Yankee Dental Show Report: Dental practice market heats up

Yankee Dental Show Report: Dental practice market heats up

February 6, 2008 -- BOSTON - Buying a dental practice these days is a lot like buying a house was a few years ago. The sale prices are high. There are lots of competing bidders. And it doesn’t seem like you can go wrong with your investment.

Unlike the housing market, though, the good times seem like they’re in no danger of going away. "It’s a seller’s market," Arthur Gordon, a practice broker with Northeast Dental Counseling, told dentists attending Yankee Dental Congress 33 here on Saturday. There are so many more buyers than sellers in some areas, he says, "you’ll have them knocking down the door to buy your property."

Gordon was one of five experts on a panel who shared key tips about buying and selling practices and entering into new partnerships.

Advice for sellers

With dental office revenues rising sharply in the last five years, dentists are finding that their practices are worth more than ever these days, Gordon says.

It’s not uncommon for dentists to gross more than $1 million a year these days. One Massachusetts practice went from $700,000 in gross revenues seven years ago to $1.7 million last year.

And nowadays, it’s not unusual for practices selling in big cities like Boston to fetch 80 percent to 90 percent of their gross revenues. In California, some practices are bringing in more than 105 percent, Gordon says.

Still, the panelists warn, sellers should think carefully before leaving their practice. "Don’t sell too early," Gordon says. "You don’t need to be pressured."

Even though the market is now bringing in great prices for dental practices, retired dentists may not be able to live off the proceeds of the sale. "You’ll always make more if you keep your practice," he says.

Once they've decided for certain that they want to sell, dentists should closely scrutinize the buyers' resume, clinical references, tax returns, credit reports, and academic records.

Also, just as in real estate, sellers will get the most out of their properties if they spend the time sprucing them up - even with just a fresh coat of paint.

Advice for buyers

Despite the high prices, there are good deals for buyers as well. Almost all dentists who buy out others’ practices wind up with successful businesses, Gordon says. Most dentists retain 95 percent of the practice’s patients, and many bring in lots of new patients, too.

To assess the value of a dental practice, buyers need to ask themselves three critical questions. Where do they want to practice? Are they clinically prepared for the practice? Are they emotionally ready to handle the responsibility of the practice?

Potential buyers should closely examine patient records, not just take a tally of how many patients are in the dentists’ computer files. Gordon suggested that buyers go so far as to determine what the dentists’ most common procedures are and how many of them they have performed.

The seller may say that the practice had 1,000 patients last year, but were half of them denture patients? If so, then repeat business will probably not be nearly as high as other potential practices.

If dentists want to start a practice with a partner, there are even more factors to consider. It’s almost like a marriage, says Jean Fallago, an attorney who specializes in dental practice sales. She advises dentists to look for more than clinical competence in a potential partner. "Make sure there’s compatibility," she says. For example, she urges dentists entering a partnership to make sure that a potential partner will take on some of the management responsibilities.

When buyers have decided that they are ready to purchase a property, they need to be prepared to give the seller a wide variety of information, says Kathleen Ells, who helps arrange financing for these dental deals. She suggests that buyers put together a portfolio with all the credentials and credit information the seller might want to see. That way, if a seller is inundated with offers, the buyer’s offer package will stand out.

Once the deal is made, buyer and seller need to work together to create a transition plan.

Ells and other panelists suggest that the departing dentist notify all his or her patients, and perhaps remain in the office for a short time to personally introduce the new dentist to some patients.

But Gordon warns that often, the shorter transition, the better. "That causes less confusion for patients and staff," he says.

Patients may be nostalgic for the old dentist, but they usually get over that pretty quickly, the panel agreed.


If you want to buy dental equipment,such asElectric Toothbrush, ultrasonic scaler dental please visit the dental website zeta-dental.com.au.
Yankee,Dental,Show,Report:,Dental,practice,market,heats,up

Inside the global dental market

Inside the global dental market

February 7, 2008 -- Looking for a current overview of the global dental market? Research and Markets' report "2007 Dental Industry Review" could be the answer. This 255-page document provides information on key business transactions of 2007.

"This is one reference document, with dozens of color charts and graphs that you will use all year long," claims Research and Markets.

Some of the topics covered include acquisitions, bankruptcies and corporate restructurings, five-year market growth, estimates for equipment, consumables, OTC products and implants, dental stock winners and losers, management changes including new presidents and CEOs, and lists of new product launches.

And how much will all this information set you back? $150.

If you want to buy dental equipment,such asultrasonic scaler dental, welding machines please visit the dental website zeta-dental.com.au.
Inside,the,global,dental,market

Yankee Dental Show Report: Dental practice market heats up

Yankee Dental Show Report: Dental practice market heats up

February 6, 2008 -- BOSTON - Buying a dental practice these days is a lot like buying a house was a few years ago. The sale prices are high. There are lots of competing bidders. And it doesn’t seem like you can go wrong with your investment.

Unlike the housing market, though, the good times seem like they’re in no danger of going away. "It’s a seller’s market," Arthur Gordon, a practice broker with Northeast Dental Counseling, told dentists attending Yankee Dental Congress 33 here on Saturday. There are so many more buyers than sellers in some areas, he says, "you’ll have them knocking down the door to buy your property."

Gordon was one of five experts on a panel who shared key tips about buying and selling practices and entering into new partnerships.

Advice for sellers

With dental office revenues rising sharply in the last five years, dentists are finding that their practices are worth more than ever these days, Gordon says.

It’s not uncommon for dentists to gross more than $1 million a year these days. One Massachusetts practice went from $700,000 in gross revenues seven years ago to $1.7 million last year.

And nowadays, it’s not unusual for practices selling in big cities like Boston to fetch 80 percent to 90 percent of their gross revenues. In California, some practices are bringing in more than 105 percent, Gordon says.

Still, the panelists warn, sellers should think carefully before leaving their practice. "Don’t sell too early," Gordon says. "You don’t need to be pressured."

Even though the market is now bringing in great prices for dental practices, retired dentists may not be able to live off the proceeds of the sale. "You’ll always make more if you keep your practice," he says.

Once they've decided for certain that they want to sell, dentists should closely scrutinize the buyers' resume, clinical references, tax returns, credit reports, and academic records.

Also, just as in real estate, sellers will get the most out of their properties if they spend the time sprucing them up - even with just a fresh coat of paint.

Advice for buyers

Despite the high prices, there are good deals for buyers as well. Almost all dentists who buy out others’ practices wind up with successful businesses, Gordon says. Most dentists retain 95 percent of the practice’s patients, and many bring in lots of new patients, too.

To assess the value of a dental practice, buyers need to ask themselves three critical questions. Where do they want to practice? Are they clinically prepared for the practice? Are they emotionally ready to handle the responsibility of the practice?

Potential buyers should closely examine patient records, not just take a tally of how many patients are in the dentists’ computer files. Gordon suggested that buyers go so far as to determine what the dentists’ most common procedures are and how many of them they have performed.

The seller may say that the practice had 1,000 patients last year, but were half of them denture patients? If so, then repeat business will probably not be nearly as high as other potential practices.

If dentists want to start a practice with a partner, there are even more factors to consider. It’s almost like a marriage, says Jean Fallago, an attorney who specializes in dental practice sales. She advises dentists to look for more than clinical competence in a potential partner. "Make sure there’s compatibility," she says. For example, she urges dentists entering a partnership to make sure that a potential partner will take on some of the management responsibilities.

When buyers have decided that they are ready to purchase a property, they need to be prepared to give the seller a wide variety of information, says Kathleen Ells, who helps arrange financing for these dental deals. She suggests that buyers put together a portfolio with all the credentials and credit information the seller might want to see. That way, if a seller is inundated with offers, the buyer’s offer package will stand out.

Once the deal is made, buyer and seller need to work together to create a transition plan.

Ells and other panelists suggest that the departing dentist notify all his or her patients, and perhaps remain in the office for a short time to personally introduce the new dentist to some patients.

But Gordon warns that often, the shorter transition, the better. "That causes less confusion for patients and staff," he says.

Patients may be nostalgic for the old dentist, but they usually get over that pretty quickly, the panel agreed.


If you want to buy dental equipment,such asElectric Toothbrush, ultrasonic scaler dental please visit the dental website zeta-dental.com.au.
Yankee,Dental,Show,Report:,Dental,practice,market,heats,up

Yankee Dental Show Report: Incisive tips on cosmetics

Yankee Dental Show Report: Incisive tips on cosmetics

February 4, 2008 -- BOSTON - Karen was trying on a bridal gown when disaster struck. With all that loose material flowing to the ground, she tripped and broke off half a maxillary central incisor. By the time she showed up at the Restorative Dental Group of Cambridge, MA, she was desperate. "I want it perfect for the wedding photos."

"No problem," responded Alan Sulikowski, D.M.D. "I can make it just like it was before."

"I don't want it like it was before," Karen said. "It was sticking out." That posed the kind of real-world aesthetics problem that Dr. Sulikowski, a Harvard University clinical instructor in prosthodontics, came to discuss at Yankee Dental Congress 33. In a three-hour presentation, he and his colleague, Elliot Kronstein, D.D.S., shared their tips for creating beautiful smiles in complicated situations.

Tip No. 1, the two presenters emphasized over and over, is teamwork. The Restorative Dental Group includes prosthodontists, an orthodontist, an endodontist, and general dentists all under the same roof. And Karen's case was a perfect example of this expertise brought to bear. There wasn't enough space to put Karen's tooth back in the correctly aligned position. And from working with the orthodontist in the practice, Dr. Sulikowski knew that there wasn't enough time before the wedding to make space by moving teeth. Just trimming down the lateral incisor wouldn't provide quite enough room either. And the other incisor already had perfect proportions.

The solution? "We had to apply the rule of frame of reference," Dr. Sulikowski said. By reducing all the incisors, including the height of the mandibular incisors, he created a set of smaller teeth so that the broken one -- with its crown -- fit attractively. The midline of the smile wasn't exactly in the midline of Karen's face, but research has shown that few people notice an off-center midline as long as it's not a crooked midline.

Teamwork and frame of reference were just the beginning of the pearls the two esthetics experts had to share.

Perfect impressions

Making exact impressions is essential to both aesthetics and functionality, said Dr. Kronstein, a prosthodontist. "It's all about the integrity of the luting gap. We're talking about beyond what you can see with the eye. We're talking about trying to finish the luting gap so it's in the range of 20 microns. How many times have we heard people say, 'Don't worry. If it doesn't fit, the resin will take up the space.' Uh, uh. I try to make sure when I take an impression of this tooth, it's 100% or it doesn't leave my office."

Papilla formation

The key to creating a pleasing papilla is that the contact point between two adjacent teeth has to be less than 5 mm from the osseous crest, according to Dr. Kronstein. The percentage of teeth with papillas drops dramatically as the contact area gets farther from the crest. "So as I prepare a tooth, I think about why I'm moving my margins where I am," he said. (When placing an implant, the distance measured should be between the contact point and the osseous crest of the adjacent tooth -- not the contact point and the implant's bone level, Dr. Kronstein said.)

Type 1 patients have long contact areas extending almost the whole length of the two teeth. "If I had a magic wand that I could wave over each patient, I would create type 1 long contact areas. With type 1, you are always guaranteed to have papilla formation," Dr. Kronstein said. Type 2 patients, in which the contact area is in the incisal third, have poor chances of papilla formation. Type 3 patients, in which the contact area is in the middle third are a little better off. "Here you have a shot, but the minute you have some inflammation, you lose the papilla," he said.

Cementation protocols

"How many times have you made a beautiful crown, and the patient says, 'My tooth looks great, it works great, but every time I touch it, it hurts.'?" Dr. Kronstein asked.

Dr. Kronstein used to experience this problem regularly -- until he began using sixth-generation adhesives, which combine self-etching primer with adhesive. "Less than 1% of my teeth now have postoperative sensitivity," he said. "The reason for that is I do not put etch directly on teeth." He now only applies etch to the luting margin. (Seventh-generation adhesives are not ready for prime time, in his opinion.)

When bonding to zirconium, you should use an agent with MDP molecule (10-methacryloyloxydecyldihydrogenphosphate), which you can find in Panavia F and Clearfil's ceramic primer, Dr. Kronstein said. MDP is also in Ivolclar, but in this product you'll need to add silane.

Dr. Kronstein also plugged Premier implant cement, a resin cement that never fully cures. "The restorations stay in place, but when you want to remove them, you can get them right off because the resin never sets. This cement has been a godsend for us in our office."

Crown materials

But Dr. Kronstein uses mostly zirconium for custom abutments in aesthetic areas. In general, he prefers all-ceramic for crowns. "I've been using all-ceramic materials throughout the mouth for the last 15 years," he said. The only exception is second molars, where he uses Empress. On first molars he uses E.Max. "So, do you need to compromise and go to zirconium which tends to impair the health of the tooth to have more strength than you need?" he asked. Not in his experience.

Likewise, the research shows there is no evidence to show that ceramometal is any better than all ceramic, he said.

Color management

Many dentists consider only the color of a restoration, not the translucency. "Any color we are trying to do will be a combination of the substrate and what's on top," Dr. Sulikowski said. Porcelain veneers are particularly sensitive to the substrate. So when preparing a veneer, consider how much light you want to show through it, a factor governed by the thickness of the veneer.

Restorative Dental Group of Cambridge uses a TD 931 transmission densitometer (Macbeth) to measure the density of veneers. The more Dr. Sulikowski wants to change the color of a tooth, the thicker the veneer he uses. With a reduction of 0.3 mm, he can take advantage of a good existing color. With a reduction of 0.67 mm, he can change the color up to two shades. And with a reduction of 0.8 mm, he can change the color more than two shades.


If you want to buy dental equipment,such asteeth whitening kit, Electric Toothbrush please visit the dental website zeta-dental.com.au.
Yankee,Dental,Show,Report:,Incisive,tips,on,cosmetics

Keep kids entertained in the chair

Keep kids entertained in the chair

February 4, 2008 -- Looking for new ways to keep your munchkin patients relaxed in the chair? The ADA now offers booklets, videos, and other fun materials designed to do just that.

According to the ADA Web site the product line,"helps entertain and educate young patients with a variety of valuable resources such as the "Happiness is a Healthy Smile" brochure, Dental Fun Book, Tough Tooth Team Bag, and the National Children's Dental Health Month poster."

View the entire collection here.(In the top left corner of page click on "Coloring Books" and "Tote Bags," and for videos click "Patient Education Videos and DVDs").To place an order call 1-800-947-4746.

The ADA also offers a range of free resources such as coloring and activity sheets, and ideas for the classroom to promote oral health among children.


If you want to buy dental equipment,such asair polisher, teeth whitening kit please visit the dental website zeta-dental.com.au.
Keep,kids,entertained,in,the,chair