/d/hKSvXY2

-The Gifts of Imperfection (by Brene Brown): https://a.co/d/hPnqAnK

-Dr. Gilbert’s Breathing Exercises: https://www.youtube.com/@breathewithsandy 

-Motivational Monday on Selfishness: https://youtu.be/zq1mcOWFp3M 

-Motivational Monday on Perfectionism: https://youtu.be/275xlwkYiQc 

Dr. Jeff Rouse is an educator and clinician who has practiced with the likes of Drs. Frank Spear and Gregg Kinzer.  He is now a Resident Faculty Member at Spear Education and maintains a private practice in prosthodontics in San Antonio, TX.  He has a unique professional journey and understands more about airway and orthodontics than many orthodontists.  We discuss that and much more, including:

• How Jeff’s background in restorative dentistry helped him gain a better understanding of how orthodontic treatment, especially treatment involving extraction of permanent teeth, led to the breakdown of the dentition and airway issues later in life.
• Why Jeff started doing orthodontics when he was practicing as a general dentist and how that led to an “ortho first” approach to patient care.
• How Jeff developed and the curriculum for airway dentistry at Spear Education.
• Why GPs and prosthodontists are more open to the impact of airway on malocclusion than most orthodontists.
• Why orthodontists are resistant to incorporating airway-focused treatment into their practice (and it has nothing to do with evidence/literature!).
• Jeff’s message to orthos who are opposed to intervening earlier than 7yo to address anatomy that can lead to airway compromise.
• The primary causes of airway obstruction in young children (HINT: It’s not genetics!)
• Why orthodontic residents are not treating young children during their training.
• What recent studies in the otolaryngological literature say is a “normal” palatal width.
• The flaws with the studies that say Phase I is ineffective and often unnecessary.
• What is within the dentist’s/orthodontist’s scope of practice when it comes to airway.
• The role that anatomy plays in obstruction of nasal breathing.
• Why watchful waiting is supervised neglect.
• What orthodontists would learn if they had to look at all their cases 20 years out of treatment.
• Whether or not extractions cause airway issues.
• How heart rate variability can be used to determine sleep-related breathing issues.
• A new referral pattern for the future to help remove some of these obstacles.
• Jeff’s advice to young orthodontists.

LINKS:

-AAO Website on age to begin orthodontic treatment: https://aaoinfo.org/orthodontics-for-children/