Ed Rabinowitz

 reveals that of the 11 dental offices included, E. coli was present on 70 percent of patient chairs, and 25 percent of reception area counter tops.

Are you doing everything you can to ensure your practice is as safe as possible for both staff and patients? If not, it could prove costly for you and your practice.

Centers for Disease Control and Prevention

, the flu causes employees to miss approximately 17 million workdays each year at an estimated cost of $7 billion in sick days and lost productivity.

“That’s crazy,” says Sarah Bell-West, PhD, scientist for 

. “And that’s why implementing a robust safety control system, as well as regularly enforcing hand hygiene and cleaning protocols, should really be top of mind for dental professionals.”

Notice that Bell-West stated “dental professionals.” That’s because all members of the practice play an important role in maintaining a health environment and facility. As such, everyone from hygienists to front office receptionists should be educated on the importance of regular cleaning and disinfection.

A good place to start, says Bell-West, is a review of 

infection control guidelines established by the CDC

 to understand how they fit within the framework of a dental practice.

Educating patients is also important, but something Bell-West says tends to get overlooked.

“We primarily focus on the staff,” she explains. “A lot of states require that every year or two you do a robust infection control training to get continuing education credit. But there isn’t as much done on the patient side.”

A good place to start is at the front reception desk. Place hand sanitizer on the countertop and a sign asking patients to please sanitize their hands before entering the practice.

“It’s a great way to get patients and staff to remember that hand hygiene is so important,” Bell-West says.

To better understand the spread of germs and infectious diseases, Bell-West refers to the 

, which consists of an external agent, such as flu or rhinovirus or even bacteria like staph or E. coli, a susceptible host, and an environment bringing the host and agent together.

What’s scary, Bell-West explains, is that many times the host doesn’t know they’re carrying a specific pathogen.

“If I walk into a dental office, sneeze into my hand, and then forget to wash my hands before shaking the hand of my dentist, I have then shared my germs with the dentist,” she says. “And what makes it super scary is that pathogens can survive outside the body for days, weeks, even months in some cases.”

That can be extremely costly to a dental practice. For example, Bell-West explains that if a hygienist is out sick for one day and there isn’t someone who can easily cover for them, that could result in having to reschedule eight to 10 patients, and lost revenue for the day.

“If somebody is out for a day because they’re ill, that can really affect a practice’s bottom line.”

Bell-West recommends dental practices implement a robust safety control system, and identifies three key steps in the process. The first is to keep ready-to-use disinfectants like 

 readily available in every operatory as well as reception and waiting areas. Make sure to regularly clean and disinfect frequently touched surfaces, such as countertops and door handles, to prevent the spread of pathogens.

Next, it’s essential to clean and disinfect the operatory between patients. For that, Bell-West recommends using 

Clorox Healthcare Hydrogen Peroxide Cleaner Disinfectant Wipes

“The really nice thing about them is they’re easy to use, and they quickly kill pathogens within 30 seconds, which is great if you’re trying to turn around a room quickly,” Bell-West says. “And, hydrogen peroxide is an amazing cleaner against things like blood, which can splatter on surfaces during dental procedures.”

Lastly, promote hand hygiene. Bell-West says that approximately 80 percent of infectious diseases spread via touch. Hand hygiene can be the first line of defense to prevent the spread of infection. And be certain to use hand sanitizers that not only kill germs, but soothe skin.

“We know healthcare professionals can wash their hands up to 100 times a day,” she says. “So it’s really important that you’re killing the germs on your skin, but you also need something like aloe or vitamin E to help repair the skin as well. At the end of the day, this is how dental teams can help promote a culture of safety, prevent the spread of pathogens, and help their practice run more efficiently.”

Articles

A recent study of 11 dental offices found that E. coli was found on 70 percent of patient chairs, and 25 percent of reception area counter tops. But a culture of safety can lay the foundation for an efficient dental practice, where both the dental professionals and patients feel comfortable.

Promoting a Safety Culture Has Financial and Health Benefits

“I strongly believe that if you find the right personality, you can train almost anyone to do the job,” said Neil Gajjar, DDS, MAGD.

It might seem like an easy task to find quality dental staff. The reality, however, is that it’s extremely challenging.

, of Mississauga, Ontario and president-elect for the 

 explained the issues are two-fold: wage expectation and risk.

“The moment you start advertising for someone with dental experience, the wage expectation is very high,” Gajjar said.

So just hire someone without extensive dental experience, right? Well, that’s where the risk comes in. First, there’s a long training process and learning curve to get them up to speed. Then once they’re trained, they go somewhere else because the wage is higher.

“Because it is such a specific niche type of market, it’s tough to find employees,” Gajjar said.

Gajjar shared an approach to hiring that has worked well for him since opening his practice 18 years ago is to hire the personality. Hire someone who is dedicated, trustworthy and has an outgoing and personable character who can put patients at ease and comfort them.

“I strongly believe that if you find the right personality, you can train almost anyone to do the job,” Gajjar said.

That means dental practices should be prepared to consider tradeoffs when hiring new employees. So in addition to sacrificing initial skills to find the right personality, you might also need to sacrifice a little personality for the right skill set.

Gajjar’s process is unique. He has two employees from the front desk conduct the initial interview, and two people from the clinical staff conduct the follow-up interview. He tells them to choose the employee, so they need to make it work.

“I sign off on the person being hired,” he pointed out. “But all the interviewing and training is staff driven. It has worked because there’s buy in.”

What about long-time, valued employees who, one day, say they have been offered a position elsewhere with higher pay that is closer to their home? Gajjar stated that this can become a delicate balancing act. Sometimes, for the very good employees, it’s not all about dollars and cents. They want to work in an environment where they’re appreciated, and it feels like home. They are not as likely to leave when offered a much better salary.

“If you have a family of four or five, and you need more money, and someone is offering it to you, it’s legitimate to come to your boss and say, ‘I’m being offered more. I don’t want to leave. What can you do?’” Gajjar explained. “That puts us in a difficult situation.”

Sometimes, he said, you have to increase that employee’s wages because they have been there for years and know all the patients. But that can start a trickle-down effect, and before long other employees are asking for raises.

“Sometimes you have to say no and cut the cord,” Gajjar said, adding “it’s the cost of doing business.”

Gajjar said that one of the biggest lessons he has learned in working with the Academy of General Dentistry is that when things go badly it doesn’t mean you’ve hired the wrong person. Most of the time, he clarified, you’ve got the right person but in the wrong position.

“We all have to keep our eyes open,” he explained. “We’ve hired this young lady for reception, but she has a great aptitude for sales, and can convince patients to have treatment done and make them feel at home. That person should become your treatment coordinator, not sitting there at reception checking people in and out.”

That means re-investing in the strong aspects of an employee’s strengths. But it’s also cost effective to train people in their specific strong points because they enjoy it. Encouraging individuals to build on the strong foundation they already have will demostrate a commitment to their personal and professional development.

“It’s a much larger investment from a management perspective to train somebody from zero to ten, then somebody who is already at five,” Gajjar said.

In addition, the minimal costs could lead to a substantial increase in revenue. Gajjar explained that convincing patients their health is a priority, and that prevention is cheaper than curing, is not easy. If there is someone in the office with those skills, and they can increase production in your hygiene department by 30 percent by utlizing them, it will bring about an influx of patients that will also drive other departments in the practice, such as restorative or cosmetics.

“If you have people coming in, and they’re telling others where they go, you have the ability to build on your patient base,” Gajjar said. “Overall, it’s a bottom line increase.”

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Describing someone as having a great personality when setting up a friend on a blind date can be an ominous sign. Personality, fine, but what does he or she look like? But when it comes to hiring dental practice employees, finding someone with the right personality is often a preferred tradeoff to coming in with the right skill set.

Finding, Keeping and Investing in Good Employees

 "The mouth is three-dimensional...you have to shape it. You have to create it.” Geri Robin, DMD, FAGD said about rendering dental treatment

She majored in biology and art, setting her sights set on a career in medical illustrating. When her guidance counselor suggested that might prove too difficult, she redirected her academic efforts. Instead, she followed in the footsteps of a friend’s father and pursued dentistry.

“Which actually was much more difficult,” 

, DMD, FAGD, a New York City-based dentist, admitted.

And while today she “truly loves dentistry,” there were times early on, she recalled, where things “couldn’t have been more terrible.”

Robin describes herself as a Bronx girl, hailing from New York City’s northernmost borough. When she completed dental school, the most logical next step was heading home to work at a clinic, but things went south pretty fast.

“I had a patient steal my prescription pad, and he was writing prescriptions for drugs down on the corner,” Robin said. “The police had to be called in.”

New to the field and without much guidance, Robin turned to her father when she began having problems with a particular treatment technique. His message was simple: “Well, you just have to learn it.” Robin recalled the moment well.

“I said to myself, ‘I’m just going to have to figure this out,’” she said. “I loved school, but now I actually had to apply those lessons. And I was going to learn from whomever I could. I tried not to think about egos and personalities, and wherever I could learn, I did.”

That’s when she became involved with the 

. She took her first course in 1989, and was immediately drawn to the instructors and facilitators. What was most impressive to her was the practice philosophy she learned from her colleagues — always strive to be the best possible dentist in all facets.

“And do as much as [you] can so people can keep their teeth for the rest of their lives,” she added.

In 2017, Robin found herself looking to grow her private practice. She found out about 

, a recent start-up with a unique approach to accessing dental care, while interviewing a hygienist.

Founder and CEO, Eva Sadej, wanted to take routine dental care and make it as easy and affordable as booking a room on AirBNB. From the busy professional with great insurance coverage, to the uninsured freelancer or startup coworker, Sadej wanted to improve access for anyone. To that end, Floss Bar developed an innovative mobile dentistry service where hygienists go directly to patients who need care.

The company operates its dental system via the hub-and-spoke model. Think central locations combined with more nimble entities that relay back and forth.

“I called Eva,” she said. “I found Floss Bar, they did not find me. And I said I want to do everything I can to help you, but I also want to grow my practice.”

There have been growing pains, to be sure, but Robin said she can’t say enough great things about the company.

The part of Robin that wanted to become a medical illustrator is still present. Art, she explained, has always been a major part of her life, and her dental profession is just a continuation of that.

“I love to create,” she explained. “I’m not saying I’m good or anything, and I’m very private about it. But I love to create. I cut up glass, and I do these five-foot by three-foot mosaics. It’s something I really look forward to, and I try to do a huge project every year.”

Robin said there’s a clear link between dentistry and her love of art, and she tries to apply aesthetics to all of the disciplines within dentistry.

“You have to be able to envision things,” Robin said, “the bite is three-dimensional. The mouth is three-dimensional. And today with dental scans, things are in three dimensions. You put a filling in someone’s mouth, whether it’s in the front or the back, you have to shape it. You have to create it.”

There’s a saying that Robin has lived by since her 20s, and today she passes on to her grown children: Chance favors the prepared mind. She said it means if you put yourself in the right place, that’s all you can do.

“You don’t know what tomorrow brings,” she remarked, “but if you put yourself in the right place, when opportunity comes, you will hopefully see it.”

Robin sees things just fine. She recently interviewed for, and was offered, an adjunct teaching position at 

“I’ve been doing dentistry for so long, I want to try being in an academic environment,” Robin said. “I’m not sure what they’re going to have me do, but I told them to put me where they think I would be able to do the most for the university. It’s very exciting.”

At the end of every workday, Robin turns to her staff and asks, “Did we offend anybody today?” By asking the question, she ensures her team prioritizes patient care by doing something good for them.

“You try so hard, and things don’t always go well,” Robin shared, “but if I can get through the day, and if I can feel that I did my best, and the patients were happy and satisfied, I go home, and I feel a sense of comfort and a sense of peace.”

Robin described herself as a happy person because she’s doing something she loves. She reminds her staff each day at morning huddles that it is the patients, especially the difficult ones, that enable them to perform great.

“And I thank my patients,” Robin said, “because if I wasn’t doing [dentistry] I would have to be home doing laundry.”

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She grew up in the Bronx. Her father was a butcher. And she had designs on becoming a medical illustrator. That career didn't materialize as she just fell into dentistry. But art remains a major part of Geri Robin's life, and she sees her dental career as an extension of that love of art and related aesthetics.

Art is a Big Part of NY Dentist's Life

"If for some reason you are billing differently than your peers, you’re going to pop up on the radar as an outlier" said attorney Ashley Morgan.

Dental insurance claims audits are on the rise, and one look at the landscape indicates the trend will continue.

Consider that, according to the Centers for Medicare and Medicaid Services, 

 reached approximately $3.3 trillion in 2016. Roughly 4 percent, or $124.4 billion, of that $3.3 trillion was spent on dental services. Expenditures on dental services exceeded the amount spent on home health services, and was more than double the amount spent on durable medical equipment.

“If dental spending is matching the spending of other areas, it would make sense that dental is going to be highly targeted by Medicaid fraud control units,” said 

, a Senior Associate Attorney with the Washington, D.C.-based law firm of Liles Parker.

As such, understanding what a dental insurance claims audit is, what triggers an investigation, and how to prepare for it is critical for oral health practitioners.

	There are essentially two different types of dental claims audits: a prepayment review, which is a review of claims prior to payment; and a post-payment review, where claims are reviewed after payment. According to Morgan, the post-payment review is the most common. In this case, an insurance company will identify specific patients and request copies of all those patient records between a designated time period, usually two years. To complicate matters, they will usually want to receive them within 30 days.

“They’re going to look at those records, and if they find issues with the documentation, such as some services don't qualify for coverage and payment under their rules, they will likely ask for those to be paid back,” Morgan explained.

Addressing a post-payment audit can consume large amounts of administrative time for a practice’s staff, as well as the providers, for pulling together all the requested records. Add in the possibility of needing to reimburse the insurer for non-qualified claims, and an audit can prove quite costly for a practice.

But it could get worse. If a dental practice does not have dental record documentation to support the services it claims were provided, the insurer might conduct a fraud investigation in the belief that the practice was billing for services that were not actually rendered. And that could lead to a criminal investigation.

	Morgan said one of the biggest triggers of a dental claims audit is data mining, which is the practice of examining large databases in order to generate new information. And one thing the government and insurance companies are very good at is compiling a lot of information about their providers. 

“They have all these different pieces of information,” Morgan explained. “And if for some reason you are billing differently than your peers, you’re going to pop up on the radar as an outlier. That would probably trigger them to have a closer look at your dental documentation, the type of services you’re providing, and the patients you’re seeing.”

An audit could also be triggered if a patient complaint is filed with either the state insurance board or the insurance company. For example, a patient might receive an Explanation of Benefits and report they did not receive the indicated services. Or, if you’re a Medicaid provider and are rendering a greater amount of services than have been identified as a risk to your geographic area, you could also trigger an audit.

Of course, there could be a very good reason why a dentist appears to be providing more services than his or her competitors. Often, it is due to improper billing.

“There may be more than one person in the practice providing these services, and [the office staff] is billing all of the services under one dentist’s number,” Morgan said. “You want to make sure you’re billing services provided by each dentist under their respective number.”

	Perhaps the best approach to take where a dental claims audit is concerned is to assume that, inevitably, your practice will be audited at some point in time. Morgan said one of the best things dental providers can do is improve their documentation.

“If I take a look at one of your notes, it needs to tell a holistic story,” she emphasized. “You can’t just have an x-ray and indicate restoration in tooth number 

. It needs to tell a complete story—how the decay was identified, and why the restoration needed to occur on this date of service&mdash;so that an independent third party can later read the note and understand what was happening.”

Morgan also strongly recommended conducting an internal audit of the practice’s documentation, and doing so by hiring an independent third party.

“They will provide better feedback than an internal review might do.”

Does your practice have a compliance plan in place? Is there a designated compliance officer to make sure everyone is in compliance? What about documentation? Is it as complete and holistic as it needs to be? If you are unable to answer a resounding 'Yes' to any of these questions, your practice could be in jeopardy of a dental insurance claims audit.

Is Your Practice Prepared for a Dental Insurance Audit?

“I try not to do anything where I’m not making back three times the money I’ve invested” said Chris Panebianco, CMO at Bankers Healthcare Group.

Marketing is more than just buying a billboard or a business card sized ad in the local newspaper, especially if the intention is to get the most out of your marketing dollars. But according to Chris Panebianco, CMO at 

“It’s not only dentists,” Panebianco said. “People overlook [the importance of making sure marketing dollars are well spent] in every aspect of business. And I think the reason why is they don’t have clear goals.”

If misery loves company, that’s fine. But otherwise, dentists would be wise to disassociate themselves from an approach that is like driving but not knowing where you are going.

	Looking at marketing through a dentist’s eye, Panebianco said it’s critical to know what you want to accomplish before spending a single penny. That means asking yourself questions such as: Is your goal to get more patients? If so, what kind of patient do you want to attract? From there, study the area where your practice is located. Do the demographics match with the group you are trying to attract? Or the service you’re looking to provide?

	Once you answer those questions, identify what it will cost to attract those individuals through a mailing campaign, or a billboard, and then back the numbers up.

	“If I know I’m going to spend $1,000, how many new patients do I need to make that back?” Panebianco questioned. “I try not to do anything where I’m not making back three times the money I’ve invested.”

	Remember, the rule of thumb is that the easiest customer to get in the door is the one who has already been to the practice.

	“Always start with your current customers,” Panebianco said. “They’re organic. They’re the patient base.”

	Of course, everyone would like to initiate a marketing plan and conquer the world, but that is not realistic. Panebianco recommended starting small and utilizing an A/B strategy.

	For example, take about 200 to 300 people in a target audience. Split that larger group in half and send each half a different message. The messages might be a free cleaning versus a free x-ray or a percentage off a procedure. That way, not only are you testing on a small scale, you are also A/B testing to see if one promotion works better than another.

	“Aim small and miss small,” Panebianco said.

	He also stresses not pulling the plug on a marketing effort too quickly.

	“I have people who are very reactive,” he said. “If you’re using direct mail, the average response time we see is about 18 days from the time we do the mailing for the bulk of the responses to come in. In this day and age people are glued to their phones and they want results now, but I think you have to be willing to commit the money and be patient.”

	Tracking is also essential. If there is an increase of 50 patients from one week to another—how does that show in the numbers? Who are they, and where are they from? When patients schedule an appointment, ask how they heard about the practice. Even if it’s not scientific, Panebianco said, you’ll get a good idea of what’s moving the needle.

	And make certain the tracking system is in place 

	“Because if you fail, you won’t know why,” Panebianco said. “It just makes good business sense.”

	Panebianco said that almost every day, he reads about a new technology or a new social network. Marketing and technology are changing—rapidly. As such, he recommends not having your dollars tied up in long-term commitments.

	“My budget is very fluid,” he says. “If something is working well I’m able to pull resources from something else. And if it’s not working well, I always have an opt out. I don’t get into long-term contracts.”

	In addition, keep your eye on your competition. Imagine putting a lot of time, effort and dollars into a marketing campaign only to find out too late that the dentist down the road is already doing that—and beating you on the price. Panebianco uses a service called 

, which he said is affordable, and provides valuable analysis of competitors’ marketing activities.

	Something as cost-effective as a Google search of dentists in the area, or a visit to their websites, will reveal what they are offering and what populations they’re targeting, and how they communicate with those target audiences.

	“It’s very important to know your surroundings,” concluded Panebianco.

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If you are planning a marketing campaign any time in the near future, the key is to try, test, retry, retest, and so on. In other words, it is an ongoing commitment you have to give your efforts time to perform. Very rarely is successful marketing a one-and-done approach.

Get the Most From Your Marketing Dollars

"I knew my real love in clinical dentistry was at the population level,” said Randi Tillman, DMD, MBA.

Managing the work/life balance was important to Randi Tillman even at a young age. And she had an excellent role model: her father, a well-respected dentist in Springfield, Massachusetts who enjoyed many interests beyond the office. From playing the piano to riding a moped and reading voraciously, Tillman’s father embraced the quality of life many people strive for but never achieve.

“I was very fond of my father and had a great deal of respect for him, both intellectually and professionally,” said Tillman, DMD, MBA, who today is the assistant vice president and chief dental officer at 

The Guardian Life Insurance Company of America

. His influence, she added, was what motivated her toward a career in dentistry, “because I perceived it as giving me an opportunity to really balance career and family life.”

Tillman took that opportunity and ran with it.

Tillman recalls having the good fortune to do an internship for three summers while in dental school within public health services. One of those stints was in the Alaska Native Medical Center in Point Barrow, Alaska, located north of the Arctic Circle. Early exposure to public health, she said, enabled her to think about dentistry in terms other than just private practice.

“We didn’t have a term for it, but it really made me aware of population health,” she said. “How can we affect more than just the individual patients who come into our office?”

Tillman began thinking more about minorities and healthcare; about underserved communities and about the poor distribution of dentists. She acknowledges it was the first time she became aware there were people who didn’t have access to the services she had taken for granted her entire life. And it set the stage for much of the future work she would do on the business side of dentistry.

“I think that as I evolved as a practitioner, I knew my real love in clinical dentistry was at the population level,” Tillman said.

That interest grew during her tenure as an associate professor at the Columbia University School of Dentistry. Tillman received a grant from the 

 to establish a curriculum in geriatric dentistry. At the time, there was very little discussion about how to treat older patients. The assumption, she recalls, was that older people would lose their teeth, and there was nothing more to it.

“In fact, that has proven not to be the case,” she said.

That experience laid the groundwork for what would become a lifelong interest in treating the underserved.

In the 1980s, Tillman had an interesting opportunity to work part-time as the dental director for Holland America Cruises, a post she held for seven years. She was responsible for placing dentists on cruise ships and writing policy for the care of crew members and officers. She was compensated with a salary, and sometimes with free cruises.

But that doesn’t mean it was all smooth sailing.

Tillman recalls that the majority of the crew on Holland America cruises at that time were Indonesian, Filipino and Dutch.

“From an epidemiologic perspective, it was very interesting,” she said.

For example, while she often saw the same level of neglect among the different populations, she would see—due in part to their different diets&mdash;dissimilar patterns of disease. For Filipinos who had a high sugar diet, Tillman witnessed a lot of tooth decay. For Indonesian populations, however, there was greater incidence of periodontal disease.

“I always felt somebody should do a study of the different populations on a cruise ship,” she said.

Over the course of her career, Tillman has become adept at bridging the gap between clinicians and payers. That is challenging, because there is historical friction between the payer community and providers.

For example, she explained that the clinician side is focused primarily on what is happening with one patient, as he or she should be. The business side is responsible for balancing the needs of multiple stakeholders: the employer (who usually purchases the benefit package), the patient, and the corporation (the insurance carrier). In order to keep the cost of dental insurance affordable, carriers, like Guardian, develop cost containment policies. These policies are contractual agreements.

“There may be times when a dentist recommends a procedure which is not covered by the insurance carrier; however, it may be in the best interest of the patient to have the procedure done nonetheless,” Tillman explained.

Dental insurance, she added, would be too expensive if there were no plan limitations.

“For me, this is why choosing the right insurance carrier to work for was so important, and why I’ve enjoyed my time at Guardian,” Tillman said. “The company is truly committed to doing the right thing and applies this mindset to help inform our decision-making on how to best serve our customers.”

Tillman said the interesting thing about dentistry is so many of the problems people have are preventable.

“Dentistry is really two diseases,” she says. “It’s dental decay, and periodontal disease. And both of those can be prevented with proper home care and seeing your dentist on a regular basis.”

Sounds simple, yet people still make poor choices.

“People haven’t changed,” Tillman said. “People still, for whatever reason, don’t want to brush or floss regularly, or partake in good oral hygiene habits. It just seems to be our nature.”

And that’s why Tillman is so thankful that she has had the opportunity to make a difference in patients’ lives, especially in terms of education about oral health and its relationship to overall health.

“That’s where I’ve had the biggest impact.”

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Randi Tillman has more than 25 years of experience in healthcare with a background in both the insurance and biotech industries. She understands both the payer and the provider perspective, and is passionate about addressing the needs of underserved populations.

"Everything I’ve ever done has been a solution to a problem that existed" says Michael Florman, DDS

Dentistry runs in Michael Florman’s family. His grandfather was a dentist, his uncle was an orthodontist, and his brother is a dentist. In fact, his uncle was often quite vocal about his feelings for the profession.

“He preached to us about what an incredible profession it is,” Florman recalls. “And how orthodontics is one of the greatest dental specialties.”

, listened. But before launching his orthodontic career, he pursued a bit of a side venture.

“I used to be in the publishing business,” says Florman, discussing how he started publishing Dental Therapeutic Digest in 1991, a PDR (Physician’s Desk Reference) for dentistry that was mailed to every dentist and hygienist in the country. Eight years later, recognizing a need for continuing education, he spun off The Academy of Dental Therapeutics and Stomatology before selling the enterprise in 2006, shortly after graduating from his orthodontic residency.

“I decided to pretty much be a full-time orthodontist,” Florman says. “So I had a career change.”

But the entrepreneurial spirit never declined.

Florman says he was always an inventor; always trying to figure out how to solve problems.

“Everything I’ve ever done has been a solution to a problem that existed,” he says.

That’s how his EverSmile venture came about. As an orthodontist doing a lot of Invisalign, one of the biggest complaints from patients was how to keep their aligners clean. They would remove them when drinking coffee, for example, and they were dirty and smelly. With his background in the dental pharmaceutical world, Florman recognized a need, and an opportunity.

“I came up with an idea for what would work and went to a friend of mine who was an oral care pharmaceutical formulator, and a bunch of orthodontist friends of mine from New York University, and they invested in it,” Florman explains. “That’s how the company was launched.”

That idea became WhiteFoam (https://eversmilewhite.com/products/whitefoam-2-pack#product-directions), a patented cleaning formula designed to clean and freshen orthodontic aligners and clear retainers on the go—a huge plus compared to having to remove aligners and soak them while at work.

“That’s very unpractical,” says Florman, noting how satisfying it is to develop a product people love and continue to purchase. “It’s an unbelievable feeling that you’ve created something that really helps people.”

But launching a company and bringing new products to market is challenging, Florman says. Much time goes into prepping the company, and working long hours without being paid. But the reward, he says, is the hope; the potential that you will build something that will become successful.

“I’ve never started a business that was easy,” Florman explains. “I’ve always had to go into debt to bring the company up to a level where we could at least say that we’re even a company. But the rewards, when it happens, it’s the greatest feeling in the world.”

Florman was heavily involved with continuing education for dentists earlier in his career. Lecturing and education, however, took a backseat to running a practice and launching EverSmile. But education, he says, is a huge part of his past.

“If I ever free up some time I will probably get back into it, because I really do enjoy it,” he says.

For now, spare time is spent closer to home. Florman and his wife recently celebrated the arrival of twins, a boy and a girl, so life, he says, has totally changed.

“It’s a whole new transition from what I used to do,” Florman says. “I pretty much have a whole different life with the kids, and I’m still practicing orthodontics full time. So, I have a busy life, but not a lot of free time outside of family and work.”

Florman’s focus now is to do things with friends and family that keep them involved in all parts of his life. Of course, that means continuing to develop innovative products that help people. Doing so requires finding new problems to solve, and Florman says there is no shortage of those.

“We’ve got a list of about six new products EverSmile is working on,” he says. “One of them, OrthoFoam, has been launched.”

The new product is similar to WhiteFoam, Florman explains, but it’s designed for children with braces.

“That product is going to help patients and orthodontists all over the world who have kids who just don’t brush enough, or brush properly,” he says. “One of the biggest problems in orthodontics is children’s hygiene.”

OrthoFoam was on display at the recent 2018 Annual Session of the American Association of Orthodontists held in Washington, DC. It’s just part of Florman’s continued efforts to address orthodontic issues.

Michael Florman, DDS, a practicing orthodontist in Los Angeles, is considered one of the top Invisalign providers in the country. But he's not satisfied with that achievement alone. As the founder and CEO of EverSmile, he continues to develop products that solve problems while helping adults and children develop good oral hygiene habits.