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Office Visit: The “Additive Dentistry” Specialists By Thomas Giacobbi, DDS, FAGD, Editorial Director, Dentaltown Magazine

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The “Additive Dentistry” Specialists

Dr. Lou Graham’s group practice of general practitioners and specialists is a patient’s one-stop-shop for long-term dentistry

Welcome to the newest installment of Office Visit, where we visit a Townie’s office and profile his or her equipment, design or unique practice philosophy. If you would like to participate or nominate a colleague, please send me an e-mail at tom@dentaltown.com.

This month, we paid a visit to Dr. Lou Graham’s practice, University Dental Professionals, in Chicago, Illinois. Dr. Graham discusses his new patient process, “additive dentistry,” office layout, team development, working in a group practice and Dental Team Concepts. 		Office Highlights

Bonding Agents
  • 1 Step Plus
  • Optibond
  • PBnt
  • XP Bond


Burs
  • Axis
  • Fissureotomy
  • Komet material
  • Numerousl Polishing
  • Shofu Robots


Cements
  • Calibra
  • Fuji Cem
  • Fuji Cem Plus
  • G-CEM
  • MaxiCem
  • MonoCem
  • NX3


Implants
  • Ankylos
  • Neoss
  • Nobel Biocare


Impression Materials
  • Aquasil
  • Flexi Time
  • Impergum
 Restoratives
  • 3M’s Ketac Nano
  • Artiste
  • Duo CeramX
  • Dyract Flow
  • Esthet-X
  • Evo Flow
  • Filtek
  • Fuji 2 LC, Xtra, Miracle Mix
  • Gradia X
  • Premise
  • Riva Light Cure & Self Cure
  • Venus
  • Vitrebond
  • Wave Medium Flow


Technology
  • 980 diode laser (KaVo and Sirona)
  • A-dec systems with built in Acteon piezo-electric systems
  • Cercon Coach (Dentsply)
  • CO2 Spectra & Deka soft tissue laser
  • Dentrix Software
  • Digital pan/ceph (Sirona)
  • Digital radiography (Kodak) with Logicon for caries detection
  • Guru (Schein)
  • Nobel Guide
  • SDI Radi LED light
  • Simplant Software
  • Velscope (LED)
Name: Lou Graham, DDS
Graduate from: Emory University Dental School
Year graduated from dental school: 1982
Practice Name: University Dental Professionals
Year when practice opened: 1984
Practice Location: Chicago, Illinois
Practice Size: 3,500 square feet
Number of Ops: 9   Staff: 14

Your office is located in a university community. How would you describe your patient population?

Our patient population is quite unique. With the international reputation of the University of Chicago and all its related graduate programs and hospitals, our patient mix is extremely diversified. We literally see dentistry from around the world and it’s quite interesting to observe.

How do you market your practice to this population?

For years we have been the worst at marketing! We follow the adage that internal referrals are the best. Earlier this year we started a program to send out a $5 Starbucks card with a personalized thank you note to patients who gave us new referrals. For three referrals, we sent out a $50 American Express gift card with a personalized note. We just finished a major upgrade with Office Site by adding customized audio and video to our Web site. Now, when you open our site, UDPdentistry.com comes alive. Other projects involve marketing via university publications and working with a direct marketing consultant to build our specialist referral practice.

You have described your approach as “additive dentistry.” How is this reflected in your treatment plans?

Life-spans continue to lengthen and our approach is to always be as conservative as possible with treatment longevity. Simple answers are a missing lower molar that either requires a bridge or an implant. But with more challenging scenarios, like a patient with anterior crowding and discolored teeth, veneers can give great results, but what would be best long term? If the patient is 60, veneers can be a great alternative to one or two years of ortho, bleaching, and maybe later, more conservative veneers. On a 22-year-old with aggressive preparations, what is long-term success and how many times will this case require repair or retreatment? Add to this, an unstable occlusion and whether or not veneers are the right answer, long term. The same approach goes into perio/restorative treatment planning, daily restorative planning and so much more.

You have two offices separated by a lobby. How do you determine which patients are part of each practice? Is there overlap? From a design standpoint, the 1,000 feet between our offices is absolutely not ideal. The building we were in was built almost 100 years ago and the opportunity came about to expand into new space located on the opposite side of the building. In our pre-existing space, Drs. Anthony LaVacca, Danielle McCarron, Rauf Yousef, and Michael Alexander practice along with our hygienists Kierah Robinson and Pam Pennamon. I operate out of the new space with Gwen Smukowski (hygienist) and an orthodontic group, Get It Straight, headed up by Dr. Neil Warshawsky. They sublet the space four days a month and have full use of the office. Neil is incredibly progressive and the relationship works out incredibly well because we can cross refer and work together on complex casework with our entire group. Along with Neil’s group, Dr. McCarron continues to expand her Invisalign practice along with other orthodontic services, including Red, White and Blue and Raintree Essix’s MTM system.

The overlap in the offices is that our digital panorex is located on the new side, which allows all of our patients to become aware of both offices and the latest technology. Within our digital panorex room, patients can immediately see the scan and, without question, it is a “wow” for them each and every time. The same room can be used to have one-on-one patient discussions and patient photography. Both offices are linked together in every other manner, so calls or any patient management can be handled by the front team.

You have a prosthodontist and periodontist in your practice. How do you manage this relationship?

Some consider it a challenge to have a general dental group coupled with a specialist group. I think we are unique because we also work with local dentists in assisting them with complex casework. Dr. LaVacca, our prosthodontist, has begun working closely with some neighboring dentists in the restorative aspects of implants. We are expanding this role by offering a full-year mini residency in restorative implant dentistry with Dental Team Concepts (DTC), along with accreditation CEUs. This unique relationship will allow our group to surgically plan and place the casework while working concurrently with the referring doctors to coordinate the restorative phase.

What is your advice for dentists considering a large group practice that would include specialists as partners or renting space?

The first step in creating a group practice is to develop your philosophical mission. My experience would truly advise a great front office manager, and definitely one clinical leader. In my case, Mary Beth Reckamp and Daniella Soro were my front management team, and Zenny Martinez, Gwen and Kierah, who have been with me for years, were the key reasons to our growth and success. Associates must be selected so carefully because they are your future. Too many times, dentists look upon them as worker-bees and this only leads to a turnstile office.

What are your tips for picking the great members of your team?

I go by the adage, “it’s so much easier to hire than fire.” With today’s complexity of laws on dismissal of employees, it becomes critical to hire correctly. For the majority of team members who I have let go, there were two essential reasons, they either didn’t have the same work ethic I had, or they just didn’t share the vision. Routinely an interview process involves an initial meeting with me after members of the team have met with the applicant. If the applicant satisfies all the criteria, we have him or her back for a series of work appointments in which we evaluate skill level. These working interviews allow us to further observe their interactions with patients and also for them to see how comfortable they are in our work environment. If we aren’t 100 percent sure, we bring the applicant back, and sometimes it can take a series of working interviews to decide. Each and every mistake I have made with a hire who didn’t work out was because we rushed this process.

Describe your approach to team development with your existing team.

Team development is life long. Our goal is to create goals for leadership and development for each team member. This begins with a written and oral understanding of what the employee is seeking and then it’s up to us to determine the right place within the team. An essential ingredient is finding the right job for the right person. All too often you might have the right person in the wrong job. Our monthly meetings allow the group to interact openly with a set agenda and this too leads to leadership/ responsibility or the lack thereof.

What are some of the physical ways your office is different than most?

From the outset of the new build-out, we worked with Ron Ehlers of Metrotech Design Group who has designed more than 100 dental offices. I wanted the office to look like my living room. He loved it! As he and Erin McLaughlan worked on design and integration, they worked with Dick Ostroski and Rich Landek from Patterson, and a master plan came to life. With today’s options, anyone can build their personality into the practice and the results can create dental environments that are truly reflective of their passion.

Our original office had neither space for a consultation room, nor a panorex, but we had more than enough lab space; we knew what we needed and what we didn’t. As we built out the new space, we decided not to squeeze four operatories into a main space but instead create three beautiful rooms. Our goal was to maximize the “old feel” of the building and maximize the 20-foot ceilings, the eight-10 foot windows, the historic moldings and so much more.

What dental equipment do most patients notice immediately?

The first thing our patients notice is our OrthoPhos digital pan by Sirona. The moment the panorex is taken, they turn around and it’s immediately up on the monitor. The fact that this picture often replaces traditional full mouth X-rays in the office is both appreciated by patients and the team. Velscope has been so widely accepted by our patients as an oral health-screening device that this also has a big impact on them. Kavo’s Diagno-dent is a consistent hit with our patients because once the technology is explained, they immediately grasp the reason why. Guru from Medvisor is a great animation resource to explain the “whys” to a patient in a very unique way. It allows the user to stop, draw and point to any part in an animation, along with importing and exporting files and pictures and allowing users to create their own presentations.

Your office seems to have a keen interest in staying current with new dental technology. Is there any new equipment you’re thinking of purchasing for 2008?

The must haves on my list for 2008 begin with the new digital scanner by 3M called Brontes. Imagine scanning a full arch in two to four minutes or two quadrants, a crown and being able to view this all on a monitor. It will show the preparation, occlusal clearance, line angles and so much more. It will allow all of us to create better and proper preparations and replace much of the traditional impression techniques. It won’t be too long before impression materials will be part of the previous generation, imagine all the happy orthodontic patients and beyond! Our offices will be moving into a true CAD/CAM field where even traditional articulations will be via computers. In 10 years, who knows where this technology will be? The other must-have upgrade in our office will be the next generation IntraOral Camera from Acteon. Products that deliver multiple clinical modalities are most beneficial. Beyond it being a superb camera, this unit offers a customized lighting system for shade selection and custom matching of teeth side by side with shade tabs, along with enhanced lighting for intraoral viewing. Coupled with Guru, case presentations will simply just flow! It’s truly so exciting, just take a deep breath and welcome the challenge.

How has Dentaltown impacted your practice?

Dentaltown has always been a unique publication to read. I particularly like the polls and the interactions on the message boards. This allows me to understand my audiences when I am lecturing and also to see and understand new clinical techniques. There are definitely new protocols published and it is very easy to follow.

What is Dental Team Concepts? How often do you present CE each year? What are your future plans for DTC?

Nearly five years ago we began a continuing education and consulting company called Dental Team Concepts (DTC). Our initial premise was to create educational programs that went beyond the single manufacture courses. Through DTC we work with multiple sponsors throughout the industry that allow us to deliver well-integrated programs. We currently have a dynamic group of 40 dentists who are involved in many different phases of dentistry. With this as a core group, we consult our client companies to evaluate current and future products, market trends and a variety of ways we can interact via the Web, journals and live lectures. With such a vast speaker pool, we will be launching a very dynamic Web site that will allow educational entities such as state groups, organizations and others to visit our site, select speakers and their subjects, and with just a phone call, the event is booked and DTC handles all of the coordination. This project will also provide our manufacture clients numerous innovative alternatives to exposing their products to dentists, hygienists, assistants and laboratory technicians. The key to all of this is that the speakers as evaluators must utilize the products in their own practices in order to offer audiences the most honest integrated programs. This is one of the fundamental core values of DTC – teach what you use.
Dentaltown Magazine
September 2025
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