The Dr. Phil Klein Dental Podcast

How confident are you that the white patch you noticed at your last exam wasn't something that needed a biopsy? The uncomfortable truth is that for every HPV-negative oral cancer, there was a visible precancerous lesion — and fewer than 5% of those lesions are identified before they become cancer.
Dr. Ashley Clark is an Associate Professor and Division Chief of Oral Pathology at the University of Kentucky College of Dentistry. She holds a DDS from Indiana University and a certificate in Oral and Maxillofacial Pathology from the University of Florida. With over 40 published papers and abstracts, more than 200 continuing education courses delivered, a Fellowship in the American College of Dentists, a Fellowship in Health Education, and authorship of the oral pathology sections of both Dental Decks and Dental Hygiene Decks, Dr. Clark is one of the most prolific oral pathology educators in the country. She has earned multiple prestigious teaching awards, serves on the Commission on Dental Accreditation review board for oral and maxillofacial pathology programs, and sits on the Advisory Board for Oral Cancer Cause.
In this episode, Dr. Clark breaks down the full spectrum of oral potentially malignant disorders (PMDs) — from leukoplakia and erythroplakia to erosive oral lichen planus and proliferative verrucous leukoplakia — and explains exactly why the dental profession is failing to intervene early enough. The conversation covers the clinical criteria that demand a biopsy with no exceptions, why the standard two-week watch-and-wait approach is inappropriate for sharply demarcated lesions, and how to structure long-term surveillance once a PMD is diagnosed. Dr. Clark also addresses the medicolegal exposure dentists face when PMDs go unmonitored, and makes a clear, evidence-based case that appropriately treating leukoplakia alone could reduce oral cancer rates by 50%.
A sharply demarcated white lesion requires a biopsy regardless of patient history, smoking status, or lesion duration — no additional clinical information changes this decision. Watching such a lesion without a diagnosis is not a valid clinical strategy because it is impossible to treat something without knowing what it is, and the most common benign diagnosis is hyperkeratosis while the most common malignant result is squamous cell carcinoma.
Autofluorescence devices can serve as a useful adjunct to white-light examination, but should not be used as standalone diagnostic tools. If a lesion loses fluorescence compared to surrounding healthy tissue, the clinician should return to white-light examination to determine whether the area is sharply demarcated — if it is, biopsy is indicated regardless of other findings.
Once a PMD is diagnosed and treated, the standard of care supported by the literature requires monitoring every six months for 20 years, with each visit including photographic documentation and probe measurement of the lesion. Any change in size, surface character, or appearance at a surveillance visit warrants a new biopsy; if the lesion remains stable, continued observation without repeat biopsy is appropriate.
When dysplasia is confirmed histologically, the recommended treatment escalates based on severity: mild dysplasia may be managed with laser ablation, while moderate dysplasia, severe dysplasia, or carcinoma in situ warrants surgical excision with a scalpel. After tissue destruction, the patient returns to the general dental office for long-term surveillance monitoring for recurrence or new sites of involvement.
General dentists are technically capable of performing punch biopsies on accessible sites including attached gingiva, buccal mucosa, lateral tongue, dorsal tongue, labial mucosa, and hard palate. Sites including the floor of mouth, ventral tongue, soft palate, and gingival bumps with aesthetic considerations are better referred to oral surgery or periodontics; post-operative management of punch biopsy sites typically requires pressure hemostasis, chemical cauterization if needed, and a single suture for tongue sites, with minimal analgesic requirements for most patients.
Perfect for: General dentists seeking clearer biopsy decision-making criteria, dental hygienists who perform oral cancer screenings, dental residents in any specialty, and practice owners who want to understand the medicolegal implications of PMD surveillance protocols.
If you've ever hesitated before recommending a biopsy, this episode will give you the clinical framework and the conviction to act.

Are you pouring money into dental marketing every month without knowing if it's actually working — or worse, overpaying for services that underperform?
Brandon Bosch is the President and Founder of Dr. Marketing, a dental-specific marketing agency with clients across the USA, Canada, Central America, and beyond. A Certified Marketing Expert in both Google and Meta advertising, Brandon has been working exclusively in the dental industry since 2008. He has led the development of hundreds of high-performing dental websites and advertising campaigns, and is a sought-after speaker at major dental conferences including New York, Chicago, Anaheim, Florida, and Hinman. His expertise spans digital advertising strategy, search engine optimization, print marketing, lead tracking, and the psychology of patient acquisition — all within the highly regulated dental landscape.
This episode cuts straight to the real-world marketing challenges dental practice owners face, from overpaying for generic services to navigating the patient flow disruptions that come with dropping an insurance plan or acquiring an existing practice. Brandon brings concrete benchmarks, actionable frameworks, and case studies drawn from years of working exclusively in the dental space. Whether you are trying to attract high-value fee-for-service patients, rebuild after a transition, or simply understand what you should actually be paying for marketing, this conversation provides the clarity and structure most dental owners are missing.
Episode Highlights:
Most dental practices have no reliable system for tracking whether their marketing investment is actually converting into new patients. Without a lead-tracking layer between your website and your patient management system, you are forced to rely solely on reception staff feedback — creating a three-way disconnect between the practice owner, the front desk, and the marketing agency that is difficult to resolve objectively.
The industry benchmarks for patient acquisition costs range from approximately $150 for emergency and hygiene-driven patients up to $450 for cosmetic, implant, and orthodontic cases. On average, a dental practice can expect to convert approximately 40% of inbound leads into confirmed appointments, meaning a pipeline of 50 leads typically yields around 20 new patients.
Practices offering promotional discounts to attract new patients should be aware that the recall rate for discount-driven patients runs between 30 and 40 percent. This self-selects for low-retention patients and actively works against long-term practice growth, making discount-based campaigns a poor investment for PPO or fee-for-service offices.
When a practice drops a major insurance plan, a significant short-term revenue decline is expected. One documented case saw monthly collections fall from approximately $85,000–$89,000 down to $65,000 before recovering to near $80,000 over a 14-to-15-month period. A strategic shift in marketing messaging — emphasizing second opinions, in-house membership plans, and third-party financing options — is essential to attracting fee-for-service patients and closing larger cases during the transition.
Short-term marketing strategies such as paid search ads, meta ads, and print campaigns generate immediate lead flow but require ongoing spend, while long-term strategies such as search engine optimization, blog content, and directory management build compounding organic traffic over time. A well-structured marketing plan uses both in combination, tailored to the specific goals and growth stage of the practice — and should be reviewed jointly by the practice owner and office manager at least once per month.
Perfect for: General dentists, practice owners considering or currently transitioning away from insurance, dental office managers, treatment coordinators, and any dental professional who wants to evaluate or improve the ROI of their current marketing investment.
If you have ever wondered whether your marketing dollars are actually growing your practice or just keeping a vendor in business, this episode will give you the frameworks to find out.

What if your dental chair is actually one of the most powerful wellness intervention points in a patient's entire healthcare journey? Most dental professionals spend more face time with their patients each year than any other clinician — yet too many are leaving that opportunity completely untapped.
Dr. Uche Odiatu, DMD, is a practicing dentist in Toronto, author of The Miracle of Health and Fit for the Love of It, and a professional member of the American College of Sports Medicine. He holds certifications as an NSCA Certified Personal Trainer, Certified Yoga Instructor, and Certified Boot Camp Instructor, and has delivered over 500 lectures across the United States, Canada, England, Denmark, Norway, Bermuda, and the Bahamas. He has presented at the American Dental Association Annual Session 14 times since 2006, making him one of the most recognized voices in dental wellness education.
In this episode, Dr. Odiatu and Dr. Phil Klein explore the mind-body-mouth connection and make a compelling case for why conversations about sleep, nutrition, obesity, stress, and exercise belong in the dental operatory. Drawing on current research in neuroscience, exercise science, gastroenterology, and sleep medicine, Dr. Odiatu offers a framework for how dental professionals can deliver high-impact wellness guidance in as little as 30 to 45 seconds chairside. The discussion reframes dental practice from a transactional model focused on procedures to a transformational model centered on patient health outcomes.
Episode Highlights:
Brain-derived neurotrophic factor (BDNF) is elevated through regular physical exercise and plays a direct role in neuroplasticity and learning. This connection between movement and cognitive performance — intuited decades ago and now confirmed by neuroscience and psychiatry — forms the foundation of the mind-body-mouth framework discussed throughout the episode.
A 2024 Journal of Obesity study found that over 90% of dental patients reported they would be comfortable having their dental provider discuss nutrition, weight management, and obesity chairside. Research also shows that obese patients — independent of smoking status and oral hygiene — demonstrate significantly greater loss of attachment, increased bleeding on probing, and tooth mobility, making weight a clinically relevant conversation in the periodontal assessment.
Sleep quality is framed as a critical systemic health indicator that dentists are uniquely positioned to address. Patients presenting with daytime drowsiness, dry mouth, or morning headaches may benefit from referral for a formal sleep study, which can reveal not only apnea events but also deep sleep duration, blood pressure variability, and nocturnal hypoglycemic episodes — all factors that affect healing and overall systemic health.
Approximately 95% of adults consume insufficient dietary fiber, averaging around 12 grams per day against a recommended minimum of 30 grams. Adequate fiber intake — both soluble and insoluble — supports the gut microbiome's production of short-chain fatty acids, which function as endogenous anti-inflammatories. Given that periodontitis, gingivitis, and most systemic diseases share an inflammatory pathophysiology, this has direct clinical relevance to the dental patient population.
Power toothbrushes and water flossing devices represent a significant upgrade over manual oral hygiene tools, with powered brushing cited as dramatically more effective than manual brushing. For patients with implants, limited dexterity, or documented poor flossing compliance — estimated at approximately 95% of patients — chairside demonstration of proper water flosser technique, including lip seal around the tip, can dramatically improve home care adherence and protect restorative work.
Perfect for: General dentists, dental hygienists, and specialists looking to expand their clinical impact beyond the oral cavity — particularly those interested in integrating wellness conversations into recall exams, new patient appointments, and restorative consultations without adding significant chair time.
If you've ever wondered how to make your practice feel more meaningful while delivering measurably better patient outcomes, this episode gives you the science, the scripts, and the confidence to start tomorrow.

Are you a dental hygienist wondering whether a periodontal specialty practice is the right career move — and what it actually looks like day to day compared to general dentistry?
Cheryl Calmis, RDH, BS, MEd, brings over 30 years of clinical dental hygiene experience with deep expertise in periodontics and diode laser therapy. She holds a Bachelor of Science in Dental Hygiene from the University of California, San Francisco, a Bachelor of Science in Biology from San Jose State University, and a Master of Education in Instructional Design from Western Governors University, where she graduated with highest honors. Cheryl has conducted pilot research for a major dental laser company, serves as a professional educator for a leading oral irrigation brand, delivers continuing education lectures on contemporary hygiene topics, and has authored articles for multiple dental publications including Today's RDH.
This episode draws a detailed clinical and professional comparison between working as a dental hygienist in a general practice versus a periodontal specialty office. Cheryl shares her own 9-year journey through general dentistry before transitioning to a perio practice, offering an honest and practical roadmap for hygienists considering a similar move. The conversation covers patient demographics, appointment structure, clinical protocols, laser use, chemotherapeutics, and the mindset required to thrive in a perio environment. For hygienists in GP settings, Cheryl also outlines how to advocate for — and build — a stronger in-house periodontal program without ever leaving their current office.
Episode Highlights:
Periodontal specialty patients differ significantly from the general practice population. Most patients referred to a periodontist are adults, often in their 50s or older, presenting with advanced bone loss, refractory periodontal disease, recession, or implant-related maintenance needs — with approximately 70% of patients having at least one implant in the mouth.
Periodontal charting is performed at every single appointment in a perio practice, not just annually. This continuous data collection allows the hygienist and periodontist to track pocket depth trends, bleeding scores, and disease stability over time — with patients often actively tracking their own numbers visit to visit.
Diode lasers are used by dental hygienists in California — and in most states — for laser bacterial reduction within periodontal pockets. This application is typically performed during non-surgical periodontal therapy or during maintenance appointments when a pocket shows signs needing additional intervention, and at the low energy levels used for bacterial reduction, tissue heat generation is not clinically significant.
Re-educating patients about the nature of bone loss is a core communication skill in periodontal practice. Patients referred from GP offices often feel demoralized after previous treatment did not reduce their pocket depths; the key clinical reframing is that bone loss represents history that cannot be reversed, and that stabilization — not resolution — is a clinically meaningful and realistic success outcome.
Hygienists in GP offices can proactively build periodontal program depth without changing jobs. By initiating a conversation with the practice owner about improving periodontal diagnosis, implementing consistent full-mouth charting, and expanding non-surgical therapy protocols, a GP hygienist can gain the clinical exposure needed to evaluate whether a specialty perio career is the right fit.
Perfect for: dental hygienists at any career stage considering a move into periodontal specialty practice, hygienists in GP settings looking to elevate their clinical role, and dental residents or students exploring the range of hygiene career pathways.
If you've ever wondered what it would feel like to do deep, focused periodontal work every single day — this episode gives you the clearest picture of what that career actually looks like from someone who's lived it.

What if you could hand a patient their finished crown before they even leave the chair — and it cost you $22 to make? Chairside 3D printing is no longer a future concept; it is happening right now in high-volume practices, and it is reshaping how dentists think about same-day restorations.
Dr. Michael Erdos is a general dentist and co-owner of Tawil Dental, a Brooklyn practice with nearly 50 years of history in cosmetic, restorative, and implant dentistry. A Columbia University College of Dental Medicine graduate and former Chief Resident at Mount Sinai Hospital, Dr. Erdos has built his clinical focus around the intersection of aesthetic dentistry, prosthodontics, and digital workflows. Over the past several years, he has worked directly with Shining3D to test, refine, and optimize in-office digital printing workflows at scale, with a particular emphasis on making AI-driven design and chairside printing practical for everyday clinical use.
In this episode, Dr. Erdos walks through a complete chairside 3D printing workflow — from intraoral scan to cemented restoration — and explains exactly how a general dentist can deliver a crown, veneer, onlay, or pediatric crown in a single visit using a compact, countertop printer that weighs under five pounds and requires nothing more than a standard wall outlet. He compares chairside printing directly to milling, discusses the ceramic-infused resin materials now cleared for permanent restorations, and shares his honest assessment of where the aesthetics stand today versus lithium disilicate. This is one of the most clinically detailed and financially transparent conversations about chairside 3D printing available to the dental profession.
Episode Highlights:
The complete chairside workflow from scan to cemented restoration can be completed in approximately 30 minutes, with a significant portion delegable to a trained assistant. The process involves scanning the full arch and bite pre-operatively, scanning the preparation, uploading to a cloud-based platform, and using AI design software to generate a restoration proposal — typically within one to two minutes — before sending directly to the printer in a single click.
Ceramic-infused resin materials now cleared for permanent restorations contain over 50% ceramic filler content, including ceramic compounds such as lithium disilicate and zirconia variants, which meaningfully increase strength and aesthetics compared to earlier-generation printable resins. While these materials do not yet rival the optical properties of pressed lithium disilicate or full-contour zirconia, post-cure staining, glazing, and nitrogen-atmosphere curing can significantly enhance final appearance and surface quality.
The additive nature of 3D printing allows for margin and contour accuracy that can surpass subtractive milling in certain applications, particularly for thin restorations such as veneers, where burr diameter in milling limits the fineness of internal line angles and margins. For no-prep or minimal-prep veneer cases, printed restorations can be bonded over natural tooth structure with minimal or no enamel reduction, then refined chairside after cementation.
From a financial standpoint, the per-restoration material cost using sealed single-use resin capsules is approximately $22, and a single capsule can accommodate multiple restorations of the same shade printed simultaneously — including up to six veneers or a three-unit bridge. At a practice fee of $750 per printed resin veneer, a four-veneer case generates approximately $3,000 in production at a material cost of $22, with the hardware investment in the printer recoupable within a single week of focused use.
Chairside printing opens a clinically and financially accessible pathway for pediatric white crown restorations as a direct alternative to stainless steel crowns, allowing the printed crown to be fabricated during the same appointment while other restorative procedures are completed. The same workflow applies to budget-conscious adult patients currently treated with direct composite bonding, converting them to indirect printed resin veneers at a price point that improves case acceptance without competing directly with laboratory-fabricated porcelain veneer cases.
Perfect for: General dentists exploring same-day digital workflows, prosthodontists integrating in-office printing, pediatric dentists seeking aesthetic alternatives to stainless steel crowns, and dental residents building their understanding of AI-assisted restorative design and chairside digital technology.
If you have been waiting for 3D printing to become fast enough, affordable enough, and simple enough to work in a real practice — this episode will show you it already has.