Life Saving Dental Hygiene with Tom Larkin DDS
Yes is the thriving Dennis show with Gary tax where we help you develop your ideal dental practice one that provides personal professional and financial satisfaction. Welcome to another edition with riding miniature on your tax, your show host my guest on today's episode is my friend Tom Larkin, and Tom, and I are going to have a great discussion about some of the really cool things that are happening in the world of oral systemic connection. In particular, Tom's gonna talk about the role of microscopes the phase contrast microscope today as a brilliant patient education tool. Tom has been a a real pioneer in the world of Pero diagnosis and treatment. And you're in for a real treat with lots of information that you can use in your practice. Dell. Patients better understand the oral systemic connection and help get more of your patients on board to accept the recommended treatment that they need and deserve. You know, before we get to that interview. With Tom Larkin though, we have another top clinical tip from Dr leeann Brady in this top clinical tip lease. To talk about the importance of your dental team member who's responsible for your dental supplies. Absolutely. Knowing your preference for materials, this is something she stumbled upon recently in her own practice, and she's got some great insights for you. You'll enjoy this top clinical tip with Dr leeann Brady. So in our clinical tip piece. Actually, I'm going to talk about something that is sort of a clinical tip is sort of a practice management tip because it actually just came up for me this week. And it's a question of the person in your office. She does your supplies ordering. Did they actually know what your preferences are about materials? And so I have to tell you for me. I have a phenomenal team member. Who does my ordering in thirty two years of practice? She's probably the best person. I've ever had this gridlock over here and clone her she is she you know, and part of the reason I say, she's the best thought it is. Because she gets it conceptually like she spends the money as if it was her money my money love to hear that. Right. But she also understands the concept that you know, I don't wanna run out of anything. I hate that. When you run out of gloves, and you have to overnight gloves rate. But I also don't want stuff expiring on the shelves that that balance that. Magic -able that she gets beautifully. And so the truth is because of that I've sort of taken a back seat like sort of step back, and I don't really manage that as actively as I once did. And it just, you know, we always learn things by them coming up, and you go maybe I should have been looking over there and that happened to me this week. So I was actually in the office is doing a central relation bite record. And I reached over for the gun and the bite, reg. And so now, I realize there's something in the gun. I've never seen before. But I'm got a patient in the chair, you know, and I'm trying to act cool. And so like read the label yet bite silicone this will work do the bite registration. And then so after the fact three awful he had threw me off a little bit. It'll it'll get your groove when that happens in. So after that Shelley, and I are having a conversation. I said so Shelly when did we start using that particular registration? She goes, oh, you know. I just ordered it because it was on sale it's cheaper anyway. And then on top of it. They had a if you buy this much, you get a discount and bite. Reg, doesn't expire we go through it really quick. So I thought this would be a great deal. And I thought you know, what she's doing exactly what I asked her to do. Right. She's thinking about the economics of the bottom line. You know, do we burn through it can afford to take this special and not throw it away. She's all of this except for one magic missing piece. She thinks all bite registration is created equal. And that I don't have a particular clinical preference, which truthfully makes a lot of sense. Why would bite registration silicone seem like an important thing? Right. It's like bathtub caulk like one brand is probably as good as commodity Ryan showing seems like a commodity and soup for me. Really? What it made me think about is that they're absolutely things that we order that are commodities. I don't care what brand of two by two. Gosh. She orders really have no preference. But there are a lot of things that we order that. I do have strong preference. And I'm guessing in our hygiene department. There's a lot of things that we order that are hygienists may have a strong preference. And that we need to help her understand that so that when she is trying to balance the budget and inventory, and all of the sales that come in the sales reps, we got this on special in that on special that she can make those decisions with all the proper information. So it was a really good learning piece for me this week that she needs to understand why I use what I use. And where I have a clinical preference in where I don't and she actually maybe needs to have some of the science background information that she doesn't always necessarily have about different products. So that she can make those decisions well on our behalf for us. What a great insight Lii, and it kind of opens up a wonderful Pandora's box of some topics. We could be doing for in-service meetings with our team members. Right. Absolutely, right. You're taking it to the. Ice level. I hadn't even thought about that. Why just tell Shelly why not tell everybody on the team? Well, I know our listeners going to get a lot of value out of that in. It's so cool when things are so current. So this is something that happened last week for you. So thanks for sharing that with us. And I'm gonna do a little tease here. Because then what I'm going to do in our next clinical tip is because I guessing everybody wants to know what bite registration. I really wanted. So I'm gonna make you wait. And you're going to have to listen to the next section and the next podcast because then we'll talk about silicone bite registration pace. Awesome. Berkeley. I mentioned in the intro that my guest on today's thriving Dennis show is my friend, Tom luck. And hey, Tom. How are you doing? Great, gary. It was awesome. Seeing you guess about two weekends ago here in Scottsdale. Arizona at the voices of dentistry summit, wasn't that fun. It's the best. There is absolutely. Yeah. The first one the very first one that was actually the third and you'll voices of dentistry conference, and you and I go back to the very first one that was held in Nashville, Tennessee, right? It was kind of special some of our listeners might recognize your voice because you are returning guest. Absolutely. And for those of you that are new to the thriving Dennis show. Tom was on a previous guest with Dr Bradley bail. And we talked all about the oral systemic connection and in particular. Dr bail who is a MD is a physician talked about it from the medical perspective. And Tom, I go back to this interview. I believe is show number episode three sixty eight sixty eight so it's kind of crazy. But I go back, and I think about that interview that I did with you. And and Brad, and I think of it as as being really a seminal interview. Because of just how important it is. Because today, we know that the healthier teeth and gums is not just about your teeth and gums, but it's your overall health, and I believe we're learning more and more and more about that every day. It's almost like we've gone past the tipping point. And even the public. You know, is is quickly getting on board with that knowledge. And I can't think of any more important information than the information that you and Brad shared an interview because I like to say one of the reasons I love dentistry is because we have the ability to change people's lives every day, but would agree with that. Oh, absolutely. Absolutely. But how about we have the ability to actually save someone's life? How about that? Yeah. That's becoming more apparent. Yeah. Yeah. For sure. So I'm going to wear to cover all kinds of new stuff today. But as a courtesy to our listeners in the show notes, I'm gonna post a link to our previous interview. And that's without your Tom Larkin, Dr Bradley bail. And if you haven't heard that click on the show notes available at thriving Dennis dot com, you'll see a link there. Just click on that download that. And listen to that after you've heard this interview because there's so much powerful information there that I believe you'll be as excited as as as I am about share. You'll be said about hearing it as I am about sharing it with you. Yeah. Hey, so so we had some fun conversation in in Scottsdale. There's all kinds of new new application new information that you're doing. So I'm gonna I'm gonna turn what's new and exciting time. Well, one of the things that when we I I think it was in the interview with Dr bail, you had mentioned that you were familiar this goes back into the eighties. A couple of people that were very important in your doctor owner read. And Dr Perry Radcliffe, and they had a program called people without Perreault where you actually showed the bacteria under the phase microscope as a motivating factor to the patient's, right? So we're using the face contrast. So for our biology nerds, by the way, I'm I'm one of those Tom. Okay. Great in. So are you? Guilty as charged. Yes. And I would politely suggest that probably ninety percent of our listeners are also biology nerds. And I use it as a term of endearment. So if you're one of those biology nerds, we're using phase contrast microscopes, we would take a Q tip. We'd run alongside the inside of the cheek. We'd make a slide in. Remember? We were doing this in nineteen eighty three when I miss we had no technology. Right. No monitors. So we would make a slide, and we would take the patient have them. Look, you know through the microscope lands, and they would see Spira Keats Betsy bugs, the language that we we. We'd say George I want you to take a look at this. You're gonna see what looks like tadpoles there on the slide. And they're they're Spira Keats. And they're the bugs in your mouth. And if you see a lot of them, it's a concern. If we see few of them, it means we're doing good. Let's take a look, and we know what we on the first path. We know what they'd see. Right, right. They'd see, you know, a an abundance of bugs. And while it didn't help us a lot at that time scientifically because we didn't have the technology to species the bugs, right? It did help in amazing way to motivate patients to accept a conservative Pernell therapy because nobody wants bugs in their mouth. Do they? That's exactly right. Yeah. So I jumped in in eighty nine okay? That's when I met Paul KYW's and brought his program in my practice and at that time. Now, the microscope is attached to a small was probably about ten inch monitor and that was a game changer. I mean once the hygienist saw how to use that tool. It just change the conversation. So I was kind of went to say, oh, gee in prevention in a going back a long ways because we actually did strep mutants cultures with with an incubator. And the I I mean, I really bought into the. The fact that this was a disease. It was preventable. So fast forward to your plan here on recognize at European. You were doing this. When this stuff was nascent. And I mean it was controversial. Yeah. It was it was in the technique. Was you know was just coming on board. And man, thanks for being a pioneer. Well, but I didn't expect anything of it the way that transpired because meaning Dr bail when I signed speak in and was one of the second or third meeting of the American Academy moral systemic Cal, then I have this whole vision of oh, my gosh, Dr bell, and Dr Donen are going to need dentists that are clued into microbiology. And that set me on a at the time. I was teaching at the university. It sent me on an entirely different path to help them define what this meant. And so at the time, we have a new technology of biofilm DNA, which there's two or three companies now where we can actually go in and speed and look at the and look at the 'Bacterial, but I went back to the microscope. And I said, listen, the beauty of the Mike. Scope was that it was a twenty five cent tasks, and we always included it in our exam fee. So we tested everyone at every appointment scenario. We have a new test the biofilm DNA now, we have a cost out of pocket cost consideration. So so my thing was let's let me create a program where we introduce the concept of hey, this stuff in your mouth is alive. Now, we're putting it on giant monitors. Right. Twenty two inch forty inch and people are really engaging in the conversation. Get sixty inch monitor. Oh my gosh. They may have some heart problems from seeing that. Yeah. So so so the whole thing of getting the patient engaged in it. Now, we can lead them down a path and say, you know, I really would like to know specifically which back there because now we know in that group of pathogens, and as you know, two or three weeks ago, there was an article in circulation on social media about PG specifically associated with Alzheimer's that was a big big big research article. And I think if I remember correctly, you had some connection with six or Krant sqi who he actually came up with the red complex, and and PG, and and he really helped find that. So what what was he in in your world or you just had to learn so six grand scheme was very prominent period. Honest who was the director of the foresight institute in Boston foresight is associated with Harvard University research institute to study all things oral health. And in nineteen ninety eight he had a groundbreaking groundbreaking discovery. He is credited with discovering the eleven eleven pathogenic bacteria that clause paired allergies. And so it took it from the mysterious state of well is it plaque is at bacteria. You know? What is it Ryan to where he threw his just copious research was able to term that's eleven specific pathogenic bacteria and Tom. How many I mean how much bacteria in the mouth? I mean, it's it's like six to seven hundred, you know, different types sightsee, by the way, many of those are actually useful absolute. So for example, you know, bacteria that aids in digestion is actually is slow so all seven hundred plus bacteria in the mouth aren't actually not all dysfunctional. But there are eleven specific ones that are bad. And it's those eleven that that 'cause parallelism so it kind of removed the mystery around it now if we could figure out if the patient has those bacteria. How do we treat it, you know? And and by the way, the mix of those eleven backstage, of course, many of our listeners also be math nerds of which I'm one of those as well. What's the possibility of the mix when we have we're testing for eleven bacteria? Well, it's eleven to the eleventh power of the of the possibility of the mixes of those bacteria, and so it's pretty exciting stuff. Hey, before we get even deeper microbiology, Tom would you just in lay terms would you credential? Dr bail did just by sharing a little bit about what you know about him because I find it would be absolutely amazing. But why would you credential him for our listeners? So he's a medical doctor. Dr Donini is a PHD nurse practitioner. They've been practicing together for about some are seventeen years, and they came up with what is called the bail donate method there the author's about called the heart attack, gene. And basically. What I recognized in two thousand and thirteen is I called them dentistry best friend because they can't practice without a dentist. They absolutely need a dentist, and they didn't start out with a hypothesis. What they did was they backed into a hypothesis and what I mean by this is that they are looking at the root cause of inflammatory based diseases heart attack stroke, diabetes, Alzheimer's, and what they found was when they had a puzzling level of inflammation. And this is measuring blood biomarkers Cleveland heartland has test for biomarkers, but they would have a puzzling high level. They were finding people that if they sent him to the dentist, and they had a tooth polled those levels immediately dropped and then they began to look more closely at the mouth, and then they were seeing paranormal disease and very small number of ended onic infections and sleep apnea. Those three drivers which are very much within the diagnostic wheelhouse of. The dentists the dental hygienists where major major factors in their methodology. So that's where they're bringing the dentist in really put putting them as a denizen physicians. Have always we've tried to work together. But really didn't have a rationale. I think they're method is the rationale, in fact, one of the things I'm going to talk about is the I'm working in a prevention clinic here in Lexington. This thing's getting kinda crazy working with physician. Okay. So yeah, lots of stuff going on there. So that's that's the kind of the cracks of the bail donate method. You know, I've had that same survey shin myself, Tom that I I've wondered why the physician community and the dental community didn't work more closely together, and I had a discussion with a young physician friend of mine, and he actually shed some light on that. Can I can I share his comments? So young physician. He's a family practitioner, and I said how come the physicians are working more closely with Dennis? And he said, you know, when I think of my medical school education. He said, do you know how much coursework was covered during my medical school education on the mouth and honest to gosh, he said a one hour lecture. Sure, it was a one hour lecture. That's it in his entire medical school education. Meanwhile, they go through extensive rotations, you know, as a as a general practitioner, he went through extensive rotations in every different area. And he said, basically what we're taught is. The dentists are the physicians of the mouth, so they do that. So you guys don't need to learn that right but meal, I gotta learn all this other stuff. So consequently, they spend all the time on the other stuff, and they get very little coverage because that's your gig. That's that's your deal Tom that trays, and it's sort of a dysfunctional coexistence. You know that we've had which is really changing now. And I've gotta give you know Dutch bail. At least partial credit for really changing that relationship with the professions because it's all about working more closely together, and you mentioned his book beat the heart attack. Gene beat the heart attack cheat new New York Times bestseller, and I'm gonna highly recommend that every one of our listeners read that book now and not only read that book, but make it book club for your entire team. And here's why. I care about you care about every one of our listeners, and I want you guys to be around for a long time fair enough. Absolutely. And this book will provide you information that you don't already know about Cardi, cardiac health, and it will motivate you and your team members to look at Perry with a whole different perspective. One of the quotes that I credit to Dr bail is this, and I may have it slightly wrong. I'm drawn this for memory. But I believe it goes like this and correct me if you know it to be different, Tom. All good health begins with the mouth, and that was said by Dr Bradley Bill, have you know, what you say that? Yeah. Absolutely. I get the wording, right? I think so or close right close to. Okay. But don't love the fact that all good health begins with the mouth, and that's coming from a physician. Sure. I mean, how cool is that? Well, I mean, you can go back historically 'cause I know you like history to Charles mayo. Founded the mayo clinic he's attributed and in nineteen fifteen with saying that the next great strides in prevention should be are going to be made by the dentist and challenged the dentists at the time and the dentist didn't understand it. Here took a hundred and four years. But here we are. Yeah. Hey before we get into all the latest greatest stuff. I want to take the discussion a little bit different direction. Can I do that? Sure. Tom. I'm saddened today. You know, as we're recording this. It's it's twenty nineteen folks may be listen to this later, but as we're recording this I'm sad today to see that in many dental practices. Peros not really even on the radar screen, right? In twenty nineteen. Can you share some thoughts about that? And if we have any listeners that are thinking, well, I've got I gotta pay attention. All this other stuff too. I really need another thing. Can we maybe provide some positive motivation positive thoughts that might help them? Put it on the radar screen. I attributed since I've had let's see maybe six or seven years experience teaching part time at universities and dental schools, and I attribute it to the lack of understanding of dental hygiene. Now, I do know that you have exposure to an exceptional program at mid western that does teach them about what a dental hygienist does. Right. So I think if I was to give you a root cause on a large scale across the education of not knowing what a dental hygienist really now. Sir. Can I call out and give some credit where Credit's due on? That are dean Dr Brad Smith. Brad is an atypical dean. He practiced dentistry for twenty five years as a practicing dentist. Wow. Before going into academics. That's unusual. So I believe that's where the Genesis of that started was that he knew how important the role of hygiene is right in a general dental practice, and it's something that he has embedded into our program. So you're absolutely right. Our students graduate with wonderful guidance and appreciation for for hygiene and the role of hygiene in in a successful practice. I learned that from Omer Omer taught me in nineteen eighty that. The backbone of a successful practice is hygiene apart then today, and again, I'm I'm sad still by by some Dennis, and they may not be in our audience. They may not be listening to this. But they're out there that think of high. Edginess a loss leader. Yeah. No mill. Mill ninety close. Yeah. Emmy from a business standpoint. And I know you're very clued into that. It's a one third component of your business. And so what I like to say is I can't think of any other profession, you can't graduate from law school and not know at one third of the practice of law is, but you can't graduate from school and not have a clue of what one third of the business of dentistry is and that's the practice of dental hygiene. Well, yo you did love your direct comments about where we're that comes from an and it might you're right. It may come from, you know, in dental school just sort of it being Nord, you know, and well, let's change that. Because it's it is it's it's one third of your tire practice should check coming from hygiene. It is. I'm going to dispel this myth right now. It is not a loss leader. It's absolutely a critical component and should be a profit center in your practice. And Furthermore, if what your practice is all about is taking the best care of patients, which are practice is built around one simple concept, which is to take care of patients the way we'd like to be taken care of then it's even more critical in patient center approach that we we focus on hygiene. So well statistic that'll that'll help too. So one of the people involved in one of the software companies that kind of plugs in and measure statistics in practice. He looked at a very large group practices. It might have been a hundred practices, and he was he was looking at the number one KPI key, performance indicator and a practice, and it was hygiene reappointment and engagement in the hygiene department, so so get this, and I'll make this brief the difference between a practice between sixty percent gauge -ment and ninety percent engagement was double the gross income double. Now. That's the driving affect of a vibrant hygiene department on overall on restorative care. Right. So how do you get the ninety percent versus sixty while at sixty percent the patient. That's coming in is coming in to get their teeth cleaned. 'cause they liked the way it feels. They liked their teeth feeling smooth the person who's engaged at the ninety percent level is a diabetic that knows that they're on three month recall, and they're using significantly less insulin because they go every every three months to see the difference in the valley. Oh, gross income at the ninety percent level. Okay. That's that's a big statistic, by the way, those statistics are unimpeachable. They they come from a database of over four thousand practices, and you know, if we didn't have you at, you know, take better care your patients. You shared a different metric there that what what was the exact metric those were engaged at ninety percent were had twice tries to gross income gross income. So I hope we got we got your attention at app, the quality of clinical care. But by the way, w if you'd be interested in in doubling your count. Pay attention to what Dutcher Larkin has to share with. Absolutely. Yeah. That's impressive. So carry it for what what? Here. We are early twenty nineteen lots of cool things happening. What's happening? Now, you're saying, okay. So one of the things I did is I sent a physician this is two years ago. It took us a while to kind of get this thing together, but I sent him to the precept or ship. And I think it was in New Orleans because I can remember. So he goes the first morning he texts me at nine o'clock in the morning. Any in the text was just this. This is so obvious. Okay. So I knew he was I knew he was immediately like getting engaged, and he just understand why no one knew this. Right. So so making long story short. He gets to roll this practice prevented practice out last summer. And so I'm helping him on the bail don't anything. And I said, let's do something different for the open house instead of engaging in marketing to the public. I have an idea. Let's do a project where we are going to bring in a group of ten to fifteen healthcare professionals and put them through the entire protocol. Right. And and so I called it. The preventative intensive. And it was a one day event. Half of the day was the medical screening and the other half was education. And I brought in Dr Gina Pritchard. Who's probably the top bailed owning practitioners in the country. She's she lives in taxes, and she's been doing this since two thousand nine okay. So she came in to do the medical, and I did the dental part, which was we had the microscope set up to the vile film. We did the biofilm DNA and then we did the sleep screening. And then we had the CMT which is crowded into media thickness ultrasound that was another part of the test. And then we did all the blood work. And so, and then we did the follow up like we can have later over zoom online, and it was just a remarkable experience. So here's a physician me and a patient and we're collaborating on their results, and I'll give you an example where someone had an elevated biomarkers. There was a nice. Nitrous oxide thing. And then Dr pitcher would say, Tom, what did you find on the sleep? And I said, hey, you know, Malam Patty score was terrible. They're they're they're very high risk for sleep apnea. They need a sleep study. So the medical and dental correlated. Okay. Now, we take the the biofilm DNA she'd say they're Milo peroxidase, which is another inflammatory marker was elevated, and it's very aural oriented, and she'd say, Tom, tell me about the paranoia pathogens will then I had the pathogen tests in front of me. And I'd say, yeah. A is off the chart PG's up here, blah, blah, blah, and everything kinda coalesced. And I said, you know, this is the integration of medicine dentistry, all of the participants. I mean, the reviews that we got they were they were fantastic sign knew. This was not a one time about this is something that we're gonna do we're doing one again in the end of April here in Lexington. And it's something that I wanted to couple of times a year because I thought you know, if we can touch ten to fifteen healthcare practitioners who see thousands of pay. Year, each you know, that's because when you become a patient because I became a patient. Doctor bales in two thousand and thirteen. This whole thing becomes very real. Okay. And so my concept was if we if I get ten or fifteen docks that this becomes real to then an it. Did it worked tremendously? So that that's been a very exciting thing for me. And it wasn't you know, it was just one of those things that I threw up on the wall in it in stock. That's exciting in a way, it's sort of as you described that to me in my mind, I'm thinking, this is what we've been wanting all this kind of collaboration and contribution from the different era with that we could talk we there was such commonality in our conversation. Right. So so here was an elevation in inflammation, that's attributed to the oral, and I had the actual results because you know, my my whole beef all along is that Dennis we're not trained to measure things. And that's where a lot of this. You know, breaking the salivary diagnostics where we actually met. Well, that's what our physicians do. They measure your cholesterol, they come up with a number. They measure your blood pressure. But dentists we look in a mouth, and we say, yeah, you look a little better. It looks better. You know, can you imagine, Tom? I just want to kind of take this to the absurd. Can you imagine going to a physician going to your your general practitioner, and the physician looking at you and say, you know, Tom, I don't need to take your blood pressure? You look nice and Catherine. That fame and you don't have wrinkles in your forehead. You don't look stressed. I don't need to take your blood pressure. Yeah. You look fine. We do that all day every day. Doing better. So so let's go back, and I gotta talk about the microscope because the very cool project. So in the process of trying to develop a course to help train dentis, I'm revisiting the microscope from eighty nine whatever dusting off the microscope, and I'm very unhappy with the technology because I can't this is not something that I can have someone by and actually requires assembly explanation, whatever. So I took an entire year. I bought everything I could online because I knew there had to be something new. And there really wasn't. Because basically what it is. It's a security camera that screwed into the top of a microscope. Okay. That's that was the camera system. And then I found out that all this stuff that were there's a lot of optics that are Chinese that are not, you know, Zeiss like a, you know, the really lab quality optics. So I was just about to give up on this whole project because I'm reaching out to different Mike. Scope companies, and I and I come across an old school company in Philadelphia. Miller precision optical, and and the guy been in the microscope business for forty years, and he'd actually done some work for one doctor Kaiser's people, and he said, Tom, what do you need? And I said just gimme the latest and greatest something chair side looking at biofilms for the hygienist. Right. And I said, I don't even want peace is, okay. Can you take the pieces up because I'm trying to strip cost down to he says. Yeah. Take pieces off this thing is going to be kinda short Squatty. And so anyway, puts it together he says if you don't like it to send it back. He sends it to me. And I was like oh my gosh. This is it. This is the microscope that I've been looking for plug and play you can put it together and five minutes, I've got an instructional video on my website. Everybody's been able to do it. So now, I have been able to actually do implementation over the internet zoom conferences, they buy the scopes set it up. And then I have a PowerPoint presentation, and I can meet with the team, and I can actually get them going doing the sampling. Implementing this online. And that was that was kinda my dream because I'm I was not remotely interested in traveling around offices, one one and and changing the culture, but but it has been a it's really worked, and I've been super happy with the ability to be able to do that. Because it what you experienced, you know, back in the eighties, and to completely, you know update that now we can have that extended conversation of these bugs are, you know, associated with this that and the other, and yeah, it's very cool. So that's I can only imagine the case acceptance. Yeah. That patients have when presented with the information. It's it's huge. And the other thing that I'm finding is that it saves time. And this is so important because I promise every hygienist that I made I promise because they don't need one more thing to do. They are they they get an anxiety attack. Dennis comes back from a conference and says, hey, I wanna implement this. Right. They. I don't have any time. And so I actually have testimonial from from two months ago or MRs no at saves me at least ten to fifteen minutes on a new patient exam. I don't talk about pockets. I don't talk about this. And I'm talking about that. I put the bacteria on the screen. There is get big they're engaged. And I said, you know, this is an infection or this is something we have to work on. And then we go from there. Love your focus on practicality. You know? I mean, it'd be wonderful. If we could put herself in a vacuum and do a do a six or seven our new patient appointment, you know, and you know, Ed, Ed livid, you know, ivory tower vacuum. But hey, we're in the real world. We've got a found a way to do this officially effective, right? And and frankly cost effectively, right? And that's been my commitment from the beginning. Because I do know that there are people that can do the biofilm DNA on every patient. They have that time. My whole thing from the beginning was if I'm gonna commit to helping with this 'cause I have to be able to implement this across any practice, right because sticking to the measure of saying, this is included in your exam is this where you know. So that people see the added value that never had that type of an exam. They're not paying extra for it. But the conversations that come out of that have such value, and that's an and this is a complete sidelight to. I also want to have the orig-. Kyw's conversation of listen, I can't afford all these rinses. Hey, can you afford some baking soda? Hey, if you want to I mean, I I don't recommend this everybody. But if you want to dilute some bleach, this is a great, Anna microbial. I mean, I want to be able to to help every patient that potentially comes through there. Right. That's interesting time because one of the goals that we have at my practice lifestyles is to make quality dentistry affordable. Right. And for me. It comes from a fundamental experience. I I was raised in a blue collar household. My dad worked for Ford Motor Company. He never made more than fifteen thousand dollars in his life grand. That was nineteen seventies money, but still wasn't very much money. Somehow. My my mom and dad raised three boys. I'm the oldest three and I have a soft spot in my heart for blue collar working class, folks. Sure my own practice. I want the imagery that we use is I want a single parent schoolteacher to be able to come to us for dental care. And so this can be done affordably which exciting. Yeah. And that's the whole thing because I'm imagining partner to practices here. And I feel like as an educator in a consultant if I can help there in that type of practice you can help any practice, but you can't do the reverse. Right. If you only work in elite practices with elite clientele that is not scalable, you can't earth off of that. Right. Right. Right. So you might if we get a little bit granular and talked about some details. Okay. So on this to implement the scope. Let's say we want, you know, we've got some listeners. They're like, I'm all in. What do I do talk about cost? What's it cost to implement scope in the practice? Just ballparks fine. Okay. So the microscope is forty seven hundred dollars. And if you have a monitor it's got an I that's the other thing too. The the camera's internal there's no external camera. It's got wifi. You can see the images on an ipad. You can take the ipad in the other room and show patient. It's it's it's it's everything I was looking for right? The course the implementation courses twenty five hundred dollars. So that's those are the two things to to get you well often going, and it's a turn key. I mean, I'm talking about including posters, go on the wall. You know, it's it's changing the whole culture of the office all of the paperwork all of the scripts around bacteria because there's conversations around bacteria. It's it's everything that you think of and you know, you're doing the limitation, correct? Yes. And then you're doing that digitally, and a largely remotely Crick crack, they they do get hard copies of everything. But everything it's digital and hardcopy both very cool. And we didn't talk about this ahead of time. So I might be put on the spot. But would you mind sharing, you know, maybe a case study of thought of or a case study example of of what's happening to client? I've got I've got. Foreign after videos on my website. That's because I'm some so focused on the sampling. That's kind of where I'm where I'm working from. And so, yeah, I've got all kinds of videos and stuff there. Well, let's share. Let's share if I know I'm putting on the spot. We didn't talk about ahead time. But let me share some data with you one of the things that we look at him. I coaching for. I look at it KPI. And one of the cases is that. I look at is of the adults in the practice. What percent are being treated with Donald coats? Right. And we know what it should be. But very often does even measure up. I it's usually sadly, a low single digit percent. Yes. You know? So what might a a listener who maybe seeing five or six percent of the adults being treated with parallel. Coz, what might they expect to see with your implemetation course, and some technology like the scope, what might they be? To see again, your results, your, you know, your gas mileage may vary. Exactly, that's the whole thing because I can say the difference between my personal practice and even the practices that I'm coaching and right now that's going to it's going to vary. Wildly. But I would say that she should be able to do thirty percent pretty pretty comfortably just by just just from the motivation factor right in in the thing is I don't get so grandma. I'm not gonna pick entre. Cameron tips. We are gonna talk on my chromium. Right. So this isn't so much technique oriented as it is behavioral modification, okay? And really increasing value of it. So. Some good. Verbal skills are not only are doctor, but our hygienists and assistant the whole team. Actually. I imagine you're covering some wonderful. Verbal skills. Absolutely. Yeah. So so perhaps a good. I level goal would be to get to the point. Where retreating thirty percent of the adults in our in our practice with some type of Donald. Without question. Okay. And it's still the proverbial tip of the iceberg. Yes. Yeah. Because sixty percent have bleeding, you know, because the whole thing is you just can't believe. Okay. And that's you know, in my courses, I just you know, what what is this stemming connect you cannot lead. If you have a bleeding of a breach of the epithelium, and if you have a breach you have back here in the bloodstream, can I can I be a devil's advocate and just role play as as a patient. Sure. But Dr everyone's comes bleed now, it's not true. That's not true. And let us show you how. Yeah. Because because I was that person. Okay. Going back to me two thousand and thirteen when I went through zoning, I wasn't a philosopher. Okay. And I talk about the whole thing with irrigation and in soft picks and trying to create a practical program. I'm not a big flaw cer-. I'm not a big fan of lossing and research today, if you had heard Donnelley's, it's it's not primary. It's inter dental stimulators. Right. So that's a whole nother conversation, but you can stop. Okay, you can excellent. And again, I believe that the mindsets changing among the public because of the more and more information getting out about the oil systemic connection. I wouldn't say it's where we want it to be yet now, but it's trending in the right direction. Yeah. So again, I'll I'll stick to this. Sort of taken position if I may with your top just playfully, I I'm on board with both feet, but. How might you? You know, we implemented our practice. If I go back and explain this kind of personally when we bought our practice and may have oh seven, and I literally I'm not exaggerating. We couldn't find a pair Donald probe. Oh, seven right. I think we could agree that that was supervised neglect, then and you know, would be even more so now, and of course, we wanted to to move the practice along we wanted to practice state of the art Perreault diagnosis and treatment, and we appl- amended the pathogenic test, you know, to to identify a parallel pathogens salary diagnostics. And I thought that when we talked to our patients about no today. We know that you have to go back to seven the public awareness was nowhere near what it is today. And we'd say to the patient that I see a concern in your mouth. It looks to me like you have an active infection. That's that's the language. We used. Looks to me like you have an active fix your mouth. And I'd like to get some more information, and you know, talked about how how we can help eliminate that infection much to my surprise. I thought people were. Oh, wow. Yeah. Let's get that taken care of. That's what I thought. I'd here. Now. That's what. What we heard was a very simple question. Does my insurance cover now? Exactly. And did. Wait a minute. Wait. You know that that that's that saying, no, wait. What wait? What didn't you hear the part about your heart? No, we didn't say that. Of course. But we're thinking that. No, I get that. That doesn't surprise me at all. And the patient would ask does my insurance cover, and we had a good answer for that. But but the basic the short version was probably not now we didn't use. We didn't say that. We can I share with you what we actually said. Yeah. So we would say well dental traits is only meant to cover the most basic things. This is a more advanced procedure think of it as being covered out of pocket. Now, we're gonna do everything possible to help you get any reimbursement from your insurance. In fact, we have a team member who's amazing at at you know, squeezing every last benefit out of your dental insurance. But think of it as not covered. And if you do end up getting a check back from your company, be sure to go thank Meg because she she got your reimbursement. Now that was a glorified way of San probably not right. And when they heard probably not guess what they said many patients set. Well, then I won't have done less insurance going to cover. So could you address that I know that there that really needs deserves a much more time own. No. And that is exactly I am so happy that you told that story because that was exactly my motivation to go to the lengths of changing something that was a game changer for me, it has whether you have insurance or not once there's just something about the visual impact of that that just engages people to the point where they'll. The most common thing they'll say is that in my mouth, and they'll say, I don't want it in my mouth. I don't want that. Okay. What are we going to do about it? And when can we get started? Okay. Those are quotes I've heard just dozens and dozens of times how many times has anybody ever said to you ever in dental office. What are we gonna do about it? And when can we get started? Okay. That speaks volumes for the power of the visual. Okay. We'll time we do here. It is the patient. That has a jacked up a smile. The kids would call it today. You know, jacked up grill. Right. And they want a beautiful smile for something coming up it might be their daughter's wedding. Or whatever it's like, hey now that we know I have jacked up small what what can you do about it? How soon can we get of? Yeah. So it's it's all about the buying you know, that people need to buy in. I mean, it's it's facilitative learning at its best. Okay. And this is a process. Okay. Then that's yeah. And so this is a tool that just greatly greatly enhances that process just tell you stories over and over if it's very surprising. How do you charge? So how do you charge for struggled with terminology the the implementation of the scope, how do you that? That. Are you talking about to the patient? He's correct. No. So verbiage is important. Okay. Think about this. So your new patient during I say, you you sound said, Gary TAY nice to meet you, Bob. We're going to clean your teeth. I'm gonna do some x rays might and the patient in their mind in their in their head has a calculator going. And if you start saying they're going to do too many things they're going to stop you. And they're going to say how much is that? Okay. So part of my script, which is really important is is included. Gary included in your exam today is a new test that we're doing for bacteria in your mouth. And it's kinda like when the doctor measures your cholesterol, because if you know that if your cholesterol numbers, high you have a high risk for heart disease will we now know that some of these bacteria in your mouth have a high level, you're at risk for heart disease too. So we include that in your exam. Okay. So now known says, well, how much is it a gap taken that barrier completely out rights? We incorporate six digital photos. As part of our new patient experience. Well, how much are those photos and our answers there included. There's there's no judge. I knew that was the answer. But I wanted you to say that because there there's no charge, right? And now that you have data, and I can only imagine that when the patients looking at the monitor cast its case acceptance has got to be extremely high. Yeah. In my my personal practice in once again, there's a difference. But everybody's got different stuff. She it was almost absolute. I mean, it was in the ninety percentile in my personal practice. Okay. Different time and place. But I don't know those two ticks in. You know, everybody tells it's it's a game changer. Wow. This is this is exciting. And of course, again, let me put my business cap on for just a minute another point of differentiation. Right. No, no question. No question. Now, the patient's going to say, well, my office is state of the art. And they've likely I mean, I hope we get to the point that this type of protocol is more standard in dentistry. But for now what a wonderful point of differentiation. Well, let me let me give you another really added value that I like, and I came up with this. Okay. One of the things, and I don't know if you were ever this person because I'm always been critical about it is when a consultant will come in and tell teams and doctors you need to ask for. Rurals? Okay. That's very common and ask for roles now me. Okay. That is the most awkward thing on earth. If I've been in practice twenty five years, and you tell me to ask her for I'm gonna tell you it ain't gonna happen. Right. I was never that guy. Okay. Thank you. But that was popular. And I don't know if anybody's still doing it. And it still comes back around yet that watch this Gary watch this really carefully because I've got I've got a very nicely done. Very simple brochure. You kinda know my style. I'm a cliff notes guy. Don't get to into deep into the into the weeds. So I'm gonna tell every I'm asking every patient every day, MRs Smith based on your history of bull look at look at anybody's health history. Everybody's got you know, all kinds of medications all kinds of issues based on this based on the fact that you're at your husband has heart disease, and I look straight in the eye. And I say they need to be in this practice. They need to be seeing hygienist. I insist on it. So I go from asking for for all now, I'm insisting on a referral. You see you see the ship there. It's radical because because because number one I'm exuding extreme confidence in what I'm doing. Okay. I have confidence in this level of practice. And I'm looking on. I'm saying you've gotta get so. And so in here, they gotta get in this hygiene program because they're diabetic and insulin's expensive. And they're gonna use less instal, get them stabilized per Donnelly. They are gonna use less insulin. Your dental your dental hygiene appointees are going to be free. Now. I mean, it's just it's all in. How you how you put that? So I took that whole ask for referral thing. And I've I've just turned it. I completely completely flipped it. This is exciting. Hey, tom. I know that our listeners are going to want to get more information and be able to connect with you. Can they do that on your website? Absolutely share your website address. If you would okay, very very easy to find its Powell POW, hygiene dot com, and that stands for proactive Orel wellness is it was the concept. So it's pal hygiene dot com. Everything you wanted to know and more. I've got seventy five articles research articles in support a bail donate. If everybody everyone wants to go, you know, if you're in a pinch. And you say I gotta go find some research. It's all there, all the microscopes all the everything is there. And if they want to reach out to you by Email can show Email address with absolutely. So it's Tom at Tom Larkin dot com. Perfect. Hey, if you're listening to this don't take your hands off the wheel we want advocate safe podcast listening. I will put Tom's website. I it's actually very easy pow POW, hygiene dot com and Tom at Tom Larkin dot com. But I'll put that in the show notes that's available at thriving Dennis dot com. Just one click will take you right there. Hey, tom. I want to thank you for continuing to push the envelope on Perio. I want to bring this back full circle. I count myself very fortunate that thirty nine years ago. Dr Reid told me that Gary just just so, you know, hygienes the backbone of a successful practice. I believe that stronger today than I did then, and you're pushing the envelope, and you're pushing it to the point where it's time. It's it's way pastime to get serious about diagnosing and treating Pero and this fits in general practice, and it fits like a glove, and you've actually made it very easy because this is something we internally with no additional cost to the patient. Yeah. There's some minor in investment, technology, technology and training. But we're we're talking about very modest. You know, this is something that that can be implemented in every practice, and man, hey, can I get you back on a future episode? And maybe if I can get you thinking about it, maybe go through the case study method. Kind of the Harvard University case study method, maybe if you could be thinking about identifying a two or three case studies, and let's walk through maybe the office that was completely oblivious to any of this. And they're starting from scratch, maybe one another one could be the office that was doing. Okay. But they knew they had room for improvement. Okay. And maybe even that third element. You know is an office that was actually doing everything but the scope now they add the scope what happened in. And I'm just suggesting those you could find any case studies. But the idea of showing what happens, and and showing the effect of implementing this cool science, and it's also behavioral I love what you said a lot of this has to do with behavioral it really isn't so much about the technique. Not not to minimize the technique techniques. Always important, but it's really not about how your Hijaz is holding scaler, right? Right. It's really about you know, our communication skills. And and you know, our ability to have crucial conversations, right? I heard something interesting close on this point. But I heard something interesting recently, and it said the author said this he said that your income is directly correlated to your courage at having difficult conversations. And I listened to that, and it instantly sort of jumped out at me as a ha that's exactly right. And it doesn't have to be confrontational. Right. It can be just, you know. Hey, tom. I care about you too much. Not to have this conversation. Right. You know? Well, hey, I really appreciate everything that you're doing. I'm really excited to share your knowledge and passion with our listeners guys as you're listening to jump on board jump on board with bull. Feet, and you will not be disappointed, Tom. Thanks for everything. You do. Thank you for having me on. Thank you. My pleasure. Hey wanna take him in? And thank our listeners. We love what we do here. The Dennis show. Couldn't do it. 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