ntd volume 3 issue 4 de

VOLUME 3 | ISSUE 4North Texas

Dentistrya business and lifestyle magazine for north texas dentists

A Life-Changing Focuson Mind, Body and SoulDr. Jodi Danna & Dr. Tina Lalangas

Smiles in the SpotlightDr. Lee Fitzgerald & Dr. Eduardo TanurTransform a Smile with the All-on-4 Technique

Money MattersManaging Your Fiduciary Risk

Practice TransitionsA Lesson in Life

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North Texas

Dentistry

BAYLOR COLLEGE OF DENTISTRYStrength in NumbersPracticing dentists join collective research effort

COMMUNITY NEWSThe George W. Bush Presidential Library and MuseumA great addition to the SMU campus

SMILES IN THE SPOTLIGHTDr. Lee Fitzgerald and Dr. Eduardo TanurTransforming a smile with the All-on-4 technique

PRACTICE TRANSITIONA Lesson in LifeThe office-sharing associate without a contract

MONEY MATTERSManaging Your Fiduciary RiskAnswers to key questions concerning retirement plans

PRACTICE MANAGEMENTCan Unresolved Conflict Be Jeopardizing Your Practice?Solutions to conflict in the dental office

PRACTICE MARKETINGBuilding a Dental Website That ConvertsTips for getting new patients

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248 ON THE COVER A Life-Changing Focus on Mind, Bodyand Soul: Dr. Jodi Danna

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ON THE COVER

A Life-Changing Focus on Mind, Body and SoulDr. Jodi Danna & Dr. Tina Lalangas

NORTH TEXAS DENTISTRY | www.northtexasdentistry.com4

I hope all of you are having a great sum-mer! It looks like we are in store for a typ-ical hot Texas one. My wish is for the WestNile to not be the threat it was last year!Try and stay cool and be safe whereveryour summer travels take you!

For this issue North Texas Dentistryvisited the practice of Dr. Jodi Danna andDr. Tina Lalangas. The practice recentlyrelocated to a new space at the same loca-tion in Plano. The facility, transformed byJ. Houser Construction, is cutting edge“cool” with all the latest bells and whistlesneeded to provide quality dental care. Withher energetic and caring personality, Dr. Danna has redefined the workplace bytreating both staff and patients like familyand guiding patients towards a higher levelof wellness.

Dr. Lee Fitzgerald and Dr. Eduardo Tanurteam up to present this issue’s Smiles inthe Spotlight. The case presentation ofthe All-on-4 protocol is thorough and thetransformation of the patient’s smile isamazing. Last year, Dr. Fitzgerald foundedthe Forte Implant Center in Plano. TheCenter presents seminars, live surgeriesand hands on training. North TexasDentistry looks forward to presenting theForte Implant Center as an upcomingcover story. Stay tuned for more informa-tion on this impressive facility.

The George W. Bush Presidential Libraryand Museum recently opened on the cam-pus of SMU. I had the privilege of touringthe library and truly enjoyed the interactivereview of history. North Texas Dentistryis pleased to present a look inside the BushLibrary and Museum and I would encour-age our readers to plan a visit this summer.

Also inside, you will discover a vast arrayof editorial topics. Money Matters looksat managing fiduciary risk and PracticeTransitions relates the sad story of a“handshake” associate agreement and theconsequences of not having a written con-tract. Don’t miss the salute to the volun-teer dentists who have made the “Save aSmile” program a continued success.

Thanks to all of you who support NorthTexas Dentistry and make its publica-tion possible!

Keep smiling and have a great day!

LuLu Stavinoha, RDHPublisher

from the publisher

Although every effort is made to ensure the accuracy of editorial material published in North TexasDentistry, articles may contain statements, opinions,and other information subject to interpretation. Accordingly, the publisher, editors and authors and theirrespective employees are not responsible or liable forinaccurate or misleading data, opinion or other informa-tion in material supplied by contributing authors. Copyright 2013. All rights reserved. Reproduction inpart or in whole without written permission is prohibited.

Advertise in North Texas DentistryFor more information on advertising in North Texas Dentistry, call LuLu Stavinoha at (214) 629-7110 oremail [email protected]. Send written correspondence to: North Texas Dentistry P.O. Box 12623 Dallas, TX 75225

North Texas

Dentistry

Ray BryantPHOTOGRAPHY

Tina CaullerWRITING / DESIGN

Publisher | LuLu StavinohaPhotographer | Ray Bryant, Bryant StudiosContributing Writers | Tina Cauller, Sharon Dolak, Dr. Lee Fitzgerald, Jennifer E. Fuentes, Dr. Richard V. Lyschik, Frank J. Mario, John Orrell, Neil Rudoff, Dr. Eduardo Tanur

Remember to “Like” us on Facebook at: http://www.facebook.com/NorthTexasDentistry


When you put the numbers together, it justmakes sense.

If you devise a research study that requiresa sampling of 60 patients, and your prac-tice sees an estimated 20 patients a yearwho fit the research criteria, chances aregood that it will take at least three years tocollect all the data you need. But what hap-pens when the pool of dentists and dentalhygienists gathering the data is broadenedto, say, ten individuals instead of one?

That’s the crux of the reorganized andnewly branded National Dental Practice-based Research Network — to collect dataover a significantly shorter time span withresearch based at the dental practice, not alaboratory. It was made possible in April2012 from a seven-year, $66.8 milliongrant awarded to the University ofAlabama at Birmingham from the NationalInstitutes of Health’s National Institute ofDental and Craniofacial Research.

Texas A&M University Baylor College ofDentistry participates in the Southwest

region, one of six that comprise thenational network. The lead institution forthe Southwest is the Dental School at theUniversity of Texas Health Science CenterSan Antonio.

On May 15, TAMBCD faculty had a chanceto hear about the network’s researchopportunities firsthand from Dr. ThomasOates, director of the Southwest region. It’sall part of a push to recruit members andexplore study ideas. As of early June, themembership count in the region hadclimbed to approximately 725, just shy ofits goal of 1,000 members.

Dental academicians and private-practicedentists and dental hygienists can choosefrom the network’s three available levels ofparticipation: informational (receive PBRNcorrespondence), limited (complete surveys)and full (participate in clinical studies).

If all goes well, research studies will com-mence in late summer 2013. For moreinformation or to enroll, visit www.nation-aldentalpbrn.org.

During the May 15 meeting, Oates likenedthe push for membership to the sense ofresponsibility often associated with anelection to public office: “If we’re not aplayer, if we’re not a part of this network,our constituency won’t be represented, andthe needs of our community won’t be rep-resented,” says Oates, who is also assistantdean for clinical research at the SanAntonio dental school.

“It’s an opportunity to give back to the pro-fession and the community,” Oates says.“We want to be able to make sure we pro-vide the best care. That’s a very strongdriver for why people want to join.” n

Jennifer Eure Fuentes is a communicationsspecialist at Texas A&M Health ScienceCenter Baylor College of Dentistry. A 2006graduate of Texas Christian University, shehas worked in the communications and edi-torial field for seven years.

STRENGTH IN NUMBERSResearch isn’t just for basic scientists. This national network allows

practicing dentists to join in on the collective effort. By Jennifer E. Fuentes

A portion of the May 15National Dental Practice-based Research Networkmeeting included brain-storming for potential research topics.

cover feature


The dentist at the heart of that practice, Dr. Jodi Danna, explains:“We decided that the grand opening of our new office would be aperfect time to offer the community a chance to get to know us andfor us to give back by offering free treatment on a Saturday to any-one in need. We got the word out about the event on Facebook andon the local news. When we got to the office that morning, there wasa line around the building of people waiting for care. We had sched-uled visits from 7am until 4pm, but we ended up treating patients

until 8:30 that evening. We saw 62 patients and provided about$18,000 worth of dental care.”

Jenna was just one of the patients Dr. Danna and her staff saw thatday. “She was so genuinely grateful and called us her ‘angels’,”remembers Dr. Danna. “At the end of the day, the staff shared otherdeeply moving and rewarding stories of their encounters. It madethe whole day worthwhile.”

A Life-Changing Focus onMind, Body and Soul

Dr. Jodi Danna and Dr. Tina Lalangasby Tina Cauller

When Jenna’s 34th birthday rolled around, there was no feeling of celebration in the air. She had been in nonstop pain for more

than four weeks resulting from neglected dental problems and, after being laid off for the second time in two years, there was

no money left to see a dentist. Jenna was thankful that her three young daughters were safe and healthy, but prayed for an

answer to her painful dilemma. Then, she saw a news story on television about a dental practice in Plano that was hosting a day

of free dental care for the members of the local community and she knew her prayers had been answered.

The entire staff jumped on board the community service event withenthusiasm, in large part, because Dr. Danna’s passion, energy andcaring are so infectious. She is a devoted mother and a naturalleader, and she encourages her staff to find joy in something thathas meaning and value. She has redefined the workplace by empha-sizing the importance of caring for the needs of mind, body and soul,treating both staff and patients like family.

An aptitude for nurturing

Dr. Danna uses her gift for heart-centered leadership and nurturingto enhance patient care, guiding patients toward a higher level ofwellness. “Being one of the 30,000 American women in dentistryhas its challenges, but as women, we also bring unique strengthsand aptitudes to the profession. I believe that caring for others is anatural strength for many women, and being a dentist gives me aunique opportunity to touch other peoples’ lives. My life is full ofrelationships that I cherish, both in and out of the office.”

As testament to the lasting bonds that are built between people inthis practice, Dr. Danna’s patients regularly invite her to their familyweddings, graduations and other important events, and return tosee her from places as far away as Seattle.

A space designed for caring solutions

Dr. Danna’s practice recently moved into a newly re-designed officespace on the ground floor of the same building. She notes, “Our spa-cious new office gives us the extra room we needed and allowed usto design the entire interior space exactly the way we wanted it. Thedesign allows for very efficient workflow and it’s a bonus that every-

thing is fresh and new. Thanks to the new space, we can comfortablyoffer the most advanced treatments, including TruDenta.”

Effective treatment for force-related conditions

TruDenta is a novel system designed to help diagnose and treatforce-related dental conditions. When not properly balanced, theforces created by the interrelated elements of the head and mouthcan result in symptoms including chronic head, neck and face pain,clenching, grinding, tinnitus, broken teeth, clicking or popping ofthe jaw and numerous others. With TruDenta, Dr. Danna is able tothoroughly examine bite and range of motion to help pinpoint thesource of the problem.

Dr. Danna suffered from chronic headaches that began at the ageof 21. After years without finding a successful treatment, Dr. Dannawas initially skeptical of the promises made by the promoters of newsolutions, including TruDenta. However, once she experienced life-changing results firsthand, she was sufficiently convinced of itseffectiveness to incorporate the system into her own practice. Now,instead of just managing symptoms, she has a tool to address thefactors that underlie the symptoms, and is gratified to see herpatients reclaim their lives. Effective solutions like TruDenta helpto continually re-energize Dr. Danna’s lifelong passion for dentistry.


J. Houser Construction designed andcreated a space that is fresh and newand welcoming to patients.

Effective solutions like TruDenta helpto continually re-energize Dr. Danna’s

lifelong passion for dentistry.


A practice culture centered on family

“I had a great dentist as a kid, and I was intrigued by dentistry froman early age. I fought hard to achieve my career goals and my per-severance has paid off. Dentistry has provided me the freedom andflexibility to attend to all the things that are important to me in mylife. I have adopted a flexible style that lets me juggle the delicatecomplexities of work, marriage, and motherhood. I can actively par-ticipate in my children’s lives – attending their school functions,caring for them when they are ill, and going on family vacations, as

well as supporting my professional growth through learning andnetworking, and participating in community activities. Creating bal-ance in both our professional and personal lives allows us to focuson what’s really important.”

A team with shared standards and values

Dr. Danna’s philosophy was a driving force behind her decision toadd to her professional “family” by bringing Dr. Tina Lalangas intothe practice in April 2013. “It is a great benefit to our patients toexpand our hours to five days a week for greater convenience andemergency coverage. I was fortunate to find an associate who sharesmy professional goals, desires, values and standards for care, and Iam confident that our patients will enjoy getting to know Dr. Lalangas.”

Dr. Lalangas is also excited to be part of a practice that embracesher own values and shares her understanding that the systems ofmind, body and soul are interconnected. “Each patient’s individualwellness results from of a whole constellation of interrelated factors.

Whether that person has chronic headaches, sleep apnea, periodon-tal issues or other health needs, we see the patient’s health as awhole. No single factor in overall wellbeing is independent of theothers.”

Each patient’s wellness results from a whole constellation of interrelated factors.

Dr. Danna & Dr. Lalangas provide a full range of familydental care, including cleanings and restorative care,wisdom tooth extraction, TruDenta treatment, periodontalcare, root canals, cosmetic dentistry and dental implants.

Dr. Danna suffered from chronic headachesand has experienced first-hand the benefitsof the TruDenta system .

Dr. Lalangas also appreciates the unique family-oriented culture ofthe practice, noting, “When you come here, you feel like a valuedpart of the family, in a place where everyone knows you and every-one cares about you. Each patient deserves to be a priority on a per-sonal level, and patients find that here.”

Together, Dr. Danna and Dr. Lalangas provide a full range of familydental care, including cleanings and restorative care, wisdom toothextraction, TruDenta treatment, periodontal care, root canals, cos-metic dentistry, and dental implants. Dr. Lalangas particularlyenjoys “happy visits” with very young children, a no-treatment visitwhich allows them to acclimate to the dental experience and launch

a lifetime of healthy habits. “They learn to expect the dental visit tobe a fun experience. They have a chance to get familiar with thetooth polisher and the ‘tooth counter’, play with the light and get toknow the team. It’s a fun experience for everybody.”

Dr. Danna and Dr. Lalangas each attend more than 75 hours of con-tinuing education a year to stay informed on the latest treatments,materials and techniques. Staff members also invest time in contin-uing education, and on returning, are asked to present what theyhave learned to the rest of the team. “As an example, we recentlyhad a team member make a presentation on what she learned about


Dr. Danna and Dr. Lalangas and their team share apassion and energy to guide patients toward ahigher level of wellness.

“Each patient deserves to be a priority on a personal level, and patients find that here.”

The spacious new office allows room to comfortablyoffer the most advanced treatments.

Dr. Jodi Danna graduated from Baylor College of Dentistry in 1995. She completed her (AEGD) Advanced Educationin General Dentistry program from Baylor in 1996. In five short years, she was awarded her Fellowship in the Academyof General Dentistry and is diligently working on her Mastership. Recently Dr. Danna has been selected for Fellowshipin the (ACD) American College of Dentistry. She has years of continuing education pertaining to cosmetic and generaldentistry as well as chronic head and neck pain. Dr. Danna is a graduate of the prestigious Las Vegas Institute forAdvanced Dental Studies and is a certified TruDenta Dentist. Dr. Danna has been in private practice for 17 years.

Dr. Danna is an active member of the American Dental Association, Texas Dental Association, Dallas County DentalSociety and Academy of General Dentistry. Dr. Danna currently serves as a TDA delegate for 5th District and hasbeen on the Board of Directors for the Dallas County Dental Society for six years. In addition to serving on the board, Dr. Danna is Chairman of the Membership Committee. This committee is designed to enhance retention and recruit-ment for the dental society. Her passion is to help dentists realize the value of organized dentistry.

Dr. Danna enjoys volunteering within the dental community and giving her time. She is also very active in the community through the Junior League ofCollin County, National Charity League and holds a board position with Plano Youth Leadership. She is a mother of two daughters, Mallory (17), McKenna(14) and has been married to Pate for 24 years. In her spare time she enjoys traveling with her husband and family and cheering her kids on at volleyballgames and cheerleading events.

Dr. Tina Lalangas joined Dr. Danna in April of 2013. A Dallas native, she graduated from The Hockaday Schooland went on to The George Washington University in Washington D.C. where she graduated with a B.S. in BiologicalAnthropology with a minor in Biology. She then went on to receive her Doctor of Dental Surgery degree from BaylorCollege of Dentistry, where she excelled in patient management and her clinical courses and received the EleanorJ. Bushee Senior Student Award from the American Association of Women Dentists. Dr. Lalangas is devoted to herpatients and actively participates in continuing education courses throughout the year to further help her patientsimprove their lives by achieving a healthy mouth and a healthy body.

Dr. Lalangas enjoys volunteering within the dental community as well as with the local Junior League of CollinCounty. She is also an active member within the Greek community of Dallas and attends Holy Trinity Greek OrthodoxChurch. Dr. Lalangas is affiliated with the American Dental Association, Texas Dental Association, and Dallas CountyDental Society and enjoys giving her time to help shape the future of dentistry through these organizations. She

and her fiancé Gavin enjoy staying active with yoga, hiking, and running. They are actively planning their wedding together and very much look forwardto their wedding in 2014.


the effects of diabetes on oral health. This way, one person’s learn-ing experience benefits the whole team,” notes Dr. Danna. “Thesepresentations have proven to be a great team-builder and they rein-force our goal of helping patients to be informed about their options.When each member of the team is on the same page, it helpspatients feel confident that they are getting the best possible care.”

With easier access to information than any other time in history,patients of all ages are learning to think about dentistry and theirown health differently. In this unique practice, patients are enjoyingthe life-changing impact of an approach to dental care that consid-ers the interrelatedness of each patient’s mind, body and soul andhelps patients begin a journey toward overall wellness – embracinga new path to health that begins at the dental office.

The practice of Dr. Jodi Danna and Dr. Tina Lalangas is located at5072 West Plano Parkway in Plano. For more information, call(972) 267-6244 or visit www.dannasmile.com.

Dr. Danna’s Plano practice recently moved into a newly re-designed office on the ground floor of the same building.

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National Archives Opens 13th Presidential Library

by John Orrell, George W. Bush Presidential Library and Museum Public Affairs Director

DALLAS -- The National Archives and Records Administration(NARA) opened the George W. Bush Presidential Library andMuseum to the public on May 1. The opening ceremony included43 ceremonial first visitors – who were made up of local studentsthroughout the Dallas-Fort Worth area.

“All of us at the Library and Museum are thrilled that after yearsof planning and shaping this idea, we have finally reached the timeand place when we can give America its 13th Presidential Library,”said Alan Lowe, the director of the Library and Museum.

The Library and Museum will serve as a resource for the study ofthe life and career of George W. Bush, while also promoting a betterunderstanding of the Presidency, American history, and importantissues of public policy.

“The Presidency of George W. Bush was witness to some of themost important events in our nation’s history,” said Lowe. “In itsinteractive, innovative exhibits, the Bush Library and Museumgives visitors an inside look at how the President and Mrs. Bushdealt with critical issues such as the attacks of September 11, 2001,the need for education reform, the financial crisis, and the wars inIraq and Afghanistan.”

By preserving and making available a vast archive of Presidentialmaterials, the Library and Museum will be able to promote a betterunderstanding of the workings of the U.S. government and the

crafting of public policy. Through its outreach programs, it willserve as an educational resource for this community, the nationand the world.

“Visitors who are planning on coming to the Library and Museumare advised to go to our website and check out the ‘FrequentlyAsked Questions’ portion of the page,” Lowe said. “This will let vis-itors know what they can and cannot bring and let them order tick-ets ahead of time, thus improving the complete visitor experience.”That information can be found at: www.georgewbushlibrary.smu.edu.

The pricing for the museum is as follows:• Adults - $16, Seniors - $13• Non-Southern Methodist University (SMU) college students $13• Youth ages 13 to 17 - $14, Children ages 5 to 12 - $10• Retired military - $10• And all children under five, SMU faculty, staff, and students, and active duty military will be admitted for free.• Group discounts are available. For more information on group rates,call (214) 346-1557 or e-mail [email protected].

There will also be a 20 percent discount for anyone that presents asame day Meadows Museum admission ticket. The MeadowsMuseum is located on the campus of SMU.


Photos courtesy of the George W. Bush Presidential Center

HOURS: Monday-Saturday 9:00 a.m. to 5:00 p.m., Sunday 12:00 p.m. to 5:00 p.m.ADDRESS: 2943 SMU Blvd., Dallas, Texas 75205

For information on tickets and frequently asked questions, go to http://www.georgewbushlibrary.smu.edu. Don’t forget to like us on Facebook at http://www.facebook.com/GWBLibrary

and follow us on Twitter at http://twitter.com/GWBLibrary.

The ticketing procedures for the Library and Museum will be atimed ticket system, much like the Perot Museum of Nature andScience, also located in Dallas.

“We highly encourage that all visitors coming to the Library andMuseum reserve their tickets online prior to arrival,” Lowe said.“While we will have 50 tickets per hour available to any customerthat wants to walk up and tour the museum, those tickets are goingto sell fast and we want to ensure that everyone gets to enjoy his orher experience.”

By using the online ticketing website, visitors will have the abilityto pick the date and time they would like to tour the Museum. Inaddition to the 50 walk-up tickets, 300 tickets per hour will beavailable to be purchased online.

Due to the low number of available parking spaces, it is recom-mended that visitors carpool or use mass transit such as theDART – which has the Mockingbird Station located directly acrossU.S. Highway 75 from the Library and Museum and will have ashuttle running to and from the station to the facility.

On the north side of SMU Boulevard there is a limited amount ofvisitor parking in the guest lot across from the main entrance.Drivers can also park in any non-reserved parking spaces on theSMU campus and at the Mockingbird Station.

When visiting the facility it is important to remember that no out-side food or drink is allowed and that weapons are not permittedon the Library and Museum property. All visitors will have to passthrough metal detectors and all bags will be examined through anx-ray scanner before entering the facility. Large bags should not bebrought into the facility.

“These precautions are for both the safety of every visitor and everyemployee within the Library and Museum,” Lowe said.

To complement the visitors experience at the Library and Museum,the George W. Bush Center has a Gift Shop for visitors to purchasesouvenirs and Café 43, which will allow everyone to have a pleasant

dining experience while at the facility, he said.

Starting May 1, The Library and Museum will be open Mondaythrough Saturday from 9 a.m. to 5 p.m. and Sundays from noon to5 p.m. The facility will be closed on Thanksgiving Day, ChristmasDay and New Years Day.

“Thanks to President and Mrs. Bush and our partnership with theGeorge W. Bush Foundation and Southern Methodist University,we have been able to create a world-class facility for generations tocome,” Lowe said.

Located on the campus of SMU – which is a nationally ranked pri-vate university in Dallas enrolling nearly 11,000 undergraduate andgraduate students from throughout the world in seven degree-granting schools – the facility is the 13th Presidential Libraryadministered by NARA, and houses the official records and arti-facts of the Presidency of George W. Bush.


Photo courtesy of the George W. Bush Presidential Center

Photo by Eric Draper

SMILESin theSPOTLIGHTLEADERS IN NORTH TEXAS DENTISTRYCREATING UNFORGETTABLE SMILES


Treatment PlanPatient underwent a CBCT scan at the initial consultation which re-vealed sufficient bone volume for implant procedures. With a case likethis, the patient could have pursued several options. Options discussedincluded removable dentures, implant-retained removable partial den-tures, and a fixed detachable implant supported denture using the All-on-4 (A04) protocol. The patient chose the All-on-4 procedure be-cause she was looking for a permanent solution with non-removableteeth to replace the entire dentition. The possibility of immediate func-tion, minimal downtime, and cost effectiveness helped determine herchoice of treatment.

The A04 TechniqueThere are several critical steps and criteria in the A04 technique involv-ing both the surgical and prosthetic phase that must be followed tohave an acceptable outcome. The patient must have a favorable med-ical condition to tolerate the procedure, adequate bone volume in theprojected implant sites, favorable biomechanical forces for implantsand final prosthesis, and adequate ridge reduction/site preparation forimplant placement and prosthetic space. In each arch, there must bea minimum of 15mm of interarch prosthetic space in the anterior seg-ment and 10mm in the posterior. In most mouths, this will leave ade-quate vertical bone height for implant placement. The limiting factorthen is the horizontal bone volume, which will determine whetherimplants can be placed. Adequate vertical bone reduction must bedone to assure there will not be prosthetic or cosmetic failure. The tran-sition to a temporary prosthesis and occlusal management in treatmentand post prosthetics are key elements as in any rehabilitation.

The A04 is a proven treatment modality in the right circumstances. It is not a default “one size fits all” treatment. The right elements mustbe in place for predictable and favorable long-term outcomes.

Case PresentationA 72-year-old white female came in for an evaluation of complaintsabout her overall appearance of her teeth. She had many missingteeth, loose teeth, broken fillings, dry mouth, her remaining occlusionwas unstable and the teeth showed stains from coffee and tobacco;consequently she wanted to replace her entire dentition. She knew apatient of our office who had the All-on-4® procedure done by Dr. Fitzgerald several years ago and was interested to see if this waspossible for her. The patient considered herself medically healthy butrevealed a history of 20 years of smoking, hypertension and periodon-tal disease. The patient is currently a non-smoker.


ProceduresThe patient was sedated intravenously for the duration of the procedure.The remaining teeth were extracted, and an alveoloplasty was done toachieve sufficient interarch space and a flat surgical and prosthetic table.Following the All-on-4 protocol, four Nobel Biocare NobelSpeedy im-plants were placed in the mandibular arch. Five were placed in the max-illa; the fifth implant was placed according to the patient’s request. Theposterior implants were placed at a 52-degree angle to increase stabilitywithin the implant, provide a decreased cantilever, lessen the force onthe distal implant, and provide better mechanical and biologic stability.Transition consisted of a fixed, detachable acrylic denture attached tothe implants via multi-unit abutments. Due to the amount of bone reduc-tion and utilization of information from a chairside interactive CBCT scan,this was a direct technique applied without the aid of a static surgicalguide. Instead, the variable position Nobel Biocare A04 surgical guidewas used for implant alignment.

ResultsAfter the surgery, follow-up with the patient began with a next-day checkup.After that we conducted weekly examinations for the following month toadjust the occlusion of the temporary prosthesis. Even occlusal contact incentric relation is ideal. After the first month, follow-up examinations occurred monthly to evaluate healing, occlusion monitoring, and patientcompliance with hygiene. After 3-4 months when the healing had com-pleted, the patient returned to have her permanent prosthesis fabricatedand installed. She has continued regular cleanings to monitor hygiene andimplant stability. She has been very satisfied with her new smile that resulted from the collaboration of Drs. Fitzgerald and Tanur.

Lee Fitzgerald, DDS, FAGD, FICOI, FICDDr. Fitzgerald graduated from Baylor College ofDentistry in 1985. He completed his Externship inOral and Maxillofacial Surgery at SouthwesternMedical School. In 2006, he graduated from theMedical College of Georgia School of Dentistry’sImplant Maxi Course.

Dr. Fitzgerald is a Diplomate of the AmericanBoard of Oral Implantology/ Implant Dentistry, Fel-

low of the International Congress of Oral Implantologists, Associate Fellowof the American Academy of Implant Dentistry, and a Fellow of the Acad-emy of General Dentistry. He maintains his practice at the Fitzgerald DentalImplant Center — an all-in-one office that includes general dentistry, CBCTscanning, surgery, and lab services under one roof.

In 2012 he founded the Forte Implant Center in Plano, Texas, and currentlyserves as its director. The Center presents seminars, live surgeries andhands-on training to promote continuing education for dental professionalsnationwide.

Eduardo Tanur, DDS, MSDr. Tanur received his MS in Periodontics fromBaylor College of Dentistry. He is a Board CertifiedPeriodontist and maintains his private practice lim-ited to periodontics and implant dentistry in Dallas.He is a former faculty member at Baylor Collegeof Dentistry and lectures nationally and interna-tionally on periodontics and implants.

For more information, contact Dr. Fitzgerald at: Fitzgerald Dental Implant Center (972) 612-7800

http://implantdentistryofdallas.com

Once upon a time...Dr. A owned a successful practice in a nice community. Threeyears earlier he hired a young dentist as an associate (Dr. B). Dr. Bwas a former patient who had known Dr. A for many years. He wasa nice young man who seemed extremely grateful for the opportu-nity to join Dr. A’s practice. Dr. A was thinking about retiring in fouror five years and thought Dr. B would be the perfect candidate tobuy his practice from him when he was finally ready to sell.

Since they had known each other for many years, Dr. A did notfeel the need for a written contract. After all they were friendsand professionals; a handshake would be sufficient. Besides that,this would give them both time to see how much they liked workingwith each other. Dr. B was very pleased at the prospect of owningDr. A’s practice someday.

Dr. A’s practice was grossing $975,000 a year when Dr. B joined thepractice. In order to provide Dr. B with enough work, Dr. A begansending many of the patients to Dr. B for treatment. These were Dr. A’s “golden years”, and now he began spending more time awayfrom the office knowing that the patients were being treated in hisabsence, and when he retired, he felt secure that he would be paidthe full value of his practice by Dr. B.

Soon Dr. A’s personal gross production kept dropping while Dr. B’s production kept increasing. Everything seemed to be pro-gressing well. Dr. B was paid on a commission basis and wasdelighted at being so busy. As time went on, most of the moneyearned by the practice was all paid out as commissions to Dr. B.Thus Dr. A’s income was dropping while Dr. B’s income was steadilyincreasing.

Midway into the third year of this working relationship, Dr. Adiscovered he had a serious medical problem and that it wasonly a matter of time before he would have to quit practicingdentistry. Dr. A had to spend more time away from the office untilfinally he decided it was time to sell the practice to Dr. B. He feltfortunate to at least have his “built-in buyer” on the premises.

Dr. A informed his now well-established associate Dr. B that it wastime for him to buy the practice. In fairness, Dr. A had the practiceappraised based on the collected production that the practice was

earning before Dr. B joined the practice. Dr. A did not feel it wasfair to have Dr. B pay more money for the additional productionadded to the practice by Dr. B. The practice was appraised at$725,000 even though its current gross revenues had grown by anadditional $300,000 for a total of $1.75M.

Dr. A sat down with Dr. B and explained that it was time for him(Dr. A) to quit, and since the practice value played a major role inhis retirement plan, it was time to work out a purchase agreement.Dr. A told Dr. B that the purchase price was based on the gross col-lections of the practice for the year prior to the time Dr. B joinedthe practice. Dr. B was astonished! He told Dr. A that Dr. A’s cur-rent production was only $200,000 for this last year, and Dr. Acould not understand how the practice could have been appraisedthat high.

Dr. A told Dr. B that the practice had grossed $975,000 before Dr. B joined the practice, and although Dr. A had lowered his ownpersonal production, it was only to accommodate the income needsof the associate.

Dr. B said that he was not under any restrictive covenant andwould just open his own office nearby before he would pay thisprice for Dr. A’s practice.He told Dr. A that since he currently didmost of the production he considered the patients to be his already,and thus would not be willing to “buy what he already owned.”

Dr. A was flabbergasted. Perhaps Dr. B did not understand, so Dr. A patiently re-explained things to Dr. B., who said that in antic-ipation of this discussion he had already spoken to his attorney andaccountant about buying the practice. They told him that he shouldbuy the practice only based on Dr. A’s current gross production of$200,000, not on the previous gross practice income of $975,000nor on the current income of $1,275,000. Dr. B then offered to pay$160,000 for the entire practice. He told Dr. A that if this were notacceptable, that he would set up his own practice in the immediatearea and notify “his” patients accordingly. Dr. A became very angryand threatened to fire Dr. B, but he knew he could not keep the prac-tice going by himself.

Dr. A kept Dr. B working while attempting to locate another pur-chaser, but no one else was interested in purchasing the practicewith Dr. B still practicing on the premises without a restrictivecovenant.


A Lesson in Lifeby Richard V. Lyschik, DDS, FAGD

practice transitions

THE OFFICE-SHARING ASSOCIATE WITHOUT A CONTRACT

Two months later, Dr. B suddenly quitand announced the opening of his newoffice nearby. Three of Dr. A’s staff mem-bers went with Dr. B for fear that Dr. Awould not practice much longer. Most ofDr. A’s former patients became aware of hismedical condition and followed Dr. B to hisnew office. Little remained of Dr. A’s prac-tice when this story unfolded. Dr. A wasmentally and physically drained. He wasfacing retirement with a disability and hisfuture financial security was in severe jeop-ardy, but there was little that could be donenow with his practice. He knew his practicehad little or no value to another doctor. Anypotential purchaser would be concernedthat any remaining patients of Dr. A wouldfollow Dr. B once Dr. A retired.

Dr. A’s only hope was to get Dr. B to buywhat was left of his practice. If he had awritten contract before allowing Dr. B tojoin the practice, this would not have hap-pened. The details should have beenworked out in advance. Now he could donothing but try to salvage what value hecould from Dr. B.

Dr. A went once more to talk to Dr. B.By this time, the associate was prepared tooffer him only $25,000 for his remainingpatient records. Dr. B no longer needed the“outdated” equipment and office space. Dr. A had no choice, he accepted the$25,000 and retired. All this resulted in aloss of $950,000. It was indeed a veryexpensive lesson for Dr. A. n

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Richard V. Lyschik, DDS, FAGD is one of AFTCO’s leading innovativeSenior Analysts who has helped over 2,900 dentists in associating, buy-ing, expanding, or merging and guided older, disabled and/or “burnedout” dentists to sell their practices. Dr. Lyschik’s clients have seen theconsiderable benefits of incentive programs, pension funding plans andincreased productivity through his guidance. There is no substitute forexperience in this business. Who better could you choose to talk to aboutyour future transition plans than a seasoned fellow dentist, a recognizedpremier transition expert, and AFTCO Analyst of the Year Award winner?Check out the impressive AFTCO website at www.AFTCO.net, then call

for a free appraisal and a no-obligation consultation with Dr. Lyschik at your office or the AFTCO officein Dallas, TX at (214) 893-0410 or 1-800-232-3826.


Dr. Mark AngerbauerDr. Sayeed AttarDr. John AvilaDr. William BaltazarDr. Daniel Bekish Dr. Amy BenderDr. Robert Beville IIIDr. John BoydDr. Jerod BrazealDr. Jessica Brigati Dr. Brandon BrownDr. Jake BrownDr. Kent BrownDr. Sonia Cartwright-SmithDr. Joe CecereDr. Sean CeroneDr. Johnny ChengDr. Jose ChowDr. Austin ChurchDr. William Cook IIIDr. Philip CordellDr. Gerald F. Cox Jr.Dr. Christopher M. DavisDr. Dakota DavisDr. Paul Davis Jr. Dr. Russell T. DixDr. R. Danford DossDr. Lauren Davis-DrennonDr. Debra DuffyDr. Chad C. DuplantisDr. Steven J. FuquaDr. Tonya K. FuquaDr. Ray C. Gillespie

Dr. Mark GivanDr. Elizabeth GoldDr. Michael GouldingDr. Erin GreerDr. Gary A. GreerDr. O.Z. Helmer Jr.Dr. Lan HoangDr. Eduardo A.C. HumesDr. David K. HunterDr. Andrew JamisonDr. Andrea JanikDr. John M. Kelley Jr. Dr. Ken KirkhamDr. David KostohryzDr. Mark C. LantzyDr. Phu H. LeDr. Ronald LeeDr. Diana LoisDr. E. Dale MartinDr. Mark A. McAdamsDr. Brad McConnellDr. David MikulencakDr. Charles MillerDr. Sarah J. MorrisDr. Jack W. MorrowDr. Partha MukherjiDr. David M. NelsonDr. Tim OakesDr. David ParmerDr. Robert PeakDr. Blanca PenaDr. Mau Pham Dr. Janell Plocheck

Dr. Samuel PreeceDr. G. Stan PreeceDr. David PurczinskyDr. Diana RaulstonDr. Susan RobertsDr. John RubinDr. William Runyon Jr. Dr. Jeff SaundersDr. Monica SaundersDr. Gregory Scheideman Dr. Mack Snead Jr.Dr. Christopher SorokolitDr. Robert SorokolitDr. Brent SpearDr. Fred SpradleyDr. Brooks M. StevensDr. Deborah SullivanDr. David TillmanDr. Abby TreeshDr. Jean TuggeyDr. Casey Turner Dr. Christa WalkerDr. Amy WattsDr. Edmond WattsDr. Bruce WeinerDr. Nathan WestDr. Kathleen WhiteDr. R. Renan Williams IIIDr. Glory WindmillerDr. Danny WrightAnonymous*

Save a Smile is an innovative, nationally recognized, collaborative program within the Cook Children’s Community Health Outreach department. The goal is to improve the health of underserved children through the prevention and treatment of oral health disease. The Save a Smile program serves an important role in Cook Children’s efforts to

community.

Our volunteer dentists have donated dental care worth more than $5.7 million to children in Tarrant County since the beginning of the program in 2003. Over the past 10 years, 170 dentists and providers have offered their services. We would like to thank these doctors for donating their time, talent and resources. They are the heart of this program, and we are honored to have them as partners.

*Participating dentist who chose to remain anonymous.

Celebrating 10 years of helping children smile!

Offering a retirement plan can be one of the most chal-lenging, yet rewarding, decisions an employer dentistcan make. Retirement plans can help attract and

maintain employees while allowing the employer dentist to savefor their retirement years with tax deductible contributions.However, administering a plan and managing its assets requirecertain actions and involve specific responsibilities and risk tothe employer dentist. Simply hiring an outside retirement plancompany, financial advisor and/or payroll company does not initself reduce your risk or liability.

What are the essential elements ofa Plan?

Each plan has required key elements. It always must have awritten plan that describes the benefit structure that guides day-to-day operations. Many organizations have “prototype” plandocuments that are pre-approved though the Internal RevenueService (IRS). Of course, there’s a caveat to all things regulatedby the IRS. Prototype documents must be strictly adhered to asdesigned and the law requires tests be performed each year toremain in compliance.

Other key elements are a trust fund to hold the plan’s assets; arecordkeeping system to track the flow of monies going to andfrom the retirement plan; depositing employee contributionsand loan payments as soon as reasonably possible but not laterthan the 7th business day after withdrawn from the employee’spaycheck. (Plans with greater than 100 participants have morestringent rules.) The law also requires notices, disclosures,forms and other documents be provided to employees eligibleto participate in the plan; plan activity must be reported eachyear to the government on Form 5500, sometime requiring theaudit of outside consultants depending the scope of investmentsin the plan or number of participating employees (usually 100

or more). Today, plan information reported to the IRS on Form5500 is a matter of public information on the Internet.

There is one essential that seems to get ignored which is equalopportunity to invest for all employees. This means theemployer dentist, who usually has the highest balance, mustprovide the same investment opportunity to participantsdepositing a small amount per paycheck. If you’re buying stocks


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Q:

ManagingYour FiduciaryRisk by Frank J. Mario


or other assets requiring a minimum purchase that youremployees cannot buy, your plan is not in compliance and haspotential liability.

Who is a Fiduciary?Fiduciary status is based on the functions per-

formed for the plan, not just a person’s title. A plan musthave at least one fiduciary (a person or entity) named in thewritten plan, or through a process described in the plan, as hav-ing control over the plan’s operation. Having said that, all planshave at least a trustee and an employer sponsor without eitherof which, the plan cannot exist. Other fiduciaries can be specif-ically named such as investment advisors, individuals exercisingdiscretion in the administration of the plan and all members ofa plan’s administrative committee.

What is the significance of beinga fiduciary?

Fiduciaries have important responsibilities and are subject tostandards of conduct because they act on behalf of participantsin a retirement plan and their beneficiaries. These responsibil-ities include acting solely in the interest of plan participants andtheir beneficiaries and with the exclusive purpose of providingbenefits to them. Any written policies such as investment policystatements or retirement plan committee decisions must haveall employees in mind when adopted. Additionally, fiduciariesmust carry out their duties prudently; diversify plan invest-ments; and pay only reasonable plan expenses.

Monitoring a Service Provider

An employer dentist should establish and follow a formal reviewprocess at reasonable intervals to monitor service providers ituses to run the retirement plan such as financial advisors orthird party administrators. Outside service providers shouldhelp the employer construct processes which are prudent fromthe IRS and Department of Labor (DOL) standards standpointwhile providing top quality service. If not, the employer dentistshould reconsider his or her options. Another component ofoversight are the fees actually charged for services rendered.The IRS and DOL have publically stated that the amount of feesis not necessarily of highest concern; it’s the quality of serviceand the complete disclosure to the employer and employee par-ticipants that ranks highest in their evaluation. In other words,paying 1.00% of the plan’s balance in fees for excellent serviceand investment performance may be better than .50% for poorplan governance and poor investment performance.

Limiting Liability

With these fiduciary responsibilities, there is also serous poten-tial liability. Fiduciaries who do not follow the basic standardsof conduct may be personally liable to restore any losses to

the plan, or to restore any profits made through improper useof the plan’s assets resulting from their actions.

Fiduciary Insurance

Your practice likely has insurance for general property & casu-alty, liability, theft, fire, workers comp, and other specialty cov-erage such as business interruption and malpractice. You canalso purchase fiduciary liability insurance for your plan to helplimit your personal financial exposure. This is not to be con-fused with fidelity coverage as required by the law to cover theloss of plan assets through malfeasance or other illegal activities.

Procedure is Key

Adopting and adhering to procedures with full documentationis key to managing your fiduciary risks. While the Departmentof Labor and Internal Revenue Service will look to content andactions in this documentation, they also like to see thatemployer sponsors are putting effort into following guidelinesand operational procedures with expert assistance from thirdparty administration professionals and financial advisors. Thisis extra important in this day and time. The DOL and IRS havebeen “turning up the heat” on plan fiduciaries in the last fewyears. The number of DOL agents has increased significantly inthe last two years and revenue derived from fines and penaltiesas a result of plan audits has skyrocketed.

Frank J. Mario is President at PensionResources Corporation. Mr. Mario waseducated in Los Angeles in BusinessLaw and Accounting in addition to hisyears of experience on the job. His 30years of experience in the retirementplan business has given him extensiveknowledge of pension plan design, con-sulting and administration. Mr. Mariocontinues his education through profes-

sional courses offered by such institutions as Penserv, Inc. and AmericanLaw Institute - American Bar Association (ALI-ABA). Mr. Mario is nowteaching continuing education courses to financial professionals. Mr. Mario is actively involved in pension and tax legislative change. Hehas served as a regional representative to PACT, Inc. (Pension ActionCouncil Task force) for 18 years and continues to work with the InternalRevenue Service and Department of Labor's ERISA Advisory Council tocomment on current agenda’s and develop witnesses for meetings andhearings. Contact Frank at [email protected] or call (972) 490-1771 ext 111.

Q:

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Midland Practice boasts long-term staff, efficient and highly profitable hygiene department. Panorex, digital imaging, and computerized operatories. No big city overhead expenses make this practice more profitable than most. Doctor is flexible with financing and he can stay on, or retire immediately.

ShermanApprox. 2,000 sq. ft., high quality, all fee-for-service GP practice. Spotless office; meticulous dentist. Truly a “turnkey” opportunity with no major investment or renovation necessary. Seller is ready to retire. Dr. generates a consistent $450K –$550K income while still taking many weeks off during the year to travel!

Irving Premier fee-for-service practice. Dentrix. Cerec. Long-term staff. Low overhead. Thousands of patients on record. Consistent gross income on a 4-day per week… in good years and in bad! Now that's a loyal patient base and a "Rock Solid" investment.

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Could Unresolved Conflict beJeopardizing Your Practice?

By Sharon Dolak, RDH and MDR Specialist, Center Director – Dallas Fort Worth for Mediators Without Borders


As a dental hygienist, I’ve witnessed con-flict in dental offices. While disagreementscan be uncomfortable, working towardspositive outcomes is possible and the situ-ation that caused the disturbance can bemade better to everyone’s benefit. Conflictoccurs when the ideas, interests, or behav-iors of two or more individuals clash and isunhealthy when it is avoided or approachedon a win/lose basis, where one side is thewinner, and another is the loser. Most peo-ple want to avoid discomfort by avoidingthe situation and hoping that everyone willsettle down and the problem will evaporate.

When handled properly, conflict can moti-vate a team towards positive growth andchange. Positive conflict can be very usefulwhen the team is focused on finding waysto resolve a problem in the office.

There are five styles we use as we navigateconflict with others:

Avoidance. Avoiding conflict is useful ifthe relationship is short-term, not impor-tant to you, or if the issue is minor.However, most conflicts are not resolvedthrough avoidance but will reappear laterand with more force. Avoidance can givethe impression that you don’t care enoughabout the person or the issue to engage inthe conflict, and can reinforce the impres-sion that dealing directly with the conflictis harmful.

Competition. This works when the rela-tionship is short-term or you’re competingin games and sports. It’s appropriate whenquick, decisive action is needed, such as inan emergency. Competition can harm rela-tionships by reducing the negotiation towin/lose. It can also escalate the conflict, orencourage passive-aggressive tactics fromthe other party. Solutions are seen aswin/lose.

Compromise. This approach can be lesstime consuming than collaboration and isoften used when other methods have failed.It works best when solutions are short-termand when both parties feel thatthis is the most reasonableapproach. Compromise canbecome an “easy way out”,resulting in modified gains andlosses. It is seldom received aswin/win. When power imbal-ances are unequal, it can be viewed as giv-ing up. Interests are met to the fullestextent possible.

Accommodation. If preserving the rela-tionship is more important than resolvingthe issue, or if the issue is more importantto one person than to the other, accommo-dation is very useful. A disadvantage is thatthe desire for harmony can supersede theneeds of the accommodating party.Creative problem solving is reduced.

Collaboration. This style preserves therelationship and both parties’ needs.Collaboration demonstrates that conflictresolution can be productive and creative,since a high value is placed on integrativesolutions. Collaboration favors those with ahigh level of verbal communication skillthat could be used to manipulate or set upa power imbalance.

Considering how closely everyone in a den-tal office works together, all of these stylesare used at any given moment during theday. There is no denying that in the short-term, a team can be in conflict with one

another and still be smiling and greetingpatients, addressing their concerns, andfixing teeth. In the long run however, dentaloffices whose team, behind the scenes, isbickering, gossiping, and in conflict, is nei-ther sustainable nor productive in eitherhuman or financial terms.

The team feels the tension while they areworking, and this can be apparent topatients. Many people are nervous aboutgoing to the dentist under the best of cir-

practice management

When we are in conflict, we saythings we do not mean and wemean things we do not say.

cumstances. Patients are not immune tofeeling subtextual nuances and, if the officeenvironment feels disruptive, patients maychoose to go elsewhere. The bottom line isthat unresolved conflict causes angst, lossof productivity and causes the practice tolose money.

A few years ago, two doctors, an office man-ager, three hygienists, two front desk staffand three assistants were embroiled inbickering, back-stabbing, and gossip. Theirbehavior was in response to the office man-ager’s operating philosophy: “the beatingswill continue until morale improves.” Theexcessive, punitive control over the teamproduced absenteeism and turnover.Production suffered, with holes in theschedule and cases dropped off the booksdue to lack of communication – and theteam’s focus was on office turmoil insteadof on their duties. In the end, no bonuses,no raises and no fun.

Here’s another scenario: there are twoemployees, who each earn $35,000 a year.During the last two months, they’ve beenengaged in a disagreement. On average,they each spent about two hours a weekgossiping, enlisting other team members toone side or the other, telling their storiesand reliving the event. Doctors and teamleaders think this is an insignificant matterand leave it to the team to “work it out”.This is a costly mistake. What most likelystarted out as a petty issue has spread andthe entire office is now caught up in profuseand idle talk. As with all workplaces, dentaloffices are comprised of people with uniquepersonalities, communication styles, andbackgrounds so naturally, conflicts willoccur.

The problem isn’t that conflict exists; it’show you deal with it or, more importantly,what transpires when it is not resolved. Theimpact of unresolved conflict in the work-place can be devastating: to the partiesinvolved, to partners and the team, topatients, and to the practice as a whole. Leftunattended, a simple conflict can cost thepractice thousands of dollars in lost time,inefficiency, turnover, and patient frustra-tion. While every dental professional knowsthat such workplace conflicts affect produc-

tivity and morale, the very real money draincaused by office drama is not as obvious. Sowhat is an office to do? When we are in con-flict, we say things we do not mean and wemean things we do not say. Rarely do wecommunicate at a deep level to expresstruly what we are thinking and feeling.

Avoidance promotes turnover and escalat-ing conflict, which are expensive emotion-ally and financially. Realistically it isdifficult, if not impossible, for people whoare warring to come to peace without someoutside influence or help.

In 2008, U.S. employees each spent 2.8hours per week dealing with conflict. Thisamounts to approximately $359 billion inpaid hours (based on average hourly earn-ings of $17.95), or the equivalent of 385million working days.

A professional mediator could be the solu-tion. A mediator provides a forum and anatmosphere for communication where par-ties gain understanding, become under-stood, and work together to explore optionsfor quick, productive resolution.

Mediation is the catalyst by which people in


dispute can exercise their own choices anddiscretion and regain a sense of controlover their lives. It is a means by whicheveryone can be an active participant in thedecision-making process and have directinvolvement in the determination of thesolution. In an informal setting, the partieshave the opportunity to express their emo-tions and realize their true interests. Thisopportunity itself is the first step, to easingemotional turmoil. Instead of having a deci-sion forced upon the parties by someoneelse (win/lose), mediation provides a forumfor the parties to craft their own decisions.The parties involved determine the resolu-tion. Once a mutually acceptable agreementis reached, the parties breathe easier andare able to end the emotional turmoil thatwould otherwise continue to plague them.

Although mediation is informal, there isnothing haphazard about it. It is a struc-tured, staged process that is designed to

facilitate and direct people from point A topoint B, from deeply felt negatives to new,agreed outcomes and constructive changes.

The Benefits of MediationResults are fast. When parties want toget on with their business and their lives,mediation may be desirable since it pro-duces results rapidly. The majority of medi-ations are completed in one or two sessions.

Privacy is protected. Mediation is pri-vate and voluntary. Sessions are confiden-tial.

Relationships are preserved. Manydisputes occur in the context of ongoingwork relationships. Mediated settlementsthat address all parties’ interests often pre-serve working relationships in ways thatwould not be possible in a win/lose deci-sion-making procedure. The team canremain intact and go back to doing what

they do best – caring for patients.

A foundation is built for future prob-lem solving. If a subsequent disputeoccurs after mediation, parties are morelikely to utilize a cooperative forum of prob-lem solving to resolve their differences thanpursuing an adversarial approach.

When I mediate a dispute, I model andteach appropriate listening techniques.Most people think of communication astalking; however, effective communicationis really about listening. Many of the mostimportant facets of your life are greatlyinfluenced by your skill or lack of skill in lis-tening. The quality of your friendships, thecohesiveness of your relationships, youreffectiveness at work, these hinge, on yourability to listen. By actively listening, I iden-tify the underlying interests in the disputeto reach resolution. Most importantly, lis-tening shows how to communicate respect-fully to inoculate against future disputes.The result is a healthy office environmentwhere increased morale and productivitycan flourish – and where your team canconcentrate on their job at hand.

In the mediation session, I identify impor-tant issues, clarify misunderstandings,explore solutions, and facilitate the processof negotiating the settlement.

Mediation requires that each person takeresponsibility for his or her part in the con-flict. Disputing team members guide theoutcome of the mediation process and itsresolution. This leads to empowerment inthe healing process.

The emotional tension dramaticallydecreases quickly most times in the veryfirst stage of mediation. That is its design,and this early response breaks the tensionallowing everyone involved to cool off andconsider better ways to cure their problems.

Mediation is, by far, the most advantageousway to reach a mutually satisfactory resolu-tion to any conflict and provides wins allthe way around: for you, your colleagues,your leadership and your patients.

Sharon Dolak RDH, MDR(817) 781-7910 [email protected]


Sharon Dolak, RDH and Mediator graduated from MontgomeryCounty College of Dental Hygiene in Pennsylvania in 1981. She cur-rently lives in Keller, Texas with her three sons and has been practicingclinical dental hygiene in Texas for 13 years. She is certified in Myers-Briggs Personality Assessment (MBTI), Thomas-Kilmann Conflict ModeInstrument (TKI), Strong Interest Inventory Assessment, and is a lifecoach. In 2006, she received her certification in mediation from TexasWoman’s University and advanced her skills and certifications toinclude Mediation, Arbitration and Workplace Mediation, earning her

the title of Mediator Dispute Resolution Specialist. In her mediation work, Sharon specializes in reducingstates of tension and getting long-term conflict resolved for people who want to be or must be in ongoingpersonal, professional, or business relationships.


Your website is not just a digital versionof your practice brochure. Sure, it shouldfeature photos of your office, explainwhich dental services you offer and ofcourse, include your address and phonenumber just like a brochure; but the bestdental websites do so much more. Theyare not brochures, but rather, patientattraction tools. The best dental websitesare built with one thing in mind; con-verting visitors to patients.

It’s not “accidental” when a person con-verts from a mere website visitor to apatient in your chair. Believe it or not,where your practice phone number islocated and how fast each webpage loadscan be just as important as your dentalcredentials for a patient who is searchingfor a dentist online.

Building a website that converts is nec-essary, but doesn’t have to be daunting.Here are 11 dental web design tips thatcan help:

Show them the way. Afterall of these years of Internet use,you’d think we’d intuitively just“know” what to do on a website,

but it turns out, we don’t. Research showsthat website visitors need to be told whatyou want them to do and in your case, how

and where they book an appointment. So,make sure you have a clear call to actionthat is incredibly easy to find. It may seemobvious, but it’s important. On your homepage, place your phone number in theupper right hand corner of your website inbig, bold font. TIP: Don’t forget aboutcalls-to-action on each individual serv-ice page too. We recommend that it be

incorporated within the web-page text.

More design isn’t alwaysgood design. Why isAmazon.com the #1 website

for converting visitors to customers?Simple. It’s incredibly intuitive and easyto search, browse and find what youwant. The same goes for dental websites.While you may be tempted to use anoverly complicated design for your web-site because it appeals to you and yourstaff, it may be too much for a first timevisitor. If you want to convert more vis-itors, make it easy and simple for themto find what they are looking for. In thiscase, simpler is better.

The faster, the better. A2012 Google study has shownthat in some instances, 400milliseconds is too long for

most people to wait for a webpage toload. While it may seem impossible tobuild a website that loads that quickly, itconfirms that if your website takes toolong to load, a potential patient will moveon to the next dental website. Make sureyour website consistently loads fast.

The power is in theheadline. Once a visitor haslanded on your website, youhave approximately 8 seconds

to grab their attention with a headline.Also, eye-tracking studies show that peo-ple tend to view web pages in the shapeof a “F”, scanning down the left hand sideand then across. Keep this in mind whenwriting the copy for your website andmake sure your most compelling contentis in the headline and in the “F” area ofyour webpage.

Be unique. You’d be sur-prised (or maybe not sur-prised) to find out that manydentists have identical copy on

their websites. While, yes, there are onlyso many ways to write about the benefitsof teeth whitening, dental implants ororthodontics, it’s important that yourwebsite have original copy that is uniqueto you. This is important for two rea-

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WEB DESIGN BEST PRACTICES

11 tips for

Building a Dental WebsiteThat Converts by Neil Rudoff

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practice marketing


sons; Google doesn’t give credit to web-sites with duplicate copy (ie., won’t rankthem well in a search) and your potentialpatients can see through generic andcopycat website content. Being just likeyour competition won’t help you convertpeople from just perusing your websiteto actual patients.

Smile and say “Cheese!”As a dentist, you’d think mostof your website visitors wouldbe concerned about which den-

tal services you provide or where you arelocated. Well, you’d think wrong; thenumber one most visited page on a den-tist’s website is the page about you, thedentist. The second most visited page isthe “About the Team” webpage. It turnsout, website visitors want to see your faceand get to know you a little before choos-ing to call and make an appointment. Toconvert visitors to patients, you musthave a dedicated page to you, the dentist– and that includes a great photo.

Tell them why you’regreat! (Then tell themagain.) In order to stand outin a sea of choices, businesses

need to clearly express their unique valueproposition. In other words, for websitevisitors to pick you over the dentist downthe street, you need to tell them veryexplicitly why they should. It’s no secretthat these days, people have nearly anendless amount of choices and in thiscase, humility just isn’t rewarded. Don’thold back when telling your website vis-itors why your practice is the best choicefor them and their family’s dental needs.

Build a responsive web-site. Your potential patientswill be accessing your websitevia desktop computers, lap-

tops, tablets and smart phones. Whileyour website design may look great on adesktop or laptop, it may not on mobiledevices. If you build a responsive web-site, your patients can still book anappointment and easily read throughyour services because it uses a flexiblegrid framework that automatically re-aligns the content to the device that

accesses it. Don’t miss out on patientsaccessing your website from their phonebecause they can’t find out how to makean appointment.

Pay attention to whatworks. The best dental web-sites keep track of what visi-tors are actually doing on theirwebsite. The easy way to do

this is by installing Google Analytics.This feature gives you priceless insightinto how your potential patients arearriving at your website and which pagesthey are viewing the most. As you canimagine, this information becomesinvaluable if you ever need to trou-bleshoot any new patient flow problems.

Use Call Tracking.Evaluation is an inte-gral part of onlinemarketing and websitedesign is no different.

You can track the efficiency of your web-site design by installing a call trackingphone number to learn how manypatients are actually converting from vis-itors to patients.

IMPORTANT: While call tracking isvery useful for ROI, it can often confuseGoogle by associating multiple phonenumbers with your practice. This caninterfere with your local listing and SEOefforts. If you choose to use call trackingphone numbers, it’s important toengage a trained online marketingexpert to help you install them on yourwebsite correctly.

People like people.A recent study shows thatconversion rates went upby 102.5% if a webpagefeatured a person instead

of an object. Quality images on your web-site are important, so feature images ofpeople when you can, especially on yourhome page. TIP: Want to increase yourwebsite visitor engagement even fur-ther? Use photos of your actual patients(with their signed permission) instead ofstock photos. n

Neil Rudoff is the Senior Account Executiveat Bullseye Media in McKinney, TX. Hereceived his BA from Tufts University in 1989and his MBA from UT Austin in 1993, and hasbeen an online marketing and web designconsultant since 2003. He can be reached at (214) 491-6166 or [email protected], LLC is a McKinney, Texasbased full-service digital marketing agencythat specializes in helping dentist leveragethe internet to grow their practices. Visit thewebsite at www.onlinedentalmarketing.com.

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ADVERTISER’S INDEX

AFTCO ...................................................23

Bryant Studio..........................................12

Bullseye Media .......................................11

Burkhart Dental ......................................19

Children 1st Dental & Surgery Center ......... inside front cover

Destiny Dental Laboratory ......................26

J. Houser Construction ...........................11

Legacy Texas Bank ................................27

Med-Tech Construction ............ back cover

Midco Dental .........................................30

Save a Smile ..........................................20

Structures & Interiors .............................25

The Glove Group ...........inside back cover

Tina Cauller ...........................................30

Transworld Systems ..............................29

TruDenta ................................................13

US Oxygen Supply .................................30

UT School of Dentistry at Houston ........21


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