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Everything Dental Blog – January 2013

Did you know there is a serious shortage of dentists in the U.S.A.?

Many of today’s young professionals are seeking career opportunities in New York, Washington, San Francisco, Los Angeles or the suburbs of our bigger cities. There is a true shortage of dentists today and many populations are under served.


There are 4,585 Dental HPSAs with 45 million people living in them. It would take 9,060 practitioners to meet their need for dental providers (a population to practitioner ratio of 3,000:1). Courtesy of – First Impressions Weekly Drill 1/15/2013
There are many incredible opportunities to start, buy or join successful dental practices throughout the USA but many young dental professionals are migrating to the up and coming towns and big cities. They believe there are more fee for service or hybrid dental practices there. Additionally, many young professionals seek communities that are close to a big city with cultural opportunities, upscale housing and premier school districts.

Why does this matter to me?

Historically, young dentists have pursued opportunities in and around the areas they wish to eventually live in. It has always been easy for these recent graduates to find one or two offices that needed an associate – and so the story went for decades. Today however, many offices are coming off of a few soft years and associate opportunities are not as omnipresent. Compound that with the enormous personal and school debt that these recent grads have and you now have a serious problem. FYI – NYU dental school is close to $90K a year today.

The national dental groups have always had access to VC (venture capital) money. This has led to enormous growth for them but they have always been challenged when it came to identifying and acquiring quality personnel. Today, these groups have developed an offering that speaks to the concerns of these young doctors. They offer a six figure income guarantee and help pay off the Drs. School debt. This is accelerating the growth of these groups into our bigger cities and suburbs. These organizations represent one of the fastest growing segments in dental care.

New Maine Law Makes Hygienists Independent

Providers and Provider Services News

A new law passed in Maine allows hygienists to serve patients at any location without supervision by dentists. This is in response to the state’s underserved areas for dental care, and takes advantage of a hygienist’s ability to reach these areas. The services the independent hygienists can provide include:
• Interview patients and record complete medical and dental histories
• Take and record the vital signs of blood pressure, pulse and temperature
• Perform oral inspections, recording all conditions that should be called to the attention of a dentist
• Perform complete periodontal and dental restorative charting
• Perform all procedures necessary for a complete prophylaxis, including root planing
• Apply fluoride to control caries
• Apply desensitizing agents to teeth
• Apply topical anesthetics
• Apply sealants
• Smooth and polish amalgam restorations, limited to slow speed application only
• Cement pontics and facings outside the mouth
• Take impressions for athletic mouth guards and custom fluoride trays
• Place and remove rubber dams
• Place temporary restorations in compliance with the protocol adopted by the board
• Apply topical antimicrobials, excluding antibiotics and including fluoride, for the purposes of bacterial reduction, caries control and desensitization in the oral cavity

If independent practitioners see a patient who requires care beyond their area of expertise, they are legally obligated to refer that patient to a dentist.

There are many industry trends listed below.
Some of these trends will not resonate with you and others will be in alignment with your philosophy and business acumen.
When it comes to change we may have personal challenges of adoption, integration and engagement.
Change is constant and adoption is a choice. Be sure to embrace change that becomes a movement or goes mainstream. If you don’t, you will be seen as behind the times.

Trends and Movements

Are you part of this ever changing world?

• Soft tissue laser therapy
• Cancer screening devices
• CadCam – digital scanning and milling systems
• 3d imaging – panoramic, come beam and hybrid machines
• Implant guided surgery
• Saliva testing
• Multi-specialty practices
• Fluoride Varnish is replacing the foam and fluoride rinse regimen
• Laser dentistry
• Digital – intra oral/panoramic radiography
• Air to electric handpieces
• Disposable diamonds replacing reusable cutting instruments
• Marketing to patient’s mobile devices
• Cloud computing
• Rotary Endo market expands (Patents expire. Choice and availability improves)
• L.E.D. curing lights are in the majority
• L.E.D. overhead operatory lights dominate new operatory light sales
• Patient communication and confirmation programs are mainstream
• Patient benefit eligibility and processing gets outsourced
• Payroll and many HR activities get outsourced
• PPO dentistry gains market share
• Discount fee plans grow in popularity
• Intra-oral camera popularity increases. Some units take excellent facial views for clear brace applications and others have visual cavity detection features
• Hygienists look to grow their relevance and accreditation
• Web and software based ordering/inventory control systems
• Dental auxiliaries join associations and seek career development
• Dentists embrace professional marketing and branding services
• More women dentists. The profession is dominated by women auxiliaries too!
• Dental groups (national and regional) are growing in numbers
• Community health centers are opening up all over the U.S.A.
• Dental offices fail to sell because they are outdated, don’t have enough ops or the seller has unrealistic expectations.
• Third party patient financing utilization
• Dentists provide snoring appliances and get involved in sleep apnea
• Orthodontic activity rises in general practices
• Total Health and the systemic link grows dentistry’s relevance

Best wishes for a wonderful 2013

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