The Dr. Phil Klein Dental Podcast

Dentists face significantly higher rates of depression, anxiety, and burnout than the general population—and it’s something we don’t talk about enough. Our guest today is Dr. Joshua Austin, a full-time restorative dentist. He lectures nationally and internationally on clinical dentistry and mental health. Dr. Austin understands the pressures of operating a dental practice firsthand. After going through a period of intense stress, he realized something had to change. He made the decision to rebuild—not just his practice, but his life. Today, we’re going to hear that story—the struggles, the wake-up call, and the intentional steps he took to find joy in dentistry again.

In a market flooded with nearly 250 prosthodontists, how do you not just survive but thrive while building a practice that patients fly across the world to visit?
Dr. Graziano D. Giglio is a board-certified prosthodontist with a distinguished career spanning over three decades in New York City. He earned his D.D.S. and completed postgraduate prosthodontic training at New York University College of Dentistry, where he currently serves as Adjunct Clinical Associate Professor. Dr. Giglio is a Fellow of the American College of Prosthodontists, the American College of Dentists, the Greater New York Academy of Dentistry, the Northeastern Gnathological Society, and the New York Academy of Dentistry. He served as President of the Greater New York Academy of Prosthodontics in 2013 and received the Prosthodontist Private Practice Award from the American College of Prosthodontists that same year. He operates an interdisciplinary practice in Manhattan with his wife, Dr. Ana Giglio, a periodontist.
This episode reveals the systematic approach Dr. Giglio has used to build a thriving 13-operatory practice with three dentists and a team of 20 in one of the most competitive dental markets in the world. The conversation explores how exceptional patient experience drives practice growth, the critical role of staff training, and practical strategies for insurance participation that maintain profitability while building the right patient base.
Episode Highlights:
The 60% insurance participation rule that determines practice profitability—accepting insurance payments below 60% of standard fees results in working for free since most dental practice overhead runs approximately 60%. Dr. Giglio recommends requiring copays upfront to ensure patient commitment and suggests limiting insurance acceptance to select plans that offer reasonable reimbursement rates.
Advanced provisional fabrication using pre-scanned digital workflows and milled shells from 130-megapascal materials like iVotion significantly reduces chair time while providing superior aesthetics and retention. These provisionals serve as practice advertisements, generate referrals from other dentists who see the quality, and eliminate emergency visits from loose temporaries when cemented with permanent cement like Duralon.
Strategic staff training protocols that prevent untrained employees from patient interaction for 90 days while using friends and family members as practice patients for new hires. This approach allows real-world training scenarios without risking negative experiences for paying patients, combined with extended function assistant training to maximize efficiency and reduce procedure times.
Front desk optimization requiring 3-4 staff members to ensure proper phone coverage and patient greeting, with specific hiring from customer service backgrounds like bank tellers, hotel concierges, and retail environments. Phone skills training emphasizes warm greetings, proper forms assistance, and immediate eye contact upon patient arrival, recognizing that first impressions often determine patient retention.
Patient trust development as the foundation for practice growth, where 70% of new patients come from word-of-mouth referrals generated through consistent exceptional experiences, compassionate care, and addressing patients' chief complaints rather than comprehensive treatment presentations that may overwhelm or intimidate new patients.
Perfect for: General dentists and specialists looking to differentiate their practices in competitive markets, practice owners struggling with insurance participation decisions, and dental professionals seeking proven systems for staff training and patient experience optimization.
Discover how exceptional patient care and systematic practice management can transform your dental practice into a destination that patients seek out and enthusiastically recommend.

Are we truly at the point where one composite material can handle both the strength demands of posterior restorations and the aesthetic requirements of anterior teeth without compromise? This question has divided the dental profession for decades as clinicians weighed the trade-offs between different material properties.
Dr. Sam Simos brings over three decades of clinical expertise to this discussion. A graduate of Loyola University's Doctorate of Dental Surgery program in 1991, Dr. Simos completed comprehensive surgical training at the Misch Institute for Dental Implants and advanced studies at the Las Vegas Institute for Advanced Dental Studies, where he now serves as one of only 78 Clinical Instructors worldwide. As founder and president of Allstar Smiles and a recognized expert in cosmetic and restorative dentistry, Dr. Simos teaches post-graduate programs to practicing dentists through his state-of-the-art Learning Center in Bolingbrook, Illinois.
This episode examines whether modern universal composites have truly overcome the historical limitations that forced dentists to choose between strength and aesthetics. We explore how advances in filler technology, resin chemistry, and shade systems are changing clinical workflows, and discuss the practical implications of simplifying composite inventory from multiple materials down to just a few shades.
Episode Highlights:
Modern high-filler universal composites can achieve 4-millimeter cure depths while maintaining excellent mechanical properties and aesthetic integration. This bulk-fill capability reduces polymerization stress compared to traditional layering techniques, as fewer increments mean less overall shrinkage stress at bonded interfaces.
Contemporary composite survival rates have dramatically improved, with long-term studies showing 85-90% survival rates at 10 years for posterior restorations. This performance allows clinicians to confidently place large direct restorations in cases that previously would have required crowns or extractions.
Cluster shade systems can effectively cover 16 Vita classic shades using just 5 universal shades through advanced optical engineering and chameleon effect properties. This approach maintains excellent shade matching while reducing inventory by up to 80% compared to traditional shade systems.
Polish retention has been significantly improved in modern universal composites through high-filler density and surface hardness optimization. This addresses one of the primary aesthetic concerns with anterior composite placement, where initial gloss must be maintained over years of clinical service.
Clinical workflow for posterior DO restorations using universal composites can be completed in 15 minutes of chair time when proper isolation, adhesive technique, and 20-second light curing protocols are followed. Selective etching of enamel margins combined with universal adhesives provides reliable bonding across all tooth surfaces.
Perfect for: General dentists, restorative specialists, and dental residents looking to simplify their composite workflows while maintaining high clinical standards. This episode is particularly valuable for clinicians considering inventory reduction and practice efficiency improvements.
Discover how modern material science is reshaping direct restorative dentistry and whether universal composites truly represent the future of everyday dental practice.

Are you feeling that creeping sense of exhaustion that makes you dread Monday morning? That disconnect where you're going through the motions but not really present with your patients?
Caitlin Parsons is a registered dental hygienist with 15 years of clinical experience and founder of The Aligned Hygienist. She's also a public speaker, podcast host, key opinion leader, and ergonomics advisor who helps dental professionals manage stress and prevent burnout through yoga therapy and mindful movement. Her expertise comes from personal experience—she hit severe burnout early in her career at age 23-24, which led to her mission of helping dental professionals prioritize their well-being.
This episode dives deep into the reality of burnout in dental practice, exploring why dental professionals are particularly vulnerable and what makes our profession different from other healthcare fields. Caitlin shares her personal journey from working five to six days a week through physical pain and emotional exhaustion to finding balance and purpose. The conversation covers practical strategies for recognizing early warning signs and implementing sustainable changes.
Episode Highlights:
Mental and emotional exhaustion, physical pain, irritability, feeling disconnected from patients, and loss of enthusiasm are key early signs of burnout that dental professionals should monitor. When addressed early, these symptoms represent smaller problems versus ignoring them until they compound into major issues requiring extensive intervention.
Dentistry's unique burnout factors include working in millimeters requiring constant precision, time pressures, production expectations, and small business ownership responsibilities that other healthcare professionals don't face. Unlike physicians working in larger systems with HR and operations support, dentists often absorb multiple business functions while maintaining clinical excellence.
The "quiet voice within" represents your body's intuition and signals about exhaustion, stress, and pain that practitioners often suppress during busy schedules. A yoga therapy study showed participants developed better self-awareness and pain self-efficacy, learning to address subtle signs before they become major problems.
Working five full clinical days per week places significant physical and mental demands on dental professionals that contribute to burnout and pain. Reducing clinical time by even a half day while maintaining administrative work can provide crucial recovery time without completely compromising productivity or financial goals.
Burnout affects patient care through decreased energy, reduced listening skills, irritability that patients can sense, and going into "robot mode" rather than providing engaged, personalized care. This impacts not only individual appointments but long-term patient retention and referral patterns that affect practice growth.
Perfect for: dental hygienists, dentists, practice owners, and dental team members at any career stage who want to recognize burnout early and implement preventive strategies for long-term career sustainability.
Don't wait until burnout forces you to reevaluate everything—learn the early warning signs and proactive steps you can take today.

Are you sitting on a goldmine of untreated cases in your own practice? Most general dentists don't realize that approximately 80% of their existing patients have some form of misalignment that could benefit from clear aligner therapy.
Dr. Avi Patel is a general dentist, founder and CEO of Clear Aligner Advisor, and recognized as the Dentist Influencer of the Year (2024). He has helped over 300 general dentists successfully integrate aligner systems into their practices through his training programs including Aligner Blueprint, Aligner Launchpad, and the Clear Aligner Confidence Bootcamp. Dr. Patel's teaching approach simplifies complex orthodontic principles into practical, step-by-step systems that help dentists offer aligners more predictably and profitably.
This episode reveals the reality behind predictable clear aligner outcomes for general practitioners. Dr. Patel shares his journey from burnout to building a thriving aligner practice, emphasizing that successful integration requires more than platform certification. The conversation explores why mentorship is crucial, how to avoid common setup mistakes that lead to posterior open bites, and why understanding force distribution animations is critical for treatment planning success.
Episode Highlights:
Case selection fundamentals focus on addressing chief complaints like crowding-related oral health issues rather than pursuing complex movements. Dr. Patel emphasizes limiting molar movement and using bite ramps to prevent passive intrusion that causes posterior open bites. Simple cases in the first six months allow skill development while maintaining predictable outcomes.
IPR precision requires verification with calibrated gauges after diamond strip use, as insufficient space creation directly impacts treatment predictability. The treatment plan may call for 0.4mm of IPR, but achieving only 0.2-0.3mm creates space deficits that compromise tooth movement and final positioning.
Attachment placement technique demands precise composite application using etch and bond only where attachments belong, followed by black light verification for complete removal. Fluorescent composites designed for aligner attachments improve visibility during removal and prevent residual composite retention that affects patient comfort.
Treatment planning modifications should optimize for patient chief complaints rather than accepting initial animated proposals from aligner companies. The animation shows force distribution on teeth, not predicted before-and-after results, requiring clinical interpretation and case-specific adjustments for successful outcomes.
Patient communication strategies position aligner therapy as oral health improvement rather than cosmetic treatment, particularly effective with existing patients who already demonstrate trust. This approach works across all age groups, including patients over 65 who remain excellent candidates for alignment therapy and often become strong referral sources.
Perfect for: General dentists considering clear aligner integration, practitioners seeking to improve existing aligner outcomes, and dental teams looking to expand comprehensive care offerings through evidence-based orthodontic treatment.
Discover how proper case selection and clinical technique can transform your aligner success rate while building long-term patient relationships.