Brews and Tiny Teeth, The Unfiltered Pediatric Dentistry Podcast – Détails, épisodes et analyse

This episode is all about clinical techniques, restorative materials, and procedures that didn't live up to the hype. Part of being a good pediatric dentist is trying new things. And sometimes these things don't always hold up as well as we would hope.

I asked listeners to write or call in and share some of their failures. I compiled a list of the 12 best ones, shared anonymously by our pediatric dental colleagues. This is a fun solo episode over a crisp beer to remind us that we all have failures, and the best thing we can do is learn from mistakes and move on.

Dr. Eric Vieth a pediatric dentist and owner of Sleepy Owl Dentistry in South Carolina. After completing his training in New York, Eric moved to South Carolina. He worked for years as the pediatric dentist doing big sedation cases for a large corporate DSO.

In 2020, he began branching out on his own to open three locations that offer EXCLUSIVELY IV sedation dentistry. We talk about how he structures his practice, building referal sources, and how he is able to provide a high level of care with this model.

A unique component of his sedation practice is that Dr. Veith offers same day consults, treatment planning, and sedation for his patients. We talk about some of the potential billing and insurance challenges associated with a sedation-only practice.

Dr. Kevin Kennedy is a pediatric dentist and practice owner from Clarksville, Tennessee. He fostered and adopted three kids during his pediatric residency before having biological children of his own. This experience really opened his eyes to the complexities and challenges of kids who have experienced loss, or as Kevin defines it "kids from hard places."

Dr. Kennedy shares his story and gives listeners some advice on how to care for these kids and communicate better with their parents.

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

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. 

Dr. Christopher Chance is a pediatric dentist and the owner of Oaks Point Pediatric Dentistry in Houston, Texas. He joins the podcast to tell us more about his start-up journey to create a boutique practice in an edgy, modern office in the growing Houston area. 

We drink a few cold beers and talk about some of the following start-up topics: 

- Using corporate associateships as a practice run for a start-up 

- Challenges with securing lending for a large or expensive practice space

- Using local resources and professionals in the community to create and design a modern practice space

- Marketing using word-of-mouth and social media

- Understanding how start-ups have a young patient base that matures over time, and how the demand for dental services evolve

Happy Holidays to all listeners and hard working pediatric dentists out there. I hope you all take some much deserved time to relax with your families. Don't forget that any listener questions, concerns, or ideas for future topics can be sent to cgoetz@troypediatricdentist.com.

Are you a well-rounded pediatric dentist? You might not be as much as you think.

If I've learned anything about dentists, it's that they are resistant to change and easily get stuck in doing things the way they've always done them. A good dentist recognizes his or her own shortcomings, and isn't afraid to try new procedures and materials, and step beyond the edge of the comfort zone. 

Dr. Sean Whalen is a seasoned pediatric dentist and practice owner from Westminster, Colorado. We discuss different techniques, procedures, materials, and ideologies that a well-rounded pediatric dentist should be offering. Dr. Whalen is passionate about providing a full range of services to best serve our patients, including interceptive ortho, oral conscious sedation, oral surgery, posterior zirconia, advanced behavior management and many others. We discuss that if we do not distinguish ourselves with our skill sets as specialists, corporate dentistry may push us out of the marketplace. 

This is the this third and final segment of our giant student loan story-time.

Dr. Jared Johnson is a pediatric dentist and the owner of Arctic Dental in Muscatine, Iowa. He started his practice from scratch along with buying the practice building, buying a home, and piling all of these things on top of his large student loan debt. Proudly wearing the badge of "reverse millionaire" we discuss how he has financially and philosophically dealt with digging out this debt hole to have a thriving and profitable career, all while being able to see a high proportion of kids with medicaid in his community. 

Our final guest features a great power-couple. Dr. Stephanie Guinn is a pediatric dentist who started a scratch practice in Grand Rapids, Michigan. Her husband, Tony, is an endodontist and a partner at his practice. They come on the show to talk about their combined 1,000,000 dollars in student loan debt, and how they have a plan to finish paying it off. Tony and I get deep into the financial weeds, but it's a great podcast for dual-specializing power-couples in the dental field.