Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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302 Smiles by Canada with Shelley Canada : Dentistry Uncensored with Howard Farran

302 Smiles by Canada with Shelley Canada : Dentistry Uncensored with Howard Farran

1/28/2016 7:59:52 AM   |   Comments: 0   |   Views: 369

302 Smiles by Canada with Shelley Canada : Dentistry Uncensored with Howard Farran




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302 Smiles by Canada with Shelley Canada : Dentistry Uncensored with Howard Farran




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AUDIO - DUwHF #302 - Shelley Canada





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VIDEO - DUwHF #302 - Shelley Canada





This episode’s discussion:

  • Celiac Disease and It's Dental Implications
  • Being a Female Dentist
  • Material Secrets
  • Money and Buying Equipment
  • Mentoring
  • Advice from my Mentors
  • How to Treat Staff


Dr. Shelley Canada has practiced family and cosmetic dentistry since 1989 when she graduated from the University of Oklahoma College of Dentistry with awards in operative and pediatric dentistry and was number one in her class in crown and bridge dentistry. She has been licensed in Texas, Oklahoma and Louisiana, and she is oral sedation certified in Texas. Dr. Canada completed a one-year general practice residency at the University of Texas Health Sciences Center at Hermann Hospital, The University of Texas School of Dentistry, Texas Institute of Research and Rehabilitation and Ben Taub Hospital in 1990 where she learned how to treat the medically compromised patient. She then completed a one-year cosmetic dentistry fellowship with Realty Publishing and Esthetic Dental Professionals in 1991. She has been in private solo practice since 1995. In 1995, she was named Young Dentist of the Year and in 2009 Dentist of the Year by the Ninth District Dental Society where she was past president. She was nominated for the Texas Dentist of the Year in 2009 and for many years has been named a Texas Super Dentist and a Houston Top Dentist along with several other national awards. Dr. Canada is a Fellow of the American and the International College of Dentists and the Delta Sigma Delta Dental Fraternity where she is a national officer. She is also very involved with the Seattle Study Club in Houston, the Westside Study Club, the Ninth District Dental Society, the Greater Houston Dental Society, the Texas Dental Association, and Delta Sigma Delta Dental Fraternity. She is a mentor to many past, present and future dental students as well. Dr. Canada's hobbies include hiking, travel, Creative Memories scrapbooking, jewelry making, crafts, Girl Scouts, and spending time with her beloved daughter and family. Dr. Canada loves to explain your dental needs to you in our relaxed and comfortable state-of-the-art dental facility. Come and see why so many people love to come to Dr. Canada!


www.smilesbycanada.com 



Howard:

It is a huge, huge honor for me to be interviewing a rock star in dentistry, Shelley Canada. I have been on ... I'm going to read your bio Shelly, it's amazing. Doctor Shelley Canada has practiced family and cosmetic dentistry since 1989 when she graduated from the University of Oklahoma College of Dentistry with awards in operative and pediatric dentistry and was number one in her class in crown and bridge dentistry. She has been licensed in Texas, Oklahoma and Louisiana, which I didn't even know in Texas you had to have a license, that's news to me. Joke, joke.



She is oral sedation certified in Texas. Doctor Canada completed a one year general practice residency at the University of Texas Health Science Center at Herman Hospital, the University Texas School of Dentistry, Texas Institute of Research and Rehabilitation and Ben Taub Hospital 1990. She then completed a one year cosmetic dentistry fellowship with Reality Publishing and Aesthetic Dental Professionals, Michael B. Miller, who is the founder of Reality. I haven't heard from him in a while. Is he still rocking and rolling with Reality?


Shelley:

He's doing awesome. He's actually teaching at the dental school now. He's taking his career into the teaching field because when you've done everything, you've got to teach it.


Howard:

Tell him I want to Podcast him.


Shelley:

I already have. I'm going to set that up for you.


Howard:

His wife is an orthodontist, Ingrid?


Shelley:

Ingrid.


Howard:

I love Ingrid, she's a sweetheart.


Shelley:

She's the best.


Howard:

Shelley has been in private solo practice since 1995. In 1995, she was named Young Dentist of the Year and in 2009, Dentist of the Year by the Ninth Distract Dental Society when she was the past president. She was nominated for the Texas Dentist of the Year in 2009 and for many years has been named a Texas Super Dentist and a Houston Top Dentist along with several other national awards. Doctor Canada is Fellow of the American College of Dentists, the International College of Dentists, and the Delta Sigma Delta dental fraternity, which I assume is just a drinking club, right?



She has served as a national officer. She is also very involved in the Seattle Study Club in Houston, The Westside Study Club, The Ninth District Dental Society, The Greater Houston Dental Society, The Texas Dental Association, and Delta Sigma Delta Dental Fraternity. She is a mentor to many past, present, and future dental students as well.



Doctor Canada's hobbies include hiking, travel, creating memories, scrapbooking, jewelry making, crafts, girl scouts, and spending time with her beloved daughter and family. She's also on the community girl scout leadership team and is PTA treasurer for her daughter's high school in Houston. Shelley, you've been a rock star for three decades. I mean really. You are amazing.



The reason I wanted to get you on here is because if I look at the data of who's emailing me, Howard@dentaltown.com, after these podcasts, I mean really, Shelley, they're all under thirty. I think a podcast thing is a kid and a cell phone and she's either sitting in the back of the dental school lecture listening to podcasts or surfing Dental Town if the lecture's boring or they're just got out of school. You have really taken a focus at mentoring young dentists along with Celiac Disease and dentistry.



I just wanted to start up and I wouldn't even need to ask you a question, but what would tell these young kids, because what they're telling me is they're scared, they've got a lot of student loan debt, and they basically don't know what to do? Some of them are wondering if they even made a bad move, like maybe when you and I got out of school back in the day that that was the glory days of dentistry in the '80s and now they're at 2016 and they went down a wrong road. What would you say to a young dentist if she said to you "Shelley, do you think this was a bad move, becoming a dentist?"


Shelley:

Never. I love dentistry, I can't even imagine life without it, so to go back and say I'd do something different, I've never regretted it for a day. There've been days where you think that. Everybody always questions "Why am I here now?" But you're never ... How do you put this? You're going to question everything in your life. You question "Am I a good Mom? Am I a good leader? Am I a good neighbor?" You always question everything you do, but if you really like the technicality, if you're good with working with your hands, I think dentistry is the perfect option.



I've gotten calls of young dentists who've called me up who've quit other careers like engineering and things like that and went into dentistry. Every single one of them has said "I hate this. I hate my job. They're not doing it right." My word to them is ... I had the same crisis conversation with my mentor. I said to the young dentist who called me recently "You have to keep looking for that right job. If that job that you have is not making you happy, you keep looking." You keep that job until you find something better, but my mentor said to me a long time ago "If you don't do it right and you don't feel good about what you've done, you call that patient up and bring them back in and do it the right way." If we would all continue to stand for our ethics and morals that we know are right, we're going to have the job that we love. If you can't find the job that you love, make the job that you love, going out on your own.


Howard:

I think it's very interesting because ... I can ask you think because I'm a boy and you're a girl, but it seems like a lot of the boy dentists, when they're trying to find an associate job out of school, they're only looking at the money and their questions in emails to me, it's money to money, percentage. They're like "This guy pays thirty five percent. I've got to pay no lab." It's just money, money, money. The girls seem to be more intuitive and intelligent are saying "Do I like this office? Do they have fun? Is this going to be a fun place for me to be happy?" Man, I'd rather take a twenty five percent ding or a fifty percent ding in my pay any day to be happy over just bringing home the bucks and being miserable.


Shelley:

That's the bottom line. When I had a job one time, the staff ... I was real young. We're talking twenty six, seven somewhere in there. The staff was not treating me right. I'd been there maybe about three months. It just seemed to be going downhill. I wasn't happy, but I loved the guy I worked for. He's still kind of a mentor to me now. I went in to him and I said "I don't know what I'm doing wrong. I know I'm not a good boss yet. I know I don't know how to direct employees yet, but what do I do to get them to respect me?"



Best advice he ever gave me. He said "I want you to go around to every single employee and sit down with them for four hours during the course of a week. Don't tell them you're doing this, but go sit down with them and tell them 'Show me kind of what you do with your job here. Show me some of the things you have to do. Who do you call? Can I just listen in and hear how you do your job?'"



I sat down with every single employee and by the end of the week ... I also did some of their job, too. I'd say "Let me call and let me see what I can find out from this patient if I apply what you just taught me." Every single employee by the end of that month, I had like four or five people I had to go sit with. Everyone treated me like way better than they treated him, because they saw my work ethic, number one, they saw that I was committed to them doing a good job and that I saw how hard they work.



Now when I go running up and throw charts at them, "Fix this problem, fix that problem" I can go, "Why don't you fix this problem after you fix your stack of recall cards or after you do that insurance verification." I knew what their job was. Also, if I don't know how to do something, I now know exactly what staff member to go talk to. That was the best advice anybody ever gave me. You really get to know that person. My relationships with that team went out the roof after that. Best thing I ever did.


Howard:

When every dentist went out and watched that new Star Wars movie, they just sat there during the whole movie fantasizing of the day that we can just hire droids to run our office. Fire all the staff and hire R2D2 and CP30. Wouldn't that just be awesome if those were all your staff?


Shelley:

Yeah.


Howard:

Shelley, you're a much better and more expert on mentoring these young kids. What kind of dilemmas or questions are you hearing? What are you hearing on the street when these kids ... What dilemmas are in their life when they're wanting mentorship?


Shelley:

The number one thing that I'm always usually disappointed. Every single year for like seven or eight years, I've had a group of like twenty to twenty five students that I mentor. They come to my office, I email them probably every month or couple of weeks, I'm constantly in contact. We have sit down sessions through the International College of Dentists where we go over ethical dilemmas. My partner and I, Tommy Harrison, we sit there and explain to them all of these ways that we've handled it, how we've had to deal with unethical drug abuse and alcoholism in our colleagues and what do you do, how do you handle that when you're working with somebody who's doing terrible dentistry. We go over all of these dilemmas with them. We reestablish rapport with these people.



I every time invite them in. "Come in at Christmas, come in at spring break, come spend the summer with me. If you have a day off, call up and see if we're doing anything interesting." Do you know how many people take me up on that? So far since November, one person.


Howard:

I know it.


Shelley:

It's sad. They don't make any effort. Back in our day, if you could get a contact with an outside dentist, man, you developed that relationship. When someone begs you to call them and come into their office, take them on and if no one's begging you to do that, then you need to go out and farm those connections. Ask a couple of people. Go ask the people at the dentist school "Who are you good friends with that they might let me come in and observe in their office?" because the more outside people you get in touch with, the better dentist you're going to be. You need to have the vision of what a good dentist looks like.


Howard:

Are these students from a dental school? You're in Houston. Is this a dental school up the street from you in Houston?


Shelley:

Yes, down at the medical center, University of Texas School of Dentistry.


Howard:

You're doing this with that dental school?


Shelley:

Right.


Howard:

Arizona has two dental schools in my back yard; one's in Mesa and one's in Glendale. I just have to tell my listeners that over the last decade, did like two kids that had the gumption to drive down and say "Hey, I want to meet you. I've heard about Dental Town, this that. I just want to shake your hand, whatever." I can tell you that five years later, they're all in the top one tenth of one percent. Now I tell them that when they come by. I say "Just the fact that you walked through my door, I can guarantee you your cream will float all the way to the top."


Shelley:

Yeah. Even if you're scared, I can't make it any less scary. They're still too scared to contact me. That's crazy. I've only heard of one time where a student contacted someone and had set up a mentorship thing for a day. When she called to confirm, the dentist said "we're kind of busy. We'll do it some other time." The dental student then went in the phone book and said "I've got this time available. I want to see who I can mentor." Calls up my office.



My staff at the front desk knows that I'll take anybody. Anybody. Dental assistants, hygienists, they've all come in and observed in my office. If they call me up, I'm going to let them. Do you know I'm still good friends with that dentist to this day? She's my patient, in fact. Any time she has a problem, she calls me up. I talk her through the contracts. I do any kind of support for her because I believe in her. She took the effort to cold call somebody and say "I'd like to come in and spend my weekend with you."


Howard:

What type of ethical dilemmas are you hearing?


Shelley:

Mostly it has to do with production. They're in there saying "Why didn't you do a root canal on that crown? Why didn't you just go ahead and do an onlay instead of that filling?" This is kind of my pet peeve about dentistry. A lot of it is wives who get involved in dental practices. They start penny pinching and running the show. A lot of young dentists want to deal with the senior associate. They don't want to deal with your wife. Wives aren't the person trained in business and dentistry, they're just all about the bottom line.



That's okay, but I also think that a lot of these associate dentists need to step in and groom the young dentists. They call me up and they tell me problems they're having with the staff and all of this. My bottom line is always go back and talk to the senior associate dentist. Chances are they've had the same problem with that staff person and they can either go talk to the staff person or they can sit down and do a three way between the three of you and come up with a solution that works.


Howard:

Are you hearing good or bad about corporate dentists? I know when we got out of school in the '80s, a lot of people that just wanted a job, they went to the Army, Navy, Air Force, Marines, and it was all well respected. They had all kinds of CE stuff. I know that there's four hundred and fifty DSOs, so you can't label them all one thing, but what are you hearing about the ones that are getting jobs at DSOs first couple years out of school?


Shelley:

Good and bad. A lot of them won't talk a lot smack on them because they don't want to blow their connection if they start saying something bad. Almost inevitably I hear not getting the equipment they need, like the burrs, the polishers, the impression material, things like that. I worked at a clinic per se when I was working at Reality. It was only a two day a week job. I was making like six hundred bucks a month. I couldn't pay my bills on that.



I got a job the other four days a week at a clinic that takes a lot of PPOs and DMOs. My favorite part about that job was going out and working in a DMO situation where I didn't get a lot of extra money, but I really got to get up my skills, my speed, how I talk to people about insurance. I learned more about insurance in that job than anything else I've ever done. I've also learned when you go and work at these corporate jobs, one thing I noticed was, this sounds bad but, the staff was more inclined to give the male dentists patients than the female patients because when you look at it from their perspective, where's your future going to lie? You're single, you're high school education. "There's a hot, young doctor here. If I pad his schedule with great patients, maybe he'll like me better." They had a lot more incentive to pad the male dentists' schedules that the females'.



That was my experience back in '91, I believe. That was when I was doing that job. I didn't like how they would take a DMO patient, they'd call in and they'd say "I need a cleaning." They'd take my blank schedule, flip it ahead three months and say "We can see you for your cleaning on March 14th at 3:00." I'm sitting there watching them do this going "No, I've got ... Schedule today, 4:30 bring them in." They're like "No, no, no, no. Be quiet, be quiet. All right. We'll see you then." They hang up the phone. I said "Why didn't you bring them in at 4:30 today?" They go "Because, don't you get it? If we scheduled them three months out, we get three months of payments. Then we don't call and confirm, so they forget. When they call back, we say 'It'll be another three months.' Now we're about six, seven months down the schedule. I've gotten enough payments that now we can afford to do your cleaning."


Howard:

Those were the HMO capitation payments where they were paying you nine dollars a months per person. I wanted to say something, what I thought was insidious about that is back in the day when I got out of school in '87 and this capitation started where the insurance companies are all saying "What we're going to do is we're going to transfer the risk from the dental insurance company to the dentist. We're just going to give you the money each month and you take care of them." The indemnity insurance was collecting twenty dollars per head and the capitation was nine dollars a head. It's like, okay, you're missing two variables, you're transferring the risk from the dental insurance company to the dentist, but then you cut his money in half. I always wondered what would've happened if they just would've said "Let's keep the money the same, but transfer the risk from the insurance company to the dentist and say 'We'll just give you twenty dollars a month per patient.'" What does the average dentist have? Eighteen hundred active patients?


Shelley:

Yeah.


Howard:

Eighteen hundred times twenty, that's thirty six thousand bucks a month times twelve is four hundred and thirty two thousand. I can't believe I figured that out, because I haven't taken geometry for thirty years. It might've really changed diagnosing [inaudible 00:19:36], because what you were talking about earlier where some of the ethical issues is the bottom line. They want you to do crowns instead of MODs. Some of these people that are out there doing these huge numbers, they haven't done an MOD filling in twenty years. Everything's a crown, a crown, a crown, a crown.


Shelley:

Right. No. I love and do lots of big fillings in my private practice. I'm good at it. It's what I like to do. I like to use different kinds of products, what I've learned through Reality. I can't ethically sit there and a patient I know is financially strapped. What I'll do a lot of times is I'll say "Okay, I'm going to stop the [inaudible 00:20:16], big buildup here, and I've got to run over on the other side and do that root canal and that crown on that tooth." That's going to eat their insurance for the whole year. Then at January first we're going to go back over here and crown that big MOD on number twelve if I feel like it needs it. Sometimes they're really small. Sometimes you have a mesial box and a distal box and you don't need to sit there and crown a whole tooth.


Howard:

Shelley, I want to keep asking you quick questions that I can ask you that I can't ask a male dentist. In my lifetime, I'm fifty three, I watched ... When I was a little kid, I grew with a mom and five sisters and all the OB GYNs were men. Now it's transferring to pretty much it's all women.


Shelley:

It's all women.


Howard:

We're seeing the exact same thing in pediatric dentistry. I was wondering I always thought to myself "If I was a man and if I was afraid of the dentist and I didn't want a shot and I didn't want to get hurt and I saw this short, fat, bald guy Howard and this really sweet, beautiful woman named Shelley, I just would naturally pick you instead of me." Do you think in an industry that's tarnished with fear and pain and hurt and shot and women are just biologically more maternal. I noticed when my four boys were little, we'd be playing all day long with them. If they fell down and got hurt, they ran and started crying. They ran around me and went straight to their mom. Do you think it's a huge advantage to be a woman graduating from dental school now as opposed to being a male?


Shelley:

Yes, I've felt that way since the day I graduated. When I was working with my pediatric patient who had giant hands and working on these little, tiny kids, he told me "You're going to have to retract. You're going to have to do this." There were times when I'd go "Just hand me the drill, man. Let me get in there and do that for you." He was awful at it. He said "I'm never going to practice pediatric dentistry when I graduate." I love kids. I won the pediatric award in school. I was like "I don't want to do pediatrics. Why are you guys giving me this award?" They're like "You don't realize how good you get along with your patients."



I know having a child made me way better on doing pediatric dentistry, because now I have something to relate to them. I say "Tell me about your kitties and puppies. What pets do you have? What games do you like to play?" I know all the questions to ask kids now, so sometimes I think men are a little afraid to get down on that personal level. I can't say that in general, because I see plenty of guys who do a fabulous job with kids and I sit there and learn.



The best example of how to do pediatric dentistry is Marvin Berman. If you could get him on a podcast, oh my gosh, he is amazing. He's out of Chicago. He's retired, but I bet YouTube has plenty of videos. Best guy I ever learned pediatric dentistry from. He's a non-sedation guy. He's crazy, best class I ever took. Eight hours of sitting there totally enthralled talking to him. I would aspire to be the Marvin Berman with kids. I'm not that good, but he's the best. He's the best example. If you're not doing good with kids, go look up some Marvin Berman videos, hands down, best guy I've ever seen.



I think women in general, we have smaller, thinner fingers. We tend to be taught from an early age to have a lot of emotional intelligence. We feel things out a little bit. Like when patients come in, the first thing I try to do is get in tune with where they are fear-wise. I don't know that a lot of men that just kind of plow in, sit down, lean them back and they don't even talk to the patient. By the time somebody sits down, my assistant's over there like "Oh my God, she's talking to them again. It's going to be five more minutes." Sometimes when I see my assistant being frustrated and I know I'm going to talk to this patient for another couple of minutes, I'm like "I got this, come back in a few minutes." Give them a chance to go sterilize some instruments and spend the time to really get to know people. You'll make a patient for life just spending those three to five minutes on a really scary filling appointment makes them feel so at ease.



The other thing I do is when I'm drilling on that patient, I also talk to my dental assistant. I talk about what was on the Beverly Hills Housewives last night. I talk about "Did you see what Trump did yesterday on the news? Did you see how those terrorists blew that ..." I really try to stay current on events, have conversations with my dental assistant. I talk about gossipy things sometimes. By the end of the appointment, my patient sits up and is like "Wow, that was very distracting. I really liked how you guys did that. Just do that talky thing that y'all do." I hear that all the time. "Just do that conversation because it really takes my mind off of what you're doing. I don't know how a lot of men do that much talking while they're working, but for me it works great with my patients.


Howard:

I wanted to ask you, this question is coming out of left field. In my backyard, Arizona, the Arizona State Dental Association just had a big conference called "Women's Issues in Dentistry". They couldn't hold a conference like that and say "Bald Dentist's Issues in Dentistry" or "Fat Bald Issues in Dentistry". To have a conference on that and have it massively well attended ... I'm prefacing this because I don't want some woman in dental school saying "Why's he asking that? We don't have any issues." Here's the thing, they're having conferences with hundreds of people coming where the headline is "Women's Issues in Dentistry" and it's all women's speakers. I'm a male, I have no credibility. Do women have any special or different issues becoming a dentist as opposed to someone who's a male?


Shelley:

Yeah. When I first got out ...


Howard:

Or do you think that's just a bunch of overrated crap hype?


Shelley:

No, no, no. No, I know years ago when ... I was told in high school "Women aren't dentists. What are you talking about?" They were right. I hadn't even met one. In my world, I don't look at things as male and female oriented, but society does. A lot of older patients are going to go for the fat, balding guy who's funny as hell. They're not going to go for the girl who's got makeup on and her hair's all fixed. They want that old style ... Men have more credibility just because of the way society stereotypes men versus women. We also don't make as much money.



I'll put it like this. When you're the mom of a baby infant who you're breastfeeding for the first year of life, you can't sit there and work eight to ten hour days. You've got to get home. When I first had my child, I would breastfeed in the morning, run to work, work three hours, take a fifteen minute break, do the breast pump, go work another three hours and race my butt home to breastfeed my kid again. Usually by the time I got home, she was crying, hungry, the whole bit.



I don't take lunches even to this day. I work straight through, but I do six hour days because I would rather spend my lunch time, food time home with my kid. I have snacks all over the office. We're supposed to do little meals all day long anyway. That's what's worked best for me being a mom. I can't work a lot of Saturdays. I missed a lot of soccer games. We have a lot of different issues, I think, just based on the pressure that we're still supposed to be super mom and that confident dentist person. We also ... Especially like a lot of the dentists that I see coming out of school ...



When I was at a recent attendance of the whole sophomore class, I'm looking around the room. I turn to the guy who's a clinic director and I said "Oh my God, I've never seen this many women before." He said "Yes, our class is fifty three percent women." In my day, we were twenty four percent of our class, and that was unheard of. They'd never even come close to that before. Nowadays, they're over fifty percent.



I'm looking around the room, it looks like a Victoria's Secret convention. They're beautiful. They're tall, statuesque and they're smart. They come up with the best questions. They're the ones packing my office when I offer that mentorship thing. Almost all of them are female who are coming in to see me. A lot of the guys will email me and stuff, but the women are good at that interpersonal connection. They just like to reach out and get to know you on that level. All of my little mentees that have really stuck to it have all been women. We have the need, I think, for connection. That's why I think we do well in dentistry, because it's such an interpersonal type of relationship.


Howard:

Back to we were saying at the beginning that OB GYN went from all male to all women. Pediatric dentistry, you look at their entrance classes, it's pretty much all women. You go to several of these ... It's fifty percent in the United States, but many of these countries that I go to, Indian, Kathmandu, Russia, Poland, they're over eighty percent women now. There's twenty five countries that have over a eighty percent woman percentage now. I just think with the ... I don't know, I think it's going to go the way of OB GYN pediatrics. I really do.


Shelley:

I can see exactly your point. I think that's a shame, because the thing that frustrates me about female dentists, and I have several friends like this, is they'll go out and they'll work for two to ten years. Then they start to have kids, more than one, and then they take several years off. I have many friends who've not come back to dentistry. The minute their husbands divorce them, which we're looking at fifty to seventy percent of those marriages ending, now all of the sudden they're in this panic. They don't have any skills. They've been out of dentistry for ten to twenty years and they come back and they have to go full blast. They're very scared.



You think you're scared coming out of school, try not practicing dentistry for ten years and see how you feel. They don't even know what the latest composites are. They don't even know if we still use Hemodyne. There's lots of things that they get very out of date in. What's going to happen is that if we have all these women coming out, their longevity is very low in comparison to a man who's going to practice fifty years before he retires.



I'm one of the few exceptions in a lot of women who've been in practice twenty six years. There aren't many very many people who have stayed with it like I have. They've gotten married, they're married to a wealthy guy or they go work part time and they teach, and they just don't apply that full time work ethic to a job.


Howard:

Yeah, I tell the young men in dental school, I said if they were smart, if I could go back into dental school, I would've married one of the girls in my class and divorced her after twenty years and just retired. That's what you've got to do at dental school. You've got to marry the girl who's going to make the most money and then divorce. We need to balance out.


Shelley:

You guys are always trying to marry the hot hygienist. Now it's come back to bite you in the butt.


Howard:

Why is that? Why is it biting us in the ...


Shelley:

They don't make any money, they just pop out babies.


Howard:

Is that right? You've got to [inaudible 00:33:17] woman does? How did you get in ... Another one of your big expertise is Celiac dentistry. How did you get interested in Celiac dentistry and how is that related to the mouth and oral health and dentistry?


Shelley:

My daughter got ...


Howard:

You're talking Celiac Sprue?


Shelley:

Right, exactly. Celiac Disease is like where you can't ingest gluten without having your bowels get inflamed.


Howard:

Is it no longer called Celiac Sprue? Is it Celiac Disease?


Shelley:

Right, Celiac Disease is the new term for it. They'll still call it Sprue, but that tends to be physicians who are sixty and above, let's say.


Howard:

I almost qualify for that. I've never heard ... Okay.


Shelley:

We were taught in school it was called Sprue. I'm fifty two, so let's say fifty and above.


Howard:

This is gluten which is found in wheat?


Shelley:

Wheat products. Wheat, barley, and rye are the three products that have gluten in it. It's a protein in the little wheat husk. It's the protein component. It's a really long, like a thirty three long strand of polypeptide chain. What happens is as that goes through the small intestine, the cilia, it actually penetrates down into the cilia and gets into the internal lining of the intestine. Your body thinks it's a foreign agent, like a virus or something. It bursts out with a big immune response, with T cells and all kinds of tumor releasing enzymes. It actually tears up the internal lining of the small intestine.



Now it's all inflamed. The cilia just disintegrate down to where now there's very little absorption and these little tiny cilia. You want the long cilia where you can absorb on this whole surface. Now it's all shrunk down and you're not absorbing nutrients. You're not getting vitamin d, so you start getting osteoporosis. You're not getting vitamin B, so you start seeing oral changes. About seventy five percent of Celiac patients over the course of their lifetime will start to get large aphthous ulcers in their mouths. You try different things and it's not toothpaste and it's not acidic foods and all of that, and you're still getting these painful aphthous ulcers, that's when you need to start looking at the fact that they probably might have some Celiac Disease.



You'll also see because they don't absorb calcium and different products like that, as their teeth develop, like if they're a child and they're having Celiac inflammation in the bowels, they're not going to be absorbing nutrients and the teeth don't form as well. When you see decalcification or mottling of the enamel edge on the first molars and the two central incisors, that's one of the biggest indications that that might be a Celiac patient. Fifteen to twenty five percent of them have herpatic derma ... Sorry, it's like a dermatitis. It looks like a herpes rash, like a really bad spreek dermatitis or something, looks like little pimples on the skin. If they have spreek dermatitis, they will end up with a positive identification for Celiac Disease.



There's a lot of blood tests that you can do for Celiac Disease. The best ones are the IGM-EMA and the -TTG. Those are the two best blood tests. Unfortunately those are very expensive. My daughter did some of the blood testing that was a lot less refined. They gave her positive diagnosis of Celiac Disease and that's why I've had to get so up on the topic. In the end, we found out it was more of an anxiety, irritable bowel type of syndrome. What I realized during all of my reading, it's like I've read over a hundred articles on Celiac Disease and how it effects the body. You name it. If you've got a patient where you see they have all these immunological disease like thyroid disease, diabetes, even MMR patients are at high risk for Celiac Disease or if anyone in their family ...


Howard:

MMR stands for?


Shelley:

Mental retardation.


Howard:

Really? That's the new name, MMR?


Shelley:

Yes. Yeah. It's ... Sorry, I'm not thinking of the name right now. That's what my retardation folks ...


Howard:

Is that mongoloid mental ...


Shelley:

Yeah. Anybody with Down's Syndrome, Trisomy, any of that.


Howard:

That's in the same cluster with thyroid, diabetes?


Shelley:

I'm just saying they're at a higher risk. Those types of patients are. A lot of the people who I know who have Celiac Disease were in their seventies before they got a diagnosis. When I would talk to them about it, they would say "I'm really glad you're talking about the aphthous ulcers and the swollen tongue" and all of the vitamin deficiency problems that we would see, because they said "I've had all those symptoms throughout my whole life." Almost all have some form of diarrhea. Nothing gets absorbed, it just goes right on through. Their bowels are all inflamed and pained. Their bellies are swollen. You look at a little kid and they look like one of those African kids with the stomach sticking way out. It's sad.



A lot of the GI doctors don't know what they're talking about. We got a bad diagnosis from a GI doctor. There are very few ... What I tell patients is if they have a lot of diarrhea, I see mottling or I see that those teeth that I'm talking about are all crowned, and I'm like "Why did they crown your ... All your first molars are all crowned. What happened?" "I don't know. They just came in and they looked weird and they had all these weird spots on them." Those kind of signs are things to look for. If we could catch kids at a really young age by seeing they have aphthous ulcers, they have diarrhea, all of their incisors look goofy, that would be a great thing, like "Let's go run these two blood tests on them and see what we can find out here."


Howard:

Is there a racial component in this, because I was noticing when I was lecturing in Ireland the grocery stores all had a Celiac, gluten free section. This is going way back in the day. An Irish dentist told me that the Irish have more Celiac than any other group of people. Have you heard that?


Shelley:

It's not Ireland, but it's northern Europe, like the Danish. I think the Danish had one of the higher instances, like Norwegians, Finlands, Sweden, all of that area, huge components up there. In America, we're in the one to two percent might have some of the genetic components. There are two genes that you can have. If you don't have them, there's no way you can have Celiac Disease. We finally genetically tested my daughter. She didn't have either gene, so there's no physical way that she has Celiac Disease. You can have these two genes and if you have one, it can be expressed as Celiac Disease. It might not be, but you can still pass this down to your child. There's a lot ... You have to have the genetic component. You can imagine that a mass of the world has all of these genetic components and they're breeding with people who have the genetic components, you're going to have a higher expression of a dormant gene.


Howard:

Genes are very important. I've noticed all four of my boys are batshit crazy. I think it's a genetic ...


Shelley:

I like Ryan, though. [inaudible 00:42:15]


Howard:

You like Ryan?


Shelley:

He's going to be a good husband some day. He was patient with this blonde girl's computer.


Howard:

Ryan is a fine young man. Basically, this is only a disease though because you don't live in China. If you moved to a rice based society, it would [cross talk 00:42:31]. If you've got Celiac Sprue, you should just move to Schengen and you'd be set.


Shelley:

There's rice and you're set. Yeah, because it's all about the wheat. Elisabeth Hasselbeck, she came to popularity because she was on one of the Survivor shows. When they put her out on this remote Australian island where she had to eat dirt, she said best she ever felt in her whole life. The show ended and she went back home to New York where they had this big family reunion to celebrate her getting off the show and what did they serve? All pasta. She immediately after she ate that meal got brutally sick. It was because her gut had finally healed on a gluten free based diet. She went back home, had a whole bunch of wheat pasta and was instantly sick. That's when she found out she had Celiac Disease.


Howard:

I was also one time talking to a dermatologist. This is way back in the day. It was about twenty years ago. He was telling me that he had read this paper where a dermatologist, epidemiologist went all over the world and whenever they went to island countries with zero processed food, there was zero acne.


Shelley:

I bet, yeah. Get rid of lots of stuff.


Howard:

Yeah, and he says "Then you come to a country like America where they only eat processed foods, they say 'It's your hormone. He's going into heat. He's a teenager.'" I'm sure everything's more complex than a simple [inaudible 00:44:05], but that ...


Shelley:

No, it's all that DMO stuff and all the chemicals they add. Look at all they have changed. I've done a lot of research through the girl scouts on food, but if you look at how much we've changed how we do even milk production and cows are eating modified grain and then they're fed all these antibiotics and all that stuff and all of the people who now have lactose intolerance. Back when you and I were growing up, none of our friends had food allergies. Now every other kid I meet has a food allergy.


Howard:

The autism rate's gone off the charts.


Shelley:

The what?


Howard:

The autism rate has gone off the charts.


Shelley:

Yeah.


Howard:

Hey, I wanted to say another male, female thing. It's so easy back when we were little and everything was they were breaking markets by Chinese, Hispanic, White, whatever. Then they got into the male, female. You said something about do women have a competitive advantage, and you said with older people, older people might think a male ... Everything I'm reading on elite market segmentation is based on how the difference in the senior citizens think versus the baby boomers or the generation x-ers, the millennials, and so many things correlate with how they think. I think a lot of male dentists, if you say alternative medicine, naturopath, they just like "You're a quack. Quack." When I look at marketing, I see still women making ninety percent of all the dental appointments. I see the older male dentists who always are ranking on the naturopaths, I'll be honest myself, I have almost no faith in the American healthcare system. I won't take any prescription pills. You go in there, you know they're just going to fillet you open, give you a stent, give a [inaudible 00:45:57].


Shelley:

[inaudible 00:45:58].


Howard:

Yeah.


Shelley:

Nobody wants to fix anything anymore. They just want to replace it. It's like the TV.


Howard:

I know.


Shelley:

There's no TV repairmen anymore.


Howard:

You hear all these dentists saying that they don't want to get on five, six, seven, chronic prescriptions and playing that game. When you say to that older dentist "Hey, what do you think of alternative medicine or naturopath or whatever?" They go ballistic, but I see dentists who basically do dentistry the same as you and I, but on their website "Ask about alternative dentistry" or "Ask about more natural alternatives." They start using those zing words. I know one dentist in the very competitive San Francisco that all he did was take his dental office off the grid with solar panels and was bragging about how he's an environmental friendly dentist and he's off the grid and they recycle everything. He says those are the biggest freaks. People drive an hour just to record him for being eco-friendly. I was going to ask you. All of this long winded crap was to get to this question. Do you think women making dental appointments would be more interested in a dentist who talked about more natural remedies or alternative things?


Shelley:

One thing I've learned early on in my career was all the people who healed super well after an extraction were my vitamin freak patients. I'd do a surgical extraction on somebody, have three stitches in them, they come back seven days later back in the old days when we took out the silk sutures, and they looked like they'd healed up a month. I'm like "What have you done differently?" "I'm kind of a vitamin C freak." Every person who had that ... I had a lady who did oral sprays with vitamin C, she had some of the worst type for perio I've seen and I'm probing her gums and not one bleeding point, yet I'm hammering on calculus down there. Her gums look amazing with vitamin C. I became early on convinced that vitamins would really help.



The point with vitamins are not all are absorbed equally. If I've learned anything through my Celiac studies, it's that vitamins go through the intestinal wall in a clump. You want to get a vitamin that's nano-encapsulated so that it breaks down and gets absorbed by these cilia a lot better than a clump that just kind of goes along and you just absorb what's on the outer edge of the clump. Vitamins make a world or difference in a lot of things. When I see a patient who's got the red, inflamed gums, they have macular degeneration, there's all kinds of different vitamin related things, even a patient has some thyroid disease. Maybe they need some iodine in their diet. There's all kinds of things that we need to now go get more versed on, because the science wasn't there back in our day. It is now. If you're not keeping up with continuing education, you're going to be practicing. You're still going to be putting copalite in a prep and sealing up the amalgam. I don't even own those things in my practice anymore. I wouldn't be caught with them.


Howard:

I'm a big believer in cranberry juice. I just think cranberry juice is good for every organ in your body. Every night before I go to bed, I always have a double Grey Goose with a splash of cranberry just for that alternative medicine. It's funny you said that because the first medicine ever invented on earth was actually vitamin C. In fact, C stands for citrus. It was the British physician who noticed one ship came back and nobody had scurvy. They surveyed the whole ship and the only thing they found in there was a barrel of limes, which is why to this day a British sailor is still called a Limey.



He went to the king and he explained this to him. He said "Next time the ships go out, I want half the ships with limes and half the ships without." Three years later they came back and the ship without the limes had the standard twenty five percent mortality rate. That was the first medicine, it was the man made observation that one boat came back with no scurvy and that physician put it together to a lime. That is just amazing. Back to the original question of this deal. Do you think that graduating from dentistry in 2016 is just as good as when you got out in 1989?


Shelley:

I think it's way better, Howard, because now you can do implants. I love doing implants. You can do veneers. You've got porcelains. Back in our day, you had copalite, amalgam. Remember when we would mix together the composite catalyst and base? Their still doing that in the prisons. It's sad. Don't get me started on that. We have so many new things. In 1981, I had a diastema between eight and nine. Ortho hadn't closed it. My dentist, Doctor Bill Lockard, said "Hang tight, and I'm going to go put this new thing on you." It was the old Nuva-fill light cured composite. I don't know if you remember Nuva-fill.


Howard:

I do.


Shelley:

Put it on my two front teeth, honey, it's still there to this day. The stuff that was just coming out when you and I were graduating, I was one of three people who took a class called dentin bonding my senior year, 1989. That's all we do now. Everything I learned in dental school outside of crown and bridge prep is pretty much out the window. Dentistry has changed so much, so much more exciting I think now.


Howard:

You walking into a que- You talked about prison dentistry. I want to go there because we've actually been ... We've had so many emails. We're trying to get that girl, Doctor Shannon Weiners. I did a Ironman with her father, Randy. Yeah, one of my Ironman buddies had six daughters and one of them's a dentist. She's works in [inaudible 00:52:20]. Didn't you actually know the famous orthodontist who went to prison?


Shelley:

Yeah. I got a letter from her last week, Doctor Clara Harris, the dentist who ran over her orthodontist husband in Clear Lake, Texas.


Howard:

Clara Harris was her name?


Shelley:

Yep.


Howard:

She was from Venezuela was it?


Shelley:

Columbia.


Howard:

Columbia?


Shelley:

Bogota.


Howard:

Was she an orthodontist or a general dentist?


Shelley:

No, her husband was. She's a GP. We did our general practice residencies a year apart. That's how we became really good friends. One of the finest people I know, still to this day. We think she's going to get out this summer. It'll have been thirteen years since she killed him. Convicted, let's say.



When that first started, about three, four years into Clara being incarcerated, she fractured off the whole lingual of number fifteen. The dentist there was putting, I'm not kidding, putting formocresol on the surface of the tooth and putting some IRM on it. Who puts formocresol on a live tooth?


Howard:

Shouldn't she have just swished with coconut oil for twenty minutes?


Shelley:

Yeah, that works every time. I hate that. He was doing all this voodoo dentistry. We went out and changed the state law so that I could go in, this is how powerful her friends are, that I could in. I did eight crowns on Clara in the prison dentistry clinic. The stuff I saw there was frightening. They had these old curing lights. They had this, I'm not kidding, the catalyst and base composite material. I said "Look, I can go ..." and I had Michael Miller with Reality on board to come in and donate like twenty curing lights and all of this material. He was like "Man, just go in and clean out my storage units and we'll donate it all to the prisons."



They wouldn't take it. I'm like "Why? Why wouldn't you take free stuff?" Because they all have to be identical, they all have to be approved through a formulary, and it can't be various materials that could be used as weapons and yada yada. It drove me crazy. It was really a very awful experience. For her, it was one of the greatest things I could've ever done for her. Every day sitting there in my chair, she was the best patient. She said "When you're here working on me, that's my mental escape for the day. I get to be transported a place where people care for me." Seeing what this population of people, it's a very enriching, rewarding experience as long as you're not too worked up about the materials you get to use.


Howard:

Yeah. It's funny how no good deed goes unpunished. Did you see Lenny Kravisch, he went to the Bahamas and set up a charity dental clinic and they shut it down because he didn't have the right permits and papers.


Shelley:

It's sad.


Howard:

It's like here's Lenny Kravitz trying to do a good thing. What's the life lesson on Clara Harris? Can really good people just snap and do something terribly bad and they're really a good person and they just snapped or what's your make of that? She did run over her orthodontist husband.


Shelley:

She ran over him, but everybody thinks she went chasing him down. She didn't. She went on the other side of a car. He jumped out to stop her and she was going ten, fifteen miles an hour and he went under the car. She did not do this multiple drive over thing. She ran over him one time.


Howard:

They said she drove around three times.


Shelley:

Right. No, she drove around the parking lot three times because she's freaking out about what just probably happened. She was really losing it. There's no way I can explain the losing it part. She'll tell you "I don't have any memory of what happened after David jumped out and stopped me." I think she knew in the back of her mind that she had run over him accidentally, but she took her car over there to bash the car of the lady he was cheating with. Didn't have anything to do with wanting to run David over. The running around the parking lot and doing all that, she's actually running over little hubs in the parking lot, not bodies.


Howard:

I have to tell you that I met the mother of my four children when I was fourteen. We were married for twenty years and she's still very, very, very, bitter about the divorce because she didn't want a divorce, she wanted a funeral.


Shelley:

I can relate.


Howard:

She can take driving lessons from Clara. What is Clara going to do when she gets out?


Shelley:

She's been doing Braille in prison, so she takes textbooks and she converts them to Braille for blind children or visually impaired children. Every state has to provide that by law for the blind population.


Howard:

Two things on you, we just started on Dental Town a mentorship programs. The dentists on Dental Town have been pioneering this mentorship program. We just launched it. It's all the buzz. I was wondering if you would just look at it since you're the most mentor expert I've ever known or heard of. Like I say, it started on Dental Town. It started on a message board thread and they were saying "Why don't you do this and that?" We just started that and I would love for you to take a look at it and see what you think. Also, any chance we ... The whole continuing education is moving online because you don't have to close down your dental office and fly to a different city. We put up three hundred and fifty courses. They've been viewed over half a million times. Any way we could score an online CE course from you? I could see you doing one on four young dentists and I could see you doing another presentation on Celiac Disease and dentistry.


Shelley:

I would love to do it, Howard. Have Ryan get in touch with me and I'll set it all up.


Howard:

All right. Ryan just email her. There's two Howards at Dental Town, Howard@dentaltown.com, but Howard Goldstein, he goes by Hogo@dentaltown.com. What if one of these kids listening to me wanted to talk to you? Are they allowed to contact you?


Shelley:

Of course. My cell phone number is 713-553-6476 and my email is D-R Canada, that's C-A-N-A-D-A at me.com, M-E.com, so it's drcanada@me.com.


Howard:

Is the question a little redundant to say are you Canadian? You can ask the question where does the name Canada come from?


Shelley:

It's German. It means canal dweller.


Howard:

Is that what Canada's named after? Is that a German name?


Shelley:

No, that's named after some old Indian name. It's an Indian tribe name up there.


Howard:

We were talking about Lenny Kravitz getting shut down in the Bahamas and Canadians like to go to the Bahamas, because they come from Canada which is C-A-N-A-D-A, so they go to the Bahamas, which is B-A-H-A-M-A. I heard that from a bartender in the Bahamas. Shelley seriously, our hour is up. Thanks for being my idol and rock star mentor for thirty years. Please take a look at Dental Town's new mentor program, because ...


Shelley:

I will, I'll get on it this week.


Howard:

If it needs tweaked or anything, I'd love to hear from the expert herself. If we could score an online CE course or two, I would love to have one on young dentists.


Shelley:

Right. I have a lot of [cross talk 01:00:21].


Howard:

In fact, Dental Town, most people wouldn't know this because [inaudible 01:00:28], but once a year we have a new grad issue, so once a year, the five thousand grads walk out and we send them a special issue of Dental Town of just issues towards the new grad. I could see that working, tying in with that where they sit there and say go on to Dental Town "What's this course, New Grad Issues from Shelley Canada?" It's an honor to meet the dentist that they named Canada after, Shelley Canada. Thank you so much for spending an hour with me today.


Shelley:

Yeah, my pleasure. I love it. Thank you for all you do for dentistry.


Howard:

Tell Michael Miller and his wife Ingrid ...


Shelley:

He's next.


Howard:

I'd like to see Clara when she gets out.


Shelley:

I will. When she gets out, we'll put her on and we'll talk about what she's seen about prison dentistry and what the population's needs are. She'd love to do that.


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