Episode #114 - Live From Seattle Study Club Symposium 2018 with Dr. Steve Carstensen

March 19, 2018

I am at the Seattle Study Club Symposium with Dr. Steve Carstensen. Steve is on the forefront of one of the most exciting things happening in dentistry today. We are going to talk about the importance of the airway in dental and medical health. We talk about how the airway can affect someone’s health, airway health for children, and how a young dentist can get started on this today.

Steve has been treating sleep apnea and snoring since 1998. He specializes in sleep education and airway health. He lectures and directs sleep education at notable institutes and universities. He is a good friend of mine, and it’s really exciting to have him here today to talk about one of the hottest topics in modern dentistry.

You can find Steve here:

Pankey Institute

Spear Aesthetics

Dental Sleep Practice Magazine

Seattle Sleep Education

Show Notes

[01:50] Steve is a restorative dentist. About 20 years ago, he started paying attention to the airways. He started helping people breathe better at night time.

[02:18]  He became an educator about airway and dentistry.

[02:37]  Now I see patients and write and teach about airway health & dentistry.

[02:46] Why is airway such a big topic in dentistry right now?

[03:29] When there is a problem we now start looking back in the patient's history and try to find the cause.

[03:45] It frequently focuses on the airway issue.

[04:51] With airway health we get a chance to improve how everybody feels.

[05:38] When patients have chronic conditions often asking them how they sleep at night is the first step to getting to the root cause.

[09:11] The importance of sleep and breathing and how they are interconnected.

[09:31] Melatonin makes us sleepy. Bluelight interrupts our production of melatonin.

[10:19] Sleep deprived children. Kids should get 12 to 13 hours of sleep during the night. Lack of sleep combined with medications is not good for kids.

[11:46] It's likely that the kids aren't sleeping well at night because they're not breathing well because of a closed airway.

[12:12] Not breastfeeding starts a child off at a bad position. Feeding kids soft foods is another factor that leads to more narrow pallets.

[13:14] Children should be breathing through their nose. If they are breathing through their mouth that is something that needs to be looked at.

[14:05] How would a young dentist incorporate airway health into his practice? How would he monetize this?

[15:36] We don't need a sleep test to know that a kid's jaw isn't developing correctly.

[16:03] Young dentists should start to pay attention to the kids in their practice and be on the lookout for airway issues.

[16:43] Airway appliances are usually covered by medical insurance.

[16:54] The total treatment cost is also less than a couple of crowns in most offices.

[17:17] Sleep courses are a hot topic right now in the world of dentistry.

[18:32] It's exciting for dentists to get a chance to work on the whole body. This is the most exciting time in dentistry.

[19:48] Now dentists have a chance to help children develop better airways.

Links and Resources:

Why We Sleep

Pankey Institute

Spear Aesthetics

Dental Sleep Practice Magazine

Seattle Sleep Education

Episode #113 - Live From Seattle Study Club Symposium with Drs. Jeff Rouse and Gregg Kinzer

March 12, 2018

This is day three of the Seattle Study Club Symposium Legacy Tour. This is the place where dentists get to learn, grow, and network with some of the best clinicians in the world. Today, I am speaking with Dr. Jeff Rouse a prosthodontist in San Antonio and Dr. Greggory Kinzer who is a prosthodontist in Seattle. 

We talk about some of the great things about the Seattle Study Club Symposium experience. For instance, being a dentist can be a lonely solo experience. Even though, you are surrounded by staff and patients having another clinician to weigh in on your cases and bounce ideas off of is really useful. The Seattle Study Club Symposium is the perfect place to get new ideas and fresh perspectives from peers and colleagues. 


You can find Jeff and Gregg here: 

Jeffrey S. Rouse, DDS 

Greggory kinzer, DDS, MSD 

Spear Aesthetics 


Show Notes 


[01:29] Jeff Rouse is here today he's a prosthodontist in San Antonio. 

[01:36] Greggory Kinzer is also here today and he is a prosthodontist in Seattle, Washington. 

[01:58] Today, we are going to talk about key moments in Jeff and Gregg's can careers when they were the most productive. 

[03:37] How having another person or a forum to bounce ideas off of really makes the job of being a dentist easier. 

[04:36] Using a study Club format enables you to get different viewpoints and ideas. 

[05:20] You have to find mentors. You have to get into a club and an environment where you can find people to mentor you. 

[06:13] Everybody has a voice with the true Study Club format. 

[06:23] When you're setting up a new study Club you have to go into it with the right idea. They shouldn't be set up by an authoritarian or person looking to gain a personal benefit from it. 

[07:09] The importance of engaging with your teachers. 

[08:00] Life is about experiences and you need to be in the moment and get as much out of the moment as you can. Especially, as a dentist. 

[09:31] Jeff shares how he has become a better dentist by observing Gregg work on his patients. 

[10:05] You don't have to be in a partnership just find opportunities to pick up pointers by osmosis. 

[10:55] Gregg points out how Jeff is actually changing dentistry with his new work with oxygen and airways. 

[11:22] The four pillars of diagnosis are different now. 

[13:42] How the airway peace actually needs to come before the generalized treatment plan. 

[14:36] You need to understand how the airway piece will impact your treatment plan and how you converse with your patients. 

[15:54] There has never been a more exciting time than now to be a dentist. 

[16:27] How they have an airway mockup to show patients how they will feel after their treatment. 

[17:08] Treating towards airway and the importance of evaluation. 

[18:08] Airway is the piece that brings the dental field and the medical field together. 

[18:58] Make yourself better than you were yesterday. Push yourself and find the information. 

[19:23] Find a cohesive facility that will help grow you by putting all of the pieces together. 

[19:46] Restorative dentists have to have a foundation. 


Links and Resources: 

Seattle Study Club Symposium 

John Kois 

Episode #112 - Live From Seattle Study Club Symposium with Dr. Christian Coachman, Dr. Kyle Stanley

March 5, 2018

Dr. Christian Coachman and Dr. Kyle Stanley are here with me today broadcasting live from the Seattle Study Club Symposium. Today, we are talking about the lip factor. We all know that Christian is the man behind Digital Smile Design. His unique digital techniques has made dental aesthetics easier and more possible when doing restorative work.

Dr. Kyle Stanley has a practice in Beverly Hills. He also works with Christian and Digital Smile Design and focuses on the lip factor and the Orofacial Club. Often times with a full mouth makeover the relationship between the teeth and the lips are focused on. When a more holistic focus that includes the entire face and the position of the lips would give a better result. We discuss this and more in this interview.

You can find Christian and Kyle here:

Digital Smile Design

Christian Coachman on Instagram

Dr. Kyle Stanley

Dr. Kyle Stanley on Instagram

Show Notes

[01:52] Dr. Kyle Stanley has a practice in Beverly Hills California. He works on the surgical and restorative side of dentistry. He was trained in Brazil and has close contact with Christian. He has also been involved with Digital Smile Design for a while.

[02:19] Kyle is also focusing on the Orofacial Club where they focus on full facial aesthetics.

[02:29] Christian is from São Paulo. Brazil. He is the developer of the Digital Smile Design technology. He is a dentist and a technician.

[02:38] He's trying to go beyond teeth and gums and focus on taking care of the patient as a whole.

[02:46] The need for differentiation and outside the box thinking.

[03:00] How human behavior, the world of dentistry, and people are changing.

[03:08] Consumers want harmony between all of the facets, so dental offices will become orofacial clinics.

[03:22] First we become facial experts and improve our relationships with plastic surgeons. We need to know everything we can to improve harmony on the face. [03:49] This new area is like an empty canvas. We are not going to learn from others, we are going to create solutions.

[04:00] This is a clinically  exciting time for dentists and an emotionally beautiful time for patients.

[05:27] Have a plan and the business after dental school.

[06:04] It's Kyle's vision to understand the face better.

[08:14] Digitally we can do all of the movement before actually touching the patient.

[09:00] We want to kill a patient virtually on the computer instead of killing them for real. We want to virtually simulate the solutions before working on the patient.

[10:04] The lip factor and the missing link in beauty is the lip. Bringing the lip into the correct position and then planning traditionally.

[12:20] The importance of finding a good mentor if you have the energy to do something new and amazing.

[13:28] Mentors don't find you a you have to find mentors. A mentee has to offer something, as well.

[14:59] The Orofacial Club is closing the gap between plastic surgery and dentistry.

[17:45] The future will be a collaboration with projects like this.

Links and Resources:

Orofacial Club


The Lip Factor

Digital Smile Design

Christian Coachman on Instagram

Dr. Kyle Stanley

Dr. Kyle Stanley on Instagram

Episode #111 - Live From Seattle Study Club Symposium with Dr. Christian Coachman, Dr. Rucardi Mitrani, Dr. Jeff Rouse The Future of Dentistry

February 26, 2018

I talk with three dental experts Dr. Christian Coachman, Dr. Rucardi Mitrani, and Dr. Jeff Rouse about the future of dentistry. We are at the Seattle Study Club Symposium in Palm Springs at the La Quinta. At the Symposium, I am surrounded by some of the best clinicians in the world and these three guys are amazing.

We talk about the amazing opportunities in dentistry today. We also talk about how young dentists have to decide whether they want to work for a corporation or if they want to have their own practice. We touch upon the all-important topic of dentists needing to understand how to run a business. Along with the opportunities provided by amazing new tools and technologies. Plus, the expense involved in acquiring or getting access to all of these new tools.


You can find our panel here:

Dr. Christian Coachman

Dr. Rucardi Mitrani

Dr. Jeff Rouse


Show Notes

[01:02] Day 2 of the Seattle Study Club Symposium.

[01:25] Dr. Jeff Rouse is a prosthodontist from San Antonio, Texas. Dr. Rucardi Mitrani is a prosthodontist from Mexico City. Dr. Christian Coachman is from Sao Paulo, Brazil, and he is a dentist and the developer of Digital Smile Design.

[02:16] Dr. Jeff Rouse has had great mentors and as always have the opportunity to be around what is cutting-edge.

[02:51] Dentists today not only have an opportunity to change people's lives aesthetically,we have the opportunity to create treatment plans at a higher level. The challenges they have are deciding what tools to actually use.

[03:31] In order to implement something like Christian's Digital Smile Design you have to practice at a much higher level.

[04:06] There are a ridiculous amount of opportunities for new dentists today. We have been trained similarly, but our focuses are different. A young dentist would be excited with all of the cool possibilities, but overwhelmed and scared with all of the new information they need to learn.

[06:38] Building a career for a young clinician on their first year out of school.

[07:02] Young dentists will often join corporate dentistry because of dead. This is a demanding and tough way to go. They could also go deeper in debt and buy a practice.

[08:23] The importance of giving back. Finding mentors and practices for young dentists to spend time in and watch and learn.

[09:09] How there are people everywhere who are willing to train.

[10:32] Everyone on stage challenges us to be a better dentist. It's exciting but scary.

[10:54] Choices we have today teach us to be better clinicians and better operators.

[11:44] Tools and technologies do help, but there is an additional cost to all of these new technologies.

[12:03] We need more centers providing support for dentists, so they can incorporate this type of technology into their practices.

[14:33] How the names and brands in corporate dentistry that we see today, won't be the names and brands of corporate dentistry in the future.
[15:14] Young dentists will have to choose whether they want to be the best, or if they want to work for one of these corporate models.

[16:02] The concept of choice and choosing to choose.

[16:25] Both options can be great. Corporations will need people running their business.

[17:08] The future model of corporate dentistry will change. It won't be seen as cheap, low-quality, and low pay.

[17:36] For this model to change, the dentists that are brought in need to be able to grow instead of just being used as as a tool.

[20:56] One of the red flags of technology is that we see a lot of crappy dentistry on Instagram.

[23:38] If you don't please people, you are going to be online with a bad reputation.

[25:57] Committing to be excellent and creating relationships.

[28:59] There's a lot of room at the top. It's not the top that's crowded, it's the bottom that is crowded. When you're at the top, you can create your own future and transform your vision into reality.

[32:33] Making choices as a dentist and putting yourself in the right places.


Links and Resources:

Seattle Study Club Symposium

Dr. Christian Coachman

Dr. Rucardi Mitrani

Dr. Jeff Rouse


Episode #110 - Live From Seattle Study Club Symposium with Dr. Brian Schroder, Dr. Robert Ritter, Dr. Joshua Austin

February 19, 2018

This is a very special edition of the Best Practices Show. We are at the Seattle Study Club Symposium in Palm Springs at the La Quinta. It is incredibly gorgeous, and I have an amazing team of experts here today. This is the 25th anniversary of the symposium and some of the best clinicians in the world are here. If you haven't been to the symposium, you should definitely check it out.


I have three very special friends and guests today. Dr. Joshua Austin practices in San Antonio, Texas and loves how special the symposium is. Dr. Brian Schroder Has a practice in San Antonio, Texas, and he is the director of The Alamo Collaborative Dental Forum. Dr. Robert Ritter has a practice in Jupiter, Florida. He has been coming to the Seattle Study Club for 10 years. Today, we share a small portion of our symposium experience with you.

You can find my expert panel here:

Dr. Brian K. Schroder

Dr. Robert Ritter

Dr. Joshua Austin


Show Notes


[01:42] Dr. Joshua Austin practices in San Antonio, Texas. He says that everything about this event is special. There is no better continuing education. There is a vision behind the way this great Symposium is put together.

[02:33] Dr. Brian Schroder Has a practice in San Antonio, Texas and he is the director of The Alamo Collaborative Dental Forum. He likes the Seattle Study Club concept so much that as a general dentist, he took over the directorship of a club.

[02:45] The concept is very special it's based on excellence and relationships. It's also based on friendships when you come to these meetings you get to catch up with people that you haven't seen in awhile.

[03:06] The phenomenal clinical education is special to Dr. Brian Schroder, but one of the things that has stood out to him is the non-clinical education. We focus so much on the clinical aspect of dentistry when we need a lot of help in the non-clinical aspects.

[03:47] Dr. Robert Ritter has a practice in Jupiter, Florida. He has been coming to the Seattle Study Club for 10 years.

[04:41] Dr. Ritter explains how dentists need help with the acquisition and business phase of dentistry.

[04:45] Dental business is a challenging environment and the Seattle Study Club provides that business acumen that we need.

[04:56] A lot of other meetings don't have all of the components that this Symposium has.

[05:09] The Symposium is like going on a cruise and whatever you want to learn can be done for you here.

[05:21] There is also so much willingness to share information here at the symposium. There are so many knowledgeable people in the industry that are willing to share without judgment.

[05:56] If you want to know something about one procedure or one idea that person is usually here, and you can ask them right to their face.

[06:32] It's great to be together and get to see the people that we actually interact with.

[07:03] How Dentistry can be incredibly lonely. Collaboration is key for improved outcomes.

[07:51] The element of sharing works incredibly well at making you perform better and feel better.

[08:30] The philosophy of utilizing specialists. Collaboration among specialist and getting everyone involved is great as well.

[09:29] Dentists can't really do everything themselves. There is no point in being the master dentist and not including anyone else in your life. Dentistry is so much more complex now.

[09:58] The future of dentistry is going to be a multi-specialty group practice. There is no way a solo practitioner could afford all of the things that you are going to need in the future.

[12:35] To avoid being in some type of DSO, you could build some type of group practice structure.

[13:04] We need to accept responsibility to seek out mentors and work collaboratively.

[14:08] There are mentors everywhere at the Seattle Study Club.

[15:01] Barriers for young dentists joining the Seattle Study Club include the time and maybe the money.

[16:33] Parents need to get over the guilt of not being with their kids every minute.

[18:09] It really comes down to building a better life for your family and also filling your tank so you can be a better person.

[19:46] Seattle Study Club is an investment and you get a huge return on your investment coming here.

[20:44] It's nerve-wracking speaking in front of the best dentists in the world, but the key is to talk about what you know.

[22:08] If you're thinking about coming to the symposium, do it now.

Links and Resources:

Seattle Study Club Symposium

Dr. Michael Cohen

Dr. Brian K. Schroder

Dr. Robert Ritter

Dr. Joshua Austin

Episode #109 - Why Your Re do Isn’t Your Lab’s Fault - How to Better Communicate

February 14, 2018

Dr. Drew Cobb of The Dawson Academy is here today to talk about why your redo isn't the lab's fault, and how to communicate better. If you don't know who Drew is, he has a practice in Washington DC, and he is an amazing dentist. Drew's father was a faculty member at Georgetown and taught Drew on his first day of dental school. You could say dentistry is in his blood, and it shows in his practice and his teaching.

After practicing dentistry for 10 years, Drew realized that there were still things he needed to learn. He went to the Dawson Academy and learned how to treat more complex cases in a predictable way. He also learned how important continuing education is. Now Drew teaches at the Dawson Academy, and he uses those methods in his practice for treating complex cases in a predictable way. The basics start with good communication with your lab, and Drew shares the exact methods to do this and have great outcomes.

You can find Dr. Drew Cobb here:

Cobb Dentistry

Dr. Andrew Cobb The Dawson Academy

Show Notes

[02:18] Dentistry runs in Drew's family. His father even taught him on his first day of dental school. He had a great foundation and practiced that way for about 10 years. Drew realized that his work wasn't lasting as long as he wanted and some complex cases were more than he could tackle.

[03:10] He read Pete Dawson's book and wanted to go to one of his lectures. It was about predictability, being a better dentist, and stopping the rat race.

[04:00] It was the best thing he ever did. Post Dawson is a lot more fun and he is hugely more profitable than before.

[04:47] Pete Dawson changes the way dentists think. Getting better as a dentist is being able to solve more complex problems.

[05:30] How dentists need to give the lab technicians the right information to do their jobs. Most only get a fraction of the information they need.

[06:17] The foundation for restorative work is based on communication. If you don't start with that, you don't get a good result.

[06:47] What's the most important step for any procedure? The one you are working on. You have to take good impressions with good materials.

[08:12] You need an accurate team member to make sure everything is measured right.

[08:34] You have to have a great team and take them on the journey with you.

[10:29] Ask what a remake costs your practice? You want to known for solving problems and predictability.

[11:56] The would I do it on me rule when making treatment plans. It's not about talking people into dentistry they don't need. It's about identifying their problems, finding solutions with the least amount of dentistry, and then providing them with that care predictably.

[13:35] Start with accuracy and accurate materials and models for good predictive dentistry. Have good clean impressions. You have to have the whole anatomy of the patient to make accurate decisions.

[14:57] Start with accuracy.

[15:57] Dental blueprint foundation. Take the before models and put them on a model in a trial run. Work it out on the models first. Work it out in your mind, and then on the models, and then on the patient.

[17:19] This should be worked out a couple of times before working on the patient. Figure out your plan to know your pathway.

[18:02] 3D checklist for how to do a wax up.

[19:16] Once we have everything it has to get to the lab accurately. We have a checklist for how to communicate to the lab. How labs spend a lot of time trying to get information they didn't get.

[22:31] It's easier to make changes in plastic than in glass. Design the prototypes the way you want and get that info to the lab.

[23:28] How the person sending the communication holds the responsibility of communicating clearly.

[24:12] With complex cases, you can't figure out how to charge without a plan.

[25:43] Have a script to communicate to the lab.

[26:23] What would you need to make a wax up? All of this information is in the Dawson Diagnostic Wizard. The lab needs everything that you would need if you were doing it.

[27:46] This is a great way to differentiate yourself to the labs.

[28:12] After the wax up, have the treatment option review with the patient.

[28:43] Three types of wax ups. Minimal - putting the wax where you need it to differentiate the change. Starting and full coverage. Case presentation wax ups.

[30:46] 3D wax up function, aesthetics, treatment plan. Now you know how to schedule. You used the wax up to do the next stage. Now you can work backwards.

[33:02] You are probably exceeding your production goal with this one patient. Give yourself the time you need. Don't try to rush and create stress.

[34:31] Primary care time blocked for longer patients. Secondary care is going from room to room.

[35:22] All dentists have general patients.

[36:16] It's your practice, you get to decide the type of cases you want to do and how you are going to practice.

[38:41] Visualize in space where things go before starting irreversible dentistry.

[39:14] Where should the front teeth go? Then find exact proportions of the teeth. Take the 2D photo and make it a 3D wax up model. See if it works functionally on the articulator.

[40:49] The importance of following a checklist. Predictability drops when not following the checklist.

[42:02] There is a person attached to what we do. Talk it out with the patient before beginning the work.

[44:49] Virtual restoration is where we are going. Figure out the change before doing something irreversible.

[45:47] Using a ct scan to do a digital wax up.

[46:53] Explain to your lab technician about what you are trying to do and why, and ask them how they want the information sent to them. Create a pathway for communication.

[47:44] After a case, do everything again and see what could be done better to make the labs job easier.

[48:29] Listen to your technician and check your ego at the door. Then celebrate your finished cases.

[49:21] Also send the end result to multidisciplinary specialists.

[50:56] The Dawson Academy is about how to do more complex cases and do dentistry that is predictable.

Links and Resources:

Dawson Academy

Functional Occlusion: From TMJ to Smile Design

Dawson Diagnostic Wizard

Free Whitepaper Confessions of a Lab Technician

Checklist Manifesto

Functional Occlusion – from TMJ to Smile Design

Cobb Dentistry

Dr. Andrew Cobb The Dawson Academy

Episode #108 - How Dentists are Saving Lives Not Just Cleaning Teeth with Dr. Amy Doneen

January 8, 2018

Dr. Amy Doneen runs The Heart Attack & Stroke Prevention Center in Spokane, WA. She has academic appointments at the Washington State University School of Medicine  and University of Kentucky Dental School. She is also the author of Beat the Heart Attack Gene. We have had her on the show before, and it was so much fun we ran out of time. She is brilliant, and you will see how everything from medicine to dental ties together in this show.

We talk about the connection between cardiovascular health and periodontal and endodontal health. Dr. Amy Doneen is extremely passionate about this subject and has the goal of knocking heart attack off the top of the list as the number one cause of death in the US by 2020. She emphasizes the importance of dental and medical practitioners working together and offers practical solutions.


You can find Amy here:

The Heart Attack & Stroke Prevention Center

Beat the Heart Attack Gene

Bale Doneen Method

Dr. Amy Doneen on LinkedIn


Show Notes

[02:31] How Beat the Heart Attack Gene is written for everyone from patients to doctors. This book will actually have patients wanting to come to the office more often once they realize how important dental health is for stroke and heart attack prevention.

[02:57] Heart attacks and strokes are claiming lives at alarming rates. Our passion is to remove heart attacks as the number one cause of death by 2020. This would be impossible without the help of our dental colleagues.

[04:04] We are passionate about nurses, doctors, and dentists talking to each other and realizing that this is connected to the entire body.

[04:35] The high risk of periodontal pathogens and how they affect the heart health. Patients are left vulnerable if you ignore what is going on in the mouth.

[05:45] No one spends more time proactively with human beings. This is an incredible dental opportunity to slow things down and make an impact to the people to you serve.

[06:34] How the medical system is broken because it picks people up after they have already failed or had a heart attack or stroke.

[07:05] People slowly develop plaque in the wall of the artery. The bodies natural response is to heal it with a scab. If the scab blocks the flow of blood it is a heart attack in the heart or a stroke in the brain. We look at the causal effects of vascular disease including periodontal pathogens.

[08:31] There are many causes of heart disease, but periodontal and endodontic problems are major causes. Dentists and hygienists deserve huge praise in the world of cardiovascular health.

[09:42] Read the literature and become your own expert. Make this a conversation instead of a challenging topic. The gum line and the roots of the teeth can cause heart attacks or plaque development.

[11:02] The Dental Endorsement Package which allows dentists to use Dr. Doneen's branding to endorse dentists that do their method.

[11:48] They provide endorsed dentists with packets and brochures to educate their patients.

[12:13] Finding a medical provider that is aligned with understanding inflammation as it pertains to cardiovascular health.

[13:22] The Preceptorship program is a 17 hour course that goes over what causes heart disease and all of the tools and treatments available to manage it. This course brings everyone up to a new level of understanding. The method is proven.

[14:57] Periodontal disease is a medical problem with a dental solution.

[15:16] Inflammation and genetics in precision health care.

[16:05] Having precision responses to pathogens based on individual genetics. How genetics are one of the most affordable tests that we can do.

[17:12] Genetic tests that give plausible health information.

[19:25] The importance of dentists and hygienists and embracing dental colleagues. Dentists should promote their focus on systemic health.

[20:43] Instead of giving floss and brushes give pedometers and think bigger.

Links and Resources:

Peer-reviewed BaleDoneen Study Published in Postgraduate Medical Journal (PMJ)

Dental Endorsement Package

The BaleDoneen Preceptorship Course

Episode #107 - The Secrets of the Next Generation of Interdisciplinary Teams

January 1, 2018

Dr. Jeff Rouse is one of the best speakers on the planet when it comes to great restorative and interdisciplinary care. Dr. Jeff Rouse is a prosthodontist who maintains two private practices which include Rouse Signature Dentistry in San Antonio, TX and  Spears Aesthetics in Seattle, WA. He is also a faculty member at Spear Education where he is a prosthodontist and expert at interdisciplinary treatment and airway management.

We talk about how to have an internal and external team when creating an interdisciplinary practice. We talk about how much responsibility to give team members and how to find and hire the best. It takes time to build a great team, and getting a way to communicate across disciplines can always be a challenge. The future of dentistry is about great health for patients and great education opportunities for practitioners and patients.


You can find Jeff here:

Spears Aesthetics

Spear Education

Rouse Signature Dentistry


Show Notes

[02:20] Jeff is a prosthodontist with two practices.

[02:32] The uniqueness of his practice is that he started looking into what was causing issues that he was seeing at the office. He started looking into airways and taking it beyond sleep apnea.

[03:09] I have formed two different interdisciplinary teams to continue to build upon what I have done. Now that team has to grow in order to satisfy the requirements of doing quality restorative care.

[04:11] How important is it to have a great time.

[04:30] Adding airway to traditional restorative dentistry can't be done without a team.

[06:03] Since 1990, he has had in practice in San Antonio, TX. In 2008, he formed his team to deal with airway in restorative patients. His Seattle team formed quickly.

[06:57] Each community is going to have strengths and weaknesses.

[07:38] He has great medical facilities and teaching facilities with incredible support from the communities in both areas.

[08:18] Outside office support. Orthodontic support for all ages and surgical cases.

[10:26] He works with multiple orthodontist in San Antonio.

[10:46] A sleep physician for adults and one for kids. You also need different labs for kids and adults.

[12:14] How sleep labs aren't a regular nights sleep, plus the studies are biased to make patients look normal.

[12:48] ENT are important, but you have to find the right one or multiple ENTs who will do what you need.

[14:41] Myofunctional therapist who works on tongue poster etc.  

[16:15] Practicing dentistry at a high level, and you have to have an interdisciplinary team.

[17:13] Finding people to find things you don't want to do. The new interdisciplinary team will soon be the norm. This is the future and it needs to be accepted. Ask around to find people you my trust and go meet them.

[18:46] It's very rare that physicians aren't interested in participating.

[19:31] Your hygienists can also be your myofunctional therapist.

[20:21] Using social media to use this as a marketing practice. Promoting a practice as a health based practice.

[21:49] Internal team. There is a price to be paid when learning anything new. Train a staff member to do this. Dental assistants are a great option to work through the protocols for data gathering.

[24:24] Find the right person and hand it off.

[24:42] Recording your training on online videos to knock out the new training.

[25:21] Communication issues. Letters and emails are kind of old school, but they work for Jeff. ENTs communicate through treatment plan notes or a protocol that they are comfortable with.

[27:12] The Mayo Clinic is interdisciplinary where all of the pieces need to connect.

[30:12] Going into the world of medicine to get a sleep appliance. Try to stay out of medicine when you can, but you will need to go there and bill through medicine from time to time. Hire a billing service.

[31:45] His front desk has an interdisciplinary system of monitoring the patient to see where they are in the process. They also review each case for a half hour each week.

[32:39] Have really smart front desk people who are also good with people.

[34:25] Having an internal people person with warm and fuzzy, but who are still competent and analytical. The best people have stories.

[36:37] Asking people their stories when interviewing.

[37:01] How much do you let your assistants do.

[37:24] Jeff does things he does with his hands. He is the only one who does it. He only does the airway interview and exam.

[43:33] Having monitors and apps to monitor sleep.

[45:46] Having an internal or external lab tech. The price of the appliance depends on the purpose of the appliance.

[47:56] Craziest team member. Actually, Jeff has the craziest patients because he doesn't fire them. Jeff has had bad staff members, but was never afraid to part ways.

[54:13] Joined and joint health is getting more combined. Disc location affects airways and oral surgeons will be having larger roles. Send people to the right person or oral surgeon.

[57:21] How this is an exciting time in dentistry. Now it is time to make people healthy. Dentistry is the number one profession in the United States.


Links and Resources:

Christian Coachman


Spear Dental Seminars

Spear Dental Workshops

Spear Online Education Use Code: BPS167

Spears Aesthetics

Spear Education

Rouse Signature Dentistry

Episode #106 - The Keys to a Successful Career in Dentistry with Dr. Robert Margeas

December 25, 2017

Dr. Robert Margeas is known as “the Dentist’s Dentist”. He has a private practice in Des Moines, Ia, and he is a good friend of mine. He is a speaker and a lecturer who I met years ago at the Seattle Study Club. He values education and had 500 CE hours in his first five years of being a practicing dentist.

We talk about keys to being a successful dentist. Robert shares the importance of education, being true to yourself, and being honest and authentic with his patients. He shares great tips for running an office the right way with an empowered team and great office culture. He also gives tips for young dentists who want to be their own bosses and his insights into the future of dentistry.

You can find Dr. Robert Margeas here:

Iowa Dental Group



Show Notes


[02:38] Dr. Margeas is a practicing dentist in Des Moines, Ia. His wife practices in Michigan. He is impressed with all his wife does to run a family and a practice. Dr. Margeas got married at 53, so he has a whole new appreciation for everything that his wife does.

[03:18] He is happy to share what he has learned over the years.

[03:51] Robert practices in the capital of Iowa, and people want to use insurance. He has an insurance based practice inside the cosmetic and restorative practice.

[04:36] Why is it important to define success. Success isn't always money.

[05:49] More dentists are signing up for corporate dentistry because they have bills to pay.

[06:55] How Robert was working as an associate at a dental clinic that was open 7 days a week. He had to work 12 days on before getting a day off. He spent his money wisely and focused on education.

[08:02] It was his priority to learn as much as he could. He made a commitment to CE. He had over 500 hours his first 5 years. He spent the money to learn things like veneers and restorative cases.

[09:04] The importance of finding a mentor. Spending money on CE is one of the most valuable things that he has done.

[10:53] It's more important to find a way to take the courses even if you have to borrow more.

[12:38] The importance of being around like minded dentists.

[13:18] Being in competition with yourself to be the best. Searching out and finding people that you want to emulate. You have to be proactive about finding a mentor.  

[16:45] How efficiency is key. Visualize where you want the end to be and be a machine and get it done. Practice to do it fast.

[18:47] Learning what you like and don't like.

[19:06] Being competent and not just doing it for just the money.

[22:53] Building the right team. Hiring based on personality and ability to communicate. Cross train your staff and don't micromanage.

[25:18] Going survivor mode. Somebody is getting voted off of the island. Straighten it out or someone is getting fired.

[26:16] Not having job descriptions, but always knowing their expectations. The staff knows that they have stuff to do no matter what. There is no office downtime.

[27:18] Robert's staff has been with him for years and he offers a great compensation plan. They are free agents, but it is his expectation for them to stay in the contract for the full year. He doesn't want staff that isn't happy.

[29:54] Attracting the right kind of patients. When buying a practice, you are buying the patients not the building or equipment. Nurturing great patients who will refer their friends.

[31:46] Having a good reputation is more important than money.

[32:18] 67% of his patients have Delta Dental. It's a cost of doing business. He has lost patients over $10.

[33:37] Always offer the best treatment and don't be offended if patients can't afford it.

[35:43] Being efficient in the three days that you are working. Patients will come to you if they value as a dentist.

[36:46] Dentistry is a tough business. You need down time to decompress.

[37:12] Finding the right lab. Automation is making things much easier because of the machinery. He picks by price, quality, and time. He works with a local lab in the community that you can grow with.

[38:26] Lab trends are going digital and getting automated. How Glidewell is setting lab fees.

[40:15] You may not need all of the fancy equipment at the beginning.

[41:18] Buy dental equipment that you are going to use.

[42:24] The importance of having a study club and being surrounded by the right professionals.

[45:25] Buying a practice is one of the best ways to build business. Profitability goes up when you produce and collect more with the same people.

[47:36] Making profit from an associate and not having them buying in and being a partner.

[51:03] Figuring out who you are and building a business to support that.

[51:37] Get as much education as you can. Learn all you can from another dentist, and then find someone to buy out.

[52:35] The importance of taking care of yourself. Dentistry requires a good support system. Rolfing and massage are very helpful. Dentistry is hard work, you need an exercise plan and to take care of yourself. When you work three days a week you can do it a long time.

[55:06] Future of dentistry. Less private practice and more corporate.

[56:12] If you learn the right techniques, you can be an entrepreneur.


Links and Resources:

Seattle Study Club

Kois Center

Ritter and Ramsey

Catch the Composite Wave: and Surf Its Potential!

Iowa Dental Group


Episode #105 - Coachman and Kois Live Planning

December 18, 2017

The Kois and the Coachman team are some of the most brilliant minds in dentistry and they are live for the first time on today’s show. This is a treatment planning session that you do not want to miss. John C. Kois, D.M.D., M.S.D. is the director of the Kois Center. Dr. Dean E. Kois D.M.D., M.S.D. is a faculty member at the Kois Center, and he maintains a private practice. He will be the surgeon in this planning session.

Dr. Christian Coachman is a frequent guest on this show and a good friend of mine. He is also the creator of the Digital Smile Design system. Dr. Francis Coachman is the Director of the DSD Planning Center and a great dentist. They are all here today, to show us how planning and treatment all come together by creating the best plan.  

You can find Coachman and Kois here:

Digital Smile Design

DSD Planning Center Director Dr. Francis Coachman

Dr. Francis Coachman

Dr. Christian Coachman on Facebook

Dr. Christian Coachman on Twitter @c_coachman

Well Clinic

Digital Smile Design on Instagram

DSD Magazine

DSD Education

Dr. Dean E. Kois

John C. Kois, D.M.D., M.S.D.

John C. Kois

Kois Center