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Everything Dental Blog – December 2012

“I look to the future because that’s where I’m going to spend the rest of my life.” – George F. Burns

2013 is going to be a great year and I am optimistic about the mood of our dental community. I believe we are in the midst of a major tipping point in the dental delivery business and profound changes are taking place all around us.

As I conduct business locally and travel around the country I have discussed our industry and trends with key opinion leaders, academia, corporate executives and clients. The number one topic is the uncertainty of the economy followed by the unknown of the Affordable Healthcare Act and everyone is talking about the dental technological revolution. 2013 will be remembered as the year when private, public and national healthcare collide. It will be interesting to see how it all unfolds over the next few years. For private care practitioners it will be a defining moment in time. The competition, emphasis on technology and the need for speed and efficiency will affect the way we deliver dentistry forever.

For the last ten years, we’ve seen multi–specialty practices spurt up, expand and populate. This trend has gone on for a while and most specialists (especially Periodontists and Endodontists) receive far less referrals than they did a decade ago. When an endodontist receives a referral from a general dentist it is generally a retreat or a complicated case. Periodontists have seen the use of local anti-biotics and soft tissue lasers by their referring base which has resulted in less referrals for them.

Many specialists have invested in professional marketing and technology to complement their advanced skill and experience resulting in an increase of referrers. Additionally, many progressive specialists have forged strategic alliances and have learned how to navigate in these new times. Many younger specialists are working in offices outside of their primary office to supplement their income. They have huge school and personal debt and the associate-ship opportunities of the past (in the private sector) are no longer omnipresent.


Between the anticipated higher taxes, the pressure to acquire technology, the burden of competition and the increase in insurance participation, the general dentist must implement certain business strategies to compete in the future. Investment in capital equipment and a renewed focus on operational and clinical efficiency is paramount! I believe dental practices will make the adjustments necessary to compete in the future. With the correct investments in people, systems, training and technology the neighborhood dental practice can deliver world class care with a diverse offering!

Same Day Dentistry

3D imaging and CadCam are no longer isolated acquisitions. They are the two hottest technologies in dentistry today. Practices that perform crown and bridge and place or restore Implants will need to acquire technology.

Same day dentistry has caught on and it is being embraced by consumers! Our patients want quality dentistry and they want it yesterday. They want white smiles, dental implants and cosmetic services like veneers. They want the best diagnosis and healthcare possible but they need certain assurances. They want it pain free. They want it affordable. They want it quick and easy and they want to go to a clean and professional office. They don’t want to come to your office for several visits if they can get the work done in one visit. Lastly, they value their insurance and want it to count towards payment in full or a significant reduction in their out of pocket expense.

What kind of practice do you want?

I have clients that have one or more whitening procedures on their schedule every day and clients that do whitening occasionally. Some clients say “it’s hit or miss with whitening. We can do a few cases one week and then go a week or two before the next case”. Could this be a marketing or pricing or focus issue?

I have clients that restore over 100 implants a year. I have clients that place implants and I have clients that rarely do implants. I hear all kinds of stuff about elective dentistry. “If it isn’t covered by insurance, they won’t do it”. Yet I have many clients that participate in insurance that excel in Implant dentistry.

I have several clients focusing on growing their hygiene department. They are transitioning patients to the perio classification and are placing Arestin daily. I have other clients that don’t believe in local anti-biotics or laser therapy and don’t waste their time because of low or no reimbursement. Thus, no assisted cancer screening, no perio charting and limited radiographs are taken. Many dentists believe hygienists are overpaid and the hygiene reimbursement is so low that they can’t afford to be comprehensive. In my opinion that is short sighted as hygiene is where dentistry is found. Hygiene is where trust is developed and it is where patients get educated about the oral systemic connection!

I have clients who are proficient at laser dentistry and use them for restorative as well as endodontic and perio procedures. I have other clients that don’t believe in laser dentistry. The idea of no anesthetic, better hemostasis, no sutures and the additional revenue from teeth whitening, crown lengthening and ulcer removal is pretty cool to me!

I have clients that perio chart every patient and others that claim they don’t have the time or can’t get their hygienist to do it. This is a leadership and standard of care issue! This is the number one reason why many offices fail at developing a perio regimen in their office!

I have clients who create extensive comprehensive treatment plans and financial solutions for any treatment plan over a single unit crown. They provide the patient with their monthly payment and demonstrate how their insurance benefit subsidizes their out of pocket cost. They then show how third party financing; like Citi Health or Care Credit can reduce their monthly payments and make the investment even more manageable for them. These offices have extensive training in this area and explain the entire process in a non-threatening and helpful manner. They’ll discuss the pros and cons and terms and rates! These offices provide this service as a courtesy because it drives case acceptance! In some instances, these offices will supply digital x-rays and photographic images to accompany the treatment plan. If you don’t treatment plan and don’t provide easy financial arrangements, than you will have less wins than if you did. It’s that simple.


Be Relevant – Be Distinct – Be Competitive – Be In Demand

National, regional and local consultants are advising their clients to become more professional and to embrace operational efficiencies. They are emphasizing the oral systemic link to differentiate their clients from the drill and fill offices down the street. This is a movement to improve the perception, relevance, value and the likeability of progressive dental facilities everywhere.


Mobile Technology

Your GPS is now on your smart phone. Your music is on your phone. Your board and electronic games are on your phone. Your contacts and e-mails are on your phone. Your calendar and your alarm clock are on your phone. Your practice appointment book is on your phone. The point is that you need to be found when someone searches for a dentist on their phone. In addition to being found, you must have a brand that resonates with people. Likeability, social responsibility and philanthropy matter to your community! Your reputation online is your reputation and you can make it great; average or nonexistent – it’s a choice!

Total Health Initiatives

Total Health initiatives are in vogue throughout the dental community.

• Offices are taking blood pressure on their patients routinely.
• Hygienists and doctors are discussing medications and pharmacology with their patients to identify the culprit behind saliva acidity, dry mouth, xerostomia and visible skin or gum conditions.
• Offices are providing non-surgical periodontal treatment with a laser or a localized antibiotic because they buy into the oral systemic link.
• Saliva testing is becoming a popular procedure to determine caries (acidity), HPV disease, periodontal disease and other diagnostic markers.
• Cancer screening devices make it easier to distinguish lesion morphology and vasculature than with the naked eye.
• Many offices are offering Snoring and Sleep disorder testing and appliances. People with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer. This does not address how their snoring interferes with others in the household!


We begin this new year with hope and renewed aspirations for our family, friends and our business. Our economy is recovering, job creation is strong and it looks like we will avoid the looming fiscal cliff. I am hopeful the President and congress will compromise before the New Year! The government and the private sector must engage in responsible actions to correct our trajectory and win the future.

Let’s make 2013 a great year!

Happy Holidays and Happy New Year!

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