Brews and Tiny Teeth, The Unfiltered Pediatric Dentistry Podcast

Danny Cammarosano is a regional director of practice finance for Provide. Provide is a tech company that has entered the dental practice lending space and has grown to be one of the top players for financing dental practices. Provide sets itself apart from the other big players like BOA and WF by offering better customer service and a more practical approach to lending. Danny shares updates to what's been changing in the practice lending space in this new era of high build-out costs, inflation, and elevated interest rates. Some of the topics that Danny covers: - What are the higher loan amounts that new practices are qualifying for? - What makes for a good borrower, and are business plans necessary? - How are repayments being structured, and how can you avoid prepayment penalties? - What is the lending forecast and what's expected to change over the coming 1-2 years? - What should a dentist consider if looking to purchase real estate or do a ground-up buildout? - How does lending change if the borrow has an established first practice and wants to open a second location? - How much will a bank lend for a partnership buyout, and is there a limit for a high production/expensive practice?

In this solo episode, I wanted to review a scoring system I created that allows pediatric dentists to reflect and compare their own attributes. Some pediatric dentists are great at running a business, some are excellent clinicians, some have great behavior management with the kids, and some are extremely efficient with their time.  But often times as dentists we fail in other categories where we should be trying to improve. For example, just because somebody can see 80 patients a day and produces 2 million dollars a year doesn’t mean that they are truly improving oral hygiene in their community, that they are actually doing good dentistry, or that they have a staff that is proud to work with them.  The scoring system includes the 10 categories relevant to a good pediatric dentist, with a 1-10 score for each (100 total possible points). The idea is to go through and reflect on these categories with minimal bias to determine how good of a pediatric dentist you are. The 10 scoring categories of a good pediatric dentist are broken down in this podcast and include: Clinical skills and outcomes Behavior management Impact on community oral health Parent perceptions Involvement in organized dentistry Office staff scores Doctor mental health Office technology and improvements Office production Office overhead

Dr. Jay Crews is a pediatric dentist who has been in private practice for 20 years. He owns a large practice in Owensboro, Kentucky, where he lives with his wife who is also a pediatrician. Dr. Crews discovered that he had worsening and profound hearing loss during his pediatric residency. He began wearing hearing aids and dealt with progressive hearing loss until it got to the point where he was nearly unable to function. He spent his days at the office lip-reading and relying on his staff to help him work through appointments with both patients and parents. In 2022, Dr. Crews underwent surgery and received a cochlear implant in his right ear. He shares this story with us and tells us how much better his quality of life is now that he can hear again. After a decade of not being able to listen to the radio or have a phone conversation, he's listening to the Brews and Tiny Teeth Podcast on his way to work in the morning. This was a great conversation and it was a pleasure to have Dr. Crews on the podcast to share his story.

Dr. Alex Otto, a pediatric dentist with a dynamic background, and her husband, Tim Otto, an MBA specializing in business systems, share their remarkable journey of launching three pediatric practices in Texas since 2020. They discuss strategic demographic analysis that guided their locations, the necessity of controlling overhead, and how current high interest rates can create unique opportunities. The couple dives into the future of pediatric dentistry, touching on the influence of corporate practices and the importance of remaining patient-focused amidst industry changes.

Dr. Arielle Faden is a pediatric dentist and practice owner out of Jersey City, which is a large metro area near New York City. She was a guest on the podcast almost two years ago when she talked about practicing as an associate in a large city like New York. Since that time, she has gone through the journey of partnering with her boss to become a 50/50 practice owner. We discuss how there's a lack of podcast content for dentists in these situations, but that partnerships are a great opportunity for dentists who aren't interested in either associating or going through the stresses of a scratch start. Some of the things Dr. Faden talks about: - How she knew that this office was the right fit for ownership - How they determined the value of the practice and purchase price - What did lending look like for this transaction - How did her income increase to cover the debt payment - How they structured the operating agreement to know who can buy what with company money, and how profits are split You can reach Arielle at ariellebethany@gmail.com

We all know the struggle of placing posterior pre-fabbed zirconia crowns on primary molars. Sometimes they fit like a glove, and sometimes they become a hot dumpster fire where you try 5 different crowns and none of them fit. Dr. Chad Davis, a pediatric dentist out of Arizona, and Dr. Andrew Johnson, a prosthodontist out of Arkansas, have worked together to develop Alphabyte. Alphabyte is a scanning system that allows you to quickly scan a primary molar and determine the correct crown size along with reduction discrepancies via a heat map to improve speed and efficiency with placing posterior crowns. Chad and Andrew come on the podcast to discuss how they developed this system, and how Alphabyte has practical applications beyond zirconia crowns. They will be at AAPD at the Kinder Crown booth where attendees can get a hands-on demo to see how the product works. You can learn more at https://alphabytedental.com/

I love interviewing a good power couple where we can have a drink and talk about teeth! Today we are joined by Dr. Beth Pfohl, a pediatric dentist, and her husband Dr. Chad Pfohl, an oral surgeon. The Pfohls are University of Iowa grads and at AAPD 2022 in San Diego, we had a few drinks at the welcome reception and I decided I needed to have them on the podcast.  Dr. Beth is unique in that she went back to dental school later in life with two kids at home, and continued for the additional two years to complete her pediatric residency. Dr. Chad is a partner at a large group practice and he shares some of his wisdom on how to find good team members and associates to bring into the practice. They come on the podcast to talk about life in the working world, as well as how to find work-life balance between running a full patient load at the office and raising good kids at home.  As pediatric dentists, we naturally love working with kids and tend to a be a very family-oriented profession. My wife announced that we will be having our first little baby girl in May, so I thought it would make for great conversation to discuss in the upcoming podcasts how having kids influenced or changed the way that pediatric dentists practice dentistry. 

Dr. Lee Boyd is a pediatric dentist and practice owner from Allen, Kentucky, a town of just 700 people. He joins us today to talk about how even in a rural practice, he is able to generate massive revenues from the incorporation of orthodontics and Invisalign.  We discuss how pediatric dentists are the oral-facial growth experts and that we should be doing our part to not only diagnose, but also to treat malocclusions and orthodontic problems for our patients. Dr. Boyd is an advocate for using iTero scanners to offer patients Invisalign (he starts over 100 cases a year), as well as using this technology to show parents different treatment outcomes during the mixed dentition phase. We talk about differences in treatment for both permanent as well as mixed-dentition cases, including how you can use clear aligners for expansion as well as impacted teeth in 90+ percent of cases.  Dr. Boyd is passionate about education on this topic, and you can hear him speak at AAPD in Orlando at the annual session in May. 

Dr. Reza Ardalan is a pediatric dentist from Port St. Lucie, Florida and the owner of Ardalan Pediatric Dentistry. He joins us on the podcast today to tell us about his practice story and his journey to become a well-known personality on TikTok as a pediatric dentist. Some of the things we discuss in this episode: - How Dr. Reza managed his $470k in student loan debt - The importance of CE and expanding your skillset - Growth of a pediatric office and when it's time to buy real estate, build, and bring on an associate. - The benefits of owning your physical office as a pediatric dentist - Why more pediatric dentists should take advantage of the power of social media Dr. Reza is optimistic about the future of our profession, and he encourages any listeners to contact him via any of his social media platforms. 

Dr. Debra Cohen is a pediatric dentist from New Jersey. She practices at Riverfront Pediatric Dentistry with Dr. Eyal Simchi. After seeing some of the recent cases on iPedo that Dr. Cohen had posted showing impressive before and after radiographs using LSTR, margin elevation, and Hall crowns, I decided it would be an interesting episode to have her on the show to discuss these techniques. Dr. Cohen talks about how at their practice, they try to use focus on positive patient experiences and avoiding sedation by using sedative fillings with glass ionomer to assess the health of the pulp. They are able to treat and save a lot of teeth without local anesthetic, complete caries removal, or the use of general anesthesia. This was a great conversation and it was interesting to learn more about treatment philosophies that deviate from what we were trained in residency, but may very well be mainstream and supported by literature in the future.