Dental student debt has reached unprecedented levels in recent years. As new dentists adapt to the healthcare world, many of them will choose jobs that pay off their loans and alleviate debt. This often results in more dentists opting for corporate roles over starting their own private practice, adding even more strain to an already fragile healthcare system where more than 100 million people in the U.S. face barriers to accessing care.
Medical student debt has lasting repercussions on communities across the country, and that gap will only continue to grow as student debt increases and incoming doctors struggle to provide local care in favor of corporate careers.
The Student Debt Crisis
According to the American Dental Education Association (ADEA), the average debt for graduating dental students in 2022 was $293,900, a 434 percent raise from an average debt of $55,000 in 1990. This amount has the ability to jeopardize a new doctor’s ability to choose their own career path. Reports show that the majority of in-debt dentists choose to work at corporate offices rather than start their own practice to secure a consistent income and pay off their loans.
Graduates are also choosing corporate companies over private practices to avoid overhead costs and gain access to new technology, but choosing the corporate route means they lose autonomy and patients are often less satisfied. According to the American Dental Association (ADA), the percentage of dentists in solo practice declined from 84.7 percent in 2005 to 73 percent in 2021, while the percentage of dentists working in large group practices increased from 16 percent in 2005 to 22 percent in 2017.
Healthcare Deserts
Condensed healthcare systems created by market consolidation and rising costs have created healthcare deserts all over the United States. Many of these healthcare deserts can be attributed to medical students choosing corporate roles over private practices due to the debt they acquire. Students with large amounts of debt can be discouraged from practicing in rural or low-income areas that may offer lower salaries or fewer employment opportunities. This pushes up-and-coming dentists to reside in condensed markets which means fewer dental offices in smaller, more rural areas.
As of 2021, 80 percent of counties in the U.S. lack proper access to the healthcare services they need to maintain health. Healthcare deserts force patients to drive upwards of 30 minutes to reach healthcare facilities where there are not enough staff to treat them. For example, of the 67 counties in the state of Florida, only one has enough dentists to treat all patients. This disparity forces patients to live without essential care that can improve their quality of life. Those without access to dental care often deal with preventable ailments that keep kids out of school and adults out of work.
Espire Dental, a fast-growing, elite, cosmetic and multi-specialty group practice, founded by dentists, is pleased to announce the acquisition of Anderson Family Dental in Colorado Springs, CO.
Founded in 2018 and headquartered in Denver, Colorado, Espire is turning the dental industry upside down with its mission to radically elevate the dental experience for both patients and team members.
Its growing footprint of 27 practices are located throughout Colorado, California, Oklahoma, and Wyoming. The addition of this new dental practice strengthens Espire’s positioning in southern Colorado, expanding excellent dental care and cosmetic dentistry options to patients in Colorado Springs.
Tim Hill, CEO of Espire Dental, shares the cultural philosophy between Espire and Anderson Family Dental. “Anderson Family Dental has a rich history of providing exceptional dental care to patients in Colorado Springs. Espire is thrilled to continue that family tradition and help take it to the next level. We are proud to be the solution for premier, private-practice dentists who would not typically join a DSO group and are honored that Dr. Anderson chose us to be his partner.”
Anderson Family Dental has been providing unmatched patient care in the Colorado Springs community for 57 years. Dr. Erick Anderson said, “Finding a partner that would appreciate the history of our family practice was important to me. When I met the leadership team at Espire, I knew that they would be a great fit for our team and patients.”
Espire provides its practices with best-in-class support including practice operations, clinical training, HR, marketing, and accounting. This allows Espire’s dentists to focus on patient care, relationships and leading their valued team members. “We’re proud of our unique culture and the way it seamlessly integrates with our outstanding support systems. Espire differentiates itself by providing business support to our practices while fostering hospitality-like experiences, which elevates the patient care and provider experience that dental practices should expect from their partner,” said Hill.
Espire is actively seeking dental practices that share a commitment to elevated patient experience, high-quality clinical care and employee fulfillment.
One of the best parts of being a dental practice broker is that I’m given a unique line of sight into new trends in the industry. Something that we’ve been noticing at Professional Transition Strategies (PTS) is that the average age of dental entrepreneurs selling their practice is getting significantly younger.
In fact, most doctors we worked with before the pandemic ranged from 55 to 58 years old, as many of them were gearing up for retirement. Now, the average age of a dentist selling their practice with us is down to 44 years old. And we suspect this is a phenomenon happening all around the country.
So, what’s causing this huge drop in age?
There are a couple factors at play, but it comes down to two major components: the industry’s consolidation wave and the fallout from the pandemic. The sweeping consolidation happening across the industry is highlighting new opportunities for dentists – and many are taking advantage of them. Coming out of the pandemic, many businesses and industries reshuffled their operations which lends itself to changes in dentistry.
Here’s a closer look at why younger dental practice owners are choosing to sell their practice sooner rather than later.
Consolidation Gives Way to Equity Arbitrage Opportunities
As dentistry is undergoing industry consolidation, it’s given rise to many new financial opportunities for dentists, which contributes to this trend. Private equity backed dental service organizations (DSOs) provide an alternative to traditional partnerships. In the past, many dental entrepreneurs on their path toward retirement would bring in an associate to take over after they stepped away; however, associateships have an extremely low success rate, making them an undesirable route for many.
Dental practices must beef up their teams’ awareness of spear-phishing attacks, currently accounting for 91% of data breaches. Your team members must understand the threat landscape and know that hackers are trying to infiltrate the practice. Dental practices face many threats. Attacks and phishing attempts continually evolve and become more sophisticated.
As a dental practice leader, you can mitigate these attempts through a security and privacy awareness training program. eLearning is a good option here. Unlike in-classroom meetups, internet-based classes are delivered on-demand and as needed. Using online platforms also expand your training and reinforcement options such as threat simulations. Third-party phishing simulations, for example, provide various scenarios that mimic real-world attacks and attempts. Doing so matters because research shows that businesses that set up simulated phishing attempts once a month have 27% fewer employees falling victim to such attacks.
In any care setting, those numbers are too high. Because dental practices have valuable patient information in their systems, dental practices are rife for an attack. That said, let me provide some best practices you need to know to get the most out of your security awareness and HIPAA training.
What to Consider When Preparing
You may have options depending on your simulation solution. In addition to email phishing, consider sending SmiShes (phishing to employees via text messaging). Or try voicemail phishing, known as Vishing.
Then, there is USB Baiting, done by seeding bogus, infected USB drives around the workspace or parking lot that can communicate back if plugged into a computer. Employing optional simulations reduces a practice’s susceptibility to phishing attacks. In addition, it allows you to change training techniques to give employees a more comprehensive range of threats they should look out for.
Dentsply Sirona, the world’s largest manufacturer of professional dental products and technologies, in partnership with Smile Train, the world’s largest cleft-focused organization, and FDI, the global voice of the dental profession, are proud to announce a major milestone in the push to advance global cleft care.
FDI and Smile Train, with support from Dentsply Sirona have developed the first-ever global standard protocols for digitalized cleft treatment. These protocols are expected to improve the accuracy and efficacy of the current treatments significantly by providing dental professionals with a comprehensive digital clinical approach across all stages of care.
To create these protocols, extensive research was conducted and consensus had to be reached amongst experts in this field. The workflows outlined in the protocols contain a wealth of information to guide dental practitioners in their work and enable best practice. The protocols encompass the fields of presurgical orthopedics, mixed dentition, permanent dentition and oral rehabilitation. Each field features a remote monitoring and oral health component.
“These protocols will help bring health and opportunity to countless children worldwide,” said Prof. Ihsane Ben Yahya, FDI president. “It took an incredible amount of research and effort to put these workflows together. Thank you to everyone involved in this landmark achievement.”
To make the mass of available information and details user friendly to apply, an interactive tool was created to display all information and help the dental professional navigate through all the different stages of care.
“The new protocols set the bar for the evolution of digital cleft care, leveraging technology that will ensure access to high-quality care for marginalized communities, and reduce the burden of care for the cleft community,” said Susannah Schaefer, president and CEO of Smile Train.
In addition, Smile Train and FDI with Dentsply Sirona’s support have developed a clinical education course that aims to provide cleft professionals worldwide with additional in-depth training on digital cleft care protocols, as well as support them as they integrate digital technologies into their treatment plans. The partnership builds on an ongoing global partnership between Dentsply Sirona and Smile Train, the world’s largest cleft-focused organization, which funded more than 730 cleft surgeries in the first year of collaboration.
In the dental industry, it is widely believed that confidentiality is crucial when a dentist chooses to sell their practice. This notion is strongly advocated by dental brokers and has been adopted by numerous dentists. In fact, a few dentists have stated that they had minimal or no communication with the buyer of their practice until the transaction was finalized.
The logic goes that there are several things that will happen as soon as anyone knows your practice is for sale:
All of your patients will leave
Your staff will leave to work someplace else
Your competitors will actively poach your patients
These are all legitimate concerns. However, if the community knows that a dentist is considering selling their practice, there can be benefits to that transparency. Let’s examine the concerns one at a time.
Will all your patients really leave?
Some might, but those are likely patients who were considering leaving for other reasons. Research suggests that insurance acceptance and convenience (location and hours) are the most common reasons that patients switch practices.
The majority of dentists considering selling their practice are planning to retire. Patients know that a dentist in their sixties is going to retire someday. Is it better for patients to find out through a postcard after you are already gone – or worse, to call for an appointment and learn you are no longer working?
In fact, being upfront with patients may prompt them to finish out a treatment plan before you leave because they trust you to do the necessary work.
While racial and ethnic diversity among health professionals is linked to improved outcomes and greater health equity, the current oral health workforce does not reflect the changing demographics of the U.S. population. The Delta Dental Institute’s campaign will drive toward a more diverse oral health workforce by establishing the Delta Dental Oral Health Diversity Fund and by supporting initiatives in oral health education, research, and community investment.
“There is an urgent need to address the ongoing lack of minority representation in the oral health professions,” said James W. Hutchison, President & CEO of Delta Dental Plans Association. “As the nation’s oral health leader, we have a responsibility to tackle this issue head-on and make progress toward improving outcomes and advancing oral health equity for all.”
The Driving Greater Diversity in the Oral Health Workforce campaign will:
Establish the Delta Dental Oral Health Diversity Fund: In its first year, the Delta Dental Oral Health Diversity Fund will make targeted investments of up to $1 million in comprehensive solutions, innovative pilots, and scalable models that inspire school-aged children from historically underrepresented groups to pursue a career in oral health.
Support oral health higher education: Delta Dental will continue its investment in the future of the oral health workforce through the funding of scholarships and infrastructure at minority serving institutions. Since 2018, Delta Dental has invested nearly $50 million in college and university programs. In addition, in 2021, Delta Dental supported scholarships, grants, and other workforce development opportunities that benefited more than 147,000 people, many from historically underrepresented groups.
Propel new research: The Delta Dental Institute has sponsored the Harvard School of Dental Medicine‘s new research on the oral health workforce. As published in the latest edition of JAMA Health Forum, lead researcher, Dr. Sung Eun Choi, SM, PhD, finds that expanding the dental workforce in oral health professional shortage areas through the National Health Service Corps would reduce the burden of dental caries among children in underserved areas and is cost-effective.
Engage with our communities: Nearly a quarter of Delta Dental community investments in 2021 were dedicated to oral health education and workforce development. Delta Dental will continue its focus on supporting historically underrepresented groups by conducting outreach to students of all ages to elevate the importance of oral health to overall health and to introduce the possibility of a career in the oral health professions.
“Taking a multifaceted approach to addressing the barriers historically underrepresented groups face in choosing careers in oral health is critical to creating sustainable change in the industry,” said Vivian Vasallo, Executive Director of the Delta Dental Institute. “Through this campaign, we will elevate the need for a more diverse oral health workforce and support the advancement of actionable solutions. We are eager to see unique, innovative proposals brought forward for consideration by the Delta Dental Oral Health Diversity Fund.”
For those interested in applying for the Delta Dental Oral Health Diversity Fund and learning more about this campaign, please visit www.deltadentalinstitute.com/fund. Eligible applicants must be based in the United States, and may include 501(c)(3) organizations, private businesses, or limited or general partnerships.
Espire Dental, a fast-growing, elite, cosmetic and multi-specialty group practice, founded and operated by dentists with a vision to create something extraordinary, is pleased to announce the recent acquisition of Fox Creek Family Dental, a five-location group with practices located in Longmont, Loveland, Thornton, Westminster and Broomfield, CO.
Founded in 2018 and headquartered in Denver, Espire Dental is both turning heads and turning the dental industry upside down, with its mission to radically elevate the dental experience among its growing footprint of 26 practices located throughout Colorado, California, Oklahoma, and Wyoming. The company actively seeks practices with a clinical philosophy focused on the patient experience, while placing significant emphasis on elevated, quality clinical care and true provider and employee fulfillment.
The addition of these five new dental practices strengthens Espire’s position in the state of Colorado, expanding quality dental care and cosmetic dentistry throughout the state.
Tim Hill, Espire Dental CEO, is excited about the cultural synergy between Espire, Fox Creek Family Dental, its owner Dr. Ryan Koenig, D.D.S, and his amazing team. “Espire is the solution for elevated private-practice dentists who would not typically join a DSO. We’re proud to partner with Dr. Ryan Koenig, his providers and practice teams who have a rich history of providing exceptional dental care within their communities. These five locations are an ideal fit with our existing Colorado footprint, and we look forward to working together to advance quality dental care to patients in Colorado.”
Fox Creek Family Dental has been providing exceptional patient care in the Longmont, Loveland, Thornton, Westminster and Broomfield communities. “When I first met the leadership team at Espire, I knew that they were creating something unique and were the perfect fit for our practice teams and patients. We searched for a partner with a proven track record to grow and support our team members, but we didn’t want to lose our personalized patient experience. We found that partner and are proud to join Espire in elevating the entire dental industry,” Dr. Koenig said.
Espire Dental provides its practices with best-in-class business support services including practice operations, clinical training, human resources, marketing and accounting. Offering business support to practices while creating hospitality-like dental experiences not only sets Espire apart from other group dental partners, but it allows its dentists to create healthy, beautiful smiles while building relationships with their patients and continue to lead their valued clinical and support team.
The Dentists Insurance Company has earned the AM Best ‘A’ (Excellent) rating for the 29th consecutive year.
AM Best Company ratings include comparisons to peers and industry standards as well as assessments of operating plans, philosophy and management.
“These consistent ‘A’ ratings reflect TDIC’s financial strength and mission to provide policyholders with outstanding insurance products and high-quality service,” said Dr. Natasha Lee, TDIC board chair. “For more than 40 years, TDIC has been committed to our goal of protecting only dentists, protecting them better than any other insurance company and being there when they need us.”
With collective strength and singular focus, TDIC offers a comprehensive suite of insurance products to more than 24,000 policyholders in 15 states and upholds its promise to protect dentists and their practices by consistently reviewing trends, auditing service processes and evolving with changing markets and policyholders’ needs.
AM Best Company is a global credit rating agency with a unique focus on the insurance industry. Insurance professionals, brokers, regulators and consumers refer to Best’s Credit Ratings as an opinion of the financial strength and creditworthiness of risk-bearing entities and investment vehicles.
For more information about The Dentists Insurance Company, visit tdicinsurance.com.
eAssist Dental Solutions (www.dentalbilling.com), the nation’s leading platform for dental billing and patient billing services for dental offices, landed the number 42 spot on the 2023 Inc. 5000 Regionals list of growth leaders in the Rocky Mountain Region. This list recognizes the innovative achievements of companies in generating sustainable growth and jobs and is one of the most esteemed honors growing private businesses and business leaders can receive.
James Anderson, DMD, and Sandy Odle co-founded eAssist in 2011 to solve an industry-wide problem with dental insurance billing and collections, by combining technology and human expertise. eAssist has grown to offer a comprehensive end-to-end solution, along with a suite of related products, ultimately helping dental practices be more efficient, profitable, and patient-focused.
“For more than a decade we have been continually seeking out feedback, input, and recommendations from our thousands of clients of all types and sizes of dental practices, and other industry influencers, to stay abreast of emerging trends and systemic issues, and then develop scalable solutions,” explained Dr. Anderson, CEO. “To do that, we have invested heavily in technology to increase process efficiency, speed, and functionality of the eAssist platform in ways that improve performance.
“Being honored again as a fastest growing company is a testament that we’re not only accomplishing what we set out to do, but also that we keep getting better at it – which is, solve more problems, for more dental practice owners, to help them be more successful,” said Dr. Anderson.”
The 