new dentist summer 2011

THE #1 JOURNAL FOR NEW DENTISTS

SUMMER 2011

PLUS

Do You Have an Exit Plan?

Could Restoration Failures Threaten Patient Confidence?

ENDODONTIC TECHNOLOGY in the New Practice

Dr. Stephen Buchanan

Everyone should smile with confidence. . . And every dentist can help.

This material is an outline only and not a contract. Benefits provided under respective Group Policy Nos. (104TLP Term Life, 1105GDH-IPP Disability Income Protection, 1108GDH-SDP Student Disability, 1106GDH OEP Office Overhead Expense Disability, 104GUL Universal Life, and 1107GH-MCP MedCASHSM) issued to the American Dental Association; insured by Great-West Life & Annuity Insurance Company and filed in accordance with and governed by Illinois law. Coverage available to all eligible ADA members residing in any U.S. state or territory. Term Life, Universal Life and MedCASH premiums increase annually, Income Protection every 5 years and Office Overhead Expense every 10 years. Premium credit discount not guaranteed but reevaluated annually. ©2011 Great-West Life & Annuity Insurance Company. The inverse boomerang logo is a registered trademark of Great-West Life & Annuity Insurance Company. All Rights Reserved. NDAD11-ND

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WWW.THENEWDENTIST.NET2 SUMMER 201 1

Dear Readers,

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

When dentists are early in their

careers, the focus, understand-

ably, is building the practice,

establishing a strong patient

base, ensuring that you are continually learning and

growing in the profession. In the first 10 years, few

are giving much thought to developing an exit strat-

egy, except perhaps new dentists like Dr. Maureen

Winslow of Iowa. She takes seriously attorney

Stephen P. Rickles advice that every dentist, no

matter how young, should have a written succession

plan if they own a practice. Learn more in Leslie Franklin’s article on page 10.

Also in this issue, Dr. Stephen Buchanan, one of the nation’s leading endodontists, urges

new dentists to use the right equipment and keep those endo patients in the practice. And

don’t miss our interview with dentistry’s periodontal guru, Dr. Robert Fazio. This Yale professor

and practicing periodontist has some surprising advice for new dentists eager to build a strong

patient base.

Additionally, New Dentist™ columnist Dr. Josh Austin explores whether dentists might be

compromising quality for aesthetics when choosing resin composites over amalgam. You won’t

want to miss his perspectives on this topic.

Finally, I encourage you to register for The New Dentist Practice Pack giveaway. Over

$16,000 in fabulous prizes will be awarded to the lucky NEW DENTIST winner, including

equipment, training, and website development. Register at www.thenewdentist.net, and while

you’re there, discover a wealth of FREE information and materials to guide you at every step

throughout your dental career.

Fondly,

Sally McKenzie,

Publisher

FROM THE PUBLISHER’S DESK

S U M M E R 2 0 11PUBLISHER Sally McKenzie [email protected]

DESIGN AND PRODUCTIONPicante Creative 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 ©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 [email protected]. For advertising information contact [email protected] or 877.777.6151. Visit our website at www.thenewdentist.net to download a media kit.

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TABLE OF CONTENTS SUMMER 2011

D E P A R T M E N T S

F E A T U R E S

2 Publisher’s Desk

26 Dental Students: What’s on Your Mind?

32 Skinny on the Street

32 Index of Advertisers

5 Reasons Why You Need Digital CommunicationsBy Fred Joyal, 1-800 Dentist

Starting Your Practice? Map Out an Exit PlanBy Leslie Franklin, Director of New Dentist Markets, Great-West Life & Annuity Insurance Company

Been There Done That: Periodontal Guru Offers Advice for New Dentists

New Endodontic Technology in the New PracticeBy L. Stephen Buchanan, DDS, FICD, FACD

What is Aspen Dental Doing for Today’s New Dentist?

The Cycle of Re-Restoration: Could Restoration Failures Threaten Patient Confidence?By Josh Austin, DDS

Cure at the Speed of LightBy Tess Fyalka, Managing Editor

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COVER PHOTO COURTESY OF L. STEPHEN BUCHANAN, DDS


5 Reasons Why You Need Digital Communications

BY FRED JOYAL, 1-800 DENTIST

Fred Joyal is the founder and spokesperson for 1-800-DENTIST® and author of Everything is Marketing: The Ultimate Strategy for Dental Practice Growth. As the industry’s foremost expert on dental consumer marketing, he has lectured at dental tradeshows nationwide and is a regular contributor to various industry publi-

cations. Fred can be reached at [email protected].

CONTINUED ON PAGE 8 >>

T ake a look around you. How many people are using their cell phones to send text messages and check email? My guess is most of them. This is more than just a fad. In fact, studies

show that Americans send one trillion text messages a year and check their email at least three times a day. There are also 500 million people on Facebook® and 50 million on Twitter®. So what does this have to do with your practice?

How you respond to the reality of digital communica-tions can determine whether your practice stays ahead or falls behind. If you do nothing, you can expect the same in return. But if you embrace digital communications and integrate email, text, and social media into your practice, you’ll save time and money and reach more patients faster. Sound good?

1 Save on paper and postage. Hand-writing appointment reminders is a nice touch, but let’s face it, this takes a lot of time out of your team’s schedule. Plus, most patients lose them or accidentally throw them away. Instead of hand-writing appointment reminders, email them or text them. You won’t have to spend a dime on paper or postage, and you’ll have a greater chance of reaching patients in a way they’re accustomed to communicating.

2 Reduce no-shows. Communicating electroni-cally not only allows you to reach your patients in a timely manner, but it also makes it easier for patients to respond quickly. This will help your staff reschedule appointments and fill schedule gaps faster, which means less production lost due to missed or forgotten appointments. Definitely use email for appointment confirmations and consider giving text messaging a try. Most people respond to text messages even faster than they do their emails.

3 Improve recare. With email and Facebook, it’s easier to stay fresh in your patients’ minds and remind them about the importance of professional dental care. But you have to use them effectively. That means building your Facebook friends list and asking your patients to “like” your business page. Then use your wall to post facts and statistics about regular dental care that will get people’s attention. With email, your team can send recare notices without ever licking another stamp. If any holidays fall in between your patients’ appointments, use email to send greetings. When

you show patients that they are on your mind, you, in turn, will be on theirs.

4 Attract more patients. Facebook can be a great public relations tool for your practice, if you follow a few rules. First, you have to continuously work on building your friends list. The easiest way to do this is to ask your friends to ask their friends to “like” your page. Second, you have to update your wall frequently; you want your prac-tice to come across as a comfortable, friendly, lively office. I suggest keeping your content fresh by posting dental tips, news, pictures, and links to interesting articles or videos. Even better, let people know how your office goes above and beyond to make patients feel comfortable. Highlight amenities you offer, like blankets, pillows, headphones, and movies. Emphasize technologies you use to reduce pain and treatment time. Show people pictures of your happy patients

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Digital Communicationscontinued from page 6

(but be sure to get permission first). In fact, have a release form for all your patients and team members.

5 Run offers that actually work. Most dentists I know offer specials on things like teeth whitening, clear braces, or exams and cleanings, but they use regular mail to promote them. This is a mistake. Think of how much junk mail you get every day – it’s too easy for your mailer to get lost in that pile. On the other hand, Facebook, email, and text messaging allow you to broadcast your promo-tions to a wide audience in a matter of minutes. You’ll be amazed at how rapidly the word spreads – and how quickly people respond. For special offers, I recommend trying Twitter,

too. There are countless stories about hugely successful Twitter promos. Who knows? Yours could start a re-tweeting flurry that lands you more patients than you ever imagined.

Now, going digital might be more than you or your staff can handle. If this is the case, I recommend signing up for an automated communications plan like Patient Activator®. Members of Patient Activator® get all the benefits I outline above, without actually having to do any of the work.

Whether you take the do-it-your-self route or sign up for a communica-tions service, it’s clear we’ve reached a point where you can’t ignore digital communications. Everyone’s using it, and they expect you to be as well.

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STARTING YOUR PRACTICE?

Before the ink had dried on Dr. Maureen Winslow’s diploma, she already knew where she would practice, with whom, and what she and her

partner would do if either one died, became disabled, or reached retirement.

Developing an exit strategy—called business succes-sion planning—might sound like something only a pessimist would do. But, in fact, it’s an integral part of a sound busi-ness plan… especially to protect the individuals involved and the continuity of the practice.

“Every dentist, no matter how young, should have a written succession plan if they own a practice,” says Stephen P. Rickles, J.D., an estate planning and tax attorney in Denver. “It’s one of the smartest business moves a dentist can make.” In fact, just like Dr. Winslow, you can get your exit game plan in place at the same time you are entering into practice.

A buy-in agreement…Maureen Winslow came to the attention of her future partner, Dr. Donna Grant, when Winslow was still in dental

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school. “My dad owns a business in my hometown of Norwalk, Iowa, and he knows Donna,” Winslow explains. “He told her that I hoped to come back home to practice after graduation.”

Dr. Grant recalls the conversation. “I’d owned my practice since 1996, and it was growing, so I was inter-ested in bringing a partner on board,” she says. “I agreed to meet Maureen, and we hit it off immediately. We started talking about working together while she was still completing her studies.”

During Winslow’s senior year, the two women attended a seminar about dental partnerships and began working with a consultant to lay the groundwork for their business relationship—how it would be structured, potential income, estimated costs, expectations for each partner, and so on. Attorneys drew up the contracts, and an appraiser valued the practice prior to Dr. Winslow’s buy-in. “We covered all the bases so nothing would hit us out of the blue,” Dr. Grant says. “We wanted to make sure we would both be happy in this partnership.”

The two agreed to phase in the partnership over five years, so when Dr. Winslow graduated in 2005, she joined the practice as an associate. That first year—the “honeymoon phase,” as she puts it—was a time to evaluate how the two dentists liked working together. During the next four years of her associateship—the “equity phase”—part of each paycheck Dr. Winslow received went into a fund for her down payment on the buy-in.

By 2010, Dr. Winslow had 1) the full down payment, 2) a bank loan, and 3) a private loan from Dr. Grant and her husband. With financing and legal agreements finalized, Dr. Winslow, at age 32, became an equal partner in Norwalk Family Dentistry. “Everything has worked out great,” Dr. Grant says.

…and an exit strategy, too As part of the partnership arrangement, the two dentists established a business succession plan that includes a buy-sell agreement. The agreement specifies what would happen to the practice if either dentist dies, becomes disabled, or retires.

If a partner dies, for example, the remaining dentist is required to buy out the partner’s share in the practice from

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her estate, which likewise is obligated to sell to the dentist. To make sure funds are immediately available to carry out the buy-sell, the agreement stipulates the use of life insurance.

Each dentist purchased insurance on the life of the other partner, owns the policy, and pays the premiums. Dr. Winslow also purchased additional life insurance to cover her practice loans.

Dr. Winslow was able to increase the ADA-sponsored life insurance she first obtained as a dental student. “The insurance gives me peace of mind that control of the practice would stay with me, not the bank, if something happened to Donna,” Dr. Winslow says. “I would own the practice outright and not be forced to sell it.”

In addition to life insurance, both dentists bought disability insurance; the buy-sell agreement stipulates that these insurance benefits must be available to buy out a disabled partner. The agreement also states that when either dentist retires, the other has a first right of refusal to buy the partner’s share in the practice. If the right is not exercised, then the retiring partner can sell her share to another dentist.

Making it workA defined exit plan removes uncertainty from what can be an already difficult situation by providing a clear road map for the owners and greater security for staff and patients. “It would be traumatic enough if one of us were to die or become disabled,” Dr. Grant says. “The whole practice would be on the shoulders of the other person. If there were no succession plan on top of that, I can’t imagine anything more stressful.”

Looking back, Dr. Winslow appreciates the time and care she and Dr. Grant took to get acquainted, experiment with working together, and set up a partnership that proac-tively covered everything from entering the practice to exiting it. “New dentists often join a practice quickly when they graduate, and sometimes the professional relationship with the other dentist doesn’t work out,” she says. “But this is my hometown, and I want to raise my two little boys here. I want this to work out—no matter what lies ahead for either of us.”

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Starting your Practicecontinued from page 10

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The New Dentist™ magazine recently had the

opportunity to sit down and talk to internationally

recognized periodontist, Dr. Robert Fazio about his

recommendations with regard to periodontal care

for patients in the new dentist’s practice. You may be

surprised to learn that he is a firm believer in keep-

ing a significant portion of periodontal care in the

general practitioner’s office.

Dr. Fazio emphasizes that there is a real advantage to establishing a conservative periodontal treatment pro-

gram in the new dentist’s practice. “The sidebar benefit is you are establishing rapport with the patients for those three or four visits. And the cost of that therapy is comparable to the cost of one or two crowns. So you are not asking the patient to spend an enormous amount of money. What’s more, you

patient. If the conditions are not appropriate for local factors and patient age, those are special circumstances that prob-ably require referral.” He notes that patients with systemic diseases, such as diabetes and those taking calcium channel blockers, also are more difficult to treat and should probably be referred. The others, general practitioners should treat in their practices.

BEEN THERE, Done That

Periodontal Guru Offers Advice for New Dentists

Dr. Fazio is co-author of The Ultimate Cheat Sheets™ - The Practical Guide for Dentists, along with Leslie S.T. Fang, MD, PhD, and Tracey Menhall, BS, MS, CPA. He is currently Associate Clinical Professor of Surgery at Yale University School of Medicine. He is also co-author of Oral Medicine Secrets and author

of the textbook Principles and Practice of Oral Medicine. A 1971 graduate of Harvard College and a 1975 graduate of Harvard School of Dental Medicine, he also completed Clinical Fellow-ships in Periodontology and Oral Medicine at Harvard. He can be reached at [email protected].


“I FIRMLY BELIEVE THAT 80% OF ALL PERIODONTAL THERAPY SHOULD HAPPEN IN THE GENERAL DENTIST OFFICE.“

He urges dentists providing periodontal treatment to pay close attention to those patients that don’t appear to be responding to Phase I periodontal therapy as that may be an indication of a more significant medical issue. “We live in a society in which 10% of the population are diabetic and 50% of them don’t know they are diabetic. If you have an ener-getic Phase I program, which I heartily recommend, be on guard for those patients that don’t appear to be responding as thoroughly as you might have thought they should.” A patient

are establishing yours as a prevention-oriented practice that is concerned about not only dentistry, but also the long-term health of the patient.”

He notes that new dentists want to think in terms of establishing a perio-management program to treat people with both gingivitis and periodontitis. I firmly believe that 80% of all periodontal therapy should happen in the general dentist office. That’s because I believe that the majority of periodontal problems can be treated with good oral hygiene instruction, solid recall, and scaling and root planing.”

Dr. Fazio finds that oftentimes newer practitioners will refer patients with periodontal disease too soon. The key, notes Dr. Fazio, is determining which patients are “winners.” “The patients that every general dentist should treat are those with enough plaque and calculus in their mouths to account for the levels of soft tissue inflammation and bone loss. The problem patient that might need to be referred to a special-ist is the one who doesn’t have a lot of plaque or calculus, and you are asking yourself why the patient is breaking down. That also applies to extraordinary disease in a young

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Endodontics will be a significant part of new dentists’ practices because many of them have been well trained in dental school, yet they have a paucity of patients. Thus, it’s hard to justify sending patients to specialty offices. Moreover, it’s a procedure with excellent net income and no lab bills.

Cost: ~$1000. Return: Know where you are in root canals at all times—they will pay for themselves within 20 RCT cases.

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New Endodontic Technology in the New Practice: WHAT TO LEAVE IN AND WHAT TO LEAVE OUT

Efficiently providing endodontic therapy at today’s high standards requires the right tools, but not all of the tools out there. What follows is a list of

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1. Guided Endo Access Burs—After using a small round bur to enter the pulp chamber, these burs are guided by their tips around its perimeter, resulting in ideal outline form. In molars they prevent pulp chamber floor perfora-tions. The best is SybronEndo’s LAX diamond.

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Dr. L. Stephen Buchanan is a diplomate of the American Board of Endodontics and a fellow of the International and American Colleges of Dentistry. He also serves as an assistant clinical professor at the University of Southern California School of Dentistry and at the University of California, Los Angeles School of Dentistry. Dr.

Buchanan also maintains a private practice limited to endodontics and implant surgery in Santa Barbara, California.

Dr. Buchanan can be reached through his company, Dental Edu-cation Laboratories, www.endobuchanan.com, [email protected], or by calling, 805.899.4529.


BY L. STEPHEN BUCHANAN, DDS, FICD, FACD

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Editor’s note: Representatives from Aspen Dental recently answered a few questions for The New Dentist™ to help our readers learn more about what this company has to offer today’s new dentist.

How does the Aspen Dental student loan reim-bursement program help New Dentists?Aspen Dental’s Student Loan Reimbursement program offers one of the smartest ways to pay off dental school debt with a benefit potential up to $150,000, no service obligation and a simple application process. Dentist student loan reimbursement payments are made in addition to basic pay. For the duration of the program, eligible employees will receive annual lump-sum payments over the course of a maximum of five years.

What is the earning potential of Dentists at Aspen Dental?Today, dentists with Aspen Dental comprise the top earners in the industry. At Aspen Dental, an individual’s income is not limited to the production of his/her own two hands. We recognize that each individual is critical to the development and financial success of the entire practice and therefore deserves to share in the financial rewards.• Associate Dentist - An associate dentist’s compen-

sation includes an annual salary with opportunity for increased earnings based on office performance. Typical annual earnings: $130, 000 to $150,000

• Managing Clinical Director (MCD) - Compensation for managing clinical directors is based on the devel-opment and growth of the entire office, with MCDs sharing in the gross profits. Typical annual earnings: $170,000 - $250, 000

• Practice Owner - Aspen Dental’s Practice Ownership Program (POP) is the fastest way to life-changing wealth. With minimal investment, Aspen Dental private practice owners may develop one or multiple office locations. The average Aspen Dental practice owner has three locations, while some have chosen to develop 10 or more offices. Typical annual earnings: $750,000 +

What opportunities does Aspen Dental offer for career and professional development?At Aspen Dental, we recognize that our success is a direct result of empowering and supporting ambitious dental professionals. We provide a professional, fast-paced, entre-preneurial work environment based on a mutual respect that

keeps our interests aligned. Together, we build and develop successful, patient-focused dental practices.

Aspen Dental provides opportunities that accommodate dental professionals with varied skills and ambitions. From associate dentist to managing clinical director to practice owner, Aspen Dental defines the path to practice ownership, making it easier by minimizing the hassles and risks associated with building a traditional private practice. In fact, the average Aspen Dental practice owner spent less than two years with Aspen Dental prior to becoming an owner.

Our philosophy is simple: Our people drive our growth. That’s why our commitment to training and development is second to none. Our training and development includes programs like our Dentist Orientation Program, Practice Execution Program, and a Practice Owners Retreat, and more.

What are the benefits of Aspen Dental’s compre-hensive marketing and business support?Aspen Dental’s Practice Support Center takes care of all the business details including: administrative, marketing, and operations responsibilities, so dentists can focus on patients’ needs and still have time for a life outside of the office.

What is Aspen Dental’s Practice Model? Aspen Dental’s practice model is based on five core tenets to improve performance and enhance patient care:• Access to Care - Breaking down the barriers that have pre-

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Could Restoration Failures Threaten Patient Confidence?

The Cycle of Re-Restoration:

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

www.thenewdentist.net/clinicalblog.php.


L ike many new practitioners, I am a second generation dentist. My father practiced dentistry in the golden age of what we now call the “old-school.” Partial gold restorations, full gold

crowns, amalgams, gold foils...all procedures my father did with frequency. The days of supporting a practice on those types of restorations is long gone. Adhesive dentistry has taken over nearly every aspect of our profession. My practice is no different. I haven’t cemented a porcelain-fused to metal crown in over two years. I have performed one amalgam restoration since my practice opened in October of 2009. I am as married to adhesive dentistry as everyone else is, but deep down, I have some concerns. Does our current adhesive dentistry have a shelf life that will shock us? I am afraid it could. My fear is that adhesive dentistry, done hastily, could speed up the frequency in which we replace restorations. The cycle of re-restoration could be moving from decades to years.

The vast majority of direct restorations performed today are resin composite. The percentage of all-ceramic crowns continues to rise every year. Are we doing the right thing by replacing that 30-year-old amalgam with marginal

leakage and cracking with a bright white resin composite? A large portion of the average general dentistry practice

involves replacing aging non-esthetic restorations with a bonded restoration on middle-aged adults. These patients have had amalgam restorations in their posterior teeth for many years. Many of these have been successful for decades. This group of patients is accustomed to long lasting restor-ative dentistry. What will they say when in five years we tell them that their new composite needs to be replaced? Are they willing to trade esthetics for a shorter-lived restoration?

Many studies have shown that when placed correctly,

BY JOSH AUSTIN, DDS

Are your restorations withstanding the test of time? Tell Dr. Austin. Blog on at www.thenewdentist.net/clinicalblog.php.

The average Aspen Dental Practice Owner spent less than 2 years with Aspen Dental prior to becoming an Owner.

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with a family history of diabetes is 2.5 times more likely to be an undiagnosed diabetic themselves. The questions that new dentists need to ask on the medical history form are “Does the patient have diabetes mellitus and also does the patient have a family history of diabetes.”

But don’t stop there, urges Dr. Fazio. With the increas-ing incidence of diabetes among the patient population, he encourages new dentists to purchase a glucometer. The device enables the dentist to check the patient’s blood glucose levels. “You can have a reading in 15 seconds. Normal levels are between 80-110. If you find that it is in excess of 110, there is a very good chance that you are deal-ing with a diabetic or someone who is borderline, and the patient needs to see their physician. For less than $50, you may help detect a life-threatening disease, and if it’s not diabetes, you are still being a thorough dentist.”

Dr. Fazio finds that certain prod-ucts encourage greater compliance among the patient population. “I think there are some very specific products you can recommend. Glide Floss, for example, is made out of material similar to GOR-TEX® rather than nylon. If the patient has older fillings, nylon floss is more likely to fray than the Glide Floss. It’s hard to convince a non-compliant patient to floss if it gets stuck between their teeth.” Dr. Fazio also gives his patients the Oral B® Advantage toothbrush. “I prefer to use an extra-soft bristle toothbrush. The advantage is that the patient can get very aggressive at the gum line. Take it up a step, the electric brush has been shown to be superior to the handheld brush. The oscillating rotating electric brushes from Oral-B (Vitality and Pro Series 5000) are reviewed in the Cochrane Database as the best in the field based on data from 35+ plaque and gingivitis studies. Dentists think about writing prescriptions for an antibiotic or for pain medications.

I encourage them to write ‘prescriptions’ for specific products that will benefit their patients and tell the patient that these are the brushes and products they should use.” Dentistry should be evidence based and that includes the doctor and hygienist product recommendations.

He also urges dentists to recommend patients use Crest® Pro-Health and Colgate Total®. “These toothpastes are differ-ent than most in that they have good data to show that they are truly antibacterial and therefore, reduce gingivitis. The differences between the two are that the Pro-Health has very good stain removal plus stain prevention data and superior anti-calculus data.” Additionally, he notes that among com-

monly used mouthwashes, Listerine® and Pro-Health are the only products that have antibacterial properties and also help control gingival problems. For these rinses to work, they must be held in the mouth for 30 seconds twice daily. Listerine® is alcohol based and burns therefore reducing potential patient compliance. The water based Prohealth is easier to use. “The Uni-versity of Florida College of Dentistry looked at combining antibacterial mouthwash and toothpaste and the use of the electric toothbrush and compared it to a conventional fluoride toothpaste and conventional handheld toothbrush. They showed 61% plaque reduction in adults and even non-compliant orthodontic patients were

showing 41% less plaque over a four-week study period when they combined the rinse and the electric toothbrush.”

Dr. Fazio also finds that investing in quality tools can be a huge cost savings and time savings for new dentists. “In recent years, I started using the American Eagle Instruments® XP Technology. They are slightly more expensive but they tend to last significantly longer. These instruments never have to be sharpened, and I do mean never. They maintain a per-fect edge through 11 layers of a proprietary hardness process. I had great success with Hufriedy for years; but these, for me, are better clinically. Since you do not sharpen the instru-ments, they are not subjected to the variability of different operator sharpening preferences; therefore, they can be easily shared by different operators.”

In building the new practice, the key, notes Dr. Fazio, is establishing a strong relationship with the patients and demonstrating that the dental team is committed to provid-ing the best care for them, which includes providing Phase I periodontal treatment.

Periodontal Gurucontinued from page 14

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CURE AT

Dr. Malcmacher, who runs a private practice in Bay Village, Ohio, has been using the cord-less FlashMax 3 curing light sold by GOLDEN DENTAL SOLUTIONS for several months. “It

was advertised as the fastest curing light available capable of curing up to a 4mm depth in just one second. Like the typical dentist, I was very skeptical if it could really live up to that goal. However, after using it and testing it myself and seeing what the Dental Advisor said about it, that one-second cure I have been waiting for is now a reality. With its cordless design, it can be taken from operatory to operatory and you can get about 200 cures on a single charge of the battery. It is a new advanced LED technology that is equiva-lent to plasma arc power at a fraction of the price. There is nothing faster or better on the international market.”

Dr. Brigham Stoker’s curing light of choice is the VALO curing light from Ultradent. This 2010 University of North Carolina Dental School graduate started his practice from scratch nine months ago in Salt Lake City, Utah. He says he was very selective when choosing his equipment. “Having a brand new practice, I really made an effort to choose equip-ment that would last, that I could rely on, and would make

procedures faster. I looked at every single light and read as many reviews as I could to try to decide if I wanted corded or cordless. In the end, I decided I wanted something that was reliable, a very slim profile, extremely sturdy, quick and easy to use.”

He notes that while he would have liked to have a cord-less curing light, reliability was more important. “I didn’t want to have to worry about the battery being charged. If it’s not charged properly, you may not get the cure that you need,” notes Dr. Stoker.

As a new dentist, he urges other new dentists to care-fully consider the reliability of the device when choosing a curing light. “This isn’t a piece of equipment that you want

BY TESS FYALKA, MANAGING EDITOR

the Speed of LightIn recent years, several faster curing lights have been introduced into the dental market-

place. According to Dr. Louis Malcmacher, an internationally known lecturer and President

of the American Academy of Facial Esthetics (www.FacialEsthetics.org), some have been

good, others have not. “In the past, some made claims that they were five second curing

lights, but then in testing they didn’t even come close to what they advertised. However,

technology has come a long way in the last few years, and the new faster curing lights

seem to have reached the tipping point where they are now state-of-the-art and the

choice for every dental office.”


PHOTO COURTESY OF ULTRADENT

WWW.THENEWDENTIST.NET 25 SUMMER 201 1

to look for the bargain on. It is used several times a day in the dental practice and you need to invest in a good one.” He notes that the VALO model is very easy to use and his assistant was able to put it to use almost immediately with little training.

For Dr. Greg Penney of Vermont, he prefers the Sapphire Plus by DenMat. He purchased his first one in April 2009 and was so impressed with it that he bought a second for the office in May of 2010. He discovered this curing light through DenMat’s continuing education course on veneers. “This was the light they recommended and it was part of the package. At the time we were using a couple of other different brands. After using the Sapphire Plus, it became the only light that we would use. Other lights typically

take about 10-20 seconds; this light cures in three-five seconds. It drastically cuts down on the amount of time. It’s great.”

Dr. Penney, a 2003 graduate of McGill Dental School in Quebec, Canada, finds that the only disadvantage is that the model he uses is somewhat bulky and can generate heat, which requires additional care during certain procedures.

He too urges new dentists to look for a curing light that is durable and reli-able. “If you can put one in every room great, but if not,

be sure to look for a light that is durable because it will take a beating. They also need to consider the curing intensity.” Dr. Penney says that next to the autoclave, it is the most used piece of equipment in his office. (L

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DENTAL STUDENTS: What’s on Your Mind?

The New Dentist™ recently talked with University of Connecticut School of Dental Medicine student Laura Huling about what attracted her to the profession and what she appreciates most about her dental school experience.

TND: Why did you choose to pursue a career in dentistry?I have always wanted to pursue patient care as my career. Be it medicine, dentistry, or nursing, they all appealed to me because you use a specific skill to care for patients who sincerely need you. Dentistry was appealing for a couple of reasons. As a dental professional, you are the diagnosti-cian and the clinician. Every day, dentists use aspects of radiology, pathology, infectious disease, and psychology in the management of their patients. Also, I felt as a dental practitioner, you must have the personality characteristics to gain the trust of your patients. The mouth and the face are very personal areas and our patients allow us to get up

close and personal with them. This challenge of trust was another aspect that appealed to me. Furthermore, I love the autonomy of the profession. A dental practitioner can make their practice fit the patient needs rather than the patients having to fit another framework.

TND: What do you feel is the greatest challenge facing dental students today?Dental students are challenged everyday of their lives. Most dental students are their own front desk, finance department, and care provider. I believe that these challenges are enough, but manageable. It is when extra challenges are further imposed on the students that stress mounts. One of the major stresses nowadays, as I am starting to realize, is licen-sure exams. The exams are now seen as a hoop that students must jump through in order to graduate rather than a true assessment of their ability to carry a dental license. Patient recruitment (and in many cases lesion recruitment), cost of the exam, and other headaches are the main challenge to the students at our school, and I am sure across the country.

TND: What is the single most important survival tip you have for dental students?I would have to say positivity. There will be days in dental school when the weight of the world is on your shoulders. Faculty are telling you that you did things wrong, your patient’s are cancelling, you are behind on your requirements, etc. Students must have the ability to know when things are out of their hands and know when to do something about it. Shake it off; you got to dental school for a reason!

TND: What do you see as the greatest challenge fac-ing new dentists entering practice today?I haven’t been acclimated to the challenges that would face new dentists and this might be the biggest challenge. Naivety on what a new dentist is to face is a weakness that many dental students have. When they are blindsided by the challenges that face new practitioners, it is tough, especially if there is no support structure. I think the best thing students can do is surround themselves with current dentists who have been through it before, and reach out to them when they need them.

Dental students, tell us what’s on your mind. Email Managing Editor Tess Fyalka at [email protected]. We want to hear from you.

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Re-Restorationcontinued from page 20

resin composite can last as long as amalgam. One in partic-ular is a 2001 article in the Journal of Esthetic Restorative Dentistry, Andre’ V. Ritter, DDS, Luiz N. Baratieri, DDS, MS, PH D. Their study showed no failures at a four-year follow-up when using a total-etch technique. I think these results may hold up in the hands of an academic-based clinical researcher. In the hands of a private practice new dentist with a stressful schedule, things might not be so equal. A recent audit of pre-doctoral records at UTHSCSA Dental School by Dr. Dave Overton and Dr. Diane Sullivan showed that class II resin composite restorations were 7.5-times more likely to fail than class II amalgam restorations. The most common mode of failure for composites was missing or loose restorations. This leads me to believe that the failure lies in lack of retention of the preparation and failure to properly execute the steps involved in dentinal bonding.

Despite what you might believe with regard to conser-vation of tooth structure, I believe that dentistry of the past required more exacting preparations. Gold inlays and onlays require tactical skill that many dental schools no

tion itself. Did I eliminate all decay? Am I close to the pulp? Are the walls smooth? Do I have retention factors other than the adhesive bond? Are the margins clean and contin-uous? After those, I begin to examine isolation. Where are the potential sources for contamination in this case? What do I need to do to mitigate those sources? Answering these

The cycle of re-restoration could be moving from decades to years.longer teach. Pin-retained amalgam restorations similarly required a high level of preparation detail. With adhesive dentistry, our preps have become much more conservative, but equally more simple. Could this lack of preparation exactness be leading to a generation of dentists who are weak on attention to detail and preparation skill?

Replacing longer-lasting restorations with shorter and shorter-lasting restorations means more and more ventures inside of a tooth. The more times we touch a bur to a tooth, the shorter life that tooth has. What starts with replacing an amalgam with a composite leads to replacing that composite with an all-ceramic crown. After that, endodontic treatment is initiated through the all-ceramic crown. After the endo fails, the tooth is extracted. That is the worst case scenario in the cycle of re-restoration.

In the past, I believe the cycle of re-restoration was slowed by technical precision and proficiency. Today, that cycle can be accelerated by poor technique with adhe-sive materials. We all need to briefly pause before every adhesive restoration we do to run through a quick mental checklist and ensure we are set up for long term success.

For me, the checklist is easy. I start with the prepara-

questions takes just a couple of seconds. I recommend everyone develop their own mental checklist before placing their final restoration to help ensure success and add years to the life of the restoration.

I have had many experiences replacing my own previ-ously placed restorations. As a new dentist, this isn’t easy. It basically means I failed in some aspect of that restoration. Sure, sometimes the blame falls on the patient’s poor oral hygiene. On the other hand, maybe that situation should have been identified and a different material used. The bottom line is that I feel our generation of dentists may be replacing more of our own restorations and more quickly than the generations before us. It will be dependent on us to ensure that we do everything possible to provide the best restoration we can for our patients.

References:

Baratieri L, Ritter A. Four-Year Clinical Evaluation of Posterior Resin-Based Composite Restorations Placed Using the Total-Etch Technique. J Esthet Restor Dent 2001; 13:50-57.

Dr. J. Dave Overton- As of yet unpublished manuscript.

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Endodontic Technologycontinued from page 16

priate apical pressures for all the different rotary files you use. After you have 250 cases under your belt, a torque limiter will save you when you take a mental holiday with a rotary file in your patient’s tooth. Dentsply/Tulsa has a very nice one made by their sister company-Midwest.

Cost: ~$988. Return: Peace of mind during shaping, no cord weight, easily moved.

4. Rotary Shaping Files—If your rotary training in dental school was limited to hand files and orifice shapers (or God forbid, Gates Gliddens) you are in for a treat. Dentsply/Tulsa’s GTX rotary files can cut a perfect shape in a root canal with just one-three instruments. Fewer instruments, less time, no apical ripping, conservative coronal enlargement, and far better canal shapes than you will ever create by hand. When you are done shaping, the GTX system-based approach has already selected all the obturation materials you will need to finish the case.

Cost: ~$8/file, 1-3 files needed per canal. Return: $500-1000/hr production during endo procedures with conservative, ideal results.

5. Obturation—This gets a little complex because you definitely need to lose that lateral condensation of cold, hard gutta-percha. I don’t recommend it, but single cone fills, in a GTX shape, are way better than cold lateral condensation as you: a. don’t have to over-shape the coronal third of the canal so two-five useless accessory cones can be crammed beside the master cone, and b. don’t have to wedge the tooth apart with a spreader. Your best bet for safe, fast, and effective 3D obtura-tion is one or both of the Centered Condensation methods.

A. Continuous Wave Technique (Single-Cone Backfill) —The lowest cost/RCT alternative is to buy a System-B electric heat source from SybronEndo so you can heat and downpack through the thermo-softened master cone. Then throw in one of Sybron’s backfilling gutta-percha cones with sealer on it and you are done.

Cost: ~$1300 upfront, $0.75/canal. Return: Cheap on a case-by-case basis, safe, three-dimensional, easier than cold lateral condensation method.

B. Continuous Wave Technique (Syringe Backfill)—If you want the next step up this ladder, you can throw in a cordless System-B backfilling syringe by Sybron or buy an Elements Obturation Unit (SybronEndo) which has both a System-B down-pack handpiece as well as a very elegant motor-driven backfill syringe so that the down-pack and backfill devices are contained in one Unit.

Cost: ~$2700 (System B/Elements Unit) ~$2270 (Cordless

System B and backfill gun). Return: You are doing the obtura-tion method most often used by endodontists worldwide.

C. Carrier-based Obturation—The other direction you can go for filling conservatively-shaped canals in three dimensions is obturators—carrier-based filling devices—with a solid core and gutta-percha or a composite material around it. These require an oven to heat them. Carrier-based obturation is at the same time the simplest 3D filling method and the most technique sensitive. Dentsply/Tulsa invented carrier-based obturation and their GT and GTX carriers lead the market. SybronEndo has recently introduced RealSeal, a Resilon (composite resin) carrier and coating.

Cost: ~$371 for the ovens, ~$8 for each obturator. Return: 2/3rds less time to accomplish exceptional three-dimensional fills of conservatively shaped root canal systems.

6. Ultrasonic Handpiece—This device—with some type of magnification (loupes or better still, a microscope)—is a must if you are doing molar endo. If as an associate you are expected to do molar RCT, request the senior partners adequately equip you. Molar endo without an ultrasonic handpiece and magnification is impossible if you care about quality outcomes. If they are really cool, they will send you to a hands-on course too (many of the dentists who sign up for our Santa Barbara teaching lab are sent by their bosses).

Cost: ~$1395 Spartan ultrasonic handpiece (w/free hand-piece), ~$81.50 BUC Ultrasonic tips (Spartan) ~$600-1200 for loops, ~$2685 SB Hands-on course. Return: Perfect visual access to pulp chamber anatomy and the cutting progress towards those elusive canals.

7. Cone Beam CT—This is a stretch, but after experi-encing the magnificence of practicing with one, doing endo without will result in feelings of victimhood and severe whining. The best dental CT machines on earth are made by J. Morita.

Cost: ~$125-250K. I know. Return: Priceless. You will know—for the first time—what is actually going on inside the teeth you are treating during root canal therapy. PH

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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.

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

Whether you’re planning to acquire a practice or start one from scratch, we’re here to help. With more than 20 years of experience in dental practice lending, we know what it takes to grow a successful business and provide the resources you need to reach your practice goals.

Let’s talk about how we can support you. Contact your financing specialist at 1-888-937-2321 or visit us at wellsfargo.com/welcomedentists to request your free New Dentist Planner.

We’re here to help you take the next stepWells Fargo Practice Finance (formerly Matsco)


ADA Insurance Plans .........1www.insurance.ada.org888-463-4545

ASPEN Dental...................21www.aspendentaljobs.com866-748-4299

Bank of America ...............27www.bankofamerica.com/practicesolutions877-541-3535

CareCredit ........................23www.carecredit.com800-300-3046 x4519

Carestream Dental, LLC ....3www.carestreamdental.com800-977-6365

DenMat .............................29 www.snaponsmile.com800-445-0345

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.

INDEX OF ADVERTISERS

Dental Dreams ..................26Midwest RegionDanielle Tharp312-274-0308 x [email protected]

Dental Education Laboratories ......................15 Buchanan Courses www.endobuchanan.com800-528-1590

Northeast/South/West RegionsChyrisse Patterson312-274-0308 x [email protected]

Easy Dental .......................19Henry Schein Practice Solutionswww.easydental.com800-768-6464

GC America ......................17www.gcamerica.com800-323-7063

Golden Dental Solutions ....8www.goldendentalsolutions.com877-987-2284

Henry Schein Professional Practice Transitions ......................IBCwww.henryschein.com/ppt1-800-730-8883

Keller Laboratories, Inc. ...13www.kellerlab.com800-325-3056

Live Oak Bank ....................9www.liveoakbank.com877-790-1678866-954-8362

MAC Practice ......................7www.macpractice.com646-305-9008

McKenzie Management ...BCwww.mckenziemgmt.com877-777-6151

BEAUTIFIL Flow Plus is a revolution-ary new type of flowable restorative opti-mized with “stay-put” handling properties that allow precision stacking and sculpting unlike any other material. Shofu’s proprietary S-PRG (Surface Pre-Reacted Glass) filler technology provides glass ionomer-like fluoride release and recharge that is especially useful for high caries index patients. For a limited time

only, two introductory kits are available. The Standard kit contains two 2.2 gram syringes of both viscosities in shades A2 and A3. Pedo kit contains two 2.2 gram syringes of both viscosities in shades A1 and Bleach

White for just $99.95. Contact Shofu Dental Corp. at 1.800.827.4638 or visit www.shofu.com.

The latest news on products and services for new dentists and their practicesVestex™ Medical Apparel from Vestagen Technical Textiles is your first line of defense against exposure to blood and bodily fluids. As a fluid barrier garment, Vestex pre-vents the acquisition, retention, and transmis-sion of contaminants. Vestex also contains an antimicrobial to prevent fabric degradation from microorganisms and to control odors. Additionally, Vestex is comfortable and keeps the wearer clean, cool, and dry. Visit www.vestexprotects.com for more information.

Mini LED DayLite™ is the lightest and brightest mini LED on the market and offers adjustable bright white light from 0 to 4,400 foot candles. With the two lithium ion batteries you will receive over 14 hours of continuous light, allowing an uninterrupted full day of work.

Clip the Mini LED DayLite™ on to any brand Dental Telescopes or Loupes to pro-vide contrast and enhance visualization. See the Visible Difference® by adding the Mini LED DayLite™ to Designs for Vision Dental Telescopes. Call 1-800-345-4009 or email [email protected].

NAPB .................................25www.napb1.com888-407-2908

Practice Pack .....................12www.thenewdentist.net877-777-6151

ProSites ...............................5www.prosites.com888-932-3644

Six Month Smiles ...........IFCwww.6monthsmiles.com866-957-7645

Ultradent VALO ................11www.valo-led.com800-552-5512

Wells Fargo Practice Finance ..............................31(formerly Matsco)www.wellsfargo.com/ welcomedentists888-937-2321

SKINNY on the Street

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

11PT3583

ALABAMAFlorence-Modern office, Room to expand, GR $656K #10110

ARIZONATuscon Area-Beautiful 4 Op, 2300 SF, Modern Equip. #12112

CALIFORNIAFolsom-GR $1.5M+, 09 Adj Net $550K #14336Fresno-Merger opportunity-IV Sedation practice, GR $933K#14250Northern-1160 SF, Pedo, GR $713K #14322Rocklin-4 Ops-Fiber Optics, 1630 SF, 3.5 Days hygiene, GR$593K #14351San Diego/City Heights-3 Chair office, Pan #14321San Luis Obispo-8 Ops, Great Location GR $1.5M+, Adj Net$691K, #14353Tracy-Equipment, furnishings, leaseholds only #14335Torrance-3 Ops, 2 Equipped, 1080 SF, GR $434K #14320Visalia-3 Ops, GR $616K, Adj Net $321K #14347Greater Fair Oaks/Sunrise Area-2400 SF, 6 Days Hygiene,GR $1.1M+ #14343Folsom-4 Ops-5 possible, 2000 SF, GR $703K #14350 Greater Sacramento Area-2600 SF, Pedo, Digital #14349Lakeport-8 Ops, GR $904K, Adj net $302K #14338Plumas County-3 Ops-4 Available, 1245 SF, GR $475K#14318 Redding-5 Ops, 2200 SF, GR $1M #14293Barstow-4 Ops, 3 Days hygiene, GR $393K, w/Adj Net $193K#14357Big Bear City-3 Ops, New lease, GR $428K #14345Grass Valley-3 Ops, GR $307K, Adj net $105K #14337Irvine & Costa Mesa-Combined Practices, GR $781K,Adjusted Net $369K #14355Laguna Niguel-4 Ops, 1500 SF, Pan, EZ Dental #14352Los Angeles-6 Ops, Laser, Pan, Ceph, GR $709K #14319Newport Beach-4 Ops, 1450 SF, 3 Days hygiene #14354Oceanside-4 Ops, 1200 SF, Office space-equip only #14346Sacramento/Roseville-Highly successful GP practice #14334San Diego-3 Ops, 950 SF, Dentrix, Pan, GR $414K #14356San Diego-3 Ops, PPO-FFS, GR $185K #14315San Diego-6 Ops, 2300 SF, GR $1.4M+ #14331 Los Angeles-4 Ops, 1200 SF, GR $274K, Adj Net $89K#14348Palm Springs-3 Ops, FFS, GR $282K, Adj Net $157K #14332

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

GEORGIAAtlanta-Looking to expand, GR $942K #19138Atlanta Suburb-3 Ops, 2 Hygiene, GR $863K #19125Atlanta Suburb-1 Op, Pedo, GR $426K #19134Dublin-GR $1M+, Asking $825K #19107Macon-3 Ops, 1625 SF, State-of-the-Art Equipment #19103Newnan-Growing opportunity, GR $420K #19141N Atlanta Suburb-Small office w/great potential, GR $484K#19142N Georgia-3 Ops, High-end practice, GR $700K+ #19137W Georgia-Modern, Great opportunity #19140

ILLINOISChicago-4 Ops, GR $709K, Asking $461K #22126NW Suburb Chicago (20 Mins Downtown)-GR $500K #22131N-NW Suburb Chicago-Newer 4 Ops, Net $730K #22133W Suburbs Chicago-5 Ops, 2000 SF, GR $1.5M #22120W Suburbs Chicago-4 Ops, $900K production+ #221361 Hr SW of Chicago-5 Ops, $500K production #22123Northwest-Established, $550K Production+ #22137

INDIANAMishawaka-4 Ops, Established, Potential #23113S Indiana-General doctor seeking practice purchaseopportunity #29102

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

MASSACHUSETTSCambridge-4 Ops, Modern, GR $1.1M #30138Middle Cape Cod-Modern, State-of-the-Art #30124Springfield-5 Ops, 2050 SF, Modern #30137N Western-Beautiful location, Real estate for sale, GR $440K#30144Fall River-Real estate for sale w/practice, GR $850K #30143

MICHIGANClinton Township-5 Ops, Remodeled, Bldg available #31114Dearborn-1500SF, Great location, Bldg for Sale #31113Detroit-3000 SF, Close to suburbs #31112Flint-5 Ops opportunity, Doctor deceased #31109Sturgis-Good area close to IN border, Bldg for sale #31111Suburban Detroit-2 Ops, 1 Hygiene, GR $213K #31105West-5 Ops, 2000 SF, Well-established, GR $520K #313501

MINNESOTACrow Wing County-4 Ops, Asking $412K #32104Suburban St Paul-Established practice, Excellent location#32111

NEBRASKABox Butte County-7 Ops, Associateship opportunity #35101

NEW JERSEYGloucester County-4 Ops, GR $1M+ #39114Marlboro-Associate positions available #39102Atlantic County/Egg Harbor Township-Established, Greatarea #392139Burlington County-Historic downtown, Large Ops, FFS#392138Camden-1300 SF, Beautiful corner location, GR $327K#392133Hudson County-4 Renovated Ops, Digital #392136Monmouth County-Hi-Tech 7 Ops, State-of-the-Art, Digital#392140Salem County-3 Ops, RE available, GR $600K #392134South Jersey-Established, Great area, GR $2.7M #392135South Jersey-SF 1600, Beautiful new facility, 4 Chairs.#392143

NEW YORKSyracuse-4 Ops, 1800 SF, GR $700K+ #41107Bronx County-5 Ops, 2100 SF, Digital #412328Suburb of Syracuse-Great practice, GR $462K #41117Geneseo-5 Ops, Turn key #41119

NORTH CAROLINANorth Durham-5 Ops, RE available #42164Raleigh-1300 SF, Established #42172Raleigh, Cary, Durham-Doctor looking to purchase #42127New Hanover County-Practice on coast, Growing area #42145Charlotte-2 Ops, Beautiful space #423105Charlotte-4 Ops, 1470 SF, Digital, Laser #423106Lenoir County-Dental office bldg & equip available #423107Lenoir County-4 Ops, 2500 SF, Room to expand #423108Asheville-Established, Excellent opportunity #42177

OHIOLima-4 Ops, Established, Stand alone, GR $490K #44164Clark County-4 Ops, 3000 SF, Turn key, GR $900K #44155Clark County-2.5-3 Day/week, Bldg avail #44167Dayton-Established, Avail immediately, GR $475K #44165Dayton-Established, 3.5 Day/week, FFS, Avail immediately#44156Scioto County-35 Year+ established, 3.5 Day/week #44171Warren County-Looking for Associate to buy-in #44169Medina- Associate to buy 1/3, Rest of practice in future#44150

PENNSYLVANIAAdams County-6 Ops, RE for sale, GR $628K #472080Carbon-Established, Digital, Laser, Pan #472088Chester County-2 Ops plumbed for 3, Established #472085Cumberland-4 Ops, GR $527K #472069Franklin County-4 Ops, 2200 SF, GR $616K #472084North Hampton-4 Ops, Paperless, GR $1.2M #472082North Hampton-3 Ops, Room to expand, GR $1M #472086NW PA/College Town-5 Ops, GR $542K #472076Snyder County-Established, 4 Days/week #72087 Bucks County-Hi-End specialty practice, GR $1M+ #47149Dauphin County-6 Ops-Opportunity for 9, Dentrix #47133Lebanon County-14 Ops, Equipment 5 years old #47147 Lehigh County-5 Ops, Pedo, FFS, Open concept #47150Luzerne County-4 Ops, 1000 SF, Real Estate available #47151Northhampton County-4 Ops, Well-established, Pan #472092

SOUTH CAROLINAColumbia-7 Ops, 2200 SF, GR $678K #49102

TENNESSEEChattanooga-Paperless office, Modern #51118Clarkesville-Excellent opportunity, GR $800K #51116Elizabethon-GR $385K #51107Nashville-Great area, GR $300K #51117Nashville-Growing location, Stand alone #51120Suburban Memphis-Nice practice, GR $946K #51113Tri Cities-TMJ practice, GR $290K #51119

TEXASDallas-3 Ops, Great potential #52106

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

VIRGINIANorfolk-Small practice w/potential #55112Loudon County-8 Ops, Great area, Space available for sale#552405/552406

WASHINGTONBurien- 5 Ops, Annual production $1.2M+ #57101

WISCONSINNW WI-4 Ops w/building for sale #58120

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

© 2011 Henry Schein, Inc. No copying without permission. Not responsible for typographical errors.

[email protected]

Approved PACE Program ProviderFAGD/MAGD CreditApproval does not imply acceptanceby a state or provincial board ofdentistry or AGD endorsement.10/19/2007 to 10/31/2011

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.

ENROLL TODAYand receive

Realizing The Practice’s True Potential,

a 5-Hour DVD Set,

FREE

“My business knowledge prior to taking the Practice Start Up Training Program was minimal. Now, I have the background and resources to address issues. I would

definitely recommend this training to my peers. The Training and Manuals are very thorough and with the one-on-one training, all my questions were answered. I am very comfortable and confident now in my ability to own a dental practice.”

new dentist summer 2011

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