Do You Know Your Team’s Threshold?

February 23, 2024 Robyn Reis

Do You Know Your Team’s Threshold? 

Robyn Reis, Dental Practice Coach 

While visiting a dental practice that had amazing hospitality and incredible relationships with its patients, I observed a doctor’s presentation to a patient who was in his forties and who had been saving for a smile makeover for a long time. The doctor did an amazing job with his presentation of what was possible and the phases of treatment. The patient was very excited, even teary-eyed.  

The patient wanted to get started and asked about the cost. The doctor said, “You know what? My team at the front are experts in figuring that out.” So, the patient was taken to the front and handed over beautifully. In a few minutes, he was presented with the treatment plan on paper with the approximate dollar amounts. In phases, they would do the full mouth. All seemed to be going well until it wasn’t. 

Intrinsically, everyone has a monetary threshold that up to a certain point, you have no problem with the amount. It’s something within your range of expectations and easy to say yes. When you cross that threshold, anxiety may creep in and for sure, you become uncomfortable.  This is what I witnessed in a matter of moments. 

I observed the front office team member look uncomfortable after glancing at the paperwork, despite being experienced with treatment presentations. The clinical assistant who had been part of the diagnosis and treatment planning process, would also help with scheduling and any questions. 

Together, they gave the patient the opportunity to ask questions after reviewing the plan again. The full mouth restoration was going to be in the neighborhood of $25,000. The first phase would be about $18,000. They offered CareCredit financing. The patient said, “It’s only $25,000 and I have $20,000 saved. This is wonderful! I don’t know how I will pay the other $5,000, but I know I have the means. It’s only $25,000.”  

The team appeared somewhat shocked because they were obviously uncomfortable with quoting that amount. This treatment plan crossed their personal thresholds. They suggested the patient go home and sleep on it “because this was a big investment.” The patient was so committed to moving forward that, despite their advice, he scheduled his first appointment. He would call them back once he figured out how to pay the remaining balance, knowing insurance would contribute very little. 

What I also found interesting was that neither team member asked for a deposit. No money was exchanged to reserve an extended appointment. The patient could back out and the doctor’s time spent on the case work-up would be uncompensated. In my experience, making a signed financial agreement would be the responsible step to take at this stage.  

This example illustrates the discomfort many dental teams feel about asking for a deposit if the treatment estimate crosses their personal threshold. Of course, dental teams will want to explain what can be done to make treatment more affordable and the financing options that are available. But it is beneficial for team members to understand their personal threshold and to become comfortable saying, “Grab your checkbook or pull out your credit card, Mr. Jones. Here’s what your investment is going to be to get started.”  

What’s your threshold? This is a great team exercise you can do at your next meeting because a patient might ask anyone they interact with about the cost of dentistry, and what options you offer for the dentistry they want.  Every team member will benefit from considering their personal threshold and discussing it — even role-playing — to become comfortable with the best ways to manage these questions. Depending on the situation, it could be referring the patient to the treatment coordinator or to the financial administrator to have a comfortable conversation. 

It is my belief that when patients are excited about what the treatment results will be and they want to move forward, it’s the right time to ask the patient to make a financial commitment to get the process started. 

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Culture Fit Versus Culture Add

February 16, 2024 Robyn Reis

Culture Fit Versus Culture Add 

Robyn Reis, Dental Practice Coach 

When you are hiring team members, you are likely thinking about how those you interview will fit into your practice culture. Do their values align with yours? Do you share similar backgrounds and philosophies? A business’s culture is a system of shared values, beliefs, and behaviors that influence how people dress, act, and perform their roles. Most practice owners work hard to have everyone get along, support one another, and work as a team to give every patient a wonderful experience. So, it’s only natural to want to find someone who fits into that culture when a position opens up. 

In the HR world, recruiters have a different approach – they are moving away from “culture fit” towards “culture add.” What does this mean exactly? A great mentor of mine, Sheri Kay, says it best, “People come together in their similarities, but they grow together in their differences.” 

On the pages of Harvard Business Review, Forbes Magazine, Fast Company, Inc., and Entrepreneur, you will read that more and more companies are moving away from the traditional culture fit that creates a monoculture where everybody has shared similarities and there is no growth. Instead, they are recreating a culture that is open to new ideas, open to conversations where people poke holes in traditional ideas and say, “Hey, what if we did this? This is what we think we want to do. Now let’s figure out why it will or will not work.” 

In recruiting a hygienist for a client, one of the candidates stood out to me. In addition to her clinical hygiene education, she also had a financial background which represented a “culture add” for this particular practice. She had a greater understanding of goal setting, the finances of the business, and how to create a profitable hygiene department. She ended up being a fantastic and productive member of their team. 

When you are in the hiring process, do you think about adding to your culture? Diverse backgrounds correlate with more diverse problem-solving and decision-making processes. In studied corporations, diversity leads to increased profitability.  

In dentistry, diverse backgrounds can lead to the attraction and retention of diverse patients. Diverse backgrounds can fill in operational holes in your business model. Does a candidate have a background in psychology, finance, education, customer service, computer IT, office administration in another industry, or marketing? Does a candidate speak a second language that will be an asset in your community? Is a candidate artistic, an exceptional writer, a community volunteer, or actively participating in other activities? 

During each interview, seek to learn what the candidate could add to your practice culture in addition to culture fit. After talking about a candidate’s resume and interests, talk about situations that occur in the practice and current needs. Ask if the candidate has ever been in similar situations and how they handled them. Do the answers indicate personality traits and strengths that will add to (complement) the team? Ask the open question, “Based on your personal experience, what insights could you add to this situation?” 

In today’s competitive market for talented team members, consider what a new hire with additional skills could add to your culture and what these new contribution possibilities could be for an amazing patient and team experience. Happy hiring! 

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Are You Prepared for Your Next Hiring Challenge?

January 25, 2024 Paul Henny DDS

Are You Prepared for Your Next Hiring Challenge?

Most dentists hire during a crisis because a vacancy created for various reasons drives a need to fill a position immediately. This high-stress, time-sensitive situation often undermines the dentist’s ability to hire more strategically and therefore move their practice up to the next level. In other words, dentists tend to re-create the status quo out of desperation, rather than strategically evolve their practice over time based on how they hire and develop team members.  

Understanding what you need and want to create ahead of time (skills and values that are non-negotiable in a person) is key. Hopefully, this article will prompt you to think about this truth as well as prepare for the next hiring challenge. 

Seek These 8 Personality Attributes 

According to Avrom King (and my own experience), there are eight personality attributes that must be predominant within a care team for it to prosper over time: 

  1. Optimism: Despite all the craziness in today’s world, team members routinely demonstrate a hopeful and positive attitude toward adversity and others.
  2. Involvement: Team members actively pursue problem identification and resolution. They are caring and committed to seeing the practice function at an optimal level.
  3. High Self-Regard (not to be confused with high self-esteem): Team members feel competent, capable, and worthy of success. They believe that their lives make a positive difference in this world, and they demonstrate it every day.
  4. Missionality: Team members are committed to living clarified personal values. This commitment goes far beyond themselves. They see their life as an integral part of a greater whole and congruent with the mission of the practice.
  5. Energetic Curiosity: Team members are stimulated by their curiosity about people, things, and challenges. Consequently, their positive energy is contagious, and their problem-solving ability is high.
  6. Resilience: Team members are flexible and able to adapt in a healthy and functional way to routine day-to-day stressors. Consequently, they don’t avoid conflict. Instead, they approach conflict maturely and with the intention of positive resolution.
  7. Self-Control: Team members know who they are, where they are, and where they want to go. They also know what they are doing – or are in the process of finding out. In other words, they are effective self-leaders with the ability to delay gratification.
  8. Relationship-Oriented: Team members prosper via long-term open, honest, and hidden-agenda-free relationships. Consequently, they’re able to seek out and effectively propagate opportunities for commitment in others through those relationships.

Conduct Behavioral Interviews and Assess Emotional Intelligence 

The bottom line is that our hiring process must be behaviorally sophisticated to predictably assemble a highly symbiotic team of emotionally intelligent individuals. Conduct behavioral interviews and make use of emotional intelligence and personality assessment tests. Behavioral hiring interviews ask candidates questions about how they handled specific situations in the past and the candidates are urged to provide somewhat detailed answers about their role, actions, and results. You may ask how they feel about the experiences and what they learned from them. Knowing what they know now, what would they do differently? Don’t shy away from asking them about their life goals and what appeals to them about working in a dental office. Are they enthusiastic about teamwork and making a difference in the lives of patients? 

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Paul Henny DDS

Dr. Paul Henny maintains an esthetically-focused restorative practice in Roanoke, Virginia. Additionally, he has been a national speaker in dentistry, a visiting faculty member of the Pankey Institute, and visiting lecturer at the Jefferson College or Health Sciences. Dr. Henny has been a member of the Roanoke Valley Dental Society, The Academy of General Dentistry, The American College of Oral Implantology, The American Academy of Cosmetic Dentistry, and is a Fellow of the International Congress of Oral Implantology. He is Past President and co-founder of the Robert F. Barkley Dental Study Club.

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Their Ideal Day 

September 22, 2023 Christine Shigaki

I’m sure there are many aspects of your work that are really fulfilling, and I’m sure there are aspects of your daily work that you wish could be easier, maybe even less stressful. What about your work brings you joy? What would it take for you to provide your best work? What would it look like? What would it feel like?

I took an informal survey of dentists and hygienists about what they would need to have an ideal day. When I examined the dentists’ answers, I realized the answers would resonate with every member of a dental team.

The top five answers from dentists were:

  1. Having the appropriate instruments to provide excellent care.
  2. Opportunity to gain knowledge and skills.
  3. Excellent performance/execution of their work.
  4. Opportunity to implement new learning.
  5. Working with patients who are grateful for their care.

All hygienists desired “time to provide appropriate care for each patient.” Specifically, they asked for:

  1. Time to select and sharpen instruments for each person and for the specific procedures they will be doing.
  2. Time to properly assess each person’s unique periodontal condition, including time to accurately measure gum pockets and recession, minimal attachment/thickness, and to assess bleeding (blood thickness, how much bleeding, and where it is coming from—is it systemic or localized?).
  3. Time to explore possibilities with patients regarding their current condition, past condition, and potential future.
  4. Time to debrief and collaborate with the doctor to explore the next steps for the patient.
  5. Supportive teamwork across the practice to provide the best care.

Speaking of collaborating with team members, I invite you to ask your team members what their ideal day would include. Discuss, as a team, your shared ideals, and expectations. Consider where expectations do not match and discuss why this is and what must change to meet shared agreements.

Understanding and affirming the needs of others will have a positive impact. The exercise of writing down what works, what could be better, possibilities, goals, and a pathway towards implementation of superior supportive teamwork is likely to increase your practice joy factor.

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Christine Shigaki

Dr. Shigaki has been in dentistry since 1989 where she started as a dental assistant while completing her undergraduate studies at the University of Washington. In 1994, she graduated with honors from University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA. Dr. Shigaki, a native of Seattle, has built her practice since 1995 and opened Belltown Dental in 2003. She is a life-long student of dentistry and believes that it is her professional responsibility to provide optimal, comprehensive care in a modern facility with state of the art equipment and techniques. She has completed and continues her studies with extensive post graduate dental education, including several dental study clubs and coursework at the distinguished Pankey Institute, where she is also currently an advisor and faculty member. Christine also facilitates teams and mentors dentists. She enjoys the work/life balance that dentistry allows her and hopes that others can find their joy in dentistry. When not at the office, teaching/studying dentistry, she enjoys spending time with her husband, two children, and extensive extended family. She enjoys being involved in her children’s activities, yoga, reading, various outdoor activities and cooking.

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Better Blood Pressure Readings Using BP Cuffs 

July 24, 2023 Lee Ann Brady DMD

In our office, we routinely take our patients’ blood pressure, and we have a variety of cuffs. Most commonly, both hygienists use one of the convenient, digital wrist cuffs. A few months back, they noticed a trend of higher BP readings than they thought were appropriate. We wondered if the wrist cuffs were giving us accurate readings. We did a little research and I decided to reach out to my own primary care physician to ask her advice.

I learned two important things about taking blood pressure:

  1. My physician recommended that we give our patients three to five minutes sitting up in the dental chair, relaxed, and not moving. While pleasant chitchat to reduce anxiety might help, we were advised to steer away from asking any medical history questions and other questions that might produce a bit of anxiety before taking the patient’s blood pressure.
  2. One of the challenges with wrist cuffs is that the cuff is supposed to be at the level of the heart. In a dental chair, the patient is likely to rest their arm on their leg unless we instruct them to do otherwise. She advised that we have the patient take the arm that is wearing the cuff and place it across their chest to hold it at the level of their heart. To be at heart level, the hand shouldn’t come up to the shoulder but be horizontal with the elbow.

My physician asked me if we have arm cuffs that go above the elbow. I told her that we have two digital arm cuffs. She said she prefers using the arm cuffs herself because they tend to be more accurate than a wrist cuff, especially in picking up subtle variations.

This great information has enabled us to take blood pressure readings with more confidence and would be valuable to share with your team members who measure blood pressure. 


In your dental practice, it’s important to create a restorative partnership with your assistants, hygienists & front office team. Make the handoff between your team seamless, build a stronger team & create lasting patient connections. Check out our three Pankey Team Courses that are coming up: Team Series

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Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded leeannbrady.com and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

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Zeroing in on Well Being at Work (Part 2): Gallup’s Universal Elements of Well Being

January 28, 2022 Bill Gregg DDS

Reading Gallup’s 2021 book Well Being at Work: How to Build Resilient and Thriving Teams by Jim Clifton and Jim Harter, has challenged me to think about:

How do we develop a dental practice in which all team members thrive?

The things that immediately come to my mind for improving front office and clinical team morale are respect, appreciation, having a voice, genuinely fair compensation, and workplace flexibility to manage true personal urgencies such as illness and maternity leave–without feeling you are letting down the team. To reduce stress and enable all team members to do their best work and experience connection with patients, dentists can improve block scheduling to focus on doing more procedures in a single appointment while seeing fewer patients in a day.

Perhaps, more things will come to your mind.

5 Elements of Net Thriving Teams

Through millions of interviews worldwide, Gallup has found there are five universal elements of well being. Gallup says they are the five things that count most and that we need to focus on to develop “net thriving teams.”

Career well being: You like what you do every day.

Every day, you and your team members have opportunity to do the type of work that you individually do best and have unpressured time to do your personal best. As dentists, we often talk about doing more of the dental procedures we love doing most. What does each of your employees do best and want the opportunity to do more?

Social well being: You have meaningful friendships in your life.

For dentists, a meaningful friend is apt to be a like-minded colleague or mentor. Your best friends might be a “mental Board of Directors” — the voices of influencers you trust running through your head. But do all your team members have a meaningful friendship at work? Collaborating around a central philosophy of care helps build meaningful relationships.

Financial well being: You manage your money well.

As dentists, we talk at The Pankey Institute about defining for ourselves what is enough money to lead a balanced work life and personal life. It is also appropriate to talk about what is enough to maintain a practice in which every team member can financially thrive. As small, private employers, what changes and team buy-in might be required to wisely stay on track?

Physical well being: You have energy to get things done.

Eat properly, get healthy sleep, and exercise daily. Foster a spirit of health within the practice. Live it. Celebrate it. This will become part of the team culture that enhances the well being of everyone.

Community well being: You like where you live.

Humans innately strive to be part of something bigger than themselves and to support the social environment in which they work. Our practices are communities that often feel like large families. We can create and foster a practice vision that includes “being a thriving, supportive, well being community.” We can “write that on the wall” in our team meetings and in how we interact with each other and the patients we serve.

Closing Thought

A culture of well being puts overall well being upper most.

I encourage you to think and journal a bit about the actions you can take to support the five universal elements of well being…the five universal elements of a thriving life.

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Bill Gregg DDS

I attended South Hills High School in Covina, Denison University in Granville, Ohio and the University of Redlands in Redlands, California prior to dental school at UCLA. My post-graduate education has included an intensive residency at UCLA Hospital, completion of a graduate program at The L.D. Pankey Institute for Advanced Dental Education ; acceptance for Fellowship in the Academy of General Dentistry (FAGD); and in 2006 I earned the prestegious Pankey Scholar. Continuing education has always been essential in the preparation to be the best professional I am capable of becoming and to my ongoing commitment to excellence in dental care and personal leadership. I am a member of several dental associations and study groups and am involved in over 100 hours of continuing education each year. The journey to become one of the best dentists in the world often starts at the Pankey Institute. I am thrilled that I am at a point in my professional life that I can give back. I am honored that I can be a mentor to others beginning on their path. As such, I have discovered a new passion; teaching. I am currently on faculty at The L.D. Pankey Institute for Advanced Dental Education devoting 2-3 weeks each year to teaching post-graduate dental programs. In other presentations my focus is on Leadership and includes lifestyle, balance and motivation as much as dentistry.

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What? Systems Can Be Fun?

September 15, 2021 Sheri Kay RDH

How about a fun pre-pandemic memory? I was on a vacation cruise and had sought out a lounge to do my yoga privately early in the mornings. One morning, I arrived to find easels displaying paintings along the walls of the lounge and a team of people from the Art Gallery. One woman held up a camera and said, “Okay, go!” Then, four others ran along the sides of the room, picking up the paintings and rushing them up to the front of the room. Then they ran back, folded the easels, and moved them as well. The woman with the camera said, “You did it,” and everyone cheered and clapped.

Later that day, I ran into the woman who had held the camera. I had to ask… you know I did, “What were you doing in the lounge this morning?” She told me that every few months they do a quality control exercise to demonstrate they can breakdown the gallery in less than five minutes, because sometimes they only have five minutes to clear the lounge between events.

I had to ask… You know I did. “So, how well did you do?” She told me they were excited to do it this time in just over a minute. She was beaming from ear to ear.

So, that got me thinking…. You know it did. Turning a task into something fun can be energizing. In dentistry, we have to breakdown operatories and setup operatories all the time. What if, while following infection control guidelines and all things OSHA, there was still an element of fun in periodically demonstrating we can do this task at high speed? What record can we beat?

While I was on this same cruise in the Caribbean, it was flu season. There were bottles of hand sanitizer everywhere, and going into the dining room, there were four stations where you could stick your hand under an automatic dispenser. The cruise line did not want to leave it up to the honor system for passengers to clean their hands, so they had come up with a fun way to make us do it. Two men with Caribbean accents and funny attire greeted everyone coming into the room. They had Bluetooth speakers and danced as they said to everyone, “Washy, washy, yay, thank you.” So, every time I went into the dining room, I had a little dance with these gentlemen and sanitized my hands. For the entire cruise, everyone sanitized their hands upon entering the dining room!

During the final night’s dinner celebration… you know the one, where they bring in the blazing dessert and dance in a Conga line to “Hot, Hot, Hot,” the “Washy, washy” guys got on the microphone and thanked us for sanitizing our hands–and allowing them to help keep us healthy. Of course, we all cheered. We loved these guys!

So, that got me thinking… you know it did! They had found a fun and engaging way to improve our health and make us feel good about following the rules. I hope you noted that in my two cruise ship stories, having fun with systems increased the group’s performance. Research consistently demonstrates that when team members are enjoying themselves, work is performed at a higher caliber and with less stress. When patients are enjoying themselves, their participation in their own health is greatly improved.

I know dental care teams well, and they love a creative challenge. Where do you have systems that are trending boring that your care team might add a little fun and spice to? Have some great examples to share? Add them in the blog comments.

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Sheri Kay RDH

Sheri Kay started her career in dentistry as a dental assistant for an “under one roof” practice in 1980. The years quickly flew by as Sheri worked her way from one position to the next learning everything possible about the different opportunities and roles available in an office. As much as she loved dentistry … something was always missing. In 1994, after Sheri graduated from hygiene school, her entire world changed when she was introduced to the Pankey Philosophy of Care. What came next for Sheri was an intense desire to help other dental professionals learn how they could positively influence the health and profitability of their own practices. By 2012, Sheri was working full time as a Dental Practice Coach and has since worked with over 300 practices across the country. Owning SKY Dental Practice Dental Coaching is more of a lifestyle than a job, as Sheri thrives on the strong relationships that she develops with her clients. She enjoys speaking at state meetings, facilitating with Study Clubs and of course, coaching with her practices.

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Conversational Recall

June 4, 2021 Sheri Kay RDH

Over the past few months, I’ve had a series of coaching sessions with frustrated dentists due to many of their exchanges with team members not being as effective as they had hoped. The dentists were confident they had been clear about their expectations, and yet there was still lagging or even absent implementation of the anticipated behavioral and system changes.

“Maybe this is not the right team member! How can they not just do what I ask them to do?”

Of course, I appreciate how disconcerting this can be, AND I want to challenge the notion that a single conversation can lead to effective change.

I imagine we can agree that most of your patients are in the midst of their own developmental process, as dental offices have quality systems in place to support this idea. A patient comes in for a hygiene appointment and they are routinely scheduled to return in 3 or 6 months to follow up, monitor for changes, and (hopefully) celebrate new levels of health. We are used to the idea of having a return date, better known as a “recall appointment.” More often than not this system works. Over time, as the recall appointments continue, trust levels increase along with deepening relationships and even case acceptance.

The question I pose is this: How can you as a leader apply this same principle to coaching your team members? I like to call this system a Conversational Recall.

What if at the end of a coaching conversation, even a short one, you create an opportunity to revisit with the team member to assess progress, problem solve any obstacles, and set a time for yet another Conversational Recall? My own experience tells me that sustained change typically occurs by implementing small changes over time. Staying connected with a team member by offering ongoing feedback and support may very well be the difference between you being frustrated by unmet expectations and your ability to celebrate high performance and heightened levels of engagement.

One aspect of leadership is setting each team member up for success. You can do this by investing time and energy, walking alongside them, and committing to following up as a pathway to letting each person know that you care. One of the greatest ways to inspire change is to demonstrate to your team members that you both value what they have to bring and that you believe in them…sometimes even more than they believe in themselves.

Another aspect of quality leadership may just lie in your ability to be congruent in all areas of your practice; do for your team what you do for your patients—if not more. Care for your team like you care for your patients—if not more. The rewards for everyone involved could be incredible!

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Sheri Kay RDH

Sheri Kay started her career in dentistry as a dental assistant for an “under one roof” practice in 1980. The years quickly flew by as Sheri worked her way from one position to the next learning everything possible about the different opportunities and roles available in an office. As much as she loved dentistry … something was always missing. In 1994, after Sheri graduated from hygiene school, her entire world changed when she was introduced to the Pankey Philosophy of Care. What came next for Sheri was an intense desire to help other dental professionals learn how they could positively influence the health and profitability of their own practices. By 2012, Sheri was working full time as a Dental Practice Coach and has since worked with over 300 practices across the country. Owning SKY Dental Practice Dental Coaching is more of a lifestyle than a job, as Sheri thrives on the strong relationships that she develops with her clients. She enjoys speaking at state meetings, facilitating with Study Clubs and of course, coaching with her practices.

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Why We Partner with a Cardiologist

March 12, 2021 Barbara McClatchie, DDS

Despite headlines you may have read, heart disease is still the number one killer in the U.S., followed by cancer and then (hopefully only temporarily) COVID-19. Gum disease is on the rise in this country. This condition affects much more than just a person’s mouth. We need to shut down the dangerous anaerobes that live in our tissue and bone that drive the oral and systemic inflammation. The bacteria that live in our mouth do not stay in our mouth! Hygienists are not only cleaning deposits off of teeth; they are managing dangerous bacteria and saving lives!

Patients see their dentist more often than they see their physician. The start to providing optimal care is having informative conversations with our patients when discussing their health history, their medications, and the tie in their periodontal and endodontic health.

Married to a cardiologist, it was beneficial for both my dental patients and his medical patients to receive integrative care, and to that end, we worked together to build a center for my restorative practice that includes oral-systemic health diagnostics, counseling, and treatment.

Pushing the Standard of Care

My practice, Complete Heath Dentistry of Columbus, is distinguished from other practices by pushing the standard of care to treat patients based on his or her risk factors for developing systemic health issues. Saliva/oral DNA testing enables us to take this proactive health approach. This testing allows us to learn if our patients have dangerous oral pathogens. It helps guide us on how to better treat our dental patients with periodontal therapy and with oral probiotics, as well as Perio Protect trays.

My husband, Dr. Eric Goulder, and I opened the first medical center in the United States with an accredited Cardiologist and Dentist to practice the Bale Doneen Method testing and care under one roof. We passionately believe a medical Bale Doneen provider cannot optimally help their patient without the assistance of a dental team that understands the value of their work.

With every patient, we discuss oral health risk factors for cardiovascular disease and strokes. We use saliva/oral DNA testing to proactively calculate the CVD risks of our patients with the recommendation they create a health plan with their doctor geared toward overall health. With focus on prevention and the elimination of disease, we work with patients to achieve optimal oral and systemic health.

Pushing Dental-Medical Integration

Across the country, dentists are teaming with cardiologists to better understand the oral-systemic connection and to help their patients discover developing risk factors for heart attack and stroke, among other diseases such as diabetes. You do not have to have a cardiologist under your roof to similarly help your patients.

You can explain to your patients that one of the most painless tests that can reveal hidden heart attack or stroke risks is a carotid artery scan (CIMT scan) that measures carotid intima-media thickness. It is an important test for individuals with few risk factors for developing cardiovascular issues. Under traditional care, 75 percent of heart attacks happen in people with normal cholesterol levels. Through this no radiation ultrasound procedure, the neck is examined so that a doctor can uncover whether or not a patient is heading for health problems. This screening detects atherosclerosis, a condition where deposits hide within the arteries. Also, it is possible to find the “age” of a patient’s arteries.

Through CIMT ultrasound testing, a cardiovascular problem can be identified 10-15 years prior to an event. While 50% of the population does not know they have a growing cardiovascular problem, this simple test provides an early diagnosis for lifestyle counseling and dental-medical treatment.

Working with your patients and their physicians, you can also recommend the NT-ProBNP blood test that is a part of the blood testing involved with the Bale Doneen Method. This test measures the amount of BNP in the blood.  When the heart is under stress, the body excretes high levels of this substance. If elevated levels are detected, it is a red flag that a person may be heading for a stroke or heart attack.

Dr. Eric Goulder and I are on a mission to push physicians to be proactive, to understand what is going on inside arteries, discover why the disease is present, and observe the disease stabilize after treatment. I encourage you to become familiar with the Bale Doneen Method if you have not already done so and become familiar with cardiologists in your area who can be of assistance to your patients. Two-way referrals are a natural outcome of developing these relationships, and patients are very appreciative.

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About Author

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Barbara McClatchie, DDS

Dr. Barbara McClatchie is on a mission to enrich the quality of life for every person she meets. Her practice, Complete Heath Dentistry of Columbus, Ohio, employs a team of professionals specializing in general restorative dentistry and uses researched-based methods that ensure optimal oral, mouth and heart health. A native of the Toledo area, Barbara graduated from The Ohio State University in 1978 with a Certification in Dental Hygiene and Bachelor of Science in Education and received her Doctorate in Dental Surgery from The Ohio State University in 1986. After that she was selected to attend a hospital based general practice residency program at OSU. She continued her study with The Pankey Institute. Dr. McClatchie won the Worthington Chamber of Commerce small business owner award for 2016-2017. She and her She has shared tips for optimal oral and heart health on Good Day Columbus and has been featured on 10TV and Columbus CEO Magazine. She is a founding member of American Academy of Oral Systemic Health and a member of many other dental organizations including the American Dental Association, Ohio Dental Association, Columbus Dental Society, OSU Dental Alumni Association, Pankey Alumni Association, AAOSH, Worthington Chamber, Worthington Chamber Board Member and the Bale Doneen Preceptorship.

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