Brews and Tiny Teeth, The Unfiltered Pediatric Dentistry Podcast

Chip Fichtner is the co-founder of Large Practice Sales and a return guest on the podcast. His firm helps practice owners complete transactions and partner with DSOs and "invisible" DSOs who allow the doctor to maintain autonomy and a minority position. We last spoke on the podcast about two years ago. Because of our episode, his firm closed a $50+ million dollar deal on a large pediatric office. Chip has a tight pulse on what's going on in the DSO world. I wanted to get an update on what DSOs are doing with pediatric practices in light of the higher interest rates. I try to ask Chip some tougher questions in this interview. In this episode, we discuss: - Is access to capital an issue for DSOs right now? - Have we seen any DSOs struggle or go under because of lower free cash flow? - What happens to the dentist's retained equity in the parent company if the parent company fails? - Who calculates EBITDA in these transactions, and where does all the variability come from? - How does LPS keep tabs and verify the quality and financials of the DSOs they work with? - What does the ideal pediatric dental practice look like in terms of commanding a high multiple? Chip can be reached at www.largepracticesales.com

Everybody in pediatric dentistry is talking about the Soan right now, so I had to learn more. On today's episode, I hosted Dr. Ann Bynum and Chris Malzone from NuSmile. Chris had sent me a demo model to try out, so I took this opportunity to talk with him and Ann about the technology. The Soan is an cordless electronic anesthetic pen. It allows you to give intraosseous injections to kids without collateral numbness. I specifically talk with Ann about the benefits of the device, technique questions, cost of using the device, and limitations. Anybody that would like to learn more is welcome to check out Nusmile.com, as they host free webinars to learn more about the device.

Dr. Benjamin Morgan joins us on the podcast today. He's a pediatric dentist and the owner of Rockwall Pediatric Dentistry in the greater Dallas, Texas area. Ben comes on to talk about a variety of topics, including his journey to practice ownership, why he dropped Texas Medicaid, creative ways that he increases his revenue, how he structures a 2-doctor practice, and what life is like being a pediatric dentist in a crowded Dallas market. We also discuss his decision NOT to build a 15,000 sq ft facility after buying the land and designing the space.

Dr. Bobby is a pediatric dentist, speaker, and authority on oral sedations. After 8 years as a pediatric dentist in the air force, he transitioned to an academic roll at Ohio State and now Cincinnati Children's Hospital. He frequently lectures for the AAPD at their sedation courses. Dr. Bobby cracks a beer with me and we talk about some great topics, including life in academics, changing parent expectations that make our job difficult, and how he uses oral conscious sedation to manage those kids that fall in between the spectrum of full mouth rehab and minimally invasive dentistry.

Kent Miller, co-founder of Dentagraphics, talks about where to start a pediatric dental practice with data-driven analysis. He shares insights on leveraging demographics and competition to identify high-potential areas. Kent highlights the significance of family dynamics, growth trends, and income levels in practice location decisions. He explores the role of AI and human insight in market analysis, emphasizing strategic factors like proximity to schools. Kent also discusses balancing career ambitions with lifestyle choices for a successful practice.

In this enlightening chat, Dr. Greg Psaltis, a recently retired pediatric dentist with 40 years of experience and a sought-after speaker on behavior management, shares his wisdom. He dives into how parenting styles, especially helicopter parenting, have shifted over the years. Tips for managing overprotective parents are offered, emphasizing the importance of listening and balance. Dr. Psaltis also recounts how behavior management has evolved in dental settings, fostering trust and comfort to enhance children’s dental experiences.

Dr. Staci Whitman, a holistic pediatric dentist from Portland, specializes in functional and natural approaches to dentistry. She discusses the vital connection between diet and dental health while emphasizing prevention over intervention. The conversation dives into innovative treatments like ozone therapy and myofunctional therapy for improving children's overall well-being. Staci also highlights the importance of personalized care and effective communication with families navigating dental decisions. Tune in for insights that challenge conventional practices and promote healthier habits!

Dr. Alex Otto and her husband, Tim, are previous guests on the podcast. Dr. Alex is a pediatric dentist, they own and operate four offices in the Austin, Texas area. Tim has an MBA and a strong business background working with fortune 500 companies. They join me on the podcast to discuss their latest project, Alcan Dental Cooperative. Alcan is a cooperative model in which pediatric dentists can join in exchange for a minority equity position. Unlike DSO/PE buyouts, a dental cooperative works by helping dentists systemize and grow their practice without being forced to sell out to a majority shareholder. The dentist keeps the practice but gets the benefit of outsourcing A/R, marketing, HR, etc. using scalable systems. This also increases practice valuation in the both companies as well. Tim and Alex explain this model to me and describe the benefits that it offers to pediatric dentists who are stuck somewhere in between the grind of solo practice ownership, and selling out the entire practice to a DSO. You can learn more at www.alcandentalcooperative.com

Chris Sands joins us today to talk debt, taxes, and wealth building. Chris is the founder of Pro-Fi 20/20, a multi-disciplinary CPA firm which helps dentists grow and increase profitability. We talk through 3 different scenarios and Chris gives his opinion on the best way to build wealth at different stages of a dentist's career. 1. Does a resident or young dentist pay off student loans at the higher interest rate, or invest in retirement? 2. Does a new practice owner focus on paying off practice debt? What are the tax implications of keeping a large debt burden around. 3. Does a seasoned practice owner expand and build a new building for tax purposes? How do you create income streams in the most tax efficient manner as possible? Chris can be reached for a consultation at info@profi2020.com

I have a short solo episode today over a cold Christmas beer. As a practice owner, you will always have pressure to do better dentistry and deliver more of it. I review five creative ways I'm going to increase my top-line revenue in 2024.