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Jonathan Louis Dent is a father, Assistant Professor of Theatre, writer, consulting astrologer and numerologist, and an initiated priest of Ifá and Ò̩ṣun. He weaves ancestral wisdom with astro-numerological insight to support clients in navigating both personal transformation and collective shifts. With a rich background in theater and performance, Jonathan's writing lives at the intersection of mysticism, politics, and the depth of the human experience.In this episode, we talk about the one universal year in numerology, the year of the fire horse, and the outer planets changing signs and what that entails for the collective. Show Notes:Jonathan's WebsiteJonathan's Instagram⁠Laura Chung Instagram⁠⁠⁠Laura Chung's Website⁠⁠ Awaken and Align Instagram⁠Join the Patreon⁠ ORDER HOW TO MANIFEST BOOK⁠ SIGN UP FOR MY NEWSLETTER⁠

Attorney Rich Lenkov, Capital Member, Downey & Lenkov, and co-host of “Legal Face-Off” on wgnradio.com, joins Wendy Snyder, filling in for Lisa Dent, to discuss several on-going legal cases across the country. Lenkov gives his thoughts on the national park and conservation groups suing the Trump Administration over National Park Service policies that “erase history and undermine science.” He […]

On Wednesday's Football Daily, Phil Egan brings you the latest from last night's UEFA Champions League action including the racism allegations in Lisbon, plus there is a look ahead to tonight's action and there is a Premier League game taking place between Wolves and Arsenal.Champions League fallout as Vinicius Junior accuses Gianluca Prestianni of racial abuse during Real Madrid's win over Benfica in Lisbon.Reaction from Jose Mourinho and strong criticism from Spanish football expert Graham Hunter on Off The Ball Breakfast.A full round-up of Tuesday's Champions League results, including Juventus' heavy defeat to Galatasaray.Late drama in France as Paris Saint-Germain fight back to beat Monaco despite a brace from Folarin Balogun.Goals from Serhou Guirassy and Max Beier secure victory for Borussia Dortmund.A look ahead to tonight's action as Newcastle United travel to face Qarabag, with Eddie Howe targeting more history.Other key ties previewed, including Inter's trip to Bodo/Glimt and Atletico Madrid on the road at Club Brugge.Mikel Arteta addresses Arsenal's growing warm-up injury concerns ahead of their clash with Wolverhampton Wanderers.Relegation battles in focus as Vitor Pereira begins his mission to keep Nottingham Forest in the Premier League.Championship and Scottish storylines covered, including play-off drama and discussion on who could succeed Martin O'Neill in the Celtic hot seat.Become a member and sign up at offtheball.com/join

Dr. Julia Garcia, psychologist, behavioral researcher, motivational public speaker, and author of “Habits of Hope,” joins Wendy Snyder, filling in for Lisa Dent, to discuss her presentation for the Glenbard Parent Series. She shares how parents can help their kids feel more connected in a digital world, feel more confident at school, and more.

Wendy Snyder, filling in for Lisa Dent, checks in with the newsroom to hear their stories, including how the grandson of the inventor of Reese's Peanut Butter Cups feels that the candy now tastes different but The Hershey Company says that they “are made the same way they always have been.”

Dan Kosta, Horticulturist at Vern Goers Greenhouse, joins Wendy Snyder, filling in for Lisa Dent, to discuss grocery produce. Kosta explains how the tomatoes that we buy at the grocery store are red in color, but are not fully ripe. Kosta shares a timeline for when people should start planting seeds for their gardens for […]

Wendy Davis joins to show to share an update to the search for her father, Dan Davis, who went missing last November. Davis joined the Lisa Dent show in December to review the details of her father’s last moments before disappearing. Now, she shares how her and her family are making the search for Dan […]

Pat Brady, SVP of Mercury Public Affairs, former chairman for the Illinois Republican Party, and former federal and state prosecutor, joins Wendy Snyder, filling in for Lisa Dent, to discuss JB Pritzker’s budget address in Springfield. Brady said the address centered around “maintenance.” “The most interesting part of the address”, Brady continued, “was the last […]

Chicago radio legend Kevin Matthews joins Wendy Snyder, filling in for Lisa Dent, to talk about meeting the Pope. Matthews and Snyder talk about being Catholic, his documentary film ‘Broken Mary: The Kevin Matthews Story,' and meeting Pope Leo XIV.

Alex Zalben, Editor of Comic Book Club, joins Wendy Snyder, in for Lisa Dent, to discuss the latest in television, entertainment, and streaming. Zalben shares news of the latest Mandalorian trailer. Star Wars’ popular television series surrounding a bounty hunter makes its first theatrical appearance this May.

Nationally syndicated financial columnist and author Terry Savage joins Wendy Snyder, filling in for Lisa Dent, to discuss taxes. She shares how seniors, who may not think they need to file taxes, might be losing out of refunds they are entitled to if they don’t file.

Wendy Snyder, filling in for Lisa Dent, checks in with the newsroom to hear their stories.

Dr. Jim Adams, Chief Medical Officer of Northwestern Medicine, joins Wendy Snyder, filling in for Lisa Dent, to discuss several health topics. He shares some information about colorectal cancer and its warning signs, whether or not people who have gotten the measles vaccine need a booster, and some lifestyles changes people can make to help reduce their […]

Bob Zeni, the Chicago Tomato Man, joins Wendy Snyder, filling in for Lisa Dent, to talk tomatoes. Zeni shares which tomato plant varieties will be available on this online shop this year.

Ilyce Glink, owner of Think Glink Media, joins Wendy Snyder, filling in for Lisa Dent, to talk about the Consumer Price Index (CPI). She covers where consumers are feeling financial relief, and where they aren’t.

Wendy Snyder, filling in for Lisa Dent, checks in with the newsroom to hear their stories.

Alex Zalben, Editor of Comic Book Club, joins Wendy Snyder, in for Lisa Dent, to discuss the latest in television, entertainment, and streaming. Zalben and Wendy talk about what TV they’re watching and shows people should look out for.

Wendy Snyder, filling in for Lisa Dent, checks in with the newsroom to hear their stories.

Dr. Dana Varble, chief veterinary officer for the North American Veterinary Community, joins Wendy Snyder, filling in for Lisa Dent, to talk all things pets. She shares how to change a dog’s licking behavior and answers listener questions.

Ron Brown, news anchor for WGN Radio and movie buff, joins Jon Hansen, filling in for Lisa Dent, to share some of his favorite rom-coms ahead of Valentine’s Day. This week he reviews 500 Days of Summer, One from the Heart, La La Land, and more.

Lou Manfredini joins Jon Hansen, filling in for Lisa Dent, in his weekly segment, Lou's To Do List. Lou answers any questions you have about projects on your to-do lists.

Jon Hansen, filling in for Lisa Dent, checks in with the newsroom to hear their stories, including Galentine’s Day.

Jon Hansen, filling in for Lisa Dent, checks in with the newsroom to hear their stories.

Pat Brady, SVP of Mercury Public Affairs, former chairman for the Illinois Republican Party, and former federal and state prosecutor, joins Jon Hansen, filling in for Lisa Dent, to discuss the Cook County board president election. Brady joined Alderman Brendan Reilly, 42nd Ward, at an event. Ald. Reilly is challenging Toni Preckwinkle. Brady believes that […]

WGN-TV weather producer Bill Snyder joins Jon Hansen, filling in for Lisa Dent, to talk about what’s behind the smell that has permeated throughout the Chicagoland area.

Kate Armanini, reporter for Chicago Tribune, joins Jon Hansen, filling in for Lisa Dent, to discuss her article. Armanini shares the reasons that more Chicago families are choosing to homeschool their children in recent years.

Erin Russell of The Russell Firm joins Jon Hansen, filling in for Lisa Dent, to discuss music copyright law. In recent years, Olympic figure skaters have turned toward popular music for their routines. This has caused some skaters to face problems with copyright claims. Russell explains the procedures that are needed to clear the music for use […]

Do you want your patients to feel confident and cared for and to become raving fans about your practice? Kiera takes listeners through specific steps to help practices refine what their patients go through upon entering to exiting your office. Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: The Dental A Team (00:00) Dental A Team listeners. This is Kiera. And today I'm excited for a quick tactical practical tip for you guys that I just think is magical. And I'll start with like a story about it to kind of kick us off. ⁓ Jason and I, we just recently went to Ruth's Chris. We decided we were gonna do a day date and Jason and I, went to the spa. I convinced him to go to the spa. He's not like obsessed about it, but really loved in like the hot tub room that they actually turned on a football game for him. So.   I don't know how the spa gods were on my side that day, but they definitely were. And then we decided to go to Ruth's Chris. And if you guys are familiar with Ruth's Chris, ⁓ it's ⁓ an amazing steakhouse. And ⁓ I noticed when we went in there, there was just a different vibe. And I've been very obsessive about high-end restaurants, reading the book, Unreasonable Hospitality. I think I'm more aware of it. If you guys haven't read that book, I definitely recommend putting that on your book wish list. And what was interesting is,   When we came in, they said, hi, Mr. and Mrs. Dent, great to see you. And they took us back to our table and the waitress was so kind to us. And she said, here's this information. What information do you guys need? There were seat spot for us. The busser came through and was like, we really love working with people like you. You guys just make our life so much easier. They're like, here, let's just box this up for you. You made great choices for you. They had all of our stuff boxed for us. The presentation was beautiful.   They didn't come by and they weren't annoying to us, but they were so genuine to us. And then as we were leaving, they said, thank you, Mr. and Mrs. Dent. And they knew all about us. Okay. So that was one experience. Another experience has been Jason and I were in Bali and we went to the four seasons and I remember if you've been to Bali, you'll understand. Jason and I both got Bali belly. And if you haven't heard mine was, I got it on our flight home. I've never in all my years of flying, knock on wood, I've never once thrown up ever on a plane.   Mine is my flight home that was a nice nine hour flight from Taiwan to San Francisco. And I threw up and had diarrhea the entire freaking time of that flight. I had thrown up about 13 times in two hours and I figured out, if I can make a system for this, like it was hold the vomit bag, go to the bathroom and brush my teeth all at the same time. I realized you can create a system for anything. So that's a little bit beside the point. So I'm here to tell you about great experiences. But at the four seasons, they were top notch. They had an app. They would text us.   When I asked them like, hey, you guys have any medicine? They're like, ⁓ we don't have medicine. Here's the pharmacy. We can get it for you. We'll have it to your room. They had it to our room for us. They brought different things for us because they knew that we were sick. They had a turndown service for us. They paid attention to our likes. Our wants, made sure everything was done every single night for us. It was one of the most incredible experiences. And I think about it, like people are like, Kiera, you traveled all over the world. You've gone to Antarctica. You go to these places. And I'm like, Bali, even though I threw up for eight hours on my flight home.   Bollywood one of my most amazing experiences and I'm like, what was it? Like it was how I felt at Four Seasons. It was how I felt of everybody was so happy for us to be there. They were so grateful for us to be there. People would say hello to us. They knew our names as we walked through. And ⁓ I've just been paying attention to like Ruth's Chris was recent. The Four Seasons was another one. And then I think about other experiences that maybe weren't as great. I think about...   Hotels Jason and I we flew home. We missed a flight coming home from an international flight So we had to snag a hotel the only hotel available for us was a hotel I will not say But it was we'll just say a budget-friendly hotel and I remember we checked in and no one was there They weren't happy to see us. They were annoyed to see us the shuttle. I'm not joking you It was supposed to be there in 15 minutes We waited two hours to get our shuttle and they kept telling us one's on the way one's on the way. They were like you need to call this person By the time we got there our bed was dirty   The bathroom was broken. And I just thought, man, I remember that experience. I don't remember the Four Seasons experience, but which one do I want to go back to? Which one do I tell my friends about? Which one am I like, I threw up and I was so sick from Bali. You guys, would never recommend doing a cooking class internationally. I know exactly what caused our sickness. my gosh. And my stomach like to this day still hurts about it. But yeah, I loved that trip so much because of how I felt. And so that's what I want to go into today of   the patient experience in designing and creating a journey that the patient wants to be a part of and they want to rave about. And I know we've talked about this at several other times ⁓ because it's something where I remember I was at a conference once and they said, Kiera, what people remember is the beginning and the end. They don't really remember the middle. And so in dental practice, it's our beginning. It's our first phone calls and it's the end on how they leave. Yes, they might remember the middle of the procedure, but typically speaking, it's those, those two points in anything like think about a show you go to. You usually remember the beginning.   You remember the end. think about Taylor Swift and I'm like, definitely remember the countdown clock. Like I can remember that. remember everything coming out. Middle, like there was a lot going on and the ending, everybody can remember that. But, and yes, there are still things and that's not to say the middle can't be great, but we want to make sure that it is this experience that people are so obsessed with because we want to help them feel so good. And I think the dental office is such an intimate space. Dentistry is intimate. Everything that we do in dentistry is intimate. And so if we can help patients feel   a certain way and that doesn't mean we have to be perfect, but it does mean that we create a patient experience and a patient journey for them. So for me, even in Dental A Team, it should be that the patient experience, our customer experience is very intentional and not accidental. So we kind of think through it, like what do want our patients to feel? What do we want our patients to say about us? And it's also crazy because you can go look at your reviews right now and see what the patient experience is today.   what you've created maybe not intentionally or intentionally. Just go read it. What is it? For us at Dental A Team, I want people to feel like it's fun. I want it to feel like it's easy. I want people to feel like, my gosh, like they understood me, that they're thinking ahead of where I'm at, that they can guide us and that we are non-judgmental and that you and your team are gonna rise to the next level. Go read our reviews. That's what it is. But that's by intentionality and design. That's our core values. That's what we talk about constantly. It's how we onboard our consultants.   It's how we refine. how we take feedback from clients of if they're not getting it, how can we make this process easier? How can we make it easier for our consultants? How can we give better education? Like what can we do because that's the experience we want them to have. And so, ⁓ this is going to be an episode. If you really want patients to feel like super confident and cared for and to become raving fans for you to where they love the dentist, you have an opportunity to change how people feel about going to the dentist. And I think it's an amazing opportunity if you choose to do it. So   Number one is like, let's think about first impression. Remember, like it's the it's the end caps. And I think if we can even just design those two really, really intentionally, like four seasons and Roos Chris, did you notice in both of those? And this is not on purpose. I just sharing the story. I talked about my entrance and my exit at Bali. We were freaking sick on that last day. And I remember that the most more than anything. Yes, they did the turn down service and that was great. But I didn't talk about our New Year's Eve dinner that we had. I didn't talk about the waiters like none of that.   And as I think back, I'm like, yeah, that was really nice. I remember our first initial and our ending. Same thing with Ruth, Chris, how they entered us and how they exited. I talked about both of those. Go back and rewind. And that was not on purpose, but this even just proves my point that the experiences you remember are those end caps, the beginning and the end. So what is our presence? So number one is how do we answer the phone on the first new patient impression? That's going to be it. I talked about this just recently. If you haven't heard that, go back and listen, but like, how do we greet people? And are we like smiling when we answer? Are we excited or are we like,   Oh my gosh, another freaking phone call, like, hello. Right? I don't know if any of you had a mom who had a mom voice where she's like, Kiera Cherie. And I was like, hello. My mom was like, I didn't do that. I'm like, oh mom, you did. And you had the snap and you'd give me those mom eyes, right? Moms had those two voices. My sister's husband, he was like, my mom used to like snarl at me with her teeth. My mom didn't do the teeth, but we all know like, and I feel like that's how it should be like, we could be busy in the patients, but as soon as that phone rings, I want our front office to feel like.   my gosh, I am so excited to be answering this phone call. We are so excited you're here. Like almost like buddy the elf, like you're so excited. Maybe not that enthusiastic, but like that same sentiment. We are so excited. So we want it to be this like welcoming. We are happy you're here. We're not annoyed that you're here. And that's the very first impression. And then when they come into the practice, this is our next first impression. And if we botch our phone, we oftentimes can make it up on our second, but I will tell you that first phone impression is going to be paramount. So get our best person answering those.   best person and all of our front office team needs to realize when you answer the phone, you go on stage and you like sit up and you smile, even put mirrors up there so they can see themselves. You guys, not a joke. My mom said I was so vain. She gave me a like desk with a mirror and I used to sit there and talk on the phone in front of the mirror. And I was like, why do you do this? And I'm like, mom, like watch how I talk and I look at things and I look at, I practice my smile and it could have been a little vanity. Uh, but I know it's helped me present and be able to speak. And I guarantee you a lot of that mirror training.   is why I'm able to go present on stage today and be able to engage and invoke emotion because I practiced for a long time in the mirror. So having that mirror, having people see how they are, because if I'm sitting down, I'm like, hey guys, welcome to the podcast versus, hey guys, welcome to the podcast. You feel two very different things. And I feel too, I'm like super jazz on the second one. The first one I'm like, cool, I got a freaking podcast today. No, like I'm excited. I'm excited to hang out with you. I'm honored that you share your time with me. So we want it to be, and whatever your experiences, and some doctors you might not be like Kiera level 20.   Well, guess what? My team is Kiera level 20. We want to answer the phone in that level. If you are more like subdued and you're more like spa boutique, your phone needs to answer. Like I would be utterly shocked if I called the spa and they're like, hi, welcome to the spa. I'd be like, whoa, tone it down. Like this is the spa. And that's even Kiera who's excited. The dental office, it's like welcoming and engaging and like, hi, I'm like so excited you called. We're truly going to take great care of you. And I'm really excited to bring you into the practice. Notice I even have a patient voice that's different than my podcast voice, which is different than a spa.   My spa was like, hi, welcome to Serenity Spa. I'm so glad you're here. And I'm Kyra Dent and I'm changing right here, but it's because I feel that. And that's what I want people to experience in our phone and how people walk in is going to be our first step. So we need you to truly train and what is it? And if you haven't built this for your front office team, help them see this is what our, this is what our patient experience is. We want a confident, energetic, calm, whatever it is, first interaction. And we want our   online experience. our website, our scheduling, our messaging, our phone messaging to follow that same experience. So if that's our first impression, they're still filling it. Then they want to make the phone call. And we want to just like reduce any friction. How can I make this easier? I'm going to send you the paperwork. I'm going to schedule you now. I'm going to make sure I get this back in 48 hours. So I've got your appointment confirmed. This is how we're going to work. And I'm also setting clear expectations of we are so excited to have you here. And these are the rules of the game that we play by.   You notice like I even feel myself go into like a confident and welcoming human. That's our first experience. And if you will refine this, you will start to notice you train your patients from day one of we are so happy to have you. This is how we operate. We have you run on time. We have you send in our information. You always confirm your appointments 48 hours ahead of time. And we are so excited to welcome you to our family, whatever it is. listening to our new patient phone calls, experiencing that, putting the mirrors up there.   And then it's a, when the patient comes into the practice, let's make sure that that's an amazing experience too. Is our waiting room area clean? Do we have our front office person? You guys like, it drives me wild when I walk into a practice and it is cluttery with paper. You guys clear that clutter and make it clean. Dental practices need to be sterile. Yes, you can have cutesy stuff, but it still needs to feel clean and sterile. Front office team members, I'm gonna be a little bit hard right now. Do not freaking eat food in the front where patients can see you.   Go to the back. watch it so often. You're just sitting there like you break your crack or anything. No one can see you. They can. They see crumbs. It just feels. People can feel perfection. They can feel cleanliness. They can feel dirtiness. And this isn't me like ripping into you. I bend that person. I used to my snack drawer down there. That's not professional and that shouldn't be in the front office. Get it into the back office. Let's make sure it's clean. You can have all your cups. You can have all the things, but it needs to be clean. It needs to be sterile. It needs to be welcoming and inviting. Think about when you walk into a hotel. It's very inviting. Some   junkie janky and you're like, I don't want to stay here. Some are like, my gosh, this is amazing. Same thing with restaurants. How do we want our patients to feel? Let's make sure that the ambiance feels the same way. Even if your front office is on the phone, you can always welcome and say hi. Like while you're on the phone, I'll be right with you. That way they can feel super welcomed or like, hey, here's an iPad. I'll chat with you. And then as soon as like, Kiera, I'm so happy you're here. Welcome to the practice. Let me grab you a bottle of water. Do you prefer stilled or, or like do you prefer room temperature or chilled?   little small things that does not take a lot of effort, but that sets a very different impression rather than welcome to the practice. Okay. So let's make sure that first impression is very, very important. This is that first end block of the practice and patient experience. It's going to make it radically different for you and your practice. Then on the other side, is it's going to be during the visit? We need to make sure that we're still well oiled because if our front and end of those bookends are good, but the middle is ick.   They're going to actually remember that more than they remember these polished pieces. So the middle doesn't have to be like perfect perfection every time. what? Dentistry runs long. But as often as we can, let's be on time to our patients. Let's make sure that we have really clean handoffs. Let's make sure that when we are presenting our exams doctors that we use that NDTR. What's the next visit? What's the date? What's the time to return and make sure our re-care cleanings are scheduled. Make sure that the patient has that every time. Look me in the eyes. Involve me in that experience of patient, doctor, clinician. We're here.   All right, Kiera, we wanna see you back in two weeks for that crown on the upper right. We're gonna take great care of you. I need about an hour and a half for that. And we'll make sure that sister Susie over here gets you scheduled for your cleaning. What questions do you have for me? I'm really excited to work with you. Great, they know. And I will tell you if doctors will take the little bit of time to be super concise and clear on next steps, next visit, that's what people are remembering. So again, remember, yes, you've got the bookends of the appointment.   but also within the appointment in the chair, they're remembering how you seat them and how you end. Doctors, the essay heard the exam, but they're remembering your anchoring point of your end point. So nail that end point. Clinical team members, remember the end point. I used to try to like make jokes at the beginning and then have a good time at the end because I knew that that's what they were going to remember. Even if the procedure was hard, I still made sure that they had a great experience at the end. And if it was a hard procedure, I'm like, gosh, you did such a good job. I'm really, really proud of you. You did it.   you're gonna have the best results after this, whatever it is, but just make sure that they're clear, especially on exams. There is nothing worse than confusion. Confusion is the enemy of execution. So be crystal clear on where we're headed. And then after that, what we're gonna do is we're gonna let them know like, here's the next visit, here's what's gonna happen, we're gonna move them through it. This way your patients are so crystal clear on what's going on. And then at the end,   We have an amazing experience. So front office team, you're back on the, you're the shining stars. You welcome them in, you talk to them on the phone, and then you're the last impression. So making sure your people who are sitting in those seats recognize their role and their value in this whole experience. So on this, it's a perfect, let's get you scheduled. I make this really easy for them. Beautiful. What questions do you have for me? We say the same thing from what they said in the clinical team to the front office team. Front office has really good notes. So the clinical team just picks it right up.   And we have this in here of a very, very, very good experience at the end. Then if they had a great experience, I asked them for a review and say, Hey, I'd love you to share your experience with us. I can't wait to see you next time. Gosh, you're seriously one of my favorite patients. And I'm so grateful you're a part of our practice. That's not that hard, but what's that patient? You remember, gosh, they loved me when I came in, they loved me when I went out. And what it is, is it's not all these little pieces. It's the experience of how they felt just like me. I didn't tell you all the nuances of Ruth's Chris   I didn't tell you that my steak was amazing. I didn't tell you I had sweet potatoes. None of that. What I did tell you is how I felt at both. And guess what? I could have told you any experience, but I told you what's crazy is even at the spa, the football game was at the end. I didn't even tell you about my massage. I told you about the little thing that stood out to me. And remember, bad things actually could be what your patient's experiencing, even though you think you've got good pieces. If I've got an amazing welcoming, but I've got a jerk of a team member who's rude,   they're gonna remember that, cause that's gonna stand out way shinier than this one. And sometimes my doctor can be amazing, but your front office cannot be the same experience and it feels disjointed. And so you gotta make sure that you're, you have a team that's very similar and that we talk about what is our experience? How do I patients to feel? What are our core values? This is culture, but it's patient experience too. And if we get a whole team rallied around this, you're going to be able to have massive raving fans, but it's done with ease. So doing simple little things. So what I would say is when we have this of,   Let's go through number one, what is our patient experience? How do we want patients to feel? Look at our reviews and see what are they already saying and is that what we want? And if not, let's change it. Then let's make sure our phone calls, our website and our first impression when they come into the practice is dialed in and exactly what we want. Let's make sure are in the middle, pretty dang good. Doctors, you're ending with great exams. Clinical team members were ending with a great experience at the end of the exam. And then we take them up to front office and front office, we shine, we dazzle and we are so grateful to have these patients.   Now, if you're listening as a front office team member, you're like, I absolutely don't want to do that. It might be a wrong seat for you. I'm just going to say that front office team members are on stage. Just like I don't want to put a Disneyland, like someone who absolutely hates greeting guests and like putting them through the ticket counter. If they're like, I hate this job. They're, they're not the person. Cause that patient's going to feel that that guest is going to feel like, ⁓ checking into a hotel. I've got the person who's like, gosh, here you are. This is just a job and you're driving me nuts versus the person like, we are so happy you're here.   Make sure I've got right people in right seats for this experience. And that's critical. They could be the right team member, just the wrong seat. So let's make sure if you're listening to this, that you love this. I truly do. And I know Tiff does, and I know Kristy does, and I know Dana does, Britt actually, she's not the front desk. She doesn't like that guys. So she's not always on the podcast. And if Britt was listening, she'd be like, that's correct. I prefer back scenes. She likes to be there. Shelbi, you've never heard Shelbi on the podcast, cause she's like hard past no Kiera, that's not who I am.   but I've got all my consultants who would be like, yeah, Trish put her on. She'd love it. She'd say to the friend, she'd make everybody her best friend, Monica, Pam. They'd love it. So make sure you've got right people, right seat, and then make sure you really commit to having this incredible patient experience and you can check it. Let's do a monthly review, like do an audit of what are the top things the reviews are saying, have Chat GPT help you. There's easy ways to make sure that what we want of our patient experience is what patients are saying. And if not commit to change, it's how patients feel that they're going to remember more than it's what you say.   And if we can help you guys reach Hello@TheDentalATeam.com. These are the small annoying like cobwebs that make the big difference for patients that we are obsessed about helping you with. So reach out, running a successful practice does not have to be hard and it can be very easy for you. So reach Hello@TheDentalATeam.com. And as always, thanks for listening and I'll catch you next time on the Dental A Team Podcast.  

Terry Savage, nationally syndicated money columnist, joins Jon Hansen, in for Lisa Dent, to discuss the latest money news. Terry talks about the record-setting day for the Dow Jones despite other markets ending the day in the red. And, as always, she answers questions from listeners.

Jon Hansen, filling in for Lisa Dent, checks in with the newsroom to hear their stories including an Olympic biathlete confessing that he cheated… on his girlfriend and the uninhabited Scottish isle that’s home to the golden granite used in Olympic curling stones.

Criminal Defense Attorney Michael Leonard of Leonard Trial Lawyers joins Jon Hansen, filling in for Lisa Dent, to discuss what Leonard calls a “bellwether” case that alleges that social media algorithms are addictive to children. Leonard and Hansen discuss the details of the trial and how this case’s verdict may affect cases in the future.

Voilà ! Je suis ressorti du fond de mon lit ! Un foutu virus qui m'a complètement démoli en moins de 24 heures mais, qui a disparu aussi vite. Désolé pour ma brève absence sans prévenir, c'était pas prévu. Aujourd'hui on y retourne pour de vrai et j'ai l'impression que j'ai pas raté grand-chose, mis … Continued

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WGN Radio News Director and host of Quest for Gold Ryan Burrow joins Wendy Snyder (in for Lisa Dent) to talk all things Milano Cortina 2026 Winter Olympic Games. Listen in while Ryan breaks down what viewers can expect while watching this year's Winter Games and what he’s most excited about.

Jon Hansen, filling in for Lisa Dent, checks in with the newsroom to hear their stories including Minute Maid discontinuing its frozen canned juices.

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Lou Manfredini joins Jon Hansen, filling in for Lisa Dent, in his new weekly segment, Lou's To Do List, sponsored by Perma-Seal. Lou answers any questions you have about projects on your to-do lists.

Pat Brady, SVP of Mercury Public Affairs, former chairman for the Illinois Republican Party, and former federal and state prosecutor, joins Jon Hansen, filling in for Lisa Dent, to discuss the Supreme Court’s decision to not take on the redistricting case in California.

Patrick Dolan, Employment Lawyer at Conti & Dolan, joins Jon Hansen, in for Lisa Dent, to discuss all things employment law. As always, Dolan answers questions from listeners.

Jon Hansen, filling in for Lisa Dent, checks in with the newsroom to hear their stories.

Kiera is joined by the tooth-healer himself, Jason Dent! Jason has an extensive background in pharmacy, and shares with Kiera where his pharmaceutical experience has bled over into dentistry. This includes the difference between anti-quag and anti-platelet and which medications are probably safe, what to do to shorten the drag time in the pharmacy, how to write prescriptions most efficiently, and more. Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: The Dental A Team (00:00) Hello, Dental A Team listeners. This is Kiera and today is a really awesome and unique day. It is, think the second time I've had somebody in the podcast studio with me live for a podcast and it's the one and only Jason Dent. Jason, how are you? I'm doing well. Good morning. Thanks for having me. It is crazy. I I watch Instagram real like this all the time where people are like in the podcast and they're hanging out on two chairs and couches and now look at us. We're doing it. Cheers. Cheers.   That was a mic cheer for those of you who are only listening, but yeah, Jace, how does this feel to be on the podcast? It's weird. Like I was not nervous at all talking about it. I got really nervous as soon as you hit play. So if I stumble over my words, please forgive me ahead of time. Well, Jason, I appreciate you being on the podcast because marketing had asked me to do a topic about teledentistry and I was like, oh shoot, that's like not my forte at all. so   You and I were actually chatting in the hot tub. call it Think Tank session and you and I, we have a lot of good ideas that come from that Think Tank. A lot of business. no phones. That's why. We do leave our phones out. But I was talking to Jason and this is actually a podcast we had talked about quite a while ago. Jason has a lot of information on pharmacy. And if you don't know, Jason isn't really, we were going through all of it last night. It's kind of a mock in the tub. And I think it's going to be great because I feel like this is an area, I'm working at Midwestern and   knowing about how dentists, pharmacology was surely not your favorite one. Jason actually helps a lot of dentists with their clearances. And so we were talking about it and I like it will just be a really awesome podcast for you guys to brush up on pharmacology, different things from a pharmacist's side. So Jason, welcome. Thank you. Yeah, no, we were talking about it and here's like, what should I talk about on the podcast next? I have all these different topics and she's like, what do you know? And the only real interaction I have with dentists is doing clearances for procedures. We get them all the time, which makes sense.   Lots of people are on blood thinner, I've always told Kiera, like, hey, I could talk about that. Like, that's kind of a passion of mine. I'm not a dentist. Or my name is Jason Dent. So in Hebrew, Jason means tooth. No, no, no, sorry. Nerves are getting to me. Jason means healer and Dent means tooth. So my name means tooth healer. So, here's a little set. Hold on, on, hold Can we just talk about? I brought that up before you could talk about it more. So.   My name means tooth healer but I did not become a dentist. I know you wanted me to become a dentist. did. I don't know why. I enjoy medicine. I know what you're going to get to already. The things you're going to ask me. There's been years of this. But nevertheless, that's my name. We'll get that out of the way. But you did give me a great last name. So I mean, it's OK. You're All is fair and love here. SEO's up for that. But yeah, Jason, I'm going to get you right into the show. And I'm going to be the host. And we're going to welcome to the podcast show. Jace, how are you?   Good, good, good. Good, good, good. So by getting into clearances, right? This is what you're kinda talking about with you know, before we get to clearances, I actually wanted Jason, for the listeners who don't know you, who haven't talked to you, who don't know, let's kinda just give them like, how did you go from, Kiera wanted you to be a dentist, to now Jason, you are on the podcast talking as our expert on pharmacy. fantastic. I've always really loved medicine, a ton. As a kid getting headaches and taking Excedrin, like you just feel like a miserable pile of crap.   and then you take two pills and all of a sudden you feel better. Like that's amazing, like how does that happen? Also getting ear aches as a kid, just being in so much pain and then taking some medicine and you start feeling a lot better. I always had a lot of appreciation for that. I've always been mechanically inclined. I went to, started doing my undergrad and took biology and learned about ATP synthase, which is a spinning enzyme that's inside the mitochondria, like a turbine engine. I used to work on small engines on my dirt bike and thought that is so cool. So I really got wrapped up into chemistry.   All the mechanics of chemistry really pulled me in. I'm not getting goosebumps. checking. I usually get goosebumps when I think about chemistry. But it's so cool. You think an engine's awesome, like pistons and camshafts and pressures, the cell is the same thing. It's not as loud, so it's not as cool. But it's fascinating. that's why we're like. ⁓   chemistry and really got into coagulation. So I did my residency after pharmacy school. we went to Arizona for three years. ⁓ You did and your main focus, you were never wanting to be the guy behind the counter. No, I haven't done that. Yeah. No, I love them though. I've always really want to go clinical. ⁓ But I love my retail ⁓ pharmacists. They're amazing resources. And ⁓ I use the retail pharmacist every day still to this day, but I went more the clinical route, really love the chemistry aspect of it.   did my doctorate degree and then I did my residency in Reno. Reno's kind That's how we got here everybody. Welcome to Reno. Strategically placed because I was really interested in critical medicine and where we're located we cover a huge area. So we pull in to almost clear, we go clear to Utah, clear to California, all of Northern Nevada. We get cases from all over. So we actually are kind like the first hub of care for lot of areas. So we really get an eclectic mixture of patients that come in that need-   all kinds of different cases that are coming to them. So it's what I really wanted. So I did my residency in critical care there. And then for the next 10 years, I worked in vascular medicine with my final five years being the supervisor of the clinic. Ran all the ins and outs of that. So my providers, two doctors were on our view. So when we talk about dentistry, talk about production, those kinds of things, totally get it. My doctors were the exact same way, my vascular providers. ⁓   There's some pains there, right? You wanna be seeing patients as much as possible, being able to help as many people, keeping the billing up. And had other nurse practitioners, four practitioners, a fleet of MAs, eight pharmacists. We also had that one location we had, going off the top of my head, I think we had eight locations running as well. And we took care of all the different kinds of vascular cases that came to us. Most common was blood clots, ⁓ which is just a...   which is an easier way of saying VTE. There's so many different ways to say a blood clot. Like you might hear patients say, I've had a PE or a DVT or a venous thromboembolism or a clot in my leg, right? They're all clots, but in different locations. Same with an MI, and MI can be a clot as well. ⁓ there's a lot of, everybody's kind of saying the same thing, but sometimes the nomenclature can make it sound hard, but it really is actually pretty simple.   No. And Jason, I love that you went through, you've been in like, and even in your, ⁓ when you were getting your doctorate, you were in the ER. You also worked in retail pharmacy. remember you having a little sticker on your hand. And retail pharmacy, I have a lot of respect for those guys. They have a lot of pressure on them. and then you also, ⁓ what was that test that you had to take that? I don't know. You were like studying forever for it. ⁓ board certification for, ⁓ NABP. Yeah. So I did that board certification as well.   And now you've moved out of the hospital side onto another section in your career. Now in the insurance, right? So it's really, really interesting. So now I'm on the other side reading notes and evaluating clinical appropriateness and trying to help patients with getting coverage and making those kinds of determinations. So yeah, I've really jumped all over. Really love my clinical days. I know. don't I don't I do miss them. But yeah, kind of had a good exposure to a lot of.   pharmacy a lot a lot of dentists actually with all the places that come through which Jason I really appreciate that and honestly I know you are my spouse and so it's fun to have you on but when I go into conversations like this I don't know any of this information and so finding experts and Jason I think here's me talk more about dentistry and my business than I do hear about him on pharmacy so as we were chatting about this I really realized you are a wealth of knowledge because you've been on the clinical side so you've done a lot of patient care and you've seen how   medications interact and I know you've had a few scares in your career and ⁓ you've known some physicians that have had a few scares and ⁓ you've seen plenty of patients pass away working in the ER and gosh in Arizona drownings were such a big deal. I remember when you were in the ER on your rotations I'd be like who died today? Like tell me the stories and you've really seen and now going on to the insurance side I felt like you could just be such a good wealth of knowledge because I know dentists are sometimes so   I would say like maybe just a little more anxious when it comes to medications. I know that dental students from Midwestern were like here was like four months and we had to like pass it, learn it. And Jason, you've done four years plus clinical residency, plus you've been in it. And something I really love about Nevada Medicine is they've been so collaborative with you.   like your heart, your cardiologist, they diagnose and then they send to you to treat with medicine and... Yeah, I've been really lucky being here in Reno too. The cardiology team has been amazing to work with. We started a CHF program, sorry, congestive heart failure program for patients. So we would collaborate with cardiologists. They'd see the cardiologists and then they send them to the pharmacist to really manage all the medications. So there's pillars of therapy ⁓ called guideline directed medical therapy and the pharmacist would take care of all that. So that's gonna be your...   your beta blockers, your ACEs, your ARBs, your Entresto, which would be a little bit better, spironolactone. So just making sure that all these things are dosed appropriately, really monitoring the heart, and make sure that patients are getting better. we've had real positive outcomes when the, sorry, this is totally off topic. do, talk about that study. When we looked at when patients were coming to see our pharmacists in our clinic that we started up, the patients were half as likely to be readmitted. And this was in 2018, and our pharmacists,   We're thinking about all the medications. We're usually adjusting diabetes medications too at the same time. Just kind of naturally just taking care of all the medications because we kind of got a go ahead from the providers, a collaborative practice agreement that we could make adjustments to certain medications within certain parameters. So we weren't going rogue or maverick, but we were definitely trying to optimize our medications as much as possible. And then years later, some studies came out with, I'm sure you've seen Jardins and Farseegh. not trying to, I'm not.   I don't get any kickback from them. I have no conflicts to share. But because our pharmacists were really optimizing that medication, those medications were later shown to reduce hospitalizations and heart failure, even though they're diabetes medications. Fascinating. So it wasn't really the pharmacists. It was just the pharmacists doing as much as they can with all the tools that were in front of them. And then we found out that the patients were going back to the hospital.   half as much as regular patients. So, yeah, being here, it's been so amazing to work with providers here. the providers here want help, want to help patients, don't have an ego. I mean, I just, it's awesome. I love it. I do love how much I think Jason sees me geek out about dentistry and I watching Jay's geek about his pharmacy and how much he loves helping patients. And ⁓ really that was the whole idea of, all right.   Dentistry has pharmacy as a part of it. And I know a lot of dentists are sending in clearances and I know working in a chair side, it would be like, oh no, if they're on warfarin or on their own blood clot, you guys, honestly don't even know half of what I'm talking about because this is not my jam, which is why Jason's here. But I do know that there was always like, well, we got to talk with their provider. And so having Jason come in and just kind of explain being the pharmacist that is approving or denying or saying yes or no to take them off the blood thinners in different parts, because you have seen several dental   I don't know what they're called. What is it? Clarence's? that what comes to you? don't even know. All day my mind, it's like, here is the piece of paper that gets mailed to you to the pharmacist and then you mail it back. So whatever that is. But Chase, let's talk about it because I think you can give the dentist a lot of confidence coming from a pharmacist. What you guys see on that side. When do you actually need to approve or disapprove? Let's kind of dig into that. Yeah. Well, first of all, I think I'm not a replacement for any kind of clinical judgment whatsoever. Every patient's different. But the American Diabetes Association, you   I work with diabetes a lot. American Dental Association has some really great guidelines on blood thinners and I would always reference them. I actually looked at their website today. Make sure I'm up to speed before I get back on this again. They have resources all around making decisions for blood thinners. And I think the one real important thing in putting myself in the shoes of a dentist or any kind of staff that's around a patient that's in a chair, if they say I'm on a blood thinner, right, a flag goes up. At least in my mind, that's what goes up.   Like, okay, how do we get across this bridge? And I think the important thing to really distinct right then when they say they're on a blood thinner is that is kind of a slang word for a lot of different medications, right? Like it's the overarching word that everybody pulls up saying, I'm on a blood thinner. It's like, okay, but I don't know what say. It's like, I have a car. You're like, okay, do you have a Mazda? Do you have?   Toyota, Honda, what do you have? or even worse it'd be like saying I have a vehicle, right? So when somebody says they're on a blood thinner, it opens up a whole box of possibilities of what they're Blood thinners are also, doesn't, when they're taking these types of medications that are quote unquote a blood thinner, it doesn't actually thin the blood, like adding water to the blood, if that makes sense, or like thinning paint, or like thinning out a gravy, right? It doesn't do the same thing. Blood thinners, really what they're doing is they're working on the blood, which.   which is really cool, try not to tangent on that. ⁓ When they're working on the blood, it's not thinning it per se, but it's making it so that the proteins or platelets that are in it can't stick together and make a cloth quite as easy. So whenever somebody's on a blood thinner, I usually ask, what's the name of the blood thinner that you're on? It's not bad that they use that slang, that's okay, on the same page, but it's really broken into two different classes. There's anticoagulant and antiplatelet.   And a way to kind of remember which is which, when residents would come through our clinics, the way that I teach them is a clot is like a brick wall. You know, it's not always a brick wall. Usually the blood is a liquid going through. But once they receive some kind of chemical message, it starts making a brick wall with the mortar, which is the concrete between the and the bricks, the two parts. When it's an anti-quagent, it's working on that mortar part. When it's an anti-platelet, it's working on the bricks part, right? You need both to make a strong clot or strong brick wall.   But if you can make one of them not work, obviously like if your mortar is just water, it's not working, right? You're not gonna make a strong brick wall. So that's kind of the two deviants right there. So that's what I do in my mind real quickly to find out because antiplatelets are usually, so that's gonna be like your Plavix, Ticagrelor, Brilinta. And hold on, antiplatelets are bricks? Good job, bricks. They're the bricks. And so the reason I was thinking you could remember this because I'm, antiplatelets, it's a plate and a plate is more like a brick.   And anti coagulant, I don't know why quag feels like mortar to me, like quag, like, know, it's like slushy in the blood, like it's coagulating. It's a little bit of that, like, honestly, I'm just thinking like coagulated blood is a little bit more mortar-ish. And so platelet is your plate, like a brick, and anti-quag is like.   the gilly between the bricks. Okay, okay, I got it. Yeah, so there's an exception to every rule, but when they're on that Don't worry, this is Kiera, just like very basic. You guys are way smarter listening to this, and that's why Jason's here. No, no, you helped me pass pharmacy school. When we were doing all the top 200, you helped me memorize all know what flexorill is, all right? That's a muscle relaxant. Cyclo? I don't know that part. It's a cyclo, because you guys are cycling and flexing. I don't actually know. just know it's a muscle relaxant, so that's about as far as I got. When we're looking at antitick platelets, so that's the brick part, so that's going to be your, you know,   Hecagrelor, Breitlingta, Clopidogrel is the most common one. It's the cheapest one, so probably see that one the most. Those, I mean, there's an exception to every rule, but that's generally being used after like a stent's placed in the heart. It can be used for VTE, there's some out there, but that's pretty rare. But also for some valves that are placed in the hearts, it can be used for that as well. So antiplatelet, really thinking more like a cardiac event, right? Like I said, there's always an exception to every rule, but that's kind of where my mind goes real quickly, because we're gathering information from the patient.   They're on anticoagulant. Those are like going to be the new ones that you see commercials for all the time. So Xeralto, Alequis, those are the two big ones right now. They're replacing the older one. And also we were supposed to do a disclaimer of this is current as of today because the ADA guidelines do change. this will be current as of today. And Jason, as a pharmacist, is always looking up on that. I had no clue that you are that up to speed on dental knowledge. so just throwing it out there that if you happen to catch his podcast,   a few years back that obviously check those guidelines for sure. But the new ones are the Xarelto and Eloquist. They're replacing the older ones of warfarin. Warfarin's been around for a really long time. We've seen that one. Those are anti-coagulants. So when you're looking, when a patient says that, generally they're on that medication because they've possibly had a clot in the past or they have a heart condition called atrial fibrillation. Those are kind of the two big ones. Like I said, there's always caveats to it, but that's kind of where my mind goes real quickly. And then,   as far as getting patients cleared, the American Dental Association has really good resources on their website. You can look at those and they're always refreshing that up. They even say in their own words that there's limited data around studying patients in the dental chair and with anticoagulants or anti-platelets. It's pretty limited. There's a few studies, some from 2015, some from 2018. There's one as recent as 2021, which is nice. But really, all of those studies come together and it's really more of an expert consensus.   And with that expert consensus, they have kind of simplified things for dentistry, which is really nice. ⁓ comparing that to, we have more data for like total hip replacement, total knee replacement. We have a lot of data and we know really what we should be doing around then. But going back to dentistry, we don't have as much information, so they always say use clinical judgment, but they do give some really great expert guidance on that. So if a patient's on an anticoagulant, ⁓   they generally recommend that it doesn't need to be stopped unless there's a high bleeding risk for a patient. as a provider or as a clinician in the practice, you can be looking at high bleeding risk. Some things that make an oral procedure a little bit lower risk is one, it's in the compressible site, right? Like we can actually put pressure on that site. That's the number one way to stop bleeding is adding pressure. It's not like it's in the abdominal cavity where we can't get in and can't apply pressure. So number one, that kind of reduces the bleeding risk.   is number one. Two, we can add topical hemostatic agents. Dentists would know that better than me. There's a lot of topical ways to do that. So not only pressure, but there's those things as well. And also, but there are some procedures that are a little bit more likely to bleed. And that's where you and dentists would come in hand in What's the word in APO? Oh, the APOectomy. I got it right. Good job. like, didn't you tell me last night that the ADA guideline was like what?   three or four or more teeth? great question. So you can extract one to three teeth is what their expert consensus One to three teeth without. Without really managing or stopping anticoagulation or doing anything like that. I think that's some good guidance from them. I'm gonna add a Jasonism on that though. So with warfarin, I do see why dentists would be a little bit more conservative or worried about stopping the warfarin because warfarin isn't as stable as these newer agents. Warfarin, the levels.   quote unquote levels can go really high, they can go really low. And if the warfarin levels are high, they're more likely to bleed. So I do think it makes sense to have a really recent INR. That's how we measure what the warfarin's doing. I think that makes a lot of sense, but the ADA guidelines really go into the simplification version of all these blood thinners. Generally, it's recommended to not stop them because the risk of stopping them outweighs the benefit of stopping them in almost every case. Almost every case.   ⁓ So when you're with that patient, right, they say I'm on a blood thinner, finding out which kind of blood thinner that they're on, you find out that they're on Xeralto, right? How long have you been on Xeralto for? I've been on it for years. You don't know exactly why, but if they haven't had any recent bleeding, you're only gonna remove one tooth. ⁓ You can do what's called a HasBlood score. That kind of looks at the bleeding risk that they'd have. That'd be kind of going a notch above, but in my mind, removing one tooth isn't a real serious bleeding risk. I'd love to hear from my dentist friends if they...   disagree, right, but ADA says one to three tooth removals, extractions, that's the fancy word. Extractions, yeah, for extracting teeth out. Is not really that invasive. Sure. It's not that high risk, so it's usually perfectly fine. So if a patient was on Xarelto, ⁓ no other, this is in a vacuum, right? I'm not looking at any other factors, which you should be looking at other factors. I would be perfectly fine to just remove one to two.   And when those clearances come in, because dentists do send them, talk about what happens. You guys were working in the hospital and you guys would get these clearances all the time. do. We get them so often. I mean, we get like four or five a day. We'd love to give it to our students, student pharmacists, and ask them what to do. And they would usually look up the American Dental Association guidelines and come up with something. We're like, yep, that's what we say too. In fact, we say it so many times a day that we have a smart phrase.   which just blows in the information real quickly and faxes it right back to the So it's like a copy paste real quick. So what I wanted to point out when Jason told me this is dentists like hearing this and learning this, this can actually save you guys a ton of time to be able to be more confident, to not need to send those clearances on. And we were actually talking last night about how I think this might be a CYA for dentists. like, as we were talking, I think Jason, you seeing so many other aspects of medicine, like you've literally seen patients die, you've seen other areas.   And so coming from that clinical vantage point, we were realizing that dentists, we are so blessed to live in an injury. I enjoy dentistry because possibly there's someone dying, not super high, luckily in dentistry. The only time that I have actually had a doctor have a patient pass away, and it was only when they were completely sedated and doing ⁓ some other things, but that was under the care of an anesthesiologist. And so that's really our high, high risk. And so hearing this, Jason,   That was one of the reasons I wanted him to come on is to give you doctors more confidence of do we have to always send to a pharmacist? I mean, hearing that on the pharmacy side, they're just sending these back and not to say to not see why a to not cover this because you might be questioning like, well, do I really need to? But you also were talking about some other ways of so number one, you guys are just going to copy back the 88 guidelines. So so 88 guidelines. Yeah. And I think that that gives a lot of confidence to a provider or a dentist is that you can go to the 88 guidelines and read them, right? Like you're listening to some   nasally monotone pharmacist on a podcast. Rumor has it, people love him at the hospital. were like, you're the voice, he's been told he has a good radio So for the clinic, I was the voice. Like, yeah, you've reached the vascular clinic, right? And they're like, oh my gosh, you're the voice. But sorry, you me distracted. That'll be your next career, Jace. You're going to be a radio host. OK. I would love that. I love music. But you're hearing from a nasally guy, but you can actually read the ADA guidelines. You just go right to the ADA, click on Resources, and under Resources, it has the   around anticoagulants, I think that's the best way to get a lot of confidence about it because they have dentists who are the experts making calls on these. I'm just reiterating what they say, but I think it makes a lot of sense to help providers. And the reason why my heart goes out to you as well is having the providers that used to work underneath me, they're always looking for our views, which is a fancy way of making sure that they're drilling and filling. Can I say that? Yeah, can say drilling and filling. They're being productive, right? They're being productive, right?   They're always looking to make sure if a patient's canceling, like get somebody in here. Like I need to be helping people all day long. That's how I, we keep the lights on. That's how I help as many people. And so if you have a patient coming in the chair and it has an issue, they say I'm on Xeralto. Well, you can ask real quickly, why are you on Xeralto? I had a clot 10 years ago. my gosh. Well, yeah, we're pretty good to go. Then I'm not worried. We're only removing one tooth or we're just doing a cavity or a cleaning. Something like that. Shouldn't be an issue whatsoever because there's experts in the dental. ⁓   in the dental society, the ADA guidelines that recommend three teeth or less, minimally invasive. They really recommend if it's gonna be really high bleeding risk. And clinically, that's where you would come in, ⁓ or yourself. know, apioectomy is one that's like on the fence line. I don't know where implants set. though, and like we were talking, implants aren't usually like a date of procedure. Most people aren't popping in, having tooth pain, and we're like, let's do an implant. Now sometimes that can be the case, but typically that one's gonna have   a few other pieces involved. And so that is where you can get a clearance if you want to. ⁓ But we were really looking at this of like so many dentists that I know that you've seen will just send in these clearances because they are. And I think maybe a way to help dentists have more confidence is because you know, I love routines. I love to not have to remember things. So why don't we throw it in, have the team member set it up where every quarter we just double check the ADA guidelines. Are there any updates? Are there any other things that we need to do on that? That way you can just see like   getting into the language of this, of what do I need to do? Because honestly, you guys, know pharmacy was not a big portion for it, so, recommending different parts, but I think this is such a space where you can have confidence, and there's a few other things I wanna get to, and I you- I some pearls too. Okay, go. I'm so when she get me into talking about drugs, I'm not gonna stop. So, some other things around that too is these newer blood thinners like Xarelto Eloquist, they now have reversal agents, so a lot of providers in the past were really worried about bleeding because we can't turn it off. We can turn those off. Warfarin has reversal as well, right?   So I'm looking at these patients. It's really low risk. It's in the mouth, generally speaking. Very rarely are they a high bleeding risk. Now if you're doing maxillofacial surgery, this does not apply, right? This does not apply whatsoever. you're like general dentist, you're pediatric dentist. Yeah, yeah, and it's kind of on the fly. So just trying to really help you to be able to take care of those patients on the moment, have that confidence, look at the ADA guidelines, have that in front of you. I don't think it's a bad thing to ever...   check with their provider if you need to. If you're thinking, I feel like I should just check with the provider, I would never take that away from you. But I just want to kind of steer towards those guidelines that I have to help. But what did you want to share? No, yeah, I love that. And I think there were just a few other nuggets that we were chatting about last night that can help dentists just kind of get things passed a little bit easier. So you were mentioning that if they were named to their cardiologist, what was it? was like, who is the last? Great question. Yeah, when a patient's on a blood thinner,   It could be prescribed by the cardiologist. It could be prescribed by the family provider or could have been punted to like a vascular clinic like where I was working. It can go to any of those. And when you send that fax, right, if it goes to the cardiologist and it's supposed to go to the family care provider, like it just kind of goes, goes nowhere, right, from there. So I think it's a really good idea to find out who prescribed it last. If the patient doesn't know who prescribed their blood thinner last, you can call their pharmacy. I call pharmacies all day long.   I have noticed in the last year, they are way easier to get a hold of, which has made my job a lot easier, working on the insurance portion. So reaching out to the pharmacy, finding out who that provider is and sending it to them, because they should be able to help with that. I thought that was a good shift in verbiage that you had of asking instead of like the cardiologist, because that's who you would assume was the one. But you said like so many times you guys would take care of them, and then they go back to family practitioner, and you guys would get the clearances, but you couldn't clear because you weren't overseeing. So just asking the patient.   who prescribed their medication for them last time. That way you can send the clearance to the correct provider. then- And they might not know. You know patients, right? They're like, I don't know, my mom's or else, I don't know who gave it to me. Somebody told me I need to be on this. But at least that could be another quick thing. And then also we were talking last night about-   ⁓ What are some other things that dentists can do when like writing scripts to help them get what I think like overarching theme of everything we discussed is one how to help dentists have less I think drag through pharmacy. ⁓ Because pharmacy can take a little while and so perfect we now know the difference between anti-quag and anti-platelet. We know which medications are probably safe. We know we can check the ADA guidelines so that we were not having to do as many clearances. We also know if they're on a medication to find out and we do need a clearance.   who we can go to for the fastest, easiest result. And now, in talking about prescriptions, you had some really interesting tips that you could share with them. Yeah, so with writing prescriptions, right, pharmacies are pharmacies. So I'm not gonna say good thing or bad thing. There are challenges working with pharmacies. I'm not gonna play that down at all. ⁓ If you're writing prescriptions and having issues and kickbacks from pharmacies, there's some interesting laws around ⁓ writing prescriptions. Say that you're trying to ⁓ prescribe   augmentin, you know, 875 BID, and you tell the patient, hey, I want you to take this twice a day for seven days, and then you put quantity of seven, because you're moving fast, right? You want it for seven days, quantity of seven. Quantity would actually be 14, right? It's not that big of a deal. Anybody with common sense would say if you're taking a pill for twice a day for seven days, you need 14 tablets. But LAHA doesn't allow pharmacists to make that kind of a change, unfortunately. They have to follow what you're saying there. So you're going to get a...   An annoying callback that says, you wrote for seven tablets. I know you need 14. Is that OK? Just delays things, right? So ⁓ I really like the two letters QS. That's Q isn't queen. S isn't Sam. Yeah. It stands for quantity sufficient. So you don't have to calculate the amount of any medication that you're doing. So for me, as a pharmacist, when I was taking care of patients, I hated calculating the amount of insulin they would need for an entire month. So I would say.   Mrs. Jones needs 15, I'd say 15 units ⁓ QD daily. ⁓ And then I say QS, quantity sufficient, ⁓ 90 day supply through refills. So the pharmacy can then go calculate how much insulin that they need. I don't have to even do that. So anytime you're prescribing anything, I like that QS personally. So that lets the pharmacy use ⁓ common sense, as I like to call it, instead of giving you a call. I think that's super helpful. I also thought of one thing too.   going back to blood thinners is when it's kind of like a real quick, like they're not gonna have you stop the blood thinner at all. like you're seeing if you can stop the blood thinner for a patient, there's some instances it's just not gonna happen. And that's whenever they've been, they've had a clot or a stroke or a heart attack within the last three months. Three months. Yeah, that's kind of like the.   Because so many people are like, they had a heart thing like six years ago. And so I think a lot of my dentists that I worked with were like, we got to stop the blood thinners. But it sounds like it's within three months. Yeah, well, I'm just the time. Like this is general broad strokes. What I'm just trying to say is when you want to expect a no real quick. Got it. Right. So because benefits of stopping a blood thinner within those first three months of an event is very, very risky versus the, you know, the benefit of reducing a little bit of blood coming out of the mouth. Right. Like that's not that bad.   when somebody's had a stroke or a heart attack or pulmonary embolism, a clot in the lung, like we can't replace the lung, heart or brain very easily. We can replace blood a lot better. We've got buckets of it at most hospitals have buckets of it, right? So I'm always kind of leaning towards I'd rather replace blood than tissue at all times. So that's kind of a quick no. If they've had one those events in the last three months, we are really, really gonna watch their brain instead of getting.   root canal, right? Like really worried about them. So you'll just say no. And they could the dentist still proceed with the procedure or would you recommend like a three month wait? Or is it provider specific way the pros and cons because sometimes you need to get that tooth out. Great question. think then it's going to come into clinical. That's that's when you send in the clearance, right? Like, and it's great to reach out to the provider who's managing it for you. But I think it's kind of good to know exactly when you get a quick no quick no is going to be less than three months.   ⁓ Or when it's going to be like a kind of a typical, yeah, no problem. If it's been no greater than six months, they're on the typical anticoagulants or alto eloquence. Nothing crazy is going on for them. You're only removing two teeth. This is very, very low risk. But again, I'd urge everybody to read the ADA guidelines. That way you feel more comfortable with it. I'm not as eloquent as they do. They do a real good job. So I don't want to take any of their credit. I think they do a real good job of simplifying that and making you feel confident with providing.   more timely care for patients. Which is amazing. And Jayce, one last thing. I don't remember what it was. You were talking about the DEA and like six month rule. yeah. Let's just quickly talk about that and then we'll wrap this because this is such a fascinating thing for me last night. Yeah. So when comes to prescribing controlled substances, most providers have to have a DEA license. OK. First of all, though, what's your take on dentist prescribing controlled substances? ⁓ I don't think, you know, I worked on the insurance side of things. Right. And I look at the requirements for the   as the authorizations, what a patient, the criteria a patient needs to hit in order to qualify for certain medications. A lot of times for those controlled substances, they have pretty significant issues going on, like fibromyalgia or cancer-related pain or end-of-life care versus we don't, in all my scanning thread, I don't have a ⁓ perfect picture memory. Sure. But I don't usually see oral.   pain in there. There is some post-operative pain that can be covered for those kind of medications but I really recommend to keep those lower and in fact in a lot of our criteria it recommends you know have they tried Tylenol first, they tried, have they filled NSAIDs or are they contraindicated with the patient. So really they should be last line for patients in my two cents but there's always going to be a caveat to the rule right? Of course. comes through that has oral cancer and you're taking   like that would make sense to me. Got it, so then back to the DEA. Yeah, okay. Okay, ready. So as a provider, you should be checking the, if you're doing controlled substances, you should be checking the prescription drug monitoring program, or sometimes called the PDMP, looking to see if patients are getting ⁓ controlled substances from another provider. So it's really just a check and balance to make sure that they're not going from provider to provider to getting too many narcotics and causing self harm or harm to others.   And so with checking that PDMP before prescribing, I think a lot of providers do that. A lot of softwares that I'm aware of, EMRs, electronic medical records, sometimes have links so that you can do that more quickly. However, I don't think it's as intuitive that they need to be checking that every six months in some states. And like here in Nevada, you're supposed to be checking it every six months, not for a patient, but for your actual DEA registration to see if anybody else is prescribing underneath you. Because if you don't check that every six months, you could get in some serious trouble with...   not only DEA, but even more the Board of Pharmacy and your state. Now, I don't know all 50 states, so I check with your state to see if you need to be checking that every six months, but set an alarm just to check that real quickly, keep your nose clean. ⁓ I've had providers, I've had to remind to do that. And if somebody was using your account, prescribing narcotics, you'd never know unless you went and checked that PDMP.   Yeah, I remember last night you were like, and if that was you, I would not want to be you. The Board of Pharmacy is going to be real excited to find you. So that was something where I was like, got it. So, and we all know I'm big on let's make it easy. And Jason, I love that you love this so much and you just brought so much value today. And like also for me, it's just fun to podcast. fun. Yeah. But I got a nerd out on my world a little bit. Bring it into yours. I work with dentists or at least you know, when I was working in Vascular Clinic all day long. Great questions that would come through. Yeah.   So I think for all of us, as a recap on this is number one, I think setting yourself ⁓ some cadences. So maybe every quarter we check our ADA guidelines and we check our, what is it, PDMP. PDMP. so each state, so they call it Prescription Drug Monitoring Program. We need that. Yeah, but there are different acronyms in different states, though. That's just what it's called in Nevada. I forget what it is in California, but you can check your state's prescription monitoring program, make sure that opioids aren't being prescribed under your name. Got it. So we just set that as a cadence.   We know one to three teeth most likely if they're on a blood thinner is According to the 88 as of today is good to go You know things that are going to get a quick know are going to be within the last three months of the stroke the heart attack or the Clot I'm thinking like the pulmonary embolus. Yeah, that's what we're trying to prevent   Those are gonna be quick knows and then if we're prescribing, let's do QS. We've got quantity is sufficient so that we're not getting phone calls back on those medications that we are. And then on narcotics, just being a bit more cautious. Of course, this is provider specific and in no way, or form did Jason come on here to tell you you are the clinical expert.   Jason's the clinical expert on medications. And if you guys ever have questions, I know Jason, you geek out and you want to talk to people so that anyone wants to chat shop. Be sure to reach out and we'll be able to connect you in. we've even talked about possibly, so let me know listeners. You can email in Hello@TheDentalATeam.com of ask a pharmacist anything. I talked to Jason. I was like,   We'll just have them like send in questions and maybe get you back on the podcast or we do a webinar. But any last thoughts, Jace, you've got of pharmacy and dentistry as we as we wrap up today? No, I think that's pretty much it. So check the ADA guidelines. I think it's really good to have cross communication between professions. Right. If you're working with the pharmacy, CVS, Walgreens or something like that or Walmart, I know that it can be challenging. Right. They're under different pressures. You're under different pressure. So I think ⁓ just coming in with an understanding, not being angry at each other.   you know what mean, is super beneficial and working together. When it comes to it, every dentist that I've talked to is actually worried about their patient. Every pharmacist that I've worked with is really worried about the patient as well. So we're trying to accomplish the same thing, but we have different rules and our hands are bound in different ways that annoy each other, right? Like I know Dr. Jones, want 14 tablets, but you said seven. And I know Common Sense says I should give them 14, but I've got to make that change.   knowing that their hands are tied by the law. They can't use as much common sense, which is aggravating. I mean, that's why I love what I gotta do here. I gotta just kind of help a lot more and use common sense and improve patient care. But those kinds of things I think are really beneficial as you work together and then not being so afraid of blood thinners, right? So I think those guidelines do a great job of giving you confidence and not worrying about the side effects. And there's a lot of things that you can do locally for bleeding.   You have a lot of control over that. I think that's pretty cool, the tools they have. Yeah. And at the end of the day, yes, you are the clinician. You are the one who is responsible for this. so obviously, chat, but I think collaborating, talking to other pharmacists, talking to them in your state, finding out what are the state laws, things like that I think can be really beneficial just to give you peace of mind and confidence. And again, dentistry, are maybe a bit more risk adverse because luckily we don't have patients dying That's great thing. Yeah, that's fantastic. I want my dentists to be risk adverse. I think so too. But Jason, I appreciate you being on the podcast today.   And for all of you listening, ⁓ more confidence, more clarity, more streamline to be able to serve and help our patients better. if we can help you in any way or you've got more questions, reach out Hello@TheDentalATeam.com. And as always, thanks for listening. I'll catch you next time on the Dental A Team podcast.  

Terry Savage, nationally syndicated money columnist, joins Wendy Snyder, in for Lisa Dent, to discuss the latest money news. She explains that private equity stocks plummeted today as a result of improvements in AI. And, as always, she answers questions from listeners.

Lin Zexu believed moral clarity and the largest drug bust in history could end the opium crisis and avert war. Yet, as his solution drained into Humen Bay, so too did the last hope of peace between China and Britain.Time Period Covered:1836–June 1839 Major Historical Figures: The Qing Empire:The Daoguang Emperor (Aisin-Gioro Minning) [r. 1820–1850]Lin Zexu, Imperial Commissioner and Governor-General of Huguang [1785–1850]Deng Tingzhen, Governor-General of Liangguang [1776–1846]Huang Juezi, Minister and court official (opium policy advocate) The British Empire:King William IV [r. 1830–1837]Queen Victoria [r. 1837–1901]Henry John Temple, 3rd Viscount Palmerston, Foreign Secretary [1784–1865]Charles Elliot, Chief Superintendent of British Trade in China [1801–1875]Lancelot Dent, Opium trader and head of Dent & Co. [1799–1875]James Matheson, Merchant and political advocate for war [1796–1878] Major Sources Cited:Fairbank, John K. Trade and Diplomacy on the China CoastPlatt, Stephen R. Imperial Twilight: The Opium War and the End of China's Last Golden AgeWakeman, Frederic, Jr. “The Canton Trade and the Opium War,” in The Cambridge History of China, Vol. 10Wakeman, Frederic, Jr. The Fall of Imperial ChinaLovell, Julia. The Opium War: Drugs, Dreams and the Making of China Learn more about your ad choices. Visit megaphone.fm/adchoices