Mary Ellen Cagnassola

Practices need to find a method of advertising that works for them, whether it's Facebook or direct outreach.

When it comes to advertising, Dr. Anissa Holmes, the creator of the online dental community 

Before Facebook became the entity it is today, Holmes paid for ads in Yellow Pages, local newspapers, airline magazines, even mailer coupons. But in 2010, she noticed something that changed the way she advertised for good. 

“When I started advertising on Facebook, I was getting five new patients for every $50 spent. The $800 I was spending on Yellow Pages delivered the same number of new patients,” Holmes said.

From there on out, her advertising decision on where to put her ad dollars was a no-brainer.

That’s not to say, however, that there is no value in traditional modes of advertising, Holmes said. Many of them are still effective, and if a practice is seeing a positive ROI from billboard and newspaper ads, they should continue doing what works for them. 

For practices just starting out or struggling to bring in new patients, though, social media is a powerful tool whose cost is a small fraction of what billboards and print ads cost.

“For my clients who we run Facebook campaigns for, none of their budgets are over $500,” Holmes said. “Billboards just don’t do what Facebook does.”

The value of Facebook is not solely due to its comparably small cost, according to Holmes. The reason Facebook is the best strategy, even stacked up against other social platforms, is because it allows businesses to target their audiences using data and measure the metrics on those ads. 

“A dentist’s target demographic is using Facebook. That’s where people hang out, when they wake up in the morning and when they go to bed at night,” Holmes explained. “Before, people were watching TV, now they’re on social media. It gives you a captive audience.” 

From age to occupation to marital status, people put a lot of themselves on Facebook, which allows you to control who sees your advertising. In fact, Facebook even tells you who has visited your website in the past, clicked your links or viewed your videos. You can then put an advertisement directly in their news feed.

While it might sound like Facebook is doing all the work for you, Holmes emphasized that the content you put out dictates the success of your ads.

The power is in images and video, she said. Show the patient what you can do for them rather than putting out generic images and content that has nothing to do with your practice.

“People don’t want to see reposts of dental cartoons. Anytime you’re posting, share the story of your practice. Use testimonials and outreach to build a community,” Holmes advised. “Once people like you and feel a connection, they will want to come in.” 

Dr. Michael Abernathy, owner of Summit Practice Solutions, favors a different approach. While he acknowledges that social media marketing is important, it is only a piece of what dentists should be doing to market themselves. 

“The type of marketing that dentists need to be doing is direct response marketing, meaning that whatever it is you’re doing, it should elicit a phone call,” Abernathy said.

But what does this mean? According to Abernathy, the most important step you can take to attract new patients is the following three things: be in network, be able to treat the whole family, and offer convenient hours. 

That being said, marketing is still a necessary part of getting your brand out to the community. For Abernathy, he found the most success by direct mail and local ads. He urges dentists to stay away from milquetoast advertisements and strive to be the “purple cow” among a herd of boring billboards.

“The real branding comes once a patient enters the office,” Abernathy explained. “Digital marketing has become too common and too impersonal. For every 100 pieces of mail you send out, you will get 1.5 new patients. But it’s effective, personalized marketing.”

Discover more Dentist’s Money Digest® news here

Recognizing Body Dysmorphic Disorder in Cosmetic Dentistry

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Even the best dentist will never be able to make a body dysmorphic patient happy. 

Dr. Michael Teitelbaum, owner and director at 

, had an inkling that something was off about his patient’s behavior.

It started with the reason the patient came into Teitelbaum’s practice. Sure, many people had sat in the same chair to have their occlusions adjusted, but this case was different.

“He said that his life would be so much better if he could have the bite adjusted on not one side of his mouth, not a section of his mouth, but one particular corner of one tooth,” Teitelbaum recalled. “It was very unusual.”

The second red flag was the miles-long list of other clinicians the patient consulted prior to Teitelbaum, all of whom were unable to successfully treat the man.

“There was one clinician who lectures a lot and who I really respect, and he had been to him 17 times to have his bite adjusted. If this guy couldn’t satisfy him, then what were the odds that I could?” Teitelbaum said.

As it turns out, he couldn’t — no matter how flawless a procedure’s results, the patient’s apparent Body Dysmorphic Disorder (BDD) would never allow him to perceive any improvement.

Warning Signs, Preparation and How to Help

BDD, defined by a persistent and intrusive preoccupation with a minor or imagined defect in one’s appearance, occurs in roughly 3 percent of the population, according to a 

. Cosmetic dentists and surgeons deal with these patients infrequently, but in higher numbers than other practitioners. And if those dentists aren’t prepared for BDD sufferers, legal and financial problems aren’t far off.

Patients with a BDD diagnosis cannot legally consent to cosmetic treatments like whitening or occlusion adjustment. Diagnosed or not, treating these patients is an exercise in futility.

“Ethically, it’s the wrong thing to do because the person has a psychiatric condition. It’s like trying to take advantage of someone who is drunk on a date — they’re not in control,” Teitelbaum said. “From a financial standpoint, it doesn’t pay to do the treatment because the patient is never going to be satisfied, and the dentist will have to redo the procedure.”

BDD patients don’t materialize often, but when they do, dentists need to be aware of the three common complaints that unite sufferers of this psychiatric condition.

Before pressing the patient about their fixations, it is crucial for the dentist’s legal protection that a trusted staff member, such as a receptionist or dental assistant, is present to witness the conversation. The number of people in the room must be kept to a minimum to secure patient confidentiality.

“If the person brings up that they can’t hold a job, can’t leave the house, and think about killing themselves, those are the three biggies,” Teitelbaum said. “There’s no reason to kill yourself because your teeth aren’t white enough. It’s not rational, and it requires diagnosis.”

Asking the right questions, the right way, is key to helping BDD sufferers, according to the study. When did the patient become aware of the problem? Why are they seeking treatment now, and how much does this problem consume their lives? If a patient is spending hours a day fixating on what most would consider a minor issue, that is not a patient a dentist should treat.

Most importantly, the dentist needs to put ego aside and accept that no matter what they do, they are never going to satisfy a person with BDD.

“It’s not anything a dentist should even try to fix on their own,” Teitelbaum warned. “It's very tricky, because dentists aren't great at referring to other practitioners in general, and it's extraordinarily difficult to refer someone to a psychiatrist. But that’s what you need to do, and you need to do it in a way that doesn’t offend the patient.”

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Cosmetic dentists and surgeons see traits of Body Dysmorphic Disorder more than any other clinician. The way you handle these cases can put you at legal and financial risk. Find out what one cosmetic dentist advises. 

The Bagua Octagon helps determine where certain energies should reside in your space.

Where you put a chair in your house or waiting room may seem a little inconsequential, but according to Feng Shui experts, the way you arrange your space has a direct effect on many areas of your life and business.

The ancient Chinese art of Feng Shui, which translates to wind-water, is all about energy. Because people are shaped by their surroundings, colors, the objects you keep in a room and where you place those objects dictates the flow of energy, or “chi”.  

As a doctor, you may question the scientific validity of this mystic art. While Feng Shui is considered a pseudoscience, redesigning your space can have a positive influence on your well-being and make your patients happy, too. Here are a few immediate ways you can improve your energy flow both at home and in your practice.

Water, according to the principles of Feng Shui, is a symbol of the flow of chi into your space. A fountain with moving water is said to encourage wealth and positive energy in your life and career. Whether it’s in front of your practice or your home, moving water can only improve your space.

Messy piles and poorly placed objects block the flow of chi into your space. While plants are beneficial when placed properly, they should not be creating an obstacle to your space. Clutter can also be a turn off for your patients, so make sure the entrance to your practice is free of any disorder.

Remember that waiting room from your childhood whose sickly yellow or sterile blue walls left you feeling on edge? Color choices can either make patients comfortable or leave them dreading their appointments. in your home, lack of attention to color can have the same consequence on you and your family.

Different colors and their placement can help different life areas, according to the Bagua Octagon, which helps determine where certain energies reside in your home. See the example above for guidance. As you can see, while painting your walls yellow can bring negative associations, centering the color unifies and balances a space.

This one may seem a tad superstitious, but shutting the doors to your bathroom at home and in your practice is said to protect your finances. Same goes for drains, which should be stopped when they’re not being used. Even if these forces don’t have the mystic influences Feng Shui claims, keeping your practice’s bathroom doors closed will keep this private space out of sight of your waiting patients.

Everyone knows wind chimes are pleasant and relaxing, but they can also encourage people to help you. In your practice, this can lead to increased motivation and productivity from your staff. You may even be able to get your family to participate around the house more by hanging a chime near the front of your home. 

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Chinese mysticism may not be a huge consideration in the way you run your practice. There is no way to verify the value of Feng Shui, but it cannot be denied that paying attention to the colors and arrangement of your home and business can make you and your patients feel more content. Continue below for DMD's top five tips to get you started on improving your Feng Shui. 

5 Feng Shui Tricks for Your Home and Practice

The average debt borrowers graduate with is more than $37,000, according to Credible.

At the American Dental Education Association’s (ADEA) estimate of $261,149, the price tag on becoming a dentist is no small fee.

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, not all cities are created equal when it comes to managing student loan debt. Employment rates, rent and living expenses vary, so it is crucial for recent grads to consider these factors when choosing where to start their lives as young professionals.

Using census data, Credible analyzed the 23 most populous U.S. cities and compared the average income of borrowers with their average monthly housing payment and the average monthly loan payments. Here are the most and least affordable places for post-grads with debt.

: $572 per month. With housing costs, this totals 31.47 percent of borrowers’ monthly income.

: $548 per month. With housing costs, this totals 31.45 percent of borrowers’ monthly income.

: $689 per month. With housing costs, this totals 31.40 percent of borrowers’ monthly income.

: $690 per month. With housing costs, this totals 31.24 percent of borrowers’ monthly income.

: $636 per month. With housing costs, this totals 31.18 percent of borrowers monthly income.

: $688 per month. With housing costs, this totals 26.24 percent of borrowers’ monthly income.

: $671 per month. With housing costs, this totals 26.65 percent of borrowers’ monthly income.

: $628 per month. With housing costs, this totals 26.94 percent of borrowers’ monthly income.

: $663 per month. With housing costs, this totals 27.38 percent of borrowers’ monthly income.

: $587 per month. With housing costs, this totals $27.84 percent of borrowers’ monthly income.

The average borrower monthly student loan payment across the U.S.

The average borrower monthly housing payment.

For recent dental school graduates, loan payments are a heavy burden, leading some to question whether their profession is worth the more than $260,000 in debt. Credible Labs Inc. released a study analyzing U.S. cities in relation to overall student loan debt. Continue below to find out which locations owe the most and the least in loans. 


Best and Worst Cities for Student Loan Borrowers

Podcasts allow you to gain knowledge and stay stimulated while performing your daily routine.

Busy schedules and long commutes often leave us with less reading time than we would like. It can be even harder to keep yourself stimulated while handling your daily responsibilities. Podcasts are one way to stay up-to-date and learn something new without stopping what you’re doing. These are DMD’s top program recommendations.

: Keeping up with the news these days is a challenge even for those who don’t have full-time schedules. “Up First” consolidates the most important pieces of information to provide lickety-split update ready for listening by the time you get out of bed.

The Times is known for its quality reporting, and they’ve carried it over to their audio platform. Host Michael Barbaro focuses NYT’s top stories, offering detailed news analysis in interviews with experts and authorities on a given topic.

Americans’ stress and anxiety have spiked recently, with many citing the news as a source of worry. “Wait Wait … Don’t Tell Me!” helps take some of the pressure off by turning the week’s noteworthy events into a comedy-powered game show. Audience members can call in to participate.

 Driving, relaxing outside, doing chores or yard work

We don’t know about you, but something about summer makes us crave some good ole’ American storytelling. A Southern gothic for modern audiences, S-Town is just in time for the warmer months. When a journalist gets a call from a small-town man about a possible murder and police cover-up, he thinks he may have the next 

 on his hands. But when he travels to the site to investigate, he finds a story — and a protagonist — he never saw coming.

 Tasks that don’t require too much of your attention

Ever wonder about the hidden forces that control the world around us? Then this program is perfect for you. Invisibilia combines narrative storytelling with scientific research to uncover all the intangible things that shape humans and their environments into what they are.

Busy schedules and long commutes often leave us with less reading time than we would like. It can be even harder to keep yourself stimulated while handling your daily responsibilities. Podcasts are one way to stay up-to-date and learn something new without stopping what you're doing. Continue below for DMD's top program recommendations.


5 Podcasts for Multitasking

Misuse or failure of tools is one way to botch a simple implant procedure.

No one likes to admit their faults, but when it comes to improving the practice of implant dentistry, factoring in human errors could reduce risks and complications.

Implants are considered simple, one-and-done procedures in dentistry, but this outlook can lead to carelessness. A new study from 

The International Journal of Oral & Maxillofacial Implants

, recognizing that complications in dentistry are usually chalked up to mechanical and biological causes, set out to demonstrate how attention to nontechnical factors can improve care and safety.

“The actual reasons for medical errors are faulty synthesis, premature closure, faulty context, errors from the use of heuristics, etc.,” researchers said in the study. “Professionals in numerous medical and paramedical specialties, including surgical oncology, anesthesiology, and veterinary medicine recognize the risk associated with ‘human factors’ and are intervening to reduce such risks.”

The following stressors and “hazardous” attitudes are causes for mistakes during procedures that may affect dentists.

 This is described by the researchers as hasty decisions and rushing to act before thinking things through. For example, a practitioner might skip a step because they have lunch plans they are prioritizing over patient care.

 Defined as a don’t-tell-me-what-to-do mentality, a dentist may deliberately go against the advice of a colleague or subordinate, even if the patient’s safety is at stake.

A dentist with this attitude feels he or she is impervious to mistakes and that errors only happen to others.

 Marked by a feeling of superiority that can affect both male and female dentists.

 Referred to by some as a “pushover,” dentists exhibiting this pessimistic attitude bends to the whims of others and does not feel his or her actions can make a difference.

This refers to emergencies during a procedure.

Missing instruments, equipment failure or inexperience with a tool.

 Incompetent or inexperienced staff, language barriers, distracted or neglectful staff, interpersonal issues.

 Lack of sleep, hunger, illness, emotional or physical discomfort.

To err is human, but there are several steps dentists can take to counteract mistakes. The study cites two specific protocols used in aviation called Human Resource Management and Threat and Error management, which can be tweaked to suit the needs of dental practices.

“The systematic use of feedback (reporting and analysis of errors by a grouping of professionals) Is another way of making human activities safer,” the researchers said. “More and more medical specialties are taking these concepts on board.”

The best and easiest way to implement new protocol is to create procedural safety checklists. The criteria are as follows:

· Checklists must be 10 or fewer items so as not to make the process tedious and, therefore, less effective.

· Pose questions to patients clearly and without risk of misinterpretation.

· Questions should not lose their meaning in translation. A good checklist is universally understood.

· Questions should also be unambiguous to staff members involved in the procedure.

· An ideal checklist is electronically formatted.

· Checklists are open to modification. As science and technology advances, so should your safety procedures.

“There is absolutely no doubt that [systematic feedback] has improved safety for practitioners and patients alike,” the researchers reported. “Implementing these approaches in the working environment is, therefore, a win-win situation for practitioners and their teams.”

In dentistry and medicine, man-made complications can damage more than just your ego. A recent study investigated the prevalence of human error in implant dentistry, and its conclusions may surprise some dentists. Continue below to find out more. 


Dangerous Influences During Implant Procedures and How to Avoid Them

Sharks can reproduce an infinite amount of teeth in their lifetimes.

Maybe it’s the gills and fins, but at first glance, sharks and mammals do not have many similarities. But according to a 

, humans have more in common with sharks than previously thought.

For the first time, researchers from the University of Sheffield have uncovered the genetics that allow sharks to regenerate teeth using a conveyor-belt system. Here is what the team learned and how their discoveries can be used to aid human tooth regeneration.

According to the study from the University of Sheffield’s Department of Animal and Plant Sciences, sharks can form a set of epithelial cells called dental lamina. These cells allow sharks to develop and regenerate teeth their entire lives. Humans have these cells, too, but they only facilitate the development of baby and adult teeth before the cells are lost.

The genetics found in sharks probably made the first vertebrate teeth

The team from the University of Sheffield discovered that these genes are around 450 million years old. This means that they make all vertebrate teeth from sharks to mammals, with mammals’ regeneration showing significant reduction over time.

Genes are responsible for the initial surfacing of shark teeth

Using catshark embryos, the team found these genes were present in the early stages of a shark’s development.

We may be able to regenerate teeth like sharks in the future

Since we share these “tooth genes” with these ancient underwater hunters, researchers may not be far away from figuring out how to manipulate them for human tooth regeneration.

“The Jaws films taught us that it’s not always safe to go in the water, but this study shows that perhaps we need to in order to develop therapies that might help with human tooth loss,” said Dr. Gareth Fraser, lead researcher for the study, in a press release.

Sharks are known for their ability to regenerate thousands of razor-sharp teeth in their lifetime. But according to a new study, everyone's favorite ocean predator can tell us something about our own species. Continue below to learn more. 


What Sharks Reveal About Tooth Regeneration

WalletHub's analysts compared the operating efficiency of the largest U.S. cities to find out which are managed best.

	Keeping a city up and running is no small feat. U.S. cities are epicenters of multiculturalism, business and activity, which makes them difficult to manage in more ways than one. So, when it comes to transportation and other public services, elected officials must work together to provide the greatest good for the greatest number. Unfortunately, the undertaking is easier said than done. 

	The effectiveness of a city, according to 

, is quantifiable. Analysts at the personal finance website compared the quality of city services against per-capita budget. Using 33 key performance indicators to measure the quality of those services, WalletHub came up with a detailed breakdown of what cities offer the most band for residents’ buck.

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Here are the best- and worst-run cities in the U.S.

·Warwick, RI, has the lowest rate of violent crime, while Wilmington, DE boasts the highest

·Portland, ME has the lowest unemployment rate, while Bakersfield, CA boasts the highest

·Tallahassee, FL has the best quality roads while Anaheim, CA has the worst

·Lubbock, TX has the least air pollution while Long Beach, CA has the most

WalletHub's latest report measures the budgets of 150 of the largest U.S. cities against the services available to its residents. Indicators such as air quality, violent crime and infant mortality were also factored in. Continue below to find out if your city made one of the lists.



Changing positions frequently is one way to combat damage to your musculoskeletal system.

Awkwardness in dentistry, according to a new study, goes far beyond dealing with difficult patients.

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“Awkward positions are a major part of a dentists’ work,” said the study's authors. “This mainly pertains to static positions of the trunk and head in contrast to ‘office work.’”

Researchers published the findings of the 2017 study in 

where they detail the results of posture analysis via the computer-assisted acquisition and long-term analysis of musculoskeletal loads (CUELA) method. Using this data, the study’s authors not only confirmed that static and ergonomically incorrect positions are the cause of musculoskeletal disorders in dentists but quantified which activities and angles are the most unfavorable.

The treatment category encompasses measurement conducted during 10 common activities performed during exams and procedures. Of the 10 different angles measured, the following activities yielded the highest static percentages (greater than or equal to four seconds), suggesting they may have the most impact on back and neck pain.

“These awkward postures result in static overexertion of the musculature which can lead to musculoskeletal disorders,” the researchers concluded. “Accordingly, many dental tasks present a potential hazard to the musculoskeletal system, such as prolonged bending or twisting of the trunk or sitting in a predefined uninterrupted fixed posture.”

The second set of data focuses on activities relating to general around-the-office tasks and activities like walking, conversing and hygiene. While these tasks showed fewer instances of constrained posture that can lead to poor musculoskeletal health, the 10 angles measured showed the following positions are most harmful.

How can I prevent musculoskeletal damage?

Overall, the greater angle values of head and cervical spine area suggest that treatment-related tasks show a higher percentage of forced postures. Treatment activities are also, for the most part, more of a strain on the head area than the trunk area. Contrarily, office work and other activities, on the other hand, affect the trunk area more than the head area.

“It has to be considered that such breaks in-between working would relieve the strain on the spine. Dentists who have a well-trained muscular system can use these short breaks to recover and are therefore pain-free,” the researchers said.

As such, the study advises that dentists change their seating position frequently to decrease static postures and optimize office work to prevent rotations in office task-related positions. Relaxation exercises for the musculoskeletal system are especially helpful for the cervical spine and could prevent pain. A prior study conducted in India concludes that use of a 

 optimises posture and can reduce work-related pain.

Discover more Dentist’s Money Digest® news here.

Ergonomics has become a buzzword in dentistry in recent years, and for good reason. One of the main causes of the prevalent muscular imbalances and problems among dental care providers are the awkward positions and repetitive movements that remain an inherent part of providing care to patients. Continue below to find out which activities are the most harmful and what you can do to prevent symptoms.


The Worst Positions for Dentists' Musculoskeletal Health

First thing’s first: You need to take care of yourself to attain professional success. Happify markets itself as an “experience” that allows you to increase emotional wellbeing and satisfaction. Everyone needs good vibes in their lives, so consider this app for science-based games and activities to conquer negative thinking, cope better with stress, track your progress and be a more positive force in the world.

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Who has time to print out copious pages of material on dental conditions and treatment options? This patient education app is exactly what you need if you are looking for a faster, more convenient way to help patients better understand their treatment needs and oral health. Though its price tag is heftier than a lot of apps you may have on your phone, this award-winning software will find a happy home on tablet devices, which have become staples in the medical industry.

DMD knows how important it is to incorporate 

 into your daily workflow. Go Banyan, previously called Social Dental, is social media marketing tool for health care providers that makes digital marketing less complicated. Upload your HIPAA-compliant photos and automate reviews, websites and practice listings in a few simple clicks. You can even get success coaching to build your brand and amp up your web presence.

According to Simmons Market Research, 19 percent of U.S. Latinos speak only Spanish, and 55 percent have limited English. This growing population accounts for 17 percent of the country, and if you practice in areas like New Mexico or California, chances are you will eventually need to accommodate a Spanish-speaking patient. This dental-specific app helps non-Spanish speaking dentists communicate with ease and  prevent misunderstandings.

As a dentist, it is very likely that you are also a small business owner. Unless you hire outside help, you are responsible for paying your employees, tracking expenses and creating fair payment options for patients. QuickBooks is an all-in-one app that helps you do all that whenever and wherever.

Cost: QuickBooks is offering a 50 percent discount right now, making the cost $24 per month. You may also opt for the 30-day free trial and pay later.

Doctor, business person, mentor, dentists wear many hats in managing their own practices, leaving many with limited time. Apps are one convenient way to optimize your working hours and create more freedom for yourself. Continue below to see DMD's top picks to help you manage you life and business.