Have you checked the bite?

Using occlusal harmony as a metaphor for team harmony, Lisa Knowles, DDS, explains how you can check your team's "bite" by addressing problems as they arise, recognizing individual team members' personalities and needs, and practicing mindfulness.

Content Dam Diq Online Articles 2017 04 April De Logo
Using occlusal harmony as a metaphor for team harmony, Lisa Knowles, DDS, explains how you can check your team's "bite" by addressing problems as they arise, recognizing individual team members' personalities and needs, and practicing mindfulness.

We all know occlusal harmony is ideal when it comes to helping our patients function well. Sometimes, though, we get one surface that seems to hit again and again. We adjust the bite extensively, yet the patient returns, only to complain of soreness on the same tooth. We adjust it again, and determined to get it right, we take out our ultrafine ribbon paper to test it. Finally, the patient taps up and down and smiles while saying, “I think you finally got it, Doc. It feels perfect.” This harmony is heavenly.

Conversely, sometimes we get a crown back from a dental lab and notice the bite is nonexistent in certain areas. There is no occlusion. That isn’t good either because surely other teeth will shift to balance out the inequity in forces and possibly damage adjacent teeth. Patients don’t know this. They think their bites feel great. But as dentists, we know we ultimately want that harmony—the feeling that everything is hitting as it should be.

We know this in the mouth, but what about outside of the mouth? Have you checked your team’s bite lately? Is there harmony? Here are a few considerations for equilibrating your team.

Is someone hitting too hard?

I once worked with an office manager who became defensive with each and every question asked. As a newer kid on the block, I did not know the social order of the practice and eagerly asked questions to learn faster. I quickly learned that this particular person did not like questions. She pursed her lips, wheeled around in her chair, let out a sigh, and then, with great effort, released the requested information from her frown. “Got it,” I thought, and from that point on, I worked around her to get the information I needed. (And I prayed that this was not how she treated our patients.)

Is someone still hitting too hard, even after making adjustments?

In the busyness of the day, it’s fair to say no one absolutely knows how he or she is acting or reacting. It may be a lack of self-awareness that causes these things to happen. I am certainly guilty of not understanding others’ viewpoints or missing cues. It happens until someone, such as a coach, leader, boss, or coworker, openly discusses these things with me. When this happens, it can hit us like a truck. Bam! We have our perspectives, but without discussion, we keep doing the only thing we know how to do. But once someone talks to us, and we gain a greater understanding of others’ feelings in the work environment, it is hard not to change our behavior. Maya Angelou said, “Do the best you can until you know better. Then, when you know better, do better.”

If a player doesn’t make adjustments after his or her behavior has been brought up, it’s time to document any situations that arise, address the behavior regularly, and think about the player’s future on the team. As with teeth, continued battering leads to breakage and dysfunction. The team can only handle so much wear and tear.

Do you set aside time to figure out and discuss the needed adjustments?

Even though it can take time, it’s important to address concerns before something breaks. Regular team check-ins and meetings are essential for a team’s success—and the more people there are on a team, the more scheduled times are needed to create harmony. Think about it. How long does it take if you need to adjust one recent restoration versus an entire quadrant of restorations, including a new implant crown and a recently delivered bite splint? More variables take more time. In a team situation, each team member represents a variable in the equation for team success.

Do not fear all of these adjustments. Patterns arise when it comes to problems, whether with teeth or personnel. Sometimes it is our fault for not checking in on our team and letting things slide out of control, like a patient who fails to get the small crack restored and later regrets it. Team problems often start small too. We can address the problems when they are manageable, or we can wait until they need attention emergently. Like we tell our patients, “Don’t wait until there is a problem. Do some preventive maintenance.” The same philosophy holds true for team harmony. Team meetings, retreats, and one-on-one discussions on a regular basis allow for these minor adjustments to take place.

What if someone is not participating at all?

How can you engage this person, and more importantly, why isn’t this person participating? It takes an entire team to function properly. When one voice is lost or dominated by someone else’s voice, we shift out of equilibrium again. As an extrovert, I know I talk more than I listen. It takes effort for me to close my mouth and listen more often. Most teams comprise introverts and extroverts. Some may want to talk more than others, and that’s OK, but sometimes extroverts dominate conversations with their ideas and input. Consider each person’s communication style. Introverts tend to prefer small groups or one-on-one opportunities. Extroverts tend to enjoy large groups with a lot of action and opportunities to speak. If we recognize differing needs, we can solve problems and achieve harmony more often.

How do we check our own bites?

Let’s not forget our own occlusal forces—our own bites. Checking ourselves is pretty difficult and usually requires help. With our teeth, we can look backwards and upside-down in a mirror and probably adjust things. I am certain others have done it. When it comes to adjusting our personalities, some do-it-yourselfers may want to consider things like personality testing and identity development readings. A coach might be able to help identify ways to improve any internal pressure that is leading to external bite problems. Our patients grind their teeth under stress and pressure; might we be letting out pressure in not-so-subtle ways?

I found a great way to relieve stress and pressure for myself, mindfulness-based stress reduction. Each day, I take a few minutes to focus on the present moment. I think of mindfulness master Jon Kabat-Zinn. To paraphrase his words, mindfulness is awareness, cultivated by paying attention in a sustained and particular way: on purpose, in the present moment, and nonjudgmentally. That is the essence of mindfulness-based stress reduction.

Sure, we have to plan ahead in dentistry, usually six months to a year ahead. We have to negotiate each day’s schedule changes and troubleshoot errors and mishaps. We have to project the financial future and consider past decisions. We have to schedule family events and maybe evening meals. Our dental lives are structured and so are a lot of our waking moments. But this is the very reason why we can benefit from mindfulness-based stress reduction techniques. Our bodies crave balance. We cannot live like rigid, scheduled robots for 24 hours a day, seven days a week. Maybe others could in previous generations when there were clearer roles for those who worked away from the home and those who worked in the home, but we don’t live that way anymore.

Most lines, roles, and expectations are blurred. In my household, the first person home begins to make dinner for the family. It’s not etched in stone that I will be the one making all of the meals, nor is it certain that my husband will always cut the grass. This can be helpful at times, and at other times, it creates chaos. So, what do we do? We add more structure, right? We plan our kids’ events and meticulously put our vacation agendas together. Sheesh, isn’t that just like work? Don’t we need some unstructured time when we’re free to think about the present moment and not next week’s grocery list or tomorrow’s dry cleaning?

Our lives are structured. We’re constantly thinking of what we’ve done and what we need to do. We leave little time to be in the moment. We crave that balance I mentioned earlier, which is, again, why I mention the term mindfulness-based stress reduction. It’s a self-help technique that has proven to be invaluable to my physical and mental health as a dentist. Learning how to live a more mindful lifestyle is crucial to our long-term success. We can eat more mindfully. We can walk more mindfully. We can even practice dentistry more mindfully.

When we balance our busy professional lives with opposite-functioning muscles and thought processes, we give our bodies and brains much needed rest. We cannot always escape to the mountains or the beach to rejuvenate, and it’s not healthy to wait until it’s time for a week of vacation. We need a daily outlet. Mindfulness-based techniques offer this possibility, and they’re certainly less expensive than a Hawaiian vacation.

I gained so much clarity after learning these techniques that I decided to get extra training to help other professionals find balance in their lives as I did in mine. I have a certification in mindfulness-based stress reduction for health-care professionals, and I have a greater understanding of the need for all of us in health care to learn to take better care of ourselves. Let’s face it - we all get “bitey” at times. Mindfulness-based stress reduction is the great equalizer. We do not always recognize that we are in need of equilibration. It takes a pulled muscle or a relationship breakdown or a financial crisis for us to realize we need more balance in our lives.

It is my passion to help others find ways to prevent crises and practice more successfully with happier, healthier, and more harmonious environments. To do this, we must remember to check the bite carefully—our bites, our teams’ bites, and our patients’ bites. When everything fits together as planned, we get harmony. It’s a lovely feeling. With work, maintenance, and mindful living, we can find it daily.


Lisa Knowles, DDS, practices in Michigan and speaks internationally on the topics of mindfulness-based stress reduction, oral and systemic connections, business communication techniques, and the economic payoffs of ecodentistry. Find out more about Dr. Knowles at Beyond32Teeth.com. Contact her at IntentionalDental@gmail.com.


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