, a dental technology company specializing in cloud-based practice management systems, digital imaging, and dental marketing services. Previously, Gaddis was the marketing director for two large dental service organizations. Prior to entering the dental industry, Gaddis was a journalist for 16 years in a variety of roles, including as a TV news producer at the CBS affiliate in Boston. You can connect with Beth Gaddis on 

Beth Gaddis

The Future of Dental Practice Management: Embedding Financial Services | Image Credit: © Planet DDS

The pressure is on dental practices to streamline operations, enhance patient care, and maintain profitability. Dental groups that used to drive growth through mergers and acquisitions found themselves unable to close deals this year and pivoted to focus on same-store growth.

That’s led to a strategic approach to integrating financial services – such as insurance claim processing, financing, and payments – directly into the practice management system to simplify operations and increase revenue.

Integrating Financial Services to Streamline Operations

Traditionally, dental practices relied on multiple software systems to manage clinical functions and financial transactions. This disjoined approach led to inefficiencies, data silos, and increased operational costs. By embedding financial services within the practice management software, we can create a seamless ecosystem that enhances productivity and patient satisfaction.

Creating a Cohesive Dental Operating System

Imagine a patient visiting a dental office where they can schedule appointments, receive reminders, complete forms, upload their insurance card, sign their treatment plan, and manage payments all online. That’s now feasible through APIs, which enable disparate computer systems to securely share data without the need for manual data entry or logging into different computer systems.

It creates a cohesive dental operating system where actions can trigger an automated workflow that used to take people hours to accomplish manually.

For example, when the patient uploads a picture of their insurance card, it can automatically start the process of verifying their insurance benefits, receiving back the data from the insurance carrier, and automatically uploading the details into the patient chart. It eliminates the need for dental team members to call the insurance carrier or log into a separate portal to access the information and then manually enter it into the patient’s file.

Automated insurance verification is just the beginning. Integrating financial services simplifies the entire collection process.

Insurance payments can be automatically received and accurately applied to patient ledgers. If the carrier pays less than expected, it can trigger an automated text message or email to the patient to let them know there is a balance due and provide a link to make payment that then is automatically applied to their account.

Typically, though, integrated financial services help create accurate out-of-pocket cost estimates, and that gives the dental practice the opportunity to discuss different options to help their patients afford the care they need.

Dental practices can offer flexible payment options, such as financing plans with a fully integrated third-party lender. Team members no longer need to log into a lender’s website to run a credit check or receive financing approval; it can all be done from within the practice management system.

Integrations also make it easier to offer card-on-file technology and automated monthly payment plans. Practices also can send out automated text-to-pay reminders, making it easier for patients to pay their bills online and enabling practices to receive payment faster.

By centralizing financial services within the practice management software, dental practices can access data analytics to drive better decision-making. The data can reveal trends in patient spending, insurance reimbursements, and operational costs, enabling practices to optimize pricing strategies and improve cash flow management.

Integrating Financial Services is Essential

The future of dental practice management software depends on developing technology that unifies clinical and financial operations. The dental industry has lagged behind other industries in adopting the technologies that automate processes and make it easy for our patients to receive the care they need. Integrating financial services is one way we can make an immediate difference.

, a leading provider of cloud-enabled dental software solutions, serving more than 13,000 practices in the United States. The company delivers a complete platform of solutions for dental practices, including Denticon practice management, Cloud 9 ortho practice management, Apteryx digital imaging with AI, and Legwork practice marketing and patient engagement. With built-in solutions including online scheduling, digital forms, DentalXChange RCM automation, text-to-pay reminders, patient referrals, and a vast API platform, Planet DDS helps dental practices and groups achieve their goals.

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A shift to integrating financial services directly into the dental PM system has taken place this year and here’s what you need to know.

The Future of Dental Practice Management: Embedding Financial Services

Thomas Passalacqua, director of business development at The Smilest Management speaks at the 2024 Dykema DSO conference | Image Credit: © Courtesy Dykema DSO Industry Group

This year has been like a tsunami, with a deluge of difficult business conditions including high supply costs, high labor costs, high interest rates, and low insurance reimbursements overwhelming many dental practices.

At the Dykema DSO Conference in Denver on July 10, dental group executives shared how they’re faring and where they are focusing their attention for the rest of the year.

Standardization, Interoperability, and Visibility of Data

One hot topic at the Dykema DSO conference was standardization and efficiency.

“Getting all of our practices on one unified, cloud-based system was absolutely imperative for us. We’re completing our rollout of the Denticon practice management system across all of our GP practices and adding Cloud 9 practice management for ortho right after that,” says Jason Heffelfinger, CEO of Dental Care Alliance, a DSO with more than 400 affiliated practices in 26 states. With both Denticon and Cloud 9 produced by Planet DDS, the platforms are integrated so patient files can be entered or accessed from either application.

“When you have one system that you can utilize across all your practices, it just makes it easier for everybody to execute. When we think about staffing, doctor days, data—it just makes it so much easier to understand where you have opportunities. Then you can thank them for the work they do, and of course, you can course-correct when necessary,” Heffelfinger explains.

AJ Acierno, DDS, president of clinical operations for Smile Brands, agrees. The company has more than 650 affiliated practices in 32 states.

“We’re an acquisition-based company and that means we inherited a ton of different systems,” Dr Acierno says. “It means everything to be able to standardize the technology and have all your data all in one place. It lets you measure metrics, apples to apples.”

Increasing Same-Store Growth Through Systems

OMS360 drove 40% organic growth in the first half of 2024 across its oral surgery business after implementing a new patient workflow, says its CEO, Trevor Maurer.

“We wanted to understand why some of our surgeons were more efficient than others, so we performed a comprehensive analysis of surgeons and workflows. We literally did a time study of our patient journey, the staff, and even the surgeons. We needed to know who was doing what, and the impact that had on the entire patient experience. From this, we identified six phases of the patient journey and detailed how long each took for our highest-performing practices,” Maurer says.

When the research came back, the data showed that it wasn’t just something the surgeons were doing but the systems they had in place that made them successful. OMS360 then modeled the stages across its practices:

Pre-appointment, such as insurance verification

“We systemized the six phases and let each team know where the inconsistencies are in their methods. Not everyone will want to make a change, and it is truly their choice,” Maurer says. “Our commitment is to enable the doctors to practice at the top of their license. If they want to do it, OMS360 can get them there. Surgeons that were under $4 million have increased to over $6 million annually.” 

“We’ve been focusing on same-day care initiatives,” says Teresa Williams, the chief financial and operations officer of Dental Express, a dental group with 6 affiliated practices in California. “We’re taking a hard look at what’s happening for each of our patients when they’re in the building. People want to get care immediately, so we’re making it easy for them through third-party financing, building larger teams so we can provide same-day care, and even expanding the footprint of our offices.”

Same-Store Growth Through Payer Mix Changes

Many DSO leaders predicted COVID-19’s impact on the global and local economy, from supply chain issues to higher prices for goods, higher wages, and higher interest rates. Himesh Kana, DMD, managing director of Dental Depot DFW, began evaluating their systems and payor mix in 2022. Dental Depot has 37 affiliated practices in Texas, Oklahoma, Arizona, and Missouri.

“We looked at our phones, we looked at our treatment acceptance rate, we looked at training, we looked at all of our payors, we looked at our data, and we looked at our patient volume,” Kana says. “We have a really solid membership model with Subscribili; it’s now our second highest segment of commercial payors, and our per visit output on our membership model is much higher, by 20% to 25%.”

The Smilist Management, a DSO with almost 100 affiliated practices in the Northeast, is focusing on revenue cycle management to drive same-store growth too.

“We negotiated a rate increase on our PPO plans. We tightened up on our RCM processes and our accounts receivable,” says Thomas Passalacqua, director of business development. “We added automation to our RCM, which has really improved patient communication, insurance verification, and collection rates.”

Artificial Intelligence to Increase Case Acceptance

Technology is another area that dental support organizations are leveraging to increase same-store growth.

“One of the newest technologies we’ve implemented is Pearl AI, which integrates directly into our Apteryx digital imaging,” says Bradley Dykstra, founder of MI Smiles Dental Group, which has 7 affiliated locations in Michigan. “A picture’s worth a thousand words, and it’s really helped the patients to visualize what we’re talking about. The clinicians like it, and it’s a time-saver for the hygienists because it shows where there is radiographic bone loss. For me, it’s a great way to gauge how each of the associates are diagnosing.”

“We have recently partnered with Overjet to incorporate AI into our operational and clinical processes,” says Kyle Smith, chief financial officer at My Community Dental Centers, a non-profit dental support organization with almost 50 locations in Michigan. The outcomes have been impressive, showcasing enhanced diagnostic accuracy, streamlined claim submissions, and improved reimbursements from payers.”

DSO leaders are evaluating other AI-powered technologies including call center bots.

“This new generation (of patients) doesn’t want to deal with people, right?” explains Dr Kana. “It’s inevitable that in 5 to 7 years, we’re going to see a lot of bots handling phone calls and bot-trained scheduling.”

A lot of the discussions at Dykema centered around new technologies and the results people have seen.

Dental Care Alliance is using Guided Biofilm Therapy (GBT), which discloses the location of plaque and removes it using air and piezo technology from EMS Dental instead of traditional scaling, root planning, and polishing paste.

Dental Express has expanded its intraoral scanner technologies and is looking to bring in AI-based scheduling technology to reduce no-shows and last-minute cancellations.

Jill Nesbitt, the founder of Optimize Dental Consulting, hosted a technology workshop at the Dykema DSO Conference with more than 40 DSO leaders from operations and IT. They discussed the emergence of new dental analytics companies that pull in data from multiple software systems including accounting, human resources, call centers, and practice management systems to help dentists and managers have a holistic view of the data driving their profit and loss statements.

Some practice management systems like Denticon are moving away from branding themselves as an all-in-one solution and to a dental operating system model, where dental practices can choose to read, share and write back information with third parties via secure APIs.

“People want the freedom to be able to integrate different software solutions into their practice management system. You see that with RCM, for example. They want to be able to verify insurance, submit claims, and reconcile payments all within their PMS, without having to launch another application,” says Dee Fischer, the co-founder of a DSO with 6 affiliated locations and is one of the best-known consultants for group practices.

Staffing Shortages and the Importance of Culture

Staffing remains an issue for almost every dental group, especially when it comes to recruiting hygienists and dental assistants.

“I’ve hired a full-time HR director to help us because it takes so much time to hire,” says Robin Reich, DDS, a past president of the Georgia Dental Association and the founder of Reich Dental Centers, a dental group with 4 locations.

“We have to be more flexible. For example, we have 2 hygienists who are pregnant, and they’re going to job share.”

“At My Community Dental Centers, we are experiencing this growing demand from our team members for shorter workweeks and alternative schedules,” says  Smith. “The challenge arises from the need to be an adaptable employer and foster a culture that emphasizes work-life balance and well-being while managing a reduced workforce and a surge in patient demand that is at unprecedented levels.”

Multiple DSO leaders cited some of the changes employees and new hires are requesting, including:

Higher salaries now instead of generous retirement plans

The staffing shortage is causing companies to recruit outside of dentistry. Fischer suggests hiring people for their personalities and skills sets:

Realtors and jewelry store salespeople for treatment presentation and collections

One tip: Evaluate the salaries in your geographic area quarterly to ensure you’re competitive. If the local Starbucks is paying $16 per hour, then you may find it hard to hire somebody for less.

Advice for Dental Practices and Emerging DSOs

“Culture is the first thing. The second is operations: build a great platform. Find those partners that you can grow alongside and really lean in with them,” says Jason Heffelfinger, CEO of Dental Care Alliance.

“For anyone looking to scale up, take a hard look at what’s made you successful and ensure you have documented those processes. Codify your SOPs so that you can replicate them,” adds Williams of Dental Express.

“If you’re looking to scale up, really sit down and look at your available cash flow,” recommends Fischer, the consultant who has worked with more than 1,000 practices. “Where people get in trouble is when they don’t understand their cash flow. If you do, then you know what you really have to work with and you can expand staff, expand hours, expand services, or expand locations.”

“We make sure all of our doctor contracts are designed for a minimum of 3 to 5 years, and we reward them with a loyalty bonus once they hit those,” explains Hoss Said, managing director of Massoumi Dental Corporation, a dental group with 6 affiliated practices in Southern California. “Our doctors have to have pride in what they do, and they make their own decisions with clinical autonomy.”

Omid Barkhordar, DDS, and his brother Hamid Barkhordar, DDS, MMSc, are co-presidents of Care Dentistry Group, a DSO with 16 affiliated locations in California.

Hamid Barkhordar has this advice for dental groups that are looking to grow.

“Keep going. It’s going to be hard. There are a lot of obstacles, but if you build a strong foundation, you focus on what you want your organization to be, then you can achieve it.”

Highlights of the hot topics and expert insights being discussed during the recent Dykema DSO Conference in Colorado.

Dykema 2024 DSO Conference: DSO Leaders Share 6 Areas of Focus for Next 6 Months

The face of dentistry is changing, both in the practice and in the boardroom.

Women now make up 36% of working dentists, an exponential increase from 1980 when only 4% of dentists were female, according to the 

In dental support organizations (DSOs), women are breaking the glass ceiling. Back in 2008, Margaret McGuckin, MBA, was the Chief Operations Officer of ClearChoice Dental Implants, a position rarely held by a woman in the industry. At the time, she was the only female executive "in the room where it happens.” This year, more than 900 leaders cheered as the recently-appointed CEO of ClearChoice Dental Implants, Rahma Samow, took the stage as one of the keynote speakers at the Women in DSO Empower and Grow conference in Las Vegas, March 6-8.

“Women in DSO is a meeting of the minds. I was very impressed with the insights and trending changes shared by the executives and business leaders on the different panels. It was very touching to hear stories of the keynote speakers, Rahma Samow and Marion Bergman, MD. It is amazing to know that women shared the same challenges on different continents,” says Emily Letran, DDS, executive coach at Exceptional Leverage, Inc, who owns two multi-specialty group practices in southern California, and is the author of several books including 

A Modern Woman: To Have It All Without Sacrifices

, which offers insights and strategies on building a strong business.

Creating a Safe Space for Honest Conversations

For many women leaders, rising to the top does mean making sacrifices – especially when it comes to balancing work with family. Many leaders shared stories on-stage and off-stage about spouses, family, or friends actively discouraging them from pursuing their careers and making judgmental comments when they missed milestone moments like their child’s first steps, school field trips, or sporting events. Many women shared personal details about health problems, relationships, and children.

“I didn't know what to anticipate as a first-time attendee,” says Ashley Bodien, communications and marketing director at My Community Dental Centers, which runs 34 dental centers in Michigan, forming one of the most comprehensive non-profit dental care networks in the country. “The relationships I made transcend industry boundaries, experience levels, and job titles. While the on-stage content presented valuable strategies and a powerful message of women's empowerment, what resonated with me was the personal interactions outside formal meetings. The heartfelt discussions at social events about family, marriage, career goals, and breaking gender stereotypes while managing the responsibilities of motherhood and personal relationships were truly impactful. These connections went beyond mere networking and exchanging business cards; they were profound, filled with laughter, empathy, and support."

Another first-time attendee was Morgan Baum, the director of human resources at Smile Design Dentistry, a DSO with 56 affiliated practices in Florida.

“I loved it. It felt very welcoming, and everyone was very humble. I didn’t feel out of place,” Baum says. “I liked that the conference put a lot of opportunities in place to network and I was able to make connections in the industry that I can use to help evaluate our processes. And I was able to have conversations about personal things that other women can relate to. We were seen as humans, not just as dental professionals. It felt like a safe space to share and deepened the connections we made even more.”

Carrie Mauterer, DDS, the clinical director at Peak Dental Services’ 40-affiliated practices in Colorado and Texas, has been to all three Women in DSO conferences.

“Leadership in dentistry can sometimes leave you feeling isolated or even like an imposter. The environment that Women in DSO nurtures is a safe place where anyone of any gender identity can share failures, successes, ideas and frustrations with other leaders in the field,” says Dr Mauterer. “Each year I learn more about the growth and trends of our dental industry through the poignant panel discussions. The most important part of the conference for me is hearing other women’s incredible stories of their lives and careers. That inspiration carries me through the next year until I can attend again.”

Celebrating Trailblazers, Mentors and Rising Stars

The themes of inspiration, innovation, overcoming obstacles, and blazing the way for the next generation of leaders come up often.

“What I found to be most inspiring this year was the keynote from (pulmonologist) Dr Marion Bergman when she shared that a family member told her she could not be a doctor. But she persevered, with the support and encouragement of her parents. We all should listen to that message, and keep going when you are told no,” says Dee Fischer, CEO of Fischer’s Professional Group and a partner in two DSOs, each with three practices. Fischer was one of the first female executives in the DSO space in the mid-1990s. She received the Women in DSO Leadership Award for Business Excellence in 2023. Fischer has mentored female practice owners and operations leaders for more than 20 years.

“There was a lot of buzz about educating the next group of leaders, especially about finding creative ways to juggle budgets and talent as private equity becomes a challenge in this economic market,” says Fischer. “Women, just like men, are looking for a coach that can align their career goals with the right training.”

Shawna Eury is the president, South Division of Dental Care Alliance (DCA), which has more than 425 affiliated practices in 24 states. Eury started as an office manager at DCA in 2009 when there were about 75 practices, and was promoted to Regional Manager, then Director of Business Improvement, then South Division Vice President, and then to President this year.

Eury has been very active in Women in DSO since it was founded three years ago and was an emcee at this year’s event.

“We’ve doubled in membership and the organization has evolved into a safe place where peers can share best practices, build relationships, leverage what we learn to enhance our own organizations, and really bring out each other’s strengths.” Eury says. “It’s not just an annual event. Women in DSO members participate in the mentorship program and in the Exchange Circles, which are 45-minute webinars where leaders share their top tips and tackle difficult topics including pay equity, incentive programs, creative staffing solutions, merger and acquisition trends, etc.”

This year, Dental Care Alliance brought 16 team members to the conference, from all levels of the organization including the CEO, CFO, regional managers, hygiene coaches, and from marketing, recruiting, and training. Many dental groups also sent more team members than ever before.

“This was my first time attending this event and it was incredible to see the talent, amazing energy and collaboration between this amazing group of leaders. I can’t wait to come back next year and bring future talent to learn from the best!” says Ana Bolin, vice president of operations at Rodeo Dental and Orthodontics, a DSO with 44 affiliated locations in Texas, Arizona, and Colorado. Rodeo Dental had five team members attend this year.

Many of the women participate as either mentors or as mentees through the Women in DSO matching program.

Caitlin Waters is the associate director of communications at Risas Dental and Braces, a group with 27 locations in Arizona, Colorado, Nevada, and Texas. Waters has been an advisory board member with Women in DSO since 2022 and was the recipient of the “Rising Star” award, which was given for the first time at the 2024 conference.

“The Women in DSO mentorship program pairs women looking to advance in their careers, and in life, with industry leaders to provide coaching, leadership development, personal guidance, and much more. My mentor ‘match’ could not have been more perfect. We are now each other’s friend, accountability partner, and life coach,” she says.

Waters’ mentor is Sarah Ruberg, CEO of Our Thrive Tribe, a social media agency that amplifies the voices of individual leaders, DSO organizations, and DSO vendor partners. Ruberg was a Top 5 Finalist for the Women in DSO Leadership Award, Business Operations.

“I almost backed out of being a mentor because it started the Monday after my Dad had passed away, and I thought how am I going to be able to provide any value to anybody right now. But mentorship was something that was really important to my Dad and it was important to me that I carry that on,” she says. “I learned so much about myself as I went through scenarios with Caitlin, would give her advice, see the results, and that increased my confidence, too.”

Elevating Networking – and the Next Generation of Dental Leaders

Women in DSO is a non-profit organization started by Aman Kaur, BDS, an experienced DSO executive with a background as CEO, COO, and Dental Director for multiple dental groups since 2010.

“Dentistry has always been a woman-dominated industry. Despite the lion’s share of work in various dental organizations being managed by women, most organization’s leadership teams continue to be male dominated,” says Dr Kaur.

“Women In DSO has a simple mission of working with these organizations, as well as the women in the industry, to ensure we have similar representation in leadership positions. It has been a joy to see Women In DSO emerge as a strong community of like-minded individuals—men and women—who are committed to elevating the dental industry by supporting each other. I look forward to seeing all of their hard work come to fruition as we lead the way for the entire healthcare industry, not just the dental teams,” she says as the 3-day conference ended.

The women who attended represented different ages, ethnicities, leadership roles, and organization sizes. Some were new to dentistry; others had worked in the industry for decades.

Both Virginia Jones, PhD, the CEO of Village Family Dental / Valleygate Dental Surgery Centers, which has 14 affiliated locations, and Juliana Pereira, the operations manager at Tend Dental, a DSO with more than 25 affiliated practices, appreciated having the opportunity to discuss current issues including technology, practical applications of AI, and cybersecurity concerns.

“We now stand as leaders in innovation, and our impact extends across all facets of dentistry. I’m grateful for the entrepreneurial women, vendors, operators and clinicians I met at the event,” says Pereira.

The networking at Women in DSO just feels different than at other events.

“I love that Women in DSO is not about competing against each other, it is about raising each other up and creating a space in which providers want to be,” says Misty Mattingly, RDH, senior vice president and chief dental hygiene officer at Sage Dental, a DSO with more than 100 affiliated practices in Florida and Georgia. Mattingly was the winner of the 2023 Women in DSO Leadership Award for Clinical Excellence and is a member of the Georgia Board of Dentistry. “It is great to collaborate and help each other since we are all dealing with similar issues, such as staffing shortages, a changing economy, and payor mix challenges.”

Teresa Williams, COO of Dental Express, a DSO with 7 affiliated locations in southern California, agrees. “The energy at Women in DSO creates an inclusive environment in which women are primed to show up for each other. You find yourself asking each other “How can I help you” instead of looking for the next big thing for your own business.”

“The biggest value stemmed not just from personal and professional growth, but also from the networking opportunities, the knowledge sharing without limitations, and the connections I made,” said Enis Guri, MS, vice president of operations for NYC Dental Smile Team, a prosthodontics and restorative group with three locations in New York City. Guri also leads M&A change implementation and integration efforts for Edgard El Chaar, DDS, PC, an interdisciplinary group practice specializing in periodontics and implants, which operates 2 locations in NYC. “As a first-time attendee at Women in DSO, the immense energy I felt is still resonating with me.”

And that’s what this non-profit organization is all about: Women In DSO gives women leaders not only a stage to share how they have overcome challenges in their personal and professional lives, but a network of friends and colleagues they can rely on throughout the year.

Waters, the recipient of the Rising Star Award, is already paying it forward.

“My advice? Take another woman with you to Empower and Grow, especially if they’ve never attended a conference before. I had the pleasure of attending with a woman whose first conference ever was last year’s Women in DSO event. It was an honor to see her confidence triple this year; she truly shined. That’s what this conference and Women in DSO is all about,” she says.

At the recent Women in DSO Empower and Grow conference dental professionals from throughout the industry connected to share challenges and successes.

In the Room Where it Happens: Female Leaders Shine at the 2024 Women in DSO Empower and Grow Conference

Mergers, acquisitions, and the consolidation of dental practices were the hot topics at the 2023 Yankee Dental Multi-Site Summit in Boston, with the biggest jaw-dropping prediction coming from Brian Colao, the Director of the DSO Industry Group for Dykema.

He predicts consolidation in dentistry will jump from 31% now to at least 75% within 15 years.

“There’s a great evolution in consolidation going on, from private dentists to small groups to DSOs, and it’s been accelerating since 2015,” Colao explains.

“The economic landscape of 2022 and 2023 presented significant challenges for many groups, largely attributable to macroeconomic variables,” says Steve Saukaitis, CEO of Select Dental Management, a group that has partnered with 37 practices across the Northeast and Mid-Atlantic regions.

“Organizations that dedicated their efforts to sustainable same-store growth and the enhancement of both patient and employee experiences have strategically positioned themselves for success,” Saukaitis continues. “These focal points are instrumental in fostering a resilient organization and driving performance in today's competitive environment.”

Operational Excellence Cited as a Must-Have for DSO Growth

“In today’s climate of rising personnel costs, shrinking margins, and costly capital, the era of growth without operational excellence is ending,” says Scott Leune, DDS, founder of Breakaway Seminars, a dental business consulting firm.

Throughout his career, Dr. Leune has opened, built, and sold numerous dental practices, and currently supports more than 20,000 dentists with purchasing, marketing, consulting, and additional services.

“Whether it be a new dentist in a single location, or an established DSO, it is vital that the owner understands how to create accountability within the team to follow best practices that maximize patient experience and healthy profits. The end result will be a practice that can easily afford today’s higher salaries while delivering a new modern level of patient care, and an owner that has excess time and financial gains without the heavy weight of staff and practice implosions,” Leune explains.

A key focus of these DSO leaders is modernizing the dental experience. This can include enhancements such as making it easier for patients to schedule and complete new patient forms online, adding artificial intelligence (AI) analysis of x-rays, implementing cloud-based dental practice management systems such as Denticon, and automating revenue cycle management through tools that streamline eligibility verification, claims processing, and auto-posting payments.

“With the economic situation we’re in now, it’s essential that we’re making it easier for people to do their jobs,” says Dee Fischer, CEO of Fischers Professional Group and a partner in two DSOs, each with three practices. “It used to be that you can hire quickly and fire quickly, but no more. Now, you have to retain people. You have to train them well. You have to create a culture where they want to stay. Companies are integrating artificial intelligence to automate what used to be very time-consuming tasks, and that’s making it easier for the dentists and team members to focus on patient care. Do that, and you’ll see the difference on your P&L [profit and loss statement].”

DSOs Investing in their Dentists and Staff

While the term DSO stands for dental support organization, it has become an umbrella term that is used for everything from small group practices owned by a single dentist, to large groups with hundreds of locations. Typically, what elevates a group of individual practices into a DSO is the consolidation of shared non-clinical services, such as human resources, marketing, credentialing, billing, IT, and real estate.

The culture and structure of each DSO can vary widely.

“A lot of dentists think that joining a DSO means they become an employee and lack the ability to invest in the business as a retirement strategy. This is sometimes the case, but more and more frequently is no longer such. Many groups are developing options such as equity incentives, equity ownership, joint ventures, profit sharing, and other models that allow for associate dentists to have ‘skin in the game.’ These structures could be individual practice-based, regionally based or even top level, company-wide. There is a variety of options out there for doctors wishing to enlist management support but still retain some form of long term financial investment and reward,” says Lorri Detrick, president and COO of Riccobene Associates Family Dentistry, a doctor-founded rapidly growing group with more than 70 locations in North Carolina, South Carolina and Virginia.

“It’s obvious that we in DSO leadership need to create value not just for our patients, but also for our providers and our teams if we hope to be successful,” says Adam Richichi, CEO of Archway Dental Partners, which has 28 practices in Connecticut and is expanding to other states in 2024.

As more private dentists and small group owners consider partnering with a larger organization, it’s important for providers to ask how the DSO will help them better care for patients.

“Scaling within the 4 walls of your practice requires the ability of your leadership team to prioritize, measure, create individual accountability, and incentivize alignment around the most impactful opportunities to improve patient care and practice growth,” says Elliot Zibel, founder of Optimus Healthcare Management and previously co-founder and CEO of Select Dental Management.

Healthy DSOs have short-term and long-term goals for implementing technology, training, and tools that will help their affiliated practices succeed.

“Understand the levers available to you to scale your dental practice, create KPIs to measure your success as you work towards your goals and create a high-performance culture by aligning the values of your team with those of your practice to ensure an environment of accountability,” says John Geary, chief strategy officer at Independence Dental Services, a partnership organization with 49 practices across 14 states.

DSOs Leveraging Specialty Care and Hygiene Programs to Propel Growth

Several of the panels at the Yankee Dental Multi-Site Summit focused on clinical quality oversight, scaling up hygiene operations, and sharing the challenges and successes different groups have had.

“There has been a strong emphasis and focus on specialty dental practices over the last few years. It was very interesting to hear from two specialty-only DSO leaders that their specialists including oral surgeons and endodontists appreciate being part of a larger community of their own specialists. A couple of the larger DSOs mentioned they are partnering with specialists who prefer to be part of a bigger team of general dentists for referrals. A big question for the future is how can we achieve more integrated dental care for patients and which model will be more successful?” asks Rashed Din, CEO of Maya Dental and a partner at Din Ventures, a private equity firm that is also an investor in Archway Dental Partners.

Many groups have leadership positions including Chief Clinical Officer, Vice President of Specialty Dentistry, and C-Suite or Director-level representation of hygienists.

“Our panel discussed the structure of hygiene leadership within our respective DSOs and the importance of implementing and maintaining hygiene representation within DSO leadership,” says Erin Kierce, RDH, MS, MPH, chief compliance/hygiene officer at Passion Dental, a group of 54 practices in New England. “We reviewed the manner in which we measure success and our respective approaches to recruiting hygienists, as well as onboarding, training, mentoring, salary and benefit considerations, and retention. Underlining it all is how we approach measuring the standard of care through quality assurance procedures.”

The Big Take-Aways from the 2024 Yankee Dental Multi-Site Summit

“The discussions on 'Same-Store Growth Through Innovation', 'Scaling Your Practice in 2024', and 'Best-in-Class Operations' directly aligned with my focus on driving operational efficiency, growth, and scalability across our footprint,” says Karla-Marie Santiago, senior director of practice optimization and growth at Oakpoint, a group with 44 locations in the Southeast region of the US.

The networking was just as important as the sessions, Santiago said. “The intimate setting enhanced my ability to forge strategic partnerships with industry leaders and vendors, crucial for our continued expansion and operational excellence.”

Whether they choose to stay in private practice, join a group purchasing organization (GPO), or explore partnering with an established DSO, dentists have more information than ever before to make an informed decision.

Group dentistry experts share strategies and predictions at the recent Yankee Dental Multi-Site Summit.