Thursday, June 27, 2013

Post-Doctoral Education

“Hi, I’m Ka – err, Dr. Divine.”

That’s how I introduced myself to my first patient at my new AEGD residency. It felt a little weird, especially because their first question to me was, “Wait, how old are you?” If they thought they were surprised then, my answer of, “Sixteen. I’m a genius,” definitely shocked them. Not true, but it usually gets a laugh. Then I explained just how many years of school I have completed and quickly moved on to the plan for the day’s appointment.

After graduating mid-May, I made my way out to Boise, Idaho, the site of my AEGD program. I was able to get some hiking in and even a bit of whitewater rafting with the current residents. Monday I officially started my AEGD residency.

Beyond working side-by-side with specialists, gaining experience in advanced cases, including implant placement and even IV sedation, completing a GPR or AEGD provides 150 approved credits toward the prestigious AGD Fellowship award. I did not initially know this when I became interested in completing a post-grad residency, but I think it’s awesome!

I’m sure many of you are aware of the requirements for the Fellowship award, but I’d like to bring it up for the dental students and new dentists like me out there.

Here are the requirements:
-500 hours of approved CE
-Passing the Fellowship Exam
-Current AGD membership for three continuous years
-A dental license that has not been suspended or revoked in the last five years and is not currently under probation, suspension, or revocation
-Attendance at an AGD convocation ceremony, held during an AGD annual meeting, to receive the award

Dental students should look into whether they can submit CE hours during dental school as student members. At Minnesota, I believe we were able to accumulate up to 50 hours of CE as students.

You may take the Fellowship exam at any time, but it is recommended that you take it within two years of graduation.

Perhaps the Fellows and Masters we have reading this could weigh in with their advice for successfully achieving this award. How has this award factored into your CE choices? Into your dental practice?

As the AGD 2013 Annual Meeting & Exhibits starts tomorrow in Nashville, I want to congratulate those members receiving their Fellowship and Mastership awards!

Katie Divine, DDS

Monday, June 24, 2013

My Wife's Birthday Gift

After nearly 34 years together, I was proud and happy to consider what to give my wife for her 60th birthday. I have learned over the years that life is very precious, and celebrating such a milestone birthday is a present in and of itself.

I started to ponder some of the benefits of being together for 34 years. We celebrated birthdays when she was getting her doctorate, in her hospital training days, and as our family grew from the two of us to three, and then to four. It is hard to imagine that, as of her birthday on May 12, I have slept each night with my wife in five different decades. How lucky. But what to get her for her 60th birthday?

We are not the kind of couple that gives special gifts on these types of occasions. Most of the time, birthdays become weekends during which we pretend we are retired and do whatever we want. It is great fun and practice for when we do retire.

But I’d inadvertently been working on a very special gift for Debbie for the past seven years. It is a gift that gives her more peace of mind, more covers at night and more space on the plane when we fly. This gift makes it easier to move me about in case I have surgery or an accident. It promises more fun in the yard as we do our seasonal cleanup and less anxiety when we prepare for our medical checkups.


I gave her something I never imagined I could give her. For her 60th birthday, Debbie got a husband who is in the best shape of his life. I’d been working on this goal for my own 60th birthday last April. Now, it has turned out to be a gift for Debbie as well.

As we age, working to be in the best shape we can for our new extended life expectancy is certainly worth the peace of mind that comes with it. The thought of recovering from an injury or illness is much more manageable now without the extra 44 pounds that I shed in my journey to become fit. Yard work is actually fun and just another part of outdoor exercising. I don’t bulge into part of her seat on the plane and my body doesn’t take as much blanket to cover it. We now view annual checkups with optimism at the prospect of finding out how much better we’re doing. Most importantly, I’ve found that exercise is a great stress reliever; we are both less stressed now.


All in all, Debbie appreciates the benefits of me putting in the time to work toward a “Men’s Health magazine body”, with the guidance for the past year of a personal trainer. At any age, health is the gift that keeps on giving.

Enjoy the journey,

Bob Oro, DMD, MAGD

Friday, June 21, 2013

My Review

In my opinion, most of us do not think we are bad dentists. However, we all have bad days. Sometimes our work may not be perfect, but overall, I think our goal is to always be very satisfied with our clinical work. You never perceive yourself as having bad intentions, so it feels surprisingly disheartening when strangers criticize you online.

The Internet has done great things for dentists in terms of marketing and keeping the public up-to-date and more aware of their oral health. But all good things must have some downside, right? When you are putting yourself out there online, you are making yourself vulnerable to all kinds of commentary.

Have you ever watched the segment that Jimmy Kimmel does with celebrities reading mean tweets about themselves? It’s funny, but it humanizes these famous people and makes you realize that they have feelings too. That’s kind of how I felt when reading some comments about me on a popular review-based website. The thing that was most upsetting was that it had nothing to do with my dental work. It basically put down the way I looked (too young), the way I talked (weird accent), and implied that I acted like I had no interest in what I was doing and cared very little about the patient. Excuse me? Let’s just get one thing straight: dentists have feelings too!

At first, I was shocked that something like this bothered me. I generally have great experiences with new patients, but we all know that no one is perfect and you cannot make everyone happy. You have all had that unpleasant first time patient encounter. Whether it was in dental school or residency, like me, I am sure most of you did not let it keep you up at night. Seeing a reminder of it forever etched in time on the Internet seemed to be much more significant in terms of affecting my self esteem.

I will be the first to admit that I do not enjoy schmoozing with patients. I am very straightforward during my consults. I like to be efficient and not waste my time or theirs. When I am the patient or a customer, I appreciate it when I am treated in a similar way. That is just my personality. I can see how that may come off as being disinterested. I realize I cannot expect everyone to love or even like me, but the fact that someone thought I was not doing the very best job that I could for him or her made me feel horrible. In the words of Carrie Bradshaw: “When it comes to life and love, why do we believe our worst reviews?”

Anyway, time went by and I started getting more reviews. Some were great and some were okay. I have definitely learned a lot from this experience, and would love to share some thoughts with you.

1. We like to believe we are in the healthcare industry. But guess what. We are also in the service industry. Like it or not, our patients are educated consumers, and contrary to what you may think, they tend to prefer great service over great dental work. Many of them will compare how you treated them to their waitress at dinner last night or a salesperson at the mall. Most patients won’t care that you spent an extra 15 minutes perfecting the contours and anatomy of that MOD composite or that you have hundreds of hours of CE under your belt. What they will care about is if you took the time to ask about their day and made sure their visit was quick and painless.

The take-home message here is this: Combine great dental work with great service. The most perfect dental work in the world will mean nothing if the patient feels they are not being treated well or given enough attention. As appealing as it may sound, you cannot turn into the Soup Nazi of dentistry if a patient even dares to question your intentions. “No teeth for you!”

2. Take those negative reviews in stride. When someone writes that I am too young or even tells me to my face (it happens often), I graciously accept the compliment. I offer tips on maintaining your youth, such as eating healthy, practicing yoga and staying out of the sun.

3. Get better at reading people. I am working in a new practice, so many of our patients are new. If they seem cagey, I try extra hard to win them over by making jokes or chatting about something other than dentistry during that initial visit. I am not great at this, but it is something I have been trying to work on.

4. When all else fails, just let it go. We all get those patients that are difficult, no matter what. Nothing pleases them, they have unrealistic expectations, and some may even threaten you with bad reviews if their demands are not met. I do not negotiate with terrorists.

5. Remember that the good, appreciative patients that you want do not look to the Internet to find a healthcare professional. I am the first to admit I frequent this site when I am traveling and want to find the best place to eat in the area or a great hotel to spend the night in. I know many of the reviews are biased. I find that it helps more when I can get an opinion from someone I know and trust. I like to think many of your best reviews will come from the patients that appreciate you the most, which they will pass on to their friends and family.

6. Still upset about something you read about yourself on the Internet? Just repeat after me: “I am good enough. I’m smart enough. And doggone it, people like me.”

Enjoy your weekend!

Lilya Horowitz, DDS

Wednesday, June 19, 2013

Keeping That Ever Elusive Work-Life Balance

You know how sometimes there seems to be a theme that weaves itself in and out of your daily life for a while? That’s been happening in my life recently. The topic? Work-life balance.

It’s one of those seemingly trite and definitely overused phrases that make some people (me) cringe. But the topic has come up so often lately that I felt perhaps I needed to honor it with some serious introspection.

As a woman who owns two different businesses, is married with adult children, is a part-time clinical instructor and lives on a farm with many loving animals and many responsibilities, how can I create balance? How can I maintain (ha!) my sanity?

Don’t get me wrong. This is by no means a gender issue. This is an issue that knows no demographic biases. At the end of the day, we all need a sense of balance.

If we are all in agreement on the premise that we all need a sense of balance, how do we go about achieving that? What can we put into place that will assure us that a balanced life will be the outcome? I guess if I really knew that answer, I would be in high demand on the talk show circuit. But, I’m not. As it turns out, I’m just trying to figure it out, too. However, I do have some tips based on the wisdom of age and my old friends, Trial and Error.

Have a Plan A, a Plan B, a Plan C and maybe even a Plan D
It sounds silly, I know. But, it has been the fact that I have back up plans for my back up plans that has helped to keep me sane. And, it keeps me from crying, “Woe is me,” and from pointing fingers (usually in the wrong direction) at who I blame for my problems. It’s too easy to make other people or situations wrong. And it serves no actionable purpose other than giving you a momentary sense of false bravado. If Plan A didn’t quite work the way you thought it would/should, put Plan B into effect without breaking stride. I’m not even talking about life plans here. I’m talking about something as trivial as running out of your favorite bonding agent. This should not even be a blip on your balance radar; Plan B should allow you to simply reach into the cabinet for the other bonding agent. And, for today, life didn’t fall apart!

Talk issues out with your trusted love circle
It turns out that Robert DeNiro was on to something when he talked about his circle of trust in the movie “Meet the Fockers.” You know who these people are in your life. Use them. Learn to open up and talk about the issues that are weighing you down. Share the burden so that you don’t tip the balance in your life. Keeping all of your concerns and worries inside will just let them build up to a point when finally something has to give. And I, for one, would not want to be around to watch that happen! Talk therapy works!

Set aside some alone time every day
I know, I know. I just went on and on about the value of talking about your concerns with someone you trust, and now I’m telling you to set aside some alone time every day. But, this is so vital to maintaining that fragile work-life balance. You need to be alone with your thoughts and meditate about the day’s events. Alone time can come in the form of workouts, walking the dog, even a cup of coffee first thing in the morning as you watch the sun peek out above the horizon. You can define your own version of alone time; just make sure you take advantage of it. It should be no less than 15 minutes and ideally 30-60 minutes. Think of it as a sort of reflection time to reevaluate your plans, issues and feelings. At the end of your alone time, you should feel somewhat refreshed and reenergized.

It’s not always easy to maintain that elusive work-life balance. The demands of both aspects of our lives are sometimes overwhelming and push us to the limits. But, if we can be mindful of these three tips, it may just make that balance a little bit easier to keep.

If you’ve got techniques that help you to maintain your work-life balance, I would love to hear them! Share them with us in the comments section below!

Meanwhile, here’s to a balanced life!
Claudia Anderson, DDS

Tuesday, June 18, 2013

Have Confidence

Do you believe in your fee? Are you worth that much? Or that little?

I took my team to the Pacific Northwest Dental Conference last weekend. We went to some great classes and had some fun, too. One of the instructors reminded me of something I need to improve: confidence. He said we should be confident in our fee. In order to present the treatment to our patients, we have to believe that is worth it. This reminded me of what I learned from Dave Ramsey last year at an EntreLeadership course.

He said that when someone pays another person for something, they are handing them a note of appreciation. (These notes happen to have presidents’ faces on them.) You have to believe that your service is worth that amount of money. If you had that service done, you would be happy to pay that much for it. If you and your team don't believe that, you cannot present a treatment plan confidently. And if you don’t believe it, you will probably communicate that to your patient, either verbally or through body language.

My wife reminds me to always tell my patients that this is the treatment that I would do for my mother or sister or wife. Only say that if it is true, of course.

If you don't believe in your fee, change it. If you don't really believe in your treatment, then take a course to build your confidence with that treatment or improve other skills. If your team is unsure of the treatment, take them to a course to increase their skills and knowledge.

Believe in your fee, and present it with confidence.

Mike Lemme, DDS

Wednesday, June 12, 2013

Do You Want to be in the Room?

Do any of you watch “The Bachelorette?” I never seen an episode before, but right now I am hanging out in a modest hotel room on a Community Dental Outreach rotation and of the thirty-five channels available, it seems like the lesser of all evils. All I can think is how unbelievably awkward it is watching her try to force a relationship with each of the guys. I can’t help but wonder if this is what my assistants experience while watching me work with a new patient for the first time. I’m tempted to hide a camera in the operatory to see how bad it is. But I digress…

“Do you want to be in the room?” Those were the first words out of the veterinary technician’s mouth when my future sister-in-law called the office to inquire about euthanasia for her aging Llewellin setter that they had saved several years before.

She was emotional and confused, and didn’t know if she wanted to be in the room. “Well, you need to know it’s $65 extra to be in the room while they do it,” the voice explained (this was in addition to the $300 base fee for the procedure). Needless to say, she found another office to help in this tough time.

There are undoubtedly good reasons for this veterinarian to charge the additional fee, but Laura felt like she was being taken advantage of while she was most vulnerable. When I heard this story, I couldn’t ignore the parallels to dentistry. The next time a potential patient calls with an emergency, how can you help him realize your office truly cares? We work hard and deserve to be compensated accordingly, but we also need to think about how our billing policies will be perceived by our patients. No one wants to feel nickeled-and-dimed!

David Coviak

Monday, June 10, 2013

Are We There Yet?

Like many of the dentists who have written for The Daily Grind, I had an idea for this blog, but it changed completely with the arrival of the mail today. I was happily greeted with a large AGD envelope marked, “REGISTRATION MATERIALS ENCLOSED.”

A year ago at this time, I was cramming to sit for the AGD Fellowship Exam. This year, I am excitedly preparing for the Fellowship Convocation. My ID badge arrived with two honorary ribbons: one signifying my 10-year anniversary as an AGD member and one declaring I am a 2013 Fellow Awardee.

I’ve written previously about working towards Fellowship, so today I want to focus on the Annual Meeting, only weeks away. First things first, it is NOT too late to attend the meeting. Online registration is still open! This will be my first time attending the AGD Annual Meeting & Exhibits. If your schedule doesn’t allow for it this year, reserve next year’s time now: June 26 to 29, 2014, in Detroit, MI (my home state!). Don’t worry. I’m fairly certain we won’t have snow then!

I have made a conscious decision to attend the conference every year. I hope you commit to doing the same. It is a great opportunity to not only fulfill needed continuing education (CE), but to network with your peers and have a good time, too. The AGD is wonderful about giving us fair warning, so add these dates to your calendar!

AGD 2015 Annual Meeting & Exhibits
June 18 to 21, 2015
San Francisco

AGD 2016 Annual Meeting & Exhibits
July 14 to 17, 2016

This year, I am doing it all. I am attending the AGD Annual Meeting for the first time, serving as course manager for several courses, and participating in Convocation. It has been an amazing and unforgettable year, and. I have learned so much during this journey.

The AGD has incredible CE programs available. Not only do they provide an opportunity every year to attend meetings that are packed with the best lecturers speaking on current trends in dental science and practice management, but they also provide periodic conferences on Practiceology and Leadership. These are skills they didn’t share in dental school. (Not that we would have had time to learn anything else after competencies, lab cases, exams, etc.) There is no doubt that we get to a point where the physical act of dentistry becomes second nature, but enhancing our ability to be a better practitioner/team leader/mentor is a lifelong process. So, no matter what “hat” you are currently wearing (owner, associate, student), the AGD has a class for that.

See you in Nashville!

Colleen B. DeLacy, DDS

Wednesday, June 5, 2013

More Similarities Than Differences

In the 70s, it was common for middle class kids growing up in Toronto to go to summer camp. I attended four different summer camps over the years, spending eight weeks away from home. The lakes in southern Ontario were great. They warmed up enough to swim comfortably on hot days when nothing could beat being near and in the water. Those camps were mostly all the same, getting kids outside and active all summer long. I wasn’t crazy about it then, but I sure miss those days now.

Today, summer camps are different. There are still the traditional camps I attended, but so many are specialized. There are sports camps, music camps, acting camps, etc. They run for one, two, or three weeks, but rarely the whole summer. The more I look at today's camps, though, the more similarities I see. These camps are simply trying to address a broader set of needs and to get kids outside and engaged.

Just short of 19 years ago, I married my wife and best friend, Tina. It was an interesting union of a Hindu family with a Jewish one. We live in a world with some amazing faiths and expressions of those faiths. The number of varieties of Christianity is wide and varied, not to mention Jewish and Muslim worship, Hinduism, Buddhism and more. We live in a fascinating world. But the more deeply I look, the more similarities I find. We are citizens of one world.

In the 1980s, the Faculty of Dentistry at the University of Toronto taught occlusion from the classic gnathological standpoint. Centric relation (CR) was the focal point for rebuilding worn or deficient occlusions and in denture fabrication. I really struggled with it and, in the end, avoided it altogether.

I worked conservatively, restoring teeth to the best of my ability, in habitual occlusion. I have been mostly successful for my now 26-year career. But I do see worn teeth, deficient dentition, collapsed bites and more. I knew that there was a way to do this and sought to learn more about occlusion. Over those 26 years, I studied the methodology of Pankey and Dawson, learned about OBI, Kois’ and Spear’s methodologies, and more. But as I stumbled upon neuromuscular approaches to dentistry, I found something that resonated with me. I studied this intensely, first at the Las Vegas Institute, and then directly with Myotronics, and finally, more recently, with Dr. Clayton Chan.

Occlusion has had considerable amounts of coverage in popular dental media. And now, better peer-reviewed publications as well. I continue to be amazed at the passionate discussions that are being held, as well as with the unfortunate animosity that has been associated with it.

I have had successes and failures in the pure gnathological CR approach, and I have had successes and failures in the pure neuromuscular approaches. But as I have studied and learned more, particularly with Dr. Chan, I have found there are more similarities than differences in the various occlusion camps. When I apply both the neuromuscular and the gnathologic approach, as I learned from Dr. Chan, I achieve the success in conservative treatment that I was not getting before, especially with patients who are in pain. I am a dentist in one profession of dentistry.

The best advice I have ever heard on this subject is from one of my prosthodontic colleagues in Calgary, Dr. Donald Reikie, during one of the local debates on occlusion. He said, “Choose the methodology that resonates for you. Learn it well and apply the principles diligently and meticulously and you will have success.”

Let’s use these words to apply our learned principles well and diligently and celebrate the similarities we have in finding healthy solutions for the patients we have the privilege to treat.

Thanks for reading.

Larry Stanleigh, DDS


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