Cliff's Notes

The Business of Dentistry

DentaCheques, ICON by DMG, Buying, Selling & Associates

Cliff’s Notes for April 5, 2009


Cliff Marsh, Henry Schein ……Cell: 201-321-7494……Fax: 201-262-2210…

“A wise and frugal Government, which shall restrain men from injuring one another, shall leave them free to regulate their own pursuits of industry and improvement, and shall not take from the mouths of labor the bread it has earned. This is the sum of good government,”

Thomas Jefferson

Inaugural address, March 4, 1801

In This Week’s E-Blast


* Cliff’s Notes Scoop! – DMG is about to introduces the most unique dental product developed in years!!

Buying, Selling & Associates

Attachment – Hygiene Special


DentaCheques is a program of the National Foundation of Dentistry for the Handicapped. More than 28,000 elderly and medically compromised people will be served this year by NFDH. You make this possible by purchasing the DentaCheques book. The DentaCheques book cost $149.00 and is a 100% tax deductable donation. The book contains $130.00 in Henry Schein discount coupons (regardless of your pricing program) as well as $1000’s of dollars in manufacture discounts and free goods. Please call me (201-321-7494) if you would like to receive the book. Henry Schein facilitates the delivery of the book and all proceeds are sent to the NFDH.

The NFDH also invites you to join DDS (Donated Dental Services). There are currently over 13,500 dentists and 3,000 labs across the nation that have volunteered for this program. If you wish to join, call 1-888-471-6334 or log onto

* New Product Introduction……………………………………..

The below link is a pre-introduction to a new product developed by DMG. This is a Cliff’s Notes Scoop. The product is called ICON. It is designed for treating caries without the loss of healthy hard tissue. No drilling is required. There are two different treatment sets, proximal & smooth surface. DMG/Zenith has not made the formal U.S. introduction. The product was introduced at the International Dental Trade Show in Germany several weeks ago. Pricing and delivery are not yet available and I have not seen the product as of yet. However, if it does what it claims, it could be revolutionary.

By viewing the video at the link below, you will know as much as I do and also be among the very first dental professionals in the United States to see this product. Please give me your feed back on the concept as well as any concerns.

Buying, Selling, Partnerships and Associates…………….

When do start planning your exit strategy? TODAY!! It does not matter if you have been in practice for 2 years or 30 years, it is never too early to start planning, it’s only too late. A properly coordinated long term plan could put a lot more money in your pocket when you are ready to make your escape. So, how should you start?

First, you need to have a conversation with your financial planner to identify the finish line. Understand, crossing the finish line does not mean the game is over. It means the responsibility is over. What a great concept. When my family asks me what I wish for, I tell them that I wish to be left alone. I’m still waiting for my wish to come true, but it is part of my plan.

Second, you need to have your practice evaluated by a “dental industry” specialist in conjunction with your accountant or financial advisor. A proper evaluation will cover finances, productivity, profits, work flow and opportunities for increased production. The evaluation should be very comprehensive and can be used for any issues requiring financial, legal or insurance documentation. Every business should be evaluated in detail so that they are better prepared to compete within their respective industries. Please contact me if you require more information on business evaluations.

Third, now that a base has been established, it’s time to create a plan. To get where to want to be, you will need advisors. You can’t do it yourself so please don’t try. Even those who become very successful could probably have been more successful if they did a little more listening.

Most dentists think they have more equity in their practices than they do. However, if they have a planned exit strategy, they will have more than they thought they had when they cross the finish line.

Henry Schein’s Professional Practice Transition Team (PPT) works with thousands of dental offices in every part of the country. Consultations are based on local geographical regions and then customized to meet specific needs. PPT also has a number of dental practices that are for sale that have been evaluated. The team also screens and evaluates possible associates and employees. We supply the information that your financial and legal advisors need, from an industry perspective, in standard and accepted accounting and legal formats.

Sample Listings:

Toms River Grossing 300k 3ops (room for 2 more) PPO and Fee for service

Oneonta grossing 500k on only120 days – Fee for service only

100 available associates (including GPR’s Graduating June 30) ready for immediate placement into dental offices. Additionally, we have a number of specialists available.

Today is Sunday, April 5th. It’s going to be sunny and in the 60’s. Get outside and let this spring time day recharge your batteries. As always, I am available if you should have any questions or concerns.

Cliff Marsh

Henry Schein Dental

P.O. Box 663, 45 Rt.46 East, Pine Brook, NJ 07058

cell: 201-321-7494 / fax: 201-262-2210

October 21, 2009 Posted by | Best Practices, Charitable Events, Practice transitions | Leave a comment

What is a Dentist, The ADA Smile Survey

Cliff’s Notes For February 22, 2009


Cliff Marsh, Henry Schein ……Cell: 201-321-7494……Fax: 201-262-2210…

In this issue:

What Is A Dentist?……. Kavo Limited Time Offer!…… The ADA Smile Survey

What is A Dentist?

On January 7th, I celebrated the start of my 33rd year working in the dental industry. However, after working with Henry Schein for the last 2 ½ years, my thoughts on what a dentist really is, has changed. Dentistry has changed. I truly believe that the modern dental office is the leading edge in almost all areas of preventive medicine. Many of you have heard me preach this concept before. That’s because I believe it to be true.

John Henry Holliday was a dentist. Dr. Holliday past away from tuberculosis on November 8, 1887. That is correct, 1887. He was best known by his nick name, Doc. For those of you who are not familiar with the American Old West, Doc Holliday was also a very talented gunfighter. He was very close to the legendary U.S. Marshal, Wyatt Earp. Doc Holliday became famous when he joined the Earp brothers in the “Gun Fight at the OK Coral”.

Doc Holliday was a dentist. He fixed teeth. He pulled, drilled & filled. Today, in 2009, we diagnose and consult with other specialist, including medical doctors. The average patient that sees a physician on a regular basis is in your office 4 to 6 times more often then they are in their medical doctor’s office. Remember, YOU ARE A PHYSICIAN! Take notice of changes in blood pressure, skin tone and review an updated medical history. Think about this, little Johnny’s family has been coming to your practice for 15 years. Little Johnny is now 16 years old and you have seen him twice a year since he was 3 years old. Now ask yourself this question, how many healthcare professional can be 12” from Johnny’s face, look into his eyes and notice that they are a little glazed and dilated? Maybe there is something that Johnny wants to tell you before you begin introducing the drugs and chemicals that you need to use to do what you do. Maybe you can use this “private” moment to be a trusted healthcare provider and educate your patient, be a confidant.

Dentists save lives! I can’t even count the number of stories I have heard about serious, life threatening, conditions that have been discovered during dental exams. Some concerns are discovered with the assistance of new technology. As an example, digital Panoramic units offer a view of the cardiac arteries, Blue Light Technology will detect abnormal tissue long before it becomes visible to the eye. However, the most important thing you can do for a patients overall systemic health is to give them a reason to see you every 3-6 months and it has to be for more than just healthy teeth and a pretty smile. It needs to be about total health. Take blood pressure, check pulse and ask questions. Repeated excessive plaque build-up should be charted and the patient’s medical doctor needs to be notified. If it is building up in the mouth, where else is it? Discuss how issues in the mouth could be related to or signals for other conditions within the body.

Give your patients that extra care. Explain to them who you are and what you do and you just may see the cancelation & no-show rate drop. Define the value of your services as more that just teeth. As always, I am always available if you should have any questions or concerns.

Kavo’s 100th Anniversary, 2 – Day Promotion

Join KaVo as they celebrate 100 Years of Dental Excellence at the Chicago Mid-Winter Meeting with these exciting “show only” promotions

Effective: February 27th – March 1st, 2009.

You need to contact Cliff before 2:00 pm on Thursday, February 26th…..The 2+1 Promotion will not be extended!


· High Speed Handpieces:

Buy 2 Premium Collection Handpieces 659B (628-0504) and 635B (628-2596),

Get 1 Premium Collection Handpiece FREE!*

· Electric High Speed Attachments:

Buy 3 GENTLEpower LUX 25 LPA (628-1526),

Get 1 GENTLEpower LUX 25 LPA, plus 6 Cans of KaVo Spray or 6 cans of KaVo QUATTROcare Spray FREE!*

· DIAGNOdent:

Buy 1 DIAGNOdent Classic (628-6150) or Pen (628-3400) Laser Caries Detection Aid,

Get a PROPHYwiz Handpiece FREE!*

*Free goods redeemed through KaVo

The ADA’s Smile Survey

The American Dental Association evaluated a survey attempting to determine what the most “attractive” physical feature is. The overwhelming answer was – The Smile. Additionally, they discovered some very interesting difference between men and women in oral health care in this study released on Feb 11, 2009.

Valentine’s Day is just passed, and what do people find most attractive in others? The smile. A national survey from the American Dental Association and Crest® and Oral B® finds that the smile outranked eyes, hair and the body as the most attractive physical feature. Yet men and women differ when it comes to taking care of their teeth and gums. The nationally representative survey of 1,000 Americans ages 18 and older found 86 percent of women brush their teeth twice or more a day, yet only 66 percent of men do so. The survey also found that women say they change their toothbrush or power toothbrush head every 3-4 months on average, yet men hang on to theirs an average of 5 months. The ADA recommends replacing toothbrushes every 3-4 months or when the bristles become frayed since frayed and worn bristles decrease cleaning effectiveness. Sadly, all Americans need to do a better job of flossing their teeth. Only half of those surveyed (49 percent) say they floss their teeth once a day or more often. And 1 out of 3 people surveyed think a little blood in the sink after brushing their teeth is normal, yet it’s not—it could signal gum disease or another health problem. Based on the previous findings, it’s obvious that some of the oral health/systemic health relationships are ignored way too often. Oral health is an important part of overall health. Regular dental check-ups are important not only to diagnose and treat gum disease and tooth decay, but also because some diseases or medical conditions, such as oral cancer, have symptoms that can appear in the mouth. Growing research indicates there may be an association between oral health and serious health conditions such as cardiovascular disease and diabetes, underscoring the importance of good oral hygiene habits.

“We need to constantly get the word out how important it is to stay on top of your oral health,” says Dr. Ada Cooper, an ADA consumer advisor and practicing dentist in New York City. “Brushing twice a day with fluoride toothpaste, flossing daily, eating a balanced diet, and visiting your dentist regularly can help keep your smile healthy.”

The ADA’s Smile Survey was supplied by the Health Compliance Team (

Post Office Box 472, Central Valley, New York 10917 Tel.: 845-460-3034 Toll Free: 800-724-1263 Fax: 845-928-1315 e-mail:

Cliff Marsh

Henry Schein Dental

P.O. Box 663, 45 Rt.46 East, Pine Brook, NJ 07058

cell: 201-321-7494 / fax: 201-262-2210

October 21, 2009 Posted by | 1 | Leave a comment

Controlling Overhead Part II, Fortune Industry Ranked #1 Most Admired, Air/Water & Dentistry

Cliff’s Notes for April 19, 2009


Cliff Marsh, Henry Schein ……Cell: 201-321-7494……Fax: 201-262-2210…

“Everything that can be invented – has already been invented”

Charles Duell

Commissioner, U.S. Patten Office, 1890

In This Week’s Blast

* Controlling Overhead – Part II

* Fortune Awards Henry Schein “Industry Ranked #1, Most Admired”

* Air, Water & Dentistry

* Replacement Turbine Summer Promotion

Controlling Overhead – Part II………………………………………………………………

Let’s pick up where we left off last week and start examining the different costs associated with running your business. The best place to start is with the biggest expense and source of stress, your staff. Again, according to national averages, one employee is required to generate $125k of gross revenue. If 30.3% of the gross is staff compensation, then the non-dentist employee’s cost would drop if production went to $150k. However, if production increases, the staff wants to be compensated for working harder and generating more revenue. This is where compensation can be controlled. You need to freeze wages and institute a bonus upon production plan. This type of program will allow the staff to benefit from the practice’s successes and work through slow times with a little extra effort.

There are many types of bonus programs that are successful. The staff needs to have it explained in detail so everyone understands the possibilities. This is when “team harmony” comes in. No, you don’t have to hold hands and sing; you just need to be on the same page.

It is tax time and some of you out there had to pay Uncle Sam because you didn’t plan correctly. Did you know that instead of sending the money to Washington, you could have invested it in your practice? Heck, you got to write the check anyway, the only difference is who the check is made out to. Hey, what about a 401K plan to help you retain those “really good” staff members? The company contribution could be tied to annual production and the tax planning possibilities would put a smile on any financial advisors face. Henry Schein, being part of the Fortune 500, has afforded us the opportunity to work with Fidelity Investments. There is no monetary compensation to Schein for this arrangement. We use Fidelity for our plans and because of the relationship, Schein clients are offered free plan set up.

Employee manuals are essential. You can not start to control your overhead unless you have a “written” set of policies, procedures and protocols. It does not take that much time to develop a manual; however, it does need to be done. Sample manual are available from the NJDA or you can contact me.

Staff compensation is the largest part of your overhead. When handled correctly, you will have a very happy staff and that leads to increased production. As I stated in last weeks E-Blast, you can not reduce your overhead, you can only control it, and so what we need to do is talk about putting patients in the chair and increasing production. Please feel free to contact me at any time.

Fortune Ranks Henry Schein #1 Most Admired Companies………………………………..

Fortune Names Henry Schein ‘Most Admired’ in its Industry

Fortune’s 2009 list of the World’s Most Admired Companies, published in March 2009, once again ranked Henry Schein “Most Admired” in the “Wholesalers: Health Care” industry. Henry Schein ranked number one in our industry for social responsibility for the fifth year in a row.

The Fortune rankings were based on a survey that included 689 companies in 28 countries and 64 industries. Henry Schein’s ranking as an “Industry Champion” was based on number one rankings in six of the nine key attributes of reputation: use of corporate assets, quality of management, long-term investment, quality of products/services, global competitiveness and social responsibility.

Air, Water & Dentistry………………………………………………………………………

You can not do dentistry unless you use air & water. Over the last several years there have been a lot of issues with water and the biofilm contamination that forms in the dental unit lines. Just in case you do not understand the biofilm issue, I’ll try to explain it as simply as I can. Biofilm is bacteria that naturally develop in nature. The EPA sets city water (tap water) standards at 200 parts/million. Bacteria that does come through the tap is basically harmless. Our immune systems are designed to protect us. However, when water is stagnant or moving very slow, it allows time for the bacteria to multiply and form that green slimy stuff called biofilm.

Dental water lines are very small. When water enters at the junction box it take a long time before it gets to the handpiece or 3 way syringe. During that time the bacteria grows very rapidly. Within 24 hours the bacteria level in your delivery unit is far above the 200 parts per million. This increase is usually not an issue with healthy patients and staff, but immune compromised patient should be screened and checked on a couple of days after treatment. What most people don’t understand is that biofilm aerosol vapor is emitted whenever water is being used in the operatory. This vapor can be a health hazard to your staff unless the unit is clean and the operatory is well ventilated. We’ll talk about hazardous vapor when we discuss air lines.

Clean water bottles look nice, but they do not solve the biofilm issue. They just allow you the ability to clean and disinfect the inside of your unit and provide medicaments during your routine procedures. Keeping your delivery unit clean will also increase the functionality of your handpieces. Water is the basis for all life. Spring water from the store has bacteria and when exposed to the environment, they will multiply. Do not use distilled water in the water bottle, it will, in time, damage your equipment due to the high Ph level.

Now, how should you address biofilm contamination? It’s easy, call me! Every office is different and there are many products on the market that will arrest the problem. Biofilm is part of our natural environment and has been around for millions of years. Biofilm control has been on a forefront in dentistry for about 15 years.

Air lines, in most cases, are not much different than water lines, however, they can’t really be cleaned and now I will let you in on the dirtiest little secret in dentistry. Did you ever wonder what the inside of your air compressor looks like? It’s probably similar to the Great Bear Swamp. Think about it, warm, dark and moist.

A compressor creates pressure by squeezing the air in the tank. When you squeeze air, condensation accumulates at the bottom of the tank. A bacterium that survives in the humidity in the air now has the opportunity to grow. Picture an air conditioner and the water that drains from the “compressor” in the unit. Your dental compressor is the same thing.

Now, let’s add another factor. Where is your vacuum pump located? Usually it is next to the compressor. Where does your vacuum pump vent? Most dental offices have no idea. It should vent outside the building. If it does not, all the bacteria and contaminants that are evacuated from the oral cavity are vented in the vacuum/compressor room and sucked up by the compressor. The bacterium is then distributed back to the operatories in an aerosol form through the handpieces, syringes, prophy-jets, etc. Did I here anyone say O.S.H.A? The remedy is easy, call a plumber to properly vent the vacuum pump. If you need to know if your pump is vented correctly, call me!

As far as the compressor tank goes, you need to make sure that the automatic drain is clean and functional so water that condensates at the bottom of the tank is expelled. Also, the desiccant air filter should be checked at least once per year and we all know how often that happens. As a matter of fact, the first question you are thinking about at this moment is what is a desiccant filter? The filter traps any moisture or debris that is coming out of the compressor. A dental compressor, unlike other industry compressors, is designed to deliver clean, dry & oil free air to your treatment rooms. If you change the oil in your car every 3,000 miles, check your compressor filter once a year. An equipment service call is all that is needed to change the desiccant filer element.

Properly maintained equipment helps an organized staff increase overall production by minimizing down time and creating a healthy work environment.

Replacement Handpiece Turbine Summer Promotion…………………………………………

ProScore High Speed Turbines are manufactured to the highest standards. There are ProScore turbines to fit almost any high speed handpiece. All Turbines carry a 6 month warranty (unless noted) and are being offered at a 15% discount. Sample pricing is below (prices shown are after discount). Turbines are new and NOT rebuilt.

ProScore Turbine to fit: Canister Style (Economy – 3 month warranty)……………………………………………………. $34.99

Star 430 Series Maintenance Free PB……………………………………………………………… $145.99

Lube Style/PB……………………………………………………………… $135.99

MW QA-L or Tradition-L…………………………………………………………………………. $135.99

Kavo PB 630/640/642……………………………………………………………………………… $135.99

635/647/649……………………………………………………………………………… $145.99

Lars, Kinetics, W&H (distributed by Adec), NSK and more. Most styles @……………………………. $135.99

Call for prices on any high speed handpiece turbine.

Sunday, April 19, 2009…………………………………………………………………………

Today is Sunday, April 19th. It promises to be a beautiful day. What ever your plans are, have fun and please be safe. As always, I am available at any time for your questions and concerns.

p.s. I hope you can make the Party @ Pier59 Studios on May 11th. Check you e-mail and fax line for details or give me a call.

October 21, 2009 Posted by | 1 | Leave a comment

Career Development, Digital Impression Systems, How to Grow Your Practice in the New Economy

Cliff’s Notes for March 22, 2009


Cliff Marsh, Henry Schein ……Cell: 201-321-7494……Fax: 201-262-2210…

“When you come to a fork in the road, take it”

Yogi Berra

In This Week’s Blast:

Career Development

Digital Impression Systems

How to Grow Your Dental Practice in the New Economy

Webcast – The Missing Link in Minimal Intervention Dentistry: Effective Caries Control

Premier Exclusive Hygiene Offer

Career Development………………………………………………

As many of you know, I spent the week of Mach 9th in West Allis Wisconsin. West Allis is where Henry Schein has their dental division executive offices and training center. Henry Schein Corporate is located in Melville, Long Island.

The session I attended is called “Career Development III”. Let me explain what we do at these week long sessions so that you can better understand what I do. Our class room curriculum was as follows;

Monday, 4 hours reviewing ADA Production & Financing Surveys and Reports and 4 hours of E-commerce marketing.

Tuesday, 8 hours of Practice Management procedure & protocol.

Wednesday, 8 hours of Practice Management Software updates & report analysis.

Thursday, 2 hours Laser Technology, 2 hours Patient Scheduling Techniques, 2 hours Practice Transitions & 4 hours Embezzlement. Yes it was a long day.

Friday, 2 hours 3D Cone Beam Technology and 2 hours “dental accounting up-dates”.

What surprises most of my clients is that we don’t talk about dental supplies. In today’s economic environment everyone is looking for answers to questions that they didn’t have or think of 1 year ago. The fact is, I and Henry Schein have a direct stake in the survival, profitability and growth of your dental practice. I have available to me, proven resources in every area of dentistry and business management. If I can help you be more profitable and do more and better dentistry, then I am doing my job. The more information and opinions you listen to, the better your ability will be in making informed decisions. In a real world, no one person can all solve your problems, however, I will be able to help you identifies “soft spots” within your operation and recommend solutions and resources if necessary.

I have been doing what I do for a long time and have seen the mistakes, well, maybe not all of them. Hey, there are some that make you shake your head and say to yourself self, “S_ _ _ you can’t make this stuff up”. Well, I guess “there are a lot of stories in the naked city” and the first person that can tell me where that quote came from, I’ll put a $50.00 credit on their account. Please call me with any questions or concerns.

Digital Impression Systems……………………………………

Digital impression systems need to be part of your future business plan. The only technology that I can see higher on the priority list would be Digital Radiography. Digital impression systems, per impression, cost the same as impression material on average; however, their value is in production. We’ll get into that later. There are several systems on the market but my favorites are the 3M Lava OCS & the i-Tero System by Cadent. Understand, these systems do not mill crowns in the office like the E4D or that other one that the “P” company sells. So, let me try to explain in 100 words or less how these systems work.

After doing your prep, you or your assistant take the camera and click & capture several pictures as instructed by the system. The impression and proposed model then appear on the screen. Just as you inspect your impression, you check on the screen and fix any voids you see. Now, you’re done. The entire process takes less than 5 minutes and there is no clean-up. I figure that you will save about 10 minutes per patient.

After completing the process, the digital image is sent to a central milling center, (i-Tero is in Carlstadt) and the model is milled as per the digital specifications. The model is then forwarded directly to the lab of your choice for any type of fabrication. Turn around time from your lab will be the same. From the time you take the impression it will take 3 days for your lab to receive the perfect model. No adjustments will be needed and the lab can begin fabrication upon receipt.

This is the future of dentistry. The systems cost about $24k so a plan needs to be in place before you jump into this. This is great technology and it will be an industry standard, however, today, it is not for everyone. The differences between the 3M & i-Tiero System are about the same as the differences in the Cerac System (by the “P” company) and the E4D System. The technological formats are different. 3M & Cerac require the use of a powder so that the digital cameras can better distinguish the tooth anatomy. The i-Teiro & the E4D utilize the newer digital laser technology in their cameras and do not need any additional coatings to capture perfect tooth anatomy.

How to Grow Your Dental Practice in the New Economy…………….

Friday, March 27, 2009 ………9:00 AM – 3:00 PM

Dental Studies Institute, 7 Speilman Road, Fairfield, NJ 973-808-1666

6 CE’s – Lunch – $125.00 – All paid attendees will receive a $100.00 Henry Schein Merchandise Certificate!!

* Digital to Software, an Introduction to the Paperless World

* Market in the New Economy

* CadCam Dentistry, Fact & Fiction

* Treatment Planning and Acceptance in the New Economy

* Over Denture Attachment, It’s easy!

For more information, please see the attached flyer or call Cliff @ 201-321-7494



The Missing Link in Minimal Intervention Dentistry: Effective Caries Control
Presenter: Dr. Hien Ngo CE Credits: 1
Webcast Begins: 3/30/09 8:00 PM ET, 5:00 PM PT
The modern Minimal Intervention Dentistry (MI) approach relies on dentists taking the dual role of physician and surgeon. So there is a need for a systematic approach to the clinical management of caries. The scope of this lecture will give an update on cariology and describe the Matrix and Traffic Light system and how it can be applied in

October 21, 2009 Posted by | 1 | Leave a comment