Dentists in this country are facing many challenges to their success as individuals. The threat of managed care, skyrocketing costs, and decreasing insurance benefits for patients are forcing many dentists to focus on the basics of business. Dentists today are becoming much more marketing savvy. Back in 1992, when Discus Dental launched the Nite WhiteŽ product line, the words 'marketing' and 'sales' were dirty words. Today, it has become much more acceptable to promote the value of dentistry. Especially in light of the millions of dollars that are being spent by insurance companies. In fact, the shift has been so dramatic that it has almost become accepted that a successful dentist markets and promotes his or her services. Practices that don't market are either practices that have been around for a very long time, or that aren't doing too well in general.

The most important thing for every dentist to do is first decide what type of dentist you are. After all, just deciding whether or not you are a managed care provider will eliminate many of the choices about the type of dentistry that you offer in your practice. As managed care becomes a larger and larger part of dentistry, many dentists will have the opportunity to define themselves based on the types of services that they offer.

The future of dentistry is in creating consumer demand. Dentistry is no longer just a need based type of health care, but rather it is part of a growing trend in improving the way we look. It is clear that the greatest opportunity for dentists in the future will be cosmetics. The procedures have dramatic and positive results. The procedures are almost entirely elective and not covered through dental benefits plans. And, cosmetic procedures can be the most lucrative and fun to perform. Not to mention such procedures as tooth whitening--they are entirely non-invasive and create a substantial source of revenue for any practice.

What about the stigma associated with the advertising and promotion of dental services?

Nearly $170 million were spent last year by insurance companies promoting dental benefits plans. The fact that anyone is even debating the issue of whether or not to promote the profession is unreal to me. There are many ways in which to professionally promote your services and if dentists are uncomfortable advertising themselves there are many high profile alternatives that are currently available. Certainly unethical advertising is always unethical. But, I think ethical, quality advertising is a good thing. It's an important thing. In my opinion, the ADA should be standing behind it. I think in the future we may very well see the ADA change or shift its stance towards advertising and marketing and sales in dentistry. I don't think a hard sell is ever a good thing when it comes to patients or customers. But what is advertising? It's letting people know what their choices are, and it's how creative you get in doing that. I think creating awareness is a very positive thing.

After all, dentistry has really changed from the old drill and fill mentality. Although you wouldn't know it belonging to a managed care plan, dentistry has really advanced. From the development of dental implants to dental sealants, which can eliminate the discomfort of cavities for children, dentistry has a great deal more to offer than most people realize.

The dramatic success of your Nite WhiteŽ tooth whitening product is proof of consumer demand for cosmetic procedures. Do you feel that this area of dentistry will continue to grow?

The market for bleaching products exceeds $50 million a year, and the market has grown by 10-20% a year for the last 5 years. In my estimation, the market could quadruple in size within 2-4 years. Tooth whitening is just starting to become popular and many people are beginning to see their dentist differently.

I also feel that increasing consumer demand comes from patients who are getting older. These patients not only have more heavily stained teeth, but they also have more disposable income and are more concerned about their health. I think that's going to really continue to fuel the growth--the baby boomers getting older and people becoming more concerned about their self image. Also, men are now more concerned about physical self image and are concerned about how they look. Men are in the cosmetic market now and they are looking for ways to look younger, better and healthier and that's one huge aspect of it. Also there is the repeat business--people who have already bleached their teeth and need to come back and touch up that smile to keep it white.

What kind of practice would benefit most from the offering of tooth whitening products?

Literally any practice can benefit from a bleaching program. Most doctors who are learning about cosmetics and aesthetics and who are trying to generate more revenue, generate more business, are using bleaching as a practice enhancer, a practice building type of product. Discus Dental, for example, offers marketing materials and marketing support including counter cards, patient brochures, post cards that can be customized to the doctors practice as patient reminder cards, statement enclosures and a direct mailer that we send out to all the doctor's patients. A lot of the more successful doctors have caught on to the benefits of marketing and they are the ones who are doing really well.

Bleaching is really unlike most other dental products. It's what we call a profit center--a revenue generating product. Other products, like impression materials for instance, are cost center products where the important factors are that it has to be efficient, it has to be easier to use, and it has to be less expensive. You want to save money, you're trying to get a better product for that money and you're trying to get better service at the same time. With bleaching it's a different thing. Buying a quality product that's reasonably priced, and getting a full marketing system, getting attractive packaging that's very consumer appealing and exciting, and getting a product that's not only effective but causes less sensitivity, tastes better and promotes patient compliance--that's really the key.

What's involved for the doctor in terms of administering a bleaching program once it's part of the practice?

The doctor typically will do the bleaching after there has been a hygiene appointment. That's an ideal time to do it. The patient should have a thorough exam to make sure that the mouth is in a healthy condition and acceptable as a bleaching candidate. Then an impression is taken, usually an alginate impression because it's quite adequate and takes only a few minutes. Then, if the doctor is using a fast setting stone like Speed Stone(tm) that sets in 5 to 10 minutes safely, then they can have the trays ready within 20 to 30 minutes. In reality, it is not even necessary for the doctor to do anything in the entire procedure except final approval. A well trained staff can effectively administer a tooth whitening program in any office. It simply becomes a regular part of oral hygiene and care.

Many dentists complain that one of the most significant challenges in dentistry is controlling overhead. How do you feel dentists should face this obstacle?

I don't think the problem is overhead, I think the problem is revenue. Certainly overhead is always important, but I think you can lose sight of the forest for the trees if you don't actually look at what's bringing in the business. The business is patients--the new patients and existing patients. It's offering them more products and more procedures and learning how to sell the same customer more products they need. I use the word customer intentionally, because patients are customers and you're there to service them if you're a doctor. It is very important to be able to offer the same patient / customer more products more effectively and more efficiently.

How does tooth whitening fit in to the managed care environment?

There are lots of different types of managed care programs. For those doctors who feel that they need to be working with managed care, bleaching is a nice adjunct to their managed care revenue. Just because patients are insured through managed care doesn't mean they're not interested in aesthetics. Managed care patients have the same exact desires as other patients. Maybe in some instances they don't have the same income and aren't able to afford as much, but that doesn't mean that is true for all of them. Doctors tend to put ceilings on their patients' abilities to afford or desire aesthetic procedures and many times just don't think about offering that aesthetic procedure, whether it's veneers, bleaching, whatever it is. I think there are a lot of missed opportunities.

Finally, what advice would you give to dentists that are looking to grow thriving and successful practices?

From my business perspective, it's important to be organized. Know your game. It is also very important to realize that patients are not only patients, but they're also customers. This means you're there to service them, to make them aware of what's available to them. If you don't, believe me, there's another dentist that's more marketing savvy, more aware and more available in his or her ability to make that service or procedure available to your patients. That's probably one of the key reasons why doctors lose patients--because other doctors are more marketing savvy. Marketing is a good word--it means letting patients know that's it's a good procedure, that it's a positive thing, that it's going to make them feel better and look better and enhance the quality of their lives. I believe marketing is the most important thing that doctors have learned in this decade. In the early part of the next decade, and the years to follow, it's going to be even more important.