Biocompatible Materials in Wellness Dentistry

You're listening to The Dr. Phil Klein Dental Podcast Welcome to the show. I'm Dr. Phil Klein. Biocompatible materials are formulated to eliminate adverse effects on a patient's biology when used in the mouth. Today, we'll be discussing how to choose the correct biocompatible materials for your patients and elevate your patients with wellness dentistry. Our guest is Dr. Katie To, a cosmetic and wellness dentist and founder of Center for Integrative Wellness and Cosmetic Dentistry in Katy, Texas. Before we get started, I would like to mention that Dr. To's webinar titled Biocompatible Materials in Wellness Dentistry is now available as an on-demand webinar on VivaLearning.com. Simply type in the search field Katie space Toh. That's K-A-T-I-E space T-O. And you'll see it. It's an excellent webinar for the entire dental team. Dr. To, it's so nice to have you on our show today. Thank you, Dr. Klein. It's absolutely my pleasure. So wellness dentistry is becoming more and more of a thing in dentistry. Whereas, you know, many years ago, the average dentist never really heard of wellness dentistry. It's certainly moved into medicine and diet and millions of other ways that we could keep our body healthy. That kind of drifts a little away from typical Western medicine where it's based on. taking drugs and doing things that are sometimes very necessary, but not all the time. So tell us what wellness dentistry is and tell us about your dental wellness practice. Yes, my pleasure to share that journey. So first, I would definitely want to love to share that. What is wellness dentistry? I know a lot of people did not see that term in dental school and start seeing it a lot lately, especially after the pandemic. But wellness dentistry been around for a long time. Literally just connecting the oral health with the whole body. And on top of that, we're layering the nutrition, the healthy lifestyle with a confident smile. Then to us, that's wellness dentistry. And our medical professional has been looking and asking for the collaboration between dental and medical. And wellness dentistry do exactly that with testing, with collaborations and referrals. I have to also clarify that Walnut Dentistry is really solid, good dentistry. It's not alternative dentistry. It's not about no x-rays and, you know, no antibiotics. It's not that. But we always ask dentists and, of course, listener to be open and say, hey, I don't know what I don't know. But once I know better, I do better. Before I get into some of the questions that I plan to ask you, what is it about a typical dentist that knows nothing about? quote unquote, wellness dentistry, what are they doing that doesn't fit in to the wellness category? Yes, a lot. Since we are taking care of the patient oral health, when we make the connection between the oral health and the whole body, we can help the patient not only saving more teeth, but actually getting healthier in the whole body. So for example, if the patient comes with cavity, We're not just talking about flossing and brushing. We also need to talking about sleep, mal-breathing, nasal breathing. Then we need to talk about nutrition. Are they on heavy inflammation diet or are they dehydrated that now the body's so acidic, including the saliva? And that's why no matter what they do, because a lot of patients, they floss, yes, they brush, but they still have cavities. So Walnut Dentist focus on the... lifestyle and the testing more than just checking for the x-ray checking for the cavity we don't want to be a tooth doctor we want to be an oral health expert and that's what wellness dentists are in your treatment planning or in your protocol when you see a patient let's start with a patient where you have your initial visit and you do your workup at what stage do you get into wellness dentistry is that something that you do with a patient once you identify all the issues in their mouth, and then you decide this person would be somebody I'd like to talk about wellness dentistry to. Who does that? What point in your journey with that patient? and so forth. Yes. As of today, our practice, seeing the patient that coming to see us, there's a wait time to see us, by the way, in Katy, Texas. So as a new patient, they come into the practice knowing that we're looking for wellness dentists. However, since we implemented wellness dentistry years ago, we start that conversation from the first appointment. We start that conversation in our intake of the form asking about their hydration, their nutrition, their sleep, even about their bowel movement, how often that is, because that's also affecting a person's toxicity and acidic level. So that world is starting from the first visit, and patients actually notice the difference in how we're asking about their history, their lifestyle, how that affecting them out. We're also looking at their saliva acidic paper test, then the pH test, and we're looking at the slide on the microscope. We're also collecting saliva tests if the microscope's showing high-risk bacteria. And we evaluate everything based on risk assessment. So one is for us starting at the first visit. And it's been doing amazing getting the patient on board. And I would say take the ownership of their health versus leave that on to the dentist and the hygienist and say, oh, you'll take care of my teen. But if something's wrong, that's the dentist's fault. But the patient needs to understand there's a lot of factors. that contribute to the health and oral health in particular. And these discussions with the patient, they come from you, Dr. To, or is it primarily between your staff and the patient? So I can tell that based on the question that we're asking, like the question on the intake forms and when we interview the patient, my team do a wonderful job of gathering that information. And I'm the person that come in and ask the patient, what is your goal? Patients really know they want to keep their teeth for the rest of their life. They want to look good. They want to eat and chew comfortable. They want to avoid emergency and pain. So in order for you to get there, this had to happen. It's not just about flossing and brushings and the right toothpaste. Then the six-month visit is more than that. If your job is so stressful and it makes you so acidic, nothing's going to last in that environment in your mouth. Right. So you make that connection. And how do you get these patients? to get into the wellness world if somebody is completely unaware of that and their habits don't fit into the protocol of wellness dentistry. You have to change all that, that whole behavioral process. Yes. So I can tell you that you're right. When we are starting wellness dentistry, not every patient is on the same path. Not every patient is ready to commit, to take care of it. So we're very good about showing them what we see. So as a new patient or even existing patient, visual is always help. So we take full series of pictures with the camera. We put it on the iPad. Patient got to be able to hold the iPad, zoom in, zoom out and see, oh, wow, my gum is inflamed. I can see that amalgam filling is cracking. Oh, I can see that decay. So helping them seeing what we're seeing is one of the very big. help and also get them to see what bacteria having them out by showing what's on the microscope. Really an eye-opening for a lot of patients. Because, you know, having patients accept the treatment for skeletal planning or gum treatment is so hard because they don't feel the pain. They're like, I don't have any problem. I don't know what bone loss you're talking about, right? Because they don't read the x-ray. However, if you start showing them this is the pathogen that we see on the microscope, this is what swimming and going crazy in your mouth, patient was like, what can I do, doc? to get rid of this, to get back to wellness. So when they come in with these issues and you talk to them about it, what do you give them to do at home? Do you have like a booklet or some video or how do you get them to understand that they're drinking way too many beverages that are very acidic or they're just not brushing their teeth at the right time or whatever it is? What is it that you do to get them into the wellness world? We give them homework. and also follow-up visit. So in our office, if you are on a moderate to high risk on your microscope slide or you are acidic, we give you a homework on things that can improve. For example, tracking your water, doing three days of your diet journal to really see what you are putting on your body. Also give them homework on starting on the water pick, rinse, certain toothpaste, and Definitely get them on like probiotic, stay away from sugars and high inflammation foods. So really, we don't want to give them 20 homework. We want to say for you, the most important thing is these three. Let's go ahead and do this and bring you back in 30 days. So keep them accountable, almost like being a health coach or a health coach for them. Say, we've seen this. Let's do this three things that you can commit it to. Then come back in 30 days and see how much improvement that we have. Yeah, that's a tremendous approach. I mean, this must be a real practice builder for you from the standpoint of marketing because the word of mouth of this will travel very quickly. And you said that your office is pretty backed up as far as getting an appointment. Five months wait list for new patients right now. Five months. Yes, I'm not proud to say that because that's not fun to say I'm calling this office and I have to wait five months to get in. However, that's just exactly what you just said, word of mouth. And also medical professionals are. love working with us because we also send them report off the visit. We really treat the visit as a dental medical collaboration so they can have the saliva testing result. They can have the cone beam CT report from radiologists or the sleep test result. So they're on the same page what's going on with the patient. As far as reimbursement, compensation from insurance companies, do you work with insurance companies to get paid for the work you do in wellness or do you just charge the patient directly and they have to get We are currently fee-for-service practice, but a lot of practice that we're coaching to implement dental wellness dentistry in the practice are still in network and a network provider. And there's a way to do that because with network providers, you need to know what code is being reimbursed. And if it's not being reimbursed, patients need to be informed ahead of time. However... When you offer this to patient, they all want wellness. They all want to keep their teeth for the rest of their life. They all want not having emergency and losing their teeth. So when you offer to that patient, just like they don't know what they don't know. And so now they know they want to do better. Let's talk about materials, dental materials. Some of them are obviously not great for the intraoral environment. You talk a lot about dental biocompatibility. If you would, what does that mean and why is it important, especially if you're trying to build a dental wellness practice? Absolutely. I remember hearing crazy story that people said, I have this done and I have this symptom. And you're like, I have no idea if it's true or not when patients come in from their practice. However, I have to say that we recognize as a patient or as a human, we get constant exposure from occupation, from environment, from medication, from food, from emotional, right? So patients. Each patient have different exposure. And so each patient have different tolerance. And dentistry, to be honest, can be toxic. And if you put something in the patient's mouth, the dental work, it's a 24 hours a day exposure. And these symptoms or these reactivity that you see could be physical symptoms or could be emotional symptoms. So on the medical standpoint, a lot of time we don't connect that for being a dentist. So material in the office, anything from anesthetic to composite to crown material to temperate material to bonding agent, any of those ingredients, if it's not compatible with the person, it's not necessarily causing... the issue at the site of application. However, it could cause issues somewhere else because that's how the mouth and the body connect works. And so in our practice, we make sure the patient have an option to get tested for material. If they say, if you come in as a new patient and you said, Katie, I'm allergic to this and that, and I'm having a lot of allergy issues, I could not breathe through my nose. Well, I don't want to put more burden into your body without knowing what's working best for your body. not just for the last patient I saw. So we offer testing and blood tests is very common where they can get blood draw and then get the material testing against all the lists that they have. Biocom labs from Colorado and Clifford testing offer that. And patient actually told me that I never get offered that in a dental office. And you know what? I could not get this done or I could not get that done. For example, before I get a hip replacement, my doctor sent me for testing. I'm like, wow, dentists, we don't think about that. When we put something in patient mouth, it's a 24 hours exposure. When you run these tests on a patient, you get results back that would actually tell you that you couldn't use a specific composite resin that's available for everybody to buy? So I would say it depends on which lab you send it to. So right now for blood serum testing, BioCalms, and Clifford, they would have the list of material of what is least reactive. And what is highly reactive? For example, I have a patient that's highly reactive to nickel, highly reactive to cadmium. And obviously, you don't want to use anything with that in the material. So they don't tell you, say, using this company or that company. They tell you the ingredient. And therefore, you can choose from the list which one have the least highly reactive material to use on that patient. All of this information, when it comes to cases, you will start seeing that if a patient had a filling done. would composite from another dentist. And she keeps saying that she had taste, bitter taste, every time she's have her tongue touching that tooth number five. And her dentist checking occlusion, taking x-ray, say margins are closed, everything is solid. And eventually telling her that it's in your head. Like, I don't see anything wrong with it. So by the time she got to my practice, I said, okay, I hear you. We always want to acknowledge the patient's concern. We don't want to discredit them because we don't know what we don't know. So I said, let's go ahead and get you testing. And the test result come back and we actually... her side of consent and agree that we're going to replace that material, take it out and replace it with a different composite. In this case, we're using Admira Fusion by Vocal. And after the procedure done, she's still numb. So we said, okay, we follow up with you with post-op call in the next 24 hours. She called the next morning and she's telling my dental assistant that, tell Dr. Katie, I have no more taste when I'm touching that tooth. What did you remove? So we remove all the old composite. air break, you know, doing the biomimetic technique on the two to make sure everything is good. And then the patient don't have that reactive sensation when they're touching that feeling. So for me, all of these stories are reinforcing that, yes, there's people that are more compatible to one material than the other. And our job is listen and really offering the tool for them to verify or to confirm that. Yeah. And you mentioned admiral fusion. Is that one of your biocompatible go-to products? Yes. So I can tell you that a lot of companies saying, oh, my materials are the most biocompatible. On our, in our practice. we have a lot of data because most of our patients getting all this biocompatibility test done. And when the test coming back, I can tell you that the number one composite that compatible with majority of them, because if not, I have to carry a certain material. Number one, that like my go-to for these cases or our patients on a regular daily basis is the Atmarifusion flowable form, packable form, bivocal. As we wrap up this podcast, and it's been very enlightening. I mean, there's a, real message here. I mean, the message that I'm getting out of this conversation is that you can actually transform your practice with the right knowledge and experience and the right staff that are on board with everything into a very successful dental wellness practice, which obviously is very successful for you because you're five months out and getting an appointment, which would be discouraging to me if I called up in your neighborhood and said, hey, I want to see Dr. To. And she says, well, you know, it's June. I can't see until January of next year. So in closing, though, what are your tips to someone who's looking to move forward and say, I really haven't focused on wellness. I want to do that because I believe in it, number one. And number two, I'd love to ratchet up my passion in my office with something like this. What would you say to somebody that's looking to do that? And also tell us how the best way for them to learn more about transforming their office into a wellness practice. I absolutely love how you put that. You are really summarizing everything that we do in wellness industry, where you have abundance of new patients that really appreciate you and what you do. You have low turnover on team member because when they work with you on a wellness practice, they cannot work in other practice that don't do the same. And of course. You have a very profitable and enjoyable practice because, of course, you know, people appreciate you and waiting to get in to see you. So in order for you to start a wellness industry, it could be something very small to implement. We having wellness dentist masterclass, which is an online form when you come in weekly. masterclass Zoom sessions, and we're teaching everything that we implement in our practice about wellness. You can find out more about that on wellnessdentistinstitute.com. It's our site that we hosting all the training for wellness dentistry. But I will tell you that taking more CE about wellness dentistry, implementing small changes in your practice, start with your exam. Asking the patient question that doesn't cost you anything extra. Start interested in the patient lifestyle, nutrition. And I'm not saying you have to be dieticians or nutritionists, but asking just certain questions and get the patient to plan the seed that like, you know, we are not just the two dentists. We actually are oral health experts where we can connect the body and the mouth and get you well, healthier. Because as you know, there's tons of research brewing that. the bacteria from the mouth affecting the brain, the heart, the cancer patient even. And so in myopractice, we see a lot of those patients and they hope to get better. Your would be amazing to be able to prevent that for your patient. So the best way is definitely taking more CE, get mentorship. ask questions, attend these webinars, and listen to podcasts like this to learn where do I learn more information on this topic. And of course, I'm always available. If you reach out on social media, DM me, send me questions. And I know you would put that contact information there for the listener, for the audience. Yeah, excellent. Very well said. Dr. To, it's been, again, Fantastic to talk to you. Hats off to you for being so successful in your passion in developing a very successful dental wellness practice in Katy, Texas. We have a lot to learn from you. We definitely want to have you on again. And in the meantime, have a great evening and thank you so much for your time. Thank you, Dr. Klein.