Dental Digest Podcast with Dr. Melissa Seibert

Join Elevated GP by visiting THEELEVATEDGP.COM In Part 2 of his conversation with Dr. Melissa Seibert, periodontist Dr. David Wong unpacks why patients actually decline treatment — and it's rarely the money or the dentistry. It's the connection you failed to build. He walks through the soft-skill work that's defined his career: reading where a patient sits on the decision-making scale, designing a separate consultation room so he can sit beside patients instead of across from them, and disarming fight-or-flight by finding common ground fast. He also shares one of the most underrated networking moves in dentistry — joining your local Chamber of Commerce — and how it helped him launch a practice from scratch. The second half pivots to the clinical: ridge preservation as a high-ROI skill for general dentists, how to think about bone graft material selection without getting overwhelmed by terminology, membrane selection for beginners through advanced users, and the specific brands David reaches for day to day. About the Guest Dr. David Wong is a board-certified periodontist and Fellow of the International Congress of Oral Implantologists — the only periodontist in Oklahoma to hold that distinction. He completed his periodontal training at the University of Missouri-Kansas City as chief resident, earned advanced implant and oral plastic surgery credentials from Temple University and the Misch International Implant Institute, and has published in the field of oral plastic surgery. Beyond his clinical work, he has spent his career studying the art of case presentation and patient communication. Chapter Markers Time Section 00:00 Pre-roll: Elevated GP 00:49 Welcome and episode preview 02:14 Why patients decline treatment — the connection problem 04:24 The mistake of trying to build trust in one appointment 05:06 Recommended books and resources on soft skills 06:44 Why David joins mastermind groups outside dentistry 08:35 The Chamber of Commerce — an untapped networking resource 10:41 How the Chamber helped David launch his practice from scratch 11:20 Ridge preservation as a high-ROI skill for GPs 12:30 Honest take on dental photography ROI 13:27 Bone graft material selection — keeping it simple 14:38 Allografts vs. xenografts and the global supply reality 15:18 Membrane selection: beginner, intermediate, advanced 16:19 The handling reality of amnion-chorion membranes 17:19 When primary closure matters 17:53 Non-resorbable / PTFE membranes — when they help, when they hurt 19:04 Subscribe CTA 19:20 The specific brands David uses day to day 20:35 The one thing David has invested most in: case presentation 21:09 Inside David's consultation room setup 23:04 Three resources for learning case presentation Key Takeaways On why treatment plans get declined. When patients say "I'll go home and think about it," dentists default to "they don't value the dentistry" or "they can't afford it." David's argument: the most common reason is that you didn't build trust or form a connection. People will spend $20,000 on a European vacation but not on asymptomatic dental work — that's a comparison about trust and felt need, not budget. Connection is a long game, not a five-minute pitch. New dentists try to close trust in a single appointment. David's reframe: you'll see this patient over years. Foster the relationship as long as it takes, and they will do the treatment — maybe not all at once, but eventually. The "I'm the doctor, you're the patient" model breaks in fee-for-service. Patients in a fee-for-service practice are decision-makers, not compliant subjects. You have to meet them as one. Design the room around the conversation. For any case over roughly $1,500, David moves the patient to a dedicated consultation room and sits side-by-side at a table — not across the operatory chair. He pays attention to where he's seated relative to the patient and the door. He has even recorded his own case presentations on camera and had them coached. The Chamber of Commerce is one of the most underused networking moves in dentistry. Every city has one. Dues are minimal or free. You get a room full of local entrepreneurs — publishers, contractors, surgeons, service providers — solving the same problems you are, just in different industries. When David launched his practice from scratch, the Chamber funded part of his open house, ran his ribbon-cutting, and brought a crowd. Get your CE ROI right. Start with skills that pay dividends immediately — molar endo, ridge preservation/socket grafting. They have low downside (a missed socket graft is no worse than not grafting at all), short learning curves, and you'll actually use them weekly. "Sexy" CE without immediate clinical application sits unused. Keep ridge preservation simple. Don't get lost in the 70/30 vs. 50/50 mineralized/demineralized debate. David teaches just two categories: mineralized cortical bone, or mineralized cortical-cancellous bone. That's it. For membranes, beginners should default to a long-lasting resorbable collagen membrane. The fancier options (cross-linked, titanium-reinforced, amnion-chorion, PTFE) are handling-skill problems before they're outcome problems. Case presentation isn't about "salesy words." It's about reading non-verbal cues, responding appropriately, and conducting the conversation — not delivering the right script. Notable Quotes "It's not necessarily just because they don't want it. It's not necessarily just because of financial constraints. It's because we didn't build the trust. We didn't form that connection." "You're going to see this patient more than one time. Hopefully ten years from now they're still your patient — so you have to foster that relationship as long as it takes." "We'll spend $20,000 on a European vacation. We won't spend $20,000 on dentistry when we're asymptomatic and have no known issues." "You spend all that money [on a photography setup] and you still use your intraoral camera to sell single-tooth dentistry. Good job." "Two, three years later, I am the guy where they're just like, 'Dr. Wong, just take my money and do it.'" "A lot of times dentists think that case presentation is using the right words — salesy words. That's not it at all." Resources Mentioned Books on influence, communication, and mindset Influence — Robert Cialdini Pre-Suasion — Robert Cialdini (the "second one" referenced in the conversation) Vanessa Van Edwards' work (and her courses on the Masterclass app) How to Win Friends and Influence People — Dale Carnegie How We Decide — Jonah Lehrer Books by Jonah Berger The E-Myth Revisited — Michael Gerber As a Man Thinketh — James Allen (~50 pages, mindset) Organizations and programs Your local Chamber of Commerce Local Toastmasters (for speaking) Spear Study Club masters program The Elevated GP (Dr. Seibert's virtual study club) Paul Homoly's case presentation program Clinical products David uses day to day Membrane: Mem-Lok resorbable collagen (BioHorizons) — current default Membrane (when available): OsseoGuard / Ossix Plus (Dentsply Sirona) — currently on hold Bone graft: MinerOss mineralized cortical or cortical-cancellous (BioHorizons) Bone graft (alternate supplier): Symbios mineralized cortical (Dentsply Sirona)

JOIN ELEVATED GP Follow @dr.melissa_seibert on Instagram Dr. Dichter brings nearly 20 years of clinical, research and teaching experience — as a general practitioner and prosthodontist — to his position with Spear. He serves as an instructor in the Treating the Terminal Dentition and Fully Edentulous Patient seminar, in addition to multiple Spear Workshops. Dr. Dichter has served as a guest lecturer and clinical instructor at Oregon Health and Science University School of Dentistry, teaching occlusion and esthetics. He has been a Spear faculty member since the company's inception, as well as a contributing author for Spear Digest. He is passionate about education and is involved with multiple study groups in the U.S. and Canada. After earning his D.M.D. from OHSU in 1995, Dr. Dichter practiced general dentistry and eventually joined a startup practice in his hometown in coastal Oregon before moving to a practice in Portland. He brought 16 years of restorative dental experience into UCLA's world-renowned, full-time advanced prosthodontics residency, which he completed in 2014.

Join Elevated GP: www.theelevatedgp.com Register for the live meeting: https://www.theelevatedgp.com/ElevationSummit Download the Injection Molding Guide: https://www.theelevatedgp.com/IMpdf Episode Description In part one of this two-part conversation, Dr. Brian Vence shares a deeply thoughtful and experience-driven perspective on what it actually takes to build a successful fee-for-service practice—one rooted not in persuasion or sales tactics, but in trust, diagnosis, and meaningful human connection. With more than three decades of clinical experience and a career dedicated to interdisciplinary, comprehensive care, Dr. Vence reframes treatment planning as a behavioral and relational process, not a transactional one. He challenges the idea that comprehensive dentistry is something that must be "sold," and instead positions it as a process of helping patients clarify their own values, goals, and tolerance for risk—at their pace, not ours. This episode explores how dentists can meet patients where they are without abandoning ideal diagnosis. Dr. Vence explains why patients often fixate on a single tooth or isolated concern, and how honoring that starting point—when done thoughtfully—can open the door to deeper, more comprehensive care over time. Rather than overwhelming patients with full-mouth solutions on day one, he advocates for sequencing conversations, building psychological safety, and creating space for patients to envision what's possible. A major theme of the discussion is the concept of "Pathways to Essential and Meaningful Treatment." Dr. Vence walks through how environment, language, and timing directly influence patient decision-making—and why treatment planning conversations are often better held outside the operatory, away from the fight-or-flight associations many patients carry with dentistry. In this episode, you'll hear: Why fee-for-service dentistry begins with mindset and culture—not insurance policies How to stop "convincing" patients and instead become a clear, unbiased sounding board Why comprehensive treatment planning is fundamentally about behavior, not procedures How environment and language influence whether patients feel safe enough to future-focus The importance of honoring patient autonomy while still holding space for ideal diagnosis Dr. Vence also shares practical insights into new patient workflows, from the first phone call to in-office consultations, emphasizing the value of curiosity, listening, and slowing down. He highlights why efficiency often crowds out effectiveness—and why the most productive clinical days are rarely about volume, but about depth of connection. This conversation is especially relevant for dentists who feel tension between practicing the dentistry they know is right and navigating patient hesitancy, financial concerns, or insurance-driven expectations. If you've ever felt frustrated trying to align comprehensive care with patient readiness, this episode offers a grounded, humane, and sustainable way forward. Part one sets the philosophical and relational foundation. In part two, the conversation continues into diagnosis, case presentation, and how to guide patients through complex decisions without coercion. This is not an episode about selling dentistry. It's about helping patients—and clinicians—make clearer, more meaningful choices.

Join Elevated GP: www.theelevatedgp.com Register for the live meeting: https://www.theelevatedgp.com/ElevationSummit Download the Injection Molding Guide: https://www.theelevatedgp.com/IMpdf Episode Description Occlusion is one of the most talked-about—and most misunderstood—topics in restorative dentistry. In this first installment of a two-part conversation, Dr. John Kois challenges many of the static, mechanical definitions of occlusion that most dentists were taught in dental school and offers a fundamentally different way of thinking about how the masticatory system actually works in real patients. Drawing from decades of clinical practice, specialty training in both periodontics and prosthodontics, and his experience educating restorative dentists around the world, Dr. Kois reframes occlusion as a dynamic, adaptive system rather than a fixed set of contacts to be checked off with articulating paper. He explains why relying solely on traditional concepts like MIP, right and left working movements, and morphological classifications often fails to predict long-term outcomes—and why this gap is at the root of many restorative failures, postoperative sensitivity, mobility, muscle pain, and patient dissatisfaction. This episode lays the foundation for understanding occlusion through the lens of function, adaptation, and risk, rather than dogma. Dr. Kois introduces key concepts such as pathway wear, jaw position relative to the head, and the body's adaptive responses to occlusal disharmony—highlighting why so many problems are misattributed to bruxism, airway issues, or "parafunction," when the true etiology lies elsewhere. You'll hear why: MIP should be viewed as a terminal position, not the starting point of occlusal analysis Static bite relationships often tell us very little about whether an occlusion is actually working Pathway wear is one of the most critical—and commonly missed—risk factors in restorative cases Many restorative "failures" are actually adaptive responses by the body trying to protect itself Dentists often succeed not because occlusion is ideal, but because patients adapt—sometimes at a long-term biological cost This conversation is especially relevant for dentists who want to move beyond single-tooth dentistry and into more comprehensive care—full-mouth cases, complex restorative planning, implant rehabilitation, and interdisciplinary treatment. If you've ever had a case that looked perfect on the articulator but unraveled clinically, this episode will help you understand why. Part one sets the conceptual framework. In part two, the discussion continues into how these principles influence diagnosis, restorative decision-making, and long-term predictability. If occlusion has ever felt confusing, frustrating, or inconsistent in your hands, this episode will help you start seeing the system differently—and more clearly.

Episode Description Most dentists think of compliance as a background concern—something administrative, abstract, or handled by "the office." In reality, it's one of the highest-risk, most overlooked areas of modern dental practice. In Part 1 of this two-part series, Dr. Melissa Seibert sits down with Evan Sampson, a healthcare attorney with over a decade of experience advising dentists and healthcare organizations on fraud, waste, abuse, regulatory compliance, and risk mitigation. Evan has served as General Counsel to a major dental support organization and held senior compliance leadership roles within the largest municipal hospital system in the United States. In this episode, he pulls back the curtain on what compliance actually looks like in day-to-day dentistry—and why well-intentioned clinicians often put themselves at risk without realizing it. This conversation reframes clinical notes as legal evidence, not just charting formalities. Together, Dr. Seibert and Evan explore how common documentation habits—templated notes, vague progress entries, auto-populated language, and inconsistent coding—can quietly become liabilities during audits, payer disputes, or board complaints. You'll hear a candid breakdown of: What fraud, waste, and abuse actually look like in everyday dental practice (and why most of it is inadvertent) Why documentation and coding errors are among the most common sources of exposure for dentists The legal risks of upcoding, unbundling, and inaccurate procedure representation Why surgical vs. simple extraction coding is so frequently audited How "write it once and forget it" charting can come back years later—with real consequences The mindset shift dentists need: writing notes as if they will be read aloud in a courtroom Why the cover-up—or "fixing" notes improperly—is often worse than the original mistake How compliance, when done well, can actually reveal missed revenue and operational inefficiencies This episode isn't about fear-mongering. It's about clarity, ownership, and professional maturity. If you're a dentist who cares deeply about doing the right thing—clinically and ethically—this conversation will fundamentally change how you think about notes, coding, and responsibility. And this is just the foundation. Part 2 will go even deeper into consent, adverse events, and proactive strategies to protect yourself, your license, and your future. If you've ever thought: "I didn't know that could be a problem." "That's how we've always charted." "The front desk handles the coding." This episode is required listening.