Things I know for sure … maybe (by Robert J. Weyant, DMD, DrPH)

From RDH Online Edition.

I’m glad it’s not only me who gets confused..

Fluoride works primarily through a systemic effect. Everyone knows that. Wait; no it doesn’t. It’s mostly topical; I saw some research. Wait! It does have a large systemic effect, I learned from some more research. Is that the only effect? No. Is it the major one? Oh my, maybe it’s both. Which effect is bigger? Does it vary by age? Who knows? Now what do I tell my students?

Well, at least I know that diet is of huge importance in controlling caries. I will tell them that. And food consistency is important — sticky is bad. No, soda pop is bad — but it’s not sticky. Well, then it’s actually frequency. No, there’s no association with frequency, I saw it in some research. Then it must be total intake. But in the U.S., sugar consumption continues to go up and caries down. Wait. We are all well over the cariogenic threshold, so it doesn’t matter. Even if it does, people won’t be convinced to change their diets. Better skip that lecture too.

Remember the answer to the old question, “Do I have to floss all my teeth?” “No, just the ones you want to keep.” But flossing isn’t associated with caries is it? Can I say that out loud? It just helps with gingivitis, which isn’t really associated with periodontal disease anymore, either, right?

But you better get your teeth cleaned regularly or you’ll get periodontal disease, or maybe not. Well, at least we know that periodontal disease causes heart disease, preterm birth, and diabetes. So let’s treat the perio and cure the other disease. That seems simple. What do you mean the other diseases don’t change when you treat the perio? That doesn’t make sense. Oh my, it’s so confusing! Mum’s the word.

Well, perhaps I should just stick with the truism that everyone should brush for three minutes and use the proper technique and the right brush, because all plaque has to be removed to prevent decay. What do you mean you can’t remove all the plaque with a brush? Say what? Not all plaque is bad? Can that be? Some people have lots of plaque and no disease? Whoa there! It’s the fluoride that does the trick. So don’t worry about brushing technique — just get the fluoride in there. Does that sound right? So confusing. But is it the topical effect or the systemic? I think I’m back where I started. I still don’t know anything. What are my students to do?

I know. I’ll tell them to send all their patients to have their third molars out. Those things are always trouble.

Robert J. Weyant, DMD, DrPH, is with the Department of Dental Public Health, School of Dental Medicine, University of Pittsburgh.

The Monday Morning Quote #66

“People often say that motivation doesn’t last. Well, neither does bathing. That’s why we recommend it daily.”

Zig Ziglar

The Weekend Read – Your Best Year Yet by Jinny S. Ditzler


This is widely proclaimed as a “classic of its kind” and suggested by every life coach in the land and beyond. I have to admit that I have not read it, until now. So, as the Christmas season is just about upon us and a New Year beckons, I have decided to use Jenny’s book to help me through my plans for the next year and beyond.

The worst review posted on Amazon is a pretty good 3-stars and says “I liked this book for the excitement that the process of working out my goals and priorities created for me. I originally started the process in August and by December I had made some very good progress. It is motivating and clear to have the 1 page ‘best year yet’ plan. The one significant flaw for me was the rather hopeful promise that it was possible to have a plan for the year put together in just three hours. I don’t believe it would be possible to do such a plan that wouldn’t need significant revision somewhere further along the line.  Overall I feel this is a good book, however I find that I needed about a week to do the plan properly. Also I needed to bolster the content with other texts concerning goal setting for me to be able to put a considered plan together.”

On the contrary the 9 5-star reviews make me even keener to get cracking, if you want to kick start your new year perhaps you might care to join me?

Let me know how you get on.

Available from my shop on Amazon. – the bogblog entry

What a great title for a website. I saw this piece in Dentistry magazine and thought I’d pass it on. I knew that  Shaenna and Phil Loughnane were great supporters of various charities in Africa but this is a new one to me. A lovely way for your team and patients to help.

What’s stopping you doing the same thing in your practice or business?

Dentists first in world to twin toilets
14th Dec 2009

Dentists are blazing a trail by being the first in the UK to sign up their surgery loos to a global toilet twinning campaign, linking them with latrines deep in the African bush.
The unusual charity fundraiser is making a splash with staff and patients alike at the Chipping Manor Dental Practice in Gloucestershire.
For just £60, twinning can help a family returning home to Burundi, a tiny country ravaged by years of civil war, to rebuild their lives from scratch.
Every ‘twinner’ receives a picture of their exclusive twin latrine to hang in their loo, complete with its Google Earth location so they can pinpoint it in the remote Rutana Province of Burundi.

toilettwinning-logoThe toilet twinning is the brainchild of UK International charity CORD which works in Africa and Asia with the victims of war and violent conflict.Business development director, Shaenna Loughnane, said: ‘Our two NHS practices in Wotton under Edge and Cirencester have 10 dentist and nurse teams and 23,000 patients and this has really captured their imagination.’
‘Our patients and staff take our clean safe toilets for granted, and for £60 we can make a tiny difference. This is the same amount that we spend on 20 boxes of gloves that lasts a dental team twp weeks. It would be great if we could motivate others in the dental industry to jump on board; practices spend thousands every year on  infection control and health and safety when people in these war-torn areas are dying from diseases that could be stopped if only they had clean, safe toilets.’
The dentists and their staff have already raised thousands for African and local charities; ten team members have also visited Tanzania to lend their dental skills as well as giving 10% of their private income to good causes.
‘But Toilet Twinning has to be the one that’s got everyone talking,’ laughed Shaenna.
It is estimated that 40% of the world’s population – 2.6 billion people – do not have access to a toilet, yet the Millennium Development Goals for sanitation will not be met until the 22nd century, 80 years past the deadline.
Left lying around, human waste is a killer with a child dying every seventeen seconds from diarrhoeal diseases.
Without proper sanitation and health training, Burundians can’t hope to keep well, to work, go to school and begin to rebuild their country.
To twin your loo, visit or call CORD on 01926 315301.

8 questions and a why – Seth Godin

I do wish I had seen this before I set up any businesses.

8 questions and a why

  • Who are you trying to please?
  • What are you promising?
  • How much money are you trying to make?
  • How much freedom are you willing to trade for opportunity?
  • What are you trying to change?
  • What do you want people to say about you?
  • Which people?
  • Do we care about you?
  • (and after each answer, ask ‘why?’)

The Monday Morning Quote

Accepting full responsibility for every little thing in your life, is what opens the floodgates to joy and power.

Or to what we here call “joypower.”

Every little thing,

The Universe

Firing Customers – Paddi Lund

I have hardly referred to the day I spent with Paddi, Fletcher and 20 or so delegates in Wakefield last month. It was an intense and long but ultimately uplifting day where it was a pleasure to watch the ah-ha moments in others as well as experiencing them myself. In spite of the fact that Paddi was suffering from laryngitis he managed (with Fletcher’s assistance) to deliver a full day.

Since than I have been receiving the newsletters from Solutions Press, go to and sign up to ‘Paddi Pages’. One of the most contentious things that Paddi preaches is the “sacking” of patients. I had trouble recently trying to persuade the team members that just because someone had money and you were able to provide a service didn’t make them the right person for your business. So when the current letter came from Brisbane it rang a few bells and I thought I’d share it, because as ever, Fletcher Potanin puts it better than I.

Dear Alun

You’ve got a decision to make!

Forgive me for being presumptuous, but I really think you do. And it’s this:

Are you in Public Service, or are you in Business?

Because really, the two are fundamentally different. If you’re in Public Service, then it’s appropriate for you to take any and all comers as customers, to attempt to treat them all equally regardless, and to respond to the obligation you feel of helping anyone with your product or service who asks.

And let’s face it. That’s how most of us in business start out.

But if you decide you are in Business, not Public Service, then that approach – attempting to be all things to all people – can actually get you in lots of trouble!

It certainly did for Paddi. You might recall this key frustration from last issue.

————  Key Frustration #5: Poor Customer Service  ————

Like most conventional dental businesses, patients were on a 15 minute treadmill. Get ’em in. Get ’em out. Drill, fill and bill. Book any real treatment for another visit – hopefully within a few months as the schedule was pretty full.

In a perfect world, this system might have worked. But in reality, the days rarely went perfectly for Paddi. A hundred different things could go wrong, and any one of them put the schedule behind – potentially good patients were kept waiting, Paddi and the team were stressed, and little genuine care and attention was afforded the poor patients.

Not a recipe for success! But Paddi had his new resolve to fix his frustrations. So after pondering it for a while, Paddi did the unthinkable,

He “sacked” 75% of his customer base! Yep. Paddi “fired”, dismissed, removed, stopped seeing nearly three quarters of the people on his books that he’d spent the better part of 15 years building up.

Have you ever dreamed of ‘firing’ some of your more painful clients? You know, the ones who complain a lot, waste a lot of time, never seem to be satisfied and actually end up costing you money to service? The reality is, it’s likely you already have many customers that you don’t need. So why not “fire” some?

Now I say “fire” in quotes because that is in effect what Paddi did, but not quite in the way that most people think.

————-  The big misconception about ‘Firing’ customers ————–

The biggest misconception most people have of what it means to ‘fire’ customers is that you actually have to ring them up, write them a letter or look them in the eye and say, “That’s it. I’ve had enough. You’re fired!” (As much as you might like to in some instances!)

No, you’ll rarely have to do any of that.

Really, the first step is simply realising not all customers were created equal! And the second step is to benevolently “fire” the worst of them! Here’s a few ways you can do it:

  • Don’t contact them anymore. Statistics indicate that 67% of customers don’t repeat buy because of perceived indifference. So just ignore customers and you’ll take care of most of the problem.
  • For your more persistent difficult customers, why not just raise your prices.  At some point they’ll either leave or you’ll be happy that the money you receive compensates you for the pain!
  • And for the really persistent customers, then you might have to take some action like writing them a letter or talking to them in person to invite them to do business elsewhere.

By the way, Paddi doesn’t turn anyone away who is in pain. On the contrary, now that he has so much more productive time, he’s happy to treat any acute cause, otherwise he couldn’t really call himself a doctor. It’s just that because he takes such good care of his customers, he doesn’t get nearly as much of that any more.

For more on the why’s, how’s and where to’s of sorting, “firing”, filtering and influencing customers, have a look at Paddi’s insights into the subject at TrainingCustomers

Is that a scary thought? “Firing” customers? It is for many of the people I talk to. Yet as Paddi so eloquently puts it, “In the matter of customers: quality surpasses quantity.”

But if you think Paddi’s approach to difficult customers was outrageous, just wait till you see how he handled the thorn in his crown that was his accounts receivable! Paddi’s approach to debt collecting will completely blow you away!

That’s for next issue.

See you then.
Kind regards,


Fletcher Potanin
Managing Director
Solutions Press Business Publishing

Exploiting Government Policy?

I am assured that this is genuine, where are we going?

GU30 7JT

Rt Hon David Miliband MP Secretary of State.
Department for Environment, Food and Rural Affairs (DEFRA),
Nobel House
17 Smith Square

16 July 2009

Dear Secretary of State,

My friend, who is in farming at the moment, recently received a cheque for £3,000 from the Rural Payments Agency for not rearing pigs. I would now like to join the “not rearing pigs” business.

In your opinion, what is the best kind of farm not to rear pigs on, and which is the best breed of pigs not to rear? I want to be sure I approach this endeavour in keeping with all government policies, as dictated by the EU under the Common Agricultural Policy.

I would prefer not to rear bacon pigs, but if this is not the type you want not rearing, I will just as gladly not rear porkers. Are there any advantages in not rearing rare breeds such as Saddlebacks or Gloucester Old Spots, or are there too many people already not rearing these?

As I see it, the hardest part of this programme will be keeping an accurate record of how many pigs I haven’t reared. Are there any Government or Local Authority courses on this?

My friend is very satisfied with this business. He has been rearing pigs for forty years or so, and the best he ever made on them was £1,422 in 1968. That is – until this year, when he received a cheque for not rearing any.

If I get £3,000 for not rearing 50 pigs, will I get £6,000 for not rearing 100? I plan to operate on a small scale at first, holding myself down to about 4,000 pigs not raised, which will mean about £240,000 for the first year. As I become more expert in not rearing pigs, I plan to be more ambitious, perhaps increasing to, say, 40,000 pigs not reared in my second year, for which I should expect about £2.4 million from your department. Incidentally, I wonder if I would be eligible to receive tradable carbon credits for all these pigs not producing harmful and polluting methane gases.

Another point: These pigs that I plan not to rear will not eat 2,000 tonnes of cereals. I understand that you also pay farmers for not growing crops. Will I qualify for payments for not growing cereals to not feed the pigs I don’t rear?

I am also considering the “not milking cows” business, so please send any information you have on that too. Please could you also include the current DEFRA advice on set-aside fields? Can this be done on an e-commerce basis with virtual fields (of which I seem to have several thousand hectares)?

In view of the above you will realise that I will be totally unemployed, and will therefore qualify for unemployment benefits. I shall of course be voting for your party at the next general election.

Yours faithfully,

Nigel Johnson-Hill

The Monday Morning Quote #65

images“Keep away from those who try to belittle your ambitions.  Small people always do that, but the really great make you believe that you too can become great.”

Mark Twain

Dental Practice Management – The Mastery Programme – Dr Marc Cooper in the UK in January 2010

Marc Cooper of The Mastery Company is visiting the UK in January and is delivering three evening presentations for UK dentists who want to acheive mastery in their practices.

Dr Cooper has been coaching and consulting in the USA and continental Europe since 1984 and is the author of 5 books.

Most dentists achieve ‘mastery’ in their clinical delivery of dentistry. At this level, they handle problems, breakdowns and issues with grace and ease. At this level of mastery they accurately forcast the future. As clinical masters they direct themselves, their patients and their staff to produce quality clinical results.

However, this level of mastery rarely translates into a comparable mastery of the business side of dental practice. The ‘Mastering of the Business of Practice’ evening event is designed to introduce British dentists to the concepts and technologies Dr Cooper has used with more than 2000 dentists over the last 25 years.

Dates & Venues:

  • January 19, 2010 ULC Eastman, Gray’s Inn Road, London.
  • January 20, 2010 Academy of Clinical Excellence, Wakefield.
  • January 21, 2010  The Health Centre, Coleshill, Birmingham.

Fee £60. Time 7pm to 10pm.

Attebndance is limited to a maximum of 25 delegates. To register online, please visist

To find out more about Dr Marc Cooper have a listen to his interview with Marita Kritzinger from Apex – here

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