Cliff's Notes

The Business of Dentistry

“Obama Care, What the Industry is Saying” & “A Product Review of the Moses Sleep Appliance”

Cliff’s Notes for July 8, 2012

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



The reason we do what we do, is so that we can to do what we want to do, when we want to do it!

It’s a tongue twister, but working as a team and making informed decisions, will get us there.



“Things may come to those who wait, but only the things left by those who hustle.”

Abraham Lincoln



This Week’s Feature on the Cliff’s Notes Channel

“Sleep Appliance – Impression & Bite Protocol”


Over 100 Dental Videos



In This Week’s Issue

  • Obama Care – What the Dental Industry is Saying!
  • Product Review – The Moses Sleep Appliance!
  • The Henry Schein Outlet Store – Special of the Week!
  • “The Root of It Commentary” – Is It Time Prepare Your Practice?


Obama Care & What  The Dental is Saying.………………………………………………..

American Dental Association

  • The American Dental Association: The group opposes a provision in the law that provides additional funding for dental therapists, who have less training than dentists but can perform basic care skills, and could offer service in areas with a lack of dentists.


  • The U.S. Supreme Court’s 5-4 ruling on the Affordable Care Act upholds the provisions establishing state health insurance exchanges and minimum benefit packages that include pediatric oral health care. This could expand dental coverage to millions of additional children, many of whom have suffered with untreated dental disease. The ADA advocated vigorously for increased children’s coverage, including how the “essential dental benefit” for children is defined, in the months leading up to the law’s passage and is grateful that it remains intact. 

However, the Court’s ruling further diminishes the likelihood that tens of millions of low-income adults will gain better access to care. Instead they will continue to face such barriers as poverty, poor health literacy, cultural and language distinctions, geographic location, and lack of access to fluoridated drinking water that prevent them from achieving good oral health. Each of these barriers must be overcome if our communities are to attain an acceptable level of oral health.

The ADA believes that all Americans deserve good oral health and access to dentists who can help them attain it. The Association will continue to advocate at the federal and state levels for laws and regulations that will improve dental coverage for adults and children who currently lack it.

With the Court’s ruling, renewed attention will be given to implementation of the ACA, including the role of dental benefits within the states’ programs. The Association also will continue its ongoing work with state dental societies to secure the best possible dental benefits for individuals—children and adults—and small businesses through the state-based health insurance exchanges.

NY Mag. On-Line:

  • ADA On Track in Aiding State Societies, Supreme Court Ruling on Health Law Changes Nothing for Dental

Yesterday’s United States Supreme Court ruling on the Affordable Care Act (ACA) means that the states will go forward with implementing the health care exchanges required by the law to be operational on Jan. 1, 2014.  The ADA and its constituent societies are well-positioned to ensure that oral health coverage is available through the state “exchanges,” through which individuals and small businesses will be able to purchase health coverage.  The Association has developed a number of tools that state societies can use to prepare themselves and their members for full implementation of the exchanges.   For more information on these tools and what your state societies are doing about health care reform, please contact your state dental association.

The American Student Dental Association:

  • Yesterday, the Supreme Court upheld the mandate in the Obama Administration’s Affordable Care Act, providing individuals lacking health care coverage pay a fine. The first fines will be taxed in 2014 in response to this surprising and controversial move. PBS, which recently dedicated a Frontline episode to access to care in dentistry, outlines the bill’s “winners” and “losers”. 

The ADA posted a statement in response to the ruling siting their March 2010 reaction to the eventual passage of the Affordable Care Act.

Though the ADA found provisions in ACA benefiting oral health, the provision most under scrutiny by dentistry is increased funding for dental therapists. Supporters see midlevel provider models as an answer to dwindling oral health resources. Critics question the ability of dental therapists to deliver quality care given their substantially limited training. ASDA’s stance is that only qualified dentists should be performing irreversible procedures. ASDA Chicago Administrative Extern, Megan Guthman, Alabama ’14, voices her concern:


  • The Regulations determine how the program will be administered, are still being created — but they only deal with children’s dentistry.  If you are an adult, to use the President’s favorite phrase: “You’re on your Own.”

The Reform of the US Health Care System, when it is fully implemented, will require everyone to purchase a Medical Insurance Policy.  This feature is the so-called Individual Mandate that will insure the medical needs of everyone.

However there is no individual Mandate for DENTAL CARE, only a provision for children’s dental care after 2014. If everyone were required to have a Dental Insurance Policy, there would be no financial reason for ignoring or postponing dental services.  However there are many folks who seek dental care only when prompted by pain, even though they have may already have dental insurance.

There is no reason why this glaring omission of coverage is allowed to remain.  Since we already borrow to subsidize health, just borrowing a little more from the Chinese could give comprehensive dental coverage for all Americans.  As it is, Dental Maladies will still pose a threat to Americans health.
 And what happens in the mouth doesn’t stay in the mouth.

When the cost of our health care is transferred to our great-grand-children, they would not even notice the small increment added for our dentistry.

Besides, our great-grand-children will already be in an enormous snit at us over the fact that we will have used up all the Fossil Fuels

The Dental Trade Alliance (The Manufacturing Sector)

  • As you have heard, the U.S. Supreme Court upheld the individual mandate contained in the Affordable Care Act which leaves the law largely intact for continued implementation. Many had argued that the individual mandate violated the commerce provisions of the constitution. The Court agrees with that argument but declared that the mandate was in effect a tax and let the law stand.


The decision by the Court doesn’t change our strategy or efforts to seek repeal of the medical device tax. We are glad that the House of Representatives voted to repeal the tax, but action in the Senate is unlikely until after the election in November.  

The results of the election will guide our steps later in the year. Should there be a ‘lame duck’ legislative session in November and December we will sound the alert for a full court press to seek congressional action before the tax goes into effect in January.

The negative effect of the tax on our industry would be substantial. The complex relationships that exist in the dental space will make implementation of the tax a challenge.

Our only goal now is repeal. We will keep you up-to-date on the latest news.

Please log onto to leave your comments….


Product Review –The Moses Appliance!……………………………………………………………………

The Moses® appliance is the most effective snore appliance on the market. This device has improved on the simple MAD designs of the past to incorporate tongue management. It actually activates reflexes to advance the tongue. It lowers elevator muscle activity, reduces clenching, decreasing bruxism. The two part design is extremely comfortable. It allows the patient to close their lips, talk and even drink. 

It has been developed by Allen J. Moses DDS, DABCP, DABDSM. He holds a faculty appointment as an assistant professor at Rush University Medical School in the Department of Sleep Disorders. He is a diplomat of both the American Board of Craniofacial Pain and the American Board of Dental Sleep Medicine.

Dr. Moses has appointed Modern Dental Laboratory USA the exclusive manufacturer and distributor of The Moses® appliance worldwide. To order The Moses® appliance a signed term sheet and adherence to the Impression and Bite Protocol is required. The appliance is distributed nationally by Henry Schein Dental.

We highly recommend a basic knowledge of Dental Sleep Medicine and professionally screening patients to determine sleep apnea level. Home Sleep LLC of Paramus NJ can supply the certified testing and educational formats for the dentist and staff. All procedures are covered by most medical insurance programs and Home Sleep is an in-network provider for the patient’s convenience and affordability.

The Moses® appliance is intended for use on adult patients as an aid for the reduction and/or alleviation of snoring and obstructive sleep apnea. Advancement of the mandible and tongue prevents collapse of the patient’s tongue on the soft palate and/or oropharyngeal airway.

For more information log onto: or contact me at any time @ 201-321-7494 or e-mail

For information on dentist & staff education as well as patient questionnaires and information, direct subscribers to Cliff’s Notes should see the attachment to this week’s report. If you can’t open the attachment please contact me at any time.

 The Henry Schein Outlet Store: Special of the Week!………………………………………………..

Outlet Store offers are limited in quantity and only available on a first come-first serve basis. The inventory is very fluid so it pays to check back frequently for new listings.

Condition: Overstock
Part Number: 5523050XN
Manufacturer Part Number: 3120
Catalog Price: $7,720.00
Special Price: $3,999.00Warranty: 6-Month
Log onto: on a Category!
Dental Handpieces
Dental Small Equipment Dental Equipment
Dental Laboratory Equipment  Dental Burs Endodontic Files and Reamers
Sterilizers Medical Equipment  

Product Categories

OVERSTOCKED: New Products that are in the manufacturer’s original sealed package
DEMO MODEL: Open-box products that have had no clinical use
RECONDITIONED: Products in excellent condition, restored to the manufacturer’s specification

All products include comprehensive warranties backed by Henry Schein

“The Root of It” Commentary for Sunday May 6, 2012 ………………………………….

Are you thinking it’s time to walk off the field? The new regulations and Obama Care may be too much to deal with? Or, are you thinking about hanging on for another 10 years? Even if you are at the beginning of your “dental life”, you need to keep an eye on the finish line. This is part of your estate planning and retirement package.

So, how do you maintain or increase the value of your greatest asset while improving your quality of life? A practice management review is a good start. It is relatively in-expensive and can be very informative. As far as recommending a practice management group, I know of several very good ones but it does require you interviewing them and the coach that will be in your office to determine your level of comfort.

Recently a Bergen County Practice sold for $235,000. The gross production was $325,000 and collections were $299,000 for the 2011 fiscal year. The seller did not prepare for the sale and left a lot of money on the table. Let’s look at some of the reasons:

  • The seller did not up-grade any business systems due to the fact that he was selling the practice and didn’t want to spend the money. Now the buyer needs to invest so the additional dollars don’t go to the seller. If the seller had invested $20k to up-grade the practice, the return could have been $50k.
  • The seller did not up-grade any of the equipment or re-decorated the office so the potential buyers are seeing “old” and the value is diminished. When you want to sell your house, the real-estate broker will suggest that you paint and replace carpet. The investment of a few thousand dollars will yield a return as much as 10 time the investment. The seller kept utilizing accounting practices that reduced his tax liability. This is the biggest mistake that the seller made. To save money on taxes he reduced the profit that the business made. A business sells for a multiple of the retained earnings (profit) so by saving $20k in tax liability he actually reduced his sale price by $80k.

Adding new procedures to your repertoire is always a good thing. With elective dentistry being almost nonexistent you need to look at different revenue streams that are considered “good medicine”. These procedures will replace revenues lost due to the national economy and will also raise your standard of care and that increases your value to your patients as well as the value of the practice. Some examples:

  • Composite facing for patients that can’t afford veneers (look for this to be big after Labor Day).
  • Oral Cancer Screening (some dental insurance companies are now covering Velscope & some medical insurance is covering Panoramic Imaging).
  • Sleep Medicine (medical insurance covers all aspects including panoramic and follow-up) Sleep Medicine is the biggest thing to hit dentistry and the national media is promoting it for you. It is considered preventive medicine.
  • Incipient decay infiltration (Icon). This product and technique just received an insurance code number of its own. Insurance companies will begin to pick this technique up as preventive medicine.

Experienced consultants can help guide you through the maze, but, before searching for consultants, I do recommend a DPAT review. A DPAT (Digital Practice Analysis Tool) will point out “leaks in the ship”. Once you locate the leaks you can establish a plan to fix them. A DPAT report uses industry, ADA and local data and does require a license fee of $149.00, however, I personally cover that cost for my clients because the value of the information it provides is part of my job. Your consultant’s success directly depends on yours.

A DPAT Report will show a perspective buyer or potential associate what your practice is capable of.

Today is Sunday, July 8th. Enjoy the day, stay cool and please be safe, there are a lot of people that need you.

Cliff Marsh

Henry Schein Dental

P.O. Box 663 / 45 Rt. 46 East, Suite 605

Pine Brook, NJ 07058

Cell: 201-321-7494

Fax: 201-262-2210!/profile.php?id=1644814090 

The Cliff’s Notes Channel 

July 8, 2012 - Posted by | Uncategorized

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