Early decisions in a dental career are the most crucial

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New dentists don’t often think of themselves as business people. But that’s exactly what they are. Whether you are starting your own practice, buying into a practice or joining an established team as an employee, your decisions are all primarily business decisions.

And the choices you make at the beginning of your career are some of the most important you’ll ever have to make.

When you leave dental school you are ready for patient care. But what about career care? What business prep have you received?  I can tell you that when I left school it was very little and that hasn’t changed much.

I was out on the street with a DDS and not much else.

Thirty-four years later, I have 14 dental offices, 23 dental associates and over 150 employees.

I learned a few things over those years. Today I coach young dentists, so they don’t have to figure out the toughest part of the job  – the business part.

I still practice dentistry day after day. Oral surgery, implant surgery, TMJ, orthodontics, endodontics, periodontics, fixed and removable prosthesis: I do it all. I can do this because I learned how to implement processes and procedures that make the business part work efficiently.

I talk to new dentists all the time and I get the same questions over and over again.

“Do I open my own practice?”

“Should I take over a practice from another dentist or join a corporate practice?”
“What should I consider before signing a contract?”

“How can I research a practice and learn more about it’s potential for growth?”

These are all great questions and I wish a simple FAQ would do the trick. But every dentist’s situation is different. While some are more entrepreneurial, others might prefer to clock in and clock out in time to hit the golf course a couple of times a week.

Defining your goals and then mapping out a career plan to reach them is something I enjoy doing.

If you’re interested in this specialized career guidance, take a look at my dental coaching program and I will help you match your plan to your goals.

Talking to dentists is a great spring break

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Last month I had a great spring break at Destin 2017. No, there wasn’t a lot of swimming, or reading by the beach. It was a different kind of break: one where I was connecting with fellow dentists and sharing best practices to make our businesses more profitable.

At these types of events the one-on-ones are great. But I was fortunate enough to have been invited as a speaker – thereby allowing me to share my practical experiences with more people dentists than I could ever have reached simply walking the halls.

With 34 years in the industry building up 14 dental practices, I played to my strengths and talked about building profitable dental operations.

Specifically I spoke about the reality that cutting corners often costs a practice more than one might think. Instead I am an advocate for investing in the processes and procedures that really drive business growth.

It comes down to what I call the SPECIAL approach:

S scheduling tips that make a big difference to profitability by increasing efficiency

P production improvements to provide better care and service to patients

E employee or team member management that make everyone want to deliver better results and perform at higher levels.

C collections improvements that will show you how to reach 98%

I internal controls to help you manage your practice

A associates and accounts receivables as a tool for growth

L liabilities and asset management to protect yourself and your business

The talk went over very well, given that in the days afterward, I was fielding questions about the SPECIAL factors from many in attendance.

If you weren’t able to make it to the conference – or even if you did – I pulled together a resource page with the slide deck of my presentation, and related materials.

If you want to talk to me about how to make your practice SPECIAL, please send me note and we can schedule a private coaching/consulting session that will help you make your dental practice more profitable going forward.

Denture solutions as varied as the patients themselves

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If a patient wants or needs a prosthesis solution, there are a few good options available.

Although many would prefer a non removable denture solution, sometimes medical history, time and / or clinical conditions and of course expense can work against that option.

When patients consider a denture solution, it is usually with limited information as to the hows and whys of such a procedure.

For example most consider a denture solution to be a one-time mattter which is not true. A removable prosthesis must be relined periodically, which can mean they will have to live without it while this is being done.

Prior to treatment planning, you need a complete review of dental records and the patient’s medical history to date.

The design of your removable prosthesis will start with which type of material should be used, such as acrylic resin, vulcanite, polystyrene, metal, or flexible material. The guide planes and the height of contour of abutment teeth are other important factors.

Whether it is a full or partial denture, the goal is to reduce or eliminate lateral forces and attempt to transmit forces parallel to the long axis of teeth. When designing your prosthesis, consider the necessary support, retention, stability, and esthetic requirements.

When creating treatment plans for full dentures, please make sure you review with your patients the fact that they will need denture adhesive for a more secure fit. The advantage here is if they do not need it, you look good. If they do, they will not be surprised.

I recommend informing patients that ideally, they would benefit from two to six implants on the upper or lower arch or both arches for the best and most secure fit. Mention that the placement of implants reduces the need for relines and in many cases reduces the bone loss caused by resorption due to disuse atrophy.

This is an important concept for your patients to understand: in the time without dental implants, they will have more and more bone loss causing their dentures to fit poorly, causing many problems as well as discomfort.

A word of caution regarding patients who come to you and only want a reline: once you do a reline on a patient who has had dentures for a long time, you will be irreversibly changing his or her denture, which can cause problems.

I strongly recommend that you consider a new prosthesis first so you never touch his or her original denture. I find that patients who have had dentures for a long time develop a feel for them, much like an old pair of blue jeans.

To learn more about helping customers transition to prosthetics and more customer-focussed approaches to dental care, please contact me.

Dental implants good but only in specific situations

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Dental implants have grown in use over the years and for good reason. In an ideal scenario, an implant can replace a problem tooth quite well.

But that doesn’t mean it’s the ideal procedure for all patients. There are many mitigating factors to consider before recommending an implant.

First, check the condition of the teeth next to the implant area. If they’re good, then I would recommend proceeding. If not, I would think a conventional crown and bridge treatment would be better.

Here are some common questions and answers that arise during treatment planning:

  • How long will the implant last?
    • Typically ten years or longer.
  • Does implant surgery hurt?
    • In most cases, implant surgery is less painful than having a tooth removed. 
  • How long does implant surgery take?
    • Most of the time, placement of a single implant will take less than fifty minutes.
  • Do dental implants fail?
    • Yes, about 10 percent fail on the lower arch and 20 percent on the upper arch.

Many factors increase the failure rate, but the most common are smoking, diabetes that is not under control, and poor patient home care.

A dental implant cannot get a cavity but it can develop periodontal disease. Other failure factors include poor quality and quantity of bone and putting the implant into function too soon.

Can you place the dental implant immediately after you extract a tooth? Yes, but you have to be able to remove the tooth with as little trauma as possible to provide the implant with the best bone available.

If the dental extraction is completed with little to no damage to the surrounding bone, than in many cases, the implant can be placed immediately.

When discussing the cost of a dental implant with your patient, make certain they understand that at least three different fees may apply.

  • The first fee is the surgical placement of the implant.
  • The second is for the implant abutment.
  • The third covers the placement of the implant crown.

Your patient should be aware of the total cost before treatment.

An implant is a good way to handle a problem tooth in the right circumstances. But a truly successful implant experience includes involving your patient in the entire process, from rates of success to the cost.

This is just one of the best practices I talk about when coaching other dentists. If you want to talk to me about coaching your practice, please contact me.

Being a coach to your patients the best dental strategy

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When working with my patients, I’ve come to see that aside from fixing their teeth, I’m also a consultant and at best, a coach to them.

If all I did was fix their chompers, that would get old rather quickly. Helping them change their habits and become proactive in their own care is a very fulfilling process for both them and myself.

As a dentist, I’m looking to establish a relationship with my patients much like a medical doctor.

Your physician talks to you about your health and what you can do to improve it. Same with dentists.

Short term thinking would have it that a dentist should allow poor patient habit to continue in order to profit off of their bad decisions.

But most of us are in the long game as dentists. We want our roles in their lives to be meaningful. We want them to change their bad habits and learn better dental hygiene.

Here’s the odd twist. Despite the seeming financial benefits of letting a patient worsen in their habits, it’s not at all true. If a patient’s dental health deteriorates one of two things will happen. They will either stop going to a dentist or only show up when they need a tooth pulled. Eventually dentures will enter the picture, another one-time solution to dental care. In short, they won’t be a patient of you – or any dentist – for long.

Keeping a patient by coaching them to better personal care will result in a fulfilling long-term relationship, one that, circumstances permitting, will see them as your patient for many years.

So if you want to bring greater purpose to your role as a dentist, become a coach to your patient. It will bring dividends both personally and financially for that matter.

If you want to learn how to be a better dental coach please get in touch. I can be your coach too.

My spring break: going to ‘Excellent’ and talking profitabilty

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Even dentists need a spring break. But I’m going to be working during mine!

It’s a good kind of work though: I’ll be talking at the Excellence In Dentistry Spring Break Seminar taking place April 27 to 29 in Destin, Florida.

Even better I’ll be speaking about one of my favorite topics: Process and Procedures to Improve Profitability.

When it comes to building a more profitable dental practice, cutting corners is a short-sighted strategy. Better to invest in processes and procedures that drive the growth of your practice.

Over the course of my 90-minute talk, I’ll outline how I did exactly that in my 14 practices and outline the simple but crucial changes you can implement to make your practice S.P.E.C.I.A.L.

These include:

S scheduling tips that make a big difference to profitability by increasing efficiency.

P production improvements to provide better care and service to patients.

E employee or team member management that drives everyone to want to deliver better results and perform at higher levels.

C collections improvements that will show you how to reach a 98% success rate.

I internal controls to help you manage your practice

A Associates and accounts receivables as a tool for growth

L liability and asset management to protect yourself and your business

So please join me on April 27th at 1:30pm at Destin for my talk and make certain to reach out to talk while there or in advance about how to improve your practice.

See you there!

Every member of your practice team is in the sales and service dept.

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