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.  

What's the Goal?

What's the goal?

It's that time of the year again.  Every December, I sit down and look at the past year and set up the plan for the next.  I do this both personally professionally.

Time to keep score - How did I do?  I definitely fell short in some areas.  And, I definitely over-achieved in others.

I look at personal accomplishments, family accomplishments, professional accomplishments, etc.

In 2012, (Tangibles)
What worked?
What didn't?
What was missing?

How do I feel about all this? (Intangibles)

Review of my Mission Statement, Vision Statement, and Core values

What are my goals for next year?
What are my priorities?

I highly recommend taking a little time to look at these things.  Living with intention is much better than blowing in the wind.

How about you...What is the goal?

Carpe Diem

This is a reprint of an article that I penned for the Journal of the Colorado Dental Association, Summer 2012 (Vol. 91, No. 3). I currently serve as Vice President.

Carpe Diem…

“If you live each day as if it is your last, one day you most certainly will be right.”  Steve Jobs, in his commencement speech to the 2005 graduating class at Stanford University. (Quote attributed to H.H. “Breaker” Morant)

Quite the statement, I must say.  Especially since cancer recently took him away from our world and into the realm of the unknown.  

Now, after reading Steve Jobs’ biography by Walter Isaacson, it was very clear to me Steve Jobs was a visionary.  He was not, however, a saint.  In fact, the book showed an accurate and honest depiction of a man that knew what he wanted and would do almost anything to get his way.  Often, he was selfish, self-centered, mean, inconsiderate, and eccentric. Hardly the traits of a saint…

But he was a visionary.  One thing that is certain, he stayed true to his vision and his vision changed the world.  The computer industry (Apple), the music industry (iPods, iTunes), movie animation (Pixar), the retail experience (Apple store), and the smart phone (iPhone) all have been re-invented through his innovation and subsequently changed our lives.

In his commencement speech he continued, “It (quote) made an impression on me. And since then, for the past thirty-three years, I’ve looked in the mirror every morning and asked myself, ‘If today were the last day of my life, would I want to do what I am about to do today?’  If the answer is no for too many days in a row, I know I need to change something.”

I know of many dentists that are not happy in their current situations.  In my life, there have been times that I, too, have been unhappy with my situation.  Like my colleagues, I felt trapped, the walls caving in on me.  One day, something inside me gave me the courage to make changes.   I made a call for help.  

That call was instrumental in me turning my life around in ways beyond what I could have ever imagined.  There have been many mentors in my life that I have called upon. I am grateful for their guidance. I would not be the man I am today without them. The key point is I called and asked for help. Help did not find me, I sought it out.

Dentistry is stressful.  A mentor, Jerry Gropper, DDS, once said of our profession, “Dentists must have the eye of a sculptor, the hands of a surgeon, the insight of a therapist, the knowledge of a scientist, and the financial acumen of a businessman.” It is no wonder so many of us have struggles. This is a tall order indeed.

How then can we get out of our proverbial “ruts”?

Thoreau said, “I know of no more encouraging fact than the unquestionable ability of man to elevate his life by conscious endeavor.”  Uh-oh....He is saying that it is going to take some work.

First we must seek out who we are and what makes us truly happy.  It could be our family life, our practice model, our friends that we surround ourselves with.  It could be small changes or big changes.  One thing that is certain - Nothing changes if nothing changes.

Stephen Covey’s book, The7 Habits of Highly Successful People, describes this necessary change eloquently in the first habit, “Be Proactive”.  He talks of courage being the most important attribute.  Courage is not the absence of fear.  It is recognizing the fear that is within you and with a leap of faith - taking action. In this case, being proactive means to make the decision to make positive changes in your life.

Next, he encourages us to “Begin With the End in Mind” (Habit 2).  In this habit we are to create a vision of a better future. Covey writes,  “To begin with the end in mind means to start with a clear understanding of your destination.  It means to know where you are going so that you better understand where you are now and so that the steps you take are always in the right direction”.  

Our happiness is determined by how well we live within our core values and to what extent we discipline ourselves to our vision.

Everyone has a bright future, if we choose to have one.  

The last book I will reference is from John Ortberg When the Game is Over, It all Goes back into the Box.  He gives the analogy of life as a calendar.  Each square in the calendar is a frame for one episode of our lives.  Nobody knows how many squares one gets, but each of us must choose how we fill them.

When we think of our day, is it filled with meaningful events with our families, patients, colleagues, etc.? Or, are we stuck in our rut, allowing the world and its pressures to create unhappiness in our lives. 

You get to choose…Carpe Diem.

Is Orthodontics Enough?

Sometimes yes, sometimes no.

Many times adults inquire about getting their smile fixed with veneers or orthodontics.  To maximize the aesthetic result, sometimes they need both.

This patient was recommended orthodontics to correct her upper and lower crowding. Due to the position of her teeth, they have worn down though function - both chewing and grinding of her teeth. She was also recommended veneers to restore the ideal and aesthetic tooth form.

Figure 1: Pre-op smile

Figure 2 illustrates what the teeth look like after the completion of orthodontics.  Her teeth are now in the correct position, but due to the wear on teeth edges, they just don't "look right."

As we were getting close to finishing her orthodontics, we had a discussion about veneers and how they can help create an amazing smile for her. 

Figure 2: Orthodontics complete

The day we removed her braces, we began the veneer process and created a more aesthetic smile with provisional veneers made of a hard plastic.  No one knew that she had any work done, except that she got her braces off.

Figure 3 illustrates the smile with the new veneers in place.  We chose to do simple teeth whitening and place veneers on only her front 4 teeth. Because we were able to idealize the position of her teeth, we could create a perfect bite and be super-conservative with the dentistry. This is the ultimate benefit of true comprehensive care.  Her smile will look amazing for years to come.  Needless to say, she is very happy!

Figure 3: Post veneer placement and teeth whitening

We love to create natural looking smiles.  A smile is a window to the soul - we do everything we can to help our patient's souls shine though! 

We offer complimentary consultations for anyone with questions about the best ways to improve their smile. To set up a free consultation, please call 303-321-4445, visit our website www.TCDOdenver.com, or our facebook site www.facebook.com/TCDOdenver

Fig 1: Pre-op

Figure 2:  Post - orthodontics, pre-veneers

Figure 3: Veneer delivery, whitening.

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