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Second Opinion by Paul Suni

Dentists Increase the Cost of Equipment


by Paul Suni  


Second opinions are common in health care; whether a doctor is sorting out a difficult case or a patient is not sure what to do next. In the context of our magazine, the first opinion will always belong to the reader. This feature will allow fellow dentists to share their opinions on various topics, providing you with a “Second Opinion.” Perhaps some of these dentists' observations will change your mind; while others will solidify your position. In the end, our goal is to create discussion and debate to enrich our profession.

- Thomas Giacobbi, DDS, FAGD
Dentaltown Editorial Director

By December 2007, I had sold most of my shares in Suni Medical Imaging to a German private equity firm and donated the rest to the American Dental Association Foundation for a dental scholarship fund. A few weeks later, probably figuring I had some free time on my hands, Dr. Thomas Giacobbi, the editorial director for this magazine, called me to find out what I had been up to. I informed Tom that I was looking forward to staying involved with the dental profession in an advising and mentoring role, and to help find new ways of contributing that didn't involve running an ongoing operation or supervising scientists and engineers on a day-to-day basis. During our conversation, while noting that I'm now out of the equipment business, Tom asked if I could give a little insight into why dentists have to pay so much for dental equipment.

When it comes to the price tag of dental equipment, you must first understand that 40-60 percent of the money dental practices pay for a piece of equipment goes into sales and marketing. In other words, it's the dental practice's cost of engaging in the purchasing activity but excluding their additional costs relating to loss of productivity during the purchasing process. In the case of equipping a two-to-three operatory practice for digital radiography, this cost can easily amount to $10,000 or more. Insane, isn't it?

It costs a lot of money to sell to dentists because it is expensive to, A: get the practice's attention through marketing efforts and, B: to go through the sales process which typically takes three to nine months – an extremely long and obscenely expensive sales cycle by most standards. These difficulties do not enhance the profitability of dental equipment manufacturers at all.
That is not the only hardship dental manufacturers suffer and that dentists wind up paying for. Let's say Dell develops a new computer design in three to six months, rolling out their marketing plan in parallel. Once they launch the product, they don't spend 10-20 years convincing their customers that the product makes sense, all the while burning cash like it's going out of style. On the other hand, dental manufacturers do exactly that. Why? Because dentists are incredibly slow to adopt anything new.

Film-sized digital radiography sensors have been on the market since shortly after my team at Orbit Semiconductor developed the sensor chips for Schick Technologies in 1992. That is 15 years ago. The percentage of dental practices that have adopted this technology is around 30 percent. Roughly speaking that means that on an average annual basis only about two percent of dental practices adopt the new technology. From a business standpoint it is a uniquely and tragically low adoption rate and this sluggishness contributes greatly to the cost of dental equipment. Waiting over long spans of time increases costs immensely. While the adoption of digital radiography has been more than two percent over the past five years, the industry has other technologies in the pipeline on the slow boat to China, and it is burning cash all the while in waiting mode with other technologies regardless of what digital radiography is doing. The overall gist is that investments turn into revenue and profits too slowly; every product winds up being costly.

Now, having been a dental manufacturer and direct seller, I must say that dental is one of the greatest places to start small and grow a business according to one's own tempo. Dentists like to buy from other dentists. Word can travel quickly in dentistry. Good tools are always in demand and it is always possible to find a way to make or market stuff cheaper or better than the other guy. And, some inventions make it big. Look at CEREC and digital radiography, for example.

So, what is it going to take for technology prices to drop? To get consumer prices, you've got to consume like a consumer. Speed up the buying, baby! Round up 50-100 of your colleagues, call up three manufacturers and inform them that you guys and gals will be placing an order this month and that you'll be happy to continue the conversation if they can guarantee a 20 percent cash discount relative to their current best price for the month. If I were the head of a company, I'd be delighted to have such an opportunity because I would consider it a substantial chunk of revenue. The reality is that dental practices are cheap. The industry always gets squeezed. The bottom line is that people can only get the best market price and no better. Nobody is going to go with a deal that isn't fair. Maybe you can even get two competing companies to bid against each other to squeeze another five to 10 percent off the price. The logic of the deal: Since you are doing the marketing and sales for the company, why should you and your buddies pay for it?
Author's Bio
Paul Suni is frequently referred to as “The Father of Dental Digital Radiography.” He is a former CEO and CTO of Suni Medical Imaging, Inc., a company he led from 1995 until 2007 when he sold it to a private equity firm. A Berkeley educated Physicist, Mr. Suni has the distinction of having reached worldwide acclaim as a leading technologist in three industries: the semiconductor industry, the optoelectronics industry as well as the dental equipment industry. He is Executive Director of Integral Cognitive Institute, an interdisciplinary think tank on Cybernetics. He also advises and leads workshops on Technology and Entrepreneurship in Dentistry. He is based in Silicon Valley, California. E-mail: psuni@msn.com. Phone: 408-596-0474.
Dentaltown Magazine
September 2025
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