Co-Editors
Amisha Singh, DDS; Allen Vean, DMD
Creative Manager Little Red Swing • littleredswing.com
Managing Editor Cara Stan
Printing
Dilley Printing
MDDS STANDING OFFICERS
President Janie Boyesen, DDS, DMSc
President-Elect Karen Foster, DDS
Treasurer Susan Kutis, DDS Secretary Bryan Savage, DDS
The Articulator is published quarterly by the Metropolitan Denver Dental Society and distributed to MDDS members as a direct benefit of membership.
Editorial Policy
All statements of opinion and of supposed fact are published under the authority of the authors, including editorials, letters and book reviews. They are not to be accepted as the views and/or opinions of the MDDS.
The Articulator encourages letters to the editor, but reserves the right to edit and publish under the discretion of the editor.
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MDDS reserves the right, in its sole discretion, to accept or reject advertising in its publications for any reasons including, but not limited to, materials which are offensive, defamatory or contrary to the best interests of MDDS. Advertiser represents and warrants the advertising is original; it does not infringe the copyright, trademark, service mark or proprietary rights of any other person; it does not invade the privacy rights of any person; and it is free from any libel, libelous or defamatory material. Advertiser agrees to indemnify and hold MDDS harmless from and against any breach of this warranty as well as any damages, expenses or costs (including attorney’s fees) arising from any claims of third parties.
The 2023 Rocky Mountain Dental Convention (RMDC) is the hallmark event for the Metro Denver Dental Society (MDDS), and I am grateful to say it was a success! It was wonderful to witness the hard-earned results of countless hours and maximum effort. I am humbled by the dedication and hard work of both the MDDS team and the army of volunteers who turned ideas and plans into reality. I would like to extend a special thank-you to Dr. Kyle O’Donnell, the Chair of the 2023 RMDC – his tireless commitment made success possible. Seeing more attendees, hearing about the top-notch quality of all of the education sessions, seeing the vitality of the Expo Hall and witnessing new and renewed connections are what made this year a success to me.
Dr. O’Donnell is a new volunteer with MDDS, which is why I was so impressed and thankful he was up to the task. Working with him also allowed me to take a trip down memory lane to when I first started as a volunteer for MDDS fifteen years ago. I had just moved to Denver, and started my first “real” job, when my office’s neighbor, Dr. Charles Danna, a past MDDS President, asked if I would be interested in volunteering with the local dental society. I thought this would provide a great opportunity to meet people, so I said yes (not fully realizing what I had said yes to) MDDS was holding its Applied Strategic Planning meeting and needed a member-at-large to participate. Two days of targeted and facilitated brainstorming and goalsetting was eye-opening, to say the least. One of the goals established was to launch a premier learning center to offer members quality continuing educational opportunities. What was even more eye-opening was when those plans came to fruition. I had just come from an academic setting, where progress happens at a slower pace. Witnessing our vision come to reality within a few short years was amazing.
I completed a research fellowship as well as a certificate in Periodontology because I love learning and being in a classroom – I wanted to continue learning, so I started volunteering at RMDC. I began as an Exhibits Host, then as a Speaker Host. I also started volunteering with the CE Committee for the newly formed Mountain West Dental Institute (MWDI), our dental education center that had emerged out of Applied Strategic Planning.
“Volunteering with MDDS has allowed me to learn so much about what happens in dentistry outside of the office —the business of dentistry, the politics of dentistry, the regulation of dentistry.”
Volunteering with MDDS has allowed me to learn so much about what happens in dentistry outside of the office – the business of dentistry, the politics of dentistry, the regulation of dentistry. It has allowed me to meet and befriend people I never would have met had I stayed within the confines of my office. And, it has made me a better leader within my practice – I apply what I’ve learned from board meetings to my staff meetings.
The Rocky Mountain Dental Convention is the result of teamwork united by a vision. Likewise, we can achieve so much with our profession, and for our profession, by working together to keep dentistry the rewarding profession I know it to be. Mother Teresa said, “Together we can achieve great things.” I believe in organized dentistry now more than ever, and we can achieve great things for dentistry when we work together.
After the whirlwind of RMDC in January comes our next Strategic Planning meeting in February, and I am looking forward to it! The members of this group bring a wealth, depth and breadth of dental and executive experience. I am excited to be part of a team that will engender ideas to help our profession and our members “achieve great things.”
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February 16, 2023 - Julián Conejo, DDS, MSc
Topic: Highly Esthetic Implant-supported Restorations with CADCAM: An update on the latest materials, workflows and techniques for 2023.
April 20, 2023 - Sang J. Lee, DMD, MMSc
Topic: Fixed implant rehabilitation and implant occlusion
June 8, 2023 - Miguel D. Vidal, DMD, MS
Topic: Selecting the Correct Implant Abutment DesignBeyond Ti-Base
September 7, 2023 - Yong-Han Koo, DDS
Topic: Robotics in Dental Implant Surgery: Safety & Precision
October 5, 2023 - Paul Chang, DDS
Topic: Management & Prevention of Peri-Implant Diseases
November 2, 2023 - Aldo Leopardi, BDS, DDS, MS, Prosthodontist
Topic: “Back to the Future”: a retrospective look at dental implant clinical complications and successes, with a view toward the future.
December 7, 2023 - Marcus Blue, DDS
Topic: Clinical advancements and predictability in bone grafting.
She is a woman. Red lipstick and stilettos may be her superpower or perhaps she favors her favorite pair of worn sneakers and a ponytail. Either way, she is a force to be reckoned with. She walks through the world, in many ways, making it turn, being a mom, a wife, a daughter, a business owner, a friend, a confidante, an advocate. She may run out of words before she runs out of hats she wears. Her determination is fierce. Her power is undeniable. But how many systemic barriers has she faced by the time she downs her breakfast smoothie and runs out the door? How many sharp corners has she maneuvered through the course of her life, silently and instinctively? Have you noticed the second skin she wears like a cloak, working so efficiently and navigating so gracefully, that the systemic inequities just fade like a shadow into the background?
This world was certainly not built for her. When it comes to anything from her clothes, to her car, to her razor, the product was not designed with her as the end user in mind. The clothing industry has influenced her relationship with her body for generations. She has yearned for pockets for most of this time. Christian Dior said in 1954, “Men have pockets to keep things in, women for decoration.”1 The crash test dummy used to proclaim the safety of the car she drives was likely outfitted to match the standard male build and size. She is 73% more likely to be injured in an accident than her male counterpart.2 By the time she reaches adulthood, she has seen tens of thousands of images which dictate how her body should look.3 She is three times more likely to have an eating disorder than a man.5 Her hips are too wide, her configuration all wrong, no matter if you ask the magazines she reads or the company that manufactured her car. She pays more for common essential items, a discrepancy known as the “pink tax” on everything from razors to deodorant and shampoo.4
At work, she gets paid 77 cents for every dollar her male counterpart earns.6 Only 12 countries in the world give her the same legal employment rights as
1. https://www.mic.com/articles/133948/the-weird-complicated-sexist-history-of-pockets
2. https://www.cnn.com/2022/12/15/world/female-car-crash-test-dummy-spc-intl/index.html
3. https://time.com/6098771/instagram-body-image-teen-girls/
4. https://www.marieclaire.com/politics/news/a15652/gender-inequality-stats/
5. https://centerfordiscovery.com/blog/get-the-facts-eating-disorder-statistics/
6. https://www.gao.gov/products/gao-23-106041#:~:text=For%20example%2C%20in%202021%3A,18%20 cents%20on%20the%20dollar).
7. https://www.humanrightscareers.com/issues/causes-gender-inequality/)
8. https://www.huffpost.com/entry/invisible-work-women-office_n_624c4effe4b0d8266ab18824
9. https://www.equalitycantwait.com/
a male.7 Nationally, she takes 10 times the amount of personal leave to care for family obligations and she spends an average of an extra two hours per day doing things like cleaning, carpooling, cooking, laundering, parenting, helping family and more. At work, she gets 44% more requests than her male co-worker to volunteer for “non-promotable” tasks at work and she says yes 76% of the time (compared to 51% of the time by men).8 All of this adds up to what is otherwise known as “invisible work.” She is underrepresented in government, in the C-suite and in leadership.4 She faces discriminatory hiring practices globally. When she retires, she is more than twice as likely as a man to live in poverty. Though her entire life, she is 35% more likely to be poor than a man.10
She pays twice as much on average for healthcare every year and yet faces poorer patient outcomes.11 She waits longer in emergency rooms, is seven times more likely to be misdiagnosed when having a heart attack, and is 60% more likely to die after being dismissed from the hospital due to errors in follow-up care.12 She experiences medication side effects twice as often as a man because drugs are designed for male bodies and women are disproportionately excluded from clinical trials.4 Cardiovascular disease, COVID-19, cancer, and reproductive health all have higher mortality rates for her because she is a woman.13 She is twice as likely to suffer from depression in her lifetime. Even her safety is more precarious; one in five of her have experienced rape or attempted rape in their lifetime.14 She also faces a higher incidence of sexual harassment, workplace violence, domestic violence, sexual exploitation and human trafficking.4 Globally, she has less access to education, is more likely to suffer from chronic hunger and starvation, and is more likely to be a child laborer. At the current rate of change, it is estimated that it will take over 200 years to achieve gender equality, just in the USA.9
And yet, she rises. She persists. She finds ways to thrive. But we owe her more. She is a woman. Hear her now. Her wellness can no longer be an afterthought. She stands before us, and she demands to be made whole. Let us start with the wellness of her mind, body and soul. Let us redesign this world so she finally belongs.
10. https://www.epi.org/publication/women-over-65-are-more-likely-to-in-poverty-than-men/
11. https://www.americanprogress.org/article/the-economic-educational-and-health-related-costs-of-being-awoman/
12. https://www.everydayhealth.com/womens-health/women-with-chest-pain-wait-longer-for-emergency-carethan-men/
13. https://www.uspharmacist.com/article/selected-womens-health-disparities#:~:text=Cardiovascular%20 disease%2C%20COVID%2D19%2C,further%20contribute%20to%20health%20disparities.
14. https://www.projecthope.org/women-carry-an-undue-mental-health-burden-theyshouldnt-have-to/05/2021/?utm_source=googlegrants&utm_medium=cpc&utm_ term=women%20health&utm_campaign=Paid&gclid=CjwKCAiArNOeBhAHEiwAze_ nKEWOsLdl5dzV9Agjv1PniMlRBOgzuCv7dHGwxqpdFMsCOeaYqtaJrBoCdKIQAvD_BwE
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More than 6,200 dentists, team members and vendors from 41 states and Canada came together at the Colorado Convention Center for the 115th Rocky Mountain Dental Convention. For three days, attendees learned from nationally-recognized speakers, connected with more than 200 exhibiting vendors and had fun at social events including the Sips & Shopping Happy Hours and Friday Night Dueling Piano Party. Join us next year in the Mile High City January 18 – 20, 2024!
Dr. Gretchen Bauer
Dr. Joshua Bender
Dr. Lane Bland
Dr. Chris Brett
Dr. Patricia M. Cabrera
Dr. Cuong Dao
Dr. Katherine Davenport
Dr. Blythe Ferguson
Dr. Anna Geving
Dr. Morgan Greve
Dr. Jessica Guter
Dr. Martha Ha
Dr. Aaron Hayes
Dr. Tedi Howell
Dr. Rose Line
Dr. Cara Maloney
Dr. Sanaz Merchi
Dr. Kim Myers
Dr. Son Nguyen
Dr. Amanda Pooler
Dr. Ines Quintanilla
Dr. Tathiana Rojas Lock
Dr. Ana Ruzo
Dr. Katherine Scholand
Dr. Abidin Tuncer
Dr. Shaina Wasser
In a culture that places a premium on success and accomplishment, it can be challenging to escape the pressure to be perfect. We run ourselves into the ground to avoid making mistakes, and when we do (because we’re human beings), we can’t help but feel like we’ve failed. Why didn’t I try harder?
DR. TIERAONA LOW DOG
Dr. Tieraona Low Dog earned her medical degree from the University of New Mexico School of Medicine. She has been invited to speak at over 600 scientific/medical conferences, authored six books and appeared on CNN and ABC’s 20/20. She is a frequent guest on the Dr. Oz Show and NPR’s The People’s Pharmacy.
I’ve always found how an individual handles their mistakes to be far more telling of their true character. In life, it’s about getting up, dusting ourselves off, owning our part, asking forgiveness when appropriate, and then moving forward with hearts open and heads high. It is through our response to life’s challenges that we truly embody our inner warriors.
In the wellness world, health is often equated with balance: eat a balanced diet, life-work balance, and a balanced lifestyle. While there is certainly a place for “balance” – the truth is that life is messy – something is always going to come along that knocks us off our center. That’s why the key to well-being may be more closely related to resilience than balance. Resiliency, from the Latin resilio, means to bounce back. When we are off balance when we shift off course, how quickly can we regain our center?
Living on this wild and beautiful land in northern New Mexico, I am constantly witnessing resiliency in action. We share this space with bears, mountain lions, coyotes, deer, elk, foxes, squirrels, groundhogs, raccoons, birds, and countless other creatures, giving us ample opportunity to observe the delicate balance between predator and prey. We have trail cameras that give us a feeling of closeness to the animals. We’ve even named all the bears, as they visit us daily. This kinship that allows us to share their land safely is one of the great gifts of my life.
But nature can be harsh. Like when Hercules, a new large black male bear, killed one of Zoey’s cubs (the other ran off) so that she would become receptive and able to mate before the summer was over. But Zoey fought hard for her cubs. Hercules’s victory was hard fought. Witnessing these sometimes-brutal ways of the natural world keeps
me in touch with the order of the universe. And it provides a valuable perspective, helping me accept the idea that death is a part of life. Connecting with nature lets me see the inner warrior spirit of the animal world and helps me understand what that means for my own fight.
I first discovered my resiliency when I began studying Tae Kwon Do, a Korean martial art, in Richmond, Virginia. It wasn’t long before I was training 15 hours a week. I watched as my body and mind were transformed, performing in ways far beyond anything I ever thought possible. Hundreds of sit-ups, pushups, front/ side/roundhouse/spinning heel kicks, blocking, punching, doing forms and sparring every day. I was surprised by how far I could push myself: beyond the exhaustion, strained muscles, and bruised shins. This was my first brush with finding my inner warrior—that spirit that drives us forward when we don’t think we can go on.
Martial arts taught me that I was the roadblock, that it was my limited belief in self that kept me from thriving. “I’m not strong enough, not flexible enough, not fast enough, not good enough.” NOT ENOUGH were words I had to learn to replace with “I AM” ENOUGH. When I learned to summon the warrior within me, I learned that my spirit was strong. And it would need to be.
In 2013 I was told that I had terminal cancer that had spread throughout my pelvis and into my liver. The oncologist said, “with treatment – a year, maybe less.” Wow. What do you do with something like that? Well, I underwent aggressive chemotherapy and radiation. It was hard. There were many moments I thought I would die. There were moments I thought death would be easier. The whole process was physically and psychologically brutal.
“Falling down is part of life. Getting back up is living.” —Anonymous
Now, more than six years into remission, I think about the great gift Cancer brought into my life. I learned to separate my feelings from my essence. I feel tired. And I am strong. I feel scared. And I am fierce. I feel sad. And I am blessed. I learned that my feelings come and go, but the essence of who I am is unshakable. Along with a deep and tremendous faith, I also recognize that all those years doing martial arts, honed my inner warrior, helping prepare me for some of my darkest days.
Plants can be powerful allies when it comes to building resiliency. Here are just two of my favorites.
Rhodiola, an herb of the far north; growing in dry, arid, cold places. Its roots give energy and strength to both the body and mind. Beloved by the Vikings, it is an herb of power. It is my go-to herb for those who are feeling tired, run-down or having difficulty concentrating. It’s an adaptogen, meaning it supports your body’s stress response.
Science suggests rhodiola may act as a botanical antidepressant, with one study showing it worked as well as the prescription medication sertraline (but with fewer side effects). I’ve found that rhodiola is wondrously helpful for patients with chronic fatigue syndrome and fibromyalgia, and it has even been shown to ease symptoms of a condition that’s affecting more and more of us—burnout.
Maca root has a history of use dating back more than 2000 years to the indigenous people of Peru, and it is still widely consumed in that region today. Another adaptogen,
• Cultivate healthy, mature relationships. We all need people we can turn to for help and who can turn to us for the same.
• Spend time in nature. Take a couple of 5-minute walks outside every day.
• Get organized. I have read and gifted to hopelessly disorganized friends both Sandra Felton's Organizing for Life and Organizing from the Inside Out by Julie Morgenstern.
• Make time for relaxation. Practice your breathing exercises every morning and night. Listen to soft, soothing music. Take a bath. Get a massage.
• Read something inspirational. The Book of Awakening by Mark Nepo and Thirst by Mary Oliver are two of my favorites.
• Get counseling if you are stuck. Cognitive behavioral therapy can help you reframe how you think about life.
• Make being active a part of your daily life. Join a yoga class, get a pedometer and work up to 10,000 steps a day, and stretch while you watch television.
• Write down one thing you're grateful for before bed. The grocery clerk who smiled at you, the spouse who made dinner or did the dishes, the child who loves you, or even the sun for shining. Practice gratitude.
• Eat healthy. Good nutrition will ensure your body is getting what it needs to function optimally. Take a multivitamin every day.
maca is prized for its ability to enhance endurance and build stamina, helping you face life’s obstacles with fortitude. In challenging times, maca can give you the strength you need to power through.
Aside from bolstering overall resiliency, maca may also improve sexual health. Researchers at the Depression Clinical and Research Program at Massachusetts General Hospital in Boston found that in women experiencing low libido as a side effect of prescription antidepressants, those who took maca reported significant improvements in sex drive. In addition, researchers are finding that maca has favorable effects on sperm quality and can help relieve menopause-related symptoms. Maca is all about vitality.
You were born resilient. No matter what you’ve been through or are going through, within you is the ability to overcome adversity. You have the strength to get through those days when nothing seems to be going right. When all you can see are your failures, and it’s hard to remember your victories. There will be those dark nights of the soul when your faith is tested, and your confidence is shaken.
During these difficult times, I encourage you to remember that it is through adversity that our character is shaped and formed. Avoiding or running away from challenges doesn’t give meaning to our lives, but discovering our values and virtues as we struggle through them does. When we’re forced to dig deep, we tap into reserves of power we never dreamed we had. Our inner warrior rises to meet us, and we’re able to face hardship with strength and grace.
It can be elusive. Yet, you know it when you see it. And, you know the feeling when you experience it. When it is present in an oral healthcare setting, a feeling of camaraderie and satisfaction is created among team members resulting in greater productivity. Patients can feel it also. What is the ‘it’ being referred to here? ‘It’ is leadership. And what do feelings have to do with it?
Feelings matter. Patients can rarely evaluate the quality of the dentistry provided. However, they usually know within the first visit whether they want to return. They also know whether they will be referring friends and family to you. Patients aren’t basing these decisions on the quality of the recently placed restorations or on the crown margins. They are deciding based on how they feel in the presence of you and your team, and that is impacted by the presence of leadership in your setting.
DR. TERRI TILLISS AND MS. LISA HINZ
Feelings are closely aligned with emotions. And emotions impact purchasing decisions. You may not often think of your patients as purchasers. They are indeed purchasing a service from you. Harvard professor Gerald Zaltman claims that 95% of purchasing decisions are driven by subconscious urges, of which emotion is the largest.1 Many decisions are not as logical as we might want to believe.
For example, when deciding about purchasing a new car, have you compared features like gas mileage and reliability and still bought the one that excited you or came in a color you loved, even if the statistics indicated that you should buy the other one? When we buy a new outfit is it because we don’t have clothes or because of the excitement we feel from the look, feel or design of the garment? We need to generate that same element of excitement and emotion in our patients and team to stay in our practices and to refer their families and friends.
As a dental student, you may not recall a curricular emphasis on learning leadership skills, however, the American Dental Association actually mandates it, and it was included in the curriculum Standard 2-19 of the Commission on Dental Accreditation Standards for Dental Education reads, “Graduates must be competent applying the basic principles and philosophies of practice management, models of oral health care delivery, and how to function successfully as the leader of the oral health care team.”2
Often leadership and management are viewed synonymously in dental settings, when in fact they are very different. The focus of leadership is on people, while management focuses on systems. Many dentists without confidence in their leadership skills abdicate by deciding to hire a very
competent office manager. While this individual is essential, being the leader in the office should not be part of the office manager’s job description. It is worth noting that leadership isn’t just the responsibility of the dentist. Leadership lies with everyone working in the dental setting. Each person has an opportunity to bring out the best by how they show up each day, through support, encouragement, positivity and effective communication. Each team member can exhibit leadership qualities that support the whole.
Leaders establish direction for their organization and inspire others to follow that direction to generate positivity and productivity. A beneficial outcome of such an influential leader is greater satisfaction of team members who want to remain on the job because they are growing and achieving mutual goals. When team members frequently move on to different employment because they aren’t motivated and don’t feel appreciated or empowered, the bottom line of the practice is impacted. The cost of frequent staff turnover is a financial and energy drain on you and the remaining team members, creating stress for everyone.
Has your team established a belief system and values and goals that serve your patients? This is critical because the success of organizations like a dental setting is predicated on their common set of values and beliefs. Team members need to buy into this set of common values. This underscores the necessity of a mission statement that defines these values and beliefs and ideally is created with contributions from the team. If you don’t currently have a mission statement that has been embraced by the team and communicated to your patients, the task of creating one can comprise your next several team meetings. You will want your mission statement to reflect the impact you desire for the
practice. Once developed, your mission statement becomes your guiding light. If decisions and practices that you consider incorporating down the road do not align with your mission, they should not be adopted. Be sure to display your mission statement, perhaps on a placard so that it is easily visible to both patients and the team.
While some people may seem to be inherently strong leaders, actually they may have learned these skills. One mustn’t be born with leadership skills to exhibit them. Strong leadership skills can be learned. Leadership researchers and experts, Kouzes and Posner have written several books with the goal of teaching others how to lead. These authors feel strongly that you don’t need to be a ‘born leader,’ but rather that leadership can be taught, studied, and practiced with excellent outcomes. Much of their work centers around five practices of exemplary leaders.2
1. Model the Way: Leaders set an example for others to follow utilizing interim goals enabling people to achieve small wins.
2. Inspire a Shared Vision: Leaders envision the future, creating an ideal image and believing they can make a difference. With quiet persuasion and passion, they help others to see these possibilities.
3. Challenge the Process: A constant quest for innovative ways to improve and change the status quo.
4. Enable Others to Act: Contributions of others are recognized which inspires further hard work and determination. Others are empowered to grow and achieve.
5. Encourage the Heart: Acknowledge feelings, celebration, and a sense of community and care.
“You don’t need to be a ‘born leader,’ but rather leadership can be taught, studied, and practiced with excellent outcomes.”
An effective way to assess one’s leadership skills is to complete what is called a 360 review. This tool allows various stakeholders in the leader’s orbit to rate a person on their leadership competencies. The raters, whose comments are provided anonymously, can include team members, peers, managers and even patients. Local leadership coaches can offer this 360 version of the Energy Leadership Index Assessment. Besides evaluating 36 leadership competencies, it also captures how an individual perceives and approaches work and
life. Being coached on these perceptions can be transformative for one’s relationships, confidence level and leadership skills.
A skilled leadership coach can be an invaluable asset for evaluating and improving leadership styles. Elevating and then improving the leadership quotient in your setting can increase the bottom line, support team camaraderie, and return that ‘feel good’ attitude to you and your patients. Don’t practice without it!
Dr. Terri Tilliss is Professor Emerita at the University of Colorado School of Dental Medicine where she was in the Dental Hygiene and Orthodontics Departments. She also taught patient communication skills to dental and medical students, publishes in the dental literature, and presents on a variety of related topics.
Lisa Hinz, CEO of The Confidence Track, offers assessments and leadership and coaching programs that focus on turning professionals into great leaders.
1. American Dental Association Commission on Dental Accreditation. Accreditation Standards for Dental Education Programs. Accessed December 23, 2022 at: https://coda.ada.org/-/media/project/ada-organization/ada/coda/files/predoc_standards. pdf?rev=20eabc229d4c4c24a2df5f65c5ea62c8&hash=B812B8A2FAF6D99F37703EE081B48E58.
2. Zaltman, G. How Customers Think: Essential Insights into the Mind of the Markets. Boston: Harvard Business School Press, 2003.
3. Kouzes JM, Posner BZ. From The Five Practices of Exemplary Leadership. San Francisco: Pfeiffer Wiley, 2003.
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KATIE THORNE, RDH, BS
Katie Thorne, RDH, BS practiced as a dental hygienist since 2011 in both private and public health settings. She is now a 3rd year DDS candidate at CU School of Dental Medicine.
She is the Advocacy Chair of the AAPHD CU Student Chapter and dedicates herself to increasing the number of first generation college graduates in dentistry. Outside of dentistry, Katie enjoys volunteering with animal welfare organizations.
As dental professionals, we play a unique and critical role in our pregnant patients’ team of healthcare providers. There is a consensus among medical professional groups that oral health contributes to a healthy pregnancy, delivery and infant.3 Despite this consensus, the majority of pregnant women in the US do not receive dental treatment.3 In order to rectify this situation, it is imperative we understand the causative factors. With data and knowledge about current guidelines, we can take concrete action to treat more pregnant women and positively impact pregnancy outcomes in our communities.
Research indicates the percentage of pregnant individuals receiving dental care is significantly lower than non-pregnant individuals.6 In fact, according to the American Public Health Association (APHA), just 46% of pregnant women in the US receive oral prophylaxis during their pregnancy.3 Furthermore, socioeconomically disadvantaged pregnant women and those without dental insurance are less likely to receive oral prophylaxis or other dental care.3
There appears to be several contributing factors leading to the low percentage of pregnant women receiving dental care.3 Low health literacy and cultural beliefs among pregnant patients and low cultural competency of dental providers are barriers to oral healthcare.3 Geographic location and lack of providers who accept Medicaid are additional barriers. Research indicates that a shocking 77% of OB/GYNs have patients who have been refused dental care by a dental professional due to their pregnancy status.3 According to the APHA, dental professionals may fear litigation or be unaware of or not understand the guidelines for caring for pregnant individuals.3 Furthermore, OB/GYNs often do not feel adequately trained to educate their patients on oral health and where to access dental care.3
Several of these barriers require large-scale industry changes, including better training in medical and dental schools and legislative changes at the state and federal levels.3 Fortunately, we can immediately ensure we are personally knowledgeable about the latest guidelines and recommendations regarding the treatment of pregnant individuals so we can confidently care for our pregnant patients. So, what are the current recommendations?
1. Oral prophylaxis: Routine oral prophylaxis is safe at any time during pregnancy.4 It is often most comfortable for the pregnant patient during the second trimester.4 There is a higher likelihood a pregnant patient will experience nausea during the first trimester making treatment difficult.8 During the third trimester, the patient may require a partially reclined position and turning slightly to their left side to avoid impingement of the vena cava by the uterus.8
2. Restorative, endodontic, and periodontal treatment and extractions: Treatment is considered safe at any time during pregnancy.5
3. Radiograph: Radiographs with abdominal and thyroid shields are safe at any time during pregnancy.5
4. Local anesthetic: The following local anesthetics with epinephrine may be used at any time during pregnancy: bupivacaine, lidocaine and mepivacaine.2
5. Nitrous oxide: As a category C drug, nitrous oxide is considered unsafe for use during pregnancy as there is a risk of fetal harm.2
In addition to reassuring our pregnant patients of the safety of dental care, we can provide education on how oral health contributes to their systemic health and the health of their child. Important topics to discuss with patients include:
1. Periodontal disease: Periodontal disease during pregnancy has been linked to an increased risk of preterm birth and low-birth weight.7 These conditions can lead to developmental dental defects such as hypoplastic enamel of the primary and permanent teeth in addition to the myriad of other health concerns associated with preterm birth and low-birth weight.7 The risk of preeclampsia and gestational diabetes mellitus also increases for pregnant women with periodontal disease.3
2. Caries: The vertical transmission of mutans streptococci can occur prior to the eruption of the child’s primary teeth.7 Fortunately, studies have demonstrated that pregnant individuals may reduce or even stave off the transfer of mutans streptococci to their infant by decreasing the level of the bacteria in their own oral microbiome.7 By treating decay prior to delivery, pregnant women can decrease their levels of cariogenic bacteria. Recommend pregnant patients use fluoride toothpaste and drink fluoridated water as well to reduce their caries risk.7 Pregnant women should also be counseled on the importance of an anti-cariogenic diet to reduce their caries risk.7
Before initiating care, motivational interviewing can be utilized to understand your patient’s priorities and goals.1 This allows our recommendations to be tailored to them.1 For instance, the patient may be especially concerned about pre-term birth because their last pregnancy did not reach full term. This information provides a segue to discuss the importance of oral health and positively reinforces the initiative they are taking to receive dental care during this pregnancy.
As a member of a pregnant person’s healthcare team, we must collaborate with the other members of the team. By establishing productive, working relationships with the OB/GYNs and midwives of our existing pregnant patients, we can provide safe, comprehensive oral healthcare and patient education consistent with the rest of the healthcare team. Consider reaching out to doctors and midwives in your area to establish a referral program
“Research indicates that a shocking 77% of OB/GYNs have patients who have been refused dental care by a dental professional due to their pregnancy status.”
early in a person’s pregnancy.1 A referral form indicating the safety of radiographs with proper shielding, appropriate local anesthesia and pain control, prophylaxis, and necessary dental treatment, patients can feel more at ease knowing their doctor or midwife approves and advocates for dental treatment. This also provides an opportunity for us to remind the medical team of the most recent recommendations and the importance of their patients’ dental care. Upon seeing the patient, positively reinforce their choice to seek dental care and reiterate why oral health is important for their health and the health of their unborn child.
In addition to in-office patient care, outreach to community organizations or programs such as WIC offices is another avenue to educate pregnant mothers on the importance of oral healthcare during pregnancy. As dental professionals, we also have a unique opportunity to advocate for pregnant
mothers and their children in government. We know that uninsured pregnant women are less likely to receive preventive dental care than their insured counterparts.3 Meeting with and informing our elected representatives of the importance of oral health and dental insurance can lead to state and federal legislation that can drastically improve the health of our community.
The data shows there is a lot of work to be done to provide equitable care for pregnant individuals. This is an opportunity for the dental community to effect positive change, including financial, both in our own practices and at the societal level. Armed with the latest guidelines and education, we can confidently treat our pregnant patients and form working relationships with OB/GYN teams to increase access and contribute to improved pregnancy outcomes for our patients and community.
1. American Academy of Pediatric Dentistry. Perinatal and infant oral health care. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2016:216-20.
2. American Dental Association. Pregnancy. Available at https://www.ada.org/resources/research/science-andresearch-institute/oral-health-topics/pregnancy. Accessed February 2, 2023.
3. American Public Health Association. Improving Access to Dental Care for Pregnant Women through Education, Integration of Health Services, Insurance Coverage, an Appropriate Dental Workforce, and Research. Available at https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2021/01/12/ improving-access-todentalcareforpregnantwomen?tag=makemoney082120#:~:text=Improving%20Access%20 to%20Dental%20Care%20for%20Pregnant%20Women,Research%20Date%3A%20Oct%2024%202020%20 Policy%20Number%3A%2020203. Accessed February 2, 2023.
4. Anita M. Mark, Pregnancy and oral health, The Journal of the American Dental Association, Volume 152, Issue 3, 2021, Page 252, ISSN 0002-8177, https://doi.org/10.1016/j.adaj.2020.12.009. (https://www.sciencedirect.com/ science/article/pii/S0002817721000179)
5. Committee Opinion No. 569: oral health care during pregnancy and through the lifespan. Obstet Gynecol. 2013;122(2 Pt 1):417-422. doi:10.1097/01.AOG.0000433007.16843.10
6. Muralidharan, C., Merrill, R.M. Dental care during pregnancy based on the pregnancy risk assessment monitoring system in Utah. BMC Oral Health 19, 237 (2019). https://doi.org/10.1186/s12903-019-0921-3
7. Ramos-Gomez FJ. Clinical considerations for an infant oral health care program. Compend Contin Educ Dent. 2005 May;26(5 Suppl 1):17-23. PMID: 17036540.
8. Scherer, S. (2022, October 27) Safely caring for pregnant dental patients. RDH Magazine. https://www.rdhmag. com/patient-care/article/14279348/safely-caring-for-pregnant-dental-patients
This is an opportunity for the dental community to effect positive change, including financial, both in our own practices and at the societal level.
ABOUT THE AUTHOR
Lexi Dunnells is a student of both dental medicine and public health at CU Anschutz. She has a background in teaching high school and is currently the president of the American Academy of Public Health Dentistry CU student chapter. As a future dentist, she is “determined to make an impact in promoting oral health equity and addressing the disparities in access to oral healthcare.”
My transition from teaching high school math to dentistry baffles most people. As different as these two careers may seem, they certainly have one thing in common: everyone loves to tell you how much they hate you.
“You teach math!? I HATED math as a kid, it’s the worst.”
“You’re in dental school? Ugh, I HATE going to the dentist! You must like hurting people.”
A cherished advisor of mine wrote in her letter of recommendation for me for dental school: “Between teaching math and pursuing dentistry, Lexi thrives on taking the things people fear and making them enjoyable.”
If you’re still baffled about why I would move from teaching to dentistry, we should talk about the other key thing these professions have in common: they present a tangible way to improve my community. As a dental student, I am mainly concerned with access to care. I have developed a study around this question. How can I make a visit to the dentist more enjoyable, less anxietyprovoking and, as a result, maybe—if I’m lucky— increase access to care while I’m at it?
There are barriers within each system and practice modality to access and utilization of dental services. One major barrier to oral healthcare utilization is dental anxiety: the apprehension that
occurs in anticipation of a dental situation.2 Many factors contribute to dental anxiety, including conditioning, cognitions (misperceptions, catastrophizing, dental beliefs), temperamental and personality characteristics, hypersensitivity to pain and social learning around dental experiences.2 When a patient experiences dental anxiety they are more likely to delay visits, then more likely to develop dental problems, and therefore more likely to only seek symptom-driven treatment, which further contributes to dental anxiety—a vicious cycle with which I’m sure you are all intimately familiar.
In order to find a way to interrupt this cycle, I developed a study to test the hypothesis that having a therapy dog chairside during the dreaded dental appointment might allow the patient to feel less anxious. There has been a recent uptick in the utilization of therapy dogs to help individuals manage anxiety as they navigate stressful situations. For example, there has been a limited number of studies on the impact of dogs on the rehabilitation of veterans with PTSD. While further research is needed, evidence from non-randomized observational studies suggests the utilization of dogs may be helpful in alleviating veterans’ PTSD symptoms and improving quality of life.6 If we could achieve a similar result in a dental setting, we could postulate that the same patient might not avoid or delay dental visits, allowing more access and utilization of preventive services and an increase in comprehensive care (as opposed to emergent care). This study was developed with the
hopes of transitioning a patient to view the dentist office as more of a primary care setting—a place more associated with health and less associated with anxiety—a dream many of us likely share.
This is where Ziggy comes in. Luckily for me, I have a therapy dog for a brother. He is an absolutely gorgeous Black German Shepherd and is also insanely smart (almost eerily so). My brilliant mother has spent the last several years training Ziggy extensively and he is now a certified therapy dog. Let’s pause and quickly differentiate between a service dog and a therapy dog. A service dog is intended to serve one person; these are the dogs you’re not supposed to pet. A therapy dog, on the other hand, is trained to serve everyone in their community. You can pet, interact with, and allow these dogs to comfort you to your heart’s desire. My mom and Ziggy bring his comforting talents to a variety of settings, including nursing homes, schools and a ranch for adults with special needs. There was just one thing missing from Ziggy’s resume: dental settings.
Luckily for Ziggy, he has a dental student for a sister. After a litany of logistical arrangements with the CU School of Dental Medicine, I brought my mom and Ziggy into the student clinics and tested my hypothesis. Here’s how it worked. There were two groups of patients: the intervention group, who got to have Ziggy sit with them during their appointment, and the control group, whose appointments were business as usual. Blood pressure and pulse were chosen to measure
“One major barrier to oral healthcare utilization is dental anxiety: the apprehension that occurs in anticipation of a dental situation.”
anxiety because anxiety causes the release of stress hormones in the body and these hormones trigger an increase in heart rate and a narrowing of the blood vessels, which causes blood pressure to rise.14 For both groups, before the appointment, the patient’s blood pressure and pulse were recorded. Throughout the appointment, the patient’s pulse was taken at 5-minute intervals. At the end of the appointment, the patient’s pulse and blood pressure were taken one more time.
The patients who had a therapy dog present during their appointment had a lower post-appointment pulse (M = 64.50, SD = 13.959) compared with the control patients (M = 76.00, SD = 8.992).
Additionally, the patients who had a therapy dog present during their appointment had a lower postappointment systolic blood pressure (M = 131.50, SD = 26.667) compared with the control patients (M = 136.75, SD = 11.399).
Subsequently, a paired t-test was performed in order to determine if a statistically significant difference in pre- and post-measurements was identified. The post-appointment pulse measurements for the intervention group (therapy dog present) were significantly lower (M = 63.20, SD = 12.691) than their pre-appointment pulse measurements (M = 72.50, SD = 13.930), with p < .001.
In summary, when Ziggy was present, the patients’ pulses decreased enough over the course of the appointment to be highly statistically significant. When Ziggy was sitting with the patients, the patients' pulses even remained steady throughout the administration of local anesthetic. Patients who had Ziggy with them during their appointment also had a lower average pulse and lower average systolic blood pressure compared to the control patients.
So, if you’ve thought about bringing a dog into your office because you like dogs or because it sounds fun, now you have some evidence to back it up. You’re welcome.
1. Lin, C.-S., Wu, S.-Y., & Wu, L.-T. (2015). The anterior insula and anterior cingulate cortex are associated with avoidance of dental treatment based on prior experience of treatment in healthy adults. BMC Neuroscience, 16(1). https://doi. org/10.1186/s12868-015-0224-9
2. Randall, C. L. (2021, June). Mental Health in Oral Healthcare general overview + the case of dental fear. Person Centered Care. Aurora, CO; University of Colorado School of Dental Medicine.
3. Rodriguez, K. E., Bryce, C. I., Granger, D. A., & O’Haire, M. E. (2018). The effect of a service dog on salivary cortisol awakening response in a military population with posttraumatic stress disorder (PTSD). Psychoneuroendocrinology, 98, 202–210. https://doi.org/10.1016/j.psyneuen.2018.04.026
4. Randall, C. L., & McNeil, D. W. (2014, May). Fears and beliefs about pain and dentistry predict treatment-seeking behavior. Poster presented at the meeting of Association for Psychological Science, San Francisco, CA.
5. Hoisington, A. J., Billera, D. M., Bates, K. L., Stamper, C. E., Stearns-Yoder, K. A., Lowry, C. A., & Brenner, L. A. (2018). Exploring service dogs for rehabilitation of veterans with PTSD: A microbiome perspective. Rehabilitation Psychology, 63(4), 575–587. https://doi.org/10.1037/rep0000237
6. Stumbo, S. P., & Yarborough, B. J. (2019). Preliminary evidence is promising, but challenges remain in providing service dogs to veterans: Commentary on preliminary efficacy of service dogs as a complementary treatment for posttraumatic stress disorder in military members and veterans (O’Haire & Rodriguez, 2018). Journal of Consulting and Clinical Psychology, 87(1), 118–121. https://doi. org/10.1037/ccp0000352
7. Høyvik, A. C., Lie, B., & Willumsen, T. (2018). Dental anxiety in relation to torture experiences and symptoms of post-traumatic stress disorder. European Journal of Oral Sciences, 127(1), 65–71. https://doi.org/10.1111/eos.12592
8. Vincent, A., Easton, S., Sterman, J., Farkas, K., & Heima, M. (2020). Acceptability and Demand of Therapy Dog Support Among Oral Health Care Providers and Caregivers of Pediatric Patients. Pediatric dentistry, 42(1), 16–21.
9. Cencirulo, J., McDougall, T., Sorenson, C., Crosby, S., & Hauser, P. (2020). Trainee experiences of racism, sexism, heterosexism, and ableism (the “ISMs”) at a Department of Veterans Affairs (VA) healthcare facility. Training and Education in Professional Psychology. https://doi.org/10.1037/tep0000312
10. Hausmann, L., Hanusa, B. H., Kressin, N. R., & Ibrahim, S. A. (2010). Perceived Racial Discrimination in Health Care and its Association with Patients' Healthcare Experiences: Does the Measure Matter? Ethnicity & Disease.
11. Woolgrove, J., & Cumberbatch, G. (1986). Dental anxiety and regularity of dental attendance. Journal of Dentistry, 14(5), 209–213. https://doi.org/10.1016/03005712(86)90003-5
12. Nieto, V., Arnett, M., & Furgeson, D. (2019). Attitudes and Access Patterns of Michigan Veterans Ineligible for Oral Healthcare Benefits: A cross-sectional study . The Journal of Dental Hygiene, 93(4), 6–13.
13. Corah, N. L., Gale, E. N., Illig, S. J. (1939). Assessment of a dental anxiety scale. Journal of the American Dental Association, 97(5). https://doi.org/10.14219/jada. archive.1978.0394
14. https://ibcces.org/learning/what-is-the-link-between-anxiety-and-high-bloodpressure/#:~:text=Anxiety%20causes%20the%20release%20of,pressure%20to%20 rise%2C%20sometimes%20dramatically.
We often get asked how to calculate the practice EBITDA (Earnings Before Interest Tax Depreciation and Amortization). Here is a simple guide to help you determine this for your practice.
Practice's Total Collections - Overhead - Dentist Compensation at FMV = EBITDA
If a practice's total collections are $1,200,000, and the overhead is $840,000, the net income equals $360,000. And if the doctor's compensation is $288,000 then the EBITDA is $72,000.
Practice's Total Collections are the total practice collections (not production).
Overhead typically includes staff wages, staff benefits, supplies, office expenses, staff contract labor, telephone, computers and IT services, postage, merchant services, advertising, uniforms, laundry, lab, rent, NNN or CAM, personal property tax, etc.
Operative Production is the cost of what you would pay an associate doctor to perform the operative production in the practice.
In our example, we take the practice’s total collections of $1,200,000 and subtract the practice overhead (this includes fixed and production expenses) of $840,000 to get a net of $360,000
Overhead does not include the following: owner's wages, associate wages, family wages, travel, auto, meals and entertainment, continuing education, professional memberships, or any other expense that a buyer would not have to assume to continue conducting business in the same manner.
Next, we subtract the cost of what you would pay an associate doctor to perform the operative production in the practice. So, if your hygiene production is 20% or $240,000 and your operative doctor production is 80% or $960,000 then you pay a doctor 30% of collections ($960,000*0.30) = $288,000
Take your net income less doctor wages to get your EBITDA | $360,000 - $288,000 = $72,000
(303)
We hope this example is helpful. Please reach out if you need an opinion of value or appraisal for your practice if you are considering selling in the next 1-5 years.
“Selecting someone to assist with the transition from a dental practice of 48 years is a difficult decision. I can't think of a more capable person than Marie Chatterley to handle this process. It was reassuring to me that she had the answers to virtually all my concerns. Her experience made me completely comfortable with the process. I will be forever indebted to her.”
Ivan Naiman D.D.Scdaonline.org/wellness
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What drew you to a career in dentistry? As a girl, I loved arts, crafts, painting and creating anything where I could skillfully use my hands. I was an art major in high school in Germany and loved all areas of design. I have always paid a lot of attention to detail. At the same time, I was interested in the medical field and wanted to help people become and stay healthy. Dentistry best combined these areas of passion for me. Once I did an internship in the dental field, it became clear dentistry was the right career choice for me.
How do you balance running a successful dental practice and recharging with your family? This is a million-dollar question, and I don't have the perfect answer to it. What helped me the most was deciding there was no such thing as a perfect work/life balance. Some weeks are better (more balanced) and some weeks are worse (less balanced). There is so much that is out of our control, but if we do our best and are honest with ourselves and others, people will appreciate us, and we feel more at ease. As a mother and a business owner, I must always multitask. I try my best to take care of many things at any given time, but I often carry guilt when I can’t be everywhere I need to be. It helps to have close friends and colleagues who struggle with the same challenges, and who can share experiences and advice. It is crucial to have an organized schedule, a support network and a backup plan. Flexibility is key, though this is a tough trait to master for many of us Type-A dentists. My life runs on a schedule, and it’s not all work. Family and fun times are scheduled too! That way, I can make time for things that are important to me.
Are there any strategies you can share that have worked in creating a positive and uplifting work environment for you and your dental team? The most important thing for me is to care. I care about my team and my patients, about their well-being, about what kind of practice I have and how we treat people. I try to lead by example and encourage my team and my patients to practice the same level of care I do. This is a guiding principle at Pearl Dentistry, and I think it’s the biggest reason patients are comfortable coming to our practice and entrusting their dental care to us. Professionalism, honesty and customer service are mandatory, and because these traits are becoming more difficult to find, treating people like they are family and with respect goes a long way. We also have fun together. I try to hire team members who have a positive outlook on life and a welcoming personality. We hold regular office team meetings, but we also meet for activities outside of the office. It brings us together as a work family.
More than half of graduating dentists are now female, what if any impacts do you think this will have on the future of dentistry?
There is data showing how female dentists, on average, earn less than their male counterparts, and are less likely to own their own practices or to specialize and advance slower in academic dentistry than men. I know many
female practice owners, specialists and successful female dentists in all areas of dentistry. I believe that female dentists can achieve whatever they desire in our profession. However, for women who want children and families, this may be more challenging as it is difficult to do it all, and even more difficult to do it all very well. In my experience, this is why mothers, on average, work fewer hours and are more often part-time. Of course, this is not true for everyone, and great quality, private practices owned by women will persist.
What are some unique challenges women dentists face in the industry? How have you addressed those? This goes along with what I mentioned above about trying to balance a work and family life schedule: being an excellent practitioner, caregiver, business owner, leader, on task at all times while also being the mother and wife you want to be. It's very busy, and our profession is both physically and mentally demanding, which can drain you.
Dentistry historically has been a profession with more women (support staff) than men, and more male dentists than female. This is changing with the increase in female dentists. Having an office full of women can be a challenge in and of itself. When I considered going into dentistry, I knew many practices with male dentists who had mostly female support staff and wives/partners at home taking care of the family. This of course is a more traditional set-up than the one I, and many of us mothers and practice owners have today. I feel very fortunate to have a team that supports me and each other, and I believe that I have worked hard at creating a cohesive "office culture." Of course, not everything is in my control, so there is always a bit of luck involved.
MARCH 4
CDA & MDDS Women in Dentistry
Upstairs Circus DTC
5370 Greenwood Plaza Blvd, #106
Greenwood Village, CO
11:00am – 2:00pm
MARCH 16
Learn to Lead - A Women
Dentists Webinar
Ms. Ricki Braswell, CAE
Virtual Interactive Lecture
6:30pm - 7:30pm
APRIL 11
CPR & AED Training
CPR Choice
Mountain West Dental Institute
925 Lincoln St Unit B
Denver, CO 80203
6:00pm – 8:30pm
APRIL 21
Botulinum Toxins (Xeomin, Dysport, Botox) and Dermal Fillers Training,
Level 1
American Academy of Facial Esthetics
Mountain West Dental Institute
925 Lincoln St Unit B
Denver, CO 80203
8:00am – 5:00pm
APRIL 22
Frontline TMJ & Facial Pain Therapy, Level 1
American Academy of Facial Esthetics
Mountain West Dental Institute
925 Lincoln St Unit B Denver, CO 80203
8:00am – 12:00pm
MAY 5
Laser Bacterial Reduction
Ms. Joy Raskie
Mountain West Dental Institute
925 Lincoln St Unit B
Denver, CO 80203
8:00am – 12:00pm
JUNE 3
MDDS Zoobilee
Denver Zoo
2300 Steele St Denver, CO 80205
11:00am – 1:00pm
= HANDS-ON EVENT
JUNE 9
Nitrous Oxide/Oxygen Administration Training
Dr. Jeffrey Young
Mountain West Dental Institute
925 Lincoln St Unit B
Denver, CO 80203
8:00am – 4:00pm
If you’re considering buying a higher-cost or luxury home, your best mortgage option could be a jumbo loan.
– Low down
Beaux Selznic
Mortgage Loan Office
3 03- 39 4- 7 075 o ffice
3 0 3 -588 -5101 c e beaux.selznick@usbank.co
N ML S # 59 5 3 2 3
CEREC Cad/Cam System for Sale. Practicing dentist is retiring, and has the following equipment for sale:
• Densply Sirona Omnicam AC Acquisition unit – software: 5.3.1: Original purchase price: $47,750
• MCXL Milling Unit w/2 motors and Densply Custom Cabinet : Original purchase price: $59,332
• Ivoclar Programat CS Oven : Original price: $9,630 This system is currently in use, in excellent working condition, and has been updated and maintained periodically by Patterson Dental Denver. Contact Dennis L. Burgner, DDS, MAGD at (303) 910-2100 or DrBurgner@yahoo.com for more information.
General Dental Practice in Denver, CO (CO 2213). Collections of $190K. This could be a Chart Sale or Practice sale. The practice occupies 1,700 square feet and consists of 4 operatories + 2 additional Ops opportunities. Price $95,000. For more info email: jed@adsprecise.com or call 303-875-8500.
Collecting $1.58M! Loyal Team willing to stay on with practice transition!! Price $995K. 6 opts, 2,000 square feet, private business offices, CBCT, New Technology CEREC, Digital Scanners, Tissue Lasers, and 3D Printer, Management centers for easy access, and much more! High visibility in a wellestablished strip mall business center. Good lease and longevity. Owner retiring but is willing to help with smooth transition. Motivated Seller. For more info email: jed@adsprecise.com or call 303-759-8425.
General Dental Practice in Downtown Denver, CO (CO 2207). Great location! Collections of $385K. The practice occupies 1,287 square feet and consists of 3 operatories. The office also includes a reception area, business area, private doctor’s office, lab, sterilization area, staff lounge, and two bathrooms. It is equipped with 10 air-driven highspeed handpieces, 1 Dexis sensor digital x-ray, 1 digital pano x-ray, vacuum pump & compressor, and 6 networked Windows computer workstations. Price $260,555. For more info email: jed@adsprecise.com or call 303-759-8425.
General Dental Practice in Southwest Denver, CO (CO 2202). Great location! Collections of $1,1M Practice occupies 1,550 square feet and consists of 5 fully equipped operatories. Potential for an additional 1,600 sq ft adjacent to this office. Dr relocating. Price $462,000. For more info email: jed@adsprecise.com or call 303-759-8425.
Beautiful OMS Practice in Boulder County, CO (CO 2128). Collections $861K, 4 ops w/ room to expand, 1,865 square feet, Sales price $440K. Don’t miss out! Established GP referral base & less $ than a startup. Great Opportunity & Price! Excellent location, Dr. retiring. ADS Precise Transitions, 303-759-8425 or jed@adsprecise.com.
Great opportunity to own Established General Dental Practice & Building in South Colorado Springs / Pueblo Area (CO2127). Collections $325K, 3 OPS with opportunity for 2 additional OPS. 2,300 square feet. Located in a lovely bedroom community setting and operates on a short work week. Patient draw is from the front range and central mountains. Practice Price is $199K + Dental Office Building $400K. Dr Retiring. For more information, please call 303.759.8425 or email jed@adsprecise.com.
General Dental Practice in Southwest Denver, CO (CO 2201). Great location! Collections of $1,1M Practice occupies 1,550 square feet and consists of 5 fully equipped operatories. Potential for an additional 1,600 sq ft adjacent to this office. Dr relocating. Price $600,000. For more info email: jed@adsprecise.com or call 303-759-8425.
General Dental Practice for Sale in Colorado Springs (CO 2124). Great opportunity to acquire and established a well-established practice in a great location. Collections $450K, 3 OPS. Dr. Retiring. Practice Building is also for sale with practice. For more information, please call 303.759.8425 or email jed@adsprecise.com.
OMS of Sale in Highly desirable Boulder County, CO (CO 2122). Annual Collections $1.7M, 3 ops, Professional building, 1,800 square feet, Sales price $895k. Great Opportunity & Price! Established customer base and much less expensive than a startup. Office Condo also for sale. Excellent location, Dr. retiring. ADS Precise Transitions, 303759-8425 or jed@adsprecise.com.
General Practice for sale in North Central Colorado (CO 2121). Occupies 1,100 square feet and consists of 3 fully equipped operatories. Doctor works two and half days a week. The office also includes a reception area, lab, sterilization area, staff lounge and a bathroom. The practice produces $510K in collections. For info contact jed@adsprecise.com or call 303.759.8425.
Great Opportunity – 30+ year established orthodontic practice for sale in excellent location of highly desirable Boulder County, Colorado (CO 2116). Collections of $400K. Sales price $199K. Tech is up to date including an iTero Element imaging system. Located in a Dr. owned 4-plex & occupies 1,400 square feet with 4 chairs. Room for expansion. Doctor is retiring. For information email: jed@adsprecise.com or call 303-759-8425.
GP for Sale: Colo Springs (CO 2010). Don’t miss out on this well-established general practice that is well-postured for growth. Located in a highly desirable area of Colorado Springs. Current collections are $319K with 3 OPS and 1,682 sq ft. Doctor works 3 days a week/ 20hrs. Lots of room for Growth! Very attractive lease terms. Sales price $199K. Doctor is retiring. For more listings visit www.adsprecise.com.
Great Price for Perio practice for Sale: North of Denver Metro area (CO 1909 ). Annual Revenues $500K, 3 Ops, 1,323 square feet. Only $165K— much less than building out. For more information, please contact jed@adsprecise.com or call 303.759.8425. For more listings visit www.adsprecise.com.
GP for Sale: Northeastern CO (CO 1735). 4 Ops, approx. $900K in collections, Stand-alone bldg. sold w/practice. Dr. retiring. For more information, please contact us at jed@adsprecise.com or call 303.759.8425. For more listings visit www.adsprecise.com.
Be an ally for someone suffering from tooth pain and contemplating pulling a tooth because of the cost of a root canal. We are offering root canal treatment for the price of an extraction ($102).
It’s a benefit for everyone. For your patients, they are saving their natural teeth while relieving pain. For you, it is optimizing treatment planning and timely intervention to address patients’ oral health needs and goals. Dentists looking to refer patients to this program can do so by emailing: sdmreferral@ucdenver.edu with promo code: ENDO21 .
