Group Function: Is Guided Biofilm Therapy the Future?

[00:00:00] . This is a production of The Very Dental Podcast Network.

[00:00:13] First you take a group of very dental people, then you add some interesting topics and a

[00:00:17] few microphones.

[00:00:18] Finally, add some laughs and collegial good cheer and you get the group function podcast.

[00:00:25] Very dental people, welcome to another episode of the group function podcast.

[00:00:29] Yes, that's right.

[00:00:30] I have multiple guests with me today.

[00:00:32] Joining me today, I have Melissa Obrotka.

[00:00:35] Melissa say hello.

[00:00:36] Hi everybody.

[00:00:37] So happy to be here.

[00:00:38] Melissa is a hygienist.

[00:00:39] She also works with EMS and she's going to tell us a lot about GBT.

[00:00:43] We're going to dig into it.

[00:00:46] Also with me Dr. Ryan Martz.

[00:00:47] Dr. Ryan Martz, how are you?

[00:00:49] I'm doing great.

[00:00:50] Thanks, Alan.

[00:00:51] Are you coming from Las Vegas?

[00:00:53] Yes, sir.

[00:00:54] Oh my gosh.

[00:00:55] Did I meet you like when you were still in dental school?

[00:00:58] Yes, we did.

[00:00:59] We did a mini podcast together on dental school and I got so ambitious and then realized dental

[00:01:04] school was ambitious enough as it is.

[00:01:07] On its own, yeah.

[00:01:08] I'm digging it.

[00:01:09] Okay.

[00:01:10] Knowing that's the case, I'm going to dig that episode up and embarrass all of

[00:01:12] us because we were young and dumb.

[00:01:15] That's how it works.

[00:01:16] Brian, thank you for coming.

[00:01:17] So I've had multiple little bites at EMS' GBT but I want someone who really knows

[00:01:27] it well to explain what the heck I'm talking about.

[00:01:29] I'm fascinated with it.

[00:01:30] I think it's probably the future of dental hygiene and I think it can solve a lot of

[00:01:36] problems that we're going to dig into a little bit later about patient engagement

[00:01:40] and prevention.

[00:01:41] So I'm not going to talk about it anymore.

[00:01:43] I want Melissa to tell us everything.

[00:01:45] Melissa, tell me a little bit about your career, how you got into GBT and what the

[00:01:49] heck it is.

[00:01:50] Absolutely.

[00:01:51] So I've been a dental hygienist for more than two decades which is insane to say

[00:01:55] out loud.

[00:01:56] But when I was about 13 years into my career, I went from general practice to periopros

[00:02:03] and I started treating these really advanced hybrid implant cases.

[00:02:06] I didn't even know these people existed let alone how to really take care of them.

[00:02:10] So I just identified right away that there was a gap in my education as a dental hygienist

[00:02:15] and there was a gap in the instruments that I had to really meet the needs of

[00:02:19] these patients.

[00:02:20] So I really kind of went on to a learning journey to figure out how I could best suit

[00:02:25] these patients that I was now seeing on a day-to-day basis.

[00:02:28] Like not one hybrid case a day.

[00:02:29] It was literally like I was seeing two or three of these patients a day.

[00:02:33] So I started learning about different things that we could do and different approaches

[00:02:38] and all the instrumentation doesn't really work around implants.

[00:02:42] So I found out about this glycine powder and I was like, okay, cool, let's check

[00:02:47] this out.

[00:02:48] How can I use glycine powder?

[00:02:51] I was looking for a way to get that into the unit I had in my office, which was a combo

[00:02:55] Proficet unit.

[00:02:57] I couldn't figure out how to get the company whose unit I made get the powder for it.

[00:03:02] So I ordered it, used it in there, broke the machine and then that's how I was

[00:03:06] like, okay.

[00:03:08] My doctor wasn't so pleased with me at the time but I was like, okay, well this

[00:03:11] is not the right powder for this device.

[00:03:13] What does this?

[00:03:14] This has to belong to something.

[00:03:15] What does it belong to?

[00:03:17] So that's where I finally discovered EMS and I was able to convince my doc based on

[00:03:23] the patients that we were seeing and the complexity of their dentistry and the delicacy

[00:03:28] of peri-implant tissue to get that right technology into the office.

[00:03:32] So my introduction to guided biofilm therapy actually came a few years later because I

[00:03:37] started doing what was GBT without really knowing it was GBT, the legacy device.

[00:03:44] I think there's a lot of people that come to it in that way.

[00:03:49] In other words, they understand the parts without realizing that there's like a system

[00:03:53] that's built around it.

[00:03:55] Exactly.

[00:03:56] There's like a whole system and a workflow and I got to tell you like the brains over

[00:04:00] at EMS are phenomenal.

[00:04:03] The science and the engineering behind it, everything is there to really allow us to

[00:04:09] provide evidence-based dentistry.

[00:04:11] So we got to integrate that technology.

[00:04:15] It evolved later into GBT.

[00:04:18] So there's a newer unit.

[00:04:19] The unit I started on was a legacy device.

[00:04:22] Now we have the airflow prophylaxis master that allows us to do the GBT protocol.

[00:04:27] So GBT is a systematic and minimally invasive way to provide elevated hygiene care for

[00:04:33] our patients.

[00:04:34] So within this workflow, we're going to assess all of our patients.

[00:04:38] That's step one.

[00:04:39] Step two is different from what we're already doing, but then where it gets a little bit

[00:04:43] different, we kind of bring old school back and step two, we're going to disclose everyone.

[00:04:47] And we're going to make that biofilm visible so that the patients understand what's

[00:04:52] going on inside of their mouths.

[00:04:54] The mind can't know what the eye can't see.

[00:04:55] And that's part of the problem we've been dealing with in the hygiene world

[00:04:59] for a very, very long time.

[00:05:01] So we disclose our patients, we make that biofilm visible, and then we go into our

[00:05:05] motivation step, step three, which is doing, I like to say now self-care rather than oral

[00:05:10] hygiene instruction.

[00:05:11] So my patient understands that this is part of their daily routine that they need to

[00:05:15] be doing.

[00:05:17] And we're doing again individualized care.

[00:05:19] So this is what we were taught in school is we don't give a one size fits all instruction

[00:05:23] to patients.

[00:05:24] We give them the care that they need and disclosing and motivating back to back really

[00:05:28] helps us do that.

[00:05:30] Then we move to step four, which is using our airflow max to remove all of the biofilm

[00:05:35] and stains systematically throughout the mouth.

[00:05:37] And for a provider, it's so it's just like it's so satisfying to watch because you

[00:05:43] just see it all disappear.

[00:05:45] Yeah. Right. You have some videos.

[00:05:47] There's a ton of YouTube videos.

[00:05:48] I'll find some. It is really satisfying.

[00:05:50] It's as satisfying as watching Jorge Zabat to take out wisdom teeth in his microscope.

[00:05:55] It is an incredibly satisfying experience to watch the biofilm removal.

[00:05:58] Everyone were laughing, but it's totally true if you watch it.

[00:06:00] It's a much better thing to doom scroll than social media.

[00:06:03] Just watch biofilm being removed.

[00:06:05] It's very satisfying.

[00:06:08] So we get to do that.

[00:06:09] And then we also it's it's a way for us to not over instrument patients or under

[00:06:14] instrument patients because we have that visual confirmation that we're done.

[00:06:18] So that increases our efficiency and it provides a minimally invasive approach.

[00:06:23] It's going to get biofilm and stain at the same time.

[00:06:25] So, again, increased efficiency.

[00:06:27] We don't have to go back and polish anything at the end.

[00:06:30] Then we have the ability in step five to use the perio flow if we need it.

[00:06:34] So that's a way to sub gingivly remove biofilm.

[00:06:37] Our airflow, the max, the super gingival approach will reach up to four

[00:06:41] millimeters sub gingivly so that perio flows kind of like the tag team from

[00:06:45] there can get into the pocket.

[00:06:46] I like to say it's like the Gracie scalar version of biofilm management

[00:06:52] because it's like really site specific and you can disrupt that biofilm

[00:06:55] community sub gingivly.

[00:06:57] And then when we get to the next step of the liaison, we're just going where

[00:07:01] calculus is present because we've managed biofilm and stain already.

[00:07:04] So now we only instrument where the calculus is present, which again,

[00:07:08] increases our efficiency and minimally invasiveness to the approach.

[00:07:13] Let me just stop you for a second.

[00:07:14] First off, you've got tissues retracted.

[00:07:16] You got their lips and cheeks out of the way.

[00:07:18] You've just moved all the biofilm.

[00:07:20] So if there is calculus, guess what?

[00:07:23] You're going to see it.

[00:07:24] You'll be able to hit it right where it is instead of like doing the thing

[00:07:27] where it does hygienist, dentist, admit it.

[00:07:30] Sometimes you just get an instrument in there because you're not sure.

[00:07:32] And you're like, well, knock it off.

[00:07:33] Is there that sort of thing?

[00:07:34] You know, like you can see it.

[00:07:35] You've taken all the other crap out of there and you can see what's left.

[00:07:37] And then you've got the perfect instruments to go after it and

[00:07:39] knock it off.

[00:07:40] Is that right?

[00:07:41] Hundred percent, hundred percent.

[00:07:43] And then in addition to that, it moves in a linear fashion.

[00:07:45] So it's not as invasive as using our traditional magnetostrictive.

[00:07:51] And it also has what's called the dynamic no pain response technology built in.

[00:07:55] So this thing is so smart that it actually feels the load resistance of

[00:07:58] the calculus and automatically adjusts the amplitude of the instrument tip to

[00:08:03] increase the power only when needed.

[00:08:05] And then it goes right back down when it doesn't detect calculus anymore.

[00:08:08] So in order to make that technology work, the provider using it doesn't

[00:08:13] need to add lateral pressure.

[00:08:14] You're literally just directing it where to go.

[00:08:17] So ergonomically, it's much more pleasing for us as a provider, but then the

[00:08:21] patient's also not feeling that pushing that we do when we traditionally have to

[00:08:25] remove a calculus deposit.

[00:08:27] So then once we're done with the PAs on step, we move to our step seven,

[00:08:33] which is check.

[00:08:34] We're just kind of looking and making sure that we've removed everything.

[00:08:37] We can still hand instrument at this point, but you don't need to do it as

[00:08:41] heavy as you have in the past with more conventional approaches.

[00:08:44] And it's more like a fine tuning.

[00:08:46] So, you know, if you're just kind of feeling around and making sure you've,

[00:08:49] you've comprehensively removed everything.

[00:08:51] I use a scalar more like an ODU Explorer and just lightly feel.

[00:08:55] And then if I do have a little fine tune, I got to do, I have the

[00:08:58] instrument in my hand.

[00:09:00] And then this is also when we could do our adjunctive therapy.

[00:09:02] So this is where, if you wanted to do like laser bacterial reduction or,

[00:09:07] you know, fluoride therapies or whatever kind of treatments that your

[00:09:11] philosophy of your practice has, you can do it at that step.

[00:09:14] And then the last step in GBT is scheduling the patient's re-care based

[00:09:18] on their bio burden, based on what we discovered with their, their amount of

[00:09:23] disclosed biofilm we saw.

[00:09:24] What is their health risk that's associated too?

[00:09:26] So it really helps kind of tie all of that together and the patient has a

[00:09:31] better understanding of the urgency and what we're recommending because

[00:09:35] they're seeing it and they're part of the whole procedure.

[00:09:37] So that's GBT in a nutshell.

[00:09:39] All right.

[00:09:39] A couple of questions first off.

[00:09:41] How much time savings is there compared to a regular, like, let's say a

[00:09:46] traditional hygiene appointment?

[00:09:48] Like it's, I think that's one of the things that people, first off, when you

[00:09:52] describe that, it sounds like that's a lot, but I mean, the reality is it's

[00:09:56] actually faster if I understand correctly.

[00:09:57] Is that telling you about that?

[00:09:58] 100%.

[00:09:59] 100%.

[00:10:00] And Ryan can attest to this too.

[00:10:01] Like you're on a healthy case.

[00:10:03] Like if you've got a maintenance case, perio maintenance case that's in every

[00:10:07] three months or a healthy patient, I'm dividing maybe 10, 12 minutes tops.

[00:10:12] Okay.

[00:10:12] Out of my appointment time.

[00:10:13] Okay.

[00:10:14] So then the other question I have is, since you're able to, it's so funny.

[00:10:18] We were talking about it before we started recording how, how old

[00:10:21] school disclosing is, but yet let's be honest, it's, it's, it's real.

[00:10:27] Uh, they used to do it when we were kids.

[00:10:29] Ryan, did you have to do it in dental school or no?

[00:10:31] Yeah, of course.

[00:10:34] I, we did it sometimes.

[00:10:35] It depended on the instructor.

[00:10:37] To be honest, I think.

[00:10:38] Dental school has great things.

[00:10:40] Sometimes we just need to carry it with us.

[00:10:42] Yeah, that's right.

[00:10:43] That's right.

[00:10:44] But the other thing is, is the disclosing I had back in dental

[00:10:47] school was nothing like what, what is a different kind of, it's not

[00:10:50] the same thing that you're used to.

[00:10:51] It's not just the one color pink on a, on a cotton swab or whatever.

[00:10:55] You know, it's, it doesn't, the disclosing solution is multiple

[00:10:58] colors and it actually colors older stuff differently than newer stuff.

[00:11:01] And so when you're showing your patient this stuff, you can

[00:11:04] actually say, well, this is this.

[00:11:06] You know, this is old.

[00:11:07] This has been here for a while.

[00:11:08] This is relatively new.

[00:11:10] And so when you do that, Melissa, and you show that patient, let's

[00:11:14] say it's someone who's not had a GBT done before they do it.

[00:11:18] And of course I think they're probably surprised cause it's very

[00:11:20] different from what they're used to.

[00:11:22] Do you find on recall that they're doing a better job because

[00:11:24] you've either grossed them out or open their eyes or both with the process?

[00:11:30] A hundred percent.

[00:11:31] And when you take your intro images to have that documentation

[00:11:35] and then you get to pull that up and say, look how much better

[00:11:38] you've done from last time to this time.

[00:11:40] That's the reward system that they need to keep on doing it.

[00:11:44] Right?

[00:11:44] Because like they, they historically we tell them to brush and floss.

[00:11:47] They come back.

[00:11:48] We yell at them again.

[00:11:49] You still may not be able to floss.

[00:11:50] They feel like what motivation do they have to continue

[00:11:53] to do these things at home?

[00:11:54] If I'm just going to get hollered at every time I come in anyway.

[00:11:58] So yeah, no, a hundred percent.

[00:11:59] The disclosing solution is huge.

[00:12:01] Like that, that's a game changer.

[00:12:03] And I didn't want to integrate it because I had PTSD with it from hygiene school.

[00:12:07] Like that's how I got graded wrong in school.

[00:12:10] Right?

[00:12:11] So I resisted it initially, but then once I just went all in and started

[00:12:16] doing that, it was such a game changer.

[00:12:18] And I remember the first patient I did it with great patient,

[00:12:21] compliant patient of record coming in every three months, doing all the

[00:12:25] things, excuse me, but then we disclosed and I found so much more

[00:12:30] biofilm than I ever imagined.

[00:12:32] And when I gave him the mirror and we were looking at it together, he's

[00:12:35] like, I thought I was doing a good job.

[00:12:36] And I said, you know what?

[00:12:37] I thought you were too.

[00:12:38] This is really, this is great information because now we just need to adjust.

[00:12:42] So it's all about like taking what you're taking the data and then

[00:12:46] just making the small tweaks and adjustments and coaching them.

[00:12:49] They're already brushing their teeth most of the time.

[00:12:52] And some of them, I'll even say some of them are even trying to floss,

[00:12:56] but they're just not doing it right.

[00:12:58] And that's where the frustration lies because they're doing the action,

[00:13:01] but they're not being successful.

[00:13:04] So disclosing really kind of puts the pieces of this puzzle together for both

[00:13:07] the patient and the provider to be able to create a better plan that's

[00:13:11] going to meet their needs.

[00:13:12] I like that.

[00:13:13] So that's what's been amazing about disclosing.

[00:13:16] I like that.

[00:13:16] Okay.

[00:13:16] So Ryan is a dentist, a practice owner in Las Vegas.

[00:13:20] And so how long, how long have you been in practice

[00:13:24] in your current place, Ryan?

[00:13:26] So graduated from university of Pittsburgh in 2017.

[00:13:30] Yep.

[00:13:31] And I'm practice ownership about just over three and a half years now.

[00:13:37] Okay.

[00:13:37] Okay.

[00:13:37] So you've, is yours a startup?

[00:13:41] Yeah.

[00:13:41] I acquired the, I purchased it from, it's an existing practice.

[00:13:45] Existing practice.

[00:13:46] That's what I wanted to know.

[00:13:47] So when you came in, were they already doing this?

[00:13:50] No, not at all.

[00:13:51] Okay.

[00:13:52] Okay.

[00:13:52] So tell me, every dentist listening to this right now is like, okay,

[00:13:56] so what does it actually look like from a dentist standpoint to add this

[00:14:00] to your, to your hygiene?

[00:14:02] Because I know that a lot of people go, that's pretty cool.

[00:14:08] I'll give it to you straight.

[00:14:09] Whether this is going to help your podcast or not, I'm just gonna,

[00:14:13] I'll give it to you straight.

[00:14:14] So ultimately why did I do it?

[00:14:17] Why, why did I even bring it in in the first place?

[00:14:19] And it started with a patient just kind of like with Melissa's story.

[00:14:22] It started with a patient that has been getting cleanings from,

[00:14:27] you know, this practice is I acquired it and there's she's been

[00:14:29] existing patient for 10 years and she's in a constant state of inflammation.

[00:14:35] And I'm like, well, what the hell?

[00:14:36] What's going on here?

[00:14:37] Like, why is she not getting healthy?

[00:14:40] And there's gotta be something that my hygienists aren't doing well or

[00:14:46] I'm not doing well, like we just got to figure out the why.

[00:14:49] And so I did like a salad saliva test and I won't name that company.

[00:14:54] Just it's not about that company right now, but they did introduce me to

[00:15:00] as one of the protocols for treating this type of bacteria that's in their

[00:15:03] mouths is, is guided biofilm therapy.

[00:15:07] Okay.

[00:15:08] And that's a standardized across for all like the top most aggressive

[00:15:13] bacteria, this is one of the most efficient ways to be able to

[00:15:17] remove the biofilm.

[00:15:18] Yeah.

[00:15:19] And then in my mind, you know how we have, we channel all those

[00:15:22] professors or some mentors are like, you hear about these things in your

[00:15:26] head, like what they said.

[00:15:27] And one thing that a process or a periodontist told me in dental school,

[00:15:32] she said it's all about the bugs.

[00:15:37] And, and so I took a step back and I'm like, wait a minute.

[00:15:41] So my most important provider in my practice, if I want to do a

[00:15:46] preventative based practice are my hygienists.

[00:15:50] Yeah.

[00:15:51] So I'm like, okay, well, I need to start with it.

[00:15:55] Then I'm like, well, how do I know my hygienists are moving

[00:15:57] biofilm?

[00:15:58] How do I know that?

[00:16:00] Because we live in a, in an age where at least in Vegas, man, it's a,

[00:16:04] it's a hygienist paradise for tempting, you know, there's this in and out

[00:16:07] in and out.

[00:16:07] And it's like, that's another challenge.

[00:16:09] And, and so how do I know as a new practice owner too is like, how do

[00:16:14] I know that my hygienists are doing a good job?

[00:16:17] How can I standardize something to why I know that at least super

[00:16:22] gingerly they're doing a good job.

[00:16:25] Yeah.

[00:16:25] And guided biofilm therapy, when we disclose and it's warmer water

[00:16:30] because you know, it's way more comfortable.

[00:16:33] I'm like, okay, well that ticks my ticks a box off my list.

[00:16:37] Another thing is, well, I want to, I don't like to high turnover

[00:16:41] for my providers.

[00:16:42] So I'm like, well, this is going to help them have a longer

[00:16:45] career for the ergonomics.

[00:16:46] I'm like, okay, well that makes sense.

[00:16:50] And then I got, and I'm like, okay, well this, this is it.

[00:16:54] So I got one unit.

[00:16:58] I had two hygienists, one with the Cavitron, one with EMS.

[00:17:02] And that's what we call a natural experiment, Ryan.

[00:17:04] That's what we call a natural experiment.

[00:17:06] Tell me about that.

[00:17:09] They probably fought over it.

[00:17:10] They probably fought over the, the,

[00:17:11] man guys, tooth and nail.

[00:17:14] I love these hygienists as a, as a, as a person, as a human, you know,

[00:17:20] they're like friends, but wow, they hated it.

[00:17:24] They hated it at first.

[00:17:25] Did they really tell you about that?

[00:17:27] They, it, it shook up their world.

[00:17:29] They were used to doing something.

[00:17:31] They walked in and here's this young Venice.

[00:17:33] I'm like, I'm going to take over the world.

[00:17:34] Right.

[00:17:35] And they're like, Oh, Whoa, I just want to come in and just go to work.

[00:17:38] I don't need this.

[00:17:39] Right.

[00:17:39] Yep.

[00:17:40] You can't hate them for that by the way either.

[00:17:41] That's real.

[00:17:42] No, I can't.

[00:17:43] And I don't, and I just realized I'm like, okay, well this is out of

[00:17:47] their comfort zone and that's okay.

[00:17:49] And, um, I actually requested Melissa.

[00:17:52] I'm like, well, I want the best shot.

[00:17:54] So I'm like, I want, I want the list.

[00:17:56] I got to call her like, please.

[00:17:57] I forgot you can get.

[00:17:59] Yeah, exactly.

[00:17:59] All right.

[00:18:01] I don't want any excuses why we can't use this thing.

[00:18:04] I'm like, I want the top trainer.

[00:18:05] I want it like, I want the buy-in because I'm like, well, they,

[00:18:09] they have to understand the philosophy and there are some

[00:18:12] tears shed by the high asset first.

[00:18:15] Melissa's nodding her head there too.

[00:18:17] It's hard.

[00:18:18] It's not easy.

[00:18:19] I mean, it's it, everything that you know about dental hygiene

[00:18:23] that we're taught, GBT flips it on its head.

[00:18:25] Yeah, it does.

[00:18:26] So it's, yeah.

[00:18:28] Yeah.

[00:18:29] So it's, you know, it's a really difficult transition initially.

[00:18:34] And even just down to the way that you instrument with your

[00:18:38] PAs on is completely the opposite technology of how, or

[00:18:42] technique that we're taught in hygiene school to use.

[00:18:44] So it does take time.

[00:18:46] It takes time to trust the technology and trust the protocol.

[00:18:50] It takes time to just see the results and hear the

[00:18:54] feedback from the patient.

[00:18:56] Like it's a process.

[00:18:57] You have to also create new muscle memory.

[00:18:59] You don't think when, when we're doing conventional hygiene,

[00:19:02] you've been doing it for a few years.

[00:19:03] You don't think you assess your thinking is done.

[00:19:06] You just start working just like you guys, when you're doing,

[00:19:08] you know, prepping a crown, you don't really have to think,

[00:19:11] you know, what are you doing?

[00:19:12] So GBT makes you think you get to that spark is that that place

[00:19:17] where you don't have to again, but how did they work through that?

[00:19:21] Okay.

[00:19:23] So I, I started cleaning, doing some cleanings.

[00:19:28] Like I got it.

[00:19:29] I knew it.

[00:19:29] I knew it.

[00:19:30] I knew it.

[00:19:30] Go ahead.

[00:19:31] I'm like, I gotta try it out.

[00:19:33] Like, all right.

[00:19:33] I can't just be like, do it.

[00:19:35] You know, like, and I got, I got experience in two years.

[00:19:38] I got experience in three years.

[00:19:39] You know, like, and I got, I got experience in two and I'm all

[00:19:42] into this by the way I do this because it is freaking satisfying.

[00:19:45] But go ahead.

[00:19:45] No one here.

[00:19:47] And I'm like, well, what are they struggling with?

[00:19:49] What are our struggles here?

[00:19:49] And I'm like, okay, I hear you guys.

[00:19:53] This is a struggle.

[00:19:54] I'm not, I'm not just saying like here's the new equipment.

[00:19:57] I'm out of here.

[00:19:58] Which is classic dentist move by the way.

[00:20:00] Very classic.

[00:20:01] Right?

[00:20:02] It is just like, this is it.

[00:20:03] And that's it.

[00:20:04] Like, oh, he just wants more money.

[00:20:05] I'm like, well, I didn't actually increase my fees at all.

[00:20:08] Yeah.

[00:20:08] Um, for the first year actually, because I wanted to prove that it is a.

[00:20:17] Top shelf service that delivers superior results.

[00:20:24] And I didn't, and I wanted to make sure the value is there for my

[00:20:27] patients and for me and for my hygienist.

[00:20:33] And so like, I went through their certification process, right?

[00:20:37] I'm like, I'm like just to do the, I took it seriously.

[00:20:40] I took, I really wanted the data to know that, all right, I have this new practice.

[00:20:45] Um, are my patients going to freak out and are they going to leave?

[00:20:50] Are they going to go early?

[00:20:51] Are they going someplace else?

[00:20:53] And it's a good question.

[00:20:56] Nine out of 10, nine out of 10 patients actually love the service.

[00:21:02] Interesting.

[00:21:03] It's a delivery so much more comfortable.

[00:21:05] Um, and it's helped me sleep more at night knowing that they're doing a good job.

[00:21:11] I can, and it's from, I love cosmetic dentistry as well.

[00:21:15] So it goes hand in hand.

[00:21:16] Like I can now use, I can get through an appointment quicker with my hygienist

[00:21:22] to get to a restorative outcome because I can use a plaque score now efficiently.

[00:21:28] If their plaque score, there's a plaque score has to be between zero

[00:21:30] and one in order to get veneers of my practice because I want longevity.

[00:21:35] So that's going to like, it's all about the bugs.

[00:21:37] Well, we got to start with the biopharm portion of it.

[00:21:39] And then because they're officially able to get through that biopharm

[00:21:43] process and allows more time for hygienists to educate.

[00:21:48] And that's the biggest key for me is are we have healthy patients

[00:21:53] because we have more time to educate them.

[00:21:58] So we were talking about this before we started recording a little bit,

[00:22:01] Melissa and I were, cause I like, and Ryan, I'm going to bring you in on this.

[00:22:04] Do you feel like, I've been talking about this on a lot of episodes.

[00:22:07] So people will be hearing a lot of this lately, but like,

[00:22:09] I feel like dentistry has kind of given up on, on prevention in a lot of ways.

[00:22:13] If you look at the, if you look at the continuing education offerings for

[00:22:16] dentists, like the sooner people don't have teeth and have implants or whatever,

[00:22:22] it seems like that's where we're heading.

[00:22:23] You know, we're not, we're not treating, we're, we're not treating

[00:22:26] teeth maybe the same way that we used to, but also there's part of that.

[00:22:29] Why do, why do we get to that?

[00:22:31] It's because we don't think people can take care of their teeth.

[00:22:34] We, we see patients that are not doing a good job and we're,

[00:22:37] we're not probably as effective at teaching at, at like, I think,

[00:22:42] I think hygiene is really good at cleaning teeth.

[00:22:45] I'm not sure we're as good at educating as we used to, but also why would we

[00:22:49] be because it feels like pushing a boulder uphill, like, you know,

[00:22:54] how many times, as Melissa and Ryan, how many times do you say the same thing

[00:22:57] over and over again to patients and they come in and it's no different?

[00:23:00] You know, it's like, I don't think we're headed in that direction either.

[00:23:02] I don't think we're headed in a positive direction.

[00:23:05] I mean, my, this is my theory and my philosophy.

[00:23:08] I like it.

[00:23:09] It's an opinion at the bottom of the evidence based pyramid here.

[00:23:12] Right.

[00:23:12] But, um, with, with student loan debt out of control with corporations go

[00:23:18] just okay, that's a model.

[00:23:20] I'm not dying.

[00:23:20] This is not a dog on that.

[00:23:21] Right.

[00:23:21] We'll hear all of it.

[00:23:22] Yes.

[00:23:22] Okay.

[00:23:23] But like, we are not headed in a prevention based mindset.

[00:23:27] Yeah.

[00:23:28] And I, I

[00:23:32] if we teach patients to take good care of their teeth at home, we have a lot

[00:23:36] less stuff to do.

[00:23:37] Guess what?

[00:23:38] We cannot prevent laziness.

[00:23:39] Okay.

[00:23:40] We're still going to have work.

[00:23:42] Yep.

[00:23:42] But, but I wanted to prove that I can make more money with a preventative

[00:23:49] mindset than a reparative.

[00:23:51] I wanted to prove that if I put my hygienist first, instead of using them

[00:23:57] as a feeder to find treatment for me to do it.

[00:24:01] Yes, I like this.

[00:24:02] Then then I can live.

[00:24:05] I wanted to prove that and I feel that I am and I have, I've increased

[00:24:13] the trust in my patients and I spent zero money on marketing and.

[00:24:20] And it's been, I've, I can't, I'm so exhausted because I'm busy

[00:24:24] and I don't want to sound like a jerk.

[00:24:26] I don't want to sound like that, but it starts with trust and this system.

[00:24:30] There's a lot of under underlying factors that allow, allow this

[00:24:33] philosophy to be able to go through.

[00:24:34] It's a protocol and then it's a philosophy.

[00:24:36] It's not just here's the latest cleaning system guys.

[00:24:39] Like you really have to, when you take on guided bio from therapy,

[00:24:45] it just, let's just remove the word EMS, just the whole principle of

[00:24:49] disclosing and focusing on biofilm.

[00:24:52] You're taking on that preventative based mindset as well.

[00:24:57] Anyways, I don't know.

[00:24:58] I don't want to get off my soap box a little bit.

[00:25:00] So, okay.

[00:25:01] And there's, there's part of something you said a few minutes ago.

[00:25:04] And I want Melissa to pick up on this because it takes a little less time

[00:25:08] to do the job when they're in the chair, when they're in recall, you're

[00:25:11] able to spend more time on prevention, which is, you know, traditionally oral

[00:25:18] hygiene instruction and Melissa and I were laughing typically in most

[00:25:20] practices, that's two minutes before they're walking out the door and you

[00:25:23] throw some floss samples at them and say, do that.

[00:25:27] Yeah, exactly.

[00:25:28] Welcome to reality.

[00:25:29] That's real.

[00:25:30] That's real.

[00:25:30] If they're lucky, they get a goodie bag for crying out loud.

[00:25:32] But so what you're saying, what Melissa, how do you use as a

[00:25:36] hygienist, how do you use this system and this workflow to spend

[00:25:40] more time and better time explaining home care?

[00:25:43] Because let's be honest, it's about the 363 days a year

[00:25:47] that they're not in my office.

[00:25:48] That's really the most important part.

[00:25:51] I mean, we can do what we can do while they're there.

[00:25:53] But if we can, if we can motivate, motivation is important.

[00:25:57] They probably need to talk about that, but if we can motivate and

[00:25:59] show them what to do and how to do it better, tell me about that.

[00:26:04] Of course.

[00:26:05] So it's kind of like telling a whole story, right?

[00:26:08] So the second they get into the room, I'm now spending a good 20

[00:26:12] minutes on my assessments, my going through their medical history, looking

[00:26:17] at familial connections so that I can have that oral systemic discussion

[00:26:22] with them too, and bridge that gap with how the pathogenic bacteria in your

[00:26:25] mouth is affecting your whole body.

[00:26:27] So that's one boom, one level of engagement right there.

[00:26:30] Then when I go through their assessments, I use voice activated

[00:26:33] periodontal charting.

[00:26:34] So I explained to them before we start that what that is and what they

[00:26:38] need to be listening for so that they're a part of that assessment with me now.

[00:26:43] So they already know if they hear me say four or five, or they hear me say

[00:26:45] interproximal bleeding or numbers higher than that, they're already in red flag mode.

[00:26:51] Then I'm disclosing them and I'm taking their inter-oral photos and showing

[00:26:56] them so that now the education is really happening.

[00:26:59] So this is where I have my periodontal charting up.

[00:27:01] I might have my radiographs up on the other screen and I can say to them,

[00:27:05] this means this and see this in your mouth.

[00:27:08] Here's the cause of that.

[00:27:09] So like here's the bacteria.

[00:27:11] See how it's darker at the gum line?

[00:27:13] That's why when I took your measurements, we had five millimeter readings here.

[00:27:16] Your tissue is bleeding.

[00:27:17] Bleeding is a sign of disease.

[00:27:19] This is also why in your radiograph, we see the bone level should be here.

[00:27:22] Now it's up here.

[00:27:23] So the bacteria has triggered your immune system and your immune system in

[00:27:29] the effort to try to heal you is eating your gum and your bone away.

[00:27:33] So we need to stop this process from happening.

[00:27:35] And this is my recommendation.

[00:27:37] Here's, here's what I would like to do to get you healthy.

[00:27:39] And then I go into, you know, if it's non-surgical periodontal therapy,

[00:27:42] I'm explaining to them the steps and the sequence we're going to go through.

[00:27:46] I like Ryan also do salivary diagnostics.

[00:27:48] So I will take a sample usually when I'm in that phase as well.

[00:27:53] And then I'm able to get them enrolled in that care.

[00:27:56] I get so much less pushback.

[00:27:58] I don't hear what is my insurance company going to pay because they

[00:28:01] understand the disease and now I've motivated them.

[00:28:05] I've created urgency between looking at what they're presenting with and

[00:28:09] then tying that back to, to their medical history and saying, Hey, listen,

[00:28:13] you know what you shared with me that your, your, um,

[00:28:15] you have a family history of heart disease.

[00:28:17] Well, the pathogens in your mouth are known to trigger these things.

[00:28:21] So this is a risk factor.

[00:28:22] I'd like to say take a salivary diagnostic, send it off to the lab.

[00:28:25] So we could see if you have those pathogens that are associated with

[00:28:29] that, and then we can create a treatment plan based on your individualized

[00:28:33] risk.

[00:28:34] I had a patient come in just a couple of weeks ago.

[00:28:37] Her son had just gotten married and I was like, how was the wedding?

[00:28:39] How did it all go?

[00:28:41] And she told me a story about how her mother who has Alzheimer's has not

[00:28:44] left the house in two years, not been in a car,

[00:28:46] but her husband was able to get her to the wedding,

[00:28:48] got her beautiful dress and she was there for pictures.

[00:28:51] And I'm like, that's so amazing.

[00:28:52] I'm so happy to hear that that happened for you.

[00:28:54] You know, 10 minutes later,

[00:28:55] I told her the connection between Alzheimer's dementia and P.

[00:28:58] ginger ballast, right?

[00:29:00] So we got her in a salivary diagnostic.

[00:29:02] We took the test and now we're putting her into more treatment so that

[00:29:06] we can prevent this risk factor associated.

[00:29:08] So that's how I use my magic minutes that GBT has given me.

[00:29:12] And I get more case acceptance for periodontal conditions.

[00:29:16] I also get more case acceptance for increasing frequency because they

[00:29:20] understand the need.

[00:29:21] But then on top of that,

[00:29:22] I can also do things like 3D scans and get patients enrolled into,

[00:29:28] you know, clear line or therapy,

[00:29:30] whatever it may be to help also reduce their periodontal risks,

[00:29:34] because if their occlusion is off and their teeth are crowded,

[00:29:36] we can't manage the biofilm.

[00:29:38] They can't manage it at home.

[00:29:40] So like this is how all the pieces of the puzzle really start to come

[00:29:43] together because we're taking all the information and we're presenting

[00:29:47] it to them in a succinct way.

[00:29:48] We're telling them that story,

[00:29:50] but also like having them be a part of the story with us,

[00:29:53] with the disclosing step and,

[00:29:54] you know, using the assessments as part of that.

[00:29:57] So it's really just,

[00:29:59] it really elevates that whole preventative mindset and there's so much

[00:30:03] less pushback because now they get it.

[00:30:06] They didn't get it before because we never had the time to explain it to them.

[00:30:08] We were too busy scraping teeth and polishing teeth.

[00:30:11] So part of,

[00:30:12] part of it is the instrumentation is just a lot shorter.

[00:30:14] It's a lot faster.

[00:30:16] You get more time,

[00:30:17] more time to talk with patients about that stuff.

[00:30:18] Here's,

[00:30:19] here's a question and Ryan has probably dealt with this,

[00:30:22] but I'm sure you have to,

[00:30:24] you knew patient.

[00:30:25] I had one earlier this week.

[00:30:27] It's been 14 years since I've been to a dental office.

[00:30:29] And so they're,

[00:30:30] it's their first,

[00:30:31] it's their first appointment.

[00:30:33] You get them in,

[00:30:34] you know,

[00:30:34] you do an exam,

[00:30:35] you probably take some radiographs.

[00:30:36] You probably,

[00:30:37] and they are,

[00:30:38] they would fall into like literally,

[00:30:40] you don't even know their period condition necessarily,

[00:30:42] although maybe their bone level looks okay on the radiographs,

[00:30:45] but the reality is they have enough stuff in there that you're kind of

[00:30:48] like,

[00:30:49] you don't even know quite where to go.

[00:30:50] So in a,

[00:30:51] in a traditional office and in an office,

[00:30:53] it's probably a,

[00:30:54] a debridement of some sort.

[00:30:56] How does that,

[00:30:57] how does that fit into the,

[00:30:59] the GBT situation?

[00:31:01] How do you,

[00:31:01] how do you handle that as a practitioner?

[00:31:03] So with somebody like that,

[00:31:05] if it's,

[00:31:05] you know,

[00:31:06] if I'm enrolling them into non-surgical periodontal therapy,

[00:31:09] obviously I'm not doing that that day.

[00:31:11] Right.

[00:31:11] So what I'm able to do is do all of that education,

[00:31:14] get the commitment to moving forward with that treatment,

[00:31:17] but I can also airflow them in that visit because I've already disclosed

[00:31:20] them and I've done the oral hygiene instruction.

[00:31:22] So now at least I can do the airflow treatment.

[00:31:25] I can reduce the bio burden and it's,

[00:31:28] it's really the start of the biofilm modulation process because we get

[00:31:32] better results with GBT by that repetitive therapy approach.

[00:31:36] So if I'm doing airflow in that first step,

[00:31:38] and I might do a little super gingival work with the,

[00:31:40] the PAs on if they have super gingival calculus,

[00:31:43] just to like,

[00:31:43] you know,

[00:31:44] get,

[00:31:44] get a little jumpstart on that.

[00:31:46] But then when they come back next time and say,

[00:31:48] I'm doing the right side of the mouth next time,

[00:31:51] then I'm going to airflow and disclose the entire mouth.

[00:31:55] I'm sorry,

[00:31:55] I'm going to disclose and then airflow the entire mouth before I work on

[00:31:58] the right side because I'm again,

[00:31:59] modulating the biofilm.

[00:32:01] Okay.

[00:32:01] And then when they come back for the left side,

[00:32:02] I'm going to repeat the same process and do the entire mouth with airflow

[00:32:05] because I'm modulating the biofilm,

[00:32:07] but I'm also able to track them with their home care as well,

[00:32:11] because I'm like,

[00:32:12] okay,

[00:32:12] great.

[00:32:12] Look,

[00:32:13] you're,

[00:32:13] we took all of this biofilm off an appointment one now appointment two,

[00:32:17] I'm disclosing you.

[00:32:18] Is it all back again?

[00:32:19] Yeah.

[00:32:19] Or do we have some improvement where they maintain it at home?

[00:32:22] You're seeing them more often than you would be even for a recall at

[00:32:26] that point,

[00:32:26] cause you're doing active period on the therapy.

[00:32:28] So you're actually,

[00:32:28] but you're still actually doing the biofilm removal because it's pretty quick.

[00:32:33] It's not,

[00:32:33] doesn't take that long.

[00:32:36] And Alan,

[00:32:36] like when you said the 40,

[00:32:37] I have been in the dentist in 14 years.

[00:32:40] Well,

[00:32:40] there's something that's been keeping them away for 14.

[00:32:44] And so they come in and you're like,

[00:32:45] you need a,

[00:32:46] I need to like fucking get you all numb and I'm going to scrape the

[00:32:50] shit out of your teeth.

[00:32:50] And they're going to go like,

[00:32:51] you're going to hurt the next day.

[00:32:52] I'm like,

[00:32:53] don't see him for another 14 years.

[00:32:55] And another 14 years.

[00:32:58] I got my hygienist is like,

[00:33:00] I got an hour.

[00:33:01] Let's go start getting up.

[00:33:02] No,

[00:33:02] I'm popping.

[00:33:03] You know,

[00:33:03] like it's like there is this.

[00:33:05] So if the,

[00:33:06] if you ease them into it and it's,

[00:33:08] you're ethically going through,

[00:33:10] you're educating them.

[00:33:11] They're like,

[00:33:12] and they're creating value in their health and they're experiencing a

[00:33:16] gentle cleaning to begin with.

[00:33:19] And I do privacy,

[00:33:20] like,

[00:33:20] look,

[00:33:21] this is the last deep cleaning I want you to have.

[00:33:23] I'm using air quotes here.

[00:33:25] Right.

[00:33:25] We're going to help teach you to prevent that from happening.

[00:33:28] Yeah.

[00:33:29] Like,

[00:33:29] are you,

[00:33:29] and then I asked him,

[00:33:30] are you interested in doing that?

[00:33:32] You're like,

[00:33:32] yes,

[00:33:32] cool.

[00:33:33] Get seeing,

[00:33:33] can you see in a couple of weeks after we airflow today?

[00:33:36] Yep.

[00:33:36] Yeah.

[00:33:37] I love that guys.

[00:33:38] I got it.

[00:33:38] I got a really fun thing for you.

[00:33:40] Ask me the last time I had given a patient local anesthesia for

[00:33:43] non-surgical periodontal therapy.

[00:33:45] When was the last time you've anesthetized for non-surgical period?

[00:33:49] It's already notes now.

[00:33:51] It's been like three or four years when I got really good at my

[00:33:54] PA's on technique.

[00:33:55] I stopped needing local.

[00:33:56] Interesting.

[00:33:57] So you're,

[00:33:58] you're using the PA's on basically what you're doing for your,

[00:34:01] your non-surgical period therapy is you're,

[00:34:04] you're disclosing removing the biofilm you can see on the teeth

[00:34:08] essentially.

[00:34:09] And then you're using the PA's on to do the surgical therapy.

[00:34:13] You're going sub-gingil with that cleaning them all up that way.

[00:34:15] Is that,

[00:34:15] is that what I'm seeing?

[00:34:16] Airflow first,

[00:34:17] then you can perioflow in the pockets better.

[00:34:19] Okay.

[00:34:20] Yep.

[00:34:20] Yep.

[00:34:21] Yep.

[00:34:21] And then for people that don't know perioflow is basically

[00:34:24] airflow under the,

[00:34:26] under four millimeters.

[00:34:27] Over four millimeters.

[00:34:28] Correct.

[00:34:29] And then yes,

[00:34:30] I'm using the PA's on into the deeper pockets and removing the

[00:34:33] calculus.

[00:34:33] And so we have a PS instrument that's the universal.

[00:34:37] And then there's the right and left versions of that that are

[00:34:39] phenomenal for reaching interproximal.

[00:34:41] There's a PI max for implants and restorative cases so that

[00:34:45] we're not scratching beautiful restorations that you gentlemen

[00:34:48] are doing.

[00:34:48] So there's a lot of different options that we have.

[00:34:51] So,

[00:34:51] and they're called instruments because that's the main mode of

[00:34:53] our instruments.

[00:34:54] Is with these technologies that allow us to remove the calculus

[00:34:58] much more comprehensively,

[00:35:00] but without the added.

[00:35:01] I Trogenic damage of scalers.

[00:35:04] Yeah.

[00:35:04] For all those hygienists out there are currently using EMS.

[00:35:07] Melissa,

[00:35:08] you're,

[00:35:09] you're like the Marshall Hanson of composite veneers.

[00:35:12] Okay.

[00:35:12] You know how to adapt that very well.

[00:35:14] It is a learning curve.

[00:35:15] Sure.

[00:35:16] But these hygienists needed like take a chill pill.

[00:35:19] I just,

[00:35:19] if they have the time to do that,

[00:35:22] like resist the urge to pick up the instrument.

[00:35:25] I just learned to adapt it more and they're like,

[00:35:27] and then,

[00:35:28] then her job becomes so much more enjoyable because I hate

[00:35:31] causing pain on patients.

[00:35:32] It just makes my anxiety go through the roof and it's like,

[00:35:35] ah,

[00:35:36] anyways,

[00:35:37] it's interesting.

[00:35:38] Ryan's talking about like the real life,

[00:35:40] the real life adaptation of this.

[00:35:42] And I mean,

[00:35:44] there's the learning curve in dentistry.

[00:35:46] We all know the story.

[00:35:47] There's always a learning curve.

[00:35:48] There's always a learning curve.

[00:35:49] In dentistry,

[00:35:50] we all know the story.

[00:35:51] There's always a learning curve with all this stuff.

[00:35:53] It doesn't sound like it's too awful horrible,

[00:35:54] but unfortunately,

[00:35:56] a lot of times this is,

[00:35:57] this is probably the last question I'm going to ask because it's an important one for the dentist who owns a practice or

[00:36:03] is,

[00:36:03] or is someone who is,

[00:36:05] is one of the purchasers for a practice or whatever.

[00:36:07] Who's like,

[00:36:08] I like this idea.

[00:36:08] I want this for my practice.

[00:36:11] How to approach the team when it's,

[00:36:14] it's you got to make it the team's idea.

[00:36:17] You almost have to try and make it their idea.

[00:36:19] On some level.

[00:36:20] And I worry about that because it's like,

[00:36:22] you know,

[00:36:23] when you force change on the team without their input,

[00:36:27] a lot of times you get heels dug in and then it makes it harder to put in place.

[00:36:33] So talk to me about that.

[00:36:34] Melissa,

[00:36:35] what tips would you have for someone who wants to add this to the practice?

[00:36:38] If it's a hygienist,

[00:36:40] then you're golden.

[00:36:41] If the hygienist wants to add it,

[00:36:42] then you're golden.

[00:36:43] You just follow the rules.

[00:36:43] Here's another one too.

[00:36:44] Since I'm speaking to the dentist audience right now,

[00:36:47] I have hygienists come up to me all the time that are like,

[00:36:50] I am a hundred percent on board with this.

[00:36:52] I cannot get my doctor to buy this equipment for the life of me.

[00:36:55] It's different and it's not a cool new toy in their operatory necessarily.

[00:37:01] It's a cool new toy in the hygiene operators.

[00:37:03] Although Ryan has used it.

[00:37:04] He knows what he's talking about.

[00:37:05] But I'm just curious.

[00:37:07] So you can have hygienists get buy-in,

[00:37:09] but if you're not sure you're gonna,

[00:37:11] what do you think?

[00:37:12] So I would ask them questions like,

[00:37:14] tell me three things that make your job hard every day.

[00:37:17] And they're probably gonna say,

[00:37:18] I don't have enough time.

[00:37:19] They're gonna say their body hurts

[00:37:21] and they're gonna say patients hate what I do.

[00:37:24] And GBT gives you back your time.

[00:37:27] Your body doesn't hurt anymore because it's literally,

[00:37:29] I call it the Tesla of dental hygiene.

[00:37:31] It's doing the work for you.

[00:37:33] You're just basically directing it where to go.

[00:37:36] And your body is not gonna hurt because you don't have to,

[00:37:39] it's not so physically demanding.

[00:37:40] It's not as labor intensive as what we're doing

[00:37:43] on a day-to-day basis.

[00:37:44] I have herniated discs in my neck.

[00:37:46] I didn't think I was gonna be practicing past 15 years

[00:37:49] and here I am going on over 20.

[00:37:51] And I can still do this job that I love.

[00:37:54] So those are really the keys.

[00:37:55] Like meet them where they are.

[00:37:57] When they're miserable about certain things,

[00:37:59] like I have an answer for this.

[00:38:00] Let's go explore it together.

[00:38:03] Ryan, you have anything to add as far as implementation?

[00:38:06] Alan, I'm gonna have to have like five more podcasts

[00:38:09] to let you know that as a provider,

[00:38:11] I have screwed it up every single way possible.

[00:38:14] I get it, man.

[00:38:15] I get it.

[00:38:16] With the EMS system,

[00:38:19] but it's the best thing I've ever done

[00:38:21] with my hygiene department,

[00:38:23] getting it to where I needed it to be.

[00:38:24] That's cool.

[00:38:25] Like I'll tell you my struggles

[00:38:27] and I'll be 100% transparent with it.

[00:38:29] And any provider who wants to just call me up

[00:38:32] and say like, all right, give me the real deal here.

[00:38:35] You know, like what are their struggles?

[00:38:38] I've had moments where I'm showing the height,

[00:38:42] because I have so many temp hygienists right now.

[00:38:44] This is hard.

[00:38:46] It's so many.

[00:38:47] That's added difficulty, right?

[00:38:48] That's definitely added difficulty, yeah.

[00:38:50] But I'm like, okay, well this sucks.

[00:38:53] This really sucks.

[00:38:55] But I pull up this EMS has this wheel,

[00:38:59] this protocol, it's a protocol.

[00:39:01] Yep, yep.

[00:39:02] And I'm like, all right guys, hygienists.

[00:39:05] Yeah, and I pulled that up

[00:39:07] and I spent, I used to say,

[00:39:09] meet me 30 minutes prior to you.

[00:39:11] I used to send them videos like,

[00:39:12] this is what you're walking into.

[00:39:13] Here we go, get ready.

[00:39:15] And then now I'm like,

[00:39:16] I can get a new hygienist,

[00:39:19] like hasn't even seen an EMS machine up and running

[00:39:22] and seeing their patient within 10 minutes.

[00:39:24] Oh my God, I love that.

[00:39:26] We are gonna do more podcasts about this stuff.

[00:39:28] That's really cool.

[00:39:28] That's awesome.

[00:39:29] Because of like,

[00:39:30] because I've added adapt to the times, right?

[00:39:33] I'm like, I want a full-time hygienist.

[00:39:35] I want one.

[00:39:37] And I have one.

[00:39:39] And she actually, and she found me from EMS.

[00:39:42] Yeah, that doesn't surprise me either.

[00:39:44] Yeah, there's a tribe there.

[00:39:46] And Melissa, that's what I really want.

[00:39:47] I want an EMS group of hygienists

[00:39:49] who actually care about that.

[00:39:50] We need like a Tinder for EMS.

[00:39:54] I wanna swipe right, please.

[00:39:56] I wanna live here.

[00:39:57] Yes.

[00:39:58] Hygiene Tinder.

[00:39:59] They can accept me too.

[00:40:00] It goes both ways, right?

[00:40:01] I think.

[00:40:02] Yep, no, I think it would work both ways too.

[00:40:04] No, that's really cool.

[00:40:05] So I feel like this is a good starting place.

[00:40:07] There's gonna be a lot of questions.

[00:40:09] This was really good.

[00:40:11] And I mean, I'm hoping to incorporate it in my office.

[00:40:14] Ryan, you've sort of inspired me

[00:40:15] because it's nice to hear someone admit that

[00:40:18] they haven't done it all right from the beginning.

[00:40:21] I was hoping you'd say that you incorporated

[00:40:23] instead of you walked into a practice

[00:40:25] that was already doing it.

[00:40:25] I'm like, yeah, that's an easy way.

[00:40:28] We did the water legs.

[00:40:29] We did so much.

[00:40:31] It's like, it's not the same practice.

[00:40:33] And I lost myself a little bit there for about a year.

[00:40:38] It's like, oh my gosh,

[00:40:39] but I gotta chill out sometimes, right?

[00:40:40] Yeah, yeah.

[00:40:41] We could chill out.

[00:40:42] I've incorporated stuff, taking a step back,

[00:40:45] but the CABA denominator

[00:40:48] that has really helped my practice

[00:40:50] is that 90% of what we're doing

[00:40:52] is about mechanical debridement

[00:40:53] and biofilm therapy and getting my patients healthy.

[00:40:56] And those pockets are dropping in a good way in numbers.

[00:41:00] That's awesome.

[00:41:01] That's awesome.

[00:41:02] That's really good.

[00:41:03] You guys, I appreciate your time.

[00:41:05] We'll do this again.

[00:41:07] This was sort of a starter to try

[00:41:08] because I'm gonna probably be talking through it

[00:41:11] as I try to incorporate in my office,

[00:41:12] but this was really good.

[00:41:13] I think people have a lot of questions.

[00:41:15] I'll see if I can bring you guys

[00:41:16] into the Facebook group if you're not there already,

[00:41:18] just in case people have questions.

[00:41:20] And if you have questions, email me

[00:41:21] and I can get this to Melissa and Ryan to talk about.

[00:41:25] And again, thank you a ton for being on.

[00:41:27] This was very helpful.

[00:41:29] This is super fun.

[00:41:30] Thank you for inviting us.

[00:41:31] I think I said a customer.

[00:41:32] I'm sorry about that, guys.

[00:41:34] It's all right.

[00:41:35] Our listeners have never heard such a thing.

[00:41:37] All right.

[00:41:40] Thanks a ton.

[00:41:41] We'll catch you guys again very soon.

[00:41:42] All right. Bye, guys.

[00:41:43] Bye.