Sleep Matters Podcast

Blame the Patient. That Works Great! With Ryan C. Javanbakht

In this episode, Ryan Javanbakht joins Jason Tierney and Dr. Erin Elliott to break down one of the biggest issues in dental sleep medicine: patient follow-through on testing. Most practices think they have a testing problem. They don’t; they have a communication problem. Patients drop off because they don’t fully understand why it matters, what happens next, or what it will cost. Without that clarity, even motivated patients hesitate and disappear. Sleep testing is the inflection point. It’s where patients either connect the dots and commit, or get confused and disappear. Clarity creates momentum. Confusion kills it. What’s on the Menu: Why Patients Drop Out of the Funnel Ryan breaks down the real failure points: unclear communication, a lack of urgency around the problem, and poor expectation-setting regarding process and cost. When those pieces are missing, drop-off is inevitable. The “Magical” Moment: Diagnosis Dr. Elliott highlights the moment everything clicks, when patients see their results and connect the data to how they feel. That’s when urgency builds, motivation increases, and cost becomes less of a barrier. Why Communication Beats Technology Tools don’t drive case acceptance; conversations do. Patients move forward when they feel heard, understand the process, and know what to expect at each step. The Two-Option Close That Works Ryan shares a simple framework: give patients two clear paths, a traditional referral or an immediate home sleep test. Clear options reduce hesitation and increase follow-through. Why Dental Patients Resist Dental patients aren’t expecting a sleep conversation; they’re expecting a cleaning. That mismatch creates friction. The solution is to slow down, separate consults, and build trust before making recommendations. How to Handle Objections Effectively Ryan outlines a simple structure: empathize, clarify, isolate, respond. It keeps conversations human and builds trust instead of pressure. The Power of “Selling the Next Step” Dr. Elliott emphasizes a key shift: don’t sell treatment. Don’t even sell the test. Focus on the next step. That’s how momentum builds without overwhelming the patient. Why Patients Need to “Want It” The goal isn’t compliance, it’s ownership. When patients reach the point of “I want this” and “I need this,” moving forward becomes natural. Clinical Concepts & Terminology Home Sleep Test (HST) A diagnostic tool that allows patients to test for sleep apnea at home, improving accessibility and completion rates. Sleep Testing Funnel The patient journey from awareness to treatment. Breakdowns at any stage reduce overall case acceptance. Conversion Rate The gap between patients referred for testing and those who actually complete it is a key measure of system effectiveness. STOP-BANG Screening A widely used screening tool to identify patients at risk for sleep apnea. Professional Organizations & Collaboration Third-Party Testing Partnerships Services like SleepTest.com [https://www.linkedin.com/company/sleeptest-dental-sleep-medicine/] help streamline insurance verification, patient communication, test completion, and physician review—reducing friction across the process. Featured Experts to Follow Ryan C. Javanbakht [https://www.linkedin.com/in/ryan-c-javanbakht-78a7988/]: CEO of SleepTest.com, focused on improving access and conversion in sleep diagnostics Recommended Tools & Resources STOP-BANG Questionnaire A simple way to begin identifying patients at risk for sleep apnea. Home Sleep Testing (HST) A patient-friendly diagnostic option that improves follow-through. SleepTest CRM A platform designed to manage patient communication, insurance verification, test coordination, and reporting. Communication Frameworks Empathize → Clarify → Isolate → Respond Two-option close strategy Consult-first workflow

The Wake-Up Call You Can’t Ignore: Pediatric Airway Awareness & Early Expansion with Dr. Johnny Ukich

In this episode, Jason Tierney and Dr. Erin Elliott talk with Dr. Johnny Ukich about the slow shift from focusing mainly on cavities and traditional pediatric care to recognizing the early signs of sleep-disordered breathing in kids. What does it take for a busy pediatric dentist to start seeing airway differently? For Dr. Ukich, that shift didn’t come from one lecture or a EUREKA! moment. It came through years of conversations, his father’s background in early orthodontic thinking, and eventually what he began noticing in his own child. Once the pieces connected, he started seeing open-mouth breathing, snoring, bedwetting, poor sleep quality, and arch development in a completely different light. This is a grounded conversation for dentists who may not feel ready to treat every airway case, but do need to know what to look for. Dr. Ukich makes the case that awareness alone can change lives, especially when it leads to earlier questions, better screening, and stronger collaboration. What’s on the Menu: * A Real Conversion Story: Dr. Ukich shares how airway was not part of his early training and how it took years in practice before the dots finally connected. * Why Personal Experience Changed Everything: Like many clinicians, the turning point came when he began seeing these patterns in his own child and could no longer dismiss them as isolated issues. * What Early Treatment Started to Reveal: Once he began expanding earlier, he saw changes parents could notice quickly, including better nasal breathing, less bedwetting, and improved sleep. * Screen Even If You Don’t Treat: One of the clearest takeaways is that pediatric dentists do not need every tool or every service in-house, but they do need to recognize the signs and start the conversation. * How He Talks to Parents Without Sounding “Salesy”: Dr. Ukich focuses on sleep quality, growth, and what parents are actually seeing at home rather than jumping straight into treatment. * Why This Has to Be a Team Approach: The episode highlights the need for collaboration with orthodontists, ENTs, lactation consultants, myofunctional therapists, and other providers. The Value Add: * It Makes Pediatric Airway Feel Practical: This episode shows what early airway awareness can look like in a real pediatric office, not just in theory. * It Reminds Providers They Can Start Smaller: Dr. Ukich makes it clear that simply asking better questions and knowing when to refer can make a real difference. Clinical Concepts & Terminology * Pediatric Sleep Questionnaire (PSQ): A screening tool Dr. Ukich uses to identify symptoms that may point to sleep-disordered breathing. * Early Expansion: Discussed as a way to support arch development, nasal breathing, and better sleep patterns when started young enough. * Myobrace: A removable appliance mentioned as part of habit correction and functional development, especially around breathing and oral posture. * Myofunctional Therapy: Referenced as part of follow-up care to help children use their lips, tongue, and oral muscles more effectively after expansion. * Acoustic Rhinometry: A tool Dr. Ukich uses to help measure nasal capacity and airway function. * Tongue-Tie Release: Discussed in the context of infant feeding, latch, and early oral development. Professional Organizations & Collaboration * AAPD Guidelines: Dr. Ukich and Dr. Elliott discuss the importance of pediatric dentistry guidelines now addressing airway screening and treatment more directly. * Collaborative Pediatric Airway Care: The conversation emphasizes working with orthodontists, ENTs, lactation consultants, craniofacial chiropractors, and myofunctional therapists rather than trying to solve everything alone. Featured Experts to Follow * Dr. Johnny Ukich [https://www.dentalcareforkids.com/meet]: A pediatric dentist sharing a practical perspective on how airway awareness changed the way he screens and treats children. * Dr. Erin Elliott [https://www.linkedin.com/in/dr-erin-elliott-b0033028/]: Co-host of the episode and one of the early voices who helped push this conversation forward in her community. * Dr. Boyd Simpkins: Mentioned in the episode as another pediatric dentist involved in this space. Recommended Tools & Reading * Gasp [https://www.amazon.com/Gasp-Airway-Health-Hidden-Wellness/dp/1536995266]: The book Dr. Ukich credits as the moment everything clicked for him. * Breath by James Nestor [https://www.amazon.com/Breath-New-Science-Lost-Art/dp/0735213615]: A recommended read for clinicians who want a more accessible entry point into breathing and airway concepts. * Pediatric Sleep Questionnaire (PSQ) [https://health.ucdavis.edu/cht/documents/pediatric-sleep-questionnaire.pdf]: A practical screening resource for identifying airway-related symptoms in children. * Myobrace: Mentioned as a tool for encouraging better breathing habits and oral function. * CO2 Laser: Discussed as a valuable tool for infant tongue-tie releases because of comfort, speed, and healing.

How to Stop Your Team From Complaining & Start Contributing With Dr. Max Kerr (Part 2)

Why do the thousands of dollars you spend on dental consultants evaporate the moment your team gets busy? Dr. Max Kerr breaks down the real reason your practice falls back into bad habits, office drama, and useless meetings. Learn how the EOS framework forces total team accountability, kills breakroom gossip, and builds a structural foundation that permanently solves your biggest operational headaches. What We Discuss with Dr. Max Kerr: * The Issues List: Why an organization with a lot of issues is actually a healthy one—as long as you have a system to capture them instead of letting them fester in the breakroom. * IDS (Identify, Discuss, Solve): The exact psychological framework to prevent endless meeting debates and force actual, tangible solutions with assigned to-dos. * Stopping Office Drama: How to empower your team to bring problems to the light, and why you should enforce a strict "don't vent to me, do something about it" culture. * The 80/20 Rule of Process: Why you don't need a 100-page SOP manual that no one reads. Learn how documenting just 20% of your core processes gets 80% of the work done safely. * The Level 10 Meeting: The strict 90-minute weekly agenda that guarantees accountability, keeps everyone on track, and eliminates the "this could have been an email" feeling. * The Foundation First: Why getting EOS off the ground takes a solid two years, and why expensive clinical consultants won't save your business if your foundational "underwear and socks" aren't properly in place. * And much more… Episode Summary: You’ve hired the consultants, read the books, and maybe even had a few productive team meetings. But two months later, the demands of the practice get in the way, and everyone reverts to their old habits. Your team is venting to each other in the hallways, administrative balls are being dropped, and your clinical excellence is being overshadowed by 1-star reviews complaining about billing errors. In this episode, Jason Tierney and Dr. Erin Elliott welcome back Dr. Kerr to dive deep into the final key components of the EOS (Traction) framework: Issues, Process, and Traction. Dr. Kerr explains why avoiding problems is a recipe for disaster and how implementing a strict, time-blocked "Level 10" weekly meeting can completely transform your practice's culture. He shares exactly how to track issues, force actionable solutions instead of allowing endless discussion, and hold team members accountable week over week. Whether you are running a single dental sleep practice or managing multiple locations, this conversation strips away the "rainbow unicorn mumbo jumbo" and gives you the essential blocking and tackling strategies needed to run a highly profitable, stress-free business. Resources and References Mentioned: * Traction: Get a Grip on Your Business by Gino Wickman [https://benbellabooks.com/shop/traction/] * Value Add: This is the foundational textbook for the Entrepreneurial Operating System (EOS) discussed in this episode. If you are tired of hitting a ceiling in your practice growth, start here to understand the Six Key Components of a successful business. * EOS Worldwide (Find an Implementer) [https://www.eosworldwide.com/] * Dr. Kerr mentions that while you can self-implement EOS, the most successful and busiest dental sleep practices in the world often hire a professional implementer. Use this directory if you want a professional to hold your leadership team accountable and fast-track your success. * Productive Dentist Academy (PDA) [https://productivedentist.com/] * Mentioned by Dr. Kerr as an incredible resource for patient interaction and team alignment. However, as Dr. Kerr notes, PDA is "downstream" from EOS. Build your EOS communication lanes and business foundation first, so that when you bring in heavy-hitting consultants like PDA, your team can actually execute their strategies. * Connect with Dr. Max Kerr: * Reach out directly via email at: mkerr@sleepbetteraustin.com

Handpiece Allergy, Toxic Tammy, and DSM “Rocks” with Dr. Max Kerr (Part 1)

The "business of dental sleep medicine" shouldn’t feel like a dirty secret - and PROFIT shouldn’t be a curse word in sleep. In this episode, Jason Tierney, Dr. Erin Elliott, and Dr. Max Kerr stop apologizing for building healthy businesses. Dr. Kerr explains how his own "rheostat regret"—a deep-seated dislike for traditional drilling and filling—led him to master the Entrepreneurial Operating System (EOS) and scale a massive sleep practice. From identifying the "Toxic Tammys" in your office to setting the 90-day "Rocks" that move the needle, this conversation is a roadmap for any dentist who wants to stop being the bottleneck in their own business. What’s on the Menu: * The Handpiece Allergy: Why Max traded the handpiece for systems and how that shift allowed him to scale patient care without burning out. * The Foundational “Underwear” of Business: Max explains why EOS is the "base layer" of a successful practice—if your socks and underwear have holes, your whole outfit (and your day) is ruined. * The "Screw Tammy" Protocol: How to handle the high-performing "Toxic Tammy" who is a hit with patients but a cancer to your team culture. * Vision vs. Hallucination: Why a mission statement isn’t enough. You need the Vision Traction Organizer (VTO) to ensure your team is actually following the map. * Setting DSM "Rocks": A breakdown of the 90-day sprint and how to keep your team focused on big-picture projects instead of just daily fires. * Voted Off the Island: Erin and Max discuss building a culture so strong that toxic employees self-select out before you even have to fire them. * Managing by the Scorecard: How to use objective data to predict your month's success before you even look at a revenue report. The Value Add: * It Connects Business Health to Patient Care: This episode makes it clear that strong care and strong operations belong together. A healthy practice can serve more people, more consistently. * It Gives Owners a Clearer Leadership Framework: Instead of living in constant reaction mode, listeners get a practical model for building alignment, accountability, and better decision-making. * Cross-Functional Buy-In: Dr. Kerr emphasizes involving key team members in vision and accountability so the practice runs with more alignment and less confusion. The Wisdom of Max: "None of us are doing this for free. If you don’t care about people, dentistry will eat you alive—but you can quantify that you’re helping someone live years longer. What is that worth to bring to market?" Clinical Concepts & Terminology: * EOS (Entrepreneurial Operating System): [https://www.eosworldwide.com/] A proven set of simple concepts and practical tools used by entrepreneurs to get what they want from their businesses. * Rocks: The 3 to 7 most important things (objectives) the company must get done in the next 90 days. * The People Analyzer: [https://www.eosworldwide.com/people] An EOS tool used to clarify if you have the "Right People" in the "Right Seats." * VTO (Vision Traction Organizer): [https://www.eosworldwide.com/vto-download] A powerful tool that helps a leadership team get 100% on the same page with where they are going and how they are going to get there. * Scorecard: [https://www.eosworldwide.com/scorecard-download] A weekly tracking tool of 5–15 high-level numbers that allow you to feel the pulse of your business. Featured Experts & Resources: * Dr. Max Kerr: [https://www.linkedin.com/in/max-kerr-b430a83/] Clinical Director of Sleep Better Austin and a certified EOS implementer. * Traction by Gino Wickman: [https://www.eosworldwide.com/traction-book] The essential reading for any practice owner looking to implement EOS. * Sleep Better Austin: [https://www.sleepbetteraustin.com/] The systems-driven sleep practice referenced as a case study in this episode.

Orange Jumpsuits, Evidence-Based Constraints, and the Provider Divider with Dr. Steve Carstensen

Dental Sleep Medicine is like Groundhog Day. Why? In this episode, Jason Tierney and Dr. Erin Elliott sit down with the "fierce advocate" himself, Dr. Steve Carstensen, to examine why the field is moving at the speed of a dial-up modem. Steve has been in the room where it happens—serving on boards, teaching the masses, and pushing the rock up the hill—and he’s got some thoughts. If you’ve ever felt like a "second-class citizen" in the medical world or wondered why we’re still arguing over home sleep tests in 2026, this one is for you. What’s on the Menu: * The "Orange Jumpsuit" Syndrome: Why the fear of regulatory "monsters" has kept dentists from practicing to their full potential. (Spoiler: You probably won’t go to prison for ordering a ferritin test). * The MD-DDS Discord: Why does the sleep physician love your outcomes but forget your name when it’s time to refer? We talk about bridging the "silo" gap without needing a medical degree. * Beyond the "Plastic Provider": If you think your only job is "mandibular advancement," you’re missing the 4th dimension. Steve breaks down Developmental Dental Facial Orthopedics and why we need to care about the brain and heart, not just the airway closure. * The Tipping Point: Is the AI-informed patient actually the one who will finally force the medical and dental communities to play nice? The Value Add: Stop playing small. Steve makes the case for moving from "cautious participation" to "meaningful leadership." You'll walk away with a clearer understanding of the structural barriers holding the industry back—and how to kick them down in your own community. "All of us is smarter than any one of us." — Dr. Carstensen’s closing wisdom  Clinical Concepts & Terminology * Developmental Dental Facial Orthopedics: A term coined by Dr. Kevin Boyd and Dr. Dave McCarty to shift the focus from just "straightening teeth" to the 4D growth and development of the airway. Learn more via Dr. Kevin Boyd’s work [https://airwayhealthsolutions.com/boyd] * The "Leaky Syndrome" Concept: Referenced in the context of functional dentistry—looking at the tube from "here to here" (mouth to gut). Dr. Witt Wilkerson’s "The Shift": [https://www.wittwilkersondmd.com/book/] A guide to health-centered dentistry and the "leaky" body systems. Professional Organizations & Collaboration Steve emphasizes joining groups where "nobody cares what’s on your badge." * World Dentofacial Sleep Society (WDSS): Founded by Dr. Audrey Yoon and Dr. Leopoldo Correa to unite dentists and surgeons globally. Website: dentofacialsleep.org [https://dentofacialsleep.org/] * World Sleep Society: The premier international organization for sleep professionals. Steve recommends their biennial congress for true interdisciplinary learning. Website: worldsleepsociety.org [https://worldsleepsociety.org/] * AAPMD & AAOSH (Collaboration Cures): The home for the "Collaboration Cures" movement, focusing on the airway, oral-systemic health, and functional medicine. Website: aapmd.org [https://aapmd.org/] | aaosh.org [https://www.aaosh.org/] * Sleep Education Consortium: Founded by Dr. Jerald Simmons, providing the 3-day comprehensive courses Steve mentioned for MD/DDS collaboration. Website: dentalsleepconference.com [https://dentalsleepconference.com/] Featured Experts to Follow * Dr. Shane Creado: The sleep physician mentioned who "loves our world" and focuses on peak sleep performance and psychiatry. Website: shanecreado.com [https://shanecreado.com/] * Dr. Audrey Yoon: A leader in pediatric dental sleep medicine and orthodontics at Stanford. Link to Clinical Profile [https://www.draudreyyoon.com/] Recommended Tools & Reading * Open Evidence: The AI tool Steve used to research "Evidence-Based Medicine" and alternative clinical trials. Website: open.evidence.com [https://www.google.com/search?q=https://open.evidence.com/] * The Tipping Point by Malcolm Gladwell: The book Steve cited when discussing how the industry will eventually shift its attitude toward airway care. Buy on Amazon. [https://www.amazon.com/Tipping-Point-Little-Things-Difference/dp/0316346624]