Who is John Galt? How Corporate Dental Offices are Disrupting the Status Quo.

Who is John Galt?

Disruptors in Dentistry

By Brett Kessler, D.D.S., CDA President

"I started my life with a single absolute
That the world was mine to shape in the image of my highest values
And never to be given up to a lesser standard, no matter how long or hard the struggle" Ayn Rand, Atlas Shrugged

Disruptors are innovators.  They are businesses that shift a mindset of how consumers think, purchase, etc. – thereby challenging established businesses.

Harvard Business School professor and disruption guru Clayton Christensen says that a disruptor displaces an existing market, industry, or technology, and produces something new and more efficient and worthwhile. It is both destructive and creative.

Some examples of disruptors are companies like Apple, Netflix, Amazon, and Uber.

I identify Apple not for the computers that it builds, but for another niche that it took over – music and listening device sales.  iPods, iPhones and iTunes have changed how we buy and listen to music. There are hardly any CD stores remaining other than those that sell used discs.  When I grew up, I would buy records.  The cover art would attract me to give new bands a listen.  I judged the band by entire albums that it recorded.  Today, we buy songs, not albums. They are instantly downloaded onto our computers.  No waiting in lines; no browsing through tedious shelves of records/CD’s.

We create playlists with the drag of a mouse.  We use auto shuffle and the “genius” feature to create our own personal radio stations. They connect to our cars, our phones, our tablets and all are stored on our computers.  CD players are becoming a thing of the past.  Music is stored on hard drives, flash drives, iPods, etc.

Netflix took how we rent movies to a new level.  For a low monthly fee, we can have unlimited movies shipped to our house – hassle free – or immediately available to view on our computer or smart TV’s through an internet connection.  Blockbuster used to charge late fees, “you-didn’t-rewind-the-VHS” fees, etc.  I dreaded having to pay this fine. The buying experience was a hassle and expensive.  Netflix is easy, customized to my preferences and instant. Are there even any Blockbuster stores left?

Amazon capitalized on the fact that a book is still readable after it had been read, music is still listenable after it had been listened to, and anything should be able to be purchased on the internet easily!  They created a personalized buying experience based on your browsing and buying habits.  It greatly affected the big chain bookstores like Borders or Barnes & Noble.  It also helps you find the lowest price for a commodity and they deliver it right to your door.  If it wasn’t exactly what you were looking for, ship it back.  Hassle-free!

Lastly, Uber is putting a huge dent in the taxi business. With Uber, you can press a button on your phone app and a nice clean car will be at your location within 15 minutes. Taxi’s get to you when they get to you and the entire cab experience pretty much stinks!

All of these disruptors have innovated, streamlined and penetrated market share. They have challenged and even ruined wildly successful businesses, while reinventing the delivery of these services.  They have changed the consumer’s mindset and changed the paradigm on how these services should be purchased, used and consumed.  The consumer experience is exactly the way the consumer prefers.  We (the consumers) wouldn’t have it any other way.

Another commonality of these disruptors is that they didn’t just enter the marketplace and were welcomed with opened arms.  The status quo or “established” business model was not happy and tried to stop them.

In reality, the status quo was asleep at the wheel. They were lazy and arrogant. They felt they were too big to fail. Those established business models that survived disruption evolved their business models to better serve their consumers.

The question, “Who is John Galt?” comes to mind from Ayn Rand’s book “Atlas Shrugged.” John Galt represents creativeness and innovation.  In the book, the status quo was constantly putting up barriers to protect its own interests in how things always have been done.

The status quo must constantly channel its inner John Galt if it wishes to remain relevant to the people it serves.

There are disruptors popping up in every niche of business, and dentistry is definitely not immune. 

Large Group Practices, better known as Dental Support Organizations, are delivering dental services cheaper, quicker and more efficient than the typical private practice. A Dental Support Organization takes care of all of the business aspects for the dentist – the billing, HR, marketing, equipment, materials, etc. 

They are aggressively growing around the country.  They are aggressively hiring new dentists.  They are aggressively advertising their services.  They have created a niche for themselves and continue to attract patients.  Some may say that they haven’t perfected the consistent customer experience yet, but at some point, this too will change.

As in private practice there are good practitioners and those who could use a little nudge to “up their game.”  The reality with the Dental Support Organizations is that they are being judged by the lowest common denominator.  For every bad patient experience, the entire organization’s reputation takes a hit. If these companies are going to take their disruption to the next level, they need to shore up some of the weaker links in their organizations.  Trust me; they are aggressively evolving their internal practices to do just this. 

I recently attended a forum on Dental Support Organizations. DSO’s are growing 15-20% per year with over 7000 dentists employed, it was illustrated that the trend in healthcare is moving toward consolidation.  Consolidation breeds efficiency, in theory.  If you look around, there are very few privately owned pharmacies; there are very few private physician offices.  They have all been engulfed by corporate entities that manage the business side of the practices. Has it improved healthcare? I’ll leave that for the reader to decide. 

Many of us in private practice (the status quo) are complaining.  Of course, it’s only natural.  The realities are, however, if the private practitioners aren’t evolving their games, they will soon be wondering where their patients have gone. Maybe some of us already are!

Graduating dental students are being hired in droves by these practices.  I asked a recent graduate who was working for a Dental Support Organization what his favorite part was about working in this environment?  He answered that he has mentorship and professional networking instantly available to him.  He admitted he gives up some of his autonomy, but implied that no job is 100% perfect.  I would agree with that statement in private practice too.  There are parts of my day that I don’t look forward to doing (usually administrative) as well. 

Most of these dentists are not joining organized dentistry.  Why?  The most common response: they are made to feel “less than” for working for those companies. 

This must stop.  We (organized dentistry) are being judged by this fact, just as some may be judging those who work for entities different than private practice. The Colorado Dental Association is charged with advancing oral health in our state.  The DSO’s in Colorado are helping us achieve this.  They are just doing it differently than the “status quo”.

We need to be much better at welcoming our colleagues.  They are working the best that they can with the opportunities that are presented to them.  I always remind young dentists to keep the patient’s best interest as their main focus.  We have a must maintain our code of ethics as a profession.

The Association of Dental Support Organizations (www.theadso.org) has emerged to help set standards for it’s members and is looking to ensure that ethical practices are in place.

Evolution is the survival of the fittest.  Those who can adapt and create change will evolve into the new paradigm, and address the needs and desires of the consumers.

The status quo does not exist indefinitely.  It will constantly be challenged.

“Who is John Galt?”

Disclaimer: I am not passing judgment on these disruptors mentioned in this article.  I am just sharing my observations and thoughts.  I may or may not subscribe philosophically with various paradigm shifts occurring in the dental marketplace.  Each serves a niche that is attractive to various people.  That is why they are growing/gaining the market share and shifting the perceptions of the consumers. When I mention “organized dentistry” I mean ADA, state associations and its components.

If you like this blog post, I would love to hear about it.  Please comment or share it on Google+, Facebook, Linked in, Twitter, etc.  If you are looking for a dentist in the Denver area, we are always looking for new patients.  Please visit our website http://www.tcdodenver.com/ or like our facebook page,  https://www.facebook.com/TCDOdenver.  Or you can contact us  the old fashion way - call us at 303-321-4445.

Thanks for reading!  BK

Who is John Galt? - Disruptors in Dentisty

Disruptors are innovators.  They are businesses that shift a mindset of how consumers think, purchase, etc.  thereby challenging established businesses.

Harvard Business School professor and disruption guru Clayton Christensen says that a disruptor displaces an existing market, industry, or technology and produces something new and more efficient and worthwhile. It is both destructive and creative.

Some examples of disruptors are companies like Apple, Netflix, Amazon, and Uber

I identify Apple - not for the computers that it builds, but another niche that it took over – music and listening device sales.  iPods, iPhones and iTunes has changed how we buy and listen to music.  There are hardly any CD stores anymore other than those that sell used ones.  When I grew up, I would buy records.  The cover art would attract me to give new bands a listen.  I judged the band by entire albums that it recorded.  Today, we buy songs, not albums. They are instantly downloaded onto our computers.  No waiting in lines, no browsing through tedious shelves of records/cd’s.

 We create playlists with the drag of the mouse.  We use auto shuffle and the “genius” feature to create our own personal radio stations.  They connect to our cars, our phones, our tablets and all are stored on our computers.  CD players are becoming a thing of the past.  Music is stored on hard drives, jump drives, iPods, etc;

Netflix took how we rent movies to a new level.  For a low monthly fee we can have unlimited movies shipped to our house  - hassle free; or immediately available to  view on our computer or smart TV’s through an internet connection.  Blockbuster used to charge late fees, “you didn’t rewind the VHS” fees, etc.  I dreaded having to to pay this fine.  The buying experience was a hassle and expensive.  Netflix is easy, customized to my preferences and instant. Are there even any Blockbuster stores left?

Amazon capitalized on the fact that a book is still readable after it had been read, music is still listenable after it had been listened to, and anything should be able to be purchased on the internet easily!  They created a personalized buying experience based on your browsing and buying habits.  It greatly affected the big chain bookstores like Border’s or Barnes&Noble.  It also helps you find the lowest price for a boxed item and they deliver it right to your door.  If it wasn’t exactly what you were looking for, ship it back.  Hassle-free!

Lastly  -Uber is putting a huge dent in the taxi business.  With Uber, you can press a button on your phone app and a nice clean car will be at your location within 15 minutes. Yellow Cab gets to you when it gets to you and the entire cab experience pretty much stinks!

All of these disruptors have innovated, streamlined and penetrated market share, challenged, and even ruined wildly successful businesses while reinventing the delivery of these services.  They have changed the consumer’s mindset and changed the paradigm on how these services should be purchased, used and consumed.  The consumer experience is exactly the way the consumer prefers.  We (the consumers) wouldn’t have it any other way.

Another commonality of these disruptors is that they didn’t just enter the marketplace and were welcomed with opened arms.  The status quo or “established” business model was not happy and tried to stop them. 

In reality, the status quo was asleep at the wheel.  They were lazy, and arrogant.   They felt they were too big to fail. Those established business models that survived disruption evolved their business models to better serve their consumers.

The question “Who is John Galt?” comes to mind from Ayn Rand’s book Atlas Shrugged! John Galt represents creativeness and innovation.  The status quo must constantly channel it's inner John Galt if it wishes to remain relevant to the people it serves.

There are disruptors popping up in every niche and dentistry is definitely not immune.  They are here and they are aggressively working to innovate and change the status quo. 

Disruptor #1 - Large Group Practices are delivering dental services cheaper, quicker and more efficient than the typical private practice.  They are aggressively growing around the country.  They are aggressively hiring up new dentists.  They are aggressively advertising their services.  They have created a niche for themselves and continue to attract patients.  They haven’t perfected the consistent customer experience yet, but at some point that they will figure it out. 

There are some really lousy dentists that practice in this setting.  There are also really good dentists in this arena too.  To be fair - There are also some really lousy dentists in private practice settings.   There are also some really good dentists in this arena too.

The unfortunate reality with the large group practices is that they are being judged by the lowest common denominator.  For every bad patient experience, the entire organization’s reputation takes a hit. If these companies are going to take their disruption to the next level, they need to shore up some of the bad players in their organizations.  They need to do this from within.

A dental organization in the Pacific Northwest is self-regulating through a peer review process similar to the one used in organized dentistry.  I commend them for taking the initiative to self-regulate and get rid of the bad apples from their branches.   

Disruptor #2 – Dental Insurance has been a driving factor in changing consumer perception with respect to the dentist.  There is a mindset that if one doesn’t have insurance they can’t go to the dentist. 

Dentistry is equal parts art and science.  The product that we deliver is a unique service and experience every single time.  The dental insurance industry has been really good at “commoditizing” these services. They view all fillings, crowns, and other procedures as commodities.  They don't take into account level of the level of difficulty it took to achieve a positive result.  Dentists must impart the value of their services to their patients and that dental insurance is a nice benefit but it the cure all to their dental health.

On the flip side - Dental insurance does help with the basic preventative services - cleanings, check ups, xrays etc.  And many people go to the dentist because of the benefits that they receive.  

Disruptor #3 – New Technology is continually changing how we practice.  Film based x-rays are as antique as the horseless carriage.  CAD/CAM, digital impressions, articulations, etc are going to make dentistry more efficient and even more predictable.

Disruptor #4 – This past year, Metropolitan Denver Dental Society (MDDS) built the first and only dental learning center operated and run by and component of organized dentistry.  The new facility has 4 fully operating dental operatories that are being used for hands on learning opportunities.  They have functioning lab benches, auditorium and video streaming from the operatories into the various remote video-viewing stations.

The Metropolitan Denver Dental Society is dedicated to supporting its members, promoting the highest ethical practice of dentistry; providing continuing professional education, including a premier annual dental convention; and oral health education to the public.  This learning center, The Mountain West Dental Institute, will help them fulfill their mission.  Many dental associations around the country are very interested to see how this works.  Some people say they took a big risk....that is what disruptors do.

The Colorado Dental Association recently hosted a presentation in which approximately 100 dentists showed up in person and an equal number viewed the presentation remotely via live streaming technology.  This new use of technology will allow dentists from around the state/country meet, learn, network and communicate.

America is the land of opportunity.  Anything is possible with creativity, hard work, perseverance and a little bit of luck.  Every business must constantly raise the bar if it is to remain relevant and vital.  The business models must evolve to stave off the disruptors and to keep the consumers interested in their product or service.

Evolution is the survival of the fittest.  Those that can adapt and create change will evolve into the new paradigm and address the needs and desires of its consumers.

The status quo does not exist indefinitely.  It will constantly be challenged. 

“Who is John Galt?”

Disclaimer –I am not passing judgment on these disruptors.  I am just sharing my observation and thoughts.  I may or may not subscribe philosophically with various paradigm shifts.  Each serves a niche that is attractive to various people.  That is why they are growing/gaining the market share and shifting the perceptions of the consumers.

If you like this blog post, I would love to hear about it.  Please comment or share it on Google+, Facebook, Linked in, Twitter, etc.  If you are looking for a dentist in the Denver area, we are always looking for new patients.  Please visit our website http://www.tcdodenver.com/ or like our facebook page,  https://www.facebook.com/TCDOdenver.  Or you can do it the old fashion way - call us at 303-321-4445.

Thanks for reading!  BK

Case study - Addressing Jaw (TMJ) Problems to a Wonderful New Smile with Veneers and Crowns.

I haven't blogged in a while....My patient care coordinator Monique asked why?

"I haven't been inspired to write lately!"

She said, "Why don't you share some of the smiles that we have improved?  They are life changing!"

I thought about it for a moment...""Not a bad idea!"

So here it goes.....

This particular patient of mine presented with jaw pain after a car accident.  He had many broken bones and chipped teeth. He went through many surgeries and has healed up nicely.

I treat a lot of patients with jaw pain.  I enjoy it - When I was in dental school, we were taught to do bite splint therapy. If they don't get better, send them to their psychiatrist as they are crazy.  I didn't buy that as I had a history of jaw problems and I wasn't crazy...

I spent many years after dental school taking classes on how to treat patients comprehensively -and this included the orthopedic treatment of the jaw and how it relates to the bite. By following some of these protocols, I am now able to treat a wide variety of dental issues predictably.

So we started with bite therapy that included various types of splints over two years to allow the jaw to heal. As his jaw healed and then stabilized, we started discussions on idealizing his bite.  He didn't present with esthetic concerns, but as we got to know each other through his treatment, he revealed to me that his front teeth chipped during the accident.

Adding length to the front teeth without addressing the function could be a very risky procedure.  The length of the front teeth could affect how one chew's food, how one grinds their teeth and also could affect how one speaks.

If the increased length interferes with the normal jaw movements or grinding patterns, the restorations are at high risk to break. It could affect the jaw muscles or one could develop headaches.  Teeth that are too long will compromise the 's', 'f', and 'v' sounds - giving the patient speech impediments.  They must also fit the features of the face to look as natural possible.

If any of these factors are not addressed, the results could be devastating.

Fig. 1 - Multiple short and chipped teeth

As part of idealizing his bite, we were able to add length and repair the smile within the harmony of his function.

Here is the after photo.

Fig. 2 -Restored smile with veneers and crowns

Happy patient.  He admits to me that he was very self conscious with his smile prior to the restorations.  Now he smiles confidently and most important, he is comfortable!

Discovery

"I never had a tooth walk into my office.  It was always attached to a person." L.D. Pankey

When I first heard Dr. Pankey's quote, I really took it to heart.  Treat the person, you may get the opportunity to treat their teeth. In dental school, we had requirements.  I needed to do 'x' amount of crowns, 'y' amount of fillings, cleanings, etc. All my efforts were to fulfill my requirements.

Once in private practice, the 'teeth requirements' became people that chose to be patients of mine.  I consider it an honor to be able to provide the best care that I can to my patients.  They choose me from personal referrals or a direct result of a marketing piece.  They stay because they trust me and my team.  In my heart, I have always wanted to get to know my patients.

In my practice, I spend a great deal of time with my new patients in consultation before we enter the clinical area.  I call this the discovery meeting.  It is an opportunity for us to get to know each other in a relaxed atmosphere.

It usually starts with some simple, "get-to-know-you" type questions - e.g. (What brings you in today? Do you live in the area? What do you do for work? What are your hobbies? etc.)

The conversation usually shifts into an exchange of values.  I describe who I am and how I practice.

I then have a series of questions for my patient to answer regarding their dental history, their perceived state of their oral health, and what their goals are for their teeth.

Now most people don't obsess over their teeth (of course, some do!).  The questions I ask are designed for the patient to start to think about potential problems- especially around the health, function and esthetics.

This leads to a discovery what the true status of their oral health.  It is key that the patient begins to "discover" this themselves as we guide them along the path.

If the questions are asked correctly, the patient does most or all of the talking, I just sit there and take notes.

I am very consultative in nature and I continue to ask questions. During the exam I continue to ask relevant questions and show patients areas I have concerns with.  This allows them to remain engaged in the process and they start to discover things at a deeper level.

I find that my job is to educate and offer solutions to potential or active dental problems.  The patient is usually armed with enough information that they can move forward with treatment at their pace.

Occasionally (this happened recently!), from the discovery interview, we decide that it is probably not a good fit to move forward with the exam.  Which is fine -  If we have different values and we discover this up front, it will save all sorts of problems and animosity down the road for both of us!

I have identified the demographic that I wish to serve.  I treat people that are truly concerned with their oral health and are willing to take an active role in optimizing it - Optimal dentistry specific to their goals.  Sometimes this is a full mouth reconstruction, sometimes it is twice a year cleanings and check ups -Whatever is appropriate.

This has led to a satisfying practice, knowing that we are partnering with our clients helping them along the path!

Who Are Our Role Models?

I recently gave a leadership lecture at the Rocky Mountain Dental Convention.  In one key part, I ask the audience to identify who inspires them. Who are your role models?

For me, it had been Lance Armstrong for many years.  I am an avid cyclist and I never missed a stage of the Tour de France - either live stream on the internet or on tv.  In fact, I remember watching late night recaps on ESPN during the Greg LeMond era - before it was really popular.  When Lance came along, I was hooked onto the entire phenomena.

I also have contributed to LIVESTRONG both through donations as well as spirit.

For years I have been defending Lance Armstrong.  He claimed to ride clean, and more importantly, he gave inspiration to the many afflicted with cancer.

I heard him speak once.  He was challenged by his oncologist after his cancer surgery/treatment that when he left the hospital, he could take one of two paths forward: 1. He can go on with his life and keep his cancer experience privately behind him, or 2. he could accept the challenge of the "obligation of the cured" - a mission to help those who are directly or indirectly suffering from the disease.

He obviously chose the second path.

That is what was most inspiring to me about Lance.

So now he comes out about his performance enhancing drug use.  The rumors were true.  I watched the Oprah interview. I felt let down by him.  He admitted his wrongdoings, but his body language showed very little remorse.  To live with that lie for so long must have been killing him spiritually.  He believed the lie, he believed the media hype.  He has a long road to redemption.

He has hurt a lot of people.  He has a lifetime of amends to make.  Hopefully he will dedicate the rest of his time here trying to right his wrongs.

But he is human!  We all make mistakes, no one is perfect.  I know I made my fair share, and I am sure I will make more as time goes forward.

Charles Barkley said in the 80's, "I am not a role model!"  It was very controversial at the time, but how true his words were. Here is a video from that era.

"I am not a role model"

He then goes on to say, "Parents should be role models" - Amen to that!  We shouldn't listen to the media on who should be our role models.  Our role models (whether we know it our not) have been with us all along the way.  They are our parents, our families, our teachers, our coaches, our friends, our colleagues, etc.

Take the time to identify them and thank them.  Then pay it forward!

I forgive Lance Armstrong for his transgressions.  At this point, I don't trust him - but I forgive him.  Consistent action towards change and amends will be the determining factor for trust from me.

That's what I am rooting for....

Here is a video from the late George Carlin on Lance Armstrong/role models that drives home my point. Warning: It contains some pretty foul language

George Carlin on Lance Armstrong

Easy on that Bite!

I practice comprehensive dentistry.  In my process, I have a three-pronged approach to address all things that could affect the oral health.  The first is health related - where we evaluate the health of the teeth, gums and oral tissues.  The second is functional - all things relating to the bite and jaw joints.  And finally, Esthetics. - anything related to the smile.  When all three are addressed, the dentistry becomes predictable.

About 70% of my patients have issues with their bite. Some knowingly, most are unaware.  Through a discovery process, my patients who were unaware, become aware of bite (occlusal) issues. This leads to discussions about how function can affect both the health and the esthetics of the teeth.

Here is an explanation that I give my patients as a take home read to further explain the goals and my process of bite therapy.  Note that the therapy is a process - it is not "here is a piece of plastic for you to chew on..."  It is a process that sometimes takes several months to properly address.  

Occlusal (Bite) Therapy

Occlusion is a dental term for how your top and bottom teeth come together—as when you bite.  Biting serves one purpose: to break up your food so it can more easily be digested. When you have a healthy bite all of your top and bottom teeth hit each other evenly with the jaw in it’s most comfortable (or orthopedically correct) position.  When the bite is idealized, you will potentially need very little dental work over the course of your life.

Occlusal (bite) therapy is usually indicated if you present with symptoms (If you find that your teeth look worn, or you are constantly touching, clenching or grinding your teeth together when you are not chewing food) or if the doctor sees signs of over-function (fractures, worn teeth or fillings, advancing gum problems, mobile teeth, etc.)  You may “over-functioning” on your teeth. This will cause problems that may need attention either now or down the road.

If your bite is not balanced, (or if you clench or grind your teeth, chew gum excessively, or bite your nails, etc.) your teeth are prone to poor performance. You can experience cracking, fracturing or excessive wear. Dental work may need to be replaced prematurely. You are more prone to gum recession or advancing gum disease, sensitive or loose teeth. Finally, your smile can be affected with ground down or chipped teeth, especially your front teeth.

An unbalanced bite can also affect the jaw joints (known as the TMJ) and associated muscles that open and close the jaw.  Depending on the problem(s), over-functioning can lead to sore jaw and neck muscles, headaches (even migraines), clicking and popping of the jaw joints during opening and closing, severe pain and limited range of motion of the jaw.

Recognizing bite problems as early as possible increases the probability that you will have good looking and functioning teeth at an elderly age. Much of the dental work in an adult’s mouth might have been avoided if the signs of occlusal (bite) disease had been recognized and addressed in the early stages.

Lucia Jig

The Lucia Jig is the usually the start of occlusal or bite therapy.  It is indicated for a number of reasons.  The first is to help you stop clenching and grinding of the teeth together.  If you are unaware of these habits, hopefully it will make you more aware.  The second indication is to relieve pain in the jaw/jaw muscles, and/or headaches. By stopping the clenching it will shut off the muscles are overworking, dis-coordinated or are in spasm. Most people find relief within a few days to a few weeks.  The more that the Lucia jig is worn, the quicker it will start to work.

This is not a permanent solution.  Once the muscles have been deprogrammed, the jaw joints (TMJ’s) slide into their orthopedically correct position.  It is to be used as indicated by the doctor.  Please if you have any questions, don’t hesitate to ask

Occlusal splint (nightguard, bite splint, etc.)

This hard acrylic appliance is custom-made to fit snugly over either your upper or lower teeth. It becomes a temporary perfect bite for you. It is a process of determining what a perfect bite is and may include several adjustments until it is idealized. The doctor will encourage feedback from you on how things are feeling when you are wearing the splint as well as when you are not wearing the splint. When it is properly adjusted and worn as prescribed, many of the signs and symptoms of bite problems often disappear as long as you wear the splint. 

The properly adjusted bite splint can then be used as a guide to idealize your bite.  In most cases if your bite is idealized, you won’t have to wear the splint anymore, and your teeth have the best chance of working for you over the course of your lifetime.

Idealizing your bite

There are several options when looking to idealize your bite.  These options will be determined once you are stable with the occlusal splint. 

Occlusal analysis: The doctor will mount models of your teeth on a mechanical jaw that can mimic all of your jaw movements.  He will then be able to determine what kind of adjustments/dental work will be needed to idealize your bite.

Options include:

Equilibration:  A focused reshaping of your teeth so that they bite together simultaneously with even pressure.  The doctor reshapes the areas that are interfering and most likely causing you to clench and/or grind your teeth.  This is usually accomplished in 1 to 3 appointments, is usually pain free during and after the procedure. 

Equilibration combined with restoration: Equilibration as above, with the combination of some teeth that need fillings, crowns, veneers, etc.

Orthodontics:  If the teeth are severely malpositioned, orthodontics may be recommended to improve their position so that the bite then be idealized with equilibration possibly combined with restorative.

           

Surgery:  For the most severe alignment issues, the bite may need to be re-set with a surgical procedure. If it is indicated we work hand in hand with some of the finest surgeons in Colorado. You will be referred for an evaluation by an Oral and Maxillofacial Surgeon.


Copyrighted material (2013) Brett H. Kessler, DDS.  

Integrity Marketing

I am working on a leadership presentation that I am giving in January at the Rocky Mountain Dental Convention.   I am also giving an abbreviated version of this presentation at the American Dental Association's New Dentist Conference (NDC) in July.  The  NDC planning committee asked my friend Rita Zamora to follow me with a presentation on Social Media and Leadership. If you don't know Rita, you should!  A link to her facebook site is  Dental Relationship Marketing.

My presentation will challenge the participant to look inward for personal exploration by identifying their core values and purpose in their lives. See What do you stand for?

Rita and I had a discussion last week about what we are respectively planning to present.   After speaking with her, I had a profound revelation about what social media really is.  Through our conversation I discovered that social media is an outlet to tell/show the world what you stand for (Core values) and how you spend your time (Purpose).

I love social media.  I use it often. We have a facebook site for the practice Facebook -TCDOdenver, but it is only one aspect of how we portray ourselves to the world.

In order to remain a viable business, we need to have a constant stream of new patients entering our practice. For this reason, we market ourselves.  We are always looking for new ways to market our practice.  Currently, we do a lot of asking our existing clientele for referrals, we market to referring dentists, we have a website, we have a decent following on facebook, twitter, and linked in.  And lastly, we have an ad in the local neighborhood newspaper. When I feel inspired, I blog.

Our top referral source is our existing patients, followed by our referring dentists.

It seems every dentist that markets themselves have the same theme in their advertising.  "We have the best new technology, comfortable setting, comprehensive care, affordable, etc."  I am sure that every dentist believes that the marketing they do accurately portrays their practice.

How does one stand out when everyone looks the same?

Potential clients search for a dental office that they think they will feel comfortable in.  Consumers are more educated today than they ever have been.  They have a wealth of information at their disposal.  Patients will choose to call based on their current needs and the identification of values that they find from their research.

Sound familiar?  Same as social media.  People will choose you based on identification of similar values.  Your "marketing" has created a persona of you and your office.  Now the most important question, does your "marketing"-based persona match the true persona of you and your office?  Does the true experience for your patients, match the expectations of that patient based on your marketing?

Consistency breeds trust.  Inconsistency creates distrust.

The educated consumer is looking for consistency.  They will not move forward with their treatment without trust.  It is very hard to have a good relationship without trust.

We have chosen to place an ad feature in a new magazine in Denver called "Reign".  It is a magazine that is geared towards the same demographic that we are looking to attract as patients -  People that truly value their health and life and want to experience life to the fullest extent. Here is a link to the ad we placed.

 http://issuu.com/reignmagazine/docs/reign_holiday_2012/107

I feel it is an accurate representation of who we are (core values) and what we do (purpose).

Marketing with Integrity

I can't end this without mentioning other people that we work with that coach us to live in integrity. They say it takes a village!

Kim McGuire - Fortune Management of Colorado
Bob Frazer - R. L. Frazer and Associates
Wendy Phillips - Big Buzz Brands

Grand Canyon Run. August 31st - September 1st 2012

I am going to start out by saying that this was, by far, the best run I have ever done.  We didn't do the full rim to rim to rim, but under the circumstances it was a wise decision. More on that later.   

The idea to do this was hatched around Christmas 2011 at Gary Benson’s house.   We have been doing these crazy adventures together for the last 20 years. As usual, he enthusiastically agreed to the idea.  My good friend and neighbor, John Stevens was on board early as well.  The three of us have had many adventures together including a mountain bike ride from Telluride, CO to Moab, UT, a few 50K’s and countless trail runs/mountain bike rides. 

 As we started to plan it, other than the mileage, the heat seemed to be the biggest challenge.  We weren't too worried about the elevation changes.  We decided that this was definitely doable at night.  To add to the adventure, we picked a full moon night to maximize the light on the trail and beauty of the scenery.  September 1st was our chosen date.

We spent most of the year doing long runs on weekends that involved big elevation changes.  We ran a few 14'ers at night to get used to using our headlights, and hand-held flashlights.  The biggest run I did was Echo Lake (10,600’) to Chicago Lakes en route to Mount Spaulding (13,858’) over night.  It was an eight-hour adventure.  After doing this I felt that I was ready for the Grand Canyon.  The others did various other excursions, including the Leadville 50 mile mountain bike race, runs up and down Argentine Pass out of Silver Plume, CO, century rides, crazy cross-training work-outs at Red Rocks amphitheater, and of course, ton’s of trail runs/snowshoe runs. 

Enter Conrad Laporte.  He began joining us on our winter snowshoe adventures in February.  He is a great athlete and friend with the same sense for adventure and zest for life that we have.  He is 20 years younger than us.  We mentioned the Grand Canyon idea and he was sold. (Not sure if it was naïveté or bravado, but he was full on board!)  We had several others of our friends that we trained with all year, but were not able to make it.  Conrad stuck around with us on our weekend adventures.  He had never run more than 6 miles before he met us.   He is such a good athlete; we all thought he would be able to pull this off, even without any experience.  Turned out, he did the best of all of us!

We started our drive at about 5:30 on Thursday morning.  On the drive, we listened, “Born to Run: A Hidden Tribe, Superathletes and the Greatest Race the World Has Never Seen” by Christopher Mcdougall on Audiobook.  It was the perfect preview to the run we were about to embark upon.  It is an amazing story with a side bar diatribe about running in barefoot shoes.  Both Gary and I ran with barefoot shoes, as we have been for the past 2 plus years.   Conrad and John wore their trail shoes. 

We arrived at the GC at noon on Friday.  John and his wife Tracy, had secured a room at the North Rim Lodge. While they were checking in at the hotel we got to see the “big hole” for the first time.

When I get nervous, I joke around a lot.  I exclaimed that the canyon wasn’t so “grand”, it was definitely great, but not “grand”.  Denial!!! Standing at the North Rim, the view is indescribable.  Pictures do not do it justice!

The plan was to start at 4pm, run through the night starting form the North Rim.  I figured it would take about 6 hours to run across from North to South, then immediately turn back to the North Rim.  I figured about 10 hours for the return trip.  We timed it so it would be cool at the bottom of the canyon.  Daytime temps go well over 100 degrees at this time of year.  The forecast at the North Rim was a high of 72, low of 49.  At Phantom Ranch (the low elevation point of the trek) the forecast was a high of 99 and low of 72.  The temp never got below 80.

We were taking the North Kaibab trail to the Bright Angel Trail.  A total of 23 miles each way with a significant descent of over 6000’ then an ascent of about 5000’ to the South Rim.

While we were preparing/resting at the North Rim Lodge, I thought that John and Conrad would go together and Gary and I would pair off due to similar abilities.  We each went over our nutrition plans and agreed to be open to the potential changes. Sometimes, for whatever reason, it just doesn’t work.  We all had a ton of food.  The trail descriptions told of several water sources along the route.  That was encouraging, but we agreed to fill our water bladders full every time – in case we miss a water station.  It will be dark and none of us had ever done this.  There was too much at stake to risk running out of water. 

4pm – we were off.  Tracy joined us on the hike down.  It started raining, thunder and lightening too.  Tracy turned back after about 30 minutes.  We put on our rain gear.  Had Tracy hiked with us for 5 more minutes, she would have seen an amazing view at the “cocnino overlook”.

The rain was cold.  I began to worry since all my warm gear was now on me and I was getting cold.  If the rain continues, it would have been a long, wet and cold night.   Got to keep moving…JFR….

The rain stopped after about 15 minutes and it got really hot and humid.  Again, worry set in.  I started to up the water intake and salt pills as I didn’t want to dehydrate or stat to cramp. 

My nutrition plan was to eat as much solid food early while supplementing with power gels, then switch to power gels only as my stomach stopped tolerating the solids.  My philosophy was to keep “topping off the tank” instead of depleting all of my energy stores and trying to catch up.  I had PB and J sandwiches, Kind and Lara bars, beef jerky, granola, cookies, gum drops, and power gels. 

The trail was very dusty and steep.  The rain wet the top layer and settled down the dust.  It made it easer to run/breathe. There were a lot of switchbacks early on and we descended quickly.  Within an hour, the trail turned rocky and technical.  The scenery was unbelievable, but it was had to run the technical trail and take in the views.  I stopped to take several pictures along the way.  I knew that once the sun went down, the scenery would be barely visible, and my camera doesn’t work well in the dark. 

We made it to the Cottonwood campground in 2 hours.  We seemed to be on track for my predicted time.  We all stuck together. John was having stomach issues early and was working himself through them.  He ALWAYS has trouble at 3 hours into a workout and this was no exception.  He changed some things up and recovered well. 

We then made it to the Phantom Ranch (PR) in 4 hours.  It was now completely dark.  No sign of the moon yet.  At Phantom Ranch we met with some campers.  There were several picnic tables set up and people were huddled around conversing.  The PR general store opened soon after we arrived and all of the campers went inside for food and beers.  I purchased a PR tee shirt for a souvenir. 

Gary and Conrad were also starting to experience stomach issues.  We filled up our water, hit the bathrooms and started back on our trek.

As we left the Phantom Ranch, we could see movement in the brush off the trail.  Our headlights lit up glowing eyes of deer literally 10 feet off the trail.  Very surreal.  I kept hoping there were no mountain lions behind the deer.  Any of these animals could have posed a serious challenge had they decided to come at us…we quietly pressed onward, and they thankfully stayed put.

We were about to cross the Colorado River.  That meant it was now all uphill until we reach the South Rim.  We power hiked from here.  No one was feeling all that great, the heat/humidity really sapped our energy.  The full moon became visible as we crossed the bridge over the Colorado River.  It was beautiful.  We tried to leave our headlamps off, but the trail was too technical.  It seemed like a long sandy hike as we came out of the direct river valley.  There were several stream crossings on the Bright Angel trail. 

We entered a steep area of switchbacks called the Devil’s Corkscrew.  Gary and I were sharing my water at this point.  His energy drink was not agreeing with his stomach at all.  We were both getting dehydrated.  Conrad and John decided to leave Gary and I at this point.  We agreed to keep in touch via walkie-talkie every hour.  Gary and I slogged up through the corkscrew.  The advantage of hiking at night is that you only focus on what you can see with your light source. 

But…we could now see the South Rim Village lit up clearly.  It looked close….but it wasn’t!

An hour went by and we contacted the other group.  They were at the Indian Garden Campground attending to the blisters on their feet.  They were waiting for us.  We all filled up to get ready for the hardest climb.  From the Indian Garden to the top is only 4.7 miles, but there was 3000 feet of climbing in front of us – and the teasing lights of the South Rim Village around every turn giving us false hope that we were close. 

There were rest/water stops at 3 miles and 1.5 miles before the Rim.  We were travelling very slowly at this point.  Arriving at each rest stop at 45 minute intervals.  That is 30 minutes to travel 1 mile.  A turtle’s pace! 

We finally reached the top at 9 hours, 11 minutes.  No one felt all that great.  My kidneys and left knee were bothering me.  After taking inventory of everyone, we decided that if it took us 9 plus hours going the easier way, it would have taken us over 12 hours to get back.  It was now 1 am.  We also would have been at the base of the canyon in the heat of the next day and it would have been quite dangerous. 

The south rim was 20 degrees colder with a stiff wind. It was probably high 40’s low 50’s   I became chilled pretty quickly.  I was not disappointed in our decision to stay the night.  We secured a room at the El Tovar Hotel.  It was very nice.  We all showered and crashed hard. 

We awoke early to try to figure out how to get back to the North Rim.  The Shuttles were $85 per person – cash.  Thankfully John’s wife Tracy agreed to drive the 4 plus hour trip around the canyon to save us.  We must have been quite a sight to see!

Tracy drove us to the North Rim and we ate at Jacob Lake Inn, a great little restaurant one hour north of the North Rim. We then went back to Kanab to sleep the night, get packed and headed back to Denver.  John and Tracy were planning to stay a few days longer to vacation together.  Although they ended up going home early Sunday Morning too.

We drove through Zion National Park and took in the views.  Equally amazing scenery as the Grand Canyon.  As we progressed home, Gary, Conrad and I were trying to think if there was any better run that we had ever done.  Gary mentioned the Porcupine Rim Trail in Moab as one of his favorites.  I agreed it was awesome but paled in comparison to what we had just done.  NOTHING COMPARED TO WHAT WE HAD JUST DONE!  Even though we didn’t complete the quest, we were alive to tell about it!

Long story short, we detoured into Moab and ran an hour on the Porcupine Rim trail before lightening strikes scared us back to our car.

Adventure complete with plans to return to the Grand Canyon in the near future to complete our quest.  We also posed the idea to do a marathon next month in Colorado Springs.

It was really nice to sleep in my own bed last night!  The perfect end to an amazing weekend!

Thanks for all the support and well wishes from our families and friends.  Your good vibes were with us every step of the way.

It seems that when I commune with nature, especially during adventures like these, I get to know myself more with every step I take. And with every step I take, I recognize what a gift my life is and how much I cherish it. I know God has a plan for me and this meditation brought me closer than ever to recognize his greatness. I feel very blessed.

Even though I was away from my family, I hope someday that we can experience portions of this with them.   I am especially grateful to have shared this with such great friends.  I am sure it was a defining moment for all of us.

Peace!

Brett

What They Didn't Teach Me in Dental School

I recently had a conversation with my brother Brad.  He is graduating from college next year and is seriously considering becoming a dentist.  We went for a hike in the mountains with my dad last weekend. While we were waiting for my dad to catch up, we began a deep, philosophical conversation.

“What do you like most about being a dentist?” he started. 

As I formulated the answer in my mind, I came up with two things: the physical aspect of dentistry and the emotional/spiritual aspect of dentistry.  When I was in dental school, they taught us the physical aspect of dentistry, i.e. how to do fillings, crowns and various other procedures.  What I learned as I got into practicing is that the physical aspect of dentistry is hugely important, but the emotional/spiritual aspect is what keeps me coming to work every day.

My answer was as follows…

I started with the physical aspect. 

The dentistry that I do improves the oral health of my patients.  I especially like to restore smiles and relieve pain.  We dentists have a reputation of causing pain, but the final outcome of the work that we do over-rides the minor discomfort that one may experience during the process. 

And quickly shifted to the emotional/spiritual aspect….

When I restore my patients’ smiles, they become more confident.  They smile more.  It’s as if their “self-conscious guard” goes down. They are more proactive in their relationships. Their performance in their work improves. They are truly grateful to me and my team for our work.  They often express their gratitude to us on how we supported them through every step of the process – from the first phone call, to the delivery and maintenance of their work. 

Toothaches can be extremely painful and could debilitate the bearer – usually when something important is happening that day. When I relieve my patients of their pain, they are also extremely grateful as they can get back to their daily routines.  Sometimes I get calls after hours.  My cell phone is on the after-hours message for my patients to call me personally.  I care enough to see my patients after hours in certain circumstances.

I like to be proactive and tell/show my patients signs of potential troubles.  Most of my patients appreciate the fact that I am proactive about my dentistry – although I am always there to be reactive when something unexpected happens.  When there is a true dental emergency, the first question out of my appointment coordinator’s mouth is “how soon can you get here?” We don’t like to see our patients in pain!

I love the fact that I get to really make a positive difference in people’s lives.  I get to see my patients over the years and share in their celebrations and be supportive in their challenges.  I get to check in to see how their children are doing and what vacations they have taken or are taking soon.  I am excited about their weddings and saddened by their losses.

Another joy is the support team that I have assembled around me.  Most have been with me from the beginning.  Currently, we have a (my hygienist Tracy’s) 4 month old baby in the office and everyone is doing their part in making sure that she is getting the attention that she needs.  Our clients are excited to meet Bentley and celebrate with us having her in the office. There is no more important time in the baby’s life and she needs to be around her mom.  We will keep her as long as we can.  We did the same thing with my two youngest daughters.

The absolute best part is I get the opportunity to work with my wife Gina who is the orthodontist in our 

office. What a gift it is to be a partner in business with my partner in life….

I could go on and on – the bottom line, I love being a dentist!

If I Speak, I do Declare!

If I Speak, I do declare!

Lately, I have been hearing an advertisement on the radio about how a deejay is getting his smile fixed with Invisalign from "Dr. Such-and-such".  The ad sounds as if the deejay is just speaking in one of his normal radio breaks.  He says how great "Dr. Such-and-such" is and how happy he is with the treatment.  My question is...Is the deejay paying for the treatment? or is he getting it done in exchange for the radio promos?

I do declare!

There is a certain media personality here in town that "trouble-shoots" for the citizens.  If something is unfair, it seems to be his responsibility to expose that unfairness and to publicly embarrass the company allegedly perpetrating the action.  I used to be with a practice that paid to be on his endorsed list as "the endorsed dentist".  We had a link to his website and we would serve as "experts" to help him expose the wrongdoings.  One day, he started to endorse another dentist on the air as the place to go for dentistry of all kinds.  In fact, he told the listeners how this doctor had changed his life by creating a new smile for him.  He no longer just had a "face for radio"!  When we called to see why we weren't consulted, as we were the preferred dentist on his list.  

The "trouble-shooter" brushed us off and said that he didn't know that we did those types of procedures.  Hmmm....What about the strict research of the company to be on the good list?  I guess the only research that was done was "Did the check clear?"   It was obvious that he never even looked at our website, or our list of services, or our dozen's of published testimonials with pictures...We achieved the "preferred" status because we paid him to have this status.  I never felt good about our relationship with this guy. 

I do declare!

When I do presentations to dentists,  I must sign all sorts of waivers and publicly announce that I have no conflicts of interests - no company is paying me to endorse the company. If I do have a conflict, I must announce it so the attendee can then make a judgment about my information that I am presenting.  Is this true, or is he just trying to promote his product?  When my colleagues and  I attend a lecture, we view the lecture with a jaded eye if no declaration is made.  

Why is it we, as dentists, can go out and not be forthcoming in our advertisements to the public?  What happened to the professionalism?  Where does ethics fit in here?

I do declare!

My declaration - all that I write here is from me (Dr. Brett Kessler) or from my wife (Dr. Gina Kessler).  All the pictures here and on our website are of our patients showcasing our work.  All of the testimonials are real and from our happy patients. All the opinions expressed here are ours!  If they are unoriginal, I will quote the source.

I welcome comments and perspectives on this.  I am no expert and would love to hear other opinions - especially if I am off base here.

If you like this blog post, I would love to hear about it.  Please comment or share it on Google+, Facebook, Linked in, Twitter, etc.  If you are looking for a dentist in the Denver area, we are always looking for new patients.  Please visit our website http://www.tcdodenver.com/ or like our facebook page,  https://www.facebook.com/TCDOdenver.  Or you can do it the old fashion way - call us at 303-321-4445.

Thanks for reading!  BK

I do declare!