Summit 2019

With March Madness culminating in another dramatic Final Four, and the NBA Playoffs just underway, what better way to talk about implementing airway into your dental practice than a basketball reference?

Growing up in the late ‘80s and early ‘90s, it was easy to be a fan of Michael Jordan. He was everywhere. I had posters of him on my walls, his shoes on my feet and his highlight video in my VCR. So, what can “His Airness” teach us about airway?

We’re all familiar with the Nike slogan made famous by Michael Jordan: “Just Do It.” I think that has to be your mindset when you start implementing airway into your practice. When I mentor attendees at Spear’s Airway Prosthodontics workshop taught by Dr. Jeff Rouse, the biggest question I get is, “How do I implement all of this stuff?” My answer is always the same: “You just have to do it.”

When you are first enlightened on airway and the dentist’s role in identifying and treating issues, the mere terminology can be daunting. Acronyms like OSA, UARS, CPC, HRPO, HRV, PSG, HST … what does it all mean? It reminds me of another time when things were new and different.

Do you remember when you first heard operative dentistry terms in dental school? Cavosurface, Intaglio, Axiogingival line angle … but what was once completely foreign is now second nature. The only way something can become routine is to just do it repeatedly. The first time you prepped a crown you had no idea what you were doing. Now, you can almost do it with your eyes closed. (Please don’t try this!)

This brings me to a major hang-up that most of us have as dentists. We want to be perfect the first time we do something and every time after. Of course, that is not possible, but it still keeps us from trying new things. We’re afraid to be wrong. We’re afraid to mess up. Here is where we can take some great advice from MJ. One of his most famous quotes is:

“I’ve missed over 9,000 shots in my career. I’ve lost almost 300 games. 26 times, I’ve been trusted to take the game winning shot and missed. I’ve failed over and over again in my life. And that is why I succeed.” — Michael Jordan

When I first started screening my patients for airway issues, I was wrong. A lot. The first cardiopulmonary coupling (CPC) report that I shared with Dr. Rouse, I interpreted almost completely wrong. Same with the second. And the third. I was wrong over and over again, but if I had kept that to myself, I would have never learned how to be right. So, I kept trying, and eventually, I got pretty good at reading those reports.

When I got home from my first Airway Prosthodontics workshop, everyone got a CPC or an HRPO. If you worked for me, you definitely got one. If you lived with me, you got both. If I caught you mouth-breathing walking down the street, I handed you a sleep screening tool. (Not really on that last one, but it’s not far off.)

I screened a bunch of people that either wouldn’t or couldn’t be mad at me if I messed up. But I didn’t stop there because even though I did a bunch of tests, I still had no idea what I was looking at. I posted them either to the Spear Talk forum on Spear Online or to the Airway Prosthodontics private Facebook group, offered my thoughts and read others’ thoughts, always knowing that Dr. Rouse would likely tell us how wrong we were. It was humbling and maybe even a little embarrassing. But that’s how I learned and that’s how I think we all should learn. It’s those moments of vulnerability and mentorship that allow us to grow and improve.

Summit 2019
Figure 1: High resolution pulse oximetry screening of one of my hygienists Before and after nasal breathing therapy.

So, get out there and we “just do it!” Screen people, get their permission to share the results, share them, be wrong, and learn! As cliche as it sounds, the most important step on any journey is the first one.

“Some people want it to happen,” Jordan also once said. “Some wish it would happen. Others make it happen.”

You didn’t learn to ride a bike or drive a car or prep a tooth by reading about it. You learned it by doing it.

I’ll agree with Mr. Jordan one more time: “I can accept failure, everyone fails at something. But I can’t accept not trying.”

John G. Imm III, D.D.S., F.A.G.D., is a Spear Digest contributor and mentor in Spear’s ‘Airway Prosthodontics’ workshop.


Comments

Commenter's Profile Image Michael M.
April 15th, 2019
Thanks Dr. TJ Imm, Awesome article!
Commenter's Profile Image Mary Anne S.
April 16th, 2019
Dr. TJ Imm, that was a wonderful article! Well done! Thanks!