New Dentist Winter 2011 by The New Dentist

THE #1 JOURNAL FOR NEW DENTISTS

Marketing

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FROM THE PUBLISHER’S DESK W I N T E R 2 0 11

Dear Readers,

PUBLISHER

Sally McKenzie Sally@thenewdentist.net

Welcome to the winter issue of The New Dentist™ magazine.

DESIGN AND PRODUCTION

arketing. It’s a word that brings to mind many things, such as special promotions, events, advertisements, catchy radio jingles, and much more. Years ago, it was not uncommon for dentists to shun the idea of marketing as if it were something you “just didn’t do.” Indeed, those were different times. Today, marketing is not only embraced by dentistry, it is a critical ongoing system in every successful new and existing dental practice. In this issue, you’ll learn that budgeting for marketing is something that must be a priority. After all, new patients don’t know about you, the fabulous services you offer, and the wonderful state-of-the art equipment you use, unless you tell them. We tap into the great minds from two of dentistry’s top full-service marketing companies and share what they believe are the “must have” essentials in branding and marketing your new practice. Additionally, find out what clinicians from around the country have to say about the whitening products they use in their practices. Turn to page 16 and learn why they chose the products they did, how patients like them, and the impact whitening services have had on their new practice marketing efforts. Also in this edition, Dr. Louis Malcmacher, one of dentistry’s leading educators and lecturers, shares insights into where he sees the future of dentistry and what new dentists should be doing today to prepare their practices for the next 20-30 years of success. And don’t miss New Dentist™ columnist Dr. Josh Austin’s take on all ceramic crowns. Once dismissed as inferior, these have become the “darlings” of cosmetic dentistry. Finally, don’t stop here. Take a moment to visit www.thenewdentist.net and discover a wealth of FREE information and materials to guide you at every step throughout your dental career.

Fondly,

Sally McKenzie, Publisher

visit www.thenewdentist.net #1 Web-site for New Dentists 2 WWW.THENEWDENTIST.NET W I N T E R 20 1 1

Picante Creative http://www.picantecreative.com MANAGING EDITOR

Tess Fyalka Tess@thenewdentist.net SALES AND MARKETING

For display advertising information contact ads@thenewdentist.net or 877.777.6151. Visit our digital media book at www.thenewdentist.net/ mediabook.htm The New Dentist™ Magazine is published quarterly by The McKenzie Company (3252 Holiday Court, Suite 110, La Jolla, CA 92037) on a controlled/complimentary basis to dentists in the first 10 years of practice in the United States. Single copies may be purchased for $8 U.S., $12 international (prepaid US dollars only). Copyright ©2011 The McKenzie Company. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical without permission in writing from the publisher. Authorization to photocopy items for internal or personal use is granted by The McKenzie Company for libraries and other users registered with the Copyright Clearance Center. Disclaimer – The New Dentist™ does not verify any claims or other information appearing in any of the advertisements contained in the publication and cannot take responsibility for any losses or other damages incurred by readers’ reliance on such content. The New Dentist™ cannot be held responsible for the safekeeping or return of solicited or unsolicited articles, manuscripts, photographs, illustrations, or other materials. The opinions, beliefs, and viewpoints expressed by the various authors and contributors in this magazine or on the companion website, www. thenewdentist.net, do not necessarily reflect the opinions, beliefs, and viewpoints of The New Dentist™ Magazine or The McKenzie Company. Contact Us – Questions, comments, and letters to the editor should be sent to Tess@thenewdentist.net. For advertising information contact ads@thenewdentist.net or 877.777.6151. Visit our website at www. thenewdentist.net to download a media kit.

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TABLE OF CONTENTS

WINTER 2011

FE AT U R ES

Marketing the New Dentist Practice

10 The Perfect Practice Location Scott McDonald, McDonald and Associates

There, Done That: 14 Been Guru Urges New Dentists to Consider Clinical Efficiency

Products 16 Whitening Open Door for Production and Profits

Tess Fyalka, Managing Editor

Ceramic Crowns, Can They 20 All Take the Pressure? Josh Austin, DDS

is Live Oak Bank Doing 24 What for Today’s New Dentists?

DEPARTMENTS 2 Publisher’s Desk 26 Dental Students:

What’s on Your Mind?

32 Skinny on the Street 32 Index of Advertisers

32 4 WWW.THENEWDENTIST.NET W I N T E R 20 1 1

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Marketing the New Dentist Practice

isit Amazon.com and look up marketing. You’ll find nearly 650,000 electronic or paper books to choose from. It’s reflective of the fact that when it comes to this particular topic, there are millions of pages of suggestions, tips, advice, and “expert” recommendations. Certainly, much of the information is good … and much of it isn’t, particularly when it comes to marketing the dental practice. Why? As you’ve likely discovered, dentistry is a little different. The dental practice isn’t Best Buy or Walgreens. Traditional marketing approaches, such as a smattering of ads, aren’t effective or economical over the long-term. And, we are sorry to say, there are no “silver bullets” that will guarantee success if you just “do this” – whatever “this” new trend might be on any given day. The fact is, marketing is a critical ongoing system in the dental practice. It is the cornerstone for attracting new patients and keeping existing patients interested in your 6 WWW.THENEWDENTIST.NET W I N T E R 20 1 1

services. Moreover, it is an investment in the present and future of your practice. It requires continuing action, a defined annual budget, and careful monitoring. The question is: How do you ensure that you are effectively marketing your practice to achieve the greatest return on this essential investment? Read on. We recently sat down with representatives from two marketing companies, Affordable Image Dental Marketing and Practice Cafe, to get their take on marketing for the new dentist’s practice. These two are among the very few companies that actually specialize in full service dental practice marketing. Most importantly, they understand the unique challenges that dentists face every day, and they have some good advice for new dentists seeking to make the most of limited marketing dollars. While the breadth of their marketing knowledge could fill a few of the better marketing books, we’ve captured four of the fundamental “rules“ here. CONTINUED ON PAGE 8 >>

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bucks – don’t we all. It is virtually guaranteed that unless he is a professional website designer you will waste valuable time, money, and patient traffic. continued from page 6 Invest in a design that is unique to Online Marketing your practice, not a template, and Establish Your Brand Marketing Budget According to Mike Shoun, owner of make sure that you will Affordable Image Dental Marketing, it own the domain name. Train all begins with branding. This is the “Some companies, Your Logo identity of the practice. It is the logo Team particularly those that or visual image that is unique to your specialize in website office. It conveys to the public that design templates, will offer to buy this is your dental practice. Along with the logo and the domain name for the doctor. The name for your practice, there are the other fundamenproblem is the company then owns the tals that will be consistently used as part of your practice domain and will not release it to the doctor. image, including the colors and fonts that are chosen as Consequently, the doctor is paying a large part of the name and logo. The objective is to design a look fee every month for that company to host the and use it consistently. For example, McDonald’s restaurants practice’s website; over a few years the doctor has paid twomay be independently owned but they are all part of one to-three times what they paid for the original design of the immediately recognizable franchise. And each one promotes site, and they still don’t own it,” emphasizes Mr. Shoun. the brand using the company colors and images that RULE #2 – Invest in a professionally designed and fully everyone knows to be McDonald’s. optimized website and make certain that you – not the “Too often we find dental offices use multiple companies website company – own it. to design their ads, website, brochures, mailers, folders and each one looks like it’s promoting a different practice. The Marketing: Investment not Expense foundation of all marketing is consistency of the brand or the Marketing dollars are as important, if not more important, look of the practice,” emphasizes Mr. Shoun. The brand is than many other practice expenditures because they bring in the recognizable image that current and prospective patients the patients that pay for everything else. High-tech equipidentify with your practice. When the image is inconsistent, ment alone will not bring in patients unless the patients it muddies the identity of the practice and the prospective know that the dentist has it. And that requires marketing. A patients’ perceptions of the practice. beautiful office will not be seen by very many people unless RULE #1 – Establish a consistent look for the practice and those in the community know that this is a beautiful, stateuse it on all practice materials and promotional pieces. of-the-art office, and that requires marketing. You may use the very best equipment and materials. You may be among eMarketing 24/7 the few to offer specific services but that won’t bring patients Brian Liddard owns Practice Cafe. He notes that a good to your door. It is marketing that brings in the patients. And practice website – not just any website – is the foundation it is patients that keep the practice going. for establishing and building a marketing presence online “Marketing can be thought of as an invitation to a party. or eMarketing. “A website works for your practice 24 hours No matter how great the party is, if no one knows about it, a day, seven days a week. Many consumers will visit your it will be a bust. Successful dentists realize the great return website prior to calling your office, so you should have a on investment that marketing can yield, and they budget website that not only looks professional but also provides significant funds for it,” explains Mr. Liddard. a good ‘user experience,’” says Mr. Liddard. Just be careful How much is enough? “For startup practices or practhat your “really cool” website doesn’t annoy visitors. He tices that want to market and grow aggressively, 4-6% of urges dentists to pass on music, dialog, or videos that autoprojected production should be allocated for marketing. matically load. Users prefer to have a choice in whether they Our typical dentist budgets $30k to $50k for the first year. want to activate those features. For established practices, 3-4% of projected production Additionally, websites require professional design to should be allocated. Our typical established dentist budgets ensure that they are fully optimized and drive traffic to your $20k to $40k per year,” notes Mr. Liddard. site. It may be tempting to have your nephew – tech savvy New dentists commonly assume that because they have as he may be – design your website. You want to save a few CONTINUED ON PAGE 22 >>

Marketing

8 WWW.THENEWDENTIST.NET W I N T E R 20 1 1

KHENG GUAN TOH/SHUTTERSTOCK.COM

THE

PERFECT PRACTICE

LOCATION

“THERE ARE TWO PRIMARY COMPONENTS IN FINDING THE PERFECT PLACE TO PRACTICE.”

tudents and residents are often chomping at the bit to FINALLY get out and start making money. But where to go? They want to jump into that great blue ocean and start swimming, but the current doesn’t quite seem right. As they visit family during holidays they will sometimes drive by a new retail area. The new Wal-Mart is being built where only an empty field was growing fallow last year. Signs proclaim that a new bookstore, building supply, and office equipment store are being built. They see a proposed professional office park will be just across the street. “I have found the perfect place to practice, but I won’t be done with school and the boards for at least a year!” they rage in frustration. “All the good spots are being taken!” And so, they have to wonder if someone else is moving into that prime practice location. And it is almost certain that someone has already got the location in his/her sights. There are two primary components in finding the perfect place to practice. Sure, we want to remember the “Location, Location, Location” mantra of placing a practice. But the forgotten component is “Timing, Timing, Timing.” Before getting into this topic, I have to admit that I am the first to say that no one can know everything. Data can be imperfect. As much as we

10 WWW.THENEWDENTIST.NET W I N T E R 20 1 1

BY SCOTT MCDONALD

would like to pretend that we know everything, we have to admit that we don’t. But we do know something. And what we know is that the profession of dentistry, profitability of practices, values of offices, and the potential for success is terrific in some places and not so great in others. The trick is being able to answer two questions: • Where? • When? It is absolutely knowable where people are moving. We know where people are working. We know where there are not enough dentists to satisfy the demand. Believe it or not, that is not really the hard part for demographers. The real heavy lifting comes from knowing WHEN this is happening. As we consider Northern Virginia (in the Washington, DC metropolitan area), it was not hard to guess when one political party was in control of both houses of Congress and the White House that there would be a significant movement toward new housing and, therefore, greater opportunities for dental practices. While generally true, this doesn’t CONTINUED ON PAGE 12 >>

Scott McDonald is owner and president of Scott McDonald & Associates, Inc., the largest provider of demographic information and analysis to dentists in the U.S. www.DoctorDemographics.com (800) 424-6222

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The Perfect Location continued from page 10 help someone who is graduating from dental school next year or who is considering a move upon the sale of a practice. In short, it is nice to know about yesterday’s news, but what about tomorrow’s? For this reason, reading what the trends of society are is vitally important for your success in the future. Dental practices do not “win or lose” based upon national trends. They often don’t owe their success or failure to statewide trends. The local trends in conjunction with all of the other trends in the economic environment are of much greater importance. That is why we believe that it is unwise to place so much emphasis upon “the big picture” when considering the future of a particular dental practice. It is the little picture that is most important. And the truth is that there are issues of timing that are relevant to “the little picture” that is local, which trumps the “big picture,” which is much larger than a practice area. So, not only is the best location to practice going to have strong local indications, so is the timing of opening a practice in a particular location. It is sad to say that we see practices get into trouble not because the location wasn’t wonderful in terms of the demographic character of the population, visibility, and price. They had problems because of their timing. For example, no matter how

In locations that are in decline due to a population that is leaving, this may be obvious. With fewer people to serve, the doctor considering the purchase of a practice will have plenty of warning signs. These signs that read “For Lease” on abandoned properties are the obvious ones. But there are other signs that the timing of a practice with a particular model may not be right. These signs are often found in the changing of the demographic character of a community. To consider two locations that fit this model well, we have to look at Saint Petersburg, FL

“The local trends in conjunction with all of the other trends in the economic environment are of much greater importance.” wonderful the potential patient base might look in terms of education and income, if there are not enough of them who are likely to seek care at this particular location, no practice model will save it. Sometimes the practice management model was just not right for the people who are living or working near the office to support it NOW. The irony is that the new owner of the practice (assuming the founding doctor could sell it) may do remarkably well because his/her timing is better. It almost always happens that the targeting is better as well. And here is the cautionary note regarding the purchase of an existing practice: timing counts. 12 WWW.THENEWDENTIST.NET W I N T E R 20 1 1

and Long Island, NY. The population has not been reduced in the last 10 years. But the demographic character of the population in terms of age, income, ethnicity, and educational level may have changed dramatically. A practice of 20 years may still be thriving. But it may be quite a different practice from the one that was started two decades ago by a bright and motivated dentist. If we are asked the question, “Is a practice in this location viable?” the answer will probably come back, “Yes.” Even when all the “classic” factors of population size, competition ratio, and age distribuCONTINUED ON PAGE 30 >>

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Guru Urges New Dentists to Consider Clinical Efficiency Dr. Louis Malcmacher is not an easy person to catch. As one of dentistry’s leading educators and lecturers, he is frequently traveling the country and the world to share his extensive knowledge and experience. Dr. Malcmacher publishes The Common Sense Dentistry Newsletter, which is sent to more than 10,000 dental professionals each month. He is president of the American Academy of Facial Esthetics, and he maintains a private dental practice in Cleveland, Ohio.

r. Malcmacher has been coaching and educating dentists for 30 years on best practices, integrating new services into the dental office, and improving clinical efficiency and practice management skills. He also works closely with dental manufacturers as a consultant and clinical researcher in developing new products and techniques. Dr. Malcmacher has been featured in numerous interviews in national media, including CNN, Fox, ABC, CBS, NBC, and the popular show 20/20; as well as The Wall Street Journal, The New York Times, USA Today, The Washington Post,

patients. Endodontic continuing education is essential. This is an area of dentistry that will serve a new dentist very well over the years. Implant dentistry is another area that is just going to continue to grow. Start on simple cases and build your way to more complex cases. As the cost of implants continues to come down, more patients are going to be able to afford implants and will be asking for them. Implants will be part and parcel of every dental practice for the next 30-50 years. Additionally, I believe that facial esthetics with Botox and dermal fillers, while somewhat new to dentistry now, in a few years will be commonplace. The American Academy

“IMPLANTS WILL BE PART AND PARCEL OF EVERY DENTAL PRACTICE FOR THE NEXT 30-50 YEARS.” and countless more. Paparazzi glitz and glam aside, this dentist is all business when it comes to sharing his recommendations and advice for new dentists. After all, in 1981, upon graduating from Case Western Reserve University School of Dentistry, he too was just beginning what would become a wildly successful career. Here’s what Dr. Malcmacher advises for new dentists seeking to make the very most of their years in the profession. Without hesitation, he emphasizes that continuing education is critical to ongoing practice success. “Every new dentist should become proficient in the new procedures and techniques that will last their entire careers. Hands-on continuing education courses are a must and preferably with live

14 WWW.THENEWDENTIST.NET W I N T E R 20 1 1

of Facial Esthetics has already trained over 5,000 dental professionals in this area, and it is the fastest growing part of dentistry right now.” In addition, Dr. Malcmacher notes that busy families are looking to do business with service providers that make things easy for them. “Flexible hours are essential so that working people can come in before or after work, and they can bring their kids in after school. And dentists need to think carefully about making their practices truly patient-centered. When you consider that over 60% of dollars spent on dentistry are spent on elective services, as competition among practices increases, it’s going to become tougher to compete CONTINUED ON PAGE 18 >>

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few years back, reality TV shows such as Extreme Makeover and The Swan were wildly popular among viewers who dreamed of having cosmetic surgery’s elite transform them into Angelina Jolie look-alikes in just one television season. Individuals would volunteer to have an extreme Hollywood-style makeover or be transformed from the “ugly duckling” into a beautiful swan. One of the most emotional scenes in the series was the moment the contestants saw their spectacular new smiles. For dentistry, it was a turning point. A hundred years of patient education couldn’t do what one season of Extreme Makeover did for public perception of the profession. For the first time in dentistry’s history, patients were demanding services in droves. The general public was finally beginning to understand and appreciate what dentistry had to offer. The floodgates opened and seemingly overnight virtually everyone wanted a whiter and brighter smile. Dr. Bill Dorfman, the original cosmetic dentist on Extreme Makeover, introduced the world to Zoom!® whitening. Crest and Colgate brought the public at-home, low-cost whitening strips. Since then, several products have entered the dental marketplace as demand has soared. Today, whitening techniques are a staple in

16 WWW.THENEWDENTIST.NET W I N T E R 20 1 1

BY TESS FYALKA, MANAGING EDITOR

the new dentist’s practice. There is a product to fit virtually every practitioner and every patient. For Dr. Chris Parsons, a 2008 graduate of the University of Maryland, it’s Perfecta-Rev! “I’ve been using it for about two years. It’s a powerful at-home whitening product, and patients are very happy with the results. They are supposed to use it for two weeks straight, but even for those patients who only use it for four or five days, they see results. It takes only 15 minutes and the patients appreciate how fast it works.” In Dr. Parsons’ Phoenix, MD based practice, which is about 30 minutes north of Baltimore, offering free whitening to patients has been an essential marketing tool. “We are driving a lot of our new patient flow with this product. New patients are looking for value and when we are offering it for free, they feel that they have nothing to lose.” What’s more, he notes, it opens the door to treatment for many patients. “We get a lot of patients who come in and haven’t been to the dentist in five or 10 years. They want their teeth to look better, but they have active dental disease. We need to eliminate perio concerns or remove decay before we can proceed with the whitening. That opens the door to treatment that patients wouldn’t have pursued if they didn’t come in for the whitening. They will get the free whitening, but we want to make sure the patient’s teeth are healthy first. Patients understand that. Compliance is pretty high when they are motivated to take care of the other problems first.” Dr. Parsons acknowledges that in the current economy it is not uncommon for patients to pursue recommended treatment in phases, but a significant

percentage of them do pursue care, and he attributes that to the fact that they want the free whitening even if they don’t get it on the first visit. “You have to create value for patients. As the new guy on the block, I have to compete with all of the established practices. Many dentists are not good at marketing. They might place an ad in a newspaper or magazine or radio, but if patients don’t see the value in making the appointment, they won’t.” Dr. Trenton Buchanan began using the KöR® Whitening Deep Bleaching™ the first day he opened his practice two years ago. This 2006 University of Alabama at Birmingham, School of Dentistry grad started his practice from scratch in November 2009. “I started using it right when I opened. I read a lot on DentalTown and I would always read Dr. (Rod) Kurthy’s posts, (Founder of Evolve Dental, and creator of KöR® Whitening Deep Bleaching™). I knew I wanted that product in my practice. I want the best technology, equipment, and materials. And nobody around me is using it, so it helps my practice stand out.” Dr. Buchanan has found the system achieves excellent results and patients are thrilled with their smiles, but he acknowledges that there was a learning curve in getting the best impression. “The better the impression is the better the results will be. The first patient that I tried it on, I took

the impression six times. I felt so bad. I was trying to open a new office. I was trying to learn new techniques. I had a million other things to do. I actually contacted Dr. Kurthy, and he took the time to email me and give me feedback on my impressions and pointers about how to improve the process.” After overcoming the initial impressionmaking hurdle, Dr. Buchanan says he’s had no trouble since. He notes that one of the best aspects of working with the KöR® Bleaching is the results that Tetracycline patients can achieve. “I find that these patients don’t want veneers but they want to do something, and they are the most compliant patients. They follow the protocols exactly. And they are so happy when they see the results because it changes their lives.” He says that on occasion, patients do experience some sensitivity, but Dr. Buchanan notes that the desensitizer that comes with the product works well. And, in some cases, the treatment protocols can be adjusted to further manage sensitivity issues. Since opening his practice, Dr. Buchanan says he has taken advantage of opportunities to talk on local television about deep bleaching. In addition, he writes about the topic regularly on his blog. He also advertises deep bleaching online and through direct mail promotions. He finds that there is a great deal of interest, and it has set his practice apart.

Dr. Buchanan also uses the Opalescence at home whitening products for patients who are interested in brightening their smiles, but either do not need deep bleaching or do not want to invest the time and money in a deep bleaching system. “Some people can achieve great results without deep bleaching, especially younger patients who may just want their smiles to be a few shades lighter. They’ve had pretty good luck with the Crest White Strips, but they want to take it to the next level.” Additionally, he says that the at-home products oftentimes are a good introduction to whitening for patients and can lead to greater interest in investing in deep bleaching down the road. Dr. Ben Gerkin of Tulsa, OK, has been using the at-home Opalescence products for seven years, which was when he graduated from the University of Oklahoma College of Dentistry and opened his own practice. Although Opalescence can be offered as an in-office service, Dr. Gerkin prefers the at-home product. He notes that with any whitening product it is essential to manage patient expectations. “I try to be honest with them about what they can expect. Some patients are going to respond better to a whitening product than others will. We have to take a lot of factors into consideration. In some cases, the patient isn’t achieving the results because they aren’t following the procedures correctly.”

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Clinical Efficiency continued from page 14

for those dollars. One way to set your practice apart is to become truly patient-centered. That means making things as easy as you can for the patient. The financial plans and treatment financing options need to be easy. It should be easy to schedule an appointment. The staff must be friendly and helpful. The easier, more pleasant, and more convenient for patients you can make working with your office, the better off you will be and the more likely your practice will grow.” Dr. Malcmacher urges new dentists to look for products and instruments that will make them more clinically efficient. “I look for anything that will make me and my dentistry faster, easier, and better. The V3 Matrix Ring by Triodent will help you breeze through posterior composite restorations. And I could not live without Gaenial Universal Composites by GC America. You can use this product in every restoration. Every dentist should have a diode laser and the Picasso Diode AMD Laser is the most affordable one on the market. Also, you really want to be known as the gentlest dentist in the area. The DentalVibe Injection comfort system

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helps eliminate the pain of an injection.” While websites, You Tube, and social media are all the rage, when it comes to building a new practice, Dr. Malcmacher says there is no substitute for pounding the pavement. “Get involved in your community. Volunteer to speak at the local elementary school, the rotary club, the senior citizen center. Pass out toothbrushes with your practice name on them. These presentations will take about 15 minutes and are great for getting your name out there.” For more information about Dr. Malcmacher and the American Academy of Facial Esthetics, visit www.FacialEsthetics.org or contact Dr. Malcmacher directly at drlouis@facialesthetics.org.

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ALL CERAMIC CROWNS, Can They Take The Pressure?

BY JOSH AUSTIN, DDS

orcelain fused to metal crowns was considered esthetic dentistry during my tenure as a dental student. All ceramic crowns were only whispered about in hushed tones by prosthodontists who considered them a “poor choice of restorative material.” As we all know, this viewpoint is beyond antiquated in today’s private practice world. People want restorations

PHOTO COURTESY OF IVOCLAR VIVADENT, INC

the 1970s and are responsible for giving all ceramic crowns the reputation of being fragile. In the late 1980s, we began to see all ceramic restorations evolve with some of the high fusing ceramic materials. These materials were somewhat stronger but lost some of their esthetics in the high firings. The more times a porcelain is fired, the more the value is lost. These crowns began to show more shades of gray and became less desirable as the esthetics disappointed. Today, we have reached further evolutions in our porcelain materials. Low fusing ceramics enable ceramists to create highly esthetic restorations much more easily. In addition, the evolution of zirconia has given clinicians multiple options regarding material selection. Concurrent evolution with

“IN MY PRACTICE AND IN MANY OTHERS, ALL CERAMIC CROWNS HAVE REPLACED PORCELAIN FUSED TO METAL CROWNS.“ that look like natural teeth. While this is technically possible with porcelain fused to metal restorations, all ceramic restorations are much more likely to achieve a natural look. In my opinion, a solid foundation in all ceramic restorations is essential to practicing dentistry today. Like almost everything in dentistry, all ceramic materials have evolved and improved drastically in recent years. And their utilization has increased exponentially. It is almost impossible to read a dental magazine without seeing several advertisements for all ceramic materials. This all ceramic explosion could not have been better timed, as the market for gold has risen to the point that dental gold is cost prohibitive. Originally, all ceramic crowns were achievable with solely feldspathic porcelain. While these feldspathic porcelain crowns were extremely esthetic, they were also extremely fragile. These types of restorations date back to 20 WWW.THENEWDENTIST.NET W I N T E R 20 1 1

resin bonded cements have also given dentists the ability to enhance the strength of ceramics after insertion. New materials hit the market daily, making it more important than ever for dentists to stay on top of changes in materials. As of this article’s publication, the two most popular all ceramics are lithium disilicate and zirconia. Each of these Dr. Josh Austin is a 2006 graduate of the University of Texas Health Science Center San Antonio Dental School. After working as an associate, Dr. Austin opened his own practice in 2009. He is a regular columnist for The New Dentist™ magazine and website. He can be reached at jaustindds@thenewdentist.net or http://thenewdentist.net/clinicalBuzz/.

What is your opinion of all ceramic crowns? Tell Dr. Austin. Blog on at www.thenewdentist.net/clinicalblog.php.

materials has strengths and weaknesses, so it is important that restorative dentists make informed decisions regarding which material to select. While zirconia restorations took hold of the market in the mid 2000s, lithium disilicate has roared in over the past five years and now seems to dominate dentistry. Lithium disilicate restorations strengthen the porcelain by adding reinforcing particles for strength. This takes the esthetics of traditional feldspathic ceramics and enhances the strength to increase the materialâ&#x20AC;&#x2122;s indications and uses. The big name in lithium disilicate is Ivoclarâ&#x20AC;&#x2122;s e.Max. e.Max itself is a brand name that encompasses several different materials including feldspathic porcelain, zirconium, and lithium disilicate. The lithium disilicate variations of e.max are e.max CAD and e.max Press. The CAD product is obviously milled out of a solid block of lithium disilicate either in a clinicianâ&#x20AC;&#x2122;s office or at a laboratory. The Press product is a laboratory only restoration. Both e.max CAD and Press are considered monolithic restorations. This means the restoration is fabricated out of one solid layer of material, unlike a porcelain fused to metal crown. Lithium disilicate restorations have become extremely popular for several reasons. They are extremely esthetic and

ceramics. There is no glass matrix in zirconia, just densely sintered zirconium oxide. This material is extremely strong but is not as esthetic as other forms of ceramics. Computer aided milling is the only way to fabricate zirconia restorations. Zirconia was introduced to the market as a coping and framework material with more esthetic feldspathic porcelains veneered over it. Lava & Procera Zirconia were and still are prominent brand names of this type of restoration. Recently, we have seen the stronger lithium disilicate ceramics used as the veneering material instead of feldspathic porcelain. The newest use of zirconia involves using it as a monolithic material to full contour. Bruxzir would be an example of this type of restoration. Esthetics and polishibility have been limitations for zirconia. There are now more shades of zirconia available; however, there are not nearly as many shades available as the other ceramic systems. While I would expect this to improve over time, I am not sure that zirconia will ever be able to compete with lithium disilicate when it comes to esthetics. Moreover, a drawback to zirconia is the inability to bond it to tooth structure predictably. Historically, any zirconia CONTINUED ON PAGE 28 >>

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can beautifully mimic natural tooth structure. In addition, they are very strong. At a compressive strength of 400 MPa, few fractures have been reported. Anecdotally, I have placed over 125 of these restorations in the past two years and have had one fracture. One contributing feature to their strength is the ability to bond these restorations in place with resin cement. Using porcelain etch and silane, lithium disilicate can be bonded to enamel and dentin. This also allows more conservative preparation than traditional materials. As with lithium disilicate, there are multiple formulations of zirconia based restorations. Unlike lithium disilicate, zirconia is distinctly different structurally from traditional

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Marketing

continued from page 8

a large family or are active in their church these individuals will be the new patients that sustain their practices. “They don’t think about the fact that may be 20-50 people. They didn’t do the math to determine how many new patients they need each month to make payments on the practice, pay the staff, pay themselves. Marketing is an investment in the success of your practice. If you cut the marketing budget or have an insufficient budget you are cutting the flow of patients to your practice,” explains Mr. Shoun. Without patients there is no practice, plain and simple.

Rule #3 - Invest in your practice. Create a budget for marketing and follow-through.

Train the Team to Realize the Dream It’s a secret that Walt Disney himself realized years ago. “You can dream, create, design and build the most wonderful place in the world, but it requires people to make the dream a reality,” he said. The same holds true for your spectacular dental practice. All the pieces are in place. The brand is well established. The website is up and running. You are ready for the marketing campaign to begin. But is your staff? Too often dentists, both new and established, will invest thousands in marketing efforts only to have them utterly destroyed by untrained and ill-prepared staff. The team must be trained to handle the phone calls effectively. Both Practice Cafe and Affordable Image Dental Marketing record practice phone calls during a marketing campaign. The reality is that far too many dentists have no idea what their staffs are telling patients. For the dental employee, the phone is typically viewed as a constant interruption to more important job duties. Few realize the powerful impact this “annoyance” has in marketing the practice for better or worse. Dentists, meanwhile, commonly view the phone duties as perfunctory. It rings, someone answers it, schedules an appointment, and that’s it. Then there’s the patient. This is their introduction to the practice. How they are treated in that first phone call will directly affect their decision to make and keep a scheduled appointment. It is not uncommon for scenarios like the following to unfold when a prospective new patient calls a practice that is staffed with an unprepared, untrained team. Mrs. Prospective Patient calls because she recently received some interesting marketing materials about a practice not far from her home. The mailer says that the doctor is taking new patients. So she picks up the phone to get more information. “The marketing

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did exactly what it should do in that it got the patient to call the practice. The problem is that the employees are not trained and are not prepared. Doctors cringe when they hear taped conversations between prospective patients and their staffs. It’s a huge eye opener,” emphasizes Mr. Shoun. He notes that it is common for new patients to experience situations such as this one. The phone rings at least five times before someone finally picks it up or it goes into voicemail and the prospective patient has to wait for a call back. If someone picks up, it’s likely the greeting will be an unenthusiastic “Doctor’s office.” It’s common that the employee won’t identify herself, the name of the office, nor ask how she can help the caller. The first impressions are horrible, but typically the patient will push on. Oftentimes it’s a mom trying to schedule appointments for herself and her children. She tells the employee, “Yes, I’d like to schedule an appointment for me and my children.” The employee sighs and asks the caller if she is a patient. The caller responds that she is not but she received a flyer in the mail indicating that the doctor is taking new patients, and she needs to schedule appointments for her family. Sadly, in many, many cases the new patient phone call goes from bad to worse. The employee oftentimes responds in a very discouraging tone telling the prospective patient that the schedule is booked up for weeks if not months or ticking off the laundry list of office policies, or putting the patient on hold indefinitely while s/he tends to other things. “There are no protocols established for how to handle the phone calls. The employees treat the phone as a nuisance, and while the marketing effort got the phones to ring, the lack of training of the staff sabotaged the effort,” says Mr. Shoun. Weak practice systems can derail an expertly designed marketing campaign in no time. Staff that are not trained to answer questions effectively or routinely send phone calls from new patients into voicemail can be a huge road block for dentists. Advertising and promotions can get the phones ringing, but whether the patient makes the appointment and proceeds with treatment will be directly influenced by the effectiveness of other key practice systems. “It is critical that doctors examine those systems and determine if the team is truly prepared to ensure the campaign’s success,” emphasized Mr. Shoun.

Rule #4 – Train your team so that they are effectively marketing your practice from the first phone call and in every patient interaction thereafter.

For further information on marketing for your practice visit www.affordableimagedental.com or www.practicecafe.com.

What is Live Oak Bank Doing for Today’s New Dentists? The New Dentist™ magazine recently spoke with representatives of Live Oak Bank about what they are doing to help new dentists. Senior Loan Officer Keith Merklin notes that now is an excellent time to build or expand the new practice. “Commercial property values are the lowest in decades. And in an effort to assist small businesses, the U.S. government has increased tax deductions. Aside from these economic factors, at Live Oak Bank, we understand the challenges unique to dentistry because we have lenders who focus solely on practice financing for dentists. Similar to Dr. Steven Beuligmann’s experience, which he has shared below, we can help new dentists consolidate debt, restructure existing loans, and can come up with creative solutions to allow you too to own your dream practice.” Dr. Steven Beuligmann of Carlsbad, California recently completed a practice expansion project with the help of Live Oak Bank. Here’s what he has to say about the experience.

You had established a successful practice but wanted to change your location to a larger facility. Why? My practice was originally located in an old office complex; it was small and antiquated with no room to expand. There was no space for new equipment, parking was inadequate, and there were too few operatories to meet our patients’ needs. We found we were occasionally turning away emergency calls because we had no place to treat the patients. So overall, I found my practice potential was limited unless I could find a way to upgrade my systems and increase traffic flow. But because I live in a small beach community, ideal locations were typically taken by residential zones or smaller office complexes with similar limitations. About 2-1/2 years ago, a new complex in downtown Carlsbad became available but sat vacant because of the recession. It was exactly what I was looking for; it offered large office spaces, abundant parking, and was close to the freeway and downtown area. However, the cost was quite high, and I was unsure I could get financing. What was the biggest obstacle in obtaining financing? I already had existing practice debt for various equipment and practice purchases, so I was only able to contribute a small down payment. I worked with a professional mortgage broker to find a local bank that might be able to help me. However, no matter how they ran the numbers, the interest rates offered made my payments unaffordable, and the amount of down payment required was out of reach. In addition, it was difficult to find an appraiser who understood the true cost per square foot of building out a 24 WWW.THENEWDENTIST.NET W I N T E R 20 1 1

modern, attractive dental office. Appraisers are often looking at shopping mall build-outs and typically appraise the cost at $100 per square foot. But this is completely inadequate if you want to create a modern, attractive environment for your patients with contemporary wallpaper, flooring, and design features. Costs can be closer to $150 to $175 per square foot, and some banks are uncomfortable with this level of investment.

How did you solve your financing challenge? I was directed to Live Oak Bank, which not only provided financing but made the loan process a pleasurable experience. They understood the marketing benefit of developing an attractive practice, and saw that my record of consistent growth was collateral they could rely on. So, rather than creating hurdles for me to overcome, they worked with me on finding solutions. They were genuine partners and shared my goal of building a successful dream practice. What did you find most daunting about building out the space for your new office? Surprisingly, the build-out itself was mostly fun because of the great team I had. The SBA loan paperwork was the most daunting aspect of the project as I had to gather volumes of documentation for SBA approval. But the team at Live Oak always had a positive, helpful attitude and made the whole process manageable. They consistently helped move the process forward. How is your new practice working out for you? It’s a dream come true! The new office is modern and gorgeous and provides a pleasurable working environment for both my staff and patients. Our equipment and systems are more efficient, so we’re able to process more patient visits and offer more comprehensive services. With our increased efficiencies, we have been able to keep our fees consistent without impacting cash flow, which is much appreciated by our patients. We are able to take in emergency clients at any time because of our additional space. And we’re able to do all this with the same size staff. CONTINUED ON PAGE 28 >>

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DENTAL STUDENTS: What’s on Your Mind?

Pacific and UCSF Students Clean Up San Fran

n a spirit of partnership and in support of the environmental health of the Bay Area, student representatives from the city’s two dental schools recently gathered along the San Francisco bay shoreline at India Basin to clean up the water and rid the shoreline of plastic pollution and other debris. Working with Sea Scavenger Conservancy, whose mission is to support the health of marine ecosystems and people, students from University of the Pacific, Arthur A. Dugoni School of Dentistry and University of California, San Francisco

visit www.thenewdentist.net #1 Web-site for New Dentists 26 WWW.THENEWDENTIST.NET W I N T E R 20 1 1

School of Dentistry partnered together in a day of community service. Students involved in American Student Dental Association (ASDA) coordinated the volunteers for the event. More than 20 students from the two schools met on the morning of Saturday, Aug. 13 to clean up the trash in a water recreation area used by local children. After the volunteers finished the clean up, children went kayaking in the bay and enjoyed a BBQ on the shore as part of an organized outing. In affiliation with ASDA, a Northern California Community Outreach Coordinator is elected for each academic year to serve as an ambassador between the Dugoni School of Dentistry and the UCSF School of Dentistry. The goal of the coordinator is to bring the dental schools together through organized,

community-oriented events. This year’s coordinator is Kristen Hann, a Class of 2012 student at Pacific. “It was nice to spend time with the UCSF students to support such a great cause,” commented Hann. Is your dental school involved in a volunteer project? Tell us about it. Email tess@ thenewdentist.net. Reprinted with permission from the University of the Pacific, Arthur A. Dugoni School of Dentistry. Dental students, tell us what’s on your mind. Email Managing Editor Tess Fyalka at tess@thenewdentist.net. We want to hear from you.

“

My great idea? Put patients at ease by spending as much time with them upright

”

in the chair as reclined.

Dr. Danny Lee Upland, California Graduate, Tufts University School of Dental Medicine Residency at UCLA ADA member Offering CareCredit since 2010

“Dentistry is not just about fixing teeth that need attention. It’s about caring for the person attached to the teeth. That’s why the amount of time I spend with patients reclined in the chair doing dentistry is directly proportionate to the time I spend with them upright—talking about what they want for their oral health, past experiences and any concerns they may have. I ask them, ‘what can I do to make this an exceptional experience for you?’ and then make sure we exceed those expectations.”

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is still the restoration of choice for short, worn, or high functioning teeth, all ceramic restorations can be reliably and predictably used on anterior and posterior teeth.

Ceramic Crowns continued from page 21

based restoration must be cemented in. If resin cement was used, it would not bond to the zirconia at all. There is considerable research underway in this area. Dr. Nassir Barghi at University of Texas Health Science Center San Antonio Dental School has been working with Bisco to formulate zirconia primers that would allow for bonding. I have yet to see any publications regarding bonding to zirconia; however, zirconia primers are available for purchase. In my practice and in many others, all ceramic crowns have replaced porcelain fused to metal crowns. In my opinion, e.max Press combines the strength, ability to bond, and esthetics better than any other material. While cast gold

visit www.thenewdentist.net

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Live Oak Bank continued from page 24

What do you recommend to new dentists thinking about starting their own practice? Your collateral and income may be limited when you’re first starting out, but be careful to not lock yourself into a practice setting that will not allow you to grow. Even if you can only equip half of your operatories at first, consider opting for a larger space that you can grow into. Continued growth is what helps you stay competitive and successful. Also, work with a practice lender who understands the dental business and is flexible in helping you meet your needs. The best bank for you may not be your local bank. Live Oak Bank is based across the country from me in North Carolina, but the distance has never been an obstacle for our working partnership. For more information, visit www.liveoakbank.com/dentists.aspx.

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The Perfect Location continued from page 12 tion are considered, the location may be appropriate for a practice. But is the timing right for a practice transition at this time? And can ANY dental practice model thrive in this period in the economic cycle? At this writing, there is a trend among certain households in the U.S. to put off large cases. This group prefers getting single tooth treatments and keeping very close to what their dental insurance will cover. That is the “economic weather” for this patient base. If a motivated, young doctor wants to open a practice with a high overhead and the latest, most expensive equipment, and cutting edge diagnostics, we believe that in THIS community, he may have a hard time. That does not mean that in three years this same motivated, young doctor won’t do brilliantly in this same location. But the approach mentioned seems to run counter to what the “economic weather” is telling us. True, the “economic climate,” which takes in a far longer time-period, may say that this is the best approach

for this same population and may say this is sheer brilliance. But unless the motivated, young doctor can hang on through the economic weather pattern, he will probably be selling his equipment for pennies on the dollar to someone whose understanding of the timing may be superior. On a last note, the thought that “all the good places are taken” is silly. In demographics, we have a term called “churning.” A population may not be growing or shrinking but it is changing (or churning). New trends are emerging. New wants and needs are being discovered all the time. The wise young doctor will keep in mind that eyeing the eddies in the current of a turbulent economy requires the skills of a surfer. The surfer may want to ride a wave out to a distant island, but that is not the way the waves are headed. They may break to the right or to the left. You may want to consider finding a place to practice (a beach) where the waves seem to break in the direction you want to travel rather than curse the ocean for keeping you from your goal.

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To learn more, or to get started, contact us at 1-888-937-2321. Or visit wellsfargo.com/welcomedentists to request your free New Dentist planner.

Wells Fargo Practice Finance is the only practice lender endorsed by ADA Business ResourcesSM

ADA® is a registered trademark of the American Dental Association. ADA Business ResourcesSM is a service mark of the American Dental Association. ADA Business Resources is a program brought to you by ADA Business Enterprises, Inc., a wholly owned subsidiary of the American Dental Association. All practice financing is subject to credit approval © 2011 Wells Fargo Bank, N.A. All rights reserved.Wells Fargo Practice Finance is a division of Wells Fargo Bank, N.A.

SKINNY

on the Street

The latest news on products and services for new dentists and their practices Quest Handpieces Lares Research has introduced Quest model handpieces, a new line of high quality, American-manufactured highspeeds that are available only through U.S. dental dealers. Quest highspeeds feature low-maintenance, long-life, ceramic bearings. The Quest stainless steel exterior and subtle grip design allows for fast, easy cleaning and autoclaving/chemiclaving. Quest highspeeds are priced for value-conscious dentists unwilling to compromise on quality and performance. They are available in models compatible with 4-hole, 5-hole, non-fiber-optic swivel (Multiflex* compatible), and fiber-optic swivel (Multiflex* compatible). Quest optional twin-beam fiber optics provide enhanced shadow-free illumination. Each handpiece carries a one-year warranty. Call 888-333-8440, ext. 1821, or visit www.laresdental.com for more information.

Lava™ Ultimate CAD/CAM Restorative

ClearCorrect Aligners

3M ESPE has introduced the Lava™ Ultimate CAD/CAM Restorative, a unique CAD/CAM material with longlasting esthetics and performance. Based on 3M ESPE’s nanotechnology, Lava Ultimate CAD/CAM restorative offers a polish that lasts, and backs it up with a 10-year warranty. This new class of CAD/CAM material provides a fast, no-firing process that is easy to mill, helping dentists maximize the productivity of their in-office restorative systems. The Lava Ultimate CAD/CAM is resilient and incredibly durable and shock absorbent. A few minutes of polishing are all that is necessary to achieve an enamel-like luster. The material also allows dentists to easily make adjustments, as well as build-up and reseal restorations. For more information, visit www.3MESPE.com/LavaUltimate or call 800-634-2249.

ClearCorrect, a brand of dental aligner created by doctors for doctors, does not charge for mid-course corrections, refinements, or final retainers. The company ships its aligners four trays at a time. This helps keep down lab-fees, since it eliminates the waste of shipping unnecessary aligners, if midcourse corrections are required. Doctors typically get four sets of trays every 12 weeks, if no course changes are needed. The result, a 32-step clear aligner program for $995, and a 12-step program for $595, that gives doctors the ability to focus on treatment outcomes without worrying about price, making treatment more affordable and profitable. Call 888-331-3323 or visit www.clearcorrect.com for more information.

INDEX O F A D V E R T I S E R S Advertisers in this issue of The New Dentist™ have made it possible for you to receive this publication free of charge. Please support these companies. Contact information can be found below or visit www.thenewdentist.net Resource section to receive information from more than one company. Affordable Image....................7 www.AffordableImageDental.com 866-693-5424

CareCredit........................... 27 www.carecredit.com/dental 866-246-6401

Keller Laboratories, Inc........ 15 www.kellerlab.com 800-325-3056

AMD Lasers............................1 www.amdlasers.com 866.999.2635

Dansereau Dental................ 23 www.dhpdental.com 800-423-5657

KöR Whitening....................... 5 www.korchallenge.com 866-763-7753

Aspen Dental....................... 30 www.aspendentaljobs.com/88 866-748-4299

Dental Dreams..................... 21 Danielle Tharp 312-274-4624 Juliette Boyce 312-274-4520

Live Oak Bank...................... 29 www.liveoakbank.com 877-790-1678 866-954-8362

Bank of America.................. 11 www.bankofamerica.com/ practicesolutions 877-541-3535

Henry Schein Professional Practice Transitions........... IBC www.henryschein.com/ppt 800-730-8883

visit www.thenewdentist.net FREE information from our Advertisers www.thenewdentist.net/resources.htm

32 WWW.THENEWDENTIST.NET W I N T E R 20 1 1

MAC Practice.......................... 3 www.macpractice.com 646-305-9008 McKenzie Management....... BC www.mckenziemgmt.com 877-777-6151 Midwest Business Capital.... 19 www.midwestbusinesscapital.com 877-751-4622 NAPB..................................... 18 www.napb1.com 888-407-2908

Powerprox Six Month Braces................................... 28 www.SixMonthBraces.com www.PowerproxDocs.com 440-646-1000 Practice Cafe...........................9 www.practicecafe.com 888-575-2233 x104 Practice Pack........................ 13 www.thenewdentist.net 877-777-6151 Six Month Smiles.............. IFC www.6monthsmiles.com CosmeticBracesSystem.com 866-957-7645 Ultradent Products, Inc....... 25 www.ultradent.com 800- 552-5512 Wells Fargo Practice Finance (formerly Matsco)................ 31 www.wellsfargo.com/ welcomedentists 888-937-2321

11PT3583

When It’s Time to Buy, Sell, or Merge Your Practice You Need A Partner On Your Side For a complete listing, visit www.henryschein.com/ppt or call 1-800-730-8883 ARIZONA

Tuscon-4 Ops, Immaculate, Well-established, GR $700K #12122 Tuscon Area-4 Ops, 2300 SF, Modern equipment #12112 Tuscon-5 Ops, 1850 SF, Highly successful, Real estate available #12121

CALIFORNIA

Coronado-4 Ops, 1400 SF, GR $405K #14366 El Dorado Hills-5 Ops, 1485 SF, GR 834K #14365 Fresno-Merger opportunity-IV Sedation practice, GR $933K #14250 Grass Valley-3 Ops, GR $307K, Adj Net $105K #14337 Grass Valley-3 Ops-4 Available, Bldg Available, GR $89K #14362 Greater Chico-4 Ops, 1200 SF, GR $584K, Adj Net $152K #14359 Irvine & Costa Mesa-Combined practices, GR $781K, Adj Net $369K #14355 Lakeport-8 Ops, GR $904K, Adj Net $302K #14338 Laguna Niguel-4 Ops, 1500 SF, Pan, EZ Dental #14352 Lindsay-2 Ops (3 Available), Practice & Building for Sale, GR $330K #14363 Los Angeles-4 Ops, 1200 SF, GR $274K, Adj Net $89K #14348 Maui-Hawaii-4 Ops, 1198 SF, GR $636K #20101 Marin County-3 Ops, 650 SF, GR $179K #14370 Newport Beach-4 Ops, 1450 SF, 3 Days hygiene #14354 Northern-4 Ops-5th Available. 1770 SF GR $638K #14251 Pleasanton-5 Ops, Excellent location, Must see! #14364 Plumas County-3 Ops-4 Available, 1245 SF, GR $475K #14318 Redding-5 Ops, 2200 SF, GR $1M #14293 Sacramento/Roseville-Highly successful GP practice #14334 San Diego-3 Ops, 950 SF, Dentrix, Pan, GR $414K #14356 San Diego-6 Ops, 2300 SF, GR $1.4M+ #14331 San Diego-3 Chair office, Pan, Intra Oral Camera #14321 San Diego/City Heights-3 Chair office, Pan #14321 San Luis Obispo-8 Ops, Great location, GR $1.5M+, Adj Net $691K #14353 Santa Clara-BUILDING ONLY 2 Units, 3776 SF #14368 Santa Cruz-4 Ops-Room for 1 more, 1855 SF, 6 Days hygiene #14361 Torrance-3 Ops, 800+ SF, GR $413K w/adj net $203K #14369

DELAWARE

New Castle-4 Ops, 1600 SF, GR $535K #172701

FLORIDA

Miami-3 Ops, Digital Sensors & Pan #183803

GEORGIA

Atlanta-Looking to expand, GR $942K #19138 Dublin-GR $1M+, Asking $825K #19107 Newnan-Growing opportunity, GR $420K #19141 N Atlanta Suburb-Small office w/great potential, GR $484K #19142 W Georgia-Modern, Great opportunity #19140 W Georgia-Wonderful opportunity, FFS, GR $690K #19143

KENTUCKY

Florence/Near Cincinnati-Modern, well equipped #26105 Louisville-Great starter practice or merger #26104

MARYLAND

Penobscot County-3 Ops, GR $203K #28114 Somerset County-3 Ops, GR $305K #28113

MASSACHUSETTS

Boston-3 Ops, Well-established, Digital, Cerec, Intraoral #30146 N Western-Real estate for sale, GR $440K #30144

MICHIGAN

Clinton Township-5 Ops, Remodeled, Bldg available #31114 Detroit-3000 SF, Close to suburbs #31112 Melvindale-Well Established, Bldg. Available #313503 Metropolitan Detroit-Specializing in Implants/Crown/Bridge #313502 Detroit Metro Area-For Immediate Sale #313505 Sturgis-Good area close to IN border, Bldg for sale #31111 Suburban Detroit-2 Ops, 1 Hygiene, GR $213K #31105 West-5 Ops, 2000 SF, Well-established pediatric practice, GR $520K #313501

MINNESOTA

Suburban St Paul-Established practice #32111

NEVADA

Nevada City-4 Ops, 5 Avail., 1555 SF, GR $491K #37108

NEW HAMPSHIRE

Southern-Oral Surgery practice, Condo for sale, GR $1.3M #38106

NEW JERSEY

Atlantic County/Egg Harbor Township-Established, Great area #392139 Burlington County-Historic downtown, Large Ops, FFS #392138 Central Jersey-Well established pediatric practice, GR $945K #392145 Hudson County-4 Renovated Ops, Digital #392136 Marlboro-Associate positions available #39102 Monmouth County-Hi-Tech 7 Ops, Digital #392140 Salem County-3 Ops, RE available, GR $600K #392134 South Jersey-Established, Great area, GR $2.7M #392135 South Jersey-1600 SF, 4 Chairs, New facility #392143 South Jersey-Spectacular Multi-Specialty Practice #392148

NEW YORK

Maui-4 Ops, 1198 SF, Pano, Laser, GR $636K #20101

Bronx County-5 Ops, 2100 SF, Digital #412328 Geneseo-5 Ops, Turnkey #41119 Onondaga-4 Ops, State of the Art #412338 Queens-Well Established, 3 Ops, Booming Location #412337 Onondaga County-4 Ops, 1800 SF, GR $700K+ #41107 Onondaga County-4 Ops, Highly Desirable Location GR $480K #412336 Suburb of Syracuse-Great practice, GR $462K #41117

ILLINOIS

NORTH CAROLINA

HAWAII

Chicago-Very Profitable, $1.3M in collections #22138 Northwest-Growth potential, GR $550K #22137 W Suburbs Chicago-Qualified Buyer to buy or merge #22135 1 Hr SW of Chicago-5 Ops, $500K production #22123

INDIANA

Mishawaka-4 Ops, Established, Potential #23113

IOWA

West Central-Ideal location, Fully digital, GR $1.6M #24101

Cabarrus County-Well established, Digital #42179 Charlotte-2 Ops, Beautiful space #423105 Charlotte-4 Ops, 1470 SF, Digital, Laser #423106 Lenoir County-Dental office bldg & equipment available #423107 New Hanover County-Practice on coast, Growing area #42145 Northwest-Seasoned practice in small town, Bldg available #42178 Raleigh, Cary, Durham-Doctor looking to purchase #42127 Wilkes County-5 Ops, Motivated Seller #42180

NORTH DAKOTA

S Central-Productive rural practice, GR $696K #43102

OHIO

Centerville-4 Ops, 8 Days hygiene, Profitable, GR $680K #44163 Centerville-4 Ops w/room for 5, very profitable, GR $900K+ #44162 Clark County-2.5-3 Day/week, Bldg available #44167 Greene County-Well managed, Low overhead, Large professional bldg #44160 N Cincinnati-Immediate sale #44172 Northern Summit County-3 Ops, Picturesque Setting #443901 Scioto County-35 Year+ established, 3.5 Day/week #44171 Warren County-Very Profitable, FFS, Digital #44176

OREGON

Salem-6 Ops, Well-established, 1500 Active patients, Dentrix #46101

PENNSYLVANIA

Bradford County-4 Ops, 2700 SF, #472094 Bucks County-Hi-End specialty practice, GR $1M+ #47149 Carbon-Established, Digital, Laser, Pan #472088 Center City Philadelphia-Well Established, 3 Ops #472098 Chester County-2 Ops plumbed for 3, Established #472085 Cumberland-4 Ops, GR $527K #472069 Dauphin County-6 Ops-Opportunity for 9, Dentrix #47133 Lancaster County-3 Ops, FFS, Loyal Pt. Base #472095 Lancaster County-3 Ops,w/room for 3 more #472097 Lebanon County-14 Ops, Equipment 5 years old #47147 Lehigh County-5 Ops, Pedo, FFS, Open concept #47150 Luzerne County-4 Ops, Real Estate available #47151 Montgomery County-State of the Art Practice #472099 Northeast Philadelphia-4 Ops, 1200 SF home office #472096 Northhampton County-4 Ops, Well-established, Pan #472092 North Hampton-4 Ops, Paperless, GR $1.2M #472082 North Hampton-3 Ops, Room to expand, GR $1M #472086 NW PA/College Town-5 Ops, GR $542K #472076 Snyder County-Established, 4 Days/week #72087 Wayne County-Beautiful 9 Ops, Dentrix #472093

TENNESSEE

Chattanooga-Paperless office, Modern #51118 Clarkesville-Excellent opportunity, GR $800K #51116 Elizabethton-Great Area, Quality Practice #51107 Maryville-Great practice, GR $739K #51109 Tri Cities-TMJ practice, GR $290K #51119

TEXAS

Dallas-3 Ops, Great potential #52106

VERMONT

Central-FFS, Real Estate for sale, GR $683K #54105

VIRGINIA

Loudon County-8 Ops, Space available for sale #552405

WISCONSIN

Southeastern-7 Ops, 6500 SF, GR 1M+ #58121

Practice Start Up PROGRAM Practice Acquisition PROGRAM 2 Days, one-on-one training. Preferred time 3 to 18 months prior to opening or purchase. 6 Months of follow up support.

Dr. Alan Shelhamer is a Successful Start-Up Oral & Maxillofacial Surgeon in Carlsbad, California

Training location La Jolla, CA or your city. Training and support materials. 16 Hours of AGD CE credits. Available for General Dentists and Specialists

ENROLL TODAY and receive Realizing The Practice’s True Potential, a 5-Hour DVD Set

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“I would absolutely recommend this for any new start up. I have been out of dental school 14 years and learned more about the business of dentistry in 2 days than I had in all that time before. I both enjoyed and benefited from the program.” — Alan Shelhamer, DDS, Diplomate, American Board of Oral & Maxillofacial Surgery

View course curriculum at w w w.mckenziemgmt.com/cons-star t u p. ht m and w w w.mckenziemgmt.com/prac ticeacquisit i o n . ht m

1.877.777.6151 info@mckenziemgmt.com