Tongue and Lip Ties

and you want to learn more about them. Anyone who passes the screening “test” is then asked to complete and sign an application (if that hasn’t been done yet) and moves on to an actual interview.

When interviewing:

• Prepare by reviewing the application and developing questions (i.e. don’t shoot from the hip!) • Avoid yes/no questions • Ensure that 60% of the questions you ask are behavioralbased questions • Focus on “fit” over experience • Interview multiple times with multiple people (ideally) • Avoid snap judgments, biases and stereotyping • Allow the candidate to do most of the talking

For the top one to two candidates create opportunities to “unmask” them to get a deeper idea of what they’re like. This could be something like taking them to lunch, which affords an opportunity to see and experience this person and how he or she interact with servers (respectfully or not) and other people. This might prove to be the best $25 you ever spent.

Incorporating the following round out the recruiting and hiring process: skills assessments, job match personality assessment, and reference and background checking – all of which are valuable components to increase success and minimize risks.

Hopefully, this information and these suggestions will lead to a great success moving forward as we being to put COVID-19 in the rearview mirror.

Tim Twig Today’s FDA August 2021

PRACTICE

TONGUE AND LIP TIES

You hear it from parents all the time. “My kid is the pickiest eater,” “We tried to breastfeed, but gave up after a month of issues,” “He’s been in speech therapy for four years.” Many of these complaints fall on deaf ears. The basis for many of these growth and development woes we hear about stem from a functional issue in the mouth, mostly due to restrictions of the tongue and/or lips. If the tongue cannot rest in the palate which is the normal resting position, you’ll see constricted upper arches and airways as well. As experts of oral health, dentists should be on the forefront of addressing these issues. Unfortunately, tethered oral tissue (TOTs) training is absent in most dental school curriculums. The subject isn’t taught even in pediatric residencies and if it is, proper diagnosis and treatment is not.

Many of the above issues stem from TOTs namely tongue and/ or lip ties. Parents often turn to their pediatricians for advice on these issues and are told there are no “tongue ties” present or the child will grow out of it. Pediatricians unfortunately also lack the formal education needed to properly identify functional issues in the mouth. Many are only concerned if the patient can’t stick their tongue “out,” but posterior lift/function is a huge part of normal tongue function. This can be disheartening because as one “issue” passes, another can occur. Even adults with TOTs are affected as they typically have sleep, breathing, head and neck tension issues. The good news is, with the right questions and some simple exam techniques, we all can start to identify issues early on and help many patients thrive!

It’s estimated that up to 30% of the population has some sort of functional restriction in the mouth. New, higher-level research is being done to turn the “fad” of tongue ties into a legitimate issue that all dental and medical providers can learn about. Great educational resources are becoming more available to people all over. Dr Richard Baxter, a pediatric dentist who runs the Alabama Tongue Tie Center and Dr Soroush Zaghi, an ENT who runs the Breathe Institute, are leading the way in both research and education. As more is done to investigate TOTs, more providers can understand what to look for and how to properly treat those issues. Releasing these tissues can be easily done with numerous instruments, although soft tissue lasers allow for quicker, cleaner and better healing than many other options. It’s important to understand that these procedures release the tissues, but without proper function, many patients will still struggle. The procedure needs to be done with a team to help with this. For infants and moms struggling with breastfeeding, working with lactation consultants and body workers is crucial. For adolescents with speech and/or feeding issues, speech language pathologists help support the healing process and teach the patient proper function. Even adults with issues need support around their surgery, which is typically done with the help of a myofunctional therapist and body worker.

When a proper assessment is done with a clean surgery and the correct support is provided, fixing TOTs issues can be lifechanging! Helping a patient speak more clearly, eat without struggles and sleep more peacefully is extremely rewarding – and with a little more training, all dentists can start asking the right questions and helping more patients daily.

Dr Casey Lynn Today’s FDA August 2021

THE ALTERNATIVE P.P.P. PLAN

In the many years that I have been a dentist, I’ve heard too little counsel given to the happy, well-adjusted, high-producing dentists. Those lonely inhabitants of what must be the most neurotic group in dentistry. No ADA Journal articles probe their ability to cope with the pressures of dentistry. No research studies examine their sturdy mental health. At dental meetings they sit contently while the emotionally unstable reveal their problems. They simply do not belong.

Yet there is hope for this stable, well-adjusted group. With effort, problems can be created, guilt induced, sorrow generated, and self esteem destroyed. The following “Principles of Problem Production (P.P.P.)” earnestly applied, can make these out-of-step dentists as miserable as the rest of us.

Snowballing.

If you face problems when they first appear, they tend to vanish away. Don’t let them. Let them get a firm foothold on you. Let them snowball you. The best “snowballers” practice a simple rule, which is, “when it is past time to do something about a problem, wait a little longer.” With staff, for example, refuse to express feelings of irritation or disappointment for days, even weeks. This will allow enough pressure to build up to blow any work relationship apart.

The Reverse Allen.

Dentists who refuse to internalize their problems and assume problems that belong to other people, are hopeless failures at problem production. However, by reversing their attitude we formulate one of the most clever problem producing techniques. Suppose a patient refuses your treatment plan. Immediately assume that it is your fault. Internalize it. Blame yourself. Before long you will have worried yourself sick.

The I-told-Me-So Syndrome.

The idea here is that we expect bad things to happen, making them more likely to occur. If you are going to a dental meeting, for example, predict that you will have a terrible time. Make yourselves believe it. When you get there, sit alone away from the action. Avoid meeting new dentists. Then, later gripe and moan about the fact that no one would have anything to do with you.

Negative Focus.

Don’t let men like Dale Carnegie and Norman Vincent Peale blind you with their positive principles. Real power lies in negative thinking. Remember the times when you were treated unfairly or when someone spoke unkindly to you. Say to yourself “I am always misunderstood and mistreated by my staff and patients.” Beware of the intrusion of happy thoughts. If you should think of something good about yourself, quickly remember a corresponding weakness. Focus on it. Internalize it. You can generate anything from anxiety to depression with the skillful use of negative thinking.

Barrier Building.

If you discover that friendship and unity has occurred in your relationship with your staff or patients, don’t panic. Several general principles, constantly applied, will soon restore those cold, uncomfortable barriers. First, never give compliments. Indeed, avoid any encouraging remarks. Next, set up criticism. Nag, complain, fuss, judge and blame others. Avoid being reasonable. Demand everything be your way. Tell your staff, “as long as you work for me, you’ll do what I want.” In no time at all, you will build up a satisfying wall of resentment.

The Martyrdom.

All that is needed to become a John or Joan of Arc is a reasonable opportunity. Dentists can overburden themselves with work, family and other responsibilities, then say to themselves, “No one cares about me. As far as my staff and patients are concerned, I’m just another slave. I work my fingers to the bone and beat my brains out for everybody and no one gives a darn. Everyone uses me.”

Burning yourselves at the stake not only generates bad feelings in yourselves, it also disgusts and irritates the people around you. This enables you to feel even worse.

These Principles of Problem Production clearly illustrate the control we have over our lives. They suggest that we not only can, but do, create for ourselves problems and unhappiness. If you recognize yourself in any of these principles, I hope you have been able to say,” Hey, that’s what I do, but I’m going to try and stop doing it now.”

We will not always have the privilege to do everything we want in dentistry, but we do have the power to enjoy most of what we do. Joy and success, or sadness and failure, are equally the offspring of our thoughts and actions. The choice is ours.

Len Aste, DDS UDA Secretary