Brews and Tiny Teeth, The Unfiltered Pediatric Dentistry Podcast

This episode is a boards-review style solo episode, where I take some time to review the AAPD guidelines, current literature, and throw in a little personal opinion on key topics in pediatric dentistry. In today's episode, I review: - Amides vs esthers, - Is septo really better? - When to give an IAN block and when to infiltrate - Buffering and computerized delivery - How to manage a local anesthetic overdose - Pharmacokinetics and contraindications to N20 - MTHFR, should we avoid N20 in these patients?

Dr. Tim Richardson is a pediatric dentist and the owner of Acorn Dentistry for Children in the greater Portland, Oregon area. After residency, Dr. Richardson bought and grew three offices in a five year period. After feeling the stresses of burnout coming on, he decided to sell these offices and start over with both a goal and team-oriented mindset. He has since started six pediatric offices in a five year period, and leads a team of nine pediatric dentists as partners and associates. In this episode, we discuss: - Where is the line drawn between "corporate" dentistry and large group practices - How to reinvest equity into growth to make other people's money work for you - Why Dr. Richardson went with a growth and volume model over being a sole practitioner - How to use real estate to minimize taxes - Why he doesn't put money into traditional investments like the stock market, and instead invests that money into his practice

Dr. Adam Priestwood is a pediatric dentist who practices in eastern Tennessee and treats a high-risk population. Dr. Priestwood comes on the podcast to talk about how he uses oral sedations to help manage shortages with his access to OR time. We talk about what the patient population is like in the Appalachia region of eastern Tennessee, oral conscious sedation strategies, Equia Forte for hypoplastic molars, when to graduated teenage medicaid patients, and personality styles of pediatric dentists. Dr. Priestwood is also a big deer and turkey hunter, so at the end we get a little off track talking about hunting. This was a great, very chill conversation for pediatric dentists in the eastern portion of the United States, or those that provide oral sedation. 

Nothing fancy in this episode, just a couple of pediatric dentists talking about some of the tough cases and mistakes they've made in their respective practices. Sometimes you just need to vent a little about work over a beer, and that's exactly what this episode is for. Thank you to Dr. Nate Green from Denver, Colorado for joining me on this episode. 

Charles Loretto is a partner at Cain Watters and Associates, a firm which needs no introduction in the world of dentistry. Charles oversees the practice transition department for CWA, and is founder of affiliate company, National Dental Placements, that assists doctors in the buying, transitioning and valuation of a practice. He and his team help hundreds of clients and non-clients with their transition goals annually.

Dr. Dallin Young is a pediatric dentist and the owner of Young Smiles Children's Dentistry in Fairbanks, Alaska. After starting a practice in a competitive area of Idaho, he decided to sell and move to the interior of Alaska. In this podcast we discuss: - How Dr. Young settled on the interior of Alaska as a location to practice pediatric dentistry. - Challenges of the weather and remoteness of the area - What does the patient population look like in Fairbanks, Alaska? - How does treatment planning change when kids are flow in from 6+ hours away for full mouth rehab? - Marketing and insurance participation considerations for practicing in such a remote area.

Dr. Kirsten Frazier is an orthodontist who recently started her own practice in South Carolina. She practiced in Chicago for several years out of residency before determining that she needed to be her own boss, and made the decision to move to a new city and plant roots in her dream practice. I wanted to bring Kirsten on to discuss and compare her start up journey to my own, to get a better sense of what challenges orthodontists face. Many pediatric dentists have spouses and significant others who are orthodontists, so this should be a great podcast for those listeners as well! In this episode, we discuss: - Growth expectations of a new ortho office - Dealing with competition and saturation - Collection systems, cash flow, and payment plans in an ortho office - The importance of social media in orthodontics, and how it differs from pediatric dentistry - What things Dr. Frazier would do different in her startup, and what advice she has for other dentists

This if the first of several solo study episodes where I will be reviewing certain pediatric dentistry topics as a way to review for board exams, as well as to review new evidence and clinical studies on the subject. Today's study topic is on sealants... how to do sealants that don't suck. Placing a good retentive sealant is one of the most technically challenging procedures to do well, and yet we don't critically evaluate how we place them often enough. There's a high degree of bias with how we evaluate our own sealants. We all know that a lot of the previously placed sealants we see come into our offices look anywhere from rough, to partially retained, to recurrent decay garbage. In this episode I review both the literature and my personal thoughts on the following: - AAPD clinical recommendations for sealants - Sealing over decay - Glass ionomer sealants and why you should consider using them - Air abrasion. The evidence is so strong for it, why does nobody use it? - Should we be bonding our sealants? - Isolite and dry shield vs rubber dam vs cotton roll sealants - Brands of sealant material - Sealing primary molars The purpose of these solo study episodes is to review what we know, what the literature says, and to challenge ourselves as providers to constantly improve our quality of dentistry. For any questions, comments, or ideas for future episodes, email me at cgoetz@troypediatricdentist.com

Dr. Eric teDuits is a pediatric dentist and a private practice owner in Madison, Wisconsin. He has been growing and expanding his practice for nearly 30 years, and he joins us today for a great discussion on how to maximize efficiency and productivity in the hygiene department.  Dr. teDuits discusses how he expanded and structured his business from one pediatric dentist to six partners with three different locations. We discuss how he brings on associates in his practice, structures buyouts, and involves the real estate. We transition into the focus of our conversation to learn more about how Dr. teDuits is able to see 60-70 recall patients in a day, with a focus on providing quality oral hygiene instruction while implementing good systems and a high-performance team to deliver the care.  We wrap up our conversation by getting Dr. teDuit's thoughts on the future of private equity and the influence of DSOs in the pediatric dental space. This was a dense and very fluid conversation, and we touch on a lot of different topics besides just improving practice recare. 

Dr. Ann Bynum is a pediatric dentist and the owner of Holly Tree Pediatric Dentistry in Simpsonville, South Carolina. She has been in private practice pediatric dentistry for over 20 years, and maintains an active roll in the AAPD while also acting as a board examiner for the ABPD. She comes on the podcast to help us answer some long overdue listener questions and answers that have built up over the months. On this version of our Pedo Pearls Power Hour, we answer questions regarding: - What's the best way to warranty restorative work that has failed? - What metrics can you track that lets you know it's time to hire an associate? - How soon in a new pediatric office should you start providing general anesthesia? - How do you control the flow of Medicaid in your practice to keep it at a healthy level? Any future questions, comments, or topics for discussion can be sent to cgoetz@troypediatricdentist.com, or DM me on facebook or instagram Casey Goetz.