New Dentist Spring 2012

THE #1 JOURNAL FOR NEW DENTISTS

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11CHA156_TheNewDentist_Ad_OL.pdf 1 1/3/12 5:37 PM

WWW.THENEWDENTIST.NET2 SPRING 20 1 2

FROM THE PUBLISHER’S DESK

S P R I N G 2 0 1 2PUBLISHER Sally McKenzie [email protected]

DESIGN AND PRODUCTIONPicante Creative http://www.picantecreative.com

MANAGING EDITOR Tess Fyalka [email protected]

SALES AND MARKETING For display advertising information contact [email protected] 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 ©2012 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 [email protected]. For advertising information contact [email protected] or 877.777.6151. Visit our website at www.thenewdentist.net to download a media kit.

visit www.thenewdentist.net

#1 Web-site for New Dentists

Dear Readers,

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

Certainly, we are all looking forward

to an improved economy in 2012.

There’s no question that the last few

years have had an impact on virtually

every business sector including dentistry. For new

dentists, establishing an appropriate fee schedule

is essential regardless of the economic whims of

the time. But what should you consider? See what

noted expert Tom Limoli advises on p. 6.

Also in this issue, you’ll learn what internation-

ally recognized pediatric dentist Dr. Marvin Berman has to say about treating children in your

practice. He also gives his perspective on what he considers to be the very best practice builder

for new dentists.

Considering starting a new practice? Turn to p. 10 and find out what two doctors who’ve

been through it advise before you take the plunge. When it comes to establishing 22 practice

systems, these doctors say there was a lot more to consider than they ever realized.

Additionally, Dr. Josh Austin reports on “game changing” discoveries in adhesive dentistry

and how previously considered “best practices” may not be the ideal approach after all.

And don’t miss what three doctors have to say about the brand of loupes that they consider

to be the very best. Turn to p. 16 and find out why they are so impressed with the brand they

chose as well as how much they had to spend to get what they wanted.

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

www.midwestbusinesscapital.com

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lending to the dental industry. With a customized lending approach, our team

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TABLE OF CONTENTS SPRING 2012

D E P A R T M E N T S

F E A T U R E S

2 Publisher’sMessage

26 DentalStudents:What’sonYourMind?

32 SkinnyontheStreet

32 IndexofAdvertisers

Dental Fees: What to Consider

What is McKenzie Management Doing for New Dentists?

Buzz Blog: 24 Hours to Productivity Powerhouse

Been There, Done That: Dr. Marvin Berman Urges New Dentists to Welcome Children

Three Doctors: Three Different LoupesTessFyalka,ManagingEditor

New Research May Alter Course of Adhesive DentistryJoshAustin,DDS

‘Painless’ Plasma Brush Becom-ing Reality, Say MU Engineers

National Student Lobby Day

Washington Dentist Wins Practice Pack

6

10

12

14

16

20

23

24

28

16 2032

14

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offices in establishing fee schedules and managing insurance reimbursement. He has watched the business of dentistry for many years. “The days of increasing fees 3-5% annually are over. Today’s dentists need to base their fees on their true overhead – what it is costing them to deliver the dentistry.”

What to Consider

DENTAL FEES:

It is said that the only thing constant

is change. Certainly, dentistry has

seen huge positive changes in

treatment options, techniques,

equipment, and products. While

change often brings improvements,

that’s not always the case. With the

economic struggles of the last few

years, dentists are being forced to take

a close look at those fees and think

carefully about whether they

can compete in today’s marketplace.

Tom Limoli, Jr. is a noted expert on proper coding and administration of dental insurance benefit claims. He serves as president of Limoli and Associates, which assists dental

For further information, contact Mr. Limoli at Limoli & Associates 800-344-2633 [email protected] or visit www.LIMOLI.com.


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In setting fees, Mr. Limoli explains that new dentists will want to understand a few of the fee schedule funda-mentals. “The office should have only one fee schedule that lists the ‘usual fee’ for each procedure that the dentist performs. State dental boards and other regulatory authori-ties frown on doctors that have multiple fee schedules, such as one for insured and one for non-insured patients.

“The ‘usual fee’ is the fee that appears on the fee schedule. The usual fee is that amount of money that dentists charge in the open, free market economy. It repre-sents the doctor’s full fee and has nothing to do with that amount of money contractually reimbursed by the patient’s benefit plan. This is simply the doctor’s baseline standard.” As Mr. Limoli explains, when it comes to “customary fees,” those are established by insurance benefit plan administra-tors based on data gathered from claims.

When a dental office establishes its usual fee, it is most often identified as simply being a reasonable fee. “Fees are and can be modified for any number of reasons,” says Mr. Limoli, but in today’s marketplace it is imperative that prac-tices make every effort to help patients feel they are getting value for the dental fees they pay.

For new dentists starting out as associates, he encour-ages them to use their “extended” treatment time to the practice’s advantage. “The new dentist may have an equal or greater level of skill as the senior doctor, but he or she is

simply not going to perform dentistry at the same speed as more experienced doctors. And you tell patients that when introducing them to the new doctor. Patients understand that.” More time to deliver treatment translates to more time to build relationships with the patients, which Mr. Limoli emphasizes has never been more essential to building a practice than in the current economy.

In fact, he encourages new dentists to take time to establish themselves in the practice before they hire a hygienist. “The dentist, himself or herself, needs to increase their skills and build relationships with patients because when you develop a relationship with the patient, they don’t question the fee.” Mr. Limoli urges dentists that work as associates to spend several hours performing dental hygiene each week, even if the practice has an established hygiene department.

In setting fees, it is essential that new dentists are well informed about where fees stand in the area that they are practicing and to be wary of creating a fee schedule that is too high or too low because it is based on third-party reimbursement rates. “You don’t want to trap yourself by attempting to establish your office fee schedule based on what some third-party payer reimburses at 65% of the 85th percentile. And don’t establish your fees based on the dentist down the hall or across the street. Your fees should be based on your overhead, expenses, patient base and your individual level of professional expertise.” He notes that new dentists also have to consider what it is costing them to perform the specific procedure.

Mr. Limoli cautions dentists against setting fees too low for some services and too high for others. “You don’t want to shoot yourself in the foot by having intentionally low fees for some procedures and then trying to make it up with


“The dentist, himself or herself, needs to increase their skills and build relationships with patients because when you develop a relationship with the patient, they don’t question the fee.”

Dental Feescontinuedfrompage6

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Two Dentists Say, ‘Get Help’ When Starting a New PracticeEditor’snote:IneachissueofTheNewDentistTM,weaskadifferentcompanytotelluswhatitisdoingfortoday’snewdentists.Inthisissue,wewentdirectlytotwodentistsstartingnewpracticesandaskedthemtosharetheirexperiencewithMcKenzieManagement’sPracticeStartUpprogram.Here’swhattheytoldusthatprogramdidforthem…

For virtually any dentist, new or experienced, the prospect of starting a new practice is daunting. Certainly, there is plenty of enthusiasm for the opportunity to do things “your way.” Every dentist

opening his/her practice wants to set up the systems the right way. The problem: Very few know what is the “right” way or the best way or the most effective way. Consequently, scheduling, collections, patient retention, employee hiring and the other 18 critical management systems take shape but too often they are ineffective, inefficient, and can’t begin to deliver the results that the doctor is hoping for in his/her new practice.

Recently, TheNewDentistTM talked with two doctors who have been through the McKenzie Management Practice Start-Up program. Dr. Brad Hunt of California started his practice six years ago, and Dr. Kathleen Ellsworth of Michigan opened her new practice in 2005. The program is designed to provide dentists just starting out with the knowledge and tools to enable them to start out “right” from the beginning. They are taught the most important building blocks of a successful practice: patients, staff, business measurements, systems, revenue, and overhead.

Dr. Ellsworth had relocated to Saranac, MI, from the Flint area. She went through the two-day training about six months before she was scheduled to open. “My friend had worked with McKenzie Management and had amazing results. When I moved and relocated my practice, I knew I needed systems. My first practice did well but when it came to having systems, I was flying by the seat of my pants.”

Dr. Brad Hunt decided to participate in the Practice Start-Up program shortly before opening his first practice in San Diego, CA. He had been a dentist in the Navy for many years, but starting his own practice was completely foreign to him. “I realized I needed help. It was very overwhelming. If I had it to do again, I would have gone to them for help a lot sooner. I didn’t realize how much we needed to get done before we opened the doors. They walked us through all the different systems we needed to have in place.”

One of the most significant benefits of the program, from Dr. Ellsworth’s standpoint, is that each member of the team clearly understands his or her responsibilities. “I came back and trained my staff on how to run the systems. Everything is in the books they sent home with me. My staff know exactly how to do their jobs. They know exactly how to answer the phone. They know exactly how to talk to the patients. They know what is expected of them. We schedule for production. I know how to communicate with them according to their personality types. What I learned through the program just makes my day so much easier and my employees’ day so much easier. I don’t feel mentally exhausted at the end of the day. We run on time. The team knows how I measure their performance, so they know exactly what to expect and they like that. We have had great success with it.”

For Dr. Hunt, one of the most significant benefits of the Start-Up program was simplifying the number of insur-ance plans that his practice would accept. “We had signed up for 18 insurance plans. Through the program, we were able to cut that back to eight.” Dr. Hunt also notes that the

Dr. Kathleen Ellsworth and her team CONTINUED ON PAGE 22 >>

What is McKenzie Management Doing for New Dentists?

WWW.THENEWDENTIST.NET 11 SPRING 20 1 2

Dental Feescontinuedfrompage8

high fees for other procedures.” He cites past fee practices in which dentists would keep hygiene fees unrealistically low, then make it up with much higher fees for other procedures, such as crowns. “Dentists have to realize that in the current economy fees cannot continue to rise. If they accept insurance and they want to set their fee for a crown at $1,000 and insurance pays only $800, they cannot look at that as $200 lost. They have to look at the reality that they don’t have a patient in the chair willing to pay $1,000.”

Mr. Limoli says he is seeing small treatment plans translate into long term success for some practices. “For new dentists, it’s critical that they pay close attention to why is the patient in the practice. Make them comfortable. Address the smaller issues. Offer the smaller restorations before you even talk about crowns. The doctors who are successful in today’s economy have a relationship with their

patients. They are focused on providing the least amount of dentistry to achieve the greatest return for the patient. Listen to the patient. Pay attention to the patient.”

For dentists who find that they have set their fees too high, Mr. Limoli recommends offering a reduction in the fee while encouraging the patient to pursue necessary treat-ment. “When the patient is in the chair and you have been telling them for the last couple of visits that some of their aging restorations are failing, pull out a business card and write a figure on the back of it. Maybe it’s $100 or $200, whatever you are comfortable with. Hand the card to the patient and tell them to give that to the business assistant at the front desk, ‘This card is worth $100 off of the fee for this procedure if you get that procedure scheduled for next week.’ The patient has to understand the importance of pursuing care and they have to believe that what you are offering has value.”

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From The New Dentist™ Buzz Blog:

Block off two hours each month over the next 12 months. These are the 24-hours that you commit to

continuously improving your practice during the next year.

Develop an agenda with input from the entire team.

Include all areas that impact the profitability/success of the practice. For example: numbers of new patients,

recall patients, collections, treatment acceptance, produc-tion, accounts receivables, unscheduled time units for doctor and hygiene, uncollected insurance revenues over 60 days, overhead, etc.

Distribute the agenda at least two days in advance of the meeting.

Assign each member of the team to report on the area for which they are responsible. For example, the scheduling

coordinator reports on the monthly production as compared to the goal, the number of unscheduled time units for the doc-tor, and the doctor’s daily average production.

Encourage team members to come prepared to discuss topics on the agenda. For example, if the doctor has

a higher number of unscheduled time units than desired, the team can discuss contacting patients with unscheduled treatment, encouraging hygiene patients with unscheduled treatment to move forward on recommended care, identifying patients with unused insurance benefits, etc.

Seek input from everyone by asking questions such as, “What is your reaction to that?” “As the patient, how

would you react?” “What are the advantages of this approach? What are the potential disadvantages?”

Delegate responsibilities and establish deadlines for completing tasks identified during the staff meetings.

For example, if hygiene cancellations are high and the group has developed a plan to reduce the cancellations the person responsible, probably the hygiene coordinator, needs to know she is accountable for implementing the changes and should be prepared to report on the effects of those changes at the next monthly meeting.

Share ideas during staff meetings for improving the work environment, the patient experience, and the efficiency

of the practice.

Designate the amount of time you will spend discuss-ing each issue and avoid getting bogged down on

unrelated topics.

Discuss only what is on the agenda.

Hold staff meetings off-site in a conference room with a conference table. Many local libraries, community

colleges, and other public facilities have public meeting rooms available for use.

Eliminate outside interruptions.

Seek consensus from the staff as to the best time to hold staff meetings; meetings scheduled outside normal work

hours should be paid.

Hold meetings at least once per month, more frequently if you are implementing several changes.

Meetings are meant to be designated times in which you can focus all of your energy and team resources on addressing key management issues and problems that arise as a part of operating a small business. Run correctly, they are the most effective means to identify and solve problems, establish policies, share infor-mation, motivate each other, define areas of responsibility, and exchange ideas. Use them to your practice’s full advantage.

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Investamere24hoursoverthenext12monthsinyournewpracticeandenjoysignificantlyimprovedefficiencyandproductivity.Monthlybusinessmeetingsthataregivenjusttwohoursofdedicated,uninterrupteddoctorandstafftimecouldbethemostcost-effective,productionefficientstepyou’lltaketoachieveyourpractice’sfullpotentialinthecomingyear.Thekey:designateeverymemberoftheteamacontributor.Here’show:

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In May of 2003 the

American Academy

of Pediatrics issued a

policy statement urg-

ing dental exams for

very young children.

The policy recommends that

infants receive an oral health

assessment from a health care

professional by six months and

be referred to a dental health professional by one

year. It was a breakthrough of sorts in the physi-

cian community’s recognition that oral health

problems can begin long before a child reaches

the age of three.

For more than 20 years, the American Academy of Pediatric Dentistry has recommended that children

see the dentist for the first time six months after the first tooth erupts or no later than their first birthday. The policy

is supported by the American Dental Association and the American Academy of General Dentistry. Although the concept of the age-one dental exam has yet to enjoy wide-spread acceptance, the “dental well baby visit,” as some practitioners have termed it, is gaining momentum. One of the most important aspects of adopting the policy, say experts, is the value of establishing a dental home.

According to internationally recognized pediatric dentist Dr. Marvin Berman, treating young children is not only essential to ensuring proper oral health care, it is one of the most important steps new dentists can take in build-

ing their practices. “There is no quicker means for dentists to set up practice, become successful, and establish their reputation than to be wonderful with children. If you are good with the kids and you are gentle, the adults buy into it and they want to become your patients too. Nothing will lead to success quicker in a new practice than the ability to work with young children,” emphasizes Dr. Berman.

However, he acknowledges that many dentists, both new and established, are afraid to treat young children. “The problem is that children cry and children scream and

this becomes a very big turnoff for dentists. They are not trained in how to manage young children in dental school.” Moreover, he notes that over the last two to three genera-tions, the culture of parenting has changed significantly. And parents today are far more permissive with their chil-dren than past generations.

“There’s not as much respect for others or manners instilled in children today. They have a much shorter attention span. They aren’t able to listen. They don’t accept figures of authority. They are more self-centered, and all of

BEEN THERE, Done That

Dr. Marvin Berman, Pediatric Guru Urges New Dentists to Welcome Children


“Treating young children is one of the most important steps new dentists can take in building their practices.”

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Early in his dental career, Dr. BJ Coakley wasn’t so sure he really wanted to put on a pair

of loupes, after all, he reasoned, what would happen if he became dependent on them. He wondered if he would be able to perform quality dentistry without them. He has long since abandoned that philosophy and today wouldn’t perform a dental procedure without them, but has discovered that he is quite capable of delivering quality dentistry with or without loupes.

Although he has tried a couple different brands, there is one that Dr. Coakley now uses exclusively. “I have been using the Heine loupes since 2007. I prefer 2.5x magnification. There are stronger ones, but I like these the best. I couldn’t practice dentistry without them. It’s as important as having the overhead light on. If I sit down and don’t have my loupes around my neck, I know it right away.”

Dr. Coakley, a 2002 graduate of the University of Medicine and Dentistry of

Three Doctors: Three Different Loupes

New Jersey, says that he has tried other brands over the years, but found them to be heavy and negatively affected both his field of vision and peripheral vision. “I actually got discouraged with loupes for a while.” He says that he was introduced to the Heine loupes by his sales representative. “I didn’t know the company at all. The sales rep asked me if I would try them for two weeks. If I didn’t like them, I could just give them back. It was a great two weeks, and I ended up buying a pair.”

Among the features that Dr. Coakley feels set this brand apart are the lightweight frame and the field of vision. “It doesn’t feel like I’m wearing much more than safety glasses. More importantly, these give me a much wider field of vision. The other loupes that I used were very focused on a small area of about two teeth. With these loupes, I can focus on the area where I am working but also beyond that. They also provide a good range of focus. I rarely have to adjust the settings. With

Each Claims His is the ‘Best’my old loupes, if I were 12-16 inches away from my work, I would lose focus. I can look around freely and move in and out of my target range comfortably.”

The Heine loupes that Dr. Coakley uses cost $1,500. He urges new dentists to take their time when considering a pair of loupes. “Comfort is very important. Try them out before you buy them, see how they fit in your practice and determine what you like and don’t like. If you are working with a quality sales rep., they will help you find a brand that works for you. Pay attention to weight and field of vision, those are key. I really feel like my loupes make me a better dentist. My diagnostic abilities are much better and that only makes for better care for my patients, which I think is great.”

For Dr. Michael Korn who is an associate dentist in Washington, the 3.0 prismatic SurgiTel loupes with a Sheervision Firefly loupe light are “amazing.” This 2010 graduate of the University of Southern California

B Y T E S S F Y A L K A , M A N A G I N G E D I T O R

Q-OpticsHeineSurgiTel


School of Dentistry says that he took time to make what he feels was the best decision. “I looked at several different brands and types of loupes but was blown away with the SurgiTel prismatic 3.0. The prismatic lenses were an extra $600 over the Galilean but considering the total cost of four years at USC Dental, $600 is nothing and well worth the investment. At the time I was worried about my field of vision being too narrow, so I limited the magnification to 3.0. I’ve since tried the 3.5 and loved them. I also went with the flip up design. Despite the heavier weight, the ability to adjust in several different planes was valuable. My next pair will be through the lens SurgiTel 3.5 now that I know the exact angle that is comfortable for me.” Dr. Korn has been using the SurgiTel brand for about four years. “The combination of pris-matic lenses and a quality loupe light gives you unparalleled clarity.”

He notes that he has found use of a loupe light to be key. “I never work without it when using my loupes. A composite flip filter is also very nice to have. I have to say SurgiTel customer service has been great too.”

Dr. Neil Patel practices in north Dallas. He uses the Q-Optic M3.5 TTL (Through the Lens) loupes. He notes that when he was in dental school he used a popular brand that was a flip up style, but he found that the weight of the lenses bothered him as did the field of vision. “With the flip-up style, your field of view is about half the size you need.”

This 2005 graduate of Tufts University School of Dental Medicine set out to conduct his own comparison study to determine which loupes would work best for him. He knew that he wanted to purchase loupes that would provide not only the necessary magnification and field of vision, but also would minimize ergonomic strain. He wanted to find a company that could provide 3.5x magnification with a 40 degree declination angle and slightly higher for his partner.

Research indicates that the three most important ergonomic factors to consider

Heine, SurgiTel, Q-Optics Loupes

CONTINUED ON PAGE 30 >>CONTINUED ON PAGE 30 >>

SurgiTel

SurgiTel’s Expanded Field front-lens-mounted (FLM) loupes Patented Compact Prism Design (patent pending): The most compact, lightweight and comfortable expanded field loupe available, unlike other expanded field loupes, which are bigger, heavier and therefore less comfortable.• Patented Vertical Slide Adjustment: For the best declination angle

and neck posture. • Patented Double Nose Pads: For the best weight distribution

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3.0x CompactPrism EVK300 Custom,10-30” 2-11”(6-28cm) 3.6-6.9”(9-18cm)






Specification Notes

Depth-of-field (DoF) – achievable DoF will vary according to:• Eye accommodation capability.• Working distance; longer working distance = longer DoF.

Field Size (FS) – achievable FS will vary according to:• How close the ocular is to the eye.• Working Distance; longer working distance = more FS.

Interchangeable Working Distance Caps• You can adjust the working distance on your SurgiTel Expanded

Field Loupes by changing the working distance caps at the end of the loupe oculars.

Heine

HEINE’s exclusive I-View adjustment system has been specially designed to offer the flexibility and variety in positioning that is essential in preventing musculoskeletal pain from static positioning. HEINE’s unique 3-point hinge system allows users to vary the angle of their loupes, providing a variety in working positions not available in fixed lens systems.

• HR 2.5 x Optics with i-View.• Achromatic optics for crisp, bright images with color correction.• Lightweight (51 g).• Water-resistant.• Independent adjustment of left and right optics for perfect PD

adjustment.• High magnification with a large field of view and excellent

depth of field.• i-View loupe mount provides any angle of view and flips up the optics

independently of the optional LED LoupeLight.

Information Courtesy of HEINE USA LTD


that plays into the fact that it scares the heck out of a den-tist that in this society the child and the dentist are consid-ered equals. So dentists are reluctant to assert themselves as authorities with children. Consequently, when it comes to treating young children, the person who is the most scared is usually the dentist,” he adds.

In addition to far more permissive parenting styles, Dr. Berman explains that compounding the challenge is that most parents do not prepare children properly for the dental visit. “There are too many comments like, ‘Don’t worry’. ‘Don’t be scared.’ ‘I’ll be right here.’ Therefore, a lot of children who should not be reluctant or afraid to see the dentist, come in scared, and their reaction is crying and screaming.”

So how does a new dentist manage the young child? Use logic, notes Dr. Berman, start with the familiar and progress to the unfamiliar. “If a child knows what a tooth-brush is, you start with that. You give them the toothbrush, you move on to the toothpaste, you move on to the water, you move on to the napkin, the mirror, and the light. A lot of dentists put the child in the chair, shine the light on them, and begin to do the dental treatment or exam with-out any preparation for the child.”

Dr. Berman also believes that once children are at age three or four, it is best if parents are not present in the treatment room with them. “Children generally behave better in the absence of their parents. You need to estab-lish a one-on-one relationship between the dentist and the child.” While children do require additional time and energy, he discourages dentists from referring young

children to a pediatric dentist. “From a practicality point of view, there are not enough pediatric dentists to treat all of the children in need of dental care. General dentists tend to overemphasize crown and bridge, endo, perio, but there is significant opportunity to grow the practice in treating young children.”

It requires a shift in attitude for many practitioners in that they need to allow more time in their schedules to build a relationship with the child. “You have to get the

Dr. Bermancontinuedfrompage14

“From a practicality point of view, there are not enough pediatric dentists to treat all of the children in need of dental care.”

child to like you, and you have to work through challenges with the child. You see, the most important part of a visit to the dentist, isn’t providing care to the child, it’s changing the child’s attitude about dentistry. Persistence and dedica-tion to the idea of making friends with the child is very

important. It is about one-on-one relationship building and that requires time.”

Additionally, Dr. Berman emphasizes that it is essential that dentists spend time with parents or guardians to edu-cate them on the importance of diet, nutrition and correct brushing. “There has to be time set aside so that you can teach the child and the parents and give them the opportu-nity to get to know you personally. That cannot be done in a hurry.”

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NEW RESEARCH May Alter Course of

Adhesive DentistryAs I have discussed in this column repeatedly,

adhesive dentistry has become the corner-

stone of modern dental practice. Nearly every

restoration we do relies to some extent on

our ability to bond to either enamel or dentin.

While we thought we knew all there was to

know about the process of bonding, new

research shows we may have been skipping an

important step the entire time.

In a previous column, I spent 1,000-plus words describing the process of bonding, emphasizing the importance of using fourth generation, total-etch, separate primer and adhesive systems. While fourth

generation bonding agents show a higher bond strength than subsequent generations, new research is showing that etching dentin might be creating a substrate that will degrade the dentin bond over time. If this proves to be true, it could alter the course of adhesive dentistry as we know it.

The issue lies with the etching of dentin. Upon expo-sure of the dentin to an acid like the phosphoric acid etch we use in bonding, matrix-bound matrix metalloproteinases (MMPs) are uncovered and activated. These MMPs have the ability to degrade the hybrid layer of resin and collagen fibrils, which reduces dentin bond strength over time. This

BY JOSh AUSTIN, DDS

could be the answer to why dentin bond’s strength fell dramatically after five years.

So now that we know that etching dentin creates this problem, we have a couple of different options to deal with these activated matrix-bound MMPs. Our first option is to continue using a total etch system with a fourth generation bonding agent. If we choose to do this, we must attempt to deactivate the MMPs. This can be done in a relatively easy and inexpensive way. If we treat the dentin after etching with 2% chlorhexidine, we can inhibit MMP activation, removing the threat to our dentin bond.

This is a pretty simple option since most of us have a 2% chlorhexidine formulation around the office. Ultradent’s Consepsis is a popular choice for this and what I use in my office. After rinsing the etch and lightly drying the tooth (being sure not to desiccate the dentin), I apply the 2% chlorhexidine with a syringe and applicator tip. The dentin is scrubbed with the liquid chlorhexidine for approximately 30 seconds. After 30 seconds, the excess chlorhexidine is blotted PH

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NEW RESEARCH May Alter Course of

Adhesive Dentistry

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 [email protected] or http://

thenewdentist.net/clinicalBuzz/.

What has been your experience with adhesives? Tell Dr. Austin. Blog on at www.thenewdentist.net/clinicalblog.php.

with a clean, dry cotton pellet. The enamel is slightly dried again, followed by application of primer for 15 seconds, light air dry, then adhesive application. The adhesive is then thinned and cured as would be done normally.

With 30 seconds and a few cents of chlorhexidine, we can dramatically improve the long term durability of our dentin bond. This seems like a small price to pay for such a dramatic improvement. After hearing and reading about this research, my initial reaction was to ask why manufacturers had not begun adding chlorhexidine to their primer solution to save the chlorhexidine application step. After some basic PubMed searches, it appears as if that is on the way. Research is currently being done on chlorhexidine, benzalkonium chloride, and MDPB (an antibacterial monomer) as additives into adhesive systems to provide anti-MMP properties along with antibac-

terial qualities. Until these “therapeutic adhesive systems” hit the market, it will be important to add chlorhexidine to our bonding process if we are using total etch fourth generation adhesive systems.

Another alternative is to avoid using a total-etch fourth generation system. While this seems to go against everything I have written about bonding, I have begun to consider the possibility of using self-etch adhesive systems with a modified procedure. Recently, two of my mentors and several highly regarded materials experts have shown confidence in 3M ESPE’s Scotchbond Universal adhesive. Scotchbond Universal is a self-etching-one-bottle system that can also be used with selective or total etch techniques. Its ability to be used with different etch techniques is what sets it apart from other self-etch systems.

For traditional class I and II restorations, it is recom-mended that a selective etch technique is used to etch the enamel only. Since the dentin is not etched with an acid, the MMPs are never activated, and dentin bond is not degraded over time. By using this type of adhesive with a selective-etch approach, we can avoid the need for MMP deactivation.

References: CompendContinEducDent.2011Sep;32(7):60-4,66.Howtoincreasethedurabilityofresin-dentinbondsPashleyDH,TayFR,ImazatoS.GeorgiaHealthSciencesUniversity,SchoolofDentalMedicine,Augusta,Georgia,USA.

ChlorhexidinePreservesDentinBondin vitroM.R.O.Carrilho,1,4R.M.Carvalho,2M.F.deGoes,1V.diHipólito,1S.Geraldeli,3F.R.Tay,4D.H.Pashley,4andL.Tjäderhane5*

Another advantage of Scotchbond Universal is its flexibility to be used with many types of restorative materials. It bonds to enamel, dentin, and porcelain, base metal alloys and high noble alloys have also tested very well. It potentially has the ability to replace several different adhe-sive products a dentist may use on a regular basis. The initial data is showing very good bond strengths, comparable with some fourth genera-tion adhesive systems. Because the product is relatively new, long term data is not available. With a selective enamel only etch technique, some 7th generation adhesive systems might begin to compete with fourth generation systems due to their lack of MMP activation.

These new revelations in dentin bonding show that we still have much to learn about

everyday procedures in dentistry. As new dentists, we will most likely see many more revelations that change the way

we perform even the most basic of clinical tasks. We must remain open to new discoveries and information in order to provide our patients the best care possible!

“By using this type of adhesive with a selective-etch approach, we can avoid the need for MMP deactivation.”


experience was instrumental in helping him to begin to understand overhead. “Coming from the military, I had a budget and we would spend it. That’s it. I didn’t have any understanding of overhead. I learned what I should be focusing on, and since I take insurance, I needed to pay attention to the adjustments. Those were killing me the first year.” Dr. Hunt also notes that he follows the hiring procedures that he learned during the training each time he hires a new employee.

Understanding the practice overhead benchmarks have been particularly helpful for Dr. Ellsworth and her team as well. “Knowing those parameters keeps you grounded. It also keeps you paying attention to what you should be spending on payroll, what you should be spending on supplies and such, so you know where you are at all times. The other thing I like is that everyone is responsible for their individual area, it’s like they are the CEO of that system. They know how to run it and how it’s measured.”

Additionally, Dr. Ellsworth finds that she immediately knows when a system is not working properly. “In the beginning, if a system broke down, we knew right away, and we could fix it immediately. Now we have been doing it long enough that we are pretty much on coast.”

Dr. Hunt urges new dentists to invest in the Practice Start Up program. “Build it into your loan. It’s as impor-tant as setting up the space, the sooner the better.” For Dr. Ellsworth, she believes the systems she has in place as a result of the training have enabled her to grow in spite of the recession. “The past two years, we grew 9.8% each year. My office experienced the best December in 2011 since we opened in 2005. I am growing like crazy. Recession? What recession?”

IfyouwouldliketotalkfurtherwithDr.Ellsworthaboutherexperience,shecanbereacheddirectlyatdr.ellsworth@[email protected].

Starting a Practicecontinuedfrompage10

“The past two years, we grew 9.8% each year. … Recession? What recession?”

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University of Missouri engineers and

their research collaborators at Nanova,

Inc. are one step closer to a painless

way to replace fillings. After favorable

results in the lab, human clinical trials

are underway on the “plasma brush.”

In less than 30 seconds, the plasma brush uses chemical reactions to disinfect and clean out cavities for fillings. In addition to the bacteria-killing properties, the “cool

flame” from the plasma brush forms a better bond for cavity fillings. The chemical reactions involved with the plasma brush actually change the surface of the tooth, which allows for a strong and robust bonding with the filling material.

“There have been no side effects reported during the lab trials, and we expect the human trials to help us improve the prototype,” said Qingsong Yu, associate professor of mechanical and aerospace engineering of MU, and Meng Chen, chief scientist from Nanova, Inc., which holds a co-patent for the plasma brush with MU.

“Tooth restorations cost Americans an estimated $50 billion a year, and it is estimated that replacement fillings comprise 75% of a

dentist’s work. The plasma brush would help reduce those costs,” said Hao Li, associate professor of mechanical and aerospace engineering in the MU College of Engineering. “In addition, a tooth can only support two or three restorations before it must be pulled. Our studies indicate that fillings are 60% stronger with the plasma brush, which would increase the filling lifespan. This would be a big benefit to the patient, as well as dentists, and insurance companies.”

‘Painless’ Plasma Brush Becoming Reality, Say MU Engineers Dental instrument uses ‘cool flame’ for fillings

The research and development team also includes Yong Wang from the School of Dentistry at University of Missouri-Kansas City and Liang Hong from the School of Dentistry at University of Tennessee-Memphis. The project has been funded by the National Science Foundation and the National Institutes of Health. Li, along with Yu and Chen, have formed Nanova, Inc., with Chen leading the plasma brush device development through the NIH Small Business Innovation Research (SBIR) program.

Human clinical trials began earlier this year at the University of Tennessee-Memphis. The researchers believe the human clinical trials will provide the data that allow Nanova to find investors and take the next steps in placing the product on the market. If the studies go well and the FDA clears the use, the researchers’ timeline indicates the plasma brush could be available to dentists as early as the end of 2013. StorycourtesyofMUNewsBureau.


FREE Podcasts

”Our studies indicate that fillings are

60% stronger with the

plasma brush, which would

increase the filling lifespan.”

PHOTO COURTESy OF UNIVERSITy OF MISSOURI


During National Dental Student Lobby Day, students converge in Washington, D.C., to make their voices heard on Capitol Hill. This unique experience gives dental students an opportunity to meet with their legislators and advocate for their profession. This event is co-hosted by the American Student Dental Association (ASDA) and the American Dental Education Association (ADEA).

Visit www.ASDAnet.org/lobbyday.aspx for event details and instructions on how to set appointments with congressmen. Register by March 12.

During last year’s National Dental Student Lobby Day, some 340 dental students from around the country visited their members of Congress to lobby lawmakers about key issues.

ASDA and ADEA jointly select issues that are important to dental students and dental education. In 2011, the organiza-tion lobbied for funding for the National Institute of Dental and Craniofacial Research and the National Institutes of Health, as well as for the Dental Emergency Responder Act of 2011 (HR 570).

Mark your calendars now for

2012 NATIONAL DENTAL STUDENT LOBBY DAY: April 16-17, 2012 at the L’Enfant Plaza Hotel

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DENTAL STUDENTS: What’s on Your Mind?

M r. Sam Bae, a fourth-year student at New York University College of Dentistry, has been

awarded first place in the basic science category of the 2011 American Dental Association/Dentsply Student Clinician Research Program at the ADA annual meeting in Las Vegas, Nevada.

Mr. Bae received the award for his work on sensory neurons involved in cancer pain and carcino-genesis that is outlined in his poster entitled “Local Effect of IB4+ Neurons

in Carcinogenesis and Pain.” Mr. Bae conducted his research under Dr. Brian Schmidt, director of the Bluestone Center for Clinical Research and professor of oral and maxillo-facial surgery at the NYU College of Dentistry. Dr. Schmidt is an expert in cancer genomics and cancer pain.

The award marks the second time that Mr. Bae has been recog-nized for his investigation of cancer pain. In April 2011, he received a Dentsply Award at the NYU College of Dentistry’s annual Student Research Day competition, which allowed him to enter the national ADA/Dentsply Student Clinician Research Program and to present his work at the Las Vegas competition.

Areyourdentalstudentsachievinggreatsuccess?Tellusaboutit.Emailtess@thenewdentist.net.

NYU College of Dentistry ’12 Student, Wins First Place Research Award

Mr. Bae has conducted research since his first year as an NYU dental student. In 2009, he coauthored a presentation on staining characteristics of sports drinks on dentin and enamel with Dr. Calogero Dimaggio, Class of 2011. Mr. Bae and Dr. Dimaggio were mentored by Dr. Mark Wolff, associate dean for predoctoral clinical education and professor and chair of the Department of Cariology and Comprehensive Care, and by Dr. Timothy Bromage, adjunct professor of biomaterials and biomimetics and of basic science and craniofacial biology.


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And the winner is … Aimée Werremeyer, DMD. Dr. Werremeyer is

the recipient of more than $16,000 in prizes as the lucky winner

of The New Dentist™ Practice Pack giveaway. She is a Boston

University, Class of 2007 graduate and recently purchased a

practice in Bellingham, WA.

“I was very surprised to learn I was the winner,” said Dr. Werremeyer. “I am really excited about the package. I think I can use all of it because I just purchased a practice on September 1, 2011, and buying a practice is more expensive than I anticipated.” The Pacific Coast native spent four years working in a community health clinic before taking the plunge to purchase her own practice. She credits her mom who was a dental hygienist for influencing her to pursue a career in dentistry.

While Dr. Werremeyer still spends some Saturdays in the clinic, she says that she wanted to purchase her own practice for a couple of reasons. “I wanted more freedom in

what I could provide to my patients. In the community clinic, you are limited on what you can do. I also enjoy having a relationship with patients. There are seven of us working at the clinic so a lot of the time you wouldn’t get the same patient, and we rotated among three different clinics.”

In her newly purchased practice, she has five employees on staff: two hygienists, two assistants, and a business assistant.

She notes that the best part of working in dentistry is “making people happy, and seeing their smiles.” At the same time, she says it is also the greatest challenge, “You want to make everyone happy but you just can’t.”

In her spare time, Dr. Werremeyer enjoys spending time with her fiancé, renovating her recently purchased home, and taking her 3- year-old pug, Diesel, to the area dog parks.

As the winner, Dr. Werremeyer will receive the following:

McKenzie Management’s Business Management Training for the Dentist/CEO - TwoFullDaysofOne-On-OneTraining- This customized training program walks new dentists step-by-step through the business side of dentistry and what it takes to be an effective leader. Dr. Werremeyer will learn how to set realistic objectives, establish effective recruitment and hiring techniques and get clear, precise answers to hundreds of practice questions.

ProSites Website and One Free Year of Website Hosting - As the Practice Pack Winner, Dr. Werremeyer will receive a FREE tailored website and one year of web-site hosting.

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InTouch Practice Communications - InTouch Practice Communications’ fully custom telephone message on hold program is truly dentistry’s standard. Hers will become one of thousands of practices to enjoy the fully custom written programs and unlimited message changes.

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a set of four instruments, bumper guards and a training DVD.

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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.”

My great idea? Put patients at ease by spending

as much time with them upright

in the chair as reclined.

“”

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Loupes continuedfrompage17

when purchasing loupes are the declination angle, working distance, and frame size/shape. Loupes with the appropriate declination angle allow the individual to work with minimal forward head posture. The further forward the head must be to see through the loupes, the more severe the strain on the neck muscles and discs.

At one point, Dr. Patel was told by another loupes manufacturer that it’s not possible to achieve a declination angle of 40+ degrees in TTL style loupes. But through online research, he found Q-Optics. “They told me they could go as high as 42 degrees, and if it didn’t work out, I would get my money back. By the time I talked to Q-Optics, I had four sets of loupes in my office. I told the company rep that they were part of an experiment. We wanted to achieve the best ergonomics we could. They came in took measurements and a bunch of digital pictures.”

Upon trying the loupes, Dr. Patel said the view was dramatically different. “It was everything I was looking for. They had the lens style I wanted, the declination angle, and the magnification.” He says that all the clinical staff now wear the Q-Optics loupes except the dental assistants.

“The best thing about Q-Optics is their customer service. Hands down I would give them 10 out of 10. The beauty of it is that they have a lifetime warranty on their loupes, and they were $600 less than the next best company that I found.” Dr. Patel has been using the Q-Optics loupes for about two years. At the time of purchase, he says that the practice paid about $1200 for the doctors’ loupes. He urges new dentists to do the research and try different brands before they invest in loupes. “Have multiple companies come in and try the different loupes side-by-side, so that you can really compare apples-to-apples. If you get a pair, try it out and send it back, then get another pair. You really cannot compare them together. Not everyone is going to be a fit for Q-Optics, but we’ve found them to be the best for our practice.”

Dr. Patel shares the story of a friend and fellow dentist that he referred to Q-Optics. “We went on a ski trip, and she could only ski for half a day because her neck was really both-ering her, and she is four years younger than me. I suggested that it might be her loupes causing the problem and urged her to try out Q-Optics. Sure enough, once she switched her loupes, her neck pain went away.”

Heine, SurgiTel, Q-Optics Loupes (cont.)

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• If you wish to change your current working distance caps, please inquire with Customer Service.

Magnification Field of View Weight Model # Working Distance 2.5x 4-5” 38g * M-2.5TTL 10” - 26” Customized 2.5x 4-5” 43g * F-2.5TTL 10” - 26” Customized 3.0x 4-5” 36g * M-3.0TTL 10” - 26” Customized 3.5x 4-5” 36g * M-3.5TTL 10” - 26” Customized

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was introduced for easy photo-documentation of suspicious lesions that might be referred to a specialist for biopsy. Learn more, call 888.541.4614 ext. 231, or visit www.velscope.com

The latest news on products and services for new dentists and their practices

DDS GP – Dental App for iPadKick Your Apps, Inc., a dentist-owned com-pany, offers DDS GP, an app for the iPad. DDS GP is now the fastest growing and highest rated dental app on the market. It is based on a few simple concepts: Deliver a tool that allows dentists to educate patients without scaring them out of the chair. Offer the prod-uct at a reasonable price never charging for updates or subscription. Reduce consult time dramatically while increasing understanding in their patients. Learn more, call 858-722-8611 or visit www.kickyourapps.com

Life Peak ~ Eco Friendly Hand Sanitizer & Soap CleanserLife Peak sanitizer is a four ingredient liquid sanitizer rinse formulation that has NO Arti-ficial Preservatives, NO Gel, NO Foam, and NO Sticky Residue. It kills 99.99% of germs and softens hands. Life Peak’s three stage sanitation process allows for moisturiza-tion to occur immediately after the initial germ killing phase. This ecologically friendly product does not contain any artificial preservatives. Learn more, call 949.273.9001 or visit www.GermsOffHands.com/

New Dentist Bookstore ...... 31www.thenewdentist.net877-777-6151

New Dentist Website .......... 11www.thenewdentist.net

Practice Cafe ..........................5www.PracticeCafe.com888-575-CAFE (2233)

SurgiTel General Scientific ...IFCwww.surgitel.com800-959-0153

Wells Fargo Practice Finance (formerly Matsco) ............... 27www.wellsfargo.com/welcomedentists888-937-2321

SKINNY on the Street

For a complete listing, visit www.henryschein.com/ppt or call 1-800-730-8883

12PT6315

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

CALIFORNIAFresno-Merger opportunity-IV Sedation practice, GR $933K#14250Glendale-FACILITY SALE! 1760 SF #14373Grass Valley-5 Ops, 1950 SF, GR $545K #14372Grass Valley-3 Ops, GR $307K, Adj Net $105K #14337Grass Valley-4 Ops (5 Available),1555 SF, GR $491K #14379 Greater Chico-4 Ops, 1200 SF, GR $584K, Adj Net $152K#14359Lakeport-8 Ops, GR $904K, Adj Net $302K #14338Hayward-4 Ops, 1600 SF, Great location, GR $501K #14371Irvine & Costa Mesa-Combined practices, GR $781K, Adj Net$369K #14355Laguna Niguel-4 Ops, 1500 SF, Pan, EZ Dental #14352Lancaster-4 Ops, 2360 SF, GR $676K #14376Lemoore/Hanford-3 Ops, Practice & Building, GR $378K#14375Lindsay-2 Ops (3 Available), Practice & Building for Sale, GR$330K #14363Los Angeles-4 Ops, 1200 SF, GR $274K, Adj Net $89K#14348Marin County-3 Ops, 650 SF, Low overhead, GR $179K#14370Northern-4 Ops (5 Available), 1770 SF, GR $638K #14251Pleasanton-5 Ops, Excellent location, Beautiful, Must See!#14364Plumas County-3 Ops (4 Available), 1245 SF, GR $475K#14318Roseville Area-5 Ops, 1887 SF, GR $568K #14381Sacramento-7 Ops, 2400 SF, GR $546K, Adj Net $159K#14374Sacramento/Roseville-Highly successful GP practice #14334San Bernardino-12 Ops, 4500 SF, Multi-specialty, GR $972K#14377Santa Clara-BUILDING Only! 2 Units, 3776 SF #14368Santa Cruz-4 Ops-Room for 1 more, 1855 SF, 6 Days hygiene#14361San Diego-3 Ops, 950 SF, Dentrix, Pan, GR $414K #14356San Diego-3 Chair office, Pan, Intra Oral Camera #14321San Diego/City Heights-3 Chair office, Pan #14321Torrance-3 Ops, 800+ SF, GR $413K, Adj Net $203K #14369Tracy-1250 SF, Remodeled pedo practice, GR $677K 14378

CONNECTICUTSouthern Coastal-Fabulous periodontal practice, GR $900K#16115

FLORIDAHialeah Gardens-4 Ops, 1 Hygiene, GR $752K #183804Miami-3 Ops, Digital Sensors + Pan #183803

GEORGIAAtlanta-Looking to expand, GR $942K #19138Dublin-GR $1M+, Asking $825K #19107N Atlanta Suburb-Small office w/great potential, GR $484K#19142W Georgia-Modern, Great opportunity #19140W Georgia-Wonderful opportunity, FFS, GR $690K #19143Suburb of Atlanta-Beautiful, Large general practice, GR$850+ #19145

HAWAIIMaui-4 Ops, 1198 SF, Pano, Laser, I/O Camera, GR $636K#20101

ILLINOISChicago-9 Ops, Multi-Dctor, GR $1.8M #22140North Central-4 Ops,Beautiful modern office, GR $850K #22141Northwest-Growth potential, GR $550K #22137W Suburbs Chicago-6 Ops, Well-established #22142W Suburbs Chicago-Qualified buyer to buy/merge #221351 Hr SW of Chicago-5 Ops, $500K production #22123

INDIANACentral-4 Ops, Building also for sale, GR $400K #23114

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

KENTUCKYLouisville-Great starter practice/merger #26104

MASSACHUSETTSN Western-Beautiful location, Real estate for sale, GR $440K#30144

MICHIGANMelvindale-Well-established, Bldg available #313503Metropolitan Detroit-Specializing in implants/crown/bridge#313502Detroit Metro Area-For immediate sale #313505Southeastern-Mobile Dentist, Great opportunity, GR $800K#313504Traverse City-3 Ops, Prime location, GR $397K #313507West-5 Ops, 2000 SF, Well-established pediatric practice, GR$520K #313501Western (Just Outside Grand Rapids)-GR $600K #313506

MINNESOTAMinneapolis-Excellent opportunity, Great growth potential#32112Suburban St Paul-Established practice, Excellent location#32111

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

NEW JERSEYAtlantic County/Egg Harbor Township-Established, Great area#392139Central Jersey-Well-established pediatric practice, GR $945K#392145Monmouth County-Hi-Tech 7 Ops, State-of-the-Art, Digital#392140 South Jersey-1600 SF, 4 Chairs, Beautiful new facility#392143

NEW YORKOnondaga-4 Ops, State of the Art #412338Onondaga County-4 Ops, Highly desirable location GR $480K#412336Queens-Well-established, 3 Ops, Booming location #412337

NORTH CAROLINAAlamance County-Well-established w/Updated equipment#42182Cabarrus County-Well-established, Excellent location, Digital#42179Cumberland County-4 Ops, Excellent location, GR $1M#42181Eastern-4 Ops, Great “”Small Town”“ practice #42174New Hanover County-Practice on coast, Growing area #42145Northwest-Seasoned practice in small town, Bldg available#42178

NORTH DAKOTAS Central-Wonderful productive rural practice, GR $696K#43102

OHIOCenterville-4 Ops, 8 days hygiene, Profitable, GR $680K#44163Centerville-4 Ops (Room for 5), Very profitable, GR $900K+#44162Dayton-Well-established, Available immediately, GR $430K#44165Greene County-Well-managed, Low overhead, Large profes-sional bldg #44160Mason/West Chester-5 Ops, State-of-the-Art, GR $2M+#44177Medina-Associate to buy 1/3, Rest of practice in future #44150N Cincinnati-Excellent net profit 4 days/week, Immediate sale#44172Northern Summit County-3 Ops, 2750 Active patients,Picturesque setting #443901Scioto County-35 Year+ established, 3.5 Day/week #44171Warren County-Very profitable, FFS, Digital #44176

PENNSYLVANIABradford County-4 Ops, 2700 SF, Borders NYS, Digital, Pan#472094Carbon-Established, Digital, Laser, Pan #472088Center City Philadelphia-3 Ops, Well-established #472098Cumberland County-4 Ops, Well-established #472003Delaware County-3 + 1 Ops, Hot area, FFS, GR $196K#472004Lancaster County-3 Ops, FFS, Loyal patient base #472095Lancaster County-3 Ops (Room for 3 more), 2200 SF #472097Luzerne County-4 Ops, 1000 SF, Real Estate available #47151Northampton County-4 Ops, Well-established, Pan #472092Northeast Philadelphia-4 Ops, 1200 SF, Home office #472096Northeast of Pittsburgh-3 Ops, Victorian Mansion, GR $1M#47140South Central-5 Ops + 3, Well-established, GR $766K#472002Wayne County-Beautiful 9 Ops, Dentrix, Pan, Real Estate available #472093

TENNESSEEClarkesville-Excellent opportunity, GR $800K #51116Elizabethton-Great area, Quality practice #51107Maryville-Great practice, Growing community, GR $739K#51109South Middle-Great practice for Young DDS, GR $375K#51122Tri Cities-TMJ practice, GR $290K #51119

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

WASHINGTONSeattle-Well-established Pedo practice, 4 Ops, GR $402K#56103

WISCONSINSoutheastern-7 Ops, 6500 SF, Bldg + Practice package deal,GR $1M+ #58121

When It’s Time to Buy, Sell, or Merge Your Practice You Need A Partner On Your Side

© 2012 Henry Schein, Inc. No copying without permission. Not responsible for typographical errors.

12PT6315_DE_Feb 1/11/12 4:17 PM Page 1

[email protected]

View course curriculum at w w w.mckenziemgmt.com/cons-star tup.htmand w w w.mckenziemgmt.com/prac ticeacquisit ion.htm

Practice Start Up PROGRAMPractice 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.

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 TODAYand 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

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

Documents

New Dentist Spring 2012