Brews and Tiny Teeth, The Unfiltered Pediatric Dentistry Podcast

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. 

McDonalds knows the cost of a sesame seed on every bun they sell, yet when you ask a dentist what their case acceptance rate/monthly breakeven amount/recall retention rate of their practice is, most have no clue. With 2021 having come to a close, now is a great time to sit down over a cold beer or a stiff whiskey and start making some spreadsheets to understand the numbers in the business you are running.  Dr. Eric Hans is a private practice pediatric dentist with nearly 25 years of business experience. We have a great conversation about important KPIs (key performance indicators) that dentists should be watching in their practice. Dr. Hans really emphasized in our discussion that building a strong relationship with both your team and the patients in your practice is the foundation to why we need KPIs in the first place.  This was a challenging topic to cover because it can be so broad, but we did a nice job touching on most aspects of it. Everybody knows that a practice owner should monitor production, collection, new patient numbers, overhead, A/R, etc. But many KPIs go a lot deeper than these numbers and are critical for keeping a pulse on how things are going in your practice.  Some of the things we talk about in our conversation: - Tracking your hygiene department, daily hygiene numbers, and restorative to hygiene ratios - Breakeven costs and when are you losing money to do dentistry - Production on GA/sedation days vs clinic days - Setting goals and how often to track them - Monitoring new patient flow, age of your patient population, and knowing how to expand your capacity - Watching your P&L, and when is it ok for your overhead to be higher

Dr.  Kathleen Schultz is a dual-specialized pediatric dentist and oral pathologist. She teaches and practices at Long Island Jewish Medical Center in New York. Dr. Schultz and I talk about a grab bag of oral path situations we sometimes encounter as pediatric dentists. Some of the topics we hit on: - Dentigerous cysts in the mixed dentition - Gun to the head, which is worse? Chewing tobacco or cigarettes? - Nutritional deficiencies and the increase in scurvy in food insecure or special needs patients - Magic mouthwash, prescribed topical agents, and geographic tongue - HPV vaccination updates - Primary failure of eruption cases Check at Dr. Schultz on her Instagram @drkathleenschultz where she posts unique and interesting peds-oral path cases. 

Dr. David Bailey is a private practice pediatric dentist in Sheridan, Wyoming. He has been using SDF in his practice for years, and was an early advocate for using it as a caries-arresting medication. While still an important component of his practice, he has since limited SDF to specific patient situations.  Dr. Bailey and I have a discussion about the potential issues with widespread SDF use in our profession, in light of recent issues regarding non-coverage by insurance companies for restorations placed on teeth previously treated with SDF. We discuss the pros and cons of its use, along with how the esthetic drawbacks can be perceived by the public. We go over six different unique patient situations in which SDF may or may not be appropriate compared to more traditional means. This was a great exercise for identifying situations in which SDF would be the perfect first-line treatment option, while in others it may do more harm than good.