Professional Courtesy: 20 Years and Counting by Dr. Thomas Giacobbi

Dentaltown Magazine

by Thomas Giacobbi, DDS, FAGD, editorial director, Dentaltown magazine

In 1998, I was three years out of dental school, recently married and driving 2,500 miles across the country to seek fame and fortune in Arizona. Two months earlier, I’d flown out for a week to interview and find a job; I wasn’t even sure if my new state would be permanent.

I started out working for Cigna Dental. The insurance company had the bright idea to own seven dental offices to serve customers in the Phoenix metro area. The job appealed to me because it was a salary position, which would allow me to buy my first house right away. The first 18 months allowed me to decide if Arizona was a good move (it was) and to begin looking for a place to practice. I was looking as construction was booming.

Before I could find a dental home, Cigna realized that owning dental offices wasn’t easy and sold the business to a DSO. The new sheriff in town expected some things that didn’t make me comfortable or happy in my job, so I appealed to my supervisor, a dentist, who said these requirements were not negotiable. I went home and updated my résumé and began sending my information to dental practices in the area. I took a chance to send a résumé to a dentist who wrote a book on practice management—yes, Dr. Howard Farran.

I’m happy to share that I just celebrated my 20-year anniversary with Dentaltown. I was hired as an associate at Howard’s practice, and watched from the sidelines as Dentaltown grew. Seeing a site dedicated to the pursuit of dental knowledge was a revelation. I did what I could to get involved and when the magazine was ready for a guiding hand, I accepted the position of editorial director. I can’t list all the wonderful experiences that followed over the years, and I don’t know what the future holds; I can only be certain that Howard created something that will inform and shape our profession for many years to come.

Reflecting on my 20 years, I decided to share some issues that have been a steady source of debate:

”In-office CAD/CAM will be the end of dental labs” or, “There aren’t enough dental technicians in the world, so you’d better learn how to make your own in-office crowns.” These statements are clearly exaggerations and, to their credit, the dental labs have responded well to this new category of technology. In fact, I think dental labs are now leading the way on efficient crown design, precision milling and 3D printing. The capital cost to live on the leading edge of technology has driven consolidation of small local labs. In-office fabrication has grown in parallel, providing a reliable alternative to fabrication of dental devices. We will continue to see the growth of in-office services through several delivery models. Just five years ago, the thought of making a denture in-house conjured visions of flasks, acrylic and dust. Now it can be done in a couple of clinical visits and printed without ever making a stone model.

“DSOs will rule the world and ruin the profession.” The record number of students applying to dental school tells a different story. Despite the high cost of obtaining a dental degree, dentistry remains a top profession in career surveys. If we learn nothing else from DSOs, you should appreciate their discipline for choosing locations and the benefit of an HR department. For example, Aspen Dental has taken a very deliberate approach in opening new offices in small, underserved communities. Recruiting and retaining talented employees has become challenging, and labor regulations are more complex than ever. If private practice is your jam, remember that anybody can greet shoppers at Walmart, but only a few can do an M.O. on #2.

I look forward to sharing the active topics each month because Dentaltown will always be a place where “no dentist will ever have to practice solo again.” If you have a favorite topic of debate, please share in the comments section under this article online at If you want to reach me directly, my email is


Support these advertisers included in the March 2020 print edition of Dentaltown magazine.

Click here for an entire list of supporters.



Townie Perks

Townie® Poll

Do you place implants in your practice?

Site Help

Sally Gross, Member Services Specialist
Phone: +1-480-445-9710
©2020 Dentaltown, L.L.C., a division of Farran Media, L.L.C. • All Rights Reserved
9633 S. 48th Street Suite 200 • Phoenix, AZ 85044 • Phone:+1-480-598-0001 • Fax:+1-480-598-3450