449: Expanding Your Thinking Beyond the Oral Cavity - Dr. Steve Carstensen - a podcast by ACT Dental

Expanding Your Thinking Beyond the Oral Cavity

Episode #449 with Dr. Steve Carstensen

People are more health-conscious than ever. And who are the best professionals to go to for better health? Dentists! But it’s not just about fixing teeth and cleaning gums. Today, Kirk Behrendt brings back Dr. Stephen Carstensen, co-founder of Premier Sleep Associates, to highlight the other side to dentistry, breathing and airway, so you can help people breathe better to live better. Don't just be another dentist — help solve airway issues before they happen. To learn how, listen to Episode 449 of The Best Practices Show!

Main Takeaways:

Start the sleep and airway conversation with your patients ASAP.

Only dentists can solve cranio-facial issues before they happen.

Be professionally curious and ask good questions.

Learn new ways to engage with your patients.

Have confidence in what you're doing.

Quotes:

“People who don't sleep well, they don't sleep well because they don't breathe well. And if we allow the body to breathe well — at any age — then the body will take care of its own sleeping problems. And the more we address this early in life, the better the physiology goes on through life.” (9:35—9:55)

“I treat 50 and 60 and 70-year-olds in my clinic. Well, all those people used to be five, six, and seven. Right? And so, what if we could treat a three-year-old and do something about breathing when they're tiny? Maybe they don't become 50 and 60 and 70-year-olds with massive problems.” (9:55—10:12)

“In dental school, we’re trained, ‘Well, these people need protection from themselves, so let's make them a nightguard.’ Nobody should have a nightguard without questions about their sleep and breathing while they sleep, because it’s so highly correlated — not cause it, but correlated. So, don't make any nightguards without asking, ‘Do you snore? Do you breathe well at nighttime? Do you wake up refreshed?’ those kinds of screening questions you can find from a STOP-BANG, for example.” (13:09—13:34)

“One of the things to consider is when patients come back to you and they say, ‘Well, I can't wear a nightguard,’ ‘Well, why not?’ ‘Well, it just doesn't feel comfortable.’ There are not very many reasons why a nightguard should feel uncomfortable. In Pankey training, early on, they said, ‘Well, it’s because you didn't have it fitted right, because you didn't have it adjusted right.’ So, we'd spend a lot of time doing that. But what we really need is more curiosity. Why didn’t it fit right? What’s going wrong? And you'll discover a lot of patients who don't breathe well. And when you start thinking about that, you can make a different appliance.” (13:44—14:13)

“Be professionally curious. Read some books. There are a lot of good books to read.” (14:20—14:24)

“Buy a copy of Breath [by James Nestor] and put it in the reception room, because people are going to have seen that. And when they see that, they might go to the dentist and say, ‘What should I think about that? I've heard of that book. Should I read it?’ or, ‘I read it. What are you going to do to help me?’ Just throw out the question. Start the conversations. And pay attention to what the answers are so that you can identify where it is that you need to learn some more stuff.” (15:04—15:28)

“Getting paid is not the biggest problem, any more than it used to be. The biggest thing is comfort and confidence in what you're doing.” (16:17—16:25)

“The key is the dentist has to get curious, and then train the team. Because in Washington State, I am legally obligated to do the exam, to ask the patient what their chief complaint is — and that's it. That's all I have to do, legally, to treat a patient with an oral appliance.” (17:02—17:25)

“People are wanting to find ways to improve their overall health. And as...

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