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September 21st, 2022

Episode 159 – Special Extended Episode: The Art of Ozone Science and Asking the Right Questions

“We have to ask our patients questions that match the current science. And asking ‘are you brushing’ isn’t good enough anymore.” -Cris Duval, RDH

Have you been curious about ozone therapy and what it can do for your patients?

So many of you have asked, which is why this is a special extended episode of Everyday Practices Dental Podcast. Featuring Cris Duval, RDH, speaker, and ozone aficionado, we dig into the benefits of ozone use in dental.

Tune in and discover how to:

  • Elevate your communication game by asking patients better questions
  • Check your mindset: optimal patient care vs minimum standard of patient care
  • Understand ozone – why it may be effective in your practice

Never miss an episode! Subscribe on iTunes & Spotify. Visit us at http://www.everydaypracticespodcast.com

EPISODE TRANSCRIPT

Regan
Our guest today is a founding member of the International associate of ozone and healthcare, founder of the lifeguard approach, and former oral wellness liaison for the bail Dhoni method. Dental Hygienist patient health advocate and Wellness Coach Chris Duvall follows the science today to deliver the latest tools, methods, and communication required to get patients the healthiest outcome possible and that includes the well-being of your practice to Chris Duvall. Welcome to the everyday practices, and dental podcasts. We’re so glad you’re here.

Cris Duval, RDH
Yeah. Thank you. Thank you. That’ll be fun.

Regan
Yeah. So, Chris, we all go back away. We’ve had you at productivity workshops. In the past. We know that you’ve developed a wellness program since 2001. You really are the authority on thinking about being the architect of change in dental practices in relation to hygiene specifically, but right now we have a problem. In hygiene, what are you seeing right now going on in the dental

Cris Duval, RDH
world? Well, I’d like to broaden this out besides just hygienist because this is a dentist problem. Also, first and foremost, I think it’s a dental problem. So you know, it just it’s a trickle-down effect from the dentist to the hygienist and the rest of the team. So I’m excited to talk about that.

Dr. Chad Johnson
You know, it even goes bigger than that not to pass the buck because I agree but then it goes into integrative medicine altogether with the community of health care providers and I see that you’ve had a history with Bail donated and I’m getting plugged in as a patient with Bail donated stuff. So I just you’ll, you’ll think it’s kind of funny. I actually did my own blood draw yesterday. And

Regan
you just did you just say you’re getting in with Bill donating yourself as a patient as a

Dr. Chad Johnson
patient. Yeah. So Dr. Gina Pritchard down in Dallas is doing my health care for the last year. So I’m dialing that in and yeah, so you know, that’s, that’s been fascinating. I want you to know, Chris, I mean, we talked earlier, but just for the listener’s sake to catch up to this. You know, I have been a fan of ozone for a while now and I was at first fascinated by it and started then pursuing it heavily when we got hit with COVID and I wanted to, you know, address some of the safety concerns and health risk management through the ozone and so I had gone to an ozone class, actually just November.

No September before COVID hit and so it was within six months that I was calling the factory I’m trying to think of the ozone manufacturer and I’ll think of it later in, which is unfortunate. In Canada that made the ozone for me and longevity, longevity, ozone generators, and, and got some of that started but it goes back even further when I was having Productive Dentist Academy when I first brought them on, which was about eight years ago.

Talk about what does my period program look like? And the evolution started with, you know, well, we want to, in essence, just when we’re talking about, you know, what, what is, what does it look like when you’re helping establish patient care and science-based evidence, you know, with dentistry just to catch people up.

When I’m doing that at first it’s, well, we’re scraping teeth to get them clean, and then, later on, it becomes Well, wait a second, okay, so we want to disrupt the biofilm and so kava trends are good, because it’s, you know, going down and a lot of dentists kind of just stop there and go, well, hopefully, we can check your bleeding and, and you know, we’ve lowered the pockets a smidge, and we’ve lowered the bleeding a smidge but I guess my pursuit went deeper into figuring out okay, how can we do better? And how can we be better than the average dental office that’s doing one or 3% perio? And get that number up? Because I mean, I just 1% perio is atrocious but it’s kind of the average, what have you found when you were talking with us?

Cris Duval, RDH
It’s very low. Their perio percentage is low and just to give you an idea of what mine was, was, I tracked it and, you know, the statistics about the amount of the population that suffer from periodontal disease is very high. You know, it’s predicted that 80% of the population show evidence of periodontal disease and keep in

Dr. Chad Johnson
mind, that’s the American Association of periodontics. So like when you give that quote, you’re not just quoting some obscure, you know, science, it’s just like, No, that’s a P.

Cris Duval, RDH
That’s from the experts. Correct. That’s when I realized that and, that’s when I decided, I’ve got to listen to the experts because what I’ve been doing isn’t good enough anymore. So along with that mindset, and then Dr. McKay took me to lunch on the first week that I worked for him and I want to tell you, this is not what he said to me, but this is what I heard. Okay, do you understand the difference? Okay, so what my message I heard, I want you to develop a wellness program for me, I want you to develop a way for patients to come back and see you when you’re healthy. I’ll give you continuing education, the technology that you need, and a personal coach.

That’s what I heard and so I took off from there, and I knew he would walk beside me and guide me and help me, but he truly empowered me to have an impact on patient health and on the practice, because let’s face it, the dentist can’t be everywhere, all the time developing protocols, and, and, you know, telling the hygienist how they should be running that part of the practice. It gave me such empowerment, and it and I was so enthused because I was gonna get an opportunity to use my intellect and my judgment and my, the way I approach patient care, I just, it was so freeing and so exciting that it just took off and so I’d encourage everybody to somehow figure out a way to give your team members not just your high dentists but your dentist, give your team members of challenge.

Change flip your leadership role in your practice, and try and create leaders in every department of your practice and have them connect us to how can we better overall as a patient take or as a team to take better care of our patients. Because let’s face it, we want you to be out in the chair, doing what you do best and that’s not necessarily managing your hygiene department or your assistants or whatever. So,

Dr. Chad Johnson
for example, in my practice, once a month, the hygienist goes to lunch specifically to have a hygiene departmental meeting, where they can talk about only hygiene matters, and problem-solve themselves to get to a solution. Now, if they need my help, or they need me to, you know, facilitate something to help them do better, then they’ll let me know but they Oh,

Cris Duval, RDH
yes. So back to what we had originally just discussed about low perio percentages, the perio percentages, and Dr. McKay’s practice coming out of the hygiene department average between 78 and 82% of the codes or the procedures that came out of my hygiene department where perio related codes you can imagine, and people say, Well, you must have been selling dentistry like crazy. Ah, I only gave patients what they wanted. These were years, our patients chose this level of health and wellness. It really had not that much to do with me other than my approach, that you weren’t

Dr. Chad Johnson
twisting their arm, you were simply guiding them to make healthy choices and sure enough, they naturally, by and large, where choosing the healthy choice,

Cris Duval, RDH
right? So what I did you, I could not go in and talk to a patient at all, you’d have to put a three-inch piece of duct tape over my mouth unless I knew the answer to one specific question before I went into an operatory and that question was, tell me about what you want for yourself.

Because once I knew that, what they wanted for themselves, all I had to do was a step in the gap that was created between where they were that day and where they wanted to be and so I asked him that question is a profound and important part of shifting your hygiene or your whole dental practice to increase health and wellness and that’s a great question for dentists to be asked to, we just make assumptions that we know what patients want, we know very well what patients need. Right? But there’s a big difference between need and want. Huge difference.

Dr. Chad Johnson
And another interesting thing is just because you’ve identified them, and you’ve treated them doesn’t necessarily even mean though that the outcomes are going to be better, because someone might be great at and I’m just being harsh for a minute, someone might be great at getting Pete patients to be like, yeah, no, I want to do better. For example, someone that’s got a 1970s model of hygiene could all of a sudden start implementing it.

So tell me what you want for yourself. And they answer and they go, Well, I just want the healthiest mouth possible and they go okay, well, we’re going to scrape even lower. That’s just like, so wait a second. So it’s not just about asking the question. So then you had to figure out okay, now we’re getting people to say yes. Now, how do we, you know, the tedious weeds of, you know, how do we improve this beyond what this standard, quote, standard of care is to optimal standard of care?

Cris Duval, RDH
Yes, not minimal? Yes, absolutely.

Dr. Chad Johnson
So how did that progression look? In under 30 minutes?

Cris Duval, RDH
Well, that’s what you know, when I started listening to the experts, as I said, and I started really thinking about that gap that was created, I wanted to make sure I was choosing the best things to recommend to the patient to close that gap and that’s when I realized there was such a mismatch between how we were taking care of patients scaling and root planing, or, you know, pro fees and polishing to the fact that the science was telling us that what’s going to impact your patient’s health and wellness most is helping them create a healthy biofilm.

I mean, you can scrape all day long and have them come in every few months, but you’re not going to have the profound health impact that you will get if you start focusing on biofilm health and so early on, we started doing bacterial testing. I was there when Tom’s neighbors introduced oral DNA A at the Chicago midwinter meeting and wait

Dr. Chad Johnson
a second, I might be a little too young. Is that where you get the neighbor’s probe? From?

Cris Duval, RDH
No, I don’t think so.

Dr. Chad Johnson
Okay, I just I was trying to put a reference to the name. Sorry, that’s

Cris Duval, RDH
he literally started oral DNA, the bacterial testing for the high-risk pathogens and got, and now he’s got a new one out called high risk five, HR five but I just get so enthused, when I see the difference in the change that can happen when a practice will start developing and matching their protocols.

Well, first of all, their mindset, and their messaging, and then their clinical habits, matching those to what the science is telling us today and that’s listening to the experts and you know, really just getting out there and, and make deciding to make that shift from merely repairing the damage and what was going on with patients to preparing patients for health and what happens, what I found, and what I turned it is my patients shifted from living in white, what I call the danger zone because so many of our patients are in the danger zone and are at risk of having catastrophic events, happen, and even death.

So I was so focused on shifting them from that danger zone to the safety zone and that said tone where the immune system can balance the bacterial load and that results when you have a healthy biofilm. It just reduces. You know, we know those high-risk pathogens, some of them are responsible, they’re causal to atherosclerosis. So what kind of an impact can we have? When were testing our patients to see what type of back pathogenic bacteria they have? And then once we know that we’re using the most effective product to get rid of those pathogenic bacteria?

Dr. Chad Johnson
Because it’s hardening the intima of your cardiovascular lining? Right?

Regan
I have a question from a patient perspective, Chris. There’s a really important nuance, I think when it comes to communication, for example, I always put myself in the hot seat. Like for years, I’ve had, like jaw discomfort and I don’t know if it’s normal, or it’s not, you know, and so I do get the head and neck screening every time I go in and I always preface this by I have a fantastic dental practice that I absolutely love.

I’m going to be more heightened to the normal I think, but I have mentioned over the years, you know, like if I have discomfort? Isn’t that a moment where we can train the team so they hear that? So you’re asking that question, what would you like? Or, what does health look like to you?

Or whatever that opening question is, I think sometimes people don’t even understand what’s normal and what’s not normal and then once that is voiced, how does the hygienist take this to the doctor or take this to the next level? So instead of glossing over and saying, Well, you know, let me know if it’s worse or anything like that, and just kind of going on with it. What is the how do you communicate that bridge? Because I love where you’re going with the what would this look like to you? What would health look like to you? What do you want for yourself?

Cris Duval, RDH 18:56
Yeah, well, it goes back to, for me, when I would hear somebody say if you said to me, I’m concerned, or should I be concerned about you know, some swelling that I have back here? My first response to you would be to tell me more about that. Because I think our big challenge in dentistry is especially you know, in medicine and dentistry, is we make assumptions about why the patient is asking that question and you just cannot make assumptions anymore about you gotta ask to follow up questions. That’s the key to expanding your service mix. So when I talk about I want to get patients living in the safety zone. What it does is I didn’t see CAC Less anymore when our patients came back to see us when they were in the safety zone and so you can imagine what that does to a one-hour appointment as to how much time I had. So I developed something called 2020 20 hygiene, which I just spent the first 20 minutes on relationship building.

The second 20 minutes is on the actual hygiene portion of the appointment but that gave me an additional 20 minutes and here’s the importance of following the science and developing your mindset, your messaging, and your clinical habits. What is most important today is our life-saving screenings. Because when I left hygiene school, I won’t tell you what year that was but basically, things have not changed in the basic hygiene protocol of how we do the hygiene visit. So I was doing oral cancer screenings.

One of my first patients in the clinic was my husband’s grandfather I found oral cancer in his mouth and it set the anchor for me that for the rest of my life and rest of my career, I was going to do a high an oral cancer screening on every single patient every time no matter what, it wasn’t negotiable. Because I knew that any patient sitting in my chair had someone at home, or in a relationship that loves them just as much as I love Gary’s uncle or grandfather. So that wasn’t negotiable for her. Yeah, I wasn’t gonna do them. So today, though, I have the time in my appointment because I’m not focusing on calculus, removal, and bleeding gums.

I have the time to do oral cancer screenings, take blood pressures, do carry free screenings. Use my telescope airway, oh my gosh, the airway is so important. That’s the essence of life is us being able to breathe and get oxygen. So there is a plethora of new life-saving screenings that we must be doing in order to save our patients’ lives and I call them these life-saving screenings. They’re lifelines between the practice and the patient and there’s nothing more important than being able to use these lifelines on every single patient.

Dr. Chad Johnson
Hey, okay, so bigger picture stuff. I, I also want to make sure that, that we’re talking for those that are listening for your sake. I mean, I almost say to, you know, swing it another way but tell me for the, you know, listener that’s, you know, listening right now about how lasers help hygienists, especially in states that allow it because there are some that, you know, are more difficult than others.

So that’s unfortunate but nonetheless, dentists can advocate their boards for these positions and I hate to make it procedural but I mean, what I’m saying is, you know, how are hygienists empowered by using lasers, for example? And what does that look like? What kind of outcome changes? Have you seen it? I threw probably seven questions that you saw, just stop.

Cris Duval, RDH
Well, I use lasers since 1999 and I use them in Dr. McKay’s practice in everything I did. You know, I’d use it to decontaminate and to breed when I was doing perio therapy but I needed something more and the rules and regulations in each state are just so cumbersome because you know, some can use it to decontaminate some can’t use it to most can’t use it to breed the granulation tissue and that to me is where the most benefit of lasers come. It’s like it jumpstarts the immune system by removing all that infection from wherever in the sulcus or anywhere in the tissue.

So I think they are of value. I. Again, I believe that a belt and suspenders approach to perio to anything is always great and that’s where listening to the science comes in is that I think we need to be using a lot more or have a lot more tools in our toolbox and for me lasers and ozone, ozone became probably the most important thing that that I did because it has so much more of a powerful effect on enhancer enhancing the oxygen delivery to the tissues, and that’s the most important biological need.

Dr. Chad Johnson
So help people understand because they’re thinking, okay, so how do you get what modalities do you use to get ozone where it needs to go?

Cris Duval, RDH
I use water ozonated water, okay, ozone gas, and ozonated oils to help get the ozone. See what happens is, if people don’t know about ozone, what it does is it creates an oxidative burst. When ozone comes into contact with other bacteria or viruses or fungi parasites, it ozone is very unstable, and it wants to revert back to its natural state and so when it comes in contact with any of those objects, what it does is it says oh, here’s my chance,

I’m going to break apart because I want to go back to where I came from and that burst when the ozone breaks apart, the old three breaks apart, it creates this oxidative burst that literally blows apart the cell wall or the membrane of any of the bacteria, viruses, fungi parasites.

So Dr. Mollica refers to it as rocket fuel and, you know, it just is we don’t have anything else. That is that fast-acting and as effective as ozone is, in my mind, it doesn’t

Dr. Chad Johnson
affect our eukaryotic cells of self. Because the cell membranes are thicker and protect like so in other words, someone could say, well, then why doesn’t it just kill us by you know, releasing all nuclear fission of the universe all in your mouth? It’s like, well, it’s specifically going after the prokaryotic and, you know, all the the the germs and the microbiomes.

Cris Duval, RDH
Yeah, and it’s a good thing, though, to use some probiotics just simply because you want to re-establish more of the good bacteria after you have had done treatment on the patient. Yeah. No,

Regan
can you imagine? No. Can you imagine how absolutely mind it’s not just mind shifting internally? How mind-bending this is to hear this from a patient perspective, Chris?

Cris Duval, RDH
To the

Regan
I’m just pausing. Take up that one little part. Three, no, you’re okay. That’s the nice part of it. Well, even if it was life, we would just say this is live folks.

Dr. Chad Johnson
Yeah. So can you imagine ready? Yeah.

Regan
Can you? Can you imagine? How not just mind shifting this is internal to the dental team but how absolutely mind-bending this is from a patient’s point of view. On all, that’s possible in a hygiene appointment. Can you imagine from the marketing perspective, Chris? I mean, we have been conditioned to feel like it is just a treadmill and yep, you’ve got a little bleeding. Yep, you’ve got a little bleeding.

Yep. You’ve got a little bleeding. I mean, we hear it over and over and over again, and are you flossing and are you brushing and it’s just kind of like your brain goes numb to it, and if you were to tell me that, if you were to meet me at that gate and say, I’m going to help get you the healthiest you can possibly be and when we eliminate that bleeding when we get to that point, we’re going to start seeing less calculus, we’re going to start to be able to have the space to do all of these other things to help you be healthy. I am onboard and I’m willing to pay anything. In order to make that happen. It’s a completely different way to look at a recare visit from my perspective.

Cris Duval, RDH
Absolutely and the thing is, is that we now know that patients want one of two things They either want to move toward the benefit of health, or they want to move away from the consequences.

So that’s so true. Yeah. So the only thing you have to do is you have to develop your messaging because how you are going to treat these patients clinically is exactly the same but you want to frame your messaging in a manner that they can buy into it because it’s what they want. So you know, if I knew somebody was going to that wanted health, I would talk very differently to them than I would to somebody that wanted to avoid the consequences of getting a swollen face as his brother did.

So it’s all in the pre-framing and that’s why I don’t really talk about I like to use the word messaging instead of communication today. Because what’s important? Malcolm Gladwell in the tipping point says that you need to have three things in order for something to catch on and now those three things are you it has to be personal, it has to be practical, and it must have a sticky message. So what I did, you know, the first time I came back, when I had what I needed to start using ozone,

I started out Monday morning, and I said, how we have taken care of you in the past just isn’t good enough anymore and so because of that, this is how I’m going to take care of you today. Hold on here just a second. This is how I’m going to take care of you today. Here is why I’m doing it this way and this is what it means to you. So those were those three you know, parcels that Malcolm Gladwell feel so important. It’s the

Regan
it’s the why that’s so important to me, from my perspective. So I’ve had hygienists in the past, switch up their routine, some of them have explained it, and some of them have not and I feel like it’s such a missed opportunity to not explain what’s going on and why it’s being done in a certain way Chad is really, really good at explaining why we’re going to do what we’re going to do, what he looks at how this is important.

So he’s telling a journey and a story with that and that’s exactly what I just saw you lay out there, Chris, we have to be able to get the patient on board and understand why this is, you know, the way that it is and how the hygiene department these days are so competitive. I think I’m seeing it all over the message boards.

So giving them these resources and tools and tying the doctrine as you did right at the beginning of our podcast, you said this is not just about hygenist. This is about the doctor, too. Doesn’t this lead itself to chat? I guess this is a question for Chad doesn’t just lead this, this conversation into the code diagnosis realm.

Dr. Chad Johnson
Yeah and like when I think about my team, you know, one, I explained to my team, you know, a new person, here’s how we’re going to do stuff and I want you to be understanding, ad nauseam, almost why we’re doing what we’re doing so that way, instead of I’ve explained to a new assistant, for example, recently,

I said, that was a really long answer but I wanted you to understand why I was choosing, you know, and what I was thinking about while I was choosing to do one or the other. So that way over time, you can know as opposed to I could have simply told you, we’re going to choose material x, but I want you to understand why we’re choosing material X over Y when we would use y when we would use X when we shouldn’t use y or when it doesn’t matter and stuff like that, you know, it gave her a context.

So that way over time, she can have the wisdom to apply. Why she’s going to choose something and then she can actually read my mind and I love the compliment that patients give when they go You guys didn’t even say anything there and it’s just like, Yeah, cuz they know what my decision tree is and I’ve communicated that with them.

Or Chris, I’ve messaged that with them, but that also then going back to your question better Regan is that with the team, I come in, and I a lot of times say now, I know this hygienist is like Carrie, for example. I know Carrie has already explained this to you. So I won’t go into much detail unless you had questions regarding that.

Oh, here’s another one, Chris, that you’ll really like Reagan along these lines, too, is with a new patient, I’ll say, Listen, you’ve got five teeth that we need to do, you know, fillings on and I could show you where if it really matters to you but there are five spots on the X-ray that I found and you know, earlier, they probably showed you where these spots were and so you know, you already know about that but I don’t want to fix these just yet. I don’t want to address that until your gums are healthy.

You know, so I don’t try and really triple down on the discussion of it much but I acknowledge that Basically what they said was, was right, and surely you heard that and if they say, I don’t get this all too much, if ever, I mean, I kind of wanted to hear it from you. I mean, maybe, but most of the time, if I empower the hygienist,

So when the hygienist is, has talked to you about how we, you know, address your periodontal therapy or your perio therapy, I want them to go through the perio therapy program with you have your reevaluation at 12 weeks, and then if they give me the green light, then we’ll move forward on your restorative work but I don’t want to work in a bloody mess. Just a minute ago, I explained to you listen, I don’t want

Regan
to say that. You say I don’t want to work in a bloody mess. I like the visual of that. Thank

Dr. Chad Johnson
you. That would go along with Blackwell’s idea of having it be sticky. Right but I explained to him I actually this is very Bruce s reg and I’ll say

Regan
it is very Bruce, as you can already I’ve heard him say that. But

Dr. Chad Johnson
you don’t. You don’t want me to put a filling in where it’s not clean? I mean, no, I want to be able to have the gums be healthy. Because I can’t have water in my restorations I need a bone dry but I also can’t have blood and spit and stuff like that.

So we need it to be perfect. In order for it to be perfect. Shonda the hygienist is going to work with you on getting your gums healthy, even before we’ve begun on the restorative work because I don’t want the fillings to fail in two or three years. I just don’t unless you’re up for that, obviously. I mean, who is no one’s ever agreed to that? So now that we’re in agreement, let’s get the gum health just right. When they give me the green light, then they’ll start scheduling you for the restorative work. Yeah,

Cris Duval, RDH
yeah. So going, going back to thank you for that but going back to when, when we’re talking about, you know, investing in your team, and I, one of my biggest joys comes, when I was able to say, with Dr. McKay hired me, he promised to invest in me, on your behalf with the skills and training needed to help you get what you want and that’s why I think that this is so important of matching our protocols to the science out there today and yeah,

Regan
that’s good. I was gonna say that’s a great segue into the ozone therapies, group,s and frontiers in ozone events. Yeah, I think that really connects us. Can you tell us a bit about this upcoming event? Well,

Cris Duval, RDH
I’ve been to five of the six events and it is such a really rich resource for learning from the experts, the latest out there that we know about ozone and they keep finding more and more information out there for us to help our patients get healthy and it’s a rich resource. There’s collaboration, there are social events, and these, the speakers that are there really, they stay the whole weekend and they’re engaged and they will engage with you in a great conversation, you know, over a glass of wine in the evening or wherever it is, you might want to get some more information and make a connection.

It’s going to be in Scottsdale, right in my backyard, which is beef, but it’s November 3 through the fifth, and then, if you would put the link where they can go to and check out the speakers and one of the things we’re now developing because I’m co-chairperson of the conference, is that the lifeguard approach is going to be having either a half day or pretty much a full day works job on exactly what we’ve been talking about today. Because what’s most important,

I think is for dentists and their teams to develop a strategy of what they’re doing and why and who they’re going to be for their patients those strategy questions are so important to answer, why are we doing this? And then, after you got your strategy, and strategic questions answered, ask yourself five tactical tools. Because all those alone is is a tactical tool to help you get what you want. So you’re going to say, you know, what are we going to do? When are we going to do it? Who’s going to do it? How are we going to incorporate ozone into our practice? You know, those are just merely tactical questions to help you get what you want. So and,

Dr. Chad Johnson
Chris, I’ve got a question. Let’s back up the horse. Let’s say someone has gone this far and listened to us, because they’re interested in this topic but then they said, but the ADA doesn’t even say that, that ozone is efficacious at all, how do we even know? So how is ozone so effective? And yet also so contrarian?

Cris Duval, RDH
Well, I have my own opinions.

Dr. Chad Johnson
And I guess to risk we can cut this out but I’m curious to know your opinion.

Cris Duval, RDH
I think it’s the impact of false information out there. The drug companies do not like ozone, it’s cheap, it’s easy to use. Ozone spin used as far back as World War One.

Dr. Chad Johnson
Tesla had a patent on it. Yes.

Cris Duval, RDH
So it’s not new but you know, people like to poopoo it and discount it and, you know, there’s certain people that have a challenge with somebody if they’re selling ozone equipment across state lines, and aren’t following the rules in that matter, but you know, you as a, as a dentist, have every right to purchase ozone and an ozone generator and, and be trained safely in the use of it and you can make that decision as to how you want to take care of your patients, and what the benefits are. It’s not up to other people, as long as you’re not doing anything illegal.

Dr. Chad Johnson
I want you to know, I’m originally Barclay. Bastian, over in Maui. I was looking at his practice. This was eight years ago, something like that and so this was when I first got introduced to ozone, I walk into his office and I said, Why does your office smell so clean? I have not smelled. Now, this is also in Maui when everything smells earthy.

Okay, you know, so like, you know, it can almost be because there’s so much rain and stuff like that it can almost indoor smell musty but there I was like, Why does your place smell fantastically clean? He said, Well, actually, I mean, I’ll tell you what, like we use ozone? And I was like, What do you mean, you use ozone? This was new to me. This was after 10 years of being in practice and he said, Well, let me show you and He then gave me also a little sample jar of pure oh three, and I then that night,

I put some in my retainer and the next morning my retainer was still fresh and I was like, we’re on to something because that’s amazing that my retainer was small and listens for the listeners. My retainers always smell fresh whether I use ozone or not because of flowers but maybe other people might find that their retainers are a little bit gross, but I was shocked about how the ozone would, in essence, it was naturally disinfecting. So that’s when it started Chris to check into this was it was a trip to Maui and I should write that off as a business trip Doggone it but I was fascinated by it but you know, I was curious what your thoughts were on why ozone just gets no offense Reagan to be the redheaded stepchild of you to know the dental industry not really the science industry but the dental industry, even the CDC In the FDA?

Cris Duval, RDH
Well, we know the reason there don’t wait.

Dr. Chad Johnson
Well, yeah but I thought, you know, I wanted to at least broach the subject for sinners that aren’t going well, I don’t see science-based evidence but the fact is, it’s out there, you just have to find it because it is poo. pooed by farm, big farm, little farm.

Regan
This is what’s so frustrating to me, Chad, that I think it circles back, Chris, to the very start of our conversation, we need to ask better questions, need to ask better questions as clinicians, patient health advocates, and patients ourselves. So in that, there comes a lot of bravery with that. I think that history has proven time and again, that it’s not always encouraged to ask questions and step outside the boundary like that. So it is, I can tell you, definitely, I’ve heard answers for my own health, there can be nothing done about certain things inside or outside of dentistry, just nothing can be done.

Well, if I switch the way I asked the question, and I look to integrative health care providers, guess what, there’s plenty that can be done, and plenty that is done but we have to know what to ask and we have to be advocates of our, of our own health. So I think what you’re, what you’re sharing in the message that you’re sharing requires a bit of bravery and it requires critical thinking.

Cris Duval, RDH
And I can tell you, I would love to tell you my own experience with something beyond ozone in the mouth. I have been a patient of Amy Donini for over 10 years and we’ve always had a challenge, getting my C reactive protein down to a level where she was really happy with it and it wasn’t anything routinely high, in my opinion, you know, it was one, one for a C reactive and she said I want it down 2.5 and the other thing was my lipids, my cholesterol was slightly high and she wanted that, you know, just due to the inflammation that’s created. She wanted that better and my things like Myeloperoxidase and f2 are Pristine and my histamine was elevated up to around 13 points something. So anyway, I was introduced to a woman that does a procedure called Ebook and which is extra corporal blood oxygenation and ozonation. It is exactly the same as dialysis

Dr. Chad Johnson
in America. Yep. Oh, and there are lots of

Regan
I don’t even know what just occurred right now. I’m excited. I’m really

Cris Duval, RDH
excited. Okay, so listen to this. So I had my call last week with Amy on my labs, and I had run my labs three months ago. So it was in March and then I ran him again. You know, a couple of weeks after doing this Ebook and I was totally amazed. I thought it was going to happen but here’s so Amy gets on the phone with me and after she says hello, the first thing out of her mouth was what have you been doing? She says your labs are perfect and I said well, I’ll be happy to tell you if you’re open to a little bit of oh, maybe the non-traditional type of treatment. So my C reactive. So I did I’ve done Eboo three times and just for your own curiosity, I’ll send you guys a couple of pictures of me doing that but my C reactive protein went from 1.1 to point five. My cholesterol went from 215 to 175. My histamine went from 13.9 to 6.9.

May you know my Myeloperoxidase all those numbers were just perfect and the great thing about the person that did this Ebook for me, she’s going to be at the ozone conference and there she’s on the workshop day she’s going to be doing some Ebook on some patients, you know, people that are attending the conference if they want to have that done they can, they can do that. So there is a lot, lots more than just traditional, you know, there’s lots of dentists that are going to be speaking on ozone,

Phil Mollica is going to be there, I’m going to be there and a bunch of other people just go to the website, we’re constantly updating it, and constantly adding content to it and it is, I think, the conference to be at if you want to have the opportunity to figure out how to better match your protocols in the dental office to the science. Because I mean, we now know that your white blood cells produce ozone when they’re fighting an infection in your body. So how cool is that? So yeah.

Dr. Chad Johnson
Alright, so I’ve got a tangible question. Because I like posing this with, you know, different clinicians, colleagues, stuff like that. Someone comes in and has 100 bleeding sites, traditionally, with SRP, I would, I don’t know if this is good or bad but if we got it down to 33 sites, so if we cut two-thirds off, and still had 33 bleeding sites, I’m talking to old school SRP, just, you know, and I’d be like, Oh, well, we improved it and I would have been happy with that. When we switched to laser,

I found that we cut those 33 remaining sites in half. So we went from 100 of this arbitrary example, bleeding sites, and we cut it down to 16 or so and if we had more than that, I’d be like, Oh, we should have been able to do better than that. You get what I’m saying, you know, like, there’s that successful. I’ve not done a good job at tracking how our ozone in the water system has helped and when we do pre-rinse and ozonation, and stuff like that but if someone is using ozone, what would be your number? No know, in your protocol altogether.

Ozone, laser, magic sauce, whatever you’re doing, how you’re talking to the patients, everything comprehensively. If someone had 100 sites, and they came back, and they had 10 bleeding sites at their re-evaluation, would you be satisfied initially? Or would you be like, Oh, that’s disappointing? I mean, what’s your number? Zero. The dog got it. I was afraid you’d say that.

Cris Duval, RDH
So there is a website by one of my mentors in ozone who I first learned about ozone through and I became part of his kitchen cadre, and his name is Dr. Kendall dome and he has a website that’s called ZTE for B G and it stands for zero tolerance for bleeding gums. So if I have a patient that we treat, and I hit let me tell you what I tell them when I send them out the door, say on their last therapy appointment. I say I’m turning the healing process over to you hold on just a second.

Dr. Chad Johnson
Oh, my I like the pregnant pause there because

Cris Duval, RDH
Oh, hold on to my computer. I just lost you guys know you didn’t work here. Well, I know but I can’t see you, I guess

Dr. Chad Johnson
is that you’re thrown down so many good things teacher?

Cris Duval, RDH
Okay. So when I walk them out the door at their last therapy appointment and by the way, please call it periodontal therapy, not quadrants of scaling and root planing. I know we you use the same code, but we’re trying to shift the insurance company and their thoughts and beliefs about what we do. So as you’re walking them out the door, I would always say I’m turning the healing process. Over to you, I have done all I can.

This next part of your healing is up to you. So let’s see what you can do to help enable your body to heal. You know, we’re just trying to get the body to heal if we use the right things like adding oxygen which is the most important component of healing of The body, we just need to add oxygen and whatever the body else the body needs, and get out of the way, and let the patient with their own body. Create the healing. Yeah. So I would. So then also, when they came back for their six-week therapy appointment,

I would always tell them to let me back up a little bit on that initial appointment when I’m doing therapies, I would always tell them when we gave them an estimate of the investment to get their gums healthy, I would always tell them, I have no idea how your body is going to respond to what we’re going to do. We know that the healing response should be great but I’m going to leave my recommendations as to how many therapies with you I’m going to leave that open-ended. Because it’s like I’m and this is what I say to him. It’s like these first therapies, I put out a major forest fire and when you come and see me in six weeks, I’m gonna look for any hotspots smoldering, smoldering? Yes. Yeah. So that’s, you know, the things that I tell them. And

Dr. Chad Johnson
I think this is important for listeners to hear because I think most people would be satisfied with 30 out of 100 and I’m just saying, so I asked the listener, what’s your number? Because you’ve got a number out of 100 that you’d say, oh, you know, that’s good and I hope it’s not 50 out of 100, you know, but if your number without some of these modalities that we’re talking about is zero or five, or let’s say you’re even beating me my number seems to be about 16 where I just go, Okay, we’re, you know, like, we’re, we’re, I’m not saying like that I’m done, or we’re all good, but I’m satisfied with that.

Like, you know, that’s not bad. So what you’re doing is even on this podcast, you’re pressing me to figure out how do I get it from 16 Even better, so I asked the listener rhetorically because you’re just listening right now in the drive, whatever in the shower, what’s your number and how can you get better because wow, zero tolerance for bleeding gums? It sounds a lot like you know, zero bone loss for implants kind of concept which is a big thing for implants but it’s for natural implants your own roots.

Cris Duval, RDH
Well, um, I have a quote and this is a crystal ball quote ignoring clinical evidence for whatever reason opens the door to a catastrophic well hold on let me I get mixed up sometimes. Can you just stop for just a second I’ll get Yes?

Dr. Chad Johnson
Yeah, we’ll just redo it okay

Oh and while you’re looking at it that up let me just say and then I’m done with pressing questions

Cris Duval, RDH
I don’t they don’t bother me.

Dr. Chad Johnson
No, I bet not but I’m just saying my brain is full and I’m done. I’m not saying you’re done. I’m saying

Cris Duval, RDH
Hold on here just a second okay, here’s the exact quote and you can credit this to me overlooking or ignoring clinically based evidence for whatever reason can have a catastrophic impact on a patient’s overall health and wellness and open the door for disease and even death so that’s why Dr. McKay and I had a zero tolerance for bleeding gum and, and so what’s most important in all that, in all that we have discussed today, is that he, he set the stage he throughout the challenge, and he was so supportive of me, and sometime I’d love to talk to you guys about what I learned from him. Uh, about having a question behind the question, he drove me crazy, because I’d go to him and I’d say something and he’d say, Well, why do you think that? Or, you know, I’d say you need to come and talk to this person. Her teeth look horrible, she needs a new smile this is when I first started working there and he’d say to me, Well, what is the patient want?

He got the point across to me very early on, that I needed to find out when I had my communication and when I talked to him about a patient, I always had to know what the patient wants. In fact, it was so important. I developed a wants to monitor that went on the back of our route sheet so that every single team member that picked up their route slip and was preparing to work with a patient, the first thing they wanted to look at was, what is this patient want for themselves? Do I talk about them? In terms of they want their teeth to look better? Or do they want their teeth to function better?

My best friend was in the office and I thought she needed to have her teeth, you know, have a cosmetic procedure done on her teeth because I thought they could look better but she only would give herself permission to move ahead with Dr. McKay. As long as we pre-framed it about how her teeth would function better. She wasn’t, you know, impressed with how her teeth looked but she wanted them to function.

Well, that was the most important thing to her and so she moved ahead, she did a beautiful design for her and so now her teeth look fabulous and they function very, very well. Yeah, this is the lifeguard approach. All this stuff is about who we’re going to be, what our mindset is, what our message is to our patients and that impacts your clinical habits of what you’re going to do.

Dr. Chad Johnson 1:02:24
You know, it reminds me of Reagan, my first job was as a lifeguard, and I get the idea of this as guarding someone’s life, and you know, like maximizing their health but I also like, each time you say it, it reminds me of my first job as a lifeguard and it would be as though if I said, How many drownings are acceptable.

Now, you know, like, how long should I wait before the person’s underwater before you go in and get them? When should we be less vigilant in keeping our eyes on the water? You know, when is it okay to screw around and push someone into the pool? When is it okay for me to close my eyes and rest? Which parents aren’t interested in having their kids observed? You know, it’s it just, it was a few years that I did that job and I actually for a teenager took it very seriously and I think that also helped me set up for being a health care provider.

Because it was an early introduction into you know, like, what’s the main goal, keep calm, and push on, you know, like get the patient healthy again, you know, if their airways blocked, unblock it, if it can’t be unblocked, figure it out, you know, like if their heart isn’t beating, beat it for them, stuff like that. So and that’s on a basic level but I that lifeguard is a great name. So the lifeguard approach because I’m just thinking, you know,

Cris Duval, RDH
yes, it’s guarding and guiding your patients with oral systemic health, and just real quick to end this, I’d love to tell you about why I call it the lifeguard approach. When I was 14, I was a champion competitive swimmer and we had an event at our home pool, I swam my race and I finished well before everybody else did. So I turned around and leaned against the wall of the pool to watch the other swimmers finish and as I did that, I grew blue a great big bubble.

I swam the race with a big water bubble gum in my mouth and I the lifeguard got down off her perch, and the timer in my lane was a physician and they knew me and had a relationship with me and as I started to leave the pool, they both stopped me and they asked me the question Do you want to live to be an adult? And I? Well, that’s a stupid question.

Of course, I do and they said, if you had aspirated that bubblegum during the race, you’d have gone dead in the water, and we would have not known how to help you, we wouldn’t know have known what the cause was, was and that has impacted me. That’s why I call it the lifeguard approach because they could have just let me walk out of the pool enclosure and said it looked at each other and said the stupid girl and let me walk off and then I could have possibly done that again, and aspirated it and I would have been in a lot of trouble. So that’s why I call this the lifeguard approach. Based on my experience as a 14-year-old kid, I’ve never forgotten it.

Dr. Chad Johnson
Well, here’s the good news. Your message that branding hit. I knew exactly. Isn’t that cool? Chris? I followed without you even saying it. I’m just Yeah, it was. That was a fantastic story. Thank you. You’re welcome. Alright, so now I need to know what did you swim?

Cris Duval, RDH
I swam everything except I was not good at breaststroke. So I always had to have a great lead. My butterfly, my backstroke and my freestyle were super dupers, and if you look at my website, Chris duvall.com. Yeah, he will see a picture of me with one of my swimming trophies. No kidding. Yeah.

Dr. Chad Johnson
Oh, there it is. I’m looking at it right now. How cool is that?

Cris Duval, RDH
Yeah and that was in Spokane, by the way. I swim in junior Olympic events and AAU-sanctioned events.

Dr. Chad Johnson
Wow. Cool. Yeah, Chris, we have been honored truly to have you on and talk through these difficult and contrarian subjects for the patient’s benefit. So I hope that people got a lot out of this, that they can take like, and there are tangible nuggets in there of what they can do to proceed Next if they want to, you know, get their patient the best health that they can.

Cris Duval, RDH
Yeah, yeah, come and see us said the ozone conference, I’ll be there and I’m happy to spend time with any teams, bring your team, don’t be one of those dentists that comes by himself and then thinks he’s gonna go home and implement that by himself into the practice. He needs his team leaders to you know, enable the team to really embrace what it is he wants for his patients or her. So exactly, it really changes the cultural view. Brace the team creates leaders out of them.

Dr. Chad Johnson
They’ll step up. Yep. Well, Chris, thank you very much, Reagan. Closing thoughts.

Regan
Thank you, Chris, for all of your bravery, and thank you for all of the mentors that you’ve had along the way that have led to sharing this with the world. It’s an honor to be in the Echelon that is you to be at that level and for everyone listening, whatever you got from this, even if it’s one, one reflection point, you’re moving that dial towards shifting the paradigm and that doesn’t happen without you, Chris, and leaders like you. So thank you so much for being our guest. Thank you for listening to another episode of the Everyday Practices Podcast.

Chad and I are here every week. Thanks to our community of listeners just like you, and we’d love your help. It would mean the world if you can help spread the word by sharing this episode with a fellow dentist and leaving us a review on iTunes or Spotify. Do you have an extraordinary story you’d like to share? Or feedback on how we can make this podcast even more awesome? Drop us an email at podcast@productivedentist.com And don’t forget to check out our other podcasts from productive dentist Academy at productivedentist.com/podcasts See you next week.

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