Dental Entrepreneur - Spring 2024

Business Principles That Make an Impact J.W. Oliver Jr.

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Welcome Greetings Dental Entrepreneurs, Spring is almost behind us as this edition gets off to print. Phew, it has been a busy season for us. How about you? So much in dentistry is disrupting our industry.

Top of mind is the struggle with team and patient retention all while keeping the cost of doing business in line to make a profit at the same time. They say, “If you are not making money, you are not in business.”

Spring 2024 Editor & Publisher Anne M. Duffy, CEO, RDH Assistant Editor Clare Yeo

We offered many alternatives to this dilemma, and I hope our authors will enlighten you with their ideas and solutions. Reach out to them if you would like to tap into their expertise. They are here for you, and so are we.

Project Manager Tari Sixpence Website Bhakti Kulmala Sales & PR Officer Nyasha Maripakwenda Layout and Design Brian Rummel Editorial Board Mary Fisher-Day Dr. Dirk Fleischman Dr. Sharon Parsons Dr. Isabel Rambob Dr. David Rice Travis Rodgers Barb Stackhouse Dr. Lucas Shapiro Dr. Tom Snyder Ryan Vet Spring 2024 Contributors Dr. Maggie Augustyn Wendy Briggs Joe Fogg Dr. Katie Lee Jane Levy JJ Littrell Jamie Marboe J.W. Oliver Dr. David Rice Dr. Luke Shapiro

Editorial Office 8334 Pineville Matthews Rd Ste. 103-201 Charlotte, NC 28226 704/953-0261 Fax 704/847-3315 anneduffyde@gmail.com Send materials to: Dental Entrepreneur Magazine 8334 Pineville Matthews Road Ste. 103-201 Charlotte, NC 28226

Our cover author, J.W. Oliver shares his heartfelt motto on fostering team culture, taking utmost care of them so that they feel appreciated and dedicated. His company, Zimworx, has been changing the norms of company culture and leading the charge by committing to the happiness and well-being of their team members, On the topic of wellness, Katie Lee shares her traumatic health experience, and how she rose from the ashes by turning into a powerful mission to spread awareness of oralsystemic health for the betterment of patients’ wellbeing.

David Rice offers words that relieves the heavy burden of imposter syndrome along with actionable and practical steps to focus on instead. And Dr. Luke Shapiro chats with DentalTok star, Dr. Joyce Kahng, about balancing different segments of her audience while growing an a community of over a million across all social channels.

Dedicating the spotlight to the movers and shakers of our industry has been something Dental Entrepreneur has done since our inception. And Dr. Maggie Augustyn introduces us to GroupUp’s founder and unashamed industry disrupter. Jamie Marboe shares a unique take on adopting a seldom-used hybrid compensation model for hygienists and how it could lead to increased workplace satisfaction for everyone involved.

Jane Levy speaks to the power of bundling to increase patient visits, more consistent care, and overall profitability for practices, as JJ Littrell encourages a business environment in which you and your team feel engaged with and connected to year-round through a seasonal team engagement framework.

Then we’ve got Joe Fogg, who explains why the Department of Labor’s ruling making it more difficult for employers to classify workers as independent contractors is better seen as a benefit. And Wendy Briggs, who brings our focus back to improving patient health through understanding their needs.

We are halfway through the year and I hope this issue inspires you as we meet yet another turn of the seasons.

Let’s Go - Summer, we are ready for you!

Cheers with love, Anne

Spotlight 6

Business Principles That Make An Impact J.W. Oliver

Culture 10

The Current Hiring and Compensation

Dilemma, Part Two Jamie Marboe

12

Seasonality: The Secret to Team

Engagement JJ Littrell

Business 16

The Bundle Effect: What Dental Practices

Can Learn From The Cable Company Jane Levy

18

Labor Protections Recently Got Stronger.

What Does This Mean for Dental Practices?

Joe Fogg

Innovation 22 Innovation and Disruption Accelerated in

Dentistry

Dr. Maggie Augustyn

Launchpad 26

rowing An Audience of Over 1 Million G On Social Media with DentalTok Star, Dr. Joyce Kahng Luke Shapiro, DDS

Impact 28

The Formula for Profitable Hygiene Wendy Briggs, RDH

32

Turning Trauma into Triumph: A Dentist’s Whole-Body Approach to Dentistry Dr. Katie Lee

36

Don’t Let Your Imposter Mindset Crush Your Career David Rice

Spotlight

Business Principles That Make an Impact.

J.W. Oliver Jr.

I

n a world driven by the familiar words and acronyms of “Profits, ROI, EBITDA, Bottom Line, and Exit Plans.”

We can easily miss the greatest values a business can have: •

Generosity

•

Transformation of Teams

•

Global Impact

ministries around the Globe. As virtuous as that sounds, when we began it was easy as 0% of Zero was… .Zero! Ha, I like to always add that because it was true. But what was once a dream to make an impact has blossomed into an organization of now 1,000+ team members and an annual donation forecasted to exceed seven figures for the current year. We will make an impact on four continents with many initiatives and sustainable projects through various local and international ministries.

While making a profit is essential to owning or operating any business, we can quickly discount the impact we can have on our teams as well as the impact we can have on an organization and communities.

The core of a meaningful life and legacy is a vision for generosity and an understanding of what it means to be a blessing to others.

The value of giving must first be modeled, and then taught so the next generation embraces generosity. Only when it becomes second nature can you truly begin to make a difference.

At Support DDS and Zimworx, we recognize this interconnectedness. Since day one, we’ve worked hard to integrate our mission statement and our core values not just as a framed placard on the wall, but into our culture and leadership. They are the guiding principles woven into our DNA and mission statement:

By not making the bottom line our bottom line, we’re not only building a stronger company, but we’re taking the steps and also contributing to a better world. No cause or contribution is too small because we understand that everything has to start somewhere. We did and we’re still learning and growing every day.

“TRANSFORMING LIVES WHILE MAKING A GLOBAL IMPACT.”

“YOU DON’T HAVE TO BE GREAT TO GET STARTED, BUT YOU HAVE TO START TO BE GREAT.”

One of our five core values is Generosity. We started the company with the principle of donating 51% of our profits to various

Traditionally, the insourcing and business support industry has always valued efficiency of effectiveness, perfection over progress,

6 Spring 2024 Dental Entrepreneur

DentalEntrepreneur.com

and processes over the people who actually make them work. We realized early on that sticking to this old way of thinking would only ever deliver short-term gains, and limit the immense impact we could have for our clients and in our communities. So we chose to focus our energy and “invest” in the one place we know makes us unique: Our teams!

That is where it all begins. We wanted to make a difference. We wanted to see lives changed. We wanted to transform communities. We wanted to see the message of Christ taken to our teams.

Our goal was to create a “GOOGLE-ISH” environment in places like Costa Rica, Zimbabwe, and now Zambia. (My only previous knowledge of any of the “Z” countries was Stevie Wonder’s reference to Zimbabwe in his hit song “Master Blaster.”)

What did we do to make a difference that separates us from a “traditional” business? Well, lots of cool things.

We opened “The Grind” coffee shop, a place where team members can enjoy a great “cuppa joe” at discounted prices. We have an active Workplace Wellness (Pastoral Care) program that offers marriage support, financial counseling, spiritual guidance, and emotional support. It’s very easy to get sucked in and forget why we were put on this earth, and our Workplace Wellness team is always on hand to spare a shoulder, encourage our teams, and share the word.

In 2023, we opened The Wellness Center fully staffed with our own internal Doctors and Nurses, to provide care, assistance, and peace of mind. With the cost of healthcare skyrocketing all

around the world, the Wellness Center is open to all our team members completely free of charge, with 24/7 access to care.

Our team members also get the chance to give back in their own personal capacities. They are the main drivers in our community reading programs for elementary kids. Each week we offer new volunteer opportunities at orphanages and abused kids’ homes so they can choose when and where they feel they can make the biggest impact outside their workspace.

Given that we offer insourcing services to clients worldwide, some of our members finish late into the evening. We didn’t want them to worry about getting home safely, so we have a fleet of late-night transport for our teams. Regardless of what time they finish, they will always be able to get home safely.

We even hired a CFO (Chief Fun Officer) to handle in-office and team-building activities like our “Office Olympics”, weekly Dental Entrepreneur Spring 2024 7

in-office yoga, self-defense classes, organized team hikes, movie theater rentals, gym memberships, and more… It’s not just about fancy posters on the wall with our mission statement and values, we actually live them out! We want our people to feel empowered, not like cogs in a machine.

I realize small businesses and even large ones may not be able to donate 51%, integrate Christ into the office, or hold office Olympics, but you can DO SOMETHING! The most important thing is that your team members see and feel that they are not only a part of the organization but that they are the organization and that their joy and well-being are appreciated, over and above their contributions between 8 to 5.

Whether you have in-office or remote/virtual staffing, treating your employees as TEAM MEMBERS, integrating them into your culture, having them enjoy coming to work, and celebrating them can transform your company from just another place to work to a coveted organization to join. This is a critical key to long-term retention. It will become your foundation for attracting and retaining the best talent while also giving them the support and environment they need to pursue and ultimately achieve their personal and professional goals.

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“DREAM BIG, START SMALL.” “Do not be conformed to this world, but be Transformed by the renewing of your mind…”

Romans 12:2

J.W. Oliver is the Visionary and Managing Partner for Support DDS and Zimworx.

They currently employ just over 1,000 team members in Africa and Costa Rica while supporting over 2,500+ Dental Practices in North America and Europe. They have a bold vision of reaching 20,000 team members by 2032. His passion is helping businesses leverage remote/ virtual teams to elevate existing teams, grow, increase productivity, improve bottom lines, and regain control over their time.

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Culture

The Current Hiring and Compensation Dilemma, Part 2 Jamie Marboe BSDH, CEO

PART TWO The phrase “back in the day” is often used to recall a pleasant or nostalgic experience from a past era or time in life, typically decades ago. It evokes memories like waking up to the smell of homemade bread that your mom made, or in our profession, reminiscing about the camaraderie shared with colleagues in earlier years of one’s career.

In the dental industry, being a hygienist was once a highly coveted and privileged role, and for many, it still holds the same significance and importance today. However, business owners are currently struggling to meet the demands of hiring and the large pay increases for the same job that was paid significantly less just two years ago. Making this feel more like a War of the Roses situation in our field.

Back in the Day, most hygienists were paid hourly rates with gradual increases of up to $1.50 every 1-2 years. This method no longer works due to the shortage of hiring resources and other factors.

Although commission has always been an alternative compensation option available for hygienists, it appears that many are apprehensive about this model. Some worry about unforeseen events causing their schedule to fall apart, while others question whether they would still be obligated to attend team meetings or receive paid holidays if they are not being paid hourly.

10 Spring 2024 Dental Entrepreneur

While I did not invent this hybrid compensation model that I am about to suggest, it is one that has been seldom used. There is no better time to implement it, and as a result, I have transitioned most of my current clients onto a pay structure that combines an hourly rate with commission based on daily goals.

The outcome has been extremely positive, as everyone involved has expressed their satisfaction with this arrangement. This new system has even reduced the likelihood of hygienists quitting to attain the same rate of pay as their peers in the industry.

The hourly rate will be just lower than the going rate in your area and the net commission based on what the provider produces over the goal each day. It looks like this: HYGIENIST BOB: •

3:1 daily goal (based on hygienist producing 3x his salary + benefits) is $1500 per 8 hr day

•

Paid $40/hr (going rate in area is $45/hr)

•

The commission is 30% of what he produces (services rendered, no exams or product) over his goal of $1500

DentalEntrepreneur.com

EXAMPLE: •

•

Hygienist A produced $1800 on Monday. $300 over his goal.

So, Bob will be paid 30% (or whatever % you agree to) of net production = $90 more that day. $40/hr x 8= $320 + $90= $410/ 8 hrs = $51.25/hr. That is $11.25 more per hour well above area going rate

A win-win, motivation for the hygienist as well as having the opportunity to increase that daily number by providing highlevel services to the patient, like perio therapy, adult fluoride, etc. The daily goal and commission cover doctors’ expenses and incentivize the provider 3 THINGS TO KNOW BEFORE STARTING THIS MODEL: 1.

Know your 3:1 for your hygiene department.

(Producing 3x their salary plus benefits) then divide that by days worked. If they work less than 8 patient hrs/day, divide that goal by hours and figure different daily goal

patients. Help create a compensation model everyone feels good about.

And, hygienists, if you are not providing the proper treatment to address the infection in your patient’s mouth (aka doing bloody prophies), start now! Be proactive with treating disease properly.

It is our responsibility to our patients we care about so much.

Be worthy of your increased salary and be proud of the services you provide.

If you have any questions about how to implement this type of hygiene compensation or about any other hygiene-related topics, please contact me.

HERE ARE A FEW INDUSTRY BENCHMARKS FOR YOUR REFERENCE: • • •

2.

3.

You must know what your write-offs are so you can pay the commission with the correct net amount produced (collectible production).

If you offer any in-office payment plans, you will need to decide on a fair compensation for those patients, it may just be their hourly rate.

Back in the Day, we never thought we would see these types of changes and dilemmas in hiring and the exploding increase in wages. It looks like it happened in the blink of an eye and truly knowing how, why it did… not sure, but it is here.

Business owners, my advice to you is to get good at knowing your numbers if you do not already. Be open to a blended pay model like this one. Start looking at your environment and leadership style. Communication is key to keeping your current team happy and listening to their concerns and needs.

Hygienists, my advice to you, is if you are happy with your current work environment but feel that you are not being compensated at a fair rate as other hygienists in your area, talk to your doctor or business owner. Do not jump ship just to get that raise.

I promise you the grass is not always greener on the other side!

• • • • •

3:1 Profitability 1/3rd covers hygiene salary, 1/3rd covers department supplies, 1/3rd goes into the bank **If you are signed with a lot of PPO’s this benchmark is harder to achieve 8-10% Cancellation or No-shows 25% > Perio performed 65% of dx production comes out of hygiene chair 75%> acceptance rate Hygiene department produces 30% of the overall production

Jamie Marboe BSDH, CEO and Founder of Marboe Dental Consulting, has accumulated more than 40 years of experience in Dentistry.

She obtained her Dental Hygiene degree from Idaho State University and held a clinical instructor position there as well. During her early career, Jamie served as a Registered Dental Assistant in her home state of California. Throughout her time in dentistry, she also became certified as an Eaglesoft trainer and still trains offices on the best uses of their software today. Her main objective is to encourage and inspire her clients to develop their team and leaders into an effective and cohesive team, and to assist them in becoming the best versions of themselves.

This led Jamie to earn the title of “Team Achiever” coach. Her commitment to the growth of people has rewarded her with countless lifelong friendships with her clients and colleagues.

Discuss and look at something like this model. Go back over your own numbers for the past 3-6 months and see what you could have earned if you were on this hybrid compensation model. Together, you can look at options that would be a winwin for the providers, the business, and most importantly, the

Dental Entrepreneur Spring 2024 11

Culture

Seasonality: The Secret to Team Engagement JJ Littrell, Co-Founder and COO of Tuatara

S

pring has sprung!

Unless we are the lucky few who live where the weather never varies from perfection, spring is, literally, warmly welcomed. We emerge from cold, grey, short days with the promise of warm breezes and the sun setting after dinner instead of before. Trees and bushes start to flaunt their colors and fragrances – anyone else a big fan of the smell of fresh cut grass?

It’s true that nature shows off in the spring and we’re never really surprised by it. Maybe it’s a little later or earlier than we expected (even Punxsutawney Phil is only right 39% of the time!). Perhaps it’s a little warmer or cooler than last year, but we know it’s coming as it always does.

There is something comforting about the seasonality of life – we know when to expect certain weather, holidays, family obligations, sports, buying cycles, and even schedules that are busier or busiest. Even though our lives are constantly in motion, knowing when to expect each season allows us to plan accordingly.

Let’s face it, if we had to choose between the changing seasons or a perpetual Groundhog Day, human nature has us reaching for the variety that comes with each season’s change.

12 Spring 2024 Dental Entrepreneur

So – if seasons appeal to our human nature, and your business, just like life, is in perpetual motion–what would happen if you intentionally brought seasonality into your team engagement process? You’d get a more engaged team and likely impressive results to boot!

SEASONS IN YOUR BUSINESS Look at seasonality in your business – conference season, vacation season, or busy season. Whether you’re in start-up mode, growth, mature, or exiting, have you ever considered whether your team feels the seasons the same way?

Owners usually have different seasons than our teams. Typically, longer-range cycles drive business owners: quarterly tax payments and annual financial goals, three-year strategic plans, growth or succession opportunities, learning additional practical skills, or crafting a new offering that can be added to your menu of services or expertise over time.

Your team members, on the other hand, typically experience completely different seasons. Perhaps they have daily production goals, a bi-weekly paycheck, or monthly performance metrics as their focus.

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Even though our lives are constantly in motion, knowing when to expect each season allows us to plan accordingly.

There are some popular systems that attempt to connect the daily rhythms of the team with the annual or longer term goals of the owner. While a system like this can support getting everyone to use the same language and be more aware of these different seasons, that is really just the beginning.

Let’s walk through how you can use seasonality in your business to build productive and engaged teams.

CADENCE, ALIGNMENT, AND TRANSPARENCY Now that we can all appreciate the value of seasons, not just in our lives, but in our businesses, let’s walk through how we can use that to support our team engagement initiatives. Our company loves alliteration, metaphors, and generally, any other tool to make learning and remembering complex topics easier to approach. When we realized the formula for success with using seasonality to create team engagement formed the acrostic CAT, we were pleased to go with it! So let’s learn about using CAT in your business: 1. CADENCE Just like seasons allow us to know what’s expected and be comfortable with what’s coming, creating cadence in your business does the same. Use cycles that already exist, like summer slowdowns or tax filing deadlines. Communicate the recurring and predictable cadences to your team, your service providers, and even your customers. This allows everyone to know what and when to expect things from you and your team.

One of our favorite cadence changes that usually has a huge ROI – is resetting your performance management cycle to an annual versus anniversary date. If everyone knows performance evaluations and potential pay changes happen each April, the process is clear and uniform for the team. This also prevents constant requests for you to consider pay increases off cycle, when it’s more challenging to review the market, your business results, or employee performance. You can say, with confidence, that unless someone’s role has changed, you review all compensation adjustments in April. No more

sleepless nights wondering how you can answer these requests without driving that employee away!

2. ALIGNMENT Knowing how you’ll be approaching key decision points and when–your team can begin to see how their performance contributes to the bigger picture. Creating alignment starts with communicating the cadence of the business, along with goals for each area and how each team member can impact the goal while being incentivized to do so. We’ll continue with the compensation cadence example from #1 above.

With an annual process already communicated to your team around how you determine compensation increases each April, here is how Alignment works beautifully: • A key part of determining compensation increases is assessing the profitability of your business from the prior year.

• You defined the main “needle mover” to increase profitability by adding new customers through current customer referrals.

• To facilitate easy referrals, you ask current customers to think of one coworker they could recommend to your business before they leave your office.

• Your team is now happy to ask and track how many current customers they asked and how many times that resulted in a new customer. They understand how their compensation is aligned with this metric, which is aligned with the overall business goal.

3. TRANSPARENCY Transparency can be the trickiest part of this process… but doing it well creates a team that is incredibly engaged, delivering excellent results, and being less susceptible to the “talent wars” we too often read about in the news.

Dental Entrepreneur Spring 2024 13

Let’s add transparency to the mix: • Before individual performance evaluation meetings occur, have a meeting with your team to go over the compensation process.

• During that meeting, explain the research you’ve done on inflation, cost of living increases in your area, and market compensation for the roles they hold.

• Share the results from their efforts to increase customer referrals, and whether that impacted profitability as you expected it would when you set goals for the year.

• Explain how each of those factors influenced the compensation changes for the year, and that you’ll be discussing their individual performance and the next 12 months’ compensation in one-on-one meetings.

A SEASON OF CATS

It can be scary to think about being open with your team about where your business is succeeding and where there are areas for improvement. We often worry that telling the team where we really, truly are can be counterproductive, whether those results are good, bad, or neutral.

The reality is, that when you have created alignment and delivered information transparently, your team can drive your business towards your goals. Oftentimes, teams grossly under or overestimate realities, and in the absence of information, they will write their own story. By responsibly sharing information, you create trust and build a team that feels empowered and engaged in something bigger than themselves. This can lead to elevating not only your team, but your business and customer experience as well.

To finish our example from the C and the A, let’s play this out for the employee compensation process. The cadence allows your team to know when performance and compensation are considered, and through alignment, they now understand that they can improve their opportunities for additional compensation by creating results through the customer referral process.

We thought about trying to take it too far here as we wrapped up and talked in idioms about spring showers raining cats and dogs… go ahead, we groaned too! But, we hope that you can see how creating a team culture of cadence, alignment, and transparency empowers and engages your teams more wholly and consistently. As you think through your business, team, and seasons this year, we hope the CAT framework helps you create a business you and your team feel engaged with, and connected to year-round!

As the Co-Founder and COO of Tuatara, a Strategic Finance Agency, JJ believes strongly that the finance function is a catalyst for business growth and sustained success. With a wide range of professional experience, JJ’s journey includes experience from Fortune 500 and Top 50 Accounting Firms to international startups, leading teams as large as 90 professionals.

Website: GrowWithTuatara.com Email: jj@growwithtuatara.com Instagram: https://www.instagram.com/growwithtuatara/

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Business

The Bundle Effect: What Dental Practices Can Learn From The Cable Company Jane Levy

O

ne of the most powerful phrases in the English language must be “It’s free!” When our cell phone plan comes with a streaming service, our car lease includes maintenance, or our meat subscription sweetens the deal with complimentary eggs, we get that awesome “it was free” feeling. In reality, we pay for each and every “bonus,” but the emotional high we experience with a bundle purchase and getting things for “free” changes the way we consume services. We rationalize a bundle purchase far differently than purchasing items a la carte, even when they are discounted.

In the case of dental membership plans, this real consumer behavior – to more highly value things perceived as being “free” – is incredibly powerful. The “it’s included” phenomenon is what turns plan members into practice loyalists who accept more treatment than patients with insurance or discount plans and reap the benefits of consistent visits to the dentist. Membership plans like those created with Plan Forward put the power in the hands of the practice to select which services are bundled so that patients want to take advantage of everything included.

THE THREE PRICING MODELS Let’s talk about the elephant in the room: insurance. Despite being extensively adopted – two in four Americans have dental insurance – it’s a bane for both patients and practices. The complexity of navigating insurance coverage tends to leave people never quite feeling confident about what is included – even though the answer might be “a lot.” Insurance is a world of exceptions; despite paying a monthly fee, certain insured services may

16 Spring 2024 Dental Entrepreneur

only be covered under specific circumstances, at certain locations, or at ill-defined intervals. The nature of insurance billing is opaque by design, meaning that patients are often unsure of whether they’ll get a bill after accepting services. Compare this to the transparency of a membership plan, which is created and managed by a practice and includes (for “free”) a specific set of services in exchange for a monthly fee. No surprises.

Historically, dental discount plans have been presented as an alternative for uninsured patients. While offering more transparency because patients are selecting services a la carte, the lack of the “it’s included” feeling means that patients traditionally accept less treatment and visit less frequently when compared to insured or membership plan patients. Patients on a discount plan still experience the anxiety of not knowing exactly what their visit to the dentist will cost, even if the services are discounted. So, while dental discount plans offer advantages over insurance by removing restrictions, maximums, waiting periods, annual limits, and denied claims, the model doesn’t encourage consistent and thorough treatment. As for practices, a dental discount plan means giving away free services and taking a hit to profitability, without the compelling potential of developing a long-term patient relationship.

That brings us to dental membership plans, the emerging favorite among patient-focused, growth-oriented dental practices. The transparency of what services are included in a dental membership plan is a huge advantage. First, patients know what package of services they have purchased, and they are motivated to use their benefits – they want to make the most of their bundle.

DentalEntrepreneur.com

They’ve paid for them, including those x-rays! On top of this, despite the care being more affordable for patients, removing the insurance middleman allows providers to still be fairly and predictably compensated. A subscription to your practice also has the benefit of enabling a direct relationship between the practice and their patient, and consistency in the care provided. This, in turn, nurtures loyalty and a higher likelihood of accepting treatment that falls outside of the bundled membership services, when needed.

SETTING A PLAN UP FOR SUCCESS As with any growth tactic, the execution of a membership plan will determine its success. “I would say every office needs to start a plan,” says Dr. Burneson, the Oregon dentist who today has grown his membership plan to more than 450 patients in just over 2 years. In 2021, however, he wasn’t seeing the results that he knew were possible.

He tried again with a new vendor by his side – Plan Forward – and relaunched his plan. “We began developing a plan that would add both ease of use and better profitability to the office,” said Dr. Burneson of turning his existing plan around so it will make money for years to come. “You have to work with people that understand this business. It’s a pretty good-sized learning curve, especially whenever it comes to technology, but I have a contact right there. She was there the entire time, making it easy for us.”

So, where does the difference lie between membership plans that succeed and those that fall short? We reviewed five practices from one of the leaders in dental membership plans, Plan Forward, to understand the actual business value of membership.

1 SUCCESSFUL PLANS GENERATE RECURRING REVENUE - STRATEGICALLY As expected, compared with uninsured patients, members visit the dental practice more often. Depending on the practice’s starting point, visits for treatment increased by more than visits for hygiene, especially in the first year after a patient becomes a member. Members also visit more frequently for periodontal cleanings and maintenance than uninsured patients. Says Dr. James Burneson, the advocate for membership plans with a practice in Oregon, “The value of membership patients is really great because these are the patients that actually have an innate reason to return to keep their health at a higher level.”

2 SUCCESSFUL PLANS UTILIZE PATIENT INSIGHTS Aside from predictable recurring income, membership plans can also provide practices with valuable insights about their patients which they can use to optimize how they package and market their plans. For practices with multiple locations, custom membership plans can be tweaked for a

unique set of services and a fee schedule for each practice, group, or region that makes the most sense.

3 SUCCESSFUL PLANS COLLECT UPFRONT Practices collect the membership fees upfront or monthly over the course of the annual contract, depending on the practice’s preferences. And with Plan Forward, the practice collects gross next-day deposits. With an average of 250 members and a $400 Annual Hygiene Plan, that’s $100,000 collected upfront. What would you do with all that extra cash?

4 SUCCESSFUL PLANS CONNECT WITH INSURED PATIENTS, TOO The intention behind a membership plan is to not only attract uninsured patients, but show your current insured patient base that there’s a better alternative. So it’s really important to factor in what insurance typically covers and what it costs your patients so your in-house membership plan is an attractive alternative. Aside from cost alone, you can also show patients that insurance is not always looking out for their best interest. Their healthcare decisions should be a personal conversation between you and them.

By bundling up necessary dental services in a model that challenges the limitations of insurance, membership plans have the power to help dental practices change course in their success.

“Plan Forward creates relationship-based patients instead of transaction-based patients, and that’s killer,” says Dr. Burneson.

It’s time that the power of “it’s included” is used to help consumers live better lives. With dental membership plans, more patients can affordably access quality dental care regardless of their insurance status, and more practices can take control of their profitability and production. That’s a bundle of benefits we can all get behind.

Jane grew up in Johannesburg. She left in 1995 to attend b-school, and embark on a career on Wall Street, investing in public & private companies. She finally saw the light in 2017 and became a dental entrepreneur.

After a few years in Henry Schein’s Innovation Center, she honed her entrepreneurial chops at Jarvis Analytics and now at Plan Forward. Now Africa is calling, and she’s planning to scale Kilimanjaro in the spring. jlevy@planforward.io | http://planforward.io https://www.linkedin.com/in/jane-levy/ PODCAST: Unveiling the Power of Membership Plans in Dentistry, with Jane Levy Dental Entrepreneur Spring 2024 17

Business

Labor Protections Recently Got Stronger.

What Does This Mean For Dental Practices?

By Joe Fogg, Founder & CEO of onDiem

The Department of Labor (DOL) quietly kicked off 2024 with a significant rule, which will make it more difficult for employers to classify their workers as independent contractors. What does this mean for dental practices and organizations, which have historically relied on temp workers and a flexible gig economy? In light of this rule, how can dental leaders mitigate financial and legal risk?

dentist-owners and practice managers must anticipate and stay updated on the complexities of labor and compliance laws, or rely on staffing services that are fully W-2 compliant.

Doing so also allows our professional community—our dental hygienists, assistants, and front-office staff—to access vital W-2 benefits and protections.

entists often remind me that they “never signed up for this.”

As the founder of onDiem, the first nationally available dental staffing platform to be fully W-2 compliant, I’ve paid close attention to legislation and governance that affects compliance and employment in our community. Here’s what our dental leaders should know about the DOL’s “Employee or Independent Contractor Classification Under the Fair Labor Standards Act Final Rule,” which went into effect March 11th of this year.

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By “this,” of course, they’re not talking about delivering essential and critical oral care. They’re referring to the complicated skills and tasks required to run a business smoothly and effectively: the human resources paperwork, the compliance research, the office management, the marketing and outreach, the financial planning, the payroll taxes, the vetting, the credentialing, and so much more.

A LANDMARK RULING

“I wanted to focus on caring for an underserved community,” one of our clients told me. “I didn’t realize I would spend so much invaluable time fixing employee classification issues at my organization.” Another dentist said, “I signed up to become a dentist, not a compliance expert. I had no idea I had to become both.”

On January 9th, the Department of Labor (DOL) announced a final ruling that would make it significantly more difficult for companies to classify their employees as independent contractors. Among the significant things to know:

In an ideal world, dental practices and DSOs would be able to focus on patient care and new business growth instead of the tedium of compliance. But to mitigate expensive legal risks,

• The “Employee or Independent Contractor Classification Under the Fair Labor Standards Act Final Rule” went into effect March 11, 2024. It overturns the 2021 Independent

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“I signed up to become a dentist, not a compliance expert. I had no idea I had to become both.”

Contractor Rule in order to be more consistent with “longstanding judicial precedent,” reduce misclassification risks, and provide greater clarity and consistency for businesses that rely on contractors.

• The goal of the Fair Labor Standards Act (FLSA) “Economic Reality” test remains the same: to determine whether the worker is “economically dependent on the employer for work or is in business for themself.” The factors in the test: 1. opportunity for profit or loss depending on managerial skill 2. investments by the worker and the potential employer 3. degree of permanence of the work relationship 4. nature and degree of control 5. extent to which the work performed is an integral part of the potential employer’s business 6. skill and initiative • Each of the factors will now be considered equally to determine worker status—making it much harder to satisfy the Economic Reality test. Employers will need to think of the test as a “totality-of-the-circumstances” test—where no factor is prioritized over the other. Employers must also now consider six factors (previously five), including investments by the worker and employer—and understand an updated analysis on how scheduling, supervision, price-setting, and ability to work for others affects the “nature of degree of control” factor.

• For context, the previous 2021 rule placed greater weight on the two “core factors” of control and opportunity for profit or loss; limited the consideration of “worker investments and initiative,” and did not allow consideration of whether or not the work performed was central to the employer’s business.

While some opponents have already announced their intent to challenge the ruling, existing state dental practice acts, IRS criteria, and DOL regulations have long affirmed strict and indisputable guidelines for classification. “Under applicable IRS and Department of Labor regulations, it is improper to classify most hygienists who work at dental practices as 1099 contractors, even when they are only working part-time or as a temp,” affirms Brian A. Colao, DSO Industry Group Director at Dykema.

“The regulations are very clear, and there can be significant consequences for misclassification of employees as independent contractors … In my experience, many practice owners across

the industry are needlessly exposing themselves and their staff to significant legal risk by misclassifying employees as independent contractors.”

When I meet with dental practice owners, DSO leaders, or state dental association leaders, I tend to ask, “Does your state dental practice act allow hygienists to have independent practices?” The answer is almost always “No”—because with very few exceptions, state dental practice acts state that hygienists must work under direction of control or direct supervision.

That means hygienists cannot be independent contractors— and that any employer who hires them as independent contractors is doing so illegally.

We don’t need to look very far to find misclassification and W-2 (non)compliance horror stories in dentistry and beyond.

For the professional, misclassification often means a lack of access to basic labor protections. For the dental practice or organization, misclassification can lead to (and has led to) costly and timely classification corrections at best—and multimillion dollar lawsuits and criminal penalties at worst.

What are the solutions here? What can a dentist, office manager, or DSO leader do to stay compliant and on the right side of the law—all while quickly and reliably filling dental chairs in the midst of an industry-wide labor shortage?

THE DOL RULING: AN OPPORTUNITY FOR REVENUE GROWTH The simple answer: Using a W-2-compliant dental staffing service removes your legal and compliance risks, allowing you to focus on other aspects of patient care and business growth.

The longer answer is perhaps a bit surprising to some; it starts by seeing the DOL ruling as less of a “restriction” and more of an opportunity to create a mutually beneficial and lucrative employer-employee relationship.

To understand this approach, we must first understand the context. Dentist-owners and managers come to my team at onDiem with a variety of concerns and asks, and they tend to fall into the following four themes: • I need dental staff now. “Can you provide dental hygienists, dental assistants, and front-office staff today?”

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• I want to connect with the most qualified talent. “I’m done hiring unreliable workers with questionable credentials. Can you give me access to professionals who are qualified, vetted, certified, and ready to work?”

• I want my dental team to perform better. “Can you provide temps that seamlessly integrate with my existing team to enhance our performance?”

• I want to grow revenue and production. “Can you keep my seats filled, so I can finally maximize production and think about growth?”

Traditional dental staffing solutions tend to focus on addressing urgent, temporary staffing needs—which isn’t necessarily wrong but can often be shortsighted and lead to costly hiring blunders.

In light of the DOL’s new rule, it’s more important than ever for employers in our industry to choose a workforce management solution that’s capable of addressing all four concerns legally and safely.

As an example: Rather than provide a temporary band-aid to temporary staffing, onDiem’s dental staffing platform gives practices and DSOs a workforce management solution that not only fills empty seats but increases the value of their business through staffing. Rather than seeing W-2 compliance as a barrier to “quick” (and often illegal) hiring, we’ve chosen to see it as a way to deepen the practice-professional relationship, improve standards of patient care, and uncover new opportunities to grow production and revenue. Here’s how we do it, in a nutshell: We provide dental staff now. We give employers access to the largest W-2-compliant dental professional community in the country—and market their open positions on their behalf.

Because onDiem is a W-2 platform, we’re able to market our suite of W-2 benefits and protections as invaluable “perks” of the job.

We connect practices with the most qualified talent. We vet and qualify all dental professionals on our platform, saving invaluable time. We do all we can to make hiring simple by taking care of all the compliance and classification headaches.

We provide complementary staffing for dental teams. Instead of seeing our job seekers as just “temps,” we invest in them as potentially key and integral members of your dental team. Every single job seeker on our platform enjoys W-2 protections that keep them stable, happy, and ready to work. We can, therefore, work with you to complement your existing team with hygienists, assistants, and front-office staff who are among the most reliable in the industry.

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We work with practices to identify new growth opportunities.

We collaborate with dentists to transition to a “staffing for production” model, which allows practices and DSOs to open new columns, open on weekends, and take advantage of other methods to improve revenue and production.

All of this, from providing qualified staff to unlocking new business growth, is possible precisely because we see classification and compliance requirements as positives—not barriers—for our industry. Every single professional on our platform enjoys W-2 benefits and protections. And because they enjoy benefits like PTO, flexible scheduling, health insurance, wellness reimbursements, workers’ compensation insurance, association membership rebates, and more—our dental professionals are more dependable, reliable, eager to work, and able to flex to our practices’ needs. Our dental practices and DSOs, in turn, can hire for greater production and revenue, because we take care of all the hiring, payroll, benefits, and compliance “fine print” at a controlled cost.

Regardless of the solution a practice or organization may choose for staffing, viewing staffing as a mutually beneficial relationship that adds, not extracts, the most value for all parties, is the key strategy to navigating labor and compliance laws with ease.

Protected workers are reliable workers, compliant practices and organizations are enticing workplaces, and establishments with dependable staffing are best positioned to grow their capacity for patient care. It’s a point of view that can unlock key growth for our industry, and help practices and organizations ride out the turbulent waves of a serious staffing shortage.

As rules shift and change, it will become even more crucial for our community to be educated on the ins and outs of classification and compliance to maintain a reliable workforce, meet revenue goals, and improve patient access to care. Dental practices and DSOs may be feeling the squeeze from the labor shortage and from stricter labor rules, and perhaps that feeling of “I didn’t sign up for this” is stronger than ever. Luckily, some of us did sign up for this—meaning no dental leader needs to navigate the tricky labyrinth of labor and compliance laws alone.

Joe Fogg is the CEO and Founder of onDiem, a W-2 dental staffing platform that boosts careers and maximizes practice value. onDiem connects dental practices and DSOs with qualified dental professionals—and empowers both the employee and employer with career and business solutions. Prior to onDiem, Joe led marketing, engineering, and product teams at Cerus Industrial to turn the company into a key market player.

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We’re the only dental staffing platform that not only fills shifts—but also maximizes the value of your business.

Hire dental staff quickly and easily.

Find dental hygienists, assistants, and front-office staff today.

Connect with top talent in your area.

Dentistry’s most qualified professionals are just a few clicks away.

Enhance your team with onDiem.

We invest in our dental workers so that they become your top talent.

Unlock new growth for your dental practice.

Discover new revenue and production levels when you hire through onDiem.

Business

Innovation and Disruption Accelerated in Dentistry Maggie Augustyn, FAAIP, FICOI

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s I was growing up, I was advised to find a job that would be relevant and needed, one with significant security of provider-ship for my future family. My upbringing, though not uncommon is not that of an average American. I moved to this country with my mom, dad, and sister at the age of 14, with nothing more than a suitcase or two. And so, in capitalizing on the sacrifices and efforts that my parents made, that we made, I was taught to be safe in my pursuits.

I did well in science and loved the subject, and thus I chose healthcare. I loved working with my hands and had a knack for art, thus I chose dentistry. I had convinced myself, as had my advisors, that there is not going to be a time in the near future where first world countries will not need a human dentist.

The job of a dentist was not going to be taken over by robots nor was it going to be moved overseas. My choice of career was conservative, realistic, and held certainty. But not everyone thought like me. I saw people who took risks, who were innovators, individuals who caused a disruption; they left me in awe.

Their courage, for me, was unfathomably uncomfortable.

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Picturing myself in the position of an entrepreneur has me uneasy, distressed, disquieted, and most of all–unsettled. I like my comfort and routine, I like my safety and security. Starting a company that has never existed before, one that interferes with the status quo, and also improves systems, rid of inefficiencies, leverages new technology, and lives in the future is something that I left to other people. And I watched, and I learned from those incredibly brave people.

One of these people, one to watch, and learn from is Yasin Abbak, an eternal entrepreneur who had recently started a company called GroupUps. Their mission? To ‘help dentists save more, together.’ The company specializes in price transparency for practice owners. It negotiates the cost of equipment including, but not limited to, CBCTs and panoramic machines, sterilizers and autoclaves, dental chairs, cabinetry, x-ray machines and sensors, 3D printers, and lasers.

What also makes the company unique is its brand neutrality. It doesn’t have agreements with select manufacturers. They work with distributors who continue giving commissions to their team. The sales force and distributors aim to attract customers they’d never met before, ones who might become a loyal folDentalEntrepreneur.com

lowing. In this way, the company creates positive change. They create opportunities for networking and collaboration amongst many sectors of our industry.

I have recently worked with GroupUps, having met them through Dental Nachos, on two large purchases: a Cone Beam machine and a handheld X-ray unit, and am hoping to add more in the near future. Many practitioners work with the company on start-ups which can even include office build-outs.

The average savings the company offers its clients is just a few dollars short of $9000. Again, this is not the savings off the MSRP; this is the savings taken from the average cataloged invoice cost throughout the country. And that number continues to increase client after client.

At the end of January 2024, the company had $1M worth of sold equipment, with a projection of $20M to be completed by year’s end. But the company is much more than a cost-saving vehicle.

It is uniquely innovative. Its owner has the courage to bring about real change, fueled by a deeply rooted passion to see independent businesses thrive on Main Street.

INNOVATION

be disrupted by using Artificial Intelligence (AI). GroupUps is on the cutting edge of implementing this.

In a short 19-question session, or rather a conversation with AI, the process of choosing which machine works for your particular office takes between 5-10 minutes. All pertinent questions are asked by the software with the purchaser being able to inquire back. The AI might ask ‘What field of view do you need?’ The purchaser can ask back ‘What is a field of view?’ and so on.

I was in disbelief when I learned that a 7-minute conversation with what is essentially a robot saved me more than 8 hours of research time. If the average hourly production for a general dentist in the United States hovers at $450 an hour, that is a potential savings of $3600.

I saw people who took risks, who were innovators, individuals who caused a disruption; they left me in awe.

When I started to consider the purchase of a cone beam machine, I was overwhelmed with the amount of choices I had present within the market.

Beware where you enter your email address, because it felt like each day I had another independent salesperson knocking on my door offering me ‘the deal of a lifetime.’

I didn’t know or understand the differences between brands, the technology they offered, their functions, or their reputations.

Learning all of that was terribly overwhelming and, above all, time-consuming. I spent hours and days researching manufacturers and their unique technology just to narrow down what it was that I thought needed.

I spent hours on calls with manufacturing reps, taking notes to later compare and decide which machine was worthy of the hefty investment. Now, I know that the process of consideration can

MORE COMPANIES WITH COURAGE TO STAY ON MAIN STREET At a time when company after company is hyper-focused on profits, and redesigns systems to leverage working their employees to the brink of exhaustion, some companies have the courage to turn that backwards. We need more websites to remember that ‘independent businesses are the lifeblood of a local economy.’ And more than just stating, we need companies to embody that with every cell of their existence.

We need to return to creating jobs, reinvesting in the local economy, and pursuing the American dream. We need to make that pursuit easier and help good people build good things.

By bringing price transparency and the opportunity to stray away from paying sticker prices, companies need to relevel the playing field.

Leveling the field brings an opportunity for more innovation.

There is more. When single practice owners save money, that money stays on Main Street. The capital trickles down to the team in the way of increased wages, health insurance, paid time off, and retirement plans.

Independently owned businesses recirculate funds back into a local economy while national chains siphon them out. This isn’t Dental Entrepreneur Spring 2024 23

anecdotal, either; a study out of Salt Lake City shows how much revenue flows back into the local economy when indie businesses are compared to national chains1. In retail, 52% of revenue goes back to the locals, as opposed to only 13.6% with chains. In the restaurant industry, it’s 78.6% compared to 30.4%2.

as only 17% of buyer time is occupied by a sales rep3. By 2025, it is expected that 80% of B2B sales interactions between suppliers and buyers will occur solely through digital channels4. There is also proof that only 24% of B2B high-quality deals were completed with sales reps, as opposed to 65% that were self-navigated in the purchase process5.

DISRUPTION

Yasin, the founder of GroupUps doesn’t necessarily hide behind the servile leadership he brings into the industry. He is fully aware that his operation is of a capitalist nature. He wants to make money. He wants to make a lot of money. He sees the future as being wide, spanning industries beyond dentistry: into medicine, veterinary medicine, chiropractic medicine, and who knows what else. He feels no discomfort as he pictures this as a billion-dollar venture. If he does get there, or rather, when he does get there, his vision driven mission will have brought multibillion dollar savings to others. He’s settled into the role of an innovator and disruptor quite comfortably. I simply can’t wait to see what he’ll do next.

Writing about company disruption is probably the most intriguing topic for me. Many of us are stuck in routines, in conventional and habitual activities. Imagining stepping outside of what we do on a daily basis seems to require too much effort, and thus, we don’t veer off programs or patterns.

That’s why having disruptors within our industry, or for that matter any industry, is such a gift. So few of us have the talent, the ability, the motivation, and the wherewithal to be that. The disruption of GroupUps comes in several ways.

It starts with the time savings of using AI and goes into being transparent and honest about pricing. And last, they go straight to the manufacturer and still share the spoils with the middle person, the sales person.

This last part might be the biggest disruption, and here is why: Boomers have essentially left private practice and gone into retirement, COVID-19 having accelerated that. Gen-X’ers have another decade or two to go. Millennials and Gen-Z’ers are about to run the show. Research shows that they don’t like to do business the same way as we do. Millennials and Gen-Z’s feel that their time is limited, their attention span is narrowed, and they want to go straight to the point.

They aren’t interested in working with salespeople, in spending hours on Zoom calls watching demos that can be boiled down into 5-minute YouTube videos. They embrace technology and digital tools to speed up the process of choice, demonstration, and delivery.

Change is coming, and we need to meet the demand, ahead of the curve. Gartner research shows that 44% of Millennials prefer no interaction with the sales force. Moreover, interest is shifting from in-person interactions to that of digital channels,

Dr. Maggie Augustyn, FAAIP, FICOI is a Dawson-trained practicing general dentist, owner of Happy Tooth, author, and inspirational speaker. She researches, writes, and speaks on the things that make us human, make us hurt, and make us come alive. She evokes emotion in her audiences, awakening all to the beauty of our chosen paths. Dr. Augustyn is one of dentistry’s most prolific writers with a “Mindful Moments” column in Dentistry Today and a frequent contributor to Dental Entrepreneur Woman, AGD’s Impact, and DentistryIQ.

3 https://w w w.naw.org/how-distributors-can-deliver-the-experience-b2b-buyers-want/#:~:text=Digital Channels: Gartner research shows, occupied by a sales rep

4

https://www.gartner.com/en/sales/trends/future-of-sales

5 https://w w w.gartner.com/en/newsroom/press-releases/2022-0622-gartner-sales-survey-finbds-b2b-buyers-prefer-ordering-payingthrough--digital-commerce

1

https://ilsr.org/key-studies-why-local-matters/#3

2 https://nebula.wsimg.com/09d4a3747498c7e97b42657484cae80d?Acce ssKeyId=8E410A17553441C49302&disposition=0&alloworigin=1

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Dental Entrepreneur Presents

THE FUTURE OF DENTISTRY PODCAST

Continuing the Conversation

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Launchpad

Growing An Audience of Over 1 Million On Social Media with DentalTok Star, Dr. Joyce Kahng Dr. Luke Shapiro, DDS

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California, and I’m from Northern California. So I moved to Southern California for him, and I made him propose. I was basically like, “Dude, I am moving for you. So the countdown begins.” He’s also a dentist and went to NYU.

Dr. Kahng is as bubbly and humble on social media as she is in person. Her journey to being one of the top content creators in the world of dental social media hasn’t been easy, but it has certainly paid off. Not only has it helped her attract patients to her practice, but she now has a second career from her sponsorships and courses.

He hates being on social media. You’ll get glimpses of him, but it’s usually not of him talking to the camera. It’s just like him doing something, and when he realizes the camera is on, he’ll put on a sad/annoyed face haha.

t may be safe to say that if you have ever been on “DentalTok,” you would recognize Dr. Joyce Kahng (@joycethedentist). With over 1 million followers across all platforms, she has been posting since 2018. She is known for her viral green screen videos in which she explains various dental procedures.

SO TELL ME ABOUT YOUR BACKGROUND. WHERE DID YOU GO TO SCHOOL, RESIDENCY, ETC? I went to the University of the Pacific (UOP) - the accelerated program in which I did three years of undergrad and three years of dental school. So I graduated in 2010 when I was quite young.

And then I did a residency in the Bronx at Jacobi.

HOW WAS NEW YORK? Those were the best years of my life - living in New York City was the best. And then I practiced in New York for a few years and met my husband who is from California. He’s from Southern

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DO YOU KEEP YOUR HUSBAND HIDDEN ON SOCIAL MEDIA OR AM I JUST NOT PAYING ATTENTION? HAHA

HOW DID YOU GET INTO SOCIAL MEDIA? So I started my Instagram account in February 2018 which wasn’t the beginning of Instagram, but I do think that was before a lot of dentists were on Instagram. I was teaching at USC at the time, and I didn’t really understand Instagram at all. I kind of thought it was a website. I had just taken over a practice, but it wasn’t that busy so I had time to teach part of the week. I was at USC just trying to figure out this Instagram thing, and there was this student - Courtnie Yoon (@cariousity_). She was an Instagram OG and had about 7,000 followers. She was in one of my classes and was like, “It’s not easy. You have to put in a lot of time.” She told me enough to be like, “Okay, this is more than a website.”

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WHAT WERE YOUR ORIGINAL INTENTIONS IN CREATING THE INSTAGRAM ACCOUNT? I made it for the practice. My actual first post was two xylitol lollipops in an X, and then it just said xylitol over it. It got very few likes. I didn’t have pictures of myself because I was huge in dental school. So I deleted all those photos, and I didn’t have anything to post. So that’s why I started doing videos because I didn’t have any photos. I remember I got a comment from one of my previous dental school professors and was like, “My god how did he find me?”

ARE YOU THE ONE WITH ALL THE CREATIVE DIRECTION OR DO YOU HAVE OTHER PEOPLE HELPING OUT BEHIND THE SCENES? I make all of my own short-form videos. I just do it directly on the platform. My whole thing is to make it easy enough for you to do it every single day. I think a lot of people overcomplicate things and outsource them. And then once you get people involved, it gets bogged down. If you depend on an editor, the editor’s taking their sweet time getting the content out. And then you have to review the content. So for me, every Thursday I just sit in my kitchen like what I’m doing now, and I just make the videos, and then I have them ready to go. I don’t have anyone filming. It’s just me in my kitchen. I also find it very difficult to film myself if anyone’s around because I’m self-conscious.

WHERE DO YOU GET YOUR IDEAS FROM? I scroll on TikTok. I then save it in a Notion planner. Some weeks, I get to Thursday and have no ideas, and those are hard weeks because then you’re just staring at a blank piece of paper. I try to post three times a week. I also have a reserve of videos that are not my best work, but I’ll still post if I need to.

AND TALK TO ME ABOUT YOUR COURSE. HOW DID THAT GET STARTED? A lot of people would ask me questions about growing on Instagram. I didn’t want to do a course initially because I didn’t want to be known as the Instagram dentist because I feel like I’m actually a legitimate dentist - like clinically a legitimate dentist.

So I didn’t want to be known as a marketer. I realized that even if you make a course, it takes a lot of time and a lot of effort, but it doesn’t do anything unless you can get leads. And then I was faced with this problem because my Instagram is where I have a lot of eyeballs, but it’s all patient-facing, and I didn’t want to start making videos to attract dentists. But dentists are the ones that I need to buy the Instagram course. In order to not dilute my

message to the patient, I run ads for the course. It’s actually not a major part of my income, but I did it because people kept asking.

WHAT RECOMMENDATIONS DO YOU HAVE FOR DENTISTS WHO WANT TO GET INTO SOCIAL MEDIA? I think that people can get into social media, but I think the expectations of what you’re going to get have to be extremely reasonable. Like you may grow in followers by outsourcing, but are those followers legitimate people who will convert and come into your office and want your services? Not as likely. There has to be a certain feel to your page. They have to get a sense of who you are. And if you’re not upfront and center on your Instagram, it’s like going into any other dental office and just taking a chance on a dentist that has good Yelp reviews. Your Instagram is your opportunity to show who you are in the absence of dentistry.

And that’s why it’s so powerful.

Dr. Lucas Shapiro is a graduate of Washington University in St. Louis and Stony Brook University School of Dental Medicine, where he received his Doctor of Dental Surgery. He completed his post-doctoral orthodontic training at Tufts University School of Dental Medicine. He currently practices orthodontics at Lemchen Salzer Ortho in NYC. He started the Instagram page @futuredentists, works with the educational organization @ignitedds, and has an orthodontic tiktok page @drshap.

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Impact

The Formula for Profitable Hygiene Wendy Briggs, RDH

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hanges in the dental market over the last few years have significantly reduced hygiene profitability in most places. Practices face rising overhead expenses, higher wages, and stagnant or falling reimbursement for hygiene services. Attempts made to address these profitability challenges by shortening or double-booking hygiene appointments have only reduced the quality of care we provide and furthered the growing divide between dentists and hygienists.

How can we provide patients with the best possible care, while also increasing hygiene profitability to a sustainable level for the long-term success of the practice?

The solution to today’s hygiene challenge requires focusing on increasing profitability, effectiveness, and production. These may sound redundant and nearly impossible to achieve, but at The Team Training Institute, we teach specific strategies and solutions that help practices achieve each of these key hygiene goals.

INCREASE PROFITABILITY With insurance fees remaining low, we have to find a way to continue to provide our patients with the same level of service, or higher, while also increasing our profitability. One of the most impactful ways to increase profitability is to do more same-day dentistry – both preventative and restorative. Combining services that may have been previously provided in 2 separate appointments into 1 reduces your overhead expense and increases profitability per visit. Offering services same-day will also increase your acceptance rate with busy patients who don’t want to

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make the time in their schedule to come back for a second visit.

The key to adding more same-day dentistry is to identify every opportunity to serve patients at a higher level and present those opportunities to the patient. We often see team members reluctant to present additional preventative services like fluoride and sealants because they feel as if they don’t have the time needed to complete these procedures. Many also have the misconception that patients won’t pay for what insurance won’t cover. Not only have we seen the evidence in thousands of dental offices that this is not true, but when patients understand the value of the care you are presenting, they appreciate the opportunity to improve their oral health and reduce their risk of needing future, more invasive treatments.

Success in serving patients at a higher level requires us to define and embody our role as a preventive therapist. This focus on prevention is critically needed today as the World Health Organization recognizes the “rapidly changing disease patterns throughout the world are closely linked to changing lifestyles which include a diet rich in sugars, widespread use of tobacco, and increased consumption of alcohol.” With oral disease highly related to these lifestyle factors, patients need us to provide protection for their teeth, in the form of preventive services, that can help offset their risk of oral disease.

We help providers implement key systems for time management that enable many simple preventive services to be completed during the scheduled recall visit. When offering preventive services, or any dental services, most patients prefer fewer visits not more. When you use language like “If possible, would you DentalEntrepreneur.com

like us to take care of this today?”, you’ll be surprised how many patients jump at the chance when offered. Preventive services often extend the appointment time by just a few minutes, if at all. Restorative services should also be offered same-day when feasible, and be upfront with patients about any expected wait time.

SECRET TO SAME-DAY SUCCESS • No nesting! Be prepared to work out of any room, at any time.

• Every room is equipped and supplied the same.

BECOME A MEMBER

• Set-ups for fluoride, sealants, and desensitizing agents are always prepped and ready.

RESULTS Tonya, a hygienist we worked with in Dr. Greg Ayer’s practice, placed 33 sealants using the same-day process that we teach at The Team Training Institute. None of those sealants had been scheduled ahead of time, all were offered and completed that same day! That’s 33 teeth that are more protected now than they would have been without Tonya’s intervention, all of which were completed the day they were diagnosed.

Janet, a hygienist we work with at Downtown Dental Group in Honolulu, is truly excellent at protecting her patients from cavities. Recently, Janet protected more than 90 teeth in one day using the systems we teach.

Many of our providers are also helping patients with early cavities arrest the progression of their incipient lesions and harness new technology to remineralize the enamel. Practices have had as many as 29 of these services provided in one day, again all of which were not on the schedule but completed once diagnosed.

All of these providers are not only improving the profitability of their practice and optimizing their roles as preventive therapists, but they are truly helping patients with their commitment to providing world-class care.

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Opportunity to write and be published via our blog and magazines.

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One-on-One on The Future of Dentistry Podcast feature with Anne Duffy, social media, and website.

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10% Friends & Family discount on the DE advertisements for members.

INCREASE EFFECTIVENESS Our effectiveness as a hygiene provider should be measured by our impact on patient health. Increasing that effectiveness and maximizing our ability to improve patient health requires us to understand the needs of our patients. We need to know what lifestyle factors they have that may increase their risk of oral disease and what systemic health conditions may be impacting their

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oral health. This deeper understanding of our patients cannot be achieved without a process for risk assessment.

Consistently using a risk assessment tool with patients helps them better understand their risk factors, how their risk can change over time, and how preventive services can reduce their risk. A basic risk assessment, including both a quick scan of the mouth and a few questions for the patient, can typically be completed in less than 2 minutes. The scan of the mouth should note any deep grooves, exposed root surfaces, history of decay, and white spot lesions. Questions for the patient should include medications that might cause dry mouth, vaping, snacking, and soda habits. Education is critical to helping patients understand the connection between these risk factors and their oral health.

Given the prevalence and mass consumption of sugary, low pH beverages, hygienists should be capable of explaining the cavities infection process in non-technical language that patients can understand. Keeping it simple is best, but a clear connection between sugar exposure, harmful bacteria, and pH of the mouth will help move patients to reduce their risk and hopefully make more informed beverage decisions in the future.

SECRETS TO RISK ASSESSMENT SUCCESS • Graphics that show the pH of popular beverages and sugar content of common products are an extremely effective part of this discussion.

• Use the latest research regarding risk factors that relate to each individual patient.

• Presenting visuals of clinical symptoms with a digital scan or intra-oral camera helps patients accept recommended solutions.

• Request a copy of The Team Training Institute’s Risk Assessment Tool by completing the contact form found at theteamtraininginstitute.com/contact with “Risk Assessment” in the message field.

RESULTS Sonali, a hygienist with Commerce Village Dentists, increased her fluoride acceptance rate to 85% in her first month after implementing a risk assessment process.

INCREASE PRODUCTION

Higher hygiene wages are a reality that does not appear to be changing anytime soon and hygienists are not going to become less critical to the success of dental practice. The simplest solution to maintaining profitability while paying higher wages is to increase hygienists’ production. Increasing production does not equate to unnecessary procedures, it simply means we are helping patients choose a higher level of care, consistently. We see patients day in and day out who need our help, but often opt out of our assistance. The results of the risk assessment give patients a compelling reason to make good preventive care decisions. These decisions should include services such as fluoride, sealants, bonded protective agents, guided enamel remineralization, and radiographs. Maximizing these services drives hygiene production while delivering a higher level of care for our patients.

When hygienists are using a risk assessment to identify patient needs, providing those needed services same-day to increase acceptance, and growing their production as a result, they should be compensated for their contribution to the practice’s profitability. Rewarding your team’s achievements helps engage and retain your current team and is a great recruiting tool. The key is to reward and compensate in a way that is sustainable for the long-term profitability of the practice. We have found that a production-based compensation model benefits hygienists, the practice, and the patients. Rewarding a higher level of care is one of the secrets to profitable hygiene.

RESULTS We regularly see hygienists’ production per visit jump to $300$400, depending on their market. Production is not the focus, instead, it is the result of elevating the care we provide day in and day out. The most rewarding part of this is that patients receive a higher level of care.

For help implementing this formula for profitable hygiene in your practice, visit theteamtraininginstitute.com.

Wendy Briggs, RDH is a practicing hygienist, strategic advisor, speaker, consultant, and best-selling author. She is the President and Founder of HygieneDiamonds as well as the President and Co-Founder of The Team Training Institute. Wendy’s excellence as a hygienist and patient care advocate has directly influenced more than 3,718 dental practices in 12 countries. She has a proven track record of supporting dentists, hygienists, and their teams in increasing patient care and doubling hygiene production. wendybriggs@thetti.com

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Across America, many kids don’t know how to prevent tooth decay.

The result can be a lifetime of poor oral health.

Every child should feel empowered to take control of their dental health.

As Title Sponsors of our HERO Program, Align Technology is helping us equip oral health advocates to encourage healthy dental hygiene habits in communities across the US. Since 2020, more than 2 MILLION kids and parents – including more than 60,000 that speak a language other than English – have learned about the importance of healthy smiles with the free resources available on our website. Join us!

Get your free oral health educational materials at AmericasToothFairy.org/resources.

Impact

Turning Trauma into Triumph: A Dentist’s Whole-Body Approach to Dentistry Dr. Katie Lee

H

ow do you find your why as a dentist? I’ve often reflected on the one event, the accident, that changed my life both personally and later, professionally. This one event shaped how I would view oral health and the scary, yet fascinating impact it has on your overall health. It was through this childhood event that my path and passion were born and have continued to be the driving force a decade later for how I view dentistry—through a holistic, whole-body lens.

At the age of fourteen, I was in a terrible ATV accident. When I should have been enjoying my early teen years, playing sports, and spending time with friends like most of my peers, I spent many days and nights in a hospital bed, my health declining before my eyes.

Before we go any further, let me backtrack a little bit… a girlfriend and I were speeding down the road on an ATV without a care in the world. And before I knew it, there was a bump, a jolt, and then blackness. Apparently, I went headfirst—while not wearing a helmet—into a telephone pole at over thirty miles per hour. I had broken every bone in my face, from my eyebrows down. I was missing part of my lip and a few teeth (they were stuck in the telephone pole). I was barely alive, in a coma for nearly a week, and had lost over ten pounds. My parents, devastated to see their daughter in such a state of deterioration, expected the worst—many doctors had informed them that if I even made it out of this alive, I would never be the same again.

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But I’m a fighter. Clinging to what little strength I had, I pulled through, and it was time to let the healing (or surgeries, more like it) begin. It took four years and nine reconstructive surgeries to repair the damage I had done to my face and my wrist. In the middle of all these surgeries, I was desperate to be a normal high school teenager; but the truth is, it was near impossible to have a “normal” life. I had surgeries scheduled for the end of each semester, a cast on my arm, and my jaw wired shut which made playing sports (let alone getting proper nutrition) a huge challenge. Missing front teeth just added an EXTRA embarrassing element to my social life… talk about pure humiliation.

And while these experiences were traumatizing, they soon made me realize how much oral health impacts your overall health and wellness even at a young age. Due to my broken jaw and teeth, I was unable to open my mouth and, in turn, unable to eat properly. The systemic health effects were almost immediate.

Pain, inflammation, and weight loss, eventually led to high liver enzymes and kidney malfunction. I was very thin and malnourished. My body was not getting the critical nutrients it needed to function and from all the inflammation and infection from my mouth, my body was on fire and shutting down. When I was finally able to open my mouth (after rib graft surgery) and have my teeth repaired, my physical and mental health improved.

To say that I was profoundly moved by this experience was an understatement. This one accident was the catalyst for the rest of my life, shaping how I viewed health and wellness and thrusting DentalEntrepreneur.com

…as dentists, it is our duty to be the first line of defense against disease for our patients—we are critical to helping patients live longer and healthier. me into the world of dentistry. As I started practicing, I noticed a lack of education about the oral-systemic connection and wanted to provide patients with the knowledge and understanding of how small improvements to their oral health could make a huge impact on their overall health.

While oral systemic health isn’t new to dentistry, the concept is just starting to rise in popularity as healthcare is evolving to a more whole-body approach. For decades, dentists and physicians have been siloed, focusing on their respective fields of expertise with little to no crossover.

For over a decade, I have witnessed, firsthand, patients with varying degrees of chronic inflammation and disease sit in my chair, pleading for a solution to their health problems. Every health problem I discovered through increased education and oral testing led to the realization that, as dentists, it is our duty to be the first line of defense against disease for our patients—we are critical to helping patients live longer and healthier.

However, as this dramatic shift in care has occurred and the data and research to support the effects of poor oral health on the body are readily available, dental professionals and doctors are working together more often to prevent disease. More and more general dentists are starting to recognize the importance of implementing oral testing and technologies into their practices that not only increase their profitability but greatly impact their ability to treat their patients.

So, what is the oral-systemic connection? As a dentist, I began to understand that a healthy smile was not only a confidence booster on the outside but was the gateway to the health of our bodies. However, for many individuals and professionals, there is often a significant disconnect in the knowledge of the oral-systemic connection. There is a deeper connection between bacteria and inflammation that occurs in your mouth and how it exacerbates disease. Knowing the fundamentals of oral health and overall health aims to reduce an individual’s risk of acquiring a multitude of health issues and prevent life-threatening diseases.

Did you know that there are over 700 bacteria found in the mouth of which 11 specific strains can lead to systemic diseases like heart disease, cancer, Alzheimer’s, and even fertility complications? Individuals dealing with disease and fertility issues will have key indicators in their mouths–discovered through innovative technologies and testing–that are flashing warning signs. I’ve personally worked with women and their spouses with fertility issues (as well as having my own issues with fertility) and have seen how proper oral healthcare and testing is a game changer in getting and staying pregnant.

So why have we missed the mark all these years when it comes to oral-systemic healthcare?

Now more than ever, it is critical for dentists, hygienists, and dental professionals to become educated in oral systemic health practices and the latest tests and technologies that can improve and save the lives of their patients. When it comes to oral testing, every dentist should be a bit nosy when it comes to the whole body’s health and well-being. There are certain simple tests, all of which can be done in the office, to help identify decay and disease.

Oral Microbiome Testing: This test will find and name pathogenic bacteria present in the mouth and how they are affecting the organ systems. This can help dentists tailor the appropriate treatment to kill the bacteria.

MMP-8 Test: This is a diagnostic test for MMP-8 enzyme levels. MMP-8 is a collagenase enzyme responsible for tissue breakdown in our mouths and throughout our bodies. This test can inform the dentist that breakdown is occurring before it is evident clinically. This means dentists can be proactive, not reactive when it comes to care, catching the degradation earlier before severe deterioration.

HbA1c Test: A blood sugar test that can screen for diabetes.

(Not all states allow dentists to test A1C, but all can test for blood sugar levels.)

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Strep. mutans bacterial test: A simple test that looks for the bacteria that causes cavities, helping determine cavity risk.

IL-6 test: This test determines if a patient has a mutation in the IL-6 gene which is a mediator of a systemic inflammatory response. Knowing this, patients can make lifestyle changes to ensure they keep their immune system quiet so that they do not develop other conditions like cardiovascular disease, diabetes, Alzheimer’s disease, and periodontal disease.

HPV salivary test: Saliva can be tested for HPV, which is important for oral cancer detection.

Implementing oral testing allows dentists to reduce an individual’s risk of acquiring a multitude of health issues that will affect their patient’s well-being. As dentists, these simple oral tests provide greater insight into a patient’s overall health, how they may be suffering, and the proper course of treatment.

Through my patients’ experiences and my own lived experience, I realized that there was a greater need to bring widespread awareness about the oral-systemic connection to the public… cue writing a book! I wrote my first book Saved By the Mouth to highlight the transformative power of oral health and its impact on overall health, wellness, and longevity. This book is an homage to my own story and the many patient stories that made a significant impact on my career and mission to provide better health outcomes.

with

Anne Duffy

P ODCA S T

For me, it’s about turning the life-threatening into the lifesaving. And every dentist with a passion for helping patients can start now.

For more information about Dr. Katie Lee and oral testing, visit https://katieleedds.com/ and Saved By the Mouth, visit https:// www.savedbythemouth.com/.

Dr. Katie Lee is a dentist, speaker, and coach who lives in Colorado. Dr. Lee graduated from the University of Illinois at Chicago in 2010 and was an owner-partner in over 80 DSO supported dental practices throughout the US and served as Clinical Partner overseeing 5 states. Currently, she consults for health technology companies and provides implant education for general dentists. She is the author of Saved By the Mouth and is opening a dental-medical integrated clinic in 2025 to better serve patients holistically.

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www.dew.life

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Annual DeW Life Retreat November 14-16, 2024 www.dew.life/events

SCAN TO REGISTER

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Impact

Don’t Let Your Imposter Mindset Crush Your Career David Rice, DDS

A

braham Maslow once said, “In any given moment we have two options: to step forward into growth or step back into safety.”

I couldn’t think of a better time or place to share this with you than in this Spring issue of the Dental Entrepreneur Magazine. If you’re a D1, 2, or 3, for better or worse, I remember wondering if I was ready for that next practical, patient, or exam.

If you’re a D4, amidst my excitement, I remember wondering if I was good enough for the real world.

Before I get into how to get over imposter syndrome and wondering if you’re good enough, there are a few things you should know: First, imposter syndrome is not a new phenomenon. Sure, social media has blown it up into some fantastic phenomena young people suffer with in today’s world, but that’s just what social and traditional media do today. They seek our inner pain and use it to drive views and clicks. I promise you, your parents, grandparents, and great-grandparents all wondered if they were good enough at one or more points in their lives.

Second, 82% of the time imposter syndrome is reported by high achievers. That means you’re in really good company when you’re not sure of yourself.

Third, it isn’t actually a syndrome. It’s more a feeling that psychology teaches us can be overcome. Translation, when you’re ready to step into growth, read below:

LEARN THE REAL DEAL. If 82% of the people who report feeling like an imposter are high achievers, and you were listening to any of your friends in that 82%, what would tell them? I’m guessing if you’re anything like me, you’d share every amazing thing they’re doing and how they’re much more qualified than they think they are.

Admittedly, the system that is dental school today could better foster how you and I feel. Let’s be honest, our medical school counterparts have some pretty great feelings about themselves you and I don’t. That said, step one is you answering a few questions about you: • What facts do you have that support you being where you are?

• Where are you today compared to where you were one short year ago?

SHARE WITH YOUR INNER CIRCLE. Sharing with everyone on social media is a bad idea. Affirmation over information is a lot of why this feeling exists. Instead, I know you have an inner circle of friends who are walking this dental path with you. Get their feedback on the same 2 questions above and get ready to smile with what you hear.

BE BETTER, NOT PERFECT. In his book Personal Power, Tony Robbins uses the acronym CANI, which stands for Constant And Never-ending Improve-

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ment. Read the next two sentences twice. You do not need to be perfect. You just need to be a little better tomorrow than today.

Start tracking your progress from week to week and month to month. It’ll make answering those questions above a piece of cake by the end of the next semester.

FOCUS AND PREPARE. Life throws incredible distractions our way. The more you focus on what’s going well for you, the more you’ll realize there’s a lot going well.

Add to that your new CANI mindset and ask yourself what you can focus on that needs improvement. Maybe it’s one class.

Maybe it’s one clinical skill. After you’ve done what you normally do, give that area or two an extra 30 minutes of focus. It adds up.

ADD THE RIGHT MENTORS The right mentors have a few things you need.

• They’ve walked in your shoes and felt what you’re feeling.

• They’ve overcome it!

• They’ll help you with each step above on a regular basis.

If I could change one thing in my dental school and new dentist experience, it would be the circle of dental mentors I had. Seek people who are highly successful at exactly what you believe you’d like to do. Make sure they are invested enough in you to spend time with you every month. Ask them to be 100% honest with you, even when honesty adds work to your day.

Dentistry is an amazing profession. Stop worrying about being good enough. You are where you are because you’ve earned it.

Till next time,

David Rice, DDS, is on a mission to improve our profession by leading the next generation of dentists to grow successful lives and practices. The founder of igniteDDS, Dr. Rice speaks to over 35 dental schools and residency programs a year on practice building, team building and wealth building. Dr. Rice is a private practitioner, educator, author, and mentor who connects students, young dentists, and professionals from diverse dental-related businesses, “ fueling passion beyond the classroom.” ignitedds.com

THINGS TO DO, PLACES TO GO Dykema Conference

July 10-12, 2024 Gaylord Rockies Resorts Aurora, CO

CE on the Beach July 25-27, 2024 Aruba

RDH Under One Roof July 18-20, 2024 Gaylord Rockies Resort

ADHA Annual Conference July 26-28 New Orleans, LA

Nachos Dental Boost August 8-11, 2024 The Loews Hotel Philadelphia, PA

Productive Dentist Academy 20th Anniversary September 12-14, 2024 Frisco, TX

Pediatric Dental Growth Summit September 12-13, 2024 The Ritz-Carlton Maui, Hawaii

Dental Culture Con Oct 24-25, 2024 Miami, FL

We’d love to see you!

Dental Entrepreneur Spring 2024 37

DeW Spring 2024

De Winter 2024

Index of Advertisers America’s Tooth Fairy..............................................................................................................................................31 DeW Retreat...........................................................................................................................................................35 onDiem...................................................................................................................................................................21 Patterson Dental.....................................................................................................................................................2,3 Productive Dentist Academy...................................................................................................................................39 SupportDDS...........................................................................................................................................................15

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