Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
How to perform dentistry faster, easier, higher in quality and lower in cost.
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1207 Melissa Turner BASDH, EDPH, Director of Volunteer Operations for Operation Grace MN : Dentistry Uncensored with Howard Farran

1207 Melissa Turner BASDH, EDPH, Director of Volunteer Operations for Operation Grace MN : Dentistry Uncensored with Howard Farran

6/12/2019 1:48:11 PM   |   Comments: 0   |   Views: 140

Melissa Turner is a dental hygienist who currently holds various roles within the dental industry—as an influencer, thought leader, advisor, and consultant. With the unique experience of practicing dentistry across the country, she is an expert in mobile dentistry as both a for-profit and non-profit delivery model. 

VIDEO - DUwHF #1207 - Melissa Turner

AUDIO - DUwHF #1207 - Melissa Turner

In addition to running a non-profit mobile program in Minnesota, she is founder of I Heart Mobile Dentistry Facebook community and is launching the first ever National Mobile Dentistry Conference in the spring of 2020. Melissa’s current goal is to re-frame the traditional views of hot-topic issues like teledentistry, direct access and independent hygiene practice, dental therapy, as well as the rise of the millennial workforce. She is an Executive Moderator for the Dental Peeps Network and works internally with companies such as onDiem, Floss Bar, and MouthWatch. Her latest advocacy efforts include launching a nationwide hashtag campaign, #LoveInTheWorkplace, in an effort to bring back love-as-an-action into dental practices everywhere.

Howard:  it is just a huge honor for me today to be podcast interviewing Melissa Turner BASDH, EDPH  that's a bachelor's Applied Sciences dental hygiene and the IDI pH is expanded practice dental hygienists who currently holds various roles within the dental industry as an influencer thought leader advisor and consultant with the unique experience of practicing dentistry across the country she's an expert in mobile dentistry as both a for-profit and nonprofit delivery model in addition to running a non-profit mobile program in Minnesota she is founder of I heart mobile Dentistry Facebook community and is launching the first ever national mobile Dentistry conference in the spring of 2020 Melissa's current goal is to reframe the traditional views of hot topic issues such as tell identity direct access independent akeem practice dental therapy as well as the rise of the Millennial workforce she's an executive moderator for the dental peeps Network and works internally with companies such as on DM floss bar and mouthwash mouthwash her latest advocacy efforts include launching a nationwide hashtag campaign love in the workplace to bring back love as an action into dental practices everywhere thank you so much for coming on the show today my Hank you for happening man it is an honor to have you on the show and just reading your intro I mean everything in your internal is a hot topic controversial no holds bar issue I mean there is nothing there is nothing boring about your resume um so let's start with the first one year the initials after your name ever most dentists understand already Ages for registered dental hygienists but you have a Bachelors of Applied Sciences that'll hygiene so that that's a more tender most scientists get that if they want to teach hygiene right correct yeah but this work - sounds worse - but the second one is your IDI pH expanded practice dental hygienist so you can do hygiene without the dentist in the room that's correct as and so I got a I'm old enough to be your hopefully just your dad and not your granddad but it's kind of funny because when you go back through dental history when dentists were just pulling teeth and doing dentures there was this early pioneer called Bob Berkeley have you ever heard of him Bob Berkeley he's been a hundred years ago and I paid way too many thousands of dollars for his book and at a but anyway Bob Berkeley was going around the country trying to tell Dentist that they need to hire this new degree professional this registered dental hygienist to do preventive and the entire pushback was dude I'm so busy pulling teeth and doing dentures I don't have time for this and then the same issues today she's a threat to my dental sovereignty and all those same issues back when everybody was losing their teeth and getting dentures and now here it is now my four kids have turned into five grandkids I'm 56 and when a hygienist wants to practice by yourself the dentist's act like she's some communist alien coming in you know ready to destroy dentistry why right why is it like that 

Melissa Turner :  well you know for one thing I think dentists are often stressed out and business I mean you name it to run the business and manage to not only do those things but then you know be the primary profit in the clinical side of things so I would imagine I'm not a dentist but I would imagine that dentists are so focused on what they can do that anything outside of that might be a little bit scary might be a little bit well I don't have time for that right now and so things like you know independent dental hygiene practices or direct access to dental hygienist are kind of scary for them until they have a bandwidth to actually you know really absorb it and to see how it can be a profitable enterprise if they embark on that so expanded practice that's a permit specifically for Oregon I just moved from Minnesota and SOTA I was a collaborative practice dental hygienist and there we had to have a written agreement with a dentist and if I did if I had that then I could practice without an on-site presence of a dentist and provide care in various but that was mostly nonprofit settings 

Howard:  so I list all those arguments of why they were against Bob Berkeley telling him to hire high just because he was literally looking at and saying do you want your children to grow up and have a denture or would you like them to have their teeth I mean they just didn't even get it same arguments they I see your dentist here show your kids moves away from home he lives in some small town it's only got a thousand people there's no dentist there and some hygienist wants to open up her own dental office right there in her own home in town of 1,000 and tell me why that's a bad idea for your own child and your grandchild and theirs and then I say so so was was Bob Berkeley wrong should we get rid of all behind us and do our own cleanings they go no so it's the same thing with expanded duty function assistance you go to Kansas and the dentist will not load three rooms he'll num-num-num drill drill drill and then the expand of duties go in there and place some matrix in place to restoration and they love it and now I'm in Arizona and I tell one of my Arizona dentists there that and they're like are you smoking that new medical marijuana I mean how  can you think something that crazy so I just really don't get it and then when I go to those small towns Moo summer in Colorado and I find an independent practicing hygienist there's no dentists that town and then the dentist five miles up the road on the highway just loves that person because they're referring them things of the that concerned them and and  they're sending them cookies and cakes and candies trying to get their business so what's

Melissa Turner: it’s a no brainer it really is it opens up a dentist's chair for more lucrative procedures they don't have to have you know husband in office hygiene so yes thank you for being able to relate to that yeah when I have this kind with dentists and they have so many times I always say that at some point you know we're all gonna be lose autonomy and being an assisted living facility or you know being a skilled nursing facility and nobody's gonna look in our mouth for weeks at a time no basic home care and it's then that we're gonna realize yeah and I wish I would have you know advocated for hygienists to have a little you know increased decreased supervision so that she can come in here and brush my teeth and make me feel better you know 

Howard: so I I gone I'd spent a whole shift in a dozen different nursing homes from Wichita Kansas to Phoenix Arizona and  first of all I'm I don't have to worry about nursing homes because when you go into nursing home they're all women and there's no men we I asked my works music surgeon one time way back to the day I was reading something that the majority of all almost all hip replacements are on women and I said in my orthopedic surgeon and doctor Jonathan Fox I said why is that our men just got stronger hips he goes no it's just very hard to break your hip while you're in the grave and he said you died right about the prime time to start breaking hips so nursing homes and broken hips is more of a woman thing but when you go in those nursing home for two 1/2 percent of Americans will finish out their life of nursing home and the dental care is an atrocity they get they average one new root surface cavity every month so as soon as grandma's been in there a year she's got 12 cavities and you're  trying to change that with mobile dentistry is that correct 

Melissa Turner : yeah that's right that's right and that's you know kind of direct access to dental hygiene and mobile dentistry at Teledyne history they kind of all go hand in hand and the same kind of like let's get better access to dental care and not just for underserved individuals not just for the indigent populations for the middle-class folks for all of us that are gonna end up in the 4% in nursing homes yeah you know 

Howard:  now that we got towards availability accessibility I think the main issue in Arizona was you know can they deliver alcohol to your door and now that we got that locked up now it's time to move on to like cleanings and industry and all that kind of stuff and then a lot of these dentists say well I don't want to do that because it's  all Medicaid but they don't realize that you go in there and you treat twelve root surface cavities with silver diamine fluoride in your only inner room for ten minutes I don't care what they're paying you I don't care it's ten twenty thirty dollars of filling you just did 12 of them in ten minutes is silver diamine fluoride is that is that part of a nursing home mobile dentistry in your mind 

Melissa Turner :  oh yeah Narsingh homeschool mobile dentistry that's probably one of the newest most important things that we can give at least to the to the public health arena to those folks yeah

Howard:  so um you have a couple different websites let's just start with your operation grace MN Minnesota org what is what's going on there so operation grace is a nonprofit charitable organization that 

Melissa Turner : I helped run and it's based in Minnesota we provide preventive and restorative care free of charge to underserved individuals mostly in high schools and then you know some homeless residences and things like that so we work closely with South era pused we have a volunteer aspect of our program we use things like Teledyne history silver diamond fluoride and you know our focus lately has really been to take a team of hygienists to each school two or three times a year and really give continuity of care and we stay there for a week and we still have about to our appointments each time and we do as many sealants as we can we do as many applications of SDF as we can and really you know just in case we never see the fusion again we put it all on them as much as they can handle and we're seeing some great results with that we just started about a year ago and in that program model and it's been very rewarding so far mm-hmm

Howard:   I think it's very cool because I usually America can be summed up in money's answer what's the question and then throughout your life journey you find people who really just care about things even there's the matter but I the websites amazing and young people listen to the show it's a it's a millennial thing old people don't listen to podcast but on your website 47% of dentists are 55 years or older and practicing in rural regions of the state we're Dennis or at least likely to practice so you just graduated last week you got $300,000 of student loans and where are you gonna go set up downtown Scottsdale where all the rich people live and nope and they won't need a dentist in Scottsdale for 20 years so when you look at these accessibility issues and find a dentist Minnesota and operation grace Minnesota is this more of a rural problem than an urban problem I mean is it

Melissa Turner:  I don't think so I think it's all across the board you know a lot of in Minnesota a lot of what operation grace does is mostly based around Minnesota Minneapolis and st. Paul because that's where most of the population is so it just depends on what your target audience is I think it's I don't think it's rural versus urban I think it's just everywhere and all the time and then it crosses the money your medicare line - and it's middle-class folks it's even even some wealthy folks that don't understand the industry and have a hard time accessing it – 

Howard: so you said something right out of the gate you said it's really three things it's tell the dentistry expanding practice hygienists and mobile dentistry you think that's the is that is this the perfect storm you're talking about

Melissa Turner:  I think so and I think it's you know the basic underlying issue is to use all if you're gonna do embark on mobile ministry you want to use all your licensed clinicians at the top of their license and that includes the dentist and that's a big key that we don't talk about a lot you know where you saw a dentist saying hey use me at the top of my license but for dentists to realize they're not being used at the top of their license that kind of put things in perspective a little bit show so I think those are the really the three keys to access and to more mobile services and 

Howard: um you are very experienced in four profit and non-for-profit and what what is your if someone from Mars asks you what's the difference between for-profit dentistry and nonprofit dentistry what would you tell them well I think 

Melissa Turner : it's all about who you serve so the for-profit dentistry would be like your typical dental office that isn't targeting underserved populations or Medicare patients it would be the ones that are just targeting you know those who have insurance and those who can afford it so I usually divide it down between nonprofit and for-profit but there's various other ways you can you can divide it as well 

Howard: do they both seem to be as efficient um yeah I mean the 

Melissa Turner :there are a few pioneers like floss bar for instance is is a company that's taking services into business places and treating employees and the way they do it is very efficient but the key is with mobile dentistry there's so many ways you can adapt it so you think that's the main efficiency with mobile dentistry you can make it what you want and you can only choose to provide preventive services you can own that you can do the full full shebang if you want and you can only have one provider doing it or you can have a million you know it's up to you so it's so adaptable and that's where the efficiency comes into play for both nonprofit and for-profit well that's 

Howard:  um so you just mentioned floss bar and the founder and CEO is eva sadok say tidge she was um she was on the podcast 900 and i'll tell you what when I posted that on dental town oh my gosh that's right it has 620 replies with 18,000 views because what  does she represent a threat to all the old guys and here's this young this young whippersnapper with this new idea and all the old guys were just lemmings ready to run off the bird why do you think the Townies what do you think all the Townies in their 50s and 60s were so shocked by the false bar well what

Melissa Turner:   it really is a new way of thinking and it's even the language they use to market is based on a millennial audience not based on the 50s and the 60s target audience and so when something is foreign to somebody they're gonna start to get a little different sense and so for me you know I looked at that and I have gone to dry bars which is what floss bars title is a play off of so you go to a big city go to a driver and you get your hair blow-dry I don't have any hair I miss that whole thing that the floss the floss bar is a play on what drop the dry bar so go to New York City and you just want to have your hair styled you go into the dry bar and they blow-dry it and they make it look really nice because blow drying is actually very difficult to do it the right way so fires a play on that word so just the name itself is geared towards a total specific you know niche and generation so you know that in itself you know somebody who's 60 year old might look at phosphor and think okay alcohol and flossing I'm not sure what's going on there but for me that that wasn't my filter I understood right away so just something as easy as that can make or break a difference

Howard:   and you um you you're having a big meeting on this coming up and I've been to so many dental meetings and a lot of them been really nice places and resorts and you go down there and they pamper you and all they have is well do you want your hair done no do you want a mani-pedi not really and I would always say you know can I get my teeth clean and they look at me like I was from Mars and I look at all these resorts and a lot of times you know all these dentists are coming in from everywhere and somebody did it so said to me hey my wife's at their hotel and she want to know why did you think there's a place she'd get it cleaning while she's here at this three-day convention in Scottsdale I say no but you know they legalize weed but you know having a hygienist drive to your hotel in a dentistry but I availability in Access is just huge and I love these different business models how was the false bar doing 

Melissa Turner :  really good we just expanded nationwide within you know the last year so things are picking up and and we're just coming up with great marketing strategies to push out soon and just stay tuned it's it's a really good thing and it's kind of you know we want it to what the dentist the practice owner to look at it as floss bar will come in and be an extension of your practice for you we will be the mobile delivery for you you just kind of rent the day or rent the chair and we will you know do everything else for you and then you get the referrals so it's a great funneling way to funnel all that all of your local patients whom you want in your practice back back to the practice itself ha um 

Howard:  so I'm you also there's a lot there's so many companies that you're familiar with another one is on the dental peeps network so for my the people list that what is the dental people name is that david black the associate coach and consultant is he he's the founder 

Melissa Turner : the founder of the duke and ricky Safran Oh Lee Duke and who else Ricky Schaffer SH a re n so tell them what what that is so the devil peeps network is the largest social media network of dental professionals nationwide basically we have about two hundred and seventy-five thousand members it spread out through probably about 200 local groups so there's a Minneapolis dental peeps a Philadelphia dental peeps and through these groups all dental professionals no matter if you're you know an office manager or a dentist you're able to network locally and so it's a really valuable tool and there hasn't been something like it prior we're your divided into locales basically so it's been a really great thing we've had a lot of local get-togethers in certain cities where people just go out and have some drinks for the day we have CE study clubs going on and lots of exciting lots of exciting things down the road and what is there I mean what do they do what is their what is their mission the general keeps network yeah my tagline is Global global global network local community something like that you're missing it now so it's  a way it's a way to connect and it's a way to you know down the road we might have some conventions or different other types of events in different ways the member benefits basically 

Howard: yeah and then you're also with on DM that's what Joe Fogg on on da so so tell them about Joe Fogg and on DM and what's all that about

Melissa Turner: so on DM is the latest and staffing app suite I like to think of it as uber meets LinkedIn for for dentistry basically real-time staffing so a practice can sign up and make a practice profile and list temporary or permanent jobs they can use it for working interviews or maternity coverage and then individual clinicians will also make profiles and it's basically you upload your resume and you make yourself look good and you set your availability if you want a temp or you set your availability if you want to have a permanent position and then real time you know I look at the jobs become available you will get alerted to the jobs and then you can also reach out to the practice and communicate with the practice on the actual app itself

Howard:  so you you said um on DM is where uber meets dentistry it were meet LinkedIn oh it's LinkedIn yeah and and explain explain that a little more what what is it we're on DM is where meets LinkedIn what do you mean by that

Melissa Turner:   well so you know these days we have the uber ization of everything we want everything in real time we want everything cloud-based in your hand and and so that's what this staffing at this on DM does but then the LinkedIn part of it is we really wanted a way to kind of vet professionals and  upload a resume and so you know make yourself look good and make yourself shine so that's where the LinkedIn aspect of it comes in and you can do some kind of some a little networking on it too if you want to reach out to our practice or if they want to reach out to a professional

Howard: and that's kind of what we're calling the gig economy yeah exactly and in the gig economy now is this more for dentist hygienist sister who is using on DM the most which one of this

Melissa Turner:  right now it is everyone and you know it absent flows we just had graduates a whole bunch of graduates use it it ebbs and flows based on the locale based on the demand you know for about two years now I've seen a huge shortage of dental assistants and I thought it was just in my area of the country and since working with on DM I realized it is everywhere and so it just really does Evan in flow and and it's it's a pretty good amount of each each role in dentistry right now 

Howard: well I mean this is um very very low unemployment I mean I I have so many people tell me right here in Phoenix I mean there's four million people in the metro and every Dentist I saw this weekend said I've been looking for a dental assistant for six weeks I have even no one's even dropped off a resume and I'm like well that work we're very very low unemployment so where when  I mean when you're down a three percent unemployment three out of a hundred people shouldn't have a job and when you meet that three out of honor people that's not employed most of them are unemployable I mean and it's really weird because five percent unemployment everybody thinks is the healthiest research lling one out of 20 people from one job to another job is the smoothest ill and when that just gets to ten percent unemployment then the  sheep get restless and who's ever in the white house is unemployed and Congress flips over so 5% optimum 10% is chaos in the street and 3% you can't find a dental assistant makes sense and you know

Melissa Turner: that's what we see with on DM you know even if we are in at 3% a practice can go and they can bet they can look at the the professionals profile and vet whether or not they even want to reach out to this professional and that's one of the key benefits to using it you know a person who uploads their resume who writes three sentences about themselves the way they write it the spelling the grammar you know that tells a lot about a person so this is it's just a good way to kind of vet professionals before you even spend time interviewing them

Howard:  I I don't even want to say this because we're being recorded online but like mymy team when you drop off a resume they're not even gonna look at it they're gonna see really had enough hustle if you're gonna follow up call email come by oh my god if you drop off a resume and then you pop it the next day and ask if you have any questions about it my team's already drooling they're all drooling like oh my god I want this first and they're hustling because that's such a huge part of success is just to get up every morning and work hard and hustle and if you don't want to get up and you don't want to work hard and you don't want to hustle I you know a lot life's gonna be tough I'm speaking about life is being tough we just had you know 6,000 dental school graduates come out last couple weeks you've been in this in this space for a long time at a very high level seeing all these things what advice would you give the graduating class they're all 24 with $300,000 in debt what would you tell this game

Melissa Turner: I would say you know what do whatever works for you know for the first five years experiment work in different practices work you know don't settle on one thing within the first five years because you don't know where the economy is going you know so many dentists come out and buy practices right away because that's what they think it's going to be successful but now there's working with DSOs you know even just volunteering you know I'm all about volunteering cuz of course I run a military program but volunteering will open your eyes to to the other avenues that better out there and networking is key you know in in my generation and below most of what we do is online so any type of in-person networking is so much more powerful and and so much more effective and you know if I have had if I would have one piece of advice that would be in you know to anyone that's graduating go and get out there Network your butt up

Howard:  yeah you're  always running for marriage not what you know it's what you know and who you know and the problem with dentist is that the  natural selection is we're not gonna let you in the club unless an undergrad you're that boring idiot who got A's in calculus and physics and in biology and I mean you know might before guys that I lived with at Creighton all got accepted that I'll school we were the biggest nerds we just lived in the library and then when they get out now the skill is not physics in chemistry and no one cares how long ago the Big Bang is and they don't care about the expansion of space and time and you if you can't talk to your patients and talk to your staff and you just gotta get out Network it but they live in fear like little say to me here in Phoenix where I live they'll say well what implant course you recommend then and I'll say what do you think about and the list three implant on courses that are all a thousand miles away I'm like well when did you walk across the street to the periodontist have you when's the last time you had lunch with a periodontist and they say never never you've never met the periodontist and he's a hundred yards from your office now well why don't you go take him to lunch he could probably teach you for free and then when you had a problem you got a buddy that you know and so it's just that networking is just everything so was so mobile dentistry five ten years from now is is it gonna be a real thing I mean is it gonna be because because I don't believe it's a real thing like right now you know like wind and solar I mean you know it's they nuclear is 20% of energy they could have scaled nuclear from 20% to a hundred percent in four years and during that same 20 years they keep talking about wind and solar and I'm like man you could at this point you could ran the whole planet on nuclear so the mobile dentistry is that bleeding-edge is that a theory or do you think how long will it take before it hits a tipping point like say five percent of all dentistry done mobile

Melissa Turner:  I think within 10 years we'll have that and then I think at ten years it'll be so commonplace that we won't even call it mobile dentistry anymore we'll just call it whatever it is just a part of how we practice I think it's really I you know I've really seen an increase in people who are interested and there's only gonna be you know a small niche of people a small percentage of people that really aren't interested in pursuing it but those that are interested are going to really grab on in the next five years I think and then put it into practice you know soon after that

Howard:  so um do you recommend a mobile dental I mean I see some kids listen to you right now he says I want to buy it a big ol RV and just drive around doing dentistry who would sell that mobile dentistry that that device 

Melissa Turner :there's a couple of ways you can go about it there's a couple different companies and then you can also you know kind of get a literal RV camper and and refurbish it as well it's it's one of those things I think we'll be seeing more companies you know launch and and target that kind of product you know in the next couple of years

Howard:  yeah so what is the target market for mobile dentistry is that mostly nursing homes and elementary schools yeah right now 

Melissa Turner : I would think it's mostly underserved people and then the two savings would be nursing homes and elementary schools yeah and you know one of the things why Operation grace serves high schools is because every there are so many mobile programs for elementary schools because all the sealant programs they want to teach kids when they're young but then by the time they get to high school they're almost underserved and you know in themselves because nobody is paying attention to them anymore so the fact that operation graces can provide restorative services and extractions you know by the time you get to high school you need those any of those services there as well and 

Howard: so we've been talking about mobile dentistry we've been talking about you know um expanded duty dental hygienist I mean competition is whatever industry now so when I was little and I was ten years old I was walking down 364 North Rutan in which seconds every third or fourth garage the dad the brother and the uncle were spending a whole day fixing this crappy American car I mean you spent at least one Saturday a month trying to get your old beater running and then they finally on Japan and Germany start selling cars that actually worked and that was the first time GM Chrysler and Ford thought damn we're actually gonna have to make a good product and if you took away all the International car makers Chrysler you know it would it would be horrible so everybody knows competition is good for every industry except their own industry they're a yeah this is whatever were but in dentistry but the best thing that could happen to dentistry especially the patients which is the only reason we went to dental school it would be more competition and so we talked about mobile but what is really tell a dentistry is that just an expanded duty in a mobile is that like forward projection and the displacement of dental services from a dental offices or is it more technology related like you know internal cameras and digital x-rays sending information back to some home base when I say tell a dentistry what does that mean to you 

Melissa Turner : so telemetry to me is basically the technology that allows you know allows a flat world basically it allows dentistry to be in multiple locations and communicate at one time so the cloud cloud-based technology is a huge part of Tele Dentistry industry and then you know you asked about rural patients who  need sir I mean this is very telling industry comes into play you have one hub you have one office and lots of folks who are using tele dentistry lots of people going out to those locations a an associate or hygienists going to a rural location and using Atilla dentistry to communicate with the main provider it's fascinating and so to me it's mostly a technology platform 

Howard: and how did you link the hashtag love in the workplace or iheart mobile dentistry with with the mobile dentistry yeah what's the link between hashtag love in the workplace or iheart mobile dentistry tell us about that what's that about I mean obviously you're a very gifted marketer I'm serious I have a flair for marketing and you have a better one than I do 

Melissa Turner : really what what my goal is with the backbone of all of these things whether it's the love in the world works workplace hashtag campaign whether it's reframing what independent dental hygenist means or is or Attila dentistry the backbone of all of that is to help kind of nudge to put it politely next the dental industry into you know getting with the times it's almost like dentistry is so silent you know we know this we're so old school it's kind of like we're trying to do analog things in a digital world some dental offices are really still doing analog in a digital world but we're not with the times yet and I think it's hurting the dental profession as a whole and so for me all of these little projects and initiatives that I'm involved with it's a way to kind of help nudge dentistry into getting with the times and it's super important so anything I think now is the time to do that because simply because it's so cliche to say or blame everything on the Millennials but because the Millennials are now you know becoming the top of the workforce and the leaders and the business owners and they're also becoming the consumers you know it's time for these things to shift but for the tide to shift a little bit

Howard: so when you say a licensed professional at the top of their dental license does that mean when they just got their dental license are when they're old and fat and bald and at the end of their license what do you mean by it working at the top of their license 

Melissa Turner : well to me that means doing all the procedures basically the most all of your procedures your entire scope and the most difficult procedures so you can have a dentist sitting down and  you know completing MLL fillings every day or you can have a dentist who is focusing on whole mouth restoration and implants and veneers and you know which dentists do you want to be if you're working at the top of your license in my mind that means you're doing those full mouth restoration and you're really focusing on all the things that you can specialize in and you're delegating all the all the other things out so you're delegating them the simple fillings out to you know your expanded functions dental assistant you're delegating you know all of your cleanings out to where they're supposed to go to the hygienist and things like that 

Howard: dental therapist is completely different then what do you call the hygienist for the expander I guess the degree you call them collaborative practice dental hygienist do you call them just be a are IDI pH expanded practice dental hygienists or you were saying that was just an organ thing 

Melissa Turner : so in the past we were called the the umbrella term was called independent dental hygienist and we have now switched to to a more definitive term direct access dental hygienist so each state probably about 40 42 out of the out of all the states call it something different so each state will have a form or a different variety of a direct access what's the term form now direct access best dental hygienists direct access dental hygienist dental hygiene services ha that is interesting

Howard:  and it used to be called independent dental hygienists or collaborative practice dental hygienists is what

Melissa Turner:  Minnesota currently calls it expanded practice Donoho Genesis but Oregon calls it you know Arizona or no not Arizona Colorado has actually has independent demo hygienists like you know you can go their own practice same with mean so each state will call it something different sometimes they're called public health dental hygienists

Howard:  so what do you think what do you think is scaling the herd of dentist right now more is it dental therapists earns an independent dental hygienist I mean yeah yeah so talk about that so what what is a dental therapist and how is it different than a dental hygienist about what a dental therapist actually is and

Melissa Turner:  the American dental hygienist Association has been has been advocating for dental hygiene or dental therapists for probably 10-15 years now it's important to note that probably only about 2 or 3 percent of dental hygienists want to become a dental therapists because it's an it's an entirely different scope of practice it's basically 50 different you know services that a dentist could provide and a dental therapist is not a dental hygienist so there's  a couple different myths that I usually have to debunk before we can even start a conversation on dental therapy so dental therapists in Minnesota you know I have friends who are going on therapists I've worked with  them a lot they have to be dual licensed as a dental hygienist so it's a completely different role and scope and and way of doing things

Howard:  so a dental hygienist legally in Minnesota can't be a dental therapist or vice versa you can if you have two different licenses 

Melissa Turner :you have to have both licenses yeah we need we just need more licenses that's that's usually the answer 

Howard: so um so what's the status on dental therapists um how does it look like now is it is it flatline is it growing is it eventually growing what's the state of a doubt look like to you well well 

Melissa Turner :so in Minnesota but prior to this year there were 89 dental therapists that were practicing and some of those were advanced dental therapists and some of those were 10 out there regular dental therapists so we're just getting to the point where we can really start to get some data and some information on how effective dental therapy has been going so if you if you look at Minnesota in specific you know the practice owners that have higher dental therapists would say it's phenomenal you know they are freed they don't have to they can or at the top of their license if we go back to our previous conversations they're free to give a dental therapist the simple extractions the  fillings they can pre pin and fill the fillings in treatment plan and so then so the more dentists can move on to do other things at that point but then you know there's  a handful of states they maybe ten states around the country who have dental therapy discussions going and each one of each one of those states is going to have a different definition for what dental therapists are their supervision and and the type of schooling they

 Howard: need so I mean I it's really neat when you're on the internet or a part of an organization where drawers in you know a bigger part of their her I mean there's eight billion people and  in the United in the world and there's two million dentist around the world and when you're out there going to conventions and lecturing and going to these other places everyone you meet that hired a dental therapist they all love it I mean well first of all they in love it why would they hire them I mean just the fact that there you have eighty nine of them hired in Minnesota that means you know unless they own their own company eighty nine different people made the decision that this is a good deal and when I asked him I say what is the good decision it's just like going back in time they say what you know is the hygienist they say well she's doing all the cleanings I can just do you know other stuff you know place implants and root canals same thing with dental therapists I mean you know my hardest day is when I walk into the dental office my fur patient is for mo D composites on two three four and five that's just work and then the next one is another quadrant of Emma I mean and so you got hygienist working a couple rooms you got dental therapists doing all the fillings and then and then the other thing is endo is just taking more time to me when I got out of school you know the endodontists we're trying to do molars in an hour but now with microscopes and and saw an endo and all these technologies a lot of my endodontists friends are saying that now they're doing one less root canal a day because they're spending more time on the molar endo because they want to have less failures they want to do more quality so  as you want to slow down and do better higher quality implants and root canals whatever well you don't wanna be in there doing your fillings and your cleanings and all that stuff like that and so I still have not met a dentist who actually has a dental therapist in their office who's told me it's a bad idea

Melissa Turner:  it's mostly from people who haven't employed them or haven't actually spoken with it's out there Buddhist or spoken to the employer of a dental therapist 

Melissa Turner : Brett Herman CEO and founder at mouthwash mouthwash mouthwash what is mouth watch and why does it interest you 

Melissa Turner : so mouth watch is for the telev industry comes into play it's a telemetry platform HIPAA compliant cloud-based and it's it's the technology behind that and then they also sell these very reasonably priced interaural cameras and they're high quality ones I've got two so a mouth watch is is really you know kind of pulls a lot of what I do together a lot of the mobile dentistry you know tella dentistry will be the backbone of that and mouth watches is one of the main players until dentistry 

Howard: and you know we're in the middle of a huge opioid crisis I mean when I was in a little kid the Vietnam War was going on and when we play games we all assumed we'd have to go to you know serve or 12 months in Vietnam and then you look at the total cash of that very long brutal war just the cows these are the American soldiers not the casualties of the beat him being on people which was ten times greater but we now have that many people dying every year from opioids and there's a Glenn Hansen DDS PhD pharmacology toxicologists at the School of Dentistry University of Utah saying that there is a complete synergism between oral healthcare and substance use disorder and it seems like this um it sounds like this stuff is hitting the rural areas even harder but they're  all related and then dr. Brittany could all a mouth watch clinical advisor is an honoree of the incisal edge but um so so how's mouth what's going well ecology would you recommend from them 

Melissa Turner :  um well right now they have tell it in their that's their main Teledyne a stereo technology and it's a platform where you can go into you know go into schools whoever  some mobile provider or can go into a location and use it on a tablet and you can bring up a patient's chart you can use it for x-rays you can you know you can assign a chart to another provider to look at and they sign it back to you and it's especially because you can it's called base but if you don't have internet access it'll store it locally until you and so you get internet access and then it'll upload to the cloud so that's a lot of problems with mobile providers the access the internet access is not you know good enough to run a cloud-based program on it so that's a benefit to mouthwash and then of course the intraoral camera that goes along with it it's just so easy to communicate and what we're also seeing now is we're seeing specialists used use it to communicate with the general dentist or you can even use it to communicate with you know the patient's physician so it's expanding you know more than just the mobile aspect of Dentistry it's expanding through throughout different kind of webs as well

Howard:  I like what a Brandt Herman saying on his mouth watch website he's a CEO he says the intro camera you've been waiting for it a price that finally makes sense it's just $299 and you're not gonna believe this when I go to a school in 87 they just came out with the intro camera up in Minnesota where you were from Paterson and yeah I went up to Paterson every year forever because my sisters in a nun Catholic nunnery right up the street so I had to go to visit Paterson for four hours in one minute to make it a tax deduction to go see my sister and that intraoral camera when it came out is called the Fuji cam it was $38,000 and now I'm a grandpa and they're under $300 isn't that just amazing yeah and

Melissa Turner:  it's autofocus I mean it's easy versus I see some of these old-school ones where you have knobs that you need to turn and chords that get in the way all kinds of things the

Howard:   30 is a thirty-eight thousand thirty eight thousand dollars and here's what here's what's even sillier about this story so everyone who jumped in on this $38,000 intro camera which was the size of a mini-fridge right and you had to fit it on a cart because you and your assistant couldn't lift it off so here you have this mini-fridge on cart paying 38 grand and about five years later they were down to about 12 from other companies but no one who bought at 38 wish they would have waited three years to buy at 12 because when you stuck that camera in the mouth and that human could see that holes in my tooth they stood at attention and they wanted to get involved and start you know brushing flossing and getting their cavities fixed and I am actually was so insane I actually bought two of the thirty eight thousand dollar ones about one and then I bought one of your like just because it was so heavy to move and then they went down to then it was Welch Allyn which was from New York and they started making him for twelve and it just blows my mind that now you can get that camera for us the inner box right yes the more you move the camera the more you're at risk of breaking them right plugging them in plugging them and moving them around and so you know Brett he usually says get one for every op that's the way and make him last and I don't call him ops because um they don't understand operation logistics I just call them Southwest Airlines planes Southwest Airlines only buys one plane a Boeing 737 and so everybody knows how to fly it everybody knows how to fix it but when you go to like American Airlines and you call in sick and you say um oh my god I can't work today I'm sick and I say okay Melissa I'm gonna call Howard and I call her I go no Melissa is this point is 747 I am certified on Airbus and then you call your best friend oh he can only fly 727 oh he given so logistics Li it's insane so everybody imagine getting on Southwest Airlines and the pilot comes on phone says people see that plane parked next to us at the next gate that's that's actually my plane and I don't know who put me on this plane but my plane has you know I mean you know it's just insane so we're all gonna have to get off the plane and get our luggage and move over because it's a different way and then I go into dentistry the hygienist is in there for an hour they do all this stuff the kid needs one cavity and you're like well let's just do it let's do it right now oh well we'd have to leave set up a room we'd have to move you well what why is that oh because we built an entire operatory but we just left out three or four little things so now we've added 20 30 40 minutes of logistics and overhead and all like I said so it's 747 every operatory is the same the reducer so and then one of my friends I hear in Prescott Mart Costas you go into any one of his dozens of dental offices and you go in there turn to the right and pull open the third drawer every drawer would have the same thing that's right and what I used to do back when I was uh had personality disorders is I'm I would get so upset when my assistant would leave the room in the Millbrook now are something go get something then I get one of those air horns I tell the patient to cover their ears our night leader the hall go am i and I'd say could you imagine being in the middle of a bypass and they say I'm sorry we got to stop and go go in the next room get something out of the third row hell it's a filling or a crown or root canal you no one's leaving the room so I made that law that one so then I thought that the staff did not like the air horn so we made a law that if you had to leave the room you could only you couldn't leave the room we had to beep the office manager and she had to get it for you just to keep showing her this is unacceptable but the dentist think I'm saving money by only buying one and those are most expensive item labor 25 to 30% the associate dentist 25 to 35 cent 55 percent of the cost is in the people and you always have people standing around waiting for a tool that's right or a chance so yeah so it's just it's just an operational logistics game so what else are you on excited about mouthwash

Melissa Turner: well they just they just partnered with dental works which is a portable equipment company and they produced the first tell ademma story mobile cart so it has a computer it has the suction drilled air water syringe it has everything all in one so that's fascinating you know like a cart that you would see in a hospital just putting with what was named the company works dentl works the MTL works dntl works one word yeah one word and but consider yeah so so that's super exciting because then that that is just another delivery model you know you can buy one for the practice and then you know move it around to each to each room and have at elementary capability there 

Howard: huh that is odd that is me so um so again to the graduating class has just got out of school what would you do if they said I'm interested in mobile dentistry tella dentistry in you know what would you what would you tell them 

Melissa Turner : so what I would say you know each state each Dental Practice Act is completely different from the next state so I would say the first thing you need to do is to learn your save practice act backwards and forwards be able to cite it verbatim because if you don't know that you don't know what your possibilities are and you know it shocks me to this day it shocks me I swear there's colleagues of mine who dentists and assistants and hygienists who haven't read their state practice Act since they were you know in school and then they're asking all of these questions well what do I do here what do i do there I'm like you need to know your possibilities first before you can embark on your journey so I would say get to know your state practice act fall in love with it turn a glass of wine or some whiskey while you read it just to get through it but do that and then the second thing is to network like I said in-person network with people who are actually on the same journey 

Howard: well said so dental works Equipment Corporation they're in Colorado - so um it's just a way is more this happening in Colorado I mean I mean I know they were the first to do many things but why don't why is um why is the first independent practicing hygienist Colorado why is dental works in Colorado what is the what do you think that is the answer to the dental entrepreneurialship in color 

Melissa Turner : yeah I don't know I wish I knew the answers of that maybe color others just cooler than everybody else I have no idea

Howard:  huh but um so that's dental works it's DM TL works equipment in Centennial California and so is there is dental works portable dental equipment is that almost entirely for mobile dentistry or are they selling a lot of Dentistry in building dentists to

Melissa Turner : it it's mostly for portable dentistry mobile dentistry and they have a lot of things on the back burner right now you know those sell portable chairs and different units just you know a unit for hygiene or you know for restorative work it's it's a great resource to have for any mobile clinician or anyone that's interested and embarking on that journey

Howard:  all right and what should I have asked you that I wasn't smart enough to ask um I think you were pretty thorough it was pretty fun yeah yeah we got talking about love in the workplace a little bit more you know what's sad about that yeah well let's let's think outside the box let's start first with and why I hate the workforce and then move into I love in the workforce so so what what is it it Tom what what is love in the workplace to bring back love is an action into dental practice everywhere and it's out of what st. Petersburg College 2011 that's just my own that's just my own hashtag campaign but I would or a Facebook a couple platforms but it was mostly Facebook yeah and

Melissa Turner:  basically what's been happening is you know in a lot of these Silicon Valley you know startups wellness is a huge you know a hot topic right now just even outside of dentistry employee wellness they you know they're putting sleep pods in different businesses and coffee bars and you know gyms and businesses just to keep up with employee wellness right but really the backbone of the love and the workplace campaign is just the simple fact that one day I woke up and realized you know it takes work to love people and so like now were you were you specifically talking about my mom or my five sisters you you work to love your spouse your partner your family your siblings and your kids but what about the people that we spend the most time with 40 hours a week you know love has been banned from workplaces for as long as I have been around you know the me to movement is part of that I was talking to a guy the other day about about this love in the workplace hashtag campaign and he says he says Melissa that's just a lawsuit waiting to happen putting love you know in the workplace they said that's my point we can't think about loving somebody as a friend or truly loving them in their jobs without some kind of skewed filter thrown on that and so really you know it's all about what my goal with this is to get all of us talking about having empathy for each other and in the workplace active listening for bosses to for employers to really you know go out of the way to love their employees for managers to really listen to their employer but also to those they manage and it's something that we just were not allowed to do right now so it's interesting people usually cringe when they think about like oh loving my boss or loving the people that I work with but it really will fix a lot of what's going on in dentistry right now but also on a broader spectrum as well 

Howard: so then I'll take the opposite you're going with you're going with the hashtag love in the workplace and what all I would say is to have love in the workplace the  best the best managers get rid of the DNF toxic people the fastest and there's nothing there's nothing more demoralizing till one of your team members who think that you like them and respect them and I've always said for 30 years out you know I got five sisters and my gosh when someone when a woman has worked for me for five years she turns into your sister I mean now and  you know and there's a lot of love and respect there and then she's looking at you like you're gonna you're gonna just allow that to happen I mean why does you just turn into psycho lady and so the best managers are the ones that you know that when they realize that Sam is toxic and insane they get rid of them and you know and so for loving the workplace for me it's uh it's hire slow fire fast when you know Marion is batshit crazy and toxic and moody it you're not gonna have love in the workplace when you keep looking the other way you know 

Melissa Turner : dental offices don't even get to that point they don't even get to a cohesive team and that's why all these consultants and consulting companies are so popular right now because these dental offices these teams can't even get to the place where they realize as a dysfunctional environment 

Howard: so so you're very successful in all these different areas I'm where does that come from with you just my drive I've always kind of been the black sheep I've always kind of asked why why is this the case and how can I make it better and so it's just who I am you know I come from a pretty conservative upbringing a pretty conservative area in Minnesota no in Pennsylvania actually are you Amish or Mennonite are you yet Amish or is that right unbeliev yeah and then we were Mennonite yeah yeah and you know why the Amish and the Mennonites they're both related so most a lot of the early emigration I say it's was Protestants for testing the Catholic faith and they're coming here and the lot almost half of more from Germany like the Amish in the night do you do you remember from your Bible studies why the Amish and the Mennonites split up you know what no I said they were against technology so they didn't like technology and that a new technology came out and  half them said we're gonna adopt this technology and the other half said no we're absolutely not it's doubles work and they split up over this new technology and guess what the technology was was it the bike buttons those buttons and now when I'm in Kansas which has the largest or the in Kansas are they Midnight's are Amish I think they're both I guess yeah and anyways it's the largest population of their group is in Kansas and it's just so adorable to be driving behind a horse and buggy with Horsham and the little girl in the back she's got the clothes on in the hat and everything and she's on her iPhone great like okay something's not right with this picture your little girls on an iPhone back there but anyway out so so you so it was the conservative family and you were ambitious and you question everything and 

Melissa Turner : I you know I'm one of the only ones to have a four-year degree and and move away from you know even consider moving away from  where I was raised and so I just been always you know why why is this the case and always had some questions and you know thankfully my parents and my family have given me the freedom to to do that as well but that's a huge thing to be a little different than they are 

Howard: and so then some kids and when they have all that some do it with just yyy with a smile on their face and just cure naturally curious but then some deal with you know upset and mad and frustrated the world and I can tell by all that you're doing the volunteer the non volunteer and all that I said I that you were born and you question all these things but you did it out of a good heart and curiosity it didn't make you mad at the world because you know 

Melissa Turner : as I as I think about dentistry and the dental profession and you know even even on the broader spectrum there's a lot of women in the workplace issues there's a lot of you know dentistry isn't very friendly to parents or mothers you know there's a lot of things like this that we need to really work on and help change we need to support mothers who are pregnant and how longer maternity leaves and you know just just things like that so there is some anger honestly there is some anger that's that's a driving force to and I think that helps to keep me going sometimes I

Howard:  I have a woman president of my company for 20 years and you look at my seven department managers it's five women and two boys but I was very since that because I had five sisters and all that sexism and all that stuff wasn't from government and workplaces my own family I could go swim and the Arkansas River which was a block from my house any guy anything but my sister's could not get within 10 foot of the edge and then I'm a boy what my sisters to swim with me but they can't swim cos they're a girl and I'm but anyway I saw this just insanity just in my own house I realize okay this this is something seriously wrong with that but let me tell you one  secret on the on any of these inequalities it just means nothing but opportunity so when all the fortune 500 companies all want to have male CEOs and department heads and all that stuff like that that means in half the humans are women that means there's just a ton of talented women that aren't employed so if you have the foresight to realize that oh my god I mean you can hire a higher quality woman because you won't get picked up by the sp500 all day long and I know so many dental manufacturers that realize that and especially ones in California they say you know nobody out here is gonna hire someone if they weren't born in the United States of America so they don't even run their ads in English because they it's gonna be a bunch of the English reading women are gonna look at it and say well don't ever hire me because I'm a girl and then the the ones that are girls are guys in different language saying well why would they run an ad in Vietnamese or Korean or Filipino if they didn't want to interview me and  that is their secret sauce to get the most competitive employees I heard the same thing from a dentist in Boston and he said my god he said I I once I realize this town is they ought to call it just little Brazil there's so many Portuguese people there and once he started running all of his adds for all dental people in in just Portuguese he had hygienist driving an hour across town to get a job there and the next thing you know his practice doubled in size just with the the Portuguese community Wow wow that's amazing yeah and in Portuguese nineteen out of twenty Portuguese speaking people are from Brazil not Portugal so so yeah so if when you see those types in justice that means that means there's big opportunity somewhere but we went way over and you got better things do you got two kids at home how are the two kids doing is that to a few or two or four two of what how many you gonna have to go to all right well hey on thanks for all that you do and thanks for ah I just love your energy I just love your think outside the box I love your flair for marketing but thank you so much for coming on the show today it was a honor to podcast interview Thank You Howard 

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