February 2008
Volume 4, Issue 2

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Trends in 2008

Roger P. Levin, DDS

Sustainable practice success requires the ability to anticipate change. Good leaders look for trends in their practices, in the industry, and in their communities to maximize opportunity and ensure a productive future. During the last 25 years, dentistry has experienced a period of accelerated change. In the coming years, dentistry will continue to change at an ever-increasing pace. Whether it is the introduction of new technologies or new services, there will be a continuing opportunity and expectation to improve the quality of patient care. While this is a positive development, the rapid rate of innovation creates challenges in terms of overhead, practice systems, training, and implementation.

Based on its own research, Levin Group has identified the following six trends as having the greatest impact on dental practices in 2008:

• dental insurance;
• technology;
• implants;
• cosmetic dentistry;
• staffing; and
• patient financing.


According to the American Dental Association’s 2002 Survey of Dental Practice, 64% of dental patients have some type of dental insurance coverage. Practitioners who believe they are not affected by dental insurance simply because they do not participate may be surprised in the future. In a good economy, patients are willing to pay out-of-pocket to see the dentist of their choice and insurance is less of a factor in their selection of a dentist. In a slower economy, however, more patients look for a practice that accepts their type of dental insurance. Overall the current insurance situation is relatively stable, but there has certainly been an increase in PPO plans, which often limit or lower reimbursements for traditional dental services and procedures. For many practices, reimbursements are lower in real dollars than 15 to 20 years ago.

One suggestion is to carefully track the percentage of patients who have dental insurance, the types of plans, the reimbursement rate, and any shifts in those indicators.


In the last 25 years, there have been incredible advances in technology, but those have come with a cost—namely, the expense of acquiring technology and the time required to train the dentist and staff on its use. While technology is a necessary practice investment, it must be the right technology for the right reason. There often does not seem to be any agreement on which technologies are central vs which are optional. Do your homework. Talk with your colleagues and investigate any technology thoroughly, especially large purchases.

One challenge is that as the cost of dentistry increases and insurance companies work to maintain or lower reimbursements, the profit margins in some practices could be squeezed tighter.


Implants will continue to experience steady growth. While many dentists still do not restore implant cases and only a small percentage are involved in the surgical aspect of implants, increasing familiarity with dental implants is beginning to cause a shift in dentistry. Levin Group has noted that certain traditional cases, such as root canals or periodontal treatment, have declined slightly as the dental implant solution has been put in place earlier to solve a particular case. Further, as general dentists become more familiar with implants, it is likely that implants will become a more common solution than traditional dentures or crown-and-bridge.

As the large baby boomer population ages, there will be an increasing demand for implant treatment. Non-implant practices may find patients leaving to seek out offices that have expertise in dental implants. Offering implant treatment as part of your service mix will allow your practice to take advantage of this continuing trend.


It is one of the most talked about fields of dentistry. Seminars fill up quickly and companies are bringing out new products almost daily. While all of this is extremely positive, many practices still have low levels of cosmetic production. If whitening is factored out of cosmetic dental services, one could make an argument that the amount of pure cosmetic dentistry being performed is far less than reported. While cosmetic dentistry has changed and improved the lives of countless numbers of patients, it is still a field that has tremendous room for growth. For many practices, single-tooth treatment remains the most common form of treatment. Again, aging baby boomers are doing everything they can to retain their youthful looks. The media has played an enormous role in educating consumers about the benefits of cosmetic dentistry. Multi-million-dollar advertising campaigns for over-the-counter whitening, along with “extreme makeover” shows, have motivated many viewers to improve their smiles.

Not many practices can become a cosmetic spa, but every practice should make cosmetic dentistry a significant part of its service mix.


Unfortunately, this trend is going in the wrong direction. Levin Group works with hundreds of dentists in its consulting programs, many of whom are increasingly challenged by attracting, training, and maintaining staff. Preliminary observation indicates that many staff members are leaving in less then 3 years, which means turnover is becoming a consistent issue in practices. Along those same lines, almost every employer in any industry today is complaining about the ability to attract qualified employees. Dentistry is no different. However, as dentistry becomes increasingly complex as a result of the ava-lanche of new equipment, products, and technologies, it is taking longer and becoming more expensive to train new team members. Practices with excellent documented business systems have less internal stress and incur far less expense in terms of training new team members.

Levin Group recommends that practices continually refine their systems, put them in writing, and use scripting as a training tool.


America has become a country that depends on debt financing for most major purchases. This means that an increasing number of American consumers will not have the financial capability of accepting treatment beyond basic dentistry unless some form of patient financing is available. It is no longer unusual for practices to process $60,000 to $100,000 in fees yearly and recent surveys indicate that more than 65% of practices offer some kind of outside financing. This is good; however, when practices attempt to increase the amount of treatment financed they often find it challenging to do so given the methodology that they are using to implement the financing. A critical factor to increasing your treatment acceptance by using a patient-financing program is proactively making every patient aware that financing is available. Just as one always expects to hear about the financing or leasing options when purchasing a new car, the same has become true of certain medical and practically all dental services. Given that dental insurance only covers a portion of most dental treatment and that some services, such as cosmetic dentistry and implants, are not fully covered, patient financing becomes increasingly important. Companies like CareCredit (Costa Mesa, CA) make patient financing easy for both the practice and patients.

Levin Group has observed that most patients who ask for some level of financing are unable to have the full treatment performed unless they have access to additional credit for the proposed treatment plan.


Dentistry will continue to change at an increasing pace. Whether it is the introduction of new technologies or new services, there will be a continuing pressure to improve the speed and quality of patient care. While this is very positive for the healthcare profession, such change also creates challenges in terms of overhead, staff training, and implementation. Good leaders find a way to take advantages of trends and turn challenges into opportunities.

Would you like to learn how you can improve your business and your life by anticipating these and other trends? Inside Dentistry readers are entitled to receive a 50% courtesy on a Levin Group Practice Analysis Program, an on-site analysis and report of your unique situation conducted by a Levin Practice Development Specialist. To schedule an appointment, call 888-973-0000 and mention Inside Dentistry or e-mail customerservice@levingroup.com with “Inside Dentistry” in the subject line.

Roger P. Levin, DDS
Levin Group, Inc
Owing Mills,Maryland

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