Patricia Pine, RDH, COM is a national and international speaker specializing in OSHA, infection control and Orofacial Myofunctional Therapy. She brings thirty plus years of experience in dentistry to provide exciting and evidenced based programs. Pat is an Authorized OSHA trainer via Federal training, she believes that OSHA safety, infection control, and whole-body health are important to providers and patients alike. Her philosophy is an empowered team is a healthy team, which in turn creates an unstoppable referral formula. Pat shares how the dental hygienist is the first line of defense. She conducts in-office trainings, boot camps, online seminars, and dental/dental hygiene conventions. She is a member of OSAP speaker’s/consultant’s bureau and publishes regularly in several dental magazines.
VIDEO - DUwHF #1256 - Pat Pine
AUDIO - DUwHF #1256 - Pat Pine
As preventive specialists RDH’s can help patients at an early age. Pat’s a Certified Orofacial Myofunctional Therapists (IAOM)and is part of the International Association of Orofacial Myology Board. Presenting how myofunctional therapy disorders affect oral and physical health, Pat reminds others that education doesn’t stop at clinical treatment. It is an on-going process to enrich ones-self and bring the highest quality of care to patients. Pat also volunteers her talents to people in need. Pat is the author of “Please Release Me – The Tethered Oral Tissue (TOTs) Puzzle it’s a great asset to any professional’s library. Pat can be reached at www.OSHAtrainingbootcamp.com or info@musclesinharmony.com.
Howard: it is just a huge honor for me today to be podcast interviewing Pat Pine RD CLM she's a licensed dental hygienist that has four plus years of experience with myofunctional therapy as an ia om certified oral facial mild functional therapist which is calm c om she enjoys helping people with many oral concerns she works with a multidisciplinary approach and encourages other disciplines to join in on total body health her goal is to help every patient leading them to a professional that has similar personalities and understandings Pat is a national and international speaker for last eight years for the dental community on a variety topics volunteers educate children on dental health she loves outdoor sports boating hiking biking walking and being with family and friends the more the merrier she's also known as an infection control specialist for the medical and dental communities for health and safety dental hygienists OSHA infection prevention consultant mild functional therapist trainer at unique dental services my gosh Pat you've done everything you are a periodontal therapist for 26 years what is what are you most you're in Lake Geneva Wisconsin right now correct see I asked her to come on my show as a podcast we're neighbors were both in Phoenix and she ran all the way to Lake Geneva what are you doing in Lake Geneva today
Pat Pine: well since it's raining not too much but so you picked a perfect day but I come out here and do ocean infection control for dental offices that need my assistance so I come in and I do a free mock inspection and then we take a couple hours and train the team keep everybody on the same wavelength
Howard: so what would it when you go into it then alike because I could talk to you about two diverse subjects and we'll start with OSHA infection control what do you think the dentist has to wear so many hats I mean my gosh she's he's freaking out trying to learn how to do molar endo and his overhead hi what does he need to know what does she need to know on infection prevention and OSHA safety what are you seeing in the field
Pat Pine: well I'm seeing a lot of non-compliance because they really don't know what they don't know so when I go in and I do my free mock inspection on I test countertops I check their water lines I do a lot that you know behind the scenes that they can't get to or the team can't get to or they assume that it's being done right I started ocean infection control in Illinois because as a temporary hygienist I went in there and there are many doctors that the offices were not suitable and the infection the sterilization process was horrible so that's how I started and then I just started expanding as more offices needed help and they can't get to it so the OSHA part is you know for the employee and the infection control is for the patient but actually they both intertwine so we need to keep everybody safe and I didn't know about all the chemicals that we do so we use quite a few chemicals that you know everybody needs to be aware of so
Howard: so sorry so how does so someone how does someone contact you what what did you
Pat Pine: call it a mock context inspection I come in earlier than the training they usually call me to come in and do a training and my trainings are four hours and I come in and do a training but before that I come in an hour earlier and do a mock inspection we take a lot of pictures I show them what fine-tuning is I'm not there to scold them or this is the way it should be this is what compliance is so I am just trying to get the team together and have them fine-tune the skills that they're already doing they might need to adjust some things and typically that's the case either they're you know there's nobody in the in sterilization on their own it's everybody's doing their own thing nobody's monitoring the sterilizer because they don't know how they don't have time they can't stand there so there's really not an abandoned dentistry for years there's really nobody that's overseeing sterilization how do we know those packets have been sterilized just because the indicators are black or brown and that's not the case so what I am finding is that people put pouches on top of the sterilizer well the heat from the sterilizer will change and they've never been sterilized so there's a lot going on out there in the in the United States that there's not a lot of compliance and those that are complying sometimes it's just tweaking a few things
Howard: so her website is OSHA training boot camp comm OSHA training bootcamp comm and then at that point you can go forward slash mock inspections where she says mock inspections are available using mock inspections we'll help practices prevent lawsuits and fines and identify areas where compliance can be improved what are the needs in the practice was safety are you keeping up with all the new CDC guidelines change --is updating your infection control can be easy and fun how much does that cost for you to come in and do an OSHA training boot camp mock inspection
Pat Pine: if I'm just coming into the do the inspection is 525 if I'm coming in to do the training and the mock inspection is free with the training it's $1,100 is that 1100 plus expenses or just 1100 flat fee well if it's in Arizona I don't charge for travel if it's out if it's out-of-state yes they pay for for travel so airplane and and
Howard: so you know I'm with social media I mean so if you talk to the CDC people in Atlanta and they have like 15,000 employees and whenever I am in there talking to someone in dental they said back in the day they knew that these infection outbreaks were probably located to this restaurant or this dental office or things like that but they just knew that but but it was hard to prove but now everything's different with DNA sequences and you've seen some dentist where we're all the local all my friends in that town said just a great guy but had no idea his autoclave quit working you know or you know or the new assistant wasn't trained my gosh and and I'm I'm looking at this dentist thing he asked to wear so many hats so right now I I'm causing anxiety to some dentists driving to work he's like he hasn't thought about his autoclave one time in the last three years and if something goes south I mean my gosh with Facebook everybody in your state will know that you know that this that this person had to have the liver transplant because they ended up going to your office how does a dentist know if he's up to date on all things OSHA autoclave how does he know this
Pat Pine: well first of all horses requirement is to have OSHA training in your office annually so I would have to say that probably 80% of the dentists don't do that I'm gonna go with 98 but that's our difference you say 80 you're not I say 98 I'm a realist okay so somewhere between 80 and 98% of all my homies did not do this was here so when they're not doing even the OSHA and I go in there and I find all these concerns it concerns me for their patients so I was recently called into an office where the Dental Board had gotten a nasty letter from a patient who apparently knew what she was talking about because I saw the letter and things happened in this office and rightfully so I think a big red flag went up and so this doctor calls me and says hey Pat you got to get in here now and I said why what's the hurry oh well the board was here blah blah blah and I'm like okay so I went in there and rightfully so they were doing things wrong and sterilization and what happens is and I'm not picking on dental assistants because I was one and I didn't know what I didn't know but you just go from office to office assuming you're doing things correctly and OSHA regulations are and they have to be trained before they even start work well I've been in dentistry long enough to know that that never happens alrights never happened in my any office I've worked at nobody's ever trained me on OSHA and so it is a little bit scary up there for the the patients and the staff assumes they know what they're doing and they really don't so everybody needs to get on board on the same page and make sure sterilization is correct there was just a doctor that was on the internet this morning and I believe it was Twitter in my opinion there is no reason for any dental office not to be compliant unless it's just that you know the doctor doesn't have the time there was another office that I went to I got the health department called me and said hey Pat come and check out this office the dental assistants were going in and out of the rooms with gloves on and a patient reported them the previous situation the patient reported so patients are watching and I think if you want a you know a reception room full of patients you really need to stay on top of what you're doing and what's going on behind the scenes because they are paying attention if you go into a drawer without gloves with gloves on and not cotton pliers or you don't take your gloves off before you leave the room people are paying attention so
Howard: so she wrote a letter to the State Board because she observed patients our staff going and now the authorized that gloves on she was the patient
Pat Pine: she was a patient and observed that so the Health Department called me and said hey go in and see what's going on and they were everybody was going in and out well you don't know where they're going and what they're touching and then they're coming back with the same gloves on so they were going into her mouth with she doesn't know if they were dirty gloves or clean gloves
Howard: Wow and and so the State Board actually hired you to go in there
Pat Pine: no they never hire me the doctor the medical the health department in this situation called the doctor and gave him my name and then in the other situation I believe that dentist heard of me or called one of his and said who who can i contact to come in and immediately and do this and then they're all frazzled so then when they're frazzled they don't listen well so you know it's and sometimes it takes two visits it doesn't always you know if you've never had OSHA training in your office ever I cannot do it in four hours it rome wasn't built in a day and I will not I will not just go in to do the job to do it I have to do it right and I'm a detailed person I'm a hygienist so I have to do it right and sometimes it takes more than twice more than one visit it's
Howard: it's amazing you know the the the big chains you know if they have several hundred offices they they have someone in charge of this entire department and those guys like Heartland and Aspen and you know they know they live in an aquarium so they're actually far more likely to be dotting eyes and crossing T's it's your good ol boy who's had in the same office for twenty thirty forty years he thinks everything's good and they don't realize when there's staff turnover you know margaret was with you for ten years and her husband got transferred and she's leaving the team and then you have this new person in and it's just so easy for something like this to fall through the cracks when you're wearing 20 20 different hats so what would you what would you say if they went to your website OSHA training boot camp comm what are they gonna find on your website
Pat Pine: well they're gonna find ways that they can contact me and figure out you know what do they need do they need fine-tuning do they need the whole kit and caboodle are they afraid if somebody comes if an inspector knocks on the door what are they gonna do I give them all that information call me roll out the red carpet they need to have everybody on board and sometimes when you have a newbie coming on the team and nobody's communicating properly because everybody's in a hurry and time is such an essence in dentistry we don't have time to do what we have what we're supposed to do and sometimes correctly that's how accidents happen that's how people get needlesticks exposures splash in the ultrasonic bag dropping the instruments in not everybody's on board with cassettes which i think is really a shame because cassettes can save a lot of time money and injury so they'll find a lot of information online on my website and I you know I've also have some webinars on there I have a webinar on disinfectants and I have a water line webinar which is very interesting because my kavett Ron tip exploded in a patient's mouth with biofilm so you talk about periodontal biofilm this was Cabot Ron biofilm from a water line that was just plugged into the city water the whole thing exploded looked like cooked spinach and I had to take it out of the patient's mouth I'm like what the heck is this and it was I was just habit Ronning and all of a sudden boom so I know what biofilm is within the water lines and it is pretty gross and you know they have biofilm worms and things so water the dental unit water lines is very important and people think because they put that blue tablet in or whatever the product they're using they think that that's enough and it's not they have to test their water lines quarterly now
Howard: do you like the dental unit water line going to the city water or do you like it where you have the bottle in each operatory where you have to fill the bottle
Pat Pine: I personally like the bottle but at this particular office it was a very old office and we didn't know back then what we know now so I did get a whole new unit out of that oh no don't give it with water with bottles what you know dental unit waterline bowels but at the time you know years ago when I worked in Illinois when this saw first came out we used bleach in the wall in the dental water and ran it through everything and we discovered you know that corroted everything well then after the bleach we put the bleach in and because patients would complain that they tasted bleach huius cope in diluted in the water then that got everything gummy so they finally discovered that there were actually products out there that we could use it won't destroy the dental units so you know it just depends on what unit you have and the manufacturer's instructions on what you should be really doing but you need to be testing your water lines because what are your water lines right now if I go in and ask a doctor whether they're CF use they look at me like I have two heads I'm like okay Kali colony forming units what's in your and they have no clue so I actually have created a book a manual for dental offices for behind the scenes on everything they have to maintain and that is I believe on my website also so I have several books that I feel that are advantageous to the dental team so somebody is maintaining that amalgam separator the vacuum system you know who's doing all this because the doctor can't do it he's seeing patients so we have to make sure that the other team members are doing doing it
Howard: so you okay so I'm on your website so OSHA training bootcamp comm is that under resources under water line charms you know
Pat Pine: well the water line charts you could go on to I created that water line chart and I don't know I just redid my website so the water line charts I created for a dental offices so that they could find the million different products it's just like it's just like going for and you know there's so many disinfectants well which one do I use I can't tell somebody what type to use
Howard: so you have a link to an article by dr. Edwin's in Mandi Jadey who's a dentist and a lawyer who's involved in hundreds of cases of breaches and infection control and perhaps most notably those involving dental unit water line contamination while at the time so do you know this guy have you I worked with him
Pat Pine: I have not I found that and thought it was information that people should know about that you know there is there are people out there that aren't doing anything yeah so he's a dentist and a lawyer and he talks about how your used water that meets EPA regulatory standards for drinking water which is less than 500 CFU per ml of heterotrophic water bacteria so what is the CFU colony formation units per milliliter consult with the double unit manufacturer for appropriate methods and equipment to maintain the quality of the water out here in Arizona where you live it see it was actually even a really bad problem in the 80s because when it's a hundred and eighteen degrees outside more stuff grows in your pipes then when you have a practice in Prudhoe Bay Alaska where it never gets you know above 6070 degrees and my gosh when we started getting into CFU stuff back in the 80s when this started coming out I mean every dentist who had a city waterline was over the over the legal limit by four four or fivefold so so kind of being connected to the city water or they can can you almost go on the record and say it's
Pat Pine: you just can't do that anymore oh yeah you cannot you can now you have to have dental unit water lines you have to end and that's why testing it so people will go our offices will go and say okay I'm using this product and this product has worked for me and I'm saying who is this
Howard: this is my granddaughter and I thought since you're a mild functional therapist if you thought I'm how she was doing sure how you suck your thumb oh she doesn't suck her thumb can you teach her how to suck her thumb so then you could correct it afterwards I could but I'd prefer not to I prefer to get that thumb out of your mouth you want to dumb it right you have gum in your mouth and chew gum no that's okay hammer squish a firmer palate you're not Jewish but um so yeah I mean we got we got to do these things so our grandkids don't come in I mean could you imagine her coming in and you think you're gonna do our this great favor by putting a ceiling on her tooth and the next thing you know you spray in her mouth ten thousand colony forming units yeah well
Pat Pine: not only that you know I hate to say this but there are kids that are sick cancer all that you know adults what-have-you we don't know where cancer comes from could we be squirting something in their mouth with it you know the hospitals if you've noticed the hospitals are taking out all their water fountains in their water product you know anything that has a water what do I want venue what do I want to say and they're taking them out because they found that Legionnaires disease is now in the hospital and people are patients friends and family are getting it as they go visit their sick relatives
Howard: yeah and that Legionnaires seems to be in I cruises all the time too I mean it seems like every time I hear of an outbreak it usually has to do with the cruise well it's it's been in hospitals and it was
Pat Pine: just recently I think in a hotel in Chicago they took out the big water feature and I believe it was the Hyatt downtown on Michigan Avenue because one of the doctors who was a brain surgeon got Legionnaires disease and died Wow but but he didn't but again because the
Howard: science is such that now they're they're treating like crime scenes so if I got that Legionnaires disease and I got it at Patricia's house and not my mom's house they can figure that out now oh yeah well because
Pat Pine: look at the the incident in Italy the lady had only gone to the dentist out of the auto that left the house twice once was for a dental appointment and then two weeks later was a dental appointment and three weeks after that she died and they went back to that dental office and found that it was just they never did anything to their waterlines and it was a plethora of bacteria and the other thing is over the weekend if you're not taking care of your water lines these bacteria and biofilm are having a party it looked like quadruples while it's not being used so the only benefit during the day is is that we're using in the hand pieces and the water air syringes and we're kind of moving the bacteria around if there is bacteria in there and and the weekends were not
Howard: Wow again it's it's so uh it's so tough because there are so many hats that you just have to worry anymore I mean it's just no wonder some dentists don't like the the business of Dentistry so so we agree that you have to have a a you can't have water coming in directly from the stream or that's just a yeah yeah and as you get closer to the equator I think it's something like 80% of the eight billion humans live within fifteen degrees of the equator I'm down here in Phoenix it's just a like say we we knew that was wrong first because it's so hot out here like today is a really cool day in Phoenix which means that let me see I'm afraid to look let's say the high today is only my gosh pad it's only gonna be 98 degrees today oh yeah 65 here yeah I mean this is a pretty Friday it's 98 degrees it's not even triple digits III I don't even know maybe the apocalypse is coming it's under a hundred but but the hotter it is the more searches so again so she's driving to work she's listening to this on her commute what other red flags well what are the red flags that should maybe let her know that maybe she's not up to date on her OSHA and infection control well is your team using utility gloves in the sterilization area with all their PPE typically I find Pat Pine: that no they are not so the doctor is at risk for any type of exposure but also let's say they get a splash of the chemical from the ultrasonic on their skin because they're not wearing their long-sleeve lab coats that doctors responsible for all of that because their doctor will not tell these team members they have to wear their PPE I want to see you in your PPE then the problem is is they're too hot well there are I do know of some lab jackets that have inner linings which sound even hotter but they're not and they're actually to make you cooler as you work and if you're hot it makes you cooler if you're if you're cool it makes you warm so there's more technology out there for team members to use and they cannot be the biggest thing that I find is happening is they're letting their team members go home in dirty scrubs and lab coats and that's a big no-no according to OSHA they need to be keeping it there that the employer dentist is the one who takes care of the laundry they can use disposables there's other things you can do if you don't have room for you know laundry washer and dryer but you know these are things that you are now spreading across the whole community mersa de-seed if MERS people older people that come in from the hospital we you know a lot of times the health history isn't taken to the complete degree and we don't know where they were yesterday they were in the spittle and now they could have c-diff or any of this other stuff and we're getting it and transmitting it to our patients and
Howard: some of this stuff is just a dime there's an article published just June 19 and this is a ninety nine so on June July just not very long ago in 2016 a dental you know water line contamination at Children's Dental Group in Anaheim California led to confirm Mycobacterium abscesses infections and 71 children Children's L group was part of a 12 practice group before being ordered to shut down by the Orange County Department of Health after five water line samples came back positive and tested for Mycobacterium abscesses over the course of a few weeks dozens of children between the ages a tune alone began showing up to the hospital complaining of facial swelling and pain I mean this this is stuff they used to always go on in the 70s and the 80s and the 90s but now when it goes on governments are going to be on top of it they're gonna like a crime scene they're gonna locate it right back to the source and then it's gonna be on on the evening news what did you think about that case
Pat Pine: oh I just wanted to cry because it there is no reason for it these kids have lost their jaws these kids have lost permanent teeth for the rest of their lives they are deceased some of them are disfigured there's no reason for this somebody needs to either you need to have a maintenance person that only does maintenance nowadays in Dallas dentistry that does sterilization and the maintenance of everything else I don't know all of the answers but I apparently they never had ocean infection control training in their offices it was 12 groups and they also found the same thing in Atlanta Georgia yeah is also a crime there is no reason for this in today's day and age with all the CE’s that are out there people that are willing to come in and help you that's what why I started because doctors are too busy the team is too busy and things are skipped because of time we want to get out of here we got to go pick up our kids we have soccer games you know we're going on vacation yeah it just can't happen but I have to say that there are and not to mention companies but there are sterilizers out there now that are all technical and the technology in them give you gives you a readout to know if all the parameters have been met further sterilization so if you purchase a sterilizer that does that your risks are less you're reducing your risks the statins now the statins have that and they are hooked up via the Internet to the company and the company can tell if you're in if your sterilizer is not working properly so there's many things out there that can be done whether they want to spend the money in my opinion it's worth spending the money I am a statin in my home when I see myofunctional patients I will not use chemicals I'm an anti chemical type of person and I would prefer not to and why are you an anti chemical type of person well we don't know where cancer comes from I won't look at what they're round up look what's going on with the round up my brother died five years ago from non-hodgkins lymphoma and I know he used roundup do I know that that's why he died no but I could bet that it was one of the causes
Howard: were you surprised when bear out of Germany bought that company I'm shocked that it's still out at Home Depot and Menards and
Pat Pine: I can't believe they still have it out when Bayer bought bought them Monsanto I just thought to myself only well
Howard: I was thinking maybe people that live in Germany at that level don't understand how many that there's 1 million attorneys in the eye saij did they just not get the legal background of Monsanto I don't know
Pat Pine: I'm shy every time I see that commercial I tell my husband I cannot believe it's still at Home Depot and I refuse to walk near it I walk around it and one of these days I'm just gonna go up to the manager and go if this causes cancer and you know it why aren't you doing something about it get it out of here because I I don't like it I can remember um I can remember you know
Howard: I grew up in Kansas and I remember you know several times were you know you'd be loading a 50 gallon barrel of some pesticide fertilizer or whatever and you'd be pouring it in there and for like three or four or five days your nose to be running or you or tingly and I used to think of myself there's there's something not right about this you know I mean even as a little kid and I remember watching this old man I'm stirring the stuff with this arm before he was getting ready to pour in there and then I'd say I'm you know are you sure you should be sticking your arm and that stuff I mean that that's that's gonna kill grasshoppers that a part per million you stuck your arm in there there's my whole life and I am the dental team
Pat Pine: now think about that what are our disinfectants that we use it's a pesticide and these gals in males I I don't I don't work with a lot of male team members there are there more coming into the to the profession but disinfectants are pesticides so they're not using their gloves their PPE their eyewear I mean I am there to help keep them safe so the more they know the better off they're going to be but a lot of these distant most of the disinfectants are a type of pesticide just like aza
Howard: just like all the toothpaste are soap companies and that the reason the reason that people got really big into two places because they were there were soaps they added fluorides they need a soap they added fluoride to the soap and that's where all of our toothpaste companies came from what's up and that's scary
Pat Pine: when they had the warning about triclosan is when I stopped using that product I don't know if I can mention the name and I would tell my patients I typed up a little thing and said warning because I recommended the product now I feel guilty that now they've come out with triclosan being so harmful and hard for kids adults everybody you wonder why our kids are having so many troubles and so I typed up a little thing and put neighbor to them at each appointment do not use this product this is our warning read about it google it and make your own decision because I don't want to tell my patients what to do and you know when they purchase products but hey if you're using this product this is what you could could be happening
Howard: yeah and it comes back to this um you know in military if you call a bomb that kills everybody in the whole village you call it a dumb bomb and the smartest weapon would be just to get the guy who's bad yeah we're still in dentistry I mean there was just AM an article out all over the weekend where exercise physiologists are showing that when you use mouthwash and it hurts your it hurts your recovery period in exercise physiology because you're killing all these organisms that are supposed to be producing nitrates nitric nitric oxide like when athletes if you take their mouth shut and teaching to breathe through your nose they actually get full better breathing because when you breathe through your nose it picks up nitric acid and nitric oxide and and it's all better and that how using mouthwash killed so many bacteria in the mouth and nasal area that it had a noticeable
Pat Pine: but I also have patients that used to rinse with alcohol type mouth washes and I would tell ask them why well because it kills the germs and I said but do you know alcohol excess alcohol also causes oral cancer so why are you using this do you drink on the weekends yes I'm not saying you're going to get cancer from this but your risks are lower and why do you need a mouthwash it depends on their oral health of course but I never recommended a product that had alcohol in it
Howard: yeah so the study exercise is known to reduce blood pressure but the activity about your mouth may determine whether we experience this benefit according to research an international team of scientists has shown that the blood pressure lowering affects his exercise is significantly reduced when people rinse their mouth with antibacterial mouthwash rather than water showing the importance of whorl bacteria and cardiovascular help the researchers now suggest that health professionals should pay attention to the oral environment when recommending interventions involving physical activity for high blood pressure the lead author Paul busco's lecture and dye attics and physiology said scientists already know that blood vessels open up during exercise as the production of nitric oxide increases diameter blood vessels anyway just goes on and on and on I'm going to go to another very controversial area where you are a leader in and that is myofunctional all things myofunctional I mean I know orthodontists I granted they might be as old as me who who don't have anything to say or agree with myofunctional they just say oh that's crazy talk and other people love it on you just wrote a book please release me the tethered oral tissue puzzle by Patricia well she says Patricia pine on her book but I know whereas Pat pine as for anyone with a tongue this book is about awareness for patients and professionals on tongue-tie lipped eyes all tethered tissues who to see exercises what questions ask it will be a great resource for parents patients and professionals keep this book in your pocket for quick reference share with your referral sources why is myofunctional tongue-tied I whipped I what white why is that controversial and where how do you see this
Pat Pine: well we didn't know what we didn't know again so when I was in dental hygiene school back in Illinois we only learned about ankyloglossia so that means that the tongue is really anchored to the floor your mouth you can't move it you can't you know really speak well as times gone on and we had a son and while we have daughter she was had no problem our son had problems nah I didn't nurse because I was in dental hygiene he was three weeks old and how I did that I'll never know but anyway he had trouble bottle feeding and what had happened is he would suck once he got that nipple of the bottle he'd sucked so hard and this would open up and then his tummy would hurt he'd scream he'd throw everything up and like what's wrong with this child I come from a family of nine children I'm number four oldest girl half yes are Catholic Catholic oh my gosh I was shocked so guess who raised the young ones I mean my mom did a great job with us but she needed another pair of hands and that was me and I so my mom bottle-fed we bottle-fed everybody under me so I knew what norm was or so I thought and this child was not being normal drinking out of a bottle so we took him to the pediatrician four different times they changed his formula they said he was allergic to it blah blah blah they were full of beans he's 19 years old I'm working in Arizona and he said mom before I forget for the 18th time millionth time he said my tongue gets caught in between these two front teeth right here and when I speak or when I stick my tongue up and I said well number one you were taught never to stick your tongue out number two you've never told me this and I've cleaned your teeth twice a year for 18 years so the doctor I was with had a laser he lasered it and he's he's been so I think but he still has a digestive problem digestion has to do with chewing swallowing and having the tongue move your food back and forth and he was not doing he was not able to do that before this so digestion there's so much more to the tongue I call it the CEO of the body and as I speak on this topic in many different arenas people are shocked and doctors md's pediatricians they don't get it they don't understand nor does the orthodontist but if a tongue that's tied and not tied like we knew it is ankyloglossia but there's four different classifications of tongue tyno and it depends on where the freedom sits and sometimes you can be a snorer and that tongue is blocking that airway but if you release it but the tongue will move forward and out of the airway with myofunctional therapy so all these men mostly men that I see that are snores instead of having their life cut short they really need to see somebody like myself to help them have tongue posture have tongue placement and make sure that their tongue is doing what it's supposed to be doing typically they're not chewing and swallowing correctly
Howard: um why is this controversial I'll give you some examples son sometimes we both about here in Phoenix it'll be on the evening news basically someone has a baby in a hospital someone comes in there and and talks to them about breastfeeding and it's probably the only conversation they're ever gonna have my my my dad passed away he still hasn't given me that birds-and-the-bees talk and I have four children and a bunch of grandchildren but no one's ever talked to them about this and they have a talk with them and a lot of times it's that person who says this baby's tongue tight or something in that and then they're going back to the pediatrician and a lot of times pediatricians say got out and I'll go see a pediatric dentist but my at your dentist friends out here say they get people talking about this all time jeanette mclean it out here she's always one parted um is this a new deal i mean did you see this 30 years ago people unfortunately because i won't you know
Pat Pine: i started dentistry when i was two and it's amazing how it has blossomed because these nursing moms are not nursing and they're frustrated and they hurt their nipples are torn to shreds the baby screaming when you have a baby it's supposed to be fun it's supposed to be a happy time well a lot of these parents it's miserable and they're like what would you do you have to work you know you're you're dealing with a baby who's not happy you're screaming you can't get any sleep so yeah it is a real deal because my youngest patient is three days old and my oldest is 89
Howard: Wow so I the 89 year old gentleman was having trouble swallowing sometimes it's from medication sometimes it's just that we're older and everything is going south the infant was definitely tongue-tied so I teach the parents the exercises they go off to the professional that's going to release the tongue and then they come back to me that same day and we make sure that it's released and that we're doing the exercises properly the doctors what I have found even with the orthodontist they don't know what they don't know but because they didn't learn it in school they're not having anything of it and it just doesn't make sense because we have proved there's a lot of research out there and we have proved that it does work now that's why I wrote the book is because our son was tongue-tied we didn't know it till he was later in life but yet he had no speaking problems he had no real health issues he was a good kid he's still a good kid and we didn't have what we have today we have a lot of a DD ADHD well that tongue is attached to our toes so point your toe and see if your tongue without went to your toe and point your toe does your um come up okay that was a joke yeah but I went to I was speaking to a men's group and they're all at me my grandchild does this my grandchild is mouth-breathing my grandchild snores horribly they can't speak they can't this they can't that so they do need myofunctional therapy we can help these kids and I have helped many children and many adults and so since we have the proof I think if the doctors don't get it then they should refer to the people that do right I feel relieved so I have I started a study group in Scottsdale so I have my doctor my chiropractor my cranial-sacral therapist my speech pathologist and myself and we work in harmony hence muscles and harmony because we all need to be there I can't do it on my own I don't have those that many licenses and I don't wish to and we need to send them to the person that knows about it and as the expert and I have gone the last five years I've gone to more courses I should have three master's degree
Howard: s that is uh that is really amazing and your are certified by the International Association of oral facial my ology and I'm willing to bet that 90% of my listeners don't have never even heard of that before so go into that what is the International Association of oral facial my ology why are you certified in it with your you're an RD h co M certified oral facial my ology what is this where does it come from etc
Pat Pine: so the International Association of oral facial my ology we're looking for some type of licensure the best we can do at this point in time is do a certification because it's we're already licensed so the only people that are legally able to do myofunctional therapy is slps speech-language pathologist or RDH already are in the mouth more than anybody else we're not afraid of the mouth we know they bite we know all about the tongue and we're very well educated which people don't realize how much education we actually do have the breathing is a big deal now a lot of the airway doctors aren't looking at the tongue tie and or the nasal passage I do they have a patent airway don't they so I do send my patients off as needed to the professional they need to you know they need to see but a co Emmas certification so I had to go the extra mile to take a test and I'll tell you it wasn't easy and as you take this test it can be an it's an open book test by the way but my book is this thick after I took that test because I had to go back and research all these questions and it was not easy I didn't find it easy at all and I've been on a hygiene for a while but I always go back to my resources and it was it was a good test I was glad I did it because it tells you how much you know or how much you don't know and then you can go back and research that huh
Howard: what I found from it is you know some of these doors on us you know they're not interested in they don't want to hear anything about it or this or that but my gosh when you're the number one goal of a species is to reproduce a bowstring and in my life anytime some mom drops a baby I mean it's just my gosh it's so serious and the word of mouth going on between the moms and things that I've seen I've seen dental offices that that cater to these questions about breastfeeding tongue-tied you know all these babies I mean most moms and most most moms would throw themselves in front of a train to save their baby so so so discounting discounting that this is a very serious thing especially when it's being discounted by a who's never gonna have a baby and never breastfeed it's kind of like I've seen this on this is what I'm saying when I was little all the OBGYNs and gynecologists were male and they didn't like what you were saying they said you're being hysterical which is the Greek word for uterus so basically they're just calling you a uterus and now all those OBGYNs that they're all women and is I think that's happening to pediatric dentistry I mean I can't tell you how many dental schools I've been into well they'll have a pediatric program there's like six students a year and that whole class is women and night I just can't see a mom having this issue is your baby tongue Taizo bothering me nursing who wants to go see short fat bald howard who's 57 and never breastfed do you think do you think pediatric dentistry is going the way of OBGYN where it's going to be a female oriented profession
Pat Pine: well it could be I don't know but they don't get it either because I've gone to speak to these PDF email pediatrician pediatric dentists and they're not getting it either so then refirm who gets it because these kids are suffering and this has gone on to adda ADHD bedwetting thumb-sucking there's a lot of issues more and that's what's in my book what are the side effects of all this down the road what you know what is this child going to grow up with as they tease them and their mouth is open and they're drooling and these there's a lot more to this that meets the eye it's just not breastfeeding there's so much more but that's where it starts you're absolutely right that's where it starts that's how we acknowledge it but that doesn't mean a breath baby that's breast feeding normally is not tongue-tied either so there's so many more avenues to this it meets the eye and that's why I keep going to conferences and speaking because when I speak then I even get more out of it because I can hear myself and what I'm saying and then other people as long as I'm helping other people I'm pretty I'm pretty happy in educating these doctors so I want to speak at more of these medical dental conferences so I can get the word out
Howard: so you're also certified in lasers they do are you passionate about any lasers well the co2 of course is
Pat Pine: what's used for frenectomy is because we don't want the diode it'll burn the tissue and cause too much scarring and when I was doing dental hygiene I would use the diode subjectively eye kills me that I can't do lathe you know releasing of these freedoms but you know I've watched enough doctors and then doctors Agee is in LA and he does he does a different type of tongue release he does a laser but he also kind of dice sexy underneath of the tongue and uses sutures so I think we're gonna get seen more of that with some of these tongue ties because some of them are very difficult and you can't I've had many difficult patients where a simple tongue release doesn't is not the answer so there was more like I said there's so much more to this tongue tie than anybody realizes or understands I get it because I've seen enough patients I totally understand it and these kids that are wired a lot of times it's their tongue and
Howard: do you know how common this is oh oh so common it's unbelievable yes and I my whole family so when I was writing my book we had a family reunion
Pat Pine: so remember I come from nine kids I had all all my siblings and their children lined up to check their tongues and we found I think four Tong Tong ties Wow
Howard: now I decided on just earlier today that I am going to limit my practice do so supera sulk Euler dentistry so uh so what super circular supra sulk Euler so I mean there's no more gum disease or periodontal shoe I would love that and and that um all the microorganisms I'm only focusing on the big the five big game in Africa you know of the the you know the Wallabies the so there's no bacteria if I can't see it it doesn't exist and I'm a super soul killer dentist if some young kid starting out today you know they ever got two hundred eighty four thousand dollars of student loans I'm do you or any of the lasers do you think a by for you I mean do you think it'd be a return on investment
Pat Pine: yeah I think the co2 would be I don't know that I'd what brand name oh well let's see the light scalpel is a good one this usually is typically the doctors I work with have low light scalpel so all the other ones I mean it just depends on what you're going to use it for and if you're going to use it let's not put it in the corner and let it collect dust like the diodes are I mean I was training hygienists on diodes and then I go back a year later and there in the corner collecting dust I think that's a waste of time and money and frustrating for me as a trainer but you know there's some nice guy there's some nice CEO tooth out there and you know it depends on what you're going to use it for it you need to get educated it to release a freedom you think it's just really easy there's so much more to it because there's an anterior and a posterior ty and if that's the case you need to know about both of them now doctor cut low is the doctor who forward my book and he read it and he's phenomenal he thought Alban E New York and he's been doing tongue releases for 37 years he's worked with the moms with the breastfeeding
Howard: so you like the you like the light scalpel that is answered for the co2 and and you think I'm but but you're saying they first got to be into it first I mean
Pat Pine: oh yeah for release to be a professional to do release yeah what we had gotten on the East Coast is a lot of doctors were going into this not knowing thinking it was just an easy easy fix let's release it with whatever they had and charging a left lung and I'm totally against that I feel if you do good work the patients will come you don't have to charge a left because the insurance companies won't pay for this so the moms are not only new moms they're breastfeeding they have a job they don't know what to do with this screaming kid the husband is upset because she can't sleep the other kids can't you know it's horrible so I say these doctors need to get on board now I have some orthodontic patients that still are we're tongue-tied severely tongue-tied and nobody recognized it so I'm happy to go in and train a team and show them what they need to do but I also would like the referral back to me so I can help these kids because we can't ignore it these kids are in trouble they can't breathe they can't think at school they're tired because they're not getting enough rest there's a lot going on they're wetting the bed they're sucking their thumb and I had a patient 50 years old sucking her thumb why so you know comes back to the Y so I work out of my home right now because I don't have enough orthodontist it will refer because they don't get it
Howard: I am I really that light scalpel um he's come out he's come in here to dental town a few times Peter Peter of a truck to the PhD I mean that guy he understands this stuff at a different level so if you're inserting a carbon dioxide he's just he's awesome yeah he's an amazing man um so I'm what advice I always switch gears completely we've already gone over one hour so my last overtime question is uh you and I have been around the block more than once or twice or three times we're out here we both live in Phoenix and there's two dental schools and 6,000 dental graduates just walked out of school a couple of months ago they're starting this whole new journey what would advice would you give them starting out trying to find themselves they're all bright-eyed and bushy-tailed they're trying to figure out you know what's up what's down looking back well if you were giving the commencement graduation speech to all these kids in 80 still and midwestern in our own backyard what would you tell him leaving dental kindergarten about to embark on their three or four decade dental journey
Pat Pine: well I yeah I've been in this long time and I feel and I've seen all different types of philosophies out there and I do feel if you do good work and you're an honest person the patients will come and I do as far as OSHA goes you can start that right off the bat get your books going get your policies in place because what I do find is there's no policies in the office and everybody does whatever they want I would get all the the behind the scenes stuff done so that makes your life easier and then you have policies and rules keep them don't let somebody shortchange you oh I have to do this I have to do that and it should be a team effort everything everybody should be cross-training that's one thing that I learned years ago is that if everybody's cross-trained everybody's looking out for the dentist and the employee the employer so that we can we can all make bonus we can all may have a paycheck we can all live the lives we want to live but I truly believe that if they do good dental work it will be rewarded in the end
Howard: well it's an honor to be your neighbor for all these years it's an honor that you came on the show I was hoping you would dry it I was hoping you drive down to always anybody see she's uh she's up in the Richie Rich part of town and when she heard that she had to go into Phoenix Arizona to see everybody how is she no she didn't have a weapon there's never 9-millimeter honor and
Pat Pine: I am NOT like Geneva with Geneva with let's see who's the guy with the classic cars getting to the Meachem he's on Lake Geneva Meachem 20 car garage up upper and lower decks I walked by his house we walked the lake but we don't go we don't know anybody on the list you know
Howard: I love riding my bike to finals is exactly 45 minutes each way if I leave it like 5:00 a.m. I get back at like 1:00 a.m. to the last hour - it's like a hundred and twenty nine thousand million degrees but I love doing up that fountain it only shoots up what 15 minutes an hour what found mills oh no every hour for 15 minutes yeah yeah but I love riding my bike up to where you live but hey thanks so much for all that you do for dentistry thanks so much for all these posts on dental town it was an honor to podcast you thank you so much for talking about all these subjects and I hope you have a rocky hot day well I'll be back on Saturday so we're coming back on Saturday but thank you for the invite I enjoyed the conversation and I will come to our two key and do this in person all right oh okay bye bye have a great day