Editor’s note: This is the ninth article in a series exploring the business aspects of the dental profession, from starting a practice and marketing to hiring staff and finances.

Dr. Deshpande

If we don’t talk about leadership in a dental office, we aren’t really discussing anything valuable, are we? Because, what is a practice without a great leader? It’s a failure.

Contrary to what most people think, leaders aren’t born, they are made. Some of it comes with experience, other times it is learned. My personal goal is to one day become the most compassionate leader possible, to both my work family and my home family. Fulfilling this big hairy audacious goal means committing every day to reflecting, pivoting and learning.

Here are some of the best advice on leadership that I’ve received from my role models:

1. Based on John Maxwell’s book, 21 Irrefutable Laws of Leadership: “failure of a subordinate, is failure of the leader.” Always remember that true leadership begins with the doctor (not the office manager) and that you need to set the tone of the level of excellence and hard work you expect in your office.

2. According to Justin Short, author of the Lifestyle Dentist podcast, “Most of the time people will set goals of a top 10 practice. However, if you have a team of average or below average how will you achieve those goals?”  Consider carefully who you are hiring to be on your team of winners. Will this person help you reach your office goals? If not, why are you even hiring them? Wait for the right person.

3. True measurement of leadership is influence. “We must learn to inspire and motivate people, not manage people.” Think about how you motivate your team and your patients to take actions? Do they quickly follow your advice and treatment plans?

4. According to Guy Raz, author of How I Built This podcast by NPR, “an important aspect of leadership is reflection.” Make it a habit to spend some time journaling, meditating and reflecting on your day. Could some conversations have gone better? Where could you have done better?

5. What gets appreciated, gets repeated. Make it a habit to thank people and mention what you are thanking them for. “I appreciate your leadership in following up with patient S and getting them scheduled! That was very important to me!”

6. From Kim Scott’s book, Radical Candor, “be quick and firm in your reprimands.” Praise lavishly in public, reprimand quickly in private.

7. Communicate regularly with your team, sit down with them and ask for feedback. Sometimes, they are able to see problems before even you can spot them. They also have better solutions. Involve them in the decision making and leadership process. Use their talents to come up with a better system!

8. Make it a habit to read more books on leadership and mindset, listen to podcasts on entrepreneurship, and building authentic relationships within your community.

9. The most important thing we all can do is help others. We are lucky to be in a profession that has plenty of opportunity for us to give back. Are you helping your team members, patients, friends and community members achieve their goals? What more can you do for them?

10, “Find a mentor, hire a coach, and don’t stop investing in yourself.” This is something my dad, one of my biggest role models, told me in 2020 when I was sitting on the couch in the middle of global pandemic, and forced out of employment. I followed his advice and feel like a different person today. If we are not constantly iterating and improving who we are people and leaders, how can we expect that from our employees?

Let’s become role models worth looking up to!

Dr. Sampada Deshpande is a general dentist based in San Francisco. A foreign trained dentist from India, Sampada earned her DDS from the University of Washington in 2018 and is a 2020-2021 UW-LEND fellow. Outside of clinical dentistry, she enjoys teaching at the New Dentist Business Club and improving access to technology in healthcare via her involvement in Samsotech. You can reach her directly at @dr.deshpande on Instagram or visit her website www.sampadadeshpandedds.com for more information.

Editor’s note: We know that finding the right practice can be overwhelming and time consuming. That’s why the ADA created ADA Practice Transitions (ADAPT), a service that matches you with practices that fit your practice approach and lifestyle. We provide customized resources to ensure you feel confident in your decisions and an ADA Advisor supports you during each step of the journey. Learn more at ADAPracticeTransitions.com.

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Wendell Curtis

dentistintulum.com

While studying for my DATs about a decade ago, I remember being frustrated with the PAT section of the exam. Why would I ever need to know which asymmetrical and strange shape would fit into which hole? How would this be relevant to the practice of dentistry? As I passed time by working on a 2,000 piece jigsaw puzzle during a 12-hour overnight call shift at my GPR, I had a moment of clarity.

Dr. Khan

I am an imaginative person by nature. I have always found creative tasks like coloring, embroidering, or crocheting not only enjoyable but relaxing. However, my true passion lies in creating order out of chaos – my chaos of choice being jigsaw puzzles.

The first commercial jigsaw puzzle was made in 1762 by London-based mapmaker John Spilsbury, who mounted a map onto a wood basing and then cut around the borders of individual countries with a scroll saw. Throughout their early years, the primary goal of jigsaw puzzles was to help children learn geography. The invention of the “tredle jigsaw” tool in the early 19th century allowed for the creation of more intricate piece shapes and faster production.

During the Great Depression the popularity of jigsaw puzzles exponentially increased and allowed families a way to spend time with one another through problem solving while distracting themselves from daily hardships. More recently, during the COVID-19 pandemic jigsaw puzzles offered a quiet, inexpensive escape from the ever changing world during a global pandemic.

Oral health is multifactorial and only after a comprehensive medical, social and dietary history are we able to get the full picture of a patient’s oral health. Similar to a jigsaw puzzle, it is only after putting together the pieces that you are able to see the entire picture; in the case of dentistry, as a provider you can now tailor treatment and oral health recommendations to the specific patient. Moreover, jigsaw puzzles challenge our perceptual ability, color matching and pattern recognition and matching – a dentist’s dream! Puzzling allows me to achieve creative meditation and mindfulness through the marriage of the left and right sides of our brain.

I reaffirmed my love for puzzles in March 2020 when “elective dental procedures” were canceled in New York State. Our clinic schedule switched to weekly shifts covering emergency patients. I was anxious not only about the consequences of a global pandemic but also the impact it would have on my didactic and clinical education during my pediatric dental residency. Organized dentistry rose to the occasion and I was inundated with hours of online CE that allowed me to strengthen my clinical acumen. Yet, my hands remained fidgety. I wanted to create. But at the same time, I wanted to seek mindfulness. I found my nirvana through jigsaw puzzles. My hands were occupied with actively searching for the next piece while my mind was laser focused on the final picture.

Puzzling, much like many dental procedures, creates a unique sense of accomplishment. A little moment of success that only happens because of my efforts and achievements. The final picture of puzzles has evolved from antiquated landscapes to modern and vibrant pictures-capes depicting a wide variety of exciting and unique illustrations.

My favorite puzzle is the Clemens Habicht, 1000 Colors puzzle where each individual picture has been engineered to be its own distinct hue. While completing this puzzle I was transported back to my dental school days of trying to rearrange the VITA Classic Shade Guide by shade or brightness. When I encountered a roadblock with the hues of green I turned to an esthetic dentistry tip by photographing the pieces in black & white to aid in distinguishing them with no luck. Soon enough, the puzzle was complete – almost too fast. It remained on my kitchen table for a week after it was completed and put a smile on my face whenever I walked past it. Once that allure faded, I quickly disassembled and started on my new adventure: a 1,000-piece puzzle of a world map composed of flowers has since been framed and is hanging in my living room.

A year and a half later, we are still in a pandemic and the uncertainty of things becoming a constant, much like puzzles as my favorite mindfulness hobby. In the face of uncertainty in our lives, working on a puzzle is grounding while being nostalgic to a life unencumbered by the burdens of technology. I always have a puzzle in progress in the corner of my apartment as a reminder that no matter how small – each step forward brings you closer and closer to the end goal.

Furthermore, puzzling requires singular attention and can be an avenue to center yourself in the disarray of colors, patterns and shapes. More than ever, mental health is the cornerstone of a successful dentist and I encourage everyone to find a hobby that is the missing piece to their overall happiness and wellness.

Dr. Sarah Khan is a New Dentist Now guest blogger. She grew up in Long Island, New York and graduated Stony Brook School of Dental Medicine in 2016. While in dental school, she concurrently completed a Master’s in Public Health. She went on to complete her GPR at NY Presbyterian/Weill Cornell in 2017 and subsequently worked in Philadelphia, PA for two years. In the summer of 2019 she started her pediatric dentistry residency at Maimonides Medical Center in Brooklyn, NY. She is passionate about health advocacy and is always looking to get involved with organized dentistry on a local, state and national level. In her free time she loves to travel with her husband, complete 2000+ piece jigsaw puzzles and laugh.  

Wendell Curtis

dentistintulum.com

We have a problem. There is a troubling gap between the medical and dental communities when it comes to cancer care. As a result, health care providers and their patients alike experience a great deal of frustration regarding the lack of dental care available to patients with cancer.

Dr. Alhajji

In my training, I met a middle-aged man who had been diagnosed with an adenoid cystic carcinoma of the left nasal cavity, for which he underwent surgery and electron beam radiation therapy.

The cancer recurred six years later, warranting another round of radiation therapy. As a result of his cancer treatment, he developed severe trismus to the extent that he was unable to remove his prosthesis. This limited our ability to perform an adequate head and neck exam and address the chronic intra-oral pain he initially came to our clinic complaining about. Despite a limited evaluation, we were able to note clinical evidence of osteoradionecrosis. The culmination of oral complications he acquired not only led him to suffer from chronic pain but also affected his speech and ability to eat.

Such catastrophic cases can be prevented or at least minimized with a simple dental assessment in anticipation of a patient’s cancer treatment, and with supportive oral care throughout the course of their cancer journey. If our team had been involved sooner, we could have facilitated a referral to a physical therapist to minimize progression of his trismus.

Dentists play an important role in enhancing the quality of life of their patients and instilling hope in their cancer journey. It’s hard enough going through cancer; it is one of the most trying experiences imaginable for our patients and their loved ones. Once a patient makes it through to the other side, the last thing they would want to deal with at that point is combatting major oral complications that can inevitably arise from cancer treatment, especially when those complications were totally avoidable

The reality is that this isn’t how things are working out. As Cancer Network observed, some cancer centers “let the patient take care of it” when it comes to dental care. Furthermore, a population-based study found only 35% of oral cancer patients have a regular dentist and routine dental care.1 In a survey of oral health supportive services for the National Cancer Institute-Designated Cancer Centers, 56% said they didn’t even have a dental department, nor did they have any sort of oral care protocol in place to address healthcare concerns that may arise during cancer treatment.2  This is a problem.

There are a few factors that can be attributed to this issue.

The first and perhaps most blaring reason is lack of access to care, mainly characterized by the fact that medical and dental insurance are based on separate insurance models; Medicare typically doesn’t cover dental procedures, and many dentists don’t accept Medicaid.

The second cause of this disconnect is a limited number of dental providers with a strong understanding of oncology. The current reality is that dental school curricula don’t emphasize dental oncology. For that reason, general dentists are not prepared to treat this patient population.

On the other hand, our medical counterparts are not adequately trained to consider the ramifications of cancer and its treatment on a patient’s mouth and overall health.

What makes matters worse, dental providers often have a lack of administrative support, or a lack of cross-trained billers (CDT vs. CPT coding), to support them with reimbursement.

Finally, a third explanation for our challenge might be described as “patient individual barriers.” They include lower socioeconomic status that impacts the ability to secure time off from work or to access transportation, language issues hindering effective communication, and patient education. After all, dental care is not the first thing that comes to mind upon a cancer diagnosis.

What is the solution?

There are a number of patient advocacy groups working on these conundrums, such as the Oral Cancer Foundation and the Santa Fe Group. Most recently this has been brought to the attention of the Lancet Series on Oral Health3, 4 and NYU Dentistry which has been designated as a WHO Collaborating Center for Quality Improvement and Evidence-Based Dentistry5.

There are also a limited number of facilities and programs attempting to bridge the medicine-dentistry gap.  I am grateful to be a part of one of them. The Oral Health Center for People with Disabilities (OHCPD) at NYU Dentistry, opened its doors in 2019 and is designed for patients with very prominent and visible physical disabilities, such as patients who use wheelchair transportation. Although society doesn’t often view cancer as a disability, it can surely affect one’s quality of life much like other disabilities. As a result, it deserves proper attention and care, which is why at the OHCPD, we are including the care of this patient population in our protocol as a mechanism to bridge this divide. Another way NYU Dentistry acts as a bridge is by waiving the cost of pre-cancer treatment dental care for those who don’t have insurance. We are also furthering the professional education of our students by modifying the protocol for the OHCPD to encompass comprehensive dental care for cancer patients, hence expanding the curriculum and educating the next generation of dentists.

In conclusion, at NYU Dentistry’s new Oral Health Center for People with Disabilities, we are leading the way to bridge the medicine and dentistry divide by helping to ensure dentists are available, visible, and accessible for this patient population. The goal is not just to survive and beat cancer, but to thrive afterwards. As Benjamin Franklin reminds us, “an ounce of prevention is worth a pound of cure.”

Dr. Dalal Alhajji, DMD, MSD, received her DMD from Boston University Henry M. Goldman School of Dental Medicine, a certificate in ‘Advanced Education in General Dentistry’ and a Master of Science in Dentistry, in Oral Medicine, degree from Case Western Reserve University School of Dental Medicine. She also completed a fellowship in Dental Oncology at Memorial Sloan Kettering Cancer Center and is now a Clinical Instructor at New York University College of Dentistry’s Department of Oral and Maxillofacial Pathology, Radiology, and Medicine.

1 Groome, Patti A., et al. “A population-based study of factors associated with early versus late stage oral cavity cancer diagnoses.” Oral oncology 47.7 (2011): 642-647.2  Epstein, Joel B., et al. “A survey of National Cancer Institute-designated comprehensive cancer centers’ oral health supportive care practices and resources in the USA.” Supportive care in cancer 15.4 (2007): 357-362.

3 Peres, Marco A., et al. “Oral diseases: a global public health challenge.” The Lancet 394.10194 (2019): 249-260.

4 Watt, Richard G., et al. “Ending the neglect of global oral health: time for radical action.” The Lancet 394.10194 (2019): 261-272.

5https://dental.nyu.edu/faculty/epidemiology-health-promotion/who-cc.html#

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Wendell Curtis

dentistintulum.com

Dr. Patel managed to see places on her bucket list, including the Maldives this summer.

I remember watching Steve Jobs’ 2005 Stanford Commencement address as a dental school applicant who was hopeful (and a bit scared) about her future. In it, he spoke of three lessons he wanted to impart on the graduating class that year. The first, the one that resonated the most with me then, and continues to echo down the hallways of my life now, was about connecting the dots.

In his speech, Steve said, “You can’t connect the dots looking forward; you can only connect them looking backward. So you have to trust that the dots will somehow connect in your future. You have to trust in something – your gut, destiny, life, karma, whatever. This approach has never let me down, and it has made all the difference in my life.”

The last 20 months have brought about a season of change that many thought would never happen in their generations. A global change in not only the way we live our lives, but also how we look at each other, and the world. And yet, through the sometimes dark, but very often gray areas we’ve each lived through, light and love still break through.

I have made new friends around the country, reconnected with people I haven’t spoken to in years, and found a path for myself in “dental-land”(what I affectionately call organized dentistry). I’ve even managed to see places on my bucket list – the Maldives this summer was truly transcendental.  In the stillness of that beautiful place, I had my first opportunity to practice mindfulness. Wherever you are – be there. Be present. It is a gift, one that many don’t have the chance to experience.

As I reflect today — with the Thanksgiving holiday only a few days away — it seems that the dots which once floated aimlessly around the picturesque background in the story of my life are starting to connect. In our separation, we actually got to be closer to each other than ever before. Love shows up. I’ve always said this: to myself, to dental students and residents and new dentists I have the honor of working with, to friends, and family alike. Be present. Time (and your good health) are precious beyond measure. I look forward to continuing to grow, to learn, and to adventure – but most importantly, to do it together with so many of my loved ones.

Be well, and be present.

Dr. Amrita R. Patel grew up in Chappaqua, New York, and graduated from the New York University College of Dentistry in 2011 before completing a general practice residency at the Nassau University Medical Center. Dr. Patel is a general dentist in private practice with her father, Dr. Rohit Z. Patel, in Westchester County, New York. She chaired the New York State Dental Association New Dentist Committee, is the International College of Dentists – USA Section Fellow Ambassador of Social Media, and currently serves the new dentists on the American Dental Association Council on Dental Benefit Plans for the 2020-21 term. She is also among the recipients of the 2021 ADA 10 Under 10 Awards.

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Wendell Curtis

dentistintulum.com

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In today’s episode, Dr. B answers a listener’s question about whether the Epstein-Barr virus is responsible for her bleeding gums. EBV is a systemic infection with an oral manifestation meaning it acts as a great springboard to talk about the oral-systemic connection as well. EBV is more colloquially known as the ‘kissing disease’ and commonly flares up in patients who have contracted it when they are run down, causing symptoms such as bleeding gums. Dr. B takes us through the signs, symptoms, and manifestations of EBV and also gets into some of the other conditions it has been linked to. After covering the basic facts about the virus, we take a deep dive into the oral-systemic connection which EBV illustrates so well. Dr. B traces a chain of connections between outbreaks of EBV, inflammation, spikes in glucose, diet, and the immune system. We also hear tips and tricks for managing EBV involving periodontal treatments, eating to combat inflammation, and keeping a close eye on glucose levels. 

Key Points From This Episode:

Introducing today’s question revolving around bleeding gums and the Epstein-Barr virusThe typical situations that lead to EBV and related conditions it causesHow recent studies have implicated EBV in the pathogenesis of advanced periodontal diseaseDiscussing how EBV illustrates the oral-systemic connection Other places EBV can be found such as in the tips of the rootsSeeing a periodontist and getting regular cleanings to suppress the viral loadThe connection between inflammation and episodes of EBVTips for keeping EBV under control around bolstering the oral microbiomeWearing a glucose monitor in between sessions with the periodontistMaintaining a diet that does not flare up glucose levels and weaken the immune system

How to Submit Your Question:

Record your question for Dr. B at speakpipe.com/askthedentist 

Links Mentioned in Today’s Episode:

Ask the Dentist

About Dr. Mark Burhenne

Follow Dr. B on Instagram @askthedentist

Follow Dr. B on Twitter @askthedentist

Ask Dr. B a Question

Functional Dentist Directory

The post How Does The Epstein-Barr Virus Affect Your Gums? appeared first on Ask the Dentist.

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Wendell Curtis

dentistintulum.com