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January 2020
Volume 41, Issue 1

A Lucrative Practice Profit Center— Hiding in Plain Sight

Herb Moskowitz, DDS

With increased competition, spiraling overhead expenses, and heightened regulatory compliance costs, it is vital for dental practices to generate profits from multiple sources. One commonly overlooked office profit center is the sale of products to patients for at-home use. Within this category lies a product group that is fundamental to the dental health of patients and deserves special emphasis. These products comprise antimicrobial rinses, irrigants, and gels, which patients can use at home as part of a daily dental hygiene regimen.

This product group addresses an area of great need, allowing dentists to provide critical support to patients in preventing and controlling periodontal disease. It is not just a desirable, adjunctive treatment. Writing in the Journal of the American Dental Association in 2006, Dr. Ira Lamster (then Dean of Columbia University's College of Dental Medicine) emphasized the importance of daily at-home use of antimicrobial mouthrinses in managing periodontal disease, stating that "helping patients to control their oral microbial biofilm is a primary responsibility of dental professionals."1

Providing these immensely important antimicrobial oral care products to patients for daily at-home use can have a huge financial impact on a dental practice, with additional profit generation being potentially substantial. Based on typical costs and selling prices available to dentists nationally, the office profit per patient per month, with the patient using the product daily, may be estimated to be $22.18, which translates to a profit of $266.16 per patient per year. If 60 patients use these products at home daily this results in an annual extra office profit of roughly $16,000. If 120 patients do so, the annual extra profit is $32,000. The extra yearly profit soars to $64,000 with 240 patients using the product daily. These numbers of patients represent approximately 5%, 10%, and 20%, respectively, of the average number of active adult patients in a solo general practice.2 A larger utilization would, of course, result in correspondingly greater profits. The additional revenue is even more meaningful because no chairtime is required to generate it.

By providing these products, a dental practice will be facilitating its patients' oral health while also garnering increased compensation. It's a scenario in which both the patient and the practice benefit.

Furthermore, this potentially lucrative office profit center can be easily and effectively integrated into a practice. The introduction of high-level molecular iodine rinses, irrigants, and gels has made the widespread use of antimicrobial oral care products for at-home daily use more practical. These products do not stain, are pleasant-tasting and safe to use, and are many times more effective than povidone iodine.3-5

Chlorhexidine gluconate (CHX) oral rinse, although useful for short-term applications, is a poor choice for daily at-home use. Indeed, because of its high alcohol content and potential carcinogenicity, it is contraindicated for daily, long-term use. CHX also lacks the broad spectrum of activity, rapid speed of kill, and substantivity attributable to high-level molecular iodine oral care products. Other undesirable sequelae that present with the use of CHX, including alteration of taste, rapid calculus build-up, and staining, do not occur with high-level molecular iodine products.6,7

Other oral rinses that contain chlorine are not as effective or substantive as molecular iodine rinses and yet are considerably more expensive. Hydrogen peroxide, although inexpensive, has only marginal effectiveness compared to molecular iodine and is contraindicated for chronic use.

Because iodine is an essential nutrient and is used at very low concentrations, it is extremely safe for chronic, long-term use. It is highly effective against bacteria, fungi, viruses, and even spores. Iodine not only is effectual against periodontal pathogens, but it is rapidly active against cariogenic bacteria such as Streptococcus mutans, penetrates oral biofilms, and destroys bacteria-producing volatile sulfur compounds.8,9 In short, it is an ideal mouthrinse for periodontal and caries control and as a halitosis preventative.

Depending on patient preference and clinical need, high-level molecular iodine oral care products may be provided as a ready-to-use mouthrinse, concentrated irrigant (for use in an oral irrigating device), or gel (for use in a full-arch custom tray).

By tapping into the at-home antimicrobial dental product group, dentists can help patients improve their periodontal health and do so inexpensively and conservatively. It's a "win-win" for both the practice and the patient, as the practice widens its revenue stream and patients daily guard against periodontal deterioration and the contributory effects of periodontal disease on numerous systemic diseases.

About the Author

Herb Moskowitz, DDS
Chairman, ioTech International (, Boca Raton, Florida, and coauthor of ioTech's US patent and global patent applications; formerly in private practice for more than 25 years

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