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Howard Speaks Howard Farran, DDS, MBA, MAGD

More by this author (315)
The Three Functions of Business; Part One

Howard Farran, DDS
MBA, MAGD
Publisher,
Dentaltown Magazine
My last three-part series dealt with the things you manage at your dental office: people, time and money. This month begins my newest three-parter, which focuses on the three functions of business; you make something, you sell something and you watch the numbers. For the purpose of this month's column, I'll focus on the first function – making something.

If all you do is X-rays, cleanings, exams, fillings and crowns, it is going to be a very difficult journey for you to become a million-dollar practice. Let's run through the specialties and you can decide if you want to make more of something or just sit on your hands, refuse to learn, stay stagnate and burn out with a dismal practice.

They always say that everything begins with your thoughts, which determine your actions, which form your habits, which form your character, which leads to your destiny. So let's change your thoughts about just a few things.

Oral Surgery
About three years ago, I had a discussion with Dr. Jay Reznick, a board-certified oral and maxillofacial surgeon, who has lent his expertise and advice to the Dentaltown.com discussion forums and online continuing education – almost from the very beginning. He practices in a suburb of Los Angeles, California, where there are almost more oral surgeons than there are Starbucks. He did not realize what an impact his contributions to Dentaltown had on the typical general dentist. He assumed that most general dentists had an oral surgeon down the street to whom they could send their patients whenever they needed treatment. He did not realize that the majority of dentists in this country, and in fact the world, practice in small communities where there was not the degree of specialist support as there was in his own town. He also did not realize that a majority of community dentists with family-oriented practices were faced almost daily with patients who needed basic oral surgery care, yet they felt uncomfortable treating these patients because of the very limited oral surgery training they received in dental school. Many times, referral of the patient to the oral surgeon was impractical because of distance or how long the patient had to wait for an appointment.

I told Jay that there was a real need for quality continuing education in oral surgery for the general practitioner, so that these dentists would feel more confident in their knowledge and competent in their surgical skills. Knowing how difficult it was for many dentists to take time away from their practices and travel to CE courses, I suggested to Jay that he think about producing some educational DVDs to help those general dentists who perform oral surgery procedures in their practices become better clinicians. Based on how hugely popular his online CE courses on Dentaltown have been, and what a great teacher Jay is, I knew that this type of continuing education would be valuable to dentists everywhere. He spent about a year looking at the oral surgery courses that were already available on DVD, outlining a basic curriculum and looking at technologies to allow him to show the viewer exactly what he wanted. After all this planning, Jay realized a single or even a series of DVD courses was not going to be sufficient. He took the concept to the next level by developing the Web site www.onlineoralsurgery.com. Jay set up a permanent three-camera video studio in one of his surgical suites, so that procedures could be recorded as they happened each day in his busy practice. He then worked day and night editing video and putting together the first video courses. If you want to make more of something, try oral surgery by letting Jay train you online.

Periodontal Surgery
How many times have you been doing a crown prep and you are packing a zero cord from Ultradent, plus a one cord, pumping epinephrine into the tissue with a ligamajet, trying to stop the bleeding, only to get a horrible impression. Hello! It's called crown lengthening. Are you telling me you can't do a crown lengthening procedure? It is as easy as a filling. You simply retract the tissue and smooth out two millimeters of bone below your crown margin. Did I tell you that insurance pays 80 percent of this procedure? Periodontists tell me every day that 20 percent of their referrals are 80 percent of their business. It's as if dentists don't even know that crown lengthening exists.

What about your three-month recalls? Most of this is supervised neglect. Patients come in every three months with 4, 5 and 6mm pockets and you just keep cleaning them out with little improvement. How about you lay a flap and then scale with vision and access to all the plaque and calculus that the hygienist was missing. Have your hygienist assist with this procedure so she will see how impossible it is to do a blind cleaning down a 6mm pocket. She will start selling more periodontal surgery than you could ever imagine. She will demand it because she'll learn what she can and cannot do. You can scale off all the calculus on a six-millimeter pocket if you can see it; if you can't see it, you can't do it - just like oral surgery! If you can't lay a flap, you can't remove wisdom teeth or place a simple root form implant. And did I tell you that insurance pays 80 percent of this? If you aren't willing to change and do this type of procedure, at least refer it out to your local periodontist, because otherwise it is simply three-month recall supervised neglect by you!

Orthodontics
Eighty percent of ortho is Class I molar and Class I canine. Only 15 percent is Class II where their liver shows when they smile, and only five percent is Class III where their lower jaw is in the next operatory! There is not enough money in the world to get me to do a Jay Leno Class III, and Class II's are difficult as well. You should probably refer these to your local orthodontist. But are you telling me that you can't do a simple Class I molar and Class I canine on a non-growing adult?! Go see Brock Rondeau to learn how to do these very simple procedures. Check out Brock Rondeau DDS, Rondeau Seminars at www.rondeauseminars.com. And what about Invisalign! If you can't do Invisalign you should just quit! If there is anything easier in dentistry, I haven't found it! If you can't do two to four Invisalign cases a month you aren't even trying. It is just simply fun and it is very profitable!

Endodontics
Endodontics is so important, if I were you I would take a steady diet of endo courses. Take every one you can find; at the very least take one a year. The demand for endo, implants, composites and ortho is growing more than 12 percent a year, while dentures and removables are contracting, and almost everything else is flat. Endo is paid 80 percent by most third-party insurance companies, and most of all, there is nothing more gratifying than getting a patient out of pain while saving a tooth, with only 35 percent overhead for the average endodontist. I've presented only a few specialties that you could easily slip into - it just takes a little more time, preparation and drive to get there. Maybe oral surgery ain't your cup of tea, or maybe orthodontics bores you, but I implore you to look past usual day-in and day-out drill-and-fill dentistry and make something more of your practice. Implementing these simple procedures into your practice can amount to a major increase in production. When you hit the million-dollar mark, you can thank me.
Dentaltown Magazine
September 2025
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