Why Dentistry Became The Calling

0:30

my name is Dr. Sena Rangeber, and my practice is called Lifetime Smiles, and we treat everyone with and without teeth. Awesome. And so could you take us back through, uh, that journey, kind of how you got into dentistry? Yeah, absolutely. So from what I remember, ever since I was a young kid, I always wanted to be a doctor. I loved helping people. And growing up, my grandfather actually was in the hospital, and when I went in, I was like I don't wanna do MD." You know? Mm. I didn't wanna tell people that their loved one is sick, so sick that they're gonna be passing. And so I always wondered why people... Some people always smile, some don't, and that always, like, sparked my curiosity. So in school, I, um, there was a Dental 101 course, and so I took it, and dentistry just was amazing. It-- There's so many things we can do in dentistry. And when I went to the course, there was orthodontics, endodontics, general dentistry, surgery. There were so many things, so I decided to go to the dental school and just assist, see how it is. Going there, it was really eye-opening. My experi-experience as, going to the dentist was just going, getting a cleaning, maybe a filling hearing, here and there. And when I went there, I was like, "Wow, there's so much we can do as a dentist." And so that's when I decided to go to dental school. And as I went there, and doing this for so long, I am just... I love it every day. And what we dentists can do, not a lot of people can, in the sense of giving someone their confidence back just by fixing even just a single chip on their tooth. So doing dentistry has just changed my life, but it has helped me change my patients' lives as well. Yeah, absolutely. So- And throughout, um, your career, uh, what has kept you passionate, um, about dentistry?

Staying Curious and Reducing Fear

2:50

Dentistry, it's a practice, right? So every day we are learning new things. And one thing I always focus on is being better Today than we were yesterday. And that's my motto at the office. Like, "Listen, guys, we're gonna do our best today and do better than what we did yesterday." And staying on top of dentistry 'cause it's always changing, right? There's so many new things coming out every single day, new products, new materials, new technologies, new ways of doing dentistry. And so that's what keeps it exciting, right? It's like always learning new things, new techniques, new ways that we can help improve the health and the smile of our patients, but making it easier and not making dentistry scary. Absolutely. Right? Yeah. And for patients that come in with some apprehensiveness- Mm-hmm what are some ways that you can take away a little bit of that nervousness? Sure. So, patients, I always joke with my team and tell them, you know, we don't have teeth walking into the office, right? We have human beings coming into the office. And for us- Teeth and dentistry is our, our world, right? For our patients, they have so much going on in their lives. They have family, work, parents, everything, and they come to the office with so much stuff going on, and a lot of them have had bad experiences growing up, and that anxiety is always there. So the... Meeting a patient for the first time, we always wanna talk to them about their goals, why they're there, what they'd like to achieve. You know, just on a human level, right? Not just getting in there and looking in their mouth, right? Um, getting to know the patient and just building some rapport with them, letting them know that we're there to help them, right? And whether they want just one tooth fixed or they want us to look comprehensively, we can do that. We don't want them to feel like, they're just a number, right? Mm. They're a human being in our office that might have some an- anxiety with dentistry. So getting to know them, just helping us understand why they're there really helps just reduce their anxiety. Yeah, especially when you're, especially when you're in a new place too. Right. Yeah. You know? And then you're, you have that, that apprehensiveness from maybe a past experience. Um, and then from your perspective, when you work with patients that have worked with other providers and said that, you know, nothing can be done, how do you approach that type of situation?

Second Opinions Without Blame

5:39

Dentistry is... There's a lot of gray in dentistry. It's not black and white, right? Most of the time there's different ways we can treat a patient. It's not right or wrong, right? It's just different, and it really depends on the doctor's skills, their training, the school they went to, how much experience they've had with that particular situation, right? So I don't say that doctor was wrong. It's just different, and I talk to the patients of what we could do at our office, how we can help them, what the risks and benefits are, and have the patient make an educated decision, right? There's just different ways we can do, uh, you know, treat a tooth, sometimes they're like, "Oh, my doctor previously told me I can do a crown and I don't wanna do a crown," and maybe they just need an onlay or an inlay or just a filling, right? So there's different reasons why certain doctors treatment plan differently. Yeah. And I think it's awesome that you take the time to educate, because it can be hard when, you know, you go to one person and then they're like, they're, "This is, this is what's happening and there's nothing you can do." And then you go to another person and they're like, "This is what's happening, and then these are, you know, different options that you have." Right. Yeah. Yeah. Mm-hmm.

Comprehensive Dentistry and Whole Body Clues

6:57

All right. So talk to me about what comprehensive dentistry means to you. Sure. So at our office, we always treat patients comprehensively. At least we'd like to if they allow us, right? So comprehensive dentistry is looking at the whole patient when it comes to their medical health, right? What medications there are, what health con- conditions they have, and then we kind of look at, okay, how is this affecting their mouth? There's so many things we can see in the mouth, right? So a lot of times we can look in a patient's mouth and say, "Hey, when was the last time you went for a physical?" 'Cause they may have diabetes, hypertension, other chronic conditions that they're just... It's been so chronic that they're used to not feeling... They're like, "It's normal." Um, so comprehensive, we look at the gums. We take measurements around the gums. It's called periodontal charting. So we wanna see where the bone level is and where the gums are. We chart if there's any bleeding, any pus, recession around the teeth. We take a dia- a diagnostic scan. It's a digital scan basically, and it's great because it's what the patient's mouth looks like at that time, and we can track it over the years to kind of see, is, are things getting worse? If they're clenchers, grinders, are they wearing down more teeth? We can't... We think we can remember, but we can't. And with digital technology now, it's very, very accurate, and we can see, is the wear getting worse? Is the recession getting worse? Are they... You know, if they have crowding, is it getting worse over time, right? And it's very different just telling a patient, right? 'Cause a lot of times, like, they'll say, "Okay," but when they can actually see it on a screen, it makes a lot more sense to them. Mm-hmm. Right? Um, so doing that, looking at where their oral health is at this moment, right? Do they have any gingivitis, or has it progressed into periodontal disease or gum disease, right? Coming up with a specific plan, um, a treatment plan that will help them get healthy again, right? And then taking a look at every single tooth for cavities, cracks, fractures, anything like that, and then looking at their overall bite, right? Um, we wanna make sure their bite is in a good, stable position so that they don't have premature wear and tear and break teeth early, right? So we wanna have healthy gums, healthy teeth, balanced bite. Awesome. And then that's so interesting to hear, like, how one... When something's wrong in one part of your body- Mm-hmm you can tell by just looking in their mouth. Mm-hmm. That's so interesting. Yeah.

Digital Dentistry and Faster Care

9:59

And then with, like, new technology and different things coming out every year, what are some things that you've noticed are different or changing now that ha- maybe weren't there when you first started dentistry? Oh my gosh. So I graduated in 2004 from dental school, and so much has changed. We have digital dentistry now. So we have scanners, which is amazing because we don't have to use that goopy stuff in- patients' mouths that nobody likes. So we scan everyone. We can make crowns in one day, right? So whe- when we see a patient that needs one, two, three crowns, we prepare the teeth, scan them, design the restorations, mill it in our office, and then put it in their mouth, and they don't have to go with temporaries, right? So before, we would prepare the tooth, put a temporary, patients would come back in three weeks, and then we have to numb them again, put it on. And a lot of times, temporaries would come off. If they have a trip, their temporary's coming off over, at another state, you know. And now like- Oh my God "Oh my God, what am I gonna do?" Um, so that has been really great. We have 3D printers where we can print night guards, we can print models. We can digitally design teeth and print the new smile design. We can print smile- like transitions basically where they can see their smile before we even touch their teeth. Wow. Right? And there's a lot of AI that's being used in dentistry now from, you know, taking notes to digital, um, like smile simulations that we can do with AI and kind of give a patient a look of how their smile may look if they decide to do cosmetic work, right? Mm-hmm. And it's really amazing 'cause it's not, it's not just a still picture anymore. You can actually do a video of them just talking- Wow and looking at their teeth, whether it's Invisalign treatment where they can see their teeth when they're, straight, or if it's just a full smile makeover. So dentistry's come a long way since I started. Yeah. That's so awesome. You're able to do different things in a shorter span of time. Oh, yeah. Yeah. Within couple of minutes probably. Yeah. Yeah. And so Invisalign has become a really popular alternative to traditional orthodontics.

Invisalign and Bite Physics

12:35

How do you approach determining if Invisalign is the right option for a patient? Invisalign is just such an incredible technology to help patients improve their bite. So orthodontics is not done just to straighten teeth, right? I think a lot of times patients think, "Oh, well, you know, s- my teeth are just spaced out," or, "They're just crooked. I don't, I don't care," right? "I don't need it to look good." The reason we do orthodontics is actually because we wanna have a stable bite where the forces are even on the teeth, so that you don't wear one side of your teeth or the other side or crack teeth, things like that. So it's all physics, right? We want our teeth to hit straight up and down when we're eating. You know, I always tell patients, "Think of it like a nail and a hammer." If you have a piece of wood and you have a nail that you're trying to hit, if you hit straight up and down, that nail's gonna go in. But if you're hitting it to the side, either the nail's gonna bend or the wood's gonna break or a combination of both. So it's the same concept when it comes to our teeth. When we're chewing, our teeth are usually going up t- up and down or, or kind of side to side, right? So with the teeth being misaligned, you're gonna have premature wear and tear on the teeth, the gums, or the bone, or a combination of them. So doing, whether it's traditional braces or Invisalign, it's really to help your bite. Now, Invisalign is just such an amazing technology where patients can straighten their teeth without looking like they're 13. So, uh, it... I treat a lot of adult patients now where they had orthodontics as a kid and they've got relapse, or they never, they never got orthodontics and now they decide to treat their teeth and get their bite correct. Getting the teeth straight is just a bonus, right? That they look straight and beautiful. So- With that, adult orthodontics is always, you know... I tell patients we're not... I would like to make it perfect, but giving an adult, the bone is different than a teenager. We can't get skeletal growth in an adult. So we always aim to making it better than where we started, and it may not become perfect like it would if they had orthodontics or Invisalign or traditional braces as a teen. As an adult, they're always gonna be in a better position with their bite, where their bite is gonna last a lot longer, their teeth will last longer, but the gums will be a lot healthier as well. So doing Invisalign, it's not just to make them straight. Mm-hmm. It's really to give the patient a really a healthy bite and healthy gums so that it pretty much lasts them the rest of their life. Yeah. And that's so interesting, the wood- the hammer and the nail analogy. Mm-hmm. I like that you use that.

Common But Not Normal Warning Signs

15:31

Yeah. So what are some other things, um, that people might not know or realize about dentistry, or they might miss? You know, dentistry, I, I feel like when patients move, the dentist is the last doctor they come to see, right? And most patients don't understand how important it is, right? If you're missing one tooth, there's actually studies done that your life will be shortened by seven years. Now, I have that article at the office, right? And that's just one missing tooth. They've actually done studies on it. Missing teeth will affect your ability to chew. It will affect the rest of the teeth, 'cause one missing tooth, the adjacent teeth kind of miss their friend, and they will tip. The teeth opposing will either come down or extrude kind of move upward. And so it will kind of have a cascade effect on the rest of the teeth. That will affect the bone and the gums with the surrounding teeth. So patients don't understand, especially at a young age, that if a tooth is broken or needs a root canal, needs fillings, get it treated early, right? The longer you wait, the worse dental problems get. So a $200 filling in a year or two can turn into a $2,000 root canal and crown, right? So the earlier you treat it, the better it is. The other thing I hope most patients understand is when your gums are, are bleeding, if you're brushing and flossing... Now, technique is important, right? 'Cause a lot of times patients say, "Oh, you know, when I floss and brush, my gums don't bleed." And we're looking in there, as soon as we touch, it's like bleeding, right? Um, normally, if you're brushing and, like, flossing under the gum tissue like you should, and they're bleeding, that's a sign of inflammation. Inflammation in the mouth is not good, and it actually goes throughout the body. Over time, that chronic inflammation will affect the rest of the body. And so if a patient sees that they're having bleeding with their gums, it's really important to see a dentist, right? Where they can evaluate. And if you treat it early, it just, it will heal. Bleeding gums, when it's gingivitis, is reversible. You can treat it. When it progresses and it starts affecting the bone, then it's not reversible anymore. Then we just have to kind of manage it and maintain it, right? That's when you start getting periodontal disease or true gum disease, where it's actually affecting the bone. So most patients say, "Oh, you know, it's just a little cavity. It's not hurting." Mm. "I'm not gonna fix it." Our teeth are amazing because when it's a small cavity, it doesn't hurt, right? You don't wanna wait till it hurts, then it's a bigger problem. That's when you know you, you really messed up. Yeah. And that's so interesting with the, with the flossing. Um, and then we kinda talked about that, where a lot of people see things that are common but not normal. Mm-hmm. Is there any other aspects that you see that are common among patients but aren't normal? Yes. So one is the bleeding gums. It's very, very common, but it isn't normal. It's just like, you know, if you washed your hands with soap and water and they started bleeding. I would be concerned, right? Yeah. It's the same. Our gums should not bleed when we're brushing and flossing. The other thing is when patients have wear on their teeth, right? Like, "Oh, you know, I've had 50, 60 years with these te- with these teeth, and it's normal for it to wear down." Usually no. Mm. Usually it wears down because the bite is in the wrong position, or they're doing parafunctional things like chewing on ice, chewing on pencils even just grinding at night, like bruxing. That will cause premature wear and tear on the teeth. So just because you're 50, 60, 70 years old, that doesn't mean that your teeth should be short little nubs, right? Mm-hmm. You should have pretty good-sized teeth if your bite is in the right place and you're not doing grinding or clenching at home. Yeah. And most people do it their, during their sleep. And a lot of times- The, like now with sleep apnea and things like that, a lot of patients who have sleep apnea or any type of sleep disturbances will clench and grind their teeth as well. Mm. So that's something that we are looking at when we see patients that are clenching and grinding as well. Interesting. Mm-hmm. And what are some habits that patients should adapt or avoid to keep their teeth healthy for a long period of time? Yeah. So, every patient's different, right? And their needs are different. Mm-hmm. So when I got out of school, it was brush and floss your teeth all the time and you'll be fine, and that's not true. Now with research and technology, a patient can floss 10 times a day with great technique and they can still have gingivitis, right? We see patients that come in and their mouth is so clean but their gums are inflamed, red, even kind of purplish. So we actually do saliva testing to see what bacteria is in their mouth that is causing this, right? So it's not always just brushing and flossing. Oh. When you go to the dentist, they really should look at your specific needs and see, okay, what's gonna help you the most, right? Sometimes patients need just plain toothbrush and floss. Sometimes patients need a waterpik. They need floss, they need brush, or like toothbrush. Sometimes they need electric tools to help, right? And if they have any type of implants, kids are in traditional braces, there are specific tools that they can use to help them maintain their teeth- Mm and their gums. So it's not a very like, you know, cookie cutter thing for everyone. Yeah. They're very, very specific to specific patient's needs. Mm-hmm. Yeah, so not a one size fits all. No. Okay. Yeah. Now basic things, right? Like on a basic level, the l- the most minimum thing you can do is brush twice a day, at least for two minutes, and floss at least once. Mm. Right? Um, when it comes to rinses- Everybody doesn't need a mouthwash, right? It really is, again, specific based on what they need. That's so interesting. Yeah. What are some things you look for when you would recommend a mouthwash? So we look for, are their mouth healthy or is it inflamed? If it's inflamed, bleeding, like they have gingivitis, things like that, there are so many different mouthwashes- Yeah. out there, right? So we kind of look for what that patient needs. There... We actually follow a list, too, of certain mouthwashes that are very acidic. Mm-hmm. And we don't usually recommend those. Um, we want the mouthwash to be more neutral or basic so that they're not putting an acidic, liquid in their mouth and rinsing it. We also try not to use a lot of, like, mouthwashes that have alcohol in it, right? 'Cause that can affect the oral microbiome as well. Mm-hmm. Awesome. And then I wanted to ask about, um, the functional TMJ treatment.

TMD Relief and Non-Surgical Options

23:32

Could you talk to me a little bit about what is TMJ and how do you treat that? Yes. So it's actually... So in the dental world, it's TMD. TMD. So it's temporomandibular- Okay dysfunction, and TMJ is our temporomandibular joint. Okay. So we all have TMJs- Okay right? But the, the condition is TMD. Okay. And so, patients will, and people overall, they just intertwine the two words. But we do treat TMJ symptoms. Okay. Right? There are different things we can treat. You can get orthotics, you can get night guards, and there's a ton of different types of night guards. Some patients can use retainers with bite ramps and things like that. What we see for patients who have tried night guards, you know, they can use, you know, try Botox- Sometimes for patients it's not enough, or some patients just don't want toxins in their body. So the M Face TMJ is really great technology that helps kind of retrain the muscles and get them to relax and improve that, those TMD symptoms. So it's really it's an amazing technology- Yeah that we've incorporated in our office. We put these pads on the cheeks, and it just it has, um, heat to it, and so it just kind of warms up, and it just kind of vi- makes the patient's teeth just kind of- Uh-huh touch a little bit. And most patients will need between four and six treatments, depending on the severity of their TMD. They, we've seen a lot of patients, and most patients by the second to third appointment, they're like, "Oh my God, my mouth just feels, like, relaxed. I'm not constantly aw- a- aware of this, like, muscle tightness in my m- face." Mm-hmm. They just like, "It just is relaxed. I can open my mouth. I can bite into a sandwich. I'm not monitoring what I'm eating because they just... it just feels more comfortable." So it's really great technology that is non-invasive. Mm-hmm. It takes 20 minutes, and within six weeks they're gonna see a lot of relief. That's awesome. Yeah. And then what are some symptoms that you see or you look for before recommending that treatment to your patients? So a lot of my patients that get this treatment, they have pain. Um, they can't open their mouth. They can open their mouth, but not comfortably. They really can't eat whatever they want because their muscles just get tired, right? A lot of them feel like it's just tightness. They're always wanting to, like, massage their muscles. You know, it's just like, it just hurts. And most of them will have headaches, joint pain, like in their joint here- Mm-hmm their TMJ. They'll have neck pain, shoulder pain. So it's all connected. They're all connected. Yeah. So if patients are so tense, their temporalis muscles will hurt as well. That's gonna cause trigger headaches, migraines, all these things. And so just releasing these temporalis muscles, their masseters, just giving them some relief with that will actually relax everything else as well. Yeah. So they start improving with how much their range of motion is. They, uh... we measure how much they can open, and their symptoms improve. Is it gonna... depending on how bad their symptoms are, it may not make it 100% go away, right? But it makes them feel a lot better, and that's what we look for, right? It's medicine. So there's nothing in medicine or dentistry that's gonna make it 100% go away, right? Mm. Even with surgeries, you know, like a knee replacement, they're not gonna tell you that your pain's gonna completely go away. It will be better, though, and that's what the TMJ functional does. It helps patients improve their quality of life. Yeah, absolutely. Mm-hmm. And was this, um, treatment something that you always had or w- is it a newer treatment? It's newer. We've had it for about a year now at our office and, um, we have... So these technologies, they're, they have facial aesthetics- Mm-hmm as well as the TMJ. So we've had it for about a year now, and it's been really successful.

Facial Aesthetics That Frame The Smile

28:08

Awesome. Yeah. And then could you talk to me a little bit about the other facial aesthetics that you guys offer? Yeah, absolutely. So we, the technology called, is called Emface and Exion. It's from BTL. That's the company that makes it. And what they do, so Emface, you wanna think of it as strengthening the muscles in your face. So just like you work out at the gym and you're strengthening your arms, your legs, your stomach, this actually strengthens the muscles of your face, where Exion helps skin quality. So it helps improve the elastin and collagen as well as hyaluronic acid, and it helps just reduce fine lines and just give your skin a beautiful glow. So together, it's amazing. Yeah. It helps naturally give you a lift by tightening the muscles and improving the skin quality with the, um, Exion treatment. That's awesome. And it's, like you said, it's a non-surgical treatment as well. It's non-surgical. It... I've done it. All of us at the office have, and it's really, really incredible. Non-surgical, not painful. It, Exion is kinda like a warm stone massage, and Emface is similar. It just basic- contracts the muscles kind of like a TENS unit, but the technology is very different than a TENS unit. Awesome. And then who might be a good fit for Emface and Exion? Anybody. But most of our patients are, um, probably I would say in their 30s and older. And we do see a lot of patients who are on GLP-1s, patients who have lost a lot of weight, and, you know, they notice that their skin is sagging a little bit. They don't wanna do anything surgical, but this is a really great option where it will help tighten the facial muscles and give them a little bit of a lift, as well as just improving i- improving the skin quality and tightening the skin as well. That's awesome. And I think a lot of people don't realize that a dental practice can address both, functional and... or function and aesthetics. Mm-hmm. So how do you bring those two sides together when you're creating a treatment plan for a patient? So that's a good question, right? We had patients like, "You guys are a dental office." "Why are you doing this?" So as dentists, we study the head and neck, right? That's the majority of our studies. We, study the whole body, but most of our focus is on head and neck. And when we learn head and neck, we learn about all the anatomy With dentistry, we're always working in the mouth, right? But the face is what frames the smile. So putting the teeth, giving someone a beautiful smile while we can improve the skin and the muscle, it just puts everything together. Yeah. So not only can we help give them beautiful teeth, but we can help lift and tighten their skin. So it just together just makes the person, you know, get, get a beautiful smile and a healthy glow without any surgery. Yeah. Right? So just enhancing their natural beauty- Mm-hmm without changing how they look, right? Yeah. It just makes them look younger, fresh, like they've got a lot of rest. And we all need that. Exactly. That's awesome. And what does it mean to you to be able to, change or help your patients improve you know, either their smile or aesthetics or some things that they are wanting to work on? It makes me feel really like, wow, you know, it just helps somebody feel good, right? Sometimes patients have things happen in their life, and just making a simple change and helping them smile and feel good about themselves, that's like the biggest reward, right? I had a patient who, young patient who had some fluorosis on, in, on her teeth, and she went to several doctors, and they told her she needs 12 to $15,000 in treatment. Wow. There were other options, right? Not just porcelain veneers. And we discussed just doing some bonding. And when I did that for her, she was crying. Oh. And it just made me feel so good that I could help her just give-- let her smile. She said that she couldn't go to job interviews because that's all people would look at. And that, that just makes me sad, right? 'Cause if we can do something, even if it gives her five years, that's great. She can get a better job and then be able to afford that, those porcelain veneers, right? So being able to do that type of treatment for patients and just give them something to smile about, it just makes me feel good. Yeah. And I feel like confidence, it changes their whole demeanor, right? Oh my God. It's unbelievable. You know, we fix their teeth and they start taking better care of themselves, right? They start working out, they eat better, they change their hair. The next time I see them in the office, they walk tall- happy, smiling. It's great. That's awesome.

Event Details Future Plans and Contact

33:55

And then can you tell me about the MFace and Exion event that you're hosting? Yes. So we are having an event on September 25th, I believe from 1:00 to 3:00. And it's we are going to be doing live demos, so whoever's interested in attending, we will try either MFace or Exion, whichever one they would like. And, um, it's gonna be great. We're gonna have raffles, music. It'll be fun. And they get to learn about the technology. Oh, that's amazing. And in looking ahead, what are you most excited about for the future of Lifetime Smiles as you continue bringing together comprehensive dentistry, advanced technology, and facial aesthetics? I'm really excited. Um, we have half of our office that's not built out yet, and what I'd like to do is bring in a whole, like, kind of wellness side of health with dentistry. Dentistry is just so connected with overall health, and so what I'd like to do is bring in, nutrition- Exercise, have, um, saliva testing, further saliva testing- Mm-hmm for other things. And just, uh, more technologies for, overall health. Yeah. Mm-hmm. That's amazing. And as we wrap up, is there anything you'd like to add that we haven't touched on today? I just... I started as just, you know, dental care, and the more I've practiced and learned that the whole mouth and body is connected, I really hope that patients take dentistry into consideration when it comes to their health, and do seek dental care as part of taking care of themselves, right? If they're going to the gym, eating healthy, but not going for their six-month checkups or three-month... every patient's different in their needs. That should be part of taking care of your body and your health. Awesome. And for anyone looking to connect with you or Lifetime Smiles, where can they find you? So, um, they can give us a call at our office. Our phone number is 571-248-0700. They can follow us on Instagram. It's, uh, mylifetimesmiles. No, I'm sorry. That's our, um I don't check my website. Our website's, um, mylifetimesmiles.com, and our Instagram handle is lifetimesmilesdentist. Okay. Awesome. Mm-hmm. Thank you so much, Dr. Rangeford, for joining me on The Alimond Show today and sharing your story with us. Thank you so much for having me.