![Wealth-Building Investment Strategies (w/Justin Smith, CFA,CFP) [Ep.61]](https://is1-ssl.mzstatic.com/image/thumb/Podcasts221/v4/dc/c6/99/dcc699c5-e602-c089-7b62-f388bd7c37bf/mza_7215416877383055546.jpg/250x250bb.jpg)
Afleveringen
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Dr. Jeff Rouse is an educator and clinician who has practiced with the likes of Drs. Frank Spear and Gregg Kinzer. He is now a Resident Faculty Member at Spear Education and maintains a private practice in prosthodontics in San Antonio, TX. He has a unique professional journey and understands more about airway and orthodontics than many orthodontists. We discuss that and much more, including:
How Jeff’s background in restorative dentistry helped him gain a better understanding of how orthodontic treatment, especially treatment involving extraction of permanent teeth, led to the breakdown of the dentition and airway issues later in life.Why Jeff started doing orthodontics when he was practicing as a general dentist and how that led to an “ortho first” approach to patient care.How Jeff developed and the curriculum for airway dentistry at Spear Education.Why GPs and prosthodontists are more open to the impact of airway on malocclusion than most orthodontists.Why orthodontists are resistant to incorporating airway-focused treatment into their practice (and it has nothing to do with evidence/literature!).Jeff’s message to orthos who are opposed to intervening earlier than 7yo to address anatomy that can lead to airway compromise.The primary causes of airway obstruction in young children (HINT: It’s not genetics!)Why orthodontic residents are not treating young children during their training.What recent studies in the otolaryngological literature say is a “normal” palatal width.The flaws with the studies that say Phase I is ineffective and often unnecessary.What is within the dentist’s/orthodontist’s scope of practice when it comes to airway.The role that anatomy plays in obstruction of nasal breathing.Why watchful waiting is supervised neglect.What orthodontists would learn if they had to look at all their cases 20 years out of treatment.Whether or not extractions cause airway issues.How heart rate variability can be used to determine sleep-related breathing issues.A new referral pattern for the future to help remove some of these obstacles.Jeff’s advice to young orthodontists.LINKS:
-AAO Website on age to begin orthodontic treatment: https://aaoinfo.org/orthodontics-for-children/
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I had the pleasure of sitting down with Dr. Helen Jones, a dentist from the UK who spent the early part of her career managing extraction cases until she became discouraged by the treatment results. It started her on a journey to find a better way to manage deficient jaw size and airway problems in younger children. It is now her mission to raise awareness regarding the benefits of beginning orthodontic treatment at a younger age than we are conventionally taught.
Helen and I discuss:
· What a paradigm is and why/how the paradigm in orthodontics is shifting from taking a reactive approach to treatment to taking a more proactive approach.
· How Helen became so dismayed by the traditional reactive approach to orthodontic treatment and how this led her to become so passionate about exploring a more proactive approach.
· How her time practicing in South Africa helped shape her approach to both dentistry and authority.
· The way the National Health Service in the UK controls what dental and orthodontic procedures that can be performed.
· The time she spent with John Mew and her thoughts on his approach to treatment, as well as why John was vilified and deemed “unfit to practice” by the General Dental Council.
· How she broke free from the dogmas imposed by the NHS and started treating preadolescent patients.
· The impact that a lecture by Dr. Brendan Stack had on her life and career.
· The role that working with osteopaths played in Helen’s understanding of the fascia and how it connects the mouth to the rest of the body.
· The importance of looking at the entire child, not just the mouth and teeth.
· The need to move away from looking at the teeth and mouth as a separate entity.
· Whether or not you can get some degree of sutural change throughout life.
· If orthodontists are resistant to a more proactive approach to treatment out of fear.
· The mission of the new interdisciplinary group of medical and dental professionals called The Society for Dentofacial Growth & Function that Helen is putting together.
· How the General Dental Council is targeting people in the UK who promote early orthodontic treatment.
· The politics and siloing of care in the British health system.
· Helen’s advice to parents and clinicians when it comes to early orthodontic treatment.
LINKS:
-Dr. DeLuke’s article in OrthoTown (Part I): https://www.nxtbook.com/farran/orthotown/orthotown-june-2023/index.php?startid=54#/p/54
- Dr. DeLuke’s article in OrthoTown (Part II): https://www.nxtbook.com/farran/orthotown/orthotown-november-2023/index.php?startid=52#/p/52
-Society for Dentofacial Growth and Function - www.ConnectingHeads.com; https://www.dropbox.com/scl/fi/vjnwtuwjh30uhiuyxzc0y/SDGF-Zoom-Meeting-June-13th-2024.mp4?rlkey=bcuyhlmghr53ahoz8jcil0bb0&st=ra5hpp1s&dl=0
-Jane Tarrant’s book Rose Loses Her Nose: https://linkbreathing.samcart.com/products/rose-loses-her-nose-book
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Don’t miss this AMAZING conversation with Dr. Marianna Evans! As a dual-trained orthodontist/periodontist and expert in anthropology, she offers a unique perspective on the etiology of malocclusion, the periodontal consequences of the traditional approach to orthodontic treatment, and the numerous benefits of initiating orthodontic treatment in younger children. She is also very knowledgeable about how airway patency impacts craniofacial growth and development and is passionate about the role the orthodontist can and should play in airway management.
Dr. Evans and I discuss:
Why and how she decided to open her own practice from scratch in 2011, and how it’s going now.Her educational background including why she decided to obtain degrees in both orthodontics and periodontics, and how it has helped her be a better orthodontist.How she developed an interest in, and eventually a passion for, anthropology by studying the Morton Skull Collection while at UPenn.The problem with using transverse norms based on post-industrial skulls.Why humans today can no longer accommodate 32 teeth, and why that is a bigger problem than we may realize.How diet and obstructed nasal breathing are turning malocclusion into a pandemic.The role of the orthodontist’s ego in the prevention of the advancement of our profession.Marianna’s advice to residents and young docs regarding questioning what they learn in their orthodontic residency.What the research says about providing orthodontic treatment to patients in the primary dentition.How the refusal of orthodontists to treat patients at a younger age will lead to the death of our specialty.The thinning of the alveolar bone that inevitably occurs during all orthodontic tooth movement.Why we should be more focused on developing the jaws in the primary dentition to allow the teeth to erupt into the center of the ridge.The need for orthodontists to look at their cases 20 years after treatment, and how that could change their perspective.The numerous flaws with the literature stating that early treatment is not effective.How to communicate to parents that their young child is in need of orthodontic treatment.Why we should be referring to the orthodontic treatment of younger patients as “preventative,” not “early.”The story of how she got connected with James Nestor and what it was like to be featured in his bestselling book, Breath.And much, much more!!LINKS:
-VISIT OUR SHOW SPONSOR - Reliance Orthodontic Products (www.RelianceOrthodontics.com)-Email Dr. Evans: [email protected]
-Email Dr. Mike: [email protected]
-Breath by James Nestor: https://a.co/d/1JGxJa8
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We all want to retire at some point, right? But how do we save enough money to retire or work because we want to, not because we have to? Mr. John Vento, my CPA, is also a Certified Financial Planner who offers his advice on how to take advantage of tax-favorable strategies to maximize your retirement savings so you can retire sooner than you may have thought!
This is the second part of a 2-part series. Part A was released last week: https://podcasts.apple.com/us/podcast/retirement-savings-strategies-part-a-john-vento-cpa/id1689703392?i=1000666226231
In this episode, John will discuss:
o Reasons why you should want to set up a retirement plan for your practice and how it can help with employee recruitment and retention.
o The SECURE Act 2.0, including when it was passed into law, when it becomes effective, and how it will impact retirement plan contributions for you and your employees.
o The recent expansion of the ability to make Roth contributions.
o Significant tax credits that are now available for making contributions to your retirement plan and the retirement plan of your employees, including:
§ The Startup Tax Credit which allows you to legally double dip by not only deducting the expenses of training your team about their retirement savings options, but also receiving a tax credit for those same expenses!
§ Employer Contribution Tax Credit which allows you to receive a tax credit to subsidize you for putting money into your employee’s retirement plan! Basically, the government is paying you to contribute to your employee's retirement!
§ The Auto-Enrollment Tax Credit which forces your employees to opt out of contributions to their retirement instead of opting in, which is how it has traditionally been set up.
LINKS:
• Point X Calculator (https://www.ventotaxandwealth.com/resource-center/retirement/saving-for-retirement)
• To purchase John’s Book: https://www.ventotaxandwealth.com/buy-the-book
• You can find more information on John and his firm, Vento Tax and Wealth Management, at www.VentoTaxAndWealth.com -
We all want to retire at some point, right? But how do we save enough money to retire or work because we want to, not because we have to? Mr. John Vento, my CPA, is also a Certified Financial Planner who offers his advice on how to take advantage of tax-favorable strategies to maximize your retirement savings so you can retire sooner than you may have thought!
In this episode, John will discuss:
• How to calculate your specific “Point X” (the point at which you reach financial freedom) and can retire using actual data from your individual situation!
• How to use a Traditional IRA to decrease your taxable income and accelerate your wealth accumulation.
• The pros and cons of a Traditional IRA vs. a Roth IRA and how to determine which is better for your circumstances.
• The tremendous advantages of owning your own practice when it comes to your ability to aggressively save for retirement and reach Point X at an earlier age.
• How to use defined benefit and/or cash balance plans to lower your tax burden AND maximize retirement savings for practice owners and independent contractors.
• How to implement different retirement plan strategies based on your particular practice situation ranging from a one-man show to a group practice.
• The tremendous advantages of employing your spouse and children and how to maximize your retirement savings when you do.
• Retirement savings strategies for older docs to accelerate their ability to get to Point X by using a 401k with profit sharing and a defined benefit cash balance plan.
• How avoiding the Medicare tax alone will more than cover the administrative costs of implementing a qualified retirement plan.LINKS:
• Link to Important Tax Information for Dentists: https://www.youtube.com/watch?v=1-EXO-IlQgs&ab_channel=DeLukeOrthodonticCoaching
• Point X Calculator (https://www.ventotaxandwealth.com/resource-center/retirement/saving-for-retirement)
• To purchase John’s Book: https://www.ventotaxandwealth.com/buy-the-book
• You can find more information on John and his firm, Vento Tax and Wealth Management, at www.VentoTaxAndWealth. -
I had an awesome conversation with Dr. Kristen Knecht, who owns and runs her own orthodontic practice in Houston, TX. Kristen opens up about her personal and professional journey, including:
How Kristen went from UConn Ortho to working for a DSO in Texas, to opening her own practice, Knecht Orthodontics in the midst of COVID.The pros and cons of working for a DSO.The lessons she learned from working for her dad’s industrial construction company.How Kristen implemented fiscal responsibility and delayed gratification to put her in a position to start her own practice.When she knew that she wanted to start her own practice and how it’s going 4 years in.The importance and value of studying your finishes and learning from what went well and what you can improve upon.How Kristen financed the finish-out of her new practice and how she used the income from her savings and associateship to help cover the expenses.The challenge of finding someone to help with the business decisions associated with starting and running a practice.Which FB groups have been a huge help to Kristen in her professional journey.How Kristen and I both evolved from a reactive, extraction-based approach to a proactive, expansion-based approach to treatment.How early arch development will dramatically decrease the incidence of canine impaction.Why our educational institutions aren’t teaching more proactive/early treatment, even though the literature is full of evidence that can be extremely beneficial.The influence that Dr. David Alfi (an oral surgeon in Houston, TX) has had on Kristen’s airway journey.The analogy between Peter Attia’s Medicine 2.0 vs. 3.0 and orthodontics.What Kristen’s colleagues say about her journey to understand the role of airway in malocclusion and provide earlier orthodontic treatment to develop the arches.Why female orthos seem more receptive to the idea of early treatment, especially as it pertains to airway, than their male counterparts.The numerous benefits of low-dose CBCT imaging and how Kristen has incorporated 3D imaging it into her practice.How Kristen utilizes myofunctional therapy to help her patients.LINKS:
-Dr. Knecht Email: [email protected]
-Dr. Mike Email: [email protected]
-Shereen Lim’s book (“Breathe, Sleep, Thrive”): https://www.amazon.com/Breathe-Sleep-Thrive-Discover-potential/dp/0645553212
-Audrey Yoon Episode: https://podcasts.apple.com/us/podcast/the-doc-podcast/id1689703392?i=1000664711076
-Audrey Yoon Article: Impact of rapid palatal expansion on the side of the adenoids and tonsils in children; Sleep Med. 2022 April ; 92: 96–102. doi:10.1016/j.sleep.2022.02.011. [https://pubmed.ncbi.nlm.nih.gov/35390750/]
-Kevin Boyd Episode: https://podcasts.apple.com/us/podcast/the-doc-podcast/id1689703392?i=1000663309000
-David Alfie Instagram: https://www.instagram.com/dr.davidalfi?igsh=MTkxd2QweGh4Z296OQ==
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Don’t miss this fascinating conversation with the amazing and world-renowned Dr. Audrey Yoon!
We discuss:
How Audrey’s journey in sleep medicine began and the role her training at UCLA played in that journey.The role that Dr. Stanley Liu played in Audrey’s passion for airway-focused orthodontic treatment.How an interaction with Dr. Christian Guilleminault (“CG”) changed Audrey’s life and launched her into a career focused on airway adult and pediatric airway. How Audrey and Mike were both inspired by medical colleagues to go out and teach about airway orthodontics.The challenges associated with using polysomnography and AHI classification for diagnosis of pediatric sleep apnea, and why CG expressed regret for creating an AHI scale for pediatric patients.The potential for a blood test that determines if a child has sleep apnea.Why it is logistically challenging and medically unethical to conduct a double-blinded RCT on the effects of with treatment and control groups.The plethora of literature that exists demonstrating the positive impact of expansion on airway patency.The difference between anatomical and neuromotor factors in the etiology of OSA/SDB.The role the dentist/orthodontist can play in the correction of anatomical factors that contribute to OSA/SDB.The recent position statement of the AADSM regarding the impact of different treatment modalities on OSA.The reason why many orthodontists remain reluctant to incorporate airway-centered treatment into their practices.Audrey’s message to the people who say that it is inappropriate or even malpractice to treat children under the age of 6yo.The fact that the American Academy of Pediatric Dentistry lists growth disturbances and airway problems as some of the considerations for treatment at any age that the issue is detected.Why Audrey sees a number of referrals from her medical colleagues seeking assistance with sleep-related breathing issues.What Audrey is working on now to advance the role of orthodontists in sleep medicine, including forming the World Dentofacial Sleep Society.And much, much more!!
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I had an amazing conversation with Dr. Scott Province, a general dentist practicing in midtown Manhattan since 1998. Until three years ago, Scott didn’t see any children in his practice, let alone perform interceptive orthodontic treatment on them. That all changed when an orthodontic colleague explained that Scott’s 9yo son with narrow arches and 10mm OJ wasn’t ready for orthodontic treatment. He tells the story of his journey since that time, and describes his quest to address malocclusion at an earlier age. We discuss:
Why Scott transitioned from an adults-only practice to one that provides early orthodontic treatment to kids.How to begin treating younger patients when you don’t have experience doing so, whether you’re an orthodontist, general dentist, or pediatric dentist.The occlusal breakdown and TMD issues that Scott so often sees in his adult patients, even if they had orthodontic treatment as a child.What most patients who had 4-bicuspids extracted as children look like decades later.How Scott has taken his practice from a “dental crisis office” to a “dental healthcare office.”How Scott’s personal story with his son motivated him to look differently at the way orthodontists traditionally approach treatment.The fact that patients can have disrupted and non-restorative sleep even if they don’t have OSA.That undiagnosed and untreated craniofacial growth and development is the root cause of so many dental problems later in life.How Scott educates his patients on the role that airway and sleep play in their malocclusion and occlusal breakdown.Scott’s process for diagnosing and treating planning pediatric patients who need early growth and development.The best type of splint to make for bruxers to prevent the mandible from falling back and occluding the airway.The courses Scott took to learn how to provide this amazing service to his patients.Scott’s experiences using braces and wires instead of using fixed expanders to develop the arches of young patients.Scott’s message to orthodontists who feel that primary care dentists shouldn’t be performing interceptive orthodontic treatment.Scott also reviews some of the cases he’s been treating and how he has changed patient lives now that he has a greater understanding of what’s possible with early orthodontic treatment!
LINKS:
-DOC Community on YouTube (to view Scott's cases): https://www.youtube.com/@delukeorthodonticcoaching
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Don’t miss this episode with the amazing Dr. Kevin Boyd! Kevin is a world-renowned expert in the area of early orthodontic treatment and we had a fascinating discussion on if, when, and why to provide orthodontic treatment to younger children. Some of the topics we discuss include:
Dr. Boyd’s professional journey that led him to focus on early orthodontic treatment.How Drs. Bishara, Andreasen, and Phol inspired Dr. Boyd during his residency training at Iowa.Dr. Boyd’s background in anthropology and how that has shaped his thinking about the etiology of malocclusion and how to treat it.Why Dr. Boyd’s training in behavioral sciences has enabled him to manage and treat younger orthodontic patients.How Dr. Mike’s training at Stony Brook with Dr. Fred Ferguson taught him how to manage and treat younger patients in his practice.What leading anthropologists say about the role of diet in the etiology of malocclusion.How the fact that children are hard-wired to imitate and please their elders relates to treating younger patients.Whether the etiology of malocclusion is genetic, environmental, or a combination of both.The functional matrix of the jaws and the naso-respiratory systemHow myofunctional therapy can improve the growth of the jaws.Whether or not you need a posterior crossbite to expand the arches.If there is a “correct” age to initiate orthodontic treatment.Why the Salzman Index is antiquated and how it is prohibiting orthodontic residents from treating younger patients.Why malocclusion is a disease of cultural industrialization.Is there an age that is “too early” to treat patients with interceptive orthodontic treatment?How to build a collaborative network with our medical colleagues, including primary care physicians.LINKS:
-Sean Carlson video on expansion in the absence of crossbite: https://youtu.be/Y1aD_iYcLKU?si=VKbjaI5hBtxjQg0Q
-Harvard study by Silver: Silver EI. American Journal of Orthodontics and Oral Surgery. 1994;30(12):635:659.
-Link to AADSM Article: https://aadsm.org/journal/special_article_1_issue_112.php
-Dunedin Study: Richmond-Rakerd LS et al. PNAS. 2021;118(3):1-12
-Ultra-Processed People by VanTullican: https://www.amazon.com/Ultra-Processed-People-Science-Behind-Food/dp/1324036729/ref=asc_df_1324036729/?gad_source=1&hvadid=693449522341&hvdev=c&hvdvcmdl&hvlocint&hvlocphy=9012267&hvnetw=g&hvpone&hvpos&hvptwo&hvqmt&hvrand=12253883059461682792&hvtargid=pla-1960574051028&linkCode=df0&mcid=f479b78a5ba03190bbb7f73789672dc7&psc=1&tag=hyprod-20-Email Dr. Mike ([email protected]) to get a copy of Dr. Boyd’s letter to the Primary Care Physician
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Don’t miss Part 2 of my conversation on personal finance and wealth-building with my financial advisor, Justin Smith, CFA, CFP! In this episode we discuss:
• Emergency Funds - who needs one, what type of expenses to include, how many months of expenses it should cover, and where you should keep the dollars.
• The philosophical approach to investing that Justin recommends to his clients.
• How to approach diversification both within and among asset classes.
• The numerous benefits of having a wider margin between income and expenses.
• How to balance saving and investing with spending and enjoying excess dollars.
• Cryptocurrency and whether or not Justin sees it as a viable asset class in an investment portfolio.
• Student debt including how to incorporate it into an investment approach and if/when it makes sense to pay it down more aggressively.
• Saving for children’s college education including when to start, how much to set aside, and if 529 plans are the best way to do it.
• What to do if you end up with excess funds in a 529 plan and the new 15-year rule for transferring money from a 529 plan to a Roth IRA.
• Justin’s closing pearls summarizing how to achieve financial freedom.LINKS
• The Real Reason Big Savers Retire Early: Minimizing Retirement Savings Needs: https://www.kitces.com/blog/retirement-savings-needs-big-savers-avoid-lifestyle-creep-to-retire-early/
• To learn more about Smith Partners Wealth Management: https://smithpartnerswealth.com/
• The Ortho Coach website: www.TheOrthoCoach.com -
Do you have a plan to achieve financial freedom? If so, is it realistic and are you on track? If not, how are you going to get there?
How to determine if/when you need a financial advisor.What a fiduciary is and why you need to make sure your financial advisor is one.The most important questions to ask a prospective financial advisor to determine if they are the right fit.If you should look for an advisor who is “fee only.”The red flags to look out for when seeking a financial advisor.If it’s possible to make a change if you feel you are not with the right financial advisor.How a good financial advisor can help you manage the emotional and behavioral side of investing.The importance of sharing a financial vision with your spouse.What “first scoop of ice cream dollars” are and why they are so important for couples to define.Whether couples should split or share bank and retirement accounts.When going to Starbucks every day or going out to nice dinners with the family can be part of a responsible financial plan. How to define savings, if there are set rules for spending vs. saving, and how to coordinate them with your personal and retirement goals.The 50:30:20 rule for spending post-tax dollars and how to coordinate that with your family’s values.Strategies on how to build a financial IQ.What Justin feels is the best book to change the way you think about money.The value of a balance sheet and how often you should update it.The traits that Justin sees most often in people who achieve financial freedom and overall contentment.
In this amazing discussion with my financial advisor, Justin Smith, CFA, CFP, we'll discuss that and much more, including:LINKS:
-NAPFA Consumer Resources: https://www.napfa.org/financial-planning/consumer-resources
-NAPFA Advisor Checklist: http://s3.napfa.cql-aws.com.s3.amazonaws.com/files/Consumer/AdvisorComparisonToolFinal-fillable.pdf
-9 Questions to Ask a Financial Advisor: https://smithpartnerswealth.com/19-questions-to-ask-your-financial-adviser/
-To learn more about Smith Partners Wealth Management: https://smithpartnerswealth.com/
-The Ortho Coach website: www.TheOrthoCoach.com -
John is a CPA, CFP, author, educator, and TV personality who has appeared on such shows as NY1 News “Money Matters,” Fox Business News, CBSN, and Reuters TV. He wrote an amazing book on achieving financial independence titled “Getting to Point X” and has published articles in Money Magazine, the Wall Street Journal, the NY Times, Forbes, US News & World Report, and Financial Advisor Magazine. John has tremendous knowledge in the tax and financial planning arena, especially as it pertains to dentists. If you’re a dentist and you want to know more about how to lower your taxes, DO NOT MISS THIS EPISODE!!
This episode is FULL of AMAZING TAX INFORMATION FOR DENTISTS, including:
How to get to what John calls “Point X,” or financial independence.The biggest expense that dental practitioners face.Legal strategies and loopholes to decrease your tax liability and increase your wealth.The difference between a tax deduction and a tax credit. The most commonly missed tax deductions and credits.How to make entertainment expenses fully deductible.What the “Ordinary and Necessary Test” is and how it’s used by the IRS.How to choose the right accountant for you and your practice.Whether your receipts should be digital or paper, how they should be organized, and for how long you should retain them.How you can save literally hundreds of thousands of dollars with the SALT deduction/credit loophole.How the ERC credit works, if you can really save up to $26k per employee, and how working with certain solicitors can lead to criminal charges and the loss of your dental license!Whether or not the Inflation Reduction Act will increase your chances of being audited.Which entity is least likely to get audited and which entity is MOST likely to get audited and if the Inflation Reduction Act will change that.The different types of IRS audits and the steps to take if you are audited.If you should pay more taxes than you need to in order to decrease the risk of an audit.Important Links:
-To purchase John’s Book: https://www.ventotaxandwealth.com/buy-the-book-You can find more information on John and his firm, Vento Tax and Wealth Management, at www.VentoTaxAndWealth.com.
-Link to John’s Newsletter: https://www.ventotaxandwealth.com/blog
-Link to John’s article on IRS Audits: https://www.ventotaxandwealth.com/tips-for-dentists
-Link to a number of tax calculators: https://www.ventotaxandwealth.com/resource-center/calculators
-Link to the IRS website on the Employee Retention Credit: https://www.irs.gov/coronavirus/employee-retention-credit
-Link to the DOC website: www.TheOrthoCoach.com -
I had an amazing conversation with my extremely impressive colleague, Dr. Steffen Decker. Steffen is a prominent orthodontist in the UK who started his career treating adults with Invisalign and lingual braces and has since developed a passion for helping younger patients with interceptive orthodontic treatment. We discuss:
How Dr. Soroush Zahgi inspired Steffen to focus more on interceptive treatment and airway.How restorative dentists such as Dr. John Kois and Steffen’s wife helped Steffen understand the detrimental long-term impacts of an extraction/retraction approach to orthodontic treatment.The role of an oral habit in the aberrant craniofacial growth and development of one of Steffen’s twin sons.The importance of a thorough diagnostic process, including listening to your patients, in order to determine the etiology of the presenting malocclusion.Why so many orthodontists remain opposed to treating patients earlier/younger.A recent debate I had with a colleague on social media about determining and treating the etiology of malocclusion.The difference between left-brained and right-brained individuals, and how that can determine who is more open to changing their approach to patient care.The logistical challenges associated with having randomized controlled studies on the benefits of early treatment, especially as it pertains to airway.Why CPAP was originally approved based upon a study with only 5 patients, yet studies showing the benefits of expansion on airway of hundreds of patients are deemed insufficient evidence of its efficacy.The influence of environmental factors on the development of malocclusion and the fallacy that the etiology of malocclusion is completely genetic.Why Steffen has parents film their child sleeping with a baby monitor and send it to him.That once you see and feel what you can do to change the lives of younger children, you will never be the same regarding your approach to early treatment.The need for all those who have had the privilege of changing a patient’s life through early treatment to share that message with others.LINKS:
-To contact Dr. Decker: [email protected]
-Tuncay & Schiffman article: https://www.researchgate.net/publication/11794785_Maxillary_expansion_A_meta_analysis
-Papadopolous Review of Tuncay & Shiffman article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111736/
-Link to episode w/parents of a 6yo patient Dr. Mike treated: https://youtu.be/wJFP_9NFnv0?si=0QhYGPAQ3HV0G2dn
-To contact Dr. Mike: [email protected]
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I am SO EXCITED to bring you today’s guest, Dr. Tom Pitts. Dr. Pitts is a true legend in the field of orthodontics who has been practicing and educating for over 50 years. We have an amazing discussion about a variety of topics, including:
How Art Dugoni influenced Dr. Pitts’ career from the very beginning.What Dr. Pitts learned from industry legends such as Ricketts, Harvold, Roth, Damon, and others.How Ricketts approach to slow maxillary expansion changed Dr. Pitts’ perspective on early treatment and arch development.Possible reasons why residents aren’t learning about the benefits of early treatment.Why general and pediatric dentists are more open to the benefits of early treatment.How to successfully achieve and maintain Class II correction in the mixed dentition.How to best retain Phase I arch development.The amazing benefits of disocclusion in both interceptive and comprehensive treatment.How the use of light, short Class II elastics is a complete game changer to achieve early and predictable sagittal correction.The 5 key components to Dr. Pitts’ vision for orthodontic treatment.How Dr. Pitts is treating full comprehensive cases in 9-13 months.The impact of extractions on lip fullness over time.The benefits of using square (versus rectangular) wires.Which arch forms to use to develop/expand the arches.The reason why Dr. Pitts developed an .021 x .026 bracket (versus the standard .022 x .028).The dates and locations of upcoming Pitts 21 Seminars.What Dr. Pitts sees as his legacy in the profession of orthodontics.*We also review various cases treated with the Pitts philosophy, so be sure to check out the YouTube link to this episode!
LINKS:
VISIT OUR EPISODE SPONSOR – Retainers for Life! Visit www.AfterOrthoRevenue.com and use code ‘DOC2024’ to get $2500 off your enrollment fee!Link to Video on DOC YouTube Channel (to view Dr. Pitts cases): https://youtu.be/NyLDNqGIsp0?si=Briqt0ud379_NcGlLink to enroll in the Pitts Seminars: [email protected] to the DOC courses on Phase I: https://theorthocoach.com/ce-courses/Links to the YouTube videos on Ph I:-Part I: https://youtu.be/AsqQDiwVn0Y?si=-glbQCLg0gnj-a73-Part II: https://youtu.be/kXZxuMiO3iE?si=YBbG1N56F6VrBbPSLinks to OrthoTown articles:-Part I: https://www.nxtbook.com/farran/orthotown/orthotown-june-2023/index.php?startid=54#/p/54-Part II: https://www.nxtbook.com/farran/orthotown/orthotown-november-2023/index.php?startid=52#/p/52 -
Get ready for an amazing conversation with Dr. Ben Miraglia where he explains his journey into the world of early orthodontic treatment, especially as it pertains to airway and breathing. We discuss:
· How Ben got involved in airway orthodontics and the primary reasons why GPs and pediatric dentists do ortho.
· How the studies demonstrating that early/interceptive ortho treatment makes no difference got it wrong.
· The validity of mandibular arch expansion in the orthodontic literature and in clinical practice.
· How anthropological research, diet, and muscle function can tell us a lot about the etiology of malocclusion.
· The way correctly executed early treatment makes a second phase easy and, in many cases, unnecessary.
· The level of resistance that is normal in nasal breathing.
· Why focusing on OSA is a fool’s errand and missing the underlying pathology.
· What the analysis of 7000 patients has taught Ben about breathing problems in patients ages 3-12 years old.
· What we can learn from Dr. E.A. Bogue’s research from the early 1900’s.
· How our early soft diets play a role in the development of the jaws, malocclusion, and sleep-disordered breathing.
· Why it’s necessary to expand upper AND lower arches in patients with a transverse deficiency, especially in the absence of posterior crossbite.
· When, where, and why malocclusion began to emerge over time.
· The role of myofunctional therapy in helping mandibular growth.
· The 2017 ADA Position Statement calling on all dentists to screen for Sleep Related Breathing Disorders.
· The role that mouth breathing plays in tooth decay in pediatric patients.
· How early expansion can lead to successful eruption of third molars in the future.
· Why the orthodontic profession still focuses more on being “tooth straighteners” than on helping younger patients grow and develop properly.
· The reason GPs and pediatric dentists are more open to early treatment than orthodontists.
· Why many patients who had upper only expansion in Phase I need extractions in Phase II.
LINKS:
-VISIT OUR EPISODE SPONSOR – Retainers for Life! Visit www.AfterOrthoRevenue.com and use code ‘DOC2024’ to get $2500 off your enrollment fee!
-Pediatric Sleep Questionnaire: https://images.app.goo.gl/ipKUowiPmbeV2my4A
-Contact Dr. Miraglia: www.AirwayHealthSolutions.com
-Subscribe to the DOC YouTube Channel: www.youtube.com/@delukeorthodonticcoaching
-Contact Dr. Mike: [email protected]
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Dr. Daniel Klauer is a general practitioner who built a practice centered around TMD and airway. He has an amazing journey and is a wealth of knowledge! Be sure to check out this episode where we discuss:
How Daniel got involved in TMD & sleep and why he is so passionate about these areas of dentistry.The value and importance of having a mentor and/or life coach.The importance of taking the time to listen to the concerns of your patients.Where the medical community is getting it wrong when it comes to patient care.The things Daniel learned in dental school that he had to “unlearn” when he got into practice.The typical process that one of Daniel’s patients goes through in his practice.The essential role that myofunctional therapy plays in the care of his patients.The role of postural decompensation of the head and neck due to nasal passageway obstruction.How in-house sleep studies can be both practical and beneficial in the diagnostic process.Why so many orthodontists don’t recognize the relationship between airway compromise and altered craniofacial growth and development.Why academia and research seem to overlook the importance and relevance of clinical experience.How the fear of a lawsuit prevents many providers from pushing the envelope with patient care.How the typical ortho office is not set up to handle/manage the treatment of young (>7yo) patients.LINKS:
-VISIT OUR EPISODE SPONSOR – Retainers for Life! Visit www.AfterOrthoRevenue.com and use code ‘DOC2024’ to get $2500 off your enrollment fee!
-Achieve Your Victory: https://www.amazon.com/Achieve-Your-Victory-Solutions-Sleep/dp/1599329034
-Get a free copy of Daniel’s book by emailing your name and address to Dr. Mike ([email protected])
-Dr. Mike’s webinar on Cleft Lip & Palate with AAPMD: https://aapmd.org/aapmd-official-webinar-store#!form/Webinars
-ADA’s 2017 Position Statement “The Role of Dentistry in the Treatment of Sleep Related Breathing Disorders”: https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/the-role-of-dentistry-in-sleep-related-breathing-disorders.pdf
-Dr. Klauer’s email address: [email protected] -
Don’t miss this amazing discussion with Dr. Karen Parker Davidson on all things nasal breathing.
How Karen became so passionate about nasal function and rhinomanometry.The role of the dentist and orthodontist in evaluating nasal function and its implications on growth, development, and overall health and well-being.The many critical functions of the nose and why nasal breathing is such a big deal.Why we should think of our nose as a reactive organ.The history and evolution of rhinomanometry, including the relationship between Drs. Claus Vogt and Dr. Christian Guilleminault.The clinical applications of rhinomanometry.How Bernoulli’s Principle relates to nasal respiration and the critical role the nasal valve plays in this process.Why a certain amount of nasal resistance is necessary for proper breathingThe difference between static and dynamic measurements for analyzing nasal breathing.Why academia does not teach physicians, nurses, and dentists about nasal breathing and rhinomanometry.What functional rhinology is and how it can help us determine who suffers from nasal resistance.What rhinopathia nocturnia (‘sleep nose’) is and how it can lead to airway disease.The flaws with the current medical model and how that translates to a reactive approach to breathing issues.What the US health system can learn from the Taiwanese health system.The case for having a 4-phase rhinomanometer in every primary care physician and dentist’s office.The importance of looking at the Weber-Fichner Law to evaluate the psycho-physics of breathing.The impact of even a few mm of orthodontic change on airflow and nasal passageway resistance.How the physics of breathing tells us that OSA is not an issue of tube collapse.Whether tooth positioners like Myobrace can cause a decrease in nasal resistance.The role that the strength of the lateral nasal walls plays in airway resistance.Which OTC nasal spray works best for patients with inflamed nasal membranes.The role that AI can play in helping analyze the data obtained from rhinomanometry. The reasons why many clinicians are resistant to incorporating this technology into their practices.The four genes that play a critical role in the width and shape of the face.What we see as the future for the science of nasal breathing and how it will be used in everyday clinical practice.
We discuss:LINKS:
-VISIT OUR EPISODE SPONSOR – Retainers for Life! Visit www.AfterOrthoRevenue.com and use code ‘DOC2024’ to get $2500 off your enrollment fee!
-Karen’s new book - https://www.amazon.com/Breathe-Through-Your-Nose-Dont/dp/B0CLNDL7RT?source=ps-sl-shoppingads-lpcontext&ref_=fplfs&psc=1&smid=ATVPDKIKX0DER
-Dr. Mike’s email: [email protected]
-Karen’s email: [email protected]
-Reach Karen on Instagram: @_thenoseknows
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Don’t miss this SPECIAL BONUS EPISODE of The DOC Podcast! I got to sit on the other side of the microphone and be interviewed by my daughter, Kendall! As part of her AICE General Paper class, Kendall had to select someone to interview to learn more about their life story and journey, and I'm honored that she chose me! So we figured we’d record it and let everyone hear our conversation! [Apologies about the audio - there was an issue with the microphones]
Why I became an orthodontist.The reasons why I decided to open my own practice right out of my residency.The resources I used to learn how to run a business.How I became involved in airway orthodontics and using braces and wires to expand/develop the arches of younger children.The impact that changing lives with airway-focused orthodontic treatment had on me.The struggle I faced after firing my associate 3 weeks into his employment.How I transitioned from running a successful private practice to teaching and coaching full-time, and the role that the COVID-19 shutdown played in this.Why we picked up our family and moved from Upstate NY to Florida in 2021, the challenges we faced, and how we’re doing now.Whether I have any regrets about leaving private practice to teach full-time.The importance of having a vision of the type of person you want to be and the type of life you want to live.The role that faith has played in my personal and professional journey.
Here’s some of what you’ll learn:LINKS:
-DOC Podcast on Vision & Goals: https://youtu.be/u6W5ErGpQ34 -
Check out this amazing conversation between Dr. Mike and Dr. Stacy! In this episode, they discuss:
The importance of looking at the etiology of malocclusion and the role airway/breathing plays in the development of malocclusion.The status of the online challenge that Dr. Mike made to debate Kevin O’Brien.The ethical and logistical challenges associated with conducting randomized control trials on patients suffering with sleep-disordered breathing.What we can learn from Peter Attia, author of Outlive: The Science & Art of Longevity.The reasons why some orthodontists still resist the notion of incorporating an airway-aware mentality into their practice.The profound impact that detecting and addressing airway issues in pediatric patients has on your practice and your purpose as a provider.How millennials and Gen Z are on track to change the course of airway dentistry for the better.The important role that the ADA is playing in advancing airway dentistry.That many of the founding fathers of medicine/dentistry (Hippocrates, Angle, etc.) were prophetic in their hypotheses regarding the origins of disease/malocclusion.The importance of breaking down the silos between the medical and dental professions, as well as within the dental profession.Signs of significant progress in the movement to advance airway dentistry and orthodontics.And much, much more!LINKS/REFERENCES
-VISIT OUR EPISODE SPONSOR – Retainers for Life! Go to www.AfterOrthoRevenue.com and use code ‘DOC2024’ to get $2500 off your enrollment fee!
-ADA Brochure on Sleep: https://engage.ada.org/p/phys/childrens-airways-711 - use code SLEEP10 to get 10% off!
-Allison Cole – Sleep is My Waking Passion Podcast - https://podcasts.apple.com/us/podcast/sleep-is-my-waking-passion/id1684976379
-ASAP Pathway: https://asappathway.com/; https://www.facebook.com/ASAPpathway
-DeLuke Orthodontic Coaching: www.TheOrthoCoach.com; https://www.facebook.com/groups/1350463785569755
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Don’t miss this amazing discussion with speech-language pathologist and myofunctional therapist Nicole Goldfarb! We discuss:
The distinction between speech-language pathology and orofacial myology/myofunctional therapy (HINT: Not all speech pathologists are not myofunctional therapists!).The fact that speech pathologists get little-to-no training in myofunctional therapy and how/why she became interested in it.How Nicole began to notice the relationship between airway and speech.That 4 in 5 kids with speech articulation issues have concomitant myofunctional issues.What orofacial myofunctional disorder is, how it presents, and what can be done about it.The importance of correct oral rest posture in normal function and proper breathing.The challenges associated with incorporating myofunctional therapy into school-based speech therapy.The impact of soft tissue on malocclusion.The proper referral process to send your patient to a myofunctional therapist.The multifactorial nature of myofunctional disorders and the importance of determining their etiology.The three systems that must be evaluated as part of a myofunctional evaluation.The relationship between parafunctional oral habits and airway.A typical course of treatment for myofunctional therapy, including the role of mouth exercises.The CAST program being developed by the ADA and how that can help parents become more aware of their child’s airway issues.What could make orthodontists more open to the concept of myofunctional therapy.LINKS:
-D'Onofrio Article: Oral Dysfunction as the Cause of Malocclusion: https://onlinelibrary.wiley.com/doi/full/10.1111/ocr.12277#:~:text=Conclusion,bite%20and%20hard%20palate%20collapse.
-To learn more about myofunctional therapy:
-International Association of Orofacial Myology (IAOM): https://www.iaom.com/
-American Academy of Orofacial Myofunctional Therapy (AOMT): https://aomtinfo.org/
-Airway Circle: https://www.airwaycircle.com/
-Oro-Myofunctional Study Group (Facebook): https://www.facebook.com/groups/443131172546099
-www.TheOrthoCoach.com
-DOC FB Page: https://www.facebook.com/groups/1350463785569755/
- Laat meer zien
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