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Most successful dentists face these 5 challenges

The dental business may look straightforward and profitable to patients taking a seat in the reception room. Treatment rates always seem high, no matter how complicated the procedure and patients frequently think dentists are wealthy business owners who can afford luxuries like expensive cars and gigantic homes.

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Read: this is how much a dental practice owner makes >>

What outsiders don’t see is the ongoing struggle for success that begins years before a dentist can purchase the American dream of homeownership, flashy possessions and money to invest back into the business.

Some lucky dentists can become a partner in the practice if it’s owned by a family member. But if the young dentist doesn't measure up to the previous owner, the chance of success will evade them, just as it would any other dentist in any other practice.

Something to think about

Say the top-rated dentist in town is retiring and his son is taking over the practice. A friend, who was a patient of the senior dentist for many years, was surprised to find out he was being treated by his dentist’s son. Assuming the son would provide the same level of care he was used to, he agreed to a dental procedure involving two crowns.

Read: this dentist shares how you should hire smart or fire stupid >>


The young dentist didn’t review the patient’s health history and therefore didn’t know the patient was on blood thinning medication. Most of the time, not knowing this information wouldn’t cause much of an issue. But in this case, the young dentist pulled the cheek tissue while using the drill and carved a small laceration into the cheek.

After the procedure was completed, the patient returned home where he continued to bleed until the next morning. The young dentist never called to check on the patient so he had no idea of the problem.

As a result, the patient decided never to see the new dentist again. The patient chose not to call and complain because he thought it wouldn’t do any good. The harm had already been done and he just wanted to forget about it.

The lesson learned here is don’t assume patients will like your work just because the senior dentist allows you to treat them. You aren’t entitled to trust you haven’t earned. The same goes for associate dentists who join a practice on the recommendation of the owner dentist.

The above is just one example of challenges dentists must overcome if they want to be successful. The COVID-19 pandemic proved there are many more serious challenges which can present themselves at a moment’s notice. From being forced to restrict treatment to emergencies only and not having enough staff to fulfill all appointments to implementing strict health protocols in the practice and reassuring patients that their safety is your priority, the coronavirus presented dental practices with a myriad of tough trials.

Here are five more common challenges you’re almost sure to face as a dental practice owner.

Challenge 1: building your own steady client base

Whether you inherit your dental practice from a family member or you buy into one as an associate, it’s up to you to set the culture and philosophy of the business. Riding on someone else's coat tails will give you a place to start. But at some point, you’ve got to assume the responsibility of providing excellent care on your own.

If you’re uncertain about how to build your brand and market your business, consider consulting with a marketing company. Having experts on your side will ensure you avoid expensive mistakes and get things right the first time. 

Challenge 2: overcoming lack of motivation due to student loan debts

Many great dentists come out of dental school with very high student loan debt as a result of costly tuition and living expenses while in school. Some dentists report that even after decades they are still paying the deficit down.

Considerable debt combined with having to work in corporate dentistry for many years before being able to afford to set up their own practice can often result in a total lack of motivation and even a dislike of the job.

COVID19 handout dental practices pdf file

In an organizational structure, dentists pressured to perform according to operating standards or financial targets don’t have the time to properly interact with the patients or always treat them as they see fit.

If you’re feeling unmotivated or burned out, it’s important to keep your eye on the end goal: opening up your own dental practice. On days where you’re struggling to push through, remember why you got into dentistry in the first place and how rewarding the job is.

Challenge 3: insurance billing

Due to the ever-increasing confusion and complexities on how to bill insurance and how to appeal denied claims, many dentists choose to outsource insurance billing to dental and medical billing experts. It’s often more cost effective because the billing company is paid on commission of collections.

Outsourcing billing is an excellent way to free up the office manager, giving them more time to talk to patients about their treatment plans, while securing financial payments increases cash flow and offers owners some peace of mind.

Challenge 4: hiring and managing the right dental staff

Dentists have also outsourced much of the hiring of staff and have saved thousands of dollars and hours of valuable time in the process. Dentists are great at dentistry but some are not so great at finding the right team members for their practices because they don’t have the time.

Using an excellent hiring tool like Cloud Dentistry instead of a tired dental temp agency when you need to fill a position is the best and most affordable choice. Leave dental temp agencies and the job boards that charge huge fees and don’t always deliver the best people in the past where they belong.

Read more about hiring dental staff here >>

Challenge 5: strictly adhering to a practice budget and creating cash flow

Control overhead expenses to the point that you know how much a single piece of 2x2 gauze costs. Many practices waste a ridiculous amount of supplies and materials because the dentist and the clinical team had no idea of the costs involved in operating a dental practice. Expensive tools are often thrown away by mistake because the system of sterilization is careless and outdated.

Both new and established dental practices struggle to pay their expenses because of negative cash flow issues. Many are on the preferred provider lists of countless insurance companies because of the belief that volume is necessary to create revenue to cover costs without creating any profit.

Third-party payers are very much involved in setting fees that they feel are acceptable, dictating treatment they’re willing to pay for and defining the order by which they think is correct to pay. The confusion stems from each insurance company having its policy provisions. It’s the dental practice, not the patient, that must understand all these nuances or payment is denied.

Create cash flow to get paid on time for all services provided, whether for the insured or non-insured patients. Establishing written treatment plans and financial policies is essential for creating positive cash flow.

The goal is to be paid all out of pocket monies at the time of service. This includes deductibles and coinsurance amounts estimated by the information gathered from insurance companies and entered into the software for calculating.

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Don’t wait until after the insurance has been paid to bill patients. This goes against cash flow, increases the accounts receivables and leads to uncollectible debt. The agreement with the insurance companies as a preferred provider is that you must collect the coinsurance and deductibles when services are rendered. Otherwise the patient is in breach of the agreement.

The five challenges covered above are by no means the only struggles a dentist building a successful practice will face. Creating sound business practices is the key to success and knowing when to reach out to those who have the expertise to help is essential.

What other challenges do you face in your dental practice? Please let us know in the comments below.