The 2020 NADSM Symposium was a huge success!

Check out these highlights from Day 1! If you haven’t signed up yet, be sure to register for the 2021 Symposium on March 5-6 in Clearwater, Florida!

What’s On Your Bucket List?

I screw up. Oh, I know, I’m sure I’m the only one. I can see you all in the comfy coziness of your glass houses. 

When I make mistakes, I like to evaluate what happened and what the root cause is so I can prevent a repeat performance. I look at the event, ask the 5 whys, consult my colleagues, and ALWAYS seek the counsel of my Mom. 

92% of the time (I made that statistic up, BTW), I find that my missteps can be traced back to my attempts to do too much. I’m either over-committing to aggressive timelines, forgetting there are only 24 hours in a day, sacrificing personal life activities for work activities, OR insisting on managing everything myself. 

Do you know what the corrective action is for each of these? 1 word: DELEGATION! You cannot be a master of all trades. Tiger Woods is a great golfer but I haven’t seen him win an Oscar. Peyton Manning is a heckuva quarterback but the expertise and dedication required mean that he’s probably not picking up his own dry cleaning or preparing the gourmet meal at Saturday’s dinner party for 10. I do a pretty darn good job leading a team of medical billers and heading up a customer support team. I run into trouble though when I also have to function as counselor, project manager, fitness coach, and everything in between. You just can’t do it all. At least I know I can’t. Neither can Peyton Manning or Tiger Woods so at least I’m in good company.

So what do you do? Again, you DELEGATE. Evaluate the tasks that make up your week & place them in 3 buckets. 

  1. Bucket #1 – These are tasks that only you can do. These should be high value activities that only you can do because of your unique education, licensing, capabilities, or experience. Think crown preps, placing an implant or delivering an oral appliance.
  2. Bucket #2 – These are activities that you can delegate. These can be low value or high value tasks. They are usually tedious, require very specific knowledge sets that you don’t inherently possess, or are absolutely necessary but can be managed by someone else. A few ideas that come to mind are medical billing for your sleep casesfinancial discussions about treatment, or completing your Medicare credentialing.
  3. Bucket #3 – This is stuff that you’re doing but NO ONE needs to do. These may be artifacts of the past. Don’t feel guilty about it. They probably made total sense at one time but they don’t really matter anymore. Get these tasks off your “to do” list. Kicking this bucket will free you up to work on things in Bucket #1 or work on that golf game with Tiger.

Create a Culture of Success

Me.  I. I try not to use either of those words, yet here I do it again…and again.  How do you turn Me and I into WE? The answer is delegation, cooperation, and training.

My business consultant made a comment to me the other day that got my attention.  Afterall, I do pay him each month; Rhonda says I should at least listen to what he says with an open ear.   “One great employee is worth three good ones.” My first thought was yeah, right. Then he went on, “How come I can consult two businesses that do the exact same thing; they have the same number of employees; yet one of those businesses does $8M a year and the other only does $2M?”

It’s the employees.  It’s YOUR employees.   Do you engage them in your DSM practice?   Do you let them interact with the patients?  Within the bounds of your state dental board, do you allow each of them to do as much as possible?  Or are you like most dentists, micromanaging your team and constantly looking over their shoulder? I hope not!

Here’s a quote from Herb Kelleher, perhaps you’ve heard of him; he’s the guy who started Southwest Airlines. “We have a strategic plan.  It’s called doing things.”

Strive to build a stellar team who engages a patient, each at some point along the preferred path, from the first phone call, to tracking down sleep studies, to verifying insurance benefits, to getting the Rx/LOMN, to scanning, to follow up, etc.  You are only as successful as your team.

SUMMARY:

Strive to be the best you can be

Assemble the BEST team possible

Be proactive; Be smart; Be efficient

Play Inside the Box

Did you have a sandbox when you were a kid? Some nice clean sand mixed with a little water and some of mom’s Tupperware, all the ingredients to build an awesome castle.  For reasons to complex to figure out, this got me thinking about titrating our dental devices. Remember the envelope of function as taught in freshman dental school, and that from a full protrusive position you lose the ability to move forward as you open more? You do recall that, right?

IWhen you think about what you have control over with OAT, it’s not much; the fit, the vertical, and the protrusion. So all your perfectly fitted device needs now is the correct vertical and protrusive position. Therein lies the challenge.

Imagine placing a dot on the lower incisor, open a little; move the jaw forward as far as you can; open a few millimeters more and then move the jaw back all the way. There you have it. Our final treatment position will be somewhere within that rectangle. I’ve heard it called many things, but “Drake’s Box” seems to have a musical ring to it, don’t you think?”

So, until I have littered that box with multiple points, I do not concede that a dental device “just isn’t working.” Armed with this knowledge, be sure to pass that along every time you do a lunch and learn for a physician. Just yesterday I said to an MD, “I’m pretty good at helping the patient find the sweet spot, but often times I need more than a single guess.” Only allowing the patient to test at a single jaw position is like having a CPAP machine that is stuck on 7cm of H2O. Please don’t tell the patient that it’s not working. Instead, explain that we simply need to adjust her device. Don’t be afraid to pick up a pen and draw Drake’s Box (hoping that with repetition it’ll catch on!) and explain this to your patients, to physicians, NPs and PAs.

In summary, the best advice I can pass on for now:

  • Less vertical is more comfortable, but MOST people require more vertical
  • Large tongues and males require more vertical
  • Mouth breathers require more vertical
  • Elastics and chin straps are aids to control the vertical
  • Sometimes, opening vertical is ALL you need to do
  • If you start at 70% of max, you’ve gone too far
  • Some patients do better with less protrusion
  • Slow, slow, slow titration is the key
  • No cats allowed in Drake’s Box!

Discover How DS3 Can Help You Become Successful at Dental Sleep Medicine!

You want to make DSM an integral part of your practice. Schedule your consultation today. No pushy sales people. No hidden agendas. We just want to learn about the current role of DSM in your practice, your goals, and determine if DS3 can help. Join 1k other dentists as a DS3 Member before May 5th and get special introductory savings.

Schedule Your FREE Consultation!

Wondering how DS3 can help guide you to your goal to implement Dental Sleep Medicine, do more of it, help more patients, and increase production? Well, just hear what your colleagues have to say – check out these testimonial videos!

My patient needs a crown but she has an MAD

We get a lot of questions about this. Your patient has a Mandibular Advancement Device (MAD) but they need a crown. What to do?

There are some proactive decisions you can make regarding materials that are designed specifically with this issue in mind OR thanks to our good friends at Dental Prosthetic Services lab (DPS) there’s another simple technique you can employ to save time and your patient’s appliance. Click below to check out a short video explaining both options.

Create a Culture of Success

Me.  I. I try not to use either of those words, yet here I do it again…and again.  How do you turn Me and I into WE? The answer is delegation, cooperation, and training.

My business consultant made a comment to me the other day that got my attention.  Afterall, I do pay him each month; Rhonda says I should at least listen to what he says with an open ear.   “One great employee is worth three good ones.” My first thought was yeah, right. Then he went on, “How come I can consult two businesses that do the exact same thing; they have the same number of employees; yet one of those businesses does $8M a year and the other only does $2M?”

It’s the employees.  It’s YOUR employees.  Do you engage them in your DSM practice?   Do you let them interact with the patients?  Within the bounds of your state dental board, do you allow each of them to do as much as possible?  Or are you like most dentists, micromanaging your team and constantly looking over their shoulder? I hope not!

Here’s a quote from Herb Kelleher, perhaps you’ve heard of him; he’s the guy who started Southwest Airlines. “We have a strategic plan.  It’s called doing things.”

Strive to build a stellar team who engages a patient, each at some point along the preferred path, from the first phone call, to tracking down sleep studies, to verifying insurance benefits, to getting the Rx/LOMN, to scanning, to follow up, etc.  You are only as successful as your team.

SUMMARY:

Strive to be the best you can be

Assemble the BEST team possible

Be proactive; Be smart; Be efficient

HST: A Welcome

Let’s discuss the 3 primary ways you can use Home Sleep Testing (HST) in your practice:

  1. Utilize your own HST device
  2. Identify an HST company and utilize their system for referral
  3. Refer to a local MD who has HST

There are pros and cons to each of these options. Whichever method you use, dentists should be screening patients, and we should be using home sleep tests as titration methods for patients that we treat with OSA.

Watch the video below to learn more about Home Sleep Test methods!

Get Ready for the Snow

Just back from family vacation in the mountains of southern California.  Cool mornings, warm afternoons. Each morning we walked up to the ski lift where, despite the 80 degree heat and barren slopes, there was a bevy of activity and workers. I ran into Jake, “El Jefe”, and he shared with me a few of the reasons the ski season goes so well for them. They work hard in the “off season”, making sure that the slopes are groomed, overgrowth is trimmed back, the lifts are serviced, chairs fixed, picnic tables made, and on and on he went. I couldn’t help but think about how this relates to what we do in Dental Sleep Medicine.

We monitor a lot of statistics around my office, and for nearly a decade now, the slowest months of the year for me have been July through September.  What to do? Worry? Thumb twiddling? Take up knitting? No. Be like Jake. Get ready for the snow. Believe that it is coming.

Be proactive and productive.  Instead, work on stuff like this:

  1. Go back in your schedule three years.  Start January 1.  Contact every patient that you made a dental device on.  My bet is a few of them have fallen through the cracks. Most are due for a follow up. Some will need a new device.
  2. Review your website.  Look at it from a NEW patient perspective.   Would I know that you make dental sleep devices?  Would I be educated about sleep apnea and want to make an appointment?
  3. Ask your friends to look at your practice brochure.   Does it make sense?   Do you get the feeling that I care about my patients?  Would someone know what I do from looking at it?
  4. Organize your lab.  Lab scripts.  Outgoing cases.  Incoming cases. Get yourself one of the fishing tackle organizers and fill it with dental sleep device paraphernalia.  
  5. Work on your progress note and letter templates.   If you’re like me, things change, and you do things differently today than you did a year ago. Update your templates and letters to reflect those new changes.  It’ll save you a lot of time down the road.
  6. Engage your team to come up with new ideas and processes. From the first phone call to the titration sleep test.  What can we tweak to make it better?

Remember that success is contingent upon preparation. Don’t take up knitting in July. Follow the steps above instead. Also, remember, this will put you in a better position when the snow is falling and patients have met their deductibles. Don’t be passive. Take an active role in your the future of your practice. Make it snow!

Device Materials/Linings

I’d like to talk about the liners I use in my dental sleep devices.

I typically use one of three liners depending on the patient:

  • Acrylic
  • Flex/Comfort Fit
  • Thermacryl/AccuFit

There are advantages and disadvantages to each of these linings – it really depends on the patinet.

Learn advantages and disadvantages for each of these liners – just click on the video below!