![An ENT's Perspective on Airway & Orthodontic Treatment (w/Dr. David McIntosh) [Ep.75]](https://is1-ssl.mzstatic.com/image/thumb/Podcasts221/v4/dc/c6/99/dcc699c5-e602-c089-7b62-f388bd7c37bf/mza_7215416877383055546.jpg/250x250bb.jpg)
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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
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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==
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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/
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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
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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
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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/
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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
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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/
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I had the pleasure of sitting down with Dr. Helen Jones, a dentist from the UK who spent the early part of her career managing extraction cases until she became discouraged by the treatment results. It started her on a journey to find a better way to manage deficient jaw size and airway problems in younger children. It is now her mission to raise awareness regarding the benefits of beginning orthodontic treatment at a younger age than we are conventionally taught.
Helen and I discuss:
· What a paradigm is and why/how the paradigm in orthodontics is shifting from taking a reactive approach to treatment to taking a more proactive approach.
· How Helen became so dismayed by the traditional reactive approach to orthodontic treatment and how this led her to become so passionate about exploring a more proactive approach.
· How her time practicing in South Africa helped shape her approach to both dentistry and authority.
· The way the National Health Service in the UK controls what dental and orthodontic procedures that can be performed.
· The time she spent with John Mew and her thoughts on his approach to treatment, as well as why John was vilified and deemed “unfit to practice” by the General Dental Council.
· How she broke free from the dogmas imposed by the NHS and started treating preadolescent patients.
· The impact that a lecture by Dr. Brendan Stack had on her life and career.
· The role that working with osteopaths played in Helen’s understanding of the fascia and how it connects the mouth to the rest of the body.
· The importance of looking at the entire child, not just the mouth and teeth.
· The need to move away from looking at the teeth and mouth as a separate entity.
· Whether or not you can get some degree of sutural change throughout life.
· If orthodontists are resistant to a more proactive approach to treatment out of fear.
· The mission of the new interdisciplinary group of medical and dental professionals called The Society for Dentofacial Growth & Function that Helen is putting together.
· How the General Dental Council is targeting people in the UK who promote early orthodontic treatment.
· The politics and siloing of care in the British health system.
· Helen’s advice to parents and clinicians when it comes to early orthodontic treatment.
LINKS:
-Dr. DeLuke’s article in OrthoTown (Part I): https://www.nxtbook.com/farran/orthotown/orthotown-june-2023/index.php?startid=54#/p/54
- Dr. DeLuke’s article in OrthoTown (Part II): https://www.nxtbook.com/farran/orthotown/orthotown-november-2023/index.php?startid=52#/p/52
-Society for Dentofacial Growth and Function - www.ConnectingHeads.com; https://www.dropbox.com/scl/fi/vjnwtuwjh30uhiuyxzc0y/SDGF-Zoom-Meeting-June-13th-2024.mp4?rlkey=bcuyhlmghr53ahoz8jcil0bb0&st=ra5hpp1s&dl=0
-Jane Tarrant’s book Rose Loses Her Nose: https://linkbreathing.samcart.com/products/rose-loses-her-nose-book
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Don’t miss this AMAZING conversation with Dr. Marianna Evans! As a dual-trained orthodontist/periodontist and expert in anthropology, she offers a unique perspective on the etiology of malocclusion, the periodontal consequences of the traditional approach to orthodontic treatment, and the numerous benefits of initiating orthodontic treatment in younger children. She is also very knowledgeable about how airway patency impacts craniofacial growth and development and is passionate about the role the orthodontist can and should play in airway management.
Dr. Evans and I discuss:
Why and how she decided to open her own practice from scratch in 2011, and how it’s going now.Her educational background including why she decided to obtain degrees in both orthodontics and periodontics, and how it has helped her be a better orthodontist.How she developed an interest in, and eventually a passion for, anthropology by studying the Morton Skull Collection while at UPenn.The problem with using transverse norms based on post-industrial skulls.Why humans today can no longer accommodate 32 teeth, and why that is a bigger problem than we may realize.How diet and obstructed nasal breathing are turning malocclusion into a pandemic.The role of the orthodontist’s ego in the prevention of the advancement of our profession.Marianna’s advice to residents and young docs regarding questioning what they learn in their orthodontic residency.What the research says about providing orthodontic treatment to patients in the primary dentition.How the refusal of orthodontists to treat patients at a younger age will lead to the death of our specialty.The thinning of the alveolar bone that inevitably occurs during all orthodontic tooth movement.Why we should be more focused on developing the jaws in the primary dentition to allow the teeth to erupt into the center of the ridge.The need for orthodontists to look at their cases 20 years after treatment, and how that could change their perspective.The numerous flaws with the literature stating that early treatment is not effective.How to communicate to parents that their young child is in need of orthodontic treatment.Why we should be referring to the orthodontic treatment of younger patients as “preventative,” not “early.”The story of how she got connected with James Nestor and what it was like to be featured in his bestselling book, Breath.And much, much more!!LINKS:
-VISIT OUR SHOW SPONSOR - Reliance Orthodontic Products (www.RelianceOrthodontics.com)-Email Dr. Evans: [email protected]
-Email Dr. Mike: [email protected]
-Breath by James Nestor: https://a.co/d/1JGxJa8
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We all want to retire at some point, right? But how do we save enough money to retire or work because we want to, not because we have to? Mr. John Vento, my CPA, is also a Certified Financial Planner who offers his advice on how to take advantage of tax-favorable strategies to maximize your retirement savings so you can retire sooner than you may have thought!
This is the second part of a 2-part series. Part A was released last week: https://podcasts.apple.com/us/podcast/retirement-savings-strategies-part-a-john-vento-cpa/id1689703392?i=1000666226231
In this episode, John will discuss:
o Reasons why you should want to set up a retirement plan for your practice and how it can help with employee recruitment and retention.
o The SECURE Act 2.0, including when it was passed into law, when it becomes effective, and how it will impact retirement plan contributions for you and your employees.
o The recent expansion of the ability to make Roth contributions.
o Significant tax credits that are now available for making contributions to your retirement plan and the retirement plan of your employees, including:
§ The Startup Tax Credit which allows you to legally double dip by not only deducting the expenses of training your team about their retirement savings options, but also receiving a tax credit for those same expenses!
§ Employer Contribution Tax Credit which allows you to receive a tax credit to subsidize you for putting money into your employee’s retirement plan! Basically, the government is paying you to contribute to your employee's retirement!
§ The Auto-Enrollment Tax Credit which forces your employees to opt out of contributions to their retirement instead of opting in, which is how it has traditionally been set up.
LINKS:
• Point X Calculator (https://www.ventotaxandwealth.com/resource-center/retirement/saving-for-retirement)
• To purchase John’s Book: https://www.ventotaxandwealth.com/buy-the-book
• You can find more information on John and his firm, Vento Tax and Wealth Management, at www.VentoTaxAndWealth.com -
We all want to retire at some point, right? But how do we save enough money to retire or work because we want to, not because we have to? Mr. John Vento, my CPA, is also a Certified Financial Planner who offers his advice on how to take advantage of tax-favorable strategies to maximize your retirement savings so you can retire sooner than you may have thought!
In this episode, John will discuss:
• How to calculate your specific “Point X” (the point at which you reach financial freedom) and can retire using actual data from your individual situation!
• How to use a Traditional IRA to decrease your taxable income and accelerate your wealth accumulation.
• The pros and cons of a Traditional IRA vs. a Roth IRA and how to determine which is better for your circumstances.
• The tremendous advantages of owning your own practice when it comes to your ability to aggressively save for retirement and reach Point X at an earlier age.
• How to use defined benefit and/or cash balance plans to lower your tax burden AND maximize retirement savings for practice owners and independent contractors.
• How to implement different retirement plan strategies based on your particular practice situation ranging from a one-man show to a group practice.
• The tremendous advantages of employing your spouse and children and how to maximize your retirement savings when you do.
• Retirement savings strategies for older docs to accelerate their ability to get to Point X by using a 401k with profit sharing and a defined benefit cash balance plan.
• How avoiding the Medicare tax alone will more than cover the administrative costs of implementing a qualified retirement plan.LINKS:
• Link to Important Tax Information for Dentists: https://www.youtube.com/watch?v=1-EXO-IlQgs&ab_channel=DeLukeOrthodonticCoaching
• Point X Calculator (https://www.ventotaxandwealth.com/resource-center/retirement/saving-for-retirement)
• To purchase John’s Book: https://www.ventotaxandwealth.com/buy-the-book
• You can find more information on John and his firm, Vento Tax and Wealth Management, at www.VentoTaxAndWealth. -
I had an awesome conversation with Dr. Kristen Knecht, who owns and runs her own orthodontic practice in Houston, TX. Kristen opens up about her personal and professional journey, including:
How Kristen went from UConn Ortho to working for a DSO in Texas, to opening her own practice, Knecht Orthodontics in the midst of COVID.The pros and cons of working for a DSO.The lessons she learned from working for her dad’s industrial construction company.How Kristen implemented fiscal responsibility and delayed gratification to put her in a position to start her own practice.When she knew that she wanted to start her own practice and how it’s going 4 years in.The importance and value of studying your finishes and learning from what went well and what you can improve upon.How Kristen financed the finish-out of her new practice and how she used the income from her savings and associateship to help cover the expenses.The challenge of finding someone to help with the business decisions associated with starting and running a practice.Which FB groups have been a huge help to Kristen in her professional journey.How Kristen and I both evolved from a reactive, extraction-based approach to a proactive, expansion-based approach to treatment.How early arch development will dramatically decrease the incidence of canine impaction.Why our educational institutions aren’t teaching more proactive/early treatment, even though the literature is full of evidence that can be extremely beneficial.The influence that Dr. David Alfi (an oral surgeon in Houston, TX) has had on Kristen’s airway journey.The analogy between Peter Attia’s Medicine 2.0 vs. 3.0 and orthodontics.What Kristen’s colleagues say about her journey to understand the role of airway in malocclusion and provide earlier orthodontic treatment to develop the arches.Why female orthos seem more receptive to the idea of early treatment, especially as it pertains to airway, than their male counterparts.The numerous benefits of low-dose CBCT imaging and how Kristen has incorporated 3D imaging it into her practice.How Kristen utilizes myofunctional therapy to help her patients.LINKS:
-Dr. Knecht Email: [email protected]
-Dr. Mike Email: [email protected]
-Shereen Lim’s book (“Breathe, Sleep, Thrive”): https://www.amazon.com/Breathe-Sleep-Thrive-Discover-potential/dp/0645553212
-Audrey Yoon Episode: https://podcasts.apple.com/us/podcast/the-doc-podcast/id1689703392?i=1000664711076
-Audrey Yoon Article: Impact of rapid palatal expansion on the side of the adenoids and tonsils in children; Sleep Med. 2022 April ; 92: 96–102. doi:10.1016/j.sleep.2022.02.011. [https://pubmed.ncbi.nlm.nih.gov/35390750/]
-Kevin Boyd Episode: https://podcasts.apple.com/us/podcast/the-doc-podcast/id1689703392?i=1000663309000
-David Alfie Instagram: https://www.instagram.com/dr.davidalfi?igsh=MTkxd2QweGh4Z296OQ==
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Don’t miss this fascinating conversation with the amazing and world-renowned Dr. Audrey Yoon!
We discuss:
How Audrey’s journey in sleep medicine began and the role her training at UCLA played in that journey.The role that Dr. Stanley Liu played in Audrey’s passion for airway-focused orthodontic treatment.How an interaction with Dr. Christian Guilleminault (“CG”) changed Audrey’s life and launched her into a career focused on airway adult and pediatric airway. How Audrey and Mike were both inspired by medical colleagues to go out and teach about airway orthodontics.The challenges associated with using polysomnography and AHI classification for diagnosis of pediatric sleep apnea, and why CG expressed regret for creating an AHI scale for pediatric patients.The potential for a blood test that determines if a child has sleep apnea.Why it is logistically challenging and medically unethical to conduct a double-blinded RCT on the effects of with treatment and control groups.The plethora of literature that exists demonstrating the positive impact of expansion on airway patency.The difference between anatomical and neuromotor factors in the etiology of OSA/SDB.The role the dentist/orthodontist can play in the correction of anatomical factors that contribute to OSA/SDB.The recent position statement of the AADSM regarding the impact of different treatment modalities on OSA.The reason why many orthodontists remain reluctant to incorporate airway-centered treatment into their practices.Audrey’s message to the people who say that it is inappropriate or even malpractice to treat children under the age of 6yo.The fact that the American Academy of Pediatric Dentistry lists growth disturbances and airway problems as some of the considerations for treatment at any age that the issue is detected.Why Audrey sees a number of referrals from her medical colleagues seeking assistance with sleep-related breathing issues.What Audrey is working on now to advance the role of orthodontists in sleep medicine, including forming the World Dentofacial Sleep Society.And much, much more!!
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I had an amazing conversation with Dr. Scott Province, a general dentist practicing in midtown Manhattan since 1998. Until three years ago, Scott didn’t see any children in his practice, let alone perform interceptive orthodontic treatment on them. That all changed when an orthodontic colleague explained that Scott’s 9yo son with narrow arches and 10mm OJ wasn’t ready for orthodontic treatment. He tells the story of his journey since that time, and describes his quest to address malocclusion at an earlier age. We discuss:
Why Scott transitioned from an adults-only practice to one that provides early orthodontic treatment to kids.How to begin treating younger patients when you don’t have experience doing so, whether you’re an orthodontist, general dentist, or pediatric dentist.The occlusal breakdown and TMD issues that Scott so often sees in his adult patients, even if they had orthodontic treatment as a child.What most patients who had 4-bicuspids extracted as children look like decades later.How Scott has taken his practice from a “dental crisis office” to a “dental healthcare office.”How Scott’s personal story with his son motivated him to look differently at the way orthodontists traditionally approach treatment.The fact that patients can have disrupted and non-restorative sleep even if they don’t have OSA.That undiagnosed and untreated craniofacial growth and development is the root cause of so many dental problems later in life.How Scott educates his patients on the role that airway and sleep play in their malocclusion and occlusal breakdown.Scott’s process for diagnosing and treating planning pediatric patients who need early growth and development.The best type of splint to make for bruxers to prevent the mandible from falling back and occluding the airway.The courses Scott took to learn how to provide this amazing service to his patients.Scott’s experiences using braces and wires instead of using fixed expanders to develop the arches of young patients.Scott’s message to orthodontists who feel that primary care dentists shouldn’t be performing interceptive orthodontic treatment.Scott also reviews some of the cases he’s been treating and how he has changed patient lives now that he has a greater understanding of what’s possible with early orthodontic treatment!
LINKS:
-DOC Community on YouTube (to view Scott's cases): https://www.youtube.com/@delukeorthodonticcoaching
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Don’t miss this episode with the amazing Dr. Kevin Boyd! Kevin is a world-renowned expert in the area of early orthodontic treatment and we had a fascinating discussion on if, when, and why to provide orthodontic treatment to younger children. Some of the topics we discuss include:
Dr. Boyd’s professional journey that led him to focus on early orthodontic treatment.How Drs. Bishara, Andreasen, and Phol inspired Dr. Boyd during his residency training at Iowa.Dr. Boyd’s background in anthropology and how that has shaped his thinking about the etiology of malocclusion and how to treat it.Why Dr. Boyd’s training in behavioral sciences has enabled him to manage and treat younger orthodontic patients.How Dr. Mike’s training at Stony Brook with Dr. Fred Ferguson taught him how to manage and treat younger patients in his practice.What leading anthropologists say about the role of diet in the etiology of malocclusion.How the fact that children are hard-wired to imitate and please their elders relates to treating younger patients.Whether the etiology of malocclusion is genetic, environmental, or a combination of both.The functional matrix of the jaws and the naso-respiratory systemHow myofunctional therapy can improve the growth of the jaws.Whether or not you need a posterior crossbite to expand the arches.If there is a “correct” age to initiate orthodontic treatment.Why the Salzman Index is antiquated and how it is prohibiting orthodontic residents from treating younger patients.Why malocclusion is a disease of cultural industrialization.Is there an age that is “too early” to treat patients with interceptive orthodontic treatment?How to build a collaborative network with our medical colleagues, including primary care physicians.LINKS:
-Sean Carlson video on expansion in the absence of crossbite: https://youtu.be/Y1aD_iYcLKU?si=VKbjaI5hBtxjQg0Q
-Harvard study by Silver: Silver EI. American Journal of Orthodontics and Oral Surgery. 1994;30(12):635:659.
-Link to AADSM Article: https://aadsm.org/journal/special_article_1_issue_112.php
-Dunedin Study: Richmond-Rakerd LS et al. PNAS. 2021;118(3):1-12
-Ultra-Processed People by VanTullican: https://www.amazon.com/Ultra-Processed-People-Science-Behind-Food/dp/1324036729/ref=asc_df_1324036729/?gad_source=1&hvadid=693449522341&hvdev=c&hvdvcmdl&hvlocint&hvlocphy=9012267&hvnetw=g&hvpone&hvpos&hvptwo&hvqmt&hvrand=12253883059461682792&hvtargid=pla-1960574051028&linkCode=df0&mcid=f479b78a5ba03190bbb7f73789672dc7&psc=1&tag=hyprod-20-Email Dr. Mike ([email protected]) to get a copy of Dr. Boyd’s letter to the Primary Care Physician
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Don’t miss Part 2 of my conversation on personal finance and wealth-building with my financial advisor, Justin Smith, CFA, CFP! In this episode we discuss:
• Emergency Funds - who needs one, what type of expenses to include, how many months of expenses it should cover, and where you should keep the dollars.
• The philosophical approach to investing that Justin recommends to his clients.
• How to approach diversification both within and among asset classes.
• The numerous benefits of having a wider margin between income and expenses.
• How to balance saving and investing with spending and enjoying excess dollars.
• Cryptocurrency and whether or not Justin sees it as a viable asset class in an investment portfolio.
• Student debt including how to incorporate it into an investment approach and if/when it makes sense to pay it down more aggressively.
• Saving for children’s college education including when to start, how much to set aside, and if 529 plans are the best way to do it.
• What to do if you end up with excess funds in a 529 plan and the new 15-year rule for transferring money from a 529 plan to a Roth IRA.
• Justin’s closing pearls summarizing how to achieve financial freedom.LINKS
• The Real Reason Big Savers Retire Early: Minimizing Retirement Savings Needs: https://www.kitces.com/blog/retirement-savings-needs-big-savers-avoid-lifestyle-creep-to-retire-early/
• To learn more about Smith Partners Wealth Management: https://smithpartnerswealth.com/
• The Ortho Coach website: www.TheOrthoCoach.com -
Do you have a plan to achieve financial freedom? If so, is it realistic and are you on track? If not, how are you going to get there?
How to determine if/when you need a financial advisor.What a fiduciary is and why you need to make sure your financial advisor is one.The most important questions to ask a prospective financial advisor to determine if they are the right fit.If you should look for an advisor who is “fee only.”The red flags to look out for when seeking a financial advisor.If it’s possible to make a change if you feel you are not with the right financial advisor.How a good financial advisor can help you manage the emotional and behavioral side of investing.The importance of sharing a financial vision with your spouse.What “first scoop of ice cream dollars” are and why they are so important for couples to define.Whether couples should split or share bank and retirement accounts.When going to Starbucks every day or going out to nice dinners with the family can be part of a responsible financial plan. How to define savings, if there are set rules for spending vs. saving, and how to coordinate them with your personal and retirement goals.The 50:30:20 rule for spending post-tax dollars and how to coordinate that with your family’s values.Strategies on how to build a financial IQ.What Justin feels is the best book to change the way you think about money.The value of a balance sheet and how often you should update it.The traits that Justin sees most often in people who achieve financial freedom and overall contentment.
In this amazing discussion with my financial advisor, Justin Smith, CFA, CFP, we'll discuss that and much more, including:LINKS:
-NAPFA Consumer Resources: https://www.napfa.org/financial-planning/consumer-resources
-NAPFA Advisor Checklist: http://s3.napfa.cql-aws.com.s3.amazonaws.com/files/Consumer/AdvisorComparisonToolFinal-fillable.pdf
-9 Questions to Ask a Financial Advisor: https://smithpartnerswealth.com/19-questions-to-ask-your-financial-adviser/
-To learn more about Smith Partners Wealth Management: https://smithpartnerswealth.com/
-The Ortho Coach website: www.TheOrthoCoach.com -
John is a CPA, CFP, author, educator, and TV personality who has appeared on such shows as NY1 News “Money Matters,” Fox Business News, CBSN, and Reuters TV. He wrote an amazing book on achieving financial independence titled “Getting to Point X” and has published articles in Money Magazine, the Wall Street Journal, the NY Times, Forbes, US News & World Report, and Financial Advisor Magazine. John has tremendous knowledge in the tax and financial planning arena, especially as it pertains to dentists. If you’re a dentist and you want to know more about how to lower your taxes, DO NOT MISS THIS EPISODE!!
This episode is FULL of AMAZING TAX INFORMATION FOR DENTISTS, including:
How to get to what John calls “Point X,” or financial independence.The biggest expense that dental practitioners face.Legal strategies and loopholes to decrease your tax liability and increase your wealth.The difference between a tax deduction and a tax credit. The most commonly missed tax deductions and credits.How to make entertainment expenses fully deductible.What the “Ordinary and Necessary Test” is and how it’s used by the IRS.How to choose the right accountant for you and your practice.Whether your receipts should be digital or paper, how they should be organized, and for how long you should retain them.How you can save literally hundreds of thousands of dollars with the SALT deduction/credit loophole.How the ERC credit works, if you can really save up to $26k per employee, and how working with certain solicitors can lead to criminal charges and the loss of your dental license!Whether or not the Inflation Reduction Act will increase your chances of being audited.Which entity is least likely to get audited and which entity is MOST likely to get audited and if the Inflation Reduction Act will change that.The different types of IRS audits and the steps to take if you are audited.If you should pay more taxes than you need to in order to decrease the risk of an audit.Important Links:
-To purchase John’s Book: https://www.ventotaxandwealth.com/buy-the-book-You can find more information on John and his firm, Vento Tax and Wealth Management, at www.VentoTaxAndWealth.com.
-Link to John’s Newsletter: https://www.ventotaxandwealth.com/blog
-Link to John’s article on IRS Audits: https://www.ventotaxandwealth.com/tips-for-dentists
-Link to a number of tax calculators: https://www.ventotaxandwealth.com/resource-center/calculators
-Link to the IRS website on the Employee Retention Credit: https://www.irs.gov/coronavirus/employee-retention-credit
-Link to the DOC website: www.TheOrthoCoach.com -
I had an amazing conversation with my extremely impressive colleague, Dr. Steffen Decker. Steffen is a prominent orthodontist in the UK who started his career treating adults with Invisalign and lingual braces and has since developed a passion for helping younger patients with interceptive orthodontic treatment. We discuss:
How Dr. Soroush Zahgi inspired Steffen to focus more on interceptive treatment and airway.How restorative dentists such as Dr. John Kois and Steffen’s wife helped Steffen understand the detrimental long-term impacts of an extraction/retraction approach to orthodontic treatment.The role of an oral habit in the aberrant craniofacial growth and development of one of Steffen’s twin sons.The importance of a thorough diagnostic process, including listening to your patients, in order to determine the etiology of the presenting malocclusion.Why so many orthodontists remain opposed to treating patients earlier/younger.A recent debate I had with a colleague on social media about determining and treating the etiology of malocclusion.The difference between left-brained and right-brained individuals, and how that can determine who is more open to changing their approach to patient care.The logistical challenges associated with having randomized controlled studies on the benefits of early treatment, especially as it pertains to airway.Why CPAP was originally approved based upon a study with only 5 patients, yet studies showing the benefits of expansion on airway of hundreds of patients are deemed insufficient evidence of its efficacy.The influence of environmental factors on the development of malocclusion and the fallacy that the etiology of malocclusion is completely genetic.Why Steffen has parents film their child sleeping with a baby monitor and send it to him.That once you see and feel what you can do to change the lives of younger children, you will never be the same regarding your approach to early treatment.The need for all those who have had the privilege of changing a patient’s life through early treatment to share that message with others.LINKS:
-To contact Dr. Decker: [email protected]
-Tuncay & Schiffman article: https://www.researchgate.net/publication/11794785_Maxillary_expansion_A_meta_analysis
-Papadopolous Review of Tuncay & Shiffman article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111736/
-Link to episode w/parents of a 6yo patient Dr. Mike treated: https://youtu.be/wJFP_9NFnv0?si=0QhYGPAQ3HV0G2dn
-To contact Dr. Mike: [email protected]
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