Dentists spend most of their working hours inside their own practices, so they usually don’t get many opportunities to see what it’s like inside another doctor’s office. Dentaltown’s recurring Office Visit profile offers a chance for Townies to meet their peers, hear their stories and get a sense of how they practice.
In Sedalia, Missouri—a small town 90 miles east of Kansas City— Dr. Jonathan Ehlers has built something big near his hometown. After graduating dental school and receiving advanced training in oral surgery, this Townie knew that if he was going to practice, he’d do it his way—with a focus on full-arch treatments and implants with the best tech the market could muster. Ehlers’ startup practice, Tiger Family Dental, opened its doors in 2016; three years later, he built a new location that more than tripled the practice size, and his plans for 2025 involve a 2,000-foot expansion, including a custom surgical suite. But Ehlers won’t be alone in that suite: He was one of the first general dentists in the U.S. to adopt an ultramodern implant robot that helps him deliver a quality of care most patients wouldn’t expect to find in a small town.
In our exclusive Q&A, Ehlers breaks down what he did to make sure his startup kept evolving, the most important areas to focus on for practice growth (physical as well as financial), what doctors must do to successfully land implant cases and more.
Dr. Jonathan Ehlers
University of Missouri–Kansas City
School of Dentistry
Tiger Family Dental
Today: 4,000 square feet; 10 operatories
By 2025: 6,000 square feet; 14 operatories
and a dedicated surgical suite
Tell us about your career so far.
In high school, I was set on medicine and pursuing plastic surgery as a specialty. When I started undergrad, I was fortunate enough to have roommates whose family members were in dentistry. After talking with them and shadowing the daily routines of dentists and physicians of
multiple specialties, it became clear that dentistry provided the work/life balance that I needed. It was also exciting that dentistry was the perfect blend of medicine, artistry and engineering. Once my second year in college started, I entered the reserved admission program with the University of Missouri–Kansas City School of Dentistry.
I graduated dental school in 2010
and worked in a federally qualified
health center for two years before
interning for a year at Truman Medical
Center’s oral and maxillofacial
surgery residency program in Kansas
City. The intern year was a good experience
in introducing me to surgery
and, more specifically, how I wanted
to practice: Although I didn’t pursue
OMFS as a specialty, it was clear to me
that I wanted to have a surgical-based
practice going forward.
I associated at an implant-heavy
practice, where I went to the Alabama
Implant Education Comprehensive
Implant Residency Program—a great
experience that dove into multiple
aspects of implant dentistry. In 2016,
I decided to move back to my hometown
and do a startup practice. That
year, Tiger Family Dental was born.
We applied Breakaway principles
and kept startup low: Our initial
footprint was 1,300 square feet and
three operatories. Through hard work
and an aggressive marketing strategy,
by 2019, we were ready to expand into
a new location. In October of that
year, we opened our new location,
with more than 4,000 square feet and
10 operatories. This allowed us to add
an associate dentist in January 2020
and additional hygienists. We’re now
anticipating adding another 2,000
square feet in early 2025, which will
give us a dedicated surgical suite
and the capacity to hire another
What did you learn going through
the startup process?
The startup process is a challenging
endeavor that is absolutely worth it.
I’m a bit biased because I’ve gone
through it, but in my opinion, the
greatest advantage to a startup is it
gives you the ability from Day One to
put your stamp on culture, treatment
philosophy, marketing, patient base
and practice identity.
My best advice is to take advantage
of those opportunities and have a plan
to execute the vision. It was important for me to develop the space with
cost efficiencies in mind. I wanted to
have a state-of-the-art office with all
the technology I needed to give my
patients the best care possible, but
also maximize cash flow as quickly
as possible. My build-out expenses—including a CBCT, IOS and digital radiography—came in at around $350,000.
We were able to eliminate this debt in
less than six months. When you focus
on the systems and an effective marketing
strategy, the numbers begin to
make sense quickly.
Another piece of advice is to know
your demographic. My community is a
blue-collar, heavy industrial/farm community
that relies on insurance. I knew
going in that it would be in the best
interest of my startup to find a way to
make the insurance industry work for
me and my patients. I ended up using
Unlock the PPO, which was a tremendous
resource. It single-handedly added
15%–20% reimbursement, compared
with my peers in my area.
The main thing I would do differently
is to better plan for growth.
Implement policies from the beginning
that foresee the growth and
handle the challenges of growing staff
from three to almost 20. I didn’t have
plans in place to handle the growth of
the team and how that growth affects
office culture. So don’t wait; invest
in yourself and your practice. Treat
growth and success as a given and
How have your priorities and
mindset changed since relocating?
The mindset that comes along with a
startup and expansion is completely
different, in my opinion. As a startup,
my focus was getting patients in the doors, keeping expenses low and
achieving the ability to cash flow as
soon as possible. From marketing to
scheduling, the goal was to attract
patients and stay busy. The expansion
for my office was about utilizing the
brand we’ve created and becoming
more discerning with our marketing.
It was no longer about getting generic
patients in the door, but the specific
patients we wanted to treat, using our
skill sets in the best way possible.
A relocation/expansion also presents
opportunities for planning and
homework. I used Design Ergo for
a block diagram for my new space.
I read up on the things offices struggled
with, and what kept coming up
were efficiencies and patient-flow
disruption. It was important that we
focused on a centralized sterilization
unit and mapped out a flow of our
patients to prevent bottlenecks at
check-in/check-out. Paying attention
to the details of something like this
has made a tremendous difference in
I’d also suggest not forgetting
about the minutiae, like making sure
to have a system of informing all
insurance networks of the location
change. This was something that we
overlooked, and claim payments were
How are you gearing up for your
expansion? What will it include?
With each expansion or achievement,
our practice vision becomes more and
more clear. Our goal as a practice is to
have two full-time associate dentists
providing comprehensive dentistry,
and my role will be to provide full-arch
implant dentistry from all-on-X
to implant overdentures to single-implant
Our expansion will include a dedicated
surgical suite that I will mainly
work out of, a dedicated entrance/
exit for our surgical patients, and a
We are also adding more hygiene
operatories, expanding team spaces,
sterilization and the lab area.
My planned expansion will get us to
14 operatories and a dedicated surgical
suite. I believe this will most likely
take me to the end of my practice
career, but one thing I’ve found over
my career thus far: Plans will always
change, and the future holds opportunities
that we’re not even aware of, so
I can never say for certain where that
How do you like to run the
business side of the practice?
I’m a big believer in delegation.
Identify the strengths of your team
members and empower them to serve
that role to the best of their abilities.
Practice ownership requires us to
wear many hats, but the practice
is at its best and most productive
when systems in place allow you
to produce dentistry when you are
in the office. Our office manager
helps with team decisions as well as
When you operate a large practice
with many employees, it’s imperative to have a highly driven, highly compensated
office manager. They will
become an extension of you, so you
can focus on the things that generate
revenue for the practice and be confident
that the business side of things is
being taken care of.
Some of your success came from
your positive experiences with a
consulting team. What positive
changes did they help you make?
Consultants and coaching are some
of the biggest ROI in dentistry. It’s so
easy to get pulled into the day-in and
day-out of owning a dental practice.
Consultants provide clarity to
your practice’s mission. I have been
fortunate enough to work with great
consultants over my career; currently,
I’m a member of Productive Dentist Academy (PDA), which approaches
your practice holistically.
PDA helped us have a mindset shift
regarding scheduling. It’s a common
error for schedulers to schedule
until the holes are filled. This creates
stress and many times hinders
production. Many days, I would find
myself exhausted and when I’d look at
production, I was at $800 or $900 an
hour. Now, we schedule a daily goal of
hourly production. If we hit our goal
with only a few patients because of
high-production procedures, we don’t
stress to fill the schedule. This has
really made a tremendous improvement
in our production and stress
level. Now, we schedule $1,800 an hour
for production, and it’s not out of the
ordinary to reach $2,500 an hour in
production on high-production days.
We all have different timelines and
aspirations with our practices, but
PDA has done a great job focusing on what that looks like individually. More
specifically, how to measure your
earnings before interest, taxes, depreciation
and amortization (EBITDA).
Knowing your EBITDA is a question
many dentists might not know they
should ask—which is problematic,
considering this is the basis of what
your practice is worth. So whether
you’re planning on selling your practice
next month or 10 years from now,
having the knowledge and analytics
to monitor where you’re tracking is
essential for planning.
Clinical calibration is also an integral
aspect of coaching. We want the patient
to receive the same high-quality care
no matter which hygienist or dentist
they see. Calibration among the team
ensures the patient is receiving the
same message, and prevents confusion
and potentially poor case acceptance.
Give us a before and after
of your marketing approach.
One of the things I adopted early in
practice ownership was spending
a significant amount on marketing
for the practice—roughly 5%–7% of
collections. I used radio, print, mailers,
streaming TV and Google ads.
Initially, any way to get your name
out will generate ROI. As we grew as
an office and patient flow was steady
(roughly 100 new patients per month),
it became clear that getting patients
wasn’t the issue, it was getting
patients who needed the treatment
we wanted to do. With PDA, we now
have a focused, broad-stroke message
across all platforms. Our message is
specific and the same whether you
see us on TV, radio or a Google ad. We
advertise comprehensive dentistry to
patients who have broken-down teeth
or need extensive work, because that’s
the dentistry we want to do.
You have a unique piece
of equipment in your office.
Tell us about the implant robot!
The Yomi robot is the most innovative
piece of dental equipment on the
market. As I’m sure most readers do
when they first hear about robotically
assisted implant placement, I thought, “No way—I’m sure it’s too expensive
for my current implant production
and office workflow.” I scheduled a
demo to work with the technology,
and a few days later I decided to make
I consider Yomi a disruptive technology,
much like Cerec was, or even
CBCT. Will there be a curve of acceptance
and adoption of it? Sure, but
like 3D imaging and digital scanning,
it will soon become commonplace to
have preplanned, real-time surgical
guidance for our implant procedures.
Surgical medicine has embraced
robotic technology for years to
improve surgical outcomes. I think it’s
time for dentistry to join the wave.
Yomi will come with an initial
investment of around the $200,000
mark, and service packages are
available that make the ownership
seamless. Yomi also provided (and
continues to provide) amazing
training for the doctor and the entire
clinical staff. It also has a dedicated
marketing team to assist in making
your local community aware of this
truly innovative technology.
Many of my colleagues asked me if
it was worth it. I say with no hesitation
that it was. Since purchasing
Yomi in December 2022, my full-arch
cases have more than doubled and my
implant volume in general has gone
from 250 implants placed to a current
projection of more than 400 this year.
YOMI BY NEOCIS
This robotic system for dental surgery allows us to have a real-time guided
implant system that we can make changes to on the fly. It has design modules
for crown design on individual implants, but also full-arch restorations,
implant placement and even guided bone reduction that allows for adequate
restorative space for the fixed prosthetic.
TRIOS 5 INTRAORAL SCANNER
Our office workhorse, this is an
imperative tool in capturing the soft
tissue necessary for a digital record
in full-arch implant dentistry. We also
use it for crown and bridge scanning,
clear aligners and night guard scans.
PRO55 3D PRINTER (SPRINTRAY)
Another integral part of our office’s
digital workflow, the Pro55 lets us
print our full-arch implant restorations
the same day as the surgery: No
more chairside pick-ups. We have
Power Dental Studio design a
direct-to-MUA arch and we print that
while the patient is relaxing in the
treatment room on the day of surgery.
We can also print occlusal guards,
clear aligner models, and definitive
restorations like crowns, inlays
This technology allows us to eliminate
the need for verification jigs during
the full-arch fixed workflow. We
can use this on the day of surgery
and from that point on, the implant
position is verified. This eliminates
multiple steps and appointments and
wasted production time.
X-MIND PRIME 3D CBCT UNIT
If I had one tool I could not practice
without, this might be it. From a
diagnostic standpoint, this was a
game-changer for our practice. From
diagnosing asymptomatic failing
restorations to pathology to precise
planning for implants, I couldn’t
practice the way I do without
You’ve mentioned the digital
workflow for your full-arch implant
cases. Can you go into a little detail
about that process?
Our first digital acquisition starts at
our consult appointment. We capture
the 3D scan of our patient for diagnostics and treatment planning.
If the patient is on board with treatment
and ready to move forward, we
will also do a full-mouth IOS scan
and bite. We also take several photos,
showing smile line and symmetry to
aid in planning.
At this point, we take all that data
and send it to our lab. We use Power Dental Studio for our full-arch cases;
the data gives Power the ability
to begin the process of designing
the case. Before the patient returns to
surgery, I can plan the case using the
implant library in Yomi’s software for
almost any implant. It also lets me see
if I’ll need any angled multiunit abutments
and the height of each. With
Yomi’s bone reduction module, we
can also digitally plan the necessary
bone reduction and reproduce that on
Surgery day begins with placing
TADs in the posterior region if the
patient is missing molars. We’ll then
do a day of IOS and bite to begin the
process: We remove all the patient’s
teeth and attach the Yomi bone link,
a fixated device that provides haptic
feedback to Yomi about where the
patient is in space.
We then take another 3D scan of
the patient with the bone link in place.
The preplanned 3D and same-day 3D
scan are merged and verified. We then
proceed with our robotically guided
bone reduction and subsequent
guided implant placement.
Once multiunit abutments are on
and the tissue is sutured, we place
white caps for the MicronMapper.
A photogrammetry scan, followed by
another IOS scan of the soft tissue,
provides Power Dental Studio with the
necessary data to design the provisional
Power Dental Studio provides
a 45-minute turnaround time, so
the workflow gives us the ability to
complete the surgery and deliver
a screwed-in, direct-to-multiunit
abutment provisional in the same day.
Once we have the design file, we will
print the provisional with our SprintRay
Pro55 3D printer using OnX
Tough. Our team members will stain
and glaze the provisional, and we’re
ready to deliver it to the patient.
The patient wears the custom provisional
for a few months, and at that
time, only a healed IOS tissue scan
is needed to fabricate the final restoration.
This efficient, predictable
workflow has made the restoration
phase of all-on-X treatment fun
and exciting, rather than stressful
You’ve had advanced training
in oral surgery. What are three tips
you have for docs who want to do
more implants or improve their
Rep, reps, reps! As with anything,
experience with the variations of
clinical presentations will provide you
with a knowledge base to handle what
comes your way. The top three things
I’d suggest would be:
1. Go all in. Implant dentistry is so
complex with the different applications,
so a weekend course will
just not cut it. A comprehensive
program that covers basic implantology,
site preparations (sinus
grafting, socket grafting, soft-tissue
and complications is imperative.
What will you do if the plan
doesn’t go as planned?
2. Never stop sharpening the skill.
Learning lateral window sinus
augmentation and doing one
sinus a year will not be adequate.
There are some great courses to
keep your skills sharp as your
practice ramps up the volume of
3. Invest in yourself. We all have
doubts at times, and it’s easy to
look at the superstars of dentistry
and think you’ll never get to that
level. The truth is that they all started somewhere as well. They
are highly skilled, but it’s because
they invested in themselves and
got in the reps to sharpen their
skill. Don’t get discouraged early
on. The learning curve can be
sharp, but investing in yourself
will pay dividends over time.
Likewise, what are a few common
mistakes you’ve seen made in
implant cases, and how could they
have been avoided?
At a lecture on implantology a few
years ago, the speaker said the more
you learn about implants, the more
you realize you don’t know. This is a
universal truth, and I would caution
against jumping in without a solid
foundational core of knowledge.
Another common mistake is not
dedicating enough time to restorative
education. Nothing will destroy good
surgical implant dentistry quicker than
poor restorative implant dentistry. Take
the time to learn the principles behind
restoring implants, and consider
planning your surgical case with the
restoration in mind ahead of time.
What’s your favorite patient story?
I have so many wonderful patient stories
that have shaped my career that
it’s hard to pick one, but I’ll go with
Rick, a hard-working Tiger Family
Dental patient who has a story that
deserves to be heard.
At our consult, Rick was reserved
and didn’t make eye contact. He was
even slightly irritable with our initial
questions. Rick had lost his teeth
because of a history of life choices that
led to rampant caries and periodontal
disease. His gag reflex was so intense,
he was unable to have anything
removable in his mouth, so he thought
the only solution would be to go
around with nothing in his mouth and
chew food with his gum tissue.
He had heard of the all-on-X
procedure and wondered if he was
a candidate. We used our CBCT to
evaluate his case and although he
was a candidate, he was going to need
bilateral sinus grafting to make all-on-
X a reality because of his maxillary
sinuses extending so far anterior.
We talked about the process and
finally presented a solution for Rick.
He was so excited that although the
process would be long, it would finally
give him the ability to chew his food
and smile with confidence.
Today, Rick enjoys eating foods
that he would have otherwise never
been able to. He smiles when he walks
through the door, and his outlook on
life has been changed forever. Using
the digital workflow streamlined the
process and provided predictable
results—results I had the confidence
to present at consult day. (Before and
after photos are below.)
Every time Rick sees us, he tells us
how we’ve changed his life and how he
tells everyone he can about the procedure.
This patient story reiterated
to me that I made the absolute best
decision not only going into dentistry
but also investing in my implant
education and investing in technology
that helps my team and I deliver the
best care possible to our patients.
Give us a snapshot of your life
outside of dentistry.
My wife and I are blessed with four
children: Kaylen (14), Calum (4),
Gemma (1) and Mara (1). Our life is
both blessed and chaotic, with sporting
events, traveling and just spending
quality time together. My parents and
sister also live in the area, so there are
many get-togethers and family dinners.
I’m an avid sports fan, so making
time for Mizzou athletic events and
Chiefs games is also in there. We’re
also people of faith, so being active
members of our local church grounds
us and reminds us of the many blessings
we are afforded daily.