The ZZZ Pack

You love him. You learned from him. He's one of the most revered figures in Dental Sleep Medicine. But do you really know him?   The ZZZ Pack dove deep with Kent Smith, DDS, D.ABDSM, a true DSM renaissance man. He shares his reasons for starting Brady Billing, details the traits the most prolific dental sleep practices have in common, talks us through his appliance selection process, and floors us with details about how he spent his COVID downtime.   But that's not all, folks.   Dr. Smith offers the secret sauce to a successful DSM practice (spoiler alert: there isn't one!), tells which DSM company's culture he tries to emulate in his own practice, makes us all feel inferior with his work attendance record, and provides some incredible feedback about an innovative, EVOlutionary new oral appliance from ProSomnus.   BONUS CONTENT: Dr. Elliott unmasks Dr. Smith's true identity! Cue dramatic cliffhanger music…

Everyone wants to belong somewhere — even the tongue. Dr. John Caulfield joined The ZZZ Pack to share his journey from treating teeth with neuromuscular dentistry to saving lives with sleep and airway.   Dr. Caulfield has more tools in his armamentarium than you have socks in your drawers, and one of these tools has eliminated patients' need for PAP or MAD. Pull up a chair as he drops knowledge on transpalatal expansion, nasal breathing, engaging consultations, and the benefits AND limitations of CBCT in airway analysis. Sleep tests, improving physiology and anatomy, and his own experience as a VIVOS patient. He created the time and space to discuss all this with the ZZZs.   Learn how to do more dentistry AND better dentistry by putting everything in the right place. Your restorations will last longer, your patients will live healthier lives, and you'll be on the path to creating a village of practitioners that stop building dams and start building bridges so everything downstream gets better.

Like most of TMD and DSM's foremost thinkers, Dr. Mayoor Patel's journey started in Zimbabwe, led to Arkansas, and eventually to finishing dental school at the age of 22. Oh, wait, that's a crazy, outlandish story - but truth is stranger than fiction.   Don't believe us? Then wait until you hear what Dr. Patel has to say about the ONE thing he's observed in all his courses that separates successful Dental Sleep Practices from those that fail to take flight. I'm just going to give you a hint - the initials are “RDH.”    And there's more folks. COVID, depression, and parafunction - Is there any overlap?    What effect does perimenopause have on sleep? I'm asking for a friend, by the way...   Do bite splints really make apnea worse? What about UARS and headaches?   Orofacial pain, TMD, and sleep - Is there really a connection?    Get your listen and learn on with The ZZZ Pack and Dr. Mayoor Patel, the dentist that is in the process of LITERALLY writing the textbook on Dental Sleep Medicine.

Madan Kandula, MD, blew the ZZZ Pack away with his iconoclastic approach to the typical sleep workflow. His pragmatism when referring to his 10 ENT offices in the Wisconsin/Chicago area as an “upper airway breathing practice” had Dr. Elliott ready to pay his relocation costs to Idaho.   Dr. Kandula dropped gems on the ZZZs about the barrier between dentistry and medicine, anatomic nasal and sinus blockages, the importance of nasal breathing, and a bunch of other things that will make you a boring dinner party guest but a much better clinician.   Want to know how his practice, Advent, continued to scale top quality care as he grew from being a single practitioner to having nearly 200 employees across 10 offices in 2 states? Curious about the slow, painful, purposeful journey to master consumer marketing? It's all here…   “If you have sleep apnea and interact with the health system, you're screwed.” That's the zeitgeist, and Dr. Kandula is doing something about it. Listen. Lots of takeaways in this episode. You need this. Your patients do, too.   DISCLAIMER: The ZZZ Pack is not responsible for any stagediving or moshing injuries resulting from Dr. Kandula's outro theme song.

Dr. Steve Carstensen wrote the book on Dental Sleep Medicine - literally. He and his co-author wrote the seminal The Clinician's Handbook for Dental Sleep Medicine.    He broke bread with the ZZZ Pack to discuss how he continues to educate, disrupt, push, pull, and cajole our sleep colleagues to do more to tackle airway issues. His excitement is palpable when he underscores dentistry's ability to look beyond the oral cavity and focus on medicine.   Dr. Carstensen's collaborative efforts with the ADA's pediatric airway task force has the potential to effect generational change. He provides interesting updates on their burgeoning pediatric airway screener; who it's being designed for; and what the American Academy of Orthodontics, the American Academy of Pediatric Dentistry, and other professional organizations think about it. You'll be surprised.    What's preventing sleep from getting more time in the dental school curriculum?   Why isn't the needle moving on the percentage of the population getting proper OSA diagnosis? Who can do something about this?   Why is there a diagnostic bottleneck, and what role should dentists play?   If there is a shortage of sleep physicians, WHY is the AASM sending letters to state dental boards discouraging dentists' involvement with sleep testing? What'd Dr. Elliott do when this came up in her home state of Idaho?   And what about companies preying on dentists with get-rich-quick DSM “turnkey” solutions?    Dr. Carstensen is one of the foremost thinkers in DSM. You're likely to increase your DSM IQ by 3-4 points just by listening to this episode. Your patients and practice will thank you for it.

So many dental sleep leaders don't remember what it was like to implement, manage, and grow dental sleep medicine in a restorative practice. They lecture about it like it's easy peasy - no biggie. The struggle is real. You know it. So do our guests...   Dr. Michael McCormick and Dr. Marc Newman share their real world journeys to make sleep an integral, life-saving, profitable part of their respective practices. Whether starting in Virginia or Indiana, their DSM paths to success take some different twists and turns.    One has used telemedicine to streamline sleep testing processes. The other owns 5 HST units. One has encountered nearly every challenge a dentist can face, while the other said it's been pretty seamless. One started with a DSM consultant. The other one began using a consultant much later.   Which one are you?    How do you measure a successful case? Is it a 50% reduction in AHI or spooning with your spouse for the first time in 22 years?   Which ZZZ Pack host provided a “EUREKA!” moment for one of the guests?   Listen to the episode to get these questions answered. Then share it with a colleague & like today's guests - GET THE SLEEP BUG! 

Oral Appliance Therapy stalwart, Sonnie Bocala, ends the ZZZ Pack's hiatus to discuss his company's pandemic pivot and the Dental Sleep Medicine field's Covid comeback. You'll be stunned as he unmasks the collaborative project that brought many labs together for a truly admirable cause.    It wouldn't be a Sonnie day though if we didn't talk OAT specifics. You'll hear which appliance he thinks is best, what makes Apex more than just an appliance manufacturer, cause and effect of appliance breakage and repairs, and tons more.    NEWS FLASH: Sonnie shares THE BIGGEST ENEMY TO ORAL APPLIANCES! He dropped it on us just before he got thunderstruck in the bonkers new Lightning Round.    Listen now to boost your DSM IQ.

There are more than 150 FDA-cleared appliances for the treatment of OSA. Who needs another one, right?    WRONG!   Chris Gillette spent the afternoon with the ZZZ PACK sharing how his decades of experience as a sleep technician led him to realize the many benefits of Oral Appliance Therapy while also identifying many of the design flaws.    This compelled him to develop, patent, and produce a new device – Bfit. What is it? How does it work? How is it different from the myriad other available devices? And most importantly, did it pass ZZZ host, Lisa Moler's litmus test?    And what the heck does “clench and replace” mean?    Join Chris in the hot seat as he talks bruxing, auto-titrating devices, and tons more. Why are you reading this? Listen now...

Tiger Woods is a champion, record setting golf legend, and he still has a golf coach. Don't you think a DSM coach might be able to help coach you and your team to new heights? That's the question posed to Erin, Lisa, Toby Breeze, and our listeners by coach extraordinaire Michael Cowen, founder and CEO of Awaken2Sleep.   Michael has been living in the sleep world for more than 17 years and has observed many of the best and worst practices. He shares the one critical issue that prevents practices from reaching their dental sleep goals. I'll give you a hint – it isn't bite technique or device selection.   Think about this scenario. Your patient is there for a prophy. You start talking about airway health and sleep. Walls go up, and trust goes down. Michael downloads with the ZZZ Pack about how to communicate and connect with patients to overcome this cynicism while building trust, conveying your “WHY,” and becoming the type of clinician that patients want to hug.  His “WHY,” regarding his early years as a pediatric sleep technician and a serious sleep-related health scare with his daughter, will leave you near tears and motivated to be more.    You'll learn how doing the Dental Sleep Medicine Hokey Pokey will help you better understand your team, your WHY, and objectively set SMART goals. Who are you? Who do you want to be? What are your skills, and what are your limitations? Michael goes deep on all these topics plus servant leadership and more before being the first ZZZ guest to leave us with a personal playlist.   Are you making excuses for why your screening processes aren't bearing fruit or your production is below goal? Do you even know what your goal is? Does your team? If you answered “yes” or “no” to any of these questions, then you need to put down that glass of chocolate milk and listen to this episode now... like right now.

David helms the ship as CEO of Respire Medical where they've taken the oral appliance market to new heights with the launch of the innovative Respire Pink AT. David dishes on new advancements to the Herbst appliance, how listening to the voices of their customers led to the changes, why their BONKERS warranty matters, and how the dental sleep field would benefit by learning analogously from other business verticals. All of this with a British accent.    David also tells what he's learned from the Who's Who of physician specialty guests he's had on his own podcast, “Sleep Talking.” You'll be stunned by his suggestion about what dentists should do to earn more physician referrals. It definitely reinforces the idea that there's more than one way to skin the proverbial cat.   David's past life as a denturist gives him unique perspectives into what dentists can do to improve the quality of the cases they receive, the future of digital impressions in DSM, and which anatomic curvature can make or break a case. He downloads some truly meaningful insights, teaches the ZZZs about spotted dick, and stuns with some of his lightning round questions.   New appliances, new perspectives, new episode. Listen, rate, comment, and tell a friend.

Dr. Sam Cress  sold his general dentistry practice and began the process of opening a new sleep and TMD practice dedicated to providing his guests with desirable experiences from he and his co-therapists. Wait, what about patients, appointments, and hygienists?    Then COVID-19 struck. What's a dentist to do? Tuck your tail and run for safety? OR BLAZE FORWARD? Dr. Cress is crazy smart and did the latter. Then the wackiest thing happened on opening day. Listen to find out about this test in resilience.  You'll get a tutorial on positive mental attitude, grit, and optimal time management.    Speaking of sleep and TMD - Dr. Cress tells us about the genesis of the Meridian PM, his patented, FDA-cleared orthotic for the treatment of the aforementioned maladies. Incorporating myofunctional therapy tenets, emphasis on the TMJ, and minimizing VDO with casted laser welded accuracy, SC makes a startling claim about the device's efficacy. You've 110% gotta hear this.    Oh, but, wait...it doesn't stop there. Hear how Dr. Cress has leveraged the wisdom of his mentors to build value for his guests so they're willing to hang sheetrock to get into the office sooner, how he's been able to avoid the medical insurance maze while getting almost everyone into the treatment they deserve, and the #1 issue dentists struggle with at his lectures.   Dr. Cress makes yet another astounding claim when he says that EVERY dentist has what they need to successfully treat TMD patients. What is it? In an episode full of quotables, you'll just have to shut up and listen…and no beans and weenies for you...

Dr. Rodgers put his shirt on to yap with the ZZZ Pack about the revolutionizing nature of post-apocalyptic telemedicine, how to manage this new workflow, and how it creates a better experience for many of his patients, particularly those with a lengthy drive. Part of this new workflow involves using the WatchPAT One after patients provide positive subjective feedback, and he wants easily obtained, accurate, objective data before sending them back to the sleep doc. And we couldn't talk about that without talking about effort belts – to be or not to be…. Dr. Rodgers answers that question.   Then he gets deep – real deep. He confesses to being a former “What If” guy. You know this person. You might even just need to look in the mirror. Symptoms include analysis paralysis, fear of taking action without determining every possible outcome for the next millennium, attending 100 hours of CE without doing one case, etc. Dr. Rodgers shares how he overcame this malady and started treating more patients – a lot more patients. What was that pivotal moment and what tactic helped the DSM practice grow exponentially?    Are your patients using CBD or THC to minimize their anxiety or insomnia? Things got a little wacky as we discussed the pros, cons, and potentially game-changing nature of widespread cannabis legalization.    COVID-19 has affected nearly every facet of life. Jeff Rodgers is one of the DSM clinicians that's adopted some cool innovations and updated his workflows to actually improve his productivity and patient experience. Listen. Learn. Act. Nobody wants to be a "What If" Guy.

Dr. Scott Simonetti dishes about the critical importance of increasing disordered breathing awareness among dentists, physicians, and patients. Patients aren't going to bust down the door asking for an appliance. Hear what dental sleep medicine signs and symptoms he's identifying and why 75% of patients that receive the patented, FDA-cleared POD appliance are women. Headaches, fatigue, clenching, difficulty staying asleep – ever heard a patient mention these issues only to dismiss them with excuses like, “well, I have young kids” or “I'm working a lot right now”? What do you do about it?   Dr. Simonetti shares the importance of recognizing TMD – improper condylar translation, deviated opening, midline misalignment, headaches, and more. But then what? And what does any of this have to do with sleep dentistry? More importantly, what do you do about it? Listen and find out. Also, some listeners may be stunned to hear about his treatment protocol as it relates to sleep tests.   Lastly, you will NOT believe what Dr. S does while his kids are asleep and his wife is watching TV.   The ZZZ PACK podcast can help your ears find your happy spot. And the POD can help patients' mandibles find their happy spots. This ain't your grandpa's sleep appliance or your grandma's podcast. Check out more on Dental Sleep Practice

The ZZZ Pack sat down (virtually, of course) with Xlear founder Nathan Jones to discuss the mind-blowing benefits of xylitol and how to educate your patients on using this "magical" ingredient. As dental pros, we know health starts in the mouth. But, how often do we consider nasal passages in our overall health, especially for dental sleep patients?  With the xylitol-based nasal treatment Xlear, studies showed a 20% increase in airway after three minutes of the FIRST use. Patients also snore less and could even stay healthier against upper respiratory illnesses … we're looking at you, COVID-19. Listen to the episode for an abundance of detail on the power of your nasal passages and how Xlear can help your patients enhance their treatment and stay healthier overall.

Gy Yatros, DMD and Richard Drake, DDS brought the “Gy and Rich Show” to the ZZZ Pack. What changes have they seen since 1st sketching a business plan for Dental Sleep Solutions on a napkin 12 years ago, how do they innovate and stay ahead of the game, and what changes do they foresee on the horizon? These two have probably presented more free Dental Sleep CE than anyone else in the field. They do it to help more dentists help more people. Their focus on pragmatism, efficiency, and productivity seems to resonate with a lot of practitioners and the #1 challenge they see in practices across the country is a real eye-opener.

Dental Sleep Medicine is growing. But not fast enough or widely enough to meet the public need for treatment.  DSM can also be competitive, particularly among appliance manufacturers. So, why would Len Liptak, CEO of ProSomnus and the crew there gather tons of information about prescribing habits, patient outcomes, and physician feedback and then openly share it with their “competitors” and others in the field? Here's a hint - It's the title of this episode.   Len & the ZZZs discuss the genesis of ProSomnus, the state of digital in DSM, how the industry can jointly drive OAT acceptance, and we share some nitty-gritty, controversial thoughts about Medicare-approved (PDAC) appliances. You'll be stunned to learn how draconian these guidelines are and what it can mean for your patients. But fret not, captain...   So much about the past, present, and bright future of DSM in this episode. It. Is. Bonkers.   Grab your headphones, open the sails, and bear down. The DSM horizon is within reach...

Dr. Jason Doucette flips toboggans while dispelling myths about the real opportunity in Dental Sleep Medicine. With a bustling restorative practice and a thriving DSM practice, he joined The ZZZ Pack to talk about the “struggle of the juggle”, the “slow brew of” DSM, competition in the field, his device of choice, the importance of a sleep champion, and much, much more.    There were laughs, tears, cartwheels, a wealth of practical inspiration, and tons more that will leave you asking, “WWJD (What Would Jason Do-ucette?”

Opportunity to develop a disruptive new oral appliance? PIVOT! Time to launch another new appliance & then your biggest competitor unceremoniously disappears from the market overnight forcing you to increase your manufacturing capacities fivefold within a week? PIVOT! Spent a year building a state of the art new corporate HQ & then COVID-19 throws an unknowable wrench into things? PIVOT! Pandemic essentially shuts down your business? PIVOT! Beatrice Robichaud is the co-founder of Panthera Dental, manufacturers and owners of the innovative, printed Panthera D-SAD device. The past couple years have seen them face innumerable significant challenges that would have crushed many businesses. Instead, they've crushed it by continuing to pivot. Heck, they've done it so often with so much success, that we're now coining it “The Panthera Pivot.” This agility, creativity, and innovation have been personified by their pivot to leverage their additive manufacturing capacities for the fabrication of PPE during the COVID pandemic to their ability to significantly ramp up to meet the demand for their proprietary D-SAD oral appliances when Resmed dipped on the Narval.  What have they done? How have they done it? And what's next? I'll give you a hint - Beatrice shares an exclusive news flash on this episode!

Help us Brett Brocki. You're our only hope.  Brett Brocki, self-proclaimed Star Wars nerd, is all about evolving, not revolving, and he wants you to get off the hamster wheel, too. The business, finance and dentistry expert delivers a goldmine of information, from how to access quality and cost-appropriate PPE right NOW (hint: step away from the black market Google search) to separating yourself from the whiners and wannabes during this time of change. He outlines how successful practices separate themselves from those that flounder and talks about the one-two power punch of dentistry and medical pros working together. Brett also details the opportunities to stay open or reopen for Dental Sleep Medicine practices. NEWSFLASH: Needing a medical device to sleep is essential, so that means you are, too. This episode is all about sharpening your ax to thrive, not just survive. It's time to wise up, grab your team and jump into your escape pod to abandon the exploding death star we've all had to manage these past few months.

Holly Ellis, DDS details her Dental Sleep Medicine journey from the “TAP SLAP” and the importance of software decisions to getting her team on board and how she responds to patients that say “I'm just here for a cleaning.” She shares how she connects the dots for patients that usually have no understanding of their sleep test results, how they relate to their chief complaints, and what their treatment options are. Dr. Ellis also downloads how she marries bluntness and caring to persuade at-risk patients to proceed with a sleep test. Holly and Jason share their own Wheel of Fortune experiences, and Dr. Elliott fights tears as she opens up about the dental school anatomy question that haunts her to this day. Spin the wheel and solve the DSM puzzle for your patients and your practice.

Starting with her own firefighter husband's journey to a healthier night's sleep, Gina Pepitone-Mattiello, RDH reminds us of the crucial role the team plays in a Dental Sleep Medicine practice. From screening to consultations and everything in between and everything beyond, she's demonstrated that a strong team is key to success. Gina has parlayed this into the position of “sleep hygienist” and her experience should awaken other practices to take action. Gina highlights how to handle patients with signs of symptoms of SDB but “just want to get their teeth cleaned” by leveraging trust and rapport that she's created. Tons of actionable information to empower your team, help your patients live healthier lives, and change your career trajectory when your roller derby career fails to take off. Oh, and she's a mean cartwheeler….

  Dr. Stacy Ochoa tells a heart-wrenching story about her Dad, pushing through fear to share her story, the crucial importance of screening kids for Sleep Disordered Breathing, and where to go from there. You'll never think of February 14th the same after hearing her touching ode to her Dad.   

It seems like kids are popping ADHD meds like Pez, but what if sleep disordered breathing is at the root of many of these issues? What if proper screening and early intervention by dental teams can help positively impact kids' sleep, cognitive behaviors, and overall health? Pediatric Sleep Disordered Breathing is a hot topic in dentistry today. Yes, lives can be saved and future generations can be reared to live healthier lives...BUT what is the business case? Dr. Jill Ombrello (who is at home with her kids during COVID-19) shares her experiences with pedo SDB including screening and treatment protocols, insight into how it's become an immensely profitable focus of her practice, and enough wisecracks to make you think she might need to add standup comedian to her CV.

Sadly, the novel coronavirus pandemic continues its life-threatening devastation across the globe. Mark Murphy, DDS has immersed himself in monitoring the pandemic's trajectory, becoming Dental Sleep Medicine's version of Tony Fauci.  In this timely episode, Dr. Murphy & the ZZZ Pack discuss current COVID-19 statistics, models regarding its spread, the importance of gratitude, and he shares the steps he's taking to continue safely treating patients with Oral Appliance Therapy. This episode provides fantastic, actionable information and DSM guidance during uncertain times. Listen. Be smart. Be safe. Be healthy...and be thankful.

During this very serious and challenging time in our lives, we thought it was perfect timing to bring a little comedy and light-hearted humor to the ZZZ Pack! Let's all take 40 minutes to unwind, relax, and laugh! We talk with Greg about his NY Times Bestselling book, "He's Just Not That Into You", sleeping in awkward hotel rooms, stand up comedy, how does someone sleep "wrong"?! and many more riveting factoids. This one is probably best listened to with your earphones on and no kiddos around :) #Fbombalert

Like the famous rapper, our guest's initials are M and M. He's also from Michigan and come to think of it, I've never seen Mark Murphy, DDS and Eminem in the same room. Are they one and the same? Mark Murphy, DDS aka Murph Doggy Dogg, aka The Silver Fox channels Eminem, Tone Loc, and Sir Mix-A-Lot...in the 1st 3 minutes. Then he gets down with The ZZZ Pack to discuss how to close more oral appliance cases, transition to a medical model, and what the Dental Sleep Field needs to coordinate to drive physician engagement and ensure the rising tide raises all ships. Then he takes us home with his insights about the future of digital technology in Dental Sleep, the next generation of appliances, and you'll be stunned to hear his views about what decreasing reimbursement might mean for your lab bill. He's the man. He's prosperous. He's funky. He's Mark Murphy, DDS. Mic drop.

    Not even a tongue retaining device can make Tarun T-Bone Agarwal hold his tongue. His no-nonsense approach to dental sleep medicine leaves no room for excuses. Laugh, get inspired, and get busy.

  You will have a hard time finding a physician that advocates Oral Appliance Therapy with the alacrity of Jagdeep Bijwadia, MD. He can't do cartwheels, but he shares some thought-provoking perspectives on the quest to improve multi-disciplinary collaboration, patient shame regarding CPAP non-adherence, and the future of telemedicine in sleep medicine. This episode is sponsored by: ProSomnus® Sleep Technologies

  Randy Curran, commonly known as the Bald Oracle of Billing has touched more medical claims for oral appliance therapy than anyone in the United States. Hear what's new in the world of medical billing for dental practices from the only dude holding a professional license to ill.

  Dental Sleep Medicine's version of Steve Jobs and Steve Wozniak dish on the DSM Facebook group, overcoming fear when making the leap from general dentistry to exclusively practicing dental sleep, their worst case scenario, the importance of teamwork, and the hidden benefits associated with screening the team and their families. All this, plus a special guest appearance from Ice-T. You'll laugh. You'll cry. You'll learn. And you might even change your career path.

The ZZZ Pack Podcast is THE prescription for dental sleep we have all been waiting for. Join our hosts for uncensored real talk on dental sleep. In this episode you will meet The ZZZ Pack... Lisa Moler: DSP Publisher, Sleep Apnea Slayer, and Patient Dr. Erin Elliott: The fearless OSA doctor aka; "The Queen of Good Air" Jason Tierney: Multi-syllabic thought provoker in all things sleep