Leona Meditz

So today; I have with me Dr Walter Below, who is a general dentist practicing in Westlake, Ohio and Dr Below is here to talk about what he’s learned that has transformed his practice to encourage other dentists to do that and talk about the steps he took. So welcome Dr Below, I’m happy to have you here.

Walter Below DMD

Oh Leona, it’s a pleasure to be here and I say that because all of my progress in the 40 plus years that I have been practicing, a lot of it has been because of your good coaching and so for that I’m very thankful and very appreciative. Well, so having said that, let me get started from the beginning.

I’ve been practicing for a long time and when I first started practicing I started with my chart, my mother’s and my brother’s chart and grew the practice from there. I was very fortunate to have a very wise mentor and he told me, he said “Below, if you’re going to do something and grow, you need to have something that you can offer to your patients that is perhaps something different from all the other 13 dentists that were in the building that I was in”

And so since perio, that was about the time when soft tissue management came out and so we started with a soft tissue Management program and then as you go through that you go through an evolution. You know you grow, you want to improve your product. so that led me to various other programs but eventually I came across Leona Meditz and her periodontal program. I mean. it’s so TurnKey, all you have to do is just do accurate pocket depths and the system rolls out for you… from how to talk to your patients, how to tell them about the oral systemic connection, the importance of periodontal pathogens and periodontal disease. That’s all in the program that Leona had established. And so, as we started doing that all of a sudden we started growing the perio program and it took off and was quite successful.

From there, as we did that, then I still used those same skills which learned, to communicate with Physicians, to tell them about how I am seeing a patient that we share in common. (that) the diagnosis of periodontal disease has been made and so now I’m communicating with you colleague physician as to what we are doing that’s going to benefit your patient and may very well well make you look good in the in the process of doing that. So those skills were skills that we carried along throughout our entire dental practice but as we became more attuned to the oral systemic connection and the role that inflammation plays in systemic disease, that led me to my current practice of sleep dentistry. And so I have been doing that now for oh perhaps about one year. Those same communication skills that I learned and how to talk to Physicians with regards to perio are now the skills that I’m using to talk to Physicians about shared patients and their sleep disordered breathing. So that’s kind of a short way of getting around it but that’s what has brought me back to today.

Leona Meditz

Well I so appreciate that and one of the things that you did is trust the process and follow the process. Not that you didn’t have questions or hiccups or anything like that but over 20 years, you didn’t second guess the process. You trusted it and did it and it didn’tmatter if you lost team members. It didn’t matter if you were able to find a team member because the system is collaborative within your team, you were able to adjust and you know it’s sustained you for 20 years now.

Walter Below DMD

One of the benefits of being a solo provider and not being involved with any corporate entities, as you mentioned about going back and forth with different team members and all that. The practice had its philosophy. This is what we do. It’s not that I’m against anything else but I’m for this and so that’s where we focused our energies in doing this and yeah, there was no reason to question when hygienists would say, “Well maybe if we did this we can do it better.” I go, “This is a great system. Work the system and as you become familiar with it, then perhaps we can discuss how we might be able to tweak that.” Well, there was no tweaking. It was a very comprehensive system that the people that were working with it saw the benefit of that and suddenly all those suggestions, they thought well if we did this became a moot issue. We didn’t do that. We followed the program and did it to our great success.

Leona Meditz

Yeah you really did. One of the things that started with you understanding structure because we met with Dr Michael Schuster and The Schuster Center well over 20 years ago and learned structure and that is also (oh can you flip onyour video again it kind yeah I musthave a bad internet connection that’s okay). So you learned alot about structure and to understand that the structure controls the outcome, whether you design a structure or you don’t design a structure, it still determines the outcome.

Walter Below DMD

Structure gives you something that you can tangibly hold on to when there comes a question. Well, how would I deal with this patient in this situation? Follow the structure right?Follow the structure. Be kind and follow the structure.

Leona Meditz

Yeah and so in the beginning the structure has been an evolution. I mean I remember what I offered you when we first started and it was just basically a PowerPoint presentation and a laser. That was it, and then it evolved into the Clean Kiss products and then it evolved into the patient portfolio and all the forms and all of that. So it it didn’t become TurnKey overnight but nobody else had a turnkey program and they still don’t.

Walter Below DMD

You know that that structure that we had done back then, with all the Powerpoints and everything else as they have evolved as you say, we still use those. We still use those to our success and I find now in this day and era of having to hire new teammates and and lack of personnel, they like the fact that what we do in this office is structured. It has logic and reason to it. It’s well backed up by science and so they they want to avail themselves of working in this office because of that and so it’s just not just scraping on teeth and gingiva is not our focus. Our focus is people. people that have and want to maintain their oral health so as we have broadened our definition of what it is that we do these other things just fall right into place with the program.

Leona Meditz

Well thank you. What is the advantage of starting with pero instead of going right into sleep? What do you see that you were able to bring in that you would not have had if you’d gone directly into sleep? Because you and I have been talking about sleep for years. We knew this was eventually where you wanted to be, so what was the reasoning?

Walter Below DMD

I think it’s good to mention what it was that eventually attracted me to sleep because that was a natural progression as wellbeing is concerned about our patients. I remember what really did it is when we were locked down with Covid, I asked the question why do I have some patients that we have done some beautiful dentistry and they just bang the heck out of it and things will start to fail and that led me down the rabbithole and eventually it came to nocturnal bruxism which is one of the symptoms of sleep disordered breathing and so once I learned that, then coming back to the practice and seeing that I had patients that we had in night guards and I even had some people in anti- snoring devices. I now know and I don’t do that any longer because snoring is a symptom of sleep apnea and if you mask that symptom these patients may never be diagnosed and that would not be a service to your patient. So now when people say, “Oh give me a sleep or a snore guard”, I’ll say first I wish to test you to make sure you do not have sleep apnea. So the skills that I had learned again, I’ll talk about the communication skills to not be fearful of talking to a physician, those are all the things that were part of the evolution that brought me along. And sleep again is an inflammatory concern, just like periodontal disease with all the pathogens, and if you can clean up their mouth and get them thinking about good health, then it made it easy as I was transitioning to say, “Have you ever considered doing something about your not being able to fall asleep so that you wake up you don’t go back to to sleep? Or that you know you hear your spouse gasping for air? You know, because they have stopped breathing.”

But the thing that really attracted me then was I could continue my career but General Dentistry wouldn’t be beating me up, you know like doing root canals on third molars. So that’s kind of how it all progressed for me.

Leona Meditz

Yeah you are the epitome of the principle that says “a little health leads to a little more health”. It started with understanding teeth structure health, you know malocclusion and all of those things that that you you now started to learn how that affected the health of the mouth and then it progressed into Perio, which was the health of the body and then it progressed to sleep apnea which uh is just another extension of that.

Walter Below DMD

What is the quote from Dr Mayo of the Mayo Clinic? That people who keep their teeth will live 10 quality years longer than people that do not! There it is, right there.

Leona Meditz

It absolutely is. Well, I appreciate, it’s been a joy to see your transformation through all the ups and downs and ins and outs. And you know putting up with me developing it because li as an innovator you start with nothing and have to develop it. What drove me was understanding the effect of Periodontal health on overall health. Once you read that research and you now know, it’s nearly impossible for you to go back and practice to what you were before.

Walter Below DMD

So yeah, making tooth dust just is not satisfying anymore. When you start to see the patient’s health turn around because of the work you’ve done in the mouth, I don’t think there’s anything more fulfilling than that. You know people will say, “Oh thank you very much!” and that’s my reward. Yes people have to pay us, I mean that’s what allows us to deliver the level of care that we do and to pay our teammates. But really what, I need is when they say thank you, you have positively affected my life. And you get a lot of that when you do this type of work.

Leona Meditz

So layered into the structure, layered into the philosophy, layered into trusting the system and the protocols because the protocols kind of turned 40yr old hygiene around. The way the hygienist sees the patient turns on it’s ear. The hygienist does not present treatment in their room, the the hygienist only gathers diagnostics on the first visit. The hygienist isn’t solely responsible as the whole team works together. So if you change hygienists your whole system doesn’t fall apart. The system part is key.

You know, you were there before and after Clean Kiss. You’ve got to talk a little about Clean Kiss, not that I want this to be a commercial but what changed when clean kiss entered the picture?

Walter Below DMD

It gave us some additional tools to help our patient. They would ask if I use this type of toothpaste or this type of toothbrush or whatever and I believe it’s more than just what products you use. But when you have a product that is efficacious and you know will really do what you need it to do, that’s why we continue to use Clean Kiss. They’re wonderful products. Nothing bad in there, all good. They’re wonderful products!

Leona Meditz

Thank You. It took me three years to make them, as you know, and you were one of the first to get on board. You were one of the first. I had the first CO2 laser in the United States. You were one of the first to buy that and so you’ve been a thought leader based on your clear philosophy.

Walter Below DMD

No, you’ve been the leader. I just had the sense to to see a good thing and to do it. I think it’s like Nike says, “Just do it.”

Leona Meditz

Sometimes, you know, just do it but let’s talk a little about finances because I know a lot of dentists because I work with AAOSH dentists and IAOMT dentists and other various groups so are you comfortable talking a little bit about the Financial gains that you’ve experienced?

Walter Below DMD

Sure. In fact, I think you’re probably more aware of that than I. Did we increase our production, what was it? 20 Grand per month?

Leona Meditz

Yep yep. Absolutely. In fact over the years, I figured it out and we talked about a little bit but I know you’re not money centric. We figured out it was over 1.6 million that you’ve made on the periodontal program alone, so I think that laser was a good investment!

Walter Below

That makes me feel even better now!

Leona Meditz

Yeah do the math, you’ll figure it out. I just thank you so much because dentists often don’t want to share their successes with other dentists. They think, maybe they see dentists as competitors and here you are encouraging dentists you know to to think differently and to really do some inside work as to what do they want to change for their patients? What do they want to improve in their patients?

Walter Below

People really do wish to improve their health but they want to be educated. No one likes to be sold anything and this program was in no way shape nor form about selling but selling is not a four-letterword and you have to do it so whether you’re selling that you need a crown here or you need a partial, whatever it may be, but you’re still serving that patient and you know the evolution of how you’re serving that patient in accordance with the technologies, the knowledge, those are all the things that the periodontal program was right on top of. It was not a static program, it was a dynamic program and it would change because of new knowledge, new technology. To get back to teammembers the hygienist realized that they needed the assistance to help them out whether they were taking the doing the bloodwork or whatever it may have been, they were very involved every step along the way and that made them feel good about what they were doing. That’s a good positive thing as well.

Leona Meditz

Yeah, success begat sucess, right and so that’s another principle. Another principle, is the “No Surprise Rule.”

Walter Below

The structure takes care of that. Every time you take a step, you introduce the next step so that patients know what to expect and you’re not surprising them. So that has to be done differently than doing a prophy, setting the patient up and telling them what’s wrong with them. When you start out and you do a pre-operative analysis of what bacteria they have in their mouth you go through therapy and then you do that that those tests again and here it is–something that you can hold in your hand. This was before this is after and you see the difference between those two. I would always be very interested when patients would say does this work? I say that it always works. What may not work is how committed you are to doing what you need to do as the patient but the the program absolutely, without question will get things back on the right track.

Leona Meditz

So spreading it out among team members, so no one person is responsible doesn’t have the whole (including the doctor) weight on their shoulders. Structuring it so that the patient has a chance to learn about what’s going on in their own body before making a decision doing the test for empirical evidence so that they know that it’s not just in their mouth it’s affecting their health through an A1Ctest or a CRP test putting that all together in a in such a way that step by step by step I can hold your hand soyou can hold your patient’s hand through that transformation and then doing it in such a way that it’s profitable: that is what everything is designed to do. Because, if it’s not profitable, it won’t be sustained.

Again, I thank you for your openness to do that and I may contact you again from time to time to do case studies or whatever so you just keep on trucking and you know my number if you need to any future help. So again, thank you so much Walt.

Walter Below DMD

Leona thank you. byebye