1 00:00:00,370 --> 00:00:04,080 Hi everyone. I'm Erica Spicer Mason with Becker's Healthcare. 2 00:00:04,240 --> 00:00:06,760 Thank you so much for joining us today for the podcast. 3 00:00:07,320 --> 00:00:10,880 We're thrilled to be joined today by Dr. Michael Silverman, 4 00:00:11,100 --> 00:00:14,160 the c e o and co-founder of Strategic Dentistry, 5 00:00:14,620 --> 00:00:19,240 who will discuss with us today how IV sedation can help grow dental practices 6 00:00:19,240 --> 00:00:23,730 and dental service organizations. So, just a little bit about Dr. 7 00:00:23,730 --> 00:00:28,210 Silverman. He's a globally recognized lecturer, educator, author, 8 00:00:28,210 --> 00:00:29,690 and patients right advocate. 9 00:00:30,160 --> 00:00:34,450 He's appeared in front of 28 dental boards to advocate for the right of dentists 10 00:00:34,450 --> 00:00:38,290 to provide sedation in an environment of safe and reasonable regulations. 11 00:00:38,740 --> 00:00:41,890 He lectures across the globe on methods, techniques, 12 00:00:41,890 --> 00:00:43,850 and the power of sedation dentistry. 13 00:00:44,730 --> 00:00:48,220 A graduate of the University of Pennsylvania School of Dental Medicine, 14 00:00:48,220 --> 00:00:50,860 and a passionate believer in lifelong education, 15 00:00:51,190 --> 00:00:54,380 he has changed the way tens of thousands of dentists practice. 16 00:00:54,870 --> 00:00:58,420 He continues to impact dentistry as a champion of safe and effective, 17 00:00:58,420 --> 00:00:59,940 minimal and moderate sedation. 18 00:01:00,630 --> 00:01:04,620 As a faculty member and the president of the D O C S education, 19 00:01:04,990 --> 00:01:09,380 he has taught over 30,000 dental professionals how to safely implement 20 00:01:09,660 --> 00:01:14,080 sedation in their own practices. With that, Dr. Silverman, 21 00:01:14,080 --> 00:01:15,760 thank you so much for joining us today. 22 00:01:16,380 --> 00:01:18,260 Thank you so much for having me, Erica. 23 00:01:18,890 --> 00:01:22,610 Great. Well, I think that bio alone speaks for itself. 24 00:01:22,670 --> 00:01:27,410 You are quite the expert on this topic, so I'm really excited to dig in. 25 00:01:28,130 --> 00:01:29,050 . Great. 26 00:01:29,780 --> 00:01:33,610 So I'm wondering if you can just maybe start us out with saying a little bit 27 00:01:33,610 --> 00:01:38,370 about IV sedation and who should add this technique to their services, 28 00:01:38,370 --> 00:01:41,010 or I should say maybe this treatment to their services. 29 00:01:41,110 --> 00:01:42,250 How would you describe it? 30 00:01:42,990 --> 00:01:46,760 Yeah. I would add this service to their treatment regimen. 31 00:01:47,350 --> 00:01:52,000 I think that when a dentist or a dental practice thinks about 32 00:01:52,750 --> 00:01:54,650 implementing IV sedation, 33 00:01:55,300 --> 00:01:59,930 it really fits beautifully with offices or 34 00:01:59,930 --> 00:02:01,490 dentists who are performing longer, 35 00:02:01,490 --> 00:02:06,090 more extensive treatment plans such as implant surgery, 36 00:02:06,090 --> 00:02:11,010 implant dentistry, full mouth restorative, you know, wisdom teeth extractions, 37 00:02:11,740 --> 00:02:16,250 um, extractions with full dentures, things that are pretty extensive. 38 00:02:16,420 --> 00:02:19,010 IV sedation fits beautifully. It relaxes the patients. 39 00:02:19,280 --> 00:02:22,810 It's also very well suited for those practices that have shorter appointments, 40 00:02:22,810 --> 00:02:26,330 sort of like the, the two ends of the spectrum. Short, 41 00:02:26,330 --> 00:02:30,690 very short appointments like when your endodontist and your periodontist whose 42 00:02:30,690 --> 00:02:34,330 typical appointments are an hour or less. Um, 43 00:02:34,330 --> 00:02:39,050 this is a way to using IV sedation to make the patient completely comfortable. 44 00:02:39,390 --> 00:02:41,810 And because the medications wear off so quickly, 45 00:02:42,000 --> 00:02:46,010 they can be released from the office in an efficient manner. 46 00:02:46,920 --> 00:02:51,870 Another area that we see a lot of dental practices do very well with 47 00:02:52,000 --> 00:02:56,630 IC IV sedation is where they happen to practice in a 48 00:02:56,630 --> 00:03:01,440 community where it's difficult to find options for 49 00:03:01,440 --> 00:03:05,840 patients to receive general dental care while sedated. 50 00:03:06,470 --> 00:03:10,000 They can't go to an oral surgeon to have a tooth restored. 51 00:03:10,650 --> 00:03:15,080 So if that community doesn't have other options, uh, a dentist that, 52 00:03:15,170 --> 00:03:19,840 or a dental practice that incorporates sedation into that 53 00:03:19,840 --> 00:03:24,040 community is very likely to get referrals from other general dentists for those 54 00:03:24,040 --> 00:03:25,560 types of patients that require it. 55 00:03:26,240 --> 00:03:30,140 One of the things just to think about IV sedation is that it's much more 56 00:03:30,140 --> 00:03:33,780 efficient in the chair time as other places. 57 00:03:33,790 --> 00:03:37,940 So high volume practices do very well with IV sedation as well. 58 00:03:38,910 --> 00:03:41,190 Great. Thank you so much for sharing that. 59 00:03:41,190 --> 00:03:45,710 It sounds like there are a lot of benefits upfront that I'm sensing already in 60 00:03:45,710 --> 00:03:46,910 terms of, you know, 61 00:03:46,910 --> 00:03:51,750 patient volume and being able to accommodate that efficiency and also making the 62 00:03:51,750 --> 00:03:52,630 patient comfortable. 63 00:03:52,860 --> 00:03:53,350 Yeah. 64 00:03:53,350 --> 00:03:56,350 Um, so I'm wondering if you can speak to that a little bit more. 65 00:03:56,380 --> 00:04:00,350 What patients do benefit the most from IV sedation? 66 00:04:01,510 --> 00:04:02,000 Well, 67 00:04:02,000 --> 00:04:06,520 patients that benefit the most from sedation and some specifically for IV 68 00:04:06,680 --> 00:04:07,513 sedation. 69 00:04:07,530 --> 00:04:12,040 So patients who have been without care for a long time often 70 00:04:12,310 --> 00:04:16,840 come into dental practices due to the fact that the practice is providing 71 00:04:17,000 --> 00:04:20,440 sedation and then they're going to have an extensive treatment plan. 72 00:04:21,140 --> 00:04:26,080 And much of the dentistry can be done in fewer appointments when a 73 00:04:26,080 --> 00:04:28,840 patient is sedated with IV sedation, 74 00:04:29,110 --> 00:04:34,000 it's clear to most of the doctors and the managers listening that high fear 75 00:04:34,000 --> 00:04:35,800 patients, anxious patients, 76 00:04:35,800 --> 00:04:39,680 phobic patients are sort of the ideal candidates for this, 77 00:04:40,380 --> 00:04:44,160 but also patients who just don't want repeat visits, um, 78 00:04:44,250 --> 00:04:46,920 to come for an example, um, 79 00:04:46,920 --> 00:04:51,400 if a patient arrives in the hygiene department and this patient 80 00:04:51,900 --> 00:04:56,600 has some periodontal problems and is gonna require four quadrants of scaling and 81 00:04:56,600 --> 00:04:57,190 replanning, 82 00:04:57,190 --> 00:05:02,080 most offices due to insurance limitations are 83 00:05:02,080 --> 00:05:05,400 strapped with four separate appointments because the insurance companies won't 84 00:05:05,400 --> 00:05:09,680 pay for four quadrants to be done in one visit. However, 85 00:05:09,950 --> 00:05:11,400 with IV sedation, 86 00:05:12,300 --> 00:05:16,160 the insurance companies will pay for all four quadrants to be done at once, 87 00:05:16,160 --> 00:05:19,440 which actually from a biological standpoint makes more sense anyway. 88 00:05:20,330 --> 00:05:22,440 We all have had patients who have a, 89 00:05:22,470 --> 00:05:26,760 a severe gag reflex or really a severe gag response 90 00:05:27,220 --> 00:05:31,440 and IV sedation eliminates gag responses. Also, 91 00:05:31,440 --> 00:05:35,080 we've had patients who are resistant to local anesthesia. 92 00:05:35,140 --> 00:05:39,240 The redheads in our community supposedly have a higher 93 00:05:39,390 --> 00:05:43,640 anesthesia, local anesthesia resistance, then the other population. 94 00:05:43,640 --> 00:05:45,440 And by using IV sedation, 95 00:05:45,530 --> 00:05:49,400 it lowers the pain threshold and therefore it allows the, 96 00:05:49,400 --> 00:05:52,280 or raises the pain threshold and allows the patient to be completely 97 00:05:52,280 --> 00:05:56,040 anesthetized. So I think that's probably Oh, yeah. 98 00:05:56,040 --> 00:06:00,000 For diabetic patients, that's another consideration, Erica. Mm-hmm. 99 00:06:00,040 --> 00:06:00,490 , um, 100 00:06:00,490 --> 00:06:05,400 IV sedation is really better for a diabetic patient because you 101 00:06:05,400 --> 00:06:09,640 really don't want a diabetic patient to go without food or water n P O for too 102 00:06:09,640 --> 00:06:14,360 long because they could have a sugar crash in their system that could 103 00:06:14,360 --> 00:06:16,680 create a serious medical problem. 104 00:06:17,140 --> 00:06:19,840 And when we use IV sedation, 105 00:06:19,880 --> 00:06:24,680 we're dripping with a dextrous solution that keeps the 106 00:06:24,960 --> 00:06:27,920 diabetic patient's blood sugar level very level, very even. 107 00:06:29,170 --> 00:06:30,200 So interesting. 108 00:06:30,210 --> 00:06:34,960 It sounds like IV sedation really solves for a lot of 109 00:06:34,960 --> 00:06:39,040 issues. You know, just the patient anxiety like you mentioned, which by the way, 110 00:06:39,070 --> 00:06:41,800 I completely relate to being in the dentist chair. 111 00:06:42,080 --> 00:06:44,960 very anxiety inducing experience for some of us. 112 00:06:44,960 --> 00:06:48,240 And then of course considering diabetics as well, 113 00:06:48,240 --> 00:06:52,400 just with the prevalence of that chronic condition throughout patient 114 00:06:52,400 --> 00:06:53,720 populations. Um. 115 00:06:54,240 --> 00:06:59,240 Erica, it's fascinating to me that at our events we 116 00:06:59,630 --> 00:07:03,360 poll our audience often not every 15 minutes we have a poll, 117 00:07:03,940 --> 00:07:05,680 and one of the polls that we do, 118 00:07:05,680 --> 00:07:10,550 we put out there is confidentially on basically 119 00:07:10,550 --> 00:07:13,870 this scale. How fearful are you of having dentistry done? 120 00:07:14,130 --> 00:07:18,710 And we do this with dentists and hygienist and dental assistants and practice 121 00:07:18,710 --> 00:07:23,470 managers. We're asking people in the dental field that practice dentistry 122 00:07:23,810 --> 00:07:26,950 how fearful they are. And you wouldn't believe it. 123 00:07:26,950 --> 00:07:30,270 It's almost consistent across the board. At every event that we do, 124 00:07:30,270 --> 00:07:35,230 67% of dentists and dental team members have a significant amount 125 00:07:35,230 --> 00:07:39,070 of fear of getting their dentistry done. It doesn't mean they don't get it done, 126 00:07:39,450 --> 00:07:42,070 but there is a significant amount of fear still out there. 127 00:07:42,620 --> 00:07:46,680 Wow. That's a really significant percentage. 128 00:07:46,810 --> 00:07:49,880 So I'm sure this would speak to many patients. 129 00:07:50,410 --> 00:07:51,243 Mm-hmm. . 130 00:07:51,820 --> 00:07:56,450 So we've talked about all these great features of IV 131 00:07:56,570 --> 00:07:57,690 sedation and mm-hmm. , 132 00:07:57,690 --> 00:08:01,050 what it can do for both practices and the patient. 133 00:08:01,270 --> 00:08:06,210 But I'm wondering if there's any disadvantages of this option and what 134 00:08:06,210 --> 00:08:09,050 would be the best ways to minimize any disadvantages here? 135 00:08:09,660 --> 00:08:11,190 Well, that's a complex question. 136 00:08:11,230 --> 00:08:15,830 Maybe what we should do is start with some of the advantages of IV sedation over 137 00:08:15,830 --> 00:08:16,663 other sedation, 138 00:08:17,270 --> 00:08:21,650 and then I can talk about the disadvantages and how we can ameliorate some of 139 00:08:21,650 --> 00:08:25,850 those disadvantages by combining oral sedatives with IV 140 00:08:26,450 --> 00:08:27,810 sedatives. Sure. 141 00:08:27,940 --> 00:08:32,010 So advantages IV sedation is titrateable, 142 00:08:32,010 --> 00:08:36,490 which means that you can give very small amounts of the sedative to the patient 143 00:08:37,120 --> 00:08:41,650 into their vein until you get to a desired result. It, 144 00:08:41,650 --> 00:08:45,270 it's very quick in, it's very quick out. Um, 145 00:08:45,970 --> 00:08:50,710 the ability to deliver both a sedative and an 146 00:08:50,750 --> 00:08:55,640 analgesic medication really helps for those doctors 147 00:08:55,640 --> 00:08:57,480 and practices that are doing surgery. 148 00:08:58,170 --> 00:09:02,880 So you can actually provide pain relief during the IV 149 00:09:03,040 --> 00:09:04,730 sedative. Um, 150 00:09:04,730 --> 00:09:08,410 another advantage is these patients who we call hypo responds, 151 00:09:08,850 --> 00:09:12,450 these are patients that just don't seem to be able to get sedated. 152 00:09:12,840 --> 00:09:17,570 A lot of them are are heavy smokers and it's very difficult 153 00:09:17,580 --> 00:09:22,010 to sedate a person who smokes a lot of cigarettes. It takes a lot of, um, 154 00:09:22,140 --> 00:09:26,850 tobacco, um, and using IV sedation because it's tri titrateable, 155 00:09:26,910 --> 00:09:30,610 you can make those patients completely comfortable. Um, 156 00:09:30,610 --> 00:09:33,650 and then we've already talked a little bit about the diabetic patient. Now, 157 00:09:33,950 --> 00:09:38,690 hypoglycemia or low blood sugar could be a problem for patients, 158 00:09:38,690 --> 00:09:42,010 but since you're dripping a dextro solution, um, 159 00:09:42,010 --> 00:09:46,610 these patients can go without food or water before they arrive at the office. 160 00:09:46,940 --> 00:09:50,410 We can provide them, as I'll talk about in a minute, some oral medication, 161 00:09:50,710 --> 00:09:52,610 and then when we put them on the iv, 162 00:09:52,610 --> 00:09:57,070 we can make sure their blood sugar doesn't drop. Another advantage would be, 163 00:09:57,480 --> 00:10:02,070 um, it, it avoids dehydration. So if they're without food or water, n p o, 164 00:10:02,070 --> 00:10:06,150 they can get dehydrated, which isn't a great thing either. Right. 165 00:10:06,150 --> 00:10:07,790 So as far as the disadvantages go, 166 00:10:07,790 --> 00:10:10,910 cuz I think we need to be upfront about all those, you know, 167 00:10:10,930 --> 00:10:14,910 the medication itself that we use, the safest medications we use, 168 00:10:14,910 --> 00:10:19,500 which are in the benzodiazepine family are very short acting. 169 00:10:19,500 --> 00:10:21,100 The duration is pretty quick. 170 00:10:21,710 --> 00:10:26,100 So if you were just doing IV sedation and say you'd had a three or four hour 171 00:10:26,100 --> 00:10:27,260 dental appointment, 172 00:10:27,440 --> 00:10:31,820 you would need to redose that person multiple times during the appointment. 173 00:10:32,390 --> 00:10:33,223 However, 174 00:10:33,670 --> 00:10:38,540 by adding an oral preload of a 175 00:10:38,860 --> 00:10:42,860 sedative before the patient is put into the 176 00:10:43,140 --> 00:10:47,820 operatory, you can avoid the frequent dosing. 177 00:10:47,830 --> 00:10:52,480 It actually extends the iv, uh, 178 00:10:52,680 --> 00:10:57,360 sedation life and it turns this disadvantage into an 179 00:10:57,360 --> 00:11:00,960 advantage. Another disadvantage, and this is someone every, 180 00:11:00,960 --> 00:11:02,680 everybody should be very cautious with, 181 00:11:02,680 --> 00:11:06,440 is the potency of the medications that we use are very powerful. 182 00:11:06,900 --> 00:11:09,600 And when you do provide those medications, 183 00:11:09,600 --> 00:11:13,480 you need to be super judicious because it's titrateable, 184 00:11:13,490 --> 00:11:18,040 it gives you that i that opportunity to add infinitesimal amounts until you get 185 00:11:18,040 --> 00:11:22,720 the result almost immediately as you're watching. So there is, you can, 186 00:11:23,260 --> 00:11:27,150 you can handle that, but it is a disadvantage. Um, 187 00:11:27,150 --> 00:11:32,030 another disadvantage, oh, patients who are afraid of the needle, 188 00:11:32,030 --> 00:11:34,490 what I call needle phobics mm-hmm. . 189 00:11:34,660 --> 00:11:36,370 So if they're afraid of the needle, 190 00:11:36,460 --> 00:11:39,650 they're gonna get a needle in their arm and they're gonna go, wait a minute, 191 00:11:39,990 --> 00:11:43,650 you know? But if you give them that oral medication ahead of time, 192 00:11:43,940 --> 00:11:46,290 it sedates them, it pres sedates them, 193 00:11:46,290 --> 00:11:50,770 it takes the anxiety level down and it makes it easier for them to accept that 194 00:11:50,770 --> 00:11:52,730 needle in the arm. And most times, 195 00:11:53,090 --> 00:11:57,440 because of the amnesic effect of these benzodiazepines, 196 00:11:57,440 --> 00:12:01,880 even in the oral formula, the patient won't even remember getting a needle. 197 00:12:01,880 --> 00:12:06,630 They'll be wake up with a bandaid on their arm and that'll be about it. Um, 198 00:12:06,630 --> 00:12:11,310 and then I talked a little bit before too about the quadrants scaling replanting 199 00:12:11,310 --> 00:12:15,310 and the disadvantage of IV sedation is, you know, 200 00:12:15,310 --> 00:12:19,870 you have to have this set up, the monitors you have to pay for training, 201 00:12:20,520 --> 00:12:22,030 um, and those kinds of things, 202 00:12:22,700 --> 00:12:27,560 but that can be offset with less chair time in the o in the patient chair time 203 00:12:27,560 --> 00:12:31,880 because it's fast in and fast out and you can do more dentistry and once in 204 00:12:31,880 --> 00:12:32,310 fact, 205 00:12:32,310 --> 00:12:36,680 a lot of these patients will ask if you could do more while they're sedated 206 00:12:37,260 --> 00:12:40,750 rather than stretching it out to extra appointments. 207 00:12:41,020 --> 00:12:42,790 I hope that answers the question. 208 00:12:43,960 --> 00:12:45,130 Very much. 209 00:12:45,140 --> 00:12:49,930 So I really appreciate that thorough explanation and also the way that you kind 210 00:12:49,930 --> 00:12:52,810 of framed how there are some disadvantages, 211 00:12:52,810 --> 00:12:57,090 but they're navigatable and they can actually be flipped into advantages 212 00:12:57,090 --> 00:12:59,610 Correct. For this option. So yeah. Yeah. Um, 213 00:12:59,610 --> 00:13:02,130 I think that's a really helpful thing for our listeners to hear. 214 00:13:02,830 --> 00:13:05,490 And this question that I wanna ask ne next, 215 00:13:05,490 --> 00:13:08,130 I was planning to ask a little further into our conversation, 216 00:13:08,130 --> 00:13:12,370 but I think it ties so nicely into what you were just saying. Um, you know, 217 00:13:12,370 --> 00:13:15,850 if anyone's listening to this and they're thinking this might be an option for 218 00:13:15,850 --> 00:13:18,690 their practice, they're probably wondering, okay, 219 00:13:18,690 --> 00:13:22,730 to navigate these advantages or potential disadvantages or, you know, 220 00:13:22,790 --> 00:13:27,770 the workarounds will their dental teams need special training to administer this 221 00:13:27,770 --> 00:13:28,550 kind of treatment. 222 00:13:28,550 --> 00:13:33,290 Yes, yes, yes, yes, yes, yes. Very important. So, 223 00:13:33,500 --> 00:13:35,170 uh, when I, when, when, 224 00:13:35,170 --> 00:13:39,450 maybe I'll get a chance to describe in one of your next questions more about our 225 00:13:39,450 --> 00:13:39,950 program, 226 00:13:39,950 --> 00:13:44,770 but our program requires our doctor participants 227 00:13:44,770 --> 00:13:48,650 to bring at least one team member to the program 228 00:13:49,320 --> 00:13:53,900 mm-hmm. and the team member being a dental assistant particularly, 229 00:13:54,070 --> 00:13:58,140 it could be a hygienist, but a dental assistant would be best because, you know, 230 00:13:58,140 --> 00:14:03,020 the dental team needs to be trained on how to monitor an 231 00:14:03,150 --> 00:14:07,580 IV sedation patient. And after the patient has, 232 00:14:08,120 --> 00:14:10,940 you know, is dismissed from the office appropriately, 233 00:14:10,940 --> 00:14:12,940 which they need to know how to do as well, 234 00:14:13,370 --> 00:14:18,140 they need to know how to transfer the data that's been stored on 235 00:14:18,140 --> 00:14:22,940 this very sophisticated monitor that captures pulse and oxygen 236 00:14:23,040 --> 00:14:27,580 and blood pressure and carbon dioxide and all these parameters 237 00:14:27,780 --> 00:14:30,940 needs to be transferred to, uh, uh, the patient's chart. 238 00:14:31,040 --> 00:14:33,980 And you don't want the doctor to be spending time d use, 239 00:14:33,980 --> 00:14:37,700 manipulating that aspect. And on top of all that, 240 00:14:37,960 --> 00:14:42,580 the dental team always frees up the doctor to do more dentistry. So we really, 241 00:14:42,580 --> 00:14:46,580 really want them to get that kind of training as well as they get a chance to 242 00:14:46,820 --> 00:14:48,820 practice with the physician, 243 00:14:48,820 --> 00:14:53,630 with the doctors in this training session on how to prepare 244 00:14:53,630 --> 00:14:56,550 for the unlikely event of a medical emergency. 245 00:14:57,390 --> 00:15:02,240 Absolutely. It sounds like training is essential in this case, 246 00:15:02,570 --> 00:15:05,880 um, for safety and, and all of that good stuff. 247 00:15:05,880 --> 00:15:07,600 So thank you for sharing of. 248 00:15:07,600 --> 00:15:11,520 That. We, we even have doctors who send their team members, 249 00:15:11,800 --> 00:15:16,280 extra team members in after they've been trained for us to train them as well, 250 00:15:16,610 --> 00:15:20,400 um, because, um, they want everybody to be on the same page. 251 00:15:21,380 --> 00:15:25,370 Absolutely. And so I wanna shift a little bit to, 252 00:15:25,570 --> 00:15:27,210 we're kind of going in that direction, 253 00:15:27,210 --> 00:15:31,850 but the benefits to the dental practice or the organization. 254 00:15:32,060 --> 00:15:34,770 So in using IV sedation, 255 00:15:34,940 --> 00:15:38,890 is there potential for return on investment? How, how does that work? 256 00:15:40,050 --> 00:15:44,560 Oh, absolutely. Well, let's, let's look at it slightly differently, 257 00:15:44,660 --> 00:15:47,800 but same question, potential for return. 258 00:15:48,650 --> 00:15:52,560 If you look at the statistics of the, in the United States, 259 00:15:52,610 --> 00:15:57,240 of the top 5% highest producing dental offices, 260 00:15:58,180 --> 00:15:59,430 almost all of them, 261 00:16:00,020 --> 00:16:04,950 I would say 19 outta 20 of them are IV sedation practices. 262 00:16:05,850 --> 00:16:07,790 And that's not a coincidence. 263 00:16:08,800 --> 00:16:13,630 So clearly providing that service brings in 264 00:16:14,100 --> 00:16:16,670 a, a changes the way the practice is run, 265 00:16:16,670 --> 00:16:20,950 as well as brings in the type of patients that really require significant amount 266 00:16:20,950 --> 00:16:25,700 of dentistry. Um, as I talked about before, 267 00:16:25,700 --> 00:16:30,500 there's more than one way for a dentist to invest in 268 00:16:30,660 --> 00:16:34,140 acquiring an IV permit or an IV certificate. 269 00:16:34,140 --> 00:16:38,140 Each state calls it something slightly differently. Um, 270 00:16:38,140 --> 00:16:43,060 the tra more traditional way was to be out of the office for two weeks of time 271 00:16:43,060 --> 00:16:46,020 where you spend time in the classroom every day, 272 00:16:46,020 --> 00:16:50,860 and then eventually you treat 20 patients with 273 00:16:50,870 --> 00:16:53,420 IV sedation and do dentistry on those patients. 274 00:16:53,840 --> 00:16:58,580 And that's pretty much the standard of requirement 275 00:16:59,350 --> 00:17:01,230 guideline throughout the country. 276 00:17:02,460 --> 00:17:06,760 The second way to do this is with a hybrid course like our program 277 00:17:07,200 --> 00:17:12,080 where the majority of the didactic information is provided 278 00:17:12,080 --> 00:17:16,960 as pre-course material where you meet with our faculty member on four 279 00:17:17,160 --> 00:17:20,360 separate occasions on Zoom after you've done study. 280 00:17:20,580 --> 00:17:23,640 And then you review that study four in four sessions, 281 00:17:24,060 --> 00:17:28,680 and then you only have a four day clinical experience where you get to treat 282 00:17:28,680 --> 00:17:29,450 those patients, 283 00:17:29,450 --> 00:17:34,360 prepare for medical emergencies and then treat 20 patients individually with a 284 00:17:34,360 --> 00:17:38,720 one-to-one faculty to doctor student ratio. 285 00:17:38,890 --> 00:17:43,600 So they really get a lot of hands-on work doing that. Um, 286 00:17:43,920 --> 00:17:48,880 cost-wise, I mean, I can just put out numbers if you'd like, if that helps. 287 00:17:49,920 --> 00:17:51,890 Sure. I think that would be really helpful. 288 00:17:52,240 --> 00:17:56,050 Yeah. So the, the tuition is around $23,000 for our program. 289 00:17:56,900 --> 00:18:00,210 Um, you'll spend a minimum of $6,000 in equipment, 290 00:18:01,170 --> 00:18:02,730 probably $2,000 in travel, 291 00:18:02,770 --> 00:18:06,570 which is a lot less than a 12 day or 14 day program. 292 00:18:07,710 --> 00:18:11,890 And then you can charge for your IV sedation treatments 293 00:18:12,470 --> 00:18:15,570 and you'll break even pretty quickly. I, you know, most people, 294 00:18:15,570 --> 00:18:18,770 if all they did was charge for the IV and didn't do anything else in their 295 00:18:19,010 --> 00:18:22,170 practices, they would break even within a couple or probably three months. 296 00:18:22,170 --> 00:18:26,330 But the truth is, is that once they start providing this service, 297 00:18:26,330 --> 00:18:28,410 they're gonna start to do wisdom teeth learn, 298 00:18:28,570 --> 00:18:32,130 learn to or already know how to do wisdom teeth extractions more effectively. 299 00:18:32,320 --> 00:18:35,010 You're gonna attract more high value patients. 300 00:18:35,670 --> 00:18:40,610 And our graduates claim that within one month they've more than made back their 301 00:18:40,610 --> 00:18:44,930 investment in time and energy and money and now they feel really great about 302 00:18:44,930 --> 00:18:47,050 what they're doing. Most importantly, 303 00:18:47,310 --> 00:18:50,530 not people just don't wanna spend a lot of time outta the office. I think. 304 00:18:51,730 --> 00:18:55,570 Of course. And I really wanna highlight too, 305 00:18:55,940 --> 00:18:58,810 it seems like there's such an emphasis on education here, 306 00:18:58,910 --> 00:19:03,570 and I know research shows, I can't cite the study off the top of my head, 307 00:19:03,570 --> 00:19:07,930 but I know that we know through research of clinical staff that they're kind of 308 00:19:07,930 --> 00:19:11,290 itching for more education opportunities and to grow their skills. 309 00:19:11,290 --> 00:19:15,570 And so I think that, you know, this does sound like a viable option for that. 310 00:19:15,930 --> 00:19:18,170 Erica, you made a very good point, 311 00:19:18,240 --> 00:19:21,370 especially today with this shrinking 312 00:19:22,660 --> 00:19:27,110 population of employee pools for our, for us dentists mm-hmm. , 313 00:19:27,110 --> 00:19:31,670 we wanna give our team members, our staff, you know, 314 00:19:31,860 --> 00:19:36,150 more, uh, responsibility, more growth, uh, 315 00:19:36,150 --> 00:19:41,150 more acknowledgement for what they do and bringing them to a program 316 00:19:41,150 --> 00:19:41,750 like this, 317 00:19:41,750 --> 00:19:45,310 asking them for their help to be able to implement all the bits and pieces of 318 00:19:45,310 --> 00:19:48,910 this really does help to cement them in your particular program. 319 00:19:49,760 --> 00:19:53,040 Right, absolutely. Well, 320 00:19:53,040 --> 00:19:57,480 thank you so much for sharing that. And I'm wondering if you could also, 321 00:19:58,150 --> 00:20:01,520 I, I'm just thinking about this topic and um, 322 00:20:01,520 --> 00:20:04,440 how many benefits there are and the education opportunities, 323 00:20:04,900 --> 00:20:09,280 and it sounds like there are a lot of practices adopting IV sedation, 324 00:20:09,370 --> 00:20:10,440 so mm-hmm. 325 00:20:10,480 --> 00:20:15,440 for any of those practices that might be on the fence or 326 00:20:15,440 --> 00:20:19,400 might have misconceptions about this therapy, 327 00:20:19,990 --> 00:20:21,160 what do you say to them? 328 00:20:21,160 --> 00:20:23,840 How do you clear up any misconceptions if there are any? 329 00:20:24,750 --> 00:20:26,400 Well, you know, it's fun because we, 330 00:20:26,490 --> 00:20:30,040 we hear after the graduation from the program, 331 00:20:30,380 --> 00:20:33,040 our program requires after the clinical session, 332 00:20:33,040 --> 00:20:37,040 they need to take a final examination. And after the final examination, 333 00:20:37,090 --> 00:20:40,960 we have a chit chat with them and they, many of them will share with us. 334 00:20:40,960 --> 00:20:44,600 Before I came to this program, I had these misconceptions. Right. And the, 335 00:20:44,600 --> 00:20:48,920 the number one misconception that that scares people off is they think their 336 00:20:48,920 --> 00:20:53,720 malpractice insurance will go up. I mean, that's kind of fearful. 337 00:20:54,110 --> 00:20:58,250 Sure. But the truth is, it will not go up. In fact, 338 00:20:58,250 --> 00:21:02,770 we've only found one malpractice company in the country 339 00:21:02,960 --> 00:21:07,850 that only had a slight increase in their premium if you were to 340 00:21:07,850 --> 00:21:11,450 provide IV sedation. So what does that tell you? 341 00:21:11,450 --> 00:21:13,650 Do you think the insurance companies are giving a big discount? 342 00:21:13,650 --> 00:21:17,010 Do you think that they're ignoring it? Probably not. Right? Mm-hmm. 343 00:21:17,050 --> 00:21:17,090 , 344 00:21:17,090 --> 00:21:22,090 it's more likely that these insurance companies haven't had claims and no claims 345 00:21:22,090 --> 00:21:24,370 means no additional liability. 346 00:21:24,420 --> 00:21:28,870 No additional liability means no additional premium. So that's a, 347 00:21:28,870 --> 00:21:33,750 that's probably the number one. Number two misconception is it's dangerous, 348 00:21:33,750 --> 00:21:34,570 you know, 349 00:21:34,570 --> 00:21:39,330 and doing it the right way is not only not 350 00:21:39,970 --> 00:21:40,803 dangerous, 351 00:21:41,000 --> 00:21:45,130 it's actually safer for medically complex patients 352 00:21:45,790 --> 00:21:50,580 because those patients when in your chair for a long period of time and 353 00:21:50,580 --> 00:21:54,980 all of their anxiety and all of their fears, and they, 354 00:21:55,300 --> 00:22:00,020 their heart and their blood pressure is raised, whereas on IV sedation, 355 00:22:00,020 --> 00:22:01,380 they're relaxed and they're less, 356 00:22:01,380 --> 00:22:04,740 less likely to have a cardiac event if they're sedated. 357 00:22:05,060 --> 00:22:08,180 Which feels so important given how many, um, 358 00:22:08,180 --> 00:22:11,660 patients we see nowadays with multiple chronic conditions. 359 00:22:11,960 --> 00:22:15,740 And the ones that need the most amount of dentistry, right. Are those patients. 360 00:22:15,740 --> 00:22:17,460 So it's really, yeah, it's, 361 00:22:17,460 --> 00:22:21,260 it's ideal for those type of patients and you need to do a very careful 362 00:22:21,260 --> 00:22:24,540 screening cuz some of those patients should not be treated in a dental office. 363 00:22:24,730 --> 00:22:29,220 Some of those patients need to be treated in a more hospital setting or need to 364 00:22:29,220 --> 00:22:32,780 have a medical anesthesiologist, you know, um, for instance, 365 00:22:32,780 --> 00:22:37,500 patients who have severe C O P D should not be treated with IV sedation. 366 00:22:37,500 --> 00:22:40,580 I mean, we have a whole list of these of course, but, but the, 367 00:22:40,580 --> 00:22:43,700 the standard medically complex patient, the one that's on, you know, 368 00:22:43,700 --> 00:22:46,260 four different medications, those are patients that are actually, 369 00:22:46,260 --> 00:22:49,780 are safer treated with IV sedation. 370 00:22:50,530 --> 00:22:51,600 Of course. Uh. 371 00:22:51,930 --> 00:22:55,240 Another one was that this hard to learn, you know, 372 00:22:55,400 --> 00:22:59,160 we've been teaching sedation now 23 years. 373 00:22:59,160 --> 00:23:02,320 We've kind of figured out the best way for people to retain the information, 374 00:23:02,320 --> 00:23:06,560 to learn the most important things, how to repeat and practice what's necessary. 375 00:23:07,290 --> 00:23:08,123 It it, 376 00:23:08,300 --> 00:23:13,200 the one thing that scares doctors is how do I give a needle in the 377 00:23:13,200 --> 00:23:15,920 arm? Or how do I access a vein? 378 00:23:16,500 --> 00:23:19,040 And I can tell the doctors who are listening, 379 00:23:19,350 --> 00:23:24,040 it's easier to access a vein in the 380 00:23:24,040 --> 00:23:28,360 arm than it is to give an inferior avelar nerve block . 381 00:23:28,970 --> 00:23:32,640 So if you can do that and you do that every day without even thinking, 382 00:23:32,980 --> 00:23:35,920 you can learn how to do, uh, vena puncture. 383 00:23:36,270 --> 00:23:39,540 Another one misconception would be poor return on investment. 384 00:23:39,720 --> 00:23:41,700 But I think we've already busted that myth. 385 00:23:42,220 --> 00:23:44,740 . Absolutely. We have . 386 00:23:45,940 --> 00:23:49,320 Too much downtime is another one I'm thinking about. Whereas, you know, 387 00:23:49,320 --> 00:23:53,160 that's one of the reasons that we designed our program for only four days out. 388 00:23:53,700 --> 00:23:57,160 But they will need to study in the evenings and on weekends. Uh, 389 00:23:57,160 --> 00:23:59,080 but they can do that in their own timeline. 390 00:23:59,080 --> 00:24:02,720 They don't have to be forced to anything particularly except for four sessions 391 00:24:02,720 --> 00:24:07,650 for one hour sessions with our faculty beforehand. And the last one, 392 00:24:07,650 --> 00:24:11,350 which is, which I'm told is very, very, 393 00:24:11,350 --> 00:24:15,390 very challenging for doctors is the application process 394 00:24:16,370 --> 00:24:17,270 for permits. 395 00:24:17,880 --> 00:24:22,390 So when you have to fill out all those complex forms and everything and submit 396 00:24:22,390 --> 00:24:24,590 it to the dental board, it's very nerve-wracking. 397 00:24:24,850 --> 00:24:29,150 And it's one of the reasons that we have a full-time regulatory attorney 398 00:24:29,660 --> 00:24:34,590 that helps each individual doctor with their permit process and screens 399 00:24:34,590 --> 00:24:39,510 and makes sure that their application has all the i's dotted and ts 400 00:24:39,510 --> 00:24:42,790 crossed before it's submitted in. Because the truth is, 401 00:24:42,790 --> 00:24:45,150 is I hate paperwork too. . 402 00:24:47,380 --> 00:24:49,710 I think a lot of folks are with you on that one. . 403 00:24:49,860 --> 00:24:50,870 Yeah. Yeah. 404 00:24:51,880 --> 00:24:56,040 Great. Well thank you so much for clearing up those misconceptions. 405 00:24:56,190 --> 00:25:00,320 I think our listeners are leaving not only with so much, 406 00:25:00,980 --> 00:25:04,530 so many rich insights on IV sedation, but also, 407 00:25:05,470 --> 00:25:06,160 you know, 408 00:25:06,160 --> 00:25:11,090 really tangible ways to get involved in this kind of treatment option if they 409 00:25:11,090 --> 00:25:15,720 haven't explored it already. Yeah. So thank you. Thank you so much Dr. 410 00:25:15,720 --> 00:25:18,680 Silverman. We really, really appreciate you joining us today. 411 00:25:19,100 --> 00:25:20,560 And if, if, um, 412 00:25:20,740 --> 00:25:24,440 the doctors and the managers and people would like to learn more, 413 00:25:24,440 --> 00:25:28,720 they can just go to our website, docs education.com/iv. 414 00:25:29,010 --> 00:25:32,840 We have quite a bit of information on that. And if you'd like to, 415 00:25:32,840 --> 00:25:35,440 you can email me at my email address, 416 00:25:35,880 --> 00:25:40,440 which is Dr MDs docs education or I'm sorry, 417 00:25:40,440 --> 00:25:44,640 docs edu.com. Um, and if you email me, 418 00:25:44,640 --> 00:25:47,600 I'll send you a special coupon, uh, 419 00:25:47,600 --> 00:25:50,400 for $500 off the IV program if you're interested. 420 00:25:51,620 --> 00:25:56,100 Great. Thank you so much for adding that helpful contact info and that offer. 421 00:25:56,100 --> 00:25:57,620 Appreciate Silverman. 422 00:25:57,930 --> 00:25:59,140 It's a pleasure. My pleasure. 423 00:26:00,010 --> 00:26:02,890 Wonderful. Well, it's been a pleasure speaking with you too. 424 00:26:03,110 --> 00:26:06,770 And I'd also like to thank our sponsor today, strategic Dentistry. 425 00:26:07,190 --> 00:26:11,570 You can tune into more podcasts and virtual events from Becker's Healthcare by 426 00:26:11,570 --> 00:26:13,930 visiting becker's hospital review.com.