Latest / Orthodontic Products Podcast / Dr Robert “Tito” Norris on How to Create Clinical Efficiencies and a Better Work-Life Balance

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Dr Robert “Tito” Norris on How to Create Clinical Efficiencies and a Better Work-Life Balance · Orthodontic Products Podcast

0:05
Hello and welcome to the orthodontic products podcast.
0:07
I'm your host Alison Werner. Today we're kicking off our 2024
0:10
season with Dr. Robert Tito Norris. I had the privilege of
0:13
profiling Dr. Norris for our September 2020 Cover Story of
0:17
the magazine, which at the time coincided with the launch of the
0:20
Norris 20/26 passive, self ligating bracket and wire system
0:24
he developed with Dynaflex. And now we have him back to talk
0:26
about the systems, products and technologies he has employed to
0:29
achieve clinical excellence so efficiently, and how that
0:33
translates into a better work life balance. Dr. Norris, thank
0:35
you for joining me today.
0:37
Thanks for having me, Alison. I really appreciate it.
0:39
Great. So for those in our audience who aren't familiar
0:42
with you, can you talk about how you got into orthodontics and
0:46
your current practice? Sure,
0:48
well, I guess I gotta go all the way back to college. And first
0:52
of all, I should probably say that I'm in treatment myself,
0:54
right now I have MARPE and a nice little gap between my two
0:57
front teeth, and I'm not enunciating as clearly as I
1:01
might otherwise. I've gotta big old custom MARPE in the roof of
1:05
my mouth. Okay, so back to back to college. I was studying
1:09
mechanical engineering at UT Austin. And my whole life, I
1:13
really wanted braces for the first time. I had job insurance
1:18
and I had no money. And so I wouldn't I got orthodontic
1:23
treatment while I was in college. And just kind of
1:25
sitting there in the chair, when I had this epiphany. It's like,
1:28
you know what, orthodontics is just a lot like engineering to
1:31
the mouth. And there's actually a person attached to it. And not
1:34
only that, the person has, you know, has feelings, it has
1:38
definite, definite emotions attached to their teeth, and
1:42
their smile, and so forth. And I noticed myself as my tooth
1:47
became straighter, just becoming more confident in myself and my
1:50
smile. And to me, it was an amazing transformation. And the
1:55
fact that I could use my engineering training and the
1:58
ability to think in three dimensions and solve three
2:00
dimensional puzzles, to apply it to this, this profession. So I
2:06
made kind of an about face and I left the College of Engineering
2:09
went into pre dent, and it was able to kind of quickly get
2:14
those prereqs taken care of, and then you know, sort of like the
2:17
rest of history, if you will. I have to say that when I was
2:21
studying engineering, I mean, I could do it, I could force
2:24
myself to do it. But I didn't love it. And I'll never forget,
2:27
like my first week of dental school when the dental anatomy
2:30
professor assigned us a book chapter to read. And then I read
2:36
it. And I just was fascinated with the anatomy of the teeth
2:41
and the fact that every tooth has a different function in the
2:44
mouth and a different shape to perform that function. And so I
2:48
ended up staying up all night, you know, up late, I read that
2:51
whole book that night. And that had never happened to me in my
2:54
educational career where I was just like really passionate
2:57
about something. And from that point on dentistry, just and
3:01
orthodontics was just no longer a chore. I mean, it was really,
3:04
it was a pursuit of a passion that I still have to this day.
3:09
And so you know, all through dental school all through
3:12
orthodontic school, I just absolutely love studying this
3:17
stuff and kind of pushing myself to learn more and stay on the
3:21
leading edge of what's out there. And and that that's part
3:25
of what led me to some of the things I've come up with over
3:30
the years.
3:31
Okay, and so you're practicing at San Antonio.
3:36
That's correct.
3:37
Okay, so, um, what I want to talk, I know you have a very
3:41
busy practice, you're treating over 900 cases annually, you had
3:44
mentioned, we had talked earlier, and you mentioned that.
3:46
So I want to talk about how you create efficiencies in your
3:49
office and the systems you've employed to treat, kind of with
3:53
your visits while maintaining those, you know, those
3:56
impeccable finishes that you want. So what is key to creating
4:00
that treatment efficiency while maintaining excellent outcomes
4:04
in your office?
4:05
I mean, I hate to boil it down to just one word, but it really
4:08
is just one word and it's systems. You've gotta have
4:13
systems from from the, for the moment that the patient enters
4:17
or calls the office, there's a system to how we answer that
4:19
phone. It's a very systematic new patient examination because
4:23
there's a lot of lot of data that we'd have to collect in a
4:27
new patient exam. And we look very thoroughly into things.
4:32
What's the position of their skeletal bones? What's the
4:35
what's their airway situation, how they're breathing? Are they
4:37
sleeping, you know, we're looking at them, facially. I
4:42
love I love David Sarver's, macro aesthetic, mini aesthetic
4:46
micro aesthetic evaluation, so we incorporate that into the new
4:50
patient exam. We incorporate Bill Robins core diagnostic
4:55
process into the base exam. And I do have a partner and
4:59
associate So we each have to have that systematic approach to
5:04
the way that we assess and diagnose patients. Furthermore,
5:08
we've had to have systems about, you know, how the braces are
5:11
placed. And so indirect bonding has been kind of a hallmark,
5:14
actually, I've been doing it since residency really helps,
5:19
you know, that bracket accuracy, just getting gets his braces on
5:22
just at the right positions. And that has been really, really
5:27
helpful in terms of creating, you know, just just parity and
5:32
equality in terms of our cases, because we all get to look
5:35
through the same set of eyes that how those brackets should
5:37
fit the teeth. And then, of course, you know, with the
5:43
advent of a more accurate bracket, wire interface system,
5:48
and the Norris system whereby we no longer have all the all the
5:53
slop that we had, when we were doing an oh two bracket system,
5:57
we now have a bracket that actually fits the wires that we
6:00
like to use. So you know, part of that systematic treatment of
6:04
a patient is to treat a patient using three or sometimes four,
6:09
orthodontic archwires, right. So that just really reduces the
6:14
number of thumbs in the pie there and really helps us
6:18
maintain our consistency no matter who's treating the
6:20
patient, you know, we can we can start them very efficiently we
6:24
can we know exactly what's going to happen at the next
6:27
appointment. All those appointments are very
6:29
systematic, and, and the data really speaks for itself. And
6:35
that is if you look at what's published out there, through
6:39
American Journal of orthodontics, and also JCO, you
6:42
know, to get a good finish, the average is somewhere between 20
6:47
and 26 appointments, which is a lot. And so we're recruiting
6:52
patients in literally half of those numbers of appointments.
6:55
Right now, our numbers are 12 appointments for teens and 13
6:58
appointments for adults. And so that is, that's really key and
7:05
to kind of keep an eye on the prize and look at how it's like
7:09
a game, right? And you've got to keep score, right? If you want
7:13
to win the game, you got to be able to keep score. So we
7:15
actually have a column within our EMR software, we happen to
7:21
use too often. Where we have created a column where you have
7:25
to fill in okay, this is appointment number one, this is
7:27
appointment number two. So it's pretty easy for us to go back
7:29
and countless number of appointments, and we're really
7:32
focused on that in terms of, you know, how efficiently can we
7:36
treat every single patient and, and get a great result, right?
7:39
Because we have to have that go through another set of systems,
7:42
another set of checklist, if you will, with before the patient
7:45
get the braces off, you know, what's their incisal display and
7:48
repose? What's does their smilearch like, where are the
7:50
buccal corridors, how's the occlusion? You know, all these
7:53
little things, that we all have to go through the same
7:56
checklist. And that is a system within our practice. And even
8:00
after the braces come off, and we start looking at things such
8:02
as you know, gingival margins, and we look at some of the micro
8:06
aesthetic issues there, you know, it's a coloration of the
8:08
teeth simply changes some teeth and some buildups you know, all
8:12
those things are once it gets a systematic approach to how we
8:15
how we view things. We do have a number of aligner patients in
8:21
our practice as well. And that is a fairly efficient way to go.
8:25
But aligners just can't do everything. So that's what we
8:29
got to embrace. We do a number of interdisciplinary treatments
8:34
in particular, we we've kind of known for patients who are
8:37
having airway issues. In fact, that's why I've been treatment
8:40
myself as I've developed sleep apnea. As I've turned 50, I kind
8:45
of developed sleep apnea. And so now I'm, you know, treating
8:50
myself and honestly, it's the last 10 nights I've slept better
8:53
to have in years and years is pretty amazing.
8:55
Okay. So you mentioned those interdisciplinary cases. Can you
8:59
talk at what how does the workflow change does the
9:02
workload change anyway with those cases to maintain your
9:05
standards?
9:06
It does. Okay. So one of the things that is the hallmark of
9:10
most of our interdisciplinary cases is that a lot of those
9:13
cases are going to have wear on the teeth and basically, this is
9:15
almost half our practice. 50% of our patients are adults. And
9:19
those patients that have worn teeth, missing teeth, fractured
9:23
teeth, whatever. The first step is, well when evaluated gingival
9:27
architecture and see if they have APE altered passive
9:30
erection, that's usually the first step is to get them back
9:33
to a periodontist, establish proper gingival architecture.
9:37
Once we have that, then we can go ahead and send them to the
9:40
dentist and have them build up those teeth so that now we're
9:43
dealing with basically virgin looking teeth they provisional
9:47
buildups on those teeth, so that now we can use use that as a
9:52
three dimensional blueprint for communication between us and the
9:56
restorative dentist because eventually those teeth are going
9:59
to be restored with you know, some long-term provisional,
10:01
something of porcelain usually. But if they can do it in
10:06
composite, or some other resin ahead of time, before they get
10:10
the braces on that it really helps us because now we have an
10:13
accurate incisal edge from which we can measure our bracket
10:16
position. And it just helps the treatment go so much more
10:20
efficiently. Furthermore, when you when you a lot of these
10:23
patients have like anterior wear and maybe not quite as much
10:26
posterior wear is but when you when you build up the teeth
10:30
anteriorly you're left with a kind of a little bit of a
10:33
posterior open bite, because we're gonna put them in some
10:35
bite turbos and so. So you're able to use extrusive mechanics,
10:38
which are much faster than intrusive mechanics, because
10:41
many, many dentists will say, hey, you know, intrude these
10:45
teeth for me, in the talking about the maxillary anterior
10:48
teeth, give them some restorative spaces, they can
10:50
then go back and lengthen the teeth at the end of the
10:52
treatment, we'd like to do it on the front end, where we just
10:55
restore the teeth on the front end, and then we can extrude the
10:59
posterior teeth into occlusion. And that's a much more efficient
11:03
way to treat these patients. And many of these patients finished
11:05
in under under a year. Selecting the treatments that are that are
11:10
most efficient and selecting an appliance it's most efficient
11:13
for each particular case.
11:16
But then you have those systems in place where you have kind of
11:19
that checklist to know what to go through so that you can
11:21
maintain that efficiency as you're going through even if the
11:24
case is a little different or a little more complex.
11:27
Absolutely. And we've got different checklists for
11:30
different types of patients. For instance, we've got a lot of
11:33
what we do to cuspid substitution. So we have a
11:35
number of patients who are missing maxillary lateral
11:38
incisors. And in my practice, we simply don't treatment plan
11:41
implants, we always do custom substitution on these cases. So
11:45
we have a very systematic checklist of what needs to
11:47
happen step by step in order to produce a beautiful smile. And
11:52
to do it in a systematic manner. And there's certain times that
11:56
we do each of these different steps and it's everybody in the
11:58
practice knows it and we sit down the assistants know what's
12:01
going to happen. And it really helps things run very smoothly.
12:06
Can you talk a little bit about what it entailed to set up
12:10
something like that a checklist or a system? Can you take an
12:13
example of one checklist or system you've put in place? And
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what kind of thought process went into it? And what kind of
12:18
data went into creating that?
12:21
Sure. So let's just take the example we're just talking
12:24
about, let's say cuspid substitution case patient was
12:27
was missing their maxillary lateral incisors. Okay, so from
12:30
the new patient exam, I mean, obviously, we want to the
12:32
beginning point of the of the treatments where ultimately
12:36
where do you want your maxillary incisors to fit in the face, the
12:38
maxillary incisors are the central focus of the smile,
12:41
okay. And in many of these cases, feel they need to be
12:44
maybe even a little bit more forward than where they are
12:46
right now. And so, you know, we before we even bond the case, we
12:51
will go ahead and convert the cuspids to the laterals. And
12:54
then we'll basically use some coil springs to push those
12:58
maxillary teeth into the correct position within their smile, but
13:01
vertically, and then we look not only where they are, up and
13:06
down, but also left and right and make sure we don't have a
13:09
cant going on. And also AP, we want to have the right smile
13:13
projection of those teeth. Once we get that set, then the next
13:17
step is for us to basically lock those teeth into place, we use
13:21
something we call a y-bar. All right, and it looks like the
13:24
letter Y goes the roof of the mouth. And it leverages off of
13:28
two palatal tads. And this would be a system where you know, the
13:31
assistant knows I mean, step one, they already know that
13:34
we're gonna be doing those, those cuspid conversions, okay,
13:38
so they have everything set up for us to do the cuspid
13:41
convergence. Step two, they know that we're going to be pushing
13:44
the teeth of the popcorns beans already ready. Step three, we
13:47
know we're going to be putting in the y bar. So we'll have all
13:49
that the TADs ready for us to insert that and the lab knows
13:52
how to build the appliance and assistants actually deliver
13:55
those appliances. And then, you know, when we're protracting the
13:59
posterior teeth, you know, the assistant knows that we gotta
14:03
have buttons on all the four fives and sevens too, because
14:05
we're gonna protract for the facial to the lingual. So all of
14:08
those little steps this this team knows the team knows every
14:12
single step along the way. How do they know because we've done
14:14
the training. Okay, so we have an in house, one of our lead
14:19
clinical assistants is our is our clinical trainer. And so we
14:22
reviewed these cases, and any new patient or any new employee
14:26
basically goes through this training manual and knows these
14:30
steps step by step by step. So there's really no surprises
14:33
here. And it just, we have such an amazing, talented team of
14:37
people because we've we've brought them up that way we
14:39
brought him through the farm league, and now they're playing
14:41
in the pros. And they I mean, when you're a pro you don't you
14:46
don't miss a step because you've done it so many times. You've
14:49
practiced it so many times. And so now it's game time and you
14:53
know what needs to be done. Everything's out, everything's
14:55
ready to roll. So when I sit down, you know, boom, they just
14:58
hand me this, this, this and this and you you know, I'm out
15:00
of there. It's just, it's just simply a matter of training, got
15:04
to have those training. And that training has to be such
15:06
systematic and different levels of expertise among the clinical
15:11
assistants as well. And everybody has a little ladder or
15:14
little little carrot to get to the next level, because that
15:17
next level, obviously means better compensation for you when
15:20
you master the clinical acumen that it takes to do some of
15:25
these more complicated movements.
15:28
Now, a key component of great outcomes and efficiencies is the
15:31
products and technologies you employ. And as you mentioned,
15:34
you have developed several orthodontic products over time
15:37
that do just that. So can you talk about the products and
15:39
technologies that are key to you getting the facial aesthetics
15:42
and finishes you want, when you're treating patients in your
15:45
practice?
15:46
Well, I think that's a great question. I mean, you know,
15:47
obviously, the Norris bracket has been, you know, the hallmark
15:51
of our practice here for the last seven years. And in the
15:55
whole thing, it's all about finishing. And for the first
15:58
time, we actually have a bracket that fits the wires that we like
16:01
to use, most people finish it in 19/25 wire, and with a 20 slot
16:05
bracket, you can get a really nice torque control of these
16:09
teeth and great rotational control. So it's just really
16:12
control and finishing what it's all about, you know, when I've
16:14
talked about those efficiency numbers, in terms of, you know,
16:17
12 or 13 appointments, you know, we don't, we don't make up that
16:20
ground in the first two or three appointments make up that ground
16:23
in the end in the finishing appointments. Because the teeth
16:27
move, you know, you put a little bend in the wire and the tooth
16:31
goes exactly where you want that to be because there's no slop in
16:33
the system. The system is a very tight, it's the difference
16:36
between, like driving like an old farm truck with a bunch of
16:38
slack and the steering wheel versus driving like a Formula
16:41
One race car, where because exactly where you need to be. So
16:45
in a way, this has made us better orthodontists because
16:47
it's made us better bracket positioners. And we've got to be
16:50
extremely accurate with our, with our bracket positioning. So
16:53
you know, first and foremost, it's just, you know, that system
16:56
right there, the smaller 020 bracket system fitting in 19/25
17:00
wire, that's the biggest thing in our practice, okay. Beyond
17:05
that, I mean, we obviously we love in ART spring, it helps to,
17:08
you know, control that torque a little a little more on the
17:10
interior teeth, it's very, we love the CS springs for class
17:15
three patients. We love the motion appliance for early you
17:19
know, kind of class two type of stuff. And yeah, those are those
17:24
are mostly, you know, other other other things, you know,
17:28
like for instance we've got a handpiece, multiple handpieces
17:30
every chair, you know, with light, we've got great lighting,
17:35
we've got suction, we have great air, I mean, it's just easy when
17:40
you sit down, everything's right there, you don't have to ever
17:42
get up and get anything. Okay. Ergonomically, you know, we did
17:47
a whole thing when I built the office in terms of ergonomics,
17:50
and I wanted every assistant to have everything. So we have a
17:53
lot of duplicity at each chair. No one ever has to get up to get
17:57
a plier. You don't pick it up at the wire, you don't have to get
17:59
up to get anything, because every unit is self contained
18:02
there.
18:03
So it's not just about having the products in the moment of,
18:07
you know, applying the braces or moving a wire, I think it's
18:11
having everything in place, from the instruments to the chair to
18:16
just be able to get going right then in there.
18:19
Execute. Okay, execute right there. And there's no delays. So
18:25
it's yeah, that's a that's a that's a, I think I recently saw
18:29
a patient in a friend of mines office, I'm not going to mention
18:32
it, but oh, my gosh, you know, the burs were over there, and
18:35
the handpieces were over there. And it was just like a madhouse
18:37
trying to get what I needed down into this one room with this one
18:41
patient. And, you know, and I realized, yeah, you know, it's
18:46
an investment to have all those things, you know, it's have
18:50
everything in each of your treatment rooms, I get it, but
18:53
it's a one time expense. And once you'd have those things,
18:56
you know, they're going to be there for years and years to
18:57
come. And you're going to save on, you know, just simply time.
19:01
I mean, that's your most valuable asset. And so, you
19:04
know, I mean, it's sort of like, what is it pennywise pound
19:09
foolish or something like that. And so I'm more than willing to
19:13
make those investments to for the ergonomic efficiencies that
19:17
we get out of it, as well.
19:20
Yeah. Well, I was my next question was going to be how
19:22
does this efficiency tie into profitability? And you kind of
19:25
talked about there about making that investment up front with
19:28
your office design and, you know, making sure you have the
19:32
resources to accommodate all those patients to begin with.
19:35
But can you talk a little bit more about how these
19:36
efficiencies within your treatment have helped with
19:39
profitability?
19:41
Well, sure, um, you know, the thing is, listen, every case
19:45
should we've kind of broken down to how many appointments did I
19:48
did it take me to finish that case? Okay. So if it took you
19:51
let's just take an example. Let's say $5,000 case, and took
19:54
you 10 appointments, okay, that's $500 per case, right? So
19:58
the same case $5000 case, if it took you 20 appointments to
20:02
treat that case, well, then you made $250 per visit. All right?
20:05
So the efficiency and the profitability is pretty obvious
20:08
the least number of appointments is making more profitable. And
20:13
yes, we all care about profit and so forth. But I'm, I'm just
20:17
at this point in my career, I'm more interested about time.
20:19
Okay. So I mean, imagine we have roughly 2000 patients in
20:24
treatment, right? And we're able to treat those patients with
20:28
half the number of appointments that we might otherwise treat,
20:31
or they might be treated in another office. So, so what I
20:35
mean, what does that what does that mean? I mean, that's,
20:37
that's, that's 1000s of appointments that we've saved.
20:39
And so what do you want to do with that time? For me, that's
20:43
more of a life balance type of question. And, you know, I, I
20:47
love what I do. I love orthodontics, but I also love a
20:50
lot of other things. You know, I love travel, I love skiing, I
20:53
love my family. You know, it's it's nice to have that sort of,
20:58
you know, ability to have some time off to sharpen the saw to
21:02
go to meetings to do other things. I don't feel like I'm
21:07
just, you know, always at the office, because I'm not.
21:10
Okay, well, that was gonna lead into my next my next question is
21:13
actually going to be about the fact that you know, you do
21:15
lecture frequently you do conduct in office courses. So
21:18
I'm guessing these fewer appointments, which frees up
21:21
that time is allowing you to do those things. So can you talk
21:23
about that work and kind of the topics that excite you that you
21:26
enjoy lecturing on?
21:29
Well, there's no way that I would be able to do all the
21:31
other things that I do. I mean, I'm a competitive swimmer. I
21:35
lift weights three days a week, I go surfing on the weekends,
21:37
you know, I take 15 weeks off every year, you know, whether
21:43
it's in meetings, or lecturing, or whatever. And there's just
21:47
there's absolutely no way I can do that stuff, if you know, if I
21:50
weren't extremely efficient at the office. And that's the only
21:54
way that's ever going to happen. And so when I give the courses,
21:57
you know, when one of the things I mean, obviously, I'd love to
22:01
talk about efficiencies, I like to teach people how to be
22:03
efficient, not only like how to place the brackets on the teeth,
22:07
but the systems and how to use for your archwires and all those
22:10
kinds of things. What excites me most I mean, honestly, I love
22:17
interdisciplinary care. And I have for a long time, I think
22:20
it's, it's, I think it's next level orthodontics, I think you
22:24
have to think quite a bit on some of these cases. And, and
22:29
some of these can be the most rewarding cases, when you're
22:31
really changing someone's life if they've got, you know,
22:33
missing teeth, worn teeth, and they live like this. And they
22:37
feel like they're almost invisible. And you give them
22:40
this new big brilliant smile. And they just I mean, they're in
22:42
tears, they just they feel self confident rather than, you know,
22:46
self conscious, you can really change someone's someone's life.
22:50
But I think as I look at at the future of orthodontics and
22:54
what's what's on the horizon, what's what's happening, I think
22:58
the biggest area for growth is going to be in the area of
23:01
airway friendly orthodontics. And I don't want to beat people
23:04
over the head with this, but my practice has changed
23:06
dramatically in the last 10 years. And, you know, we're
23:10
helping people in ways that we've never been able to help
23:13
them before. And, you know, patients come in, and we go
23:18
through a whole exam, and you know, they just came to
23:20
straighten their teeth, and they end up you know, improving their
23:24
airway and they're sleeping better, they're breathing
23:26
better, and their life has completely changed, you know,
23:29
whether it's children or whether it's adults. You know, now we
23:33
have those technologies to to help everybody. Basically, I'm
23:38
kind of living proof right here with my MARPE going on. I'm 57
23:42
years old, I'm very hard headed, and I got a skeletal split of my
23:46
maxilla. And I basically resolved my sleep apnea here in
23:51
a relatively short period of time. That was unheard of when I
23:54
graduated from residency 30 years ago. And that we would be
23:59
you know, not just straightening teeth, but really helping people
24:02
live better lives, live longer. I mean, just simply speaking,
24:06
you know, if you can resolve someone's sleep apnea, you've
24:09
given them 10 years to their life. That's phenomenal. Yeah, I
24:13
mean, what's your most precious valuable asset it's time and
24:17
time and time you've given 10 more years of life. So you know,
24:21
for those who have not gotten on the I want to say bandwagon but
24:26
who have not gotten educated themselves in terms of the
24:29
benefits of a MARPE or a custom MARPE dun procedures, sharpe
24:34
procedures, those kinds of things. If we're not looking at
24:36
airway, you're never going to find it in dentists are in a
24:39
very dentists and orthodontists are in a very unique position to
24:43
recognize early signs of airway problems. Everything anything
24:48
from just like snoring to tooth grinding, okay, open bites,
24:54
tongue thrusts, all these kinds of things can have to tie into
24:57
that the airway component So that's one of my favorite
25:00
lectures to give. And they tend to be very eye opening for a lot
25:03
of patients, and they go back and they look at their patients
25:05
with a different, totally different way. And and now that
25:09
we have all this all these new tools at our disposal, I mean,
25:13
orthodontics has been through a major overhaul here just fairly
25:18
recently.
25:19
Yeah. I know. Before working on orthodontics magazine, I
25:25
actually did work on a sleep medicine museum or magazine. So
25:29
I'm actually curious, have you incorporated questions about
25:35
sleep habits and breathing into your patient evaluations?
25:39
Absolutely. That's a seminal part of it. In fact, the
25:43
Chervine Sleep questionnaire is its diagnostic. It's actually,
25:48
for instance, remember, when you were a general dentist, like if
25:50
someone brought to you, like a, like a bitewing X ray, and it
25:54
had a, you know, it looked like a cavity, a caries lesion on
25:57
there. I mean, you were pretty much committed to it, you
25:59
couldn't ignore it, right? Like, you would have to treat that
26:02
cavity or at least inform the patient that you have a cavity
26:05
that needs to be treated, or it could turn into a root canal, or
26:07
you could lose a tooth. Well, the Chervine sleep
26:10
questionnaire, which is part of what we do, you know, for
26:12
kiddos, and we have another one for adults, it is a validated
26:17
instrument. In other words, you know, if if someone answers, you
26:21
know, eight or more on that Chervine sleep questionnaire,
26:24
you can send that to an ENT, and they can't ignore it. For years
26:29
and years and years, I was trying to do more airway stuff,
26:31
and if sending these patients to these local ENTs. And there was
26:35
a well, yeah, they have class three tonsils, but you know,
26:38
I've seen bigger, insurance isn't going to cover it unless
26:40
they've had so many infections. Meanwhile, you know, the poor
26:43
child is not sleeping, not thriving, they're struggling,
26:48
they're they're mouth breathing. It's, it's really, it's really
26:51
been a shame that we haven't had the support, but once you kind
26:55
of educate your colleagues and align them and show them what
26:59
you can do, and how they can help as well. It's really,
27:03
really great to have that interdisciplinary team on board
27:06
with everything.
27:08
Going back to your lecturing and everything, and you're in-office
27:11
half his courses. Do you have anything coming up in the next
27:14
few months?
27:15
Absolutely. Well, there's there's two courses coming up.
27:17
One is next month, that's going to be in Scottsdale, and I'm
27:21
lecturing with Chad Foster there. And that's going to be
27:25
focused really more on orthodontic aesthetics and
27:27
finishing. And that's, a course, that we've given several times.
27:30
And the feedback that we've gotten has been has been really,
27:33
really positive, very eye opening for a lot of people.
27:37
He's got some really, really great stuff to share. And of
27:42
course, we both make some contributions there. And then we
27:45
do an in house course twice a year, every May, and every
27:50
October. And those can be found on the Dynaflex website, if you
27:54
just open up dynaflex.com and it'll pop up right there. Yeah,
28:00
once you're up to date in office course, and we cover everything
28:03
from indirect bonding MARPE even systems within the practice, you
28:08
know how to answer the phone? We do. Yeah, I mean, we actually is
28:14
very much involved in taking excellent records. You know,
28:19
Disney level service, team building training, you know, all
28:23
is a pretty comprehensive thing. And then we go through airway we
28:26
get through interdisciplinary care, cuspid substitution, solar
28:30
transplantations. It's more of a hands on type of thing.
28:33
So Excellent. Well, Dr Norris thank you so much for speaking
28:37
me today. I really enjoyed our conversation and I hope our
28:41
audience finds everything you had to say really helpful,
28:43
because I think it was.
28:45
Thank you so much Alison. It's been a pleasure.
28:48
Great, great. Yes. Great to see you again, too. Okay, take care.
28:52
As always, thank you for joining us. Be sure to subscribe to the
28:55
orthodontic products podcast to keep up with the latest
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episodes. And be sure to check out orthodontic products
28:59
online.com to keep up with the latest industry news. Until next
29:02
time, take care.