March 27, 2024 • 37 mins
Get insights into the world of specialized dental care as Dental Wealth Nation showcases a compelling discussion with Lisa Kerbo, an experienced dental hygienist renowned for her work with special needs patients. This conversation is a must-listen for dental practitioners eager to enhance the inclusivity and diversity of their practice.
The episode is filled with stories of Lisa's journey, her transitional challenges, and how she succeeded in integrating special needs care into her practice. She generously shares how continuing education and active volunteering are initial steps towards embarking on this journey of unique patient care.
This conversation also delves into the pivotal aspects of legalities and hospital credentialing. Lisa offers valuable recommendations on where to focus when venturing into this specialized field of dentistry. The episode firmly emphasizes that a practitioner's commitment to inclusivity can make a significant difference in the life of a patient with special needs.
Remarkable wisdom also stems from the-heartfelt experiences shared by our guest about accommodating patients with chronic illnesses and dementia. The conversation provides a clear illustration of how to assemble and reinforce a dedicated team, while also driving home the significance of comprehensive caregiver involvement as a cornerstone for customized patient service.
One innovative highlight of the discussion is Lisa's 'Dental Sensory Kit', designed to acclimate special needs patients to a dental office environment. This component of the conversation underscores the episode's core message: By taking strategic steps and staying committed, dental practitioners can create an atmosphere that is not only integrative and productive, but also immensely comforting for special needs patients.
Listen to this engaging episode for expert advice and firsthand insights into making dental healthcare more accessible, more inclusive, and profoundly beneficial for all patients, regardless of their unique needs.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:03):
As a driven dentist, you see the world differently, where some see scarcity, you see abundance.
When others want to give up, you keep going. You're building an amazing life of significance.
That means you can't rely on ordinary advice from ordinary advisors to get to your goals.
You want advice that's going to help maximize your net
(00:24):
worth so you can take even better care of the
people you love the causes you care about and
make your dent in the universe but the
fact is this advice remains hidden because relatively few professionals are
well versed in them and the extremely affluent don't care to let you know about
them join us as we pull back the curtain to reveal the often hidden advice and
(00:49):
strategies used by today's most successful individuals individuals, and families.
Welcome to Dental Wealth Nation. Here's your host, Tim McNeely.
Welcome everyone to another episode of Dental Wealth Nation.
And at Dental Wealth Nation, we're all about helping you build an amazing life
(01:09):
of significance where you can have even more impact on the people you love,
the causes you care about, and really make a significant significant impact
in your practice for everyone who walks in those doors.
And that's why I'm so excited about today is because by the time we finish today,
you're going to have a framework and you're going to walk away knowing that
anybody can work with special needs patients.
(01:30):
More importantly, you're going to have some tips and tricks and strategies that
you can use for those special needs patients that are already in your office.
But most importantly of all, you're going to walk away feeling empowered and
ready to treat those special needs patients with with confidence.
And when it comes to helping dentists do this, I don't know of anyone better than Lisa Kerbo.
And Lisa really comes to us with experience in this area firsthand.
(01:55):
She has a son who's special needs and really just has that empathy and that understanding.
And she works in a dental office. She's an RDH and you're going to get to learn
firsthand from a caregiver who understands this area better than most people
out there. Lisa, welcome to the show.
Thank you for having me. I'm excited to be here. Oh my gosh,
I am just so thrilled about this because, like I said, we want to make a difference
(02:19):
for everyone in the world.
And sometimes segments of the population get overlooked because of a fear,
misunderstanding, or we just don't know what to do.
And so that's why I'm so excited to have you here.
And so give me a little background on you and really what drew you to this area
to focus on treating special needs patients in a dental practice. this?
(02:40):
Well, my oldest son has Asperger's, which is now ASD1.
And so I have a nephew as well that has Asperger's as well.
So I've kind of had that in my family for a while and it's just given me a heart for it.
And I have had patients for many years with special needs and I just feel like
there's so much we can do for them and there's getting to be more and more out
(03:02):
in the public eye where we see them regularly.
So we see a lot of patients that are special needs in my office and And I just,
I feel a special sense of protection around them, want to help them and treat them really well.
So as you were growing up with a mom, with a son who has special needs,
did you make some dental trips?
(03:23):
Did you go to the dentist's office? What was that like?
Well, for me, my son is very high functioning, but because I'm a dental hygienist,
we started with teeth very young.
So for me, it was constant. constant, I was always looking in their mouth,
which I think really helped to desensitize them to that.
Whereas a lot of special needs are not desensitized to it. So it's a little
(03:43):
bit more traumatic for them. But for us, it was, let me see your teeth.
Let me see your teeth. I mean, this was on a constant basis.
So for them, for my son, it's like, okay, this is just part of everyday life. So.
Okay. And so have you seen some challenges with parents coming in with special needs kids?
And what are the challenges you typically see them face?
(04:05):
Well, it varies very widely because every special needs patient is different.
Just like every patient is different.
You've got some that are very excited to be here, just like your neurotypical patients.
You can walk in, do everything that you need to do without any concerns.
And you've got those that you might not even get them into the office.
You might barely get them back to the operatory, maybe not even in in a chair.
(04:28):
So it, it ranges very widely. So every person you're going to do something a
little bit different with,
you need to be able to roll with the punches and change your flow so that you
can go with what they need and kind of tune into them and see what it is that
they're comfortable with.
So, I mean, this sounds like something where you really do need some experience
(04:52):
and really know how to do this, because it sounds like right when these patients
come in your practice, you're really not quite sure what direction this could go in.
And so I bring that up to say, right, if you're a dentist, if you're thinking
about starting to integrate this into your practice, what are even the first
steps you should really take to become successful and know how to work with
(05:14):
special needs patients?
Well, I know they've integrated it now with CODA into the schooling,
but for those that after the fact may not have, or sorry, before that became
part of it, that just depends on what they've had coming into their office.
So continuing education is very key in that even volunteering at places that
(05:34):
have special needs to have some exposure to the special needs patients gets
you a little bit desensitized to it so that it's not so scary to do.
In my office, I've made a special needs questionnaire so that we can send it
out to the caregiver before they come in, which gives us a lot of information
on what's worked for them in the past, what hasn't worked for them,
(05:56):
what their home care is like.
And that gives us a lot of insight before they ever even come into our office
so that we're able to kind of get an idea of maybe what will and won't work.
So we know where to push and not push.
Okay and so really those initial steps are
just continuing to get education through ce courses
(06:17):
or are there other avenues that a doctor can
turn to as they're taking those initial steps to really
gain education in this area there's lots of online articles there's a lot of
support groups that you could actually go into like watch videos for the different
support groups for like autism awareness and ADHD awareness that they're like
(06:40):
on Facebook and YouTube.
They can help you get more comfortable with seeing what they're like,
talking with your other dental professionals that see them or your medical professionals
that see them to get some tips and tricks on what you should and shouldn't do.
But being around them, once you've done a few, they're all different.
But once you've done a few, you kind of get your foot in the door and you get
(07:02):
a little little more comfortable with it.
And as you get more comfortable, you start to be in tune of what you can and
can't do with them. So practice. There's a lot of practice.
Now, I mean, this may be a question that's really obvious, but I don't know the answer to it.
But how does this fit in with the Americans with Disabilities Act and the requirement to treat patients?
(07:23):
Is this something that all dentists must be equipped to and ready to treat?
Or can they refuse treatment on a patient if they're not equipped to treat them
well? So they can if they're not comfortable with it, then they can say we're
not like they're not set up for it. We're not set up for this. We're not comfortable.
This is past my area of expertise.
(07:43):
You might be better served here. And that's also good for the patient when that's
the case, because you don't have someone who isn't ready for that,
which may not work out well.
They may scare the patient enough that they don't want to come back.
So it happens in that it's kind of sad that it happens because it happens more
often than it should because more people should learn how to do it.
(08:05):
But you're not required to because if someone is totally uncomfortable with
it and you require them to do that, that's not going to be a good experience for anybody.
Okay. So this isn't necessarily a requirement, but it's something like you said.
That as the population of special needs patients continue to grow,
it certainly is an area that most dental practices should look at being able to treat. Yes.
(08:30):
And so now you are at a dental practice now, and you help manage the special
needs program that's there.
And so how did this start, and what have been some of the results that you've
seen as you've added this to the practice that you're at?
Well, I'm clinical and admin side. I'm on both sides. And so we started,
I've seen off and on for my whole practice, but I would say probably a good
(08:53):
15, 18 years ago is when I started seeing some more severe special needs patients.
And start a little bit and work your way through those. And then we get a few more.
And then the word kind of got out that we started to see them because the doctor
I work with has a very big heart for special needs as well.
Then we got credentialed for the hospital. And because we can take patients
(09:15):
to the hospital for general sedation,
because a lot of special needs need it, not all, but quite a few,
then that kind of got the word out that, okay, they see special needs, they can sedate.
And so that sends more and more.
And the special needs communities talk to each other.
So when they say, I'm having trouble finding a doctor, where do you go?
(09:36):
Then they're saying, we're going to this doctor and we're going to this office.
And so the word gets around pretty quickly.
And other dental offices heard that we see them.
And so other dental offices are referring to us as well to say,
hey, we've got this special needs patient. They need to be sedated.
You know, it's kind of past our area. We can see a lot of them.
(09:59):
Now, kind of coming back to that education piece, right?
You're a doctor, you're considering really upping your education because you
have a heart for this and you do. You want to serve the community.
What are some of the first things that you can really spend your time on learning
about when it comes to special needs?
Needs. So I would pick some of the main ones that you would see the most like
(10:21):
Down syndrome, autism, ADHD is considered a special needs as well.
Just some of those really more common ones and look more into the medical side
of it and just kind of the background of it.
So you're a little more familiar with the different aspects of it.
Not knowing that Down syndromes tends to have heart issues doesn't mean you
(10:43):
can't treat them because it's not a lot different than say you're 70 or 80 year
old patient that has heart issues as well.
So it, a lot of it's similar to what you've learned. You're just putting it
into a different category.
So people will say, well, I can't see them. They have a heart issue,
but they will see this adult male that has a heart issue.
It's not really that much different, but just getting into the medical side, just some backgrounds.
(11:08):
Again, I still think volunteering with, if there's anything around you that
has works with special needs, if you can volunteer to work with them,
that would be fantastic because you get to be in their element and see what
they're like and how they react with people.
Okay. So that's kind of your recommendation is really, if you want to jumpstart
this, right? All the education's great. All the CE is great, right?
(11:30):
We never want to downplay any of that, but you really kind of got to jump in,
so to speak, and just start doing and volunteering at an organization may be
a great way to do that. that.
Yeah. Okay. What would be some of those organizations that a dentist might look for?
Well, in every community is going to have something a little bit different,
some, but some, even like an autism awareness walk, they tend to have walks for those.
(11:53):
Our community has some day programs and probably some evening programs,
but day programs where you could go and maybe volunteer for a day here and there,
just working with them, sitting with with them, reading with them.
Different programs have different things that you can do with them. So contact those.
You can usually even just Google special needs programs near me and they'll
(12:16):
come up with the different things that are around you.
There's group homes as well and sometimes they'll allow you to come in.
Every community is different on what they have. They're minimizing the amount
of groups homes they have because they're trying to get more patients back with
or they're patients to us, but they're trying to get the special needs people
back with their families and less in group homes.
(12:37):
Used to, it was always group homes and they're trying to get further and further
away from that. And every state's a little different on how many group homes they have.
Okay. All right. No, that, that's certainly helpful. And then kind of coming
back to the, the practical aspect of in your practice, right?
When you started kind of rolling this out 18 years ago, what were the really
(12:58):
kind of first steps that you took, like the, the practical tactical stuff that
you started doing in the office to really get ready for this?
I heard you mention even, you know, really working with the caregivers before
the patient comes in, or are there other things that, that you should be considering in your practice?
Well, knowing that they need more time. So you might have a particular person kind of picked out.
(13:22):
So like in my office, I see them all first.
So if they're really more like a neurotypical and they're able to come into
the chair and do everything, then after I've seen them, then they may be with another hygienist.
Or if they're not, then they may stay with me. But having kind of a person picked
out that's going to be a little more interactive with them at the beginning
so they can kind of learn what works well for them, what doesn't.
(13:45):
It's hard if you've got multiple, say, hygienists, like I'm a hygienist,
and each one doesn't know the difference.
But like this one knows that they don't like to be talked very loud or don't
like the TV on, and this one doesn't know it, and they come in and do that.
Whereas if you kind of have them with the same person for a little while,
you get to learn those different things about them.
And when you can get ready to pass them on, if you need to pass them on,
(14:08):
you can share that information, working with the caregiver to find out ahead
of time that information so that when they come in, you're kind of prepared.
You either don't have something out they don't like or have something out that they do like.
Like they love sunglasses and you can have clear or sunglasses.
Make sure you have fun sunglasses for them. or they know that like a particular
(14:31):
toothbrush, if you can have that toothbrush or certain something on the TV,
things like that, knowing that ahead of time is really good.
But definitely having one person in the beginning working with them is helpful.
Okay. So really kind of having that singular point of contact who can,
who can really kind of serve as the treatment coordinator for this patient is
(14:53):
very helpful then is what I hear you you saying?
When you start out, yes, definitely.
Okay. And so how has that evolved for your team in your office over time then?
So like for our team, when they call the office, my front office team is really
good about asking those questions.
And then we have that questionnaire that can go out to the caregiver.
(15:13):
They make sure they put them on my schedule and allow me enough time to either
do not much of anything depending on the patient or do everything.
So we work with my schedule to be able to allow that to happen.
And then just good communication of making sure I know this is a special needs patient coming in.
Here's what the information we got until we get their paperwork back.
(15:37):
Here's what we know about them so I can kind of prepare and plan for them.
Okay. All right. Very, very fascinating. And even earlier, you mentioned credentialing
with hospitals, and this is something that the dentist you've worked with has gone through then.
Yes. So we go to an ambulatory surgical care center. Some people will go to
(15:58):
the actual hospital in an outpatient setting.
So I know there are some hospitals that will not allow a dentist to come in
that is not a pediatric dentist who does not have that board certification.
But in our area, we're able to do that. And I know a lot of other areas are,
so you can get credentialed to come in.
Generally an anesthesiologist or a nurse anesthetist is the one doing the anesthesia.
(16:22):
So you're, it's not part of your license.
You focus in on the dentistry while they take care of the patient.
As far as the anesthesia goes, you can get everything done in one sitting,
just about depending on what they need.
Get one big sitting, give them a good reset. And then then maybe after that
they can go into the office.
Like I have some, I can clean them in the office, but the treatment is too hard
(16:45):
on them in the office with the anesthetic and how long they have to sit there.
And there's more involved obviously with the dental treatment than the cleaning
that all the drill sounds and stuff that they're not really quite used to.
So we get them a good reset. Then they come back and we're able to keep them
clean in the office and prolong them them having to go back to the hospital.
(17:05):
Okay. And so do you really kind of, is there a transition period then between
working in the hospital to working back in the practice?
Everybody's a little different. So we've got those that every cleaning is in
the hospital, but we don't take them every six months when that's the case.
Generally, it's about once a year, maybe once every 18 months,
depending on the patient.
(17:26):
But if they can be treated in the office, then once we get them reset,
then we just bring them back in at their regular time period and start cleaning them.
And a lot of them want, because we didn't do too much to them in the office,
they're not too scared to come back to us.
And we're able to just work them into the regular schedule.
You just have to play it really by ear. I have some patients that they stand
(17:49):
in the corner. They come in, they stand in the corner.
We barely get a look in their mouth and it's like, okay, that's all we can do
to you. And we know we take them to the hospital, do everything there,
their exam, their x-rays, any fillings we need.
And now they're reset until we can see them again in about a year and work with
parents or caregivers on home care to try to minimize what we have to do besides
(18:11):
the cleaning and stuff when they go to the hospital.
Okay. So, so what I kind of keep hearing in a lot of your answers to these questions
is it, is it really comes down to, to knowing the patient really,
really well and being able to provide that customized service so that they feel safe,
they feel comfortable and they, they get the care they need.
(18:32):
Is that really what I'm hearing?
And that, it sounds like that might be the best advice you can give someone
is just get to know the patient.
Yes. Yeah. Get to know them, especially through their caregiver,
because a lot of them are nonverbal, but their caregiver knows them best.
They know that, hey, we've never been able to do anything in the office.
OK, you tell me that before they come in. I'm going to kind of plan for that.
(18:55):
But see if maybe I can do a little bit.
Maybe I can do a photo where they've never been able to do a photo before.
Well, if that works and they see their teeth, maybe I can do an X-ray.
All right. Now we've got an X-ray. They've never done that before.
But listening to the caregiver and knowing what is possible or what has not
been possible and then saying, hey, what do you think about us trying this?
(19:18):
They are in tune with them and they can feel their body language.
You can feel their body language and they can feel yours.
So if you're really scared and fearful when they're coming in,
they're going to know it. And that's it.
You're not going to get a lot done. But if you, when they come in and if you're
happy and kind of positive and upbeat, you might get further than anyone's ever gotten before.
(19:39):
Wow. Oh, that, that has to be so rewarding. It really is.
It really is. I had one the other day. Mom said she, she came up and she gave
me a hug and mom said, she doesn't hug anybody but family members.
She said, there must be something special about you. I'm like,
there's, there's nothing special about me.
I just, I love them. I love them. And she said, well, she can feel it.
(20:02):
Wow boy and i can feel it too just talking
to you lisa your passion your care your concern just
really comes through and i right and
i guess that's the other thing right how important is
it that the team's heart is really in this as opposed to it's just well we got
to do this right like how big of a difference do you think that makes i think
(20:23):
it makes a big difference having everybody on board makes a difference because
if somebody is really not wanting to do it at all they're going to make it harder for you.
So just getting everybody on board saying we want to do this.
We want to help out this population.
And there's good reasons for it, even financial reasons for it,
because you bring in one special needs patient. Well, they have a family.
(20:45):
So you brought in that special needs patient. Now you may have in siblings.
OK, now you may have in parents.
Maybe you have maybe like we do orthodontics some as well.
So we've brought in all the siblings and And the parents and then some siblings
have done orthodontics.
So that one special needs patient has brought in all kinds of stuff.
So there's a good financial reason for it as well. Not to mention just there
(21:07):
are so many special needs patients out there and they deserve our care and they deserve good care.
But if you have somebody who's not on board, it does make it harder.
Just try to get the team on board. We're going to do this. It's important for
the patients. It's important for the practice. It's important for the community.
And I want to come back to those statistics in a moment, but coming back to
(21:27):
the team here, as you were rolling this out or as you've worked with offices,
have you seen resistance in someone as the office is really trying to get going?
And how do you handle that resistance? distance?
I haven't run into it too much because I think the majority of people want to be helpful.
They just don't know how to do it. So I really haven't run into that too much.
(21:51):
I'm sure there is some out there and I've run into it in stories where the patient's
family have come in and telling us about a previous office they've been at where
they've come in and they said that they got in there and they got in the waiting
room and the front desk came out and said,
we're not going to to be able to see you. We're not going to be able to treat you.
We're not set up for it. So I've had stories about it, but I've not run into
(22:12):
people that I have come in contact with that are unwilling.
Okay. So it's really just more of the offices not being set up for this and
not really having the knowledge to know how to do this then.
Yeah. And the comfort level.
And I think the comfort comes with knowledge and practice.
Okay. So, you know, you mentioned the stats. Do you have any stats on on special
(22:35):
needs patients and really just how big of a, of a population this is?
I, I do it, but I'm, it's not in my head exactly, but I think it's something like one in 45.
I may be wrong on this. I thought it was like one in 45.
Um, people now have some kind of special need.
I could be totally off on that number because it's been a little bit since I
(22:56):
had that number memorized, but it has become a lot more prevalent because for
one they're, they're diagnosing better. So you've had preemie babies that before maybe didn't make it.
Well, now with medical intervention, they are making it.
And so therefore, they've got special needs that go along with the preemie.
So that medical intervention is increasing that.
(23:18):
Also, better diagnostics. So now they may have been out there before,
but we didn't know that's what they had. So now they're being diagnosed earlier.
And also just being in the community. Whereas when I was in school,
you had the special needs and they were inclusion.
They were in inclusion. So they were in their own special classrooms and now
(23:38):
they're in the general population.
So kids are seeing them in school because they're trying to get the mainstreamed.
So it's becoming more, we're becoming more aware. And again,
the numbers are increasing.
Wow. Well, right. And this is just so huge and so important.
I know in the financial world, this is something we certainly deal with also,
(23:59):
just in working with parents of special needs and setting up special needs trust
and really making sure that the child is going to be taken care of.
And so I love that you're really pushing this forward in health care also and
in the dental office because it's so, so important.
And, you know, you really do have a unique background in this too,
Lisa, right? Dental hygienist, office manager.
(24:21):
I think you've done the hospital coordination as well as your personal experience.
And so, you know, how do you think those have really played together in a way
that you're able to share and help these practices do this and really do it well?
Well, because I know all the sides of it, it really helps for me to be able to explain it.
Whereas if I was just coming from the hygiene side, I could talk about the clinical
(24:43):
side, which is very important.
But doing the hospital coordinator, I can talk to them about here's how you
need to do this side of it.
And office manager, here's the financial side of it, of how it helps your office.
So I really think it helps me be able to talk to all the different parts of
the office to help everybody get on board on how they can do this,
(25:04):
how they can integrate it into their office and make it make sense for them.
Well, and you bring your unique experience to stages in dental conferences all
over, don't you? Yes. Yes.
So tell me a little bit about what you're doing there and the education that you're offering.
Well, I've got some conferences coming up that I'll be going to.
So I speak on special needs in general so that I talk about the different parts of it.
(25:27):
And again, kind of like we're talking about today, how they can implement it
into their office, give them background information, some tips and tricks on
how to help these patients.
I also talk on chronic illness and dementia.
I have a spouse who has chronic illness. And so that's kind of given my heart that way too.
And I'm the caregiver to him as well. So that gives me a little bit of insight
(25:49):
on the caregiver side, as well as like my son having Asperger's.
But like I said, he's very high functioning, so he actually can live totally
independent and he has a career.
So he's very, very good with that.
Well, excellent. It has to make you proud as a mom. It does.
Oh, that's excellent. And you've
also created some unique things for your practice, too, to really help.
(26:13):
And one of those is a dental sensory kit. I've never heard that term before today.
And so walk me through what the heck is a dental sensory kit?
Because I'm guessing a lot of our listeners have never heard that term either.
No, so this, I'll pull some of the stuff out. This is a dental sensory kit.
I make, you can put them in like a pencil box or just a little clear box.
(26:33):
So I'll just walk through some of the few things that I put in there.
You can make them on your own, or I eventually will be selling them on my website
if you don't want to make your own.
So simple things so that like the caregiver can do practice visits at home.
And that's a lot of it is desensitizing them. They They have a lot of sensory
issues and we have all kinds of tastes and textures and new things that they don't use at home.
(26:56):
So if you do a dental sensory kit, you can have practice visits at home and
they can be exposed to a lot of this many, many times before they come into the office.
So simple things that we all have is mask and bib and gloves so that the caregiver
can do that, put that on and kind of be the dentist or be the hygienist.
They can put the gloves in their mouth and see what it tastes like kind of get that feel.
(27:20):
Also put a suction in there which we
all have so they can feel what that feels like because it's a foreign taste
either be plastic or if it has a taste to it but it's a weird feeling nothing
like it at home and so that would be a good practice i have a little bite blocks
so that they can practice having something hold them open feel what that feels
(27:41):
like to be open what's a good comfort zone?
Is it too far back? Does it activate their gag reflex?
But the more they practice with that, then if we use that, then it's not so big of a deal.
We all have profiangles. I put profiangles in there so they can feel it.
They can touch it. They can rub it on their teeth and see what that's like.
I put profi paste in there because that is a big texture thing for them.
(28:03):
It's very gritty. There's all kinds of flavors.
Mint is a little hard for a lot of them because it's really spicy.
So a lighter flavor is a good one to send home with them. But that way they
can taste it. They can feel that texture.
Just put a little bit like on their tongue and they feel it.
Then you can do that multiple times so they get a little more used to it, a little more used to it.
(28:25):
I put a mirror in there, a disposable mirror, so they can practice with a mirror
there. They can do it themselves.
Their caregiver can do it, but it also helps their caregiver.
If they're trying to look in their mouth and see something, it gives them that opportunity as well.
I've put in a toothbrush, a regular toothbrush. There's a one called the triple brush.
(28:45):
And it kind of I have one, but this is not my favorite.
And I don't know if you will be able to see it. I will do my best to get it up there, right there.
Yeah. All right. Yeah, that looks very good. But it brushes all three sides at the same time.
And so that way, if you're not able to brush them very well,
it gives you an opportunity to do more in a short amount of time.
(29:06):
There's another one I'm looking at that's electric. It's not a triple brush.
It's a totally different one. I'm hoping to get some practice with that pretty soon to see.
And then this is the one people will question me on. I put a fluoride tray in
there. But I don't put it in there for fluoride. I put it in there because you can take it apart.
And then let's say they need to have an impression. That usually isn't going
(29:26):
to go well at first because they got something in their mouth.
They've got something gooey in their mouth, but you can take it apart and practice
putting it in and letting them sit.
Five seconds, maybe at first, then maybe 10 seconds, 20, and then just work your way up.
That's the thing about desensitizing is it's you do a little bit,
then a little bit longer, a little bit longer.
Sometimes it never works. Sometimes none of this will ever work.
(29:50):
Every patient is so different.
But if you try, you might find that it does work.
And now we can clean them in the office because they've been exposed to all of this.
But these are really good to have these little kits at home to do those practice visits.
So that it's not so new and boring to them. It's they've had a chance.
So I'll be selling those just more. You can make them in your office because
(30:13):
most of this stuff everybody has.
But I think it would be a good thing for a lot of people to have those.
Oh, yeah, no, absolutely. And that's so amazing. I just put your website down in the comments.
And if you're listening and you have any questions for Lisa, please chime in.
This is your opportunity to ask questions and learn from an expert in this area.
(30:34):
And so we're having an amazing conversation on how you can treat special needs
patients in your practice and really just make a big impact for just an amazing
part of the population that's out there.
And Lisa was just sharing that dental sensory kit. What a great idea, Lisa.
And what a great way to really help the patients.
And so, right, you know, we've been talking just about all these things.
(30:57):
So what are some of the benefits that you've seen to your practice over the
last 18 years as you've really been working in this area?
Well, it's actually increased the amount of patients. It brings in new patients because they're new.
The special needs patient will be new. And like I mentioned earlier.
Because we were successful with them, now siblings, parents are like,
(31:19):
well, you see siblings. Yes, we'll see their siblings.
Then I said, well, do you see adults? Yes, we see adults. So now the parents come in.
And because our office also does orthodontics, they'll say, well,
this kiddo needs orthodontics. Do you do that?
Yes, we do. So now we can do orthodontics on them.
So because we saw the one special needs kiddo, we brought in an entire family.
(31:41):
So we get all the treatment for an entire family. So not just cleanings,
but, you know, your fillings, your crowns and orthodontics so that one kiddo can bring in a whole lot.
Well, then that even their extended family or special needs community is very
tight knit and they can say, well, who do you see?
Well, I see them and then they will go and call us. And now the same thing starts over.
(32:07):
And then when you're in the hospital, it's a benefit because if you can do all
that work in one sitting, that's extremely productive.
Whereas let's say it takes an hour to do, we'll say two fillings for a special needs patient.
If you could do it, if you could do it now in an hour in the hospital,
you can do maybe six fillings.
(32:27):
That's a lot more productive and that's just a very small
example if they need crowns well you can if it takes an hour and a half to do
a crown in the office it doesn't take that long to do a crown in the operatory
and you've got maybe they need three crowns we can do all three crowns because
they're under sedation you should get them all done wow it can be very productive.
(32:52):
Okay. Productive and rewarding, right?
What a great combination. Oh, that's so exciting.
Yes. We've had some parents that they come out because they had a decay in the
front and were missing teeth and broke it off.
And we were able to do, not everybody's a candidate for it, but we were able
to do a bridge and the mom was in tears because like my baby has beautiful smile again.
(33:13):
So sometimes that works really well. It just, you have to,
look at each patient as what's best for the patient. But in those cases,
boy, do you feel good after.
Yeah. Wow. Well, and this really addresses a lot of access to care issues too.
And so, I mean, what's your view on how this really fits in with access to care?
(33:34):
There is a struggle with access to care for special needs. There definitely is.
And we hear about it regularly when they call us and they say,
we haven't been able to find anybody.
I've got patients coming to me from four hours away because they haven't been
able to find anybody local that's willing to see them. Wow.
So if the more people are comfortable with it, it increases their access to care.
(33:57):
And we just, with more people that are, that we're finding their special needs
or that are being diagnosed, we need more dentist offices that are able to see
them. So they're not having to travel.
They are used to traveling because a lot of their doctors are in specialists are in the bigger towns.
But if we could maybe cut down some traveling and have something more local
(34:18):
for them, that would be great.
Now, this is so exciting and so beneficial.
And Lisa, how can we find you? I've put your website in there,
but what are some of the upcoming conferences that you'll be at and how else
can we get in touch with you?
I'll be at the Special Care Dentistry Association meeting that's in September.
And I'll also be at what we have, have the Smile Source Exchange.
(34:41):
I'll be that in September as well. And then just some local groups I'll be around.
I also have articles in RDH Magazine, RDH eVillage, and Today's RDH online.
So if you Google my name, Lisa Curbo RDH, those articles will come up.
They're also on my website as well.
Yeah, I know your website is really a wealth of knowledge and you've contributed
(35:02):
some original thought leadership here. And so what a resource.
Thank you for doing that. Thank you.
And so before we sign off here, any closing thoughts?
Just like some of the tools that you might want to use. You don't have to buy special stuff.
Some things you can, but like you can get pool noodles to help have them have something in the chair.
(35:24):
You can buy wedges on Amazon that you could use in a bed.
You don't have to get specific dentistry stuff for some of these things. Weighted blankets.
Ask them what they have at home that works for them and have them bring it with it.
Bring it with them. So anybody can do this.
You just a little bit of comfort, a little bit of practice, and we can see more
(35:45):
special needs and increase access to care for them while increasing productivity.
Wow. No, what a great thing, Lisa. And thank you once again,
just for your contribution to this area and helping to make the world a little
bit brighter place for such an amazing group of people.
Thank you. And so I'd encourage everyone, go check out Lisa's site.
(36:06):
If you get a chance to see her speak, I would absolutely encourage you to do that.
And I would encourage you to find if you've got the heart and consider adding
this to your practice because it really will make a big difference.
And it can help grow the practice, too. You can do well by doing good.
And that, to me, is always a win-win situation.
So, Lisa, thank you for being an amazing guest.
(36:28):
Well, thanks for having me. I had a good time.
Well, good. Good. And we look forward to seeing all our guests here again here
on the Dental Wealth Nation show. Thanks, Lisa. Thanks.
You've been listening to Dental Wealth Nation. We hope you've gotten some useful
and practical information from the show.
Join us next time as we pull back the curtain to reveal the often hidden advice
(36:49):
and strategies used by today's most successful individuals and families and
help maximize your net worth so you can take even better care of the people you love.
Till next time, make sure to hit the website at dentalwealthnation.com.
As a driven dentist, you see the world differently, where some see scarcity, you see abundance.
When others want to give up, you keep going. You're building an amazing life of significance.
That means you can't rely on ordinary advice from ordinary advisors to get to your goals.
You want advice that's going to help maximize your net
(00:24):
worth so you can take even better care of the
people you love the causes you care about and
make your dent in the universe but the
fact is this advice remains hidden because relatively few professionals are
well versed in them and the extremely affluent don't care to let you know about
them join us as we pull back the curtain to reveal the often hidden advice and
(00:49):
strategies used by today's most successful individuals individuals, and families.
Welcome to Dental Wealth Nation. Here's your host, Tim McNeely.
Welcome everyone to another episode of Dental Wealth Nation.
And at Dental Wealth Nation, we're all about helping you build an amazing life
(01:09):
of significance where you can have even more impact on the people you love,
the causes you care about, and really make a significant significant impact
in your practice for everyone who walks in those doors.
And that's why I'm so excited about today is because by the time we finish today,
you're going to have a framework and you're going to walk away knowing that
anybody can work with special needs patients.
(01:30):
More importantly, you're going to have some tips and tricks and strategies that
you can use for those special needs patients that are already in your office.
But most importantly of all, you're going to walk away feeling empowered and
ready to treat those special needs patients with with confidence.
And when it comes to helping dentists do this, I don't know of anyone better than Lisa Kerbo.
And Lisa really comes to us with experience in this area firsthand.
(01:55):
She has a son who's special needs and really just has that empathy and that understanding.
And she works in a dental office. She's an RDH and you're going to get to learn
firsthand from a caregiver who understands this area better than most people
out there. Lisa, welcome to the show.
Thank you for having me. I'm excited to be here. Oh my gosh,
I am just so thrilled about this because, like I said, we want to make a difference
(02:19):
for everyone in the world.
And sometimes segments of the population get overlooked because of a fear,
misunderstanding, or we just don't know what to do.
And so that's why I'm so excited to have you here.
And so give me a little background on you and really what drew you to this area
to focus on treating special needs patients in a dental practice. this?
(02:40):
Well, my oldest son has Asperger's, which is now ASD1.
And so I have a nephew as well that has Asperger's as well.
So I've kind of had that in my family for a while and it's just given me a heart for it.
And I have had patients for many years with special needs and I just feel like
there's so much we can do for them and there's getting to be more and more out
(03:02):
in the public eye where we see them regularly.
So we see a lot of patients that are special needs in my office and And I just,
I feel a special sense of protection around them, want to help them and treat them really well.
So as you were growing up with a mom, with a son who has special needs,
did you make some dental trips?
(03:23):
Did you go to the dentist's office? What was that like?
Well, for me, my son is very high functioning, but because I'm a dental hygienist,
we started with teeth very young.
So for me, it was constant. constant, I was always looking in their mouth,
which I think really helped to desensitize them to that.
Whereas a lot of special needs are not desensitized to it. So it's a little
(03:43):
bit more traumatic for them. But for us, it was, let me see your teeth.
Let me see your teeth. I mean, this was on a constant basis.
So for them, for my son, it's like, okay, this is just part of everyday life. So.
Okay. And so have you seen some challenges with parents coming in with special needs kids?
And what are the challenges you typically see them face?
(04:05):
Well, it varies very widely because every special needs patient is different.
Just like every patient is different.
You've got some that are very excited to be here, just like your neurotypical patients.
You can walk in, do everything that you need to do without any concerns.
And you've got those that you might not even get them into the office.
You might barely get them back to the operatory, maybe not even in in a chair.
(04:28):
So it, it ranges very widely. So every person you're going to do something a
little bit different with,
you need to be able to roll with the punches and change your flow so that you
can go with what they need and kind of tune into them and see what it is that
they're comfortable with.
So, I mean, this sounds like something where you really do need some experience
(04:52):
and really know how to do this, because it sounds like right when these patients
come in your practice, you're really not quite sure what direction this could go in.
And so I bring that up to say, right, if you're a dentist, if you're thinking
about starting to integrate this into your practice, what are even the first
steps you should really take to become successful and know how to work with
(05:14):
special needs patients?
Well, I know they've integrated it now with CODA into the schooling,
but for those that after the fact may not have, or sorry, before that became
part of it, that just depends on what they've had coming into their office.
So continuing education is very key in that even volunteering at places that
(05:34):
have special needs to have some exposure to the special needs patients gets
you a little bit desensitized to it so that it's not so scary to do.
In my office, I've made a special needs questionnaire so that we can send it
out to the caregiver before they come in, which gives us a lot of information
on what's worked for them in the past, what hasn't worked for them,
(05:56):
what their home care is like.
And that gives us a lot of insight before they ever even come into our office
so that we're able to kind of get an idea of maybe what will and won't work.
So we know where to push and not push.
Okay and so really those initial steps are
just continuing to get education through ce courses
(06:17):
or are there other avenues that a doctor can
turn to as they're taking those initial steps to really
gain education in this area there's lots of online articles there's a lot of
support groups that you could actually go into like watch videos for the different
support groups for like autism awareness and ADHD awareness that they're like
(06:40):
on Facebook and YouTube.
They can help you get more comfortable with seeing what they're like,
talking with your other dental professionals that see them or your medical professionals
that see them to get some tips and tricks on what you should and shouldn't do.
But being around them, once you've done a few, they're all different.
But once you've done a few, you kind of get your foot in the door and you get
(07:02):
a little little more comfortable with it.
And as you get more comfortable, you start to be in tune of what you can and
can't do with them. So practice. There's a lot of practice.
Now, I mean, this may be a question that's really obvious, but I don't know the answer to it.
But how does this fit in with the Americans with Disabilities Act and the requirement to treat patients?
(07:23):
Is this something that all dentists must be equipped to and ready to treat?
Or can they refuse treatment on a patient if they're not equipped to treat them
well? So they can if they're not comfortable with it, then they can say we're
not like they're not set up for it. We're not set up for this. We're not comfortable.
This is past my area of expertise.
(07:43):
You might be better served here. And that's also good for the patient when that's
the case, because you don't have someone who isn't ready for that,
which may not work out well.
They may scare the patient enough that they don't want to come back.
So it happens in that it's kind of sad that it happens because it happens more
often than it should because more people should learn how to do it.
(08:05):
But you're not required to because if someone is totally uncomfortable with
it and you require them to do that, that's not going to be a good experience for anybody.
Okay. So this isn't necessarily a requirement, but it's something like you said.
That as the population of special needs patients continue to grow,
it certainly is an area that most dental practices should look at being able to treat. Yes.
(08:30):
And so now you are at a dental practice now, and you help manage the special
needs program that's there.
And so how did this start, and what have been some of the results that you've
seen as you've added this to the practice that you're at?
Well, I'm clinical and admin side. I'm on both sides. And so we started,
I've seen off and on for my whole practice, but I would say probably a good
(08:53):
15, 18 years ago is when I started seeing some more severe special needs patients.
And start a little bit and work your way through those. And then we get a few more.
And then the word kind of got out that we started to see them because the doctor
I work with has a very big heart for special needs as well.
Then we got credentialed for the hospital. And because we can take patients
(09:15):
to the hospital for general sedation,
because a lot of special needs need it, not all, but quite a few,
then that kind of got the word out that, okay, they see special needs, they can sedate.
And so that sends more and more.
And the special needs communities talk to each other.
So when they say, I'm having trouble finding a doctor, where do you go?
(09:36):
Then they're saying, we're going to this doctor and we're going to this office.
And so the word gets around pretty quickly.
And other dental offices heard that we see them.
And so other dental offices are referring to us as well to say,
hey, we've got this special needs patient. They need to be sedated.
You know, it's kind of past our area. We can see a lot of them.
(09:59):
Now, kind of coming back to that education piece, right?
You're a doctor, you're considering really upping your education because you
have a heart for this and you do. You want to serve the community.
What are some of the first things that you can really spend your time on learning
about when it comes to special needs?
Needs. So I would pick some of the main ones that you would see the most like
(10:21):
Down syndrome, autism, ADHD is considered a special needs as well.
Just some of those really more common ones and look more into the medical side
of it and just kind of the background of it.
So you're a little more familiar with the different aspects of it.
Not knowing that Down syndromes tends to have heart issues doesn't mean you
(10:43):
can't treat them because it's not a lot different than say you're 70 or 80 year
old patient that has heart issues as well.
So it, a lot of it's similar to what you've learned. You're just putting it
into a different category.
So people will say, well, I can't see them. They have a heart issue,
but they will see this adult male that has a heart issue.
It's not really that much different, but just getting into the medical side, just some backgrounds.
(11:08):
Again, I still think volunteering with, if there's anything around you that
has works with special needs, if you can volunteer to work with them,
that would be fantastic because you get to be in their element and see what
they're like and how they react with people.
Okay. So that's kind of your recommendation is really, if you want to jumpstart
this, right? All the education's great. All the CE is great, right?
(11:30):
We never want to downplay any of that, but you really kind of got to jump in,
so to speak, and just start doing and volunteering at an organization may be
a great way to do that. that.
Yeah. Okay. What would be some of those organizations that a dentist might look for?
Well, in every community is going to have something a little bit different,
some, but some, even like an autism awareness walk, they tend to have walks for those.
(11:53):
Our community has some day programs and probably some evening programs,
but day programs where you could go and maybe volunteer for a day here and there,
just working with them, sitting with with them, reading with them.
Different programs have different things that you can do with them. So contact those.
You can usually even just Google special needs programs near me and they'll
(12:16):
come up with the different things that are around you.
There's group homes as well and sometimes they'll allow you to come in.
Every community is different on what they have. They're minimizing the amount
of groups homes they have because they're trying to get more patients back with
or they're patients to us, but they're trying to get the special needs people
back with their families and less in group homes.
(12:37):
Used to, it was always group homes and they're trying to get further and further
away from that. And every state's a little different on how many group homes they have.
Okay. All right. No, that, that's certainly helpful. And then kind of coming
back to the, the practical aspect of in your practice, right?
When you started kind of rolling this out 18 years ago, what were the really
(12:58):
kind of first steps that you took, like the, the practical tactical stuff that
you started doing in the office to really get ready for this?
I heard you mention even, you know, really working with the caregivers before
the patient comes in, or are there other things that, that you should be considering in your practice?
Well, knowing that they need more time. So you might have a particular person kind of picked out.
(13:22):
So like in my office, I see them all first.
So if they're really more like a neurotypical and they're able to come into
the chair and do everything, then after I've seen them, then they may be with another hygienist.
Or if they're not, then they may stay with me. But having kind of a person picked
out that's going to be a little more interactive with them at the beginning
so they can kind of learn what works well for them, what doesn't.
(13:45):
It's hard if you've got multiple, say, hygienists, like I'm a hygienist,
and each one doesn't know the difference.
But like this one knows that they don't like to be talked very loud or don't
like the TV on, and this one doesn't know it, and they come in and do that.
Whereas if you kind of have them with the same person for a little while,
you get to learn those different things about them.
And when you can get ready to pass them on, if you need to pass them on,
(14:08):
you can share that information, working with the caregiver to find out ahead
of time that information so that when they come in, you're kind of prepared.
You either don't have something out they don't like or have something out that they do like.
Like they love sunglasses and you can have clear or sunglasses.
Make sure you have fun sunglasses for them. or they know that like a particular
(14:31):
toothbrush, if you can have that toothbrush or certain something on the TV,
things like that, knowing that ahead of time is really good.
But definitely having one person in the beginning working with them is helpful.
Okay. So really kind of having that singular point of contact who can,
who can really kind of serve as the treatment coordinator for this patient is
(14:53):
very helpful then is what I hear you you saying?
When you start out, yes, definitely.
Okay. And so how has that evolved for your team in your office over time then?
So like for our team, when they call the office, my front office team is really
good about asking those questions.
And then we have that questionnaire that can go out to the caregiver.
(15:13):
They make sure they put them on my schedule and allow me enough time to either
do not much of anything depending on the patient or do everything.
So we work with my schedule to be able to allow that to happen.
And then just good communication of making sure I know this is a special needs patient coming in.
Here's what the information we got until we get their paperwork back.
(15:37):
Here's what we know about them so I can kind of prepare and plan for them.
Okay. All right. Very, very fascinating. And even earlier, you mentioned credentialing
with hospitals, and this is something that the dentist you've worked with has gone through then.
Yes. So we go to an ambulatory surgical care center. Some people will go to
(15:58):
the actual hospital in an outpatient setting.
So I know there are some hospitals that will not allow a dentist to come in
that is not a pediatric dentist who does not have that board certification.
But in our area, we're able to do that. And I know a lot of other areas are,
so you can get credentialed to come in.
Generally an anesthesiologist or a nurse anesthetist is the one doing the anesthesia.
(16:22):
So you're, it's not part of your license.
You focus in on the dentistry while they take care of the patient.
As far as the anesthesia goes, you can get everything done in one sitting,
just about depending on what they need.
Get one big sitting, give them a good reset. And then then maybe after that
they can go into the office.
Like I have some, I can clean them in the office, but the treatment is too hard
(16:45):
on them in the office with the anesthetic and how long they have to sit there.
And there's more involved obviously with the dental treatment than the cleaning
that all the drill sounds and stuff that they're not really quite used to.
So we get them a good reset. Then they come back and we're able to keep them
clean in the office and prolong them them having to go back to the hospital.
(17:05):
Okay. And so do you really kind of, is there a transition period then between
working in the hospital to working back in the practice?
Everybody's a little different. So we've got those that every cleaning is in
the hospital, but we don't take them every six months when that's the case.
Generally, it's about once a year, maybe once every 18 months,
depending on the patient.
(17:26):
But if they can be treated in the office, then once we get them reset,
then we just bring them back in at their regular time period and start cleaning them.
And a lot of them want, because we didn't do too much to them in the office,
they're not too scared to come back to us.
And we're able to just work them into the regular schedule.
You just have to play it really by ear. I have some patients that they stand
(17:49):
in the corner. They come in, they stand in the corner.
We barely get a look in their mouth and it's like, okay, that's all we can do
to you. And we know we take them to the hospital, do everything there,
their exam, their x-rays, any fillings we need.
And now they're reset until we can see them again in about a year and work with
parents or caregivers on home care to try to minimize what we have to do besides
(18:11):
the cleaning and stuff when they go to the hospital.
Okay. So, so what I kind of keep hearing in a lot of your answers to these questions
is it, is it really comes down to, to knowing the patient really,
really well and being able to provide that customized service so that they feel safe,
they feel comfortable and they, they get the care they need.
(18:32):
Is that really what I'm hearing?
And that, it sounds like that might be the best advice you can give someone
is just get to know the patient.
Yes. Yeah. Get to know them, especially through their caregiver,
because a lot of them are nonverbal, but their caregiver knows them best.
They know that, hey, we've never been able to do anything in the office.
OK, you tell me that before they come in. I'm going to kind of plan for that.
(18:55):
But see if maybe I can do a little bit.
Maybe I can do a photo where they've never been able to do a photo before.
Well, if that works and they see their teeth, maybe I can do an X-ray.
All right. Now we've got an X-ray. They've never done that before.
But listening to the caregiver and knowing what is possible or what has not
been possible and then saying, hey, what do you think about us trying this?
(19:18):
They are in tune with them and they can feel their body language.
You can feel their body language and they can feel yours.
So if you're really scared and fearful when they're coming in,
they're going to know it. And that's it.
You're not going to get a lot done. But if you, when they come in and if you're
happy and kind of positive and upbeat, you might get further than anyone's ever gotten before.
(19:39):
Wow. Oh, that, that has to be so rewarding. It really is.
It really is. I had one the other day. Mom said she, she came up and she gave
me a hug and mom said, she doesn't hug anybody but family members.
She said, there must be something special about you. I'm like,
there's, there's nothing special about me.
I just, I love them. I love them. And she said, well, she can feel it.
(20:02):
Wow boy and i can feel it too just talking
to you lisa your passion your care your concern just
really comes through and i right and
i guess that's the other thing right how important is
it that the team's heart is really in this as opposed to it's just well we got
to do this right like how big of a difference do you think that makes i think
(20:23):
it makes a big difference having everybody on board makes a difference because
if somebody is really not wanting to do it at all they're going to make it harder for you.
So just getting everybody on board saying we want to do this.
We want to help out this population.
And there's good reasons for it, even financial reasons for it,
because you bring in one special needs patient. Well, they have a family.
(20:45):
So you brought in that special needs patient. Now you may have in siblings.
OK, now you may have in parents.
Maybe you have maybe like we do orthodontics some as well.
So we've brought in all the siblings and And the parents and then some siblings
have done orthodontics.
So that one special needs patient has brought in all kinds of stuff.
So there's a good financial reason for it as well. Not to mention just there
(21:07):
are so many special needs patients out there and they deserve our care and they deserve good care.
But if you have somebody who's not on board, it does make it harder.
Just try to get the team on board. We're going to do this. It's important for
the patients. It's important for the practice. It's important for the community.
And I want to come back to those statistics in a moment, but coming back to
(21:27):
the team here, as you were rolling this out or as you've worked with offices,
have you seen resistance in someone as the office is really trying to get going?
And how do you handle that resistance? distance?
I haven't run into it too much because I think the majority of people want to be helpful.
They just don't know how to do it. So I really haven't run into that too much.
(21:51):
I'm sure there is some out there and I've run into it in stories where the patient's
family have come in and telling us about a previous office they've been at where
they've come in and they said that they got in there and they got in the waiting
room and the front desk came out and said,
we're not going to to be able to see you. We're not going to be able to treat you.
We're not set up for it. So I've had stories about it, but I've not run into
(22:12):
people that I have come in contact with that are unwilling.
Okay. So it's really just more of the offices not being set up for this and
not really having the knowledge to know how to do this then.
Yeah. And the comfort level.
And I think the comfort comes with knowledge and practice.
Okay. So, you know, you mentioned the stats. Do you have any stats on on special
(22:35):
needs patients and really just how big of a, of a population this is?
I, I do it, but I'm, it's not in my head exactly, but I think it's something like one in 45.
I may be wrong on this. I thought it was like one in 45.
Um, people now have some kind of special need.
I could be totally off on that number because it's been a little bit since I
(22:56):
had that number memorized, but it has become a lot more prevalent because for
one they're, they're diagnosing better. So you've had preemie babies that before maybe didn't make it.
Well, now with medical intervention, they are making it.
And so therefore, they've got special needs that go along with the preemie.
So that medical intervention is increasing that.
(23:18):
Also, better diagnostics. So now they may have been out there before,
but we didn't know that's what they had. So now they're being diagnosed earlier.
And also just being in the community. Whereas when I was in school,
you had the special needs and they were inclusion.
They were in inclusion. So they were in their own special classrooms and now
(23:38):
they're in the general population.
So kids are seeing them in school because they're trying to get the mainstreamed.
So it's becoming more, we're becoming more aware. And again,
the numbers are increasing.
Wow. Well, right. And this is just so huge and so important.
I know in the financial world, this is something we certainly deal with also,
(23:59):
just in working with parents of special needs and setting up special needs trust
and really making sure that the child is going to be taken care of.
And so I love that you're really pushing this forward in health care also and
in the dental office because it's so, so important.
And, you know, you really do have a unique background in this too,
Lisa, right? Dental hygienist, office manager.
(24:21):
I think you've done the hospital coordination as well as your personal experience.
And so, you know, how do you think those have really played together in a way
that you're able to share and help these practices do this and really do it well?
Well, because I know all the sides of it, it really helps for me to be able to explain it.
Whereas if I was just coming from the hygiene side, I could talk about the clinical
(24:43):
side, which is very important.
But doing the hospital coordinator, I can talk to them about here's how you
need to do this side of it.
And office manager, here's the financial side of it, of how it helps your office.
So I really think it helps me be able to talk to all the different parts of
the office to help everybody get on board on how they can do this,
(25:04):
how they can integrate it into their office and make it make sense for them.
Well, and you bring your unique experience to stages in dental conferences all
over, don't you? Yes. Yes.
So tell me a little bit about what you're doing there and the education that you're offering.
Well, I've got some conferences coming up that I'll be going to.
So I speak on special needs in general so that I talk about the different parts of it.
(25:27):
And again, kind of like we're talking about today, how they can implement it
into their office, give them background information, some tips and tricks on
how to help these patients.
I also talk on chronic illness and dementia.
I have a spouse who has chronic illness. And so that's kind of given my heart that way too.
And I'm the caregiver to him as well. So that gives me a little bit of insight
(25:49):
on the caregiver side, as well as like my son having Asperger's.
But like I said, he's very high functioning, so he actually can live totally
independent and he has a career.
So he's very, very good with that.
Well, excellent. It has to make you proud as a mom. It does.
Oh, that's excellent. And you've
also created some unique things for your practice, too, to really help.
(26:13):
And one of those is a dental sensory kit. I've never heard that term before today.
And so walk me through what the heck is a dental sensory kit?
Because I'm guessing a lot of our listeners have never heard that term either.
No, so this, I'll pull some of the stuff out. This is a dental sensory kit.
I make, you can put them in like a pencil box or just a little clear box.
(26:33):
So I'll just walk through some of the few things that I put in there.
You can make them on your own, or I eventually will be selling them on my website
if you don't want to make your own.
So simple things so that like the caregiver can do practice visits at home.
And that's a lot of it is desensitizing them. They They have a lot of sensory
issues and we have all kinds of tastes and textures and new things that they don't use at home.
(26:56):
So if you do a dental sensory kit, you can have practice visits at home and
they can be exposed to a lot of this many, many times before they come into the office.
So simple things that we all have is mask and bib and gloves so that the caregiver
can do that, put that on and kind of be the dentist or be the hygienist.
They can put the gloves in their mouth and see what it tastes like kind of get that feel.
(27:20):
Also put a suction in there which we
all have so they can feel what that feels like because it's a foreign taste
either be plastic or if it has a taste to it but it's a weird feeling nothing
like it at home and so that would be a good practice i have a little bite blocks
so that they can practice having something hold them open feel what that feels
(27:41):
like to be open what's a good comfort zone?
Is it too far back? Does it activate their gag reflex?
But the more they practice with that, then if we use that, then it's not so big of a deal.
We all have profiangles. I put profiangles in there so they can feel it.
They can touch it. They can rub it on their teeth and see what that's like.
I put profi paste in there because that is a big texture thing for them.
(28:03):
It's very gritty. There's all kinds of flavors.
Mint is a little hard for a lot of them because it's really spicy.
So a lighter flavor is a good one to send home with them. But that way they
can taste it. They can feel that texture.
Just put a little bit like on their tongue and they feel it.
Then you can do that multiple times so they get a little more used to it, a little more used to it.
(28:25):
I put a mirror in there, a disposable mirror, so they can practice with a mirror
there. They can do it themselves.
Their caregiver can do it, but it also helps their caregiver.
If they're trying to look in their mouth and see something, it gives them that opportunity as well.
I've put in a toothbrush, a regular toothbrush. There's a one called the triple brush.
(28:45):
And it kind of I have one, but this is not my favorite.
And I don't know if you will be able to see it. I will do my best to get it up there, right there.
Yeah. All right. Yeah, that looks very good. But it brushes all three sides at the same time.
And so that way, if you're not able to brush them very well,
it gives you an opportunity to do more in a short amount of time.
(29:06):
There's another one I'm looking at that's electric. It's not a triple brush.
It's a totally different one. I'm hoping to get some practice with that pretty soon to see.
And then this is the one people will question me on. I put a fluoride tray in
there. But I don't put it in there for fluoride. I put it in there because you can take it apart.
And then let's say they need to have an impression. That usually isn't going
(29:26):
to go well at first because they got something in their mouth.
They've got something gooey in their mouth, but you can take it apart and practice
putting it in and letting them sit.
Five seconds, maybe at first, then maybe 10 seconds, 20, and then just work your way up.
That's the thing about desensitizing is it's you do a little bit,
then a little bit longer, a little bit longer.
Sometimes it never works. Sometimes none of this will ever work.
(29:50):
Every patient is so different.
But if you try, you might find that it does work.
And now we can clean them in the office because they've been exposed to all of this.
But these are really good to have these little kits at home to do those practice visits.
So that it's not so new and boring to them. It's they've had a chance.
So I'll be selling those just more. You can make them in your office because
(30:13):
most of this stuff everybody has.
But I think it would be a good thing for a lot of people to have those.
Oh, yeah, no, absolutely. And that's so amazing. I just put your website down in the comments.
And if you're listening and you have any questions for Lisa, please chime in.
This is your opportunity to ask questions and learn from an expert in this area.
(30:34):
And so we're having an amazing conversation on how you can treat special needs
patients in your practice and really just make a big impact for just an amazing
part of the population that's out there.
And Lisa was just sharing that dental sensory kit. What a great idea, Lisa.
And what a great way to really help the patients.
And so, right, you know, we've been talking just about all these things.
(30:57):
So what are some of the benefits that you've seen to your practice over the
last 18 years as you've really been working in this area?
Well, it's actually increased the amount of patients. It brings in new patients because they're new.
The special needs patient will be new. And like I mentioned earlier.
Because we were successful with them, now siblings, parents are like,
(31:19):
well, you see siblings. Yes, we'll see their siblings.
Then I said, well, do you see adults? Yes, we see adults. So now the parents come in.
And because our office also does orthodontics, they'll say, well,
this kiddo needs orthodontics. Do you do that?
Yes, we do. So now we can do orthodontics on them.
So because we saw the one special needs kiddo, we brought in an entire family.
(31:41):
So we get all the treatment for an entire family. So not just cleanings,
but, you know, your fillings, your crowns and orthodontics so that one kiddo can bring in a whole lot.
Well, then that even their extended family or special needs community is very
tight knit and they can say, well, who do you see?
Well, I see them and then they will go and call us. And now the same thing starts over.
(32:07):
And then when you're in the hospital, it's a benefit because if you can do all
that work in one sitting, that's extremely productive.
Whereas let's say it takes an hour to do, we'll say two fillings for a special needs patient.
If you could do it, if you could do it now in an hour in the hospital,
you can do maybe six fillings.
(32:27):
That's a lot more productive and that's just a very small
example if they need crowns well you can if it takes an hour and a half to do
a crown in the office it doesn't take that long to do a crown in the operatory
and you've got maybe they need three crowns we can do all three crowns because
they're under sedation you should get them all done wow it can be very productive.
(32:52):
Okay. Productive and rewarding, right?
What a great combination. Oh, that's so exciting.
Yes. We've had some parents that they come out because they had a decay in the
front and were missing teeth and broke it off.
And we were able to do, not everybody's a candidate for it, but we were able
to do a bridge and the mom was in tears because like my baby has beautiful smile again.
(33:13):
So sometimes that works really well. It just, you have to,
look at each patient as what's best for the patient. But in those cases,
boy, do you feel good after.
Yeah. Wow. Well, and this really addresses a lot of access to care issues too.
And so, I mean, what's your view on how this really fits in with access to care?
(33:34):
There is a struggle with access to care for special needs. There definitely is.
And we hear about it regularly when they call us and they say,
we haven't been able to find anybody.
I've got patients coming to me from four hours away because they haven't been
able to find anybody local that's willing to see them. Wow.
So if the more people are comfortable with it, it increases their access to care.
(33:57):
And we just, with more people that are, that we're finding their special needs
or that are being diagnosed, we need more dentist offices that are able to see
them. So they're not having to travel.
They are used to traveling because a lot of their doctors are in specialists are in the bigger towns.
But if we could maybe cut down some traveling and have something more local
(34:18):
for them, that would be great.
Now, this is so exciting and so beneficial.
And Lisa, how can we find you? I've put your website in there,
but what are some of the upcoming conferences that you'll be at and how else
can we get in touch with you?
I'll be at the Special Care Dentistry Association meeting that's in September.
And I'll also be at what we have, have the Smile Source Exchange.
(34:41):
I'll be that in September as well. And then just some local groups I'll be around.
I also have articles in RDH Magazine, RDH eVillage, and Today's RDH online.
So if you Google my name, Lisa Curbo RDH, those articles will come up.
They're also on my website as well.
Yeah, I know your website is really a wealth of knowledge and you've contributed
(35:02):
some original thought leadership here. And so what a resource.
Thank you for doing that. Thank you.
And so before we sign off here, any closing thoughts?
Just like some of the tools that you might want to use. You don't have to buy special stuff.
Some things you can, but like you can get pool noodles to help have them have something in the chair.
(35:24):
You can buy wedges on Amazon that you could use in a bed.
You don't have to get specific dentistry stuff for some of these things. Weighted blankets.
Ask them what they have at home that works for them and have them bring it with it.
Bring it with them. So anybody can do this.
You just a little bit of comfort, a little bit of practice, and we can see more
(35:45):
special needs and increase access to care for them while increasing productivity.
Wow. No, what a great thing, Lisa. And thank you once again,
just for your contribution to this area and helping to make the world a little
bit brighter place for such an amazing group of people.
Thank you. And so I'd encourage everyone, go check out Lisa's site.
(36:06):
If you get a chance to see her speak, I would absolutely encourage you to do that.
And I would encourage you to find if you've got the heart and consider adding
this to your practice because it really will make a big difference.
And it can help grow the practice, too. You can do well by doing good.
And that, to me, is always a win-win situation.
So, Lisa, thank you for being an amazing guest.
(36:28):
Well, thanks for having me. I had a good time.
Well, good. Good. And we look forward to seeing all our guests here again here
on the Dental Wealth Nation show. Thanks, Lisa. Thanks.
You've been listening to Dental Wealth Nation. We hope you've gotten some useful
and practical information from the show.
Join us next time as we pull back the curtain to reveal the often hidden advice
(36:49):
and strategies used by today's most successful individuals and families and
help maximize your net worth so you can take even better care of the people you love.
Till next time, make sure to hit the website at dentalwealthnation.com.
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